WO2011148336A1 - Instruments pour opérations orthodontiques - Google Patents

Instruments pour opérations orthodontiques Download PDF

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Publication number
WO2011148336A1
WO2011148336A1 PCT/IB2011/052296 IB2011052296W WO2011148336A1 WO 2011148336 A1 WO2011148336 A1 WO 2011148336A1 IB 2011052296 W IB2011052296 W IB 2011052296W WO 2011148336 A1 WO2011148336 A1 WO 2011148336A1
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WO
WIPO (PCT)
Prior art keywords
tightening
tie
torque
orthodontic
forceps
Prior art date
Application number
PCT/IB2011/052296
Other languages
English (en)
Inventor
Andrea Bazzucchi
Original Assignee
Andrea Bazzucchi
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Andrea Bazzucchi filed Critical Andrea Bazzucchi
Publication of WO2011148336A1 publication Critical patent/WO2011148336A1/fr

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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
    • A61C7/02—Tools for manipulating or working with an orthodontic appliance
    • 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
    • A61C7/02—Tools for manipulating or working with an orthodontic appliance
    • A61C7/026—Tools for manipulating or working with an orthodontic appliance for twisting orthodontic ligature wires

Definitions

  • the invention refers to applications and treatments of orthodontic type usually aimed to correct directional defects and/or dental malpositions. More particularly, it involves new instruments for releasing, positioning and locking the tightening ties for the tooth support connections (brackets), adapted to provide a release of the ties that is quick, automatic and at the same time optimized from the standpoint of the stress supplied to the single tooth.
  • Bracket small connections 1 which support the arch 4 in fixed orthodontics. There are different types of brackets that are selected by the orthodontist according to the technique employed.
  • Metal arch the main arch 4 that is inserted in the bracket 1 with the task of guiding the movement of the teeth, in accordance with the form modeled by the orthodontist.
  • Metal ties 2 fine ties that lock the main arch 4 in the brackets.
  • Elastic bands they can be used to create additional movement forces of the teeth in fixed orthodontics.
  • Precompressed springs small springs (coil springs) that, when positioned between the brackets, cause the opening or closing of the spaces.
  • the most well-known fixed orthodontic apparatus is composed of metal or ceramic brackets 1 which, when fixed to the teeth, are coupled by mechanical instruments: wires, elastic bands, extra-oral tractions and springs, capable of bringing them into the correct positions.
  • the orthodontic connection (bracket) 1 is the main element of the fixed apparatus. It has a base treated in a manner so as to allow the adhesion to the tooth, and a body in which two fundamental components are obtained: the groove with rectangular section (slot) for the insertion of metal wires and the tabs for the retention of the ties necessary for locking the wires in the bracket.
  • the orthodontic bracket is defined Twin Bracket Edgewise. "Twin” because it is formed by a double pair of tabs, while “Edgewise” refers to the possibility of inserting rectangular wires in its slot.
  • the tooth can be made to move in all directions and with every type of movement. For example, a tooth can be moved towards the central line of the mouth, or moved away from the same; it can be moved towards the abutment surface, or towards the gum base, or towards the tongue or cheek.
  • the active elements of the inserted apparatus easily cause coronal tilt movements.
  • the crown is moved in the direction of the force and the root in the opposite direction: the tooth thus carries out a rotation-translation movement, with (in the most classic form) the center of rotation at the apical third of the root.
  • the object of the present invention is to carry out evaluations in real time on the forces which come to stress the single tooth, and still in real time activate a series of signals related to the attainment of the desired direction and force/pressure level in a manner so as to establish, in a semi-automatic manner, the attainment of the pre-established torque load and the passage to closure with tie means on the bracket of the subsequent tooth.
  • the object of the present invention is also that of providing instrumentation for orthodontic operations with a system for monitoring the torque which allows - at the time of application of the tie on the bracket - an interactive control by the orthodontist of the force and stress to be applied in relation to the movement of the tooth, such control being supported by sensors and detectors as well as by the interactive display of the operative conditions.
  • Another object of the invention is to define the use of force sensors and an apparatus with relative SW for the diagnosis of the recovery times of the tooth, by means of monitoring the torque at the time of application of the tie on the bracket, in a manner so as to define optimal stress characteristics.
  • one object of the present invention is to provide an apparatus for orthodontic operations, with torque monitoring system, that employs standard technologies, materials and constituent elements in the scope of the instruments used for dental orthodontics, in order to ensure the device has limited cost and easy maintenance.
  • the instruments are provided for an orthodontic treatment in which the directional movement carrier of the assembly is rendered precise and predictable, so that the teeth can be moved into a specific position in accordance with a programmed application plan of forces comprised between predetermined values.
  • the apparatus comprises forceps, which are operative due to a motor control group that imparts a rotation movement to the forceps themselves.
  • forceps in such embodiments are characterized by the fact that they have a torque limiter which actuates the interruption of the forceps rotation, when the locking torque of the tie on the bracket reaches a maximum pre-established level.
  • the presence of such limiter has already been described in other patents and requires expedients which were not considered herein since they are already known.
  • a rotary cylindrical element is considered provided with forceps 14 comprising jaw locking means actuatable from a control which is provided outside the rotation group of said forceps; a control function is however introduced by a pressure/force sensor 7 prearranged for adjusting the rotation which tightens the tie 2 on the side of the intertwining of the two twisted terminal wires in a manner so as to fix and lock the tie 2 on the bracket 1 with the relative integral correction arch.
  • FIGURE 1 is a section view of a typical orthodontic tie
  • FIGURE 2 is a schematic representation of the tie positioned on the brackets in which the steel metal arch is already inserted
  • FIGURE 3 is an external axonometric view of a tightening tie according to the invention.
  • FIGURE 3 A is an enlarged view detail of Figure 3
  • FIGURE 4 is a schematic representation of the signals which pass between the chair/patient and a control processor.
  • FIG. 2 Schematically reported in Figure 2 is a cross section of a bracket which is usually arranged on the median axis of the orthodontic arch; such arch is retained in position by means of two upper and lower (copper) wires 3' and 3" of the tie which was already reported in section in Figure 1.
  • Such tie is constituted by a wire made of nickel-chrome alloy and the two wires - symmetric components with respect to the median axis in the open section of insertion on the tabs of the bracket 1 - come to be twisted on each other in order to be able to fix the tie on the bracket itself, and come to constitute a two-wire intertwining.
  • the tightening tie 8 functions in a manner so as to grasp the terminal pair of intertwined wires, so as to subject it to a rotation motion and to have a greater quantity of twisted wire and simultaneously a fixing that is more or less tight (strong, medium, loose, etc.) on the tabs of the bracket 1 until a predetermined torque is finally obtained on the single tooth.
  • the tightening tie 8 used for fixing the orthodontic tie to a bracket 1 during an orthodontist treatment, provides for one or more basic forceps 14 - possibly with different shapes - which are longitudinally extended from a termination of the dispenser 8 in a manner such that the forceps can be opened or closed in order to pick up the wire of the tie.
  • the tightening tie 8 externally has a typical cylindrical shape, to be gripped like a pen, or it is a "pistol" shape characterized by a grip 10; on the upper part of the same, a key 9 is prearranged at the index finger of the dentist, which allows activating/deactivating the rotation movement of the forceps via pressing the key itself.
  • outwardly projecting forceps are prearranged, which allow the insertion of the twisted wires 3 on the termination of the tie, in a terminal locking element, exiting from the structure of the tightening tie.
  • a display 13 with relative numeric keypad 11 On the upper part of the tightening tie 8, visible to the orthodontist while he operates, is a display 13 with relative numeric keypad 11. On such keypad, it is possible to set the size of the maximum torque to which it is desired to subject the patient in the specific session, or the typical discrete level - strong, medium, loose - that it is desired to adopt for the fixing of the tie.
  • the greatest risk run at the time of application of the tie is that an excessive force is applied on the tooth due to an excessive torque exerted through the tie.
  • a profile of the operations is stored along with a relative application program of the stresses on the dental arch caused by the orthodontic apparatus.
  • the dentist office is equipped with a data bank in which an application program is defined for each patient.
  • the orthodontist inserts the code of the patient himself on the keypad of the tightening tie 8 and a connection is established in real time, possibly of wireless type, with the processor 6 and the relative data bank, from which the profile of the maximum stresses for the current session is obtained.
  • a weight sensor 12 is prearranged on the chair where the patient is seated; so that it detects the same initial session weight, it maintains active such predefined threshold level in the operations program, and is in any case user-settable.
  • a time window is used for defining a time interval within which one can operate with delimited values of maximum stress on the tie 2 of the current patient tooth.
  • the weight sensor 12 operates by means of an RX/TX device, it too positioned on the chair of the patient, resetting the tightening tie itself for new max/min threshold values each time that the weight sensor 12 detects a substantial variation of weight on the chair. This is done in order to ensure that when the patient has terminated the session, and moved away, the request for a reset of the limit operation threshold is automatically provided in order to prevent an exchange of application profiles between multiple patients, which would invalidate the principle of the maximum stress threshold level within which one can operate.
  • a connection is established with a device associated with the patient chair, and such connection can be implemented via cable or wireless.
  • the tightening tie 8 will request - by means of a light signal, for example - the reinsertion of the patient code, in order to establish the stress values.
  • the structure is simplified and provides for an external configuration like a cylindrical pen, which can be gripped like a pencil, with the initial preset made by computer and visualizer on the display of the computer itself.
  • a key 20 is externally present that activates/deactivates the rotation, like a dental drill, and on the end there are the forceps 14 for the insertion of the wire.
  • the simplest configuration provides that the same orthodontist loads the limit value of the torque.
  • the forceps 14 in any case form part of an independent head and are interfaced in a releasable manner at one end of the motor element that provides the rotary motion through a coupling of bayonet type, which therefore allows the tie insertion element 14 to be released and possibly sterilized.
  • the optimized structure according to the present invention comprises a speed reduction system, which is constituted by inserting a mechanical brake on the axis of the rotor.
  • Such mechanical brake is activated by a bistable relay which allows reducing the rotation speed up to total blocking.
  • a control is present that can be set by a program or a user over predefined limit values. Upon reaching such predefined limits, a sharp braking is imposed on the rotor.
  • the braking action intervenes at the moment when an excessive stress is detected on the tooth by a force microsensor 7 inserted between the tooth and the bracket or in the bracket/tooth/tie air space, particularly in the relative twisted zone, with an extractable tip.
  • force detectors are extremely widespread in other fields of the art.
  • Such pressure microsensors are prearranged in order to provide a measurement that is both precise and sensitive in relation to the measurement to be carried out, with sensitivities that vary from milliNewtons up to nanoNewtons.
  • the use of the described equipment also derives from the specific calibration of each microsensor which ensures high accuracy of the measurement and high reading speed.
  • the size of such microsensors 7 is on the order of tenths of a millimeter, i.e. on the order of magnitude of a pencil tip; such characteristic ensures that they can be inserted in very small spaces, that they are ideal for medical-dental applications.
  • the use has its origins in the same stainless steel constitution as an elliptical spring, which is elastically deformed when loaded. Such structure allows the device to accurately and reproducibly measure the applied forces.
  • a Wheatstone bridge is normally used that gives, in output, a signal that is sensitive and linearly proportional to the force itself.
  • the elliptical cross section and the ribbon cable of flat type retain the device anchored and oriented in the context of the bracket/tooth/tie structure.
  • the implant and movable insertion techniques can be of various type. They can be directly detected from the data sheets of the manufacturing company, and for this reason they are not further discussed herein.
  • the apparatus for orthodontic operations according to the present invention in any case comprises sections for sending the power supply voltage to the sensor 7, for detecting the continuous signal and the relative AID conversion, and then for registering the signals in output from the sensor itself.
  • a typical force and/or pressure sensor 7 according to the present invention is structured in elongated manner, preferably in pointed form, constituting a sensitive end adapted to be arranged between the tooth and the bracket.
  • the measured quantity is reported on one or more display units 13, of the same orthodontist instrument 8 or on a video of a PC 6, in any case in real time since they can be considered the most suitable operations for the current execution step.
  • a display 13 which reports the monitoring values detected by the force sensor. There is then a confirmation, also visual, that the treatment takes place in a suitable manner.
  • the sensor unit 7 for measuring the forces that operate on the tooth.
  • the functioning is based on a sensor which is configured for being placed between the bracket 1 and the tooth in timely contact with the external zone of the bracket 1 at the twisted zone of the tie.
  • the sensor unit is capable of supplying detectable signals that are indicative of the force to which the tooth is subjected.
  • the sensor device also communicates the data to a mass memory of the processor 6.
  • the relative processor processes the detected parameters and supplies a derivative signal which is indicative of the load conditions of the tooth in the zone subjected to dental operation.
  • An automatic control program - residing in the processor unit 6 - based on a specific algorithm (specified below), is capable of supplying the corrections to be actuated in the treatment that is being arranged for the teeth.
  • the sensor unit 7 is capable of supplying a signal indicative of the forces at play in real time, whereas the processor and memory unit 6 can on one hand acquire the information from the sensor on the forces that operate on the tooth, and at the same time, by intervening on the process, interactively provide a variation on the maximum value of the torque to be applied.
  • the orthodontist is allowed to display a projection of the possible effects of the application of a more or less considerable force.
  • the detectable signals are communicated to a data processor 6 on which the applications dedicated to the processing of the detected signals are present.
  • a data processor 6 on which the applications dedicated to the processing of the detected signals are present.
  • Such processor provides a signal in turn susceptible to being reinserted in the closed chain control in order to carry out, in relation to the realignment needs of the malpositioned tooth, an interactive regulation of the torque pressure and of the times for applying such torque.
  • the sensor 7 carries out the measurement of the force in real time, in a manner so as to adjust the intensity of the force itself that derived from the tie which is tightened during treatment.
  • the device is settable by the operator based on the type of orthodontic operation, as well as on the basis of the position of the teeth in the dental arch, setting precise values (of the torque) for each particular case; such values are acquired by a table and are stored and dynamically managed by means of an algorithm employed by the device 8.
  • the load torque is placed at a value selected by the operator, who cannot err in his operation since he will only have to press keys for every specific case; or, once a code is received, it will be the system 6 that automatically selects the values of the load torque (through a relative internal consultation table).
  • the device has a sensor 7 (e.g. needle-like) which monitors the values.
  • This data is communicated in real time to a microprocessor control unit 6, which can interrupt the functioning of the tie fixing device 8 in case of values that excessively differ from the nominal values, also actuating a monitoring with closed cycle control integrated in the device that undertakes the dental operation.
  • one is able to operate in a manner so as to provide a further display function of the teeth subjected to treatment and a series of parameters indicative of the relative positioning during the operation.
  • the type of diagnostic detection obtained from the data provided by the sensor 7 is indicative of the torque pressure to be applied and at the base of the operation regulation process by the device that actuates the procedure.
  • the functionalities of the sensor 7 according to the present invention can be activated in order to provide signals indicative of one or more parameters associated with the stress to which the tooth is subj ected.
  • several signals are simultaneously acquired and the same are processed.
  • Such directly detectable signals are brought to a processor 6 which, on the basis of a table system and a set algorithm, is capable of interactively monitoring the conditions of the tooth due to the active presence of the orthodontic apparatus.
  • the orthodontic views of the teeth with the relative directional defects are made visible on a monitor, as required by the dentist or medical operator, in general.
  • the dental technician sees, simulated on the video, what the profiles of the dental arch would be with the improvements on the malpositions deriving from the application of the forces to a lesser or greater extent, also in relation to the application times of the same.
  • Figure 4 shows the sensor unit 7 interfaced, in wireless mode, with a reading and processing apparatus 6, since it is the processor which analyzes the detectable response to the stress imparted on the basis of a control algorithm - keeping under consideration the characteristic parameters of the tooth - and supplies the data (such as the maximum limit of the torque) that is communicated to the software which activates and controls the locking of the tie on the bracket.
  • a reading and processing apparatus 6 since it is the processor which analyzes the detectable response to the stress imparted on the basis of a control algorithm - keeping under consideration the characteristic parameters of the tooth - and supplies the data (such as the maximum limit of the torque) that is communicated to the software which activates and controls the locking of the tie on the bracket.
  • the torque was activated until a level was reached which signaled the torque limiter, which exerted control; the regulation introduced provides for supplying a torque of predetermined discrete size depending on the type of tooth and on the type of malposition.
  • the treatment of orthodontic diseases depends on the capacity to examine and verify the tooth conditions in an accurate and objective manner. This is particularly important from the standpoint of public health or clinical situations in general.
  • the instrumentation for orthodontic operations with a system for monitoring the torque as described does not carry any danger, since the power supply is at low voltage.
  • the signals can also be transmitted in wireless mode.
  • the instrumentation for orthodontic operations with torque monitoring system is a revolutionary system that totally changes the working method of the dentist. It represents the maximum functionality in the relationship between the field and operator-objective parameters, manual ability and visibility of the operator, passive collaboration of the patient and maximum efficiency of the assistant.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

La présente invention concerne des instruments pour opérations orthodontiques avec un système de surveillance du couple qui utilise un lien de serrage (8) qui comprend : a - une pince (14) pour saisir et serrer une paire de fils d'extrémité enlacés d'un lien (2), b - un moteur, avec la source d'énergie relative pour actionner un mouvement de rotation de la pince (14) pour avoir une fixation/attache ajustable qui est plus ou moins serrée - résistante, modérée ou lâche sur le bracket correspondant jusqu'à l'obtention d'un couple prédéterminé sur une seule dent, c - un écran (13) qui permet de détecter les valeurs de surveillance en temps réel, d - un clavier destiné à définir le réglage sur lequel la procédure de serrage opère. Un processeur qui se trouve à l'extérieur ou à l'intérieur du lien de serrage permet différents types de commandes en se basant sur la détection en ligne du couple appliqué.
PCT/IB2011/052296 2010-05-27 2011-05-26 Instruments pour opérations orthodontiques WO2011148336A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITRM2010A000282 2010-05-27
ITRM2010A000282A IT1401191B1 (it) 2010-05-27 2010-05-27 Strumentazione per interventi di ortodonzia.

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Publication Number Publication Date
WO2011148336A1 true WO2011148336A1 (fr) 2011-12-01

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WO (1) WO2011148336A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5885072A (en) * 1995-10-23 1999-03-23 Kim; Joong H. Automatic ligation tool to fasten ligature wire to orthodontic bracket using driving apparatus
US20030047230A1 (en) * 2001-09-12 2003-03-13 Kim Joong-Han Apparatus for ligating wires
KR100472905B1 (ko) 2004-03-31 2005-03-14 주식회사 피앤에스미캐닉스 치아 교정용 결찰 철사의 결찰 장치
WO2009080947A1 (fr) 2007-12-07 2009-07-02 Vineis Sas - Construction Mecanique De Precision Appareil de serrage d'une ligature rigide de maintien des arcs orthodontiques montes sur des brackets

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5885072A (en) * 1995-10-23 1999-03-23 Kim; Joong H. Automatic ligation tool to fasten ligature wire to orthodontic bracket using driving apparatus
US20030047230A1 (en) * 2001-09-12 2003-03-13 Kim Joong-Han Apparatus for ligating wires
KR100472905B1 (ko) 2004-03-31 2005-03-14 주식회사 피앤에스미캐닉스 치아 교정용 결찰 철사의 결찰 장치
WO2009080947A1 (fr) 2007-12-07 2009-07-02 Vineis Sas - Construction Mecanique De Precision Appareil de serrage d'une ligature rigide de maintien des arcs orthodontiques montes sur des brackets

Also Published As

Publication number Publication date
IT1401191B1 (it) 2013-07-12
ITRM20100282A1 (it) 2011-11-28

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