Maxillary SECOND primary molar

STEP 2 - Impact on occlusion

Evaluate how this potential space loss might affect the developing occlusion.

Look at the arch as a whole—as a general rule:

If a child has crowding, a space maintainer is more likely to be beneficial

If a child has spacing, a space maintainer is less likely to be beneficial

If, based on the results of Step 1 and Step 2, you would like to space maintain, select an appliance in Step 3.

Space loss is likely to have the greatest negative impact in a child who has features of malocclusion that require space for correction. This means not only crowding (ie. a tooth size arch length discrepancy), but also curve of Spee and protrusion, as these too require space to correct.

Proper assessment requires you to look at this case through an orthodontic lens. For a more thorough explanation of the relationship between space loss and the developing occlusion, please see the learning content section on Impact on Occlusion.