jaw contour anchoring

Abstract

Orthodontic correction devices can have a palatal contour anchorage (PCA) feature that generally matches the shape of a patient's hard palate. This PCA feature can be slightly offset in construction to intentionally push against the patient's palate and / or gums to provide anchorage support for the staged translation of the teeth. With the PCA feature, the required anchorage is transferred from the teeth to the palate, and adjacent teeth are no longer subject to the unwanted side effects of reactive forces.

Description

[0001] This application is a divisional application of Alain Technologies Ltd.’s invention patent application (filed on July 20, 2018, application number 201880061673.4, invention title “Jaw Contour Anchoring”).

[0002] Cross-references to related applications

[0003] This application claims priority to U.S. Provisional Application No. 62 / 535,751, filed July 21, 2017, which is incorporated herein by reference in its entirety for all purposes.

[0004] By incorporating via reference

[0005] All publications and patent applications mentioned in this specification are incorporated herein by reference to the same extent as if each individual publication or patent application were specifically and individually indicated to be incorporated herein by reference. Technical Field

[0006] Embodiments of the present invention generally relate to dental instruments for manipulating teeth, and more generally to dental instruments that apply force to both teeth and jaws and / or gums to manipulate teeth. Background Technology

[0007] Many dental treatments involve repositioning uncorrected teeth and altering the bite structure to improve cosmetic appearance and dental function. Orthodontic repositioning can be accomplished, for example, by applying controlled forces to one or more teeth over a period of time.

[0008] Examples of orthodontic repositioning that can occur during a dental procedure include the use of one or more positioning dental appliances (such as braces) to realign teeth. Placing the appliance on the teeth provides controlled forces at specific locations to gradually move the teeth into a new configuration. Repeating this process with successive appliances of progressive configuration allows the teeth to be moved through a series of intermediate arrangements to the final desired arrangement.

[0009] The goal is to provide a dental appliance that moves teeth to the next progressive segment while minimizing unwanted tooth movement. Summary of the Invention

[0010] The present invention generally relates to dental appliances for manipulating teeth, and more generally to dental appliances that apply force to both teeth and jaws and / or gums to manipulate teeth.

[0011] Any of the methods and devices described herein may include: a tooth contact portion (e.g., a tooth portion or a tooth receiving portion) that applies force to a tooth received therein; and an anchoring portion that applies a reaction force to at least a portion of the gingiva and / or palate in the patient's oral cavity, the reaction force at least partially balancing the force applied to the patient's tooth or multiple teeth through the tooth portion.

[0012] For example, this document describes an orthodontic appliance comprising: a dental portion having a dentition receiving cavity configured to be placed on one or more teeth of a patient, the dental portion being configured to contact one or more predetermined surfaces of one or more teeth of the patient when the dental portion is placed on one or more teeth of the patient; an anchoring portion extending from the dental portion, the anchoring portion having a profile matching a surface profile of at least a portion of the patient's gingiva and / or palate within the patient's oral cavity, wherein said portion of the gingiva and / or palate within the patient's oral cavity is selected from the group consisting of: hard palate, soft palate, buccal gingiva, and lingual gingiva; wherein the anchoring portion is configured to apply a reaction force to said at least a portion of the gingiva and / or palate within the patient's oral cavity, said reaction force at least partially balancing the force applied by the dental portion to the patient's teeth or teeth when the dental portion is placed on one or more teeth of the patient.

[0013] Typically, the anchoring portion can be configured to disperse reaction forces such that the amount of force applied to any discrete parts of the gums and / or jaw is limited to below a threshold, preventing damage (including necrosis) to these tissues when the device is worn for extended periods. However, in general, the force applied by the anchoring portion can be large enough to counteract the force applied by the tooth portion. For example, the anchoring portion can have a sufficiently large surface area to disperse reaction forces, such that the anchoring portion is configured to apply less than a predetermined amount of pressure to the gums and / or jaw.

[0014] Therefore, typically, a predetermined amount of pressure (and / or a predetermined amount of force) can be a force and / or pressure (or a threshold force and / or pressure, above which damage will occur) that causes tissue damage to the gums and / or jaw in the patient's oral cavity. Tissue damage can be capillary damage, peeling, necrosis, etc.

[0015] The profile of the anchor portion typically matches, at least partially, the surface profile of a portion of the hard palate and / or gingiva. For example, the profile of the anchor portion may match the surface profile of a portion of the buccal gingiva. The profile of the anchor portion may match the surface profile of a portion of the lingual gingiva.

[0016] Any device described herein may also be used with one or more additional anchoring or securing devices, including, but not limited to, temporary anchoring devices (TADs). For example, the anchoring portion may include a temporary anchoring device housing for receiving a portion of the implanted temporary anchoring device.

[0017] As mentioned, the dental portion may include one or more anchorage receptacles configured to receive anchors that have been attached to one or more teeth of the patient.

[0018] This document also describes methods for moving one or more teeth of a patient using any of the orthodontic appliances described herein. For example, a method for moving one or more teeth of a patient may include: placing a dental region of the orthodontic appliance on one or more teeth of the patient, wherein the dental region includes a concave surface for receiving one or more teeth of the patient, wherein the orthodontic appliance further includes an anchoring portion extending from the dental region and conforming to the patient's jaw; applying one or more forces to one or more teeth of the patient with the dental portion; applying a reaction force to a portion of the patient's gingiva and / or jaw with the anchoring portion, said reaction force at least partially balancing the one or more forces applied by the dental portion, wherein the patient's gingiva and / or jaw is selected from the group consisting of: hard jaw, soft jaw, buccal gingiva, and lingual gingiva; and moving one or more teeth of the patient.

[0019] In any of these methods, the method may include distributing reaction forces over a sufficiently large surface area of ​​the patient's gums and / or jaw to avoid or reduce damage to the patient's gums and / or jaw.

[0020] The steps of applying one or more forces with an orthodontic appliance may include applying a distalizing force configured to move one or more teeth distally. A reaction force may be applied to the hard palate. Applying one or more forces with an orthodontic appliance may include applying a rotational force configured to rotate the teeth. A reaction force may be applied to the lingual or buccal gums. Applying one or more forces with an orthodontic appliance may include applying a compressive force to one or more teeth. A reaction force may be applied to the hard palate. Alternatively or additionally, a reaction force may be applied to the hard palate to push one or more anterior teeth outward.

[0021] The steps of applying one or more forces with an orthodontic appliance may include applying tilting forces to one or more teeth.

[0022] In some variations, one or more forces applied to the patient's teeth by the orthodontic appliance, along with reaction forces, can be used to pull the patient's maxilla forward.

[0023] This document also describes methods for manufacturing any of the orthodontic appliances described herein. For example, a method for manufacturing an orthodontic appliance may include: receiving data, said data including a three-dimensional representation of the patient's teeth, gingiva, and jaw within the patient's oral cavity; generating a model of the patient's teeth, gingiva, and jaw within the patient's oral cavity using the received data; determining, based on the generated model of the patient's teeth, a force to be applied to one or more teeth to move one or more teeth in a desired direction; determining, based on the determined force applied to one or more teeth and the generated model of the patient's teeth, gingiva, and jaw within the patient's oral cavity, one or more locations on the gingiva and / or jaw within the patient's oral cavity for balancing the force applied to the one or more teeth; determining the shape of the orthodontic appliance based on the generated model of the patient's teeth, gingiva, and jaw within the patient's oral cavity, the determined force applied to one or more teeth, and the determined reaction force applied to one or more locations on the gingiva and / or jaw within the patient's oral cavity; and manufacturing the orthodontic appliance based on the determined shape.

[0024] For example, a method for manufacturing an orthodontic appliance may include: generating a digital model of a patient's teeth and jaw and / or gingiva within a patient's oral cavity, wherein each tooth is a separate object capable of independent movement in the digital model, and wherein the jaw and / or gingiva are also separate objects; generating an ordered sequence of stages of tooth positions, wherein the ordered sequence of stages includes stages of initial tooth positions, multiple stages of multiple intermediate tooth positions, and stages of final tooth positions; determining multiple first forces that can be applied to the teeth by the orthodontic appliance to move the teeth from one stage to the next stage; and determining whether the multiple first forces that can be applied to the teeth by the orthodontic appliance to move the teeth from one stage to the next stage include moving one or more teeth along an undesirable path. The orthodontic appliance is used to move one or more teeth in the desired direction. If the multiple first forces include one or more forces that move one or more teeth in the undesired direction, the appliance is used to determine whether one or more forces applied to the jaw and / or gingiva by the orthodontic appliance can be used to replace or counteract one or more forces that move one or more teeth in the undesired direction, and to generate multiple second forces that can be applied to the teeth in combination with one or more forces applied to the jaw and / or gingiva. The shape of the orthodontic appliance is determined based on the multiple first forces applied to the teeth by the orthodontic appliance or the multiple second forces applied to the teeth in combination with one or more forces applied to the jaw and / or gingiva. The orthodontic appliance is manufactured based on the determined shape to move the teeth from one stage to the next.

[0025] Any of these methods may further include determining the level of pressure applied to the jaw and / or gingiva by the orthodontic appliance when the patient wears it. For example, the method may include modifying the shape of the orthodontic appliance when the determined level of pressure applied to the jaw and / or gingiva by the orthodontic appliance exceeds a set or predetermined level, wherein the modified shape of the orthodontic appliance reduces the level of pressure applied to the jaw and / or gingiva below the set or predetermined level.

[0026] Modifying the shape of an orthodontic appliance may include increasing the size of the portion of the appliance that is configured to contact the palate and / or gums.

[0027] The method may also include a stage of manufacturing a series of orthodontic appliances to sequentially move teeth from their initial positions to their final positions.

[0028] In any of the devices and methods described herein, the predetermined amount of pressure can be pressure that causes pain in the gums and / or jaw of the patient's oral cavity.

[0029] For example, in some embodiments, the predetermined pressure can be less than 5 MPa to 90 MPa. In other embodiments, the predetermined pressure can be less than 200 gf / mm² to 1500 gf / mm².

[0030] In any of the apparatuses and methods described herein, the predetermined pressure can be the pressure typically applied to the jaw tissue by dentures. For example, the pressure can be as high as approximately 4 kPa to 350 kPa.

[0031] This article also describes an orthodontic system comprising: a plurality of dental appliances configured to be sequentially applied to a patient's dentition and gingiva and / or palate, each dental appliance comprising: a dental portion having a dentition receiving cavity configured to be placed on one or more of the patient's teeth, the dental portion being configured to contact one or more predetermined surfaces of the patient's one or more teeth; an anchoring portion extending from the dental portion and configured to adjoin at least a portion of the patient's gingiva and / or palate within the patient's oral cavity, wherein said portion of the gingiva and / or palate within the patient's oral cavity is selected from the group consisting of: hard palate, soft palate, buccal gingiva, and lingual gingiva; wherein the anchoring portion is configured to apply a reaction force to at least a portion of the gingiva and / or palate within the patient's oral cavity, said reaction force at least partially balancing the force applied by the dental portion to the patient's teeth or teeth when the dental portion is placed on one or more of the patient's teeth; wherein the anchoring portions of two sequentially applied dental appliances are configured to contact different portions of the patient's gingiva and / or palate. Attached Figure Description

[0032] The novel features of the present invention are specifically set forth in the appended claims. A better understanding of the features and advantages of the invention can be obtained by referring to the following detailed description and accompanying drawings, which illustrate illustrative embodiments utilizing the principles of the invention, wherein:

[0033] Figure 1A A cross-sectional view of a dental appliance is shown, the dental appliance having (1) a tooth receiving portion having a tooth receiving cavity and (2) a palatal / gingival contour anchoring (PCA) feature that generates a compressive force for compressing one or more teeth.

[0034] Figure 1B Showing the combination with the above Figure 1A A cross-sectional view of another embodiment of a dental appliance similar to the described embodiment, but with additional stress relief features.

[0035] Figure 1C yes Figure 1A and Figure 1B The cross-sectional view of the dental appliance shown illustrates how offsets along the x, y, and / or z axes are used to control the position of the contact area on the jaw surface.

[0036] Figure 2 An embodiment of a dental appliance having a tooth receiving portion and a PCA feature is shown, the PCA feature generating a distal force for displacing one or more teeth distally.

[0037] Figure 3 An embodiment of another dental appliance 300 that can be applied to the maxillary and mandibular arches to rotate teeth is shown.

[0038] Figure 4A and Figure 4B An embodiment of another dental appliance that can be applied to the maxillary and mandibular arches to rotate teeth is shown.

[0039] Figure 5 A cross-sectional view showing an embodiment of a dental appliance that can be used to tilt teeth (particularly posterior molars) inward or outward.

[0040] Figure 6 Examples of dental appliances that can be used for mandibular advancement and / or repositioning (such as moving the mandible or maxilla forward or backward) are shown.

[0041] Figure 7 An embodiment of a dental appliance that can be used to rotate teeth is shown.

[0042] Figure 8 An embodiment of a dental appliance is shown, which can be used to push the anterior teeth outward by applying force to the front portion of the hard palate.

[0043] Figure 9A and Figure 9B This demonstrates how one type of dental appliance can be used to produce two different types of tooth movement, depending on the specific construction of the device.

[0044] Figure 10 Another embodiment of a dental appliance that can be used to rotate teeth is shown.

[0045] Figure 11 This is a flowchart illustrating a computer-implemented method for manufacturing dental appliances.

[0046] Figure 12 This is a flowchart illustrating another computer-implemented method for manufacturing dental appliances.

[0047] Figure 13 It is a graph showing the relationship between force and time for the limits of tissue damage or stimulation.

[0048] Figure 14 It is a digital model of the patient's jaw and dentition, constructed by digitally scanning the patient's jaw and dentition.

[0049] Figure 15 This demonstrates how teeth can be moved in stages while maintaining jaw geometry at rest. Detailed Implementation

[0050] In some embodiments, dental appliances for orthodontic treatment include a palatal / gingival contour anchoring (PCA) feature that substantially conforms to the shape of a portion of the patient's hard palate, soft palate, buccal gingiva, and / or lingual gingiva. This PCA feature is designed to be constructed slightly offset when worn by the patient to intentionally push against the patient's hard palate, soft palate, buccal gingiva, and / or lingual gingiva to provide anchoring support for phased translational movement of the teeth, for example, in vertical push-in, vertical push-out, intermediate, buccal, lingual, and / or distal directions. By transferring the desired anchoring from the teeth to the hard palate, soft palate, buccal gingiva, and / or lingual gingiva via the PCA feature, adjacent teeth are no longer subjected to undesirable reactive forces or are subjected to a reduced amount of undesirable reactive forces, thereby reducing tooth movement in undesirable directions.

[0051] In some embodiments, the dental application is an orthodontic appliance for correcting a patient's teeth. The appliance may be an orthodontic appliance, such as a transparent shell appliance having a dental receiving cavity that can be placed on one or more of the patient's teeth. Additionally, the appliance may include one or more PCA features. The dental receiving cavity is sized and shaped to fit onto one or more teeth to contact one or more of the patient's teeth, and when the dental receiving cavity is placed on one or more of the patient's teeth, applies force to one or more predetermined surfaces of the patient's one or more teeth. The PCA feature may extend from the dental receiving cavity and has a profile that matches the surface profile of at least a portion of the gingiva and / or palate within the patient's oral cavity. The hard palate, soft palate, buccal gingiva, and / or lingual gingiva may be used to provide anchorage for the PCA feature.

[0052] When the device is worn on the teeth by a patient, the PCA features apply a reaction force to at least a portion of the gingiva and / or palate in the patient's oral cavity, the reaction force at least partially balancing the force applied to the patient's teeth or teeth by the dental arch receiving cavity.

[0053] Typically, PCA features can have a sufficiently large surface area to disperse reaction forces, such that the PCA features are configured to apply less than a predetermined amount of pressure to the gingiva and / or palate. The predetermined amount of pressure can be pressure that causes pain, irritation, or tissue damage (such as capillary damage, inflammation, peeling, or necrosis) to the gingiva and / or palate within the patient's oral cavity.

[0054] In some embodiments, the pressure applied by the PCA feature is less than about 90 MPa. In other embodiments, the pressure is less than about 5 MPa to 90 MPa, or less than any value within that range. In some embodiments, at the lower end of this range (i.e., 5 MPa), pressure can be applied to the palate for up to 2 weeks before irritation or tissue damage occurs, while a pressure of 90 MPa can rapidly cause irritation or tissue damage. In some embodiments, the device may have a PCA feature that distributes the load across the gingiva and / or palate and applies pressure below a maximum threshold of 90 MPa. In some embodiments, i.e., in which the load is applied between 5 MPa and 90 MPa or less than 5 MPa and 90 MPa, the location where the load is applied to the palate and / or gingiva by the PCA feature may be periodically changed, such as between applications of a sequential device, so that specific locations on the palate and / or gingiva are not subjected to a substantial amount of pressure that could cause tissue irritation and / or damage for a considerable period of time.

[0055] In some embodiments, the applied pressure is selected to be below the patient's pressure pain threshold (PPT). In some embodiments, the PPT is between approximately 200 gf / mm² and 1500 gf / mm². In some embodiments, the pressure level that can be applied using the PCA feature in the jaw position is approximately four times that in the cheek position before reaching the PPT threshold.

[0056] The limits of tissue damage and / or irritation can be illustrated as follows, where the limits are a function of the magnitude of the force / pressure and the duration of the applied force / pressure, as shown in the figure. Figure 13 As shown, the force / pressure applied by the PCA feature is plotted against the time of application. Figure 13 As shown, the higher the applied force / pressure, the shorter the time required before tissue damage and / or irritation occurs; conversely, the lower the applied force / pressure, the longer the time required to cause tissue damage or irritation. Based on this force / pressure and time relationship, it can be determined that, for PCA characteristics requiring a specific force / pressure, the frequency of load application on the jaw and / or gingiva should be varied. For example, for a device applying 5 MPa, the load application location should be changed at least every 2 weeks.

[0057] In some embodiments, the applied pressure is selected to be within the range of pressure exerted by the filling on the palatal tissues (e.g., the crest of the palate, the middle palate region, the palatal region, the mandibular region, and the crest of the mandible, for example) during various activities such as chewing food. In these embodiments, the pressure can be between approximately 4 kPa and 350 kPa. For example, to compress all the upper teeth, a force of approximately 56 N is required (4 N per tooth x 14 teeth). Applying a force of 46 N using a PCA feature with a contact area of ​​approximately 20 mm x 20 mm will result in a pressure of approximately 130 kPa applied to the contact area (assuming all the force applied by the PCA feature can be used for compression), which is well within the range applied by the filling during use. Compressing fewer teeth with the same size contact area reduces the applied pressure, and reducing the contact area of ​​the PCA feature increases the pressure applied to the contact area for a given force. The size, location, and orientation of the PCA contact area can be determined based on a calculated force required to perform the desired tooth movement and the target pressure to be applied by the PCA feature.

[0058] For example, Figure 1AA cross-sectional view of a dental appliance 100 is shown, the appliance having (1) a tooth receiving portion 102 with a dentition receiving cavity 104 and (2) a PCA feature 106, the PCA feature being formed and sized to press against the patient's jaw to generate a compressive force that is directed in the opposite direction and can be used to compress one or more teeth. The dentition receiving cavity 104 may have a reservoir 108 for receiving a tooth anchor 110, which may be attached to the patient's tooth and facilitate the application of the compressive force to the tooth. Alternatively or additionally, the dentition receiving cavity 104 may be sized and shaped to fit over the undercut of a tooth, such that the tooth receiving portion 102 can transmit the compressive force to the tooth via the undercut. Without the PCA feature 106, the compressive force would need to be balanced by applying a compressive reaction force to adjacent teeth.

[0059] Figure 1B Showing the combination with the above Figure 1A The described embodiments are similar to those of a dental appliance 100. Figure 1B In the illustrated embodiment, the dental appliance further includes a stress-relieving feature 112, which may be positioned on the appliance between the tooth receiving portion 102 and the PCA feature 106. In some embodiments, the stress-relieving feature 112 may be an accordion-like or spring-like engagement structure that may be slightly buckled, deformed, and / or compressed. This slight buckling can be helpful during initial insertion of the device by making it easier and more accurate to secure the receptacle 108 to the anchor 110. In some embodiments, the stress-relieving feature 112 may be made of a more elastic material than the rest of the appliance, and / or may be manufactured thinner than the rest of the appliance. Additionally, the stress-relieving feature 112 may also function as a suspension to provide a safety mechanism that alleviates high loads and helps to distribute the load evenly over the desired portion of the jaw surface.

[0060] Figure 1C yes Figure 1A and Figure 1B The illustrated cross-sectional view of the dental appliance 100 shows how the offset of the PCA feature 106 along the X, Y, and / or Z axes relative to the jaw can be used to control the position of the jaw surface contact area. For example, in order to perform such... Figure 1A and Figure 1BAs illustrated in the tooth compression diagram, an offset of a portion of PCA feature 106 along the vertical Z-axis can cause the offset portion on the corresponding region of the maxilla to apply pressure as anchorage. As the vertical offset increases, the pressure applied to the jaw increases. To specify and / or change the location where the vertically offset portion applies pressure on the jaw, X-axis and / or Y-axis offsets can be applied to the Z-axis offset portion of the PCA feature when manufacturing the next appliance in a series of appliances for moving the tooth. X- and Y offsets allow the anchorage location to change between successive appliances, which reduces the duration of force / pressure applied to a specific portion of the jaw, thereby reducing the risk of irritation and / or damage to the jaw tissue.

[0061] Figure 2 An embodiment of a dental appliance 200 applicable to the maxillary and mandibular arches for distalizing teeth is shown. The dental appliance 200 may have a tooth receiving portion 202 and a PCA feature 206 that conforms to and applies pressure to the anterior portion of the hard palate to generate a distalizing force that can be used to distalize one or more teeth, such as molars. The size and shape of the tooth receiving portion may be configured to closely conform to the tooth to be moved, such that the force can be effectively transmitted to the tooth. Alternatively or additionally, a tooth anchor may be attached to the tooth, and a receptacle for receiving the tooth anchor may be added to the tooth receiving portion 202 to aid in the transmission of the distalizing force to the tooth. In the absence of the anterior PCA feature 206, the intermediate reaction force caused by molar movement that would have been transmitted to the PCA feature 206 will instead be transmitted to the adjacent molar.

[0062] Figure 3 An embodiment of a dental appliance 300 applicable to the maxillary and mandibular arches to rotate teeth is shown. The dental appliance may have a tooth receiving portion 302 and a PCA feature 306 extending from a gingival incision in the tooth receiving portion. The PCA feature 306 may conform to the lingual gingiva and be used to anchor a first-order (z-rotational) reaction force that balances the first-order rotational force applied by the tooth receiving portion 302 to rotate the teeth. Although the PCA feature 306 is shown conforming to the lingual gingiva, in some embodiments, the PCA feature 306 may alternatively conform to the buccal gingiva to generate rotational force in the opposite direction. This type of PCA feature is generally referred to herein as a tab or tab feature. Figure 3 As shown, PCA feature 306 extends from the portion of the tooth receiving portion 302 that covers the molar, so PCA feature 306 can also be referred to as a molar pad.

[0063] Figure 4A and Figure 4BAn embodiment of another dental appliance 400, which can be applied to the maxillary and mandibular arches to rotate teeth, is shown. The dental appliance may have a tooth receiving portion 402 and a PCA feature 406 extending from a gingival incision in the tooth receiving portion. The PCA feature 406 may conform to the facial / buccal gingiva and be used to anchor a first-order (z-rotational) reaction force that balances a first-order rotational force applied through the tooth receiving portion 402 to rotate the teeth. Figure 3 and Figure 4A and Figure 4B The dental instruments shown can be used to rotate teeth in either direction.

[0064] Figure 5 A cross-sectional view is shown of an embodiment of a dental appliance 500 that can be used to tilt teeth (particularly posterior molars) inward or outward. The dental appliance 500 may have a tooth receiving portion 502 and a PCA feature 506, the size and shape of which are configured to conform to the palate and / or lingual gingiva. In some embodiments, the PCA feature may press against the sides of the palate and / or lingual gingiva to generate outward and / or inward forces on the teeth to tilt them outward and / or inward. In some embodiments, the PCA feature does not apply sufficient force to the palate to cause palatal expansion.

[0065] Figure 6 An embodiment of a dental appliance 600 that can be used for mandibular advancement and / or repositioning (such as moving the mandible or maxilla forward or backward) is shown. The dental appliance may have a tooth receiving portion 602 and a PCA feature 606, in which case the PCA feature is a mandibular repositioning and / or advancement feature, its size and shape configured to conform to the maxilla and / or tongue and / or buccal gingiva. The dental appliance 600 may also have a pair of wings 608 extending from opposite sides of the tooth receiving portion 602, extending laterally and toward the mandible. The wings 608 may extend from the posterior portion of the receiving molar of the tooth receiving portion 602. The dental appliance can be worn on the lower dentition together with the complementary pair of wings extending laterally and toward the maxilla. As described herein, the appliance for the lower dentition can be an orthodontic appliance having wings and optionally a PCA feature extending above the gingiva. The dental appliance on the mandible may have a PCA feature whose shape and size conform to the tongue and / or buccal gingiva. When the mouth is closed, the two pairs of wings lock together to force the lower jaw to align with the upper jaw as desired, such as by moving the lower jaw forward. The PCA feature can help counteract and / or distribute the forces generated by the wings to the palate and / or gums, rather than applying all the forces to the teeth.

[0066] Figure 7An embodiment of a dental appliance 700 that can be used for rotating teeth is shown. The dental appliance may have a tooth receiving portion 702 and a PCA feature 706 that conforms to at least a portion of the maxilla. As shown, the tooth receiving portion 702 receives only one pair of molars on each side, but in other embodiments, the tooth receiving portion 702 may receive fewer or more teeth or all the teeth in the maxilla. The dental appliance 700 functions similarly to Figure 3 The dental appliance 300 shown, except that the PCA feature 706 extends to cover the palate rather than a relatively small flap-type feature, allows the PCA feature 706 to be applied by offsetting one or more discrete portions having the PCA feature 706 from the natural contours of the gingiva and / or palate, such that when worn, the offset portions push against the gingiva and / or palate to apply force. Figure 3 The force exhibited by the flaps is similar to that of the teeth. This force can be used to balance the force required to rotate the teeth.

[0067] Figure 8 An embodiment of a dental appliance 800 is shown, which can be used to push anterior teeth outward by applying force to the anterior portion of the hard palate. The dental appliance 800 may have: a tooth receiving portion 802 for receiving teeth such as molars and serving as an anchor; and a PCA feature 806 sized and shaped to conform to the palate and apply pressure to the anterior portion of the hard palate when the patient wears the device. As shown, the PCA feature 806 may cover both the hard and soft palates, but in other embodiments discussed below, it may cover only the hard palate.

[0068] Figure 9A and Figure 9B This illustrates how a type of dental appliance 900 can be used to produce two different types of tooth movement, depending on the specific construction of the device. The dental appliance 900 has a tooth receiving portion 902 and a PCA feature 906, the PCA feature being sized and shaped to conform to and apply pressure to the hard palate, particularly the anterior portion of the hard palate. Figure 9A As shown, if a considerable number of molars are received by the tooth receiving portion 902 to act as anchors, the pressure applied by the PCA feature 906 can be used to push out the anterior teeth while causing minimal or no movement of the molars. Alternatively, as Figure 9B As shown, if a relatively small number of teeth (such as molars) are received by the tooth receiving portion 902, the pressure applied to the anterior portion of the hard palate by the PCA feature 906 can be used to displace the posterior teeth received by the tooth receiving portion 902. Figure 9BAs shown, a tooth anchor can be fixed to a tooth, and a corresponding tooth anchorage 908 can be included in the tooth receiving portion 902 to improve force transmission to the tooth and improve the stability of the device on the tooth. Generally, the fewer teeth received by the tooth receiving portion 902, the greater the movement of the received teeth due to the applied force. Conversely, since the force is distributed across a large number of teeth, this reduces the force applied to each tooth individually, thus using more teeth as anchors results in less tooth movement.

[0069] Figure 10 An embodiment of a dental appliance 1000 is shown, which can be used to rotate teeth and interact with... Figure 7 The illustrated embodiment is similar, but with an additional PCA feature to provide additional leverage. The dental appliance 1000 may have a tooth receiving portion 1002 and a PCA feature 1006 that conforms to at least a portion of the maxilla. As shown, the tooth receiving portion 1002 receives only one pair of molars on each side, but in other embodiments, the tooth receiving portion 1002 may receive fewer or more teeth or all teeth in the maxilla. The function of the dental appliance 1000 is similar to... Figure 7 The dental appliance 700 shown is similar, but has one or more additional PCA features 1008, 1009 extending around additional adjacent teeth, such as premolars. The additional PCA features 1008, 1009 may extend around the adjacent teeth on the lingual gingiva as shown and / or may extend around the adjacent teeth on the buccal gingiva and serve to provide additional leverage to balance the applied forces used to rotate the teeth.

[0070] All the different types of PCA features described in this article can be used alone or in combination to achieve various types of tooth movement. Because PCA features are low-profile, they generally do not interfere with the tongue and can be applied to the mandibular arch, lingual or buccal gingiva, and both the hard and soft palate. The application, location, size, and shape of facial / buccal PCA features, as well as other PCA features described herein, can be varied and combined as needed to improve prescribed treatment. For example, combining facial PCA features with lingual PCA features can be used to assist first-order or z-axis rotations. PCA features can be placed under the crown or in the interdental (IP) region (i.e., the space between the crowns), or both can be used in combination. The size (i.e., surface area) and shape of PCA features can be designed according to the required anchoring system and can be symmetrical or asymmetrical.

[0071] These PCA features can be used to enhance existing solutions used in dental appliances, such as attachments, tongue root torque (LRT), precision cutting, occlusal bevels, etc., or designed as stand-alone solutions to minimize, reduce or eliminate the need to use existing solutions.

[0072] For example, PCA features can be used to enhance existing orthodontic schemes, thereby providing anchoring features for individual segments of the orthodont (i.e., for example, such as...). Figure 2 As shown, the compression anchoring feature is located on the front section of the orthosis.

[0073] In some embodiments, the facial / buccal flaps of the orthodontic appliance may include precise cutting features. In some embodiments, the orthodontic appliance may include one or more flaps to minimize or reduce appliance deformation by transferring some of the force from the appliance to the flaps through anchoring to adjacent crowns.

[0074] LRT (Low-Range Thermodynamics) is used to generate a type of tangential tilt where the tooth rotates using the crown cusp as the center of rotation (i.e., the root swings when the crown is stationary). LRT enhancements include minimizing the need to open / deform the appliance and / or reduce extreme appliance track activation by increasing appliance stiffness. Additional anchorage can be provided by extending the appliance through PCA (Positive-Cut Aspect) features or by adding material below the crown portion of the appliance, so that the appliance does not open or deform. For example, the appliance can be trimmed longer so that its edges extend beyond the gingival line.

[0075] A lower ridge placement can be achieved by adding material beneath the crown (i.e., extending the edge of the aligner beyond the gingival line), which prevents a portion of the device from being cut off (e.g., unintentionally cutting the device during manufacturing if a portion is placed too close to the gingival line), thus eliminating the need for a large gap with the gingival line. By extending the length of the aligner beyond the gingival line and further repositioning the trim, this feature (i.e., the PCA feature) is less likely to be accidentally cut off.

[0076] Adding anterior jaw contour anchor below the anterior occlusal ramp allows occlusal forces to be distributed from the orthodontic appliance onto the PCA feature, which reduces unwanted appliance deformation.

[0077] Orthodontic appliances with PCA features can be used as standalone appliance programs and can replace attachments for patients presenting well. As described in this article, first-order tooth rotation can be achieved using a combination of facial / buccal anchorage and lingual anchorage to generate torque using the crown surface. Third-order torque can be generated by strategically placing anchorage features to modify appliance stiffness and combining them with staged configurations to influence the torque-to-force (M / F) ratio. For example, Figure 7This demonstrates support for mid-distal tilt control. As described herein, tooth squeezing can be achieved by using anchoring features to generate appropriate reaction and squeezing forces, increasing stiffness in the appliance, and using undercutting and staged compression to achieve squeezing forces. As described herein, the M / F ratio is a biomechanical value that describes the type of 3D body movement an object will experience when one or more forces are applied. “Torque” = torque of force = torque = force x distance. Typically, in the applications described herein, an M / F ratio of 0 causes body translation of the tooth, while an M / F ratio of 10 causes, for example, crown tilting.

[0078] The advantages of PCA include: (1) the anchorage is not from adjacent crowns, which minimizes or reduces unwanted brace reaction forces on adjacent teeth; (2) it can increase the stiffness of the brace in the strategic direction, thereby improving the brace's ability to move tooth segments; (3) it can be used to enhance existing brace programs and can be developed to minimize or replace them; (4) it does not require metal or manual repair wires for installation; (5) it is more comfortable, with a fully digital, custom organic design; (6) it can move teeth in a way that surpasses the expansion of rapid palatal expanders; (7) PCA can be phased in small, precise increments; and (8) PCA offset is calibrated to reduce tissue damage.

[0079] Equipment manufacturing

[0080] The design and manufacturing process, specifically tailored to the custom features of each patent, provides dynamic flexibility to alter the feature's position, size, and shape at specific stages of treatment. For example, the process allows for (1) displacement / movement of the anchoring position during treatment to reduce the time of contact between soft tissue and the orthosis, thereby minimizing stimulation; and / or (2) alteration of the anchoring position, shape, and / or size to adjust (based on force or pressure) during treatment to accommodate changes in the bow. Suitable manufacturing processes include additive manufacturing, one-piece thermoforming, one-piece direct printing manufacturing, two-piece hook-and-loop fasteners, two-piece acoustic welding, and two-piece adhesive bonding.

[0081] Figure 11 This is a flowchart illustrating a computer-implemented method for manufacturing dental appliances. The method can be implemented on a computer having a processor, memory, and software programmed to perform the following steps. In step 1100, the method begins by receiving data including a three-dimensional representation of the patient's teeth, gums, and jaw within the patient's oral cavity. For example, the patient's dentition and jaw can be digitally scanned and imaged, and the resulting data can then be sent to a computer, such as... Figure 14As shown. In step 1102, a model of the patient's teeth, gums, and jaw within the patient's oral cavity is generated using the received data. In step 1104, the force applied to the teeth to move them in the desired direction and amount is calculated. In step 1106, reaction forces applied to one or more locations on the gums and / or jaw within the patient's oral cavity are calculated to balance the forces applied to one or more teeth. In step 1108, based on the generated model of the patient's teeth, gums, and jaw, the calculated forces applied to the teeth, and the calculated reaction forces applied to one or more locations on the gums and / or jaw, the shape of the orthodontic appliance is determined. In step 1110, the orthodontic appliance is manufactured based on the determined shape.

[0082] Figure 12 This is a flowchart illustrating another computer-implemented method for manufacturing dental appliances. The method begins in step 1200 by generating a digital model of the patient's teeth and jaw and / or gingiva, wherein each tooth is a separate object that can be moved independently within the digital model, and the jaw and / or gingiva are also separate objects that can be moved independently. As described above, the patient's dentition and jaw can be digitally scanned and imaged, and the resulting data can be sent to a computer, such as... Figure 14 As shown. In step 1202, while keeping the jaw geometry static, an ordered sequence of stages for generating tooth positions is generated, as follows. Figure 15 As shown, the ordered sequence of stages includes stages for the initial position of the teeth, multiple stages for multiple intermediate positions of the teeth, and stages for the final position of the teeth. In step 1204, the force that can be applied to the teeth by the orthodontic appliance to move the teeth from one stage to the next stage is calculated. In step 1206, the method checks whether the force includes one or more forces that cause one or more teeth to move in an undesirable direction. If not, the method continues to step 1208 to manufacture the orthodontic appliance to move the teeth from one stage to the next stage without any PCA features. If yes, the method continues to step 1210 and checks whether one or more forces applied to the jaw and / or gingiva are used to replace or counteract one or more forces that cause one or more teeth to move in an undesirable direction. If no, the method continues to step 1212 to manufacture the orthodontic appliance to move the teeth from one stage to the next stage without any PCA features. If yes, the method continues to step 1214 to manufacture the orthodontic appliance to move the teeth from one stage to the next stage with PCA features.

[0083] The method described above may further include calculating the pressure level applied to the jaw and / or gingiva via the PCA feature when worn by a patient, and modifying the size and / or shape of the PCA feature when the determined pressure level applied to the jaw and / or gingiva exceeds a set or predetermined level. Modification of the size and / or shape of the orthodontic appliance may reduce the pressure level applied to the jaw and / or gingiva below the set or predetermined level.

[0084] Typically, the software workflow for manufacturing can be divided into seven steps: (1) dividing the teeth and jaw separately; (2) moving the teeth in stages; (3) assessing the force / torque required to move each tooth; (4) determining whether jaw segmentation is necessary; (5) calculating the force / torque transmitted on each tooth; (6) modifying the design of the appliance; and (7) building the appliance.

[0085] (1) Separately divide the teeth and jaw: The patient's teeth can be separate objects that can be moved independently. The patient's entire upper jaw can also be a separate object.

[0086] (2) Staged tooth movement: The patient's teeth are moved in stages according to the desired treatment plan.

[0087] (3) Assess the force / torque required to move each tooth as planned in the previous steps: Orthodontic experience based on phenomenological models can be used to determine the force to be applied to the teeth in order to move them in the desired direction using the following formula: (Fx,Fy,Fz,Mx,My,Mz)=f(Tx,Ty,Tz,Rx,Ry,Rz), where F = force (usually in Newtons), M = torque (usually in Newton-millimeters), T = translation axis (usually in millimeters), and R = rotation axis (e.g., usually segmented in degrees). For example, physical simulations can be performed using finite element analysis (FEA).

[0088] (4) Determine if jaw segmentation is necessary: ​​Consider whether the sum of forces or torques required for segmented tooth movement has an unbalanced force system that may produce undesirable side effects, and consider whether the movement will benefit from jaw anchoring support.

[0089] (5) The force / torque transmitted to each tooth by the appliance is calculated by modifying the appliance to include PCA features, the amount of activation applied to each tooth, and the local pressure applied to the palate or gingiva. The force can be determined using, for example, a computational model of an FEA-based orthodontic appliance, or by the method described in U.S. Patent No. 9,375,300, which is incorporated herein by reference in its entirety.

[0090] (6) Modify the design of the appliance by changing the following: activation amount, location, and amount of pressure applied to the palate and / or gingiva. Ensure that the applied pressure is within safe limits and falls within permissible ranges to avoid tissue damage. Ideally, the force is distributed over a sufficiently large area across the entire palate and / or gingiva to ensure that the risk of patient discomfort is minimized.

[0091] (7) Constructing instruments: Applying the shape of the jaw to each stage of the treatment and constructing instruments.

[0092] When a feature or element is referred to herein as being “on” another feature or element, it may be directly on the other feature or element, or there may be intermediate features and / or elements present. Conversely, when a feature or element is referred to as being “directly on” another feature or element, there are no intermediate features or elements present. It should also be understood that when a feature or element is referred to as being “connected,” “attached,” or “joined” to another feature or element, it may be directly connected, attached, or joined to the other feature or element, or there may be intermediate features or elements present. Conversely, when a feature or element is referred to as being “directly connected,” “directly attached,” or “directly joined” to another feature or element, there are no intermediate features or elements present. Although one embodiment has been described or illustrated, the features and elements thus described or illustrated can be applied to other embodiments. Those skilled in the art will also understand that a structure or feature mentioned as being “adjacent” to another feature may have portions overlapping with or located near the adjacent feature.

[0093] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the invention. For example, as used herein, the singular forms “a,” “an,” and “described” are also intended to include the plural forms unless the context clearly indicates otherwise. It will also be understood that when the terms “comprising” and / or “including” are used in this specification, they indicate the presence of the stated features, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term “and / or” includes any and all combinations of one or more of the associated listed items and may be abbreviated to “ / ”.

[0094] For ease of description, spatially relative terms such as “below,” “under,” “down,” “above,” “up,” etc., are used herein to describe the relationship of an element or feature to other elements or features as shown in the figures. It will be understood that, in addition to the orientations depicted in the figures, spatially relative terms are also intended to include different orientations of the device in use or operation. For example, if the device in the figures is inverted, an element described as “below” or “under” other elements or features would be oriented as “above” other elements or features. Thus, the exemplary term “below” can include both above and below orientations. Other ways of orienting the device (rotation 90 degrees or other orientations) may be taken, and the spatially relative descriptive terms used herein shall be interpreted accordingly. Similarly, unless otherwise specifically indicated, the terms “up,” “down,” “vertical,” “horizontal,” etc., are used herein for illustrative purposes only.

[0095] Although the terms “first” and “second” may be used herein to describe various features / elements (including steps), these features / elements should not be limited by these terms unless the context otherwise indicates. These terms may be used to distinguish one feature / element from another. Therefore, without departing from the teachings of the invention, the first feature / element discussed below may be referred to as the second feature / element, and similarly, the second feature / element discussed below may be referred to as the first feature / element.

[0096] Throughout this specification and the following claims, unless the context otherwise requires, the word “comprising” and variations such as “including” and “having” mean that various components (e.g., compositions and devices that include means and methods) may be used together in methods and articles. For example, the term “comprising” will be understood to imply the inclusion of any of the stated elements or steps, but does not exclude any other elements or steps.

[0097] As used herein in the specification and claims, including in the examples, and unless explicitly stated otherwise, all figures may be read as if they begin with the words “about” or “approximately”, even if the term is not explicitly stated. When describing magnitude and / or location, the phrases “about” or “approximately” may be used to indicate that the described value and / or location is within a reasonably expected range of value and / or location. For example, a numerical value may be + / - 0.1% of the stated value (or range of values), + / - 1% of the stated value (or range of values), + / - 2% of the stated value (or range of values), + / - 5% of the stated value (or range of values), + / - 10% of the stated value (or range of values), etc. Unless the context otherwise indicates, any numerical value given herein should also be understood to include approximately or approximately that value. For example, if the value “10” is disclosed, then “about 10” is also disclosed. Any numerical ranges described herein are intended to include all subranges contained therein. It should also be understood that, as those skilled in the art would appropriately understand, when a disclosed value is “less than or equal to” that value, it also discloses “greater than or equal to” that value and the possible range between values. For example, if the value “X” is disclosed, it also discloses “less than or equal to X” and “greater than or equal to X” (e.g., where X is a numerical value). It is also understood that throughout the application, data is provided in a variety of different formats, and that this data represents a range of endpoints and start points, as well as any combination of data points. For example, if a specific data point “10” and a specific data point “15” are disclosed, it should be understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15, as well as between 10 and 15, are considered to be disclosed. It should also be understood that each unit between two specific units is also disclosed. For example, if 10 and 15 are disclosed, it also discloses 11, 12, 13, and 14.

[0098] Although various illustrative embodiments have been described above, numerous changes can be made to the various embodiments without departing from the scope of the invention as described in the claims. For example, in alternative embodiments, the order in which the various method steps described are performed can often be changed, and in other alternative embodiments, one or more method steps can be skipped entirely. Optional features of various apparatus and system embodiments may be included in some embodiments, while they may not be included in others. Therefore, the foregoing description is provided primarily for illustrative purposes and should not be construed as limiting the scope of the invention as set forth in the claims.

[0099] The examples and illustrations included herein are shown by way of illustration, not limitation, of specific embodiments in which the subject matter can be practiced. As mentioned, other embodiments can be utilized and derived therefrom, allowing for structural and logical substitutions and changes without departing from the scope of this disclosure. These embodiments of the subject matter of the invention may be referred to individually or collectively herein by the term "invention," and are not intended to spontaneously limit the scope of this application to any single invention or inventive concept if, in fact, more than one has been disclosed. Therefore, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may replace the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of the various embodiments. Combinations of the above embodiments and other embodiments not specifically described herein will be apparent to those skilled in the art upon reading the above description.

Claims

1. An orthodontic device, the device comprising: A dental portion having a dental receiving cavity configured to be placed on one or more teeth of a patient, the dental portion being configured to contact one or more predetermined surfaces of one or more teeth of a patient to apply a distal force to move one or more teeth in a distal direction; as well as An anchoring portion extends from the tooth portion and is configured to adjoin at least a portion of the patient's jaw located within the patient's oral cavity, wherein the portion of the jaw located within the patient's oral cavity is selected from the group consisting of the hard jaw and the soft jaw. The anchoring portion includes a jaw contour anchoring feature offset from the jaw contour to apply pressure to the front of the jaw during wear and having a sufficiently large surface area to disperse the reaction force acting on the at least portion of the jaw located within the patient's oral cavity. The reaction force at least partially balances the force exerted by the dental portion on the patient's tooth or teeth when the dental portion is placed on one or more of the patient's teeth. The jaw contour anchoring feature does not apply a sufficient amount of force to the jaw to cause jaw expansion, and the shape and / or size of the orthodontic appliance is modified such that the level of force applied to the jaw and / or the patient's gingiva does not exceed a predetermined level.

2. The apparatus of claim 1 further includes a stress relief feature located between the jaw contour anchoring feature and the tooth portion.

3. The apparatus of claim 2, wherein, The stress relief feature is configured to buckle, deform, and / or compress to facilitate the initial insertion of the device.

4. The apparatus of claim 3, wherein, The stress relief features include folded or spring-like joint structures.

5. The apparatus according to claim 1, wherein, The anchoring portion has a profile that matches the surface profile of at least a portion of the patient's jaw located within the patient's oral cavity.

6. The apparatus of claim 1, wherein, The anchoring portion has a sufficiently large surface area to disperse the reaction force, such that the anchoring portion is configured to apply less than a predetermined amount of pressure to the jaw.

7. The apparatus according to claim 6, wherein, The predetermined pressure is the pressure that causes tissue damage to the jaw located inside the patient's mouth.

8. The apparatus of claim 7, wherein, The tissue damage refers to capillary damage, peeling, or necrosis.

9. The apparatus according to claim 1, wherein, The contour of the anchoring portion at least partially matches the surface contour of a portion of the hard jaw.

10. The apparatus of claim 1, wherein, The anchoring portion includes a temporary anchoring device housing for receiving a portion of the implanted temporary anchoring device.

11. The apparatus according to claim 1, wherein, The dental portion includes one or more anchorage receptacles configured to receive anchors already attached to one or more teeth of the patient.

12. A method for manufacturing an orthodontic appliance, the method comprising: Receive data, which includes a three-dimensional representation of the patient's teeth, gums, and jaw located within the patient's oral cavity; The received data is used to generate a model of the patient's teeth, gums, and jaw located inside the patient's mouth; Based on the generated model of the patient's teeth, determine the force applied to one or more teeth to move one or more teeth in a distal direction; Based on the determined force applied to one or more teeth and the generated model of the patient's teeth and jaw located in the patient's oral cavity, determine one or more locations on the jaw located in the patient's oral cavity to use the reaction force to balance the force applied to one or more teeth. and Based on a generated model of the patient's teeth and jaw located within the patient's oral cavity, the shape of the orthodontic appliance is determined by applying a defined force to one or more teeth and a defined reaction force to one or more locations on the jaw located within the patient's oral cavity, such that the reaction force is distributed through a jaw contour anchoring feature offset from the jaw contour to apply pressure to the jaw during wear and having a sufficiently large surface area to disperse the reaction force, the jaw contour anchoring feature not applying a sufficient amount of force to the jaw to cause jaw expansion; Modify the shape and / or size of the orthodontic appliance so that the level of force applied to the jaw and / or the gingiva does not exceed a predetermined level; as well as The orthodontic device is manufactured based on the determined shape.

13. The method of claim 12, further comprising forming a stress relief feature between a tooth portion having a cavity for receiving one or more teeth of a patient and the jaw contour anchoring feature.

14. The method of claim 12, further comprising determining the pressure level applied to the jaw by the orthodontic appliance when the patient wears the orthodontic appliance.

15. The method of claim 12, wherein, Modifying the shape of the orthodontic appliance includes increasing the size of the portion of the orthodontic appliance configured to contact the jaw.

16. The method of claim 12, further comprising a stage of manufacturing a series of orthodontic appliances to sequentially move teeth from an initial position to a final position.

17. An orthodontic appliance, the appliance comprising: The dental portion has a dental receiving cavity configured to be placed on one or more teeth of a patient, the dental portion being configured to contact one or more predetermined surfaces of one or more teeth of a patient; as well as An anchoring portion, extending from the tooth portion and configured to adjoin at least a portion of the patient's gingiva and / or palate located within the patient's oral cavity, wherein the portion of the gingiva and / or palate located within the patient's oral cavity is selected from the group consisting of: hard palate, soft palate, buccal gingiva and lingual gingiva; The anchoring portion includes a jaw contour anchoring feature offset from the jaw contour to apply pressure to the jaw during wear, and has a sufficiently large surface area to disperse reaction forces located on the gums and / or at least a portion of the jaw within the patient's oral cavity. These reaction forces at least partially balance the forces exerted by the dental portion on one or more of the patient's teeth when the dental portion is placed on one or more of the patient's teeth. The jaw contour anchoring feature does not apply sufficient force to the jaw to cause jaw expansion, and the shape and / or size of the orthodontic appliance is modified such that the level of force applied to the jaw and / or the gums does not exceed a predetermined level.

18. A method for manufacturing a series of orthodontic appliances, the method comprising: Receive data, which includes a three-dimensional representation of the patient's teeth, gums, and jaw located within the patient's oral cavity; The received data is used to generate a model of the patient's teeth, gums, and jaw located inside the patient's mouth; For each orthodontic appliance: Based on the generated model of the patient's teeth, determine the force to be applied to one or more teeth to move one or more teeth in the desired direction; Based on the determined force applied to one or more teeth and the generated model of the patient's teeth, gums, and jaw located in the patient's oral cavity, determine one or more locations on the gums and / or jaw located in the patient's oral cavity to use to balance the reaction force applied to one or more teeth. Based on a generated model of the patient's teeth, gums, and jaw located within the patient's oral cavity, a defined force is applied to one or more teeth, a defined reaction force is applied to one or more locations on the gums and / or jaw located within the patient's oral cavity, and the shape of the orthodontic appliance is determined based on the force / pressure and time relationship of the reaction force, such that the reaction force is distributed through a jaw contour anchoring feature with a sufficiently large surface area to disperse the reaction force, the jaw contour anchoring feature being offset from the jaw contour to apply pressure to the jaw during wear, the jaw contour anchoring feature not applying a sufficient amount of force to the jaw to cause jaw expansion; Modify the shape and / or size of the orthodontic appliance so that the level of force applied to the jaw and / or the gingiva does not exceed a predetermined level; as well as The series of orthodontic devices are manufactured based on the determined shape.

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