WO2017006177A1 - Ensemble à double aligneur - Google Patents

Ensemble à double aligneur Download PDF

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Publication number
WO2017006177A1
WO2017006177A1 PCT/IB2016/000976 IB2016000976W WO2017006177A1 WO 2017006177 A1 WO2017006177 A1 WO 2017006177A1 IB 2016000976 W IB2016000976 W IB 2016000976W WO 2017006177 A1 WO2017006177 A1 WO 2017006177A1
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WO
WIPO (PCT)
Prior art keywords
aligner
tooth
teeth
target
dual
Prior art date
Application number
PCT/IB2016/000976
Other languages
English (en)
Inventor
Fuming Wu
Jihua Cheng
Original Assignee
Align Technology, Inc.
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
Priority claimed from US15/202,384 external-priority patent/US10743964B2/en
Application filed by Align Technology, Inc. filed Critical Align Technology, Inc.
Publication of WO2017006177A1 publication Critical patent/WO2017006177A1/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
    • A61C7/08—Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch

Definitions

  • This inventi on relates in general to a system of repositioning teeth for use in orthodontic treatment. More particularly, this invention relates to the use of orthodontic appliances for producing tooth movements.
  • Orthodontic treatments involve repositioning misaligned teeth and improving bite configurations for improved cosmetic appearance and dental function.
  • Repositioning teeth is accomplished by applying controlled forces to the teeth over an extended period of time. This is conventionally accomplished by wearing what are commonly referred to as "braces".
  • Braces comprise a variety of appliances such as brackets, bands, archwires, ligatures, and O-rings. After they are bonded to the teeth, periodic meetings with the orthodontist are required to adjust the braces. This involves installing different archwires having different force-inducing properties or by replacing or tightening existing ligatures. Between meetings, the patient may be required to wear supplementary appliances, such as elastic bands or headgear, to supply additional or extraoral forces.
  • polymeric positioning appliances are generally transparent, providing an improved cosmetic appearance, and impart substantial force on the teeth, due to stiffness of the appliance.
  • Each aligner shell has an inner shape that is configured to move the patient's teeth to the next planned position.
  • a "lag of movement" occurs when a patient's teeth do not follow this planned movement by not moving or moving in an unplanned direction.
  • this lag of movement becomes too great, that is, when the difference between the current position of the patient's teeth and the planned position at which the aligner is to move the teeth becomes too great, in many cases, the aligner is no longer able to be snapped onto the patient's teeth. Accordingly, improved appliances and techniques are needed to reduce this lag in movement during orthodontic treatment, and to reduce unwanted tooth movements.
  • FIG. 1 A illustrates the dual aligner assembly, in accordance with an embodiment.
  • FIG. IB illustrates an enlarged section A of the dual aligner assembly shown in FIG. 1A, in accordance with an embodiment.
  • FIG. 2A illustrates the dual aligner assembly, in accordance with an embodiment.
  • FIG. 2B illustrates a dimple formed in the inner aligner as an exterior protrusion, in accordance with an embodiment.
  • FIG. 2C illustrates a gap formed between the inner aligner and the outer aligner of the dual aligner assembly, in accordance with an embodiment.
  • FIG. 2D illustrates a ridge formed within a gap, as an exterior protrusion of the dual aligner assembly, in accordance with an embodiment.
  • FIG. 2E illustrates a ridge formed within a gap, as an exterior protrusion, in accordance with an embodiment.
  • FIG. 2F illustrates a ridge formed by a continuous protrusion in an aligner surface, in accordance with an embodiment.
  • FIG. 2G illustrates a continuous ridge disposed in an appliance cavity in a vertical orientation, in accordance with an embodiment
  • Figure 2H illustrates a non-continuous ridge disposed in an aligner surface and vertically oriented, in accordance with an embodiment.
  • Figure 21 illustrates a cross sectional view of the ridge.
  • FIG. 3 A illustrates aligner action using a conventional aligner.
  • FIG. 3B illustrates aligner action using a conventional aligner.
  • FIG. 3C illustrates a dual aligner assembly snapped onto the patient's teeth, in accordance with an embodiment.
  • FIG. 3D illustrates a dual aligner assembly snapped onto the patient's teeth, in accordance with an embodiment.
  • FIG. 4A illustrates a conventional aligner system.
  • FIG. 4B illustrates a side-perspective view of the conventional aligner system of FIG. 4A.
  • FIG. 4C illustrates a dual aligner assembly snapped onto the patient's teeth, in accordance with an embodiment.
  • FIG. 5 A illustrates a single aligner of a conventional aligner system pressing against the lingual surface of the teeth.
  • FIG. 5B illustrates a dual aligner assembly, in accordance with an embodiment.
  • FIG. 6 illustrates an example jaw, which is variously depicted in FIGS. 1A, 5A and 5B, together with a dual aligner assembly which has been configured in accordance with an embodiment.
  • a dual aligner assembly includes a plurality of aligners.
  • the plurality of aligners includes a first aligner and a second aligner.
  • the first aligner includes a first material having a first shape corresponding to a set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of target teeth of a plurality of teeth of a dental arch of a patient, wherein the first orthodontic force generates movement of the set of target teeth to the set of target tooth positions.
  • the second aligner includes a second material having a second shape corresponding to a combination of current tooth positions of the set of target teeth, the set of target tooth positions, and a thickness of the first aligner, wherein the second aligner partially encloses the first aligner and provides an anchor for at least a portion of the first aligner, wherein via the anchor, a combination of the first aligner and the second aligner provides added support for the accurate movement of the target teeth to the set of target tooth positions via the first orthodontic force and prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
  • the first aligner is an inner aligner that is partially enclosed by an outer aligner.
  • the second aligner is an outer aligner that partially encloses an inner aligner.
  • the second aligner is an inner aligner that is partially enclosed by a third aligner.
  • the unwanted tooth positions include tooth positions other than the following tooth positions: the current tooth positions of the set of target teeth; one or more tooth positions that represent movement of at least one tooth of the set of target teeth to the set of target tooth positions; and the set of target tooth positions.
  • the second aligner is more rigid than the first aligner. In one embodiment, the second aligner is less rigid than the first aligner. In one
  • the second aligner is equal in rigidity to the first aligner.
  • the first aligner includes: a first force enlargement element.
  • the first force enlargement element includes: a contact region between the first aligner and the second aligner, wherein the contact region provides an anchor point at the second aligner and for the first aligner, whereby the first orthodontic force, via the anchor point and by the first aligner, is increased against at least one tooth of the set of target teeth.
  • the first force enlargement element includes a dimple. In another embodiment, the first force enlargement element includes a ridge. In yet another embodiment, the first force enlargement element includes an outward protrusion. A dimple and a ridge, in some instances, are formed to be outward protrusions.
  • the dual aligner assembly includes a second force enlargement element.
  • the second force enlargement element includes: a non-contact region between the first aligner and the second aligner, wherein the non-contact region provides an area into which a movement of at least one tooth of the set of target teeth to at least one target tooth position of the set of target tooth positions is accomplished.
  • the first aligner includes a dimple.
  • the first aligner includes a ridge.
  • the first aligner includes an outward protrusion.
  • the plurality of aligners further includes: a third aligner that includes a second material having a third shape corresponding to a combination of the current tooth positions of the set of target teeth, the set of target tooth positions and a thickness of the second aligner, wherein the third aligner partially encloses the second aligner and provides an anchor for at least a portion of the second aligner, wherein via the anchor, a combination of the first aligner, the second aligner and the third aligner provides a third orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
  • the unwanted tooth positions include tooth positions other than the following tooth positions: the current tooth positions of the set of target teeth; one or more tooth positions that represent movement of at least one tooth of the set of target teeth to the set of target tooth positions; and the set of target tooth positions.
  • the third aligner is an inner aligner that is partially enclosed by an outer aligner.
  • the third aligner is an outer aligner that partially encloses an inner aligner.
  • the third aligner is an inner aligner that is partially enclosed by a fourth aligner.
  • the fourth aligner in one embodiment, includes the features described herein in relation to the third aligner, except that the fourth aligner also accommodates not only the features of the first and second aligner, but also accommodates the features of the third aligner.
  • a dual aligner assembly includes: a plurality of aligners. The plurality of aligners includes a first aligner and a second aligner.
  • the first aligner includes a first material having a first shape corresponding to a first set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of target teeth of a plurality of teeth of a dental arch of a patient, wherein the first orthodontic force generates movement of the set of target teeth to the first set of target tooth positions.
  • the second aligner includes a second material having a second shape corresponding to a combination of current tooth positions of the set of target teeth, the first set of target tooth positions, at least a second set of target tooth positions, and a thickness of at least the first aligner. The second aligner partially encloses the at least first aligner and provides an anchor for at least a portion of the at least first aligner.
  • a combination of the first aligner and the second aligner and any intermediate aligner positioned between the first aligner and the second aligner provides added support for the movement of the target teeth to the set of target tooth positions and provides a second orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment, in particular provides a second orthodontic force that retains said set of target teeth within prescribed paths during orthodontic treatment.
  • Embodiments disclosed herein include a dual aligner assembly for moving teeth to a desired position.
  • the dual aligner assembly includes an outer aligner, and at least one inner aligner.
  • the inner aligner(s) is formed based on the patient's teeth position in the next stage.
  • the inner aligner(s) is made of soft and thin polymeric film.
  • the outer aligner is formed based on the combination of the current position and the "next" position of the patient's teeth, as well as the thickness of the inner aligner(s).
  • the outer aligner is made of hard and thick polymeric film.
  • the inner and outer aligner may be composed of material having more, less, or the same amount of rigidity.
  • the outer aligner functions as anchorage for the inner aligner(s), enabling the inner aligner(s) to move the patient's teeth to desired positions with larger and more accurate forces than enabled by conventional aligner systems.
  • the dual aligner assembly in various embodiments, includes protrusions (e.g., dimples, ridges) that increase the engagement between the outer aligner and the inner aligner(s), thereby providing even greater anchorage support to the inner aligner(s).
  • protrusions e.g., dimples, ridges
  • dimples and/or ridges may be formed in the inner aligner and fill a portion of the gap between the outer aligner and the inner aligner(s) or between multiple inner aligners. These dimples and/or ridges aid in creating more accurate forces near the patient's gingival line to move the patient's teeth to the desired teeth positions.
  • embodiments enable an increase of force that may be applied by the inner surface of the most inner aligner against a patient's tooth or teeth in order to move the patient's teeth to desired tooth positions.
  • difficult tooth movement may be accomplished, such as posterior arch expansion, pure translation and multiple teeth extrusion.
  • a multiple anterior tooth extrusion may be performed to fix a patient's open bit
  • a posterior distalization may be performed to create space in order to resolve spacing issues in a patient's bit
  • a patient's posterior cross bite or scissor bite may be fixed by moving a patient's molar faster than would be accomplished with conventional technology.
  • embodiments described herein may be applied to achieve any type of tooth movement, in any direction, in any arbitrary plane of space.
  • the discussion begins with a description of a conventional aligner system.
  • FIGS. 1A and IB illustrate the dual aligner assembly, in accordance with
  • FIGS. 2A-2E illustrate sections of various dual aligner assemblies having been snapped onto the patient's teeth, including example dimple and ridge protrusions, in accordance with embodiments.
  • FIGS. 2F-2I illustrate example designs/configurations of ridged protrusions.
  • FIGS. 3A and 3B illustrate aligner action resulting from implementation of a conventional aligner.
  • FIGS. 3C and 3D illustrate aligner action resulting from implementation of the dual aligner assembly.
  • FIGS. 4 A and 4B illustrate aligner action resulting from implementation of a conventional aligner.
  • FIG. 4C illustrates aligner action resulting from implementation of the dual aligner assembly.
  • FIG. 5 A illustrates the limitations of a conventional aligner system and the benefits of the novel dual aligner assembly.
  • FIG. 5B illustrates the novel dual aligner assembly in operation.
  • Conventional aligner systems are used to treat thousands of mild and moderately difficult orthodontic cases each month.
  • Conventional aligner systems include many technological improvements that improve the predictability and performance of the product, thereby also enabling the conventional aligner system to treat more difficult orthodontic cases.
  • technological improvements include optimized attachments, power ridges, and rubber bands.
  • Some optimized attachments are shown to improve the rotation of premolars and canines to fix severe crowding, while other optimized (extrusion) attachments are shown to extrude anterior incisors to fix an open bite.
  • the power ridge technology is shown to move the root lingually, to improve the clinical profile of an upper jaw.
  • the rubber band technology is shown to help A/P movement (A/P class correction).
  • the tooth's initial position is acquired from the patient's initial impression without treatment.
  • the treatment goal is set up by the software and/or the user as the final desired position.
  • some intermediate positions are created through tooth path planning and can be assigned the symbols i (tooth's initial position) and i + 1 (an intermediate position).
  • the patient wears the aligner that is manufactured based on the position i + 1.
  • One major problem with the conventional aligner system is the lack of predictability of tooth movement, such as when teeth do not follow the planned tooth movement from i to i + 1 and when the lag of the movement from i to i + 1 is too large.
  • the lag is too large, the difference between the current teeth position and the aligner is also too large so that the aligner cannot be snapped onto the teeth anymore.
  • the planned treatment has to be restarted ("middle course correction"), the remaining manufactured aligners are wasted, and the required treatment time is extended.
  • the aligner itself is plastic and is in the shape of teeth, and the force created by the aligner placed on the teeth comes from the deformation of the plastic shell of the aligner.
  • the deformation is caused by the patient's teeth pushing against the plastic shell.
  • the conventional aligner is more rigid near the incisal edge of the patient's tooth and is weaker near the gingival line of the patient's tooth.
  • the same deformation created by the patient's teeth pushing against the plastic shell at the gingival line will produce less force than the patient's teeth pushing against the plastic shell at the incisal edge.
  • the dual aligner assembly includes the following structural features:
  • An inner aligner that is softer and thinner than the outer aligner.
  • the inner aligner is manufactured based on the teeth position of the next stage (e.g., i + 1).
  • the inner aligner is used to create small and constant orthodontic force to move the teeth.
  • first aligner is also used to describe the inner aligner, according to one embodiment.
  • inner aligner is used to refer to an aligner that is manufactured based on the teeth position of any position of a stage of treatment that comes after the teeth position of the next stage, such as i + 1 + n where n is any stage of treatment after the treatment stage that follows the current position of the teeth.
  • the outer aligner is stronger and thicker than the inner aligner.
  • the outer aligner is big enough to hold the inner aligner.
  • the inner aligner is able to anchor onto the outer aligner and use the outer aligner as support to provide larger and more accurate forces against the patient's teeth as the patient's teeth deform the inner aligner.
  • the dual aligner assembly is most often discussed herein in terms of "outer aligner” 3)
  • the outer aligner is large enough to hold the teeth position from the initial position, i, to the next position, i + 1, such that there is not extract force if the patient's teeth movement follow the planned movement treatment.
  • Dimples and/or ridges may be added to the inner aligner to push the teeth.
  • Dimples and/or ridges may be added to the outer aligner to create larger and more accurate forces to push the patient's teeth toward the next position, i + 1.
  • the dual aligner assembly is described in general with reference to an inner aligner and an outer aligner, it should be understood that the dual aligner assembly may include multiple inner aligners, each inner aligner capable of including the features described below. Further, while the dual aligner assembly is described in general with reference to an outer aligner being of a more rigid composition than the inner aligner, it should be understood that the dual aligner assembly may function as intended with an outer aligner being of a less rigid composition or of a composition with an equivalent rigidity compared to the inner aligner(s), in accordance with an embodiment.
  • the outer aligner Since the outer aligner has a greater rigidity than the inner aligner, in response to the inner aligner pushing against the outer aligner due to the deformation, the outer aligner pushes back against the inner aligner with a designated force that causes the inner aligner to press against the patient's teeth to effect a planned movement treatment of the patient's teeth to the desired position.
  • the pressing of the outer aligner against the inner aligner causes the force with which the inner surface of the inner aligner presses against the patient's teeth to be increased at the gingival line.
  • the conventional aligner would open up at the gingival line and not be able to create the necessary force to press against the gingival line of the patient's teeth; the novel dual aligner assembly described herein provides a force for applying pressure against the patient's teeth in a planned movement treatment.
  • the inner aligner includes at least one dimple and/or ridge (as will be explained below with reference to FIGS. 2A-2E) designed to deform and create force to push against a particular tooth that is to be moved according to a planned movement treatment.
  • each ridge and/or dimple of the inner aligner may be deformed outward (in the direction toward the outer aligner) by the patient's teeth pressing against the inner surface of the inner aligner.
  • the outer surface of the dimple and/or ridge of the inner aligner then contacts the more rigid inner surface of the outer aligner.
  • the outer aligner resists the movement outward of the edges of the dimples and/or ridges where the dimples and/or ridges contact the outer aligner (contact points), thereby causing the inner surface of the inner aligner to press against (push back with an equal and opposite force as that force applied by the inner aligner against the outer aligner) the patient's teeth at positions corresponding to the positions of the dimples and/or ridges.
  • the outer aligner while the inner aligner generates force (via engagement with the outer aligner at predetermined positions) to achieve the planned tooth movement, the outer aligner provides tooth movement guidance. This will provide extra guidance for movement of the patient's teeth, compared to conventional aligners, thereby making the patient's tooth movement more predictable.
  • FIG. 1 A illustrates the dual aligner assembly 100 together with a patient's dental arch 1 18, in accordance with an embodiment.
  • FIG. 1 A shows the dual aligner assembly 100 snapped onto the dental arch 1 18 of a patient.
  • the dual aligner assembly 100 includes multiple aligners, wherein at least one inner aligner 106 is housed within an outer aligner 104.
  • the dual aligner assembly 100 includes the inner aligner 106 and the outer aligner 104.
  • the inner aligner 106 is the aligner that is positioned to be closer to the patient's teeth 102.
  • the inner aligner 106 is designed and manufactured to hold the patient's teeth 102 in the desired next position (e.g., + J).
  • the inner aligner 106 is made of a soft and thin plastic film and delivers small and constant orthodontic force to the patient's teeth 102 at predetermined contact points, such as at contact region one 108 and contact region two 1 16.
  • the shape of the inner aligner 106 is the shape of all of the patient's teeth 102 posited in the next position of treatment, i + 1, such as the target tooth position 1 14.
  • FIG. 1 A shows the patient's tooth 120 in its current position. As can be seen, the inner aligner 106 is shaped to accommodate holding the patient's tooth 120 in the target tooth position 1 14.
  • the outer aligner 104 partially encloses the inner aligner 106 and is designed to hold the inner aligner 106 and to hold the patient's tooth 120 in either the tooth's current position 1 10 or the target tooth position 1 14, or any tooth position representing planned treatment movement to achieve the target tooth position 1 14 from the tooth's current position 1 10.
  • the outer aligner 104 is made of hard or thick plastic film and provides anchorage for the inner aligner 106.
  • the shape of the outer aligner 104 is the shape of the combined shapes of the patient's teeth 102 in their current position 1 10 and patient's teeth 102 in the target tooth position 1 14.
  • the shape of the outer aligner 104 also accommodates the thickness of the inner aligner 106.
  • the outer aligner 104 does not create any extract forces against the patient's tooth 120 (or teeth). However, if the patient's tooth 102 is even slightly wavering (moving away) from the determined movement pathway from the tooth's current position 1 10, i, to the target teeth position 1 14, i + 1, then the outer aligner 104 presses against the inner aligner 106, thereby creating an extracting force against the patient's tooth 120 that is wavering from the desired treatment movement pathway.
  • FIG. 1A also shows the contact region one 108 and the contact region two 1 16.
  • Each contact region includes the section of the inner aligner 106 which is contacted by the patient's tooth 120 as well as the material of the inner aligner 106 surrounding the contact point (that is affected by the tooth contact).
  • the patient's tooth 120 contacts the inner aligner 106.
  • the inner aligner 106 deforms at the contact regions, and the material at the contact regions one 108 and two 1 16 are stretched outward toward the outer aligner 104.
  • the outer aligner 104 functions to reduce and/or eliminate any further stretching of the inner aligner 106 outwards. This reduction and/or elimination of any further stretching is effected since the outer aligner 104, in accordance with an embodiment, is designed with a higher rigidity than the inner aligner 106.
  • the outer aligner 104 pushes back against the inner aligner 106 with the same force at which the inner aligner 106 is pressing against the outer aligner 104.
  • the inner aligner 106 then translates this force to the patient's tooth 120 by pressing against the patient's tooth 120, supported by the anchoring engagement with the outer aligner 104, and guides the patient's tooth 120 toward the target tooth position 1 14.
  • FIG. IB illustrates an enlargement of section A of FIG. 1 A.
  • FIG. IB shows the contact region two 1 16 in which the patient's tooth 120 is contacting the inner aligner 106.
  • the patient's tooth 120 pushes the inner aligner 106 outward a certain distance into the gap area 128.
  • the inner aligner 106 and the outer aligner 104 are manufactured such that upon being pushed some predetermined distance outward, the inner aligner 106 contacts the outer aligner 104.
  • the patient's tooth 120 is able to push the inner aligner 106 outward toward the outer aligner 104 and even cause the inner aligner 106 to contact the outer aligner 104, since the outer aligner 104 is stronger and more rigid than the inner aligner 106, the patient's tooth 120 is less able to also cause the outer aligner 104 to be pushed outwards.
  • the outer aligner 104 pushes back against the inner aligner 106, and hence the patient's tooth 120, with an equal and opposite force.
  • the inner aligner 106 anchors against the outer aligner 104 and translates the force pressed against its outer surface, from the outer aligner 104, to the patient's tooth 120.
  • the outer aligner 104 will prevent the inner aligner 106 from stretching outward much further (if any further), thereby substantially stopping the outward stretching of the inner aligner, and therefore keep the patient's second tooth 124 within a certain predetermined distance from its original position.
  • the outer aligner may be designed to reduce or eliminate this unwanted movement of the patient's neighboring tooth.
  • Shaped Features for the Inner Aligner e.g., Dimple, Ridge
  • the inner aligner is manufactured to include shaped features thereon, such as, but not limited to, dimples and/or ridges. Since the outer aligner is larger than the inner aligner, in many situations, there may be some gap area between the two aligners. This gap area can be filled by these shaped features, thereby enabling interactivity between the inner aligner and the outer aligner. As will be explained, with reference to FIGS. 2A-2E, shaped features, such as a dimple and/or a ridge, will provide extract and controllable forces to push the patient's teeth toward target tooth positions. Of note, while FIGS. 2A-2E illustrate dimples and ridges, it should be understood that the shaped features may be of a shape other than dimples and ridges, but that are capable of providing extract and controllable forces as will be described herein.
  • Shaped features achieve force profiles favorable to specific types of tooth movement and can include both attachment-type features as well as non-attachment type features.
  • Non-attachment type features can include various shaped alterations or protrusions in a surface of the dual aligner assembly, such as ridges (e.g., interior or exterior), dimples, and the like.
  • ridges e.g., interior or exterior
  • dimples e.g., appliance protrusion
  • Ridges by comparison, for example, are protrusions having an unequal length and width.
  • Interior protrusions such as interior ridges, include a groove or protrusion in an inner aligner that recesses toward an inner surface (e.g., tooth contacting surface) of the inner aligner.
  • Exterior protrusions and ridges bulge toward an exterior surface of the inner aligner system.
  • Protrusion type features such as dimples and ridges, can be either filled with material (e.g., composite material) or left unfilled. If it is filled, the composite can be controlled to solidify after the desired shape and/or volume of the filler is obtained.
  • material e.g., composite material
  • ridge-shaped protrusions may provide differences and/or advantages for an application of force to the patient's teeth compared to other protrusion shapes, such as dimples.
  • dimples having a substantially equal length compared to width will typically provide more of a point application of a force to a surface of a tooth.
  • a ridge-shaped protrusion may allow an application of force to be more evenly distributed along a surface of a tooth, and may provide more precisely controlled tooth movement in some instances.
  • ridge- shaped protrusions provide more protrusion configuration and design options, provide a greater range of force values that can be selected and delivered to the target tooth compared to non-ridge shapes (such as dimples), and can therefore be more likely to impart the desired load against the target tooth.
  • the use of ridges compared to other more simplified shapes e.g., a single dimple) provide a greater range of available force values or selections for imparting the desired load vector, or force direction and/or magnitude along a tooth surface, thereby providing more treatment options.
  • FIGS. 2F-2I designs/configurations of ridged protrusions are illustrated with reference to FIGS. 2F-2I, as will be explained below.
  • FIGS. 2A-2E illustrates sections of various dual aligner assemblies together with the patient's dental arch, in accordance with embodiments.
  • FIG. 2A illustrates the dual aligner assembly 212, the inner aligner 202 and the outer aligner 204 designed in combination, to cause the patient's tooth to move to the right.
  • the inner aligner 202 is manufactured based on the next position, i + 1 (tooth in target position 206), while the outer aligner 204 is manufactured based on the combination of the tooth in its current position 208, z, and the tooth in its target position 206, i + 1.
  • i + 1 tooth in target position 206
  • the inner aligner 202 (which is designed to hold the patient's tooth in its target tooth position 206) is pressed outward toward the inner surface of the outer aligner 204.
  • the outer aligner 204 (which is designed to hold the patient's tooth either in its current position 208, in the target position 206, or any position there between) provides extra support to the inner aligner 202.
  • the inner aligner 202 contacts the more rigid outer aligner 204 and the outer aligner 204 resists the movement outward by the inner aligner 202 via its greater rigidity.
  • the outer aligner 204 provides anchorage (and thereby support) for the inner aligner 202 to resist the outward movement, thereby enabling the inner aligner 202 to avoid continued expansion outwards.
  • the force with which the inner aligner 202 presses against the outer aligner 204 is received in an equal and opposite direction via the outer aligner 204 pressing back and against the inner aligner 202. This received force is then translated through the inner aligner 202 to the patient's tooth. This translated force causes the inner aligner to press against the patient's tooth, guiding the patient's tooth toward the desired target position 206.
  • FIG. 2B shows a dimple 222 formed in the inner aligner 214 as an exterior protrusion, near the gingival line and partially filling the gap 220 of the dual aligner 218, according to an embodiment.
  • the inner aligner 214 is shaped to
  • the inner aligner 214 via the support of the outer aligner 216, provides the resistance to the patient's tooth from moving outwards in the direction of the dimple 222.
  • FIG. 2C shows a gap 236 formed between the inner aligner 226 and the outer aligner 228 of the dual aligner assembly 230, according to an embodiment.
  • the dual aligner assembly 230 is designed to move the patient's tooth upward (lingually).
  • FIG. 2D shows a ridge formed within the gap 244, as an exterior protrusion If the dual aligner assembly 242, in accordance with an embodiment.
  • the ridge 246 is filling the gap 244 near the gingival line.
  • the patient's tooth contacts the inner aligner 240.
  • the inner aligner 240 expands outwards toward the outer aligner 238.
  • FIG. 2E shows a ridge 258 formed within a gap 260 of a dual aligner assembly 252 and between the inner aligner 248 and the outer aligner 250, as an exterior protrusion, in accordance with an embodiment.
  • the ridge 258 is shown from the perspective of the mesial-distal direction.
  • the ridge 258 enables the engagement of the inner aligner 248 with the outer aligner 250, enabling the inner aligner 248 to use this engagement to help anchor the inner aligner 248 such that the inner aligner 248 may remain in contact with the tooth. Via this contact, the inner aligner 248 applies a force against the tooth, moving the tooth from its current position 256 to the target tooth position 254.
  • FIG. 2F illustrates a ridge 262 formed by a continuous protrusion in an aligner surface. While the geometric features of the ridge 262 may vary along the length, the ridge 262 is continuous in the sense that it is configured to contact a tooth surface along an uninterrupted length.
  • the ridge 262 is illustrated as having a more horizontal orientation relative to the tooth or, in other words, perpendicular to the tooth in the crown to tooth direction.
  • a continuous ridge 254 is illustrated disposed in an appliance cavity in a vertical orientation.
  • FIG. 2H illustrates a non-continuous ridge 270 that is disposed in an aligner surface and vertically oriented.
  • FIG. 21 shows a cross-sectional view of the ridge 270, illustrating the sort of corrugated surface forming the non-continuous ridge by a series of dimples or bumplike protrusions 266a, 266b, 266c.
  • such bump-like protrusions can each include a portion of the protrusion that contacts a tooth surface, with each tooth contacting surface of a protrusion separated by non-tooth contacting regions of the ridge having a different height.
  • Parameters of tooth contacting and non-contacting aspects of a non-continuous ridge, as illustrated, can be defined, at least in part, by fabrication methods (e.g., direct fabrication, vacuum molding, etc.) used. Both continuous and non-continuous type ridges function to apply a force vector along a length of the tooth, rather than at a single point with a single dimple or bump-like protrusion.
  • Shaped features such as ridges can be designed in various shapes (e.g., curve, "L” shaped, “T” shaped, hook, etc.), as well as orientations (e.g., vertical, horizontal, slanted, etc.) and are not limited to any particular shape or orientation.
  • the gap between the inner aligner and the outer aligner can include a plurality of shaped features, such as protrusions.
  • the gap can include at least two shaped features, such as protrusions that are shaped and positioned within the cavity, such that each of the protrusions are brought into contact with the received patient's tooth when the dual aligner assembly is initially worn by the patient.
  • a number of protrusions e.g., two or more
  • the shaped features of the present invention can optionally include attachment type features.
  • Attachment may be any form of material that may be attached to the tooth whether preformed, formed using a template or in an amorphous form that is attached to the surface of the tooth. It can be disposed on the tooth surface using an adhesive material, or the adhesive material itself may be disposed on the surface of the tooth as an attachment.
  • the attachments operate to provide "bumps" on a surface of the tooth which otherwise would be difficult for the dental appliance to grip. Attachments may also be engaged by the appliance in a manner that favors delivery of desired force directions and magnitudes.
  • Attachments typically include a material bonded or attached to a surface of the tooth, with a corresponding receiving portion or couple built into the tooth receiving appliance.
  • an attachment-type feature can include an orphan attachment, or any appropriate shaped material bonded to the crown surface, but with no receptacle or receiving portion build into the appliance to receive the attachment shape. Instead, the generated force concentrates on the contact area between the aligner surface and the attachment.
  • FIGS. 3A and 3B illustrate aligner action using a conventional aligner.
  • FIGS. 3C and 3D illustrate aligner action using the dual aligner assembly, in which the root of the patient's tooth is moved buccal-lingually, in accordance with an embodiment.
  • FIGS. 4A and 4B illustrate aligner action using a conventional aligner.
  • FIG. 4C illustrates aligner action using the dual aligner assembly, in which the root of the patient's tooth is moved in the mesial-distal direction, in accordance with an embodiment.
  • the current position 302 of the patient's tooth 308 is shown, as well as the target tooth position 304 for the patient's tooth 308.
  • the conventional aligner is shown, having been designed to form the shape of the target tooth position 304.
  • the patient's tooth 308 is planned to be moved bucally (to the right direction).
  • the single aligner 306 is formed based on the patient's target tooth position 304 in the next stage (z + 1).
  • the single aligner 306 is shown snapped onto the patient's dental arch (in this case, a portion of the single aligner 306 is shown snapped onto a patient's tooth 308).
  • the single aligner 306 Since the patient's tooth 308 is still in its original position, the single aligner 306 becomes deformed. Additionally, since the incisal edge 310 is more rigid than the gingival portion of the single aligner 306, at the incisal edge 310, the single aligner 306 remains stiffer and deforms less than other less rigid portions of the single aligner 306 (in response to contact with the patient's tooth 308). The portion 312 of the single aligner 306 near the gingival line tends to open outward to a certain extent, depending on its degree of rigidity.
  • FIG. 3C illustrates a portion of the outer aligner 320 and the inner aligner 318 in relation to each other.
  • the inner aligner 318 is formed to be the shape of the target tooth position 328.
  • the outer aligner 320 is formed to be the shape of the combination of the current tooth position 330 and the target tooth position 328.
  • the inner aligner 318 and the outer aligner 320 are formed such that a gap 324 is created on one side of the patient's tooth between a portion of the area between the inner aligner 318 and the outer aligner 320.
  • the inner aligner 318 and the outer aligner 320 are formed such that the outer aligner 320 follows the form of the inner aligner 318 closely.
  • the outer aligner is also formed to be the shape of the target tooth position 328 on one side of the patient's tooth, the outer aligner 320 will prevent the inner aligner 318 at the gingival area from popping outwards and keep the inner aligner 318 in contact with the patient's tooth. Since the pressure applied to the patient's tooth at the gingival line is closer to the root 332 of the tooth, a predetermined (and wanted) amount of torque 326 is applied, and the root 332 of the patient's tooth may be moved more efficiently.
  • FIG. 3D illustrates a portion of the outer aligner 338 and the inner aligner 336 in relation to each other.
  • the inner aligner 336 is formed to be the shape of the target tooth position 344, with a dimple 348 formed as an exterior facing protrusion in the inner aligner 336.
  • the outer aligner 338 is formed to be the shape of the combination of the current tooth position 346 and the target tooth position 344.
  • the inner aligner 336 and the outer aligner 338 are formed such that a gap 342 is created on one side of the patient's tooth between a portion of the area between the inner aligner 336 and the outer aligner 338.
  • the inner aligner 336 and the outer aligner 338 are formed such that the outer aligner 338 follows the form of the inner aligner 336 closely.
  • the outer aligner 338 is also formed to be the shape of the target tooth position 344 on one side of the patient's tooth, the outer aligner 338 will prevent the gingival area of the inner aligner 336 from popping outwards as well as keep the inner aligner 336 in contact with the patient's tooth.
  • the outer aligner 338 applies a force against the dimple 348 (and hence the inner aligner 336) at the gingival line 350 and also applies a force 352 against the inner aligner 336 at the incisal edge of the patient's tooth.
  • the addition of the dimple 348 (or ridge, in other embodiments) near the gingival line enables an even greater force to be applied by the inner aligner 336 against the patient's tooth near the gingival line; the addition of the dimple 348 enables the dual aligner assembly 340 to move the root of the patient's tooth even more than that movement that is created and shown in FIG. 3C.
  • the current position 402 of the patient's tooth is shown, as well as the target tooth position 404 for the patient's tooth, using a conventional aligner system having a single aligner 406.
  • the conventional aligner is shown, having been designed to form the shape of the target tooth position 404 and to move the patient's tooth distally.
  • an attachment 408 is added to the tooth near the gingival line of the patient's tooth to help create more force via the contact 410 between the single aligner 406 and the patient's tooth to move the root of the patient's tooth in the desired direction to reach the target tooth position 404.
  • FIG. 4 A is shown from a side perspective view as being snapped onto the patient's dental arch (in this case, a portion of the single aligner 406 is shown snapped onto a patient's tooth). Since the patient's tooth is still in its original position, the single aligner 406 becomes deformed upon contact with the patient's tooth. Such contact will push the single aligner 406 open and create space 412 between the single aligner 406 and the patient's tooth near the gingival line, so that the attachment 408 is not fully engaged and not enough force is created to move the root of the patient's tooth to the desired position.
  • the single aligner 406 deforms less than the deformations occurring at other less rigid portions of the single aligner 406.
  • the portion of the single aligner 406 near the gingival line 426 tends to open outward to an extent dependent on its degree of rigidity.
  • FIG. 4C illustrates a portion of the outer aligner 418 and the inner aligner 416 in relation to each other.
  • the inner aligner 416 is formed to be in the shape of the target tooth position, while the outer aligner 418 is formed to be in the shape of the combination of the current tooth position and the target tooth position.
  • the inner aligner 416 becomes deformed and is pushed outward by the patient's tooth.
  • the outer aligner 418 is also formed to be in the shape of the target tooth position on the side of the attachment, the outer aligner 418 will prevent the inner aligner 416 at the gingival line 428 from popping outwards and keep the inner aligner 416 in contact and engaged with the attachment point 422 of the patient's tooth. This continued engagement creates a bigger force with which the inner aligner 416 applies pressure to the patient's tooth in the distal direction.
  • Dual Aligner for Arch Expansion Arch expansion is a frequently used technique to fix jaw crowding malocclusion. Arch expansion is done by moving posterior teeth (molars and premolars) in the buccal direction. With the use of conventional aligners, arch expansion may be difficult for several reasons.
  • molars are bulky and are difficult to move by the conventional aligner system.
  • the conventional aligner is made from the same plastic film with uniform thickness, the force that is applied to posterior teeth is the same as the force applied to teeth other than the posterior teeth. Due to the same force being applied to different areas of the dental arch, the process of moving groups of teeth using the conventional aligner system is difficult.
  • conventional aligners are formed based on a group of teeth that are positioned in the next stage (z + 1), so that there is no relative shape change for the teeth positioned in the middle of the group of teeth.
  • An aligner is formed to have the shape of the patient's teeth in the target tooth position. For example, the teeth T3, T4 and T5 are targeted to move into the target tooth position 502, while all of the other teeth are targeted to remain in their current position.
  • the aligner 504 When the single aligner 504 is snapped onto the patient's dental arch, the aligner is deformed mostly between the moved and the stationary teeth, shown in FIG. 5A as being deformation area one 506 and deformation area two 508. Partly, this is because the portion of the single aligner 504 surrounding the tooth T5 uses the portion of the aligner surrounding the tooth T6 as anchorage to provide support for pushing the tooth T5 toward the target tooth position 502. However, there is not enough force to move the middle tooth T4 to the target tooth position, since the tooth T4 is between the two teeth, T3 and T5, which are already moving.
  • the neighboring teeth T2 and T6 to the moving teeth T3 and T5 may be receiving force from the deformation of the aligner occurring around the aligner area near teeth T3 and T5, thereby creating unwanted movement in the neighboring teeth T2 and T6.
  • the single aligner 504 presses against the lingual surface of the teeth T3 and T5 to move the teeth T3 and T5 in an outward direction 510 and 512, but does not apply enough force to the middle targeted tooth T4 to cause the tooth T4 to also move in an outward direction 514.
  • the teeth of the dental arch shown in FIG. 5 A, other than the teeth T3, T4 and T5, are not targeted to move.
  • the aligner deformation mostly happens between the moved and the stationary teeth, such as between the teeth T5 and T6 at deformation area one 506 and between teeth T2 and T3 at deformation area two 508. There may be enough force to move teeth that are near the stationary teeth, but there is not enough force provided by the single aligner 504 against the patient's teeth to move the middle tooth T4 of the group of the targeted teeth.
  • FIG. 5B illustrates a dual aligner assembly 522 in operation, in accordance with an embodiment.
  • An inner aligner 520 is formed to have the shape of the patient's teeth in the target tooth position 532.
  • the teeth T3, T4 and T5 are targeted to move to the target tooth position 532, while all of the other teeth are targeted to remain in their current position.
  • An outer aligner 518 is formed to have the shape of the combination of the patient's teeth in their current position and the target tooth position 532. Dimples and/or ridges may be formed as part of the inner aligner 520 or attached thereto. For example, FIG.
  • 5B shows dimple one 524, dimple two 526 and dimple three 528 formed in the inner aligner 520 to fill a portion of the gap 530 between the inner aligner 520 and the outer aligner 518 on the lingual side of the teeth.
  • the outer aligner 518 is rigid enough such that each dimple positioned next to a different tooth experiences about the same deformation, such that similar forces against the teeth are created at the dimple regions (the dimple region includes the dimple base and point).
  • the reaction forces 534 to the pressure applied by the inner aligner 520 against the patient's teeth near the dimple regions are then distributed such that the patient's entire dental arch functions as an anchorage for the inner aligner 520 to provide support for the movement of the target teeth, T3, T4 and T5.
  • the outer aligner 518 provides support to the inner aligner 520, even at the position of the middle tooth T4, such that the inner aligner 520 is able to provide enough force to the patient's middle tooth T4 to move the middle tooth to the desired target tooth position 532.
  • the outer aligner 518 provides anchorage for the inner aligner 520, prevents the inner aligner 520 from deforming outwards, and keeps at least portions of the inner aligner 520 in contact with the patient's teeth.
  • the middle tooth T4 may also be moved to a target tooth position 532.
  • the outer aligner 518 in one embodiment, is made from a stronger and thicker material than the inner aligner 520. Additionally, since the outer aligner 518 is the envelope of the current and the next position, there is minimum deformation to the inner aligner 520 due to the tooth position change of the targeted teeth T3, T4 and T5. In contrast, in the conventional aligner system with a single aligner, only the neighboring teeth would provide anchorage support for the movement of the target teeth, T3, T4 and T5.
  • the dual aligner assembly includes an inner aligner, an outer aligner, and one or more intermediate aligners for being positioned between the inner aligner and the outer aligner.
  • a dual aligner assembly includes a plurality of aligners.
  • the plurality of aligners includes a first aligner and a second aligner.
  • the first aligner includes a first material having a first shape corresponding to a first set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of target teeth of a plurality of teeth of a dental arch of a patient, wherein the first orthodontic force generates movement of the set of target teeth to the first set of target tooth positions.
  • the second aligner includes a second material having a second shape corresponding to a combination of current tooth positions of the set of target teeth, the first set of target tooth positions, at least a second set of target tooth positions, and a thickness of at least the first aligner. According to some embodiments, there exists an
  • the intermediate aligner in between the first aligner and the second aligner.
  • the intermediate aligner is formed based on a second set of target tooth positions that is different from the first set of target tooth positions.
  • the second aligner accommodates not only the first set of target tooth positions considered by the first aligner, but one or more other sets of target tooth positions considered by the one or more intermediate aligners.
  • the second aligner also accommodates the thicknesses of the first aligner and any intermediate aligner.
  • the second aligner partially encloses at least the first aligner (as well as any intermediate aligners) and provides an anchor for at least a portion of at least the first aligner (and any intermediate aligners).
  • the anchorage the principal of operation of which is described herein
  • a combination of the first aligner and the second aligner and any intermediate aligner positioned between the first aligner and the second aligner provide a second orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
  • unwanted tooth positions includes tooth positions other than the following tooth positions: the current tooth positions of the set of target teeth; one or more tooth positions that represent movement of at least one tooth of the set of target teeth to any set of target tooth positions (including the first set of target tooth positions and at least a second set of target tooth positions); and any set of target tooth positions (including the first set of target tooth positions and at least a second set of target tooth positions).
  • Each of the inner aligners of the multiple aligners may include inward and/or outward protrusions (e.g., dimples, ridges, etc.), the operation of which are described herein.
  • the dual aligner assembly includes three or more aligners which are combined to provide more exact and desired forces directed toward a predetermined tooth/teeth, in order to provide a more efficient and accurate orthodontic process.
  • the steps of manufacturing the dual aligner assembly include the following: 1) Create a mold of the jaw with the patient's teeth positioned in the next stage position. 2) Use a vacuum thermoforming process to create the inner aligner from the mold. 3) Create a combined model of the patient's teeth, in the current stage and the next position. Then, inflate the model with a thickness of the inner aligner thickness. 4) Create a mold of a combined jaw model, using a vacuum
  • the outer aligner is made from the combination of teeth from the current position of the patient's teeth (z) and the desired next stage position (z + 1) of the patient's teeth.
  • the manufacture of the outer aligner is different from the conventional manufacture of an aligner for the patient's teeth in the current position of the teeth as well as different from the conventional manufacture of a single aligner. Further, the manufacture of the outer aligner, according to embodiments, is different from the manufacture of the inner aligner of the dual aligner assembly.
  • the first step is building a 3D solid model to combine the teeth in two positions, as well as accommodating the thickness of the inner aligner.
  • the process to create the 3D solid model includes the following: 1) For each of the patient's teeth, based on the tooth's next position, create a next position 3D tooth model.
  • the current tooth position and the next tooth position are used to create an outer aligner's mold model. Between the current tooth position and the next tooth position, one more intermediate tooth positions may be added to create intermediate 3D tooth models.
  • the union Boolean operation is applied to an offset tooth model, to a current tooth model and to an intermediate tooth model(s). By introducing the intermediate tooth model(s), the tooth movement is more guided from its current position to the next position and the aligner surface has smoother transitions.
  • the dual aligner system 600 includes an inner aligner 610 and an outer aligner 620.
  • the dual aligner system 600 is intended to effect incremental repositioning of individual teeth in the jaw as described generally above.
  • the dual aligner system 600 in one embodiment, includes a plurality of aligners (one or more inner aligners and an outer aligner), each having a polymeric shell having cavities shaped to receive and resiliently reposition teeth from one tooth arrangement to a successive tooth arrangement.
  • the polymeric shells in one embodiment, will fit over all the teeth present in the upper or lower jaw. Often, only certain one(s) of the teeth will be repositioned while an aligner positioned exterior to an inner aligner provides a base or anchor region for holding the inner aligner in place as it applies a resilient repositioning force against the set of target teeth to be positioned at a set of target tooth positions.

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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

L'invention concerne un ensemble à double aligneur comprenant une pluralité d'aligneurs, comprenant un premier aligneur et un second aligneur. Le premier aligneur présente une première forme correspondant à un ensemble de positions de dents cibles et applique une force orthodontique contre un ensemble de dents cibles. La première force orthodontique génère un mouvement de l'ensemble de dents cibles vers l'ensemble de positions de dents cibles. Le second aligneur présente une seconde forme correspondant à une combinaison de positions de dents courantes de l'ensemble de dents cibles, à l'ensemble de positions de dents cibles, et à une épaisseur du premier aligneur. Le second aligneur abrite partiellement le premier aligneur et fournit un ancrage pour au moins une partie du premier aligneur. Grâce audit ancrage, une combinaison du premier aligneur et du second aligneur fournit une force orthodontique qui empêche l'ensemble de dents cibles de se déplacer à des positions de dents non souhaitées pendant un traitement orthodontique.
PCT/IB2016/000976 2015-07-07 2016-07-07 Ensemble à double aligneur WO2017006177A1 (fr)

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US201562189259P 2015-07-07 2015-07-07
US201562189384P 2015-07-07 2015-07-07
US62/189,384 2015-07-07
US62/189,259 2015-07-07
US15/202,384 US10743964B2 (en) 2015-07-07 2016-07-05 Dual aligner assembly
US15/202,384 2016-07-05

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EP3363405A1 (fr) * 2017-02-17 2018-08-22 Vali-Pursche Pouran Réglage orthodontique de la position des dents
CN110691561A (zh) * 2017-06-02 2020-01-14 西诺德牙科设备有限公司 由热塑性膜或板制成的牙科辅助物的生产方法
DE202021106975U1 (de) 2021-12-21 2022-01-17 Pouran Vali-Pursche Kieferorthopädische Zahnstellungsregulierungseinrichtung

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WO2001080764A1 (fr) * 2000-04-25 2001-11-01 Align Technology, Inc. Systemes et procedes pour modifier les applications du module d'elasticite
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3363405A1 (fr) * 2017-02-17 2018-08-22 Vali-Pursche Pouran Réglage orthodontique de la position des dents
CN110691561A (zh) * 2017-06-02 2020-01-14 西诺德牙科设备有限公司 由热塑性膜或板制成的牙科辅助物的生产方法
CN110691561B (zh) * 2017-06-02 2021-10-08 西诺德牙科设备有限公司 由热塑性膜或板制成的牙科辅助物的生产方法
DE202021106975U1 (de) 2021-12-21 2022-01-17 Pouran Vali-Pursche Kieferorthopädische Zahnstellungsregulierungseinrichtung
EP4201369A1 (fr) 2021-12-21 2023-06-28 Pouran Vali-Pursche Dispositif de postionnement dentaire orthodontique

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