WO2018160870A1 - Facette composite amovible - Google Patents

Facette composite amovible Download PDF

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Publication number
WO2018160870A1
WO2018160870A1 PCT/US2018/020504 US2018020504W WO2018160870A1 WO 2018160870 A1 WO2018160870 A1 WO 2018160870A1 US 2018020504 W US2018020504 W US 2018020504W WO 2018160870 A1 WO2018160870 A1 WO 2018160870A1
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WO
WIPO (PCT)
Prior art keywords
dental appliance
teeth
mai
gum line
dental
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PCT/US2018/020504
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English (en)
Inventor
Ray F. Stewart
Original Assignee
Bay Materials Llc
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Publication date
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Publication of WO2018160870A1 publication Critical patent/WO2018160870A1/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
    • A61C13/00—Dental prostheses; Making same
    • A61C13/08—Artificial teeth; Making same
    • A61C13/082—Cosmetic aspects, e.g. inlays; Determination of the colour
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K6/00—Preparations for dentistry
    • A61K6/15—Compositions characterised by their physical properties
    • A61K6/16—Refractive index

Definitions

  • the disclosure relates to improved dental materials and dental appliances made therefrom.
  • a number of useful dental appliances are produced by forming a shell adapted to fit over one or more teeth, for example orthodontic tooth positioners or aligners, as described in: Chisti et al, US Patent No. 5,975,893, Phan, et al, US Patent No. 6,524,101, Tricca et al, US Patent No. 7,255,561; retainers, as described in: Anderson, WO 2006009745, Stewart, WO 2013130552; mouth guards, as described in: Mack, US Patent Publication No. 20110179851, Ambis,
  • US Patent No. 6,454,565 discloses methods and constructions to produce devices having different mechanical properties in different areas.
  • US Patent No. 9,138,298 discloses a dental aligner incorporating reinforcing fabric in selected regions to modify forces on teeth to facilitate movement.
  • US Patent No. 8,986,003 discloses an aligner made of a polyurethane resin wherein at least the facial surfaces are a pearlescent white color. The entire disclosure of each of those patents and publications is incorporated herein by reference for all purposes.
  • Such devices may be conveniently manufactured by one of several methods including thermoforming, subtractive machining, additive (3D) printing or by other known methods or combinations of methods.
  • Some dental appliances function to impart substantial force on the teeth and can prevent tooth movement or lessen mechanical impact to teeth.
  • the rigidity of such a polymeric appliance is a result of the modulus of the thermoformable polymer materials from which it is made. The higher the modulus of the materials, the more rigid the appliance. However, the more rigid the appliance, the more difficult it is to fit it over the teeth and the less comfortable it is for the wearer.
  • the polymeric shells may be degraded by the environment in the oral cavity and lose their effectiveness over time in terms of mechanical properties or aesthetics.
  • Dental appliances comprising a laminar shell composed of at least two layers, with at least a portion of the innermost layer configured to engage individual teeth and the outermost layer having a lower elastic modulus than the inner layer have been described.
  • Such appliances impart different forces to the immediately underlying teeth, for example the portion of the appliance covering the molars imparts a different force than portions of the appliance covering the remainder of the teeth.
  • Dental appliances have also been described that comprise a laminar shell having an inner layer and an outer layer, wherein the inner layer includes at least two segments which conform to individual teeth or groups of teeth, and the outer layer joins segments of the inner layer together, wherein the outer layer has a lower modulus of elasticity than the inner layer.
  • Dental appliances for delivery of substances to teeth or gums concurrently with the realignment of teeth using elastic polymeric shells have been described.
  • the substance is provided in active form in or on a carrier or binder, encapsulated in the device or microencapsulated in a polymer material used to make the shell.
  • Exemplary agents include, antibiotics, bleaching materials such as carbamide peroxide, fluoride, breath fresheners and the like.
  • Currently available options to improve the appearance of teeth have substantial disadvantages.
  • Many cosmetic procedures make use of bleaching agents which are applied directly to the teeth. Such bleaching agents can damage the natural tooth structure itself and/or can produce inconsistent cosmetic effects or stains on the natural tooth structure and/or fillings or crowns.
  • Other proposed cosmetic procedures make use of treatments which form a coating over the teeth. Such treatments are difficult to apply uniformly and accurately, often degrade relatively rapidly, and can be difficult to remove.
  • Cosmetic options for improving the appearance of teeth are described for example, in US Patent Nos. 4,032,627;
  • improved dental appliances which can be applied to a person's teeth.
  • the dental appliances improve the appearance of one or more teeth and conform to a model corresponding to one or more of a person's teeth, the model having a gum line and a gingival area, the one or more teeth extending above the gum line, and the gingival area being below the gum line.
  • the dental appliances comprise two or more distinct materials adapted to conform to at least a portion of teeth (Al) and a corresponding gingival region (A2), wherein at least a portion of the material(s) conforming to at least a portion of the teeth (MAI) is trimmed to the gum line and at least a portion of the material(s) conforming to the gingival area (MA2) is trimmed over (beyond) the gum line, for example to approximately 0.5mm, 1mm, 2mm, 3mm, 4mm, and 5 mm, 1 to 2.5mm, 2 to 3mm, or 3 to 4mm over the gum line.
  • At least a portion of MA2 has one or more different optical properties than MAI .
  • Exemplary optical properties are light transmission, reflection, anti-glare, gloss control, haze and color.
  • the dental appliance comprises a first or innermost component and a second or outermost component, which may be made of the same materials, similar materials or different materials, and the innermost component and the outermost components of the dental appliance may be attached or laminated to one another.
  • the light transmission of MAI is less than the light transmission of MA2.
  • the light transmission of MAI may be less than 80%, less than 70%, less than 60%, less than 50%, 70-80%, 60-70%, 50-60%, 40-50%, 30-40%, or 20-30% and the light transmission of MA2 may be greater than 70%, greater than 80%, greater than 85%, greater than 90%, 70-80%, 80-90%, 90-95%, or 95-100%.
  • MAI may comprise one or more optical additives such that, when measured using the LAB scale on a reference black color tile, the composition has an L value of from 15 to 70, an A value of 0.5 to 3.0, and a B value of less than 5 and/or when measured using the LAB scale on a reference yellow color tile, has an L value of from 50 to 100, an A value of 0.5 to 5.0, and a B value of 5 to 35.
  • the haze value of MAI may be greater the haze value MA2.
  • the material(s) conforming to at least a portion of the teeth may have one or more material properties that are different from at least a portion of the material(s) conforming to the gingival area (MA2).
  • the material properties may be: (1) the mechanical property of modulus where the modulus of MIA is greater than or equal to the modulus of MA2; (2) the physical property of oxygen permeability where the oxygen permeability of MA2 is greater than the oxygen
  • permeability of MAI is greater than the fluid permeability of MA2; (4) the biochemical property of antibacterial activity, wherein the antibacterial activity of MAI is greater than the antibacterial activity of MA2; and (5) the biochemical property of calcium binding, wherein the calcium binding activity of MAI is greater than the calcium binding capacity of MA2.
  • a dental appliance comprising a polymeric shell adapted to fit over teeth wherein the dental appliance comprises the chemical property of catalytic activity.
  • the catalytic activity may be decomposition of a peroxy compound or photocatalytic activity.
  • FIG. 1 is a schematic depiction of a cast model of the teeth of an individual.
  • FIG. 2A is a schematic depiction of a first or innermost polymeric material thermoformed over a cast model of the teeth.
  • FIG. 2B is a schematic depiction of a side view of single tooth showing a first or innermost polymeric material thermoformed over the tooth.
  • FIG. 3A is a schematic depiction of a first or innermost polymeric material thermoformed over a cast model of the teeth, where the polymeric material is carefully trimmed very close to the gum line and closely following the shape of teeth.
  • FIG. 3B is a schematic depiction of a side view of a single tooth showing a first or innermost polymeric material thermoformed over the tooth, where the polymeric material is carefully trimmed very close to the gum line and closely following the shape of the tooth.
  • FIG. 4A is a schematic depiction of a first or innermost polymeric material thermoformed over a cast model of the teeth, carefully trimmed very close to the gum line and placed back on the model to create a dental appliance where the polymeric material part does not extend beyond the tooth area.
  • a second or outermost polymeric material was thermoformed over the appliance resulting in a laminated structure, where the outermost material extends over the gum line.
  • FIG. 4B is a schematic depiction of a side view of single tooth showing a first or innermost polymeric material thermoformed over the tooth, carefully trimmed very close to the gum line with a second or outermost polymeric material thermoformed over the first or innermost polymeric material resulting in a laminated structure, where the outermost material extends over the gum line.
  • FIG. 5A is a schematic depiction of a first or innermost polymeric material thermoformed over a cast model of the teeth, carefully trimmed very close to the gum line and placed back on the model to create a dental appliance where the polymeric material part does not extend beyond the tooth area. A second or outermost polymeric material was thermoformed over the appliance resulting in a laminated structure and trimmed approximately 2 mm beyond the gum line generally conforming to the edge of the teeth.
  • FIG. 5B is a schematic depiction of a first or innermost polymeric material thermoformed over a cast model of the teeth, carefully trimmed very close to the gum line and placed back on the model to create a dental appliance where the polymeric material part does not extend beyond the tooth area.
  • a second or outermost polymeric material was thermoformed over the appliance resulting in a laminated structure and trimmed approximately 2 mm beyond the gum line with a substantially straight edge, not directly conforming to the contours of the teeth.
  • FIG. 5C is a schematic depiction of a side view of single tooth showing a first or innermost polymeric material thermoformed over the tooth, carefully trimmed very close to the gum line with a second or outermost polymeric material thermoformed over the first or innermost polymeric material resulting in a laminated structure, where the second material is trimmed approximately 2 mm beyond the gum line.
  • Al is used herein with reference to a portion of teeth, e.g., two or more teeth, for example, 2, 3, 4, 5, 6, 7, 8, 9, 10, 1 1, 12, 13, 14 or 15 teeth for each of the upper and lower jaw.
  • A2 is used herein with reference to a gingival region corresponding to (or adjacent) the portion of the teeth identified by "Al ".
  • the term "dental appliance” is used herein with reference to any device placed in or on the teeth and which improves the appearance of the person's teeth.
  • the appliance may also provide orthodontic, prosthetic, retaining, snoring/airway, cosmetic, therapeutic or habit-modification.
  • coloring agent is used herein to denote a coloring agent that is soluble or molecularly dispersed in a polymer.
  • elastic modulus is used herein with reference to the rigidity of a material and/or resistance of the material to elastic deformation. The higher the elastic modulus of the material, the more rigid.
  • fluorescent agent is used herein to denote a material that absorbs light in one region of the spectrum and emits light in the same or different region of the spectrum. The emission may be almost immediate or may be delayed.
  • the fluorescent agent is selected from the group consisting of triazinestilbenes, coumarins, imidazolines, diazoles, triazoles, benzyloxazolines, and biphenyl-stilbenes or other fluorescent agents.
  • gingiva line is referred to herein as the line separating the gum (or gingiva) from the exposed part of the tooth.
  • incident light is used herein to denote light which shines onto an object and which may be reflected, scattered or least partially absorbed by the object.
  • light scattering particles is used herein to denote particles having a size from about 0.2 to about 20 ⁇ and which are transparent or substantially white. By white is meant that the particles do not absorb significant amounts of light in the range from about 400 nm to about 700 nm.
  • light transmission is used herein to denote the amount of light passing through a sample. Unless otherwise stated, transmission refers to visible light as measured by a method similar to ASTM D1003 - 11 Standard Test Method for Haze and Luminous Transmittance of Transparent Plastics. Light transmission may also be measured using a colorimeter and a white reference sample, in which case the measurement includes two passages of light through the sample. Other measurements may be used and specific methods reported based on equipment used and sample characteristics.
  • MA2 is used herein with reference to a material conforming to at least part of the gingival area. MA2 has at least one different material property than MAI.
  • material properties is used herein with reference to properties selected from the group consisting of mechanical, optical, chemical, physical, electrical and biochemical properties.
  • optical additive is used herein to mean an additive which substantially changes the color or light transmission properties of the polymeric material.
  • An optical additive comprises one or more of a pigment, a dye, light scattering or absorbing particles and a fluorescent material with optical properties.
  • pigment is used herein to denote a solid particulate coloring agent which can be mixed with a polymer or a mixture of more than one polymer.
  • the polymer(s) may be selected from the group consisting of elastomers, polyesters, polyurethanes, polyolefins, acrylic resins, methacrylic resins, polyamides, polycarbonates, polyethers, ionomer raisins, cellulose esters, cellulose ethers, and fluoropolymers, examples of which are listed in Table 5.
  • reflected light is used herein to denote incident light which reflects off the surface of an object after impinging on the object.
  • scattered light is used herein to denote light which diverges from a straight path after it has impinged on an object.
  • shell is used herein with reference to polymeric shells which fit over the teeth and are removably placeable over the teeth.
  • stain resistant is used herein with reference to a material designed to be resistant to being stained.
  • thermoplastic polymer is used herein to denote a polymer which is relatively hard at a lower temperature, which becomes relatively soft when subjected to heat and pressure, and again becomes relatively hard when cooled, provided that the heat and pressure do not chemically decompose the polymer.
  • thermosetting polymer is used herein to denote a polymeric material which is a solid or viscous material at a relatively low temperature and which, when subjected to heat and/or suitable radiation, and/or when the material undergoes one or more chemical reactions, changes irreversibly into an infusible polymer network.
  • thermoset polymer is used to denote a cured thermosetting polymer.
  • teeth and teeth include natural teeth, including natural teeth which have been modified by fillings or by crowns, implanted teeth, artificial teeth that are part of a bridge or other fitting secured to one or more natural or implanted teeth, and artificial teeth that are part of a removable fitting.
  • trimmed to the gum line is used herein to mean that at least a portion of a dental appliance or shell is formed, trimmed (or cut) on or close to the line where the gum meets the tooth (i.e., the gingival line or gingival margin).
  • an aligner have different material properties in different regions of the dental appliance.
  • devices having different mechanical properties in different areas may be prepared by thermoforming one or more thermoplastic components over a model of the patient's teeth.
  • thermoformed devices When such devices are constructed from thin plastic sheets by thermoforming (typically with a thickness of from about 0.25 to about 4 mm) the thermoformed device will be removed from the model and the excess material trimmed. Trimming may be done at the gum line closely following the shape of teeth (FIG. 1) or somewhat below (beyond) the gum line such that the device covers part of the gingiva (FIG. 2). Studies disclosed herein have shown that aligners which are trimmed approximately 1-2 mm below (beyond) the gum line are more effective in retaining strength and moving teeth than comparable aligners trimmed at or very near the gum line.
  • appliances trimmed at the gum line are more prone to breakage and can be more irritating to the patient than devices that extend below (beyond) the gum line.
  • aligners typically a polyester resin or polyurethane
  • aligners are rigid and inflexible making removal difficult. Additionally, such aligners suffer from low oxygen permeability.
  • a dental appliance alter the cosmetic appearance of teeth.
  • bleaching trays are used to hold a tooth whitening agent (typically hydrogen peroxide or carbamide peroxide) adjacent to tooth surfaces.
  • a tooth whitening agent typically hydrogen peroxide or carbamide peroxide
  • these trays are trimmed below (beyond) the gum line, the gingival area is subjected to harsh bleaching agents which may cause irritation or damage to the gum tissue.
  • a dental appliance comprises two or more materials adapted to conform to at least a portion of teeth (Al) and to at least a portion of a corresponding gingival region (A2), wherein at least a portion of the material(s) conforming to a portion of the teeth (MAI), and a material conforming to at least a portion of the gingival area (MA2), differ in at least one material property selected from a mechanical, optical, electrical, physical, chemical or biochemical property.
  • the dental appliance comprises at least an inner and outer component.
  • the inner and outer components may comprise distinct or different materials and there may or may not be a distinct dividing line between them.
  • the components may or may not be layers. When the components are layers, each layer may comprise a different material.
  • the components of a dental appliance may different in a mechanical property, e.g., elastic modulus, and/or other mechanical properties.
  • Elastic modulus is a measure of how well a material resists deformation. If a sample has a high modulus, it resists deformation. If a sample has a low modulus, it is easily deformed.
  • the elastic modulus of a material is enhanced or otherwise modified by inclusion of an additive, for example, CaCCb, talc, TiC , glass, diamond or a polymer powder or by methods such as layering, coating, treating the material or appliance with a chemical agent, or altering the temperature.
  • a dental appliance will have an elastic modulus of from 0.5 to 5 GigaPascal (GPa), for example, 0.5 GPa, 0.6 GPa, 0.7 GPa, 0.8 GPa, 0.9 GPa, 1.0 GPa, 1.1 GPa, 1.2 GPa, 1.3 GPa, 1.4 GPa, 1.5 GPa, 1.6 GPa, 1.7 GPa, 1.8 GPa, 1.9 GPa, 2.0 GPa, 2.1 GPa, 2.2 GPa, 2.3 GPa,
  • GPa 2.5 GPa, 2.6 GPa, 2.7 GPa, 2.8 GPa, 2.9 GPa, 3.0 GPa, 3.1 GPa, 3.2 GPa, 3.3 GPa, 3.4 GPa, 3.5 GPa, 3.6 GPa, 3.7 GPa, 3.8 GPa, 3.9 GPa, 4.0 GPa, 4.1 GPa, 4.2 GPa, 4.3 GPa, 4.4 GPa,
  • the modulus of material (MAI), which covers the teeth is 1.5 times, 2 times, 3 times, 4 times, 5 times, 6 times, 7 times, 8 times, 9 times, 10 times, from 1 to 2 times, from 2 to 3 times, from 3 to 4 times, from 4 to 5 times, from 5 to 6 times, from 6 to 7 times, from 7 to 8 times, from 8 to 9 times, or from 9 to 10 times the modulus of material (MA2), which covers the gingival area.
  • the modulus of material (MAI), which covers the teeth is the same as the modulus of material (MA2), which covers the gingival area.
  • the modulus of material (MA2), which covers the gingival area is 1.5 times, 2 times, 3 times, 4 times, 5 times, 6 times, 7 times, 8 times, 9 times, 10 times, from 1 to 2 times, from 2 to 3 times, from 3 to 4 times, from 4 to 5 times, from 5 to 6 times, from 6 to 7 times, from 7 to 8 times, from 8 to 9 times, or from 9 to 10 times greater than the modulus of material (MAI), which covers the teeth.
  • Optical properties include but are not limited to visible light transmission, reflectivity, antiglare, gloss control, and haze and color.
  • the polymeric composition can contain a single optical additive or a mixture of two or more optical additives.
  • the polymeric material can contain other additives which are not optical additives.
  • the optical additives may be one or more optical additives selected from the group consisting of pigments, dyes, light scattering particles and fluorescent materials.
  • the light transmission of MAI is less than MA2. In some embodiments, the light transmission of MAI is less than 80%, less than 70%, less than 60%, less than 50%, 70-80%, 60-70%, 50-60%, 40-50%, 30-40%, or 20-30% and the light transmission of MA2 is greater than 70%, greater than 80%, greater than 85%, greater than 90%, 70-80%, 80-90%, 90-95%, or 95-100%. [0076] In some embodiments, the haze value of MAI is greater than MA2. In some embodiments, the haze value of MAI is less than 10 and the haze value of MA2 is greater than 10.
  • the material(s) containing an optical additive can optionally have one or both of the following characteristics: (1) absorption of light within the range of about 550 to about 700 nm; or (2) when measured on a reference white color tile using the CIELAB color scale values for the combination of the white color tile and the material have an L value of between about 80 and 95, an A value from about -2 to + 2 and a B value is from about +2 to -10. See, e.g., US Patent Publication No. 20150374464, expressly incorporated by reference herein in its entirety.
  • the material(s) containing an optical additive when measured on a reference black color tile can alter the perceived color of the black color tile when measured using a Byk Gardner Colorimeter as follows. Color measurement was made directly on the black tile and the CIELAB color scale values were recorded. Next, a thin film of water was applied to the color tile and the test film was laid onto the tile and gently smoothed to remove excess water to provide good optical coupling between the film and the color tile. The color measurements were then repeated, measuring on the combined structure and the LAB color values recorded, as shown in Tables 1 and 2.
  • the materials increase the "brightness" as shown by the L values - decrease the yellowness of the tiles as shown by the B values.
  • the materials have a visible light transmission of greater than 50%, 60%, 70%, or 75%.
  • the materials have an incident light reflection of greater than 20%, 25%, 35%, 45%, 55%, 60%, or less than 80%, 70%, 60%, 50%, 40%.
  • the dental appliance is adapted to fit over one or more teeth and at least a portion of the gum wherein a portion of the dental appliance covering at least a portion of a tooth exhibits a whitening effect and a portion covering the gum is substantially transparent.
  • the dental appliances described herein are used for orthodontic treatment while concurrently providing a dental/periodontal therapy or a cosmetic treatment modality.
  • Such treatments are traditionally provided with the use of a variety of accessories and devices applied when the repositioning appliance is removed from the patient's mouth.
  • Bleaching trays are used to hold a tooth whitening agent (typically hydrogen peroxide or carbamide peroxide) adjacent to tooth surfaces. However, because these trays are trimmed below (beyond) the gum line the gingival area is subjected to harsh bleaching agents which may cause irritation or damage to gum tissue.
  • a tooth whitening agent typically hydrogen peroxide or carbamide peroxide
  • the dental appliances described herein incorporate a
  • the dental appliance comprises a laminated structure where a second or outermost polymeric material is trimmed approximately 2 mm beyond the gum line, either conforming to the edge of the teeth or having a substantially straight edge and extending beyond the gum line, but not directly conforming to the contours of the teeth.
  • the dental/periodontal or cosmetic treatment modality is provided in a form that must be activated in order for it to be effective.
  • the dental appliance comprises a dental/periodontal or cosmetic treatment modality in the form of a decomposition catalyst.
  • the decomposition catalyst activity is for decomposition of a peroxy compound and is present in the innermost portion of the dental appliance that conforms to the teeth or conforms to the teeth and the gums.
  • the dental appliance comprises a single material comprising a decomposition catalyst and the material is (a) not trimmed; (b) trimmed to the gum line; or (3) trimmed approximately 2 mm beyond the gum line, either conforming to the edge of the teeth or having a substantially straight edge and extending beyond the gum line, but not directly conforming to the contours of the teeth.
  • the dental appliance comprises more than one material comprising a decomposition catalyst and the material is: (a) not trimmed; (b) trimmed to the gum line; or (3) trimmed approximately 2 mm beyond the gum line, either conforming to the edge of the teeth or having a substantially straight edge and extending beyond the gum line, but not directly conforming to the contours of the teeth.
  • the catalytic activity is derived from Zeolite Socony Mobil-5
  • Zeolite SM-5 an aluminosilicate zeolite belonging to the pentasil family of zeolites.
  • the chemical formula is Na n Al n Si 96 - n Oi 92 - 16H 2 0 (0 ⁇ n ⁇ 27) and it is available from multiple sources.
  • This Zeolite is insoluble, non-toxic, and known to catalyze the decomposition of peroxides such as hydrogen peroxide producing oxidizing species including hydroxy radicals. See, e.g., Gabriel Ovejero et al, Ind. Eng. Chem. Res. , 2001, 40 (18), pp 3921-3928, entitled, "Wet Peroxide Oxidation of Phenolic Solutions over Different Iron-Containing Zeolitic Materials”.
  • the catalytic activity is derived from one or more of an iron, nickel or manganese compound.
  • the catalytic activity is derived from a heterogeneous catalyst or magnetically separable iron mixed oxides such as (Co(II), Cu(II), Mn(II) ferrite and magnetite.
  • the dental appliance comprises a dental/periodontal or cosmetic treatment modality in the form of a photocatalytic agent.
  • the photocatalytic agent is present in the innermost portion of the dental appliance that conforms to the teeth or conforms to the teeth and the gums.
  • the dental appliance comprises a single material comprising a photocatalytic agent and the material is (a) not trimmed; (b) trimmed to the gum line; or (3) trimmed approximately 2 mm beyond the gum line, either conforming to the edge of the teeth or having a substantially straight edge and extending beyond the gum line, but not directly
  • the dental appliance comprises more than one material and the material comprising a photocatalytic agent is: (a) not trimmed; (b) trimmed to the gum line; or (3) trimmed approximately 2 mm beyond the gum line, either conforming to the edge of the teeth or having a substantially straight edge and extending beyond the gum line, but not directly
  • the photocatalyst is comprised of a finely divided titanium dioxide, CuO-Sn02, ZnS-CdS, ZnO, or Nb205 or other known photocatalytic agent.
  • the catalytic activity is provided by Anatase titanium dioxide a photocatalytic semiconducting material. Anatase is known to produce hydroxyl radicals and other oxidizing species in the presence of UVA (400 nm) light.
  • the dental appliance comprises a dental/periodontal or cosmetic treatment modality in the form of a component having antibacterial activity.
  • the antibacterial activity of MAI is greater than the antibacterial activity of MA2.
  • the calcium binding capacity of MAI is greater than the calcium binding capacity of MA2.
  • MAI has greater mineralizing activity than MA2.
  • the calcium transport property of MA2 is greater than the calcium transport property of MAI.
  • the dental appliances or shells may vary in terms of fluid permeability. This can be optimized by varying the diameter and the density of pores. The pore density and diameter can be of uniform or non-uniform distribution across the dental appliance or shell. The dental appliances or shells may vary in terms of oxygen permeability and or fluid permeability.
  • the oxygen permeability of MA2 is greater than MAI. In some embodiments the rate of saliva transport is greater for MAI than MA2.
  • the dental appliance comprises at least a first or innermost component and a second or outermost component.
  • a first or innermost component of the dental appliance or shell more closely tracks the conformation of the teeth than the second or outermost component.
  • the first or innermost component has a thinner wall thickness than a second or outermost component.
  • the innermost and outermost components comprise similar or the same materials.
  • the innermost component fitting over the teeth is trimmed to the gum line such that there is little to no coverage of the gingiva. In some embodiments substantially, all of the innermost material is trimmed to the gum line over the region which is readily visible to an observer when the appliance is worn. In some embodiments some of the innermost materials are not trimmed to the gum line over a region which is not readily visible to an observer when the appliance is worn (e.g., the back of the teeth). In some cases, the innermost component fitting over the teeth comprises more than one layer or more than one material and has a thickness as shown in Table 3.
  • a second or outermost component of the dental appliance or shell has less contours (i. e., is less conformal) than the first or inner component.
  • the outer component is not coextensive with teeth, may be transparent or translucent and has a thickness as shown in Table 4. Table 4. Exemplary Thickness Ranges for Outermost Component of Dental Appliances.
  • a second or outermost component of the dental appliance is one or more of thicker, stronger, and more transparent than the first or innermost component of the dental appliance.
  • the components of the dental appliance are attached or laminated to one another.
  • the outermost component is not trimmed to gum line and extends over the gum line, for example, ., 1 mm, 2mm, 3mm, 4mm, 5mm, 6mm, 7mm, 10mm, 1 to 3mm, 2 to 4mm, 4 to 6mm, 5 to 6mm, 6 to 7mm, 7 to 8mm, 8 to 9mm, or 9 to 10mm over the gum line.
  • the components of the dental appliance may or may not be layers, and the material that extends beyond the gum line is not the same as the material that covers the teeth.
  • the components of the dental appliance may or may not be layers, and the material that extends beyond the gum line is the same as the material the covers the teeth.
  • the dental appliance shells are of variable thickness, for example, 0.2mm, 0.3mm, 0.4mm, 0.5mm, 0.6mm, 0.7mm, 0.8mm, 0.9mm, 1.0mm, 1.1mm, 1.2mm, 1.3mm, 1.4mm, 1.5mm, , from 0.2mm to 0.6mm, from 0.4mm to 0.8mm, from 0.6mm to 1.0mm, from 0.8mm to 1.2mm, or from 1.0mm to 1.4mm.
  • the thickness may vary for different portions of the dental appliance or shell either by design or by virtue of the manufacturing process.
  • the polymer in a material used to make the dental appliance or shell can be a homopolymer, or a random, block or a graft copolymer.
  • the composition can contain a single polymer or a mixture of two or more polymers.
  • the polymer is substantially transparent.
  • the optical characteristics of the dental appliance or shell are dominated by optical additives which are mixed with the polymer.
  • the polymer is a semicrystalline polymer which scatters light.
  • the devices described herein may be prepared from any suitable plastic or polymeric resin, examples of which are listed in Table 5.
  • the shell material may be a thermoplastic or a thermoset resin.
  • the polymer can optionally have one or more of the following characteristics (i.e. a single one of the following characteristics or any possible combination of two or more of the following characteristics).
  • the polymer comprises a thermoplastic polymer.
  • the polymer comprises a thermoset polymer.
  • the polymer is an elastomer, preferably an elastomer having elongation to break greater than 200% and a 100% modulus of less than 25 MP A.
  • the dental appliance or shell can be prepared by thermoforming one more materials which are or are not of uniform thickness, for example by thermoforming one or more materials over a model of the teeth to which the dental appliance is to be fitted.
  • the polymeric materials in the dental appliance may comprise two or more different polymeric materials, such as polymers disclosed above, and one or more additives.
  • a material for example, an elastomeric polyurethane, is provided in the form of a uniform sheet having a thickness of 0.5mm, 0.625mm, 0.76mm, 1.0mm, from 0.40 to 0.55mm, from 0.55 to 0.65mm, from 0.65 to 0.76mm, from 0.76mm to 1.0mm, or from 1.0mm to 1.1mm.
  • the material is provided in the form of discs, squares, triangles or other shapes of the material having a thickness of 0.5 mm, 0.625mm, 0.76mm, 1.0mm, from 0.40 to 0.55mm, from 0.55 to 0.65mm, from 0.65 to 0.76mm, from 0.76mm to 1.0mm, or from 1.0mm to 1.1mm.
  • a material for example, a rigid polyurethane (for example, ZENDURA A, Bay Materials LLC), is provided in the form of a uniform sheet having a thickness of 0.5 mm, 0.625mm, 0.76mm, 1.0mm, from 0.40 to 0.55mm, from 0.55 to 0.65mm, from 0.65 to 0.76mm, from 0.76mm to 1.0mm, or from 1.0mm to 1.1mm.
  • a rigid polyurethane for example, ZENDURA A, Bay Materials LLC
  • the material is provided in the form of discs, squares, triangles or other shapes of the material having a thickness of 0.5 mm, 0.625mm, 0.76mm, 1.0mm, from 0.40 to 0.55mm, from 0.55 to 0.65mm, from 0.65 to 0.76mm, from 0.76mm to 1.0mm, or from 1.0mm to 1.1mm.
  • a material for example, polymethyl pentene (e.g., TPX) or polyethylene terephthalate glycol (PETG) is provided in the form of a uniform sheet or discs, squares, triangles or other shapes of the material having a thickness of 0.4mm, 0.5 mm, 0.625mm, 0.76mm, 1.0mm, from 0.3 to 0.4mm, from 0.4 to 0.5mm, from 0.5 to 0.6mm, from 0.6 to 0.7mm or from 0.7mm to 1.0mm. (maybe we can condense as the "polymer" and the thickness are essentially independent variables
  • the teeth are natural looking and as white as desired by the patient or individual whose teeth are being treated.
  • one material used to make the dental appliance comprise one or more additives that provide the appropriate color to the teeth.
  • a material for example, pigment-containing rigid polyurethane is provided in the form of a uniform sheet, or discs, squares, triangles or other shapes of the material having a thickness of 0.0125, 0.025, 0.05, 0.125, 0.25, 0.5 mm, from 0.125mm to 0.5mm, from 0.05 to 0.5 mm, 0.125 to 0.5 mm [0124]
  • a material, for example, a polyurethane treated with Anatase, Zeolite or another agent is provided in the form of a uniform sheet, discs, squares, triangles or other shapes of material having a thickness of 0.125 mm, 0.25mm, 0.3mm, 0.35mm, 0.4mm, 0.45mm, 0.5mm, from 0.125 to 0.3mm, from 0.25 to 0.4mm, or from 0.4 to 0.5mm.
  • polymeric materials described herein can be prepared by conventional methods well- known to those skilled in the art of polymer technology.
  • a polymeric dental appliance is produced by shaping, e.g., thermoforming a polymeric sheet of a selected material over a model of the teeth.
  • one or more additional materials are thermoformed over a model of the teeth resulting in a laminate.
  • the dental appliance is a composite. In some embodiments, the dental appliance is 3D printed. In some embodiments, the dental appliance is produced by spraying a polymer solution over a model or dip coating.
  • compositions and methods are further illustrated by the following examples.
  • the examples are provided for illustrative purposes only. They are not to be construed as limiting the scope or content of the subject matter disclosed herein in any way.
  • a tooth model as shown in FIG. 1 is created by casting dental stone using a silicone dental impression according to standard methods routinely employed in the art. The cast model is trimmed and imperfections repaired. Alternatively, a model is produced by 3D printing or stereolithographic printing (SLA).
  • SLA stereolithographic printing
  • a series of elastomeric polyurethane sheets 0.5 mm (Bl), 0.625 (B2), 0.76 (B3), and 1.0 (B4) mm having a durometer of 55D are prepared by extrusion of Pellethane 2363-55D (Lubrizol) using a 3 ⁇ 4" extruder and flat sheet die.
  • Pre-dried discs or sheets of ZENDURA A, 0.25 mm (CI), 0.5 mm (C2), 0.625 (C3), 0.76 (C4), and 1.0 (C5) thick rigid polyurethane are provided (Bay Materials, LLC).
  • a series of lightly pigmented rigid polyurethane films (D, E, F, G) of varying thickness were prepared by extrusion of a blend of Isoplast 2530 White (Lubrizol) having an estimated 1.5 % titanium dioxide pigment and Isoplast 2530 (Lubrizol).
  • the ability of the films to alter the perceived color of both a black color tile and a yellow color tile were measured using a Byk Gardner Colorimeter as follows. Color measurement was made directly on the color tiles and the LAB color values were recorded. Next, a thin film of water was applied to the color tile and the test film was laid onto the tile and gently smoothed to remove excess water to provide good optical coupling between the film and the color tile. The color measurements were then repeated, measuring on the combined structure and the LAB color values recorded. Film composition, structure and measured color values are shown in Tables 6 and 7.
  • Table 7 Film Composition. Structure and Measured Color Values on Yellow Color Tile.
  • the translucent lightly pigmented films increased the "brightness" as shown by the L values and decreased the yellowness of the tiles as shown by the B values.
  • Zeolite Socony Mobil-5 (Zeolite SM-5) is an aluminosilicate zeolite belonging to the pentasil family of zeolites. Its chemical formula is Na n Al n Si 96 - n Oi 92 l6H 2 0 (0 ⁇ n ⁇ 27) and is available from multiple sources. This Zeolite is insoluble, non-toxic and known to catalyze the decomposition of peroxides such as hydrogen peroxide producing oxidizing species including hydroxy radicals.
  • Zeolite SM-5 impregnated polyurethane sheets have an approximate thickness of 0.25 mm (HI) and 0.76 mm (H2).
  • a 2 % w/w solution of polyvinyl alcohol (PVA) was prepared by dissolving Evanol 75- 15 (Kuraray) in hot water followed by cooling. To 100 ml of a 2% PVA solution was added 10 grams of submicron particle size Anatase titanium dioxide a photocatalytic semiconducting material. Anatase is known to produce hydroxyl radicals and other oxidizing species in the presence of UVA (400 nm) light. The mixture was stirred with a high-speed overhead mixer for 30 minutes. Sheets of transparent rigid polyurethane (Bay Materials, LLC) were coated with the PVA
  • a tooth model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.5 mm thick sheet of rigid polyurethane (C2) was thermoformed over the model.
  • C2 rigid polyurethane
  • the thermoformed sheet was removed from the model and carefully trimmed very close to the gum line, as shown in FIG. 3A, and placed back on the model. The molded part did not extend beyond the tooth area.
  • a 0.5 mm thick sheet of polyurethane elastomer (Bl) was thermoformed over the appliance resulting in a laminated structure.
  • the dental appliance was removed from the model and trimmed approximately 2 mm beyond the gum line over most of the dental appliance, as shown in FIG. 5A (dental appliance 1). This dental appliance can be used as a retainer to maintain teeth in their correct position.
  • a tooth model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 1 mm thick sheet of rigid polyurethane (C5) was thermoformed over the model.
  • the thermoformed sheet was removed from the model and carefully trimmed very close to the gum line, as shown in FIG. 3A (dental appliance 2a).
  • the process was repeated except with the thermoformed sheet trimmed about 2 mm below (beyond) the gum line over most of the dental appliance, as shown in FIG. 5A (dental appliance 2b).
  • the process was again repeated but using a 1 mm thick sheet of polyurethane elastomer (B4) which was molded and trimmed at the gum line (dental appliance 2c).
  • Dental Appliances 2a, 2b and 2c are examples of prior art devices.
  • the results presented in Table 3 highlight the deficiencies of the materials used to make currently available dental appliances, and the advantages of the present devices.
  • a tooth model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.05 mm thick sheet of pigment containing rigid polyurethane (E) was thermoformed over the model.
  • the thermoformed sheet was removed from the model and carefully trimmed very close to the gum line, as shown in FIG. 3A, and placed back on the model. The molded part did not extend beyond the tooth area.
  • a 0.76 mm thick sheet of rigid polyurethane (C4) was thermoformed over the appliance resulting in a laminated structure.
  • the dental appliance was removed from the model and trimmed approximately 2 mm beyond the gum line over most of the dental appliance, as shown in FIG. 5A (dental appliance 3).
  • a model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.05 mm thick sheet of pigment containing rigid polyurethane (E) was thermoformed over the model.
  • E pigment containing rigid polyurethane
  • C4 rigid polyurethane
  • a model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.05 mm thick sheet of pigment containing rigid polyurethane (E) was thermoformed over the model.
  • E pigment containing rigid polyurethane
  • C4 rigid polyurethane
  • Dental appliances were prepared in the manner and construction of dental appliance 3 using each of film D, E, F, and G (a series of thin, lightly pigmented rigid polyurethane films; dental appliances 6, 7, 8, 9) An additional dental appliance was made using two layers of film E followed by one layer of (C) and then trimming 2 mm beyond the gum line (dental appliance 10)
  • Polymethyl pentene is a transparent polymer available under the trade name TPX from Mistui Chemical. Polymethyl pentene has very high oxygen permeability, approximately 100 times greater than polyethylene terephthalate glycol (PETG) a material commonly used to make dental appliances such as aligners and retainers. PETG sheets may be obtained from Great Lakes Orthodontics. DX310 grade of TPX was extruded to produce sheet having a thickness of 0.5 mm (L).
  • PETG polyethylene terephthalate glycol
  • a model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.5 mm thick sheet of PETG was thermoformed over the model.
  • the dental appliance was removed from the model, trimmed at the gum line and placed back on the Model.
  • a 0.5 mm thick sheet of TPX (L) was thermoformed over the appliance resulting in a laminated structure.
  • the dental appliance was removed from the model and trimmed approximately 2 mm below (beyond) the gum line over most of the dental appliance to provide an appliance having increased oxygen permeation over the gum line (dental appliance 11).
  • a model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.25 mm thick sheet of anatase impregnated polyurethane (Jl) was thermoformed over the model.
  • the dental appliance was removed from the model, trimmed at the gum line and placed back on the Model.
  • a 0.625 mm thick sheet of polyurethane elastomer (B2) was thermoformed over the appliance resulting in a laminated structure.
  • the dental appliance was removed from the model and trimmed approximately 2 mm below (beyond) the gum line (dental appliance 11).
  • a model of the upper teeth of an individual was placed in a Biostar pressure forming machine and a 0.25 mm thick sheet of Zeolite SM-5 impregnated polyurethane (HI) was thermoformed over the model.
  • the dental appliance was removed from the model, trimmed at the gum line and placed back on the Model.
  • a 0.625 mm thick sheet of polyurethane elastomer (B2) was thermoformed over the appliance resulting in a laminated structure. The dental appliance was removed from the model and trimmed approximately 2 mm below (beyond) the gum line, (dental appliance 12)
  • This dental appliance can be utilized as a bleaching tray in combination with one or more peroxy compounds, for example hydrogen peroxide or carbamide peroxide.
  • peroxy compounds for example hydrogen peroxide or carbamide peroxide.
  • Peroxy compounds put inside the tray selectively decompose at the surface of the teeth generate strong whitening effects without need for acceleration by light or other means. Additionally, it is observed that the peroxide activation occurs selectively at the tooth surface relative to the gingival area resulting in less irritation to gum tissue.
  • compositions comprising, and grammatical equivalents thereof, are used herein to mean that, in addition to the features specifically identified, other features are optionally present.
  • a composition or device “comprising” (or “which comprises”) components A, B and C can contain only components A, B and C, or can contain not only components A, B and C but also one or more other components.
  • the defined steps can be carried out in any order or simultaneously (except where the context excludes that possibility), and the method can optionally include one or more other steps which are carried out before any of the defined steps, between two of the defined steps, or after all the defined steps, except where the context excludes that possibility.
  • first and second features are generally done for identification purposes; unless the context requires otherwise, the first and second features can be the same or different, and reference to a first feature does not mean that a second feature is necessarily present (though it may be present).
  • the selected component can be a single one of the specified sub- components or a mixture of two or more of the specified sub- components.

Abstract

L'invention concerne des matériaux dentaires et des appareils dentaires améliorés, fabriqués à partir de ceux-ci, qui confèrent un aspect naturel aux dents, possèdent une certaine plage de flexibilité et de résistance, et présentent un confort et une efficacité améliorés dans des traitements orthodontiques et d'autres traitements.
PCT/US2018/020504 2017-03-02 2018-03-01 Facette composite amovible WO2018160870A1 (fr)

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WO2022079544A1 (fr) * 2020-10-13 2022-04-21 3M Innovative Properties Company Procédés de régulation du trouble dans des appareils orthodontiques comprenant des polymères semi-cristallins

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