الفهرس 
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Abstract
Bilateral fixed space maintainer appliances (lingual arch, Nance appliance and transpalatal arch) are usually used after early bilateral loss of primary molar in mixed dentition period to preserve and maintain arch length. Despite, the widespread use of these types of space maintainers their effects on jaws growth is a raising up question. Therefore, the present study was undertaken to study and compare the effects of using bilateral fixed passive types of space maintainers on transverse and antroposterior maxillary and mandibular skeletal and dentoalveolar growth during early mixed dentition period. Eighty children from 7 to 9 years old had upper or (and) lower bilateral unrestorable badly destructed primary molars indicated for tooth extraction and space maintainer appliances after eruption of first permanent molars were selected from the Paediatric Dentistry Department outpatient clinic, Faculty of Dentistry, Mansoura University. Children were healthy free from any history of systemic illness, had a normal occlusion and free from any facial or skeletal disharmony. The selected cases were included into four treatment groups each with a constructed different type of space maintainer appliances and had 20 appliances per each group:- group I: Lingual arch (LA) space maintainer with U shape loops. It was used in mandible after eruption of lower permanent central and lateral incisors. group II: Nance palatal arch appliance (NA) space maintainer. It was used in maxilla after early loss of upper primary molars. group III: Transpalatal arch (TPA) space maintainer with omega loop. It was used in maxilla after early loss of upper primary molars. group IV: Bilateral Band and loop (B&L) space maintainer appliances on right and left first permanent molars. It was placed in upper or lower jaws after early loss of second primary molar. Study casts using alginate impression and digital antroposterior and lateral cephalograms records were taken at insertion of the appliances and every 6 months recall observation visits for 18 months. Cast and digital cephalograms images were analyzed using software-measuring programs. Transverse and lateral skeletal and dentoalveolar growth patterns during treatment with each appliance used were studied every six month for one and half year to detect the effect of appliances used on growth parameters studied. Data collected, tabulated, and statistically analyzed to study effects of each space maintainer appliance used on jaws and dentoalveolar growth. We concluded that bilateral fixed space maintainer appliances did not affect transverse and lateral skeletal growth of both maxilla and mandible. They decreased but did not prevent the maxillary and mandibular transverse dentoalveolar widths growth during early mixed dentation. Lingual arch, Nance appliance, and bilateral band and loop space maintainers are effective in preserving and maintaining arch length and perimeter after early loss of primary molars during mixed dentation period. Transpalatal arch appliance is not as effective as Nance appliance and bilateral band and loops in case of early bilateral loss of maxillary primary molars.