Functional appliance therapy with the bionator

Schwartz

et al. 2016

Acta Sci. Health Sci.

ABSTRACT. The purpose was to investigate the amount of skeletal and dentoalveolar changes after early treatment of Class II, Division 1 malocclusion with bionator appliance in prepubertal growing patients. Forty Class II patients were divided in two groups. Treated group consisted of 20 subjects treated consecutively with bionator. Mean age at the start of treatment (T0) was 9.1 years, while it was 10.6 years at the end of treatment (T1). Mean treatment time was 17.7 months. Pretreatment and post-treatment cephalometric records of treated group were evaluated and compared with a control group consisted of 20 patients with untreated Class II malocclusion. Intergroup comparisons were performed using Student's ttests and chi-square test with Yates' correction at a significance level of 5 per cent. Bionator appliance was effective in generating differential growth between the jaws. Cephalometric skeletal measurements ANB, WITS, Lafh, Co-A and dental L6-Mp, U1.Pp, IsIi, OB, OJ showed statistically significantly different from the control. Bionator induced more dentoalveolar changes than skeletal during treatment in prepubertal stage.Keywords: activator appliances, malocclusion, cephalometry.Alterações esqueléticas e dentárias induzidas pelo bionator no tratamento precoce da classe II RESUMO. Este estudo quantificou as alterações esqueléticas e dentoalveolares no período pré-puberal de crescimento após o tratamento da má oclusão de classe II, divisão 1 com bionator. Quarenta pacientes classe II foram divididos em dois grupos. Um grupo com 20 pacientes tratados consecutivamente com bionator. A média de idade no início do tratamento (T0) foi de 9,1 anos, enquanto ao final (T1) foi de 10,6 anos. O tempo médio de tratamento foi de 17,7 meses. Os dados cefalométricos antes e após o tratamento foram avaliados e comparados com um grupo controle de 20 pacientes com má oclusão de classe II, divisão 1 não tratada. A comparação intergrupo foi realizada pelo teste t de Student e teste qui-quadrado com correção de Yates para um nível de significância de 5 por cento. O aparelho foi efetivo em gerar diferencial de crescimento entre os arcos dentários. As medidas cefalométricas esqueléticas ANB, WITS, Lafh, Co-A e as dentárias L6-Mp, U1.Pp, IsIi, OB, OJ demonstraram diferença estatística significante entre os grupos. O bionator induziu maiores alterações dentoalveolares que esqueléticas no tratamento da classe II, divisão 1 durante o período pré-puberal.Palavras-chave: aparelhos ativadores, má oclusão, circunferência craniana.

Section: Discussionsupporting

confidence: 90%

Skeletal and Dental Changes Induced by Bionator in Early Treatment of Class Ii

Schwartz

et al. 2016

Acta Sci. Health Sci.

“…The studies that analyzed the long-term effects of bionator treatment 4,5,9,10 were conducted by using CCA. The CCA methods used in those studies do not allow an understanding of the changes in mandibular morphology (shape) that occur with bionator therapy.…”

Section: Discussionmentioning

confidence: 99%

“…It stimulates the lip closure with favorable negative pressure, thereby helping the mandible find its anterior position in the appliance with a concomitant effect on lip and cheek musculature. 10 The dentoalveolar compensation in the BG was probably related to lip closure and improvement of tongue position (a new neuromuscular pattern) induced by the appliance. 18 In the standard Balters bionator used in our study, the buccal shield does not touch the upper incisors and does not have inferior incisal coverage, which can play a role in dental compensation rather than orthopedic correction.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are still controversies concerning the long-term effects of FJO on the maxilla and the mandible. [9][10][11][12][13] All of the conflicting findings could be due to discrepancies in age selection, skeletal maturity, matching with control groups, treatment duration, and great variability in the cephalometric variables adopted by the different investigators. Furthermore, conventional cephalometric analysis (CCA), despite being individualized, does not always prove effective in determining accurately the location and mode in which changes in shape and size occur within the craniofacial complex.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator

Bigliazzi

Franchi

Bertoz

et al. 2014

The Angle Orthodontist

Objective: To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Materials and Methods: Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. Results: TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. Conclusions: This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes. (Angle Orthod. 2015;85:790-798.)

Australian Dental Journal

“…[30][31][32][33][34][35][36] The studies reporting a positive effect on mandibular growth still leave this question unanswered due to characteristics such as lack of a control group, 21,27 clinically minimal effects 20 and patients being retained with a mandibular positioning appliance. 20,25 The clinical significance of a measured increase in mandibular length needs to be considered in terms of forward chin positioning.…”

Section: Mandibular Growthmentioning

confidence: 99%

Current concepts on functional appliances and mandibular growth stimulation

Collett

2000

The mode of action of functional appliances, particularly in relation to stimulating mandibular growth, is a controversial subject. Many of the reports concerning growth effects of functional appliances have been characterized by poor methodology. In assessing functional appliances, results from prospective randomized clinical trials should be given prominence. On the basis of available evidence, it cannot be concluded that functional appliances are effective in stimulating and increasing mandibular growth in the long term. Although favourable growth changes have been reported following phase 1 therapy, they are generally not substantial and long term stability appears to be poor.