Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
  • A61C7/14—Brackets; Fixing brackets to teeth
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
  • A61C7/14—Brackets; Fixing brackets to teeth
  • A61C7/145—Lingual brackets
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
  • A61C7/20—Arch wires
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
  • A61C7/28—Securing arch wire to bracket
• • B—PERFORMING OPERATIONS; TRANSPORTING
  • B33—ADDITIVE MANUFACTURING TECHNOLOGY
  • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
  • B33Y80/00—Products made by additive manufacturing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/002—Orthodontic computer assisted systems
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
  • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
  • A61C7/14—Brackets; Fixing brackets to teeth
  • A61C7/16—Brackets; Fixing brackets to teeth specially adapted to be cemented to teeth
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
  • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
  • Y10T29/00—Metal working
  • Y10T29/49—Method of mechanical manufacture
  • Y10T29/49567—Dental appliance making

Definitions

• the invention relates to a method for producing an individualized orthodontic appliance for the treatment of a patient, intended to be used in the case of a lingual technique, that is to say with the appliance disposed on the face posterior not visible teeth.
• At least one orthodontic arch in other words a wire exerting on the teeth a force tending to bring them, from their initial unsatisfactory position, called “bad position”, to a satisfactory final position, called “corrected position”;
• fasteners also commonly known as “brackets”, each provided with at least one groove for receiving an orthodontic arch; these fasteners are individually fixed on the teeth of the patient, in a specific position allowing the orthodontic arch to transfer on the teeth the forces necessary for them to go from the wrong position to the corrected position during the treatment.
• Mass production uses tools specifically designed for each type, shape or model of part to be produced. These series parts have a very important dimensional accuracy of the order of 1/100 mm. The manufacture of the first part of the series takes time for the design and the programming of the tooling, but once these have been made, the manufacture of the following parts can be realized in large series in a very short time which compensates the significant cost of specific tools.
• Classically the methodologies used to produce orthodontic fasteners as standard are Metal Injection Molding (MIM), Ceramic Injection Molding (CIM), extrusion cutting and machining (the different machining processes are described by the NFE 05-019 standard).
• Rapid prototyping or “additive or subtractive manufacturing” consists of producing the part by progressive addition or subtraction of layers of material for direct or indirect manufacture.
• the manufacture is direct in the case where it is carried out in particular by laser sintering, indirect in the case where it is carried out in particular by casting with lost wax.
• a single individualized fastener can be manufactured faster than by machining or another method using specialized tools.
• the dimensional accuracy of this method is only of the order of 1/10 mm, which may be insufficient. Because of this, rapid prototyping is not suitable for producing complex shapes and more particularly precise orthodontic fasteners.
• CLASS It consists of two plaster casts with an impression of the arch and teeth in the wrong position of the patient. One of these casts is kept, the other is used by the technician to make a model of the arcade with the teeth in the corrected end position. For this purpose, the teeth of the molding are cut one by one and repositioned in said corrected positions (so-called “set-up” stage). Then the technician places serial attachments on pre-existing gauges, which seem to him the best adapted to the internal curvature of the teeth in certain zones of the arch (for example facing the incisors, facing each of the canines, facing each of the series of premolars and facing each series of molars), and approaches these sets gauge-fasteners of the teeth of the molding.
• Each gauge gauge corresponds to a preformed arc available in a range of standard orthodontic arches.
• the result is that one or some of the series fasteners can come to rest directly on the teeth of the molding, but that empty spaces exist between the other fasteners and the other teeth. These voids are filled with a resinous material to hold the fasteners in place.
• a photocopy of the molding is then made with the fasteners in place, from which the shape of the orthodontic arch which will be necessary to position the teeth in the corrected position is determined.
• the fasteners are partially trapped in small resin shells, placed on the teeth of the molding in the wrong position using holding devices, and then a silicone transfer key is made of the whole of the arcade, by means of which one can perform in a single operation the simultaneous transfer by gluing of all the fasteners on the teeth of the patient in the wrong position.
• the preformed orthodontic arch is then placed in the grooves of the series fasteners, where it is then blocked by closing the inlet of the groove to prevent it from escaping, and the treatment can begin.
• this process requires a very important time of realization and technicians extremely qualified and meticulous for its practice in the best conditions in order to obtain the best desirable results. Its use is restrictive for the patient because the orthodontic arches are not adapted precisely to the patient's morphology.
• this methodology has the advantage of allowing the use of series fasteners which may be integrated construction of a locking system of the arc in the groove by clipping or otherwise, called "self-ligating fasteners".
• this assembly can be made in the form of a single piece incorporating all the components that have just been mentioned, or in the form of two or three separate pieces that are then attached to each other;
• an orthodontic arch whose shape and dimensions can be standardized, exhibiting a substantially continuous curvature with the possible exception of zones corresponding, for example, to the transition between teeth or groups of teeth of different natures (for example between canines and premolars and / or between premolars and molars), and defining a succession of portions, each having a substantially continuous curvature.
• this arc has not undergone a complex conformation operation intended to adapt its shape in a fine manner to each of the patient's teeth.
• the orthodontic arch can therefore be of the known type called "straight wire” extending in a single plane and manufactured according to standardized models.
• the object of the invention is to propose a method for designing and manufacturing an orthodontic appliance which makes it possible to achieve an excellent compromise between the contradictory requirements of precision of the apparatus manufacturing and the minimal cost of this manufacture, while maintaining, of course, optimum performance for successful orthodontic treatment.
• the subject of the invention is a method for producing an individualized orthodontic appliance for the treatment of a patient, said appliance comprising at least one orthodontic treatment arch and a plurality of elements each comprising a fastener provided with at least one groove into which said orthodontic arch can be inserted, each fastener being intended to be placed on a base intended to be placed on a posterior surface of a tooth, said method providing for digitally designing said bases individually after having formed a representation model in corrected position of the arch and the faces of the teeth on which said bases are to be fixed, characterized in that:
• each base and its adapter compensate for differences in the morphology of the posterior surfaces of the teeth.
• said bent orthodontic arch is produced by means of said apparatus
• All of said bases can be manufactured by rapid prototyping.
• the subject of the invention is also an individualized orthodontic appliance for the treatment of a patient, said appliance comprising at least one orthodontic treatment bow and a plurality of elements each comprising a fastener provided with at least one groove in which said bow orthodontic may be inserted, each clip being intended to be placed on a base intended to be placed on a posterior surface of a tooth, characterized in that at least some of the bases are manufactured by rapid prototyping, the fasteners are series fasteners the orthodontic arch is a specifically folded bow, and said apparatus is made by the foregoing method.
• At least some of the fasteners are self-ligating.
• the method according to the invention makes it possible to achieve a compromise between different techniques known in isolation, by coupling their advantages, that is to say the manufacturing technologies by computer-assisted prototyping and mass production, but grouped here to form a whole coherent to obtain a performance apparatus with a cost as limited as possible.
• this method requires the manufacture of a specifically bent orthodontic arch instead of allowing to be content to use a standard orthodontic arch (straight wire) or not having only a limited number of folds with standardized locations and conformations.
• the advantage of the method according to the invention is to make possible the exclusive use of "standard” fasteners, so prepared in advance and having well standardized shapes and dimensions, by coupling their use with prototyped bases, so bases conformed to the morphology of the posterior surface of the teeth.
• This prototyped base pair and standardized fasteners have the clear advantage of combining the precision of the positioning of the bases with the very high dimensional accuracy of the series fasteners, as well as their possibility of being self-ligating.
• the insertion groove of the arc is configured with excellent dimensional accuracy; this allows the bow to be positioned there with a minimum clearance, and therefore to exert its action on the tooth with a precision as high as desirable to bring it to its intended end position.
• the groove can be given a complex configuration providing one or more anti-friction zones where there is no contact between the fastener and the arc.
• the serial manufacture of the fastener also allows to give it a complex shape, it can easily integrate a self-ligating device, which rapid prototyping manufacturing does not allow or in much less satisfactory operating conditions. If the self-ligating fastener is not available, the arc in the groove must be maintained by means of an elastomeric seal added to the fastener. This procedure increases the time of installation or adjustment of the equipment at each session, whereas in the case of a self-ligating fastener, a simple gesture of the orthodontist on the element ensuring the ligature is sufficient to achieve this. maintenance.
• the element ensuring this autoligature has the same surface qualities as the remainder of the fastener, while the elastomeric shutter has a high coefficient of friction with the metal of the arc, which hinders the sliding of the bow in the throat, so the good positioning of the tooth from its malposition.
• elastomeric ligatures undergo a significant degradation of their mechanical properties after only a few weeks, or even a few days.
• fasteners are self-ligating, but of course we can predict that only some of them are of this type.
• the digital design of the bases is made from a digitization of the arcade in corrected position and geometric parameters of the fasteners intended for them. In parallel with the latter, the method provides for the numerical design of orthodontic arches.
• the digital files generated by CAD will be used for the production of databases by rapid prototyping, this method having sufficient precision for their manufacture. Some bases can be made by rapid prototyping and others by another method without departing from the spirit of the invention.
• the digital arch design files will be used for the production of arcs by automatic orthodontic wire shaping machines.
• the bases are installed on the model of the arcade, and the series fasteners, previously manufactured and can thus be drawn from a pre-existing stock of standardized models in shape and dimensions, are fixed on the bases by welding or any other means. reliable bonding (gluing, or clipping if the designs of the base and the attachment allow).
• orthodontic arches are designed only in a second step and not in parallel. So :
• said bent orthodontic arch is produced by means of said apparatus
• the apparatus is thus made and can be transferred to the patient's arch by conventional techniques.

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• Health & Medical Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
• Epidemiology (AREA)
• Life Sciences & Earth Sciences (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Manufacturing & Machinery (AREA)
• Materials Engineering (AREA)
• Engineering & Computer Science (AREA)
• Chemical & Material Sciences (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Applications Claiming Priority (2)

Publications (1)

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Country Status (11)

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Citations (1)

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• 2009
  • 2009-11-25 FR FR0958348A patent/FR2952803B1/fr not_active Expired - Fee Related
• 2010
  • 2010-11-24 AU AU2010326479A patent/AU2010326479A1/en not_active Abandoned
  • 2010-11-24 CA CA2782046A patent/CA2782046A1/en not_active Abandoned
  • 2010-11-24 US US13/512,181 patent/US20130125398A1/en not_active Abandoned
  • 2010-11-24 BR BR112012012682A patent/BR112012012682A2/pt not_active IP Right Cessation
  • 2010-11-24 KR KR1020127016398A patent/KR20120101086A/ko not_active Application Discontinuation
  • 2010-11-24 EP EP10799098A patent/EP2503952A1/de not_active Withdrawn
  • 2010-11-24 MX MX2012005967A patent/MX2012005967A/es not_active Application Discontinuation
  • 2010-11-24 WO PCT/FR2010/052506 patent/WO2011067510A1/fr active Application Filing
  • 2010-11-24 JP JP2012540479A patent/JP2013512023A/ja active Pending
  • 2010-11-24 CN CN2010800598513A patent/CN102711655A/zh active Pending

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