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300 - Evaluation of Space Maintainers and How Practitioners Utilize these Appliances

Saturday, May 24, 2025
12:00 PM - 12:15 PM MDT
Has Audio

    Presenting Author(s)

  • Alexandria M. Thomas, DDS

    Chief Resident
    University of Nebraska Medical Center
    University of Nebraska Medical Center
    Omaha, Nebraska, United States

    • Co-Author(s)

  • AB

    Alexandra L. Bilunas, DDS

    Assistant Professor of Pediatric Dentistry
    University of Nebraska Medical Center
    Omaha, Nebraska, United States

    • Research Mentor(s)

  • AB

    Alexandra L. Bilunas, DDS

    Assistant Professor of Pediatric Dentistry
    University of Nebraska Medical Center
    Omaha, Nebraska, United States

    • Program Director(s)

  • ZH

    Zachary L. Houser, DMD

    Program Director
    University of Nebraska Medical Center
    Omaha, Nebraska, United States

Abstract:

Purpose:  
Space maintenance appliances play an essential role in pediatric dentistry, yet there is limited data examining patient-related factors such as recall status, pre-cementation oral hygiene, and social history. Additionally, current research has not compared appliances commonly used in practice with those utilized in residency programs. This study aims to evaluate the utilization of space maintenance appliances by practitioners and residents, identify factors influencing appliance selection, and provide insights into patient candidacy.

Methods:
An anonymous survey was distributed via the American Academy of Pediatric Dentistry (AAPD) listserv to pediatric dentists and residents. The 21-question survey assessed the types and frequency of space maintainers used in practice, those taught in residency, and patient factors influencing appliance selection. Descriptive statistics summarized the data.

Results:
A total of 594 responses were analyzed. Lower lingual holding arches (LLHA), maxillary nance appliances, and band and loop space maintainers were the most commonly used appliances in residency. Behavior was the most important factor in determining patient candidacy for space maintenance, while lack of compliance was the primary cause of failure for both unilateral and bilateral appliances. Practices accepting Medicaid reported a higher median number of unilateral space maintainers compared to those that do not.

Conclusions:
Clinicians and residents reported feeling adequately trained in space maintainer placement, with most placing approximately 40 appliances during residency. No significant differences were found in appliance usage across residency programs, and both residents and practitioners use similar appliances. These findings offer insights into residency training experiences and clinical decision-making regarding space maintenance, particularly in populations with higher Medicaid utilization.

Identify Supporting Agency and Grant Number:

Research supported and approved by the University of Nebraska Medical Center Institutional Review Board #0804-24-EX.