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ABSTRACT
111
Website:
www.jisppd.com
DOI:
10.4103/0970-4388.130783
PMID:
******
Introduction
The most effective way to prevent mesial drift after
early loss of primary molars is to insert a durable
space maintainer.[1] Band and loop space maintainer
is the most commonly used one. Potential
disadvantages of the conventional type have led to
the development of ber reinforced composite resin
(FRCR) technology which includes polyethylene
ber.[2]
Very few literature reports on use of polyethylene
FRCR (Ribbond) as space maintainers. Hence,
the present study has been taken up to develop a
clinically acceptable, less time consuming, and patient
friendly FRCR space maintainer as an alternative to
conventional band and loop space maintainer.
Journal of Indian Society of Pedodontics and Preventive Dentistry | Apr-Jun 2014 | Vol 32| Issue 2 |
Garg, et al.: A comparative evaluation of conventional band and loop space maintainer with the ber reinforced composite resin space
maintainer in children
Inclusion criteria
A. Clinical criteria
Premature loss of primary rst molar in two
quadrants.
Sound and healthy abutment teeth.
Presence of Angles Class I molar relationship
and/or presence of ush terminal/mesial step
primary molar relationship.
Absence of abnormal dental conditions such as
cross bite, open bite, and deep bite.
B. Radiographic criteria
Absence of periapical pathology.
Presence of succedaneous tooth bud.
Presence of more than 1 mm bone overlying
the succedaneous tooth germ and/or less
than one-third of the root of the permanent
tooth formed.
Exclusion criteria
Journal of Indian Society of Pedodontics and Preventive Dentistry | Apr-Jun 2014 | Vol 32| Issue 2 |
112
Garg, et al.: A comparative evaluation of conventional band and loop space maintainer with the ber reinforced composite resin space
maintainer in children
checked using visual analogue scale (six point facial WongBaker Scale)[5] [Figure 4] after the treatment completion.
Time taken was recorded in minutes for both the
procedures and measured with the help of a stop watch.
Results
Statistical analysis
Group I (n = 30)
Group II (n = 30)
No hurt
Hurts little bit
Hurts little more
Hurts even more
Hurts whole lot
Hurts worst
No.
%
14
46.7
13
43.3
2
6.7
1
3.3
0
0.0
0
0.0
1.331.52
No.
%
0
0.0
0
0.0
4
13.3
17
56.7
8
26.7
1
3.3
6.401.43
No hurt
113
No. of cases
Percentage
5
2
4
16.67
6.7
13.3
14
1
2
2
46.7
3.3
6.7
6.7
Group I (n = 30)
Group II (n = 30)
No.
21
8
1
No.
0
13
17
%
70.0
26.7
3.3
1-15 min
%
0.0
43.3
56.7
>30 min
Group I (n = 23)
Group II (n = 19)
Successful
Failure
No.
19
11
No.
11
19
%
63.3
36.7
%
36.7
63.3
Journal of Indian Society of Pedodontics and Preventive Dentistry | Apr-Jun 2014 | Vol 32| Issue 2 |
Garg, et al.: A comparative evaluation of conventional band and loop space maintainer with the ber reinforced composite resin space
maintainer in children
Discussion
In the quest for providing optimal dental care, the age
old maxim of prevention is better than cure holds
true. In this endeavor the pedodontist is more evenly
poised to carry the mantle of providing the required
services. For the preventive approach to be truly
effective it needs to be applied at its earliest, that is, at
the primary prevention level.[6]
When a primary tooth is extracted or is exfoliated
prematurely, the teeth mesial and distal to the space
tend to drift or be forced into it.[7] This may result
in problems like reduction of arch space, blocked or
deected eruption of permanent teeth, supraeruption of
opposing teeth, interference in occlusion, unattractive
appearance, food impaction areas, and an increased
incidence of caries and periodontal diseases.[8] One of
the approaches to control this space discrepancy is by
the provision of space maintainer appliances.[9]
Ideally, space maintainers should not interfere with
masticatory function or inhibit or deect normal
growth changes; should be simple to construct and
maintain; durable, strong, and stable; passive in not
imposing pressure on remaining teeth that might affect
orthodontic movements; and easily cleanable without
enhancing dental caries or soft tissue pathology.[1,10]
Owen (1971) revealed various factors to be considered
in assessment of the need for a space maintainer.[10,11]
Space maintainers may be removable or semixed
or xed, with bands or without bands, functional
or nonfunctional, active or passive or combinations
of above; of which xed appliances are the most
advantageous.[3]
Of all the xed space maintainers used in pediatric
dentistry, the band and loop ones are the most
prevalent.[12,13] They adjust easily to accommodate
changing dentition. But due to its varied disadvantages,
attempts have been made to utilize newer materials in
its fabrication.[7,14] Development of FRC technology
has brought a new material into the realm of metalfree, adhesive esthetic dentistry.[2] Various commonly
used bondable reinforced bers in clinical practice are:
Fibers impregnated with resin (Vivadent, StickTech,
Pentron), glass ber (GlasSpan and Polydentia),
and ultrahigh molecular weight polyethylene ber
(Ribbond).[15]
Ribbond consists of bondable, reinforced ultra-highstrength polyethylene bers with a high elasticity
coefcient (117 GPa) and molecular weight that makes
them resistant to stretch and distortion and a high
resistance to traction allowing them to easily adapt to
tooth morphology and dental arch contour.[3] The key
to Ribbonds success is its lock-stitch feature design
that transfers forces throughout the weave without
stress transfer back into the resin. It is biocompatible,
esthetic, translucent, and an easy-to-use reinforced
Journal of Indian Society of Pedodontics and Preventive Dentistry | Apr-Jun 2014 | Vol 32| Issue 2 |
114
Garg, et al.: A comparative evaluation of conventional band and loop space maintainer with the ber reinforced composite resin space
maintainer in children
Figure 5: Failures associated with band and loop and ber reinforced
space maintainers: (a) Debonding at enamel-composite interface, (b)
debonding at ber-composite interface, (c) failure of band and loop
due to cement loss, and (d) slippage of band gingivally
115
Journal of Indian Society of Pedodontics and Preventive Dentistry | Apr-Jun 2014 | Vol 32| Issue 2 |
Garg, et al.: A comparative evaluation of conventional band and loop space maintainer with the ber reinforced composite resin space
maintainer in children
Conclusions
1.
References
11.
12.
13.
14.
15.
16.
17.
18.
1.
19.
20.
21.
22.
23.
Journal of Indian Society of Pedodontics and Preventive Dentistry | Apr-Jun 2014 | Vol 32| Issue 2 |
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