America's Dental Bookstore

(for instructions on using this site, see our home page)

Return to Shopping Cart

America's Dental Bookstore

Dental Books
Anatomy Books Anesthesia & Sedation BooksBehavior of Patients
Clinical Dentistry & Treatment PlanningCosmetic Dentistry BooksDental Assisting Books
Dental EmergenciesDental Hygiene BooksDental MaterialsEndodontics
Fixed ProsthodonticsHistory of DentistryHumor ImplantologyLaboratory Technology
MicrobiologyOcclusion & TMJ BooksOral BiologyOral Pathology & Oral Medicine
Oral PhysiologyOral SurgeryOrthodonticsPediatric DentistryPeriodontics & Prevention
PharmacologyPractice ManagementPractice Mgmt. Finance & Regulations
Practice Mgmt. MarketingPractice Mgmt. TheoryPsychology & Patient AnxietyRadiology
Removable ProsthodonticsRestorative DentistryTest Preparation Books

Consumer Information Books
Amalgam & MercuryBraces Children's BooksGeneral Care & Misc. Books
Consumer Information About Cosmetic DentistryDental Articles

The Masters of Functional Orthodontics

“It is only fitting, as we enter a new millennium, that we call attention to an aspect of orthodontics that has been buried under the onslaught of brackets, bands, exotic wires, efficient bonding media, and hoopla about how efficient these devices are. . . . The book is a treasure trove of information and historically based, time-tested, and proven techniques by world-class authors and clinicians . . . [and] makes it abundantly clear that it is from the past that we learn much about the present and the future of our specialty.”

—From the Foreword by Thomas M. Graber, editor-in-chief, World Journal of Orthodontics


Presentation by Prof Guiseppe Armocida
Foreword by Dr Hans Peter Bimler
“Review and Outlook on Orthodontics” by Dr Hans Peter Bimler
Foreword by Dr Thomas M. Graber
Chapter 1 The Road to Discovery: Milestones in History
Chapter 2 Dentistry, Orthodontics, and the First Concepts of Functional Therapy
2.1 From Ancient Times to the Middle Ages
2.2 The Middle Ages to the 1700s: Pierre Fauchard, Le Chirurgien Dentiste
2.3 The 19th Century: The Birth of Scientific Orthodontics and the Discovery of Rubber
2.4 Edward H. Angle: A Great Turn-of-the-Century Teacher
Chapter 3 The Advent of Functionalism: From the Pioneers’ Ideas to the 20th Century Masters
3.1 The Origins of Functional Orthopedics: The Pioneering Years
3.2 Myofunctional Therapy
3.3 Pierre Robin (1867–1950): Dentofacial Orthopedics and the Eumorphic Method
3.4 The Golden Years: From Pre–World War II, to the Postwar Years, to the 1960s: Andresen, Häupl, Muzj, Bimler, Balters, Klammt, Fränkel, Stockfisch, and Hoffer
3.5 The Contemporary Period
Chapter 4 The Masters of Functional Therapy
4.1 Viggo Andresen
4.2 Hans Peter Bimler
4.3 Wilhelm Balters
4.4 Georg Klammt
4.5 Rolf Fränkel
4.6 Hugo Stockfisch
4.7 Edmondo Muzj
4.8 Oscar Hoffer
Chapter 5 Functional Orthopedics and Prospects for the 21st Century: A Look at the Future
Index of Names


“Form follows function.”
— Frank Lloyd Wright

This well-known aphorism could not help but relate to a highly biologic discipline which, during therapy, has an important traveling companion: growth. Functional orthopedics differs from other branches of orthodontics in various and specific ways: from the etiologic bases of malocclusions to their diagnosis, from the age of the patient to the techniques used. Basically, the characteristic that distinguishes functional orthopedics is the maximum attention it focuses on growth factors and the development of osseous bases and their related neuromuscular structures. Therefore, we can properly speak of functional orthopedics to delineate its specific field of action. The presence of correct maxillomandibular relations and the optimal arrangement of dental elements in the arch are the result of a balanced combination of many factors, natural and environmental.

A rather important role is played by the neuromuscular complex of the stomatognathic system, which is heavily responsible for the adequate development of the osseous bases. In turn, these bases are fundamental to achieving the correct dental-occlusal relations. The health of the dental-maxillofacial complex thus originates in the delicate, early stages of growth and development; it is in this sphere that functional orthopedics acts.

Functional orthodontic therapy was born between the end of the 19th century and the start of the 20th century. Especially in Europe, functionalist schools and philosophies grew and flourished, and even today research in this field never ceases to make further progress and discoveries. More than a century from its origin, the ideas, developments, and prospects of this fascinating discipline are recorded in a single work that recognizes its maturity and scientific basis. The Masters of Functional Orthodontics describes the broad therapeutic potential of this discipline, in part through a critical review of its history, from birth to the present day. The special design of the book, from the sequence of its chapters to its illustrations and layout, is intended as a further stimulus to learn more about this interesting and up-to-date orthodontic discipline.

There are many purposes of orthognathodontics, one of the newest dental therapy specialties and one that, like other relatively new branches of medicine, is destined for further development and scientific progress. To understand the sphere of action of orthognathodontics in its entirety and complexity, it helps to analyze the Greek etymology from which it derives: orthos, straight; gnathos, jaw; and odontos, tooth. From this relationship emerges considerations of extreme importance: If the ultimate aim is a regular arrangement of the dental elements, with precise intra-arch and interarch relations, we must absolutely not neglect the basic concept in which each individual dental element should be considered within the global dental-maxillofacial complex. Often, for practical reasons, the terms orthodontics and orthognathodontics are used interchangeably. Without detracting value from the term orthodontics, the term orthognathodontics is preferable, because there are many reasons for considering dental elements and arches as part of the broader and more complex system that is the stomatognathic apparatus. This reflection is a dutiful one: It is indisputable that tooth arrangement and maxillomandibular relations are influenced by supplementary factors, such as the size and position of the osseous bases, muscle development and activity, and the function and parafunction of each individual.

This point shows that the orthodontist—or better, the orthognathodontist—must have in-depth knowledge of the dental-maxillofacial complex, which ranges from embryology to histology, anatomy, biology, physiology, pathology, and therapy and includes sufficiently solid knowledge of pediatrics, otorhinolaryngology, auxology, anthropology, and, considering the young age of patients, some fundamentals of child psychology.

The purpose of orthognathodontics is therefore to achieve correct occlusion, optimal mastication and speech, and a satisfactory esthetic appearance. After stressing the importance that anatomic and functional factors have on the arrangement of teeth in the dental arch, the follower of orthognathodontics is perfectly aware that the goal of correct occlusion can be reached not only through strictly dental factors but also through other variables, the so-called functional variables. The orthognathodontist therefore can work not only in the mechanistic sense of correcting dental irregularities within the narrow context of the arches but also in a broader sense: on the osseous bases, which influence interarch relations, and on muscle functioning, of great importance in the development and spatial positioning of the jawbones themselves. Essentially, treatment can be dual: On the one hand, dysgnathia can be corrected by regularizing intra-arch and interarch dental relations; in this case, the work is limited to the anatomic sphere of the alveolar space, although doubtless there are also repercussions on the reciprocal spatial relations of the osseous bases. On the other hand, the therapy’s field of action also encompasses extradental spaces and tissues: the oral cavity proper, the vestibule of the mouth, and the extraoral zones. This is where functional orthopedics works. Therefore, we can intuit how the goals of orthognathodontics can be basically reached through two approaches: a mechanistic type that essentially acts on individual teeth and the arches and a functional type that acts primarily on bone and muscle structure, that is, on the individual’s function and parafunction. This distinction in therapeutic approach is not meant to imply a hierarchy of values between mechanical and functional orthodontics but rather to show how closely they complement one another. The purpose of these reflections is to be able to establish that the “mechanistic” orthodontist is —without forcing the definition too much—a “functionalist”. If, in this treatise covering the history of orthognathodontics from its dawn to the official birth of functional orthopedics, we were to discover that functional concepts were already present in work by authors classically defined as “mechanistic,” then we could fairly confidently state that, even with their specific differences and particularities, the divergence in the two trends was not so very great. To facilitate our task, a clear definition of functional orthopedics is needed, to give us a precise key for interpreting, from the functional standpoint, the attempts, successes, and failures of the early orthognathodontic scholars.

The principle inspiring functional orthopedics came from new assumptions in the study of the genesis of dysgnathia: Great importance was given to purely myodynamic factors in the development of the stomatognathic apparatus (referring to the influence intraoral and perioral musculature has on skeleton growth). A necessary condition for optimal dental arrangement is an equally correct relation of the osseous bases, both in the purely dimensional sense and in terms of the reciprocal relations between maxilla and mandible in the three planes of space.

We can intuit that the ultimate aim of functional orthopedics is to restore correct function during the age of development: This concept is well expressed by Eschler’s aphorism, “Modify the function to restore the shape.” Nonetheless, in the sphere of diagnostics, the functional approach has always existed. In fact, viewing myodynamic factors as responsible for malocclusions was, and is, a common heritage of both the mechanistic and the functional schools, although they differed in their more strictly therapeutic approaches. It was only in much more recent times that we witnessed the birth and official development of functional orthopedics as an operative and applicative technique. The spread of this method in Europe, spurred by the validity of its diagnostic assumptions and clear therapeutic results, in fact dates from the start of the last century, an epoch in which classic American orthodontists had already dictated the fundamental criteria for orthognathodontic treatment.

We shall now take a look at the differences (not the similarities) between the functional and the mechanistic schools. Basically, they consist of the corrective devices used and, as a consequence, the age of treatment. The forces used in mechanical orthodontics originate in purely mechanical appliances: arches, springs, bindings, and screws, devices made in the laboratory, while functional orthopedics originates from sources intrinsic to the body: muscle activity, structure, and tone. However, we should not forget how the action of mechanical devices can, in reality, activate important functional reactions, favoring corrective input and preventing negative situations, and how, vice versa, functional appliances with particular construction specifications act more closely on dentition, the skeleton, and the muscles themselves.

In even more general terms, it should be reiterated that, even making use of fixed appliances, today’s expert orthodontist thinks of the functional elements from the diagnostic as well as the therapeutic standpoint, considering broadly and with every means everything—development, growth, musculature, soft tissues, and joints—that is involved with and accompanies every dental movement.

It is therefore our opinion that, at the present time, differentiating between the two techniques is relevant only for nosographic-classificatory and historical purposes. This differentiation is significant only organizationally and for systematic grouping.

In the course of our study, we will try to identify the “functional” aspects of the history of orthognathodontics and to show that functional orthopedics has always existed, developed, and progressed in step with orthognathodontics as a whole.

Aurelio Levrini and Lorenzo Favero