Lingual Arch Space Maintainer

Presented by : Rahaf Najjar

Definition:Fixed, passive, non functional space

maintaining appliance.Bilateral mandibular appliance.

Used to control:1.Antero-posterior tooth movement 2.Arch perimeter distortion

Indications:Bilateral loss of single / multiple 1ry lower

molars, after eruption of lower incisors.

Minor movement of anterior teeth

Maintenance of leeway space

Contraindications:Before the eruption of permanent lower

incisors.

Disadvantages Advantages1) doesn't prevent extrusion

of opposing teeth.2) High chance of appliance

distortion by tongue force.3) Can promote decay in pts

with bad OH.

1) Allow eruption of permeant without interference.

2) Not easily displaced.3) Easy to maintain good OH.4) Can be modified and used

as space regaining appliance.

5) Patients comfort.

Parts of the Appliance:2 bands in permeant 1st molars/ rarely in

2nd deciduous molars (E’s).Stainless steel wire.The wire is soldered to the bands.

Fabrication:Bands are adapted to the molars.

A pick up alginate impression is taken.

prefabricated 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

Modifications:Auxiliary springs

incorporated to bring about minor individual tooth movement

Looped lingual arch

3D® Lingual Arch:This appliance allows for a set-up of a more

positive anchorage for a variety of treatment functions. The Lingual Arch plugs into the lingual tube and is available in eight sizes.

The Pedo Partial Appliance:Fabricated with a lingual arch soldered to bands

and pedo teeth in acrylic. Each tooth is reinforced to prevent breakage.

References: Paul S. Casamassimo DDS MS . Pediatric Dentistry: Infancy

through Adolescence, 5th edition https://www.rmortho.com/products/3d-lingual-arch/  Angus C. Cameron BDS. Handbook of Pediatric Dentistry,

4th edition  Jeffrey A. Dean DDS MSD. McDonald and Avery Dentistry

for the Child and Adolescent, 9th Edition