Stating that in the case of early loss of primary teeth before falling off, fixed or movable appliances made to prevent problems such as crowding in permanent teeth, impacted teeth, driving in the wrong direction are called ‘placeholder’, Beykent University Faculty of Dentistry Department of Pedodontics Dr. Lecturer Member Dilek Özge Yılmaz gave information about the tool known as ‘placeholder’ in dental treatment.
Stating that placeholders are of great importance in terms of aesthetics, phonation, preservation and continuity of tooth arch length and symmetry, Dr. Yılmaz said, “Even though placeholders are useful, they cannot fully fulfill the functions of the teeth and they need to be renewed at regular intervals with the development of the child. For this reason, milk teeth that are healthy in the mouth are the most ideal placeholder ”.
Reminding that some issues should be taken into consideration before using a placeholder, Yılmaz said, “Factors such as the age of the patient, the order of eruption of the teeth, the delay in the eruption of the permanent tooth, the time after tooth extraction, the amount of bone on the permanent tooth germ and congenital deficiency of the permanent tooth should be taken into consideration.” he spoke.
Talking about the types of placeholders, Yılmaz continued as follows:
“The placeholder appliances used to prevent the loss of arch size due to early milk tooth loss are limited in two main groups. These are called fixed placeholders and movable placeholders. “
Sharing examples of fixed placeholders, Yılmaz said, “These include Band Loop, Crown Loop, Distal Extension Placeholder, Lower Jaw Lingual Arc, Nance Apparatus, Transpalatal Arc fixed placeholder types. The most common problem associated with fixed placeholders is adhesive loss. Other problems; The formation of decay due to loss of adhesive, the implantation of the ring of the appliance in the gum, the development of metal allergy, the inability to prevent the support tooth from turning or tipping. In order to check the compatibility of the support teeth and the appliance, the patient should be called for controls every 6 months and the appliance should be removed when it is determined that the permanent tooth is erupting.
Yılmaz said that movable placeholders are placeholder appliances designed to be used in clinical situations where permanent first molars start to erupt, but not fully. He stated that in case of loss of teeth due to trauma, caries or infection in the early period, toothed placeholders can also be made to provide aesthetics and phonation. He stated that the movable placeholders should be used regularly, except to be removed while eating and to be brushed and reinserted after eating.
Yılmaz ended his words as follows:
“Movable placeholders should be stored in the appliance box to prevent them from being lost when removed. The fixed placeholder can only be removed by physicians. No force should be applied to the appliances through the finger or tongue. All appliances should be cleaned and brushed regularly. Fixed appliances should be put back in place in case of shaking or dislodging. If the apparatuses are broken within the planned treatment period, they should be reconstructed. Appliances should be checked every 6 months, and if there is an inconsistency in terms of growth and development, they should be renewed. “