Clinical effectiveness of space maintainers and space regainers in the mixed dentition: A systematic review

Abstract

Background: The aim of this systematic review was to address the clinical effectiveness of space maintainers and space regainers in the prevention and correction of dental arch decrease in the mixed dentition. Methods: An electronic search was conducted using five databases and 6 relevant journals. Inclusion criteria were: Randomized Controlled Clinical Trials (RCTs), Controlled Clinical Trials (CCTs), cohort studies and case-control studies of children in the mixed dentition requiring a space maintainer or a space regainer, children with mild to moderate crowding, and with Class I and mild Class II or Class III skeletal pattern. Results: Following the three phases of a systematic search, 11 were included for the final analysis, of which 1 article was found to be of critical risk, 2 articles of serious risk and 8 articles of moderate risk of bias. Conclusions: Space maintainers may preserve arch length and prevent crowding in mildly to moderately crowded cases, but at the cost of proclination of the lower incisors. Space regainers were somehow effective in distalizing the maxillary and mandibular first permanent molars and thus contributing to the resolution of mild to moderate crowding in the mixed dentition. However, considering the low evidence provided by this systematic review, high-quality studies are needed.Registration: PROSPERO (CRD42020170035).