ABSTRACT
RESUMEN Fundamento: Existen modalidades de tratamiento para los trastornos temporomandibulares, una de ellas es la Ortopedia funcional de los maxilares. Objetivo: Evaluar la efectividad del Bionator de California en la disminución del grado de severidad de los trastornos temporomandibulares. Metodología: Se realizó estudio experimental, abierto, controlado y aleatorizado en el servicio de Prótesis Estomatológica de la Clínica Estomatológica de Fomento en el período de septiembre de 2019 a septiembre de 2021. Se seleccionaron 60 pacientes con trastornos temporomandibulares que cumplieron los criterios de selección, mediante asignación aleatoria se establecieron los grupos: Estudio (tratado con Bionator de California) y control (tratado con férula neuromiorrelajante). Se utilizaron métodos del nivel teórico, empírico y estadístico. La variable de respuesta principal fue: Efectividad del Bionator de California en el grado de severidad del trastorno temporomandibular. Resultados: Al inicio del estudio predominó la severidad moderada de trastornos temporomandibulares en ambos grupos, pero a los 6 meses de tratamiento predominaron los asintomáticos (66.7 %) en el grupo estudio y 36.7 % en el grupo control, con diferencia estadísticamente significativa entre ambos grupos. Conclusiones: El tratamiento con el Bionator de California fue efectivo porque se logró disminuir el grado de severidad de los trastornos temporomandibulares.
ABSTRACT Background: There are treatment modalities for temporomandibular disorders, one of them is functional orthopedics of the jaws. Objective: To evaluate the effectiveness of the California Bionator in reducing the degree of severity of temporomandibular disorders. Methodology: An experimental, open, controlled and randomized study was carried out in the Dental Prosthesis service at Fomento Dental Clinic from September 2019 to September 2021. 60 patients with temporomandibular disorders who met the selection criteria were selected. The groups were established by random assignment: Study (treated with Bionator from California) and control (treated with a neuromyorelaxant splint). Method theoretical, empirical and statistical levels were used. The main response variable was: Effectiveness of the California Bionator in the degree of severity of the temporomandibular disorder. Results: At the beginning of the study moderate severity of temporomandibular disorders prevailed in both groups, but after 6 months of treatment asymptomatic predominated (66.7%) in the study group and 36.7% in the control group, with a statistically significant difference between both groups. Conclusions: The treatment with the California Bionator was effective because the degree of severity of temporomandibular disorders was reduced.
Subject(s)
Severity of Illness Index , Activator Appliances , Temporomandibular Joint Disorders , Orthodontic Appliances, Functional , Occlusal SplintsABSTRACT
O objetivo desse estudo retrospectivo foi avaliar os efeitos esqueléticos do Bionator de Balters na maxila em pacientes portadores de maloclusão Classe II, divisão 1 de Angle nos diferentes tipos faciais. Foram obtidas radiografias em norma lateral de 60 pacientes divididos por tipo facial (sendo 15 pacientes dolicofaciais, 27 pacientes braquifaciais e 18 pacientes mesofaciais assim classificados, utilizando-se o índice VERT de Ricketts). Os pacientes com idades entre 7 a 12 anos foram tratados por um mesmo ortodontista com mais de 20 anos de experiência por um período médio de 26 meses. Um grupo de 15 pacientes portadores de maloclusão Classe II divisão 1, não tratados com idades entre 8 e 12 anos foi acompanhado por um ano e utilizado como grupo controle. Foram analisadas as medidas do ângulo Ba-Na-A, para avaliar a posição sagital da maxila, e do ângulo S-Na-PP, para avaliar a rotação da maxila. Nenhuma das medidas teve alteração clinicamente significante e também não houve diferenças significantes entre os grupos estudados. Baseado nesses resultados, conclui-se que o Bionator de Balters utilizado no tratamento da maloclusão Classe II de Angle não afeta a posição e inclinação da maxila durante o tratamento deste tipo de maloclusão.
The aim of this retrospective investigation was to evaluate the skeletal effects of the Balters Bionator on the maxillae of patients with Class II-1 malocclusion in the various facial types. Lateral radiographs of 60 patients classified according to the facial type (15 dolichofacial, 27 brachifacial and 18 mesofacial, according to Ricketts VERT index). The patients age ranged from 7 to 12 years and were treated by the same clinician who had more than 20 years of experience for a mean period of 26 months. A group of 15 patients with Class II malocclusion untreated and with age ranging from 8 to 12 years was observed for a year to be used as a control group. The angle Ba-Na-A was used for the evaluation of the sagittal position of the maxillae and the angle S-Na-PP, for the rotation. None of the measurements had any clinically significant change, and there were no statistically significant differences between the studied. Based on these results, it is concluded that the Balters Bionator used on the treatment of the Class II Angle malocclusion, does not affect the position and inclination of the maxillae during the treatment of this type of malocclusion.
ABSTRACT
Fundamento: La ortopedia funcional de los maxilares es utilizada en el mejoramiento de las relaciones intermaxilares y de la articulación temporomandibular. Objetivo: identificar el efecto del Bionator de California en los pacientes con trastornos temporomandibulares. Metodología: Se realizó un estudio con diseño experimental en 32 pacientes entre 15 y 59 años del área Norte de Sancti Spíritus, de septiembre de 2011 a marzo de 2014, que acudieron al departamento de Prótesis Estomatológica de la Clínica Estomatológica Provincial de Sancti Spíritus. Se utilizaron métodos empíricos, estadísticos y procedimientos matemáticos. Resultados: El 56,2 % de los pacientes con trastornos temporomandibulares se encontraron en las edades de 24 a 32 años y el 75,0 % fueron del sexo femenino. Los contactos prematuros con un 78,1 % y las interferencias en el lado de balanceo con un 46,8 %, fueron las interferencias oclusales más representadas. Entre los signos y síntomas, los más representativos fueron: el ruido articular (71,8 %), la rigidez (68,7 %) y el cansancio muscular (65,6 %). A los seis meses de uso del aparato seis pacientes erradicaron el trastorno y los demás pasaron a categorías inferiores. En la evaluación al año, se eliminó el trastorno en el 34,3 % de los pacientes. Conclusiones: Los resultados obtenidos en la evolución del tratamiento con el Bionator de California ponen de manifiesto el cambio favorable de la mayoría de los pacientes con trastornos temporomandibulares, expresado en el cambio del grado severo a asintomático.
Background: The functional jaw orthopedics is utilized in improving jaw relationships and temporomandibular joint. Objective: To identify the effect of California Bionator in patients with temporomandibular disorders. Methods: An experimental design study was performed in 32 patients between 15 and 59 years from the North area of Sancti Spíritus, from September 2011 to March 2014, who attended the Department of Prosthodontics of the Provincial Dental Clinic of Sancti Spíritus. Empirical, statistical and mathematical methods were used. Results: 56.2 % of patients with temporomandibular disorders were found in the age of 24 to 32 years, and 75.0 % were female. Prematurities with 78.1 % and interferences in the balancing side with 46.8 % were the most represented occlusal interferences. Among signs and symptoms, the most representative were: joint noise (71.8 %), stiffness (68.7 %) and muscle fatigue (65.6 %). After six months of using the device six patients eradicated the disorder and the others went to inferior cathegories. In the assessment year, the disorder was eliminated in 34.3 % of patients. Conclusions: The results obtained in the treatment outcome with California Bionator demonstrate the favorable change in the majority of patients with temporomandibular disorders, expressed in the change of severe to asymptomatic degree.
Subject(s)
Humans , Temporomandibular Joint Disorders , Activator AppliancesABSTRACT
Objetivo: comparar no plano sagital os efeitos esqueléticos e dentoalveolares para a maxila e mandíbula, como consequência do uso dos aparelhos Bionator, Klammt e SN1 no tratamento de más-oclusões esqueléticas Classe II. Material e métodos: foi realizado um estudo prospectivo de 21 crianças com má-oclusão esquelética de Classe II, tratadas com Bionator, Klammt ou SN1. Compararam-se mudanças no componente maxilar, mandibular e dentoalveolar através de medições e ângulos cefalométricos no plano sagital. Contrastaram-se as médias de longitudes e ângulos entre T1 e T2 pelas análises t student e wilcononox. Mediante Anova, foi contrastada a porcentagem da mudança nas medidas de interesse para os três grupos. Resultados: foram avaliadas 42 radiografias cefalométricas laterais (21 iniciais T1, 21 finais T2). Entre os participantes, 62% eram meninos e 38% eram meninas. A média das idades para início do tratamento foi 9,5 ± 1,2 anos. O SN1 apresentou a maior média de mudança na longitude mandibular Co-Pg (6,69 ± 3,3) e Co-B (6,59 ± 1,42). Encontrou-se a maior média de mudança relativa na altura do ramo mandibular no Bionator (9,52 ± 7,21). As mudanças dentoalveolares foram clinicamente relevantes para os três aparelhos. Conclusão: os aparelhos ortopédicos maxilares estimulam o crescimento mandibular sagital e vertical, controlam a posição sagital da maxila e geram mudanças dentoalveolares favoráveis para a correção de más-oclusões de Classe II.
Objective: comparing in the sagittal plane the skeletal and dento alveolar effects for the maxilla and the mandible as a result of the use of Bionator, Klammt and SN1 as a treatment of malocclusions class II skeletal. Material and Methods: a prospective study was realized on 21 boys and girls with skeletal Class II malocclusion under treatment with Bionator, Klammt or SN1, in which compare the changes in the maxillary, mandibular and dento-alveolar component by means of measurements and cephalometric angles in the sagittal plane. The averages of lengths and angles between T1y T2 was compare by t-student and wilcoxon tests. By Anova tests, contrasted the percentage of change in the measures of importance for the three groups. Results: 42 lateral skull radiographs were evaluated (21 initial-T1, 21 final-T2). 62% of participants were male and 38% were women. The average age for onset of treatment was 9.5 ± 1.2. The SN1 presented the highest average percent of change of the Co-Pg mandibular length (6.69 ± 3.3), Co-B (6.59 ± 1.42). A higher average relative change in the height of the ramus was found in Bionator (9.52 ± 7.21). Dento alveolar changes were clinically relevant for all three devices. Conclusion: orthopedic appliances stimulate mandibular sagittal and vertical growth, control the sagittal position of the maxilla, and generate favorable dento alveolar changes to correct class II malocclusions.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Orthodontic Appliances, Functional/adverse effects , Mandible , Maxilla , Malocclusion, Angle Class II/epidemiology , Malocclusion, Angle Class II/therapy , Data Interpretation, StatisticalABSTRACT
O objetivo deste estudo foi avaliar as alterações do perfil facial induzidas pelos aparelhos de Herbst e Bionator no tratamento da má oclusão de Classe II, divisão 1ª. Uma amostra de 90 telerradiografias laterais de 45 indivíduos no estágio pré-pubertário foi subdividida em dois grupos experimentais e um controle. O primeiro grupo, composto por 15 indivíduos rasileiros, com idade média de 9,4 anos, foi tratado com o aparelho de Herbst por um período de 7 meses. O segundo grupo, composto por 15 indivíduos brasileiros, com 9,9 anos de idade em média foi submetido à bionatorterapia por um período médio de 21 meses. O grupo controle de 15 indivíduos, não tratados ortodonticamente, pareados quanto às idades óssea e cronológica dos grupos experimentais, provém do Burlington Growth Centre, Universidade de Toronto, Canadá. A comparação intragrupo foi realizada por meio do teste t de Student e a comparação intergrupos por meio da ANOVA complementada pelo teste de Bonferroni. Os resultados evidenciaram que apenas o grupo tratado com o aparelho de Herbst mostrou alterações significativas do perfil facial com melhora da convexidade do perfil facial e protrusão do lábio inferior.
The aim of this study was to evaluate the facial profile changes due to natural growth and induced by Herbst appliance and Bionator in the treatment of Class II, division 1 malocclusion. In order to do that, we used a sample of 90 lateral radiographs of 45 individuals in pre-pubertal stage, divided up in two experimental groups and one control. The first group, composed of 15 brazilian individuals, with initial mean age of 9.4 years, was treated with the Herbst appliance for a period of seven months. The second experimental group consisting of 15 brazilian individuals, initial mean age of 9.9 years has gone through bionator therapy for an average period of 21 months. The control group of 15 individuals, who were not treated orthodontically, comes up from the Burlington Growth Centre, University of Toronto, Canada. The intragroup comparison was performed using the Student t test and intergroup comparisons by ANOVA complemented by the Bonferroni test. The results have shown that only the group treated with the Herbst appliance presented significant changes in facial profile with improvement of its convexity and lower lip protrusion.
Subject(s)
Humans , Male , Female , Child , Activator Appliances , Malocclusion, Angle Class II , OrthodonticsABSTRACT
Objetivo: avaliar cefalometricamente a influência do Bionatorde Balters no plano oclusal em pacientes dolicofaciais portadoresde maloclusão de Classe II de Angle associadas ao retrognatismomandibular, durante a fase de crescimento. Metodologia:a amostra consistiu de 40 telerradiografias obtidas em doistempos (T1: inicial; T2: após bionatorterapia) de 20 pacientes,sendo 10 do sexo masculino e 10 do sexo feminino com idadesvariando entre 7 e 15 anos (média de 9,03). Resultados e Conclusões:constatou-se um controle bastante eficiente da inclinaçãodo plano oclusal, provocando sua rotação anti-horária, o que éconsiderado essencial na estabilidade dos resultados.
Aim: the purpose of this study is a cephalometric evaluationof the influence of the Balters Bionator on the occlusal plane indolichofacial patients with mandibular Class II malocclusionduring growth period. Methods: the sample comprised of 40 lateralcephalograms taken at two times (T1: initial; T2: after bionatortherapy)from 20 patients, 10 females and 10 males withage ranging between 7 and 15 years (average 9,03). Results andconclusions: an efficient control of the occlusal plane inclinationwas evidenced resulting counter clockwise rotation which wasessential for the achievement and stability of the results.
ABSTRACT
La eficiencia en la corrección de la maloclusión de clase II, mediante la utilización de aparatos ortopédicos funcionales se ha reportado en la literatura desde tiempo atrás. Diferentes estudios han permitido esclarecer la forma en que los aparatos ortopédicos funcionales actúan sobre las estructura óseas, musculares, y dentales en pacientes que se encuentran en estadios previos al pico máximo puberal. Los aparatos ortopédicos funcionales aprovechan las fuerzas naturales del crecimiento y desarrollo, lo que logra una función normal del sistema estomatognático que garantiza adecuada masticación, deglución, fonación, mejora la estética y el autoestima del paciente en edades tempranas. El objetivo de este reporte de caso es mostrar los resultados satisfactorios que se logran con el tratamiento de maloclusiones clase II división 1 en pacientes jóvenes utilizando un aparato ortopédico funcional como el Bionator del Dr. Balters, también dar a conocer los cambios favorables tanto faciales, como dentales y cefalométricos, que fueron el resultado del diagnostico apropiado, selección adecuada del aparato ortopédico y excelente cooperación del paciente.
The efficiency of correction of Class II malocclusion, using functional appliances have been reported in the literature some time ago. Several studies have showed how functional orthopedic appliances act on bone, muscle, and dental structures of patients who are at stages prior to the pubertal growth peak. Functional appliances take advantage of the natural forces of growth and development which achieves a normal function of the stomatognathic system that ensures adequate chewing, swallowing, speech, aesthetics and improving patients selfesteem at early age. The purpose of this case report is to show how satisfactory results are achieved with the treatment of Class II division 1 malocclusion in young patients using a functional appliance as Dr. Balters Bionator. Also to present the positive facial, dental and cephalometric changes, which were the result of proper diagnosis, proper selection of the appliance and excellent cooperation of the patient.
Subject(s)
Malocclusion, Angle Class II/prevention & control , Activator Appliances , Orthodontics, Corrective , Orthopedic EquipmentABSTRACT
OBJETIVOS: avaliar a efetividade do aparelho ortopédico Bionator de Balters no tratamento da Síndrome da Apnéia Obstrutiva do Sono (SAOS). METODOLOGIA: foram selecionados 16 pacientes (18,8 por cento do gênero feminino e 81,3 por cento do masculino) que apresentaram a SAOS mediante diagnóstico. Dos 16 pacientes que utilizaram o aparelho ortopédico Bionator de Balters, apenas 9 apresentaram boa aceitação (56,25 por cento) e concluíram o tratamento. Estes foram submetidos a nova polissonografia, realizada com o paciente fazendo uso do aparelho ortopédico Bionator de Balters, para avaliar a eficácia deste dispositivo no tratamento do ronco e da apnéia. A comparação entre os resultados do IDR (índice de distúrbio respiratório) inicial (11,5) e final (4,2) foi realizada utilizando-se o teste t pareado (α = 0,05). RESULTADOS: observou-se melhora estatisticamente significativa do IDR após a utilização do dispositivo. CONCLUSÕES: a utilização do aparelho ortopédico Bionator de Balters pode ser considerada um método de tratamento da SAOS em casos leves ou moderados, apesar de ser um método pouco tolerado pelos pacientes.
AIM: to assess the effectiveness of the Balters Bionator orthopedic appliance for the treatment of the Obstructive Sleep Apnea Syndrome (OSAS). METHODS: Sixteen patients (18.8 percent women and 81.3 percent men) that presented OSAS on diagnosis were selected. Of the 16 patients that used the Balters Bionator orthopedic appliance, only 9 presented good acceptance (56.25 percent) and concluded the treatment. They were submitted to another polysomnography exam, performed with the patients using the Balters Bionator orthopedic appliance, in order to assess the effectiveness of this device in treating apnea snoring. Comparison between the results of the initial (11.5) and final (4.2) RDI (respiratory disturbance index) was made by the paired t test (α = 0.05). RESULTS: A statistically significant improvement in the RDI was observed after the device was used. CONCLUSIONS: The use of the Balters Bionator orthopedic appliance may be considered as a method for treating OSAS in light or moderate cases, in spite of being a method hardly tolerated by patients.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Orthotic Devices/adverse effects , Orthotic Devices , Snoring/diagnosis , Sleep Apnea Syndromes , Polysomnography , Data Interpretation, StatisticalABSTRACT
OBJETIVO: este trabalho objetiva verificar as alterações do plano oclusal funcional de Ricketts, utilizando as variáveis que orientam este plano nas análises cefalométricas de Ricketts e Schawrz-Faltin, em pacientes portadores de má oclusão de Classe II de Angle, 1ª divisão, associada ao retrognatismo mandibular, cuja terapêutica indicada tenha sido a Bionatorterapia. METODOLOGIA: a amostra coletada neste estudo retrospectivo consta de 128 telerradiografias em norma lateral de 64 indivíduos retrovertidos, neutrovertidos e provertidos, de ambos os gêneros, no estágio de desenvolvimento da oclusão em fase mista ou permanente jovem. A faixa etária dos indivíduos selecionados para o estudo variou entre 7 anos e 1 mês a 13 anos e 2 meses no momento T1, sendo a média inicial de 10 anos de idade. A média de duração do tratamento foi de 19,7 meses. RESULTADOS E CONCLUSÃO: os resultados mostraram comportamentos distintos do plano oclusal, conforme o tipo facial retrovertido, neutrovertido ou provertido. O controle do plano oclusal na Bionatorterapia, pelo manejo do Bionator conforme o tipo facial de cada paciente, por meio de desgastes seletivos no acrílico e conseqüente erupção diferenciada dos dentes, pode influenciar favoravelmente o crescimento geral da face em cada tipo facial.
AIM: This work aims to verify the changes of Ricketts functional occlusal plane making use of variables which guide this same plane in the cephalometric analysis of Ricketts and Schwarz-Faltin among patients with Class II, division 1 malocclusion, associated to mandible retrognathism, whose therapy indicated has been Bionatortherapy. METHODS: The sample collected in this retrospective survey has 128 lateral cephalograms of 64 retroverted, neutroverted and proverted individuals, of both genders, at the stage of developing occlusion, either in mixed phase or permanent young. The age scale of individuals selected by the survey goes from 7 years and 1 month up to 13 years and 2 months in the T1 moment, with an initial mean age of 10 years. The mean length of time of treatment has been of 19.7 months. RESULTS AND COONCLUSION: The overall results have been submitted to statistical analysis and have shown that in the group of retroverted patients the occlusal plane goes round clockwise, in the group of neutroverted ones, the occlusal plane did not show up any relevant alterations between moments T1 and T2, and in the group of proverted patients the occlusal plane goes round counterclockwise. The occlusal plane control in the Bionatortherapy through the handle of the Bionator according to the facial type of each patient, through selective worn out acrylic and consequent diversified eruption of the teeth, can indeed cause favorable influence towards the overall growing up of the face in every facial type.
Subject(s)
Humans , Male , Female , Child , Adolescent , Activator Appliances , Malocclusion, Angle Class II , Malocclusion , Orthopedics , RadiographyABSTRACT
The purpose of this study was to evaluate treatment effects of the modified Teuscher appliance (MTA) in early Class II division 1 malocclusion. For this purpose, treatment effects of the bionator were compared with those of the MTA. The twenty subjects who were treated excellently with bionator and MTA were selected in each group. In pre- and post-treatment lateral cephalograms, 50 variables were measured, and then the differences between pretreatment and posttreatment data of the bionator and the MTA were statistically evaluated by t-test. The results were as follows : 1. The linear measurements that showed large difference between the bionator group and the MTA group are U1 to FH, U1 to PP, U6 to FH, U6 to PP, Ar-Pog, ramus height, L1 to A-Pog, L1 to facial plane (p0.05). These results suggest that the bionator influence the mandiblar growth and lower dentoalveolar structures more than the MTA, and the MTA influence upper jaw and upper dentoalveolar structures more than the bionator comparatively in early Class II division I malocclusion.
Subject(s)
Activator Appliances , Jaw , Malocclusion , PemetrexedABSTRACT
Objective:To study the treatment effects of 12 cases of Class II division 1 malocclusion using Bionator appliances. Methods:12 cases of Class II division 1 malocclusion were selected and treated with Bionator appliances. The changes of teeth, skeletal and facial appearance were analyzed by cephalometry before and after the treatment of Bionator appliances. Results:①Bionator appliances can hardly restrain the maxillary growth. ②Bionator appliances can promote the mandibular ramus and body growth and improve the soft tissue profile. ③Bionator appliances can reduce the labial inclination of upper incisors of Class II division 1 malocclusion and can increase the height of dental alveolar of upper and lower jaw. Conclusion:In Class II division 1 malocclusion treatment, Bionator appliances can obtain satisfactory effects.
ABSTRACT
The purpose of this study was to evaluate the indications of bionator in Class II division 1 malocclusion. The 48 subjects were classified into good result group(groupl) and poor result group(group2) in reference to posttreatment molar relation, posttreatment overbite and overjet, posttreatment profile, and relapse. Pretreatment lateral cephalograms were calculated and evaluated by t-test and stepwise discrminant analysis. The results were as follows; 1. In jaw bone relationship, ANB, facial convexity angle, AB to facial plane angle were significantly different between two treatment groups. In denture pattern, Ll to facial plane, Ll to A-Pog, FMIA, and Ul to facial plane were significantly different and in soft tissue profile, protuberance of lower lip and upper lip were significantly different between two treatment groups. 2. The results in according to discriminant analysis stated that Ll to facial plane, ANB, FMIA and protuberance of lower lip help prediction of treatment result of bionator. 3. 3 major influential variables were obtained by stepwise discriminant analysis - Ll to facial plane, articular angle and ANB difference. And Fisher discriminant function was made by these three major variables.
Subject(s)
Activator Appliances , Dentures , Jaw , Lip , Malocclusion , Molar , Overbite , RecurrenceABSTRACT
The purpose of this study was to evaluate treatment effects of bionator in Class II division 1 malocclusion by FEM(Finite Element Method). The 73 subjects were classified into good result group and poor result group in reference to posttreatment molar relation, posttreatment overbite and overjet, posttreatment profile, and relapse. Pretreatment and posttreatment lateral cephalograms were taken and FEM was performed. The results were as follow; 1. There was no statistical significance in treatment changes between the sexes, and between the treatment result groups. 2. Treatment changes were not significantly different among the age groups. 3. The effect of treatment period groups on skeletal and dentoalveolar changes were analyzed using ANOVA. Body of maxilla, upper incisor, anterior face, ramus, upper anterior face, lower anterior face and treatment effect were correlated with the treatment period, but correlation coefficients were low. 4. The results of present investigation confirm that Class II bionator can assist in the correction of Class II division 1 malocclusion, mainly due to dentoalveolar changes. 5. There is significant difference in skeletal and dentoalveolar pattern between good result group and poor result group. In poor result group, maxilla was relatively downward and backward rotated, mandible was relatively backward rotated, upper incisor was in relatively lingual position, lower incisor was in relatively labial position.