Inflammatory Fibrous Hyperplasia Secondary to Band and Loop Space Maintainer in a Child: a Rare Clinical Presentation

Space maintainers play an important role in pediatric dentistry for maintaining the arch length and preventing unwanted tooth movement following early extraction of primary teeth. The band and loop space maintainer is one among the frequently used space maintainer due to its simplicity and effectiveness. However, chronic irritation from appliance components, plaque accumulation, or repeated manipulation of the appliance by children can lead to reactive soft tissue lesions.

An eight-year-old girl reported with a soft tissue enlargement in the mandibular left posterior buccal mucosa. A band and loop space maintainer had been placed one year earlier after premature loss of the mandibular left first primary molar. Clinical examination revealed a localized sessile buccal mucosal overgrowth adjacent to the loop component of the appliance. The lesion was attributed to chronic mechanical irritation caused by repeated cheek manipulation of the appliance. The appliance was removed, and the lesion was surgically excised under local anesthesia with conscious sedation. Histopathological examination confirmed inflammatory fibrous hyperplasia. Postoperative healing was uneventful, with complete mucosal recovery during periodic follow-up.

This case highlights a rare soft tissue complication associated with a band and loop space maintainer. Repeated manipulation of the appliance by the child appeared to cause chronic trauma to the buccal mucosa, resulting in inflammatory fibrous hyperplasia. Proper appliance design, patient and parent education, and periodic clinical reassessment are essential to detect early signs of irritation and prevent such reactive lesions in children.