Dental Education Lecture: Early Cementation for Space Maintenance

John loses two baby molars (between #19 and L on your right-hand side; between #30 and S on your left-hand side in Fig.1) prematurely.  We make two space maintenances: the one on the right called Distal Shoe; the other called Band and Loop.  John is supposed to return in two weeks.  Instead he comes back in three months.  We cannot seat these two space maintenances in his mouth, and decide to remake them.  We have to retake impression and pour the model.  The old space maintenances cannot be seated in the new model, either (Fig.2).  It appears that the teeth #19 and 30 have moved forward as indicated by arrows.  The changes are quite substantial in three months.

We take two X-ray pictures (Fig.3 and 4).  It looks like that there are barely enough spaces for the tooth #20 and #29 to erupt.  The spaces above them (between #19 and L, and between #30 and S, respectively) are not wide enough. John may need space regainer to recover the lost spaces.  Anyway, change happens in kids rapidly.  In order to reduce hassle, parents should bring kids back to dental office for cementation as soon as possible.

Xin Wei, DDS, PhD, MS 1st edition 10/26/2009, last revision 10/27/2009