Evaluation of the clinical results and effects on oral helath of fixed space maintainers prepared and applied with different design and production methods

Objective: The aim of our study is to compare the space maintainers (SM) produced by digital workflow by laser sintering 3D printing method, with the band-loop space maintainers produced by traditional methods in terms of clinical success, retention and effect on periodontal health. Method: 70 children aged between 5-10 years (mean: 6,99±1,18) were included in the study. The patients included in the study were divided into 2 groups. Laser Sintering (LS) Group (n=34): The patients were scanned with 3Shape TRIOS® (Copenhagen/Denmark) intraoral scanners. For this group SMs produced with CAD/CAM aided LS 3D imprinting method from a titanium-based metal powder. Band-Loop (BL) Group (n=36): Impressions taken with alginate. Traditional BL SMs were produced by adjusting the bands on the plaster model, and bending and soldering the wires. Patient's preference of impression technique was evaluated right after the impressions by a questionnaire. At the 6th month controls, retention and effects on oral hygiene of the space maintainers were evaluated. Results: Sixteen (38%) SMs from the BL group and 25 (65.7%) from the LS group were considered unsuccessful, and BL SMs were found to be more successful in terms of retention (p=0.007). The mean survival time of the SMs was significantly higher in the BL group than LS group (p=0.035). There was no significant difference between the baseline and control GI/PI values of the two groups. The 6th month general GI/PI values of the LS group were significantly lower than the baseline values (p<0.005). A decrease in 6th month GI/PI data was also seen in the BL group, but only the decrease in GI data was significant. The GI/PI values of the supporting tooth were significantly increased in both groups (p<0.005). Considering the results of the questionnaire, it was seen that the LS group patients interpreted their experience more positively. Conclusion: The clinical success of BL SMs (62%) was higher than LS SMs (34%), there was no difference between SMs in terms of their effects on periodontal health and oral hygiene. It has been found that the GI/PI values of the abutment tooth increased regardless of the type of fixed SM, and the pediatric patients preferred intraoral scanners as the impression method.