This application claims priority under 35 U.S.C. 119 from prior German Patent Application Number 10 2012 224 328.3, which was filed on Dec. 21, 2012.
The invention relates to a guidance element for a tooth as well as to a set of guidance elements having a corresponding orthodontic treatment splint.
For the orthodontic treatment of patients there are inter alia the following two alternatives:
In a first alternative having fixed braces brackets are glued onto the teeth of the patient which are to be treated and connected to one another by an orthodontic wire. The brackets have a pad for connection to the tooth and a bracketbody having a slot which receives the archwire. The brackets can be arranged buccally or lingually.
In a second alternative, small guidance elements are glued onto the teeth of the patient which are to be treated. The patient receives a corresponding treatment splint into which the patient “bites”, whereby the guidance elements on the teeth engage with correspondingly assigned guiding pockets in the treatment splint. The guiding pockets are arranged in the treatment splint such that they exert the desired orthodontic forces and/or torques onto the teeth via the guidance elements.
Generally, in this alternative the complete orthodontic treatment of the patient is planned at the computer by means of a software, i.e. an existing initial situation is converted into a desired target situation: for that purpose the guidance elements, for example from a predefined library of guidance elements, are arranged on the teeth which are to be treated. Subsequently, different treatment stages are defined within which certain partial steps of the treatment shall be achieved. For each of these treatment stages a treatment splint is calculated and produced subsequently. If treatments are necessary in the upper and in the lower jaw, the patient receives the necessary treatment splints for the upper and for the lower jaw for each treatment step. After completion of a treatment stage the patient exchanges the treatment splint, i.e. he exchanges the “old” for the “new” treatment splint, until the treatment is completed. Usually, in this treatment which is also called aligner therapy as a rule 20 treatment stages are defined, wherein a lower or higher number of stages is possible, too, though.
It is a disadvantage of the first alternative that with buccal brackets it is optically not attractive and also involves a high hygienic effort on the side of the patient.
A disadvantage of the second alternative is that certain treatment steps, for example the rotation or angulation or extrusion of a tooth, can be carried out only difficulty or not at all with the treatment splints.
A guidance element for a tooth for interacting with an orthodontic treatment splint is provided by the invention. The guidance element has a tooth connection surface and at least one engagement surface for engagement in the treatment splint in order to exert orthodontic torques and/or forces onto the tooth during the engagement, including at least one slot for reception of an orthodontic treatment arch.
Further features, details and advantages of the invention unfold from the claims and from the following description of preferred embodiments as well as from the drawing. There are shown:
a preferred guidance element according to the invention comprises at least one slot. By this at least one slot the guidance element has become a hybrid element: it can be used as a conventional guidance element in the course of a therapy using an aligner but also as a conventional standard bracket in the course of a therapy using standard brackets.
Usually, it will not be possible that the patient wears the treatment splint if an orthodontic treatment arch is ligated into the guidance elements as in this case the treatment splint would have to have free spaces for the treatment arch. In such a case the patient would wear the treatment splint until an exchange to the next treatment splint would fall due. Then, however, one would not change to the next treatment splint but an orthodontic treatment arch would be inserted in order to carry out the next treatment step therewith, for example the extrusion of a tooth. Only when this treatment step would be completed, the orthodontic treatment arch would be removed and it would be exchanged for the next treatment splint. Thus, by means of the guiding elements, either a treatment step would be carried out with the treatment splints or a treatment step would be carried out by means of an orthodontic treatment arch. Therein one can switch between these two treatment alternatives any number of times and there can also be carried out any number of steps of a treatment alternative successively before one switches again to the other treatment alternative. This gives a great freedom of treatment to the attending orthodontist.
In exceptional cases, however, it is possible to carry out both treatment alternatives simultaneously. If for example a treatment splint is arranged only over a portion of a jaw, for example over the left half of the lower jaw, a treatment using an orthodontic treatment arch could take place in the right half, for example the extrusion of a tooth. Further, it is also possible to shorten the treatment splint for example at a tooth in gingival-occlusal direction in order to arrange a guidance element for an extrusion there.
The at least one engagement surface can be a distal and/or a mesial and/or an occlusal engagement surface. In case the guidance element is a buccal or a lingual guidance element, the at least one engagement surface can also be or comprise, respectively, a buccal or a lingual engagement surface.
Advantageously, a guidance element has at least two and further preferred at least three slots.
Preferably, at least one of the at least one slot is self-ligating. However, it is also possible and lies within the scope of the invention that hooks or knobs or the like are provided at the guidance element in order to attach a ligation thereto for ligating an orthodontic treatment arch thereto.
Preferably, the guidance element at least partially consists of a ceramic material, a plastic material, for example PEAK, PEEK, PEKK, PEEK, PEKKTON, a metal, as for example gold, or an alloy and optionally at least partially has a coating, for example of teflon, in order to predefine or influence friction properties and/or corrosion properties.
Advantageously, at least one of the at least one slot has a circular, a square, a rectangular or a polygonal shape in the cross section.
A slot can be arranged within the guidance element centrally or gingivally or occlusally in occlusal-gingival direction.
Preferably, a shape and/or size of the tooth connection surface is adapted to a predefined tooth, for example to a canine or to an incisor.
Since the guidance element as hybrid element is supposed to be applicable as a standard bracket within a conventional standard bracket therapy, it can have any additional components which are known from standard brackets, as for example hook, wing, knob, tube or an undercut, for example in order to hook in a rubber strap.
Hence, for an orthodontic treatment of a patient a set of at least two guidance elements according to the invention as well as at least one corresponding treatment splint is necessary. Usually, one guidance element is required for each tooth of the jaw which is to be treated. However, it lies within the scope of the invention that not all but only a few teeth of a jaw, respectively, are provided with the guidance elements according to the invention.
The at least one required treatment splint can be a treatment splint for the upper jaw or one for the lower jaw. Usually, however, one treatment splint for the upper jaw and one for the lower jaw will be required, as in many cases a treatment of both jaws takes place.
Advantageously, multiple treatment splints for the upper jaw and/or for the lower jaw are provided for different treatment stages of an orthodontic treatment, respectively.
It is possible and lies within the scope of the invention that for at least one tooth of the patient several guidance elements are provided in order to simultaneously arrange them on the tooth in at least one treatment stage.
Preferred embodiments of the invention will now be discussed with respect to the drawings. The drawings may include schematic representations, which will be understood by artisans in view of the general knowledge in the art and the description that follows. Features may be exaggerated in the drawings for emphasis, and features may not be to scale.
In
In gingival-occlusal direction the treatment splint 5 has different heights: in the region of the molars it advances to the gingival edge, in the region of the canines it has only a small distance to the gingival edge and in the region of the incisors it advances approximately to the middle of the incisors.
In
The guidance element has engagement surfaces 1E opposite and facing away from the tooth connection surface by which it is in positive engagement with a guiding pocket of the treatment splint 5. For formation of the glued connection between the tooth 3 and the guidance element 1 the tooth connection surface 1T is provided by which the guidance element 1 is glued onto the buccal tooth surface of the tooth 3.
The guidance element 1 has a buccal engagement surface 1Eb which is divided into several sections 1Eb1, 1Eb2, 1Eb3 and 1Eb4, wherein these run at an angle to one another, respectively, see
The guidance element 1 has a mesial and a distal engagement surface 1Em, 1Ed, wherein these, respectively, are divided into individual sections 1Em1, 1Em2, 1Ed1, 1Ed2. The engagement surfaces 1Em, 1Ed run symmetrically to a median plane MP running vertically in
Further, the guidance element 1 has a slot 1S in order to arrange an orthodontic treatment wire therein. In the present case, the slot 1S is an open slot and has a circular cross section and is arranged perpendicularly to the longitudinal axis of the guidance element 1. The guidance element 1 has an almost wedge-shaped wire insertion region 1W in order to allow an easy insertion of the orthodontic wire into the slot 15. The wire insertion region 1W also runs perpendicularly to the longitudinal axis of the guidance element 1 and comprises a buccal and a lingual wire insertion surface 1Wb, 1W1.
The guidance element 1 and the slot 1S, respectively, is self-ligating: an orthodontic wire is inserted along and between the wire insertion surfaces 1Wb, 1W1 into the slot 1S, wherein the wire is deformed slightly at the narrowest site of the wire insertion region 1W. When the wire is arranged within the slot 1S it can only be removed again from the slot 1S by applying a corresponding gingivally directed force.
In the region of the guidance element 1 the treatment splint 5 is shortened in gingival-occlusal direction to such an extent that an orthodontic wire can be arranged within the slot 1S despite the engagement of the teeth 3 with the treatment splint 5, for example in order to carry out an extrusion, as described above.
The guidance element 1 is produced as one-piece and consists of a synthetic material, for example produced in a spray process or in a milling process.
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A further difference are the mesially and distally arranged hooks 7 in order to ligate an orthodontic wire into the slot 1S with their assistance and with a ligation.
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In this embodiment the insertion of the orthodontic wire is achieved in that the guidance element 1 consists of a softer material than the orthodontic wire and in that the distance of the wire insertion surfaces 1Wb, 1W1 to one another is chosen accordingly. In a variant of this embodiment a suitable shaping instead of a softer material is chosen: the convex course of material above the buccal wire insertion surface 1Wb shown in
In
In the course of an orthodontic treatment the guidance elements 1 can be used in two ways: on the one hand a force can be exerted onto the teeth 3 assigned to the guidance elements 1 by the treatment splints 5 by means of the guidance elements 1 in order to achieve an orthodontic movement of the teeth 3. On the other hand an orthodontic treatment can take place by means of an orthodontic wire using the guidance elements 1 by arranging a wire within the slot 1S of the respective guidance element 1, as it is known with conventional brackets.
Therein the geometrical dimensions of the guidance elements 1 correspond to those that are present at known guidance elements for the aligner therapy. In particular the height of the same in lingual-buccal direction is smaller than 2 mm and preferably smaller than 1.5 mm.
While specific embodiments of the present invention have been shown and described, it should be understood that other modifications, substitutions and alternatives are apparent to one of ordinary skill in the art. Such modifications, substitutions and alternatives can be made without departing from the spirit and scope of the invention, which should be determined from the appended claims.
Various features of the invention are set forth in the appended claims.
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10 2012 224 328 | Dec 2012 | DE | national |
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20140178830 A1 | Jun 2014 | US |