Elastodontic Therapy with Oral Bioactivator Devices: A Review

Abstract

Scientific studies have shown that dysfunctional problems associated with dysmorphisms are the base of malocclusion. The position of the mouth and the head is a component of the general postural arrangement, so any head misalignment creates disharmonies and tensions among the neck muscles. Elastodontics is a treatment based on the use of removable elastomeric devices. These functional appliances are made of elastomeric material, acting tridimensionally on a neuromuscular system with orthopaedic and dental effects. Bioactivators have a vestibular and lingual flange with a free central area that permits them to position teeth without constraints. The flanges are linked by an occlusal plane that maintains the two skeletal bases and teeth in first-class normocclusion with propulsive and retropulsive effects on the maxilla and mandible. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This review aim is to describe the indications and limits of orthodontic therapy with elastomeric devices to provide an overview of elastodontics.

Effects of Removable Functional Appliances on the Dentoalveolar Unit in Growing Patients

“…Moving on with the evolution, the first elastodontic functional device, known as an "activator", was presented in France by Soulet and Besombes in 1950. The idea behind this device was that the material of which the device was made allowed for the induction of skeletal and neuromuscular effects, alongside the repositioning of the mandible and the maxilla within the cranial system [29,30].…”

Elastodontic Appliances for the Interception of Malocclusion in Children: A Systematic Narrative Hybrid Review

“…The activator's material allowed for the induction of neuromuscular and skeletal effects, as well as the renormalization of the mandible and maxilla positions within the entire cranial system. This treatment was classified as interceptive orthopedics by Besombes [42,43].…”

“…Up to the border, the vestibular flanges operate as a sort of lip bumper, and the fornixes also stimulate the matrix bone proprioceptively. As a result, both arches are active at the same time, performing an orthopedic action in the following four different planes: vertical, transverse, sagittal, and torsional [43].…”

“…From this point of view, elastodontics enable the clinician to avoid impression maneuver, which is not comfortable for the patient because no construction bite is required. Moreover, although there is not much available in the way of research, EAs are not susceptible to caries, and they do not harm the periodontium or promote root resorption [43]. From this perspective, it is important to emphasize that elastodontic devices do not necessitate tooth anchorage, as opposed to fixed appliances with cemented orthodontic bands, which, in certain instances, can potentially lead to infiltrations and cavities on the involved dental elements.…”

Preformed Elastodontic Appliances: Awareness and Attitude of Orthodontists and General Dental Practitioners

“…In the last decades, the use of prefabricated removable elastodontic appliances (EAs) made of a soft silicone elastomer or polymer/elastomer combination has largely increased in the context of interceptive orthodontics [4,5]. These appliances have different designs and configurations, generally combining the action of a functional appliance, a preformed positioner, and a myofunctional appliance activated by muscular activity [6,7].…”