Biobloc
Biobloc is a type of orthodontic appliance used to posture forward the lower jaw. There are many other types of appliances such as Twin blocs, Frankels, Bionators, Twin force bite correctors, class II elastics and others, which attempt to do the same thing, but these other appliances exert a backward force or headgear effect on the growing maxilla. The result is an increase in the overall length of the front teeth and restriction of maxillary forward growth.The main reason these other appliances do not achieve what the Biobloc therapy achieves is the fact that Biobloc therapy is based around the "fixing" of the environmental problems that have reduced or stalled or distorted the genetic potential of the patients growth, and such is termed "growth guidance" In particular the biobloc stage three is not a functional orthopeadic appliance like the other appliances mentioned in this descriptor; rather it is a therapeutic appliance specifically designed to get the tongue posture and function back into harmony with the other facial and masticatory muscles so that the result- a more attractive and correct face and dentition and posture- is going to remain after treatment has finished.
The Biobloc accomplishes forward positioning without adverse side effects by the use of flanges which do not touch the patient's tissue unless they posture their lower jaw open or back. The Biobloc is best used during the mixed dentition when growth is still available. For this reason, the Biobloc is primarily used on children between six and ten years of age. It can be used with any dental class and by combining it with a technique that includes extraction of the primary C, D and E teeth, and can close the bite in such a way that only surgery could accomplish for an adult.
Biobloc was first used by Dr. John Mew. His research into the subject revealed that the position of the jaw is influenced by tropic factors. Using proper posture of the mandible could guide the jaws to grow their proper form. Further, tropic factors are the cause of malocclusion.
Biobloc Orthotropics® is both a philosophy and technique of developing both the upper and lower jaws forward. It has scientifically been shown to convert unfavorable vertical facial growth to more favorable horizontal facial growth1 and improve the airway2. Biobloc Orthotropics® has also been shown to produce more balanced faces than traditional orthodontics3.
Traditional orthodontics focuses largely on retractive (pulling teeth back in the face) mechanics and assumes that upper teeth often protrude in the face (buck teeth) even when studies have been published in the refereed literature that true protrusion of upper teeth is relatively rare4. Traditional orthodontics uses headgears, extractions, and temporary anchorage devices to largely retract teeth in the face. Such treatment can easily compromise the tongue space and airway with a possible outcome of Obstructive Sleep Apnea if the airway is compromised enough. It is impossible to predict at what point OSA will occur. Esthetically the result can be patients with flat cheeks, long faces, large nose-lip angles, weak chins, and substantial strain needed to approximate the lips.
A challenge to traditional orthodontic retractive mechanics came in the 1980s with so called "functional appliances" which were purported to "grow the mandible forward". Among the appliances which were part of this movement were Bionators, Orthopedic Correctors, Twin-Blocks, Herbst, Jasper Jumper, Twin Force Bite Correctors, MARA, Frankel, etc. Such appliances are all tooth borne and pit the lower jaw against the upper jaw with mechanical connections of upper teeth to lower teeth. The muscles of the lower jaw pull back, transmit that force to the upper teeth through the appliances, and the upper teeth retract back in the face (headgear effect). The result is a "moderate midfacial dentoalveolar retrusion"5 with both traditional orthodontics and so called "functional appliances".
Biobloc Orthotropics® recognizes that malocclusion is just one of many things which occurs secondary to altered rest position of the mandible, tongue, and lips. The face falls back with all malocclusions, and this has been documented6 and described for over 100 years7,8,9. Biobloc Orthotropics® develops the upper jaw properly and advances the upper teeth forward in the face where they were meant to be.
Advancing the upper front teeth often 8–10 mm. is the first of two major differences between this type of treatment and all other forms of orthodontic treatment. A removable appliance is used to simultaneously expand (laterally) and advance (forward) the upper front teeth.
When the upper jaw is properly developed an appliance to remind the patient to posture the lower jaw forward is used. (This appliance is a Stage III Biobloc which is a postural appliance whose goal is to produce proper rest oral posture.) The patient is taught to keep their teeth together, tongue to the palate, and lips together at rest. This appliance is attached to the upper teeth and engages the lower jaw with guides (flanges) which extend downward to the floor of the mouth. These guides are adjusted so that any pulling back of the lower jaw will result in an uncomfortable sensation to the soft tissue on the floor of the mouth. This keeps the patient from letting their lower jaw fall back and it eliminates the headgear (retractive) effect of other appliance systems. These guides touching the soft tissue prevent pitting the upper and lower jaws against each other. This is the second major difference between Biobloc Orthotropics® and all other forms of orthodontic treatment.
Once the patient has learned to keep their teeth together, tongue to the roof of the mouth, and lips together at rest with the help of the Stage III Biobloc appliance they taper back from full-time wear and the correction becomes permanent. The future growth of their entire lower face is more forward and toward their genetic potential for ideal growth. Their reward is fuller cheeks, a better nose-lip angle, proper vermilion border of the lips, proper lower face height, a nicer profile, and probably an improved airway.
Biobloc Orthotropics® was developed by Dr. John Mew. His research into the subject revealed that the position of the jaws is influenced by tropic factors. He has put forth the "tropic premise" which states, "If the tongue rests against the palate with the lips in contact and the teeth together for between 4 and 8 hours a day then the facial and dental appearance will be ideal."
Therefore, the goal of Biobloc Orthotropics® is to establish proper rest oral posture which features :
1. Teeth together lightly 2. Tongue to the palate with the tip behind the upper incisor teeth 3. Lips together without strain.
The success of Biobloc Orthotropics® depends almost entirely on the cooperation of the patient in the effort to permanently change their rest oral posture.
The goals of Biobloc Orthotropics® are different than traditional orthodontics. The process of Biobloc Orthotropics® is much different and much more dependent on patient compliance than traditional orthodontics. And the results of Biobloc Orthotropics® (more balanced faces, improved proper oral posture, and enhanced airways) are much different than traditional orthodontics.
Singh GD, Medina LE, Hang WM (2009). "<!Soft Tissue Facial Changes Using Biobloc Appliances: Geometric Morphometrics.>". International Journal of Orthodontic. 20-2:29-34.CS1 maint: Multiple names: authors list (link) :
Singh GD, Medina LE, Hang WM (April 2007). "Evaluation of the Posterior Airway Space Following Biobloc Therapy: Geometric Morphometrics". Journal of Craniomandibular Practice. 25 (2): 84–89.CS1 maint: Multiple names: authors list (link)
Mew J. (2007). "Facial Changes in Identical Twins Treated by Different Orthodontic Techniques". World Journal of Orthodontics. 8 (2): 174–188.
McNamara, JA (1981). "Components of Class II Malocclusion in Children 8-10 Years of Age". Angle Orthodontist. 51: 177–202.
Johnston, L (1999). "Growing Jaws for Fun and Profit: A Modest Proposal". Craniofacial Growth Series. 35. Center for Human Growth and Development, U of Mich.
Mew J (1986). "Biobloc".
Catlin, G. (1891). "Shut Your Mouth and Save Your Life".
Price, W. (1939). "Nutrition and Physical Degeneration".
Corruccini, R. (1999). "How Anthropology Informs the Orthodontic Diagnosis of Malocclusion's Causes".
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