Abstract
Various embodiments of orthodontic appliances are disclosed to dispose a patient's lower dentition (2) and upper dentition (2) in Class I occlusion. A representative appliance (180) includes an occlusal ridge (182) that extends over the mesio-lingual cusp and the mesio-buccal cusp of a lower first molar (14a) on one side of the patient's dentition (2), and includes another occlusal ridge (182) that extends over the mesio-lingual cusp and the mesio-buccal cusp of a lower first molar (14b) on the other side of the patient's dentition (2). Such an appliance (180) addresses a Class II malocclusion by encouraging or facilitating movement of the mandible in a mesial or anterior direction such that each such occlusal ridge (182) ends up being disposed between a corresponding upper first molar (32a, 32b) and a corresponding second bicuspid (30a, 30b).
Claims
1-67. (canceled)
68. An orthodontic appliance, comprising: an overlay comprising an occlusal surface; a first occlusal protrusion on said occlusal surface that extends from a lingual of said overlay to a buccal of said overlay on a first side of a midline of said overlay, wherein anterior and posterior portions of said occlusal surface that adjoin said first occlusal protrusion are recessed relative to said first occlusal protrusion; and a second occlusal protrusion on said occlusal surface that extends from said lingual of said overlay to said buccal of said overlay on a second side of said midline of said overlay that is opposite said first side, wherein anterior and posterior portions of said occlusal surface that adjoin said second occlusal protrusion are recessed relative to said second occlusal protrusion.
69. The orthodontic appliance of claim 68, wherein said overlay is at least generally U-shaped.
70. The orthodontic appliance of claim 68, wherein said overlay is selected from the group consisting of an Essix appliance, a retainer, and a positioner.
71. The orthodontic appliance of claim 68, wherein said overlay is configured for positioning on multiple teeth between said first occlusal protrusion and said second occlusal protrusion when said orthodontic appliance is in an installed configuration.
72. The orthodontic appliance of claim 68, wherein said overlay is configured for addressing a Class II malocclusion such that when in an installed configuration on a lower dentition: 1) said first occlusal protrusion is disposed over both a mesio-lingual cusp and a mesio-buccal cusp of a corresponding lower first molar; and 2) said second occlusal protrusion is disposed over both a mesio-lingual cusp and a mesio-buccal cusp of a corresponding lower first molar.
73. The orthodontic appliance of claim 68, wherein said overlay is configured for addressing a Class III malocclusion such that when in an installed configuration on a lower dentition: 1) said first occlusal protrusion is disposed over both a distal-lingual cusp and a distal-buccal cusp of a corresponding lower first molar; and 2) said second occlusal protrusion is disposed over both a distal-lingual cusp and a distal-buccal cusp of a corresponding lower first molar.
74. The orthodontic appliance of claim 68, wherein said overlay is configured for addressing a Class II malocclusion such that when in an installed configuration on an upper dentition: 1) said first occlusal protrusion is disposed over both a distal-lingual cusp and a distal-buccal cusp of a corresponding upper first molar; and 2) said second occlusal protrusion is disposed over both a distal-lingual cusp and a distal-buccal cusp of a corresponding upper first molar.
75. The orthodontic appliance of claim 68, wherein said overlay is configured for addressing a Class III malocclusion such that when in an installed configuration on an upper dentition: 1) said first occlusal protrusion is disposed over both a mesio-lingual cusp and a mesio-buccal cusp of a corresponding upper first molar; and 2) said second occlusal protrusion is disposed over both a mesio-lingual cusp and a mesio-buccal cusp of a corresponding upper first molar.
76. An orthodontic appliance, comprising: an overlay comprising an occlusal surface, a buccal surface, and a lingual surface; a first lingual cuspal extension that protrudes lingually from adjoining portions of said lingual surface on a first side of a midline of said overlay and that protrudes occlusally beyond said occlusal surface; and a second lingual cuspal extension that protrudes lingually from adjoining portions of said lingual surface on a second side of a midline of said overlay and that protrudes occlusally beyond said occlusal surface, wherein said second side of said midline of said overlay is opposite said first side of said midline of said overlay.
77. The orthodontic appliance of claim 76, wherein said overlay is at least generally U-shaped.
78. The orthodontic appliance of claim 76, wherein said overlay is selected from the group consisting of an Essix appliance, a retainer, and a positioner.
79. The orthodontic appliance of claim 76, wherein said overlay is configured for positioning on multiple teeth between first lingual cuspal extension and said second lingual cuspal extension when said orthodontic appliance is in an installed configuration.
80. The orthodontic appliance of claim 76, wherein said overlay is configured such that when in an installed configuration on a lower dentition: 1) said first lingual cuspal extension is disposed over a single cusp of a corresponding tooth; and 2) said second lingual cuspal extension is disposed over a single cusp of a corresponding tooth.
81. The orthodontic appliance of claim 76, wherein said overlay is configured for addressing a Class II malocclusion such that when in an installed configuration on a lower dentition: 1) said first lingual cuspal extension is disposed over only a mesio-lingual cusp of a corresponding lower first molar; and 2) said second lingual cuspal extension is disposed over only a mesio-lingual cusp of a corresponding lower first molar.
82. The orthodontic appliance of claim 76, wherein said overlay is configured for addressing a Class III malocclusion such that when in an installed configuration on a lower dentition: 1) said first lingual cuspal extension is disposed over only a distal-lingual cusp of a corresponding lower first molar; and 2) said second lingual cuspal extension is disposed over only a distal-lingual cusp of a corresponding lower first molar. 2 0 83. (New) The orthodontic appliance of claim 76, wherein said overlay is configured for addressing a Class II malocclusion such that when in an installed configuration on an upper dentition: 1) said first lingual cuspal extension is disposed over only a distal-lingual cusp of a corresponding upper first molar; and 2) said second lingual cuspal extension is disposed over only a distal-lingual cusp of a corresponding upper first molar.
84. The orthodontic appliance of claim 76, wherein said overlay is configured for addressing a Class III malocclusion such that when in an installed configuration on an upper dentition: 1) said first lingual cuspal extension is disposed over only a mesio-lingual cusp of a corresponding upper first molar; and 2) said second lingual cuspal extension is disposed over only a mesio-lingual cusp of a corresponding upper first molar.
Description
BRIEF DESCRIPTION OF THE FIGURES
[0032] FIG. 1 is an occlusal view of a lower arch/dentition and an upper arch/dentition.
[0033] FIG. 1A is an enlarged occlusal view of the lower arch/dentition shown in FIG. 1, with the lower second bicuspid and the lower second molar having been removed from one side of a midline for the lower arch/dentition.
[0034] FIG. 2 is a lingual view of one side of the lower arch/dentition and upper arch/dentition, and where the molars of the lower arch/dentition and the molars of the upper arch/dentition are in Class II malocclusion.
[0035] FIGS. 3A-3C are sequential lingual views of one side of the lower arch/dentition and upper arch/dentition, along with a schematic of an orthodontic appliance that facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0036] FIGS. 4A-4C are sequential lingual views of one side of the lower arch/dentition and upper arch/dentition, along an occlusal wire that facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0037] FIG. 4D is a perspective view of the occlusal of the lower arch/dentition, along with a pair of orthodontic appliances that are disposed on opposite sides of the midline of the lower arch/dentition, where each appliance includes an occlusal wire of the type shown in FIGS. 4A-4C.
[0038] FIG. 4E is an occlusal view of an orthodontic band and a lingual attachment that may be used to install the occlusal wire shown in FIG. 4D.
[0039] FIG. 4F is a perspective view of one of the orthodontic appliances that is shown in FIG. 4D, where a pair of posts are used to dispose the occlusal wire over the occlusal of the corresponding tooth.
[0040] FIG. 4G is a perspective view of a variation of the portion of the orthodontic appliance that is shown in FIG. 4F, where a pair of posts are used to dispose an occlusal bar over the occlusal of the corresponding tooth.
[0041] FIGS. 5A-5C are sequential lingual views of one side of the lower arch/dentition and upper arch/dentition, along an occlusal wire loop that facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0042] FIG. 5D is an occlusal view of an orthodontic band with a lingual attachment for installing an occlusal wire loop of the type shown in FIGS. 5A-5C.
[0043] FIG. 5E is a perspective view of an orthodontic band with a lingual attachment for installing an occlusal wire loop of the type shown in FIGS. 5A-5C.
[0044] FIGS. 6A-6C are sequential lingual views of one side of the lower arch/dentition and upper arch/dentition, along an occlusal wedge that facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0045] FIG. 6D is an enlarged view of the occlusal wedge shown in FIGS. 6A-6C.
[0046] FIG. 6E is a perspective, occlusal view of the lower arch/dentition, along with a pair of orthodontic appliances that are disposed on opposite sides of the midline of the lower arch/dentition, where each appliance includes an occlusal wedge at least generally of the type shown in FIGS. 6A-6C.
[0047] FIG. 7A is a perspective view (looking both occlusally and from a distal or posterior location) of an orthodontic appliance that includes a pair of lingual cuspal extensions that are disposed on opposite sides of the midline of the lower arch/dentition and that facilitate changing from at least one type of malocclusion to a Class I occlusion.
[0048] FIG. 7B is a perspective, anterior view of the orthodontic appliance shown in FIG. 7A, and when installed in a patient's mouth.
[0049] FIG. 7C is a perspective view of the occlusal of the lower arch/dentition, along with a variation of the orthodontic appliance shown in FIGS. 7A and 7B but that still facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0050] FIG. 7D is a schematic of a portion of the orthodontic appliance of FIG. 7C that includes one of the lingual cuspal extensions.
[0051] FIG. 8A is an occlusal view of a crown that incorporates an occlusal ridge that facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0052] FIG. 8B is a perspective view of the crown shown in FIG. 8A. FIG. 8C is an occlusal view of a crown and representative positions for an occlusal ridge that facilitates changing from at least one type of malocclusion to a Class I occlusion.
[0053] FIG. 9A is an occlusal view of an orthodontic appliance in the form of an overlay that is disposed over multiple teeth of a dentition and that incorporates a pair of occlusal ridges that are disposed on opposite sides of the midline of the corresponding dentition and that facilitate changing from at least one type of malocclusion to a Class I occlusion.
[0054] FIG. 9B is a perspective view of the overlay shown in FIG. 9A.
[0055] FIG. 9C is an enlarged perspective view of one of the occlusal ridges incorporated by the orthodontic appliance shown in FIGS. 9A and 9B.
DETAILED DESCRIPTION
[0056] Various embodiments of orthodontic appliances will be described with regard to the above-noted figures. Each of these embodiments have the following common characteristics: 1) they are installed on a single dental arch or dentition (e.g., a patient; a model); 2) they include at least one portion that protrudes beyond an occlusal plane of the corresponding dentition; 3) each such protrusion directly engages the opposing dentition (i.e., the dentition that is opposite of the dentition on which the orthodontic appliance is installed) to prevent jaw closure than other than when the dentitions are disposed in Class I occlusion (versus engaging an orthodontic appliance on the opposing dentition)—the protrusion provides an occlusal obstruction unless/until the upper and lower dentitions are disposed in Class I occlusion; 4) each such protrusion may cam off of or engage a surface of a single tooth in the opposing dentition (e.g., a distal aspect or a mesial aspect of the tooth) to facilitate or encourage advancement of a corresponding jaw in a mesial or anterior direction so as to dispose the upper and lower dentitions in Class I occlusion; and 5) each such protrusion may be disposed in a space between a pair of adjacent teeth in the opposing dentition when the upper and lower dentitions are in Class I occlusion (and that allows closure of the jaws). In a preferred embodiment, a protrusion of the above-noted type is disposed on opposite sides of the midline of the dentition on which the orthodontic appliance(s) is installed, preferably on corresponding teeth on opposite sides of this midline (e.g., on a first molar on each side of the midline for the corresponding dentition; on a second molar on each side of the midline of the corresponding dentition). That is, preferably one occlusal protrusion is disposed on one side of a midline of a patient's dentition, while another occlusal protrusion is disposed on the other side of the midline of this same dentition.
[0057] In the case of a Class II malocclusion, the patient's mandible (lower jaw) is in a retracted or retruded state or condition relative to the patient's maxilla (upper jaw). In this case, the embodiments described herein may be used to facilitate or encourage mandibular growth (in the mesial or anterior direction) and/or to restrict maxillary growth (in the mesial or anterior direction), all to cause the molars of the upper and lower dentitions of the patient to occlude in a Class I molar relationship. In the case of a Class III malocclusion, the patient's maxilla is in a retracted or retruded state or condition relative to the patient's mandible. In this case, the embodiments described herein may be used to facilitate or encourage maxillary growth (in the mesial or anterior direction) and/or to restrict mandibular growth (in the mesial or anterior direction), all to cause the molars of the upper and lower dentitions of the patient to occlude in a Class I molar relationship.
[0058] The orthodontic appliances described herein are preferably installed on a first molar of the relevant dentition, but alternatively could be installed on a second molar as noted. The noted protrusion of each such appliance preferably engages and cams off of a single tooth in the opposite dentition, preferably a first or a second molar, all to encourage or facilitate movement of one of the upper jaw or the lower jaw in the mesial or anterior direction (e.g., if an orthodontic appliance with an occlusal protrusion is installed on a first molar in one of the patient's dentitions, the occlusal protrusion should engage the corresponding first molar in the other of the patient's dentitions; if an orthodontic appliance with an occlusal protrusion is installed on a second molar in one of the patient's dentitions, the occlusal protrusion should engage the corresponding second molar in the other of the patient's dentitions). The protrusion of a given appliance may be disposed over a mesio-lingual cusp (or which may be also referred to as a mesial-lingual cusp) and a mesial-buccal cusp of the tooth on which the appliance is installed, or may be disposed over a distal-lingual cusp and a distal-buccal cusp of the tooth on which the appliance is installed, depending upon whether the appliance is installed on the upper dentition or the lower dentition, and further depending upon whether a Class II malocclusion or Class III malocclusion is being addressed by the orthodontic appliance. The occlusal protrusion of the orthodontic appliances described herein, in order to function in the manner described herein, may be characterized as being located close to but spaced from either the mesial aspect or the distal aspect of the corresponding tooth (again, depending upon whether the appliance is installed on the upper dentition or the lower dentition, and further depending upon whether a Class II malocclusion or Class III malocclusion is being addressed by the orthodontic appliance).
[0059] FIG. 1 illustrates a lower dental arch or dentition 2, along with an upper dental arch or dentition 20 of a patient. The lower dental arch 2 generally includes the same type of teeth on each side of a midline 40 thereof. Teeth on one side of the midline 40 include an “a” designation, while teeth on the opposite side of the midline 40 include a “b” designation. The lower dental arch 2 includes the following teeth: a lower central 4a and 4b, a lower lateral 6a and 6b, a lower cuspid 8a and 8b, a lower first bicuspid 10a and 10b, a lower second bicuspid 12a and 12b, a lower first molar 14a and 14b, and a lower second molar 16a and 16b. The upper dental arch 20 generally includes the same type of teeth on each side of a midline 50 thereof. Teeth on one side of the midline 50 include an “a” designation, while teeth on the opposite side of the midline 50 include a “b” designation. The upper dental arch 20 includes the following teeth: an upper central 22a and 22b, an upper lateral 24a and 24b, an upper cuspid 26a and 26b, an upper first bicuspid 28a and 28b, an upper second bicuspid 30a and 30b, an upper first molar 32a and 32b, and an upper second molar 34a and 34b.
[0060] The lingual for each of the lower dentition 2 and the upper dentition 20 is identified by reference numeral 62 in FIG. 1 (e.g., the tongue side of the corresponding dentition), while the labial or the buccal for each of the lower dentition 2 and the upper dentition 20 is identified by reference numeral 64. The mesial direction is identified by the arrow 66, while the distal direction is identified by the arrow 68 in FIG. 1 (“mesial” and “distal” being defined in relation to the midline of the corresponding dentition; e.g., the mesial direction on a given side of a given dentition means proceeding in the direction of the corresponding midline and along the corresponding dentition).
[0061] FIG. 1A shows the lower dentition 2, with the lower second bicuspid 12b and the lower second molar 16b having been removed to enhance labeling of the lower first molar 14b. The lower first molar 14b includes an occlusal surface 70, a lingual side 72 (i.e., located on the lingual 62 of the lower dentition 2), an oppositely disposed buccal or labial side 74 (i.e., located on the buccal 64 of the lower dentition 2), a mesial side 76 (i.e., located on the mesial of the lower first molar 14b), and a distal side 78 (i.e., located on the distal of the lower first molar 14b). Each tooth in each of the lower dentition 2 and the upper dentition 20 of course may be similarly defined.
[0062] FIG. 2 is a lingual view of one side of the lower dentition 2 and the upper dentition 20, for the case where the lower dentition 2 is retracted relative to the upper dentition 20 (e.g., a Class II malocclusion). This undesirable “offset” is further indicated by the line on the upper first molar 32a and the line on the lower first molar 14a. An occlusal plane 60 is also depicted in FIG. 2. The occlusal plane 60 may be characterized as a reference plane that is at least generally tangent to each of the lower dentition 2 and upper dentition 20 when the mandible and maxilla are in a closed position. A Class III malocclusion would be the inverse to what is shown in FIG. 2. In a Class III malocclusion, the upper dentition 20 is retracted relative to the lower dentition 2.
[0063] Various embodiments of orthodontic appliances will now be described. Although these orthodontic appliances may be illustrated as being installed on the lower dentition 2 of a patient, alternatively they could be installed on the upper dentition 20 of the patient. Each of these embodiments includes at least one occlusal protrusion. Each such occlusal protrusion is the occlusal-most portion of the corresponding appliance—the remainder of the appliance is recessed relative to each such occlusal protrusion (e.g., its apex).
[0064] A schematic of one embodiment of an orthodontic appliance in accordance with the foregoing is illustrated in FIGS. 3A-3C and is identified by reference numeral 80. The orthodontic appliance 80 is installed on the lingual 62 of the lower dentition 2 in FIGS. 3A-3C, and includes a first portion 82 that protrudes beyond the occlusal plane 60. FIG. 3A illustrates the lower dentition 2 in a retracted position relative to the upper dentition 20 (e.g., a Class II malocclusion). With the dentitions 2, 20 being in this relative position, the first portion 82 of the orthodontic appliance 80 prevents closure. That is, the first portion 82 of the orthodontic appliance 80 on the lower dentition 2 will engage the upper dentition 20 (e.g., the occlusal surface 70 of the upper first molar 32a). Directing the lower dentition 2 in the mesial direction 66 (or the anterior direction) will align the first portion 82 of the orthodontic appliance 80 with the space between the upper first molar 32a and the upper second bicuspid 30a of the upper dentition 20 (FIG. 3B). At this time the dentitions 2, 20 may be moved to the closed position illustrated in FIG. 3C where the first portion 82 of the orthodontic appliance 80 (lower dentition 2) will be disposed within the space between the upper first molar 32a and the upper second bicuspid 30a (upper dentition 20) and which should retain the lower dentition 2 in this position relative to the upper dentition 20 (e.g., in Class I occlusion).
[0065] A schematic of another embodiment of an orthodontic appliance in accordance with the foregoing is illustrated in FIGS. 4A-4C. This orthodontic appliance is installed on the lower dentition 2 in FIGS. 4A-4C, and includes an occlusal wire 92 that is disposed on/above the occlusal surface 70 of the lower first molar 14a. This occlusal wire 92 may be anchored to the lower first molar 14a on the lingual 62 of the lower dentition 2 in any appropriate manner. This occlusal wire 92 may extend across a substantial portion of the occlusal surface 70 of the lower first molar 14a (e.g., the occlusal wire 92 may extend from the lingual 62 of the lower dentition 2 and may terminate at or near the buccal 64 of the lower dentition 2).
[0066] FIG. 4A illustrates the lower dentition 2 in a retracted position relative to the upper dentition 20 (e.g., a Class II malocclusion). With the dentitions 2, 20 being in this relative position, the occlusal wire 92 prevents closure. That is, the occlusal wire 92 on the lower dentition 2 will engage the upper dentition 20 (e.g., the occlusal surface 70 of the upper first molar 32a). Directing the lower dentition 2 in the mesial direction 66 (or the anterior direction) will align the occlusal wire 92 with the space between the upper first molar 32a and the upper second bicuspid 30a of the upper dentition 20 (FIG. 4B). At this time the dentitions 2, 20 may be moved to the closed position illustrated in FIG. 4C where the occlusal wire 92 (lower dentition 2) will be disposed with the space between the upper first molar 32a and the upper second bicuspid 30a (upper dentition 20) and which should retain the lower dentition 2 in this position relative to the upper dentition 20 (e.g., in Class I occlusion).
[0067] When the occlusal wire 92 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class II malocclusion: 1) the occlusal wire 92 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of a lower first molar (e.g., 14a or 14b); and 2) the occlusal wire 92 may engage a mesial aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the occlusal wire 92 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class III malocclusion: 1) the occlusal wire 92 may be disposed over a distal-lingual cusp and a distal-buccal cusp of a lower first molar (e.g., 14a or 14b); and 2) the occlusal wire 92 may engage a distal aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0068] When the occlusal wire 92 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class II malocclusion: 1) the occlusal wire 92 may be disposed over a distal-lingual cusp and a distal-buccal cusp of an upper first molar (e.g., 32a or 32b); and 2) the occlusal wire 92 may engage a distal aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the occlusal wire 92 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class III malocclusion: 1) the occlusal wire 92 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of an upper first molar (e.g., 32a or 32b); and 2) the occlusal wire 92 may engage a mesial aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0069] FIGS. 4D-4F show one implementation of the occlusal wire 92 of FIGS. 4A-4C. FIG. 4D shows the lower dentition 2 with an orthodontic appliance 100 being installed on the lower first molar 14a, 14b on each side of the midline 40. A band 110 is installed on the lower first molar 14a, and another band 110 is installed on the lower first molar 14b. A lingual attachment 112 is installed on the lingual of each band 110. Each lingual attachment 112 includes a pair of vertically oriented (extending in an occlusal/gingival dimension) tubes 114. The orthodontic appliance 100 is in the form of (or includes) an attachment having a pair of posts 104 (disposed in the tubes 114 of the lingual attachment 112), and an occlusal wire 102 (corresponding with the above-described occlusal wire 92). The orthodontic appliance 100 could be viewed as what is shown in FIG. 4F, or what is shown in FIG. 4F in combination with the orthodontic band 110 and lingual attachment 112 of FIGS. 4D and 4E. In any case, the occlusal wire 102 is illustrated as having a free end 103, which may be disposed at least generally at the buccal 64 of the lower dentition 2 (e.g., the occlusal wire 102 may extend from the intersection of the occlusal surface 70 with the lingual side 72 of a lower first molar 14a or 14b, to the intersection of the occlusal surface 70 with the buccal side 74 of this same lower first molar 14a or 14b).
[0070] FIGS. 4G shows a variation for the orthodontic appliance 100 of FIGS. 4D-4F. The orthodontic appliance 100′ presented in FIG. 4G would be installed on the lingual of each band 110 (FIGS. 4D and 4E). The orthodontic appliance 100′ is in the form of (or includes) an attachment having a pair of posts 104′ (disposed in the tubes 114 of the lingual attachment 112—FIGS. 4D and 4E), and an occlusal bar 102′ (corresponding with the above-described occlusal wire 92). The occlusal bar 102′ is illustrated as having a free end 103′, which may be disposed at least generally at the buccal 64 of the lower dentition 2 (e.g., the occlusal bar 102′ may extend from the intersection of the occlusal surface 70 with the lingual side 72 of a lower first molar 14a or 14b, to the intersection of the occlusal surface 70 with the buccal side 74 of this same lower first molar 14a or 14b). The occlusal bar 102′ has a slight curvature proceeding from the lingual to the buccal, and with the apex of this curvature being at least generally midway between the lingual and the buccal (e.g., the apex projects in the mesial direction).
[0071] A schematic of another embodiment of an orthodontic appliance in accordance with the foregoing is illustrated in FIGS. 5A-5C and is identified by reference numeral 120. The orthodontic appliance 120 is installed on the lingual 62 of the lower dentition 2 in FIGS. 5A-5C, and includes an occlusal wire loop 122 that protrudes beyond the occlusal plane 60. An aperture 124 of this occlusal wire loop 122 projects or faces in the mesio-distal dimension.
[0072] FIG. 5A illustrates the lower dentition 2 in a retracted position relative to the upper dentition 20 (e.g., a Class II malocclusion). With the dentitions 2, 20 being in this relative position, the occlusal wire loop 122 of the orthodontic appliance 120 prevents closure. That is, the occlusal wire loop 122 of the orthodontic appliance 120 on the lower dentition 2 will engage the upper dentition 20 (e.g., the occlusal surface 70 of the upper first molar 32a). Directing the lower dentition 2 in the mesial direction 66 (or the anterior direction) will align the occlusal wire loop 122 of the orthodontic appliance 120 with the space between the upper first molar 32a and the upper second bicuspid 30a of the upper dentition 20 (FIG. 5B). At this time the dentitions 2, 20 may be moved to the closed position illustrated in FIG. 5C where the occlusal wire loop 122 of the orthodontic appliance 120 (lower dentition 2) will be disposed with the space between the upper first molar 32a and the upper second bicuspid 30a (upper dentition 20) and which should retain the lower dentition 2 in this position relative to the upper dentition 20 (e.g., in Class I occlusion).
[0073] FIGS. 5D and 5E show one implementation of the occlusal wire loop 122 of FIGS. 5A-5C. A band 110 may be installed on the lower first molar on each side of the midline 40 of the lower dentition 2. A lingual attachment 112′ is installed on the lingual of each band 110. The orthodontic appliance 130 is in the form of (or includes) an attachment having a first portion 133 (e.g., a mesio-distally extending wire segment) that is appropriately anchored to the lingual attachment 112′), and an occlusal wire loop 132. The occlusal wire loop 132 defines an aperture 134 that projects (or is oriented) in the mesio-distal direction.
[0074] When the occlusal wire loop 122 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class II malocclusion: 1) the occlusal wire loop 122 may be disposed over a mesio-lingual cusp of a lower first molar 14 (e.g., 14a or 14b), and including being disposed over a single cusp of this lower first molar; and 2) the occlusal wire loop 122 may engage a mesial aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the occlusal wire loop 122 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class III malocclusion: 1) the occlusal wire loop 122 may be disposed over a distal-lingual cusp of a lower first molar (e.g., 14a or 14b), including being disposed over a single cusp of this lower first molar; and 2) the occlusal wire loop 122 may engage a distal aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0075] When the occlusal wire loop 122 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class II malocclusion: 1) the occlusal wire loop 122 may be disposed over a distal-lingual cusp of an upper first molar (e.g., 32a or 32b), including being disposed over a single cusp of this upper first molar; and 2) the occlusal wire loop 122 may engage a distal aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the occlusal wire loop 122 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class III malocclusion: 1) the occlusal wire loop 122 may be disposed over a mesio-lingual cusp of an upper first molar (e.g., 32a or 32b), including being disposed over a single cusp of this upper first molar; and 2) the occlusal wire loop 122 may engage a mesial aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0076] A schematic of another embodiment of an orthodontic appliance in accordance with the foregoing is illustrated in FIGS. 6A-6C. This orthodontic appliance is installed on the lower dentition 2 in FIGS. 6A-6C, and includes an occlusal wedge 142 that is disposed on/above the occlusal surface 70 of the lower first molar 32a. This occlusal wedge 142 may be anchored to the lower first molar 32a on the lingual 62 of the lower dentition 2 (e.g., via an orthodontic band 110 and a corresponding lingual attachment 112) or in any other appropriate manner (e.g., by being incorporated into an overlay, for instance at least generally in accordance with FIGS. 9A-9C that are discussed below). This occlusal wedge 142 may extend across a substantial portion of the occlusal surface 70 of the lower first molar 32a (e.g., the occlusal wedge 142 may extend from the lingual 62 of the lower dentition 2 and may terminate at or near the buccal 64 of the lower dentition 2).
[0077] FIG. 6A illustrates the lower dentition 2 in a retracted position relative to the upper dentition 20 (e.g., a Class II malocclusion). With the dentitions 2, 20 being in this relative position, the occlusal wedge 142 prevents closure. That is, the occlusal wedge 142 on the lower dentition 2 will engage the upper dentition 20 (e.g., the occlusal surface 70 of the upper first molar 32a). Directing the lower dentition 2 in the mesial direction 66 (or the anterior direction) will align the occlusal wedge 142 with the space between the upper first molar 32a and the upper second bicuspid 30a of the upper dentition 20 (FIG. 6B). At this time the dentitions 2, 20 may be moved to the closed position illustrated in FIG. 6C where the occlusal wedge 142 (lower dentition 2) will be disposed with the space between the upper first molar 32a and the upper second bicuspid 30a (upper dentition 20) and which should retain the lower dentition 2 in this position relative to the upper dentition 20 (e.g., in Class I occlusion).
[0078] FIG. 6D shows a schematic of an orthodontic appliance 140 that includes the occlusal wedge 142. The occlusal ram 142 may include an inclined surface 144 and an inclined surface 146. One of these inclined surfaces 144, 146 may engage a mesial or a distal aspect of the corresponding first molar in the opposite dentition (depending upon whether the appliance 140 is installed on the lower dentition 2 or the upper dentition 20, and further depending upon whether a Class II or Class III malocclusion is being addressed), and which may be used to advance either the mandible or the maxilla in the mesial or anterior direction (to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion).
[0079] FIG. 6E shows one implementation of the occlusal wedge 142 of FIGS. 6A-6C. FIG. 6E shows the lower dentition 2 with an orthodontic appliance 140′ being installed on the lower first molar 14a, 14b on each side of the midline 40. A band 110 is installed on the lower first molar 14a, and another band 110 is installed on the lower first molar 14b. A lingual attachment 112 is installed on the lingual of each band 110, and the occlusal wire 102 is interconnected therewith via disposing the posts 104 in the tubes 114 (FIGS. 4D-4F). The occlusal wedge 142′ may then be formed over the occlusal wire 102 (e.g., using a light-curable material).
[0080] When the occlusal wedge 142 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class II malocclusion: 1) the occlusal wedge 142 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of a lower first molar (e.g., 14a or 14b); and 2) the occlusal wedge 142 (inclined surface 144) may engage a mesial aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the occlusal wedge 142 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class III malocclusion: 1) the occlusal wedge 142 may be disposed over a distal-lingual cusp and a distal-buccal cusp of a lower first molar (e.g., 14a or 14b); and 2) the occlusal wedge 142 (inclined surface 146) may engage a distal aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0081] When the occlusal wedge 142 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class II malocclusion: 1) the occlusal wedge 142 may be disposed over a distal-lingual cusp and a distal-buccal cusp of an upper first molar (e.g., 32a or 32b); and 2) the occlusal wedge 142 (inclined surface 146) may engage a distal aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the occlusal wedge 142 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class III malocclusion: 1) the occlusal wedge 142 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of an upper first molar (e.g., 32a or 32b); and 2) the occlusal wedge 142 (inclined surface 144) may engage a mesial aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0082] Another embodiment of an orthodontic appliance in accordance with the foregoing is illustrated in FIGS. 7A and 7B and is identified by reference numeral 160. Here the orthodontic appliance 160 is in the form of an overlay that is disposed over multiple teeth in the lower dentition 2 (including multiple teeth on each side of the midline of the corresponding dentition). This overlay may be an Essix appliance, a retainer, or a positioner. A lingual cuspal extension 162 may be integrally formed with the overlay on each side of the midline. In the embodiment of FIGS. 7A and 7B, each lingual cuspal extension 162 is actually disposed over/extends occlusally from a mesio-lingual cusp of the corresponding lower first molar 14a, 14b. A first molar that has a mesio-lingual cusp, a mesio-buccal mesial cusp, a distal-lingual cusp, and a distal-buccal cusp. FIG. 7C presents a variation of the embodiment of FIGS. 7A and 7B, namely with regard to the shape of the lingual cuspal extension 162′. FIG. 7D is a schematic of a portion of the overlay for the orthodontic appliance 160′ that includes a lingual cuspal extension 162′. In the case of the appliances 160 and 160′, each lingual cuspal extension 162, 162′ is disposed over and extends occlusally from only the mesio-lingual cusp of the corresponding lower first molar 14a, 14b—the appliances 160, 160′ do not include any cuspal extension over the mesial-buccal cusp of the corresponding lower first molar 14a, 14b.
[0083] When the orthodontic appliance 160 (FIGS. 7A-7B) or the orthodontic appliance 160′ (FIG. 7C) is installed on the lower dentition 2 for addressing a Class II malocclusion: 1) each lingual cuspal extension 162, 162′ may extend occlusally from a single, mesial cusp of a tooth in the lower dentition 2 (e.g., a mesio-lingual cusp of a lower first molar (e.g., 14a or 14b)); and 2) each lingual cuspal extension 162, 162′ may engage a mesial aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the orthodontic appliance 160 (FIGS. 7A-7B) or the orthodontic appliance 160′ (FIG. 7C) is installed on the lower dentition 2 for addressing a Class III malocclusion: 1) each lingual cuspal extension 162, 162′ may extend occlusally from a single, distal cusp of a tooth in the lower dentition 2 (e.g., a distal-lingual cusp of a lower first molar (e.g., 14a or 14b)); and 2) each lingual cuspal extension 162, 162′ may engage a distal aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0084] When the orthodontic appliance 160 (FIGS. 7a and 7B) or the orthodontic appliance 160′ (FIG. 7C) is installed on the upper dentition 20 for addressing a Class II malocclusion: 1) each lingual cuspal extension 162, 162′ may extend occlusally from a single, distal cusp of a tooth in the upper dentition 20 (e.g., a distal-lingual cusp of an upper first molar (e.g., 32a or 32b)); and 2) each lingual cuspal extension 162, 162′ may engage a distal aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the orthodontic appliance 160 (FIGS. 7a and 7B) or the orthodontic appliance 160′ (FIG. 7C) is installed on the upper dentition 20 for addressing a Class III malocclusion: 1) each lingual cuspal extension 162, 162′ may extend occlusally from a single, mesial cusp of a tooth in the upper dentition 20 (e.g., a mesio-lingual cusp of an upper first molar (e.g., 32a or 32b)); and 2) each lingual cuspal extension 162, 162′ may engage a mesial aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0085] It should be appreciated that a lingual cuspal extension 162, 162′ of the type that is incorporated by the orthodontic appliance 160 (FIGS. 7A-7B) and the orthodontic appliance 160′ (FIG. 7C) could be incorporated by an orthodontic appliance that is installed on a single tooth (e.g., a lingual cuspal extension 162 or 162′ could be integrated with an orthodontic band via a corresponding lingual attachment). In such a case, an orthodontic appliance that incorporates such a lingual cuspal extension 162, 162′ would typically be installed on each side of the corresponding dentition (lower dentition 2 or upper dentition 22). Both Class II and Class III malocclusions could be addressed in the same general manner as described above with regard to the embodiments of FIGS. 7A-7C.
[0086] FIGS. 8A and 8B present an orthodontic appliance in the form of a crown 170 that is installed on a single tooth in the corresponding dentition. The crown 170 includes an occlusal ridge 172 that extends across an occlusal surface 174 of the crown 170, typically from the intersection between the occlusal surface 174 and a lingual side 176a of the crown 170 to the intersection between the occlusal surface 174 and a buccal side 176a of the crown 170. One portion of the occlusal surface 174 of the crown 170 extends from the occlusal ridge 172 to the intersection between the occlusal surface 174 and a mesial side 178a of the crown 170. Another portion of the occlusal surface 174 of the crown 170 extends from the occlusal ridge 172 to the intersection between the occlusal surface 174 and a distal side 178b of the crown 170. The occlusal surface 174 may be characterized as being defined entirely by the occlusal ridge 172 and a remainder of this occlusal surface, where this remainder is recessed relative to the apex of the occlusal ridge 172.
[0087] The occlusal ridge 172 could be of the same configuration as the above-noted occlusal wedge 142 (FIGS. 6A-6C). However, the occlusal ridge 172, particularly when integrally formed with the crown 170, may be configured to include only a single inclined surface (e.g., one of inclined surfaces 144, 146 from FIG. 6D). FIG. 8C is a schematic of the crown 170, and illustrates two representative positions for the occlusal ridge 172a and 172b). FIG. 8C also illustrates the occlusal ridge 172 having a peak 173 that exists between a pair of inclined surfaces (e.g., surfaces 144 and 146 shown in FIG. 6D).
[0088] When the crown 170 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class II malocclusion: 1) the occlusal ridge 172 of the crown 170 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of a lower first molar (e.g., 14a or 14b); and 2) the occlusal ridge 172 of the crown 170 (corresponding with inclined surface 144 in FIG. 6D) may engage a mesial aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the crown 170 is installed on a lower first molar (e.g., 14a or 14b) for addressing a Class III malocclusion: 1) the occlusal ridge 172 of the crown 170 may be disposed over a distal-lingual cusp and a distal-buccal cusp of a lower first molar (e.g., 14a or 14b); and 2) the occlusal ridge 172 of the crown 170 (corresponding with inclined surface 146 in FIG. 6D) may engage a distal aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0089] When the crown 170 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class II malocclusion: 1) the occlusal ridge 172 of the crown 170 may be disposed over a distal-lingual cusp and a distal-buccal cusp of an upper first molar (e.g., 32a or 32b); and 2) the occlusal ridge 172 of the crown 170 (corresponding with inclined surface 146 in FIG. 6D) may engage a distal aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the crown 170 is installed on an upper first molar (e.g., 32a or 32b) for addressing a Class III malocclusion: 1) the occlusal ridge 172 of the crown 170 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of an upper first molar (e.g., 32a or 32b); and 2) the occlusal ridge 172 of the crown 170 (corresponding with inclined surface 144 in FIG. 6D) may engage a mesial aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0090] The orthodontic appliance 180 shown in FIGS. 9A-9C is in the form of an overlay that is disposed over multiple teeth in the lower dentition 2 (including multiple teeth on each side of the midline of the corresponding dentition, and further including where the overlay is disposed over an entirety of the dentition on which it is to be installed). This overlay may be an Essix appliance, a retainer, or a positioner. The orthodontic appliance 180 includes an occlusal ridge 182 that extends across an occlusal surface 184 of the appliance 180, typically from the lingual 62 to the buccal 64. The discussion of the occlusal ridge 172 for the crown 170 is equally applicable to the occlusal ridge 182 for the appliance 180.
[0091] When the appliance 180 is installed on the lower dentition 2 for addressing a Class II malocclusion: 1) each occlusal ridge 182 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of a corresponding lower first molar (e.g., 14a or 14b); and 2) each occlusal ridge 182 (corresponding with inclined surface 144 in FIG. 6D) may engage a mesial aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the appliance 180 is installed on the lower dentition 2 for addressing a Class III malocclusion: 1) each occlusal ridge 182 of the crown 170 may be disposed over a distal-lingual cusp and a distal-buccal cusp of a corresponding lower first molar (e.g., 14a or 14b); and 2) each occlusal ridge 182 (corresponding with inclined surface 146 in FIG. 6D) may engage a distal aspect of the corresponding upper first molar (e.g., 32a or 32b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0092] When the appliance 180 is installed on the upper dentition 20 for addressing a Class II malocclusion: 1) each occlusal ridge 182 may be disposed over a distal-lingual cusp and a distal-buccal cusp of a corresponding upper first molar (e.g., 32a or 32b); and 2) each occlusal ridge 182 (corresponding with inclined surface 146 in FIG. 6D) may engage a distal aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the mandible in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion. When the appliance 180 is installed on the upper dentition 20 for addressing a Class III malocclusion: 1) each occlusal ridge 182 may be disposed over a mesio-lingual cusp and a mesio-buccal cusp of a corresponding upper first molar (e.g., 32a or 32b); and 2) the occlusal ridge 182 (corresponding with inclined surface 144 in FIG. 6D) may engage a mesial aspect of the corresponding lower first molar (e.g., 14a or 14b) to encourage or facilitate movement of the maxilla in the mesial or anterior direction 66 to dispose the lower dentition 2 and upper dentition 20 in Class I occlusion.
[0093] The foregoing description of the present invention has been presented for purposes of illustration and description. Furthermore, the description is not intended to limit the invention to the form disclosed herein. Consequently, variations and modifications commensurate with the above teachings, and skill and knowledge of the relevant art, are within the scope of the present invention. The embodiments described hereinabove are further intended to explain best modes known of practicing the invention and to enable others skilled in the art to utilize the invention in such, or other embodiments and with various modifications required by the particular application(s) or use(s) of the present invention. It is intended that the appended claims be construed to include alternative embodiments to the extent permitted by the prior art.
[0094] The following claims encompass the present invention. The orthodontic appliances that are addressed in the following method claims are themselves also within the scope of the present invention. The present invention is also encompassed by an orthodontic model (e.g., a stone model or digital model of both an upper dentition and a lower dentition for a patient), where a pair of occlusal protrusions (incorporated by a single orthodontic appliance, or where each occlusal protrusion is associated with a separate orthodontic appliance) are disposed on opposite sides of the midline of a common dentition.
