Effectiveness of Distal Shoe Space Maintainers for First Permanent Molar Eruption: A Systematic Review

Background: Premature loss of the second primary molars can result in arch space loss and later malocclusion. Distal shoe space maintainers (SMs) are used to guide the eruption of the permanent first molars, although their clinical effectiveness remains under-evaluated. Objective: We aimed to assess...

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Detalles Bibliográficos
Autores: Marqués Martínez, Laura, Esteve-Ferre, Carla, Galán López, Lidia, Aura-Tormos, Juan Ignacio, Guinot Barona, Clara, García Miralles, García Miralles, Esther
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad Católica de Valencia San Vicente Mártir
Repositorio:RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
Idioma:inglés
OAI Identifier:oai:dnet:riucv_______::537f045c5d5079e15fe3982ad3a6038a
Acceso en línea:https://hdl.handle.net/20.500.12466/7702
Access Level:acceso abierto
Palabra clave:Distal shoe
Space maintainer
Premature tooth loss
Èruption guidance
Paediatric dentistry
Systematic review
32 Ciencias Médicas
Descripción
Sumario:Background: Premature loss of the second primary molars can result in arch space loss and later malocclusion. Distal shoe space maintainers (SMs) are used to guide the eruption of the permanent first molars, although their clinical effectiveness remains under-evaluated. Objective: We aimed to assess the clinical effectiveness and complication profile of distal shoe SMs in paediatric patients following premature loss of second primary molars. Methods: A PRISMA-compliant systematic review was conducted, with protocol registered in PROSPERO (CRD420251101518). Searches in PubMed, Scopus, Web of Science, Embase, and Cochrane Library identified clinical studies evaluating distal shoe appliances in children aged ≤6 years. Risk of bias was assessed using ROBINS-I and JBI tools. Results: Six clinical studies comprising 67 patients were included. Overall eruption success was 95.5% (64/67), with minor complications occurring in 25.4% of cases. Modified designs demonstrated fewer complications, although sample size was limited. Due to heterogeneity of methods and outcomes across studies, results are reported as descriptive metrics rather than inferential estimates. Conclusions: Distal shoe space maintainers are effective in promoting eruption of the first permanent molar with an acceptable complication profile. Their success depends heavily on technical execution and case selection. Further prospective studies with larger cohorts are required to validate optimal procedural parameters.