Soft Tissue Complications and Clinical Decision-Making in Distal Shoe Therapy: A Prospective Clinical Follow-Up Study
University of Florida
Summary
Distal shoe space maintainers are the standard of care for guiding the eruption of permanent first molars following the premature loss of the primary second molars. Although this therapy represents established clinical practice, prospective evidence regarding soft tissue complications and predictors of treatment outcomes remains limited. This observational study will prospectively collect clinical outcome data during routine treatment visits. The aims of the study are to characterize patterns of complications, evaluate outcomes related to patient adherence, and identify predictors of treatment success. Ultimately, this study seeks to support the development of standardized strategies for clinical monitoring and complication management.
Description
The premature loss of a primary second molar prior to the eruption of the permanent first molar represents a significant clinical challenge in pediatric dentistry. Without appropriate intervention, the unerupted permanent first molar invariably drifts mesially during its eruptive path, resulting in severe arch length deficiency, impaction of the permanent second premolar, and complex malocclusions. The distal shoe space maintainer is the definitive intervention for these cases; its subgingival guide plane acts as a critical buttress, directing the permanent first molar into its correct anatomi…
Eligibility
- Age range
- 3–9 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria * Pediatric participants aged 3 to 9 years * American Society of Anesthesiologists (ASA) Physical Status I or II * Clinical indication for distal shoe therapy as the standard of care * Undergoing distal shoe space maintainer placement * Parent or caregiver able to provide consent and comply with follow-up visits Exclusion Criteria * Presence of systemic medical conditions that may affect bone metabolism or wound healing * Patients unable or unwilling to comply with the planned follow-up schedule (up to 24 months) * Patients with contraindications to distal shoe therapy ba…
Interventions
- OtherStandard Clinical Practice Regimen
his study involves the prospective observational monitoring of clinical outcomes during standard distal shoe therapy. Research activities consist of systematic documentation of clinical data, including radiographic assessment of the intra-alveolar blade depth measured from the mesial margin of the permanent first molar, standardized gingival health scores, and caregiver-reported compliance. No experimental modifications to the clinical device or surgical procedures are performed, ensuring the study reflects routine clinical practice.
Location
- Department of Pediatric Dentistry, Universit of Florida, College of DentistryGainesville, Florida