Comparative Study of the Bionator and Multi. P Appliances in the Treatment of Class II Malocclusion: a Cephalometric Study

Morteza Oshagh, Mahtab Memarpour, Hooman Zarif Najafi, Somayeh Heidary

Background: Functional appliances such as Bionator have been used to treat Class II malocclusion. The purpose of this study was to compare the skeletal, dental and soft tissue effects of Bionator appliances with Multi-P (a newly developed appliance) in the treatment of Class II malocclusion.

Subjects and methods: 45 class II children were chosen and randomly assigned to either the Bionator or Multi-P treatment group. After excluding 13 patients from the study, 21 patients in Bionator and 11 patients in Multi-P group have participated in the study. Lateral cephalograms were analyzed at the beginning (To) and at the end of treatment (T1) to evaluate the changes in both groups. The paired t.test and Leven’s test were enrolled for statistical analysis.

Results: Reduction of ANB angle was detected in both treatment groups. The Bionator group underwent insignificant greater mandibular advancement as measured by the SNB angle. (p= 0.737) The mandibular plane angle increased insignificantly in both groups. (p> 0.05) The inclination of upper incisors decreased significantly in Multi-P group. (p= 0.042)

Conclusion: Both appliances are effective therapeutic means for class II treatment associated with mandibular deficiency and may lead to normalization of the dentoskeletal parameters at the end of the treatment.
Bionator; Multi-P; Class II malocclusion;Cephalometric trial

MiguelI JA, CunhaII DL, Calheiros AA, KooII D. Rationale for referring class II patients for early orthodontic treatment. J Appl Oral Sci. 2005;13(3):312-7.

Read MJ. The integration of functional and fixed appliance treatment. J Orthod. 2001;28(1):13-8.

Martins RP, da Rosa Martins JC, Martins LP, Buschang PH. Skeletal and dental components of Class II correction with the bionator and removable headgear splint appliances. Am J Orthod Dentofacial Orthop. 2008;134(6):732-41.

Malta LA, Baccetti T, Franchi L, Faltin K Jr, McNamara JA Jr. Long-term dentoskeletal effects and facial profile changes induced by bionator therapy. Angle Orthod. 2010;80(1):10-7.

Ahn SJ, Kim JT, Nahm DS. Cephalometric markers to consider in the treatment of Class II Division 1 malocclusion with the Bionator. Am J Orthod Dentofacial Orthop. 2001;119(6):578-86.

Kinzinger G, Frye L, Diedrich P. Class II treatment in adults: Comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery- A cephalometric study to evaluate various therapeutic effects. J Orofac Orthop. 2009;70(1):63-91.

Kinzinger G, Czapka K, Ludwig B, Glasl B, Gross U, Lisson J. Effects of fixed appliances in correcting Angle Class II on the depth of the posterior airway space: FMA vs. Herbst appliance--a retrospective cephalometric study. J Orofac Orthop. 2011;72(4):301-20.

Stec-Slonicz M, Weindel S, Paurevic S, Lisson JA. Arch changes after Class II, Division 1 treatment with jumping-the-bite appliances. J Orofac Orthop. 2008;69(5):373-82.

O'Brien K, Wright J, Conboy F, Chadwick S, Connolly I, Cook P, et al. Effectiveness of early orthodontic treatment with the Twin-block appliance: A multicenter, randomized, controlled trial. Part 2: Psychosocial effects. Am J Orthod Dentofacial Orthop. 2003;124(5):488-94.

Faltin KJ, Faltin RM, Baccetti T, Franchi L, Ghiozzi B, McNamara JA Jr. Long-term effectiveness and treatment timing for Bionator therapy. Angle Orthod. 2003;73(3):221-30.

Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. 4th ed. St. Louis: Mosby Inc; 2007. Chap 13. P. 512.

Almeida MR, Henriques JF, Almeida RR, Almeida-Pedrin RR, Ursi W. Treatment effects produced by the Bionator appliance. Comparison with an untreated Class II sample. Eur J Orthod. 2004;26(1):65-72.

Frye L, Diedrich PR, Kinzinger GS. Class II treatment with fixed functional orthodontic appliances before and after the pubertal growth peak - A cephalometric study to evaluate differential therapeutic effects. J Orofac Orthop. 2009;70(6):511-27. 14. Ren Y. Soft tissue changes inconclusive in Class II division 1 patients treated with Activator and Bionator appliances. Evid Based Dent. 2007; 8(2):49.

Flores-Mir C, Major PW. A systematic review of cephalometric facial soft tissue changes with the Activator and Bionator appliances in Class II division 1 subjects. Eur J Orthod. 2006; 28(6):586-93.

Araujo AM, Buschang PH, Melo AC. Adaptive condylar growth and mandibular remodelling changes with bionator therapy--an implant study. Eur J Orthod. 2004;26(5):515-22.

De Almeida MR, Henriques JF, Ursi W. Comparative study of the Fränkel (FR-2) and Bionator appliances in the treatment of Class II malocclusion. Am J Orthod Dentofacial Orthop. 2002;121(5):458-66.

Jena AK, Duggal R, Parkash H. Skeletal and dentoalveolar effects of Twin-block and Bionator appliances in the treatment of Class II malocclusion: A comparative study. Am J Orthod Dentofacial Orthop. 2006;130(5):594-602.

Multi-P Brochure. RMO Europe. Rocky Mountain Orthodontics. Available at: https://www.rmortho.com/products services /products /multi-p/

Janson GR, da Silva CC, Bergersen EO, Henriques JF, Pinzan A. Eruption Guidance Appliance effects in the treatment of Class II, Division 1 malocclusions. Am J Orthod Dentofacial Orthop. 2000;117(2):119-29.

Keski-Nisula K, Keski-Nisula L, Salo H, Voipio K, Varrela J. Dentofacial changes after orthodontic intervention with eruption guidance appliance in the early mixed dentition. Angle Orthod. 2008;78(2):324-31.

Keski-Nisula K, Hernesniemi R, Heiskanen M, Keski-Nisula L, Varrela J. Orthodontic intervention in the early mixed dentition: a prospective, controlled study on the effects of the eruption guidance appliance. Am J Orthod Dentofacial Orthop. 2008;133(2):254-60.

Tümer N, Gültan AS. Comparison of the effects of monoblock and twin-block appliances on the skeletal and dentoalveolar structures. Am J Orthod Dentofacial Orthop. 1999;116(4):460-8.

Baltromejus S, Ruf S, Pancherz H. Effective temporomandibular joint growth and chin position changes: Activator versus Herbst treatment. A cephalometric roentgenographic study. Eur J Orthod. 2002;24(6):627-37.

Rudzki-Janson I, Noachtar R. Functional appliance therapy with the Bionator. Semin Orthod. 1998;4:33–45.

Sidlauskas A. The effects of the Twin-block appliance treatment on the skeletal and dentolaveolar changes in Class II Division 1 malocclusion. Medicina (Kaunas). 2005;41(5):392-400.

Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA Jr. Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review. Am J Orthod Dentofacial Orthop. 2006;129(5):599.

Barnett GA, Higgins DW, Major PW, Flores-Mir C. Immediate skeletal and dentoalveolar effects of the crown- or banded type Herbst appliance on Class II division 1 malocclusion. Angle Orthod. 2008;78(2):361-9.

Janson GR, Toruño JL, Martins DR, Henriques JF, de Freitas MR. Class II treatment effects of the Fränkel appliance. Eur J Orthod. 2003;25(3):301-9.

Antonarakis GS, Kiliaridis S. Short-term anteroposterior treatment effects of functional appliances and extraoral traction on class II malocclusion. A meta-analysis. Angle Orthod. 2007;77(5):907-14.

Patel HP, Moseley HC, Noar JH. Cephalometric determinants of successful functional appliance therapy. Angle Orthod. 2002;72(5):410-7.

Aelbers CM, Dermaut LR. Orthopedics in orthodontics: Part I, Fiction or reality--a review of the literature. Am J Orthod Dentofacial Orthop. 1996;110(5):513-9.

Wadhawan N, Kumar S, Kharbanda OP, Duggal R, Sharma R. Temporomandibular joint adaptations following two-phase therapy: an MRI study. Orthod Craniofac Res. 2008;11(4):235-50.

Basciftci FA, Uysal T, Büyükerkmen A, Sari Z. The effects of activator treatment on the craniofacial structures of Class II division 1 patients. Eur J Orthod. 2003;25(1):87-93.

Sharma AA, Lee RT. Prospective clinical trial comparing the effects of conventional Twin-block and mini-block appliances: Part 2. Soft tissue changes. Am J Orthod Dentofacial Orthop. 2005;127(4):473-82.

Varlik SK, Gültan A, Tümer N. Comparison of the effects of Twin Block and activator treatment on the soft tissue profile. Eur J Orthod. 2008;30(2):128-34.

Kasai K. Soft tissue adaptability to hard tissues in facial profiles. Am J Orthod Dentofacial Orthop. 1998;113(6):674-84.

Ramos AL, Sakima MT, Pinto Ados S, Bowman SJ. Upper lip changes correlated to maxillary incisor retraction--a metallic implant study. Angle Orthod. 2005;75(4):499-505.

Baccetti T, Franchi L, Toth LR, McNamara JA Jr. Treatment timing for Twin-block therapy. Am J Orthod Dentofacial Orthop. 2000;118(2):159-70.

Schaefer AT, McNamara JA Jr, Franchi L, Baccetti T. A cephalometric comparison of treatment with the Twin-block and stainless steel crown Herbst appliances followed by fixed appliance therapy. Am J Orthod Dentofacial Orthop. 2004;126(1):7-15.

Bowman SJ, Johnston LE Jr. The esthetic impact of extraction and nonextraction treatments on Caucasian patients. Angle Orthod. 2000;70(1):3-10.

Refbacks

  • There are currently no refbacks.