Twenty-year follow-up of functional treatment with a bionator appliance (part 2): a retrospective cephalometric analysis of skeletal and dentoskeletal changes

Abstract

Objectives To investigate skeletal and dentoskeletal changes 20 years after bionator treatment. Materials and Methods Analog lateral cephalograms of 18 subjects treated with a bionator appliance during growth were digitized with a transmitted light scanner. Inclusion criteria were: increased overjet (≥4 mm), skeletal Class II, available lateral cephalograms before (T0), after (T1), and 20 years after (T2) treatment with only a Bionator. To assess standard cephalometric parameters, the software ivoris analyze was used. Data were analyzed using Friedman's two-way analysis of variance by ranks followed by Dunn's post hoc tests (P ≤ .05). Results During therapy (T0–T1), ANB decreased significantly by 1.9° and remained unchanged long term. SNA slightly decreased (−0.6°) during treatment, SNB and SNPg increased (+1.4°, +1.7°). All three parameters showed a significant increase at T2 (+1.2°, +1.6°, +1.6°). Vertical measurements (ML-NL, ML-NSL, NL-NSL) remained almost unchanged during therapy. NL-NSL also was unchanged during the long-term interval; ML-NSL and ML-NL decreased significantly (−3.4°, −4.9°). During treatment, the maxillary incisors retroclined (OK1-NL: −1.6°, OK1-NA: −0.6°), the mandibular incisors proclined (UK1-ML: +3.5°, UK1-NB: +4.9°), neither significantly. Long term, there was a nonsignificant tendency toward proclination of upper (OK1-NL: +0.1°, OK1-NA: +0.7°) and retroclination of lower incisors (UK1-ML: −1.5°, UK1-NB: −5°). Conclusions Changes of ANB after bionator treatment without additional fixed appliances remained stable after 20 years. The observed long-term changes are probably consequences of well-known physiological and age-related processes.

Anterior open bite treatment using Balters class II bionator: a case report

“…Different case reports on the therapeutic approach used in this study strongly reinforce the need for study over the years, considering dental characteristics, timing, and treatment methods (PAKSHIR et al, 2017). Despite the satisfactory number of studies in the scientific field on malocclusions and their causes, especially concerning case reports, a greater number of publications are still needed regarding the use of Balters Bionator and its results, in the short and long term, as authors still significantly diverge Children between 6 and 7 years old, like the patient in the study, with an established malocclusion, should always be evaluated for the need for orthodontic treatment with removable or fixed functional orthopedic appliances, allowing an improvement in occlusal disharmony (JUNGBAUER, 2023).…”

“…This appliance is particularly indicated for patients with orofacial dysfunctions, such as persistent sucking habits or habitual mouth breathing, and it should harmonize the muscles of the tongue, lips, and cheeks. The Balters' Bionator is a functional orthopedic appliance that acts on the patient's craniofacial structure (JUNGBAUER et al, 2023).…”

Tratamiento de mordida abierta anterior con uso de bionator de Balters clase II: un informe de caso

“…Los niños entre 6 y 7 años, como la paciente del estudio, con una maloclusión instalada, deben ser siempre evaluados para determinar la necesidad de tratamiento ortodóntico con aparatos ortopédicos funcionales removibles o fijos, lo que permite mejorar la desarmonía oclusal (JUNGBAUER, 2023). El uso del aparato Bionator, en comparación con el de otros, como la barra lingual, ha demostrado ser más eficaz en el cierre de la mordida abierta (MOUSA et al, 2021).…”

“…Este aparato se indica especialmente en pacientes con disfunciones orofaciales, como hábitos de succión persistentes o respiración bucal habitual, y debe armonizar los músculos de la lengua, labios y mejillas. El Bionator de Balters es un aparato ortopédico funcional que actúa en la estructura craneofacial del paciente (JUNGBAUER et al, 2023).…”