Loop Space Maintainer Research Articles

Clinical assessment of the abutment teeth of children undergoing space maintainer therapy: A randomised controlled trial

Introduction: The band and loop space maintainer are one of the most commonly used fixed space maintainers in children. However, prolonged use of appliances in the oral cavity may lead to changes in gingival health and an increased risk of caries. Objectives: This study aims to evaluate the clinical parameters of the abutment teeth, specifically the banded teeth and the tooth to which the loop is extended. Methods: This prospective clinical study included 35 children between the age group of 5 to 9 years. The children were examined at baseline and 6-month follow-up. The abutment teeth were evaluated on bleeding on probing, pocket depth, gingival index, and occurrence of primary/ secondary caries. Results: There was a significant difference in the bleeding on probing, pocket depth, gingival index, and occurrence of primary/ secondary caries (p<0.05). Conclusion: Precautions and thorough knowledge about the consequences of the delivery of appliances can prevent and overcome the causes. Oral health education and constant motivation should be provided to the children on dental hygiene and regular follow-ups to avoid any extensive invasive management.

Fracture Resistance of Space Maintainers Produced Using 3D Printable Materials.

This study aimed to evaluate the fracture resistance of space maintainers (SMs) produced using 3D-printable materials (metal, resin and polyetheretherketone [PEEK]) after thermal aging and compare them with conventional space maintainers. A standardised typodont model for paediatric dentistry was utilised, and band and loop space maintainers were designed digitally using computer-aided design (CAD) technology. Four groups were established: Conventional, 3D printed metal, 3D printed resin, and 3D printed PEEK. Fracture resistance was assessed after 10,000 thermal cycles, simulating oral conditions. Fracture tests were conducted using a universal testing machine, applying vertical force to the band and loop junction until fracture. Statistical analyses were performed using one-way ANOVA and the Tukey HSD test (P<0.05). Although the fracture resistance values showed that metal, resin, and PEEK 3D printed band and loop space maintainers can be acceptable clinically, the permanent resin may be preferable to printable material because of their aesthetic properties.

Clinical Effectiveness of Various Unilateral Fixed Space Maintainers vs Band and Loop Space Maintainers in Mixed Dentition: A Systematic Review

Clinical Effectiveness of Various Unilateral Fixed Space Maintainers vs Band and Loop Space Maintainers in Mixed Dentition: A Systematic Review

Assessment of Knowledge and Utilization of Prefabricated Band and Loop Space Maintainers in Primary Dentition Among Dentists: A Cross-Sectional Questionnaire Study.

Preserving primary dentition is essential for maintaining optimal oral health and development in children. Premature loss of primary teeth due to caries, infection, crowding, or trauma can necessitate orthodontic intervention and lead to various complications. Space maintainers are critical for preserving arch space until the eruption of permanent teeth, thereby preventing issues such as ectopic eruption, crowding, and malocclusion. Despite their advantages, prefabricated space maintainers (PSMs) are underutilized. This study aims to evaluate the knowledge, attitudes, and practices of Indian dentists regarding PSMs in primary teeth. A cross-sectional questionnaire survey was conducted among 100 dental practitioners in Chennai. A 10-item self-administered questionnaire, developed based on a comprehensive literature review and expert consultations, assessed demographics, knowledge of PSM indications and techniques, current practices, perceived barriers, and preferences for continuing education. The questionnaire's reliability was confirmed with a Cronbach's alpha value of 0.85. Descriptive statistics, including frequencies andpercentages, were used to summarize the participants' demographic characteristics, knowledge levels, and current practices related to PSMs. Of the 100 respondents, 86 (86%) were males and 14 (14%) were females. Only 19 (19%) reported using PSMs, while 36 (36%) used conventional space maintainers. A significant proportion (42 (42%)) of the respondents held a master's degree in dental surgery, yet only 11 (11%) had participated in Continuing Dental Education (CDE) programs on space maintainers. The perceived benefit of PSMs being a single appointment procedure was acknowledged by 82 (82%) of the respondents, whereas 76 (76%) participants identified cost as a major drawback. Notably, 45 (45%) practitioners did not consider PSMs necessary. This survey highlights notable obstacles in the adoption of PSMs among Indian dentists, emphasizing the need for focused educational initiatives. Improving knowledge and practices related to PSMs can enhance pediatric dental care and oral health outcomes in India.

Effectiveness of traditional band and loop space maintainer vs 3D-printed space maintainer following the loss of primary teeth: a randomized clinical trial

This study evaluates the efficacy of 3D-printed band and loop space maintainers (3D-BLSMs) to mitigate concerns caused by early primary tooth loss in children when compared to their conventional equivalents. Over 9 months, 62 participants aged 6 to 12 years participated in a randomized clinical study. This study evaluated their failure rates (de-cementation, debonding, solder breakage, loop breakage, band breakage, and abutment tooth fracture), gingival health, and patient overall satisfaction. Random assignments were made to place the participants in two groups: traditional band and loop space maintainers or the 3D-BLSMs. The findings show that at 9 months, 3D-BLSMs provided significantly higher survival rates (77.4%) than conventional maintainers (51.6%, p < 0.01). Gum inflammation was mild in both groups, highlighting the need for good oral hygiene. In both groups, patient satisfaction exceeded 90%. Although there was some pain at first with 3D-BLSMs, this eventually subsided and aesthetic preferences disappeared. There were no negative consequences noted, and both groups needed ongoing dental treatment. In conclusion, with excellent patient satisfaction in both groups, 3D-printed space maintainers offer greater long-term durability in reducing dental concerns following early primary tooth loss.

Factors Influencing the Fit and Retention of Computer-aided Design/Computer-aided Manufacturing-based Three-dimensional Printed Band and Loop Space Maintainers.

Tirupathi S, Rathi N. Factors Influencing the Fit and Retention of Computer-aided Design/Computer-aided Manufacturing-based Three-dimensional Printed Band and Loop Space Maintainers. Int J Clin Pediatr Dent 2024;17(6):734-735.

Comparative Evaluation of Gingival Health Among Children With Stainless Steel Crowns and Stainless Steel Bands: A Split-Mouth Randomized Controlled Trial.

Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction applianceto maintain the space for the eruption of underlying teeth in case of early loss in children are some of the most commonly practised proceduresthat pediatric dentists undertake in their day-to-day lives. Maintaining good oral hygiene for better gingival health is important. If it is not taken care of,gradual destruction of supporting soft and hard tissues of the teeth occurs. There were numerous studies conducted over the past few years,but no split-mouth study compares the crowns and bands. Hence, this study compares the gingival health between stainless steel crowns and band and loop space maintainers. Materials and methods This split-mouth randomised controlled trial included 31 children aged between four and nine years who had stainless steel crowns on one side and a band and loop space maintainer on the other side of the mandibular arch. The split-mouth study was carried out to minimise the outcome bias as oral hygiene practices differ from one individual to another. Presence/absence of bleeding on probing (BOP)and the Gingival Index (GI) using theLoeandSilness GI were assessed at baseline and at six months. Data was entered in an Excel sheet (Microsoft Corporation,Redmond, Washington, United States) and analysed in IBMSPSSStatistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). The significance level was fixed as 5% (α = 0.05). The Shapiro-Wilktest was used to assess the normality of parameters of gingival health. The parameters are described in terms of mean, standard deviation, frequency and percentages. Intragroup analysis was done using Friedman tests across the timelines. Intergroup analysis using Mann-Whitney U tests was done between the groups at different timelines. Results At the beginning of the study, 46 children (22 girlsand 24 boys) were enrolled considering the dropout. However, 15 children did not attend the follow-up review, resulting in a loss to follow-up. Consequently, only 31 children, each with a band and loop space maintainer and a stainless steel crown, were included for the final interpretation of the results in this study. At one month, both BOP and GI were significantly different (p<0.05) between the stainless steelcrown and stainless steel band where the crown showed better gingival health and absence of bleeding than the band and loop. At three months and six months, gingival health improved in both groups, but there was no significant difference between the groups. The Friedman test revealed that both the stainless steel crown and stainless steel band groups had a significant difference at six months from baseline. Mann-Whitney tests were done to analyse the difference in parameters at baseline and at six months between both groups. There was no significant difference in the baseline in the parameters between the groups. Conclusion Within the limitations of the study, this study concludes that the gingival health based on BOP and GI shows a significant difference across the timeline within the groups, namely, stainless steel crown and stainless steel band, but no significant difference between the groups at various timelines.

Chairside digital design and manufacturing method for children's band and loop space maintainers.

This study proposes a chairside digital design and manufacturing method for band and loop space maintainers and preliminarily validates its clinical feasibility. Clinical cases of 10 children requiring space maintenance caused by premature loss of primary teeth were collected. Intraoral scan data of the affected children were also collected to establish digital models of the missing teeth. Using a pediatric band and loop space maintainer design software developed by our research team, a rapid personalized design of band and loop structures was achieved, and a digital model of an integrated band and loop space maintainer was ultimately generated. A chairside space maintainer was manufactured through metal computer numerical control machining for the experimental group, whereas metal 3D printing in the dental laboratory was used for the control group. A model fitting assessment was conducted for the space maintainers of both groups, and senior pediatric dental experts were invited to evaluate the clinical feasibility of the space maintainers with regard to fit and stability using the visual analogue scale scoring system. Statistical analysis was also performed. The time spent in designing and manufacturing the 10 space maintainers of the experimental group was all less than 1 h. Statistical analysis of expert ratings showed that the experimental group outperformed the control group with regard to fit and stability. Both types of space maintainers met clinical requirements. The chairside digital design and manufacturing method for pediatric band and loop space maintainers proposed in this study can achieve same-day fitting of space maintainers at the first appointment, demonstrating good clinical feasibility and significant potential for clinical application.

Stress induced on permanent mandible first molar and space maintainer under normal masticatory forces: a finite element study.

The band and loop space maintainer is used to maintain the missing space of deciduous molars which are lost early. When the second deciduous molar is lost prematurely, the stress on the first permanent molar during different degrees of development may vary when it is the abutment. The design and use of the space maintainer may also lead to damage of the loop. The purpose of this article is to use the finite element method to study the stress on the first permanent molar and the loop with or without occlusal contact, with the first permanent molar of four different degrees of development serving as the abutment. We aimed to guide the clinical design and use of the space maintainer. We developed finite element models of the mandibular first permanent molar and the band and loop space maintainer, and simulated alveolar bone, periodontal ligament (PDL), enamel and dentin. The four developmental stages were 1/2 (I), 2/3 (II), 3/4 (III) and full development (IV). Ansys Workbench was used to analyze the effects of root development and occlusal contact between the loop and the opposite jaw on abutment teeth and the loop. Abutment teeth were statically loaded vertically and obliquely with a force of 70 N. The loop was statically loaded vertically with a force of 14 N. The stress on all structures and the displacement trends of the loop were calculated. The stress on enamel, dentin, PDL and alveolar bone were similar, and the concentration was consistent. But if there was occlusal contact, the loop produced maximum displacement at the near middle edge of contact with the anterior teeth. When the loop was in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group I > group IV > group III > group II, and the maximum principal stress peak change was: group I > group III > group II > group IV. The change of the equivalent stress peak value of the loop under oblique load was: group I > group III > group IV > group II, and the maximum principal stress peak change was: group III > group I > group II > group IV. When the loop was not in occlusal contact with the opposing occlusal tooth, the peak value of the equivalent stress on the space maintainer under vertical load was: group IV > group I > group II > group III, and the maximum principal stress peak change was: group IV > group I > group II > group III. The change of the equivalent stress peak value of the space maintainer under oblique load was: group I > group IV > group II > group III, and the maximum principal stress peak change was: group I > group IV > group II > group III. Our results suggested that whenever possible, choosing the teeth with nearly complete root development as the abutment of the space maintainer is advisable. The design and use of the band and loop space maintainer should avoid occlusal contact with the occlusal teeth to prevent deformation of the loop.

Arm design of band and loop space maintainer affects its longevity: a patient-specific finite element study.

Fixed space maintainers (FSMs) are commonly utilized in pediatric dentistry to prevent space loss following premature tooth extraction. Although previous studies have examined the survival rates and causes of FSM failure, the impact of arm design on failure has not been investigated. This study aimed to investigate the tensile and compressive stresses related to FSMs with different arm designs and evaluate the effect of arm designs on FSM failure. Cone beam computed tomography images of a child who experienced premature loss of a primary mandibular left second molar tooth were retrieved from our database, then processed and simulated using the Rhinoceros software. Finite element analysis was performed to evaluate the stresses on four distinct FSM arm designs under simulated chewing forces. The results showed that the straight-arm FSM design exhibited the highest von Mises principal stress, while FSMs with curved arms and surrounding primary mandibular left first molar in the mesial area demonstrated the lowest von Mises stress accumulation. Intense stress accumulation on the distal surface of tooth 74 was observed in the test models due to the transmitted forces by the FSM. The maximum principal stresses accumulated at the base of the alveolar socket of the mesial root of tooth 36, while the minimum principal stresses were identified at the mesio-marginal area of the alveolar crest. The arm design played a crucial role in enabling the appliance to effectively withstand the stresses accumulating on the Space maintainer (SM) and orthodontic band. Bending the SM arms to match the surrounding profile with curvature increased the stress absorption capacity by increasing the arm length.

Clinical application of a digital semi-rigid bridge space maintainer fabricated from polyetheretherketone for premature loss of primary molars

BackgroundPremature loss of primary molars can be treated with a band loop space maintainer (SM). However, fabricating a conventional band loop SM requires multiple clinical and laboratory procedures, which can potentially affect the accuracy of the SM. Moreover, the conventional SM is unable to fully restore masticatory function and maintain the vertical dimension of the edentulous space. In this current study, a fully digital workflow to fabricate a semi-rigid bridge SM made from polyetheretherketone (PEEK) has been described and evaluated for its clinical effectiveness.MethodsA total of 15 children (eight males and seven females) between the ages of 4–8 years, who experienced the premature loss of a single primary molar, were included in this study. Digital impressions were taken using the CEREC CAD/CAM chair system and imported into CAD software to design the semi-rigid bridge SM, which was fabricated using PEEK block as the maintainer material. The digital SM was tried-in and bonded to the abutment with resin cement. The edentulous space was measured immediately after bonding (T0) and 1 month (T1), 3 months (T2), and 6 months (T3) after treatment. The periodontal condition and mobility of the SM and abutment were also examined.ResultsThe use of digital impressions resulted in a decreased occurrence of the pharyngeal reflex. The digital semi-rigid bridge SM, fabricated with PEEK, was both convenient and aesthetically pleasing, and successfully restored the anatomy and masticatory function of the missing primary molar. None of the 15 semi-rigid bridge SMs or abutments became loose or fell off during the study, and only one child presented with gingivitis. Furthermore, the difference in the edentulous space at T0, T1, T2, and T3 was not statistically significant (all P > 0.05).ConclusionsThe digital semi-rigid bridge SM fabricated with PEEK was clinically effective in maintaining the missing space and had advantages over the traditional band/crown loop SM.

Simplify your practice with 3D printed space maintainer

Preventive orthodontics is an aspect of pediatric dentistry, which requires exclusive set of skills and understanding to aid the patient’s treatment and properly align teeth. The safest way to prevent future malocclusions from tooth loss is to place a space maintainer (SM), which is advocated to embrace the space until the eruption of succedaneous permanent teeth. SM manufacturing is a painstaking process that requires plentiful communication with the laboratory to suitably complete and provide the patient with optimal results. Band and loop SM is mostly indicated for the premature loss of single primary molar, but this appliance has a number of limitations. Digital technology has resulted in decreasing human errors by automating the dental model fabricating process with three‑dimensional printing. The current paper provides an insight of the use of this new technology in pediatric dentistry for manufacturing of new type of SMs and a case report

Comparative Evaluation of Fixed Functional Cantilever Space Maintainer and Fixed Nonfunctional Space Maintainer: A Randomized Controlled Trial.

Effective way to prevent mesial drift after the early loss of primary first molars is by inserting a durable space maintainer. Several space maintainers are available; fixed nonfunctional (FNF) space maintainer (crown and loop) is commonly used when abutment teeth need full-coronal restoration. Disadvantages of crown and loop space maintainer are nonfunctional, nonesthetic, and fracture of solder loop. To overcome this drawback, new design of fixed functional cantilever (FFC) space maintainer (crown and pontic) using bis-acrly composite resin. The study evaluated the longevity and acceptance of an FFC and compared it with a FNF space maintainer. A total of 20 healthy children, aged 6-9 years, were selected having bilateral premature loss of lower deciduous first molars. FFC space maintainer in one quadrant and FNF space maintainer in the other was cemented. The subject's acceptance of treatment was checked using a visual analog scale after the treatment completion. Criteria for complication leading to the failure was assessed in both the designs in the 3rd, 6th, and 9th month. Cumulative success longevity was obtained at a 9 month evaluation. Patient acceptability was greater in group I (FFC) in comparison to group II (FNF). In group I, fracture of the crown and pontic was the common complication leading to failure, followed by attrition of the crown and loss of material due to abrasion. In group II, fracture of the solder joint was the common complication leading to failure, followed by slippage of the loop gingivally and cement loss. The longevity of groups I and II were 70 and 85%, respectively. FFC can be considered a viable alternative to conventional FNF space maintainers. Sathyaprasad S, Krishnareddy MG, Vinod V, et al. Comparative Evaluation of Fixed Functional Cantilever Space Maintainer and Fixed Nonfunctional Space Maintainer: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(6):750-760.

Shear Bond Strength of Different Types of Cement Used for Bonding Band and Loop Space Maintainer

Shear Bond Strength of Different Types of Cement Used for Bonding Band and Loop Space Maintainer

Children’s satisfaction and survival rate of fiber-reinforced space maintainer versus band and loop space maintainer in children with premature loss of maxillary primary first molar

Background: Band and loop space maintainer (BLSM) are well tolerated and long-lasting appliances, but it comes with several drawbacks, including longer lab times, more frequent cement loss dislodgements, longer visits, and the inability to avoid the rotation or tilting of neighboring teeth. These limitations motivate the search for alternative appliance such as fiber-reinforced space maintainers. Aim of the study: Evaluation of children’s satisfaction and survival rate of fiber-reinforced space maintainer versus band and loop space maintainer in children with premature loss of maxillary primary 1st molar. Materials and Methods: Thirty patients, randomly divided into two groups (n=15). BLSM group: which included (15) patients who receive band and loop space maintainer. FRSM group: which included (15) patients who were received fiber-reinforced space maintainer. The patients were evaluated for satisfaction based on Likert -type scale and survival rate. Results: The FRSM group showed a higher satisfaction score than BLSM group. For survival rate the fiber-reinforced space maintainers showed a greater success rate than band and loop space maintainers. Conclusions: The FRSM can be used as an alternative to BLSM regarding clinical performance and patient’s satisfaction in children with premature loss of maxillary 1st primary molars.

Comparison of fit accuracy between conventional and CAD/CAM-fabricated band-loop space maintainers.

The aim of this in vitro study was to evaluate the band fit of metallic band-loop space maintainers fabricated by conventional and 3D printing technologies for clinical applications. Sixteen digital intraoral impressions were selected, and resin models were printed with a 3D printer. Forty band-loop space maintainers were fabricated (20 each for both the conventional and digital groups). To evaluate the band fit of conventional and CAD/CAM-fabricated space maintainers, cement space was visualized with low-viscosity condensation silicone material on resin models. Digital evaluation was carried out using dual scan method by superimposing two scans of resin models covered with or without a silicone layer on the abutment tooth. The mean quadratic deviation (root mean square, RMS) was calculated. The RMS values between the groups were evaluated with Student's t test. Statistical significance was set at p<.05. No statistical significance was found between the conventional and digital groups (p=.56). Within the limitations of this study, the band fit of conventional and CAD/CAM-fabricated space maintainers had no difference. Future research into CAD/CAM-fabricated appliances from different perspectives such as fracture strength and patient comfort is warranted.

23 - Mechanical Strength Evaluation of a Printed Dental Space Maintainer

Due to the latest progress of 3D scanning and printing technology in the medical field, attempts have been made to apply this technology also in preventive orthodontics in order to obtain an aesthetic dental space maintainer. The aim of this study is to observe the mechanical load distribution on a SLA band and loop space maintainer in order to develop a high-precision aesthetic dental space maintainer using computer-aided design (CAD) / computer-aided manufacturing (CAM) and 3D printing by resin-based additive technique. On account of increasing aesthetic requirements, an initiative was made to replace the classic band and loop space maintainer with a metal-free appliance, using an innovative technique for creating the esthetic design of the space maintainer. Four band and loop space maintainers were achieved through stereolithography (SLA). After scanning the dental cast, a 3D software Exocad was used to establish the design of the dental space maintainer. They were manufactured using two different 3D printers, two with Formlabs form2 using C&B Micro Filld Hybrid (MFH) resin and two with Creality using NextDent SG resin. After printing, all samples were placed in an isopropyl alcohol bath to clean them of residues and resin excess, then placed in the UV oven for drying. Shortly afterwards processing they were subjected to the mechanical strength test by compression using the Zwick/ Roell Z005 device. For the fulfillment of the mechanical resistance tests, the dental cast made by the classic plaster technique was used as support. Following mechanical tests, it was observed that these devices yielded to the action of a vertical force between 16-31 N. There were no significant differences between the two materials, but the highest resistance was observed in the C&B Micro resin Filld Hybrid (MFH) using Formlabs form2 printer which is consistent with the minimum masticatory forces developed in mixed dentition 26.21-41.5 N for males and 8.05-12.61 for females. Given the importance of dental aesthetics nowadays, 3D printing offers the possibility to manufacture an aesthetic dental space maintainer device with a better adaptation to the clinical situation. The mechanical properties being closely related to the object design, it is important to ensure a sufficient thickness of the device to prevent fractures under the masticatory forces.

Comparison of Shear Bond Strength of Three Luting Materials Used in Band and Loop Space Maintainer Cementation: An In Vitro Study

Introduction: Aim of this study is to compare shear bond strength of different luting materials used in fixed space maintainer cementation. Methods: Thirty intact extracted human third molars randomly divided into three equal groups: group A: RelyX luting 2 (resin modified glass ionomer); group B: TOTALCEM (self-adhesive resin cement/ dual cure); group C: Transbond plus (compomer). After bonding procedures, the samples were kept in distilled water at 37°C for 24 hours prior to the shear bond strength test. Data were analyzed blindly by one-way ANOVA test and the Tukey post hoc test using R software. Results: There were statistically significant differences between the three luting materials (P < 0.001). Conclusion: TOTALCEM showed significantly higher shear bond strength than RelyX luting 2 and Transbond plus. With respect to limitations of in vitro studies, long-term clinical studies required.

Comparison of the Conventional Band and Loop Space Maintainers with Modified Space Maintainers: A Split-mouth Randomized Clinical Trial.

Aim and backgroundSpace maintainers (SMs) are used to preserve space created by premature loss of primary teeth. The most commonly used band and loop (B&L) SMs have several demerits, e.g., non-functional, poor gingival health, limited survival, laboratory work for fabrication and multi-sitting procedure, etc. This study aimed to compare the efficacy of conventional B&L SMs with conventional tube and loop (CTL), bonded tube and loop (BTL) and bonded B&L in terms of gingival health, survival time, and patients’ and parents’ satisfaction.Materials and methodsFifteen children between 4 years and 8 years of age with at least two fresh extraction sites of primary molars contra- or bilaterally in each child (total 30 fresh extraction sites) were included in the study. Conventional B&L on one site while bonded loop (BL)/CTL or BTL on the other site were delivered, based on random allocation. An evaluation was done at 1st, 3rd, 6th, and 9th months for survival time, gingival health, and patients’/parents’ satisfaction. Results were statistically analyzed using independent t-test and Chi-square test under SPSS version 20.0 software.Results100% B&L and CTL while only 60% BL and 80% BTL survived till the end of the study. For gingival health, statistically significant differences were obtained at 1st, 3rd, 6th, and 9th month's intervals (p < 0.05) when CTL was compared with B&L, BL, and BTL. In terms of patients’ acceptance, all the SMs were well accepted by the patients. However, on the intergroup comparison, patients’ acceptance was higher with bonded SMs.ConclusionConventional tube and loop SMs were found to be most efficacious in terms of survival time, gingival health, and patients’ satisfaction.Clinical significanceTo find a better alternative for the conventional B&L SMs.How to cite this articleTyagi M, Rana V, Srivastava N, et al. Comparison of the Conventional Band and Loop Space Maintainers with Modified Space Maintainers: A Split-mouth Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(S-1):S63–S68.

Clinical Effectiveness of Fiber-reinforced Composite Space Maintainer and Band and Loop Space Maintainer in a Pediatric Patient: A Systematic Review and Meta-analysis.

BackgroundObjectives: This systematic review aimed to evaluate the clinical effectiveness of fiber-reinforced composite space maintainer (FRCSM) and band and loop space maintainer (BLSM) in a pediatric patient.Materials and methodsEligibility criteria: Randomized controlled trials (RCTs) were conducted on 3–12-year-old children who received FRCSM and BLSM. Information sources: Literature search of electronic databases such as PubMed, Cochrane, and Google Scholar for the time period of 2000 to October 2020. Risk of bias: Cochrane collaboration's risk of bias tool was used to assess the risk of bias.ResultsIncluded studies: The search resulted in 147 published studies. After the removal of duplicate studies and full-text analysis, eight studies were selected. Synthesis of results: Fiber-reinforced composite restoration (FRCSM) was judged to be good for short-term space maintenance with good esthetics, less time-consuming, and good patient and parental acceptance. Meta-analysis was done for failure rate at 6 months and 12 months. After 6 months, the FRCSM group showed less failure, with a risk ratio of 0.83 (95% CI = 0.47–1.49; Z value = 0.61). However, after 12 months, the FRCSM group showed more failure, with a risk ratio of 1.30 (95% CI = 0.04–4.23; Z value = 0.44). Description of the effect: FRCSM performed better than BLSM for a short-term, i.e., around 6 months but after 12 months of space maintainer placement BLSM performed better than the FRCSM.DiscussionStrengths and limitations of evidence: The strength of this systematic review is its complete adherence to the PRISMA statement 2009. This review attempted to evaluate the effectiveness of FRCSM when compared with BLSM which has not been evaluated before. Additionally, only RCTs were included in this review adding to its validity. This review also included a meta-analysis that compared the failure rate at the 6th and 12th month. The main shortcoming of this systematic review is the limited number of databases searched and the limited number of existing studies. Interpretation: Within the limitations of this review, it can be stated that the FRCSM is an effective space maintainer for short-term space maintenance. However, it is necessary to conduct more RCTs with larger sample size, preferably using a split-mouth design to improve the longevity of FRCSM. Additionally, it is also necessary to standardize the technique of fabrication of FRCSM since an existing study showed high heterogeneity in the technique of fabrication.OtherFunding: None. Registration: The protocol of this systematic review was registered on PROSPERO (ID-CRD42020165831).How to cite this articleKamki H, Kalaskar R, Balasubramanian S, et al. Clinical Effectiveness of fiber-reinforced Composite Space Maintainer and Band and Loop Space Maintainer in a Pediatric Patient: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S82–S93.