Towards a Caries-Preventive Space Maintainer: A Comparative Evaluation of Caries Risk in Children Treated with Fiber-Reinforced Composite Loop and Conventional Band-and-Loop Appliances

Abstract

Background: Premature loss of primary molars in children necessitates space maintainers to prevent malocclusion. Conventional band-and-loop (BL) space maintainers have long served as a reliable treatment modality for many patients, despite having certain inherent limitations. On the other hand, fiber-reinforced composite loop (FRCL) space maintainers offer an adhesive alternative, but comparative data on caries risk remain limited. Objective: To compare caries risk on abutment teeth between FRCL and conventional BL space maintainers over a 12-month follow-up period in children with premature primary molar loss. Methods: A quasi-experimental study was conducted on 30 fresh extraction sites (15 patients, each receiving both devices contralaterally or bilaterally) at Bangabandhu Sheikh Mujib Medical University, Dhaka, from June 2023 to September 2024. Group A received FRCL (n=15 sites), and Group B received conventional custom-made BL (n=15 sites). Caries on abutment teeth was assessed visually, tactilely, and radiographically. Fisher's exact test compared groups. Results: At 12 months, Group A (FRCL) showed 0% caries incidence on abutment teeth, while Group B (BL) showed 26.67% (4 of 15 sites) caries incidence. The difference was statistically significant (p=0.03). No caries was detected in either group at baseline or 3 months. Caries in Group B first appeared at 6 months (6.67%) and progressively increased through 9 (20%) and 12 months. Conclusion: Fiber-reinforced composite loop space maintainers demonstrated significantly lower caries risk on abutment teeth compared to conventional BL space maintainers at 12-month follow-up, suggesting superior caries-preventive properties in pediatric patients.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 60-66