Abstract
Distal shoe appliance (DSA) is an important tool in paediatric dentistry for space maintenance, when there is a premature loss of primary second molar, for guiding the un-erupted permanent rst molar. The purpose of our case report is to discuss the design and fabrication of a modied DSA. In this modied appliance, the primary mandibular incisors were bonded and the primary mandibular canines were banded which were used as abutments for eruption guidance of un-erupted permanent mandibular molars. This appliance was retained in the oral cavity for 8 months until the eruption of rst permanent molars on either side of the arch. It is therefore, a noteworthy and a novel design which can be used for eruption guidance of permanent molars, if at all there be a clinical scenario where there are inadequate abutments due to early loss of all primary molars bilaterally.
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