METHOD FOR PRODUCING A PRESTRESSED TOOTH REPOSITIONING DEVICE

Abstract

A method for producing a prestressed tooth repositioning device, comprising: a) Producing a real or digital model of a jaw or jaw section of a patient with at least one misaligned tooth b) Producing a real or digital model of a jaw or jaw section of a patient in which the position of at least one tooth is changed in comparison to the model mentioned in step a) c) Digital or real positioning of a real or digital tooth repositioning device on the real or digital model mentioned in step b), d) Transferring the real or digital tooth repositioning device according to step c) to the real or digital model with at least one misaligned tooth according to step a), with the real or digital tooth repositioning device being prestressed, and e) Optionally, producing a real prestressed tooth positioning device on the basis of the digital tooth repositioning device according to step d) by way of a CAM method (FIG. 3B)

Claims

1. A method for producing a prestressed (pre-loaded) tooth repositioning device, comprising: a) Producing a real or digital model of a jaw or jaw section of a patient with at least one misaligned tooth (actual condition) b) Producing a real or digital model of a jaw or jaw section of a patient in which the position of at least one tooth is changed in comparison to the model mentioned in step a) (target condition), c) Digital or real positioning of a real or digital tooth repositioning device on the real or digital model mentioned in step b), d) Transferring the real or digital tooth repositioning device according to step c) to the real or digital model with at least one misaligned tooth according to step a), with the real or digital tooth repositioning device being prestressed, and e) Optionally producing a real prestressed tooth positioning device on the basis of the digital tooth repositioning device according to step d) by way of a CAM method.

2. The method according to claim 1, also comprising the following: f) Transferring the real or digital prestressed tooth repositioning device with the aid of a stress-conserving transfer template to the jaw or jaw section of a patient with at least one misaligned tooth.

3. The method of claim 1, wherein the tooth repositioning device comprises at least one arch wire element and at least two attachments.

4. The method of claim 3, wherein the arch wire element consists of a wire with a polygonal cross section.

5. The method of claim 3, wherein at least one attachment comprises a polygonal bore or recess.

6. The method of claim 3, wherein at least one attachment comprises a ligature with a lock.

7. The method of claim 1, wherein the digital or real positioning of a real or digital tooth repositioning device takes place on the real or digital model mentioned in step b), wherein at least two attachments are disposed on at least two teeth of the model and then an arch wire element is introduced into correspondingly shaped bores or recesses of the attachment, or an already prefabricated combination of at least two attachments with an arch wire element already introduced into them is affixed to the at least two teeth. in situ an attachment, having a bore or recess for the arch wire element, is produced on at least one tooth of the model, and then an arch wire element is introduced into correspondingly shaped bores or recesses of the attachment, or

8. The method of claim 1, wherein the real model of the jaw or jaw section with at least one misaligned tooth (actual state) is produced by taking an impression in dental impression compound and then casting the same with dental casting compound.

9. The method of claim 1, wherein the digital model of the jaw or jaw section with at least one misaligned tooth (actual state) is produced by a three-dimensional imaging method.

10. The method of claim 1, wherein the real model of the jaw or jaw section in which the position of at least one tooth has been modified (target condition) is produced by sawing off the said tooth and placing it on a socket of a deformable material, and then manually manipulating the position of the said tooth.

11. The method of claim 1, wherein the digital model of the jaw or jaw section in which the position of at least one tooth has been modified (target condition) is produced by digital manipulation of the image or data set representing the jaw or jaw section.

12. A prestressed tooth repositioning device, produced with the method of claim 1.

13. A prestressed tooth repositioning device according to claim 12, having at least two attachments and one arch wire element.

14. The use of a prestressed tooth repositioning device according to claim 12 for treating dental misalignment in patients.

15. A stress-conserving transfer template for transferring a prestressed tooth repositioning device to the jaw or jaw section of a patient with at least one misaligned tooth.

16. A kit for correcting dental misalignments, comprising a) a combination of at least two attachments with an arch wire element already arranged therein, wherein the said combination is arranged in the area of a jaw section of a patient having at least one misaligned tooth (actual state) and b) at least one dental splint made of a resilient material, wherein the said dental splint is arranged in at least one area of the patient's jaw section located outside of the area mentioned under a).

17. A kit for correcting dental misalignments, comprising a) a combination of at least two attachments with an arch wire element already arranged therein, wherein the said combination is arranged in the area of a jaw section of a patient having at least one misaligned tooth (actual state) and b) at least one dental splint made of a resilient material, wherein the said dental splint is arranged in at least one area of the patient's jaw section located outside of the area mentioned under a), wherein the combination of at least two attachments and one wire arch element is produced with the method of claim 1.

18. The kit of claim 16, wherein the dental splint consisting of a resilient material is an aligner, retainer or positioner.

19. The kit of claim 16, wherein the at least one dental splint has a recess in the area of the combination of attachment and arch wire element.

20. The kit of claim 16, wherein at least one dental splint has an enlargement in the area of the combination of attachment and arch wire element.

21. The kit of claim 16, wherein the at least one dental splint in the area of at least one attachment has an enlargement in which the bracket may be received by press fit.

22. The kit of claim 16, wherein the said kit has several dental splints consisting of a resilient material, wherein at least one dental splint has a geometry selected to support the repositioning of at least one misaligned tooth from the actual state into a transition state, accomplished by the combination of attachment and arch wire element, and one dental splint has a geometry selected to support the repositioning of the at least one misaligned tooth from the transition state to a target state, accomplished by the combination of attachment and arch wire element.

23. The use of the kit of claim 16 for treating dental misalignment in patients.

24. The use according to claim 23, wherein for successive treatment of dental misalignment, several dental splints consisting of a resilient material, are used, wherein at least one dental splint has a geometry selected to support the repositioning of at least one misaligned tooth from the actual state into a transition state, accomplished by the combination of attachment and arch wire element, and one dental splint has a geometry selected to support the repositioning of the at least one misaligned tooth from the transition state to a target state, accomplished by the combination of attachment and arch wire element.

Description

DRAWINGS AND EXAMPLES

[0089] The present invention will be explained in further detail using the figures and examples presented in the following. It should be noted that the figures and examples are only descriptive in nature and are not intended to limit the invention in any way,

[0090] FIG. 1A shows a dental arch of a patient with misaligned teeth 11, 12, 13 and the tongue 14.

[0091] FIG. 1B shows a reproduction 15 of this dental arch in plaster, produced for example by creating an impression of the dental arch according to FIG. 1A in a dental impression compound and then casting it with a plaster material.

[0092] Alternatively the reproduction of the dental arch can also be produced using an alveolar ridge model as disclosed in WO2014096341 from the present applicant, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0093] FIG. 1C shows a setup 16, which is produced starting from the reproduction of the dental arch with misaligned teeth according to FIG. 1B and shows the final state of the dental configurationor a transition state thereofto be produced clinically.

[0094] The setup in FIG. 1C can be produced, for example, by removing the misaligned dental model from the reproduction of the dental arch according to FIG. 1B, placing it in a wax socket, reinserting it into the dental arch, and manipulating it into position after heating the wax.

[0095] Alternatively, this setup can also be produced by a so-called CAD/CAM method. In this, the reproduction of the dental arch with misaligned teeth according to FIG. 1B is scanned in using a 3-D scanner. The subsequent manipulation step for repositioning the misaligned dental model is performed digitally with the aid of a suitable software program, after which, finally with the aid of a CAM procedure, for example using a 3-D printer or a milling machine, the setup with the repositioned tooth models is produced. Methods of this type are disclosed, for example, in the EP patent EP2263598 B1, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0096] Alternatively, this setup can also he produced by a so-called CAD/CAM method. In this, the reproduction of the dental arch with misaligned teeth according to FIG. 1B is scanned in using a 3-D scanner. The subsequent manipulation step for repositioning the misaligned dental model is performed digitally with the aid of a suitable software program, after which, finally with the aid of a CAM procedure, for example using a 3-D printer or a milling machine, the setup with the repositioned tooth models is produced. Methods of this type are disclosed, for example, in the EP patent EP2263598 B1, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0097] Alternatively this setup can also be produced using an alveolar ridge model as disclosed in WO2014096341 from the present applicant, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0098] Alternatively this setup can also be produced using a typodont as disclosed in WO2014135599 A1 from the present applicant, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0099] FIG. 2A shows the setup according to FIG. 1C with attachments 21, 22, 23 and an arch wire element 24 to be fastened to this attachment placed thereon. For example, the arch wire element consists of a wire with a rectangular cross section, which is introduced into correspondingly shaped bores or recesses of the attachments by press-fit. In this manner attachments and arch wire elements can transfer tilting and rotational moments relating to all six degrees of freedom to one another.

[0100] An advantageous aspect of this embodiment is that the attachmentsunlike conventional attachmentsneed not have a front-opening lock and a corresponding ligature, since the arch wire element need not necessarily be inserted from the front into the attachment already fixed in place, but can be introduced from the side into the attachments or the bores provided therein. Alternatively to the embodiment shown in FIG. 2A, an already prefabricated combination of attachments with an arch wire element already introduced into them can also be affixed to teeth.

[0101] In FIG. 2B the arch wire element is shown in position on the attachments. In this configuration, which corresponds to the final state of the dental configurationor a transition state thereofthe arch wire element is not tensioned.

[0102] FIG. 2C shows the combination 25 of attachments and arch wire element after releasing the attachment from the setup.

[0103] FIG. 3A shows how the non-stressed combination 25 of attachments and arch wire element is now brought into the reproduction 15 of the dental arch with misaligned teeth shown in FIG. 1B. This is done by affixing the attachments to the dental model. In this process the arch wire element is stressed, since the attachments are tilted or rotated relative to the wire arch element and in this way, tilting and rotational moments build up.

[0104] In a next step, which is shown in FIG. 3B, the combination 25 or attachments and arch wire element prestressed in this way is fixed using a transfer template 31 and removed in a stress-preserving manner from the dental models of the reproduction 15 of the dental arch with misaligned teeth.

[0105] In a next step, which is shown in FIG. 4A, the prestressed combination 25 of attachments and arch wire element is now brought with the aid of the transfer template 31 onto the dental arch of the patient with misaligned teeth shown in FIG. 1a. In this process the attachments are affixed to the teeth.

[0106] The combination 25 of attachments and arch wire element is prestressed, and the arch wire element has the tendency to return to its configuration shown in FIG. 2B. In this process, by means of the attachments it exerts tilting and rotational moments on the teeth to be corrected into their position and thus brings about a change in the configuration of the teeth to the final state of the dental configuration to that which is shown in FIG. 4C--or a transition state thereof

[0107] FIG. 5 shows a prestressed combination 51 of attachments and arch wire element produced with the method shown in FIGS. 1-4 which relates to only part of the jaw of a patient (partial braces). In the example shown, the position of one tooth 52 must be corrected considerably, whereas the positions of the other teeth do not need to be corrected, or only minimally corrected.

[0108] FIGS. 5A-5C show the incremental correction pathway that is followed by the tooth to be corrected based on the tilting and rotational moments exerted by the prestressed arch wire element.

[0109] FIG. 6 likewise shows a prestressed combination 61 of attachments and arch wire element produced with the method shown in FIGS. 1-4 which relates to only part of the jaw of a patient (partial braces). In the example shown, only the position of one tooth 62 must be corrected considerably. Additionally, in FIG. 6 a partial aligner 63 is shown, which has a recess in the area. of the combination 61 of attachments and arch wire element. The aligner serves to stabilize the additional teeth in the patient's jaw and optionally may also have a repositioning effect on individual teeth, the need for correction of which is less than with regard to tooth 62.

[0110] The aligner also serves for stabilizing the teeth surrounding the tooth 62 to be corrected, to which the combination 61 of attachments and arch wire element is fastened, and which serve as abutments for these teeth. In this way the aligner prevents the position of teeth surrounding the tooth 62 to be corrected from shifting.

[0111] FIGS. 6A-C show the incremental correction pathway that is followed by the tooth to be corrected based on the tilting and rotational moments exerted by the prestressed arch wire element. In this process the aligner may also consist of a series of incremental aligners, which have successive repositioning effects on additional teeth in the patient's jaw. Such incremental aligners are disclosed, for example, in the EP patent EP2263598 B1 and EP patent EP1369091 B1, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0112] FIG. 7 likewise shows a combination 71 of attachments and arch wire element produced with the method shown in Figs, 1-4, which relates to only part of the jaw of a patient (partial braces). In the example shown, only the position of one tooth 72 must be corrected. Additionally, in FIG. 6 an aligner 73 is shown, which has a recess in the area of the combination 71 of attachments and arch wire element. The aligner serves to stabilize the additional teeth in the patient's jaw and optionally may also have a repositioning effect on individual teeth, wherein the need for correction is less than with regard to tooth 72.

[0113] The aligner also serves for stabilizing the teeth surrounding the tooth 72 to be corrected, to which the combination 71 of attachments and arch wire element is fastened, and which serve as abutments for these teeth. In this way the aligner prevents the position of teeth surrounding the tooth 62 to be corrected from shifting.

[0114] FIGS. 7A-C show the incremental correction pathway that is followed by the tooth to be corrected based on the tilting and rotational moments exerted by the prestressed arch wire element. In this process the aligner may also consist of a series of incremental aligners, which have successive repositioning effects on additional teeth in the patient's jaw. In this manner the volume of the expansion in the area of the tooth 72 decreases successively. Such incremental aligners are disclosed, for example, in the EP patent EP2263598 B1 and EP patent EP1369091 B1, the full contents of which are referenced here and the contents of which are included by reference in the disclosure content of the present application.

[0115] FIG. 8 shows that a combination 81 of attachments 82 and optionally prestressed arch wire elements 83 is also capable of extracting a tooth 84 from the jaw. A correction relating to this degree of freedom is difficult to accomplish with conventional aligners.

[0116] FIG. 9 shows a combination 91 of attachments 92 and arch wire elements 93, in which only two teeth 95 on one side of the tooth 94 to be corrected serve as abutments. In the extreme case only a single adjacent tooth may serve as an abutment. This embodiment is especially possible because the pretensioning represented symbolically by reference symbols 96 may also be able to eliminate the sliding mechanics that occur with conventional methods. Therefore in Fig, 9 the arch wire element can be solidly affixed on the attachments.

[0117] This configuration is optionally supported by the combination with a dental splint as described above. The latter makes it possible, by stabilizing the teeth that serve as abutments for the tooth to be corrected, to reduce the number of the said teeth serving as abutments.

REFERENCES

[0118] E. E. Hemayed, S. M. Yamany, and A. A. Farag, 3D model building in computer vision with orthodontic applications, Technical Report TR-CVIP 96, CVIP Lab., University of Louisville, November 1996. [0119] Biggerstaff R H. Computerized diagnostic setups and simulations. Angle Orthod. 1970 January,40(1):28-36. [0120] Kuroda T I, Motohashi N, Tominaga. R, Iwata K. Three-dimensional dental cast analyzing system using laser scanning. Am J Orthod Dentofacial Orthop. 1996 October;110(4):365-9.

[0121] Ender A I, Mehl A. Influence of scanning strategies on the accuracy of digital intraoral scanning systems. Int J Comput Dent. 2013;16(1):11-21.

[0122] McNamara, Orthodontic and Orthopedic Treatment in the Mixed Dentition, Needham Pr (June 1993), page 347