Comparison of the effect of different lingual arch space maintainers on oral health in children- A randomised clinical trial

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Janvi M Gandhi
Vignesh R


Functional lingual arch, space maintainer, space loss, premature loss, functional space maintainer


Background: Fixed functional space maintainers are found to be associated with increased plaque accumulation when compared to removable space maintainers or conventional fixed space maintainers.
Aim: To evaluate the effects of different lingual arch space maintainers on the oral health of children.
Materials & Methods: 20 patients selected between the ages 7-9 for whom fixed lingual arch space maintainers were indicated.
Group 1 (n=10)- Conventional lingual arch space maintainer, Group 2 (n=10)- Functional lingual arch space maintainer. The plaque index (PI), gingival index (Gl), records were obtained at four time periods; T1: before insertion of appliance, T2: 3 months after insertion, T3: 6 months after insertion, T4: 12 months after insertion.
Results: The results depicted that in both functional and conventional lingual arch groups plaque index did not differ significantly during intergroup comparison but intragroup comparison for both groups at different time intervals showed increased plaque accumulation (p value-0.001), especially around the band region of both the appliances and beneath the acrylic resin in the functional group. The changes in the gingival index did not differ significantly between the conventional and functional group at any of the measurement periods (p > 0.05).
Conclusion: Fixed space maintainers lead to increased plaque accumulation around the banded molars in children. After a regular follow up of 1 year, increased plaque accumulation was seen in both groups especially after 6 months and 12 months. Proper maintenance and strict oral hygiene measures must be practised during the use of these appliances.

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1. McDonald and Avery Dentistry for the Child and Adolescent [Internet]. 2011. Available from:
2. Arikan V, Kizilci E, Ozalp N, Ozcelik B. Effects of Fixed and Removable Space Maintainers on Plaque Accumulation, Periodontal Health, Candidal and Enterococcus Faecalis Carriage. Med Princ Pract. 2015 Jun 4;24(4):311–7.
3. Chalakkal P, Ferreira AN, Da Costa GC. Functional Lingual Arch with Hinge-type
Lockable Dentulous Component [Internet]. Vol. 10, International Journal of Clinical Pediatric Dentistry. 2017. p. 302–8. Available from:
5. Ngan PW, Wei SH, Yen PK. Orthodontic treatment of the primary dentition. J Am Dent Assoc. 1988 Mar;116(3):336–40.
6. Owen DG. The incidence and nature of space closure following the premature extraction of deciduous teeth: a literature study. Am J Orthod. 1971 Jan;59(1):37–49.
7. Habib A, Ghoneima A, Diar-Bakirly S. Management of mandibular incisors crowding by using passive lower lingual holding arch: a case series and literature review. J Clin Pediatr Dent. 2023 Mar;47(2):101–7.
8. Chen CY, Hsu KLC, Marghalani AA, Dhar V, Coll JA. Systematic Review and Meta-Analysis of Passive Lower Lingual Arch for Resolving Mandibular Incisor Crowding and Effects on Arch Dimension. Pediatr Dent. 2019 Jan 15;41(1):9–22.
9. Souto R, Colombo APV. Prevalence of Enterococcus faecalis in subgingival biofilm and saliva of subjects with chronic periodontal infection. Arch Oral Biol. 2008 Feb;53(2):155–60.
10. Boyd RL, Baumrind S. Periodontal considerations in the use of bonds or bands on molars in adolescents and adults. Angle Orthod. 1992 Summer;62(2):117–26.
11. Govindaraju L., Subramanian E.M.G., Jeevanandan G. Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial. International Journal of Clinical Pediatric Dentistry. 2021;14(S2): S179-S185.
12. Govindaraju L., Jeevanandan G., Subramanian E. ABO blood grouping: A potential risk factor for early childhood caries - A cross-sectional study. Indian Journal of Dental Research. 2018;29(3): 313-316.
13. Priyadarshini P., Jeevanandan G., Govindaraju L., Subramanian E.M.G. Clinical evaluation of instrumentation time and quality of obturation using paediatric hand and rotary file systems with conventional hand K-files for pulpectomy in primary mandibular molars: a double-blinded randomized controlled trial. European Archives of Paediatric Dentistry. 2020;21(6) : 693-701.
14. Jeevanandan G., Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial. European Archives of Paediatric Dentistry. 2018;19 (4) : 273-278.
15. Sruthi S., Jeevanandan G., Govindaraju L., Subramanian E. Assessing quality of obturation and instrumentation time using Kedo-SG blue, Kedo-SH, and reciprocating hand K-files in primary mandibular molars: A double-blinded randomized controlled trial. Dental Research Journal.2021;18: 76.
16. Jeevanandan G., Govindaraju L., Subramanian E.M.G., Priyadarshini P. Comparative evaluation of quality of obturation and its effect on postoperative pain between pediatric hand and rotary files: A double-blinded randomized controlled trial. International Journal of Clinical Pediatric Dentistry.2021;14 (1) :88-96.
17. Asif A., Jeevanandan G., Govindaraju L., Vignesh R., Subramanian E.M.G. Comparative evaluation of extrusion of apical debris in primary anterior teeth using two different rotary systems and hand files: An in Vitro study. Contemporary Clinical Dentistry. 2019;10 (3): 512-516
18. Juliet S., Jeevanandan G., Govindaraju L., Ravindran V., Subramanian E. Comparison between Three Rotary Files on Quality of Obturation and Instrumentation Time in Primary Teeth-A Double Blinded Randomized Controlled Trial. Journal of Orofacial Sciences. 2020;12(1) :30-34.
19. Preethy N.A., Jeevanandan G., Govindaraju L., Subramanian E.M.G. Comparison of shear bond strength of three commercially available esthetic restorative composite materials: An in vitro study. International Journal of Clinical Pediatric Dentistry. 2020;13 (6) : 635-639