A fixed or removable appliance

designed to keep open the space

created by the early loss of a primary
tooth.

Broadly into four categories. They can

be fixed or removable, and they can be
unilateral or bilateral.

A removable space maintainer, of course,

can be removed. A fixed space maintainer
is fixed (i.e., held) to a tooth or to more
than one tooth. Fixation usually is done by
cementing the space maintenance
appliance in place.
Unilateral space maintainers are fixed to
one side of the mouth and bilateral space
maintainers are fixed to both sides of the
mouth. Fixed space maintainers can be
unilateral or bilateral.

This photograph shows an example of a

fixed bilateral space maintainer. The
appliance is cemented on the two second
primary molars. Fixed bilateral space
maintainers on the mandibular arch often
are called lingual arch space
maintainers.Mandibular fixed bilateral
space appliances generally are preferred
by clinicians over removable space
maintainers. Fixed appliances are easier
to maintain and they are less likely to be
removed, damaged, or lost by the child.

Also known as bilateral fixed space maintainers

This photograph shows an example of

a fixed unilateral appliance on the
maxillary left side for a seven year-old
patient. The photograph demonstrates
the appliance after cementation. This
appliance is referred to as a band and
loop space maintainer and is a favorite
among many clinicians.

This appliance is called a distal shoe space

maintainer or a distal extension space maintainer.
It is used to prevent first permanent molars from
moving mesially with the premature loss of second
primary molars. The example shown is a crown
with a distal extension segment soldered to the
crown. The distal segment is extended into the
tissue against the unerupted first permanent molar.
The distal extension, also called a distal shoe, is
used when the second primary molars are lost prior
to the eruption of the first permanent molars (i.e.,
very premature loss).