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This appliance is called a distal shoe space maintainer or a distal extension space maintainer. It is used to prevent first permanent molars from moving mesially with the premature loss of second primary molars. The example shown is a crown with a distal extension segment soldered to the crown. The distal segment is extended into the tissue against the unerupted first permanent molar. The distal extension, also called a distal shoe, is used when the second primary molars are lost prior to the eruption of the first permanent molars (i.e., very premature loss).
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