History of Dental Orthopedics:
If I may paraphrase Sir Isaac Newton, “ Progress can only be made when great men(dentists) stand on the shoulders of the giants before them.”
The clinical use of “plates “ in orthodontics dates back to 1879, by Dr. Norman Kingsley, with his “bite-jumping appliance”. Kingsley did not wish to protrude the lower teeth with this plate, but stimulate mandibular growth instead. This early appliance, created by Kingsley, is considered by some experts to be one of the first prototypes of functional oral appliance.
Later, in the early 1900’s various other professionals would create their own versions of the functional oral appliance. In 1902, Dr. Pierre Robin used the “Monobloc” to treat his patients’ malocclusions; that were diagnosed with glossoptosis syndrome (now referred to as Pierre Robin syndrome). However, unlike Dr. Robin’s purposeful treatments of malocclusion, Dr. Viggo Andresen, a general dentist from Denmark, serendipitously discovered he could stimulate growth in his patients’ mandible with extended use of a temporary “plate”. Dr. Andresen later attempted to treat his own daughter’s malocclusion with a Hawely appliance and succeeded. Later, Dr. Andresen moved to Oslo, Norway to team up with Dr. Haupl. Dr. Haulp’s theory of dental orthopedics was influenced by Wilhem Roux’s theory of functional adaptation. Together, in 1936, both Dr. Andresen and Dr. Haupl, created the “Norwegian system” to help correct class II malocclusions. Similarly to Dr. Andresen’s accidental discovery of functional orthopedics, in 1938, Dr. Bimler, a surgeon treating jaw injuries in WWII, discovered that some of his patients who developed scar tissue after surgery would actually have an increase in mandibular width. Dr. Bimler finally deduced that the scar tissue was actually creating tension in the lateral direction and stimulating growth of the mandible, however, it wasn’t until in 1949 when he finalized the “Bimler” oral appliance.
Unfortunately, in 1939, after WWII broke out, most of the scientific research being performed in Europe came to a halt. It wasn’t until years later and after the war ended did research on functional oral appliances start to regain some momentum.
In 1950, Dr .Wilhelm Balters created the “Bionator” which was a modification of Dr. Andresen’s earlier functional oral appliance. Moreover, around this time period, Dr. Schwarz designed the “Double Plate” which resembled the “Monobloc”, but was in two pieces instead of one. In 1957, Professor Rolf Frankel created the “functional regulators” a system of oral functional appliances to correct all types of malocclusion. Later, research by Dr. Moyer and Dr. McNamara at the Univesity of Michigan and Dr. Petrovic and Stutzmann of Strasbourg brought on a collaborative effort between the European and American philosophies and theoretical backgrounds of functional jaw orthopedics. In the 1970’s and 80’s Dr. William Clark created the “twin block appliance” and Dr. John Mew created the “Biobloc” therapy and the concept of orthotropics, both appliances focus on stimulating growth in the mandible.
The goal of this short piece on the history of dental orthopedics is by no means an exhaustive analysis of the evolution of oral functional appliances, but a primer for the curious dentist who wishes to step outside the mainstream paradigm of dentistry and view our modern problems of malocculsion through a different lens.
Onward and forward,
Vincent Buscemi; Dental Student
Haupl, Karl. Textbook of functional jaw orthopaedics. American Journal of Orthodontics. Volume 42, issue 7, July 1956 pages 553-554.
Mew, John. Bioblock Therapy. American Journal of orthodontics. Vol 76, Issue 1. 1979. Pages 29-50.
Schmuth, Gottfriend. Milestones in the development and practical application of functional appliances. American Journal of Orthodontics. Volume 84. Issue 1. July 1983. Pages 48-53
Wahl, Norman. Orthodontics in 3 millennia. Chapter 9:Functional appliances to midcentury. American Journal of orthodontics and Dentofacial orthopedics. Volume 129, Issue 6 June 2006. Pages 829-833