Space MaintainersFixed Unilateral Appliance

This photograph shows an example of a fixed unilateral appliance. The photograph demonstrates the appliance after cementation. This appliance is referred to as a band and loop space maintainer and is a favorite among many clinicians.

Space MaintainersFixed Bilateral Space Maintainer

This photograph shows an example of a fixed bilateral space maintainer. The appliance is cemented on the two second primary molars. Fixed bilateral space maintainers on the mandibular arch often are called lingual arch space maintainers. Mandibular fixed bilateral space appliances generally are preferred by clinicians over removable space maintainers. Fixed appliances are easier to maintain and they are less likely to be removed, damaged, or lost by the child.

Space MaintainersMaxillary Removable Bilateral Space Maintenance (Nance Appliance)

The photograph shows a maxillary fixed bilateral space maintainer. This type of space maintainer also is known as a Nance Holding Arch or a Nance Appliance. Note the small acrylic button which will rest against the palatal tissue with this appliance. Some clinicians object to the button since it can create tissue irritation. Therefore, it is important that patients and parents be instructed to make sure that the patient meticulously flosses under the acrylic button. The Nance Holding Arch is used in situations where premature bilateral loss of maxillary primary teeth has occurred.

Space maintainers come in a variety of types which can be constructed differently and used in different parts of the mouth.  There are four categories of space maintainers fixed, removable, unilateral, or bilateral.

Missing anterior teeth

Space preservation for posterior unerupted teeth