title: Space maintenance.
abstract: OBJECTIVE
  The use of a space maintainer appliance, or restoration of a carious primary tooth that can then act as a natural space maintainer, may potentially obviate the consequences of loss of arch length and the need for complex orthodontic treatment at a later stage. Nevertheless, all space maintainer appliances are plaque retentive and may predispose to dental caries and gingival inflammation. Space maintainer appliances may also impinge on the soft tissues, interfere with eruption of adjacent teeth, fracture, and become dislodged or lost. This review article provides a summary of the available evidence, and considers the indications for space maintenance.
  
  
  METHODS
  Medline and Ovid Medline were scanned, and additionally a hand-search of non-listed peer-reviewed papers written in English was performed. A total of 16 pertinent papers published between 1987 and 2007 that satisfied the inclusion criteria were selected for discussion.
  
  
  CONCLUSIONS
  There is limited evidence to recommend either for or against the use of space maintainers to prevent or reduce the severity of malocclusion in the permanent dentition. Decisions regarding the use of space maintainers should be guided by balancing the occlusal disturbance that may result if one is not used against the potential plaque accumulation and caries that the appliance may cause.
authors.affiliation: Department of Orthodontics, Eastman Dental Hospital, University College London Hospitals NHS Trust, London, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Laing
authors.forename: Paul
authors.initials: P
authors.lastname: Ashley
authors.forename: Farhad B
authors.initials: FB
authors.lastname: Naini
authors.forename: Daljit S
authors.initials: DS
authors.lastname: Gill
mesh_terms: D003773:Dental Plaque / Q000209:etiology; D003793:Dental Restoration, Permanent; D006801:Humans; D008310:Malocclusion / Q000517:prevention & control; D016382:Orthodontic Appliance Design; D013027:Space Maintenance, Orthodontic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014094:Tooth, Deciduous