Bands or crowns in space-maintaining orthodontia?

We’ve written before about choosing your orthodontic supplies. We said the key considerations are brand reputation, functional utility, durability, and quality of after-sale support.

Let’s do a little deep-dive.

One of the orthodontic things we supply is kits full of space-maintainer bands, for kids who lose molars early. As you know, the idea is to keep gaps open for the eruption of new molars. During this time, the concern is for good hygiene around those bands, for healthy gingiva.

We’re asked sometimes, ‘Why bands? Is there any difference in gingival health between stainless steel crowns and band and loop space maintainers?’

There’s a study about that. It’s a split-mouth randomised controlled trial of 46 children (22 female), 4 - 9 years old, who had stainless steel crowns on one side of their mandibular arches and band and loop space maintainers on the other side.[1] Split-mouth, of course, is a form of repeat measure controlling, to correct for differences in patients’ oral hygiene practices.

In this study, investigators evaluated bleeding on probing (BOP) and Loe and Silness gingival index (GI) rating in each of these patients.

Thirty-one children stayed for the whole study. At one month, both BOP and GI were significantly more favorable (p<0.05) for the crown than for the band and loop. At three and six months, however, gingival health improved in both groups, with no significant difference between them. This was ascertained by Friedman and Mann-Whitney analyses.

There was a difference in gingival health across the timeline within the groups, in other words, but no difference between the groups in the end. The answer is, you can use either method of space-maintaining.

We like keeping up to date on these studies. It means that when you ask us good questions like this one, we have the answers for you.

[1] Fathima A, Jeevanandan G. Comparative Evaluation of Gingival Health Among Children With Stainless Steel Crowns and Stainless Steel Bands: A Split-Mouth Randomized Controlled Trial. Cureus. 2024 May 16;16(5):e60473. doi: 10.7759/cureus.60473.