Distal Guide As a Substitute for Distal Shoe Space Maintainer: a Case Series Study

Early loss of the primary second molar (DSM) before the eruption of the permanent first molar (PFM) may result in its mesial drift during the eruption. Traditionally, a distal shoe space maintainer is used in this situation to control the path of eruption and preserve the space. However, considering its disadvantages, an alternative appliance needs to be developed for guiding the unerupted PFM. The purpose of this article is to represent an innovative design for preserving space after the early loss of the DSM, describe the fabrication process, and present some data on the successful results of using the appliance in five cases.