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The drawing demonstrates another approach, where two fixed unilateral space maintainers are used (band and loop space maintainers). The choice of whether to use a maxillary fixed bilateral appliance or two fixed unilateral appliances is left to the preference of the clinician. As we have emphasized, fixed space maintainers are almost always preferred over removable appliances, although a removable bilateral appliance could be used in a situation like the one shown in the drawing.
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