International Journal of Clinical Pediatric Dentistry

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VOLUME 14 , ISSUE S1 ( Special Issue (Pediatr Orthodont), 2021 ) > List of Articles


Clinical Effectiveness of Fiber-reinforced Composite Space Maintainer and Band and Loop Space Maintainer in a Pediatric Patient: A Systematic Review and Meta-analysis

Henpu Kamki, Ritesh Kalaskar, Hemraj Badhe

Keywords : Band and loop space maintainer, Fiber-reinforced composite space maintainer, Primary dentition, Space maintainer, Systematic review

Citation Information :

DOI: 10.5005/jp-journals-10005-2044

License: CC BY-NC 4.0

Published Online: 27-12-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Background: Objectives: This systematic review aimed to evaluate the clinical effectiveness of fiber-reinforced composite space maintainer (FRCSM) and band and loop space maintainer (BLSM) in a pediatric patient. Materials and methods: Eligibility criteria: Randomized controlled trials (RCTs) were conducted on 3–12-year-old children who received FRCSM and BLSM. Information sources: Literature search of electronic databases such as PubMed, Cochrane, and Google Scholar for the time period of 2000 to October 2020. Risk of bias: Cochrane collaboration\'s risk of bias tool was used to assess the risk of bias. Results: Included studies: The search resulted in 147 published studies. After the removal of duplicate studies and full-text analysis, eight studies were selected. Synthesis of results: Fiber-reinforced composite restoration (FRCSM) was judged to be good for short-term space maintenance with good esthetics, less time-consuming, and good patient and parental acceptance. Meta-analysis was done for failure rate at 6 months and 12 months. After 6 months, the FRCSM group showed less failure, with a risk ratio of 0.83 (95% CI = 0.47–1.49; Z value = 0.61). However, after 12 months, the FRCSM group showed more failure, with a risk ratio of 1.30 (95% CI = 0.04–4.23; Z value = 0.44). Description of the effect: FRCSM performed better than BLSM for a short-term, i.e., around 6 months but after 12 months of space maintainer placement BLSM performed better than the FRCSM. Discussion: Strengths and limitations of evidence: The strength of this systematic review is its complete adherence to the PRISMA statement 2009. This review attempted to evaluate the effectiveness of FRCSM when compared with BLSM which has not been evaluated before. Additionally, only RCTs were included in this review adding to its validity. This review also included a meta-analysis that compared the failure rate at the 6th and 12th month. The main shortcoming of this systematic review is the limited number of databases searched and the limited number of existing studies. Interpretation: Within the limitations of this review, it can be stated that the FRCSM is an effective space maintainer for short-term space maintenance. However, it is necessary to conduct more RCTs with larger sample size, preferably using a split-mouth design to improve the longevity of FRCSM. Additionally, it is also necessary to standardize the technique of fabrication of FRCSM since an existing study showed high heterogeneity in the technique of fabrication. Other: Funding: None. Registration: The protocol of this systematic review was registered on PROSPERO (ID-CRD42020165831).

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  1. Reddy NV, Daneswari V, Shruti G, et al. Premature loss of primary teeth on arch dimensions in 6- to 10-year-old schoolchildren in Khammam town, Telangana state. Int J Pedod Rehabil 2018;3(2):67. DOI: 10.4103/ijpr.ijpr_28_17.
  2. Cavalcanti AL, Alencar CR, Bezerra P, et al. Prevalence of early loss of primary molars in school children in Campinagrande. Brazil Pak Oral Dent J 2008;28(1):113–116.
  3. Ngan P, Alkire RG, Fields HE. Management of space problems in the primary and mixed dentitions. J Am Dent Assoc 1999;130(9):1330–1339. DOI: 10.14219/jada.archive.1999.0403.
  4. Setia V, Pandit IK, Srivastava N, et al. Space maintainers in dentistry: Past to present. J Clin Diagn Res 2013;7(10):2402. DOI: 10.7860/JCDR/2013/6604.3539.
  5. Lin YT, Lin YT. Long-term space changes after premature loss of a primary maxillary first molar. J Dent Sci 2017;12(1):44–48. DOI: 10.1016/j.jds.2016.06.005.
  6. Tahririan D, Safaripour M, Eshghi A, et al. Comparison of the longevity of prefabricated and conventional band and loops in children's primary teeth. Dent Res J (Isfahan) 2019;16(6):428–434. DOI: 10.4103/1735-3327.270784.
  7. Qudeimat MA, Fayle SA. The longevity of space maintainers: a retrospective study. Pediatr Dent 1998;20(4):267–272.
  8. Mittal S, Sharma A, Sharma AK, et al. Banded versus single-sided bonded space maintainers: A comparative study. Indian J Dent Sci 2018;10(1):29. DOI: 10.4103/IJDS.IJDS_76_17.
  9. El-Patal MA, Asiry MA, AlShahrani I, et al. The effect of fiber-reinforced composite versus band and loop space maintainers on oral Lactobacillus acidophilus and Streptococcus mutans levels in saliva. J Indian Soc Pedod Prev Dent 2018;36(3):301. DOI: 10.4103/JISPPD.JISPPD_155_18.
  10. McDonald RE, Avery, et al., In: Dentistry for the child and adolescent. 7th ed., St. Louis: Mosby; 2000. p. 686. DOI: 10.4103/JISPPD.JISPPD_155_18.
  11. Kulkarni G, Lau D, Hafezi S. Development and testing of fiber-reinforced composite space maintainers. J Dent Child 2009;76(3):204–208.
  12. Rani R, Chachra S, Dhindsa A, et al. Clinical success of fixed space maintainers: Conventional band and loop versus fiber-reinforced composite loop space maintainer. N Niger J Clin Res 2020;9(15):1–6. DOI: 10.4103/nnjcr.nnjcr_32_19.
  13. Garg A, Samadi F, Jaiswal JN, et al. ‘Metal to resin’: a comparative evaluation of conventional band and loop space maintainer with the fiber reinforced composite resin space maintainer in children. J Indian Soc Pedod Prev Dent 2014;32(2):111. DOI: 10.4103/0970-4388.130783.
  14. Potgieter N, Brandt PD, Mohamed N. Clinical evaluation of the loop-design fibre-reinforced composite and the band-and-loop space maintainers. S Afr Dent J 2018;73(7):436–441. DOI: 10.17159/2519-0105/2018/v73no7a1.
  15. Kamal YM, Mohammed KN. Evaluation of posterior fixed functional space maintainers made of fiber reinforced composite. Oral Health Dent Manag 2017;16:1–5.
  16. Setia V, Pandit IK, Srivastava N, et al. Banded vs bonded space maintainers: finding better way out. Int J Clin Pediatr Dent 2014;7(2):97. DOI: 10.5005/jp-journals-10005-1245.
  17. Tunc ES, Bayrak S, Tuloglu N, et al. Evaluation of survival of 3 different fixed space maintainers. Pediatr Dent 2012;34(4):97E–102E.
  18. Subramaniam P, Babu GK, Sunny R. Glass fiber–reinforced composite resin as a space maintainer: a clinical study. J Indian Soc Pedod Prev Dent 2008;26(7):98
  19. Ramakrishnan M, Dhanalakshmi R, Subramanian EM. Survival rate of different fixed posterior space maintainers used in paediatric dentistry–a systematic review. Saudi Dent J 2019;31(2):165–172. DOI: 10.1016/j.sdentj.2019.02.037.
  20. Kargul B, Çaglar E, Kabalay U. Glass fiber-reinforced composite resin as fixed space maintainers in children: 12-month clinical follow-up. J Dent Child 2005;72(3):109–112.
  21. Saravanakumar MS, Siddaramayya J, Sajjanar AB, et al. Fiber technology in space maintainer: a clinical follow-up study. J Contemp Dent Pract 2013;14(6):1070. DOI: 10.5005/jp-journals-10024-1453.
  22. Hitchcock HP. Preventive orthodontics. In: Finn SB, ed. Clinical pedodontics. 4th ed., Philadelphia: W. B. Saunders Company; 1973. pp. 342–369.
  23. Artun J, Marstrander PB. Clinical efficiency of two different types of direct bonded space maintainers. ASDC J Dent Child 1983;50(3):197–204.
  24. Zachrisson BU. Clinical experience with direct bonding in orthodontics. Am J Orthod 1977;71(4):173–189. DOI: 10.1016/0002-9416(77)90247-0.
  25. Soares FZ, Rocha Rde O, Raggio DP, et al. Microtensile bond strength of different adhesive systems to primary and permanent dentin. Pediatr Dent 2005;27(6):457–462.
  26. Baroni C, Franchini A, Rimondini L. Survival of different types of space maintainers. Pediatr Dent 1994;16(5):360–361.
  27. Croll TP. Prevention of gingival submergence of fixed unilateral space maintainers. ASDC J Dent Child 1982;49(1):48–51.
  28. White SN, Caputo AA, Anderkvist T. Effect of cantilever length on stress transfer by implant-supported prostheses. J Prosthet Dent 1994;71(5):493–499. DOI: 10.1016/0022-3913(94)90189-9.
  29. Kara NB, Çehreli S, Sağırkaya E, et al. Load distribution in fixed space maintainers: a strain-gauge analysis. Pediatr Dent 2013;35(1): 19E–22E.
  30. Sasa IS, Hasan AA, Qudeimat MA. Longevity of band and loop space maintainers using glass ionomer cement: a prospective study. Eur Arch Paediatr Dent 2009;10(1):6–10. DOI: 10.1007/BF03262659.
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