The premature loss of temporary teeth is one of the etiological factors in the establishment of malocclusion, which will depend on the type of tooth lost and the time when the loss occurred. The etiology is multifactorial and has been associated to different factors such as loss of space, impaired eruption of the successive tooth, presence of rotations, changes in arch dimensions, midline discrepancies and crowding; in addition, the loss of interproximal contacts as a consequence of caries or extractions in the temporal molar region may result in loss of space due to deviations of the adjacent pieces of space. Adequate management of the space depends on several elements, such as the patient’s dental age, dental rash pattern and sequence, amount of alveolar bone covering the permanent tooth, the time that has elapsed since extraction, degree of crowding and space available in the arches and patient cooperation in both dental procedures and maintenance of good oral hygiene. Space maintenance is therefore indicated when there is premature loss of one or more temporary teeth. The choice of whether or not to place a space maintainer, as well as the type, corresponds to criteria such as: when the tooth is lost, how many dental pieces have been lost, the presence or absence of the permanent successor, the level of cooperation of the patient and the oral health. For all of the above, the conservation of space is an integral part of preventive and interceptive orthodontics.
(Rev Esp Ortod. 2018;48(2):062-067)