The aim of this manuscript analyses the efficacy of Transpalatal Arch (TPA) and Nance Button (NB) in maintaining space after the premature loss of upper primary molars. Study design: 54 subjects who needed space maintenance in the upper arch (23 in the TPA group and 31 in the NB group) and had radiographic follow-up until the appliance removal were enrolled in the study. The space loss was obtained from measurements carried out in initial and final radiographs. Type of dental loss and changes in molar relationship were also recorded. Results: The mean of space loss in the TPA group was 1.336mm, while in the NB group was 0.695mm, with no statistically significant differences between the total space loss neither the type of dental loss within the NB or TPA group (p >0.05). Conclusions: The loss of space in the unilateral second primary molar is higher in the TPA group than in the NB group, with significant statistically differences (p<0.05). It is concluded that the loss of the leeway space using a TPA as a space maintainer is greater than using a NB.

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