Case report – distoclusion treated with Bimler A períod of 12 months

Abstract

The Bimler type A utilizes forces derived from muscles, particularly the tongue, concomitantly, it acts as a systemic, dynamic and functional treatment, Bimler appliances transmit neural excitation throughout the system. The objective of this study was to present a clinical case and demonstrate the efficacy of the functional orthopedic appliance, specifically the Bimler A elastic modeler, in the treatment of a patient diagnosed with distoclusion (prognathism of the maxilla and retrognathism of the mandible) according to Bimler and McNamara cephalometry. The case involved a 9-year and 11-month-old male patient with atypical swallowing, respiratory issues, and allergic conditions such as asthma. Clinical examination and complementary tests revealed a large overjet, a narrow maxilla and mandible, an open bite, and distoclusion (retrognathism). The proposed intervention included the installation of the Bimler Elastic Modeler (BEM), type A. The treatment duration was 12 months, with ongoing monitoring every 2 or 3 months. The comprehensive approach, combining BEM type A, chewing exercises, and occlusal adjustments, resulted in orthopedic changes improved mandibular, tongue, lip, and head posture, as well as enhanced chewing balance. Importantly, the appliance effectively repositioned the mandible into a more balanced, normoccluded position without the need for elastic or constant forces. Beyond the orthodontic changes, the active engagement of facial expression muscles during these activities contributed to an overall improvement in facial harmony, achieving lip seal and notable enhancements in breathing. These positive changes extended to the patient’s daily activities and sports performance. The observed outcomes not only increased the child’s active participation in the treatment but also positively impacted self-esteem, driven by the aesthetic, functional, and psychological improvements experienced.