Clinical Technique: Space Maintenance Following the Premature Loss of Primary Molars using Innovative Fixed Unilateral Space Maintainers (Smart Appliances)

Space maintenance has been of paramount significance following the premature loss of primary molars to prevent developing features of malocclusion. Numerous types of space maintainers (SM's) have been devised to guide the eruption of developing teeth and maintain the relationship of remaining teeth. Fixed unilateral SM's are more commonly used appliances in clinical practice. The traditional fixed unilateral SM's advocated following the premature loss of primary molars have certain disadvantages in their clinical use. Modifications in their designs are needed to meet the ideal requirements of a space maintainer. This paper aims to introduce an innovative design of fixed unilateral space maintaining appliances (Smart Appliances) that are intended to overcome the disadvantages of the conventional ones. The loop of a band-and-loop space maintainer is modified to allow physiologic canine movement during the eruption of permanent incisors. A stainless steel crown is accommodated to make it a functional appliance. A modification of non-pressure type distal shoe, fixed unilateral saddle appliance is designed to guide the eruption of the first permanent molar.