Leeway Space Research Articles

Do Hall Technique Crowns Affect Intra-arch Dimensions? A Split-mouth Quasi-experimental Non-randomized Feasibility Pilot Study.

The Hall technique preformed metal crowns (HT-PMCs) are allegedly oversized, temporarily altering inter-arch relationships. Intra-arch dimensions and leeway space (LWS) HT effects are unknown. To study single HT-PMC intra-arch effects and treated tooth dimensional changes. Split-mouth, quasi-experimental, non-randomized feasibility pilot study. Intraoral scans (iTero II®) were taken preorthodontic separator placement (scan1), immediately post single HT-PMCs (scan2) in 13 children, and 1 month later (scan3) in eight children. Control and study quadrants' lengths ("arcs") and HT-PMCs/control tooth dimensions [mesiodistal (MD), buccopalatal/lingual (BP/L), diagonal (Diag1/Diag2)] were recorded in mm (OrthoCAD® software). Paired t-test, repeated analysis of variance (ANOVA) post hoc analysis statistics (p < 0.05). Compared to scan1, the mean study arc increased by 0.7 mm (±0.5) (n = 13, t-test, p < 0.001) at scan2, while at scan3, it increased by 0.8 mm (±0.34) (n = 8, repeated ANOVA, p = 0.008). The HT-PMCs-treated tooth mean dimensions increased at scan2 by 0.9 mm (MD), 0.8 mm (BP/L), 0.5 mm (Diag1), and 0.7 mm (Diag2) (t-test, p < 0.001) with similar observations at scan3. There were no significant changes in the control arc or the control tooth measurements. One single HT-PMC increased the intra-arch quadrant length by approximately up to <1 mm. The HT-PMC-treated tooth was marginally oversized. This pilot study paves the way for a more robust study with a larger sample size. AlRamzi B, AlHalabi M, Kowash M, et al. Do Hall Technique Crowns Affect Intra-arch Dimensions? A Split-mouth Quasi-experimental Non-randomized Feasibility Pilot Study. Int J Clin Pediatr Dent 2024;17(6):673-682.

Severe Crowding Associated with Lower Canine Premature Resorption: Interceptive Treatment with Clear Aligners-A Pilot Study.

Early mixed dentition represents a critical phase since crowding conditions can occur. The interceptive resolution of dental crowding allows favorable arch and occlusal development. The aim of the present investigation was to evaluate dentoalveolar changes of clear aligner treatment planned to manage lower incisor crowding, loss of arch length, and midline deviation in early mixed dentition. A total of 13 patients (7 females, 6 males, 9.4 ± 1.2 age) treated with clear aligners were selected. Arch dimensions and incisor inclinations were evaluated before (T0) and at the end of interceptive treatment (T1). A paired t-test was chosen to compare T1-T0 changes. The level of significance was set at 5%. The greatest significant increase in mandibular width was observed at the level of the first deciduous molars (+2.44 ± 1.4 mm), followed by the second permanent molars (+2.16 ± 1.4 mm). Lower arch length and arch depth showed a statistically relevant increase (2 ± 0.6 mm and 4.5 ± 1.6 mm, respectively). The mean lower dental midline changes were statistically significant (1.42 ± 0.73 mm). Early treatment with clear aligners, including the combination of transversal arch development, maintenance of leeway space, and guidance of eruption, represents a valid treatment strategy in early mixed dentition to manage arch crowding and occlusion development.

Fungal footprints in oral cancer: unveiling the oral mycobiome.

Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer, with a high mortality rate. There is growing evidence supporting a link between oral cancer and the microbiome. The microbiome can impact various aspects of cancer, such as pathogenesis, diagnosis, treatment, and prognosis. While there is existing information on bacteria and its connection to oral cancer, the fungi residing in the oral cavity represent a significant component of the microbiome that remains in its early stages of exploration and understanding. Fungi comprise a minuscule part of the human microbiome called the mycobiome. Mycobiome is ubiquitous in the human body but a weakened immune system offers a leeway space for fungi to showcase its virulence. The role of mycobiome as a colonizer, facilitator, or driver of carcinogenesis is still ambiguous. Reactivating the mycobiome that undergoes collateral damage associated with cancer treatment can be watershed event in cancer research. The coordinated, virulent, non-virulent behavior of the fungi once they reach a critical density must be hacked, considering its diagnostic, prognostic and therapeutic implications in cancer. This review highlights the diversity of the mycobiome and its potential role in oral cancer.

Utilitarian fixed space maintainer in an 8-year old with multilateral dentoalveolar abscess- A case report

Early exfoliation of primary molars is common among pediatric patients. Construction of a space maintainer should be in accordance with the age of the child and developmental status of the dentition. Pediatric dentists should not only address the space loss but also consider the functional, emotional and hygienic challenges the child might face. The subject was 8 years old and presented with multilateral dentoalveolar abscess and difficulty in chewing. Pain of the involved teeth was addressed through multidisciplinary approach followed by construction of utilitarian fixed space maintainer. The conclusion was that the construction of bilateral utilitarian fixed space maintainer not only addressed the preservation of leeway space but also restored the functional efficacy.

Does Early Treatment Improve Clinical Outcome of Class II Patients? A Retrospective Study.

The present study was carried out to evaluate the benefits from one-phase Class II Early Treatment (ET) using extraoral forces and functional appliances but without intermaxillary forces and eventual lower leeway space preservation compared to two-phase Class II Late Treatment (LT) with the need for extractions and full fixed appliances as well as lower incisor proclination. The ET group (n = 239, 115 M, 124 F, mean age 10.6 ± 1.2 years), with first premolars not in contact and the second deciduous lower molars preserved, was compared to the LT group (n = 288, 137 M, 151 F, mean age 12.4 ± 1.5 years). The ET group was first treated with headgears, growth guide appliances, or Teuscher activators and, in borderline crowding cases, with lower space maintenance by a lingual arch, lip bumper, or fixed utility arch. The LT group and the second phase of ET were treated with full fixed appliances including intermaxillary forces such as Class II elastics or noncompliance devices; headgear and a growth guide appliance were also used. Cephalograms and plaster models were taken before (T1) and after treatment (T2) to calculate cephalometric changes and space balance discrepancies. The differences between T1 and T2 were analyzed by a t-test for normally distributed data and by the Mann–Whitney Test for nonnormally distributed data at a level of p < 0.05. The groups were defined as statistically homogeneous at T1. A statistical analysis showed that the ET group (mean treatment time 35.3 ± 13.3 months) was significantly associated with a 22.2% lower extraction rate, 15.9% less need for a full fixed appliance, and more than 5° less incisor proclination in the nonextraction cases compared to the LT group (mean treatment time 25.9 ± 8.1 months); treatment time significantly increased in the ET group compared to the LT group. Early Class II treatment resulted in a significant treatment effort reduction in more than one third of the patients and less lower incisor proclination, even if it clinically increased treatment time.

Reconsideration of Leeway Space Calculated Using Models from Same Patients at Different Growth Stages.

In this study, original leeway space was determined using plaster models prepared from the same individuals over successive years and compared with that reported in an earlier study. The plaster models used for measurement were prepared from a normal dentition group comprising 64 patients and a crowded dentition group comprising 29. The mesiodistal crown width of the deciduous canines, deciduous first molars, and deciduous second molars, as well as that of the canines, first premolars, and second premolars was measured. Leeway space was then calculated and the results compared with that previously reported. The average maxillary and mandibular leeway spaces calculated in the same individuals were 1.46 and 2.66 mm, respectively, whereas those calculated from data collected from different individuals were 0.89 and 2.83 mm, respectively. No direct statistical comparison of leeway space between this and the earlier report was possible. The present results did indicate, however, that it was larger in the maxilla than previously reported. A larger leeway space is advantageous for the normal arrangement of the permanent teeth. While the mesiodistal crown width of some of the lateral segment teeth in the present study was significantly larger in boys than in girls, no significant difference was observed in leeway space between sexes. The mesiodistal width was larger in multiple permanent teeth such as canines in the crowded dentition group, and this difference was significant in boys. On the other hand, no difference was observed in mesiodistal width in the deciduous teeth between the two groups. These results showed a tendency toward larger teeth and less leeway space in the permanent dentition in the crowded dentition group, which may have been a factor in why such crowding occurred.

Effects of Gender and Age in Mandibular Leeway Space for Taiwanese Children.

Purpose: Leeway space is clinically crucial in pediatric dentistry because it is utilized to resolve tooth crowding and allow the first molars to drift mesially to establish a Class I molar relationship in the later stages of mixed dentition. This study investigated leeway space in the mixed dentition of Taiwanese children of different sexes and ages. Materials and Methods: The digital panoramic dental films of 182 lower arches of 119 boys and 63 girls aged 5–10 years were analyzed in this retrospective study. The mesiodistal crown widths of the primary canines and first and second molars and the permanent canines and first and second premolars were measured using medical imaging software. Differences in leeway space were statistically analyzed. Results: The average leeway space was 1.29 ± 1.48 mm on each side of the lower arch. The leeway space of children aged 5–6 years was significantly greater than that of children aged 7–8 years. No gender difference in crown width was discovered, except with regard to the primary first molar. Although no gender difference in leeway space was observed, permanent teeth affected leeway space more for girls than for boys. Conclusion: In Taiwanese children, although leeway space does not differ by sex, age affects leeway space. However, permanent tooth size has an influence on the leeway space of girls.

Does arch length preservation in mixed dentition children affect mandibular second permanent molar eruption? A systematic review and meta-analysis

BackgroundArch length preservation strategies utilize leeway space or E-space in the mixed dentition to resolve mild to moderate mandibular incisor crowding. The purpose of this systematic review of the literature was to analyze the effects of arch length preservation strategies in on mandibular second permanent molar eruption.MethodsA search for relevant articles published from inception until May 2020 was performed using PubMed/Medline, Cochrane databases, Clinicaltrials.gov, Google scholar and journal databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted for the conduct of the systematic review. Using RevMan 5.3 software, the most pertinent data were extracted and pooled for quantitative analysis with 95% confidence intervals. Heterogeneity was analyzed by using Cochran Q test and I squared statistics.ResultsA total of 5 studies involving 855 mixed dentition patients with arch length preservation therapy were included in the qualitative analysis. Pooled estimate of the data from two studies revealed 3.14 times higher odds of developing mandibular second molar eruption difficulty due to arch length preservation strategies using lingual holding arch (95% CI; OR 1.10–8.92). There was no heterogeneity found in the analysis. The certainty levels were graded as very low.ConclusionsThis systematic review demonstrates that arch length preservation strategies pose a risk for development of mandibular second molar eruption disturbances, but the evidence was of very low quality.Registration number: CRD42019116643.

Comparative Analysis of Space Maintenance Using Transpalatal Arch and Nance Button.

54 subjects who needed space maintenance in the upper arch (23 in the TPA group and 31 in the NB group) and had radiographic follow-up until the appliance removal were enrolled in the study. The space loss was obtained from measurements carried out in initial and final radiographs. Type of dental loss and changes in molar relationship were also recorded. The mean of space loss in the TPA group was 1.336mm, while in the NB group was 0.695mm, with no statistically significant differences between the total space loss neither the type of dental loss within the NB or TPA group (p >0.05). The loss of space in the unilateral second primary molar is higher in the TPA group than in the NB group, with significant statistically differences (p<0.05). It is concluded that the loss of the leeway space using a TPA as a space maintainer is greater than using a NB.

Effects of Combined Rapid Maxillary Expansion and Facemask Therapy on the Mandibular Dental Arch in Mixed Dentition.

The aim of this study was to evaluate changes in the mandibular dental arch and incisor alignment induced by combined bonded Rapid Maxillary Expansion (RME) and Face Mask (FM) therapy in the mixed dentition stage in which leeway space was used throughout the treatment. This retrospective study evaluates pretreatment (T0) and posttreatment (T1) cephalometric radiographs and orthodontic models of 25 patients (mean age: 10.75±2.64), in mixed dentition, having skeletal Class 3 anomaly (ANB<0) with maxillary retrognatism (SNA=77.2±0.68) and bilateral posterior crossbite treated with bonded Hyrax RME-FM. Mean treatment duration was 10.4 months. Dental model measurements were performed using the 3Shape OrthoAnalyzerTM 2013-1 program. Changes in the mandibular incisor and first molar positions were determined on cephalometric radiographs. Statistical evaluation was done with a paired t-test. A significant increase of 1.2 mm was found in intermolar width (p<0.001) in the mandibular dental arch. There was a significant decrease (1.4 mm) (p<0.001) in arch depth and an increase in arch length discrepancy (1.7mm)(p<0.01). There was a significant increase (0.8mm) (p<0.05) in the incisors' irregularity score (LII). IMPA showed a significant decrease (p<0.05). Clinicians should be aware that mandibular crowding tends to increase during this type of combined therapy.

Mean Leeway space in Nepalese children attending a tertiary care hospital, Bhaktapur: A radiographic evaluation

Background: Leeway space becomes important during the change of dentition and occlusal development.&#x0D; Objectives: The study was designed to measure the mean leeway space of maxilla and mandible of Nepalese children using Orthopantomogram radiographs and also to compare the difference between mean leeway space in male and female children.&#x0D; Methodology: After ethical approval, 270 OPG (Orthopantomogram) radiographs of age groups 6-12 years Nepalese children exhibiting mixed dentition were selected for the study after following the inclusion and exclusion criteria by convenience sampling method. A digital measurement in the OPG software was used to measure the mesiodistal width of deciduous canine and molars along with permanent canine and premolars in all quadrants.&#x0D; Results: The mean leeway space on maxilla was seen to be (0.86 ±1.97mm) while for mandible was (2.45± 1.85 mm).The leeway space in both maxilla and mandible was seen to be more in females (0.87 ± 1.87 mm) and (2.52 ± 1.85 mm) than in males (0.85 ± 2 mm) and (2.40 ± 1.90mm)respectively.&#x0D; Conclusion: The mean leeway space in Nepalese children was found to be less than the standard “Leeway space of Nance” which could be due to population tooth crown differences and various environmental factors. Further studies could be recommended in the future both radiographically and clinically for obtaining a standardized leeway space for Nepalese population.

Impact of proximal cavities and primary molar absence on space in the dental arches.

BackgroundA recently proposed treatment protocol for dental caries in primary teeth, called Ultra Conservative Treatment (UCT), keeps medium to large cavities open so that children can keep them clean with tooth brushing and fluoride toothpaste. However, carious lesions have been related to malocclusion and decrease of space for the eruption of the permanent successor.MethodsThis cross-sectional study evaluated dental casts of 235 schoolchildren, aged 6–7 years old of six public schools in deprived suburban areas, and with at least two cavitated dentin carious lesions. The casts were grouped according to the location of cavitated dentin lesions into non-proximal cavity (NPC), proximal cavity with buccal or lingual surface contact point to adjacent tooth (PCCP) and proximal cavity without contact to adjacent tooth (PCWC), as well as the absence of primary molars due carious lesions (PMA). The relationship between location of cavitated dentin lesions or absence of primary molars with C+D+E and D+E space was analyzed.ResultsChildren with absence of primary molars exhibited the smallest C+D+E and D+E space in the maxilla (P < 0.001) and mandible (P < 0.001), followed by proximal cavity without buccal or lingual surface contact. No significant difference was observed between NPC and PCCP groups in upper and lower arches.DiscussionPCWC are associated with minor (less than the leeway space) C+D+E and D+E space loss in both arches, and additional space loss is noted when primary molars are prematurely lost. These results may have implications for orthodontic and restorative dental care decisions in children.

Orthodontic knowledge and referral patterns: a survey of paediatric specialists and general dental practitioners

Abstract Introduction Early diagnosis and referral is essential in order to provide the best orthodontic care. Paediatric specialists (PSs) and general dental practitioners (GDPs) are usually the first dental professionals to diagnose a malocclusion. Aim To evaluate the knowledge and approach of PSs and GDPs in the management of children in reference to the timing of referral and early orthodontic intervention. Methods A survey assessed referral patterns and the respondents’ orthodontic knowledge regarding treatment timing and indications for early treatment in the early and late mixed dentition. Results One hundred and seventeen dentists participated in the study, of whom 79 were GDPs and 38 were PSs. The average total accuracy score in a 27-knowledge questionnaire was 68.6%, resulting in a statistically significant difference between the PSs and the GDPs. This difference arose from confusion regarding the prevention of maxillary permanent canine impaction and the need for a leeway space maintainer. Conclusions The GDPs and the PSs had a sound knowledge of orthodontics and a reasonable referral pattern, although the knowledge of PSs was significantly higher than that of the GDPs. There is a need for further education regarding orthodontic treatment needs and timing both in undergraduate/postgraduate training as well as in professional continuing education programs.

Statutory rights and de facto constitutional supremacy in Hong Kong?

Abstract Fundamental rights in the Hong Kong Special Administrative Region (Hong Kong) are protected in its Basic Law and the Hong Kong Bill of Rights Ordinance (BORO). The Hong Kong Basic Law enshrines most of the BORO rights, thereby expressly conferring constitutional status on these rights. But there are a number of BORO rights that are not protected in the Basic Law. This article analyzes the cases in which the Hong Kong judiciary has addressed disputes concerning three exclusive BORO rights: (i) the right to participate in public affairs; (ii) the right to a fair hearing in civil cases; and (iii) the prohibition against cruel, inhuman, or degrading treatment or punishment. We will also explain how the courts have conferred de facto constitutional supremacy on all these statutory rights, while simultaneously providing significant leeway and decisional space for the government to craft a considered response in their remedial legislation, thereby promoting a constitutional dialogue between the judiciary and the government on rights-protection in Hong Kong.

Leeway Space Mandibula pada Siswa Suku Minang di Sekolah Dasar Lubuk Sikaping, Sumatera Barat

The prediction of permanent size of theet which haven’t errupted to determine the value of place needed, availability of space and predict the storage of space. Is one of important aspect in diagnosis and treatment planning on the period of mixed dentition. Prediction method that used commonly is Moyers method which the data is taken from Kaukasoid ras. The objective of the research is to see the difference of leeway space of mandibula on Minang man and woman students of elemantary school Lubuk Sikaping. The method of this research is cross sectional comprative study. 56 samples of mandibula study are taken from the student of SDN 06 Pauh, SDN 09 Pauh, and SDN 10 Pauh Lubuk Sikaping at the age of 8 to 10 years and they are Minangnese. The results are analyzed statistically by t-test on significant degree 95%. This research indicates that the large average of man mandibula leeway space on the left (1,76 mm) and on the right (1,85 mm). And the average of leeway space of woman mandibula leeway space on the left (2,03 mm) and on the right (2,16 mm). The analyze t-test result on the significant degree 95% show there is no significant difference (p&gt;0,05) between man and woman students. Therefore, it can be concluded that the large average of leeway space of man and woman mandibula in Minang students of elementary school Lubuk Sikaping showed no significant difference in size.

LEEWAY SPACE MANDIBULA PADA SISWA SUKU MINANG DI SEKOLAH DASAR LUBUK SIKAPING, SUMATERA BARAT

The prediction of permanent size of theet which haven’t errupted to determine the value of place needed, availability of space and predict the storage of space. Is one of important aspect in diagnosis and treatment planning on the period of mixed dentition. Prediction method that used commonly is Moyers method which the data is taken from Kaukasoid ras. The objective of the research is to see the difference of leeway space of mandibula on Minang man and woman students of elemantary school Lubuk Sikaping. The method of this research is cross sectional comprative study. 56 samples of mandibula study are taken from the student of SDN 06 Pauh, SDN 09 Pauh, and SDN 10 Pauh Lubuk Sikaping at the age of 8 to 10 years and they are Minangnese. The results are analyzed statistically by t-test on significant degree 95%. This research indicates that the large average of man mandibula leeway space on the left (1,76 mm) and on the right (1,85 mm). And the average of leeway space of woman mandibula leeway space on the left (2,03 mm) and on the right (2,16 mm). The analyze t-test result on the significant degree 95% show there is no significant difference (p>0,05) between man and woman students. Therefore, it can be concluded that the large average of leeway space of man and woman mandibula in Minang students of elementary school Lubuk Sikaping showed no significant difference in size.

Longitudinal eruptive and posteruptive tooth movements, studied on oblique and lateral cephalograms with implants

The purpose of this study was to investigate the eruptive and posteruptive tooth displacements of untreated growing subjects longitudinally and the potential connections between posteruptive displacement of the maxillary and mandibular first molars and skeletal facial growth. The sample comprised 11 series of right 45° oblique cephalograms and lateral cephalograms of untreated children with metallic implants of the Björk type obtained from the archives of a growth study. Cephalograms generated at approximately 2-year intervals between the ages of 8.5 and 16years were selected and traced. Superimpositions of serial tracings of oblique cephalograms on stable intraosseous implants were made to determine the displacements of buccal segment teeth in both arches, and superimpositions of serial tracings of lateral cephalograms were used to evaluate growth of the jaws. Continuous mesial tipping of the maxillary molars was observed from 8.5 to 16years of age, averaging 8.2° ± 5.5° for the first molars and 18.3°± 8.5° for the secondmolars. Compared with the maxillary molars, the mandibular first molars showed less change in angulation except in the later mixed dentition when more than half of the subjects had accelerated forward tipping of the first molar in the late mixed dentition associated with migration into the leeway space. Average amounts of cumulative eruption from 8.5 to 16years of age were 12.1±2.1mm downward and 3.8±1.7mm forward for the maxillary first molar. The mandibular first molar showed 8.6±2.3mm of eruption and 4.4±1.9mm of mesial migration. Peak velocity of vertical eruption of the maxillary and mandibular first molars corresponded to the skeletal vertical growth spurt. The maxillary canines and first premolars showed remarkable and continuous uprighting migration during eruption, averaging 9.5° ± 5.0° and 10.5° ± 6.7°, respectively. However, when they erupted into the occlusion, their changes in angulation reverted to forward tipping. The same tendency was also found in themandibular canines and first premolars. Remarkable eruption and migration occur to the teethof both arches during childhood and adolescence. Rates of first molar eruption during adolescence follow the general pattern of somatic growth. We infer that maintaining the original distal crown angulation of the maxillary molars may be an effective protocol for preservation of anchorage.

Impact of dentofacial development on early mandibular incisor crowding.

In this retrospective longitudinal study, we evaluated the influence of dentofacial development on mandibular incisor crowding from the early mixed dentition (T1) to the early permanent dentition (T2). The sample was selected from 1212 longitudinally followed untreated subjects. Cephalometric radiographs and dental casts of 42 subjects (mean age, 8.66years) with mandibular incisor crowding were evaluated at T1 and T2. Dentoskeletal variables were compared, and their influence on crowding changes was estimated. The sample was divided regarding incisor crowding severity (≤2mm and>2mm) and behavior (improvement and worsening), and the variables with a significant influence on the crowding changes were compared between the groups (P<0.05). Incisor crowding decreased from T1 to T2. The crowding changes were influenced by the amount of initial crowding, leeway space, incisor protrusion, and maxillary width increase. Crowding of 2mm or less was not a good predictor for self-correction, with similar chances for improvement or worsening. Incisor crowding reduction can be expected from the early mixed to the early permanent dentition. The potential for crowding reduction was associated with greater initial incisor crowding, leeway space, incisor protrusion, and maxillary width increase. A crowding threshold of 2mm was not a valid borderline condition to define the self-correction prognosis.

PERBANDINGAN RERATA BESARAN LEEWAY SPACE SUKU BANJAR DENGAN RERATA LEEWAY SPACE MENURUT PROFFIT (Studi Analitik Observasional Radiograf! Periapikal pada Masa Gigi Bercampur)

Background: Leeway space is an excess space available because of the differences between the amount of mesiodistal width of canine, first premolar and second premolar and the amount of mesiodistal width of primary canine, first molar and second molar. There's a variation of Leeway space among individuals. This variation occurs because of growth and development period which are influenced by environmental factors, nutrition and ethnic variations. Purpose: The purpose of this study was to determine the difference in the average Leeway space of Banjarese population with the size of Leeway space according to Proffit.Method: This study used an observational analytic with cross sectional approach. The number of mesiodistal width of primary c, m1, and m2 is substracted with the number of mesiodistal width of permanent C, P1, and P2 of 77 samples to determine the average Leeway space and then compared with the Leeway space according to Proffit. Measurements were done using a digital caliper followed with data analysis using Mann-Whitney test.Result: The average of Banjarese population Leeway space is 0.37 mm in each region of the maxilla and 2.2 mm in each region of the mandible. Results of the Mann-Whitney test showed that there were significant differences in maxillary Leeway space of Banjarese population compared to the Leeway space according to Proffit.Conclusion: The conclusion of this study is there were differences between the average Leeway space of Banjarese population with the Leeway space according to Proffit.

Management of space in the mixed dentition: The use of lip bumper

Management of dental space problems continues to play a substantial role in interceptive orthodontics. In the mixed dentition, moderate crowding problems can be resolved through preservation of the Leeway space, regaining space or producing limited expansion. The lip bumper is a functional device that is used successfully to intercept developing dental and occlusal problems by allowing a proper development of the arch length and width for eruption of the permanent teeth. A nine-year-old female patient with the chief complaint of delayed eruption and lack of space in the left mandibular quadrant for the eruption of the entire permanent teeth. She was successfully treated in duration of 9 months with a lip bumper and expansion therapy.