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Space maintainers part 2: impression taking and preparation for laboratory work Space maintenance General considerations and principles of management: The premature loss of primary teeth due to caries, trauma, ectopic eruption, or other causes may lead to undesirable tooth move- ments of primary and/or permanent teeth including loss of arch length. Arch length deficiency can produce or increase the severity of malocclusions with crowding, rotations, ectopic eruption, crossbite, excessive overjet, excessive overbite, and unfavorable molar relationships.87 The dental profession has re- commended the use of space maintainers to reduce the preva- lence and severity of malocclusion following premature loss of primary teeth.17,88,89 Space maintenance may be a consideration in the primary dentition after early loss of a maxillary incisor when the child has an active digit habit. An intense habit may reduce the space for the erupting permanent incisor. Adverse effects associated with space maintainers include: (1) dislodged, broken, and lost appliances; (2) plaque accumu- lation; (3) caries; (4) interference with successor eruption; (5) undesirable tooth movement; (6) inhibition of alveolar growth; (7) soft tissue impingement; and (8) pain.87,90-92 Premature loss of a primary tooth of any type has the potential to cause loss of space available for the succeeding permanent tooth, but there is a lack of consensus regarding the effectiveness of space maintainers in preventing or reducing the severity of maloc- clusion.87,93-95 Treatment Early loss of a primary molar often allows the adult first molar to tip and move mesially. The basic unilateral Space Maintainer is used for holding molar position. Note: The forces during eating can cause this Space Maintainer to move gingivally at the loop. This can cause tissue irritation and will allow the banded molar to tip mesially. A better choice would be appliance Alginate impression wax band band and loop transpalatal arch lower lingual holding arch Ibrahim dabouse الدكتور ابراهيم دبوس Jordan الاردن عمان The laboratory work of space maintainer second step: pouring the impression with stone The laboratory work of space maintainer first step: waxing the band in impression to fix it in place / dr.ibrahim.d. .