Arched Palate Research Articles

Marfan’s Syndrome with Tetralogy of Fallot in an Adult Female with Bronchiectasis

Marfan’s syndrome is an autosomal dominant genetic disorder related to a mutation in fibrillin gene type 1 involving mainly the cardiovascular, ocular, skeletal, and pulmonary systems. A 22-year-old female patient presented with cough, blood-stained sputum, and fever for 4 months. The patient was tall and on skeletal examination, high arched palate, arm-span longer than height, positive finger thumb sign, arachnodactyly, asymmetrical chest, and skin striae were present. Family history of Marfan’s syndrome was present. Echocardiography showed large ventricular septal defect with aortic override and severe pulmonary stenosis. CECT thorax showed bronchiectasis changes. Marfan’s syndrome with cardiovascular abnormalities usually has aortic dilatation, aortic regurgitation, aortic aneurysm, mitral valve prolapse, mitral regurgitation, etc. In this case, the patient has Marfan’s syndrome with tetralogy of Fallot (TPF) and bronchiectasis. The association of TOF with Marfan’s syndrome is one of the rarest findings.

FRASER SYNDROME: A CASE REPORT

Fraser syndrome (cryptophthalmos syndrome) is a congenital anomaly in which cryptophthalmos is the main feature. Other malformations can include syndactyly, craniofacial and urogenital anomalies. It is a rare autosomal recessive condition with FRAS1, FREM2 and GRIP1 genes mutation. We report a case of 2 months old male child born to consanguineous parents. He presented with unilateral cryptophthalmos and some features that were compatible with diagnostic criteria of Fraser syndrome such as syndactyly, high arched palate with ankyloglossia, cryptorchidism and hypospadias. It can be diagnosed by antenatal ultrasound and clinical examination. We also present the criteria for diagnosing Fraser syndrome, its prenatal findings and ocular management.

Xerostomia – An Unknown Oral Manifestation in AAA Syndrome

Background: The triple A syndrome (AAAS), also termed Allgrove syndrome (AS), is a very rare chromosomerecessive disorder that was 1st identified in 1978 by Jeremy Allgrove and colleagues in 2 unrelated siblings.In most cases, there is no associated family history. The syndrome comprises of Achalasia, Addisonianismand Alacrimia. It has an estimated prevalence of 1 per 1,000,000 individuals. About 200 cases have beenreported worldwide as of date, showing a great variability in severity as well as in clinical manifestations.Consistent oral findings could be noticed such as high arched palate, oral pigmentation, fissured or atrophictongue, and xerostomiaCase report: We report the case of a 25-year-old girl who presented with Triple A Syndrome with allcharacteristic clinical features.Conclusion: The aim of this case report is to highlight the dental involvement in Allgrove syndrome. Inaddition, we aim to emphasize the need for the oral physician to accurately diagnose the condition, managethe oral manifestations, and to collaborate with other dental specialists to provide optimum dental care tothese patients.

THE FEATURES OF SURGICAL TREATMENT AND MORPHOLOGICAL ASPECTS OF EPULIS AND PAPILLOMA IN CHILDREN

The paper presents the findings of the study on the features of surgical treatment and morphological structure of epulis and papillomas in children.
 The clinical aspect of the paper concerns 123 children with epulis and 185 with papillomas, who were treated at the clinic of the Department of Pediatric Oral Surgery for the period of 10 years. Verification of the histological structure of neoplasms to determine the final diagnosis was performed by the faculty staff of the Department of Pathological Anatomy with Autopsy Course.
 Statistical processing of the digital data and analysis of the findings of the study showed that epulis and papillomas are more common in girls than in boys (in 2.5 and 2.3 times higher, respectively). A clear pattern of their diagnosis by age was established. Thus, the peak incidence of epulis was recorded in young adolescents of lower and higher secondary school ages (60.3% and 36.6%, respectively). Papilloma was also found quite often in the same age groups (47.0% and 31.4%, respectively).
 After comprehensive examination, the clinical diagnosis of the giant cell epulis was established in 21.1% of cases, and the share of its fibrous and angiomatous forms accounted for 35.0% and 43.9%, respectively. Neither patients with epulis of all its types nor their relatives could clearly determine the time periods of the appearance of the first clinical signs of the disease.
 All patients with papillomas and their relatives complained of the presence of newly formed masses on the oral mucosa or skin, which caused some discomfort, growing slowly, rarely reaching large sizes. The exact time periods of their occurrence could not be specified.
 Treatment of epulis, provided outpatiently for all patients under local anesthesia, was aimed at elimination of the etiological factor (if detected) and surgery.
 No recurrences were noted after removal of fibrous epulis and in cases of treatment of angiomatous epulis recurrence occurred in 1 girl. Among patients with giant cell epulis, recurrence after surgical removal was observed in 4 patients, 3 of whom underwent repeated surgery with preservation of teeth. In 1 child recurrence occurred for the third time and tooth extraction and partial resection of the alveolar ridge was made as part of the inpatient treatment.
 Treatment of papillomas involved surgical removal of neoplasms at the border of healthy tissue up to the submucosal layer using an electrocoagulator or radio knife.
 Depending on the clinical situation and localization of the tumor, manipulations were performed under local (161 cases - 87.0%) anesthesia at the polyclinic, and in 24 children (13.0%) with labile mental health and localization of papilloma on the soft palate, uvula, palatal arches, anesthesia was performed at inpatient. No complications during surgery and in the postoperative period were observed.
 The surgical material was always sent for histological examination, the results of which allowed determining one of the mentioned nosological forms.
 Morphological study has established, that the clinical diagnosis did not coincide with the morphological one in 5 cases (4.1%) in fibrous epulis, in 8 - 6.5% in angiomatous and in 10 - 8.1% in giant cell forms, which together made their discrepancy in 23 observations (18.7%).
 Thus, epulis and papillomas located in the oral cavity have a certain similarity in clinical symptoms and require careful differential diagnosis, and given their unique morphological structure, the final diagnosis must be established taking into account the findings of histopathological examination, as inconsistency of clinical and histopathological examinations, for example, in epulis, reaches 18.7%.
 When planning the treatment, in an every single case the type, extent and site of surgery, as well as type of anesthesia should be carefully considered.
 The presented material can serve as the basis for further in-depth scientific and practical research on comparison of clinical manifestations and immunohistochemical features of epulis and papillomas depending the age of patients.

Successfully Tracheostomy and Monobloc Advancement with External Frontofacial Distraction Followed by Simultaneous Adenoidectomy, Conchotomy, and Septoplasty in Severe Late Crouzon Syndrome

A 10-year-old male patient presented with Severe Late Crouzon Syndrome, with turri-brachycephaly, andsevere exorbitism of both eyes, visual loss, beaked nose and maxilla hypoplasia. The head circumference was54 cm and 90 precentile. Patient had a high arched palate, tonsil hypertrophy and type III malocclusion. Fromthe multidisciplinary meeting, in the first stage it was decided to first secure the airway with Tracheostomythen immediately followed by Monobloc Advancement with External Frontofacial Distraction. Then inthe second stage, after removal of the rigid external distractor, by 9 months after first surgery, the patientunderwent a simultaneous procedures of Adenoidectomy, Conchotomy, and Septoplasty. Thus, after patientgot stable in follow-up, Nasendoscopy and Tracheostomy devices was removed. After 11 months follow-up.Visual function still not getting better. However turri-brachycephaly, exorbitism of both eyes, beaked noseand maxilla hypoplasia, head circumference, arched palate, tonsil hypertrophy and the malocclusion weregetting much reduced, and the patient getting happier and more active.

Fistula incidence after primary repair and correlation with cleft width-to-palatum width ratio: A prospective cohort study

BackgroundCleft lip with or without cleft palate is one of the most common birth defects and is certainly the most visible. Fistula rate after primary palatoplasty was ranging between 10 and 23% and could be detected in the first three weeks after surgery. The cleft width is the frequent factor which was assumed to correspond to fistula occurrence. This study aimed to find correlation between fistula occurrence with cleft width and palatum width ratio after primary palate repair. MethodsA prospective cohort study was conducted on 16 subjects, which consisted of 10 males and 6 females. We measured width of cleft palate, width of rest palate and width of palate arch on three level measurements (posterior, junction and anterior). The surgery was performed using the two-flap and three layers suturing technique. ResultsSixteen patients were enrolled in this study during January and February 2008 . Ten patients were diagnosed with unilateral cleft palate while six patients had bilateral cleft palate. Mean of age was 22.31 ± 5.86 month. Correlation analysis between fistula occurrence and cleft width, cleft width-remnant palate width ratio and cleft width-palate arch width ratio using logistic regression did not show statistical correlation, and the same result was found between fistula occurrence and hemoglobin level, white blood count, nutritional status, cleft type and caries dentis factors (p > 0.05). ConclusionWidth of the cleft is not a factor associated with fistula occurrence. Two-flap three layers technique could be considered as a simple technique and gives a low rate of fistula occurrence.

The value of a simple method to decrease diagnostic errors in Turner syndrome: a case report

IntroductionTurner syndrome is a genetic disorder in females and is the result of complete or partial loss of an X chromosome during fertilization. The missing X chromosome is originally either from the mother's ovum or the father's sperm cell. Approximately 45% of patients have the 45,X karyotype and the rest have other variants of Turner syndrome, which are either mosaicism patterns or structural abnormalities of the X chromosome. Here, we report a case of Turner syndrome that is the fifth case of Turner syndrome with balanced Robertsonian translocation of (13;14)(q10;q10), and the sixth case with 44,X chromosomes, reported in the literature thus far.Case presentationA 10.3-year-old Persian girl was brought to our clinic by her parents, with the complaint of failure to thrive and short height. She had been examined and investigated by endocrinologists since the age of 4 years, but no definite diagnosis was made. At the time of presentation, she had been through three provocative growth hormone tests and had been on no medications for about a year. Her physical examination revealed mild retrognathia and micrognathia. Initially, she was started on somatropin treatment which, after 12 months, did not appropriately improve her height velocity. Therefore, a more thorough physical examination was performed, in which high arched palate and low posterior hairline were observed. There was also a difference between target height and patient height standard deviation scores. Karyotype study was requested, and Turner syndrome was confirmed.ConclusionThe diagnosis of this case was not straightforward, both because the somatic presentations were not obvious, and because the physicians had not looked for them when performing the physical examinations. This case report introduces a rare 44,X chromosome karyotype of Turner syndrome and highlights the value in using the difference between target height and patient height standard deviation scores as a simple and inexpensive tool for diagnosis of this syndrome.

SPECIAL CHILD CARE: WEST SYNDROME MANAGEMENT DURING COVID-19 PANDEMIC

West syndrome is a clinical condition characterized by the combination of an abnormal EEG showing chaotic pattern called hypsarrhythmia, infantile spasms, and delayed development or loss of acquired milestones. The oral manifestations of the conditions are wide and varied ranging from poor oral hygiene, bleeding gums, periodontitis, altered chronology and delayed eruption, high arched palate and extensive caries in multiple teeth. COVID-19 has affected the provision of dental care to all, especially special child care. Henceforth with an aim towards provision of treatment for reliving pain in needful patient, the oral health management was carried out keeping in mind the current pandemic scenario and practice restrictions.

Rubinstein-Taybi syndrome: principal oral and dental disorders and literature update

Introduction: Oral and dental (OD) disorders in children with Rubinstein-Taybi syndrome (RTS) are frequent but not well-known by dentists and pediatricians due to the syndrome being extremely rare. Objective: To describe the OD findings observed in a 5-year-old girl with RTS and to update the literature. Clinical case: The patient presented the following OD manifestations: prominent lower lip, narrow mouth opening, narrow and arched palate, history of angular cheilitis, micrognathia, poor lingual motility, plaque and tartar, bleeding from gingival areas due to poor dental prophylaxis, and malocclusion in the form of an anterior open bite. These OD manifestations are seen in more than 40-60% of patients with RTS. Conclusions: Professionals who treat children with RTS should become aware of the advisability of referring them to the pediatric dentist from 1 year of age and performing check-ups every 6 months. Dental management is often difficult so collaboration with anesthesiologists is recommended in order to carry out a safe and effective treatment.

Oral Manifestations of Rett Syndrome-A Systematic Review.

Rett Syndrome is an x linked developmental disorder which becomes apparent in females after 6 to 18 months of age. It leads to severe impairments including loss of speech, loss of hand movements/manual dexterity, characteristic hand movements such as hang wringing and intellectual disability/learning problems. This systematic review was carried out to identify the dental manifestation of Rett syndrome and to shed light on treatment options available for oral health problems associated with Rett syndrome. A systematic literature search was conducted on the PubMed, Scopus, Biomed, Web of Science, Embase, Google Scholars, Cochrane and CINAHL using the following entries: Rett syndrome (n = 3790), Oral health and Rett syndrome (n = 17), dental health of Rett syndrome patients (n = 13), and the MeSH terms listed below: Rett syndrome and Oral Health (n = 17), Rett syndrome and dentistry (n = 29). The final review included 22 search articles. The most common oral findings was bruxism. Masseteric hypertrophy was also reported. Anterior open bite and non-physiological tooth wear was observed. Other oral manifestations of Rett syndrome included mouth breathing, tongue thrusting, digit/thumb sucking, high arch palate. Increased awareness and dental education amongst dentists and assistants regarding the dental manifestations of Rett syndrome and similar neurodevelopmental disorders is required to improve the level of care and empathy they can provide to these differently able patients. Research on dental aspects of Rett is scarce and this remains a neglected topic.

Maternal Folic Acid Deficiency Is Associated to Developing Nasal and Palate Malformations in Mice.

Craniofacial development requires extremely fine-tuned developmental coordination of multiple specialized tissues. It has been evidenced that a folate deficiency (vitamin B9), or its synthetic form, folic acid (FA), in maternal diet could trigger multiple craniofacial malformations as oral clefts, tongue, or mandible abnormalities. In this study, a folic acid-deficient (FAD) diet was administered to eight-week-old C57/BL/6J female mouse for 2–16 weeks. The head symmetry, palate and nasal region were studied in 24 control and 260 experimental fetuses. Our results showed a significant reduction in the mean number of fetuses per litter according to maternal weeks on FAD diet (p < 0.01). Fetuses were affected by cleft palate (3.8%) as well as other severe congenital abnormalities, for the first time related to maternal FAD diet, as head asymmetries (4.6%), high arched palate (3.5%), nasal septum malformed (7.3%), nasopharynx duct shape (15%), and cilia and epithelium abnormalities (11.2% and 5.8%). Dysmorphologies of the nasal region were the most frequent, appearing at just four weeks following a maternal FAD diet. This is the first time that nasal region development is experimentally related to this vitamin deficiency. In conclusion, our report offers novel discoveries about the importance of maternal folate intake on midface craniofacial development of the embryos. Moreover, the longer the deficit lasts, the more serious the consequent effects appear to be.

Three dimensional movement analysis of maxillary impacted canine using TADs: a pilot study

BackgroundThe aim of the present study was to compare two different anchorage systems efficiency to disinclude impacted maxillary canines using as evaluation tool superimposed Cone Beam Computed Tomography (CBCTs).MethodsThe study has been conducted with two parallel groups with an allocation ratio of 1:1. Group test received treatment using as anchorage a miniscrew, control group was treated using an anchorage unit a trans palatal arch (TPA). Both groups received a calibrated traction force of 50 g. CBCT before treatment and 3 months after traction were superimposed and canine tip and root movement were evaluated in mm/month ratio.ResultsNo differences were observed between groups for apex displacement, tip displacement and observation timespan. Twenty-two patients (12 female, 10 male, mean age:13.4 years) undergoing orthodontic treatment for impacted maxillary canines were recruited for this study. No differences were observed between groups for apex displacement, tip displacement and observation timespan.ConclusionsThe present pilot study provided no evidence that indirect anchorage on miniscrews could make canine disimpaction faster than anchorage on a TPA.An apex root movement of 0.4–0.8 mm per month was found, while average canine tip movement ranged between 1.08 mm and 1.96 mm per month.No miniscrews failures were observed.Trial registrationThe study reports the preliminary results of the randomized clinical trial registered at www.register.clinicaltrials.gov (registration number: NCT01717417).

Orofacial-digital syndrome type 1 with patchy scalp alopecia in an Indian child

Introduction: Oral-facial-digital syndrome (OFDS) is a rare type of ectodermal dysplasias characterized by malformations of the face, oral cavity, and digits. The OFDS type 1 is most common and has an X-linked dominant inheritance. Case report: We report a child with a single patch of scalp alopecia who was found to have typical oral malformations such as high arched palate, accessory frenulae, tongue hamartoma, and dentition abnormalities. . She had associated central nervous system malformations and was diagnosed with OFDS 1. Discussion: The case highlights importance of recognizing this syndrome to detect systemic abnormalities on time.

Orofacial Findings and Dental Management of Noonan Syndrome: A Case Report

Noonan Syndrome (NS) is an autosomal dominant condition caused by mutations in multiple genes in the RAS-MAP (Mitogen-Activated Protein) Kinase pathway. It is typically characterised by short stature, broad webbed neck, abnormal chest shape, congenital heart defects and developmental delay. Oral manifestations include high arched palate, micrognathia, malocclusion, impacted teeth and jaw bones. Presented here is a case of NS in a 26-year-old female, reported to the dental clinic in College of Dentistry, Princess Nourah Bint Abdulrahman University. The cranio-dentofacial features of this syndrome can be diagnosed by the dentist and these features can be unrecognised by the physician. The dentofacial features of the patient included a broad forehead, down slanting palpebral fissure, flat base of the nose and low junction of the ears, prominent nasolabial folds, Class III molar malocclusion, edge-to-edge bite, high arched palate, and congenitally missing teeth. The present patient was first diagnosed by a dental professional and hence, this case report aims to present this syndrome from a dental viewpoint. The treatment plan was to improve her oral hygiene, retain the deciduous tooth and space maintainer in the congenitally missing tooth to preserve space for the future prosthodontic treatment.

Cerebro-Costo-Mandibular Syndrome in a COVID-19 Positive Neonate: Clinical and Radiological Findings

Cerebro-costo-mandibular syndrome (CCMS) is also known as rib-gap defect with micrognathia syndrome. It is a condition comprising a constellation of mandibular hypoplasia presenting as micrognathia, abnormalities of roof of mouth (palate) and posterior rib defects as its basic features. Other signs and symptoms may include microcephaly, spina bifida. These anatomical problems predispose these patients to respiratory difficulties associated with upper airway obstruction, reduced thoracic capacity and scoliosis. We describe a sporadic case of a full-term female neonate born to a COVID-19 infected mother in third trimester with features of micrognathia, high arched palate with palatal hypoplasia, cervical spina bifida along with preauricular skin tag and congenital heart disease, presenting as respiratory distress at birth Cerebro-costo-mandibular Syndrome (CCMS) and with a good short term outcome.

Anthropometric analysis of palatal rugae pattern, face form and arch form among Indian population at Moradabad, India

Purpose: To evaluate the correlation between the palatal rugae pattern, face form and arch form among Indian population at Moradabad, India. Materials and Methods: Alginate impressions of maxillary arch was made and cast was poured immediately with type III dental stone. A sharp graphite pencil was used for marking outline of the rugae on the cast. A digital caliper was employed for measurement of length of palatal rugae. Palatal rugae were analysed in accordance with Thomas and Kotze classification. Arch form of these models was determined with using 3M Unite template. For assessment of the face form, the subjects were seated in an upright position on the operator chair and the camera was stabilized on a tripod. Then photographs of the frontal profile were taken. These photographs were used for the analysis of the face form. The data was subjected to one way analysis of variance test and Post Hoc test. Results: The average number of primary rugae (10.76%) were found to be more predominant than secondary (2.12%) and fragmentary rugae (1.54%). The most predominant shape of palatal rugae were curved (42.19%) followed by wavy (32.71%), straight (17.37%) and circular (0.92%). Based on the direction of the rugae, forward rugae (54.27%) were found more common followed by backward rugae (37.26%) and perpendicular rugae (0.55%). Base on the unification of rugae pattern, diverging rugae (4.55%) were found to be more common than the converging rugae (1.57%). The most common face form was ovoid (72.4) % followed by tapered (24.4%) and square (3.2%). The most prevalent arch form was ovoid (62.2%) seen followed by the tapered (26.0%) and square (4.8%) arch form. It was found that there was significant correlation between the face form and arch form among the study subjects (p0.05). In term of arch form and face form, ovoid was the most common followed by tapered and square. Conclusion: Within the limitations of this study, it was concluded that there was significant correlation

LINC-16. MEDULLOBLASTOMA IN A BOY WITH RUBINSTEIN-TAYBI SYNDROME: A CASE REPORT

BACKGROUNDRubinstein–Taybi syndrome (RTS) is characterized by multiple congenital anomalies and associated with mutations in CREBBP (70%) and EP300 (5–10%). Previous reports have suggested an increased incidence of benign and possibly also malignant tumors, but the correlation remains unclear. Here we present a case of a patient with RTS and medulloblastoma. CLINICAL CASE: A 5-year-old male presented with increased intracranial pressure. An MRI revealed a 4.2 x 4.7 cm mass in the midline of cerebellum arising from the floor of 4th ventricle. The patient underwent a complete resection and pathology revealed medulloblastoma, classic histology. Staging established no disseminated disease. At diagnosis, a peculiar phenotype consisting in mild mental retardation, microcephaly, down-slanting palpebral fissures, broad nasal bridge, highly arched palate, mild micrognathia, screwdriver incisors and wide thumbs and toes was noted. Clinical genetics evaluation was consistent with RTS. Karyotype was performed and normal. Further genetics testing was not done. Treatment consisted in 8 cycles of chemotherapy and craniospinal radiation (2300 cGy to spine, 5500 cGy Total). At the end of treatment, there was no evidence of disease. He was under surveillance for 33 months free of disease, but relapsed with a supratentorial meningeal disease that ultimately resulted in death.CONCLUSIONThis report highlights the fact that pediatric medulloblastoma can be associated to RTS, in this case associated to classical histology and recurrent disease.

Space Maintainer: A Review

Space maintainers are useful incases of deciduous teeth to protect the dentition from malposition,impaction,crowding,etc. They can also be used inmixeddentition. Various types of space maintainersare there forParticular treatment. This is mainly aimed atthe management of space in children. This article mainly aimsat Bandandloop,Distal shoe, and trans palatal arch space maintainers.

The impact of nasal surgery on sleep quality

ObjectiveNasal obstruction is considered to be one of the risk factors for obstructive sleep apnea, together with a high arched narrow palate, elongated uvula, malocclusion, and tongue and tonsil size. The impact of nasal obstruction on sleep apnea is controversial, however, and its relation to sleep quality is rarely discussed. The purpose of this study was to investigate the independent effect of nasal obstruction on sleep quality. MethodsSixty-nine patients with nasal obstructive symptoms and without sleep apnea episodes were enrolled from September 2018 to August 2019, and compared before and after surgery with thirty-four patients who had benign diseases of the thyroid or parathyroid as a control group, to investigate effects of surgery. Sleep quality was evaluated using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J). All cases were reassessed at three months after surgery. ResultsThe postoperative PSQI scores in the nasal surgery group were significantly lower than the preoperative scores (p < 0.001). In contrast, there was no statistically significance difference between the pre- and postoperative PSQI scores in the neck surgery group. Difference of PSQI scores before and after surgery in the nasal surgery group was significantly higher than the neck surgery group. ConclusionsThis double-arm study suggests that reduction of nasal disfunction with nasal surgery contributes significantly to sleep quality, in patients who may not have noticed their impaired quality of sleep previously because of their long-term nasal symptoms.

Effects of Fixed and Removable Space Maintainers on Dental Plaque and DMFT/dft Values

Purpose: Space maintainers are important for the health and placement of children’s primary and permanent teeth. However, plaque and caries levels can be negatively affected when a dental appliance is in the mouth. This study aims to evaluate the oral health of pediatric patients that have space maintainers applied as a result of early tooth loss. Methods: This study included 100 systemically healthy patients between the ages of 4-15 years that were treated with space maintainers due to early loss of teeth. Decayed, missing, filled tooth index values and dental plaque status of the participants were recorded. Controls were performed in the 6th and 12th month. The index results were compared and evaluated statistically using ANOVA and paired-t-tests. Results: A total of 116 space maintainers, including 36 band and loops, 16 lingual arches, 21 palatal arches, 43 removable appliances, were evaluated in the study. Statistically significant differences were found between the pre-treatment and post-treatment index values (p&lt;0.001). In the group of band and loops and removable space maintainers; the increases in DMFT/dft values of 6th month and 12th month according to initial DMFT/dft values were statistically significant (p&lt;0.05). For plaque index, the increase in 12th month of all types of appliances were found statistically significant (p&lt;0.001). The greatest increase in plaque index level was seen in the teeth of patients that had been treated with a lingual arch. Conclusions: Incompatible space maintainers can lead to caries, increased plaque accumulation, demineralized areas, and periodontal problems. The accumulation of plaque and difficulty of cleaning the teeth, especially in the fixed space maintainers, negatively affects the health of teeth. For this reason, good oral hygiene should be provided to patients and controls should be regularly performed.