BackgroundExploring the integration of 3D‐printing technology in space maintainer (SM) manufacturing could offer innovative solutions and insights for enhancing SMs.AimTo compare the clinical success, retention, and periodontal effect of traditional band–loop (TBL) SMs with 3D‐printed SMs.DesignSeventy children (mean age: 6.99 ± 1.18) were divided into two groups. Laser sintering (LS) group (n = 34): Patients were scanned with an intraoral scanner. SMs were produced with LS 3D‐printing method from a titanium‐based metal powder. T group (n = 36): Impressions were taken with alginate. SMs were produced by adjusting the bands and soldering the wires on the model. The retention and effects on oral hygiene of the SMs were evaluated at the sixth month. Preference for impression technique was assessed by a five‐question survey.ResultsThirty‐eight percent of T SMs and 66% of LS SMs failed (p = .007). The mean survival time was significantly higher in the T group (p = .035). No difference was found between the initial and control full‐mouth Gingival Index (GI) and Plaque Index (PI) values of the two groups. Both groups had increased GI/PI values in abutment teeth. Patients in the LS group interpreted their impression experience more positively.ConclusionIt is important to provide oral hygiene education before applying fixed SMs and utilize more digital workflow in paediatric dentistry.