Fully digital workflow for the fabrication of a tooth-colored space maintainer for a young patient

Objectives: Preventive orthodontic therapy with a band and loop is recommended to reduce the prevalence and severity of malocclusion on premature loss of a primary molar. However, when young patients are less cooperative and have a severe gag reflex, using traditional impression methods may be challenging. The use of a conventional metal space maintainer (SM) requires manual laboratory procedures and does not provide optimal esthetics. Moreover, gingival submergence of the wire and gingivitis caused by metal structures may occur. This clinical report describes a complete digital workflow for the fabrication of a zirconia SM to overcome these limitations. Clinical Considerations: An 8-year-old boy with a band and loop SM for a missing primary mandibular right second molar presented with plaque accumulation around the band, soft tissue impingement by the loop, and loss of cement. A reverse band and loop SM had been proposed for the restoration of the primary mandibular right first molar. After conservative tooth preparation, a digital impression procedure was performed. A customized band and loop SM was designed using a computer-aided design software and milled out of the zirconia block. After sintering, the SM was luted with adhesive resin cement. Conclusions: Using an intraoral scanner, computer-aided design, and computer-aided manufacturing technology, the limitations of traditional impression procedures were overcome, and a zirconia SM with mechanical, biological, and esthetic advantages was fabricated. Clinical Significance: Advancements in dental materials and digital technologies allow for the efficient fabrication of a tooth-colored SM with an improved patient satisfaction and reduced human error.