Evaluation of skeletal and dental effects of lower lingual arch as a space maintainer

In 1904, lower lingual arch was assigned to Lourie by Dewey. Mershon was the responsible for the popularization of the appliance. Orjinally, Nance described the indication of the lingual arch for the maintenance of the distance between permanent incisors and molars transition from mix dentition to permanent dentition. Particulary, early loss of primary second molars had the greats effects on dental arch length and may lead to the development of crowding, impaction of permanent teeths and oro-facial problems. A lower lingual arch is usually recommended as a holding device to maintain arch length and to prevent mesial migration of the mandibular first molars. Despite its widespread use, comparatively little is known about the effect of a lower lingual holding arch on preserving lower arch dimensions, tooth position and the efficiency of the device on mandibular growing. The aim of this study is to evaluate the effects of a lower lingual holding arch in arch dimension, positions of mandibular molars and incisors and mandibular growing. Thirty-four children who needed space maintainers ( 18 males and 16 females ) were included to the present study. The patients were divided to two groups according to their lack of second decidious molars on one or both sides. In the first group 16 children ( 8 males /8 females, average age 8,8±0,9 years ) were treated with lingual arch appliance with one side and 18 children ( 8 females/ 10 males, average age 8±0,7 years ) with both sides in the second group. Lateral cephalograms, dental pantomograms and study casts of the patients, were taken at the beginning and at the end of the study period. Average treatment time was 20,4±4 months. Statistically significant differences were found in all treatment groups compared with pre-treatment and post-treatment, between groups in the means of arch dimension and the position of mandibular molars and incisor. Lingual arch with one side was found better than both side. A lingual holding arch seems to be an effective tool in maintaining arch length and usual mandibular growing but at the expense of slight mandibular insisor proclination