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The chairside-fabricated distal shoe appliance, with a stainless steel crown as the retainer, is an efficacious and costeffective appliance for guiding the unerupted permanent first molar into position after premature loss or extraction of
the second primary molar. The fabrication technique is illustrated in this case report and data is presented on the
success rate of the appliance.

The distal shoe appliance is used to maintain the space of a primary second molar that has been
lost before the eruption of the permanent first molar. The result of this mesial drift is loss of arch length
and possible impaction of the second premolar


Premature loss of a primary second molar may lead to space loss in the dental arch. This space loss tends to be more severe in
unfavourable malocclusions. The distal shoe space maintainer (DSSM) may be beneficial in controlling the path of eruption of an
unerupted permanent first molar from the primary into the early mixed dentition.

This article describes the technique for achieving optimal fit of a chairside-fabricated band and DSSM in a single visit by
contouring the distal shoe blade, and by extending it to the mesial surface of the permanent first molar.

Follow-up care
Upon the eruption of the permanent first molar DSSM may be modified to a reverse band-and-loop, or replaced by a lingual
holding arch.