US2406527A - Orthodontic appliance - Google Patents

Description

Aug. 27, 1946. BERKE ORTHODONTIC APPLIANCE Filed Feb. 26, 1944 mfl m V e W M Z Patented Aug. 27, 1946 UNITED sm PATENT" OFFICE Joseph D. BerkejNew York, N. Y;

Application February 26, 1944, Serial No. 524,076

Claims.

This invention relates to the art or technique dontia and the provision of an improved orthodontic appliance for treating malocclusion.

In the treatment of malocclusion, different teeth of a given denture are required to be subjected to forces differing both in magnitude and direction for accomplishing various movements, differing with the nature or degree of dislodgment of the teeth from the arch line and the plane of occlusion. In general, a tooth or the teeth may require an uprighting movement for correction for mesial inclination (inclination sidewise with reference to the medial plane), an uprighting movement for correction for distal inclination (inclination backwards with reference to the arch line), a bodily movement to arch aligning position, an elevation or depression movement towards the occlusion plane, a rotative movement for axis orientation, or a combination of two or more of these corrective movements. The orthodontic appliance commonly employed in modern orthodontia in the treatment of malocclusion comprises a ribbon or equivalent arch mechanism. This a mechanism consists of a bracketon a tooth envelopin band and a suitably anchored arch wire or ribbon seated in a suitably slotted or receptacled part. of the bracket. Lig'atures anchored to the band are connected by the orthodontist to the arch wire and this connection is made so as to apply, both directionally and magnitudinally, the proper correctiveforces to the tooth. The ligature wire also serves to hold the arch wire seated in or to the bracket. T make effective the various corrective forces referred to, the arch wire also has to be bent at selected points along its length. Thus, for example, for a correction for mesial inclination, the archwire has to be bent to an inclined position in a vertical plane-,so as to be tensioned against spaced points on the bracket and thereby exert the required turning torque on the tooth. Many improvements have been suggested or devised for this technique, but in all of them, so far as I am aware, the arch wire has to be manually locked to the bracket so as' to be firmly seated therein and the arch wir has to be manually bent or adjusted to the individual teeth of each denture, andin most cases the use of ligature wires has to be resorted to. I

The orthodontia technique employing these appliances of the prior artis most difllcult both for the orthodontist and the patient. Besides obviously requiring great skill, even after proper diagnosis, to fairly accurately predetermine, both for magnitude and direction, the corrective forces to be applied, the workof bending and adjusting the arch wire to shape and of properly positioning and tieing in the ligature wires is hard and tedious to the doctor and trying and tiring to the patient.- Moreover, this work and the initial application of the orthodontic appliance is based upon a static diagnosis whereas a dynamic condition is brought about as soon as the teethmove responsive to the applied forces. The result is that the appliance is soon out of adjustment, and not being built for self-correction or automatic adjustment, frequent trips to the doctor are required or readjustments, to the discomfort both to the orthodontist and the patient.

In the orthodontia technique of my present invention, the proper corrective forces come into play by dint of the inherent or designed structure of the orthodontic appliance rather than by the manner in which the appliance is applied to the patient and adjusted. The orthodontic appliance of the present invention also comprises a band bracket and an arch wire, Without more, however, and both of specialconstruction, so designed that the following results and advantages are'accomplis'hed:

1. The arch Wire is directly mountable on and receivable by the bracket, without prebending or distortion or any other adjustment'and without theme of ligature wires or other locking or connecting means; 7

2. The forces come into play by the relation ship automatically assumed between the arch wire and the bracket by dint of theirstructure; and these forces that become applicable are substantially correct, both directionally and magnitudinally, for producing the desired corrective movement or movements of the teeth; and

3. The forces vary in the right directions and in the right magnitudes as the corrective movements take place in the use or wearing of the appliance, whereby self-adjustment takes place.

As a corollary, just as no adjustment is needed in initially applying the device to the denture, s0 noreadjustments are required as the correction'movements of the teeth take place.

To the accomplishment of the foregoing objects and such other objects as mayhereinafter appear, my invention relates to the orthodontic appliance as sought to be defined in the appended claims and as described in the following Fig. 5 is a view showing a length of the arch wire used;

Fig. 6 is a view of the latter taken iXLOIOSS-r section in the plane of the line 66 of Fig. 5

Fig. '7 is a plan view ofa; denture showing. the orthodontic appliance of the presentlinvention applied thereto for. producing a numberof' types of corrections;

mg." 8 is a front view'of the orthodonticapplian'ce'showing thesameapplied for correcting amesia}- inclination; e v p p Fig-L 9-is a side i'ew ofthe latter with parts shown in section; and Fig. 10- is an enlarged View of a development of the -centralandlateral incisors of' Fig. '7' showing the: orthodontic appliance and exemplifying cer tjairrprinciplesof operation thereof.

Referring now more n detail to the" drawing 7 and having reference first to Figs. 1 to new of, the orthodontic appliance of the present, invention comprises a button bracket which may be attached to or formed" part of a tooth band asshowm in Figs: 1 to 3 of the drawing and generally, designated as B, and a; resilient and flexible arch wire which preferably embodies a construction as shown in Figs. 5' and 6 ofthe drawing and generallydesignated as A, the said arch wire A and the button bracket B. being designed to cooperate or become interrelated as generically shownii'n Fig. 4 of the drawing and as exemplified by" denture application in the renclining, figures of the drawing. Referring now'to Fig. 41othe drawing, which shows a unit segment or component part'of the orthodontic structuiethe resilient and flexible arch wire A. is provided in one ofits segments with a loop member generally designated as l, the said loop member. being receivable. by the button 6' offthe bracket B. The loop member lis"; formed by top. and bottomcomponent ele ments of strands ZOI-and. 22' joined or connected together at spaced points as by means of the link yfl and 251 which latter may be suitably brazed or Welded to the strandsaZD and 2-2 The button I) comprises a' shank 23 and a head 30'. The elements of the button. b and; the elements of the loop l' are elongated and Dleferablyin the"horizontai'direction as clearly sh'owniin Fig. 4. With this: construction the loop member 1 when slipped over the head. 30 of the button b distends or expandsinto the-position shown inv full lines'in: Fig. 4; and then contracts itself into engagemer-itwith theshank28 of the button 11' as-fshownby the dotted linesin Fig. 4,, the normal; configuration of the loop; the resiliency ofgthei elements thereof andlthe anchorage of the strands-thereof at th'e'joined' points. or links 24 and 26; all contributing. to causing the loop a forces, all as will be further described more in detail hereinafter. 7

Referring now to Figs. 1 to 3 of the drawing, the button bracket B is fixed to a tooth encircling band 32 as by being brazed or welded thereto and in such a position as to occupy the center of the labial surface of the tooth when the band is applied to the tooth. The shank 28 of the bracket may also be provided with one or more orifices 34 depending npom the linear dimensions of the button b. f

The brackets may be made in a number of sizes particularly with respect to the linear button dimensions depending upon the tooth to which it is to be applied and the degree of correction needed therefor.

The arch wire may be constructed as best shown in Figs. 5 and 6 of the drawing. This arch wire A may comprise two parallel wire strands 36 and 38 connected along their lengths at-selected points such as All, til to fornr a-series of loops Z, I each embodying a construction" and formation such as shown and such as'hasbeen of component parts each the form of a loop member capable of functioning in the manner depicted in Fig; 4- of the drawing and more par ticularly described presently.

From theconstruction thus far described; it will be evident that the arch wire A is directly mountable on and receivable by a: number of brackets such as 3', without necessity of prebending or distorting the sameor'supplying any other adjustment and without the use of any ligature" wires or other locking Or connecting means: After the bracket bands. are applied to the patientstooth, the arch wire anchored at it's ends in a: conventional manner is then a plied by merely slipping the component loops 2, I over the heads I), b of the band brackets; after the: manner depicted in Fig; 4 or the drawi'ng; Eacn applied'loop member distendsor expands" itself ash is slipped over. the head of its button and contracts itself" into; engagement. with x the shank of such button. Immediately thisis done, each used loop member becomes lockedgor held in position by its button head and becomes effective" to: apply the corrective forces by its engagement with its associated button'shank and also withiit's' button head; 1 In Fig. T fthe drawing, I" show thearch wire A. applied: to a denture D and toa number of band brackets B, 13-. mounted on various teeth of the denture. In. this-figure fillu'strate a nillnber of different types of teeth dislod'gments. requiring diflierentcharactersof correction. Thus the central incisors t" and. I? (also shownin Fig. 1-0 of the drawing) are shown as requiringan upright ing correctionv fora'mesial inclination (shown in Fig; 10) and also-a/rotative movementifor axis orientation (as shown.- in Elsi-7).; The second bicuspid, left;v t is-showrr as requiring: a bodily correction but one-of:- larger' degrees The: appl-i-- cation ofthe principles: of theinvention tothe production of these: different corrections: will, it is believed, exemplify the; basic principlesiofsiop oration-of: the presentyconstruction. In: 7 the arch wire A is also-shown anchored onpthe meagre? I hammers i and f by means'offthe usual anchor c ampsaz nd'u.

"Rererrin -'-'now' to Figs. '8 and cor the drawing,

same as it is operative on a tooth requiring a -correction'for"mesial inclination and for axis 'orientationFAs shown in Fig. '10 of the draw- 'ing, after the loop 1 is slippedover the button of the bracket, the oppositestrands 20 and 22 thereof contract and come into engagement with the: opposite sides 46 and 48 of the button shank 28. The inclination of the tooth and the correspending inclination of the button shank, which latter is extended in a horizontal direction, causes the remaining distention or expansion of the loop as shown in Fig. 10, with the result that theopposite strands 20 and 22 of the loop exert a light torque pressure on the opposite sides of the shank Z8 creating the turning torque indicated by the two arrows 50 and 52. It will be noted that the torque exerted on opposite sides of the shank is in the same rotative direction and in a direction for correcting for the mesial inclinationof the incisor t. In this figure is also shown the adjacent central incisor t which, however, is shown to require a smaller correction for mesial inclination. Here it will be noted that because ofthe correspondingly smaller inclination of'the button shank 28' and the resulting smaller distortion or distention of the loop Z, the turning torque forces represented by the arrows 54 and 56' are quantitatively smaller than those operating upon the. tooth, t. Thus from a consideration of Fig. 10 of the drawing, it will be apparent that by virtue of the inherent or designed construction of the bracket buttons and the arch wire, not only do the corrective forces come into play automaticallyas soon as the arch wire is applied, but that-for corrections for 'mesial inclination the forces that become operative automatically are correct not only directionally but magnitudinally to correspond to the existing corrective needs. The pressures or forces required physiologically are extremely light and steady; the natural resiliency and flexibility of the arch Wires and their component'loops and the relationship between the component loops and the bracket buttons are such as to produce this very light yet steady pressure.

From a consideration of Fig. 10, it will be also evident that the orthodontic appliance is selfadaptablefor the dynamic condition which exists, and that it does not require the continued adjustments which characterize orthodontic appliances now in use. From a comparative consideration of the two central incisors t and t it will be seen that as the tooth moves in response to the turning torque forces from a position such as is assumed for the tooth t to a position such as is' assumed for the tooth t th turning torques automatically become smaller and smaller until a balanced condition is obtained when the tooth is fully uprighted. Thus the applied forces vary in the right directions and in the right magnitudes as the corrective movements take place in the use or earing of the appliance, selffa'djus'tment thereby continuously taking place.

Still viewing such figures as Figs. 8 to'10'of the. I

drawingit-will be noted that-each segment-or loop is individual in action, that corrective move ment of the tooth is determined by the orientation of the bracket and the interrelation between the loop of thearch wire therewith rather than upon any imparted distortion to the arch wire, the line or plane of the arch not being manually disturbed.

It will also be noted that the corrective movement depends upon opposite action of the two component strands of the arch mechanism. This appliance also eliminates jiggling of the tooth since there is no unwarranted movement due to any action and reaction of a spring arch' 'wire. The recoil of band and arch mechanisms incident to prior constructions is eliminated.- There. is complete control of pressure applied to each tooth. The force applied is determined by the relationship between the arch and the bracket button, predetermined by and inherent in the design and structure of these parts. The magnitude of the force is, 'ofcourse, dependent upon the length of the bracket button, the length of the loop-segment and the gauge of the arch wire; and suitable selections" may be made depending upon the particular case presented by the patient. e 1

Referring now againto Fig. '7 of'the drawi it Will be seen how this orthodontic structure operates for producing other types of corrections. Both central incisors t and Bare shown requiring'axial orientation. .From Fig. '7 it will be seen that the engagement of the strands of the arch wire with the button heads 30, 30 of the button brackets makes operative turningforces represented by the arrows 58 and 60'f or effecting this desired correction. The same action takes place, that is, the engagement of the loop wire with the button head, for correcting for distal inclination. Where a toothsuch as the second bicuspid t requires a short bodily move ment to arch aligning position, the arch wire may be directly connected to the button bracket as shown in Fig. '7; and here again the tension or pullis the result of the engagement of the strands 'ofthe loop with the head of the bracket button. Where, however, atooth such as the second bicuspid it requires a large bodily movement to arch aligning position as shown in Fig. 7, ligature wires may then be resorted to. To this end, the shank of the button is provided with the orifices 34, 34 heretofore referred to, and a ligature wire 62 is then used the same being threaded through these orifices to connect the bracket to the elementsv of the arch wire. It will be evident that for producing an elevation or depression movement towards the occlusion plane, the action of the arch wire will be one of tensioning engagement with one side (top or bottom) of the elements of the button. Thus the device is adapted for the various corrections 1. An orthodontic appliance comprising in 7 7 afitQmhinafi fin a. hhttenzhre seh att ehahle t 600th, said tenqhraelhethevihg-h.hhttpnrehhnk and head, and a; re ilient, :ehd :flexthh ze e wiremevideh a re ilient ehslhex hmJeQ member, staid leep mem e fleeing. *neeeiwehk .hy he button 1 ;s 'hhreehet; lthehloep membe exmhsiing .3451 1 .1s1h pedh e -th heed eithe button, anerzeentrhct he tself into ngage ent he. shank-e:- the h tteh, th hate Jqqpwem her flexibly and r s ently B nt ng oh eid-hhh qh hraek t to apply the 'eh h etwe .i r-ees tethe tee h-y e thedentie :eihh ience comprisi,-hg .in (cembihet eh e be dettac eble to a tooth abut ten hraeket 0h e d bend, eh d utt n b acket .h ng e utten shan .eeheeh and a e: ash-heat and flexible a eh whee l-previded wi h. :resihent rred-flex ble leenmemben the said. 1 9? member Jeeing rec vabl he he button o d bracket th lo p h emher' handih e it .ehppedp e the h ad 0 th button a d eon- Machine it elf into. fl a$m1' wi h the ishank 'e th :huttQh; t e vsaid 0p m m fle bly rand :reeihe t y ae ine on s d buttonbra ket to apply theerree i em e e th teeth.

The hrt dent appl anc of c aim ,1 in wh ehth at en h d a d h' m a e e ng ted in a, horizentaldireetien. v

e A, An :o th dqnt e vahnli mce. eomp s e mmbihetien a utton h eeket htt Qha rw 1a eeth. :s id hhtte .hr-aek t ha er at n :shehk e hd:.a'heed,ehd 1 res lie t and z exible arch W e @h sied Vwitha resiilent and flexible 1 09 mm- =be1t thers id ee m mbe b ing cei a le y the hutton-of s id mck tth ,loep me pendi g (as s sl p ed ove t e head of .the .,b. .t eha d contra ti t el mp e ga ement with t e i an of the uttoh. th said hav ngep e d bottom strands f exibly end ;r. s h t s' ee h on pposite h e ef he bu ter but in the samerrotetive direet'iqn t0 cor.- rest for "mesial inclinatipn DI the, teeth.

,5; erthodentic' applianee gqrqprismg in eccvmb inati on a, band attaehable to a \tooth arbut-x ton bracket on saiq band, t-said butter; bracket having a. button shankhangl :a .head, and are-s11 ieht'and ,flexihle arch wire provided with .a re..- ilient and flexible loop'member, the said loqp trhet he iteeli into en ageme t w th -the;.-heh of the button, the said p memhfihha ih xfil v.ahrl 'het em strands flexibly. end che ehtlrh ing en 92190i hides e the hutheh; e

rection, each of said button braeketg haV ixrg' Y- g button shank and a; head, arrq a resilient and ,fiexibleaifch wirehcemprising a-seriesqf ee negt member-being receivable by the-button .Qf said brac et, the member ex anding ,as his sl-ipped'over the h ad .o the'butten and eon- 7 ed e l nt nd exi le IQQP m mbehs, a legp me ber be ng i dividua he J ne et,v eae h- ;di clual p mem er e h xeeeivabl "by -the button its-b a ket s ch 10 p mem er x? p n ng s t i el ppe We t e head 9 t l- 6 ml?- ten and contracting it lf into eng gement with the hank" of t b tto su .lehnmemher fieh- .i-h y and. resi i nt y ac i g u e at ee y enthe shank o head or e h o said hutton hme ethte ap y the Q -re thre f rces o the tooth, hs ehes fer. mesial inc nation, distal i elm t ohlex mir ventatio elevation prvdepression, and arch 11 n- ;ing, or for producinge eombih t pn q suehh v echense t'lfhe orthodont c applia c Q hhmi in which the res l ent and fl xib e reh wire mmprivses. two pa alle w re strands. uni ed ht epeeefl int rvals t form the serie o.f ednneeted oop mem ers, 1 'fi-jilh orthod ntic appliance of claim 16 whi t utte head and h hehks Q the but. n br ckets are lehgated in a l lrlhrizen te11 d m hen, nd in which th shank are enfi iatesi Z69 eive ig re wi es, 4

The orth d nt c apn ahee o 6 in which t e n heed h h he ks 9f theibutr ton bracketsare elong ategina.jhorizqntal di tie a din wh h the esih nta'hd fL xih wire eom prises two parallel wire'stranq [ed at spaced. intervals to form the series pf e911: nected-loop'members.

10-. 'ln-anorthodont-ic appliance, a re'sflientagd I

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