Conventional orthodontics utilize fixed braces such as brackets and bands. Often rubber bands and other force systems (neckgears, springs, etc.) are then attached to the braces to effectively move or direct the teeth and/or jaws to the desired position(s). There are those patients who have problems that primarily involve the jaws where conventional braces may not be adequate to correct the bite. In these instances, orthodontists utilize other force systems to promote an increase in jaw growth that would not ordinarily occur with fixed appliances alone. These removable appliances are called "functional appliances."
One type of functional appliance that has been used in our office for years is the Bionator. There are other types (the Twin Block, the Frankel, the Herbst, etc.) that also may be used, all with different treatment goals and varying degrees of success. Bionators are used primarily for those patients who have a short lower jaw, excessive deep bite, or both. Bionators are usually adjusted every 2-3 months and are worn 20 hours per day for 6-18 months. As treatment success progresses, the hours per day are reduced. Speech is influenced initially, however, after a week, speech will greatly improve. The appliance is removable and is removed when playing sports, musical instruments, brushing, eating, etc.
Often, our office will place a Bionator in combination with a neckgear. Both types of appliances are utilized in skeletally deficient lower jaw cases effectively promoting a more balanced upper and lower jaw relationship. Bionators are worn prior to full braces in order to address the skeletal deficiency first. They are most effective during the greatest growth period for children (9-12 years old). Following the improvement of the skeletal discrepancy, comprehensive orthodontics will be initiated.