WO2022232890A1 - Procédé de transfert d'ancrage absolu de dispositifs d'ancrage temporaire vers un appareil orthodontique d'alignement et accessoires respectifs obtenus pour le traitement orthodontique - Google Patents

Procédé de transfert d'ancrage absolu de dispositifs d'ancrage temporaire vers un appareil orthodontique d'alignement et accessoires respectifs obtenus pour le traitement orthodontique Download PDF

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Publication number
WO2022232890A1
WO2022232890A1 PCT/BR2021/050186 BR2021050186W WO2022232890A1 WO 2022232890 A1 WO2022232890 A1 WO 2022232890A1 BR 2021050186 W BR2021050186 W BR 2021050186W WO 2022232890 A1 WO2022232890 A1 WO 2022232890A1
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WIPO (PCT)
Prior art keywords
geometric
anchorage
orthodontic
compartment
pin
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PCT/BR2021/050186
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English (en)
Portuguese (pt)
Inventor
José Miguel OCANHA JUNIOR
Original Assignee
Ocanha Junior Jose Miguel
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Filing date
Publication date
Application filed by Ocanha Junior Jose Miguel filed Critical Ocanha Junior Jose Miguel
Priority to PCT/BR2021/050186 priority Critical patent/WO2022232890A1/fr
Publication of WO2022232890A1 publication Critical patent/WO2022232890A1/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
    • 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

  • the present invention patent deals with a method of transferring the absolute anchorage of temporary anchorage devices to an orthodontic aligner device and respective accessories obtained for orthodontic treatment designed for complex clinical situations in which the present dental anchorage is insufficient for the desired orthodontic movement or when most of the teeth commonly used in anchorage constitute the active unit of the mechanical system.
  • Said method of absolute anchorage transfer is comprised of a set of steps that enable the transfer of absolute anchorage from temporary anchorage devices (TADs) to adapted orthodontic appliances through the predictability of the accessories obtained, significantly expanding the use of several three-dimensional biomechanical configurations at the same time. treating complex cases with aligners and vehemently reducing the amount of unwanted side effects in orthodontic therapy.
  • the active unit is that tooth or group of teeth that need movement to correct the malocclusion in question. Consequently, the passive or anchoring unit is that group of teeth responsible for promoting resistance to the movement of the active unit.
  • REPLACEMENT SHEETS (RULE 26) active) and therefore suffers less movement.
  • the active unit expresses greater movement in the face of the same force system as it represents a significantly lower resistance in relation to the passive unit.
  • orthodontic anchorage can be defined as the resistance that one or more dental elements offer to movement when submitted to the application of a pressure or traction force. Therefore, teeth or groups of teeth that have greater resistance to movement commonly anchor and allow the movement of teeth that have less resistance.
  • the ideal condition would be one in which the orthodontic force is able to move the active unit of the system without exceeding the resistance capacity of the passive or anchoring unit.
  • REPLACEMENT SHEETS (RULE 26) patient collaboration, a fact that can impose severe limitations on obtaining good results.
  • absolute anchorage is one in which the forces acting on the anchorage unit are completely dissipated and do not generate unwanted side effects in orthodontic therapy.
  • the ideal device would be the one capable of generating absolute anchorage for the movement of all teeth, including those that are commonly used as a passive or anchoring unit, thus expanding the possibilities in the orthodontic treatment of complex cases.
  • TADs Bone-integrated Implants and Temporary Anchorage Devices
  • TADs Temporary Anchorage Devices
  • mini-screws or mini-implants have become the main examples of intraoral absolute anchorage.
  • Bone-integrated implants are placed in regions of tooth loss and offer absolute anchorage for the movement of the remaining teeth. After their use for orthodontic purposes, they are used for prosthetic rehabilitation.
  • Temporary anchor devices are temporarily installed in certain areas of the oral cavity, remaining transmucosal, allowing orthodontic appliances to use anchorage directly from cortical bone and basal bone. After their use for orthodontic purposes, they are removed from the oral cavity.
  • REPLACEMENT SHEETS (RULE 26) a head with circular grooves (linear depressions) to couple the devices, transmucosal profile and the threadable portion.
  • PI 0909679-5 discloses a temporary anchoring plate for use in orthodontics that is made of medical Titanium in four models, containing three perforations for fixation in cortical bone, perforations for the use of elastic ligatures or fixation of springs with a metallic tie. The function of these perforations is to allow fixation of orthodontic biomechanics systems as needed in orthodontic treatment.
  • PI 0602728-8 discloses an orthodontic anchorage system by cast bars, being an upper device of maximum anchorage, a lower device of maximum anchorage, an upper device of moderate anchorage and a lower device of moderate anchorage.
  • WO2019217993A1 discloses an orthodontic device including a body which is formed integrally of a relatively rigid material. The body has a longitudinal axis being elongated so as to provide a first end portion and a second end portion. The end portions are joined by a rod. The end portions each have an attachment zone which is secured to adjacent teeth by an adhesive.
  • US2013323664A1 discloses a method of orthodontic anchorage and personalized appliance affixed to teeth, ATDs and/or dental positioning and stabilization appliances and/or orthodontic aids.
  • Each device has mechanical fasteners structured to hold segments of a flexible curable resin cord called a flexible fit module (FFM).
  • FFM flexible fit module
  • the FFM is moldable and adaptable to the oral cavity between mechanical closures in a first uncured mode where it is cut to length, positioned around the anatomy of the mouth and secured to clips or closures at each end.
  • Each fastener has a clamp attached to orthodontic aids, braces, or a DAT for anchorage purposes. One end of this custom appliance is usually secured by means of a clamp.
  • REPLACEMENT SHEETS (RULE 26) manufactured as part of a bracket or band for a tooth. The other end is connected to an appliance, small or auxiliary.
  • Another objective is to present a method of transferring the absolute anchorage of temporary anchorage devices to orthodontic appliances, aligners and respective accessories for orthodontic treatment that takes advantage of mini implants.
  • REPLACEMENT SHEETS (RULE 26) instead of a mini plate, significantly simplifying the surgical installation and the postoperative period for the patient.
  • the objective of this invention is to present a method of transferring the absolute anchorage of temporary anchorage devices to an orthodontic aligner device and respective accessories for orthodontic treatment whose simplicity makes it possible to be used by any orthodontist, dispensing with the domain of the segmented arch technique to create efficient loops , as in fixed orthodontics, since the complex biomechanics are intrinsically created in the aligners, through the planning software already on the market.
  • Another objective of this invention is to present a method of transferring absolute anchorage from temporary anchorage devices to orthodontic aligner appliances and respective accessories for orthodontic treatment capable of providing different forces and moments of force, such as traction, projection and geometries, all directly incorporated into aligners, such as Invisalign ® , benefiting from absolute anchorage from cortical and/or alveolar bone, without side effects on teeth formerly used as a passive unit, without the need to use intraoral elastics or to change the position of the teeth. mini implants with the course of treatment and without the orthodontist's obligation to master orthodontic biomechanics to treat complex cases.
  • Figure 1 shows a schematic view of the steps that make up the method of transferring absolute anchorage from temporary anchorage devices to orthodontic aligner appliances;
  • FIG. 26 shows schematic views in enlarged form to illustrate the steps for obtaining the geometric pin
  • Figure 2C shows views of mounting the geometric housing on the geometric peg formed in the temporary anchor, DAT
  • figure 3 represents in enlarged form an illustration of the anchoring point obtained by assembling the active aligner device on the geometric pin provided in the head of the temporary anchoring device
  • figures 4A and 4B show perspective views of a second constructive variation of the compartment obtained in the aligning device and respective geometric pin provided in the head of the temporary anchoring device
  • figures 5A and 5B show perspective views of a third constructive variation of the compartment obtained in the aligning device and respective geometric pin provided in the head of the temporary anchoring device
  • figures 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34 and 35 represent biomechanical situations common in orthodontics in complex cases in which the innovative method provides an efficient system of forces capable of correcting the most varied malocclusions
  • Figure 6 shows intrusion of the maxillary posterior
  • Figure 12 illustrates total distalization of the maxillary dental arch with an alveolar bone anchorage transfer method in the palate;
  • Figure 13 shows sequential distalization of maxillary teeth with anchor transfer method in alveolar bone in the palate;
  • Figure 14 shows the simultaneous application of geometry to correct the occlusal plane of the maxilla, distalization and intrusion of the maxillary posterior teeth with the anchorage transfer method in the zygomatic abutment;
  • Figure 15 illustrates intrusion of lower posterior teeth with the method of anchorage transfer in the body of the mandible;
  • Figure 16 represents sequential distalization of the lower posterior teeth with the method of anchorage transfer in the body of the mandible;
  • Figure 17 shows the total distalization of the lower dental arch with the method of anchorage transfer in the body of the mandible;
  • Figure 18 represents the simultaneous application of intrusion and distalization of the lower posterior teeth with the method of anchorage transfer in the body of the mandible;
  • Figure 19 shows the intrusion of lower anterior teeth with the alveolar anchorage
  • FIG. 26 shows retraction of lower anterior teeth with root inclination control with anchorage transfer method in alveolar bone in the mandible;
  • Figure 25 illustrates mesialization of mandibular posterior teeth with an alveolar bone anchorage transfer method in the mandible;
  • Figure 26 shows sequential distalization of posterior maxillary teeth with palatal raphe anchorage transfer method;
  • Figure 27 represents total distalization of the maxillary posterior teeth with a palatal raphe anchorage transfer method;
  • Figure 28 shows a situation similar to the geometry VI of a palatal bar for expansion of the posterior teeth of the maxilla with a palatal raphe anchorage transfer method;
  • Figure 29 shows a situation similar to palatal bar geometry VI for maxillary premolar expansion with palatal raphe anchorage transfer method;
  • Figure 30 represents the distalization of the upper dental hemiarch with a situation similar to the palatal bar IV geometry with palatal raphe anchorage transfer method;
  • Figure 31 shows
  • the present invention patent refers to the "METHOD OF TRANSFER OF ABSOLUTE ANCHORAGES OF TEMPORARY ANCHORAGES FOR ORTHODONTIC ALIGNMENT APPLIANCES AND RESPECTIVE ACCESSORIES OBTAINED FOR ORTHODONTIC TREATMENT", more precisely it is a method of transfer of absolute anchorage (10) of temporary anchor devices (20) for orthodontic appliances active aligner (32) for orthodontic treatments designed for complex clinical situations in which the present dental anchorage is insufficient for the desired orthodontic movement or when a large part of the teeth constitute the active unit of the mechanical system .
  • method of transferring absolute anchorage (10) of temporary anchoring devices (20) includes obtaining accessories in the form of geometric compartment(s) (31) in shaped ledge(s) in an aligner called template (30), of the Invisalign ® type, which composes a mold to obtain the respective geometric pin(s) (11) formed in the head(s) ( 21) of the temporary anchoring device(s) (20), and the association of the assembly of the compartment(s) (31) present in the active aligners (32) in the geometric pin(s) (s) (11) makes up the anchor point (PTA) designed for tooth movement by obtaining specific and three-dimensional orthodontic forces and moments for the treatment of complex malocclusions supported by the absolute anchorage of mini-implants.
  • template (30) of the Invisalign ® type
  • Said absolute anchorage transfer method (10) of temporary anchor devices (20) has the following steps:
  • Step (Tl) Request for transfer of absolute anchorage (10) from the temporary anchorage devices (20) - DATs - to the aligners by
  • REPLACEMENT SHEETS (RULE 26) orthodontist during the prescription of orthodontic treatment with aligners, such as Invisalign ® , and the prescription is made through the website (ST) of the accredited orthodontist, such as IDS, Invisalign ® DoctorSite.
  • Step (T2) Integration and corresponding selection of flap (t2) on site (ST) for anchorage with anchor point system (10A) to be selected in the treatment prescription sequence where the orthodontist must indicate the approximate position of the head (21) the temporary anchor device (20), which must have been captured and properly recorded in the intraoral scan; - Step (TS) -
  • the site technician (ST) introduces the anchor point system (10A) in the tooth movement simulation software, such as Clincheck ® , for the case in question.
  • the conventional mechanical algorithm of the orthodontic movement simulation software (sw) in the presence of the anchor point system (10A), must consider forces and moments of force in addition to the teeth present, as well as disregard the side effects of the therapy that will be dissipated. by absolute anchoring. Afterwards, the orthodontist can edit the movements according to their knowledge and considering the presence of absolute anchorage coming from the anchor point system (10A); - Step (T4) - After the ClinCheck ® virtual treatment plan is approved, the anchor point system (10A) is installed in the patient's mouth following the sequence: a) The patient already has temporary anchoring devices installed in his mouth ( 20) - DATs - which were captured by the initial scan and which provided the prescription and planning with an anchor point system (10A); b) The aligner called template (30) made on the virtual model obtained by intra-oral scanning with temporary anchoring devices (20) - DATs - which has geometric compartment(s) (31) provides the making of the pins (s) geometric(s) (11), and for that the
  • REPLACEMENT SHEETS (RULE 26) template (30) is fitted over the patient's teeth and the heads (21) of the temporary anchor devices (20) - DATs - are perfectly surrounded by the geometric compartment(s) (31) of the template (30 ); c) After checking the proper alignment of the geometric compartment(s) (31) of the template (30) with the head(s) (21) of the temporary anchoring device(s) (20) - DATs - the template (30) is removed from the patient's mouth and light-curing composite resin (40) is inserted into each geometric compartment (31) of the template (30), position coincident with the head (21) of the temporary anchor device (20) ; d) Once the composite resin (40) is inserted into the geometric compartment (31) of the template (30), it must be repositioned on the patient's teeth.
  • the composite resin (40) completely surrounds the head (21) of the temporary anchor device (20). Any excess of composite resin (40) must be removed by the orthodontist; e)
  • the next step is the photopolymerization of the composite resin (40). After light-curing, the template (30) is removed and the composite resin (40) is adhered to the head (21) of the device (20) obtaining the geometric pin (11); f) After making the geometric pin (11), the subsequent active aligners (32) must present the geometric compartments (31) for all stages in which absolute anchorage is necessary and has been planned in ClinCheck ® ; g) The geometric compartments (31) of the active aligners (32) must fit perfectly over the geometric pins (11), remaining retained to them, so that the forces applied between them are transferred, through this connection, to the teeth involved by active aligners (32). Said connection between the geometric pins (11) and the geometric compartments (31), in which forces and moments of forces for orthodontic therapy are applied, composes anchorage points (PTA).
  • the accessories obtained are comprised of the geometric compartments (31) and respective pins (11), both with corresponding geometric shapes, said geometric compartments (31) comprising negative fittings provided for in the active aligner (32) and have a 'U' section with side walls (31a) that are juxtaposed with the side walls (11a) of the respective pin (11) to obtain three-dimensional forces, as well as providing a lower opening (31b) from whose edge flaps (31c) develop, separated by cutouts (31e) and responsible for retaining along the faceted edge (11b) of each pin (11).
  • each pin (11) that has a geometry corresponding to the geometry of the geometric compartments (31) provides a faceted upper edge (11c) composing ramps that enable the opening of the flaps (31c) when mounting on the corresponding pin (11) which, in turn, On the other hand, it provides a lower faceted edge (11b) which also composes ramps where the flaps (31c) are juxtaposed, thus providing the maintenance of the fit between the compartment (31) and pin (11) for the use of forces between the surfaces active from both.
  • the geometric shapes of the geometric compartments (31) and pins (11) can vary according to the movements necessary for the case in question.
  • each geometric compartment (31) and pin (11) has a rectangular prism (see figure 2C) with a base and apex in a rectangular trunk and quadrangular cross-section with faceted extreme edges (31d) and (llb)/(llc) , as well as flat side walls (31a)/(lla). These flat and parallel surfaces allow various activations between the geometric housing (31) and pin (11) that generate forces and resultant force moments in all spatial planes.
  • each geometric compartment (31') and pin (11') has a hexagonal prism (see figures 4A and 4B) with a hexagonal trunk base and apex and faceted extreme edges (31d') and (llb')/( llc'), as well as,
  • each geometric compartment (31") and pin (11") has a spherical shape, where the spherical surface of the pin (11") simultaneously provides the functions of insertion ramp, active surface and retention ramp, while on the edge of the geometric compartment (31") cutouts (31e") are provided to create flexibility at the time of assembly, since the geometric compartment (31") provides a dimension of three quarters of the dimension of the pin (11") exceeds its equator by a quarter, thus promoting retention of the compartment (31") on the pin (11") in the portion below the equator.

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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 procédé de transfert d'ancrage absolu de dispositifs d'ancrage temporaire vers un appareil orthodontique d'alignement et des accessoires respectifs obtenus pour le traitement orthodontique, utilisé pour des situations cliniques complexes dans lesquelles l'ancrage dentaire présent est insuffisant pour le mouvement orthodontique souhaité ou lorsqu'une grande partie des dents constituent l'unité active du système mécanique; ledit procédé comprend l'obtention d'accessoires sous la forme d'un ou de plusieurs compartiments géométriques (31) en relief formés en un modèle (30) composant le moule pour l'obtention d'une ou de plusieurs tiges géométriques (11) respectives formés sur les têtes (21) d'un ou de plusieurs dispositifs d'ancrage temporaire (20), l'association du montage du ou des compartiments (31) du ou des aligneurs actifs (32) sur la ou les tiges géométriques (11) composant le point d'ancrage (PTA) et le ou les aligneurs actifs (32) étant conçus en vue d'un mouvement des dents et de l'obtention de forces orthodontiques spécifiques et tridimensionnelles pour le traitement de malocclusions complexes appuyées sur l'ancrage absolu des mini-implants (DAT).
PCT/BR2021/050186 2021-05-03 2021-05-03 Procédé de transfert d'ancrage absolu de dispositifs d'ancrage temporaire vers un appareil orthodontique d'alignement et accessoires respectifs obtenus pour le traitement orthodontique WO2022232890A1 (fr)

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PCT/BR2021/050186 WO2022232890A1 (fr) 2021-05-03 2021-05-03 Procédé de transfert d'ancrage absolu de dispositifs d'ancrage temporaire vers un appareil orthodontique d'alignement et accessoires respectifs obtenus pour le traitement orthodontique

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PCT/BR2021/050186 WO2022232890A1 (fr) 2021-05-03 2021-05-03 Procédé de transfert d'ancrage absolu de dispositifs d'ancrage temporaire vers un appareil orthodontique d'alignement et accessoires respectifs obtenus pour le traitement orthodontique

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Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6309215B1 (en) * 1997-06-20 2001-10-30 Align Technology Inc. Attachment devices and method for a dental applicance
WO2004098435A2 (fr) * 2003-05-02 2004-11-18 Malin, Leo, J. Implant dentaire et procedes associes
US20050019721A1 (en) * 2000-12-13 2005-01-27 Align Technology, Inc. Systems and methods for positioning teeth
US20070077532A1 (en) * 2003-05-02 2007-04-05 Harter Robert J Spherical drill bushing for installing a dental implant
BRPI0513859A (pt) * 2004-07-26 2008-05-20 Dentsply Int Inc sistema para corrigir molaclusões de uma arcada extrema
KR20100053261A (ko) * 2008-11-12 2010-05-20 이태경 정밀유도식립을 위한 임플란트용 스텐트의 고정체
KR20140109638A (ko) * 2013-03-06 2014-09-16 이태경 임플란트 시술유도 홀 공정용 부재
US20160278882A1 (en) * 2015-03-25 2016-09-29 Ormco Corporation Fabricating custom extensions to thermoformed aligners
KR20200053901A (ko) * 2018-11-09 2020-05-19 박숙규 투명 치아교정시스템

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6309215B1 (en) * 1997-06-20 2001-10-30 Align Technology Inc. Attachment devices and method for a dental applicance
US20050019721A1 (en) * 2000-12-13 2005-01-27 Align Technology, Inc. Systems and methods for positioning teeth
WO2004098435A2 (fr) * 2003-05-02 2004-11-18 Malin, Leo, J. Implant dentaire et procedes associes
US20070077532A1 (en) * 2003-05-02 2007-04-05 Harter Robert J Spherical drill bushing for installing a dental implant
BRPI0513859A (pt) * 2004-07-26 2008-05-20 Dentsply Int Inc sistema para corrigir molaclusões de uma arcada extrema
KR20100053261A (ko) * 2008-11-12 2010-05-20 이태경 정밀유도식립을 위한 임플란트용 스텐트의 고정체
KR20140109638A (ko) * 2013-03-06 2014-09-16 이태경 임플란트 시술유도 홀 공정용 부재
US20160278882A1 (en) * 2015-03-25 2016-09-29 Ormco Corporation Fabricating custom extensions to thermoformed aligners
KR20200053901A (ko) * 2018-11-09 2020-05-19 박숙규 투명 치아교정시스템

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