|Year : 2012 | Volume
| Issue : 5 | Page : 26-28
Fiber reinforced composite loop space maintainer: An alternative to the conventional band and loop
Ramakrishna Yeluri, Autar Krishen Munshi
Department of Pedodontics and Preventive Dentistry, K. D. Dental College and Hospital, Delhi N. H. #2, Mathura, Uttar Pradesh, India
|Date of Web Publication||17-Apr-2012|
Department of Pedodontics and Preventive Dentistry, K. D. Dental College and Hospital, Mathura-Delhi N. H. #2, Mathura - 281 001, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
The stainless steel band and loop appliance is the most commonly used fixed space maintainer in pediatric dentistry. But there are several disadvantages with this appliance such as the need for a cast or a working model, decalcification of the abutment tooth, loosening because of breakage or dissolution of the luting agent, tendency to get embedded in the soft tissue and the possibility of metal allergy. The purpose of this article is to present a simple, laboratory design of a "Fiber Reinforced Composite" (FRC) loop space maintainer and discuss the advantages over the traditional band and loop space maintainers.
Keywords: Band and loop, fiber reinforced composite, ribbond, space maintainer
|How to cite this article:|
Yeluri R, Munshi AK. Fiber reinforced composite loop space maintainer: An alternative to the conventional band and loop. Contemp Clin Dent 2012;3, Suppl S1:26-8
|How to cite this URL:|
Yeluri R, Munshi AK. Fiber reinforced composite loop space maintainer: An alternative to the conventional band and loop. Contemp Clin Dent [serial online] 2012 [cited 2015 Nov 30];3, Suppl S1:26-8. Available from: http://www.contempclindent.org/text.asp?2012/3/5/26/95099
| Introduction|| |
Premature loss of the primary teeth is a common occurrence in children. The safest way to prevent future malocclusions pertaining to early loss of a primary tooth is to place a space maintainer that is effective, durable and economical. Among the various space maintainers used in pediatric dentistry, band and loop is the most commonly used fixed space maintainer. However, the construction of band and loop requires three steps, it involves a clinician as well as a laboratory technician, and therefore it is expensive. With the advances in the technology and materials, there is a need to search for an alternative to overcome various disadvantages ,,,, of the band and loop space maintainer. Since the introduction of the acid-etch technique, [6 ] its area of application has increased rapidly and some types of direct bonded space maintainers have been tested clinically. ,,, The purpose of this article is to present a simple, laboratory design of a "Fiber Reinforced Composite" (FRC) loop space maintainer and discuss the advantages over the traditional band and loop space maintainers.
Design and construction
The initial framework of FRC loop was constructed using a commercially available polyethylene fiber system (Ribbond, Inc., Seattle, WA, USA). Ribbond fiber of 40 mm length and 2 mm in breadth was wetted with unfilled adhesive resin (Adper™, Single Bond, 3M-ESPE, St. Paul, MN, USA) to formulate the loop, leaving 5 mm of fiber on each end for attachment to the abutment tooth [Figure 1] and [Figure 2]. A thin layer of restorative composite resin (Filtek Z 350, 3M-ESPE, St. Paul, MN, USA) was added to the outer portion of the fiber, leaving the 5 mm of fiber on each end to provide initial rigidity, handling and adaptability to the unetched middle third of the buccal and lingual surface of the mounted molar tooth in acrylic [Figure 3] and [Figure 4]. The assembly was then light cured for 40 seconds through its entire length. The loop was then detached from the tooth; restorative composite resin (Filtek Z 350, 3M-ESPE, USA) was added to the inner portion of the loop except the 5 mm of the fiber on each end and light cured for 40 seconds. The loop was finished and polished with finishing burs and soflex discs [Figure 5]. The buccal and lingual surfaces of the tooth were etched with phosphoric acid (Scotchbond™, 3M-ESPE, USA) for 15 s, rinsed with water, dried, and bonding agent (Adper™, Single Bond, 3M-ESPE, USA) was applied and cured for 40 seconds. The loop was finally attached to the tooth using restorative composite resin (Filtek Z 350, 3M-ESPE, USA) followed by finishing and polishing [Figure 6].
| Discussion|| |
The design presented in this article involves the use of FRC ribbon. Composites that are reinforced with polyethylene fibers or glass fibers can result in materials with enhanced mechanical properties, , i.e. stiffness, strength, toughness and fatigueness. Fibers produce a load-enhancing effect on brittle composite materials by acting as the stress-bearing component and by crack-stopping or crack-deflecting mechanisms. , Ramos et al. demonstrated that composite test bars containing ribbond fibers had significantly higher fracture strength over non-reinforced test bars.
Although the design presented in this article matches with that of Gajanan et al.,  there is a huge difference in the technique of fabrication. The previous designs of FRC space maintainers ,, (FRCSM) are rigidly bonded to the teeth adjacent to the space, which may adversely influence the growth and development, exfoliation of primary teeth and the eruption of succedaneous teeth. Whereas the design presented in this article overcomes all the disadvantages of previous designs of FRCSM, thus simulating the conventional stainless steel band and loop space maintainer. Gajanan et al. concluded that ribbond space maintainer as well as repaired ribbond space maintainer are comparable to the conventional band and loop in terms of physical strength. McDonald and Avery  suggested that the band and loop space maintainer should be removed once a year to inspect, clean and apply fluoride to the tooth. FRC loop space maintainer seems to eliminate these annual maintenance steps.
Hence, FRC loop space maintainer may be a clinically acceptable and expedient alternative to the conventional band and loop appliance, but further studies are needed to verify the success of these space maintainers over longer periods of observation time.
| References|| |
|1.||Hill CJ, Sorenson HW, Mink JR. Space maintenance in a child dental care program. J Am Dent Assoc 1975;90:811-5. |
|2.||Caroll TP. Prevention of gingival submergence of fixed unilateral space maintainers. J Dent Child 1982;49:48-51. |
|3.||Ghafari J. Early treatment of dental arch problems. I. Space maintenance, space gaining. Quint Int 1986;17:424-32. |
|4.||Baroni C, Franchini A, Rimondini L. Survival of different types of space maintainers. Pediatr Dent 1994;16:360-1. |
|5.||Qudemiat MA, Fayle SA. The longevity of space maintainers: A retrospective study. Pediatr Dent 1998;20:267-72. |
|6.||Buonocore MG. A simple method of increasing the adhesion of acrylic filling materials to enamel surfaces. J Dent Res 1995;34:849-53. |
|7.||Swaine TJ, Wright GZ. Direct bonding applied to space maintenance. J Dent Child 1976;43:401-5. |
|8.||Palmer ME. Bonded space maintainers. J Clin Orthod 1979;13:176-8. |
|9.||Artun J, Marstrander PB. Clinical efficiency of two different types of direct bonded space maintainers. J Dent Child 1983;50:197-204. |
|10.||Santos VL, Almeida MA, Mello HS, Keith O. Direct bonded space maintainers. J Clin Pediatr Dent 1993;Summer 17:221-5. |
|11.||Rudo DN, Karbhari VM. Physical behaviors of fiber-reinforcement as applied to tooth stabilization. Dent Clin North Am 1999;43:7-35. |
|12.||Issac DH. Engineering aspects of the structure and properties of polymer-fiber composites: Proceedings of the first symposium on fiber-reinforced plastics in dentistry.August 27-29, 1998, pp.1-12. J Dent 2000 |
|13.||Gordon JE. The new science of strong materials. Princeton, NJ: Harmondsworth Penguin; 1976. |
|14.||Ramos V, Runyan DA, Christensen CC. The effect of plasma-treated polyethylene fiber on the fracture strength of polymethyl methacrylate. J Prosthet Dent 1996;76:94-6. |
|15.||Gajanan K, Domenic L, Sara H. Development and testing of fiber-reinforced composite space maintainers. J Dent Child 2009;76:204-8. |
|16.||Zuhal K, Semra ME. Success of reinforced fiber material space maintainers. J Dent Child 2004;71:158-62. |
|17.||Kargul B, Esber Ç, Ugur K. Glass fiber-reinforced composite resin as fixed space maintainers in children: 12- month clinical follow-up. J Dent Child 2005;72:109-12. |
|18.||Subramaniam P, Babu GK, Sunny R. Glass fiber-reinforced composite resin as a space maintainer: A clinical study. J Indian Soc Pedod Prev Dent 2008;Supplement 2008:S98-103. |
|19.||McDonald RE, Avery DE. In: Dentistry for the child and adolescent. 7 th ed. St. Louis: Mosby: 2000. p. 686. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]