Modifications of a Distal Shoe Space Maintainer for Preserving Arch Integrity in Children: A Review of Published Literature
Aim: This paper aims to appraise the treatment options explored in the existing literature to perform space maintenance in the event of prematurely lost primary second molars preceding the permanent first molar eruption. Background: The primary second molars play a critical role in the eruption guid...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2025-04-01
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| Series: | Journal of South Asian Association of Pediatric Dentistry |
| Subjects: | |
| Online Access: | https://www.jsaapd.com/doi/JSAAPD/pdf/10.5005/jp-journals-10077-3333 |
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| Summary: | Aim: This paper aims to appraise the treatment options explored in the existing literature to perform space maintenance in the event of prematurely lost primary second molars preceding the permanent first molar eruption.
Background: The primary second molars play a critical role in the eruption guidance of the first permanent molars, and their premature loss may lead to arch-length inadequacy, increased overbite, etc., in children. In cases where the primary second molars are indicated for extraction, the distal shoe space maintainer (DSSM) has been considered to perform dual functions of space maintenance while acting as a guide for the eruption of the permanent first molar. At present, besides the traditional Willet's distal shoe appliance, multiple modifications of this appliance have been described in the literature. However, there is limited summative literature available that attempts to study these modifications and suggest the clinical indications.
Review results: A search was carried out in PubMed and extended to Google Scholar and Semantic Scholar by two authors using the combination of keywords such as: premature loss of deciduous molars, distal shoe, space maintainer, eruption guidance. All relevant articles that showed up in search results and were published between 1980 and 2024 in the English language were included. This narrative review discusses the various designs of DSSMs and their respective advantages and disadvantages as published in the selected papers.
Conclusion: Multiple designs of the distal shoe have been explored for different clinical situations. However, factors like longevity and failure have not been discussed adequately owing to short-term follow-ups. Since the available literature is in the form of case reports, more research with longitudinal studies and randomized controlled trials is needed.
Clinical significance: This review offers an evidence-based appraisal of DSSMs based on available literature. |
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| ISSN: | 2582-1024 |