Distal Shoe

The Distal Shoe is the most technique-sensitive space maintainer. It uses a metal guide plate extending into the alveolar ridge to guide the unerupted first permanent molar into its correct eruption path.

• Molar Band — On the primary first molar (or second primary molar if present) • Metal Guide Plate — Extended subgingivally into the extraction socket • Wire Framework — Connecting band to guide plate • Solder Joints — Silver solder connections

After extraction of the primary second molar, the guide plate is positioned in the extraction socket, extending into the alveolar ridge. As the first permanent molar erupts, it contacts the guide plate and is directed into the correct position in the arch.

1. Pre-extraction impression or scan 2. 3D-print model 3. Fit band on abutment tooth 4. Fabricate guide plate — extend 4-5mm below the alveolar crest 5. Solder guide plate to band 6. Clinician inserts guide into socket at time of extraction 7. QC: Guide plate length, angle, band fit (extreme precision required)

• Guide Plate: 0.032" SS sheet or 0.036" SS wire, smooth surface • Band: Preformed SS, precisely fitted • Extension: 4-5mm subgingival into extraction socket • Critical: Correct angle — must guide the permanent molar mesially and occlusally • QC: Guide plate measurement, angle verification, pre-extraction fit check