SPACE REGAINER

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o Space Management:- It includes the measures that diagnose
and prevent or intercept situations, so as to guide the
development of dentition and occlusion.

o Space Maintainer:- According to Boucher space maintainer

is a fixed or removable appliance designed to preserve the
space created by the premature loss of a primary tooth or a
group of teeth.

• Martinez and Elsbach - space maintainer are the orthodontic

appliances used to prevent loss of arch length.

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• Space Regaining:
The process of gaining the space lost by drifting f adjacent teeth
following premature loss of deciduous teeth.

• Space Regainer:
A fixed or removable appliance capable of moving a displaced
permanent tooth into its proper position in dental aech

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 SPACE LOSS
o Most Common Reasons for Space Loss:-

 Ectopic eruption of teeth.

 Premature loss of primary teeth.
 Congenitally missing teeth.
 Teeth lost due to trauma.
 Unrestored proximal carious lesions.
 Delayed eruption
 Ankylosis of primary molars
 Disproportionate tooth size
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 CAUSES OF PREMATURE LOSS:
o Caries

o Trauma

o Failure of endodontic treatment in primary teeth

o Systemic causes

o Resorption of roots

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 Diagnostic records &
Analysis

• Clinical examination.

• Study models.

• Space analysis.

• Radiographs.

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 MIXED DENTITION
ANALYSIS
1) MOYERS MIXED DENTITION ANALYSIS
2) TANAKA AND JOHNSTON ANALYSIS
3) NANCE MIXED DENTITION ANALYSIS
4) HUCKABA’S MIXED DENTITION ANALYSIS
(RADIOGRAPHIC METHOD)
5) HIXON OLDFATHER ANALYSIS

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 Methods
• Methods are divided into:
1. Fixed appliance
2. Removable appliance

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 Fixed appliance
• Open coiled space regainer
• Jackscrew space regainer
• King appliance
• Gerber space regainer
• Hotz lingual arch
• Lip bumper appliance

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 OPEN COIL SPACE REGAINER

- Band adapted on to tooth

& an open coil inserted
into a U shaped wire.
Wire is inserted into
molar tube on the band
& whole assembly is
cemented on tooth

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Fabrication:

- Band adapted on tooth

- Molar tubes welded to the band

- Tubes should be parallel to one another

- Impression with alginate; cast is

prepared

- 0.7mm wire is bent to a ‘U’ shape to fit

molar tubes

- Anterior part of wire contacts the tooth

mesial to edentulous area 11
• At junction of straight part & curved part of wire, both
bucally & lingually, solder is flowed to make a stop

• Open coil spring is cut enough, so as to extend from

the stop to a point about 2mm distal to anterior limit
of tube on molar band

• Coil spring is slipped on wire, wire is put in tubes

• Band with the wire & compressed spring is cemented

on molar

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 JACKSCREW SPACE REGAINER

- Consists of 2 banded adjacent teeth & a threaded

shaft with a screw & a locknut

Fabrication:
- Band is adapted & impression made; cast prepared

- A 0.036 buccal tube is welded to molar band

- Jackscrew unit consists of one adjustment nut & one

lock nut on a threaded shaft. Slide the threaded end of
the shaft into the molar tube
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• Mesial end of shaft is
trimmed and contoured to
band on tooth mesial to
edentulous space

• End of shaft should be

trimmed so that it extends
2 mm from distal end of
tube

• Cemented

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 KING’S APPLIANCE (1977)

- Anchorage unit is a fixed lingual arch with bands fitted

on the first deciduous molar of the treatment side and
the fist permanent molar on the opposite side

- Edgewise bracket is spot welded to the buccal surface

of the primary molar band, and the completed
anchorage unit is cemented in place

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• A band with an angulated buccal tube is cemented on
the malpositioned molar, and a straight section of wire
with an open coil spring is introduced into the buccal
tube and ligated into the bracket

• A millimeter a month is satisfactory progress in the

repositioning of first molar

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GERBER SPACE REGAINER

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 HOTZ LINGUAL ARCH

• Hitchcock in 1974 introduced a modification of

lingual arch – “Hotz lingual arch” with U loops
which is used for moving molars distally.

• The loop on the active side is adjusted periodically

once a month.

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 LIP BUMPER

• Lip bumper appliance is used in the mandibular arch

for gaining space or for distalization of molar and its
counterpart in the maxillary arch is Denholtz
appliance

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 REMOVABLE SPACE REGAINER
 Sling shot space regainer
 Split saddle space regainer
 Finger spring
 Jack screw

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 Sling Shot Space regainer

- consists of a wire elastic

holder with hooks

- the distalizing force is

produced by the elastic
stretched on the middle of
the lingual surface of the
molar to be moved.

- The other is arranged in the

same position on the buccal
surface of the molar
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• Elastic between the hooks while the appliance is outside
the mouth

• The elastic can be changed once each day

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 SPLIT SADDLE SPACE
REGAINER

- consists of an acrylic block

that is split buccolingually
and joined by wire in the
form of a buccal and a
lingual loop

- appliance is activated by
periodic spreading of the
loops

- The activator block is split

with a disk after the
appliance has processed

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- Using canine retractors,
using screws, quad helix

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 FOLLOW UP

Removable type:

• Check whether the patient is using it or not

• Whether there is any distortion or breakage of the appliance

or irritation of soft tissue

• If the teeth are emerging underneath the appliance the portion

of the acrylic is cut off to give way for the teeth to erupt into
position
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Fixed appliances

• Check for any breakage of the appliance at the soldered

joints or band material

• Appliance is removed every 3 to 6 months and abutment

tooth is checked for any caries or decalcification.

• Polishing of the abutment is done followed by fluoride

application. Then the appliance is recemented in position

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 REFERENCES
• Orthodontic current principles and techniques. -
Graber
• Hand book of Orthodontics -Moyers
• Fundamental of Pediatric Dentistry- Mathewson
• Textbook of Pedodontics-Shobha Tandon

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THANK YOU