Space maintainer combination of a double tube with acrylic resin material is a modification tool that is used to maintain space for deciduous teeth have been dated prematurely (premature loss) with regard to the development of bone laterally. Purpose: The purpose of this paper is to provide an explanation of the use of conventional space maintainer to space maintainer with a combination of double tube, developed in children aged 4-14 years in the Hospital University of Muhammadiyah Yogyakarta Indonesia, with many weaknesses and evaluation of this tool.