Aim and background: Space maintainers (SMs) are used to preserve space created by premature loss of primary teeth. The most commonly used band and loop (B&L) SMs have several demerits, e.g., non-functional, poor gingival health, limited survival, laboratory work for fabrication and multi-sitting procedure, etc. This study aimed to compare the efficacy of conventional B&L SMs with conventional tube and loop (CTL), bonded tube and loop (BTL) and bonded B&L in terms of gingival health, survival time, and patients’ and parents’ satisfaction.
Materials and methods: Fifteen children between 4 years and 8 years of age with at least two fresh extraction sites of primary molars contra- or bilaterally in each child (total 30 fresh extraction sites) were included in the study. Conventional B&L on one site while bonded loop (BL)/CTL or BTL on the other site were delivered, based on random allocation. An evaluation was done at 1st, 3rd, 6th, and 9th months for survival time, gingival health, and patients’/parents’ satisfaction. Results were statistically analyzed using independent t-test and Chi-square test under SPSS version 20.0 software.
Results: 100% B&L and CTL while only 60% BL and 80% BTL survived till the end of the study. For gingival health, statistically significant differences were obtained at 1st, 3rd, 6th, and 9th month\'s intervals (p < 0.05) when CTL was compared with B&L, BL, and BTL. In terms of patients’ acceptance, all the SMs were well accepted by the patients. However, on the intergroup comparison, patients’ acceptance was higher with bonded SMs.
Conclusion: Conventional tube and loop SMs were found to be most efficacious in terms of survival time, gingival health, and patients’ satisfaction.
Clinical significance: To find a better alternative for the conventional B&L SMs.
Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6):610–616. DOI: 10.1902/jop.19184.108.40.2060.
Hojat M, Louis DZ, Maxwell K, et al. A brief instrument to measure patients’ overall satisfaction with primary care physicians. Fam Med 2011;43(6):412–417.
Srivastava N, Grover J, Panthri P. Space maintenance with an Innovative “Tube and Loop” space maintainer (Nikhil Appliance). Int J Clin Pediatr Dent 2016;9(1):86–89. DOI: 10.5005/jp-journals-10005-1340.
Sakaguchi RL. Review of the current status and challenges for dental posterior restorative composites: clinical, chemistry, and physical behavior considerations. Summary of discussion from the Portland composites symposium (POCOS) June 17–19, 2004, Oregon Health and Science University, Portland, Oregon. Dent Mater 2005;21(1):3–6. DOI: 10.1016/j.dental.2004.10.008.
Bhasin AS. Simplified bonded space maintainer-a case report. J Indian Dent Assoc 2011;5(1):29.
Swartz ML, Philips RW, Clark HE. Long-term F release from glass ionomer cements. J Dent Res 1984;63(2):158–160. DOI: 10.1177/00220345840630021301.
Millett DT, McCabe JF, Bennett TG, et al. The effect of sandblasting on the retention of first molar orthodotic bands cemented with glass ionomer cement. Br J Orthod 1995;22(2):161–169. DOI: 10.1179/bjo.22.2.161.
Swaine TJ, Wright GZ. Direct bonding applied to space maintenance. J Dent Child 1976;43(6):401–405.
Subramaniam P, Babu G, Sunny R. Glass fiber-reinforced composite resin as a space maintainer: a clinical study. J Indian Soc Pedod Prev Dent 2008;26(3):98–103. DOI: 10.4103/0970-4388.43192.
Deshpande SS, Bendgude VD, Kokkali VV. Survival of bonded space maintainers: a systematic review. Int J Clin Pediatr Dent 2018;11(5):440–445. DOI: 10.5005/jp-journals-10005-1554.
Peter S. Essentials of preventive and community dentistry. 4th ed., Arya Medi Publishing House Pvt Ltd; 2010. pp. 492–493.
Qudeimat MA, Fayle SA. The longevity of space maintainers: a retrospective study. Pediatr Dent 1998;20(4):267–272.
McDonald RE, Avery DR. Dentistry for the child and adolescent. 7th ed., 2001. pp. 677–741.
Tunison W, Flores-Mir C, ElBadrawy H, et al. Dental arch space changes following premature loss of primary first molars: a systematic review. Pediatr Dent 2008;30(4):297–302.
Tanić T, Blazej Z, Radojicic J. The effects of early loss of primary lateral teeth. FU Med Biol 2008;15(2):68–73.
Ghafari J. Early treatment of dental arch problems - space maintenance, space gaining. Quintessence Int 1986;17(7):423–432.