Lingual Holding Arch Space Maintainer

• Presented by:

Jigyasha Timsina

Contents

• Introduction • Indication and contraindication• Advantages and disadvantages• Fabrication • Modification • Patient Instruction

• Space maintaining appliance

• Bilateral ,Non functional ,Passive mandibular arch appliance

• Fixed type of space maintainer

• Controls 1.Antero-posterior tooth movement 2.Arch perimeter distortion

CONTRAINDICATION

Before the eruption

of mandibular incisors

INDICATIONS

Bilateral loss of posterior teeth

Minor movement of anterior teeth

Maintenance of leeway space

Space regaining

Advantage

Many modifications

are possible

Can also be used to regain space

Disadvantage

Construction is difficult

Chances of distortion

of appliance by tongue pressure

• Consists of :

1.round stainless steel or precious alloy

wire (0.32 to 0.40 inches in diameter)

2.molar bands -most commonly on

permanent first molar rarely second

deciduous molar

•

Wire soldered or welded to the band

Fabrication

Bands are adapted to the most posterior tooth remaining on the arch

A pick up alginate impression is taken.

pre fabricated wire placed or soldered to the band or can be custom made in lab

• Wire should contact cingulum of mandibular incisors slightly above gingival papillae .

• Should lie on gingival third of primary molar

• Should rest at middle third of banded molar

Wire should have 3-4 mm

contact with the band to provide long solder joint

Konstantinos et al suggested giving 2 omega bands in canine region.

Original design consisted of 2 inch adjustment loops so as to allow for adjustment of length

• Passivation

achieved by heating the wire to dull brownish appearance

MODIFICATIONS

• Auxiliary springs incorporated to bring about minor individual tooth movement

• Looped lingual archwire

• Ellis loop lingual archwires

Instruction to the patients

• Brush teeth at least 2 times daily. • Use a water pick or floss to remove food

caught underneath the appliance. • Contact if bands come loose or anything

breaks or wire gets bent.• Warm salt water rinses for sores. • 'Rescue' wax for bands until cheeks get

used to new appliance

References

• Textbook of Pediatric Dentistry

-Nikhil Marwah

• Text book of Pedodontics

-Shova Tandon

• Internet sources