It is called maintainer to all that device, either fixed or removable, aimed at preserving the space left by one or several teeth, provided that its use is checked by analyzing the space.
- If a milk tooth falls prematurely and the final tooth is not yet ready to erupt, the other teeth present in the mouth will move to close that space. When then comes the moment to erupt the final tooth finds that it has no space.
- If the space of the lost tooth is not maintained prematurely, all the dental gear is destabilized generating asymmetries and crowding.
- Avoid crowding and need to make extractions in the future due to lack of space.
- Avoid erupting teeth out of place (outside or inside the dental arch: high canines, teeth lying down, double row, etc).
- Maintain correct eruption guidance in lateral sectors.
- Allow an occlusion of class I molar type to be established.
- Maintain the basic functions of the dentition in case of multiple losses.
- Avoid the appearance of habits (interposition of tongue between jaws when swallowing, for example).
- Keep the space until the eruption of the permanent successor occurs
- Do not interfere with the normal eruption of permanent
- Do not interfere with the development of bone bases
- Prevent the extrusion of the antagonist tooth
- Restore the functions of the temporary dentition: phonation, swallowing, chewing
- Simple design that allows a correct hygiene
- According to their characteristics, they can be classified as fixed or removable
- According to lost teeth can be classified into: incisors, canines, molars or multiple
- All of them can be Passive devices, which only keep the lost tooth space, or Assets, which recover all or part of the space already lost.
TYPES OF MAINTAINER:
They are devices built on bands or preformed crowns, placed on the teeth adjacent to the lost space, on which the wire that covers the edentulous space is welded.
- They do not require patient collaboration
- They generally maintain the space of only one tooth
- Metallic Made to measure in the laboratory.
- They do not reset functions
- They require less vigilance by the dentist
- Very comfortable for the child
- They are used to maintain the space of incisors, canines and temporary molars lost prematurely.
- It is the treatment of choice for its efficacy and the need for minimal collaboration on the part of the child and his parents.
- When aesthetic and functional needs are few.
- When a crown is indicated to restore a tooth that is intended to be used as a pillar
- Patients with few collaborators
- Very young patients
- When the patient is allergic to resin
They are devices built on resin and retained in the mouth by means of hooks on the abutment teeth, to which active elements such as screws or springs can be added when trying to recover space, as well as to personalize it.
- In resin, retained by hooks: simple, ball and Adams.
- They allow the replacement of several teeth and their functions.
- They require patient collaboration.
- They require more frequent controls (adjustments of the hooks and opening of “windows” as the eruption progresses).
- They can be used as active devices (adding expansion screws, springs and other accessories to go placing some teeth at the same time).
- They prevent the extrusion of the antagonist tooth.
- They are built by indirect method (laboratory).
- Absence of distal support to stabilize a fixed maintainer
- To replace temporary incisors or molars or multiple dental losses
- In patients who can be checked periodically
- In collaborating patients
- When seeking restitution of functions (speaking, swallowing, chewing)
- By aesthetic indication
- In patients with high propensity to decay, since it allows a better hygiene
- Patients allergic to resin
- Patients with few collaborators or difficult follow-up
- Close eruption of the permanent