Space maintainers which are fixed or fitted onto the teeth are called fixed space maintainers.

 Advantages

  1. Bands and crowns are used which require minimum or no tooth preparation.
  2. They do not interfere with passive eruption of abutment teeth.
  3. Jaw growth is not hampered.
  4. The succedaneous permanent teeth are free to erupt into the oral cavity.
  5. They can be used in un-co-operative patients; patient co-operation is not required.
  6. Masticatory function is restored if pontics are placed.

Disadvantages

  1. Elaborate instrumentation with expert skill is needed.
  2. They may result in decalcification of tooth material under the bands.
  3. Supra eruption of opposing teeth can take place if pontics are not used.
  4. If pontics are used it can interfere with vertical eruption of the abutment tooth & may prevent eruption of replacing permanent teeth if patient fails to report.

Care of Fixed Space Maintainer

  1. Don’t bite down on hard candy, whole apples, ice or anything else hard.
  2. Don’t chew bubble gum, chewing gum or stick candy.
  3. Swallowing or eating will be difficult until the child adjusts.
  4. The tongue can be irritated until the child adjusts.
  5. Don’t play with the wire with your fingers or tongue.
  6. If the space maintainer loosens, contact clinic for an appointment.
  7. The space maintainer may require alteration when permanent premolars erupt.

Types of Fixed Space Maintainer

  1. Band and Loop/Crown and Loop/Band and Bar Space Maintainer

It is indicated to hold molar position when there is a premature loss of 1st or 2nd primary molar.

 


  1. Lingual Arch Space Maintainer

The lower lingual holding arch is indicated when there is bilateral loss of mandibular primary teeth or loss of multiple mandibular primary teeth unilaterally. The permanent incisors must be erupted.


  1. Transpalatal Bar Space Maintainer

A transpalatal arch is best indicated when one side of the arch is intact and several primary teeth are missing on the other side.


  1. Nance Palatal Arch Space Maintainer

Nance palatal arch space maintainer incorporates an acrylic button that rests directly on the palatal rugae.


  1. Distal Shoe Space Maintainer

The distal shoe is indicated in cases where the second primary molar is lost prematurely. This appliance guides the first permanent molar into place and prevents mesial drifting of the tooth


 

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