Long-Term Dentoskeletal Effects and Facial Profile Changes Induced by Bionator Therapy

Abstract

Objective: To evaluate the long-term skeletal and soft tissue changes induced by the bionator in Class II subjects. Materials and Methods: The treatment sample consisted of 20 Class II patients (6 males and 14 females) treated consecutively with the bionator. The sample was evaluated at T1, start of treatment; T2, end of bionator therapy; and T3, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T1); at posttreatment, 12 years 4 months (T2); and at long-term follow-up, 18 years 11 months (CS 6). The control group consisted of 20 subjects (8 males and 12 females) with untreated Class II malocclusions. Lateral cephalograms were analyzed at the three time points for all groups. Student's t-tests were used for comparisons of starting forms, and of the T1-T2 and T1-T3 changes between groups. Results: The bionator group showed significant, favorable T1-T2 changes both at the skeletal and dentoalveolar levels. The vertical dimension was increased. Significant modifications were assessed for the soft tissues as well. The treated group showed a final improvement in soft tissue pogonion of about 2.5 mm. Significant mandibular changes were noted in the treated group, with a net average 3.3 mm long-term increase in mandibular length compared with untreated Class II controls. Conclusions: This study suggests that bionator treatment of Class II malocclusion maintains favorable results over the long-term with a combination of skeletal, dentoalveolar, and soft tissue changes. (Angle Orthod 2010;80:10-17.)

Effect of Bionator and Farmand Appliance on the Treatment of Mandibular Deficiency in Prepubertal Stage

“…This causes a clockwise rotation of the mandible, which is favorable in horizontal growers. Similar findings for Bionator have been reported in the literature, which confirm the results of the current study (19,21). …”

“…The Bionator is a tooth-borne apparatus that has been reported to produce considerable changes in dentoskeletal structures through a repositioning of the lower jaw in a more forward position, establish normal overjet and overbite, control dental eruption, and improve facial structures (19).…”

Morphometric analysis of treatment effects of the Balters bionator in growing Class II patients

“…Many studies that investigated the dentoskeletal effects produced by the bionator appliance in patients with Class II, division 1 malocclusion, [16][17][18] but they all used CCA. CCA cannot analyze adequately the shape detail demonstrated by the cephalogram, and, therefore, it is not capable of fully evaluating craniofacial form (size + shape).…”

“…[16][17][18] Long-term studies are needed to determine the extents to which these mandibular shape changes are maintained and their influence on facial esthetics.…”

“…12-16 While short-term and long-term effects of the bionator appliance on Class II division 1 malocclusion have been previously investigated, [16][17][18] the CCA methods used in those studies do now allow understanding of the changes in mandibular morphology (shape) that occur with bionator therapy.…”