Treatment of angle class II malocclusions with a newly modified bionator combined with headgear

The bionator is one of the most commonly used functional appliances in treating Angle Class II division 1 malocclusions. However, the original type of bionator often causes lower incisor flaring and is limited in cases with mild crowding. There is little published literature on treating Angle Class II division 2 malocclusions using bionators. Our group suggested some modifications to the original-type bionator, including addition of an anterior resin cap, upper and lower labial bows, an expansion screw and a posterior resin wedge, to attempt to overcome limitations of the original design. This article shows our results on two male patients, one with an Angle Class II division 1 malocclusion with a large overjet and the other with an Angle Class II division 2 malocclusion. The treatment was completed using a newly modified bionator with no other fixed appliance and resulted in a decrease in facial convexity, a reduced overjet and overbite, ideal interincisal relationships, and a harmonious profile.