title: Modified distal shoe appliance--fabrication and clinical performance.
abstract: When the primary second molar is prematurely lost, mesial movement and migration of the permanent first molar often occurs. This is one of the most difficult problems of the developing dentition confronted by pediatric dentists. Use of a space maintainer that will guide the permanent  first molar into its normal position is indicated. In cases with bilateral premature loss of primary molars, the conventional design of distal shoe poses a variety of problems and, therefore, necessitates a customized design for the eruption guidance of permanent first molars. The purpose  of this case report is to discuss an innovative design of a distal shoe appliance, which was used with good clinical results.
authors: Department of Pediatric Dentistry, School of Dentistry, Al-Arab Medical University, Benghazi, Libya. drrags80@gmail.com
authors: Kumar Raghav
authors: KR
authors: Gujjar
authors: K R
authors: KR
authors: Indushekar
authors: H V
authors: HV
authors: Amith
authors: Shefali Li
authors: SL
authors: Sharma
mesh_terms: D002675:Child, Preschool; D003731:Dental Caries / Q000628:therapy; D006801:Humans; D008297:Male; D008644:Mesial Movement of Teeth / Q000517:prevention & control; D008963:Molar / Q000473:pathology; D016382:Orthodontic Appliance Design; D011859:Radiography; D013027:Space Maintenance, Orthodontic / Q000295:instrumentation*; D014078:Tooth Eruption / Q000502:physiology; D014081:Tooth Extraction / Q000379:methods; D014094:Tooth, Deciduous / Q000473:pathology; D014097:Tooth, Unerupted / Q000000981:diagnostic imaging / Q000503:physiopathology