3D Printing – Martin G. Martz, Andrew S. Martz
Abstract for “Tooth positioning device with interconnecting elements curved”
“A removable, thin shell tooth positioning device with a plurality o tooth-clasping components for removably engaging attachments bonded onto select teeth. Flexible curved interconnecting elements connect the tooth-clasping element on adjacent teeth.”
Background for “Tooth positioning device with interconnecting elements curved”
“Field of Invention”
“The present invention is generally applicable to orthodontics.” The present invention relates to a tooth positioning device with interconnecting elements that curve.
“Statement on the Problem”
“A variety of aligners for orthodontic treatment have been used over the years to reposition teeth. The terms “aligner” and “positioner” are not interchangeable. The terms?aligner?,?positioner? und?tooth positioning device? are often interchangeable. They are often used interchangeably in orthodontics.
This type of orthodontic treatment usually involves separate appliances for the upper or lower teeth. The appliance fits over the teeth and covers most of the facial andlingual surfaces as well as the majority of the occlusal and biting surfaces. The plaster models used to make the early positioners in the prior art were based on three-dimensional negative dental impressions. By using a small jeweler?s saw or rotary cutting disks, the plaster dental models could be modified to reposition the plaster teeth in a more pleasing, straighter arrangement. Then, dental wax was used to hold the new arrangement. The basis for the manufacturing of the positioners is the reset teeth molds. The positioner’s material is resilient and can be used to move the teeth into a new, straightened position. Many of the designs that were disclosed in the prior art showed the teeth being moved in an incremental manner. It is difficult to make a series of appliances if each tooth arrangement must be done by hand with plaster and wax.
Digital technologies were introduced in the early 1990s and have since provided orthodontists fundamentally new tools to deliver orthodontic treatment. They allow for precise, small-scale fabrication of tooth models. Commercially-available CAD/CAM software can produce the desired tooth models, from which a progressive series of appliances can be manufactured. These tools include 3D imaging to visualize the patient’s teeth and CAD/CAM (computer aided design and manufacture) systems that create virtual models for orthodontic treatment. Then, custom-made orthodontic appliances can be made.
To create Invisalign-type aligners, a technician scans the patient’s upper model set and lower model set. This allows for CAD-manipulatable virtual models. A model set is usually composed of one upper and one below plaster models of the teeth, palate, and gums. After obtaining the virtual malocclusion model, the technician will perform extensive manipulations of that virtual malocclusion. This involves extensive repositioning the teeth in a sequential and comprehensive manner, resulting in a final or ideal occlusion. The final occlusion shown in the virtual model corresponds to the complete repositioning and adjustment of the patient’s upper & lower occlusions that would be required after successful conventional orthodontic treatment.
“After all the above steps are completed, the technician now has two versions of the patient?s teeth in the virtual CAD environment. The first version is the original malocclusion, while the second represents the ideal occlusion. The technician can also have the ending and the beginning states.
The next step in Invisalign is the creation of a series of incremental, progressive physical forming models. Each of these forming model represents a snapshot showing the patient’s future occlusion at particular incremental steps in the proposed treatment sequence. The technician creates a virtual “first transition model” to accomplish this. This model involves a slight repositioning or all of the teeth. The first model shows some or all of your teeth being subtly moved to a virtual transition position, which is in the desired direction. A second virtual transition model allows the virtual teeth to be moved in the desired direction. Invisalign technicians aim to create a series progressive models that are biased slightly more than the last one and move the teeth closer to their final target positions. The final forming model will take the finalized models from each of the transition positions and place them in their final desired positions.
“Once such a series of virtual intermediate forming models has been created and a final forming model has been created by the Invisalign technician, the digital code representing each of the models in the series is directed to operate a computer numerically-controlled (CNC) machine known as a rapid prototyping machine. The series of physical forming model are created using any number of traditional processes such as stereolithography or 3D printing within a rapid prototyping device. Each series of virtual intermediate models is then grown into hard copies and finally the final model.
The next step in Invisalign is to mount each series of physical models in a sucking machine. This uses a combination heat, pressure and vacuum to create the actual series progressive aligners out of plastic sheet material with a constant thickness. After the series of progressive aligners have been trimmed and formed, they are packaged and shipped to their attending dentist. After the aligners are trimmed and formed, the orthodontist schedules a patient’s appointment. The patient is then given the aligners along with instructions. The patient is asked to wear the first pair of aligners for two weeks. The patient is instructed to remove the first set and transition to the next series.
The aligners are used to encourage the patient’s smile to follow the Invisalign technician’s positional biases. By using the resilient polymeric material of the aligner, the teeth are gradually biased and urged toward the desired positions. The aligners provide gentle, but constant forces that cause the teeth to move in the desired direction. This triggers certain physiological processes which involve the creation and resorption of bone supporting the roots. This results in the gradual, progressive orthodontic movement that the roots of the teeth undergo through the bone to reach desired positions and orientations.
“Physiologic processes are when forces are applied on teeth. This results in bone resorption or new bone apposition. Research has shown that light, gentle continuous forces can cause the fastest tooth movement. When the appliance is placed for the first time, conventional aligner appliances apply more force to the teeth. The forces then decay quite quickly after a few days. Many stages of aligners correspond to small incremental movements. This is done to keep the forces lighter and to restore the force when it has decayed by moving on to the next stage. While multiple stages of aligners may theoretically allow for lighter, more continuous forces to be delivered, there are still issues with tooth engagement and keeping the force delivery within the required physiological range.
“Conventional removable aligners have limitations due to their design and the mechanical properties that clear thermoplastic materials currently used. Clear polymeric materials are nearly indistinct from metal braces and fixed stainless steel hardware. However, the flexibility of conventionally-formed aligners made from polymeric materials has been severely limited. This is especially true when aligning teeth that have not been properly aligned at the beginning of treatment.
Even though very small movements are made during each stage, the appliance might not properly engage the teeth that require to be moved. This is because the appliance isn’t flexible enough and isn’t designed to allow for movement within the material plane. An aligner that fails to properly fit a tooth will cause it to not move in the right place to be able to accept the next aligner in the series. There are two options available if aligners do not properly engage a tooth: 1) reduce the amount of movement that is attempted at that stage; or 2) place a larger bonded attachement on the tooth. These solutions will require the computerized treatment plan to be reworked. The plan must be revised as the aligners fit becomes less comfortable with each stage. After a few stages it becomes apparent that the computerized treatment plan was not accurate. This will require a revision.
“Solution to the problem”
“The present invention aims to overcome limitations caused by the inflexibility of the appliance material. It provides a tooth-clasping component for each tooth that is connected to adjacent teeth by curved interconnecting components. Because the interconnecting elements bend in a flexible way, each tooth-clasping element can be held securely in place. The choice of materials, the cross-section and the shape of interconnecting element determine the flexibility of interconnecting components. Most embodiments of interconnecting elements in the present invention use a small radius loop configuration. The radius of the loop should be approximately half the width of the tooth.
“This invention provides a removable and thin-shell tooth positioning device that has a plurality tooth-clasping components for removably engaging attachments bonded onto selected tooth teeth with flexible curved interconnecting pieces connecting the tooth-clasping element on adjacent teeth.”
These and other features and advantages of the invention will be easier to understand if you look at the detailed description and the drawings.
“Turning towards FIG. 1. The present tooth positioning device includes the following main elements: (1) bonded attachements 12A,12B bonded to selected lingual or buccal surface teeth 11; (2) tooth clasping element 15 that can be removed from the bonded attachments 12-A,12B; (3) curving interconnecting elements 17 that extend between adjacent tooth-clasping components 15. The tooth-clasping element 15 includes recesses that can be used over buttons or projecting elements called “bonded attachments?” 12A,12B are bonded directly on the teeth. The patient cannot usually remove the bonded attachments 12A and 12B during active orthodontic treatment.
“It is desirable that the tooth-clasping elements 15 of the front teeth be made from a clear polymeric materials. To produce the right tooth alignment appliances, a variety of plastic materials such as urethanes or polycarbonates can be thermoformed on tooth models. Any suitable material may be used. You should also know that the tooth-clasping component 15 can be either a separate part or a functional area of a single-piece appliance.
“The bonded attachments 12A and 12B are usually bonded to selected teeth 11’s buccal orlingual surfaces, as shown in FIG. 1. As shown in FIG. 5, bonded attachments can be rectangular with parallel sides. Although FIG. 5 shows a typical shape, it is possible to use bonded attachments in many other shapes. The bonded attachments 12,A and 12B serve two purposes. First, they increase the retention of tooth-clasping components 15 to the teeth 11 (or, in other words, the appliance will be less likely to become detached from the desired place on the teeth); second, the bonded attachements 12A,12B have a shape that allows tooth-clasping element 15 to transmit desired forces in three dimensions to the teeth, thereby controlling root movement. FIG. 5 shows the rectangular bonded attachment 12A. 5 The attachment 12A is a rectangular bonded attachment. This control can also be achieved by the inner surfaces of an attached projection, such as grooves and special shapes. Special outside shaping or grooves can be used to guide the tooth-clasping component into its proper position. Pre-made bonded attachments are possible from any material, including clear or tooth-colored ceramic material, dental composite, and any other suitable clear plastic material. Attachments 12A can be attached to the teeth using traditional bonding techniques or adhesives that are well-known in this art. This includes the steps of mildly acid-etching enamel before bracket placement. An art technique called indirect bonding is used. A guide of flexible material, pre-formed, holds the attachments in place while the adhesive cures. This ensures accurate attachment placement. Pre-made molds that can be used to place one tooth at a given time in dental composite are also available. Another option is to use a 3D CAD/CAM mold. The shape and size of the bonded attachements are designed in the computer. A 3-D printer prints a model of the entire arch, with all attachments attached. This mold can be used to create and place dental composite attachments at the exact location on the teeth.
“Preferably the tooth-clasping components 15 have a hole of exact dimensions (e.g. a rectangular hole), through which the bonded attach 12A,12B projects to removably connect the tooth-clasping component 15. A recess inside the tooth-clasping elements 15 can also be used. This is because the printing process allows for a better fit than thermoforming.
“The tooth-clasping components 15 can be attached to flexible, curved interconnecting element 17 of different types, as shown in the drawings. The appliances may be made from one piece of material. In some instances, the tooth-clasping elements and flexible interconnecting components are part of a single unit. Functionally, the tooth-clasping elements 15 and 17 are located in different parts of the single-piece positioning device.
“It is expected that the improved teeth positioners of this invention will be produced using computerized 3-DCAD/CAM software. This function is possible with many off-the-shelf software programs. To simplify the use of the software, it is a good idea to create new software that can be easily integrated with the skills of end-users of orthodontics. This function can be performed by open-source software. The surface is defined by the standard surface mapping computer algorithms as a series triangles. Vacuum-forming thermoplastic material over digitally generated models and combining the thermoformed part of the appliance with other elements can be used to produce the actual appliances. The next step involves using computer-automated trimming technologies like laser cutting or CNC milling. Vacuum thermoforming could also be used to produce the clear elements of tooth-clasping. The tooth-clasping and flexible interconnecting elements can all be vacuum-formed together in the single-piece embodiments according to the invention.
Positioners can also be made by 3D printing without the need to first create 3D models. Direct 3D printing has the advantage that complex shapes can be printed more quickly and require less trimming. This saves time and helps to avoid waste material. New 3D printers are capable of printing multiple materials simultaneously. Flexible interconnecting elements can be printed alongside the tooth-clasping part. They could also be made from different materials. You can mix or intertwine the materials, which eliminates the need to attach them separately. Direct CNC milling the appliances, or parts of them from a block made of plastic material is another option. The present appliances are expected to be manufactured in series. Each appliance will move the teeth only a little distance. Then, the next stage will continue the movement in small increments towards the goal. The appliance can be made in a way that fits over the teeth for each stage. To fit over the teeth, the appliance must be bent. Each tooth should be fully engaged by the tooth-clasping components 15. After the appliance has been worn for several weeks, the resiliency will allow the teeth to move toward the final stage. Next, the appliance will be attached to the teeth. This will move the teeth the prescribed distance. As the process of straightening teeth progresses, it is possible to need to take new impressions and digital scans every few steps.
“Many of these accompanying drawings show teeth-clasping elements placed over individual teeth. It is possible to create a separate tooth clasp for each tooth, if adjacent teeth are aligned. This is common and is expected to happen during later stages. If adjacent teeth are aligned well, it is possible to combine tooth-clasping parts. In certain stages of treatment, it may be possible to combine teeth in groups to serve as anchorage units. This will allow for better control of the movement of other teeth. The present appliance can then be broken into thin-shell segments. Each segment of thin-shell can be designed to fit into a set of adjacent teeth, i.e. one or more adjacent teeth. Only select teeth can be equipped with bonded attachments 12A and 12B to engage the corresponding tooth-clasping elements of the thin-shelled segments. This concept is similar to orthodontic treatment with fixed braces. To perform certain movements more efficiently, you can combine the features of multiple embodiments in this disclosure to create one appliance.
“To sum up, FIGS. The embodiment of the present invention shown in FIGS. 1-4 comprises clear tooth-clasping element 15 that is fitted over teeth 11, to which bonded attachments (12A,12B) have been placed on both their buccal and lingual side. Flexible U-shaped interconnecting elements 17 are used to connect the tooth-clasping components 15 to each other. These wire loops are attached to the flange (16 or extension) 16 of tooth-clasping element 15. This covers part of the gum tissue that is adjacent to the teeth on the buccal as well as the lingual sides. FIG. FIG. 2. This is a frontal view of a wire interconnecting component 17 with flattened ends. It is best to use nickel-titanium-shaped-memory wire. However, other materials are possible. The tooth-clasping elements 15 and interconnecting elements 17 will be almost invisible on the teeth 11. This embodiment is likely to be the most flexible and can be used to correct crowding and tooth rotations in situations that other embodiments are not possible. Because of the many parts and materials, this embodiment can be more difficult to make. You can mount the curved interconnecting elements 17 in an inverted position. Inverted loops are preferred for posterior teeth, even though they will be more visible.
“In particular, the 12A and 12B bonded attachments are preferred to be placed on the buccal or lingual aspects of all upper and lower teeth. However, there may be instances when not all teeth have all attachments. The illustrations show rectangular bonded attachments. The tooth-clasping element 15 is preferably made from a clear plastic material. The tooth-clasping elements are designed to fit the contours of the teeth as well as the bonded attachments. The bonded attachments 12A,12B can project through an optional window, or they can be completely covered by the appliance. The tooth-clasping component 15 fits tightly to the bonded attachment 12A-12B and the tooth crown covered by the tooth clasping device 15 so that forces transmitted to the tooth clasping 15 can be transmitted directly to it. You can direct the forces in any direction you need to correct malocclusion. To prevent wire being pulled from the covering material that forms the tooth-clasping elements 15, the curved interconnecting elements 17 should be made of flattened wire.
“This embodiment of invention includes a removable orthodontic device that can be worn by an orthodontic patient, after the bonded attachments 12A and 12B have been placed by the orthodontist. Preferably, the method allows for great precision such the aforementioned indirect bonding technique or a computer-generated mould. The appliance will be made in multiple stages, each one moving the teeth in small increments toward a final desired goal envisioned by the orthodontist and planned in the computer using commercially-available CAD/CAM software designed for this purpose. This method is best used when the teeth are at their most crowded and irregular. Ni?Ti wires have a greater flexibility than any other interconnecting elements. This should enable complete engagement of the tooth-clasping element in complex orthodontic cases that were previously not possible with removable positioner appliances.
The present appliance can be made from either a model of the patient?s dental anatomy made with conventional plaster, or a dental rock model made by pouring plaster or stone uncured (wet), into an impression made of silicone, alginate, polyvinyl Siloxane, polysulfide rubber, or any other suitable dental impression material. The plaster or stone is dried and trimmed with a standard rotating wheel model trimmer to make the base flat and smooth. Alternatively, the dental model can be obtained by using conventional digital scanning techniques of the teeth directly in the mouth using a commercially-available digital intra-oral scanner, or the plaster or stone model can be scanned using a commercially available digital model scanner, or the impression itself can be scanned using a digital scanner or a computerized tomography scanner (CT). From the digital data obtained by the scan, a three-dimensional model can be produced using a commercially available stereo lithographic printer, or a commercially-available rapid prototyping printer, or a model can be produced using a commercially-available CNC milling machine operating on any suitable material, most likely a plastic block.”
The base of the dental model has three-dimensional images (anatomic portions) of the teeth. Virtual teeth are images of teeth that are identical in size, shape and relative locations to the real teeth. The model of the tooth is a faithful representation of the actual teeth in the patient’s mouth.
“The bonded attachments 12A and 12B are used to attach an altered shape to the tooth, but it is different from the surface. These attachments are essential for ensuring that the removable appliance is placed in the right place on each tooth. Bonded attachments allow the tooth-clasping component to transmit forces to the teeth so that the tooth can be positioned in the desired position in all three dimensions. The bonded attachments extend from the teeth’s surfaces. In this illustration, the attachments are straight to align the tooth-clasping elements in the desired position. The bonded attachments should be applied to the teeth before any tooth movement.
“The tooth-clasping components 15 were created using an exact model of the teeth 11. FIG. FIG. 1 shows that there are 15 separate tooth-clasping components 15 that can be placed over each arch tooth. The shapes correspond to each tooth’s shape. Even though the teeth are touching, it is clear that there are gaps between each tooth-clasping component. The tooth-clasping elements inner surface should have the exact same dimensions and shape as the tooth on which they will be applied. The tooth-clasping material 15 has a thickness so the outer surface will be slightly larger than the inner surface. The outer surface is basically a slightly larger or inflated version the inner surface. The components of the tooth-clasping elements 15 touch the tooth 11 on the buccal, occlusal (top and bottom of bottom teeth), and lingual (inner).
The tooth-clasping component 15 may also include an extension (16 or clear flange) 16. The flange 16 extends approximately 2 to 3mm over the patient’s gum tissue on both the facial and the lingual sides of each tooth. However, the flange doesn’t have to be that far. The gum tissue is not usually touched by the flange 16. The clearance should be at least 0.5 to 1.0 mm.
The flange 16 can be used as an attachment point for flexible curved interconnecting components 17. The flexible interconnecting element 17 can be attached directly to the main body 15 of the tooth-clasping elements 15, such as in the space between the bonded attachments 12A, 12B, and the gum line. This is especially useful for posterior teeth, where concealing the loop behind the lip would not be as important. This would reduce interference between the loops, buccal frenum attachments, and other features. With the same size loops, the appliance would have a smaller vertical dimension.
“In this particular embodiment, each interconnecting component 17 is a U-shaped, heat-treated Ni?Ti memory wire. To avoid direct contact with gum tissue, the U-shaped interconnecting elements 17 extend slightly outward. It also maintains an open space 19 between adjacent tooth clasping elements. This allows for movement and allows for a range of motion. You can adjust the dimensions of the U-shaped loop and the heat treatment of the wire to obtain the desired shape-memory characteristics. This will allow you to apply the desired physiologic forces to the tooth-clasping element and, consequently, the forces to your teeth. The flexible interconnecting elements can be made from any material. The attachment means of the interconnecting elements 17 and the tooth-clasping section are not shown in this particular embodiment. This is due to their transparency, which would make them difficult to see.
“It is important to note that interconnecting elements 17 have flattened edges 18 in the embodiment shown at FIGS. 1. and 2. 1. and 2. The wire is prevented from being pulled out by the clear plastic they are encased in because of their bent ends. The interconnecting element can be attached to the tooth-clasping elements’ flange using a variety of methods. Clear cold-cure acrylic can be used to cover the wire much in the same manner that retainers are attached to wire elements. (2) The same material that is used to make the tooth-clasping elements could be used in a molten form using a glue gun nozzle. A thin layer could then be applied to the wire. This could be automated and the nozzle controlled robotically on an assembly line. (3) A small, plastic panel about the same size as that of the tooth-clasping elements could be placed on top of the flexible interconnecting elements ends. While it is held in place, an ultrasonic welding waveguide horn could also be attached to the plastic panels to fuse the small panel and the flange together.
“Alternatively, you could flatten the ends of the wire segments to stop it from pulling out of plastic. You could also use other methods such as a zigzag, bending the wire to an L-shape or double the wire to make a T-shape.
“It is worth noting that longer segments of wire can be used than those shown in FIGS. 1. and 2. One loop could connect multiple tooth-clasping components together with a longer section of wire. You can attach the wire using one of two methods: (1) Direct cementation with a composite cement or plastic cement covering the wire; (2) The tooth clasping elements could have a groove to receive the metal. If the groove is made so that the opening to accept the wire is slightly smaller then the wire and the area of the groove where it is to reside, the wire might snap into place. To receive a square or rectangular cross-section wire, the groove can be rectangular or square. You can even have multiple loops in the wire.
“FIG. FIG. 3 shows a right-side view of some upper teeth, with a portion the same type as the removable appliance in FIG. These teeth had 1 installed. Reference number 11A denotes the root of the upper right Cuspid tooth. You can see the mesial surface of the upper right cuspid crown at 11B, just beyond the mesial edge. FIG. FIG. 4. This shows five views of one tooth (upper right premolar), with bonded attachments 12A, 12B, and a tooth-clasping component 15. There are also U-shaped wire loop interconnecting elements 17 that can be seen from different angles.
“Note that the size 12A of the bonded attachments varies depending on the size and shape of the teeth. In this view, the bonded attachments protrude through holes in clear tooth-clasping components. These holes are the same size as the bonded attachments. It is not necessary that bonded attachments be rectangular. Also, the holes should not be drilled into the tooth-clasping element to permit protrusion of bonded attachments through these elements. The necessary clasp function will be provided by a simple recess on the inner surface the tooth-clasping elements that corresponds to the selected bonded attachment geometry. Even though the teeth may be in direct contact, there are 19 spaces between the tooth-clasping components 15. This space prevents tooth-clasping elements 15 from interfering with one another. FIG. FIG.
“FIG. “FIG. In this example, the x-axis is horizontal in the anterior-posterior direction. The vertical axis of the y-axis can be found in Figure 1. The horizontal axis of the transverse direction is the z-axis. The bonded attachment can be placed away from the crown. The force that acts on the bonded attach can cause the tooth to move in a different direction depending on its direction.
“FIGS. FIGS. 6-9 show three transverse movements along the z axis as illustrated in FIG. 5 (i.e. not in the X and Y planes of bonded attachments. All drawings show the upper right premolar tooth, viewed from the distal side. All these movements require that teeth are repositioned from their original positions to the desired position. This can be done either using a 3-dimensional digital file or a dental model. FIG. FIG. 6 is a reference view. FIG. FIG. 7 shows the lingual transverse movement (CC) of the root, with the center of it remaining in its original position. This movement is called root tipping and is difficult to achieve even with fixed braces. To ensure the desired movement, a trans-palatal support bar would be ideal. Although the bonded attachments are used to move the teeth vertically, there are also small transverse movements that occur on the tooth surface.
“FIG. 8 shows buccal transverse motion of the crown, with the center (or center resistance, CR) to movement of a tooth remaining in its original position. Tipping the crowns of teeth is easy because the roots of teeth tend to stay in place. This movement is achieved by the combination of movements on the buccal andlingual surfaces of the teeth, as well as the bonded attachments. This drawing shows that the vertical and transverse movements of the bonded attachments are approximately equal. However, the crown’s transverse tipping movements occur naturally when opposing vertical forces apply to the crowns of teeth. This is due to the resistance of bone around the roots.
“FIG. “FIG. 9 shows buccal and lingual transverse movements of the entire tooth with the center resistance (CR), and center of the crown(CC) moving exactly in the same distances and in the exact same direction. The tooth is not tipped. This type of movement is possible with bonded attachments. The bonded attachments must be very strong in their engagement with the tooth-clasping element and the flat top or bottom surfaces of the bonded attachments.
“FIG. “FIG. If a tooth is being extracted as part of an orthodontic treatment plan, it will be necessary to close the space while keeping the roots parallel on both sides of the extraction space. This will prevent the crowns from tipping into the extraction site. Fixed braces can also cause this problem. Fixed braces can be solved by placing a rigid arm with an anchor and a hook on the brackets. This allows for elastic bands to be used to close the space. The tooth’s center of resistance is found in the middle of its root. The elastic force will reduce the tipping moment by placing the attachment point for elastic band close to the tooth’s center of resistance. This method of closing the space will result in roots staying parallel. The tooth-clasping element 15’s flange 16 can also be extended to reach the center of resistance. An elastic band 71 may be used in the same manner. The forces on the buccal andlingual sides of the teeth would be parallel and the rotational moment with the band 71 on the buccal would be cancelled. It would be difficult for a dental patient who has a long appliance arm covering their gum tissue on the lingual end of their teeth to wear such an elastic band. However, this is possible under certain circumstances. It all depends on the curvature and shape of the palatal tissues. It could also be used to move roots, for example, to raise a tipped tooth. However, there is not enough interdental space. A group of teeth could be used as an anchor to prevent us from tipping teeth we don’t want to tip.
“FIGS. 11. and 12. show an embodiment made from one piece of clear, printed or vacuum-formed material. The flexible plastic interconnecting element 40 may not be as flexible as wire interconnecting pieces, but it will be much easier to make the appliance if the loops are less visible. The flexibility of clear plastic curved interconnecting components will make it possible to use the same assembly and manufacturing process as the first embodiment without the need for wire loops. The instructions for laser cutting or computerized milling will not be as easy if the appliance is thermoformed.
“This embodiment uses the same bonded attachments 12A and 12B as in the other embodiments. The removable positioning device is made in two parts, one upper and one lower. Each arch appliance is made as a single-piece appliance, with areas that serve as tooth-clasping element 15 and flexible, curved interconnecting elements 40. The areas of the appliance that are designed to engage the teeth and serve as tooth-clasping components are nearly identical in shape and form to the ones used in the previous versions. The 40 regions of the appliance that perform the role of flexible interconnecting elements have a curvature and are roughly the same size as the U-shaped wire connecting element of the first embodiment. It functions almost exactly the same as the first embodiment except that the plastic loop isn’t as flexible and as strong as a wire one. Although this embodiment can be used to make a thermoformed appliance that is placed over a number of tooth models, it may require more work to trim the excess material. This can be done with a laser or CNC milling cutter. However, it will require more complicated programming than for current aligners. Only the edge of the gum line must be trimmed. The entire apparatus could be 3D printed. This is likely to be the future of the industry once non-toxic, printable plastics are available.
For example, a flat, U-shaped ribbon of metal or plastic can serve as the curved interconnecting elements. However, FIGS. FIGS. 13-21 show that the physical properties and cross-sections of interconnecting elements can change by placing reinforcing or ridges 43, 44. The ribs 43 can strengthen U-shaped loops, and change their torsional and flexible properties. To increase tooth-clasping element strength, the ribs 44 can be extended beyond the loops onto tooth-clasping components 15. They are particularly effective in the central area of the clasps 15, where they engage the bonded attachments (12A, 12B). These strengthening ribs 43 and 44 can be made easily if the appliances have been printed with a 3-D printer. The interconnecting elements can be any shape you like, including oval, rectangular, multi-stranded cable or composite structures.
“FIG. FIG. 13 shows an enlarged portion of the appliance. 12. The flexible interconnecting element’s outer edge will have reinforcing Ridges 43 printed into it. The ridges 43 extend onto both the flange portion of the tooth clasping element and the main tooth-contacting section of the tooth clasping element. The reinforcing Ridge extends and becomes continuous on one tooth, in this instance the upper right canine tooth. A reinforcing Ridge 44 surrounds the entire bonded attachment on that tooth’s buccal surface. The reinforcing edges are used to increase strength and control the flex properties of the tooth-clasping and flexible interconnecting elements. This disclosure does not restrict the reinforcing Ridges 43, 44 to a particular place or configuration. The reinforcing edges can be placed anywhere they are required to increase strength and control the flex properties the tooth-clasping and flexible interconnecting elements.
“FIGS. 14-21 show several configurations of reinforcing Ridges that can be placed on flexible interconnecting elements and tooth-clasping components. Reinforcing Ridges can take any cross-sectional form. FIG. FIG. 14 shows two rectangular projections that form a C-shape. FIG. FIG. 15 shows one rectangular projection that forms a T-shape. FIG. 16 shows double rectangular projections. FIG. FIG. 17 shows two rectangular projections that form an I-shape. FIG. FIG. 18 shows two tapered projections that form a C-shape. FIG. FIG. 19 shows a single, tapered projection that forms a T-shape. FIG. FIG. 20 shows double-taped projections. FIG. FIG. 21 has tapered projections on both sides to create an I-shape.
“The embodiment shown in FIG. 22 uses interconnecting elements 41 in an U-shape. Inverted loop geometry is better to keep favorable forces applied to teeth and minimize tooth tipping during closure. The loops that are open inverted may make it more difficult for tooth-clasping elements to be placed on the teeth. This embodiment can be made using thin-shell vacuum-formed plastic. The loops can then be fully formed with the normal configuration. The loops can then be heated and flexed down to change their configuration. This invention should be easy to mass-produce using computer 3-D printer technology. The inverted configuration does not require any additional steps for loop flexion. FIGS. The wire interconnecting elements may also be made with wire loops in an inverted configuration. This is because wire loops are better suited to closing interdental spaces.
“Returning back to FIG. 22. This type of appliance can also made from a thermoformed sheets by heating the loops of interconnecting elements 41, and then bending them down into an inverted position. To heat and re-form thermoplastic material, an electric heat gun equipped with a blower or an ultrasonic welding machine could be used. The appliance can be printed in an inverted position if it is printed. The appliance doesn’t extend as far into the buccal vestibule and is therefore less likely to cause irritation to the cheek tissue or gum tissue. It also has a mechanical advantage. A loop that is open is better for moving roots closer together. The roots will be closer if the loop is inverted and it is opened. The same inverted loop geometry can be used in the first embodiment. However, you wouldn’t want to bend them downward. The wires should be arranged in an inverted position at the beginning.
“The FIG. “The FIG. 23 embodiment involves modification of materials used in forming positioner devices and could be applied any or all of these embodiments of this invention. We can use a 3-D printer to make a tooth-positioning device. Multiple print nozzles are capable of printing more than one material at a time. This capability allows us to print appliances made entirely from one material or with mixed or blended materials. We can also print appliances with portions made from one material and others made of another material. This will enable certain areas of the appliance to have more or less flexibility depending on the elastic modulus. FIG. FIG. 23 shows the tooth-clasping components 15 made from one material and the curved interconnecting pieces 42 made from another. The entire appliance will be printed in one piece. This means that the components won’t need to be attached or assembled in any particular order. As it prints one part of the appliance, the printer will move on to the next layer. The junction between the two materials can be simple butt-joint where one material ends and the other begins. Or, it can be more complicated intertwined zones with two materials interconnecting in such an way that the junction is stronger and resists pulling apart. There are many properties that can be shared between the two materials, including elastic modulus, color and transparency, strength like yield strength, tensile strengths, breaking strength, and clarity. If the printer can be programmed to intertwine or mix the materials in a short junction zone, the junction between the two materials might be stronger.
The type of malocclusion to be treated can affect the flexibility of interconnecting elements. To make it easier to insert a tooth that is severely rotated or tilted, a flexible interconnecting material can be used in the initial stages of treatment. The loops can become stiffer in later stages to allow for more control over final tooth position. Wire sizes can also be varied depending on the stage of treatment that fixed braces are used. Flexible materials can be used to interconnect elements while stiffer materials can be used to interconnect them.
“The embodiment shown in FIG. 12 The U-shaped interconnecting elements 40 are made from the same clear material as the tooth-clasping components 15. The appliance shown in FIG. 12 is a monolithic, one-piece structure. FIG. FIG. 23 can be fabricated in one piece using a 3-D printer capable of printing multiple materials at once. Preferably, the tooth-clasping elements 15 and 42 are made from a clear material. The interconnecting element 42, which is made of another material to control the flexibility properties of the curved loop, is also preferred. The printer uses multiple print nozzles to make it possible to blend the materials at the point where they join. The attachment of the two parts is not necessary.
FIG. “The embodiment shown in FIG. 24 is made of one piece of clear material as it covers the anterior tooth. You can either thermoform a sheet of material to cover the anterior teeth or print it using a 3-D printer. As in the first embodiment, interconnecting elements are not separately manufactured. A single-piece dental positioning appliance can be vacuum-formed on top of a plastic model. The appliance’s flange 16 extends over the gum tissue. This embodiment differs in that the flange 16 covers the entire interdental area, including the interdental and papillae. The plastic shell material is used to make cuts between the teeth. However, the shell does not completely separate into the tooth-clasping elements. The area 51 that is cut between the teeth forms a U-shaped interconnecting piece 52. It ends at the gum line. The appliance’s flange section, which includes the area between the teeth that covers the interdental papillae 51, serves the same purpose as the interconnecting loop-shaped 17 between two adjacent tooth-clasping element in the earlier embodiments. The flange extension of this appliance over the gum tissue would not allow for sufficient material to allow the interdental portion to perform the role of flexible interconnecting elements. This appliance would be printed on a 3-D printer and will have the same shape and size as the thermoformed version. The printer would not make cuts in the material to create the interdental gaps. Instead, it would simply not print those areas where the thermoformed appliance was removed.
“Alternatively, you can use the FIG. 24 can also be made by removing some of its appliance material to make it more flexible. This material can be considered’removed’ in two ways. If the appliance is thermoformed, then you can remove a portion of it by using a CNC laser cutter or CNC milling machine. A 3-D printer can be used to fabricate the appliance. However, only a portion of the plastic covering the teeth will be printed. This leaves spaces that are not covered. FIG. 24 is a similar embodiment to FIG. FIG. 24 looks very similar to FIG. 24 is very similar to the embodiment in FIGS. 11 and 12. Both embodiments can be made from one piece of material that covers each dental arch. Flexible interconnecting elements are the flange material that covers the gum tissue and the lingual and facial sides of the teeth. The additional flange material that covers the interdental area serves as the flange material. FIG. 2 shows the additional flange material that covers the interdental gum tissue (specifically the interdental-papillae). 24. However, it should be understood that this additional flange material covering the interdental gum tissue area (specifically covering the interdental papillae) is only shown in FIG.
The embodiment in FIGS. may be used at certain stages of treatment with an appliance system. 1-4 between two adjacent tooth, the embodiment of FIGS. 11-12 between two adjacent teeth, the embodiment from FIGS. 24 between the two next teeth. As the teeth align better, you will see groups of teeth being combined into units that lack interconnecting elements. In a separate disclosure, a space closing appliance is also shown. This allows the teeth to be combined into groups. FIG. FIG. 2.4-24 does not have any additional curved loops that can be used as flexible interconnecting elements, as in FIGS. 11. 11, 12. 11. and 12. 24. This version is simpler than FIGS. 11, and 12 are simpler and smaller than FIGS. These devices could still be more effective for small movements that a traditional tooth positioning appliance, which is currently manufactured by many companies.
“FIGS. 25-27 illustrate an embodiment that has clear tooth-clasping components 15 and interconnecting elements 30, which are U-shaped in horizontal plans and extend outward from the tooth clasping element. The tooth-clasping component 15 is connected to its neighboring tooth-clasping part using flexible U-shaped interconnecting element 30 that curve outward in horizontal planes. These elements are attached between the crown portion and the tooth-clasping elements. The interconnecting elements 30, which can have a curvature in multiple planes, could also be connected to one another. Materials of the tooth-clasping element 15 and interconnecting element 30 should be of different materials. The interconnecting element 30 is more flexible. This design could be printed easily using a multi-nozzle 3D printer. The interconnecting elements 30, which are oriented in a horizontal plane, would face away from the teeth. This means that the curve’s outer portion would be directed toward the cheek on the buccal attachment side and towards the tongue on lingual side. It is preferable to have four interconnecting elements between each pair of tooth-clasping element adjacent, one above another on the buccal and the lingual sides. You could use any number of interconnecting components. This embodiment is expected to be able to correct minor rotations or crowding.
“This embodiment may have the added benefit of being less visible than those in FIGS. 1-4, 11-12. The interconnecting elements 30, for example, can be made from any flexible material, including clear vinyl, clear silicone and clear urethane. Clear is not necessary for the posterior teeth. They will be rarely seen. The flexible interconnecting elements of the positioner can be printed simultaneously with a 3-D digital printer.
“FIGS. 28 and 29 illustrate an embodiment of a tooth-clasping component 15 that has been preloaded to better engage a tooth. This modification can be applied to any of the previously disclosed embodiments. Modifying the digital data set that corresponds to the shape of a dental model at any stage could allow the labial or lingual surfaces 13A and 13B to be moved inward towards the center of the tooth. This is located between the gum line and the level of bonded attachment. The appliance will fit tighter along the gum line, regardless of whether it is printed or thermoformed from a digitally-printed tooth model. The thermoformed positioners are prone to stretching after a few days of wear. The material will begin to relax. After being worn, the appliances loosen up. A digital modification to the tooth surface before the creation of the appliance will result is a tooth-clasping component that is preloaded when it fits over the full size natural tooth. This allows for a more snug fit.
“In particular, the area between the bonded attachments (and the gum line) is modified in the digital model that represents the 3-D surface contours. The areas 13A and 13B, which represent the buccal and the lingual portions of the patient?s tooth, are moved inward towards the center of their tooth by approximately 1-25% of its thickness. A digital model of the tooth is created to fabricate a thermoformed appliance. If a 3-D printed appliance is not required, the modified surfaces 13A and 13B, which represent the areas of the patient’s tooth from the gingival edge of the bonded attachment to the gum line, are moved inward toward the center of the tooth by a distance of approximately 1-25%. The change in the surface contours will not affect the gum line flange regions. However, when the appliance is placed on teeth, the actual contour of the tooth will push the tooth-clasping elements outward. The gingival flange will be moved slightly outward from the gum tissue to allow for more clearance so that the appliance does not impinge on the gum tissue.
“FIG. “FIG. 30” illustrates another embodiment, with longer interconnecting elements 17A & 17B on the buccal as well as lingual sides. The interconnecting elements 17A and 17B run between the appliance segments 60-602 and pass over one or more teeth. FIGS. FIGS. 31 and 32 show an alternative embodiment of the appliance that has longer interconnecting elements 17. These are only for the buccal portion of the appliance segments.
These embodiments could be used in situations where we want to intrude on incisors. The interconnecting elements 17A and 17B run from the canine to the central incisor. They do not include the lateral. The four incisors can be held together as one unit by a single appliance segment (61), while the remaining teeth to either side of the incisors can be held together by two appliances segments 60 and 62. These devices are intended to solve the problem of intrusion. The majority of the intrusion force is placed on lateral incisors, but the intrusion force is dissipated slightly when it is transferred onto the larger central incisor. This is because the larger tooth requires more force to penetrate it.
“FIGS. 33 and 34 are yet another embodiment of this invention with longer interconnecting components 17 between the tooth-clasping element 15 on each individual tooth. These interconnecting elements 17 are more irregular in shape and have a longer range of relative motion between the teeth-clasping element 15 and their respective teeth. The physical properties of interconnecting element 17 can also be customized based on their dimensions, shapes, and material properties.
“FIG. 35 shows the posterior teeth connected to one tooth clasping component, which extends from the second molar down to the cuspid. The flexible, clear, transparent interconnecting element 17 (one on each side, with the right side being shown in the figure), is made from the same continuous piece plastic as the rest of this appliance. It extends forward and touches the central incisor. This allows the four-unit anterior tooth clasping elements to wrap the incisors in the same way as in FIGS. 33 and 34. The appliance is activated so that the vertical force is directed straight upwards at the central incisors.
“FIG. FIG. 36 shows a similar appliance as FIG. 35 shows a similar appliance to FIG. 36, however the active interconnecting elements 17 are made from wire connected with the posterior tooth clasping component. Although the attachment method is not shown in this example, it could be any of the previously discussed methods for attaching wires. The wire is equipped with a helical coil at the end that attaches to its posterior tooth clasping component. The anterior end extends forward to the four unit tooth clasping elements surrounding the incisors. The wire will attach to the four-unit anterior teeth clasping element in the area of gum tissue covering the crowns of each tooth. This will make it less obvious under the upper lips. The wire should be attached. It will run all the way from the top of the four incisors to the left. This wire will mirror the wire on right and contain a helical coil. It is possible to attach the left and right-side posterior tooth clasping elements across your palate using any rigid material, including clear plastic. You can attach the left and right posterior segments to one another across your palate with a metal or plastic trans-palatal bar or arch.
“The disclosure above describes a variety of embodiments of this invention, as well as the accompanying drawings. The teachings of this invention can be modified, altered, or used in other ways, as long as they do not depart from the scope of the invention, which is set forth in the claims.
Summary for “Tooth positioning device with interconnecting elements curved”
“Field of Invention”
“The present invention is generally applicable to orthodontics.” The present invention relates to a tooth positioning device with interconnecting elements that curve.
“Statement on the Problem”
“A variety of aligners for orthodontic treatment have been used over the years to reposition teeth. The terms “aligner” and “positioner” are not interchangeable. The terms?aligner?,?positioner? und?tooth positioning device? are often interchangeable. They are often used interchangeably in orthodontics.
This type of orthodontic treatment usually involves separate appliances for the upper or lower teeth. The appliance fits over the teeth and covers most of the facial andlingual surfaces as well as the majority of the occlusal and biting surfaces. The plaster models used to make the early positioners in the prior art were based on three-dimensional negative dental impressions. By using a small jeweler?s saw or rotary cutting disks, the plaster dental models could be modified to reposition the plaster teeth in a more pleasing, straighter arrangement. Then, dental wax was used to hold the new arrangement. The basis for the manufacturing of the positioners is the reset teeth molds. The positioner’s material is resilient and can be used to move the teeth into a new, straightened position. Many of the designs that were disclosed in the prior art showed the teeth being moved in an incremental manner. It is difficult to make a series of appliances if each tooth arrangement must be done by hand with plaster and wax.
Digital technologies were introduced in the early 1990s and have since provided orthodontists fundamentally new tools to deliver orthodontic treatment. They allow for precise, small-scale fabrication of tooth models. Commercially-available CAD/CAM software can produce the desired tooth models, from which a progressive series of appliances can be manufactured. These tools include 3D imaging to visualize the patient’s teeth and CAD/CAM (computer aided design and manufacture) systems that create virtual models for orthodontic treatment. Then, custom-made orthodontic appliances can be made.
To create Invisalign-type aligners, a technician scans the patient’s upper model set and lower model set. This allows for CAD-manipulatable virtual models. A model set is usually composed of one upper and one below plaster models of the teeth, palate, and gums. After obtaining the virtual malocclusion model, the technician will perform extensive manipulations of that virtual malocclusion. This involves extensive repositioning the teeth in a sequential and comprehensive manner, resulting in a final or ideal occlusion. The final occlusion shown in the virtual model corresponds to the complete repositioning and adjustment of the patient’s upper & lower occlusions that would be required after successful conventional orthodontic treatment.
“After all the above steps are completed, the technician now has two versions of the patient?s teeth in the virtual CAD environment. The first version is the original malocclusion, while the second represents the ideal occlusion. The technician can also have the ending and the beginning states.
The next step in Invisalign is the creation of a series of incremental, progressive physical forming models. Each of these forming model represents a snapshot showing the patient’s future occlusion at particular incremental steps in the proposed treatment sequence. The technician creates a virtual “first transition model” to accomplish this. This model involves a slight repositioning or all of the teeth. The first model shows some or all of your teeth being subtly moved to a virtual transition position, which is in the desired direction. A second virtual transition model allows the virtual teeth to be moved in the desired direction. Invisalign technicians aim to create a series progressive models that are biased slightly more than the last one and move the teeth closer to their final target positions. The final forming model will take the finalized models from each of the transition positions and place them in their final desired positions.
“Once such a series of virtual intermediate forming models has been created and a final forming model has been created by the Invisalign technician, the digital code representing each of the models in the series is directed to operate a computer numerically-controlled (CNC) machine known as a rapid prototyping machine. The series of physical forming model are created using any number of traditional processes such as stereolithography or 3D printing within a rapid prototyping device. Each series of virtual intermediate models is then grown into hard copies and finally the final model.
The next step in Invisalign is to mount each series of physical models in a sucking machine. This uses a combination heat, pressure and vacuum to create the actual series progressive aligners out of plastic sheet material with a constant thickness. After the series of progressive aligners have been trimmed and formed, they are packaged and shipped to their attending dentist. After the aligners are trimmed and formed, the orthodontist schedules a patient’s appointment. The patient is then given the aligners along with instructions. The patient is asked to wear the first pair of aligners for two weeks. The patient is instructed to remove the first set and transition to the next series.
The aligners are used to encourage the patient’s smile to follow the Invisalign technician’s positional biases. By using the resilient polymeric material of the aligner, the teeth are gradually biased and urged toward the desired positions. The aligners provide gentle, but constant forces that cause the teeth to move in the desired direction. This triggers certain physiological processes which involve the creation and resorption of bone supporting the roots. This results in the gradual, progressive orthodontic movement that the roots of the teeth undergo through the bone to reach desired positions and orientations.
“Physiologic processes are when forces are applied on teeth. This results in bone resorption or new bone apposition. Research has shown that light, gentle continuous forces can cause the fastest tooth movement. When the appliance is placed for the first time, conventional aligner appliances apply more force to the teeth. The forces then decay quite quickly after a few days. Many stages of aligners correspond to small incremental movements. This is done to keep the forces lighter and to restore the force when it has decayed by moving on to the next stage. While multiple stages of aligners may theoretically allow for lighter, more continuous forces to be delivered, there are still issues with tooth engagement and keeping the force delivery within the required physiological range.
“Conventional removable aligners have limitations due to their design and the mechanical properties that clear thermoplastic materials currently used. Clear polymeric materials are nearly indistinct from metal braces and fixed stainless steel hardware. However, the flexibility of conventionally-formed aligners made from polymeric materials has been severely limited. This is especially true when aligning teeth that have not been properly aligned at the beginning of treatment.
Even though very small movements are made during each stage, the appliance might not properly engage the teeth that require to be moved. This is because the appliance isn’t flexible enough and isn’t designed to allow for movement within the material plane. An aligner that fails to properly fit a tooth will cause it to not move in the right place to be able to accept the next aligner in the series. There are two options available if aligners do not properly engage a tooth: 1) reduce the amount of movement that is attempted at that stage; or 2) place a larger bonded attachement on the tooth. These solutions will require the computerized treatment plan to be reworked. The plan must be revised as the aligners fit becomes less comfortable with each stage. After a few stages it becomes apparent that the computerized treatment plan was not accurate. This will require a revision.
“Solution to the problem”
“The present invention aims to overcome limitations caused by the inflexibility of the appliance material. It provides a tooth-clasping component for each tooth that is connected to adjacent teeth by curved interconnecting components. Because the interconnecting elements bend in a flexible way, each tooth-clasping element can be held securely in place. The choice of materials, the cross-section and the shape of interconnecting element determine the flexibility of interconnecting components. Most embodiments of interconnecting elements in the present invention use a small radius loop configuration. The radius of the loop should be approximately half the width of the tooth.
“This invention provides a removable and thin-shell tooth positioning device that has a plurality tooth-clasping components for removably engaging attachments bonded onto selected tooth teeth with flexible curved interconnecting pieces connecting the tooth-clasping element on adjacent teeth.”
These and other features and advantages of the invention will be easier to understand if you look at the detailed description and the drawings.
“Turning towards FIG. 1. The present tooth positioning device includes the following main elements: (1) bonded attachements 12A,12B bonded to selected lingual or buccal surface teeth 11; (2) tooth clasping element 15 that can be removed from the bonded attachments 12-A,12B; (3) curving interconnecting elements 17 that extend between adjacent tooth-clasping components 15. The tooth-clasping element 15 includes recesses that can be used over buttons or projecting elements called “bonded attachments?” 12A,12B are bonded directly on the teeth. The patient cannot usually remove the bonded attachments 12A and 12B during active orthodontic treatment.
“It is desirable that the tooth-clasping elements 15 of the front teeth be made from a clear polymeric materials. To produce the right tooth alignment appliances, a variety of plastic materials such as urethanes or polycarbonates can be thermoformed on tooth models. Any suitable material may be used. You should also know that the tooth-clasping component 15 can be either a separate part or a functional area of a single-piece appliance.
“The bonded attachments 12A and 12B are usually bonded to selected teeth 11’s buccal orlingual surfaces, as shown in FIG. 1. As shown in FIG. 5, bonded attachments can be rectangular with parallel sides. Although FIG. 5 shows a typical shape, it is possible to use bonded attachments in many other shapes. The bonded attachments 12,A and 12B serve two purposes. First, they increase the retention of tooth-clasping components 15 to the teeth 11 (or, in other words, the appliance will be less likely to become detached from the desired place on the teeth); second, the bonded attachements 12A,12B have a shape that allows tooth-clasping element 15 to transmit desired forces in three dimensions to the teeth, thereby controlling root movement. FIG. 5 shows the rectangular bonded attachment 12A. 5 The attachment 12A is a rectangular bonded attachment. This control can also be achieved by the inner surfaces of an attached projection, such as grooves and special shapes. Special outside shaping or grooves can be used to guide the tooth-clasping component into its proper position. Pre-made bonded attachments are possible from any material, including clear or tooth-colored ceramic material, dental composite, and any other suitable clear plastic material. Attachments 12A can be attached to the teeth using traditional bonding techniques or adhesives that are well-known in this art. This includes the steps of mildly acid-etching enamel before bracket placement. An art technique called indirect bonding is used. A guide of flexible material, pre-formed, holds the attachments in place while the adhesive cures. This ensures accurate attachment placement. Pre-made molds that can be used to place one tooth at a given time in dental composite are also available. Another option is to use a 3D CAD/CAM mold. The shape and size of the bonded attachements are designed in the computer. A 3-D printer prints a model of the entire arch, with all attachments attached. This mold can be used to create and place dental composite attachments at the exact location on the teeth.
“Preferably the tooth-clasping components 15 have a hole of exact dimensions (e.g. a rectangular hole), through which the bonded attach 12A,12B projects to removably connect the tooth-clasping component 15. A recess inside the tooth-clasping elements 15 can also be used. This is because the printing process allows for a better fit than thermoforming.
“The tooth-clasping components 15 can be attached to flexible, curved interconnecting element 17 of different types, as shown in the drawings. The appliances may be made from one piece of material. In some instances, the tooth-clasping elements and flexible interconnecting components are part of a single unit. Functionally, the tooth-clasping elements 15 and 17 are located in different parts of the single-piece positioning device.
“It is expected that the improved teeth positioners of this invention will be produced using computerized 3-DCAD/CAM software. This function is possible with many off-the-shelf software programs. To simplify the use of the software, it is a good idea to create new software that can be easily integrated with the skills of end-users of orthodontics. This function can be performed by open-source software. The surface is defined by the standard surface mapping computer algorithms as a series triangles. Vacuum-forming thermoplastic material over digitally generated models and combining the thermoformed part of the appliance with other elements can be used to produce the actual appliances. The next step involves using computer-automated trimming technologies like laser cutting or CNC milling. Vacuum thermoforming could also be used to produce the clear elements of tooth-clasping. The tooth-clasping and flexible interconnecting elements can all be vacuum-formed together in the single-piece embodiments according to the invention.
Positioners can also be made by 3D printing without the need to first create 3D models. Direct 3D printing has the advantage that complex shapes can be printed more quickly and require less trimming. This saves time and helps to avoid waste material. New 3D printers are capable of printing multiple materials simultaneously. Flexible interconnecting elements can be printed alongside the tooth-clasping part. They could also be made from different materials. You can mix or intertwine the materials, which eliminates the need to attach them separately. Direct CNC milling the appliances, or parts of them from a block made of plastic material is another option. The present appliances are expected to be manufactured in series. Each appliance will move the teeth only a little distance. Then, the next stage will continue the movement in small increments towards the goal. The appliance can be made in a way that fits over the teeth for each stage. To fit over the teeth, the appliance must be bent. Each tooth should be fully engaged by the tooth-clasping components 15. After the appliance has been worn for several weeks, the resiliency will allow the teeth to move toward the final stage. Next, the appliance will be attached to the teeth. This will move the teeth the prescribed distance. As the process of straightening teeth progresses, it is possible to need to take new impressions and digital scans every few steps.
“Many of these accompanying drawings show teeth-clasping elements placed over individual teeth. It is possible to create a separate tooth clasp for each tooth, if adjacent teeth are aligned. This is common and is expected to happen during later stages. If adjacent teeth are aligned well, it is possible to combine tooth-clasping parts. In certain stages of treatment, it may be possible to combine teeth in groups to serve as anchorage units. This will allow for better control of the movement of other teeth. The present appliance can then be broken into thin-shell segments. Each segment of thin-shell can be designed to fit into a set of adjacent teeth, i.e. one or more adjacent teeth. Only select teeth can be equipped with bonded attachments 12A and 12B to engage the corresponding tooth-clasping elements of the thin-shelled segments. This concept is similar to orthodontic treatment with fixed braces. To perform certain movements more efficiently, you can combine the features of multiple embodiments in this disclosure to create one appliance.
“To sum up, FIGS. The embodiment of the present invention shown in FIGS. 1-4 comprises clear tooth-clasping element 15 that is fitted over teeth 11, to which bonded attachments (12A,12B) have been placed on both their buccal and lingual side. Flexible U-shaped interconnecting elements 17 are used to connect the tooth-clasping components 15 to each other. These wire loops are attached to the flange (16 or extension) 16 of tooth-clasping element 15. This covers part of the gum tissue that is adjacent to the teeth on the buccal as well as the lingual sides. FIG. FIG. 2. This is a frontal view of a wire interconnecting component 17 with flattened ends. It is best to use nickel-titanium-shaped-memory wire. However, other materials are possible. The tooth-clasping elements 15 and interconnecting elements 17 will be almost invisible on the teeth 11. This embodiment is likely to be the most flexible and can be used to correct crowding and tooth rotations in situations that other embodiments are not possible. Because of the many parts and materials, this embodiment can be more difficult to make. You can mount the curved interconnecting elements 17 in an inverted position. Inverted loops are preferred for posterior teeth, even though they will be more visible.
“In particular, the 12A and 12B bonded attachments are preferred to be placed on the buccal or lingual aspects of all upper and lower teeth. However, there may be instances when not all teeth have all attachments. The illustrations show rectangular bonded attachments. The tooth-clasping element 15 is preferably made from a clear plastic material. The tooth-clasping elements are designed to fit the contours of the teeth as well as the bonded attachments. The bonded attachments 12A,12B can project through an optional window, or they can be completely covered by the appliance. The tooth-clasping component 15 fits tightly to the bonded attachment 12A-12B and the tooth crown covered by the tooth clasping device 15 so that forces transmitted to the tooth clasping 15 can be transmitted directly to it. You can direct the forces in any direction you need to correct malocclusion. To prevent wire being pulled from the covering material that forms the tooth-clasping elements 15, the curved interconnecting elements 17 should be made of flattened wire.
“This embodiment of invention includes a removable orthodontic device that can be worn by an orthodontic patient, after the bonded attachments 12A and 12B have been placed by the orthodontist. Preferably, the method allows for great precision such the aforementioned indirect bonding technique or a computer-generated mould. The appliance will be made in multiple stages, each one moving the teeth in small increments toward a final desired goal envisioned by the orthodontist and planned in the computer using commercially-available CAD/CAM software designed for this purpose. This method is best used when the teeth are at their most crowded and irregular. Ni?Ti wires have a greater flexibility than any other interconnecting elements. This should enable complete engagement of the tooth-clasping element in complex orthodontic cases that were previously not possible with removable positioner appliances.
The present appliance can be made from either a model of the patient?s dental anatomy made with conventional plaster, or a dental rock model made by pouring plaster or stone uncured (wet), into an impression made of silicone, alginate, polyvinyl Siloxane, polysulfide rubber, or any other suitable dental impression material. The plaster or stone is dried and trimmed with a standard rotating wheel model trimmer to make the base flat and smooth. Alternatively, the dental model can be obtained by using conventional digital scanning techniques of the teeth directly in the mouth using a commercially-available digital intra-oral scanner, or the plaster or stone model can be scanned using a commercially available digital model scanner, or the impression itself can be scanned using a digital scanner or a computerized tomography scanner (CT). From the digital data obtained by the scan, a three-dimensional model can be produced using a commercially available stereo lithographic printer, or a commercially-available rapid prototyping printer, or a model can be produced using a commercially-available CNC milling machine operating on any suitable material, most likely a plastic block.”
The base of the dental model has three-dimensional images (anatomic portions) of the teeth. Virtual teeth are images of teeth that are identical in size, shape and relative locations to the real teeth. The model of the tooth is a faithful representation of the actual teeth in the patient’s mouth.
“The bonded attachments 12A and 12B are used to attach an altered shape to the tooth, but it is different from the surface. These attachments are essential for ensuring that the removable appliance is placed in the right place on each tooth. Bonded attachments allow the tooth-clasping component to transmit forces to the teeth so that the tooth can be positioned in the desired position in all three dimensions. The bonded attachments extend from the teeth’s surfaces. In this illustration, the attachments are straight to align the tooth-clasping elements in the desired position. The bonded attachments should be applied to the teeth before any tooth movement.
“The tooth-clasping components 15 were created using an exact model of the teeth 11. FIG. FIG. 1 shows that there are 15 separate tooth-clasping components 15 that can be placed over each arch tooth. The shapes correspond to each tooth’s shape. Even though the teeth are touching, it is clear that there are gaps between each tooth-clasping component. The tooth-clasping elements inner surface should have the exact same dimensions and shape as the tooth on which they will be applied. The tooth-clasping material 15 has a thickness so the outer surface will be slightly larger than the inner surface. The outer surface is basically a slightly larger or inflated version the inner surface. The components of the tooth-clasping elements 15 touch the tooth 11 on the buccal, occlusal (top and bottom of bottom teeth), and lingual (inner).
The tooth-clasping component 15 may also include an extension (16 or clear flange) 16. The flange 16 extends approximately 2 to 3mm over the patient’s gum tissue on both the facial and the lingual sides of each tooth. However, the flange doesn’t have to be that far. The gum tissue is not usually touched by the flange 16. The clearance should be at least 0.5 to 1.0 mm.
The flange 16 can be used as an attachment point for flexible curved interconnecting components 17. The flexible interconnecting element 17 can be attached directly to the main body 15 of the tooth-clasping elements 15, such as in the space between the bonded attachments 12A, 12B, and the gum line. This is especially useful for posterior teeth, where concealing the loop behind the lip would not be as important. This would reduce interference between the loops, buccal frenum attachments, and other features. With the same size loops, the appliance would have a smaller vertical dimension.
“In this particular embodiment, each interconnecting component 17 is a U-shaped, heat-treated Ni?Ti memory wire. To avoid direct contact with gum tissue, the U-shaped interconnecting elements 17 extend slightly outward. It also maintains an open space 19 between adjacent tooth clasping elements. This allows for movement and allows for a range of motion. You can adjust the dimensions of the U-shaped loop and the heat treatment of the wire to obtain the desired shape-memory characteristics. This will allow you to apply the desired physiologic forces to the tooth-clasping element and, consequently, the forces to your teeth. The flexible interconnecting elements can be made from any material. The attachment means of the interconnecting elements 17 and the tooth-clasping section are not shown in this particular embodiment. This is due to their transparency, which would make them difficult to see.
“It is important to note that interconnecting elements 17 have flattened edges 18 in the embodiment shown at FIGS. 1. and 2. 1. and 2. The wire is prevented from being pulled out by the clear plastic they are encased in because of their bent ends. The interconnecting element can be attached to the tooth-clasping elements’ flange using a variety of methods. Clear cold-cure acrylic can be used to cover the wire much in the same manner that retainers are attached to wire elements. (2) The same material that is used to make the tooth-clasping elements could be used in a molten form using a glue gun nozzle. A thin layer could then be applied to the wire. This could be automated and the nozzle controlled robotically on an assembly line. (3) A small, plastic panel about the same size as that of the tooth-clasping elements could be placed on top of the flexible interconnecting elements ends. While it is held in place, an ultrasonic welding waveguide horn could also be attached to the plastic panels to fuse the small panel and the flange together.
“Alternatively, you could flatten the ends of the wire segments to stop it from pulling out of plastic. You could also use other methods such as a zigzag, bending the wire to an L-shape or double the wire to make a T-shape.
“It is worth noting that longer segments of wire can be used than those shown in FIGS. 1. and 2. One loop could connect multiple tooth-clasping components together with a longer section of wire. You can attach the wire using one of two methods: (1) Direct cementation with a composite cement or plastic cement covering the wire; (2) The tooth clasping elements could have a groove to receive the metal. If the groove is made so that the opening to accept the wire is slightly smaller then the wire and the area of the groove where it is to reside, the wire might snap into place. To receive a square or rectangular cross-section wire, the groove can be rectangular or square. You can even have multiple loops in the wire.
“FIG. FIG. 3 shows a right-side view of some upper teeth, with a portion the same type as the removable appliance in FIG. These teeth had 1 installed. Reference number 11A denotes the root of the upper right Cuspid tooth. You can see the mesial surface of the upper right cuspid crown at 11B, just beyond the mesial edge. FIG. FIG. 4. This shows five views of one tooth (upper right premolar), with bonded attachments 12A, 12B, and a tooth-clasping component 15. There are also U-shaped wire loop interconnecting elements 17 that can be seen from different angles.
“Note that the size 12A of the bonded attachments varies depending on the size and shape of the teeth. In this view, the bonded attachments protrude through holes in clear tooth-clasping components. These holes are the same size as the bonded attachments. It is not necessary that bonded attachments be rectangular. Also, the holes should not be drilled into the tooth-clasping element to permit protrusion of bonded attachments through these elements. The necessary clasp function will be provided by a simple recess on the inner surface the tooth-clasping elements that corresponds to the selected bonded attachment geometry. Even though the teeth may be in direct contact, there are 19 spaces between the tooth-clasping components 15. This space prevents tooth-clasping elements 15 from interfering with one another. FIG. FIG.
“FIG. “FIG. In this example, the x-axis is horizontal in the anterior-posterior direction. The vertical axis of the y-axis can be found in Figure 1. The horizontal axis of the transverse direction is the z-axis. The bonded attachment can be placed away from the crown. The force that acts on the bonded attach can cause the tooth to move in a different direction depending on its direction.
“FIGS. FIGS. 6-9 show three transverse movements along the z axis as illustrated in FIG. 5 (i.e. not in the X and Y planes of bonded attachments. All drawings show the upper right premolar tooth, viewed from the distal side. All these movements require that teeth are repositioned from their original positions to the desired position. This can be done either using a 3-dimensional digital file or a dental model. FIG. FIG. 6 is a reference view. FIG. FIG. 7 shows the lingual transverse movement (CC) of the root, with the center of it remaining in its original position. This movement is called root tipping and is difficult to achieve even with fixed braces. To ensure the desired movement, a trans-palatal support bar would be ideal. Although the bonded attachments are used to move the teeth vertically, there are also small transverse movements that occur on the tooth surface.
“FIG. 8 shows buccal transverse motion of the crown, with the center (or center resistance, CR) to movement of a tooth remaining in its original position. Tipping the crowns of teeth is easy because the roots of teeth tend to stay in place. This movement is achieved by the combination of movements on the buccal andlingual surfaces of the teeth, as well as the bonded attachments. This drawing shows that the vertical and transverse movements of the bonded attachments are approximately equal. However, the crown’s transverse tipping movements occur naturally when opposing vertical forces apply to the crowns of teeth. This is due to the resistance of bone around the roots.
“FIG. “FIG. 9 shows buccal and lingual transverse movements of the entire tooth with the center resistance (CR), and center of the crown(CC) moving exactly in the same distances and in the exact same direction. The tooth is not tipped. This type of movement is possible with bonded attachments. The bonded attachments must be very strong in their engagement with the tooth-clasping element and the flat top or bottom surfaces of the bonded attachments.
“FIG. “FIG. If a tooth is being extracted as part of an orthodontic treatment plan, it will be necessary to close the space while keeping the roots parallel on both sides of the extraction space. This will prevent the crowns from tipping into the extraction site. Fixed braces can also cause this problem. Fixed braces can be solved by placing a rigid arm with an anchor and a hook on the brackets. This allows for elastic bands to be used to close the space. The tooth’s center of resistance is found in the middle of its root. The elastic force will reduce the tipping moment by placing the attachment point for elastic band close to the tooth’s center of resistance. This method of closing the space will result in roots staying parallel. The tooth-clasping element 15’s flange 16 can also be extended to reach the center of resistance. An elastic band 71 may be used in the same manner. The forces on the buccal andlingual sides of the teeth would be parallel and the rotational moment with the band 71 on the buccal would be cancelled. It would be difficult for a dental patient who has a long appliance arm covering their gum tissue on the lingual end of their teeth to wear such an elastic band. However, this is possible under certain circumstances. It all depends on the curvature and shape of the palatal tissues. It could also be used to move roots, for example, to raise a tipped tooth. However, there is not enough interdental space. A group of teeth could be used as an anchor to prevent us from tipping teeth we don’t want to tip.
“FIGS. 11. and 12. show an embodiment made from one piece of clear, printed or vacuum-formed material. The flexible plastic interconnecting element 40 may not be as flexible as wire interconnecting pieces, but it will be much easier to make the appliance if the loops are less visible. The flexibility of clear plastic curved interconnecting components will make it possible to use the same assembly and manufacturing process as the first embodiment without the need for wire loops. The instructions for laser cutting or computerized milling will not be as easy if the appliance is thermoformed.
“This embodiment uses the same bonded attachments 12A and 12B as in the other embodiments. The removable positioning device is made in two parts, one upper and one lower. Each arch appliance is made as a single-piece appliance, with areas that serve as tooth-clasping element 15 and flexible, curved interconnecting elements 40. The areas of the appliance that are designed to engage the teeth and serve as tooth-clasping components are nearly identical in shape and form to the ones used in the previous versions. The 40 regions of the appliance that perform the role of flexible interconnecting elements have a curvature and are roughly the same size as the U-shaped wire connecting element of the first embodiment. It functions almost exactly the same as the first embodiment except that the plastic loop isn’t as flexible and as strong as a wire one. Although this embodiment can be used to make a thermoformed appliance that is placed over a number of tooth models, it may require more work to trim the excess material. This can be done with a laser or CNC milling cutter. However, it will require more complicated programming than for current aligners. Only the edge of the gum line must be trimmed. The entire apparatus could be 3D printed. This is likely to be the future of the industry once non-toxic, printable plastics are available.
For example, a flat, U-shaped ribbon of metal or plastic can serve as the curved interconnecting elements. However, FIGS. FIGS. 13-21 show that the physical properties and cross-sections of interconnecting elements can change by placing reinforcing or ridges 43, 44. The ribs 43 can strengthen U-shaped loops, and change their torsional and flexible properties. To increase tooth-clasping element strength, the ribs 44 can be extended beyond the loops onto tooth-clasping components 15. They are particularly effective in the central area of the clasps 15, where they engage the bonded attachments (12A, 12B). These strengthening ribs 43 and 44 can be made easily if the appliances have been printed with a 3-D printer. The interconnecting elements can be any shape you like, including oval, rectangular, multi-stranded cable or composite structures.
“FIG. FIG. 13 shows an enlarged portion of the appliance. 12. The flexible interconnecting element’s outer edge will have reinforcing Ridges 43 printed into it. The ridges 43 extend onto both the flange portion of the tooth clasping element and the main tooth-contacting section of the tooth clasping element. The reinforcing Ridge extends and becomes continuous on one tooth, in this instance the upper right canine tooth. A reinforcing Ridge 44 surrounds the entire bonded attachment on that tooth’s buccal surface. The reinforcing edges are used to increase strength and control the flex properties of the tooth-clasping and flexible interconnecting elements. This disclosure does not restrict the reinforcing Ridges 43, 44 to a particular place or configuration. The reinforcing edges can be placed anywhere they are required to increase strength and control the flex properties the tooth-clasping and flexible interconnecting elements.
“FIGS. 14-21 show several configurations of reinforcing Ridges that can be placed on flexible interconnecting elements and tooth-clasping components. Reinforcing Ridges can take any cross-sectional form. FIG. FIG. 14 shows two rectangular projections that form a C-shape. FIG. FIG. 15 shows one rectangular projection that forms a T-shape. FIG. 16 shows double rectangular projections. FIG. FIG. 17 shows two rectangular projections that form an I-shape. FIG. FIG. 18 shows two tapered projections that form a C-shape. FIG. FIG. 19 shows a single, tapered projection that forms a T-shape. FIG. FIG. 20 shows double-taped projections. FIG. FIG. 21 has tapered projections on both sides to create an I-shape.
“The embodiment shown in FIG. 22 uses interconnecting elements 41 in an U-shape. Inverted loop geometry is better to keep favorable forces applied to teeth and minimize tooth tipping during closure. The loops that are open inverted may make it more difficult for tooth-clasping elements to be placed on the teeth. This embodiment can be made using thin-shell vacuum-formed plastic. The loops can then be fully formed with the normal configuration. The loops can then be heated and flexed down to change their configuration. This invention should be easy to mass-produce using computer 3-D printer technology. The inverted configuration does not require any additional steps for loop flexion. FIGS. The wire interconnecting elements may also be made with wire loops in an inverted configuration. This is because wire loops are better suited to closing interdental spaces.
“Returning back to FIG. 22. This type of appliance can also made from a thermoformed sheets by heating the loops of interconnecting elements 41, and then bending them down into an inverted position. To heat and re-form thermoplastic material, an electric heat gun equipped with a blower or an ultrasonic welding machine could be used. The appliance can be printed in an inverted position if it is printed. The appliance doesn’t extend as far into the buccal vestibule and is therefore less likely to cause irritation to the cheek tissue or gum tissue. It also has a mechanical advantage. A loop that is open is better for moving roots closer together. The roots will be closer if the loop is inverted and it is opened. The same inverted loop geometry can be used in the first embodiment. However, you wouldn’t want to bend them downward. The wires should be arranged in an inverted position at the beginning.
“The FIG. “The FIG. 23 embodiment involves modification of materials used in forming positioner devices and could be applied any or all of these embodiments of this invention. We can use a 3-D printer to make a tooth-positioning device. Multiple print nozzles are capable of printing more than one material at a time. This capability allows us to print appliances made entirely from one material or with mixed or blended materials. We can also print appliances with portions made from one material and others made of another material. This will enable certain areas of the appliance to have more or less flexibility depending on the elastic modulus. FIG. FIG. 23 shows the tooth-clasping components 15 made from one material and the curved interconnecting pieces 42 made from another. The entire appliance will be printed in one piece. This means that the components won’t need to be attached or assembled in any particular order. As it prints one part of the appliance, the printer will move on to the next layer. The junction between the two materials can be simple butt-joint where one material ends and the other begins. Or, it can be more complicated intertwined zones with two materials interconnecting in such an way that the junction is stronger and resists pulling apart. There are many properties that can be shared between the two materials, including elastic modulus, color and transparency, strength like yield strength, tensile strengths, breaking strength, and clarity. If the printer can be programmed to intertwine or mix the materials in a short junction zone, the junction between the two materials might be stronger.
The type of malocclusion to be treated can affect the flexibility of interconnecting elements. To make it easier to insert a tooth that is severely rotated or tilted, a flexible interconnecting material can be used in the initial stages of treatment. The loops can become stiffer in later stages to allow for more control over final tooth position. Wire sizes can also be varied depending on the stage of treatment that fixed braces are used. Flexible materials can be used to interconnect elements while stiffer materials can be used to interconnect them.
“The embodiment shown in FIG. 12 The U-shaped interconnecting elements 40 are made from the same clear material as the tooth-clasping components 15. The appliance shown in FIG. 12 is a monolithic, one-piece structure. FIG. FIG. 23 can be fabricated in one piece using a 3-D printer capable of printing multiple materials at once. Preferably, the tooth-clasping elements 15 and 42 are made from a clear material. The interconnecting element 42, which is made of another material to control the flexibility properties of the curved loop, is also preferred. The printer uses multiple print nozzles to make it possible to blend the materials at the point where they join. The attachment of the two parts is not necessary.
FIG. “The embodiment shown in FIG. 24 is made of one piece of clear material as it covers the anterior tooth. You can either thermoform a sheet of material to cover the anterior teeth or print it using a 3-D printer. As in the first embodiment, interconnecting elements are not separately manufactured. A single-piece dental positioning appliance can be vacuum-formed on top of a plastic model. The appliance’s flange 16 extends over the gum tissue. This embodiment differs in that the flange 16 covers the entire interdental area, including the interdental and papillae. The plastic shell material is used to make cuts between the teeth. However, the shell does not completely separate into the tooth-clasping elements. The area 51 that is cut between the teeth forms a U-shaped interconnecting piece 52. It ends at the gum line. The appliance’s flange section, which includes the area between the teeth that covers the interdental papillae 51, serves the same purpose as the interconnecting loop-shaped 17 between two adjacent tooth-clasping element in the earlier embodiments. The flange extension of this appliance over the gum tissue would not allow for sufficient material to allow the interdental portion to perform the role of flexible interconnecting elements. This appliance would be printed on a 3-D printer and will have the same shape and size as the thermoformed version. The printer would not make cuts in the material to create the interdental gaps. Instead, it would simply not print those areas where the thermoformed appliance was removed.
“Alternatively, you can use the FIG. 24 can also be made by removing some of its appliance material to make it more flexible. This material can be considered’removed’ in two ways. If the appliance is thermoformed, then you can remove a portion of it by using a CNC laser cutter or CNC milling machine. A 3-D printer can be used to fabricate the appliance. However, only a portion of the plastic covering the teeth will be printed. This leaves spaces that are not covered. FIG. 24 is a similar embodiment to FIG. FIG. 24 looks very similar to FIG. 24 is very similar to the embodiment in FIGS. 11 and 12. Both embodiments can be made from one piece of material that covers each dental arch. Flexible interconnecting elements are the flange material that covers the gum tissue and the lingual and facial sides of the teeth. The additional flange material that covers the interdental area serves as the flange material. FIG. 2 shows the additional flange material that covers the interdental gum tissue (specifically the interdental-papillae). 24. However, it should be understood that this additional flange material covering the interdental gum tissue area (specifically covering the interdental papillae) is only shown in FIG.
The embodiment in FIGS. may be used at certain stages of treatment with an appliance system. 1-4 between two adjacent tooth, the embodiment of FIGS. 11-12 between two adjacent teeth, the embodiment from FIGS. 24 between the two next teeth. As the teeth align better, you will see groups of teeth being combined into units that lack interconnecting elements. In a separate disclosure, a space closing appliance is also shown. This allows the teeth to be combined into groups. FIG. FIG. 2.4-24 does not have any additional curved loops that can be used as flexible interconnecting elements, as in FIGS. 11. 11, 12. 11. and 12. 24. This version is simpler than FIGS. 11, and 12 are simpler and smaller than FIGS. These devices could still be more effective for small movements that a traditional tooth positioning appliance, which is currently manufactured by many companies.
“FIGS. 25-27 illustrate an embodiment that has clear tooth-clasping components 15 and interconnecting elements 30, which are U-shaped in horizontal plans and extend outward from the tooth clasping element. The tooth-clasping component 15 is connected to its neighboring tooth-clasping part using flexible U-shaped interconnecting element 30 that curve outward in horizontal planes. These elements are attached between the crown portion and the tooth-clasping elements. The interconnecting elements 30, which can have a curvature in multiple planes, could also be connected to one another. Materials of the tooth-clasping element 15 and interconnecting element 30 should be of different materials. The interconnecting element 30 is more flexible. This design could be printed easily using a multi-nozzle 3D printer. The interconnecting elements 30, which are oriented in a horizontal plane, would face away from the teeth. This means that the curve’s outer portion would be directed toward the cheek on the buccal attachment side and towards the tongue on lingual side. It is preferable to have four interconnecting elements between each pair of tooth-clasping element adjacent, one above another on the buccal and the lingual sides. You could use any number of interconnecting components. This embodiment is expected to be able to correct minor rotations or crowding.
“This embodiment may have the added benefit of being less visible than those in FIGS. 1-4, 11-12. The interconnecting elements 30, for example, can be made from any flexible material, including clear vinyl, clear silicone and clear urethane. Clear is not necessary for the posterior teeth. They will be rarely seen. The flexible interconnecting elements of the positioner can be printed simultaneously with a 3-D digital printer.
“FIGS. 28 and 29 illustrate an embodiment of a tooth-clasping component 15 that has been preloaded to better engage a tooth. This modification can be applied to any of the previously disclosed embodiments. Modifying the digital data set that corresponds to the shape of a dental model at any stage could allow the labial or lingual surfaces 13A and 13B to be moved inward towards the center of the tooth. This is located between the gum line and the level of bonded attachment. The appliance will fit tighter along the gum line, regardless of whether it is printed or thermoformed from a digitally-printed tooth model. The thermoformed positioners are prone to stretching after a few days of wear. The material will begin to relax. After being worn, the appliances loosen up. A digital modification to the tooth surface before the creation of the appliance will result is a tooth-clasping component that is preloaded when it fits over the full size natural tooth. This allows for a more snug fit.
“In particular, the area between the bonded attachments (and the gum line) is modified in the digital model that represents the 3-D surface contours. The areas 13A and 13B, which represent the buccal and the lingual portions of the patient?s tooth, are moved inward towards the center of their tooth by approximately 1-25% of its thickness. A digital model of the tooth is created to fabricate a thermoformed appliance. If a 3-D printed appliance is not required, the modified surfaces 13A and 13B, which represent the areas of the patient’s tooth from the gingival edge of the bonded attachment to the gum line, are moved inward toward the center of the tooth by a distance of approximately 1-25%. The change in the surface contours will not affect the gum line flange regions. However, when the appliance is placed on teeth, the actual contour of the tooth will push the tooth-clasping elements outward. The gingival flange will be moved slightly outward from the gum tissue to allow for more clearance so that the appliance does not impinge on the gum tissue.
“FIG. “FIG. 30” illustrates another embodiment, with longer interconnecting elements 17A & 17B on the buccal as well as lingual sides. The interconnecting elements 17A and 17B run between the appliance segments 60-602 and pass over one or more teeth. FIGS. FIGS. 31 and 32 show an alternative embodiment of the appliance that has longer interconnecting elements 17. These are only for the buccal portion of the appliance segments.
These embodiments could be used in situations where we want to intrude on incisors. The interconnecting elements 17A and 17B run from the canine to the central incisor. They do not include the lateral. The four incisors can be held together as one unit by a single appliance segment (61), while the remaining teeth to either side of the incisors can be held together by two appliances segments 60 and 62. These devices are intended to solve the problem of intrusion. The majority of the intrusion force is placed on lateral incisors, but the intrusion force is dissipated slightly when it is transferred onto the larger central incisor. This is because the larger tooth requires more force to penetrate it.
“FIGS. 33 and 34 are yet another embodiment of this invention with longer interconnecting components 17 between the tooth-clasping element 15 on each individual tooth. These interconnecting elements 17 are more irregular in shape and have a longer range of relative motion between the teeth-clasping element 15 and their respective teeth. The physical properties of interconnecting element 17 can also be customized based on their dimensions, shapes, and material properties.
“FIG. 35 shows the posterior teeth connected to one tooth clasping component, which extends from the second molar down to the cuspid. The flexible, clear, transparent interconnecting element 17 (one on each side, with the right side being shown in the figure), is made from the same continuous piece plastic as the rest of this appliance. It extends forward and touches the central incisor. This allows the four-unit anterior tooth clasping elements to wrap the incisors in the same way as in FIGS. 33 and 34. The appliance is activated so that the vertical force is directed straight upwards at the central incisors.
“FIG. FIG. 36 shows a similar appliance as FIG. 35 shows a similar appliance to FIG. 36, however the active interconnecting elements 17 are made from wire connected with the posterior tooth clasping component. Although the attachment method is not shown in this example, it could be any of the previously discussed methods for attaching wires. The wire is equipped with a helical coil at the end that attaches to its posterior tooth clasping component. The anterior end extends forward to the four unit tooth clasping elements surrounding the incisors. The wire will attach to the four-unit anterior teeth clasping element in the area of gum tissue covering the crowns of each tooth. This will make it less obvious under the upper lips. The wire should be attached. It will run all the way from the top of the four incisors to the left. This wire will mirror the wire on right and contain a helical coil. It is possible to attach the left and right-side posterior tooth clasping elements across your palate using any rigid material, including clear plastic. You can attach the left and right posterior segments to one another across your palate with a metal or plastic trans-palatal bar or arch.
“The disclosure above describes a variety of embodiments of this invention, as well as the accompanying drawings. The teachings of this invention can be modified, altered, or used in other ways, as long as they do not depart from the scope of the invention, which is set forth in the claims.
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