Bimler bit shaper

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The denture shaper according to Hans Peter Bimler is a functional orthodontic brace , which is characterized by a particularly delicate and flexible construction. The spring action of the denture former lying loosely between all teeth stimulates the mouth muscles (so-called chewing gum effect). Among the functional orthodontic devices, it is also distinguished by the fact that it can correct not only the bite position, but also misalignments of teeth using the strength of the oral muscles. This will avoid pain from the treatment. Its skeleton design hardly restricts the remineralization of the teeth by the saliva circulation, so that it is also suitable for periodontally damaged patients or those with an increased risk of tooth decay. Instead of the average values ​​of an ideal of beauty, the Bimler therapy aims to allow the patient's jaw and dental arches to mature into an individual shape and size with healthy functions that fits the face and remains stable in the long term. This is documented by follow-up examinations of patients after 25 to 40 years and is justified with a self-regulation that the Bimler denture shaper enables the chewing organ to do. Using dental measurement points, Bimler recorded growth curves for his patients that show the shape of the dental arches prior to and during the course of therapy. The comparison of otherwise similar cases with and without a lack of space showed that the denture shaper activates self-healing powers to stimulate growth when there is a lack of space. B. made it possible to increase the width of both jaws by 6 mm. If there was no lack of space, a similar type of denture former did not stimulate jaw growth.

historical development

After the war, Bimler first worked as an ENT doctor and then completed additional dental training in order to dedicate himself to orthodontics. With the meager resources of the post-war period, he constructed the denture formers, because he found activators too voluminous and too rigid and the band-and-arch designs of fixed braces too dangerous and too expensive. In the diagnostic field, he developed a compact cephalometric analysis in order to interpret the different rapid treatment progress of his patients and to enable treatment prognoses . The structure of the facial skull is examined in the X-ray image and in particular the inclination of the jaw is related to the inclination of the floor of the nose. If the Bimler therapy is carried out on time, it also normalizes unfavorable vertical facial growth, with or without an open bite . Instead of the more drastic methods that are common today, such patients with denture shapers only need more time than patients with the more frequent horizontal facial growth. Nevertheless, the Bimler therapy has become a niche method and is now used e.g. B. still practiced in South America, Cuba and occasionally in Japan. Bionators are better known in Germany in holistic orthodontics .

Application, modifications

Wire parts of a Bimler-A basic device
Bimler-A basic device, without additional springs

Because the resilient denture formers act like a massage on the tooth retaining tissue, it is usually sufficient to only wear them at night. Bimler's contemporary Hugo Stockfisch recommended that his more voluminous, partially elastic Kinetor should be worn at night and 2-3 hours during the day. The health effect of the denture shapers is similar to that of the function regulator . Both can leave space for the wisdom teeth with early application , but denture shapers can be equipped with additional elements such as B. better design finger springs for tooth corrections. In contrast to active plates or Crozat devices , however, they are not suitable against the expenditure of entire groups of teeth. The recording of growth curves can be used in late cases with crowding in order to decide individually whether enough jaw growth can be stimulated or whether extractions are indicated for a stable result. The Bimler-Extra variants designed for such cases can also be used against non-investment gaps .

The basic device of the Bimler A series , which would be suitable for 90% of children's treatments, looks complicated, but consists of 3 upper and 2 lower wire elements, which are held together in 2 upper plastic wings and a lower, small sheet metal rail called a cap. The upper elements correspond to those of the elastic-open activator (EOA) according to Klammt: a circumferential labial arch, a thicker Coffin spring that connects the wings, and a thinner pair of springs behind the incisors. A pair of lower jaw half-arches emerge from the wings, which cross the dental arch after a loop and open into the cap, which is filled with plastic. The coping also holds the thin lingual loop behind the lower incisors. All elements are available pre-formed in several sizes. With this equipment, the upper dental arch can be influenced from the inside and outside and the lower from the inside, and the lower jaw part can be gradually bent forward against backbite positions. Additional springs z. B. to classify canines or to close the diastema can be added. If the jaw is tight, a variant is recommended that contains an expansion screw instead of the Coffin spring. If the jaw width is sufficient, it should be replaced by a Coffin pen, as this is more beneficial for self-regulation and stability of the result.

In contrast, the Bimler-B device is designed for the treatment of cover bites in the permanent dentition and always requires a screw. This makes it more rigid in order to withstand the considerable biting force and to convert it effectively into protrusion of the upper jaw and intrusion of both jaw fronts. For this purpose, the labial arch of the B device is folded in such a way that it replaces the weak lingual springs as an elongated arch. At the same time, the patient bites the coping with the upper incisors and the front part of the extensor arch with the lower incisors. A piece of silicone hose can be pulled onto it for better effect. Although the tolerances for a successful adjustment are tight with the B device, it was known in the GDR for covering bite treatment in adults. In mixed dentition, cover bites also respond to A devices, which are easier to use.

Bimler-C device (progeny device)

The Bimler-C devices are intended against progeny , and because of the different chewing motor skills of progenics, they are also designed to implement increased vertical forces. They can already be used in the primary dentition and instead of the labial arch they have an opposing arch. At the bottom they do not have a cap, but the lower jaw arches are connected by a miniaturized tongue grid. In addition, molar supports block the bite so that a frontal cross bite can be transferred. Until this is achieved, C-devices have to be worn full-time, with patients even noticing an uncomfortable feeling in the temporomandibular joints when taking the device off. These prognostic devices also train the masticatory muscles, which stabilizes the result.

Overall, pure Bimler therapies can be viewed as low-intensity orthodontic treatments. Because they often get by with long control intervals and only 1 or 2 of these devices that grow with them, as it were, whereby the transition to the retention phase is fluid.

From the upper part of the Bimler A device and the lower part of the more stable U-bracket activator according to Karwetzky , the Maxillator according to Hangl was later developed.

Individual evidence

  1. ↑ Bimler, HP (1984): The cross-system indication of elastic dentition shapers. Progress Orthodontist. 45: 33-44
  2. ↑ Bimler, AB (2004): The denture former and the X-ray evaluation according to Dr. med. Bimler. Quintessenz Zahntech 30: 419 - 23
  3. ↑ Bimler, AB (1998): The Bimler cover bite apparatus (type B). Quintessenz Zahntech 24: 1151-60
  4. ↑ Bimler, HP (1979): Progeny treatment with denture formers. Progress Orthodontist. 40: 485-93

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