WO2015040495A2 - Système/procédé de production d'appareils orthodontiques - Google Patents

Système/procédé de production d'appareils orthodontiques Download PDF

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Publication number
WO2015040495A2
WO2015040495A2 PCT/IB2014/002784 IB2014002784W WO2015040495A2 WO 2015040495 A2 WO2015040495 A2 WO 2015040495A2 IB 2014002784 W IB2014002784 W IB 2014002784W WO 2015040495 A2 WO2015040495 A2 WO 2015040495A2
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WIPO (PCT)
Prior art keywords
teeth
aligner
protrusions
cuffs
forces
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PCT/IB2014/002784
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English (en)
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WO2015040495A3 (fr
Inventor
Lam Seng TAN
Kok Liang Tan
Ronny Wai Kin LEE
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Megabite 3D Pte Ltd.
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Publication of WO2015040495A2 publication Critical patent/WO2015040495A2/fr
Publication of WO2015040495A3 publication Critical patent/WO2015040495A3/fr

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    • 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
    • A61C7/08—Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch
    • 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

Definitions

  • the present invention is in respect of an orthodontic appliance including aligners used in orthodontic treatment.
  • the invention relates to the production and/or method of manufacture of aligners as well as the design and application of orthodontic aligners for the adjustment or repositioning of teeth as well as the extrusion of teeth in an effective way.
  • braces and aligners are appliances used by the orthodontist to realign teeth to their correct respective positions and/or to adjust or reposition the teeth relative to each other so that they are evenly aligned and enable proper bite as well as promote aesthetically pleasing appearance.
  • Orthodontic braces are traditionally used at the commencement of treatment as there is usually a need to apply a relatively stronger corrective force for the repositioning of teeth. This would be applicable to teeth that are misaligned to a greater degree.
  • an aligner or retainer is typically used to promote further incremental movements or to maintain the new position of the teeth.
  • the aligner is an orthodontic appliance that encases either the upper or lower teeth, either all or some of the teeth and that may be removed and refitted by choice.
  • the aligner is usually made of a transparent material, for instance, polyurethane and polyacetate.
  • attachments such as elastic bands, are fixed to hooks fixed to openings or pockets created on the external surfaces of the aligner.
  • a series of aligners is often used during the course of the treatment, as the alignment of the teeth improves each aligner differently designed to continuously correct teeth that are themselves being repositioned along the way.
  • the aligner is traditionally fabricated in the following way. It involves taking an impression of the dentition and gingival surfaces of a patient by applying an appropriate material such as polyvinylsiloxane and producing therefrom a digital CT scan of the impression. Alternatively a digital scan of the teeth and gingival surfaces can be made directly with an intraoral scanner. Teeth in the digital scan are individually sectioned and alterations are made to represent the intended relative positions of teeth after the treatment.
  • a physical model is fabricated.
  • the polymeric material is then "sucked-down" over the physical model to produce the aligner. This process is also known as thermoforming.
  • a clear aligner is produced, with appropriate post-fabrication trimming of the excess material.
  • a variation of the aligner is the positioner.
  • This orthodontic appliance is basically a combination of the upper aligner and lower aligner. It is worn usually during sleep time and is intended to exert forces over both maxillary (upper) and mandibular (lower) teeth and the jaws of the patient to treat malocclusion. The production process is even more tedious as it involves separately fabricating the maxillary part and the mandibular part and then fusing the two parts into a single positioner in a further step.
  • All current aligners do not have an ideal grip, particularly along the sides where the walls nearer the opening of the aligner where the teeth first enter. At these ends of the walls, the stiffness are reduced by up to a power of 3.
  • the walls of the aligner can be considered to be unsupported beams.
  • the springiness is increased by 8 times while the strength is cut by half. For example, if the distance between point A on the occlusal surface and point B in the middle of a tooth is 6mm, and the distance between point A on the occlusal surface and point C at the base of a tooth is 12 mm, then the springiness of the aligner wall at point C is eight times compared to that at point B.
  • U.S. Patent No. 8,060,236 B2 (System for Producing Orthodontic Aligners by CNC Machining) discloses a CNC method of producing aligners ("CNC Machined Aligner Patent").
  • CNC Machined Aligner Patent discloses a CNC method of producing aligners
  • the following are stated to be drawbacks/ disadvantages to the process of production of suck-down aligners including a) thinness in areas of high convexity of the aligner (page 12, line 60 of the CNC Machined Aligner Patent); b) the production method is unable to accommodate thickness where required, for various purposes (pages 14-16); c) the suck-down aligner is unable to incorporate structural attachment points for other orthodontic components (page 12, lines 35- 48, page 15, lines 15-60); d) heat shrinkage problems during production causes distortion in the aligner structure (page 13, lines 8 - 38).
  • a more recent fabrication process employs three-dimensional printing of the aligner using an altered digital scan of the aligner, created from a digital scan of the teeth and gingiva. This seeks to improve the conventional process of production by the more accurate three- dimensional point-by-point printing or construction of the aligner.
  • the three-dimensional printing enables the production of aligners that already incorporate the repositioned sections to promote the movement of teeth, and the removal of sections to allow the fixing of auxiliaries (such as buttons and elastics) as well as to accommodate attachments to the tooth surface. This obviates the need for further post-production work, for instance, in milling openings through removal of sections in the aligner.
  • U.S. Patent Application Publication No. 2013/0095446 seeks to create an aligner that may be: a) thicker at the occlusal surfaces to prevent cracking on these surfaces (p 6 at [0081]); b) thicker to ensure "the structural integrity of the aligner" (p 6 at [0077]);
  • the invention also seeks to have different thicknesses of the mesial occlusal surface to "alleviate impacting of the molars in the mesial area resulting from the use of the appliance" (p 6 para [0076]. It seeks to have "a greater thickness on the distal area of the appliance and a lesser thickness on the proximal area of the appliance” (p 2 para [0020]) for example, “to create a guiding ramp for the teeth” (p 2 at [0020]). Again, these relate to the comfort and ease of fitting and wearing of the aligner.
  • a variation to the above versions of the aligner is one that employs attachments to the tooth in conjunction with the traditional aligner shaped to accommodate and cover over such attachments, as disclosed in U.S. Patent No. US 8,562,337 B2.
  • This patent uses extrinsic attachments on the surface of the teeth. These attachments are flexible or active and interact with the aligner to create corrective forces. The flexing of certain components of the attachment arises from the aligner pushing against the attachment, which in turn gives rise to forces on the tooth. This method has numerous drawbacks.
  • the microscopic nature of the active or flexible attachment and the absence of magnifying apparatus to precisely fix the attachment in the right angle and position on the tooth mean that it is difficult to predict and calibrate the type and strength of the forces being created.
  • the force is created by the interaction of the aligner making contact with the flexible attachment.
  • the surface of the aligner that makes contact with the attachment
  • the resulting force from the attachment may be diminished, imprecise or even incorrectly angled.
  • Moving the tooth in a particular direction may require the creating of parallel and equal forces in the same direction (for instance, to shift the tooth sideway to close or narrow a gap with an adjacent tooth) or in different directions (for instance, to rotate the tooth along its axis).
  • This usually requires the use of attachments on both surfaces of the same tooth.
  • the two sets of forces may be unequal. This may create an undesired rotational effect when only a translational force was intended. Alternatively, an unintended translational force is created when only equal rotational forces were required.
  • the incremental movement of the tooth due to the use of the active attachment may also result in an unintended alteration of the angle of the force. This is likely to arise from a different interaction between the aligner and the now differently angled attachment (due to the incremental shift of the tooth).
  • the additional step of bonding the attachments to the teeth means additional treatment time and this results in an inefficient process.
  • the attachments may also wear out in its tensile forces over time and this would reduce the impact of the corrective forces.
  • the improper re-wearing of the aligner after eating or brushing may affect the intended corrective forces intended from the interaction of the attachment with the aligner surface.
  • attachments are affixed to the external surface of the teeth, this would counteract a purpose for aligners being worn i.e. it is made with a clear material to reduce its visibility. Such attachments would affect the aesthetic appearance of the wearer.
  • Another invention U.S. Patent Application Publication No. 2011/0020761 discloses an aligner with variously shaped separate attachments for providing forces against teeth. These attachments are made from a shape memory alloy and affixed to the inside surfaces of the aligner. Alternatively, raised surfaces may form the contours of the inside surfaces of the aligners to exert corrective forces. The use of additional attachments comes with obvious disadvantages of dislodgement and risk of distortion.
  • the use of the elastic material for the attachments means that there is less control over the manner of expansion of the compressible elastic matter that is used to exert the corrective forces, which in turn affects the precision of the forces. There is also no consideration of how to deal with the loosening of the grip of the aligner, especially around the walls near the opening of the aligner.
  • This invention discloses the use of an internal lining on the inside surfaces of the aligner that is tacky and sticky and which is flexible enough to allow greater surface to surface contact for all of the surfaces of the teeth. This is for the purpose for preventing localized stress and incorrect forces on certain points of the teeth due to the design of the aligner.
  • the present invention provides a method for the design and production of an orthodontic appliance including an aligner with cuffs or ridges for an improved grip and customized contact points that come into intimate contact with specific points on the teeth.
  • the aligner is designed with precise dimensions so as to avoid unnecessary pressure on such teeth where no realignment of the teeth is required, and customised contact points to exert precisely directed forces only on required teeth.
  • Disclosed aligners do not have a perfect fit to the teeth, even at the occlusal area where the aligner interact with the teeth the most.
  • the corrective force is also significantly reduced near the base of the teeth as the aligner loses its grip when it extends its cover from the occlusal to the base of the teeth.
  • the loosening of the fit of the aligner wall means that even the fit near the crown or the occlusal surface of the teeth is affected, thus distorting and/or diminishing the corrective force at such ends.
  • the present invention is based on the understanding that current available aligners mainly exert the corrective force on and/or near to the occlusal surface of the crown.
  • the rigidity and fitting of the aligner is reduced by a power of 3 as the aligner is extending to the base of the tooth. Therefore, the corrective force is also reduced by a power of 3 at the base of the tooth as compared to that at the occlusal end.
  • a series of ridges or cuffs are incorporated as part of the design nearer the gingival areas i.e. along the edges of the inside surfaces nearer the opening of the aligner.
  • Selected ridges or cuffs will have customised protrusions to exert translational, rotational, extrusive and/or pulling forces along the base of the teeth so as to move them to new desired positions as well as the usual forces pushing teeth inwards or outwards. It can also provide supporting and retention force to the tooth which is desired to remain still.
  • Reinforcing strips may be added as part of the design of the labial, lingual, buccal and occlusal surfaces of aligner to improve its structural integrity. The reinforcing strips may be added at the outer lingual and buccal surface of the aligner where such points achieve maximum convexity.
  • This design is more advantageous than currently available aligners because the corrective force is exerted more accurately and precisely near to the centre of gravity of the tooth, therefore, inducing better and more accurate bodily movement of the whole tooth.
  • Currently available aligners only exert corrective force on and/or near to the occlusal surface of crown of the tooth, leading to inaccurate and unwanted movement like tipping.
  • the present invention is created to exert forces for movements that are greater than the incremental movements normally associated with conventional aligners and similar orthodontic appliances. Further, the aligner will have interproximal curvatures around selected teeth to improve its function of readjustment of the teeth.
  • the occlusal, buccal and lingual sections of the aligner are also designed based on digitally altered images to reflect the desired positions of teeth to promote the corrective forces and the speed of correction.
  • the invention also introduces a method of capturing digital images of the teeth and altering the digital information by adding cuffs or ridges, some of which have customised protrusions and further altering the digital positions of selected teeth so as to enable fabrication of aligners that exert clear and precise corrective forces.
  • This digital information is then processed to create the 'negative' or inverse image that represents the intended shape of the aligner. There can be further processing of these inverse images by adding of reinforcing strips.
  • the aligner will not require add-ons or any attachments to the aligner or the surfaces of the teeth.
  • the orthodontic appliance can be produced by any one of the traditional production processes and/or by 3-D printing, though it should be ideally produced by 3-D printing.
  • FIG. 1 is a flow-chart of the design and production method for the aligner.
  • FIG. 2 illustrates the altered digital images of a series of teeth incorporating the depressions arising from which the ridges or cuffs (some with protrusions and others without protrusions) will be formed as part of the aligner.
  • FIG. 3 illustrates a three-dimensional view of an aligner showing the surfaces that cover the occlusal sides of the teeth and showing the cuffs or ridges on the inside walls of the aligner
  • FIG. 3A illustrates a three-dimensional view of the aligner in FIG. 3 showing opening of the aligner through which the teeth enter and showing the cuffs or ridges near the opening of the aligner
  • FIG. 3B illustrates a three-dimensional close-up view of a section of the series of cuffs or ridges with protrusions of the aligner in FIG. 3.
  • FIG. 3C illustrates a cross section of a segment of the aligner in FIG. 3 showing cuffs or ridges and space between the aligner and the tooth.
  • FIG. 4 illustrates a plan view of an aligner showing the curvatures into the interproximal spaces between teeth.
  • FIG. 5 illustrates a plan view of an aligner showing a protrusion on a ridge or cuff to create a force to push the tooth in alignment with other teeth.
  • FIG. 6 illustrates a plan view of an aligner showing two protrusions, each creating a force on adjacent teeth .
  • FIG. 7 illustrates a cross section of an aligner showing the protrusions exerting an extrusive force.
  • FIG. 8 illustrates a side view of the molars and an aligner showing the protrusions exerting a translational force on a tooth.
  • FIG. 8A illustrates a plan view of the molars and the aligner of FIG. 8.
  • FIG. 9 illustrates a plan view of the crown of molars and an aligner showing the protrusions exerting a rotational force.
  • FIG. 10 illustrates a plan view of an incisor and the effect of the cuffs or ridges with protrusions exerting a rotational force on the tooth
  • FIG. 10A illustrates a side view of the incisor of FIG. 10 and a cuff or ridge exerting a rotational force.
  • FIG. 10B illustrates a front view of the incisor of FIG. 10 and a cuff or ridge exerting an opposite rotational force.
  • FIG. 11 illustrates a three-dimensional view of an aligner showing the reinforcing strips and the cuffs.
  • One embodiment of the present invention is an aligner with a specially customized interior surface that makes contact with the teeth and a further embodiment has a customized exterior surface incorporating reinforcing strips.
  • the aligner is designed to exert stronger and precisely angled forces to push the teeth in various directions. Accentuating the curvature of the general arc of the aligner or accentuating the curvature of the segment of the aligner around particular teeth and/or the depth of the curvature in between teeth increases the grip and/or produces corrective forces on the tooth.
  • These forces may be created to have effect in several directions and include translational, rotational, extrusive and/or pulling forces as well as forces to push teeth inwards or outwards for alignment along a row of teeth. A combination of these forces may also be created and exerted on a tooth.
  • the present invention also deals with the method of designing and fabricating orthodontic appliances.
  • FIG. 1 shows the flow-chart for the method of gathering and analyzing digital data relating to the maxillary (upper) teeth and mandibular (lower) teeth. It also illustrates the various steps taken to alter the digital images for the purpose of enabling the design and construction of an aligner that has ridges or cuffs and other protrusions and points of contact that create various forces.
  • the ridges or cuffs are part of the material that forms the interior of the aligner walls and are not separate attachments. Additionally, reinforcing strips may form part of the design of the exterior of the aligner walls i.e. buccal, lingual and labial external surfaces of aligner walls.
  • the process of designing the aligner using the computer methodology enables high degree of accuracy in ensuring that there is no contact between the inner walls of the aligner with any part of any tooth unless absolutely necessary to fulfil the function of exerting corrective forces or enhancing the grip of the aligner over the teeth.
  • FIG. 3 shows a three-dimensional view of one embodiment of the invention, being a clear aligner (300) with a customized interior surface based on altered digital images of the teeth.
  • a series of cuffs or ridges (301) are located on the inner walls of the aligner as indicated in FIG. 3.
  • the creation of the altered digital images is detailed in FIG. 1, which will be subsequently elaborated upon.
  • FIG. 3A shows a three-dimensional view of the aligner in FIG. 3 showing opening of the aligner through which the teeth enter and showing the cuffs or ridges (301) near the opening of the aligner
  • Selected ridges or cuffs will have customised protrusions (a type of which are as shown in FIG. 3B) to exert translational, rotational, extrusive and/or pulling forces along the base of the teeth so as to move them to new desired positions as well as the usual forces pushing teeth inwards or outwards.
  • the design is created to exert forces for movements that are greater than the incremental movements normally associated with conventional aligners and similar orthodontic appliances.
  • FIG. 3B illustrates a three-dimensional close-up view of a section of the series of cuffs or ridges with protrusions (302) of the device in FIG 3.
  • the protrusions may be angled or shaped according to the intended strength and angle of the corrective force.
  • FIG. 4 illustrates a plan view of the aligner (400) showing the curvature to promote a force to push tooth in alignment with other teeth.
  • a series of cuffs or ridges (401) are part of the design of the aligner and are located nearer the gingival areas i.e. along the edges of the inside surfaces nearer the opening of the aligner. This enhances the grip of the aligner on the teeth, thus ensuring it stays in place for a longer period of time. This in turn promotes the integrity and direction of the various corrective forces that are sought to be exerted on specific teeth (which will be elaborated upon below).
  • the external walls of the aligner may incorporate, as part of its contours, reinforcing strips designed as part of the aligner and made from the same material (and not as separate attachments).
  • a strip extends from the edge of the aligner nearer the gingival area to the occlusal surface of the external wall. These are illustrated in an embodiment of the aligner in FIG. 11.
  • the strip may appear on any one or more of the segments on either or both of the external surfaces of walls of the aligners (i.e. on the labial, lingual, buccal and occlusal sides of the aligners) (1101).
  • Another strip or strips may also appear across the breath of the tooth parallel to the gingival area (1101).
  • the introduction of the series of cuffs or ridges ensure that the walls of the aligner maintain a gap (303) (as illustrated in FIG. 3C) with such surfaces of the teeth where contact is not necessary.
  • the creation of this feature of the aligner is further aided by the use of the computer design methodology and the current more precise 3-D printing fabrication process.
  • FIG. 4 also illustrates the curvature (402) of a section of the aligner walls to as completely (or as completely as the interproximal space will allow) curve around the labial, buccal and lingual surfaces of the tooth and the mesial and distal surfaces to the extent allowable.
  • this exerts a directed translational force on the tooth (as illustrated in FIG. 8 and FIG. 8A).
  • the ridge or cuff may incorporate a specially angled protrusion to exert a directed force.
  • the aligner walls should be as thin as possible and be made from a material of lower elasticity and higher modulus for the purpose of controlling the type and direction of the forces being exerted on the teeth where contact is made between the ridge or cuff.
  • a material that is compressible will have the effect of maintaining the duration of force when the material is pressed against a tooth (as disclosed at [0095] of U.S. Patent Application Publication No. 2011/0020761 Al); however, its propensity to expand due to its elasticity or flexibility also seriously undermines the direction of a force, especially one that is intended to be other than perpendicular to the surface of the tooth
  • FIG. 5 Another embodiment of the invention (500) is shown in FIG. 5 where the protrusion (501) extending from a ridge or cuff is designed to exert a precise force on one side of a misaligned tooth, the direction of the force being shown by the arrow in FIG. 5.
  • the rest of the aligner wall may be made as thin as possible.
  • the challenge is to simultaneously exert corrective forces using the same aligner.
  • the current practice is to design an aligner that are variously thicker at the relevant sections but this increases the discomfort and undermines one purpose of wearing aligners i.e. they are intended to be non- visible.
  • a thinner aligner (600) that achieves the comfort and non-visibility objectives as well as exert precise corrective forces is illustrated in FIG. 6.
  • the protrusions (601) from the ridges or cuffs are part of the architecture of the inner surfaces of the aligner and the respective protrusions press against the misaligned teeth to move them to their respective correct positions.
  • the direction of the corrective forces are indicated by the arrows in FIG. 6.
  • Other embodiments include the use of variously shaped and differently angled protrusions from the ridges or cuffs to achieve similar forces.
  • FIG. 7 a cross-section of a tooth is shown with the aligner (700) fitting over the crown and sides of the tooth and showing the protrusions as part of the inner-surface landscape of the aligner.
  • the angle of the protrusions (701) is designed to create a resultant downward pull on the maxillary (upper) tooth (the resulting pull constituted by the forces shown by the arrows).
  • a similar design can be created for the aligner for the mandibular (lower) teeth but this time to create an upward extrusive effect.
  • a properly angled protrusion extending from the cuff or ridge may be created instead to produce the desired extrusive force. Differing contours on the opposite sides of the same tooth may necessitate the use of different extrusions/protrusions.
  • the side view of the aligner (800) shows the exerting of a translational force on a tooth that is separated by a gap from an adjacent tooth.
  • the arrows in FIG. 8 indicate the direction of the forces.
  • the available aligners are not designed to perform this function.
  • FIG. 8A to enable an effective translational force, equal and parallel forces should be exerted on both sides of the same tooth and as much along the plane of the tooth as possible and in the direction of the gap. This ensures an even resultant force along the plane of the tooth.
  • the curvature (801) of the aligner over each side of the tooth (that is to be translated) must be designed to more closely curve over and into the interproximal space between the tooth (to be translated) and the adjacent tooth (where no adjustment is required). This design that creates a delving into the interproximal space between the two teeth enables the exertion of a force closely parallel to the plane of the tooth (to be translated).
  • the aligner is designed to accommodate the translation of the tooth to fill up the gap. Referring now to FIG. 9, a view of the crown of molars is shown with the aligner (900) showing the ridges or cuffs (901) exerting rotational forces (as indicated by the arrows) on one of the molars.
  • FIG. 10 illustrates a view of the occlusal surface of incisors and the aligner (1000) showing the ridges or cuffs (1001) exerting rotational forces on an incisor (1002).
  • the arrows in FIG. 10 indicate the direction of the forces exerted by cuffs or ridges and protrusions therefrom.
  • FIG. 10A shows a side view of the incisor (1002) and its root (1004) and a cuff or ridge (1001) of the aligner exerting a rotational force, with the arrow showing the direction of the force.
  • the cuff or ridge (1001) is near to and shaped according to the curve of the gum line (1003).
  • FIG. 10B shows the front view of the same incisor (1002) and another cuff or ridge (1001), with another arrow indicating an opposite force. Together, the two opposite forces shown in FIG. 10A and FIG. 10B constitute the rotational effect.
  • the emphasis here is the application of a force or forces near the base or gingival areas of the tooth so that there is no unwanted tilting effect if the force or forces were applied to a point further away from the base or gingival area of the tooth.
  • Embodiments of the present invention can be introduced to a single tooth, a combination of teeth, a section of the teeth, or the whole set of teeth, to achieve different treatment objectives.
  • inventions include the design and incorporation of ridges, mounds, nodes, nodules, or any other extrusion or protrusion and the closeness of fit of certain sections of the aligner against selected teeth that would create a combination of any of the translational, rotational, extrusive and/or pulling forces above described.
  • inventions will cover the cervical area of the teeth, with a gap of 0.5m to the gum.
  • the width of the cuffs and ridges can vary from 0.1 to 1mm.
  • another embodiment of the invention can extend the aligner to cover the gum. Gum movement under treatment incorporating the present invention is more predictable, and with less distortion. No gum trauma or less gum trauma will be induced under treatment with the current invention. Therefore, extending the aligner to cover the gum can give better grip and support of the aligner. This in turn enhances the efficiency of the treatment with the present invention.
  • braces Ordinarily the braces would be used for a longer period to deal with more severely misaligned teeth before a transition to the traditional use of an aligner or a series of aligners.
  • the treatment time using the braces may be shortened. This is advantageous as braces are uncomfortable and aesthetically less pleasing and also interferes with eating and brushing of the teeth.
  • the lower reliance on external attachments under the present invention also means less wear and tear and the possibility of detachment of such attachments.
  • Patent No 8,562,337 B2 that uses active attachments bonded to the teeth, these have the distinct drawback of detachment during brushing or eating (when the aligner is removed), and the risk of distortion and also being aesthetically displeasing as the attachment is visible through the transparent (or near transparent) aligner.
  • the aligner under U.S. Patent No 8,562,337 B2 is by its concept bulkier as it has to be expanded in sections to accommodate the active attachments. This itself undermines the purpose of having an aligner that is as thin as possible to reduce visibility and discomfort.
  • the corrective forces intended to be created by flexing of the active attachments (bonded to the teeth) may decay and/or become imprecise through the wear and tear of and/or damage to the attachment or the aligner surface through the improper taking off and re-fitting of the aligner in the patient's daily routine.
  • the present invention overcomes the above as well as accelerates the treatment progress.
  • the sure contact of specially created points of contact against selected teeth also means higher precision in the type and extent of the force sought to be exerted.
  • These objectives can be achieved while retaining the thinness of the aligner to the extent that such aligners can be fabricated in appropriate thinness without compromising structural integrity.
  • the aligner under the present invention combines the advantages of optimising corrective efficiency to a high level of precision and direction while retaining the clarity and thinness of the appliance. Depending on the extent of the misalignment, it either eliminates the need for use of external attachments or at least reduces the time and degree of reliance on such external aids. This arises from the design that is created to exert forces for movements that are greater than incremental movements normally associated with current aligners. The time for fixing the aligner is shortened and the time required to wear the aligner is also reduced.
  • a positioner is an orthodontic appliance for the purposes of treating malocclusion. Patients are required to wear a positioner at night when they are sleeping. Positioners will adjust the relative position of the patient's upper jaw and lower jaw in order to achieve a better occlusal surface of the teeth.
  • One positioner is a composite of two aligners, one for the upper teeth and one for the lower teeth. Air holes are embedded in a positioner to allow a patient to breathe while wearing the positioner.
  • a positioner incorporates the present invention will also have the effect of moving the teeth to the desired location and orientation incrementally.
  • a positioner incorporating the present invention will be more effective while being thinner, lighter and more comfortable for the patients to wear.
  • the present invention is an orthodontic appliance is designed to avoid unnecessary contact with surfaces of the teeth while increasing the precision and durability of specific forces against sections of the teeth through a combination of features that promotes the grip of the appliance (thus preventing slippage or loosening), and enable ridges or cuffs (some with specially angled protrusions) to create clear and precise forces.
  • the avoidance of extraneous attachments and of sticky or tacky materials and of compressible material means it avoids the many problems associated with such attachments and such materials (as elaborated above).
  • the invention also discloses the method of designing and customising the aligner.
  • FIG. 1 details the steps to be taken to gather, analyse digital data of the teeth and the further steps to alter the digital images to design and construct the aligner.
  • the teeth of patient is scanned for digital data of the three- dimensional configuration of the teeth and gingival areas (Original Images'). These Original Images (101) are then analysed for the positions of the teeth and their contours. A further set of images is created showing the teeth in their desired adjusted positions, and creating depressions 0.5 mm from the gingiva and shaped (according to the curve of the gingiva edge) to correspond with the cuffs or ridges on the aligner and with such adaptations for protrusions in the images of the adjusted teeth ('Teeth Images') (102).
  • Teeth Images Based on Teeth Images a further set of negative or inverse images (representing the intended shape of the appliance) is created ('Aligner Images A') (103).
  • the three-dimensional inverse images represent the form of the appliance into which the teeth will fit and will have as part of the design cuffs (with protrusions) corresponding to the depressions creating in the Teeth Images.
  • Aligner Images A are further altered by moving the sections of the image to indicate the position of certain teeth to its incremental or final position ('Aligner Images B') (104).
  • Aligner Images B are further revised by increasing the extent and depth of curvature along the side of each tooth and in between two adjacent teeth, in order to achieve the optimum contact between the aligner and the teeth at the point with maximum convexity. This design maximizes the direct and efficient exertion of corrective forces on the teeth at the right direction, and avoids unnecessary contact and unwanted forces between the aligner and the teeth ('Aligner Images C) (105).
  • the next step involves confirming the boundaries of the virtual appliance by reference to the gingival and other areas and create openings and pockets for external attachments (where necessary), and further adding reinforcing strips at selected external surfaces of each segment of the aligner corresponding to the space for each tooth.
  • a further set of images are produced ('Aligner Images D') (106).
  • Aligner Images D are sent for fabrication of the aligner by 3-D printing or such mode of production available (107).
  • the fabricated aligner is fitted on the patient (108).
  • Digital information of the aligner as worn on the teeth of patient is collected for data of the nature of the fit of the aligner including in particular the specifically designed curvature and the angle of the ridges or cuffs, and protrusions therefrom and other points of contact.
  • a further scan is taken for digital information of the aligner as worn on the teeth of patient to analyze the extent of the movement of the teeth and the nature of the fit of the aligner including in particular the specifically designed curvature and the angle of the ridges or cuffs, and protrusions therefrom and other points of contact.
  • Step 2 of FIG. 1 (102) is repeated where further treatment is required and a new aligner needs to be fabricated.
  • a variation to the above methodology is the production of a series of aligners based on the predicted incremental changes in the position of the teeth that are being moved.
  • the patient changes his or her aligner at regular prescribed intervals on each visit to the orthodontist.
  • already-produced aligners in the series may not infrequently have to be discarded due to the teeth not showing the correct movements as predicted, thus rendering them unsuitable for use.
  • a new set of aligners would have to designed and fabricated.
  • each aligner may be designed and fabricated one at a time as set out in FIG 1. This is due to the ease and speed of carrying out 3-D printing quickly so as to likely obviate the need to fabricate a series of aligners in advance.

Abstract

L'invention concerne un procédé de conception d'un appareil orthodontique comprenant un aligneur. Les surfaces intérieures de l'appareil sont conçues avec des points particuliers de contact avec les dents pour créer des forces spécifiques et précises en vue de déplacer les dents mal alignées. L'invention concerne un procédé de création et de modification d'images numériques de la structure des dents afin de fabriquer un appareil orthodontique. L'appareil est produit conformément aux images négatives (ou inversées) d'images numériques modifiées et ajusté sur le porteur pour atteindre l'objectif d'un déplacement précis des dents vers de nouvelles positions.
PCT/IB2014/002784 2013-09-18 2014-09-18 Système/procédé de production d'appareils orthodontiques WO2015040495A2 (fr)

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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017182122A1 (fr) * 2016-04-20 2017-10-26 Chhatwani, Sachin Gouttière pour le traitement d'une malposition dentaire dans une dentition, procédé de fabrication d'une gouttière et utilisation d'une feuille thermoformée pour la fabrication d'une gouttière servant au traitement d'une malposition dentaire dans une dentition
WO2018065817A1 (fr) * 2016-10-04 2018-04-12 Eggert Boehlau Méthode de traitement dentaire combinant des positionneurs et des aligneurs dentaires
EP3443929A1 (fr) * 2017-08-14 2019-02-20 Cheng-Hsiang Hung Dispositif de correction orthodontique
CN112790880A (zh) * 2021-02-02 2021-05-14 上海允泉新材料科技有限公司 抗蠕变的牙套及其制作方法
EP3831337A1 (fr) * 2019-12-04 2021-06-09 Oxilio Ltd Procédés et systèmes de fabrication d'un aligneur orthodontique comportant des blocs de fixation
EP4233779A3 (fr) * 2015-07-07 2023-12-06 Align Technology, Inc. Fabrication directe d'aligneurs avec un couplage de force interproximal

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US6572372B1 (en) * 2000-04-25 2003-06-03 Align Technology, Inc. Embedded features and methods of a dental appliance
US6524101B1 (en) * 2000-04-25 2003-02-25 Align Technology, Inc. System and methods for varying elastic modulus appliances
US20060177789A1 (en) * 2005-02-04 2006-08-10 O'bryan Robert Orthodontic system
US20060188834A1 (en) * 2005-02-18 2006-08-24 Hilliard Jack K Method for creating features in orthodontic aligners
US8899977B2 (en) * 2008-01-29 2014-12-02 Align Technology, Inc. Orthodontic repositioning appliances having improved geometry, methods and systems
CA2771309C (fr) * 2009-08-21 2017-09-05 Dentsply International Inc. Fabrication d'aligneur orthodontique par procede de recouvrement

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4233779A3 (fr) * 2015-07-07 2023-12-06 Align Technology, Inc. Fabrication directe d'aligneurs avec un couplage de force interproximal
WO2017182122A1 (fr) * 2016-04-20 2017-10-26 Chhatwani, Sachin Gouttière pour le traitement d'une malposition dentaire dans une dentition, procédé de fabrication d'une gouttière et utilisation d'une feuille thermoformée pour la fabrication d'une gouttière servant au traitement d'une malposition dentaire dans une dentition
WO2018065817A1 (fr) * 2016-10-04 2018-04-12 Eggert Boehlau Méthode de traitement dentaire combinant des positionneurs et des aligneurs dentaires
EP3443929A1 (fr) * 2017-08-14 2019-02-20 Cheng-Hsiang Hung Dispositif de correction orthodontique
KR20190018398A (ko) * 2017-08-14 2019-02-22 청 시앙 훙 치과교정술적 교정 장치
CN109381267A (zh) * 2017-08-14 2019-02-26 洪澄祥 齿列矫正装置
KR102106213B1 (ko) 2017-08-14 2020-05-04 청 시앙 훙 치과교정술적 교정 장치
US11197740B2 (en) 2017-08-14 2021-12-14 Cheng-Hsiang Hung Orthodontic correction device
EP3831337A1 (fr) * 2019-12-04 2021-06-09 Oxilio Ltd Procédés et systèmes de fabrication d'un aligneur orthodontique comportant des blocs de fixation
CN112790880A (zh) * 2021-02-02 2021-05-14 上海允泉新材料科技有限公司 抗蠕变的牙套及其制作方法

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