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Dentistry/Pedo and space maintainers.


I'm a recent grad , just started working on kids and was wondering...7 yr old patient has all lower and upper incisors and first perm molars, all his primary second molars extensive decay, nonrestorable,  and primary first molars, all with distal decay (and/or mesial) knowing  that all Perm first molars erupted, primary seconds out, primary first need restorative, .....
1. In ur opinion, is bilaterial fixed space maintainers  better than band and loop and Why?
2. Also if decay in primary molars is either a DO two surface or three surface MOD would u think SSC better  to do for high caries risk patients?
3. When do u impress for space maintainers, do u need I give to heal? I know we could do before extractions and lab fabricate, but if teeth already extracted will u wait for tissue to heal few weeks?
Thank u very much , looking Forward to ur response :)

1. I prefer bilateral fixed space maintainers since a single appliance will provide the necessary arch length control for the longest period of time.
2. I prefer to avoid ssc and would rather use composite resin restorations unless there is absolutely no possibility for improved oral hygiene, diet and routine examinations in the future.  In a youngster where future preventive strategies are successful the avoidance of ssc is a much more esthetic and rewarding choice for the patient and family.
3. Tissue healing can usually occur adequately within one week to allow the start of appliance fabrication (banding and impressions).  Healing should be complete by the time appliance cementation is done.


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Dr. Randolph Myerson


Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.


I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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