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Right and left side fixed unilateral band and loop space maintainers also could be used, as shown in the drawing. Nevertheless, we believe most clinicians would select the fixed bilateral lingual arch appliance since the permanent lower incisors already are fully erupted. However, both the fixed bilateral and the fixed unilateral approaches are acceptable. Removable appliances can be used more successfully as children grow older. Nevertheless, even with older children, the loss and damage rate for removable appliances is high.
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