Managing the Leeway Space in Mixed Dentition Using a Passive Lingual Arch: A Systematic Review.

Abstract

Background/Objectives: Dental crowding and the premature loss of one or more deciduous teeth are common issues during the growth phase that accompanies the transition from mixed to permanent dentition. The aim of this systematic review is to examine the effectiveness of using a passive lingual arch in preserving the length of the lower arch and managing the leeway space, analyzing the effects on the linear and angular positions of the permanent teeth. Methods: A systematic review of the literature was conducted using the PubMed, Web of Science, Scopus, and Cochrane Library database. After an initial selection of 306 articles, seven studies that met the defined selection criteria were included. These articles were used to compile the PICO table. Results: The studies examined agree that the application of the passive lingual arch is useful in preserving the length of the lower arch during the transition from mixed to permanent dentition. The observed changes in the linear and angular positions of the permanent teeth, particularly the distoinclination of the permanent molars and the proclination of the incisors, were considered indicative of the effectiveness of this technique. However, one author did not observe these changes, noting only a prevention of mesioinclination and lingualization of the molars and incisors. Conclusions: The use of the passive lingual arch in the transition from mixed to permanent dentition proves to be advantageous for correcting mild anterior crowding, maintaining residual spaces after the premature loss of deciduous molars, and preventing the impaction of permanent premolars. This simple and effective orthodontic device can be applied in clinical practice, always based on an accurate diagnosis and a well-defined treatment plan.