4th Scenario of 10th Block

Premature Loss and Space maintainer

DIFFICULT TERMS

QUESTIONS

1. Etiology of premature loss

2. Definition of premature loss
3. The treatment of premature loss
4. What are the indications and contraindications of space maintainer
5. The differences between space maintainer, space regainer and space retainer
6. The effect of premature loss
7. What are the advantages and disadvantages of space maintainer and spece
regainer
8. What is the effect of one sided chewing
9. How to prevent premature loss
10.What are the classification of space maintainer
11.Why his lower front teeth overlap with another
12.How to determine oral hygiene status in mixed dentition

ANSWERS

1. Etiology of premature loss

- Trauma and caries
- Malignancies like leukemia and periodontitis
- Nutrition
- Metabolism disorder like diabetic in children (type 1)
- Environment factor

2. Definition of premature loss

- When loss of decidui teeth and permanent tooth not ready to erupt
- Early primary tooth loss
- The loss of second molar decidui because of caries or ectopic eruption of first
molar permanent

3. The treatment of premature loss

- Space maintainer and space regainer
- Space mainater: 2-4 mm
Space retainer 2-4 mm (if the first molar drifting)
Space regainer >4 mm
- Use of Space regainer when the space 2-4 mm and the teeth is mesial drifting
Have 2 conditions of mesial drifting
 - When the space 0-2 mm: observation

4. What are the indications and contraindications of space maintainer

Indications
- Premature loss
- Lack of the space 2-4 mm

Contraindications
- Theres no alveolar bones
- If theres already enough space to permanent tooth erupt
- Patient who have allergy to the space maintainer materials (acrylic,
alloy/steel)
- Patient who not cooperative
- If theres no permanent tooth germ (Anodontia)

5. The differences between space maintainer, space regainer and space retainer
Space maintainer
- When the desidui teeth have space to permanent teeth erupt but we have to
maintain the space because the permanent teeth wont erupt right away
- To keep the teeth organized like it used to be
- To keep the space
- Using wire

Space regainer
- When theres not enough space for permanent teeth erupt
- To moving the teeth
- To make space

Space retainer
- Orthodontic
- treatment after orthodontic to keep the condition of the teeth
- tools of space maintainer
- not using wire

6. The effect of premature loss

- One side chewing
- Spacing and difficult to speak
- Crowding
- Bad oral hygiene
- First molar moves to mesial and disturb the eruption of the other teeth
- First molar not standing straight (mesial drifting)
- Diastema
- Theres no enough space for permanent teeth
- Caninus moves to distal
- Malocclusion

The different between overlap, crossbite and crowded

7. What are the advantages and disadvantages of space maintainer and spece
regainer
Advantages
- For mastication, chewing and speak (SM)
- For aesthetic (SM)
- Gain space for permanent tooth (SR)

Disadvantages
- (Removbale SM) the patient isnt cooperative
- (Fixd SM) dangerous to make children use fixed appliances because they
easily get caries (adjacent tooth gigi yang berdekatan )
- (fixed with loop) the loop enter until the gum so it can cause gingivitis
- (SM and SR) It can hurt the soft tissues

8. What is the effect of one sided chewing

- Dirty (bad oral hygiene in the side that doesnt use for chewing)
- Malocclusion
- No stimulus for the growth
- Trouble on TMJ (clicking)

9. How to prevent premature loss

- Prevent caries
Consume less sweet foods
Maintain the oral hygiene to avoid caries
Use TAF and fissure sealant
- Eat enough nutrition
- Prevent trauma

10.What are the types of space maintainer and space regainer (and its function)
- Fixed with band
- Fixed without band
- Removable with band (semi fix)
- Removable without band
- Functional (it can use for eat because theres pontic/anasir teeth)
- Unfunctional

- Fixed
Distal shoe appliances
Band and loop
Acrylic Hawley retainer

Types!!!

- Removable
- Fixed
- Semi fixed

11.Why his/her lower front teeth overlap to another

12.How to determine oral hygiene status in mixed dentition
13.Mention kinds of space analysis for primary and mixed dentition