Three-dimensional orthodontic retainer and method for making a three-dimensional orthodontic retainer

20220031427 · 2022-02-03

    Inventors

    Cpc classification

    International classification

    Abstract

    The invention relates to a three-dimensional orthodontic retainer (2) and to a method for producing such a retainer (2) in which the three-dimensional orthodontic retainer (2) is matched to the exact shape of the adjacent teeth (3) and is produced from a blank (1) in such a manner that the physical properties of the material of the remaining part of the blank (1) are unchanged in the retainer (2). The method for producing the three-dimensional orthodontic retainer (2) comprises the following method steps: creating three-dimensional model of the structure of the patient's teeth (3); designing a customised, precisely fitting model of the retainer (2); producing the retainer (2) on the basis of the designed 3D model by computer-controlled deposition or application of material.

    Claims

    1. Three-dimensional orthodontic retainer (2) adjusted to the exact shape of the adjacent teeth (3) and produced from a raw material (1), wherein the physical properties of the raw material (1) are unchanged in the retainer.

    2. Three-dimensional orthodontic retainer (2) according to claim 1, wherein the nano- and microstructure of the retainer (2) corresponds to the original nan- and microstructure of the raw material (1).

    3. Three-dimensional orthodontic retainer (2) according to claim 1, wherein the retainer (2) essentially has a semicircular, flattened or tapered profile, and the flat side of the profile faces the teeth.

    4. Three-dimensional orthodontic retainer (2) according to claim 1, wherein the retainer (2) is provided with one or more fastening elements (22), which serve for firmly anchoring the wire (21) to the teeth.

    5. Three-dimensional orthodontic retainer (2) according to claim 1, wherein the retainer (2) features a loop in the interdentium.

    6. Three-dimensional orthodontic retainer (2) according to claim 1, wherein the retainer (2) is colored.

    7. Method for producing a three-dimensional orthodontic retainer (2) from a raw material (1) adjusted to the exact shape of the teeth (3), comprising the following steps: 1) creation of a three-dimensional model of the structure of the teeth (3) of the patient 2) design of an individual accurately fitting model of the retainer (2) 3) production of the Retainer (2) based on the designed 3D model wherein the raw material (1) is in the form of a raw piece (1) during step 3) the physical properties of the material of the remaining part of the raw piece (1) are unchanged in the retainer, and the retainer is elaborated from the raw piece (1) by computer controlled removal of material.

    8. Method according to claim 7, wherein the removal of the material is achieved by milling.

    9. Method according to claim 7, wherein the removal of the material is achieved by laser treatment.

    10. Method for producing a three-dimensional orthodontic retainer (2) from a raw material (1) adjusted to the exact shape of the teeth (3), comprising the following steps: 1) creation of a three-dimensional model of the structure of the teeth (3) of the patient 2) design of an individual accurately fitting model of the retainer (2) 3) production of the Retainer (2) based on the designed 3D model wherein during step 3) the physical properties of the raw material (1) are unchanged in the retainer, and the retainer is elaborated from the raw material (1) by computer controlled application of material.

    11. Method according to claim 10, wherein the application of the material is achieved by 3D printing or sintering or laser melting.

    12. Method according to claim 7, wherein the retainer (2) is polished electrochemically during step 3).

    13. Method according to claim 7, wherein the retainer (2) is made of titanium or titanium-alloy.

    14. Method according to claim 13, wherein the titanium-alloy is Ti-6AL-4V (Titanium Grade 5 ELI).

    15. Method according to claim 13, wherein the titanium-alloy is a shape memory material.

    Description

    [0005] The drawings show:

    [0006] FIG. 1 raw piece

    [0007] FIG. 2a-b manufactured three-dimensional orthodontic retainer, on the upper jaw

    [0008] FIG. 3a semicircular profile of the retainer

    [0009] FIG. 3b retainer with elongated, tapered profile

    [0010] FIG. 4a retainer with fasteners

    [0011] FIG. 4b retainer with fanciful fasteners

    [0012] FIG. 5 process flow

    [0013] FIG. 6 three-dimensional orthodontic Retainer elaborated in the raw piece

    [0014] For the production of a three-dimensional orthodontic retainer (2) according to the invention, a biocompatible material is preferred as the starting material, which contains as few allergens as possible. Suitable materials are metal, metal alloys such as Ti—Mo or Ti-6AL-4V (titanium grade 5 ELI, as used in medical technology), ceramic materials (such as Zircon), plastics or any combination of such materials. In order to avoid problems for the wearer, it is useful if the starting material does not contain substances such as nickel, which are known to cause allergic reactions. The present retainer (2) is made of a raw material (1), which may be in the form of a raw piece (1). The raw piece (1) may have any shape, as long as it is large enough that a retainer (2) can be worked out of it. No surface of the raw piece (1) needs to correspond to a side of the manufactured retainer (2), since the exact fit of the retainer (2) can be achieved by the manufacturing process alone. Preferably the raw piece (1) is a standard plate having a predetermined thickness and a lateral extent greater than that of the finished retainer (2) (FIG. 1). The three-dimensional orthodontic retainer (2) made from the raw piece (1) has at least one elongated wire (21) which connects and stabilizes two or more adjacent teeth (3) (FIGS. 2a-b). According to the invention, the shape and the diameter of the retainer (2) are formed individually and specifically for each case allowing it to be adjusted to the exact shape of the adjacent teeth (3) of a patient at least locally. In the preferred embodiment, the retainer (2) has an arbitrary 3-dimensional shape and runs along the local recesses of the surface of the respective tooth (3). This allows for optimal placement of the retainer (2) on the denture, which is crucial for both the function of the retainer (2) and for the comfort of the wearer. On the one hand, for the effectiveness of the retainer (2), the elongated wire (21) must precisely affect the specific zones of the teeth (3) determined by the dentist and, at the same time, occlusal contact points should be avoided when extreme movements of the jaware taken into account. On the other hand, it is important for the comfort of the wearer that the retainer (2) protrudes from the teeth (3) as little as possible and fits as closely as possible over the entire length.

    [0015] An additional essential feature of the present retainer (2) is its nano- or microstructure which is identical to the nano- or microstructure of the raw piece (1). Retainers (2) are usually thinner than 1 millimeter and still have to withstand the chemical and physical stress in the mouth for years. The oral environment is moist and warm, and during chewing, retainers (2) are subjected to numerous pressure and tension cycles. Since the properties of a material, in particular the fatigue strength, depend strongly on its nano- or microstructure, it is crucial for the durability of the retainer (2) that the ideal nano- or microstructure achieved the manufacturer of the raw piece (1) is preserved during the production process. This applies to advanced materials such as shape memory alloys to a greater extent. Shape memory properties are based on a particular arrangement of atoms in a regular pattern, where defects such as dislocations and twinning of the crystal lattice have a critical impact. According to the invention, it is thus provided that in the manufacturing process of the present retainer (2) the nano- or microstructure remains unaffected so that no additional defects are generated.

    [0016] In a possible embodiment, the elongated wire (21) of the retainer (2) essentially has a semicircular profile, wherein the approximately flat side of the profile faces the respective tooth (3) and the rounded side faces the lip (for a labial retainer (2)) or the tongue (for a lingual retainer (2)) (FIG. 3a). Thus, the retainer (2) has a stable contact surface with the teeth (3), on the one hand, allowing optimal attachment to the teeth and, on the other hand, has a tongue or lip-protecting outer surface. In another embodiment, the elongated wire (21) of the retainer (2) has an elongated profile forming a tapered guide surface (FIG. 3b). Thus, the contact area between the retainer (2) and the tooth (3) is even greater and the retainer (2) is anchored more firmly to the tooth (3). With the flattened profile, the retainer (2) also protrudes less so that it feels more comfortable to the wearer and reduces the potential for food to get stuck in the corners between the retainer (2) and the tooth (3). This profile shape is also suitable for creating guide surfaces that taper off on canine teeth.

    [0017] In one possible embodiment of the retainer (2), the at least one elongated wire (21) is additionally provided with one or more fastening elements (22) which serve for firmly anchoring the wire (21) to the dentition (FIG. 4a). Depending on the customer request or the requirement of the situation, these fasteners (22) can be designed arbitrarily. In a particular embodiment of the retainer (2), the fastening elements (22) are annular and arranged around the molars. In an alternative embodiment, the fastening elements (22) are regions of the elongated wire (21), which have a larger contact surface with the adjacent tooth (3). This allows a better attachment of the wire (21) to the teeth. In a further embodiment, the fastening elements (22) can assume an imaginative form for decorative or playful purposes, for example for children (FIG. 4b).

    [0018] Advantageously, the present retainer (2) can have a loop allowing the patient to simply clean the interdentium with dental floss. In addition this can create additional retentions for the bond.

    [0019] The retainer (2) can also be dyed individually according to customer requests. Again, variations and “gadgets” are possible that delight children and make the insertion of a retainer (2) less “tragic”.

    [0020] Basis of the invention is a method which allows to manufacture a three-dimensional orthodontic retainer (2) as described above with an arbitrary and individual three-dimensional shape, wherein the raw piece (1) is not altered, that is, the nano- or microstructure in the raw piece (1) remains unchanged in the manufactured retainer (2). The inventive method consists essentially of 3 steps (FIG. 5):

    [0021] 1) Creation of a three-dimensional model of the structure of the teeth (3) of the patient

    [0022] 2) Design of an individual accurately fitting model for the retainer (2)

    [0023] 3) Production of the Retainer (2) based on the designed 3D model

    [0024] In possible embodiments of the invention, the method for each of these steps may include one or more subtasks. One possible method for step 1) is:

    [0025] 1) Creation of a three-dimensional model of the structure of the teeth (3) of the patient: [0026] a) Acquisition of the three-dimensional intraoral structure [0027] b) Creation of a 3D model of the dentition

    [0028] Step 2) may include one or more of the following subtasks:

    [0029] 2) Design of an individual accurately fitting model of the retainer (2): [0030] a) Import of the 3D model of the dentition into a CAD software [0031] b) Design of a 3D model of the retainer (2) on the basis of the 3D model of the dentition [0032] c) Individualization of the designed 3D model of the retainer (2)

    [0033] Step 3) may include one or more of the following subtasks:

    [0034] 3) Production of the Retainer (2) based on the designed 3D model: [0035] a) definition of the processing strategy of the raw piece (1) [0036] b) computer controlled production of the retainer (2) from the raw piece (1) [0037] c) finishing

    [0038] In the first step 1), the three-dimensional intraoral structure is detected, preferably by means of a non-contact optical imaging method (step 1 a, FIG. 5). This can be done depending on the embodiment of the method using extra-oral or intraoral scanning devices. In extraoral scanning devices such as X-ray machines, the three-dimensional structure of the dentition is determined by digital volume tomography. Intraoral scanning devices have a hand-held probe that can be inserted directly into the patient's mouth, and with which the spatial structure of the dentition is detected by, for example, confocal microscopy, photogrammetry, or interferometry. Compared to conventional dental impression taking with impression trays, these optical methods can offer significant advantages: they are contactless, much faster and significantly more precise. An optical dental impression with accuracy in the micrometer range is detected within a few seconds. If no intraoral scanning device can be used, it is possible to take a classic impression with the impression tray first, and then scan this negative directly or via a positive model made from for example out of plaster. Thereafter, this data is converted into a 3D model of the patient's tooth structure (3), often with included 3D visualization software (step 1 b, FIG. 5).

    [0039] In the second step 2), the created 3D model is imported into a CAD software (step 2a, FIG. 5) and serves as the basis for the computer-aided design of a 3D model of the retainer (2) according to the tooth structure and dental indication with the above mentioned advantageous features: fit, with adjusted profile, little protrusion by taking advantage of the recesses on the surface of the respective tooth (3), not impacting any occlusal contact points if possible, etc. (Step 2b, FIG. 5). Optionally, once the basic structure of the retainer (2) has been determined, the designed retainer (2) can be additionally personalized according to the customer's request, for example with an imaginative design of the wire (21) or of possible fastening elements (22) (step 2c, FIG. 5).

    [0040] In the third step 3), the retainer (2) is produced on the basis of the designed CAD model. According to the invention, the retainer (2) is machined in its final form by computer-controlled removal of material from a raw piece (1) made of metal, high-performance ceramics or plastic or another bio compatible material. Alternatively, a retainer of the final shape may also be formed by computer-controlled application of raw material (1), using a suitable adaptive method, such as laser sintering or 3D printing using the same materials. Also material combinations, so-called composites, for example in PEEK (polyether ether ketones), can be used, whereupon different processing tools can be selected depending on the raw material.

    [0041] In particularly advantageous embodiments of the method, the removal of the material is carried out by multi-axis machining of the piece of material, for example with the aid of a multi-axis milling machine, water jet cutting machine or laser cutting machine. For this purpose, the machining strategy of the raw piece (1) is determined first (step 3a. FIG. 5). On the one hand, the geometry of the raw piece (1) is taken into account when determining which portion of the raw piece (1) is suitable for the formation of the retainer (2) according to the CAD model, while the surrounding material is removed (FIG. 6). The geometry of the raw piece (1) is ideally chosen so that as little as possible of the material is lost during the preparation of the retainer (2). On the other hand, the exact process of elaboration is defined and the machine programmed accordingly, in particular the milling or cutting speed, the order of the tools used, the holding points and the position of the remaining connection points (12) between the retainer (2) and the raw piece (1) (FIG. 6). When machining the piece of material, it is important that the remaining material is not altered in order to avoid residual stresses, defects such as dislocations and twinning of the crystal lattice and micro-cracks in the material. Due to the small thickness of a finished retainer (2), this is difficult to achieve with the conventional milling or cutting strategies. Therefore, specific milling and cutting strategies are used, such as those developed for the production of thin-walled electronic components. The principles of such strategies are described in the PhD thesis of Michiel Gijsbrecht Roeland Popma (“Computer aided process planning for high-speed milling of thin-walled parts”, Universiteit Twente, 2. June 2010).

    [0042] According to the invention, the material application can be carried out by adaptive methods such as 3D printing or sintering or laser melting. In these methods, the raw material (1) in the form of powder or granules, which has a specific nano- or microstructure, is melted together by the 3D printing or sintering or laser melting process completely or partially. When cooling and curing of the liquid phase, the material recovers its original nano- or microstructure of the solid state. As is the case when material is only removed, these methods have the advantage that the retainer (2) is produced directly into its final form. It is particularly important that the material of the retainer (2) is not altered during the manufacturing process to avoid residual stresses and defects such as dislocations and twinning of the crystal lattice, as well as micro-cracks in the material. Particularly advantageous is the selective laser melting method, because it is well suited for the manufacture of complex objects with a small thickness. The principles of this method are explained in DE 19649865.

    [0043] After the computer-controlled preparation of the retainer (2) from the raw piece (1) (step 3b, FIG. 5), an additional finishing may be necessary (step 3c, FIG. 5). If the elaborated retainer (2) still has connection points (12) with the raw piece (1) (FIG. 6), these must first be broken, and the retainer (2) must be polished at these points. This may require a certain amount of manual work. To round sharp edges of the retainer (2), in one possible variant of the method, the entire retainer (2) is additionally polished, either manually or electrochemically by placing it in an electrolytic bath. If the retainer (2) consists of a titanium alloy, in a further variant of the method, the electrolytic bath can also be used for coloring the retainer (2). By adjusting the immersion time and the current intensity, any desired color can be achieved.

    [0044] In one embodiment of the present method, after finishing, an additional check of the manufactured retainer is performed to ensure that it corresponds to the designed 3D model and thus fits with the required accuracy. In order to achieve this, the geometry of the manufactured retainer could be detected using a scanning device and compared with the planned 3D model. Alternatively, a conventional impression of the teeth could be made with an impression tray and from it a model of the teeth (3) is created out of gypsum, allowing the fit of the retainer to be checked before its use in the patient's mouth.

    [0045] The production method according to the invention has many advantages. First, a retainer (2) of any three-dimensional structure is made from a piece of material in a single process step, which is much simpler, faster, and more economical than previously known methods. Second, this method allows the production of a three-dimensional retainer (2) without altering the raw piece (1). The Retainer (2) is thus made in a purely passive manner, that is, it consists solely of unaffected material whose original nano- or microstructure is unchanged. As a result, residual stresses and nano- or microstructural defects in the retainer (2) are avoided, so that the obtained retainers (2) are more stable and have a longer life cycle. Third, the method of the present invention allows manufacturing a retainer with high accuracy of fit and comfort for the wearer. Fourth, there is also the possibility of customizing the retainer according to customer wishes and creating imaginative forms.