Title 3D Printed Space Maintainers May Be More Effective at Maintaining Space than Conventional Space Maintainers
Clinical Question For a pediatric patient needing a band and loop space maintainer, would 3D printed space maintainers compared to conventional space maintainers be as effective at orthodontic space maintenance?
Clinical Bottom Line 3D printed space maintainers may be more effective at maintaining space than conventional space maintainers. Only one case study of one patient is available and in that study the 3D printed space maintainer was not fractured while the conventional space maintainer did have a fracture. Research has found that 3D printed space maintainers are a clinically acceptable alternative to traditional space maintainers and although not statistically significant, 3D printed space maintainers that use CAD/CAM technology have shown to fit more accurately.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
34192758Khanna/2021One 6 y/o patientCase Report
Key resultsIn this split-mouth case report, the 3D printed band and loop space maintainer had less plaque accumulation and did not fracture like the conventional band and loop space maintainer.
31249187Pawar/ 2019One 7 y/o patientReview
Key resultsNo results were presented, rather the issues of conventional band and loop space maintainers were outlined, and a 3D printed band and loop space maintainer was proposed for further research.
35122341Muge Tokuc/ 202216 Intra Oral Impressions Selected from children aged 8-10Laboratory study
Key resultsNo significant difference was found regarding the band fit of conventional and CAD/CAM-fabricated, 3D printed space maintainers.
Evidence Search (3D Printing or Additive manufacturing or Direct Metal Laser Sintering or Multi Jet Fusion or Polyamide or Stereolithography or STL) AND (space maintainer)
Comments on
The Evidence
Available evidence is weak. Only one case study of a 3D printed band and loop space maintainer has been completed, and the in vitro study only measures fit. In the case study, they utilized a split mouth design utilizing the same arch; the 3D printed band and loop was printed in one single unit using metal like the traditional band and loop. Traditional band and loop require soldering and, in this study, which commonly happens, the soldered arm had a radiographic fracture; there was no comment on whether this impacted the amount of space maintained. Both space maintainers were made of similar metal and the same lab was used. For traditional band and loop space maintainer fabrication, a band is placed before the impression is taken which was a cause of discomfort, and patient behavior compliance declined.
Applicability Premature loss of primary molars due to caries is a common occurrence in pediatric dental patients and maintaining space is crucial for the developing dentition. Conventional band and loop space maintainers require more skill by lab technicians and messy impressions. The ability of a 3D printed band and loop space maintainer that utilizes a digital impression can expedite the process of delivering a band and loop space maintainer if the office has a 3D printer; reduces room for human error; creates more comfort for the pediatric patient; and ultimately provides a more effective, safe and biocompatible means to maintaining space in the event of premature loss of the primary dentition. 3D printed is more expensive than traditional band and loop space maintainers, which influences decision making on which option to utilize in patient care.
Specialty (Pediatric Dentistry)
Keywords Space maintenance, pediatric dentistry, band and loop, 3D printing
ID# 3496
Date of submission 11/19/2022
E-mail tuft@uthscsa.com
Author Jacob Tuft DMD
Co-author(s) Rene Slykhous DMD
Co-author(s) e-mail slykhous@livemail.uthscsa.edu
Faculty mentor Dr. Maria Karakousoglou BDS MS
Faculty mentor e-mail karakousoglo@livemail.uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available