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Abstract
The aim of this study is to evaluate the use of glass fiberreinforced composite resin (GFRCR) as a space maintainer and to
compare it with a conventional band-and-loop space maintainer. A total of 30 children (23 boys and 7 girls) aged 68 years were
selected for the study. Each of these children required maintenance of space due to premature loss of primary first molars in at
least two quadrants. In one quadrant, a GFRCR space maintainer was applied and in the other quadrant a band-and-loop space
maintainer was cemented. Patients were recalled at regular intervals over 12 months and retention of both the types of space
maintainers was evaluated. The retention of the GFRCR space maintainer was found to be superior to that of the band-and-loop
space maintainer, but this difference was not statistically significant.
Keywords: Band-and-loop, glass fiberreinforced composite resin, retention, space maintainer
normal function.[3] It has also been suggested that the bandand-loop space maintainer should be removed once a year
to allow inspection, cleaning, and application of fluoride to
the teeth.[4]
Introduction
When a primary tooth is extracted or is exfoliated
prematurely, the teeth mesial and distal to the space tend
to drift or be forced into it. This may result in the impaction
of the succedaneous tooth, a shift of the midline of the
dental arch to the affected side, and over-eruption of the
opposing tooth, with subsequent impairment of function.
Maintenance of the space may eliminate or reduce these
consequences.[1]
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Results
At the 1st month follow-up, there were no failures in either
type of space maintainer. At the 3rd month, 80% success was
observed with GFRCR space maintainers. The 20% failure
was mainly due to debonding at the enamel-composite
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interface (10%) and fracture of the fiber frame (10%). Thirtythree percent [Figure 3] of band-and-loop space maintainers
showed cement loss [Figure 4], i.e., there was 67% success.
At the 6th month, 66.7% success was observed with the
GFRCR space maintainer. Failures were due to debonding at
the enamelcomposite interface (4.2%), fracture of the fiber
frame (8.3%), and debonding at the compositefiber interface
(4.2%). The band-and-loop space maintainer showed 43.3%
success; 25% showed cement loss and 10% showed breakage
[Figure 5]. At the 12th month, the overall success was 53%
for GFRCR and 33.3% for band-and-loop space maintainers.
On analysis, there was statistically no significant difference
in retention between these two types of space maintainers
[Table 4 & Graph 1].
Discussion
The space maintainer most commonly used in the event of
premature loss of a single posterior tooth is reported to be
the band-and-loop or crown-and-loop space maintainer.[11]
These appliances adjust easily to accommodate changing
dentition. But they have disadvantages, such as a tendency
for disintegration of the cement, inability to prevent the
Evaluation
criteria
1st month
n = 30
0
3rd month
n = 30
0
6th month
n = 20
0
12th month
n = 13
0
Cement
failure
10
(33.3%)
5
(25%)
3
(23.1%)
Breakage
Caries or
gingival
inflammation
Total no.
of failures
2
(10%)
0
10
(33.3%)
7
(35%)
3
(23.1%)
Distortion
GFRCR space
maintainer
(n = 30)
Band-and-loop
space
maintainer
(n = 30)
Number
PerNumber
Perof space centage of space
centage
maintainer
maintainer
present
present
At 1st month
30
100.0
30
100.0
At 3rd month
24
80.0
20
66.7
At 6th month
20
66.7
13
43.3
At 12th month 16
53.3
10
33.3
P value
0.243
0.069
0.118
Table 5: Types of failures seen with GFRCR and band-and-loop space maintainers
Type of failure
failure (%)
Debonding of enamel
composite interface
Debonding of composite
fiber interface
Fracture of fiber frame
Caries or gingival
inflammation
P < 0.0015**
1 (4.2)
1.000
5 (16.7)
0(0)
P < 0.0105*
P value
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Type of
failure
Distortion
Cement
failure
Breakage
Caries or
gingival inflammation
18 (60)
P < 0.00025**
2 (6.7)
0 (0)
P < 0.7615
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100
100%
100
90
80%
80
Percentage(%)
70
66.7%
66.7%
60
53.3%
50
43.3%
40
33.3%
30
20
10
Third month
Sixth month
Twelfth month
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References
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Conclusion
The following conclusion was drawn from this study:
GFRCR space maintainers showed superior retention (53%)
compared to band-and-loop space maintainers (33.3%),
but this difference was not statistically significant.
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