JP2008507381A - Two-step invisible orthodontic method - Google Patents

Description

[Technical field]
The present invention relates to an improved method of correcting malocclusion. The present invention includes the first step using conventional molar correction devices such as bands, wires and the like. The second stage uses plastic trays to apply orthodontic forces to treat malocclusions.

BACKGROUND OF THE INVENTION
Orthodontic surgery conventionally involves the use of instruments, wires or some other form of ligation to form a space and move teeth within the space. The common language used is braces. This is a very labour-intensive system that requires frequent reassurance by the orthodontist to adjust the wire. These braces are uncomfortable for some adult patients and attached to the teeth using a time consuming adhesive / acid system for the practitioner. This is also expensive.

  Align Technology introduces the treatment of patients, mainly adults, using a series of plastic trays designed by computer. For these trays, take an original impression of the patient's teeth, create an actual impression using a digital database, then develop that type of information to treat the patient's malocclusion without the brace. Create a series of trays to try. This has been found to be very expensive and time consuming as it takes a long lead time to start treatment and a plastic tray takes a long time to affect tooth movement. Busy patients must be patient and follow the prescription carefully, and the orthodontician / manufacturer may need to remediate a series of trays because of noncompliance or hypothetical errors in the computer requiring interim correction. Also have to be reworked. Align, the first inventor of the digital aligner, has in fact acquired an interim correction and insurance patent at the start of treatment. Although the treatment that a patient receives is virtually invisible, it can take several years to complete and generally involves significant compromise as compared to conventional treatments.

  It is estimated that there are millions of patients who would like to correct their anterior teeth but refuse to use braces, or those who can not afford the use of the above system. Some of these patients are also interested in dental laminates to hide treated parts in appearance, but these are also expensive and require periodic replacement. Therefore, in order to meet the needs of the patients mentioned above, it is not as expensive as the invisa line system, and it is not necessary to fix the externally visible braces to the teeth, and using the almost invisible plastic tray system, unmatched externally visible teeth It is important to design a system that can correct the The Invisia line system also greatly limits the types of patients that can be treated using the design.

  Transparent plastic tooth positioners have been developed for over 50 years in order to guide the teeth to near their treatment goals after fixed treatment. Digital imaging in orthodontic surgery is disclosed, for example, as early as US Pat. No. 5,605,459. Ormco describes the manipulation of digital images of teeth to make braces in US Pat. No. 5,533,895 and other prior patents.

  Laser scanning for generating 3D models of teeth is disclosed in US Pat. Nos. 5,338,198 and 5,452,219. Digital manipulation is described in U.S. Patent Nos. 5,607,305 and 5,587,912.

  In stage 1, an apparatus such as Pendex as shown in FIG. 1 can be used to expand the maxillary arch width while retaining the anterior teeth with a transparent passive tray. The above-mentioned expansion makes it possible to obtain a large space, so that the easy repositioning of the anterior teeth to the prescribed ideal finish is maintained more easily and as expected, without much loss of enamel. be able to.

  Quadruplexes have been useful for several decades, especially for expanding unnaturally narrow arches of young women. After phase 1 with quadruplexes, most obstacles are removed from the digital model and the case for pathway analysis, allowing the quadruplex to be virtually visible.

  The palatal arch bar and its sheath create large spaces that allow the molars to move freely backwards, rotating and disallizing the molars while holding the anterior teeth in a passive transparent tray during phase I It is a very simple device.

  The lingual arch used on the back of the lower jaw teeth is connected to the molar band and is used to upset the anterior teeth while applying a slight pressure to promote the dental alveolar lateral growth. In this case, the lower plastic tray is not used until stage II, and the use space will again be increased while making the digital prescription tray for stage II.

[Summary of the Invention]
The present invention provides a method of orthodontic displacement teeth in two stages, the method comprising: rotating, reshaping, pressing, or leveling of the molar region using conventional molar correction devices and therapies. First stage aesthetic treatment plan starting with CAD / CAM path analysis to consider the need for stripping and the most suitable place to apply it based on tooth width or arch width. Create a transparent retaining tray to control teeth and teeth balance during phase 1. After Phase I correction, create a new impression where the molars have been corrected, stripping in place and occlusal capture if necessary, then digitally or practically restoring the teeth to the ideal occlusion Set up and make a series of plastic trays that complete the correction from the position of step I to the final ideal position that is kept with the retaining tray.

  The present invention relates to an improved method of aesthetically treating more patients using a two-step treatment plan. In the present invention, an impression or digital scan and occlusal capture of a patient's teeth is sent digitally to a 3D modeler such as OrthoCAD, which begins with the creation of a digital model of the teeth and their relationships. Crowding in millimeters is determined and malocclusion types are analyzed to plan the following process. The indicated band or acrylic plate is attached to the posterior molars and at least one tooth space in each arch using mechanics such as derotate, reduce, torque, expand and / or upright of the molars Form a space equivalent to This makes it possible to treat the anterior teeth better with plastic activators, without using fixed appliances treatment and anchorage for better retention after treatment.

Detailed Description of the Invention
Because it is virtually impossible to look at the molars behind the mouth, more conventional instruments can be used to manipulate the molars to gain more space for the anterior teeth. The expert can use lip bumpers, closets, paratal bars, herbal strikes, distal jets, magnifying screws, Molar Movers, and other molar manipulation devices known to the practitioner, as variously shown in FIGS. This generally restores space for at least one anterior tooth in each arch by rotation and upright only. Thereby, a sufficient space for correction is formed in the front teeth, and anchorage suitable for forward movement is provided. If necessary, additional space can be obtained by carefully stripping the teeth on the order of 0.5 mm per side. The goal is to open an unobstructed path that straightens the teeth. Stage I is estimated to last 2 to 6 months. A record of the measurement of the individual tooth and arch width before and after stripping is kept. Again, digital 3D simulations allow path analysis and determination of the ideal amount of space needed and where it can be obtained. In borderline cases, it may be possible to avoid extraction between stripping of the anterior teeth and rotation of the molars.

  After setting the anchorage on molars and stripping the teeth as needed, a new impression or digital scan and occlusal acquisition is sent to a digital computer aided design company for molar correction, anchorage and stripping. After Stage I treatment, treatment analysis is performed.

  Analysis of the new scan or impression of the current tooth, and the new and improved condition of the anterior tooth. There is a great deal of literature and clinical results with regard to correcting molar rotation and retaining them without any cosmetic effects. Cetlin, Gianelly et al. Write about these low compliance devices with significant impact. As shown by Margolis and Cetlin in the last century, the greatest development in molars is obtained, and it is computer analyzed when it is thought that some anterior-posterior correction was achieved by control of the removable plate in the anterior teeth. Some people call it "drift-odontics" in order to wait for the middle or premolar to move to its final position, after leaving a space in front of the molars. This avoids great discomfort when trying to mechanically correct the premolars, but in the extreme case an activator (active plastic tray) can be used. Devices such as RPE, SPE, Pendulum, Burstone, etc., may replace the paradental arch bar system for upper molars and lip bumpers for lower molars, but an inexpensive PAB / bumper system common to the art is the preferred embodiment. Is intended.

  After the band is removed, a final tray, such as tray 10 in FIG. 5, is formed for all the teeth and worn to complete correction and begin retention.

  In general, this process addresses millions of adults with molars in or near Class I or Class 1 class 1 and with crowded anterior teeth. Also, many patients who have already done orthodontic treatment at a young age and who only need to correct unsightly rotation can benefit from this system.

FIG. 1 is a perspective view of one embodiment of a conventional molar correction device useful in the practice of the present invention. FIG. 7 is a perspective view of another embodiment of a conventional molar correction device useful in the practice of the present invention. FIG. 7 is a perspective view of another embodiment of a conventional molar correction device useful in the practice of the present invention. FIG. 7 is a perspective view of another embodiment of a conventional molar correction device useful in the practice of the present invention. FIG. 1 is a perspective view of a tray useful as a retainer or as one of a series of aligner trays used in the practice of the present invention.

Claims (1)

A method for orthodontic treatment of dislocation teeth in two stages,
a. First stage cosmetic treatment plan starting with rotating, reshaping, pressing, or leveling of the molar region using conventional molar correction devices and therapies.
b. CAD / CAM path analysis to consider the need for stripping and the most suitable place to apply it based on tooth width or arch width,
c. Making a transparent retention tray to control tooth-to-tooth balance during phase 1, and d. After Phase I correction, create a new impression where the molars have been corrected, stripping in place and occlusal capture if necessary, then digitally or practically restoring the teeth to the ideal occlusion Set up and perform a series of plastic trays to complete the correction from the position of phase I to the final ideal position to be kept with the holding trays How to do orthodontic treatment.

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