The Bionator Appliance for Pediatric Sleep

The Bionator is a  removable orthodontic appliance that can  be used to treat overbites and improve teeth positions in patients with an underdeveloped lower jaw, patients with a deep bite and Class II malocclusion, retrognatic children.

 It's designed to be worn during a patient's growth phase, usually 12 to 16 hours a day, to help establish a more favorable jaw relationship. The bionator is most effective for patients aged seven years or older, and optimal results are obtained while the patient is still growing.

The appliance is designed to hold the mandible in a forward position using acrylic. An excellent designed  Bionator will have an acrylic ramp waxed into the lower so the teeth can hit it and slide forward into good cap. Screws can be added to provide transverse expansion, much like a Schwartz right on the midline. Facially-angled grooves are cut in the upper and lower of the posterior acrylic, helping to guide the eruption of the posterior teeth and correcting a deep bite. This function is selectively erupting posterior teeth while expanding the dental arches.

While the anterior teeth are covered with an acrylic cap, the posterior teeth remain uncovered. The maxillary incisors contact the acrylic cap on a flat plane. This prevents the anterior teeth from erupting incorrectly and also prevents the lower incisors from flaring, an effect that may occur when forces are exerted on the lower jaw.

Now remember the tongue has to be correctly positioned, there is no acrylic in the palatal area. The two sides of the appliance are joined using a  Trans-Palatal arch wire or omega loop coffin spring which is fitted across the palate to increase flexibility.  I have made them both ways and have never seen the difference.

Sagittal Screws can be added for lateral expansion but truth is I have never genuinely seen this this adaption work out or better off leaving them off the Bionator, I will note if you want the Sagittal Screws on the appliance, it is now called an Orthopedic Corrector and not a Bionator, but everything else remains the same.

I wrote this article because, just this week, I have already made six Bionators, and they are experiencing a significant resurgence. With the increased focus on pediatric sleep issues, the Bionator is becoming an increasingly relevant solution.

For more information please feel free to reach out to me at my Lab.

Gergens Orthodontics
623-879-6066