The use of Distal Shoe Space Maintainer in Pediatric Dentistry; A Systematic Review

Objectives: Early loss of a second deciduous molar before the eruption of first permanent molar can lead to space deficiency in the dental arch. The Distal Shoe Space Maintainer (DSSM) is indicated in such situation to avoid space loss. We sought to assess the efficacy and safety of this appliance. Methods/Statistical Analysis: We performed a comprehensive search on PUBMED, Cochrane libraries, LILACS and EMBASE. Our primary outcome measure was the effectiveness of space maintenance. Other outcome measures were the gingival response and patient’s tolerance to DSSM. We also assessed the design and quality of each study. Findings: Six articles which met our inclusion criteria were analyzed. Insufficient information was given in the studies regarding the efficacy in space maintenance or gingival response to the DSSM. The appliance was well tolerated by patients in 4 studies. Application/Improvement: Neither the efficacy of DSSM nor the gingival response to it has been investigated in the available studies. There is evidence that patients tolerate the DSSM well.The studies were shown to be of poor design and quality.