Orthodontic appliance system and method of manufacturing same

Abstract

An orthodontic appliance system for orthodontic treatment of teeth. The system includes a template with a cavity. The accessory is removably received in the receiving portion and has a surface including an adhesive surface. A method of manufacture includes constructing a bracket assembly including a base and placing a template in contact with the bracket assembly. The method includes inserting the accessory into the receptacle. During detachment, the attachment remains coupled with the template in the receptacle. A method of manufacture includes providing a mold for a patient's teeth. The mold includes at least one protrusion and a through channel. The method includes placing a container of dental composite material in fluid communication with the through-channel, placing a template on the at least one protrusion, injecting the dental composite material from the container through the through-channel into the receptacle, and removing the template from the at least one protrusion having the filled receptacle.

Description

TECHNICAL FIELD

[0001] The present invention relates generally to orthodontic appliances for orthodontic treatment, and more particularly to an orthodontic appliance system comprising a plurality of orthodontic appliances and methods of manufacturing orthodontic appliances and systems. BACKGROUND

[0002] Orthodontics is the practice of manipulating teeth to correct malocclusions between the upper and lower dental arches. Typically, treatment of a malocclusion involves applying corrective forces to the teeth using orthodontic appliances. Over time, these corrective forces force the teeth to move to their orthodontically correct positions.

[0003] One way of applying corrective forces is to use orthodontic appliances known as aligners. Aligners are provided as a series of removable appliances that gradually reposition a patient's teeth from their initial orientation to their orthodontically correct orientation. A patient undergoing treatment using aligners can put in and take out the aligners at will. When one aligner has moved the teeth to the final orientation of that aligner or close to the final orientation, the patient begins using the next aligner in the series according to a treatment plan formulated by a clinician.

[0004] To make the aligners, a clinician first obtains a computer model of the patient's dentition. This model can be generated from data by taking an impression of the dentition and scanning the impression into a computer. Alternatively, the data can be generated by directly scanning the patient's teeth using an intraoral scanner. In either case, the scanned data is subsequently used to construct a computer model of the patient's dentition.

[0005] Once the computer model is obtained, the orthodontist can manipulate the individual teeth in the computer model to determine the final orientation of each tooth of the dentition that provides the corrected dentition. A plurality of computer models can then be generated, each corresponding to the initial orientation, one or more intermediate orientations, or the final desired orientation of the dentition. The clinician designs the movement of the teeth from the initial orientation through each of the intermediate orientations to the final desired orientation. This predetermined movement is referred to as a treatment plan.

[0006] In view of the fact that certain tooth movements exceed the range that can be achieved by a single aligner, the treatment plan is typically divided into a number of incremental movement stages. The movement of the teeth for each stage is typically achieved by a single aligner. Each stage can correspond to one of the computer models of the patient's teeth in a particular orientation.

[0007] Once a treatment plan is designed using a series of computer models corresponding to stages of tooth movement, a series of appliances corresponding to the series of models can be manufactured. First, a mold is manufactured from each model. Then, an appliance is manufactured from the mold. In this way, the appliance can reflect the position of the patient's teeth according to one stage of treatment. Manufacturing each appliance in the series typically involves forming a piece of plastic over a mold built based on the patient's teeth at a particular stage of treatment according to the treatment plan. After forming, the waste material in the piece can be trimmed away to produce the appliance. The trimming can utilize CNC milling or other computer-controlled cutting systems.

[0008] During treatment using the appliances, certain types of malocclusion can require the use of specialized appliances at one or more periods of the treatment plan. These specialized appliances are incorporated into the models as an element of the treatment plan and are designed to work in conjunction with the appliances to produce tooth movement forces that cannot be achieved with the appliances alone.

[0009] One type of appliance is an attachment. An attachment is an object that is placed on the surface of a tooth and protrudes outward from it. Thus, the attachment essentially provides additional surfaces through which the orthodontist can engage with the appliance to manipulate the patient's teeth. Typically, the attachment can be formed from a dental composite material that self-adheres to the tooth when the composite material is cured. For example, the clinician can form the attachment by hand. In this regard, the clinician selects the attachment material to be used and fills a cavity with the selected material. The cavity defines the desired shape of the attachment and can be formed in a template of the patient's teeth. Once the material solidifies or hardens, the attachment assumes the shape of the cavity. The template fits closely over the teeth and positions the attachment in the desired location on the patient's teeth. The cavity in the template, in combination with the surface of the tooth, forms the shape of the attachment.

[0010] Prior to using the template, the clinician can prepare the surface of the selected tooth for the attachment at the beginning of one stage of treatment. Once the tooth is prepared, the clinician fills each cavity in the template with the dental composite material. When all cavities are filled, the clinician places the template over the patient's teeth. As the dental composite material cures, it adheres to the designated surface location of the tooth of the template. The shape of the dental composite material corresponds to the shape of the cavity in the template on the surface of the tooth. This process results in the attachment, i.e., the cured dental composite material, being bonded to the surface of the patient's tooth. The attachment is a temporary appliance. They can be used for a predetermined period of time that is less than the entire treatment plan, i.e., less than all stages of treatment. The attachment typically cannot be removed by the patient.

[0011] Once the attachment is positioned on the selected tooth, the one or more appliances include a receptacle into which the attachment is at least partially received when the appliance is worn in the patient's jaw. During treatment, the one or more appliances can forcibly engage the attachment to exert a force on the one or more teeth in accordance with a treatment plan.

[0012] While attachments are successfully used with appliances, there are still problems with their placement and use. There is a need for improved orthodontic appliance systems to simplify orthodontic treatment and improve treatment predictability during treatment with appliances. SUMMARY

[0013] In one aspect of the disclosure, an orthodontic appliance system for orthodontic treatment of a patient's teeth is provided. The system includes a template including a shell having at least one cavity configured to receive a tooth. The shell has a plurality of walls defining the at least one cavity. The plurality of walls are configured to conform to at least a portion of one or more surfaces of the tooth. At least one of the plurality of walls includes a receptacle open toward the at least one cavity. An attachment is removably received in the receptacle and has one or more surfaces including an adhesive surface. The adhesive surface is exposed to the at least one cavity and is used to adhere to the tooth.

[0014] In one embodiment, the attachment is a solid object.

[0015] In one embodiment, at least one of the plurality of walls is a labial wall.

[0016] In one embodiment, the system further includes an appliance configured to apply a tooth moving force to the tooth. The appliance includes a shell having at least one cavity configured to receive the tooth. The shell has a plurality of walls defining the at least one cavity. The plurality of walls are configured to conform to at least a portion of one or more surfaces of the tooth. At least one of the plurality of walls includes a receptacle open toward the at least one cavity and is configured to receive the attachment when the attachment is adhered to the tooth. The shell of the appliance differs from a corresponding wall of the plurality of walls of the template in a location of the at least one of the plurality of walls.

[0017] In one embodiment, the system further includes an etched template in which the shell having at least one cavity is configured to receive the tooth. The shell has a plurality of walls defining the at least one cavity. The plurality of walls are configured to conform to at least a portion of one or more surfaces of the tooth. At least one of the plurality of walls includes a window through which a surface of the tooth can be contacted when the etched template is placed on the tooth.

[0018] In one aspect of the disclosure, a method of manufacturing a template for orthodontic treatment of a patient's teeth is provided. The method includes providing a mold of the patient's teeth. The mold has at least one protrusion in the shape of at least one of the patient's teeth. The method includes securing an attachment to the at least one protrusion and forming a sheet of material over the at least one protrusion and the attachment to form a deformed region in the sheet of material. The deformed region has a plurality of walls that define at least one cavity configured to accommodate the at least one of the patient's teeth and a receptacle. The method includes removing the sheet of material from the at least one protrusion while the at least one attachment is retained in the receptacle.

[0019] In one embodiment, prior to securing the attachment, the method further includes providing the attachment and placing the attachment on the patient setup card at a location corresponding to the at least one of the patient's teeth in the patient's mouth.

[0020] In one embodiment, prior to securing the attachment, the method further includes providing the attachment and applying an adhesive to the attachment, and securing the attachment to the at least one protrusion includes adhering the attachment to the at least one protrusion.

[0021] In one embodiment, prior to securing the attachment, the method further includes providing the attachment, placing the attachment on the patient setup card at a location corresponding to the at least one of the patient's teeth, picking up the attachment from the location, and applying an adhesive to the attachment. In this embodiment, securing the attachment to the at least one protrusion includes adhering the attachment to the at least one protrusion.

[0022] In one embodiment, prior to securing the attachment, the method further includes 3D printing the attachment.

[0023] According to one aspect of the disclosure, a method of manufacturing an orthodontic aligner system for orthodontic treatment of a patient includes constructing a bracket assembly, the bracket assembly including a base, one or more pillars and / or beams extending from the base, and an attachment extending from the one or more pillars and / or beams. The method further includes placing a template in contact with the bracket assembly. The template includes a first shell having at least one cavity configured to accommodate a tooth. The first shell has a plurality of walls that define the at least one cavity. The plurality of walls are configured to conform to at least a portion of one or more surfaces of the tooth. At least one of the plurality of walls includes a receptacle open toward the at least one cavity. In the method, the placing includes inserting the attachment into the receptacle, and separating the attachment from the one or more pillars and / or beams. During the separating, the attachment remains coupled with the template in the receptacle.

[0024] In one embodiment, constructing the bracket assembly includes 3D printing the bracket assembly.

[0025] In one embodiment, the one or more pillars and / or beams extend at a non-orthogonal angle relative to the base.

[0026] In one embodiment, placing the template includes orienting the template at a non-orthogonal angle relative to the base such that the attachment is received in the receptacle.

[0027] In one embodiment, placing the template includes temporarily adhering the attachment in the receptacle.

[0028] In one embodiment, the bracket assembly includes a weak area between the attachment and the one or more struts and / or beams, and separating includes disconnecting the one or more struts and / or beams from the attachment at the weak area.

[0029] In one embodiment, separating includes cutting the one or more struts and / or beams proximate the attachment.

[0030] In one embodiment, the method further includes providing a second shell having at least one cavity configured to receive a tooth. The second shell has a plurality of walls defining the at least one cavity. The plurality of walls are configured to conform to at least a portion of one or more surfaces of the tooth. The method includes machining a window in at least one of the plurality of walls. The window is positioned to expose a surface of the tooth when the shell is positioned on the patient's teeth.

[0031] In one embodiment, the method further includes providing a plurality of aligners for use by the patient.

[0032] According to one aspect of the disclosure, a method of manufacturing an orthodontic aligner system for orthodontic treatment of a patient includes providing a mold of the patient's teeth. The mold has at least one protrusion shaped like at least one of the patient's teeth. The at least one protrusion includes a through channel. The method includes placing a container of a dental composite material in fluid communication with the through channel and placing a template on the at least one protrusion. The template includes a shell having at least one cavity configured to receive a tooth. The shell has a plurality of walls defining the at least one cavity. The plurality of walls are configured to conform to at least a portion of one or more surfaces of the tooth. At least one of the plurality of walls includes a receptacle open toward the at least one cavity. In the method, placing includes aligning the receptacle with the through channel, injecting the dental composite material from the container through the through channel into the receptacle, and removing the template from the at least one protrusion having the filled receptacle.

[0033] In one embodiment, injecting includes injecting a predetermined amount of the dental composite material into the receptacle.

[0034] In one embodiment, the method further includes placing a foil film on the filled receptacle.

[0035] In one embodiment, the method further includes placing the template in a light-protective container prior to shipping. BRIEF DESCRIPTION OF DRAWINGS

[0036] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the application and, together with the detailed description given below, serve to explain various aspects of the application.

[0037] FIG. 1A is a perspective view of one embodiment of a template for an orthodontic appliance system for patient orthodontic treatment.

[0038] FIG. 1B is a cross-sectional view of the template shown in FIG. 1A

[0039] FIG. 2A is a perspective view of one embodiment of an appliance for an orthodontic appliance system for patient orthodontic treatment.

[0040] FIG. 2B is a cross-sectional view of the appliance shown in FIG. 2A

[0041] FIG. 3 is a perspective view of an exemplary template in use illustrating FIG. 4 FIG. 1A

[0042] FIG. 5 is a perspective view of a bracket system and template and accessory assembly according to one embodiment of the present application.

[0043] FIG. 6 is a schematic view of a patient set-up card for organizing accessories according to one embodiment of the present application.

[0044] FIG. 7 and FIG. 8 is a perspective view of one embodiment of manufacturing a template and accessory pre-assembly according to one embodiment of the present application.

[0045] FIG. 9 is a cross-sectional view taken along section line 8-8 in FIG. 8

[0046] FIG. 10 is a perspective view of one method of manufacturing a template appliance according to one embodiment of the present application.

[0047] FIG. 11 is a partial cross-sectional view of one receptacle taken along section line 10-10 in FIG. 10

[0048] FIG. 12 is a cross-sectional view of the template of FIG. 11 covered receptacle filled with foil cap.

[0049] FIG. 13 ​​​​​​is a perspective view of an etching template according to one embodiment of the present invention. DETAILED DESCRIPTION

[0050] Embodiments of the present invention relate to orthodontic treatment systems comprising a plurality of orthodontic appliances. Exemplary systems include one or more dental appliances, one or more attachments, and a template for placing the attachments on the patient's teeth. The attachments cooperate with the appliances during orthodontic treatment when the attachments are placed on the patient's teeth. This cooperation can facilitate the application of additional or different forces to selected teeth in accordance with a treatment plan. In some variations, the orthodontic treatment system includes an etching template to assist the clinician in preparing the patient's teeth for the attachments. Regardless, the orthodontic treatment system can be used in the orthodontic treatment of a patient. In some embodiments, such as orthodontic treatment systems comprising appliances and attachments, the appliances and attachments are configured to be used together during orthodontic treatment. In other embodiments, the appliances are configured to be used sequentially, in other words, one after the other, with or without other appliances. For example, in an orthodontic treatment system comprising a template, attachments, and appliances, the template is used to place the attachments on the patient's teeth, and the appliances cooperate with the attachments to provide orthodontic treatment. The template and the appliances are not used together, but each serves a particular purpose in the orthodontic treatment. Advantageously, orthodontic treatment systems according to embodiments of the present invention improve the predictability of orthodontic treatment.

[0051] To the accomplishment of the foregoing and FIG. 1A and FIG. 2A In one exemplary embodiment, the orthodontic appliance system 10 includes a template 12 (shown in FIG. 1), one or more attachments 20 (shown in FIG. 2), and one or more dental appliances 14 (shown in FIG. 3). As shown, the template 12 and the appliances 14 have similar appearances. However, the template 12 and the appliances 14 are designed to provide different functions in the orthodontic treatment of a patient, as described below. Exemplary embodiments of the orthodontic appliance system 10 can include only the template 12 and the attachments 20 (without the appliances 14). Another exemplary embodiment of the orthodontic appliance system 10 includes the template 12, one or more attachments 20, one or more dental appliances 14, and an etching template 16. Exemplary embodiments of the etching template 16 will be described below with reference to FIGS. 4-6. FIG. 1A FIG. 1B FIG. 2A FIG. 13

[0052] With reference to FIG. 1A and FIG. 1B ​​​​The attachment 20 is designed to be affixed to the patient's teeth, and thus detaches from the template 12 when the template 12 is positioned on the patient's teeth. In an exemplary embodiment, the attachment 20 is a solid object, and as an example and not a limitation, can be composed of a polymer. The attachment 20 has a three-dimensional (e.g., a cube, a cuboid, a prism, or a pyramid) shape. Further, the three-dimensional shape can be regular or irregular. Thus, the attachment 20 has a plurality of surfaces, e.g., planar surfaces, that intersect each other at edges, and the edges can intersect to form vertices. One of the surfaces is an adhesive surface 28 through which the attachment 20 is adhered to the tooth surface. In other exemplary embodiments, the attachment 20 can be an uncured dental composite that is cured after use of the template 12 to form a cured dental composite on the patient's teeth. The uncured dental composite is not a solid object, but upon curing forms a solid object. As an example of pre-assembly, the template 12 and one or more attachments 20 or dental composite that can be cured to form the attachment 20 can be assembled during manufacturing, or assembled immediately after manufacturing but prior to shipping the template 12 to the clinician.

[0053] Pre-assembly of the attachment 20 (or uncured dental composite) with the template 12 is advantageous. Generally, the process of the clinician manually filling the receptacle in the template with dental composite is avoided. In other words, the clinician does not need to first prepare the template by filling it with dental composite. Thus, pre-assembly reduces the time of the orthodontist and limits or eliminates the possibility of overfilling the template with excess dental composite. Elimination of overfilling avoids the necessity of cleaning flash from the patient's teeth after the attachment is secured to the teeth, thereby saving time for the clinician. Flash is created due to excess composite material flowing onto the tooth surface beyond the intended boundaries of the attachment. If not removed by the clinician in a cleaning step, the flash can trap food debris near the tooth surface. Overfilling also causes the attachment to deform after the composite material is cured. Further, in another extreme case, pre-assembly of the attachment 20 with the template 12 also eliminates the possibility of underfilling with dental composite. In this case, the attachment is not formed correctly in shape. The incorrectly formed attachment can result in a deformed attachment. For each of the deformed or malformed attachments, each lacks the desired configuration needed to perform the correct treatment. Thus, the desired forces on the teeth can not be achieved during orthodontic treatment. By avoiding these formation issues, and according to embodiments of the present application, the attachment 20 is formed more accurately, and thus the orthodontic treatment that follows using the appliance 14 is more consistent and predictable.

[0054] In embodiments of the present application, the template 12 is designed to position each attachment 20 on the patient's teeth in the correct orientation and position. The template 12 includes a hollow shell 22 configured to enclose the crowns of one or more teeth of the patient. The shell 22 can be a soft and pliable resilient material, thus having a rubber-like elasticity. In one embodiment, the resilient material of the shell 22 is different than the material of the appliance 14. The resilient properties enable the template 12 to be placed on the patient's teeth and then easily removed after the attachments 20 are affixed to the patient's teeth without interfering with the attachments 20. Unlike the appliance 14 (described below), the template 12 does not exert tooth-moving forces on the patient's teeth.

[0055] In FIG. 1A and FIG. 1B In the exemplary embodiment shown, the shell 22 is formed with a plurality of cavities 24 that collectively define a rim 26. Each cavity 24 can be shaped to accommodate a particular tooth of the patient. The rim 26 defines an opening 30 in the shell 22 and defines a gingival margin of the shell 22. The patient's teeth are accommodated in their respective cavities 24 through the opening 30.

[0056] To conform to the patient's teeth, the shell 22 has wall portions that contact certain surfaces of the patient's teeth and define the cavities 24. For example, the wall portions include occlusal walls 40, labial walls 42, and lingual walls 44. In FIG. 1B the walls 40, 42, 44 are shown relative to an anterior tooth cavity 46. The shell 22 can also include distal portions 50 that surround the cavities 24 that accommodate the rearmost molars. When the cavities 24 accommodate the patient's teeth, the walls 40, 42, 44, and 50 generally conform to the corresponding surfaces of the respective teeth of the patient, and the rim 26 is located near the patient's gums.

[0057] Referring to FIG. 1A and FIG. 1B In one embodiment, the shell 22 includes one or more receptacles 52 formed in the labial walls 42. The receptacles 52 can appear as a bubble in the wall 42 and are formed by a 3-D protrusion in the wall 42 that extends outwardly away from the surrounding wall. Thus, when the template 12 is placed on the patient's teeth, the wall 42 at the receptacle 52 does not conform to the tooth surface. Instead, the receptacle 52 creates a void space between the wall 42 and the tooth surface. In FIG. 1A In the exemplary embodiment shown, the template 12 includes seven receptacles 52. Each of these receptacles 52 is formed in the labial wall 42. The receptacles 52 are open to the respective cavities 24. Embodiments of the present application are not limited to templates 12 with seven receptacles 52 as shown. It is contemplated that more or fewer receptacles 52 can be used, for example, one receptacle 52. Furthermore, in accordance with embodiments of the present application, receptacles 52 can be formed on the lingual wall 44 (or distal wall 50) of the shell 22.

[0058] As one example, and with reference to FIG. 1B , the receptacle 52 is open toward the cavity 54. The attachment 20 is positioned in the receptacle 52 and can be flush with the inner surface of the labial wall 42 as shown. In this way, the bonding surface 28 of the attachment 20 can be used to contact a tooth in the cavity 54 when the template 12 is positioned over the patient’s teeth. Once placed on the patient’s teeth, the attachment 20 can be used to contact the appliance 14 to move a particular tooth of the patient in accordance with a treatment plan.

[0059] Referring now to FIG. 2A and FIG. 2B , one exemplary embodiment of the orthodontic appliance system 10 further includes one or more appliances 14. The template 12 and attachment 20, along with the appliance 14, can form an exemplary set of orthodontic appliances that are shipped to a clinician for use. For example, once the attachment 20 is secured to the patient’s teeth using the template 12, the appliance 14 can be coupled to the patient’s jaw such that orthodontic treatment can begin.

[0060] In this regard, the appliance 14 is designed to work in conjunction with the attachment 20 to move the patient’s teeth in accordance with a treatment plan. The appliance 14 includes a hollow shell 60 that is configured to enclose the crowns of one or more teeth of the patient along with the attachment 20. The shell 60 can be one or more layers of an elastic material, such as a thermoplastic material, and is capable of generating tooth movement forces upon elastic deformation. Similar to the shell 22 of the template 12, the shell 60 of the appliance 14 is formed with a plurality of cavities 62 that collectively define a rim 64. Each cavity 62 can be shaped to accommodate a particular tooth of the patient. The rim 64 defines an opening 66 in the shell 60 through which the patient’s teeth can enter their respective cavities 62. As shown, the rim 64 of the appliance 14 can form a gingival margin of the shell 60 and have a scalloped appearance to follow the gum line of the patient. Comparing FIG. 1A and FIG. 2A , the rim 64 of the appliance 14 differs in configuration from the rim 26 of the template 12, which is more linear and less scalloped.

[0061] Referring to FIG. 2B , to conform to the patient’s teeth, the shell 60 has wall portions that contact certain surfaces of the patient’s teeth. For example, the wall portions include an occlusal wall 70, a labial wall 72, and a lingual wall 74. The shell 60 can also include distal walls 80 (indicated in FIG. 2A ) that surround the cavities 62 that accommodate the patient’s back molars. In FIG. 2B , the walls 70, 72, 74 are shown with respect to the anterior tooth cavities 76. When worn on the patient’s teeth, the walls 70, 72, 74 of each cavity 62 generally conform to the corresponding surfaces of the respective tooth of the patient, and the rim 64 is located near the patient’s gum line. AlthoughFIG. 1A The template 12 and FIG. 2A The appliance 14 shown in FIG. 6 appears similar in the locations of the walls 40, 42, 44, 50 and 70, 72, 74, 80, but generally the configurations of the two can be significantly different, particularly as treatment progresses, as the walls 70, 72, 74 and 80 in a series of appliances 14 change orientation according to desired tooth movement. Moreover, the thickness of the shell 22 of the template 12 and the thickness of the shell 60 of the appliance 14 are not necessarily equal, as shown.

[0062] In one embodiment, the shell 60 of the appliance 14 includes one or more receptacles 82 formed in the labial wall 72. At each receptacle 82, the wall 72 is offset from the fit to the corresponding tooth to accommodate the attachment 20. Thus, the receptacle 82 forms a void space (in the absence of the attachment 20) that is open toward the corresponding cavity 62. As one example, and with reference to FIG. 2B , the receptacle 82 is open to the cavity 76. In FIG. 2A the exemplary embodiment shown, the appliance 14 includes seven receptacles 82. Each receptacle 82 can have a different configuration, but generally has a regular orthogonal configuration, including one or more surfaces and edges that are not generally found on teeth. One or more surfaces and edges of the attachment 20 are configured to mate with one or more surfaces and edges of the receptacle 82. In exemplary embodiments, each receptacle 82 conforms to the size and shape of the receptacle 52 of the template 12, as shown for example in FIG. 1A In one embodiment, the receptacle 82 is the same size and shape as the receptacle 52 of the template 12, thus conforming to the configuration of the corresponding attachment 20.

[0063] In exemplary embodiments, there are seven receptacles 82, each formed in the labial wall 72 of the shell 60. Embodiments of the present application are not limited to appliances 14 having seven receptacles 82, although the number of receptacles 82 in the shell 60 can be at least equal to the number of attachments 20 on the teeth of the patient. It is contemplated that more or fewer receptacles 82 can be used, for example, one receptacle 82 for a single attachment 20. Moreover, in accordance with embodiments of the present application, receptacles 82 can be formed on the lingual wall 74 of the shell 60.

[0064] With reference to FIG. 3 and FIG. 4 In preparation for orthodontic treatment, the clinician positions the template 12 on the plurality of teeth 90 in the jaw 92 of the patient, as indicated by the arrow 94. Although not shown, once the template 12 is positioned on the teeth 90 of the patient, the attachment 20 in each receptacle 52 is secured to the corresponding tooth 90. The clinician then removes the template 12, as shown in FIG. 4 .

[0065] When the template 12 is removed as indicated by arrow 94, the attachments 20 remain affixed to the respective teeth 90 of the patient. Although the patient's jaw is not shown, the same procedure can be performed on the other jaw of the patient. According to one embodiment, the attachments 20 can be adhesively affixed to the teeth of the patient. After the attachments 20 are affixed to the teeth 90 of the patient, the patient couples one of the appliances 14 to their teeth and begins orthodontic treatment according to the prescribed treatment plan. At the end of treatment, or when the attachments 20 are no longer needed, the clinician can remove them.

[0066] According to embodiments of the present application, the templates 12 and attachments 20 are pre-assembled prior to shipping to the clinician or patient. With reference to FIG. 5 to FIG. 11 , an exemplary manufacture and pre-assembly of the attachments 20 with the templates 12 is described. With reference to FIG. 5 In one embodiment, the attachments 20 are 3D printed as part of a scaffold assembly 100. As shown, the scaffold assembly 100 includes one or more posts 102 extending from a base 104. Beams 106 can extend between adjacent posts 102 to mechanically stabilize the posts 102. The individual attachments 20 are 3D printed in a predetermined orientation at the end of selected posts 102 and / or beams 106. The orientation of the posts 102 and / or beams 106 and the attachments 20 can facilitate insertion of the attachments 20 into the corresponding receptacles 52 in the templates 12.

[0067] In this regard, in the exemplary embodiment shown, the posts 102 can have different heights from one another and / or form non-orthogonal angles with respect to the base 104. This is by design. Advantageously, 3D printing the attachments 20 held in place by the posts 102 and / or beams 106 can facilitate printing of attachments 20 that would otherwise not be able to be printed on a horizontal printer surface. For example, attachments 20 that form undercuts or invaginations when positioned on teeth can not be able to be 3D printed directly on a horizontal printer surface. However, with the aid of the scaffold assembly 100, the attachments 20 can be oriented in a manner that facilitates 3D printing. Moreover, 3D printing of the attachments 20 is advantageous.

[0068] For example, 3D printing the attachments 20 eliminates the use of dental composite material. In this way, a material that is harder and more durable than dental composite material can be selected for the attachments 20. For example, the attachments 20 can be composed of one or more of the following materials: DentaCore® from Dentca, Inc. of Torrance, California TMmethacrylate-based photopolymerizable resins; Methyl methacrylate polymethyl methacrylate (MPM-PMMA) from Heraeus Kulzer GmbH; CLC-PMMA-OFC from GC Corporation; Isosit (UDMA and inorganic fillers) from Ivoclar Vivadent AG; and PMMA with cross-linking of the polymer chains from Candulor AG. It is believed that harder, more durable materials are advantageous because they resist wear more effectively than dental composites. The attachments 20 according to embodiments of the present application are able to resist losing their initial shape due to rounding during use. Thus, the force application from the appliance 14 is maintained, causing the patient's teeth to move as predicted. Embodiments of the present application facilitate more efficient appliance-attachment force transmission over longer periods of time because the attachments 20 can maintain their designed shape for longer periods of time. This facilitates more predictable orthodontic treatment. As a further advantage, 3D printing allows the bonding surface of the attachment 20 to be manufactured with a surface topology (e.g., a grid) that forms a stronger bond between the attachment 20 and the tooth through the intermediary adhesive.

[0069] In one embodiment, once the rack assembly 100 is complete, the template 12 is placed onto the rack assembly 100 and the attachments 20 are inserted into the receptacles 52. As shown, the template 12 can be oriented at a particular non-orthogonal angle relative to the rack assembly 100 so that each receptacle 52 is oriented to receive an attachment 20. Temporary adhesive (not shown) can hold the attachments 20 in the respective receptacles 52. The attachments 20 are then disconnected from the posts 102 and / or beams 106 at a local weak area of the attachment 20 proximate to the rack assembly 100. In this regard, the attachments 20 can be snapped off of the posts 102 and / or beams 106 so that the attachments 20 remain adhesively housed in the receptacles 52. Alternatively, the attachments 20 can be disconnected from the rack assembly 100 by cutting at a location where the attachment 20 is connected to the posts 102 and / or beams 106. The weak area or cutting location can be proximate to the bonding surface 28 of the attachment 20 that is secured to the patient's teeth. FIG. 1B After the remaining portion of the rack assembly 100 is removed, adhesive can be applied to the base surface 28 of each attachment 20. The template 12 with the pre-assembled attachments 20, with or without the appliance 14, can then be shipped to the clinician or patient.

[0070] Reference is now made to FIG. 6 and FIG. 7In another embodiment, the attachments 20 are either 3D printed on the bracket assembly 100 or printed on a surface and then transferred to the patient setup card 110. Exemplary materials that can be used to print the bracket assembly 100 and the attachments 20 include, but are not limited to, the same materials listed above, namely: the methacrylate-based photopolymer resin from Dentca TM of Torrance, California; methyl methacrylate polymethyl methacrylate (MPM-PMMA) from Heraeus Kulzer GmbH; CLC-PMMA-OFC from GC Corporation; Isosit (UDMA and inorganic fillers) from Ivoclar Vivadent AG; and PMMA with cross-linking of the polymer chains from Candulor AG. In FIG. 6 one example of a process that includes 3D printing of the attachments 20, the attachments 20 are printed and then placed in the quadrants 112, 114, 116, 118 in the patient’s mouth according to the individual teeth of the patient. For example, with respect to the patient setup card 120, the lower left quadrant 116 shows six attachments 20 and the lower right quadrant 118 shows four attachments 20, while the upper jaw has no attachments as shown in the quadrants 112 and 114. This arrangement ensures that the attachments 20 are placed correctly.

[0071] Referring to FIG. 7 one embodiment of the process of forming the template 12 can include deforming a workpiece 130 with a mold 132. The mold 132 can be one of a series of molds, each mold fabricated based on a corresponding computer model of the patient’s dentition, and each mold capturing a target orientation of the patient’s teeth during orthodontic treatment. By way of example only and without limitation, FIG. 7 the mold 132 shown in FIG. 13 can represent the patient’s teeth prior to treatment. The mold 132 can include a base 134 that supports a plurality of protrusions 136 in the form of model teeth extending from a model gum 138 (i.e., the gum line). Thus, each model tooth 136 can have an orientation that is configured to produce a corresponding cavity 24 in the template 12. The model gum 138 desirably provides a limiting boundary for the location of the edge 26 of the template 12. The computer model used to fabricate the mold can be generated based on the patient’s initial dentition and a computer model of the desired virtual movement of the patient’s teeth. One or more molds 132 can be 3D printed.

[0072] In accordance with FIG. 6After printing attachment 20 and placing it on setting card 110, and after manufacturing mold 132, in one embodiment of the invention, attachment 20 can be removed from patient setting card 110 and attached to the corresponding tooth 136 of mold 132. In this regard, a robotic arm with a suction cup end effector (not shown) can be programmed to pick up attachment 20 from setting card 110 and place them onto the corresponding tooth 136. During the picking and placement process, an adhesive (not shown) can be applied to attachment 20. This adhesive can temporarily adhere attachment 20 to the tooth 136 of mold 132. Exemplary adhesives include LeGlue (i.e., a dextrin / polymer resin mixture) commercially available from Le-Glue, Dalton, Georgia, and Tecbond 2507FS commercially available from Priddy Sales Company, Fort Worth, Texas 76126.

[0073] In one embodiment, after the attachment 20 is placed on the mold 132, the workpiece 130 deforms above the mold 132 and the attachment 20. The deformed workpiece 130 is as follows: FIG. 8 As shown, workpiece 130 is removed from mold 132. As shown, workpiece 130 includes a deformation region 140 corresponding to template 12. During deformation or when removing the deformation region 140 from mold 132, attachment 20 temporarily fixed to mold 132 detaches from mold 132. A cross-sectional view of the deformation region 140 is shown below. FIG. 9 As shown. Therefore, in one embodiment of the invention, attachment 20 forms a receiving portion 52 in template 12 and is pre-assembled with template 12. After deformation, template 12 may correspond to edge 26 ( FIG. 8 The position (shown by the dashed line) separates from the rest of the deformed workpiece 130. Once separated, the template 12 can be used for orthodontic treatment, such as... FIG. 3 and FIG. 4 As shown in general and as described above.

[0074] Now for reference FIG. 10 , FIG. 11 and FIG. 12 In one embodiment, a dental composite material is injected into template 12. In this regard, refer to... FIG. 10 , use and FIG. 8The illustrated mold 132 is similar in some respects to a mold 150. The mold 150 can include a base 152 from which model gingiva 154 and model teeth 156 extend. As shown, selected model teeth 156 include a through passage 160 that extends generally in a labial-lingual direction (or, in other words, from an interior to an exterior of the selected model teeth 156). The through passage 160 is formed at a location where the attachment 20 is to be positioned on the patient's teeth. Although a circular through passage is shown, embodiments of the present application are not limited to a circular configuration, other configurations (e.g., rectangular, triangular, irregular, etc.) are possible.

[0075] A pre-formed template 12, including a receptacle 52 corresponding to the selected model teeth 156, is coupled to the mold 150. This is shown in FIG. 10 with arrow 162. Prior to or after the template 12 is coupled to the mold 150, and with reference to FIG. 11 a barrel 170 is inserted into or through (as shown) the through passage 160 of each selected model tooth 156. The barrel 170 contains a predetermined amount of dental composite material. The calculated amount of dental composite material is injected from the barrel 170 through the through passage 160 into the receptacle 52. In one embodiment, the mold 150 or a selected region of the mold 150 that includes the through passage 160 can be heated in order to achieve more consistent flow of the dental composite material during injection. In this manner, the receptacle 52 is filled with dental composite material 164. The dental composite material 164 subsequently cures into an attachment, typically cured with ultraviolet light after it is adhered to the patient's teeth.

[0076] In an exemplary embodiment, the filling process is then repeated for each receptacle 52. For example, the cartridge 170 is then moved to the next through passage 160 and a calculated amount of dental composite material is injected into the next receptacle 52. The calculated amount of dental composite material required for each receptacle 52 can vary because each receptacle 52 can have a different volume and therefore require a different amount of composite material to fill the volume. In this way, each receptacle 52 of the template 12 is filled with an exact amount of dental composite material for that receptacle 52, receptacle by receptacle. Advantageously, by depositing a predetermined amount of material into each receptacle, overfilling and underfilling of the receptacles 52 is avoided. In one embodiment, the cartridge 170 contains just enough dental composite material to fill one of the receptacles 52. A new cartridge 170 can then be inserted into each through passage 160 and the exact filling of each receptacle 52 can be performed simultaneously. Although not shown, in another exemplary embodiment, the passages in the mold 150 are interconnected and extend from the model teeth adjacent the receptacles 52 to a single injection location. Thus, the passages fan out from the single injection location to each receptacle 52. A single cartridge 170 can be inserted at the single injection location of the mold 150. Controlling the flow of composite material from the unique cartridge 170 can provide exact control of the filling of the receptacles 52.

[0077] Referring now to FIG. 12 In one embodiment, after the receptacles 52 are filled with dental composite material 164, a foil cap 172 is placed over the dental composite material 264 to prevent premature curing of the composite material 164 before the composite material is applied to the patient's teeth. The template 12 with the filled receptacles 52 can be transported in a light-protected container, such as a sealable foil bag, to prevent premature curing of the composite material. The clinician or patient removes the template 12 from the container and removes the foil cap 172 before applying the template 12 with the filled receptacles 52 to the patient's teeth. This procedure is generally as shown in FIG. 3 and FIG. 4 After the foil cap 172 is removed and the template 12 is placed on the patient's teeth, the composite material can be cured by exposing it to ultraviolet light or other curing source. Once cured, the composite material forms the attachment 20. The template 12 can be removed from the patient's teeth before or after the composite material 164 is cured.

[0078] In one embodiment, and with reference to FIG. 13 The orthodontic treatment system 10 can further include an etching template 16. The etching template 16 can be used in conjunction with the above-referenced FIG. 1A and FIG. 1BThe described template 12 is used prior to and can be used prior to use of the appliance 14. In this regard, the etching template 16 can visually locate the areas of the tooth surface to which the attachments 20 are to be attached to the patient's teeth. The clinician can then use the etching template 16 as a guide to clean and prepare the tooth surface for the attachments 20. Typically, preparing the tooth surface includes etching a surface layer of the tooth with an etching solution. Once etched, the adhesive can better adhere to the tooth surface. The etching template 16 can protect the surface of the patient's teeth from inadvertent exposure to the etching solution.

[0079] In the illustrated example embodiment, the etching template 16 includes a shell 174 that is configured similarly to the shell 22 of the template 12. In this regard, the shell 174 is formed with a plurality of cavities 176 that collectively define a rim 180. Each cavity 176 can be shaped to receive a particular tooth of the patient. The rim 180 defines an opening 182 in the shell 174 and defines the gingival margin of the shell 174. The teeth of the patient are received through the opening 182 into their respective cavities 176.

[0080] To conform to the teeth of the patient, the shell 174 has wall portions that contact certain surfaces of the teeth of the patient. For example, the wall portions include a bite wall 184, a labial wall 186, and a lingual wall 190. The shell 174 can also include a distal wall 192 that surrounds the cavities 176 that receive the distal molar teeth. The location and orientation of each of the walls 184, 186, 190, and 192 can be consistent with the corresponding walls 40, 42, 44, and 50 of the template 12. As such, the etching template 16 is received on the teeth of the patient in the same orientation as the template 12 is received on the teeth of the patient.

[0081] With continued reference to FIG. 13 In one embodiment, the shell 174 includes one or more windows 194 formed in the labial wall 186 of the shell 174. The windows 194 are positioned in the locations of the receptacles 52 of the template 12 when the attachments 20 are secured to the teeth of the patient. In this regard, the clinician can use the windows 194 as a guide to clean and prepare the tooth surface for the attachments 20. Typically, preparing the tooth surface includes etching a surface layer of the tooth with an etching solution. Once etched, the adhesive can better adhere to the tooth surface. The etching template 16 can protect the surface of the patient's teeth from inadvertent exposure to the etching solution. FIG. 13In the illustrated example embodiment, the etching template 16 includes seven windows 194. Each of these windows 194 is formed in the labial sidewall 186. The windows 194 open to the respective corresponding cavities 176 and are generally shaped like the area of the bonding surface 28 of the attachment 20 on the patient's teeth. However, the shape of the windows 194 is not limited to the illustrated rectangular shape. Further, embodiments of the present application are not limited to the etching template 16 having seven windows 194 as illustrated. It is contemplated that more or fewer windows 194 can be used, for example, one window 194. However, the number of windows 194 can be equal to the number of receptacles 52 in the template 12. The formation of the windows 194 in the shell 174 is not particularly limited by any method. For example, the windows can be shaped or machined (e.g., punched) in the shell 174.

[0082] In use, the etching template 16 is inserted over the patient's teeth. The windows 194 are generally aligned with the locations on the teeth where the attachments 20 are to be attached. The clinician can then prepare the tooth surfaces at the specific areas indicated by the windows 194. Once each tooth has been prepared, the etching template 16 is removed and the template 12 is positioned over the patient's teeth in accordance with embodiments of the present application. The attachments 20 (or dental composite 164) are then adhered to the teeth at the prepared areas. When the attachments 20 are adhered to the patient's teeth or the dental composite 164 is cured, the template 12 is removed and the aligner 14 is coupled to the patient's teeth so that orthodontic treatment can begin.

[0083] While this application has been described in connection with various embodiments thereof, it will be understood that the application is capable of further modifications. This application is intended to cover any variations or equivalents of the described embodiments that come within the scope of the claims. Thus, the application is not intended to be limited to the embodiments described herein but is to be accorded the full scope of the claims, wherein in the claims, means-plus-function clauses are to be construed to cover the structures described herein for performing the function and their equivalents.

Claims

1. An orthodontic appliance system for orthodontic treatment of patients' teeth, the system comprising: A template comprising a housing having at least one cavity configured to receive a tooth, the housing having a plurality of walls defining the at least one cavity, the plurality of walls being configured to conform to at least portions of one or more surfaces of the tooth, at least one of the plurality of walls including a receiving portion opening toward the at least one cavity; as well as An accessory, removably housed in the receiving portion, and having one or more surfaces including an adhesive surface exposed to the at least one cavity and for bonding to a tooth.

2. The system according to claim 1, wherein, The attachment is a solid object.

3. The system according to claim 1 or 2, wherein, At least one of the plurality of walls is a lip wall.

4. The system according to any one of the preceding claims, further comprising: An orthodontic appliance configured to apply tooth movement force to the tooth, the appliance comprising a housing having at least one cavity configured to receive the tooth, the housing having a plurality of walls defining the at least one cavity, the plurality of walls being configured to conform to at least portions of one or more surfaces of the tooth, at least one of the plurality of walls including a receiving portion opening toward the at least one cavity and being configured to receive the attachment when the attachment is bonded to the tooth. The housing of the orthodontic appliance is located at a position relative to the corresponding wall among the plurality of walls of the template.

5. The system according to any one of the preceding claims, further comprising: An etching template comprising a housing having at least one cavity configured to receive the tooth, the housing having a plurality of walls defining the at least one cavity, the plurality of walls being configured to conform to at least portions of one or more surfaces of the tooth, at least one of the plurality of walls including a window through which the surface of the tooth can be contacted when the etching template is placed on the tooth.

6. A method for manufacturing a template for orthodontic treatment of a patient's teeth, the method comprising: A mold of the patient's teeth is provided, the mold having at least one protrusion in the shape of at least one of the patient's teeth; Secure the attachment to at least one of the protrusions; A sheet is formed on the at least one protrusion and the attachment to form a deformable region in the sheet, the deformable region having a plurality of walls defining at least one cavity and a receiving portion configured to receive the patient's tooth; as well as The plate is removed from the at least one protrusion while the at least one accessory is retained in the receiving portion.

7. The method according to claim 6, wherein, Before securing the attachment, the method further includes: Provide the aforementioned attachments; and The accessory is placed on the patient setting card at the position corresponding to at least one of the patient's teeth in the patient's mouth.

8. The method according to claim 6, wherein, Before securing the attachment, the method further includes: Provide the aforementioned attachments; and Apply adhesive to the accessory. Attaching the accessory to the at least one protrusion includes bonding the accessory to the at least one protrusion.

9. The method according to claim 6, wherein, Before securing the attachment, the method further includes: Provide the aforementioned attachments; Place the accessory on the patient setting card at the position corresponding to at least one of the patient's teeth; Pick up the accessory from the said location; and Apply adhesive to the accessory. Attaching the accessory to the at least one protrusion includes bonding the accessory to the at least one protrusion.

10. The method according to any one of claims 6 to 9, wherein, Before securing the attachment, the method further includes: The accessory was 3D printed.

11. A method of manufacturing an orthodontic appliance system for orthodontic treatment of a patient, the method comprising: Construct a support assembly, the support assembly including a base, one or more pillars and / or beams extending from the base, and attachments extending from the one or more pillars and / or beams; The template is placed in contact with the support assembly, the template including a first housing having at least one cavity configured to receive a tooth, the first housing having a plurality of walls defining the at least one cavity, the plurality of walls being configured to conform to at least portions of one or more surfaces of the tooth, at least one of the plurality of walls including a receiving portion opening toward the at least one cavity, wherein placement includes inserting the attachment into the receiving portion; and Separate the attachment from the one or more pillars and / or beams. During separation, the attachment remains coupled to the template in the receiving portion.

12. The method according to claim 11, wherein, Constructing the scaffold assembly includes 3D printing the scaffold assembly.

13. The method according to claim 11 or 12, wherein, The one or more pillars and / or beams extend at non-orthogonal angles relative to the base.

14. The method according to any one of claims 11 to 13, wherein, Placing the template involves orienting the template relative to the base at a non-orthogonal angle, such that the accessory is accommodated in the receiving portion.

15. The method according to any one of claims 11 to 14, wherein, Placing the template includes temporarily attaching the attachment to the receiving portion.

16. The method according to any one of claims 11 to 15, wherein, The support assembly includes a weak region between the attachment and the one or more pillars and / or beams, and separation includes disconnecting the one or more pillars and / or beams from the attachment at the weak region.

17. The method according to any one of claims 11 to 16, wherein, Separation includes cutting the one or more pillars and / or beams near the attachment.

18. The method according to any one of claims 11 to 17, further comprising: A second housing is provided, the second housing having at least one cavity configured to receive the tooth, the second housing having a plurality of walls defining the at least one cavity, the plurality of walls being configured to conform to at least portions of one or more surfaces of the tooth; as well as A window is machined in at least one of the plurality of walls, the window being positioned to expose the surface of the tooth when the housing is positioned on the patient's tooth.

19. The method according to any one of claims 11 to 18, further comprising: Multiple orthodontic appliances are provided for use by the patient.

20. A method of manufacturing an orthodontic appliance system for orthodontic treatment of a patient, the method comprising: A mold of the patient's teeth is provided, the mold having at least one protrusion in the shape of at least one of the patient's teeth, the at least one protrusion including a through channel; The container of the dental composite material is positioned in fluid communication with the through channel; The template is placed on the at least one protrusion, the template comprising a housing having at least one cavity configured to receive a tooth, the housing having a plurality of walls defining the at least one cavity, the plurality of walls being configured to conform to at least portions of one or more surfaces of the tooth, at least one of the plurality of walls including a receiving portion opening toward the at least one cavity, wherein placement includes aligning the receiving portion with the through channel; Injecting dental composite material from the container through the through-channel into the receiving portion; and Remove the template from at least one protrusion having the filled receiving portion.

21. The method according to claim 20, wherein, The injection involves injecting a predetermined amount of dental composite material into the receiving portion.

22. The method of claim 20 or 21, further comprising: Place a foil film on the already filled container.

23. The method according to any one of claims 20 to 22, further comprising: The template was placed in a light-proof container before transportation.

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