MANUFACTURE OF PATIENT-SPECIFIC ORTHODONTIC BRACKETS WITH TOOTH-SPECIFIC BREAKAWAY MECHANISM
20220039917 · 2022-02-10
Assignee
Inventors
- Dylan Winchell (Canton, MA, US)
- Samuel VanNoy (Somerville, MA, US)
- Kelsey Fafara (Melrose, MA, US)
- Alfred Charles Griffin, III (Boston, MA, US)
Cpc classification
B33Y10/00
PERFORMING OPERATIONS; TRANSPORTING
B22F10/14
PERFORMING OPERATIONS; TRANSPORTING
B33Y50/00
PERFORMING OPERATIONS; TRANSPORTING
C04B2235/6026
CHEMISTRY; METALLURGY
B22F2999/00
PERFORMING OPERATIONS; TRANSPORTING
B22F10/12
PERFORMING OPERATIONS; TRANSPORTING
B33Y80/00
PERFORMING OPERATIONS; TRANSPORTING
B22F2999/00
PERFORMING OPERATIONS; TRANSPORTING
B33Y70/10
PERFORMING OPERATIONS; TRANSPORTING
Y02P10/25
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
B22F10/12
PERFORMING OPERATIONS; TRANSPORTING
International classification
A61C7/00
HUMAN NECESSITIES
B33Y10/00
PERFORMING OPERATIONS; TRANSPORTING
B33Y50/00
PERFORMING OPERATIONS; TRANSPORTING
B33Y70/10
PERFORMING OPERATIONS; TRANSPORTING
Abstract
Embodiments may provide improved techniques for creating custom lingual or labial ceramic orthodontic brackets, and which provides the capability for in-office fabrication of such brackets. For example, a method of manufacturing customized ceramic labial/lingual orthodontic brackets by ceramic slurry-based AM may comprise measuring dentition data of a profile of teeth of a patient, based on the dentition data, creating a three dimensional computer-assisted design (3D CAD) model of the patient's teeth using reverse engineering, and saving the 3D CAD model on a computer, designing a 3D CAD bracket structure model for a single labial or lingual bracket structure, importing data related to the 3D CAD bracket structure model into a ceramic slurry-based AM machine, directly producing the bracket (green part) in the ceramic slurry-based AM machine by layer manufacturing, and processing the brackets in a sintering and debinding oven prior to direct use.
Claims
1. A method of manufacturing customized ceramic labial/lingual orthodontic brackets by additive manufacturing, said method comprising: measuring dentition data of a profile of teeth of a patient; based on the dentition data, creating a three-dimensional computer-assisted design (3D CAD) model of the patient's teeth, and saving the 3D CAD model; designing a virtual 3D CAD bracket structure model for a single labial or lingual bracket structure based upon said 3D CAD model; importing data related to the 3D CAD bracket structure model into an additive manufacturing machine; and directly producing the bracket with the additive manufacturing machine by layer manufacturing from an inorganic material including at least one of a ceramic, a polymer-derived ceramic, and a polymer-derived metal.
2. The method of claim 1, wherein the additive manufacturing machine uses a slurry based process.
3. The method of claim 2, wherein the slurry-based process includes at least one lithography-based manufacturing, inkjet printing, slip casting, laser lithography additive manufacturing, direct light processing, and selective laser melting.
4. The method of claim 1, wherein the 3D CAD bracket structure model includes data defining a stress concentrator comprising two separate cuts made along a central line of the bracket running occlusal/gingivally, whereby the bracket will reliably fracture and debond when mesial/distal pressure is applied.
5. The method of claim 4, wherein a first cut is along a base of the bracket, comprises a polygon having a depth up to 0.03 mm from the tooth surface.
6. The method of claim 5, wherein the polygon has a width greater than 0.1 mm and up to 75% of the bracket width.
7. The method of claim 6, wherein the second cut is a stress concentrator cut from a front of the bracket.
8. The method of claim 7, wherein the second cut comes to a peak or pointed tip in order to provide for consistent fracturing.
9. The method of claim 8, wherein the cut is started from 0.1 mm to 1 mm from the tooth and extends the remainder of the bracket structure, with a final width which can range from 5% to 50% of the bracket width.
10. The method of claim 9, wherein a curve of the cut in the gingival/occlusal direction matches a curvature of the tooth along the same line.
11. The method of claim 4, wherein the stress concentrator comprises alternate shapes, as well as changing the direction of the stress concentrator. The shape of the channel could also be altered while remaining custom contoured to provide different force profiles, to avoid food traps and increase cleanliness, or to strengthen the structural integrity of the bracket i.e. stronger tie wings. Another improvement area would be adjusting the design to allow orthodontists to debond brackets with a standard utility plier while the wire is still engaged. This would ensure patients do not accidentally swallow brackets during debond and would highly increase the efficiency of the debonding process. In this scenario the algorithm, shape of the channel, as well as the location of the channel could be adjusted.
12. The method of claim 4, wherein the stress concentrator has a profile that is one of a peak, a pointed tip, triangular, circular, rectangular, or another polygon.
13. The method of claim 4, wherein a profile of the stress concentrator additional shapes may be useful in tuning the exact strength of the bracket, as well as providing easier pathways for manufacturing.
14. The method of claim 4, wherein the tie-wing and slot designs are varied.
15. The method of claim 4, wherein the stress concentrator travels in the mesial/distal direction, or on a diagonal between the two directions. Altering this direction could reduce the risk of bracket debonding when using high force attachments such as forsus springs or other orthodontic functional appliances.
16. The method of claim 4, wherein the stress concentrator is adapted so as to fracture upon application of a normal force.
17. The method of claim 16, wherein the normal force is applied in at least one of a mesial-distal direction, an occlusal-gingival direction, or to any opposite corners.
18. The method of claim 16, wherein the stress concentrator is adapted to provide predictable fracture of the bracket upon application of the normal force, enabling debonding of the bracket though a combination of tensile and peeling forces.
19. The method of claim 18, wherein the combination of tensile and peeling forces is less than a shear bond strength of a bonded bracket.
20. The method of claim 16, wherein the normal force is about 10-180 Newtons, inclusive.
21. The method of claim 4, wherein the 3D CAD bracket structure model includes data defining a contour of a surface of a base of the bracket.
22. The method of claim 21, wherein the contour is adapted to a shape of a tooth to which the bracket is to be bonded.
23. The method of claim 22, wherein the contour is further adapted based on at least one of an in/out and offset of the bracket, a tip of the slot, and a torque.
24. The method of claim 3, wherein the 3D CAD bracket structure model includes data defining a stress concentrator in a base of the bracket.
25. The method of claim 24, wherein the base stress concentrator is curved to match the tooth surface and act as a channel for bonding material.
26. The method of claim 24, wherein the stress concentrator is in a middle vertical third of the bracket.
27. The method of claim 24, wherein the stress concentrator includes a weakened area including a tooth curved depression in the bracket base in an occlusal-gingival direction.
28. The method of claim 27, wherein the stress concentrator matches a contour of the tooth for that portion of the bracket positioning.
29. The method of claim 24, wherein the stress concentrator is constant in depth from the tooth surface.
30. The method of claim 28, wherein the stress concentrator has a depth of 0.10 mm to 1.2 mm, inclusive.
31. The method of claim 24, wherein the stress concentrator varies in depth from the tooth surface.
32. The method of claim 31, wherein the stress concentrator has a variance in depth of 1-50%, inclusive, of a distance from the tooth surface to the deepest part of fracture groove.
33. The method of claim 32, wherein the stress concentrator has a negative draft angle.
34. The method of claim 4, wherein the stress concentrator is a variable distance from the tooth.
35. The method of claim 34, wherein the stress concentrator is located at a distance between 0.1 mm and 0.75 mm from the surface of the tooth.
36. The method of claim 35, wherein the stress concentrator is located at a distance from the tooth is determined based on the distance between the tooth and the back of the slot of the bracket.
37. The method of claim 4, wherein the stress concentrator matches a curvature of the tooth surface.
38. The method of claim 4, wherein the stress concentrator has a variable width.
39. The method of claim 38, wherein the stress concentrator has a width between 0.1 mm and 0.75 mm.
40. The method of claim 4, wherein the stress concentrator is manufactured using additive manufacturing to create the fault line with precision that allows all appliances to break with a precise force regardless of their dimensions or placement.
41. The method of claim 38, wherein the stress concentrator has smoothed edges to avoid trapping intra-oral debris.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] The details of the present invention, both as to its structure and operation, can best be understood by referring to the accompanying drawings, in which like reference numbers and designations refer to like elements.
[0026]
[0027]
[0028]
[0029]
[0030]
[0031]
[0032]
[0033]
[0034]
[0035]
[0036]
[0037]
[0038]
[0039]
DETAILED DESCRIPTION OF THE INVENTION
[0040] An embodiment of the present invention provides improved techniques for creating custom lingual or labial ceramic orthodontic brackets, and a method of manufacturing a tooth specific fault line in the bracket to facilitate debonding.
[0041] An exemplary flowchart of an embodiment of a direct manufacturing process 100 of lingual or labial orthodontic brackets by ceramic slurry-based AM is shown in
[0042] In 104, based on the given dentition data, a 3D CAD model of the measured teeth is constructed based on the dentition data and saved in the computer in a typical file format, such as the .stl, Additive manufacturing File (AMF) format or any other 3D vector file. The exterior structure of teeth is complicated, usually including irregular curves. The software may then be used to re-arrange the teeth in the model to the desired treatment outcomes that may be based on the long-axis of a tooth.
[0043] In 106, additional information, such as the desired torque, offset, angulation of select brackets and occlusal/incisal coverage for placement guide is entered.
[0044] In 108, the bracket (or brackets) is designed by the software based on the input 3D CAD model of the measured teeth, the model of the desired treatment outcomes, and the input additional information. The output of the design process may be a 3D CAD model. Such a 3D CAD model may be designed for a single lingual/labial bracket structure, including the bracket guide and bracket pad in contact with teeth surface, as well as the slots for the ideal position according to the orthodontia requirement, ceramic bracket material, and tooth profile.
[0045] 3D CAD bracket structure models are processed to generate manufacturing control data for use by the production equipment. For example, where the ceramic slurry-based AM equipment is used to produce the brackets, the software slices the 3D CAD bracket structure models to separate it into thin layers and get the horizontal section model for each layer. Based on this section model, the DLP equipment can directly produce ceramic brackets, ensuring the shape of each layer is consistent with the 3D CAD structure data. For example, the thickness of such layers may be about 20 μm to about 50 μm (micrometers or microns) with a manufacturing accuracy of about 5 μm to about 10 μm by using between-layer additive error compensation.
[0046] Returning to 108 of
[0047] DLP is another ceramic additive manufacturing (AM) process that works by stacking layers of a photocurable resin with a ceramic oxides such as Aluminum Oxide (Al.sub.2O.sub.3) or Zirconium Oxide (ZrO.sub.2), Nitrides or Silicates solid loading, and followed by a thermal debinding and sintering step. The higher resolution of this process is made possible by the LED light's digital mirror device (DMD) chip and optics used. (Stereo-)Lithography-based ceramic manufacturing (LCM) has improved this process making it more accurate with higher resolution (40 μm) and rigidity. The LCM process involves the selective curing of a photosensitive resin containing homogenously dispersed oxide or glass ceramic particles that can be fabricated at very high resolution due to imaging systems which enable the transfer of layer information by means of ever-improving LED technology, though a laser may also be used for photopolymerization.
[0048] In 110, post-processing may then be applied. For example, a thermal treatment (for binder burnout) and a sintering process may be applied to achieve optimal or improved ceramic density. For example, the debinding and sintering phase may include removing the green bracket from the device, exposing the blank to a furnace to decompose the polymerized binder (debinding), and sintering of the ceramic material.
[0049] The pad (bonding pad) of the bracket may be less than 0.4 mm thick from the tooth. The bracket placement guide may be placed occlusally/incisally to guide the correct placement of the bracket on the tooth. Examples of raw materials of the brackets may include powder of high strength oxide ceramics such as Aluminum Oxide (Al.sub.2O.sub.3) and Zirconium Oxide (ZrO.sub.2), or other high strength ceramic compositions.
[0050] The base of the bracket may be adhered to the tooth surface and the bracket slot may be matched to the archwire. According to requirements of mechanical properties, different composition of material may be required for the layers during the DLP manufacturing process. After being built up, the brackets may have a gradient and better performance.
[0051] Further, the bracket surface may be processed based on clinical demand.
[0052] At 112, the bracket is ready to be placed.
[0053] Typically, the thickness of the bracket pad may be less than 1 mm for lingual brackets and less than 1.5 for labial brackets. Suitable manufacturing materials may include high strength oxides, nitrides and carbides ceramics including but not limited to: Aluminum Oxide (Al2O3), Zirconium Oxide (ZrO2), Alumina-toughened Zirconia (ATZ), Zirconia-toughened alumina (ZTA), Lithiumdisilicate, Leucitesilicate or Silicon Nitride. The bracket pad may be adhered to the tooth surface with well-known dental adhesives. The bracket slot may be matched to the archwire, which may be straight or custom bent. Depending upon the manufacturing process used, different ceramics or composition of powder may be required for the layers. For example, if a selective laser melting manufacturing process is used, an LED light source may be used for the selective curing of a photosensitive resin containing the oxide or glass ceramic particles. Different layers may use different ceramics or compositions of powder.
[0054] An embodiment of an orthodontic bracket 200 is shown in
[0055] This auxiliary slot/stress concentrator can be applied to a variety of orthodontic appliances such as brackets or attachments. Curved tie wing edges can be applied to increase structural integrity and manufacturability and the slope of auxiliary slot into fault line can be designed to decrease layer separation for high quality manufacturability. A channel in the base can also be curved to the shape of the tooth and act as a stress concentrator point as well as an egress channel for excess bonding material.
[0056] The algorithm could be altered to allow a different force value based on a doctor's preference or if the force value is too high or low for a given patient population. Adolescents often do not follow best practices for orthodontic treatment, in which case a higher debond force value could be used to ensure brackets do not debond early due to abnormal mastication forces, i.e. biting on a pen. In cases where adults may not have these issues and orthodontists may prefer to not have to use a higher force to debond the feature would not have to be tuned.
[0057] The benefit of this invention is the improvement of consistency in the debonding force for customized brackets. Both brackets (LFO and 3M) which currently utilize a version of a stress concentrator mechanism use a singular, though different, shape for the stress concentrator, regardless of the tooth morphology. Due to the variety of bracket shapes provided by LFO's customization, a singular shape results in variation in the bracket breaking force. By linking the shape of the stress concentrator to the shape of the tooth, and controlling the depth of this stress concentrator by the thickness of the bracket, a more reliable breaking force can be achieved. This improved breaking force consistency allows for a more positive experience, particularly when debonding a sequence of brackets all at once. Additionally, it allows for improved tuning of the exact strength if it is found that the currently set strength is too low or high.
[0058] Variations of the invention consist of alternate shapes for the stress concentrator itself, as well as changing the direction of the stress concentrator. The shape of the channel 202 could also be altered while remaining custom contoured to provide different force profiles, to avoid food traps and increase cleanliness, or to strengthen the structural integrity of the bracket i.e. stronger tie wings. Another improvement area would be adjusting the design to allow orthodontists to debond brackets with a standard utility plier (aka Weingart or Howe pliers) or novel specialty plier while the wire is still engaged. This would ensure patients do not accidentally swallow brackets during debond and would highly increase the efficiency of the debonding process. In this scenario the algorithm, shape of the channel, as well as the location of the channel could be adjusted.
[0059] This improved stress concentrator uses a profile with a peak, however, circular, rectangular, or another other closed shape may be used as the profile for the stress concentrator. Additional shapes may be useful in tuning the exact strength of the bracket, as well as providing easier pathways for manufacturing.
[0060] By varying the tie-wing and slot designs, the same feature could conceivably be created traveling in the mesial/distal direction, or on a diagonal between the two directions. Altering this direction could reduce the risk of bracket debonding when using high force attachments such as 3M Forsus springs or other orthodontic functional or class II/III “bite correctors”.
[0061] The bracket pad, which holds or connects the bracket to the tooth surface, may be designed specifically according to the tooth surface profile, instead of a generalized gridding pattern. The customized brackets can meet individual case demand, such as increased anterior labial crown torque required in certain types of cases. For example, as shown in
[0062] A side view of an exemplary printed bracket 600 is shown in
[0063] Using the ceramic slurry-based AM technique can turn the designed model into a ceramic product rapidly. The bracket manufacturing involves few steps and can be done on site, saving time and cost.
[0064] The described techniques may be used to manufacture brackets from consisting of high strength oxides, nitrides and carbides ceramics including but not limited to: Aluminum Oxide (Al2O3), Zirconium Oxide (ZrO2), Alumina-toughened Zirconia (ATZ), Zirconia-toughened alumina (ZTA), Lithium Disilicate, Leucite Silica or Silicon Nitride.
[0065] The described techniques may be used to attain a true straight wire appliance where bracket placement accuracy is improved, thus reducing treatment time and error; or may also be used in conjunction with a custom-bent arch wire to achieve ideal results.
[0066] Patients currently pay higher fees for white-colored ceramic brackets over metal due to their increased esthetics. For example, many patients desire a bracket that matches the color of the tooth to which the bracket is attached. This may cause the bracket to be less visible and provide improved appearance. As another example, embodiments of the present invention may provide the capability to produce clear brackets, which may provide still improved appearance. Additionally, embodiments of the present invention may provide the capability to produce brackets in almost any color desired or selected, for example, in bright colors for use in children and some adults. Likewise, embodiments of the present invention may provide the capability to produce brackets having visible shapes that are not dictated by function, such as in the shape of animals, vehicles, toys, etc., for example, for use in children and some adults.
[0067] The described techniques may be made cost-effective to the point where an individual orthodontic practice could purchase the required equipment and software. This would provide the capability to simplify their bracket inventory instead of stocking brackets of different prescriptions.
[0068] Digital light processing (lithography-based) of ceramics has many advantages for orthodontic bracket fabrication, in comparison to selective laser sintering/melting (SLM) which uses thermal energy, and 3-D printing (3DP) systems that use a binder and polymer-derived ceramics (PDCs). For example, DLP may provide higher surface quality, better object resolution, and improved mechanical properties. PDCs structured using light in a stereolithographic or mask exposure process may also be used as a ceramic AM method for bracket fabrication.
[0069] The procedure for the layering additive manufacturing (AM) methodology of the labial/lingual orthodontic brackets by lithography-based DLP (e.g. U.S. Pat. No. 8,623,264 B2) is as follows.
[0070] An example of a lithography-based DLP process is described in U.S. Pat. No. 8,623,264 B2, which is incorporated herein by reference, but may be briefly summarized as follows: a light-polymerizable material, the material being located in at least one trough, having a particularly light-transmissive, horizontal bottom, is polymerized by illumination on at least one horizontal platform, the platform having a pre-specified geometry and projecting into a trough, in an illumination field, wherein the platform is displaced vertically to form a subsequent layer, light-polymerizable material is then added to the most recently formed layer, and repetition of the foregoing steps leads to the layered construction of the orthodontic bracket in the desired prescription/mold, which arises from the succession of layer geometries determined from the CAD software. The trough can be shifted horizontally to a supply position, and the supply device brings light-polymerizable material at least to an illumination field of the trough bottom, before the at least one trough is shifted to an illumination position in which the illumination field is located below the platform and above the illumination unit, and illumination is carried out, creating a “green bracket”.
[0071] The light-polymerizable material or photo-reactive suspension (slurry) can be prepared based on commercially available di- and mono-functional methacrylates. An example material might be a slurry blend of about 0.01-0.025 wt % of a highly reactive photoinitiator, about 0.05-6 wt % a dispersant, an absorber, and about 2-20 wt % of a non-reactive diluent. A solid loading of high strength Oxide ceramics such as Aluminum Oxide (Al.sub.2O.sub.3) and Zirconium Oxide (ZrO.sub.2) powder can be used, but this process may extend to other ceramic materials.
[0072] An exemplary block diagram of a computer system 700, in which the processes shown above may be implemented, is shown in
[0073] Input/output circuitry 704 provides the capability to input data to, or output data from, computer system 700. For example, input/output circuitry may include input devices, such as keyboards, mice, touchpads, trackballs, scanners, etc., output devices, such as video adapters, monitors, printers, etc., and input/output devices, such as, modems, etc. Network adapter 706 interfaces device 700 with a network 710. Network 710 may be any public or proprietary LAN or WAN, including, but not limited to the Internet.
[0074] Memory 708 stores program instructions that are executed by, and data that are used and processed by, CPU 702 to perform the functions of computer system 700. Memory 708 may include, for example, electronic memory devices, such as random-access memory (RAM), read-only memory (ROM), programmable read-only memory (PROM), electrically erasable programmable read-only memory (EEPROM), flash memory, etc., and electro-mechanical memory, such as magnetic disk drives, tape drives, optical disk drives, etc., which may use an integrated drive electronics (IDE) interface, or a variation or enhancement thereof, such as enhanced IDE (EIDE) or ultra-direct memory access (UDMA), or a small computer system interface (SCSI) based interface, or a variation or enhancement thereof, such as fast-SCSI, wide-SCSI, fast and wide-SCSI, etc., or Serial Advanced Technology Attachment (SATA), or a variation or enhancement thereof, or a fiber channel-arbitrated loop (FC-AL) interface.
[0075] The contents of memory 708 varies depending upon the function that computer system 700 is programmed to perform. In the example shown in
[0076] In the example shown in
[0077] It is to be noted that additional functionality may be implemented in end user devices, such as end user devices 104 shown in
[0078] As shown in
[0079] An example of an orthodontic bracket 800 is shown in
[0080] An example of an orthodontic bracket 1000 is shown in
[0081] An example of an orthodontic bracket 1100 bonded to a tooth 1102 is shown in
[0082] An example of an orthodontic bracket 1200 is shown in
[0083] An example of an orthodontic bracket 1300 is shown in
[0084] An example of an orthodontic bracket 1400 is shown in
[0085] Finite-element analysis has revealed that mesial-distal forces on the side of the tie-wings results in a concentration of forces in the middle third of the bracket base. In embodiments, fracture groove 1402 may be defined as an area of removed material from where such forces would have been most concentrated. The addition of fracture groove 1402 lowers the forces required to predictably create a bracket fracture down the middle vertical third of the bracket, which aids in debonding the ceramic bracket from the tooth. The weakened area and the fracture force can be optimized by adjusting the dimensions of the groove and/or the auxiliary slot.
[0086] In embodiments, fracture groove 1402 may be constant in depth from the tooth surface, as shown in
[0087] An example of an orthodontic bracket 1500 is shown in
[0088] Although specific embodiments of the present invention have been described, it will be understood by those of skill in the art that there are other embodiments that are equivalent to the described embodiments. Accordingly, it is to be understood that the invention is not to be limited by the specific illustrated embodiments, but only by the scope of the appended claims.