DE10003885A1 - Metal wire teeth brace is manufactured in different sizes, for patients of different ages and the tooth bow size - Google Patents

Abstract

Metal wire teeth brace is manufactured in different sizes, for patients of different ages comprises a bow of one of the following alloys: (i) Chrome cobalt alloys (e.g. blue Elgiloy); (ii) beta titanium alloys, e.g. TMA; (iii) flexible nickel-titanium alloys, e.g. m-Niti; or (iv) stainless steel alloys. Metal wire teeth brace is manufactured in different sizes, for patients of different ages and the tooth bow size. The brace comprises wire of minimum strength 0,017 x 0,025 inch and max. strength 0,021 x 0,025. The wire bow comprises one of the following alloys: (i) Chrome cobalt alloys (e.g. blue Elgiloy); (ii) beta titanium alloys, e.g. TMA; (iii) flexible nickel-titanium alloys, e.g. m-Niti; or (iv) stainless steel alloys. The wire bow is inserted into mouth on certain teeth (a) in front: on the brackets of the teeth no. 21/12 and (b) in the back: into the tape auxiliary tubes of the teeth no. 6/6. The bow does not contact the remaining teeth, brackets or tapes. The wire bow bends downward behind teeth no. 2/2 and to the height of the cut edge of the teeth no. 2/12 vertically, and runs horizontal for 2-3 mm. Then the wire turns upward again, and runs horizontal to the rear on a somewhat higher level than the height of the front section of wire, which runs between the teeth 2/2, so that it runs somewhat higher than the slot of the Bracket of the teeth No. 5/4/3/3/4/5.

Description

1. The designation

A device for 3-dimensional control of the effects of "KL II elastic bands" in the upper jaw in orthodontics. ( Fig. 1, 2, 3, 4, 5)

2. The department of orthodontics, definition

"The main tasks of orthodontics are: prophylaxis, diagnostics and Therapy for malformed dentures and tooth position abnormalities. " Orthodontics Prof. Dr. Peter Schopf, head of the department for Orthodontics at the University of Frankfurt.

2.1. Classification: Class II 2.1.1 Definition

The technical term "CLASS II MALOCCLUSION" describes the malformation of the teeth, in which the teeth of the lower jaw have a more rearward position in relation to the teeth of the upper jaw than in the neutral teeth ( Fig. 8)

2.1.2. The blame for the "KL malocclusion" 2.1.2.1 Only in the upper jaw

with two options:

• a) only "dental alveolar":
  Here the bone base or skeleton ( 35 in Fig. 6) of the upper jaw (upper jaw) has a neutral relationship to the lower jaw (lower jaw), but the teeth with their alveolar bones ( 34 in Fig. 6) in the upper jaw protrude too much forward (forward) .
• b) "Skeletal and Dental Alveolar":
  Here both the upper jaw base and the teeth with their alveolar bones are advanced.

2.1.2.2. Only in the lower jaw

Here the entire body of the lower jaw is shifted back. In the lower jaw (UK), the body of the UK is almost always to blame for a relocation. Therefore, the dentist tries - if she is "KL II malocclusion" in the UK - to bring up the entire lower jaw (skeletal correction: 52 in Fig. 9) and not only the lower teeth with their alveolar bones alone (dental-alveolar correction: 53 in Fig. 9)

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The lower jaw is covered with the facial skull with ligaments, muscles and the TMJ connected (elastic binding).

This elastic binding allows the UK to make the desired correction (Advance).

Due to the renovation in the "temporomandibular joint" the neur is moved forward Maintain the position of the lower jaw in patients who are still growing and fully tolerated.

We call this correction "skeletal correction". In adults but almost only a "dental-alveolar" correction is possible.

2.1.2.3. Guilt in both jaws (upper and lower jaw) 2.1.3. Treatment goal

Achieving a neutral relationship between the top and bottom gearing by:

• a) The advancement of the relocated lower jaw
• b) The distalization (returning movement) of the advanced upper or upper teeth with their alveolar bones ( 38 in Fig. 7)

2.1.4. Treatment apparatus: there are 2 options a) Therapy with removable devices (loose clips) b) Therapy with fixed appliances (fixed brackets)

Since the "Kl II control sheet" invented by me has its scope in I have orthodontic treatment with fixed appliances briefly describe them.  

2.1.5. The fixed appliances in the Orthodontics

These basically consist of the following elements: ( Fig. 10)

• a) Metal straps: ( 53 in Fig. 10)
  These are cemented on the molars, the ligaments have a soldered or welded lock from the outside (buccal side: 66 , 67 , 68 , 69 , 70 in Fig. 11)
• b) Brackets: ( 63 in Fig. 10) have a "slot" for clamping the arch, in some cases they also have a hook ( 58 , 60 in Fig. 10) for hanging rubber rings. ( Fig. 12)
• c) Arcs: (metal wires: 57 , 62 in Fig. 10)
  These elastic wires exert the forces on the teeth through the brackets and bands. They are fastened in the "slots" of the brackets and in the "locks" of the bands with fine wires or "rubber ligatures".

2.1.6. Treatment of "KL II malocclusion" with fixed appliances

This treatment comes with various devices and devices carried out. Because of their effectiveness, simplicity and good tolerability the "Kl II elastics" and "Kl II Elastics" are the most common and most commonly used method to correct the "Kl II malocclusion".

These "Kl II Elastics" are elastic rubber rings ( Fig. 12), which the patient hangs on the hook of the band or bracket 24 hours a day. ( 56 , 59 in Fig. 10).

There are also the "tension springs" that have the same function ( Fig. 32), but they are firmly inserted by the orthodontist on the same teeth that the "Kl II rubbers" should have. These tension springs also essentially belong to the "Kl II rubbers".

As a rule, the "Kl II rubbers" from the canine tooth (tooth No. 3) are in the upper limb has a long strong root - to tooth number 6 in the UK - because of its long broad roots the most stable tooth in the UK is - hooked.  

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Since the "Kl II control sheet" is used in:

• 1. control of side effects and in:
• 2. optimizing the effects of the Kl II elastic bands in the upper jaw, I will see the effects of these elastic bands only in the upper jaw represent:

2.1.7. The effects of the "Kl II elastic bands" in the OK 2.1.7.1. Note 1

Because the lower jaw most of the time in the so-called "rest position" position remains, except when speaking and chewing, the next drawings to analyze the "Kl II Elasitics" and their effects in this Jaw position shown.

2.1.7.2. Note 2

Since the elastic band or its force (F in Fig. 13) runs obliquely, an "extruding force vector" (F2 in Fig. 123) is created on the teeth 3 | in addition to the distalizing force vector (F1 in Fig. 13) 3 in the UK.

2.1.7.3 Note 3

The arch ( 62 in Fig. 10) in the UK holds the teeth together, but remains elastic (depending on the alloy and thickness of the arch), and thus two effects arise simultaneously:

• a) On the supporting teeth (No. 1, 2, 3 in the OK)
• b) On the entire upper toothing

2.1.7.4. The end effects of the "Kl II elastic bands"

• 1. A force F (F in Fig. 13) that has two components:
  • a) the extruding vector (F2 in Fig. 13), which moves teeth 1, 2, 3 downwards
  • b) the distalizing vector (F1 in Fig. 13) which moves the teeth with their surrounding alveolar bones backwards.
• 2. Two torques:
  • a) the torque D1 (D1 = r1 × F1, Fig. 13) generated by the distalizing force vector F1.
  • b) the torque D2 (D2 - r2 × F2, Fig. 13) generated by the extruding force vector F2.
  and so the top toothing ultimately moves as in Fig. 14.

3. The problems

The invention (Cl II control sheet) eliminates the side effects of "Cl II elastic bands "in the upper jaw.

These side effects in the OK are:

3.1 Problem No. 1: The extruding force (F2 in Fig. 13)

The extrusion of the front teeth (No. 1, 2, 3) in the upper jaw can have undesirable consequences in certain cases, e.g. For example: in cases of "Kl II malocclusion" in which the patient has a short upper lip or a "gum smile" (in English: Gumsmile) ( Fig. 15), each extrusion of the upper anterior teeth causes an exacerbation of this unaesthetic appearance.

3.2. Problem No. 2: The torques D1 + D2 (in Fig. 13)

The two torques act together in one direction, so that the upper toothing rotates clockwise, which increases the negative effect of the above-mentioned extruding force vector (F1 in Fig. 13) and then causes the entire occlusal plane to tilt ( 79 in Fig. 14).

3.3. Problem No. 3: The insufficient anchorage in the OK

The elastic band in the OK is hung in one of these places

• a) on the hook of tooth No. 3 ( 60 in Fig. 10)
• b) on the hook of tooth No. 4 ( 58 in Fig. 10)
• c) on the hook that is placed on the arch between tooth no. 2, 3 ( 61 in Fig. 10)

The alternative b) has a fairly strong extruding force vector, therefore their application is limited to certain cases, where these Extrusion is desired.

Methods a) and c) are the most used alternatives. Although it maximizes (especially alternative c) the desired distalizing force vector (F1 in Fig. 13) and minimizes the often undesirable extruding force vector (F2 in Fig. 13), the anterior teeth (especially teeth No. 1, 2) are unfortunately ) weak anchorage.

The force F is mainly distributed among these weak teeth consequently represents a major obstacle for the orthodontist, stronger To use elastic bands.

However, this is often desirable to the entire relocated lower jaw to be presented (the desired "skeletal correction" of the "KL II malocclusion")

If the orthodontist is now using a rigid, strong straight arch ( 74 in Fig. 14) to alleviate the problem. e.g. B. steel wire gauge 0.019 × 0.025, he has a new problem:

The strong arch improves the anchoring of the weak on the one hand Anterior teeth, on the other hand, however, it is too strong and rigid to at the same time Correction of misaligned teeth, where elasticity and light forces provided that the correction of the "Kl II malocclusion" is carried out. So the practitioner has to make these two corrections "one after the other" and not perform "together".

4. The shortcomings of previous solutions 4.1 The solution No. 1: The alternative "c" in 3.3

• 1. Inserting the hook more down (on the arch itself) and more forward (between teeth # 3 and # 2) so as to minimize the "extruding" force vector (F2 in Fig. 10)
• 2. The shortcomings:
  • a) Although the "extruding force vector" (F2 in Fig. 25) is halved by the deeply inserted hooks, the distance-r- ( 142 in Fig . 25) has increased ( 139 in Fig. 25), and thus the total torque (D in Fig. 25) is increased: (D = r × F), therefore it is important, if no rotation in the OK toothing is desired, to compensate for this torque with an opposite torque, which is only possible with a "straight running arc"" not possible.
  • b) As described in detail in 3.3, the weak teeth (No. 3, 2, 1) are more burdened by this "forward" position of the hook, especially if the continuous arch ( 62 in Fig. 10) is not strong enough, such as the case when the correction of misaligned teeth is intended.
    In these cases, the arch must be soft and elastic to deliver small forces, which allows the "weak" front teeth to bear most of the strength of the "Kl II rubber" (problem 3.3).

So this solution minimizes problem # 1, but worsens it Problems # 2 and # 3.

4.2. Solution No. 2

The use of a "utility sheet" around the "extruding To balance force vector:

1.

The "utility sheet" according to "Ricketts" ( Fig. 16) is made of a "chrome-cobalt" alloy (blue Elgiloy), and of wire thickness 0.016 × 0.022 or - 0.016 × 0.016 "inch".

By activating this arch on "intrusion" on the front teeth No. 1 and 2 ( Fig. 17), an "intruding force" ( 100 in Fig. 18) arises, which the extrusion of the front teeth by the extruding force vector ( 101 in Fig 18) of the "II Kl elastic". compensates.

2. The shortcomings

Although this method solves problems # 1 and # 2, the problem remains No. 3 open: The weak anchorage for the "Kl II elastic bands" in the OK.  

4.3 Solution No. 3 1. The "tip-back" bend

This is a bend in the straight arch ( Fig. 20), which has a similar effect to the effect of a "utility arch" that is activated on intrusion of the front. (see 4.2).

2. The shortcomings

As in 4.2, problem No. 3 is not solved, and if a strong one rigid arc is used, then we have the same disadvantages as in of solution no.1 (see 4.1):

A strong rigid arch is good for anchoring the "Kl II rubbers" but bad for correcting misaligned teeth and vice versa.

5. The solution: The invention: The "Kl II control sheet" ( Fig. 1 + 2 + 3 + 4 + 5)

This is a wire arch that - in addition to the straight one Arch - on teeth No. 6. 2. 1 | 1. 2. 6 is used. This bow eliminates with its special construction, strength and Alloy the side effects of the "Kl II elastic" and offers several Advantages over the conventional techniques of treatment with the "Kl II elastic bands ".

5.1 State of the art

• 1. The construction of the "utility bow" (see 4.2) has been in since 1979 "Rickettstechnik" known: (see pages 311 to 317 in "Bioprogressive Therapy "by Robert M. Ricketts - The German Edition 1995, Hüthig- Publisher, ISBN 3-7785-2369-4)
• 2. The so-called "tip-back bend" (see 4.3) has also been around for a long time known.

The "Kl II control sheet" differs significantly from these two constructions (as we will see in 5.3).  

5.2 The technical description of the invention 5.2.1 The alloy

The "Kl II control sheet" can basically be made from 4 alloys:

• a) Chrome-cobalt alloys (e.g. blue Elgiloy)
• b) Beta titanium alloys (e.g. TMA)
• c) Stainless steel alloys
• d) the solid nickel-titanium alloys (M-Niti)

5.2.2 The strength

The "Kl II control sheet" can be used in wire thicknesses of:

• a) Minimum thickness from 0.017 × 0.025 inches to
• b) maximum thickness of 0.021 × 0.025 inches can be made

5.2.3 The construction (form)

• a) seen from above, the "Kl II control arch" has the shape of a dental arch in the upper jaw ( Fig. 2)
• b) the "Kl II control arch", seen from the side, makes 1-2 mm distal (backwards) of the brackets of teeth 2 | 2 a downward step (4 in Fig. 1), which is approximately the height of the cutting edge of the teeth 2 | 2 reached.
  This step is 2-3 mm long, the wire goes up to 1-3 mm higher than the front part (6 in Fig. 1) of the arch. Then the wire runs horizontally and straight up to 1-6 mm in front of the "auxiliary tape tube" of teeth 6 | 6 ( 69 in Fig. 11) where the wire makes a loop ( 3 in Fig. 1) that opens when the front part of the arch is lifted up. (i.e. activated on the front's corrosion, Fig. 21, 154 in Fig. 26).
  After the loop, the bow runs straight, then there is a "V-bend" or a "Stop" ( 13 , 16 in Fig. 3) so that the bend or the "Stop" fits the brackets of the teeth 2 1 | 1 2 is passive. ( Fig. 5)
• c) The "Kl II control sheet" has a ready-made "tick" (available in stores) at each stage, which is pressed onto the wire and thus attached. The opening of the tick faces forward (mesial, 5 in Fig. 1).
• d) the "Kl II control sheet" can also be produced in alternative forms ( Fig. 22, 23).

5.3 The news in the "Kl II control sheet"

• 1. The "Kl II control sheet" differs in strength
  This sheet has at least a thickness from 0.017 × 0.025 inch to a thickness of 0.021 × 0.025 inch compared to the "Utility", which has a thickness of only 0.016 × 0.016 or 0.016 × 0.022.
• 2. The "Kl II control sheet" differs in the alloy
  This bow can be made of harder alloys such. B are made of stainless steel compared to the alloy of "Utilities", which is only made of relatively soft chrome-cobalt alloy (blue Elgiloy).

3. The "Kl II control sheet" differs in its construction (compare the side image of the "Utility" in Fig. 18 with the side image of the "Kl II control sheet" in Fig. 26)

• a) the "step" (4 in Fig. 1) that positions the hooks deep.
• b) the "hooks" ( 5 in Fig. 1) for hanging the "Kl II rubbers".
• c) the "loop" ( 3 in Fig. 1), which allows elastic activation (intrusion of the front) despite the strength and rigidity of the wire from the "Kl II control bow".
• d) the absence of the large step ( 94 in Fig. 18), which characterizes the "utility" (3-5 mm high), so that the "Kl II control arch" after (distal) the step (4 in Fig. 1) runs very close to the back of the brackets. ( Fig. 26) This saves the patient the often occurring irritations on the inner cheek mucosa due to the high level of "utilities".
  Instead of this step I have attached a "V-bend" or a "Stop" ( 13 , 16 in Fig. 3) to attach the "Kl II control bow" to the "auxiliary tape tube": ( 124 Fig. 24) of teeth 6 | 6 to support.

4. The "Kl II control sheet" differs in its function

Unlike the "Utility", the function of the "Kl II control sheet" is wearing the "Kl II elastic band" and the control of their effects in all Space dimensions due to its strength, rigid alloys and the special Construction.  

5.4 The function

• 1. The extracts of the extruding force vector in the upper and lower jaw are reduced by about 50% due to the deeply inserted ticks ( 5 in Fig. 1). With function 3, this function solves problem No. 1.
• 2. The thickness (from 0.017 × 0.025 inch) and the alloy (all a, b, c, d, in 5.2.1 are not super-elastic alloys) make the "Kl II control bow" strong and rigid enough to make the "weak" Tie front teeth "(No. 1, 2, 3) with the large teeth of the upper jaw (No. 6), and thus - especially if a" normal "straight arch ( 26 in Fig. 5) additionally connects all teeth with each other - the power of the "Kl II elastic band" distributed to all teeth if possible.
  With function 4 and function 5, this function solves problem No. 3
• 3. The loop ( Fig. 21) plays the role of an "elastic hinge" which, despite its thick thickness and strong alloys, allows the bow to produce a biologically desirable elastic activation, and not the biologically harmful rigid activation when the loop is not would be present.
  An "intrusive" activation ( Fig. 26) on the front teeth can then be bent without hesitation in order to compensate for the extruding force vector, ( 133 in Fig. 24), problem No. 1.
  With a further intensification of the "intrusive" activation on the front, the torques D1 and D2 ( 129 , 128 in Fig. 24) - problem No. 2 - are also neutralized.
  This function solves problems # 1 and # 2 with function 1.
• 4. By means of the "V-bend or the" Stop "the" Kl II control bow "is supported on the back by the" auxiliary tape tube "of teeth 6 | 6, which each have 3 strong roots and are therefore the strongest anchoring teeth in the upper jaw. ( 127 in Fig. 24).
  The distalizing force vector ( 135 in Fig. 24) can thus the front teeth 3 2 1 | 1 2 3 only together with the strong molars 6 | 6 move backwards.
  To ensure that the teeth are firmly anchored 6 | 6 compared to other teeth in the upper jaw, I will present this information according to "contemporary orthodontics, Mossby, 1993, ISBN 0-8016- 6393-8, page 308, Fig. 10-26": the relative anchoring values of the following teeth will be like this rated:
  Tooth number 1 in the OK = 230
  Tooth number 2 in the OK = 194
  Tooth number 3 in the OK = 282
  Tooth number 4 in the OK = 254
  Tooth number 5 in the OK = 254
  Tooth number 6 in the OK = 533
  Tooth number 7 in the OK = 450
  If the total anchoring value of the teeth 3 2 1 | 1 2 3: 2 × (230 + 194 + 282) = 1412, we see that with the "support" of the "Kl II control sheet" on the teeth 6 | 6 the anchorage value increases to 2478, which means an anchorage increase of 75%. This anchoring can be done even more by inserting a "palatal strap" close to the palate on the teeth 6 | 6 reinforce. This function with functions 2 + 5 solve problem no.3.
• 5. Since an elastic straight arch (eg "super elastic niti" 0.0165 × 0.022 inch) "runs under" the "Kl II control arch" ( 157 in Fig. 26), we have the following functions:
  • 1. the straight arch strengthens the anchorage by binding the teeth 5 4 3 | 3 4 5 with teeth 6 2 1 | 1 2 6.
  • 2. At the same time, the elastic straight "Niti" arch can - if necessary - correct the "misaligned teeth" in the area of the teeth 5 4 3 2 1 | 1 2 3 4 5 as the rigid, strong "Kl II control sheet" is on the front teeth 2 1 | 1 2 only "supports", it does not prevent the desired small tooth movements. ( Fig. 28) This combination:
    • 1. reinforces the anchoring in the OK (solution of problem No. 3)
    • 2. Saves the orthodontist a lot of time by correcting two problems simultaneously and not "one after the other":
    • 3. a the correction of the "Kl II malocclusion" with its right to strong anchoring (which the "Kl II control sheet" offers).
    • 4. b the correction of the "misaligned teeth" ( Fig. 28) with their claim to a soft elastic arch that delivers small continuous forces.
• 6. The "advancement" of the front teeth when the arch is made of a more elastic alloy than steel. (e.g. M-Niti 0.017 × 0.025 or Elgiloy 0.018 × 0.025). However, this remains as a secondary function and must be carried out with appropriate caution, e.g. B .:
  • 1. the activation of the "advancement", ie limit the distance between the front teeth and the arch to 1 mm.
  • 2. binding the brackets of the teeth to be brought forward with elastic "rubber ligatures" instead of the "wire ligatures". (To make the exerting force as elastic as possible).
• 7. Summary of the functions of the bow:
  • a) With functions 1, 2 and 3, the "Kl II control sheet" solves problems No. 1 and No. 2 of the "Kl II elastic bands".
  • b) With functions 4 and 5, the "Kl II control sheet" solves problem no. 2 of the "Kl II elastic bands".

6. Practical example

Note: I calculated the assessment of the necessary activations below with the note that the measurements of the distances r1, r2, r3, r4, ( 158 , 165 , 166 , 160 in Fig. 27) and the angle ( 136 Fig . 26) can only be estimated on average (based on the models of different patient groups). The orthodontist varies these activations individually.

6.1 The presentation

If a static balance (balance) can be achieved on the upper face: ie neither extrusion nor intrusion of the front are desired. Then we have to:

• 1. calculate the extrusive force vector ( 133 Fig. 24):
  • a) the tensile force F ( 134 Fig. 24) can be easily measured in the mouth with a "spring balance" or "tension and" pressure balance ( Fig. 29) (assumed in our example that F = 150 g per side) .
  • b) in the physiological "rest position" of the lower jaw (as described in 2.1.7.1.), the angle ( 136 in Fig. 24) is an average of about 10 °.
  • c) it can be quickly calculated by sine or cosine that for a tensile force (F) of 150 g per side one:
    • 1. extruding force vector F2 ( 133 Fig. 24) of about 26 g per side and one
    • 2. Distalizing force vector F1 ( 135 Fig. 24) has about 148 g per side.

The general "extruding force" of both elastic bands on the right and left is about 50 g. This is the average intrusive force to which the orthodontist must activate the "Kl II control sheet" in order to neutralize the extrusive force vector ( 133 Fig. 24) when elastic bands of 150 g are used per side.

With the neutralization of the force vector F2 by the intrusive force F3 ( 155 Fig. 26), which was generated by the activation of the "Kl II control sheet", the torque D2 ( 129 Fig. 24) is simultaneously eliminated.

• 1. The torque D1 ( 128 Fig. 24)
  An approximately stronger "intrusive activation" than the force F2 ( 133 Fig. 24) creates the following forces and torques:
  • 1. the intrusive force F3 ( 155 Fig. 26) on the upper face
  • 2. the "reaction": an equal but opposite "extrusive force" F4 ( 148 Fig. 26) on tooth No. 6 (see page 14 in "Orthodontic Mechanics and Common Sense" by Thomas F. Mulligan, German translation 1987 from Klaus E. Färber, "American Orthodontics", University Library Hamburg-Saar No. Z-G209)
  • 3. the torque D3 ( 152 Fig. 26): D3 = r3 × F3
  • 4. the torque D4 ( 150 Fig. 26): D4 = r4 × F4
  The torques D3, D4 both act in a direction opposite to the torques D1 + D2 ( 128 , 129 in Fig. 24). If no rotation is desired, the torques must neutralize:
  D1 + D2 = D3 + D4 ⇒ D1 ( 162 ) + D2 ( 159 ) = D3 ( 164 ) + D4 ( 163 ) (all numbers in Fig. 27)
  In order to calculate the torques D1, D2 more easily and precisely, we will calculate the summing torque D (= r × F) instead of the two torques: D = D1 + D2
• 2. The assessment of the activation required:
  • a) F: ( 168 Fig. 30) is known in our example F = 150 g
  • b) r: ( 177 Fig. 30): this is the distance between
    • 1. the common "resistance center" of the upper toothing W ( 180 Fig. 30), which lies between the roots of the teeth No. 4 and No. 5 on each side and is approximately 4/6 the length of the root, Measured localized by gengwal whale bones
    • 2. the force F ( 186 Fig. 30).
      This distance can be estimated (for my patient impressions) by an average of 14 mm. r = 14 mm ( 177 fig. 30)
  • c) D: ( 178 Fig. 30) = r × F = 14 × 150 = 2100 gr.mm per side ⇒ D = 4200 gr.mm in total
  • d) r3: ( 183 Fig. 30): the straight distance between:
    • 1. the force F3 ( 184 Fig. 30)
    • 2. the "center of resistance" of upper teeth: W ( 180 Fig. 30)
      This distance can be estimated by an average of 22 mm: r3 = 22 mm
  • e) r4: ( 179 Fig. 30): the straight distance between:
    • 1. the force F4 ( 176 Fig. 30)
    • 2. the resistance center W ( 180 Fig. 30)
      The distance r4 can be measured with approximately 13 mm r4 = 13 mm
  • f) now with a simple calculation you can find the forces F3, F4:
    D3 = r3 × F3, D4 = r4 × F4
    If no rutation is desired ⇒ D = D3 + D4 but F3 = F4 in the absolute values, only the opposite directions
    ⇒ D = r3 × F3 + r4 × F3
    ⇒ D = 22 × F3 + 13 × F3
    ⇒ 2100 = 35 × F3
    ⇒ F3 = 2100/35 = approx. 60 g
    ⇒ F4 = F3 = 60 g on each side
    ⇒ F3 on both sides = 120 g ⇒ the orthodontist needs an intrusive force of about 120 g on the front to neutralize the rotation of the upper teeth

6.2. Final consideration

When using "Kl II control sheet" with strong "Kl II rubbers" 150 g per side (300 g total), the orthodontist needs on average:

• 1. 50 g of intrusive forces on the upper front to neutralize the extruding force vector F2 ( 133 Fig. 24)
• 2. an additional intrusive activation of 120 g to neutralize the torque D ( 178 Fig. 30).
  This makes a total intrusive activation on the upper face of 170 g to neutralize the extrusion and tilting of the upper face

The "Kl II control sheet" gives the practitioner the desired control over the vertical effects of the "Kl II rubbers" and their sliding "side effects" in the UK according to the following formula:
(Assuming that the tensile force of the "Kl II rubbers" is 150 g per side).

• 1. no vertical changes on the OK front is desired:
  the activation of the arch on "Intrusion of the front" of 170 g creates a static balance of the upper anterior teeth when using strong "Kl II elastic bands" of 150 g per side.
• 2. A slight extrusion of the maxillary anterior teeth and intrusion of the molars is desirable: (as in the cases of the "frontal open bite": Fig. 19)
  The activation of the "Kl II control sheet" on the upper anterior teeth must be less than 170 g (e.g. 120 g). The residual force (50 g extrusion) extrudes the front teeth somewhat, which helps to close the "frontal open bite", at the same time the force causes a torque that the upper toothing slides forwards and downwards (clockwise, Fig. 14). This also helps to correct the "frontal open bite"
• 3. The intrusion of the maxillary anterior teeth and the extrusion of the maxillary molars (especially 6 | 6 is desired) as in the cases of the "deep bite": Fig. 31):
  The opposite is to be done here. The intrusive force of the "Kl II control sheet" on the maxillary anterior teeth must be more than 170 g (eg 220 g). So the maxillary anterior teeth are intruded, the maxillary molars (6 | 6) extruded and the OK toothing counterclockwise, which corrects the "deep bite".

7. The advantages and the Applications of the invention

• 1. Due to its deeply inserted hooks (as described in 5.4.1) there is a reduction in the extruding force vector in the upper and lower jaw (which is often an undesirable side effect of the "Kl II rubber bands") when using the "Kl II rubber bands" by at least 50% ( Fig. 25).
  This reduction is important in the OC (as described in 3.1.), But it is even more important in the UK, since every extrusion of the supporting tooth in the UK (tooth No. 6) has drastic consequences in certain cases: In the cases of "Cl II Malocclusion "combined with" frontal open bite "( Fig. 19) or" tendency to open bite "causes any extrusion in the posterior region of the tooth (eg tooth 6) to worsen the" frontal open bite ".
• 2. The large reinforcement of the anchorage in the OK for the "Kl II elastic bands" by:
  • a) its thickness (as described in 5.4.2)
  • b) due to its rigid alloy (as described in 5.4.2)
  • c) by resting on the teeth 6 | 6 (as described in 5.4.4.)
  • d) by combining it with a second elastic straight arch ( 174 in Fig. 28 as described in 5.4.5).
• 3. The elimination of the sometimes undesirable rotation or tilting of the upper toothing by the torque D ( Fig. 13 as described in 5.4.3 and 5.4.7).
  This elimination can be done by the loop (3 in Fig. 1), which allows the arch - despite its rigidity and strength - to exert an "elastic intrusion" of the front teeth and thus two torques: D3 + D4 ( 182 + 181 in Fig. 30) generated, which compensate the torque D ( 178 in Fig. 30), and thus prevent the rotation of the upper toothing.
• 4. The correction of the vertical "denture malformations" z. B. a "frontal open or deep bite" ( Fig. 19, 31) simultaneously with the horizontal correction (the correction of the "Kl II malocclusion"). By increasing or decreasing the intrusive activation of the "Kl II control sheet", the practitioner can, depending on the indication, intrude or extrude the front teeth in the upper jaw (as described in 6). This simultaneous correction of horizontal and vertical problems shortens the total treatment time.
• 5. The "Kl II control sheet" enables the practitioner to simultaneously correct the misaligned teeth "during the correction of the" Kl II malocclusion "(as described in 5.4.5, Fig. 28). This also has the advantage of reducing the total treatment time (two Corrections possible at the same time).
• 6. The "protrusion" of the front teeth as a secondary function (as in 5.4.6 described).
• 7. The possibility of "Kl II control sheet" for transverse corrections too activate: Thanks to its strength and solid alloy, the "Kl II Control sheet "can be set wider or narrower, resulting in leads to the desired correction.

Important remark

If the patient's cooperation in attaching the "Kl II elastic band" is not ensured, with the result that the activation of the "Kl II control sheet" acts only on the teeth, the orthodontist must use "spring balancers" instead of the rubbers ( Fig. 32) use that are attached by him to the teeth with fine wires. In this way, the effectiveness of the entire power system of the "Kl II control sheet" can be guaranteed.

List of reference drawings Fig. 1 The "Kl II control sheet"

1

the "distal end" of the bow, which is inserted into the "auxiliary tape tube"

2

the "stop"

3rd

the "loop"

4

the downward step

5

the hook"

6

the front part of the arch

Fig. 2 The "Kl II control sheet" (seen from above)

7

the "distal end" of the bow, which is inserted into the "auxiliary tape tube"

8th

the "stop"

9

the "loop"

10th

the downward step

11

the hook"

12th

the front part of the arch

Fig. 3 Side view of two alternatives of the "Kl II control sheet"

13

a "V-bend" or a "V-bend"

14

the "loop"

15

the rear part of the arch, which runs slightly higher than the front part

16

a "stop"

17th

the "loop"

18th

the rear part of the arch, which runs slightly higher than the front part

Fig. 4 The "Kl II control sheet" (seen from the front)

19th

the "loop"

20th

the hook"

21

the front part of the arch

22

the downward "stage

Fig. 5 The "Kl II control sheet" in the mouth

23

the "V-bend"

24th

the "loop"

25th

the downward "step"

26

the straight running elastic wire

27

a "bracket"

28

a "rubber" or "wire ligature" that inserts the arch into the "slot" of the Brackets

29

jammed.

29

the hook"

Fig. 6 The upper jaw and lower jaw

30th

The body (skeleton, bone base) of the lower jaw

31

Tooth number 6 in the upper jaw

32

Tooth number 6 in the lower jaw

33

Tooth number 3 in the upper jaw

34

The "alveolar bone" in the upper jaw.

35

The body (skeleton, bone base) of the upper jaw

36

The "alveolar bone" in the lower jaw.

Fig. 7 The names of the tooth movements and directions of force in the Orthodontics

37 + 38

The "distalization": the movement backwards.

39 + 43

The "extrusion": the movement "out" of the bones.

41 + 44

The "intrusion": the movement "into" the bone.

42 + 46

The "Mesialization" or the "Advancement": The movement forward.

40

The roots of tooth number 6 in the lower jaw (UK).

45

The roots of tooth number 6 in the upper jaw (OK).

47

The upper jaw: Abbreviation: OK.

48

The lower jaw: Abbreviation: UK.

Fig. 8 The "neutral occlusion" and the "Kl II malocclusion"

49

Neutral occlusion

50

Cl II malocclessin.

Fig. 9 The correction possibilities of the "Kl II Malokklusin" in the UK

51

The lower jaw.

52

A "dental alveolar" correction.

53

A "skeletal" correction.

Fig. 10 Fixed appliance in orthodontics: (lateral View)

54

The bands of teeth number 6 in the upper and lower jaw.

55

Teeth number 4 and 5 in the OK.

56

"Kl II elastic band", which runs between tooth no. 3 in the upper jaw and tooth no. 6 in the lower jaw.

57

A straight arch in the UK.

58

Hook for hanging the rubbers. (Tooth number 4 in the OK).

59

A "Kl II elastic band" hung on a hook that is attached to the bow.

60

Hook for hanging the rubbers. (Tooth number 3 in the OK).

61

A hook that is attached to the bow.

62

A straight arch in the OK.

63

Brackets.

Fig. 11 The band of tooth No. 6 in the OK

64

The ribbon.

65

Tooth number 6 in the OK

66

Solder joint.

67

The "buccal" -, (outside), - closed the band.

68

Hook for hanging the rubbers

69

The ribbon's "auxiliary tube".

70

The "main tube" of the castle.

Fig. 12 Rubber rings of various strengths and sizes Fig. 13 The forces and torques caused by the "Kl II elastic band" be generated

71

The direct distance r1, hissing the force F1, and the "center of resistance" of the upper toothing.

72

The "center of resistance" of the entire top gear.

73

The direct distance r2, hiss of the force F2, and the "center of resistance" of the upper toothing.

74

A straight arch
F The power of the "Kl II elastic band".
F1 The horizontal (distalizing) force vector.
F2 The vertical (extruding) force vector.
D1 The torque generated by the force F1 on the center of resistance of the upper toothing: D1 = r1 × F1.
D2 The torque that is generated by the force F2 at the center of resistance of the upper toothing: D2 = r2 × F2.
Tool The "resistance center" of tooth No. 1 in the OK.

Fig. 14 The final movement of the upper toothing (represented by teeth no. 1, 2, 3, 6) as a result of the effect of the "Kl II elastic bands"

75

Tooth number 6 in the OK.

76

The "new" position of the center of resistance of the upper toothing.

77

The "original" position of the center of resistance of the top gear.

78

The front teeth in the upper jaw: (No. 1, 2, 3).

79

The new "tilted" occlusal plane in the OK.
D. The torque that causes the tipping.

Fig. 15  Patient with "gum smile": (with much visible gums when Smile).

80

The tooth flesh to be seen

81

The "smile line".

Fig. 16 "Utility sheet" in 2 forms for the OK (after Ricketts.)

82

The "distal end" that goes into the auxiliary tube "(

69

in

Fig.

11

) of volume 6 comes in.

83

The upward step.

84

the front part of the arch.

85

"Utility bow": Form No. 1.

86

The "distal end" that goes into the auxiliary tube "(

69

in

Fig.

11) of volume 6 comes in

87

the front part of the arch.

88

"Utility bow": Form No. 2.

Fig. 17th Side image for the activation of the "utility" on intrusion of the front

89

the "distal end" after activation

90

the "distal end" before activation

91

the "large" level that identifies the "utility".

Fig. 18 "Utilit arch" activated on the intrusion of the front used with a "Kl II elastic band" that runs "typically" (from tooth 3 in the OK to the 6th in the UK)

92

the "auxiliary tape tube" of tooth 6 in the OK

93

a straight arch

94

the "level" of the "utility"

95

the center of resistance of the upper toothing

96

the direct distance between the "center of resistance" (

95

)

97

F1: the distalizing force vector from the force F (

103

)

98

the hook for hanging the rubber

99

the "utility" activated for the "intrusion of the front"

100

the intruding force (by activating the utilities "

101

the extruding force vector from the force F (

103

)

102

the straight bow in the UK

103

the force F of the elastic band

104

Bracket

105

the hook for hanging the elastic band

Fig. 19 "KL II malocclusion" combined with a "frontal open bite"

106

the "Kl II malocclusion"

107

the "frontal open bite"

Fig. 20  "Tip-back" bend with a wire arch 0.018

108

the "tip-back" bend

109

the arch wire

Fig. 21  The "loop" of the "Kl II control sheet" that opens when the front part of the arch is lifted up

110

the "distal end" of the arch

111

a "stop"

112

the "loop"

113

in the direction of the front part of the arch

Fig. 22 "The Kl II control sheet" in "Alternative B"

114

the "distal end" of the arch

115

a "V-bend" or "V-bend"

116

the stage"

117

the hook

118

the front part of the arch

Fig. 23 the "Kl II control sheet": "Alternative C"

119

the "distal end" of the arch

120

the "loop"

121

the stage"

122

the hook

123

the front part of the arch

Fig. 24  the acting forces and torques when the "Kl II Elastic bands "on the" Kl II control sheet "are (the" Kl II Control sheet "deactivated here)

124

the "stop"

125

r1: distance between W (

126

) and F1 (

139

)

126

the "center of resistance" of the upper toothing

127

the roots of the tooth

6

128

D1: the torque generated by force F1 (

135

) and distance r1 (

125

) arises: D1 = r1 × F1

129

D2: the torque generated by force F2 (

133

) and distance r2 (

130

) arises: D2 = r2 × F2

130

r2: the distance between W (

126

) and F2

131

the "Kl II control sheet"

132

an elastic straight arch

133

F2: the extruding force vector of force F (

134

)

134

the power of the "Kl II elastic band"

135

F1: the distalizing force vector of force F (

134

)

136

the angle between the horizontal plane and the elastic band or its force

Fig. 25 A comparison between the vertical force vectors of "Kl II Elastic bands "in 1 "Typical elastic band" ( 147 , 139 ) and 2 an elastic band, inserted on the "Kl II control sheet" ( 143 , 146 )

137

the extruding force vector of the rubber on tooth 6 UK in the "Kl II control sheet"

138

the extruding force vector of the rubber on tooth 6 UK in the "typical Kl II elastic band"

139

the force of the elastic band that acts on the UK

140

the distance between W (

141

) and the force of the rubbers on the "Kl II control sheet"

141

the center of resistance of the upper toothing

142

the distance between W (

141

) and the power of the "typical elastic band"

143

the force of the rubber that acts on the UK

144

the extruding force vector on the OK front (rubber on "Kl II control sheet"

145

the extruding force vector on the OK front ("typical Kl II rubber)

146

the force acting on the OK front as a whole (rubber on "Kl II control sheet")

147

the force acting on the OK front as a whole ("typical rubber")

Fig. 26 The acting forces and torques when activating the "Cl II control sheet" on intrusion of the front

148

F4: the extrusive force on tooth 6

149

r4: distance between F4 and W (

151

)

150

D4: The torque generated by F4 (D4 = r4 × F4)

151

W2 of the upper toothing

152

D4: The torque generated by F4 (D4 = r3 × F3)

153

r3: distance between F4 and W (

151

)

154

the "Cl II control sheet" activated on intrusion of the front

155

F3: the intrusive force on the upper anterior teeth (by activating the "Kl II control sheet"

156

the "Kl II control sheet" inserted after activation

157

an elastic straight arch

Fig. 27 The detailed description of the forces and Torques when the "Kl II control sheet" intrudes on the front activated and also "Kl II elastic bands" are attached

158

r1: distance between W (

161

) and F (

171

)

159

D1: The torque (D1 = r1 × F1)

160

r4: distance between W (

161

) and F4 (

173

)

161

Center of resistance of the upper toothing

162

D2: the torque (D2 = r2 × F2)

163

D3: the torque (D3 = r3 × F3)

164

D4: the torque (D4 = r4 × F4)

165

r2: distance between W (

161

) and F2 (

196

)

166

r3: distance between W (

161

) and F3 (

168

)

167

the activated "Kl II control sheet"

168

F3: the intrusive force on the upper anterior teeth (generated by the activation of the Kl II control sheet "

169

F2: the distalizing force vector generated by F (

170

)

170

F: the power of the "Kl II elastic band"

171

F1: the extruding force vector generated by F (

170

)

172

the angle between F and the horizontal plane

173

F4: the extruding force (reaction of the force F3)

Fig. 28 The combination of the "Kl II control sheet" (to correct the "Kl II malocclusion") with a "super elastic A. Niti arch" (Zur Correction of misaligned teeth)

174

a "super elastic" straight "A Niti" bow

175

missing teeth

Fig. 29 Train and pressure scales Fig. 30 The total force F and the total torque D of the "Kl II Elastic band "against the forces and torques of the activated" Kl II Control sheet "

176

F4: the extrusive force (reaction of the force F3,

184

)

177

Distance between W (

180

) and F (

186

)

178

D: the torque D = r × F

179

r4: distance between W (

180

) and F4 (

176

)

180

the center of resistance of the upper teeth

181

D4: the torque (D4 = r4 × F2)

182

D3: the torque (D3 = r3 × F3)

183

r3: distance between W (

180

) and F3 (

184

)

184

F3: the intrusive force generated by the activation of the "Kl II control sheet"

185

the activated "Kl II control sheet (on intrusion of the front teeth)

186

the force F of the "Kl II rubber"

Fig. 31  "Kl II malocclusion" combined with "deep bite"

187

the "Kl II malocclusion"

188

the "deep bite"

Fig. 32  Tension spring

189

the ring for attaching the tension spring with "wires" to the brackets or bands

190

the tension spring.

Claims (6)

1. metal wire bow; which, seen from above, resembles the average arch shape of the upper jaw (OK).

• - The wire arch is made in different sizes depending on the age, gender and dental arch size of the patient.
• - The wire bow is made from (seen on average) square wire with a minimum thickness of (0.017 × 0.025 inch) and a maximum thickness of (0.021 × 0.025).
• - The wire bow is made from one of these alloys:
  • a) "Chrome-cobalt" alloys (e.g. "blue Elgiloy")
  • b) "Beta-Titanium" alloys (e.g. TMA)
  • c) less elastic "nickel-titanium" alloys (e.g. "M-Niti")
  • d) stainless steel alloys
• - The wire arch is inserted in the mouth on certain teeth.
  • a) In front: on the brackets of teeth no. 21 | 12th
  • b) Back: into the "ligament auxiliary tubes" of teeth No. 6 | 6

Otherwise the wire arch will have no contact with the rest of the teeth, brackets or ligaments. ( Fig. 5)

• 1. The wire arch is characterized in that it is distal (behind) on both sides of teeth No. 2 | 2 bends down and up to the level of the cutting edge of teeth No. 2. | 2 vertical, and about 2-3 mm again runs horizontally. Then the wire goes up again and runs further back at a slightly higher level than the height of the front part of the wire, which is between the teeth 2 | 2 runs so that it is now slightly higher than the slot of the bracket of teeth No. 5. 4. 3 | 3. 4. 5. or V. IV. III | III. IV. V is located ( 4 in Fig. 1).

2. Metal wire bow according to claim 1, characterized in that on downward steps, distal teeth 2 | 2, a metal hook with opening to the front and inside is attached. ( 29 in Fig. 5) 3. Metal wire bow according to claim 1, characterized in that the wire just before the band locks (tubes) of the teeth 6 | 6 forms a loop that opens when the front part of the arch is lifted up. ( 3 in Fig. 1, 112 in Fig. 21) 4. Metal wire bow according to claim 1, characterized in that on both ends of the wire bow a "stop": (metal ring, 16 in Fig. 3, 111 in Fig. 21) is attached, or a "V-bend" ( 13 in Fig. 3), which is on the front side of the "ligament auxiliary tube" ( 69 in Fig. 11) of the ligaments from the teeth 6 | 6 supports. 5. In modification no. 1 of the main construction, the metal wire bow according to claim 1 is characterized in that the loop itself is supported on the auxiliary tape tube (without "stop" or "V-kink": Fig. 23). 6. In modification no. 2 of the skin construction, the metal wire bow according to claim 1 is characterized in that only the "stop" or "kink" is made and the "loop" is dispensed with ( Fig. 22).