THERAPY OF SKELETAL OPEN BITE AND SKELETAL CLASS III USING BIONATOR ACCORDING TO BALTERS TYPE III

In the period of puberty growth spurt, functional therapy can be successfully performed using the Bionator according to Balters. This case report aims to show the successful treatment of a skeletally open bite and overbite in a 13- year-old girl. The clinical examination revealed an enlarged lower third of the face, an open bite in the area of the frontal teeth (1.5 mm), and occlusion of / class III. Analyzing the initial profile teleradiograph, she was diagnosed with skeletal class III (ANB= -2°), skeletal open bite (B= 31°)), increased corpus of the mandible (by 8 mm), and a tendency towards a vertical type of facial growth (Bjork=400°). Balters type III bionator was indicated. The active phase of therapy lasted 19 months. During this period, the patient wore the appliance continuously during the day and night. Control examinations were performed every 6 weeks. After finishing the active phase of therapy, the value of the ANB angle on the control profile teleradiograph was 1°, with the presence of a vertical growth tendency (Bjork= 402°) and an enlarged body of the mandible of 3.3 mm. Clinical examination revealed a stable Class I occlusion and a flap depth of 2 mm. A bionator according to Balters, is a tooth-worn functional appliance, that gives a successful therapeutic result by affecting the change in the position and activity of the tongue while suppressing the excessive sagittal growth of the lower jaw.