ORIGINAL ARTICLE

 

Longitudinal study on skeletal changes during and after bionator therapy using metallic implants

 

 

André da Costa Monini^I; Luiz Gonzaga Gandini Júnior^II; Lídia Parsekian Martins^III; Dirceu Barnabé Raveli^III

^IDDS, MS. Graduate student, Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University, Brazil
^IIDDS, MS, Ph D., Professor, Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University, Brazil; Adjunct Clinical Professor, Baylor College of Dentistry, Dallas, TX, USA and Saint Louis University, Saint Louis, MO, USA
^IIIDDS, MS, Ph D. Professor, Department of Orthodontics and Pediatric Dentistry, Araraquara Dental School, São Paulo State University, Brazil

Correspondence

 

 

---

ABSTRACT

AIM: To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations.
METHODS: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2.
RESULTS: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction.
CONCLUSIONS: The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation.

Keywords: Angle's class II malocclusion, activator appliances, maxillofacial development.

---

 

 

Full text available only in PDF format.

 

 

References

1. McNamara Jr JA. Components of Class II malocclusion in children 8-10 years of age. Angle Orthod. 1981; 51: 177-202.         [ Links ]

2. Araújo AM, Buschang PH, Melo ACM. Adaptive condylar growth and mandibular remodelling changes with Bionator therapy -an implant study. Eur J Orthod. 2004; 26: 515-22.         [ Links ]

3. Croft RS, Buschang PH, English JD, Meyer R. A cephalometric and tomographic evaluation of Herbst treatment in the mixed dentition. Am J Orthod Dentofacial Orthop. 1999; 116: 435-43.         [ Links ]

4. Faltin Jr K, Faltin RM, Baccetti T, Franchi L, Ghiozzi B, McNamara Jr JA. Long-term effectiveness and treatment timing for bionator therapy. Angle Orthod. 2003; 73: 221-30.         [ Links ]

5. Pancherz H, Fischer S. Amount and direction of temporomandibular joint growth changes in Herbst treatment: a cephalometric long-term investigation. Angle Orthod. 2003; 73: 493-501.         [ Links ]

6. Pancherz H, Ruf S, Kohlhas P. "Effective condylar growth" and chin position changes in Herbst treatment: a cephalometric roentgenographic long-term study. Am J Orthod Dentofacial Orthop. 1998; 114: 437-46.         [ Links ]

7. Williams S, Melsen B. The interplay between sagittal and vertical growth factors. An implant study of activator treatment. Am J Orthod. 1982; 81: 327-32.         [ Links ]

8. Melo ACM, Santos-Pinto A, Martins JCR, Martins LP, Sakima MT. Orthopedic and orthodontic components of class II, division 1 malocclusion correction with Balters bionator: cephalometric study with metallic implants. World J Orthod. 2003; 4: 237-42.         [ Links ]

9. Björk A, Skieller V. Facial development and tooth eruption. Am J Orthod. 1972; 62: 339-83.         [ Links ]

10. Björk A, Skieller V. Growth of the maxilla in three dimensions as revealed radiographically by the implant method. Br J Orthod. 1977; 4: 53-64.         [ Links ]

11. Björk A, Skieller V. Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod. 1983; 5: 1-46.         [ Links ]

12. Björk A. Facial growth in man, studied with the aid of metallic implants. Acta Odontol Scand. 1955; 13: 9-34.         [ Links ]

13. Björk A. Variations in growth pattern of the human mandible: Longitudinal radiographic study by the implant method. J Dent Res Suppl. 1963; 42: 400-11.         [ Links ]

14. Buschang PH, Gandini Jr LG. Mandibular skeletal growth and modeling between 10 and 15 years of age. Eur J Orthod. 2002; 24: 69-79.         [ Links ]

15. Gasson N, Lavergne J. Maxillary rotation during human growth: annual variation and correlations with mandibular rotation. A metal implant study. Acta Odontol Scand. 1977; 35: 13-21.         [ Links ]

16. Odegaard J. Mandibular rotation studied with the aid of metal implants. Am J Orthod. 1970; 58: 448-54.         [ Links ]

17. Melsen B. Effects of cervical anchorage during and after treatment: An implant study. Am J Orthod. 1978; 73: 526-40.         [ Links ]

18. Kim J, Nielsen IL. A longitudinal study of condylar growth and mandibular rotation in untreated subjects with class II malocclusion. Angle Orthod. 2002; 72; 105-11.         [ Links ]

19. Lavergne J, Gasson N. A metal implant study of mandibular rotation. Angle Orthod. 1976; 46: 144-50.         [ Links ]

20. Lee RS, Daniel FJ, Swartz M, Baumrind S,Korn EL. Assessment of method for prediction of mandibular rotation. Am J Orthod Dentofacial Orthop. 1987; 91: 395-402.         [ Links ]

21. Gu Y, McNamara Jr JA. Mandibular growth changes and cervical vertebral maturation: a cephalometric implant study. Angle Orthod. 2007; 77: 947-53.         [ Links ]

22. Gasson N, Lavergne J. The maxillary rotation: Its relation to the cranial base and the mandibular corpus.An implant study. Acta Odontol Scand. 1977; 35: 89-94.         [ Links ]

23. Doppel DM, Damon WM, Joondeph DR, Little RM. An investigation of maxillary superimposition techniques using metallic implants. Am J Orthod Dentofacial Orthop. 1994; 105: 161-8.         [ Links ]

24. Solow B, Iseri H. Maxillary growth revisited: An update based on recent implant studies. In: Davidovitch Z, Norton LA. Biological mechanisms of tooth movement and craniofacial adaptation. Boston: Harvard Society for the Advancement of Orthodontics; 1996. p.507-27.         [ Links ]

25. Baumrind S, Korn EL, Ben-Bassat Y, West EE. Quantitation of maxillary remodeling. 1.A description of osseous changes relative to superimposition on metallic implants. Am J Orthod Dentofacial Orthop. 1987; 91: 29-41.         [ Links ]

26. Baumrind S, Ben-Bassat Y, Korn EL, Bravo LA, Curry S. Mandibular remodeling measured on cephalograms. 1.Osseous changes relative to superimposition on metallic implants. Am J Orthod Dentofacial Orthop. 1992; 102: 134-42.         [ Links ]

 

 

Correspondence to:
Luiz Gonzaga Gandini Júnior
Av. Casemiro Perez, 560, Vila Harmonia
Araraquara, São Paulo, Brasil. CEP 14802-600
E-mail: luizgandini@uol.com.br

Received for publication: November 26, 2009
Accepted: March 8, 2010