The present invention relates to methods and apparatus for orthodontics. More particularly, the present invention relates to methods and apparatus for orthodontic brackets which may also function as attachments to correcting malocclusions.
Orthodontics is a specialty of dentistry that is concerned with the study and treatment of malocclusions which can result from tooth irregularities, disproportionate facial skeleton relationships, or both. Orthodontics treats malocclusion through the displacement of teeth via bony remodeling and control and modification of facial growth.
This process has been traditionally accomplished by using static mechanical force to induce bone remodeling, thereby enabling teeth to move. In this approach, braces having an archwire interface with brackets are affixed to each tooth. As the teeth respond to the pressure applied via the archwire by shifting their positions, the wires are again tightened to apply additional pressure. This widely accepted approach to treating malocclusions takes about twenty-four months on average to complete, and is used to treat a number of different classifications of clinical malocclusion. Treatment with braces is complicated by the fact that it is uncomfortable and/or painful for patients, and the orthodontic appliances are perceived as unaesthetic, all of which creates considerable resistance to use. Further, the treatment time cannot be shortened by increasing the force, because too high a force results in root resorption, as well as being more painful. The average treatment time of twenty-four months is very long, and further reduces usage. In fact, some estimates provide that less than half of the patients who could benefit from such treatment elect to pursue orthodontics.
Kesling introduced the tooth positioning appliance in 1945 as a method of refining the final stage of orthodontic finishing after removal of the braces (debonding). The positioner was a one-piece pliable rubber appliance fabricated on the idealized wax set-ups for patients whose basic treatment was complete. Kesling also predicted that certain major tooth movements could also be accomplished with a series of positioners fabricated from sequential tooth movements on the set-up as the treatment progressed. However, this idea did not become practical until the advent of three-dimensional (3D) scanning and use of computers by companies including Align Technologies and as well as OrthoClear, ClearAligner, and ClearCorrect to provide greatly improved aesthetics since the devices are transparent.
However, these aligners may not be suitable or they may be inadequate to correct many different types of malocclusions. Some treatments may require the use of an archwire traditionally used with braces. Also, the treatments may require the use of attachments where different types of attachments may be used with aligners to facilitate the movement of particular teeth. The attachments may be bonded upon the surface of a crown and they may be shaped in various configurations and positioned in different orientations depending upon the movement to be imparted to the tooth.
However, corrections which are optimally performed by a combination of an archwire and/or treatment using attachments with aligners may require two different treatment types which add to costs, patient discomfort, and treatment times. Accordingly, there exists a need for efficiently and effectively performing treatments which facilitate both an archwire and attachment use for moving of one or more teeth.
Braces are systems used to align teeth having a wire component and brackets to hold the wire in place upon the teeth of the patient. Such brackets can be either made of stainless steel, ceramic, or other biocompatible materials which are usually prefabricated to the different forms to adapt the particular type of teeth. Different wires may be placed in the bracket slots. These brackets may incorporate self-ligating features which do not require any other mechanisms such as rubber bands. Orthodontists, using different sets of wire, may sometimes bend the wire into different shape to place them into the bracket slots in order to gradually align the teeth via the forces exerted from the wire. Because treatment with braces typically require a high level of technical skill, a fabricated splint, e.g., 3D printed, which function as brackets may be used to easily install, remove, or reposition the brackets.
In many aligner cases, attachments may be used to increase the contact areas on one or more of the tooth crowns to augment the grip of an aligner upon the teeth of a patient. The shape and mechanics of the attachments that imparts the force and torque to the teeth, and the software algorithms that place the attachments on crowns, defines the application and function of a particular attachment.
To place the attachment on a tooth crown, the software may be used to first detect what movements are imparted to the tooth. There may be multiple movements programmed on the tooth simultaneously. The software may be used to determine for which movement the attachment will be placed, where the attachment will be placed on the tooth crown, what direction the active surface will be oriented by a protocol, which should have all the constraints that make the attachment feasible for 3D printing and thermoforming, including but not limited to margins to the occlusal, gingival, distal, and mesial sides, the maximal prominence on the crown. The shape, position, prominence, and orientation of the attachment may be generated by software, such as UDESIGN by uLab Systems, Inc. (San Mateo, Calif.), as described herein.
One variation of a bracket system which may be comprised of multiple components may be fabricated using, e.g., 3D printing techniques. These brackets may have a bracket main body having a longitudinal length for securing upon the crowns of a patient's teeth. The main body may each define a wire slot which extends in a direction transverse to the longitudinal axis of the main body to accommodate the insertion of a wire. The main body may be secured to the crowns which require treatment using the wire.
Once the main body has been suitably secured to the crowns of interest, a wire may be inserted into the wire slots of each main body and a flexible covering which is designed to conform to the main body may be attached over and secured upon the main body to retain and secure the wire within each wire slot, e.g., via press fit, adhesives, various other locking mechanisms. The main body and/or covering may be fabricated from any number of materials such as metals or polymers which can allow for the fabrication of the components using, e.g., 3D printing.
In yet another variation, the main body or any number of other conventional bracket and/or attachment features may be utilized in a multi-component attachment system. A first component may generally comprise a pad such as a bracket pad having an interface surface and one or more locking and/or registration features for attachment with any number of second components. The first component may further have an attachment surface opposite to the interface surface for securement to the surface of a crown using any number of attachment mechanisms such as adhesives.
The second component may have one or more corresponding registration features for insertion and/or alignment with the underlying locking and/or registration features of the first component. The second component may be aligned and secured to the first component via any number of securement mechanisms. Once the second component has been secured to the first component, the main body may be used as described herein or any other second component may be used as designed for its intended purpose.
Braces are systems used to align teeth having a wire component and brackets to hold the wire in place upon the teeth of the patient. Such brackets can be either made of stainless steel, ceramic, or other biocompatible materials which are usually prefabricated to the different forms to adapt the particular type of teeth. Different wires may be placed in the bracket slots. These brackets may incorporate self-ligating features which do not require any other mechanisms such as rubber bands. Orthodontists, using different sets of wire, may sometimes bend the wire into different shape to place them into the bracket slots in order to gradually align the teeth via the forces exerted from the wire. Because treatment with braces typically require a high level of technical skill, a fabricated splint, e.g., 3D printed, which function as brackets may be used to easily install, remove, or reposition the brackets.
In designing an orthodontic attachment for use with an aligner in correcting for malocclusions, the orthodontic attachment may be initially designed utilizing the clinical experience of a practitioner such as an orthodontist and the attachment design may be subsequently optimized through machine learning. The various orthodontic brackets and/or attachments may be designed utilizing automated design software (e.g., UDESIGN, uLab Systems, Inc., San Mateo, Calif.) and forming processes such as those developed by uLab Systems, Inc. These software and forming processes which may be used with the bracket and attachment components described herein are further described in U.S. Pat. Pubs. 2017/0100207; 2017/0100208; 2017/0100209; 2017/0100210; 2017/0100211; 2018/0078347; 2018/0078343; 2018/0078344; 2018/0078335; 2017/0100214, each of which is incorporated herein by reference in its entirety. The attachments described herein may also be used with any number of other teeth planning treatment systems such as those produced by Align Technologies, Inc. (San Jose, Calif.).
Once the main body 10 has been suitably secured to the crowns C of interest, a wire 16 may be inserted into the wire slots 12 of each main body 10 and a flexible covering 14 which is designed to conform to the main body 10 may be attached over and secured upon the main body 10 to retain and secure the wire 16 within each wire slot 12, e.g., via press fit, adhesives, various other locking mechanisms, etc., as shown in
Additionally and/or alternatively, the main body 10 and covering 14 may also be designed to incorporate one or more active surfaces which may allow for the main body 10 and covering 14 to be used as attachments in combination with an aligner, if so desired. In this manner, the main body 10 and covering 14 may incorporate the one or more active surfaces for engagement with the aligner when placed upon the teeth for selectively urging a number of specified movements to the tooth or teeth of interest. An example is illustrated in
Turning now to
Once the wire 16 has been suitably positioned within the wire slot 12, the covering 14 may be placed upon the main body 10 and secured into place. The covering 14 may have a surface 40 which conforms closely to the interface surface 34 of the main body 10 and may extend from a first end which may curve in a shape to conform to a first end of the main body 10 and terminate in a retaining feature 42, e.g., a ball-like feature or shoulder, which may be received by a receiving channel or undercut 46 defined at the first end of the main body 10. A second end of the covering 14 may similarly curve into a retaining feature 44 which likewise conforms to the second end of the main body 10 to facilitate the securement of the covering 14 upon the main body 10. A cork-like feature or retaining member 36 may extend from the inner surface of the covering 14 and terminate in a contact surface 38 in a shape which corresponds to the tapered wire receiving channel 30 such that when retaining feature 42 is positioned within the channel or undercut 46 and the curved retaining feature 44 is secured upon the second end of the main body 10, the retaining member 36 may extend into the receiving channel 30 such that the contact surface 38 pushes against or upon the wire 16, as shown in
In the event that the main body 10 and covering 14 are also optionally utilized as attachment features for use with an aligner, the outer surface of the and main body 10 and conforming covering 14 may incorporate one or more active surfaces designed to contact against the aligner to impart specified movements to the crown C. The contact surface 34 of the main body 10 and/or the inner surface of the covering 14 may optionally incorporate an adhesive or other features to facilitate the attachment between the main body 10 and the covering 14 in this and the other variations described herein. In order to remove the covering 14 from the main body 10, the covering 14 may be pressed down from one end upon the main body 10 allowing for the lifting of the covering 14 from its side to flex it outward to unlock it from the main body 10.
Another variation is shown in the side view of
In yet another variation, the main body 10 described herein or any number of other conventional bracket and/or attachment features may be utilized in a multi-component attachment system. As shown in the top, side, and bottom views of
As shown in the side views of
In yet another example,
These examples of the various types of second components are intended only to be illustrative of the different configurations which may be used so long as the components incorporate the locking and/or registration features for proper alignment to the first component 60.
The applications of the devices and methods discussed above are not limited to the one described but may include any number of further treatment applications. Modification of the above-described assemblies and methods for carrying out the invention, combinations between different variations as practicable, and variations of aspects of the invention that are obvious to those of skill in the art are intended to be within the scope of the claims.
This application claims the benefit of priority to U.S. Prov. 63/032,986 filed Jun. 1, 2020, which is incorporated herein by reference in its entirety.
Number | Date | Country | |
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63032986 | Jun 2020 | US |