INBDE (Integrated National Board Dental Examination) Practice Exam

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What space maintainer is used for primary first molar loss if lower permanent incisors have erupted?

LLHA or Nance
Band and Loop
Distal Shoe
Transpalatal Arch

The correct answer is: LLHA or Nance

When a lower primary first molar is lost and the permanent incisors have already erupted, a space maintainer that can prevent mesial movement of the permanent molars as well as maintain space for the lower incisors is needed. The LLHA (Lower Lingual Holding Arch) or Nance appliance is designed specifically for this purpose. The LLHA keeps the lower molars from drifting forward, preserving space for the permanent teeth to erupt properly. The other options are not the most suitable choices in this scenario: - Band and Loop: This is used when there is unilateral or bilateral premature loss of primary molars, not when permanent incisors have erupted. - Distal Shoe: This is used for cases where the second primary molar is lost before eruption of the permanent first molar, not when the permanent incisors have already erupted. - Transpalatal Arch: This appliance is used to maintain upper dental arch space, not lower arch space, making it less appropriate in this situation.