Clinical Evaluation of Different Designs of Fixed Space Maintainer: A Randomized Clinical Trial

Evaluation of survival rates for three space maintainers (SMs) of different designs compared to the standard one.

A total of 52 extraction sites in children aged 4-7 years with prematurely lost primary molars were selected for this study. The whole sample was divided into four groups of 13 each. In group I, Band and Loop (B&L); group II, single-sided Band and Loop (Ss B&L); group III, Direct Bonded Wire (DBW); and group IV, Tube and Loop (T&L). Children were recalled at 3, 6, 9, 12, and 15 months. Cumulative survival rates of SMs were estimated using the Kaplan-Meier method with a logrank test.

Although there was a nonsignificant difference in the number of failed cases among all groups, the overall survival rate for group I was 69.2%, group II was 53.8%, group III was 38.5%, and group IV was 30.8% at the end of the study. The failure types for B&L were solder breakage (75% of the total failure rate) and cement dissolution (25%); for Ss B&L, they were solder breakage with lost loop (50%), soft tissue impingement (33%), and dislodgment (17%); for DBW, they were composite-wire interface debonding (75%) and enamel-composite interface debonding (25%); and finally, for T&L, they were lost T&L (56%), soft tissue impingement (22%), and total loss (22%).

Banded SMs survived for a longer time than bonded ones, with superior performance for B&L compared to Ss B&L. In addition, bonded SMs required strict isolation conditions. DBW could be used in the maxilla rather than the mandible and was preferable for older children.

Hemdan ME, H El Kalla IHH, El Agamy RA. Clinical Evaluation of Different Designs of Fixed Space Maintainer: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(4):442-450.