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The infra-occluded primary molars were extracted at age 10 before infra-occlusion became too extensive, and a lingual arch space maintainer was placed.
If the child is missing the first primary molar, in addition to the second primary molar, a lingual arch appliance may be placed but only after all four incisors have erupted.
He recommended a passive lingual arch when the leeway space was equal to or greater than the degree of anterior crowding.