Distal Shoe Space Maintainer

Distal Shoe Space Maintainer

Write short note on distal shoe space maintainer.
Answer. It is also known as Roche’s appliance or Willet’s appliance or Intra-alveolar appliance or Cantilever fixed type space maintainer.

“Steps to explain the design and components of the distal shoe space maintainer”

Distal Shoe Space Maintainer Types

• Fixed
  • Functional
  • Non-functional
• Removable.

Fixed Distal Shoe Space Maintainer

Read And Learn More: Mandibular Growth, Functional Matrix Theory & Space Maintainers in Orthodontics

Distal Shoe Space Maintainer Design

“Common challenges in using the distal shoe space maintainer effectively”

Roche design a crown and band appliance along with distal intragingival extension which guide fist permanent molar to erupt.

• First primary molar is banded. Place the band over steel crown on abutment tooth.
• Make the impression with bands in the place. Subsequently remove the bands from the teeth and place as well as stabilize the impression before pouring the model.
• Prepare the dental stone model.

“Role of the distal shoe space maintainer in preserving space for permanent teeth”

• As extraction of deciduous second molar is not done, cut the tooth from the model. Prepare the hole in the model to simulate distal root of second deciduous molar.
• Measure the mesiodistal width of second deciduous molar.
• As if second deciduous molar is absent, take a radiograph to measure mesiodistal space.
• A simple basic method is to measure contralateral side second deciduous molar.
• V shaped gingival extension is about 1 to 1.5 mm below mesial marginal ridge of permanent fist molar.

Distal Shoe Space Maintainer Indication

In patient where there is early loss of primary second molar before eruption of permanent fist molar.

“Importance of studying the distal shoe space maintainer for better outcomes”

Distal Shoe Space Maintainer Contraindications

• In patients where several teeth are missing, abutment to support the appliance may be absent.
• In patient with poor oral hygiene.
• In cases where there is lack of patient or parent cooperation.
• In medically compromised cases such as rheumatic fever, congenital heart defects, juvenile diabetes and blood dyscrasias.

Removable Distal Shoe Space Maintainer

Starkey has given this appliance.

“Understanding the role of the distal shoe space maintainer in pediatric dentistry”

Removable Distal Shoe Space Maintainer Fabrication

• In its fabrication the tooth which has to be extracted should be cut of and a depression should be made in model to allow processing of acrylic extension.
• Acrylic extends in alveolus and guide the erupting fist molar in position and maintain space for second premolar.
• Cut the extension once the permanent molar erupts in occlusion.

Removable Distal Shoe Space Maintainer Indication

In unilateral or bilateral early loss of primary second molar before eruption of permanent fist molar.