Tooth repositioning systems and methods

Abstract

Described is a tooth repositioning system and method that employs one or more braces mounted on the patient's teeth. The braces include: an arch member; a plurality of spring members coupled to or disposed on the arch member; and a plurality of fixing members for one-to-one fixing to a corresponding plurality of teeth of the patient, the fixing members being supported by the arch member. The arch member and the plurality of springs together comprise a two-dimensional structure having a length dimension and a width dimension with the width varying along the length dimension, the two-dimensional structure being bent into a three-dimensional structure.

Description

[0001] This application is a divisional application of an invention patent application whose applicant is Bryce Technology Co., Ltd., with an application date of December 6, 2016, application number 201680081315.0, and invention name is "Tooth Repositioning System and Method".

[0002] Cross-references to related patent applications

[0003] This application claims priority to each of U.S. Provisional Application No. 62 / 263,659, filed on December 6, 2015, U.S. Provisional Application No. 60 / 352,025, filed on June 20, 2016, and U.S. Provisional Application No. 62 / 393,526, filed on September 12, 2016, each of which is incorporated herein by reference in its entirety. Technical Field

[0004] Generally speaking, embodiments of the present invention relate to systems and methods for repositioning teeth, including orthodontic systems and methods that include or employ one or more appliances that are mounted (removably or non-removably) to the teeth of a patient. Background Art

[0005] In orthodontics, repositioning teeth for aesthetic or other purposes is performed with orthodontic devices traditionally known as braces. Braces typically consist of brackets, archwires, O-rings, and ligatures. In addition to braces, which typically have aligners on the front of the teeth, other methods include lingual orthodontics (which uses aligners behind the teeth) and clear aligners, such as Invisalign. TM Aligners (which use a clear polymer shell that goes over the teeth). Summary of the invention

[0006]

[0013] Embodiments described herein relate to systems and methods for repositioning teeth and include or employ one or more appliances mounted (either removably or non-removably) on the patient's teeth.

[0007] According to various embodiments, an orthodontic appliance for installation on a patient's teeth includes: an arch member; a plurality of spring members connected or arranged on the arch member; and a plurality of fixing members for fixing to a plurality of teeth of the patient, the fixing members being supported by the arch member. In these examples, the arch member and the plurality of springs together comprise a two-dimensional structure having a length dimension and a width dimension and a width varying along the length direction, and the two-dimensional structure is bent into a three-dimensional structure.

[0008] According to another example of an orthodontic appliance, each fixing member includes: (a) a separate corresponding male connector element that is configured to engage with one or more separate corresponding female connector elements that are bonded to one or more of the patient's teeth; or (b) a separate corresponding cover that is configured to fit over and onto one or more of the patient's teeth.

[0009] According to another example of a brace, when the brace is mounted on the patient's teeth, the arch member is constructed to correspond to the arch of the patient's jaw and extend along the arch of the patient's jaw; and when the arch member extends along the patient's jaw, each spring member is arranged along the arch member at a position between two teeth in the patient's jaw.

[0010] According to another example of an orthodontic appliance, further comprising a plurality of arms extending from the arch member, each arm being associated with one or more teeth of the patient, wherein each respective one of the plurality of fixing members is attached to at least one different respective one of the arms relative to each other fixing member. In such an example, each fixing member comprises: (a) a separate respective male connector element configured to engage with one or more separate respective female connector elements bonded to the one or more teeth of the patient; or (b) a separate respective cap configured to fit over and onto the one or more teeth of the patient.

[0011] According to another example orthosis, each respective one of the plurality of spring members is disposed along a different respective one of the arms relative to each other spring member.

[0012] According to another example of the orthosis, each spring member is provided on a corresponding one of the plurality of arms at a position between the arcuate member and a fixing member attached to the arm.

[0013] According to another example orthosis, each fixing member is separate from and does not cover any portion of the spring member of the arm to which the fixing member is attached.

[0014] According to another example of an orthodontic appliance, each fixing member includes a separate corresponding cover, and the cover is configured to fit over and onto one or more teeth of the patient when the orthodontic appliance is installed, so that the multiple fixing members include multiple covers arranged along the arch member, and each separate corresponding cover is separated from one or more other covers of the multiple covers.

[0015] According to another example appliance, each securing member includes a T-shaped member configured to engage a slot in a female connector element bonded to one of the patient's teeth.

[0016] According to other examples of embodiments, an orthodontic appliance for mounting on a patient's teeth includes: an arch member; a plurality of arms extending from the arch member, each arm being associated with a corresponding one of the patient's one or more teeth that is different relative to each other arm of the plurality of arms; and a plurality of fixing members for fixing to the patient's plurality of teeth, wherein each corresponding fixing member of the plurality of fixing members is attached to one or more arms.

[0017] According to another example of the orthosis of the above embodiment, each respective one of the plurality of fixing members is attached to a different respective one of the plurality of arms relative to each other one of the plurality of fixing members.

[0018] In another example of an orthodontic appliance according to the above embodiment, each fixing member includes: (a) a separate corresponding male connector element, which is configured to engage with one or more separate corresponding female connector elements, and the female connector elements are bonded to one or more teeth of the patient; or (b) a separate corresponding cover, which is configured to fit over and onto one or more teeth of the patient.

[0019] According to another example of the above embodiment, the corrector further includes a plurality of spring members, which are connected to one or more of the plurality of arms or are disposed on one or more of the plurality of arms, so that one or more of the arms include at least one spring member.

[0020] According to the orthosis of another example of the above-described embodiment, each spring member is provided on a corresponding one of the plurality of arms at a position between the arcuate member and the fixing member attached to the arm.

[0021] According to the orthosis of another example of the above-described embodiment, each fixing member is separated from and does not cover any portion of the spring member of the arm to which the fixing member is attached.

[0022] According to another example of an orthodontic appliance of the above embodiment, each fixing member includes a separate corresponding cover, and the cover is configured to fit over and onto one or more teeth of the patient when the orthodontic appliance is installed, so that the multiple fixing members include multiple covers arranged along the arch formed by the arch member, and wherein each separate corresponding cover is separated from one or more other covers of the multiple covers.

[0023] According to an example of an embodiment, a method for manufacturing an orthodontic appliance for installation on a patient's teeth includes: cutting a flat sheet into a two-dimensional shape structure having a length dimension and a width dimension and a thickness corresponding to the thickness of the sheet; bending the two-dimensional shape structure into a three-dimensional structure, the three-dimensional structure having an arch member and a plurality of spring members connected to the arch member or arranged on the arch member; supporting a plurality of fixing members on the arch member, the plurality of fixing members being used to be fixed to a plurality of teeth of the patient.

[0024] According to other example methods, each fixing member includes: (a) a separate corresponding male connector element that is configured to engage with one or more corresponding female connector elements that are bonded to one or more teeth of the patient; or (b) a separate corresponding cover that is configured to fit over and onto one or more teeth of the patient.

[0025] According to other example methods, when the braces are mounted on the patient's teeth, the arch member is constructed to correspond to the arch of the patient's jaw and extend along the arch of the patient's jaw; and when the arch member extends along the patient's jaw, each spring member is arranged along the arch member at a position between two teeth in the patient's jaw.

[0026] According to other example methods, cutting also includes cutting the flat sheet to form a plurality of arms extending from the arch member, each arm being associated with one or more teeth of the patient, wherein supporting the plurality of fixing members includes: positioning each corresponding fixing member of the plurality of fixing members on a different one or combination of arms relative to each other fixing member.

[0027] According to other example methods, each fixing member includes: (a) a separate corresponding male connector element that is configured to engage with one or more corresponding female connector elements that are bonded to one or more teeth of the patient; or (b) a separate corresponding cover that is configured to fit over and onto one or more teeth of the patient.

[0028] According to other example methods, each respective one of the plurality of spring members is disposed along a different respective one of the plurality of arms relative to each other spring member.

[0029] According to other exemplary methods, each spring member is disposed on a corresponding one of the plurality of arms at a location between the arcuate member and a fixed member attached to the arm.

[0030] According to other exemplary methods, supporting the plurality of fixing members includes supporting each fixing member in a position separate from and not covering any portion of the spring member of the arm to which the fixing member is attached.

[0031] According to other example methods, supporting multiple fixed members includes providing separate corresponding covers that are configured to fit over and onto one or more teeth of the patient when the braces are installed, and supporting each cover so that the cover is arranged along the arch member and so that each separate corresponding cover is separated from one or more other covers of the multiple covers.

[0032] According to other exemplary methods, supporting a plurality of securing members includes supporting a plurality of T-shaped members, each T-shaped member being configured to engage a slot in a female connector element bonded to one of the patient's teeth.

[0033] According to other examples, the method further includes: obtaining a three-dimensional image or template of a desired tooth arrangement of the patient's teeth; and

[0034] The three-dimensional image or template is converted into a two-dimensional image or template; wherein cutting the flat sheet into the two-dimensional structure includes cutting the flat sheet into a shape corresponding to the two-dimensional image or template.

[0035] According to other example methods, the planar sheet includes a Nitinol sheet.

[0036] According to other exemplary methods, the planar sheet includes a memory shape metal sheet.

[0037] According to other exemplary methods, at least one of a length dimension or a width dimension of the two-dimensional shape structure varies across the width or length of the two-dimensional shape structure. BRIEF DESCRIPTION OF THE DRAWINGS

[0038] Figure 1 is a perspective view of an orthosis according to an example of the first embodiment.

[0039] Figure 2 is a perspective view of a corrector according to another example of the first embodiment.

[0040] Figure 3 is a perspective view of a corrector according to another example of the first embodiment.

[0041] Figure 4a-4c is a perspective view of a spring for an orthotic device according to various examples of the first embodiment, the second embodiment, the third embodiment, and the fourth embodiment.

[0042] Figure 5 is a perspective view of a corrector according to another example of the first embodiment.

[0043] Figure 6 is a perspective view of a corrector according to another example of the first embodiment.

[0044] Figure 7is a perspective view of an upper jaw and a lower jaw with an example of a female connector element.

[0045] Figure 8 is a perspective view of an orthotic device according to an example of the second embodiment.

[0046] Fig. 9 is a perspective view of a corrector according to another example of the second embodiment.

[0047] Fig.10 is a perspective view of a corrector according to another example of the second embodiment.

[0048] Fig.11 is a perspective view of a corrector according to another example of the second embodiment.

[0049] Figure 12a-12h is a perspective view of components of a male connector element and arm for an orthosis according to another example of the second embodiment.

[0050] Fig.13a is a perspective view of an upper jaw with another example of a female connector element.

[0051] Fig.13b yes Fig.13a A perspective view of a female connector element of the type shown.

[0052] Fig.14 is a perspective view of a corrector according to another example of the second embodiment.

[0053] Fig.15a is a plan view of an example of a male connector element.

[0054] Fig.15b is a perspective view of another example of a female connector element.

[0055] Fig.15c It is bonded to a tooth Fig.15a The male connector element connects to the Fig.15b A perspective view of a female connector element.

[0056] Fig.16a is a front view of an example of a male connector element for an orthosis.

[0057] Fig.16b It is possible to Fig.16a A perspective view of an example of a female connector element used together with a male connector element.

[0058] Fig.16c is based on Fig.16a and Fig.16b A perspective view of an example of a male connector element housed within a female connector element.

[0059] Fig.17a is a perspective view of a rectifier or a component of a rectifier according to another example of the first embodiment.

[0060] Fig.17b yes Fig.17a A stereoscopic view of an appliance mounted on a plurality of teeth with female connector elements bonded to the teeth.

[0061] Figure 18a-18d These are stereograms and plan views of the components and two-dimensional (2D) representations of the orthotic device.

[0062] Fig.18e and Fig.18f is a perspective view of an orthotic device according to an example of the second embodiment, Figure 18a-18d components and representations to construct.

[0063] Figure 19a-19b is a perspective view of a tool and components for manufacturing an orthotic device according to a third embodiment.

[0064] Fig.19c According to the third embodiment Figure 19a-19b A stereoscopic view of the manufactured orthosis.

[0065] Fig. 20 is a flow chart of a process for manufacturing an orthosis according to various embodiments.

[0066] Fig.21 is a flow chart of another process for making an orthosis according to various embodiments.

[0067] Fig.22a is a schematic diagram of an orthosis according to a third embodiment in a passive state.

[0068] Figure 22b is a schematic diagram of an orthodontic appliance according to a third embodiment connected to teeth and in an active state.

[0069] Fig.23a is a schematic diagram of an orthosis according to a fourth embodiment in a passive state.

[0070] Figure 23b is a schematic diagram of an orthodontic appliance according to a fourth embodiment connected to teeth and in an active state.

[0071] Fig.24 is a generalized schematic diagram of a processing system that can be used to implement certain examples of the embodiments.

[0072] Fig.25 is a front view of an example of a T-shaped male connector element.

[0073] Figure 26a-26f Shows acceptance or is used to accept, for example but not limited to Fig.25 A perspective view of an example of a female connector element with a T-shaped male connector element of the type shown in FIG.

[0074] Fig.27a and Figure 27b are front views of two examples of annular male connector elements.

[0075] Fig.28 is engaged with the female connector element Fig.27a Front view of the male connector element. DETAILED DESCRIPTION

[0076] In the following description of various embodiments, reference is made to the accompanying drawings which form a part of the description, in which are shown by way of illustration specific embodiments in which the invention may be practiced. It should be understood that other embodiments may be utilized and structural changes may be made without departing from the scope of the various embodiments disclosed in this disclosure.

[0077] Embodiments described herein relate to systems and methods for repositioning teeth. Specific embodiments relate to systems and methods for repositioning teeth from an original tooth arrangement (OTA) to a desired final tooth arrangement (FTA). In certain embodiments, tooth repositioning can be accomplished in a single step using one appliance. In other embodiments, tooth repositioning involves multiple steps that are performed incrementally using multiple appliances. Embodiments involving multiple steps (or multiple appliances or both) may include one or more intermediate tooth arrangements (ITAs) between the original tooth arrangement (OTA) and the desired final tooth arrangement (FTA).

[0078] Certain embodiments use a non-sliding mechanism where one or more aligners can be installed behind the teeth for patients where aesthetics are important. Other embodiments may employ other suitable mechanisms to install one or more aligners behind or in front of the patient's teeth, or both behind and in front of the patient's teeth. The decision whether to place an aligner in front of or behind the teeth is typically made by a clinician, physician, or other trained personnel in conjunction with the patient.

[0079] Certain embodiments described herein include or employ fixed braces that cannot be removed by the patient once the braces are installed on the patient's teeth. Other embodiments described herein include or employ removable braces that can be selectively removed by the patient and installed on the patient's teeth. Embodiments that include or employ fixed braces may require or involve less patient cooperation and training than embodiments that include or employ removable orthodontic techniques.

[0080] Certain embodiments described herein can reduce the number of visits to clinicians by patients and the duration of clinician and patient visits. In addition, certain embodiments can reduce the total treatment time compared to traditional orthodontic procedures.

[0081] In certain embodiments described herein, the planning of tooth movement may be computerized, which may simplify the treatment process for the clinician and may improve treatment accuracy compared to traditional techniques.

[0082] One or more of the orthoses and methods described herein may include or be combined with one or more bone anchoring devices, but are not limited to temporary anchoring devices, mini-plates, implants, and the like.

[0083] The system or method according to the first embodiment includes or employs a pin and tube type brace. Certain pin and tube type braces have been used in conventional systems, such as the Begg brace system. The brace according to the first embodiment includes one or more springs between a male connector element and an adjacent male connector element. In some examples of the first embodiment, one or more springs are disposed between each male connector element and each adjacent male connector element. In other examples of the first embodiment, one or more springs are disposed between some pairs but not all pairs of adjacent male connector elements. For example, a rigid portion of the brace may be disposed between a pair or some pairs of adjacent male connector elements. In another example, one or more springs may be disposed between male connector elements that are not directly adjacent to each other. Each spring is a force generating component of the brace. In a particular embodiment, each spring is made of a flexible material, such as but not limited to a shape memory alloy, such as but not limited to Nitinol. In a particular embodiment, one or more springs or other portions of the brace (or the entire brace) are made of a flexible flat sheet (e.g., a shape memory alloy, such as but not limited to Nitinol), which is cut into a desired two-dimensional shape and then bent into a desired three-dimensional shape of the brace. In such embodiments, the two-dimensional shape can be configured to a desired width as well as length, which can provide additional design options compared to conventional bent wire brace systems in which a single diameter wire is bent and arranged into a desired shape. In certain embodiments, computerized design and manufacturing can be employed to design or construct the two-dimensional shape and / or bend the two-dimensional shape into the three-dimensional shape of the brace. In certain examples, each spring is designed using computerized design techniques, wherein the design takes into account which tooth is to be moved and the desired amount and direction of movement of the tooth.

[0084] In a first embodiment, the male connector element is configured to engage with a female connector element or bracket that is attached to the surface of the tooth. The size and / or shape of the female connector element or bracket can be customized for each tooth or for each patient (or for both). Alternatively, the female connector element or bracket can be configured to be applied to any patient or tooth (or a group of multiple patients or multiple teeth) and may not be customized for each tooth or patient. Any suitable female connector element that is configured to engage and secure with a male connector element on an orthodontic appliance can be used in the various embodiments described herein, including but not limited to the examples of female connector elements, traditional double brackets, self-ligating brackets, etc. described herein.

[0085] A system or method according to an example of the second embodiment includes or employs an appliance having a plurality of separate arms, the plurality of separate arms being configured to be connected to a corresponding plurality of patient teeth, wherein each arm of the appliance is configured to be connected to a corresponding tooth that is different relative to each other arm of the appliance. In other examples of the second embodiment, the appliance may include: an arm configured to be connected to a plurality of teeth; or a plurality of separate arms configured to be connected to a corresponding one of a plurality of teeth of a patient, or various combinations of arm-to-tooth connections as described herein. In such an example of the second embodiment, the appliance includes a single rigid rod to which each separate arm is attached. In other examples, the appliance includes more than one rigid rod, and one or more arms are attached to each rigid rod. One or more (or each) arms may include one or more springs. In a particular example, each arm (or each spring or both) may be designed using computerized design techniques, wherein the design takes into account which tooth is to be moved and the desired amount and direction of movement of the tooth.

[0086] In an orthosis according to the second embodiment, a separate respective male connector element may be formed on or otherwise attached to each respective arm, such as at an end of each arm opposite the end of the arm attached to the rigid rod. Each male connector element may be configured to engage with a respective female connector element or bracket.

[0087] Similar to the first embodiment described above, the female connector element or bracket of the second embodiment can be customized in size and / or shape for each tooth or for each patient (or for both). Alternatively, the female connector element or bracket can be constructed for application to any patient or tooth (or a group of multiple patients or teeth) and may not be customized for each tooth or patient. Unlike certain traditional orthodontic techniques in which all teeth are connected to a single archwire, which can cause unintentional movement of nearby teeth, certain embodiments described herein allow the clinician to control the movement of each tooth independently of other teeth.

[0088] In a specific example of the first and second embodiments, the female connector element is constructed as a double bracket (e.g., having a vertical slot and a transverse horizontal slot), and the male connector element is locked to the double bracket, wherein the male connector element is constructed as a T-shaped structure or wire that can be engaged in the slot of the double bracket. After engagement, the T-shaped structure of the male connector element can be fixed to the double bracket, for example, by a clinician when installing the aligner on the patient's teeth through one or more ligatures, O-rings or other suitable fixing mechanisms. In other examples, the female connector element is constructed as a self-ligating bracket, which can then "close" and firmly hold the T arm, with or without additional fixing mechanisms. In other examples, the female connector element and the male connector element have other suitable structures that allow those elements to be selectively connected and separated, with or without additional fixing mechanisms as described above.

[0089] A system or method according to a third embodiment includes or employs an appliance having a similar construction to that of the first embodiment, but also configured to be selectively removable to allow a patient (or clinician) to selectively install and remove the appliance from the patient's teeth. The appliance according to the third embodiment includes a plurality of aligner covers in place of the male connector element described above. Each aligner cover is configured to be fixed to a corresponding tooth by fitting over and onto the tooth. In other examples, one or more aligner covers may be configured to be fixed to a set of teeth for each cover. For example, the aligner cover may include an acrylic cover or a cover made of other suitable material, such as a material that helps to hold each cover to the patient's teeth. In certain embodiments, additional or alternative connector elements (such as, but not limited to, clasps or other attachment mechanisms) may be provided to help attach one or more (or each) covers to the corresponding teeth.

[0090] In a corrector according to the third embodiment, one or more springs may be disposed between adjacent calibrator covers. In certain examples of the third embodiment, one or more springs are provided between each calibrator and each adjacent calibrator cover. In other examples of the third embodiment, one or more springs are disposed between some pairs but not all pairs of adjacent calibrator covers. For example, a rigid portion of the corrector may be disposed between a pair of adjacent calibrator covers or some pairs of adjacent calibrator covers. In a further example, one or more springs may be disposed between calibrator covers that are not directly adjacent to each other. Each spring is a force generating component of the corrector. In a particular embodiment, each spring is made of a flexible material, such as, but not limited to, a shape memory alloy, such as, but not limited to, nitinol.

[0091] In a third embodiment, each cover can be customized in size and / or shape to correspond to the size and shape of a tooth (or multiple teeth) to which the cover is fitted. Alternatively, the aligner cover is constructed to be applied to any patient or tooth (or a group of multiple patients or multiple teeth), and is not customized for each tooth or each patient. In some examples of the third embodiment, each aligner cover can be individually connected to a support rod instead of being directly connected to any other cover for adjacent teeth. In other examples, one or more aligner covers can be connected to one or two adjacent aligner covers so that two or more aligner covers can be connected together along the arched structure of the support rod. This provides significantly greater flexibility for the brace according to the third embodiment, which can allow clinicians to complete treatment with fewer braces. In a specific example, each cover is associated with a single corresponding tooth (is configured to be fixed to a single corresponding tooth), and is individually attached to the support rod relative to each other cover of the brace, so that multiple separate covers are fixed to multiple separate teeth on a one-to-one basis. In other examples, one or more covers of the brace are configured to cover and fit (fixed to) multiple adjacent teeth. Such one or more caps configured to be secured to a plurality of adjacent teeth may be individually attached to the support rod, separate from one or more other adjacent caps of the appliance.

[0092] A system or method according to a fourth embodiment includes or employs an appliance having a similar construction to the second embodiment, but further configured to be selectively removable to allow a patient (or clinician) to selectively install and remove the appliance from the patient's teeth. Similar to the second embodiment, an appliance according to an example of the fourth embodiment has a plurality of separate arms configured to be individually connected to a corresponding plurality of teeth, wherein each arm of the appliance is configured to be connected to a different corresponding tooth relative to each other arm of the appliance. In another example of the fourth embodiment, the appliance may include: an arm configured to be connected to a plurality of teeth; or a plurality of separate arms configured to be connected to a corresponding one of the patient's teeth, or various combinations of arm-to-tooth connections as described herein. The appliance includes a single rigid rod to which each separate arm is attached. In other embodiments, the appliance includes more than one rigid rod, and one or more arms are attached to each rigid rod.

[0093] In place of the male connector element of the second embodiment, the aligner according to the fourth embodiment includes a separate respective aligner cap formed on or otherwise attached to each respective arm, for example at the end of each arm opposite the end of the arm attached to the rigid rod. The aligner caps of the fourth embodiment can be configured similarly to the aligner caps described herein for the third embodiment to be secured to the patient's teeth by fitting over and onto the teeth. However, the separate aligner caps of the fourth embodiment are attached to the ends of the separate respective arms.

[0094] Systems or methods according to the second and fourth embodiments, wherein the appliance includes a plurality of individual arms configured to be individually connected to a designated tooth or a corresponding plurality of teeth, can provide and control unique advantages in the movement of individual teeth. These advantages can enable clinicians to reduce the reciprocating movement of teeth, thereby reducing treatment time, root resorption, and the number of trips required for patients to see the orthodontist. Thus, compared to conventional orthodontic techniques in which multiple teeth are connected to a single archwire so that moving one tooth can result in unintended movement of nearby teeth, the specific embodiments described herein allow clinicians to control the movement of each tooth independently of each other tooth. Additional control can be provided in examples in which the appliance includes a temporary anchor device (TAD) retainer as described herein.

[0095] Systems or methods according to the third and fourth embodiments, wherein the aligner comprises a plurality of aligner covers configured to be secured to the patient's teeth by fitting over and onto the teeth, may provide the unique advantage of enabling the aligner to be easily removed by the patient or clinician in a manner similar to that done with conventional clear aligners.

[0096] In addition, the embodiments described herein allow for computerized design and manufacturing, for example, designing or custom constructing various aspects of one or more braces, including designing or customizing one or more of the width, thickness, shape, and spring tension or strength of each spring in the braces. Computerized design and manufacturing techniques can be used to design and / or manufacture each spring in a brace according to any embodiment, or each arm in a brace according to the second and fourth embodiments, based on which tooth or teeth are to be moved and the desired amount and direction of movement. In particular embodiments, computerization and / or manufacturing techniques of the shapes and features of the braces described herein may provide significant advantages over conventional pin-and-tube braces, including braces made from manually or machine-bent wires with "U"-shaped segments between adjacent pairs of teeth.

[0097] Using systems or methods according to embodiments described herein, translational orthodontic tooth movement is possible in one or more or all three directions in space (i.e., mesiodistal, buccolingual, and occlusal). Alternatively or in addition to translational movement of the teeth, one or more or all three rotational movements including torque, angle, and rotation (i.e., buccolingual root torque, mesiodistal angle, and mesio-external rotation) are also possible.

[0098] First embodiment

[0099] As described above, the system or method according to the first embodiment includes or employs a pin and tube type aligner. The aligner according to the first embodiment is constructed to be fixed to multiple (or all) teeth of the patient's upper or lower jaw. In a specific embodiment, the system and method according to the first embodiment is a non-sliding system and method that employs an aligner with a non-sliding mechanism. In some examples, the aligner according to the first embodiment can be manufactured after a three-dimensional (3D) digital OTA is rearranged as a 3D digital FTA, and the shape of the aligner configured to apply force on the patient's teeth is designed (through computer-aided design or other suitable design techniques) to move the teeth from the OTA to the FTA (or to the ITA, or from the ITA to the FTA or another ITA).

[0100] Examples of the orthodontic appliances 100, 200, and 300 according to the first embodiment are shown in Figure 1-Figure 3 The aligners 100, 200, and 300 (and components of the aligners) may be made of any suitable material, including, but not limited to, nitinol (NiTi), stainless steel, beta-titanium, cobalt-chromium or other metal alloys, polymers, or ceramics, and may be made as a single, unitarily formed structure, or alternatively, as multiple separately formed components connected together in a single structure.

[0101] exist Figure 1 In the exemplary embodiment, the aligner 100 includes an arch structure that is configured for the upper jaw (to conform to the arch of the patient's upper jaw). The aligner 100 does not include a palatal arch feature. Figure 2 The exemplary orthotic device 200 in FIG. Figure 1 appliance, but including the palatal arch feature 202. Figure 3The exemplary appliance 300 in includes an arch structure that is configured for the mandible (to conform to the arch of the patient's mandible) and includes a stable lingual arch feature 302. In other examples, the appliance according to the first embodiment can be configured for the mandible but without a lingual arch feature. Thus, some examples of the appliance according to the first embodiment include a palatal arch feature or a lingual arch feature, while other examples of the appliance according to the first embodiment can be configured without a palatal arch feature or a lingual arch feature. Typically, including a palatal arch feature or a lingual arch feature will depend on the type of dental malocclusion or the preference of the clinician (or both).

[0102] Figure 1-Figure 3 The examples of orthotics 100, 200, and 300 shown in FIG. 1 include a plurality of male connector elements and a plurality of spring members. Figure 1 The orthosis 100 includes a male connector element 104 , and spring members 106 and 108 . Figure 2 The orthosis 200 in FIG. 2 includes a male connector element 204 , and spring members 206 and 208 . Figure 3 The orthosis 300 in the embodiment includes a male connector element 304, and spring members 306 and 308. Each spring member is composed of a portion or segment of the orthosis 100, 200 or 300, which has the shape or configuration and elastic properties of a spring, such as to apply one or more tensions or pressures, to apply forces in one or more of three directions, to apply torques in one or more of three directions, or to absorb motion, or a combination thereof. Figure 1-Figure 3 In the example devices 100, 200 and 300 of the present invention, each spring member is disposed between a pair of adjacent male connector elements. In other examples, one or more spring members may be disposed between male connector elements that are not directly adjacent to each other. In other examples, one or more pairs of adjacent male connector elements on the orthosis may be connected by a rigid portion of the orthosis, rather than by a spring connection.

[0103] In the exemplary aligners 100, 200 and 300, a mesiodistal spring is included between the male element of the canine and the second premolar, for example, to pull one or two adjacent teeth toward another adjacent tooth ( Figure 1-Figure 3 In the orthodontic appliance 100, the mesiodistal spring is shown at "108". In the orthodontic appliance 200, the mesiodistal spring is shown at "208". In the orthodontic appliance 300, the mesiodistal spring is shown at "308". According to the first embodiment, one or two mesiodistal springs may be omitted from some other examples of the orthodontic appliance.

[0104] Figure 1-Figure 3The example shown includes a separate, corresponding male connector element for each separate corresponding tooth in the jaw to which it is secured. Figure 1-Figure 3 The example shown includes a separate respective spring located between each pair of adjacent male connector elements (and therefore, between each pair of adjacent teeth when the appliance is mounted on the patient). In other examples, an appliance according to the first embodiment may include fewer male connector elements than teeth in the jaw to which it is secured, or may have springs disposed between one or more, but not all, pairs of adjacent male connector elements. In general, the number and tooth locations of male connector elements and springs will depend on the desired tooth repositioning step or process, as determined, for example, by a clinician.

[0105] When the aligner 100, 200, or 300 is secured to the patient's teeth, the spring members 106 and 108, or 206 and 208, or 306 and 308 are configured to exert the necessary force on the teeth to move the teeth from their OTA to the desired FTA (either directly in one step, or, alternatively, in multiple steps via one or more ITAs). The spring members may be configured to move the teeth in one or more (or all three) translational directions. Alternatively or additionally, the spring members may be configured to move the teeth in one or more (or all three) rotational directions.

[0106] exist Figure 1-Figure 3 In the illustrated exemplary orthotics 100, 200, and 300, the spring members are shown as having a spiral or annular configuration, wherein the segments of the spring form one or more loops. In other examples, one or more (or all) of the springs may have other suitable shapes, such as, but not limited to, a U-shape (with one or more U-shaped segments). In certain examples, the springs are formed from curved segments of the overall arcuate structure of the orthotic. In other examples, the springs are formed as separate components that are attached to (or attached to form) the arcuate structure.

[0107] Examples of different U-shaped springs 400, 402, and 404 that may be employed in an orthotic device according to the first embodiment are described in Figure 4a-4c is shown in Figure 4a In the example of , the U-shaped spring 400 has an increasing thickness in the occlusal direction, which limits the flexibility of the orthosis in this direction. Figure 4b In the example of , the side of the spring 402 to be attached to the more misaligned tooth is thinner and more flexible than the rest of the spring. The spring can have varying thicknesses so that it is thinner (and more flexible) on the side where the tooth needs to be further displaced. Figure 4cIn the example of , the U-shaped spring 404 is configured to be thinner and more flexible in the oblique direction, which enables the adjacent teeth to move in the occlusal direction and the buccolingual direction simultaneously, for example, to move along a diagonal vector between the occlusal direction and the buccolingual direction.

[0108] In a specific example, the direction and magnitude of the force and torque applied by the spring depends at least in part on the shape, width, thickness and length of the spring. In such an example, the shape, width, thickness and length of each spring are selected and designed to produce the desired tooth movement and take into account the position of the spring on the braces (including the size and type of the teeth located between the connected springs). For example, the thickness and geometry of each spring can be selected or designed to increase the flexibility of the spring when the adjacent teeth need to be further displaced or when the size of the teeth (such as but not limited to the lower incisors) is small. In a specific example, a processing and software system with finite element analysis capabilities can be used to determine the optimal geometry and thickness of the spring, for example, for applying the selected force to accelerate tooth movement in one or more directions in the buccal-lingual direction, the occlusal direction and the mesio-distal direction.

[0109] Additional exemplary aligners 500 and 600 are provided in Figure 5 and Figure 6 Shown in. Figure 5 The exemplary appliance 500 in FIG. 1 is configured for use with teeth of the upper jaw and is similar to Figure 2 , but includes a plurality of U-shaped spring members 506 between adjacent pairs of male connector elements 504. Figure 6 The exemplary appliance 600 in FIG. 1 is configured for use with teeth of the mandible and is similar to Figure 3 , but includes a plurality of U-shaped spring members 606 between adjacent pairs of male connector elements 604.

[0110] In addition, the aligners 500 and 600 include mesiodistal springs 508 or 608 between male connector elements to be secured to female connector elements located on the canines and second premolars, for example, to close the gap formed by the extracted first premolars ( Figure 5 and Figure 6 The male connector elements 504 and 600 may have a configuration similar to that described herein. Figure 1-Figure 3The exemplary orthosis 500 includes a palatal arch feature 502, while the exemplary orthosis 600 includes a lingual arch feature 602. As described herein, the palatal arch feature 502 and the lingual arch feature 602 may be similar to the palatal arch feature 202 and the lingual arch feature 302, respectively. Other exemplary orthosis according to the first embodiment may not include a palatal arch feature or a lingual arch feature.

[0111] The aligners 500 and 600 may be designed to be used for the first or subsequent use of the aligner (for example, but not limited to, Figure 1-Figure 3 The aligners 100, 200, or 300 shown in the drawings are installed after the aligners 100, 200, or 300 have already moved teeth from the OTA to the ITA (or from one ITA to another ITA) and have subsequently been removed. Thus, the aligners 500 and 600 can be designed to move teeth from the ITA to the FTA (or to another ITA). Alternatively, the aligners 500 and 600 can be designed to move teeth from the OTA to the ITA, or from the OTA to the FTA, without changing the aligner at the ITA.

[0112] Figure 1-Figure 3 , Figure 5 and Figure 6 The exemplary orthotics 100, 200, 300, 500, and 600 shown in the drawings do not include an anchor retainer. However, in other examples, one or more anchor retainers, such as but not limited to anchor retainers 812 and 904 (in combination with Figure 8 and Fig. 9 ) may be included in the orthosis 100, 200, 300, 500 and 600 to allow the clinician to secure one or more temporary anchor devices TAD (or other suitable anchor devices) relative to the anchor device holders 812 and 904 as described herein.

[0113] Figure 1-Figure 3 , Figure 5 and Figure 6 The exemplary appliances 100, 200, 300, 500, and 600 shown in the drawings include a separate male connector element for securing to each separate corresponding tooth of the jaw to which the appliance is secured. In other examples, an appliance according to the first embodiment may be secured to fewer than all of the teeth in a jaw (or may include fewer male connector elements than the teeth in the jaw to which it is secured). For example, an appliance according to the first embodiment may be configured as a segmented appliance for moving some but not all of the teeth in a patient's jaw.

[0114] An example of such a situation is when only the front teeth are misaligned and need to be moved. In this example, the braces according to the first embodiment can be constructed with male connector elements that are used to connect to the front teeth in the jaw (rather than other teeth in the jaw). In other examples, the segmented type braces according to the first embodiment can be constructed to open a space for an implant or to align teeth that are tilted into an extraction space. In those examples, the braces according to the first embodiment can be constructed with male connector elements that are used to connect to one or more teeth that need to be moved to form the desired space or correct the tilt (rather than other teeth in the jaw).

[0115] As described above, the male connector element is configured to engage and connect to a female connector element or bracket attached to a tooth surface. Such a female connector element is attached to the tooth prior to installing the aligner 100, 200, 300, 500 or 600.

[0116] Various examples and configurations of male connector elements and associated female connector elements may be employed in various examples of the first embodiment (and other embodiments) described herein. Some examples of orthotics according to the first embodiment include Figure 1-Figure 3 , Figure 5 and Figure 6 The male connector element shown and described (for securing to a Figure 7 Other exemplary orthotics according to the first embodiment include Figure 8-12h The male connector element shown and described (for securing to a Fig.13a and Fig.13b Other orthotics according to the first embodiment include Fig.15a The male connector element described and shown (for fixing to a Fig.15a and Fig.15b Other orthotics according to the first embodiment include Fig.16a The male connector element described and shown (for fixing to a Fig.16a and Fig.16c Other exemplary orthotics according to the first embodiment include Fig.17a The male connector element described and shown (for fixing to a Fig.17b Other exemplary orthotics according to the first embodiment include Fig.18e and Fig.25 The male connector element described and shown (for fixing to a Figure 26a-26f Other exemplary orthotics according to the first embodiment include Fig.27a and Figure 27bThe male connector element described and shown (for fixing to a Fig.28 Other orthotics according to the first embodiment include male connector elements having other suitable configurations for securing to female connector elements having other suitable configurations.

[0117] exist Figure 1-Figure 3 , Figure 5 and Figure 6 In the example shown, each male connector element includes a generally wedge-shaped body having a wide end and a narrow end, the wide end extending from or otherwise attached to the arcuate structure of the aligner. The narrow end of each male connector element has a protrusion and a depression that engage with corresponding depressions and protrusions on the female connector element, respectively, when the aligner is mounted on the patient's teeth.

[0118] Figure 7 A representation of an OTA image of the patient's upper and lower jaws is shown with examples of female connector elements 700 attached to the lingual surfaces of the teeth on the upper and lower arches. The female connector elements 700 are attached to the teeth on the upper arch and similar female connector elements 700 are attached to the teeth on the lower arch. In other examples, for example, the female connector elements 700 can be attached to the buccal surfaces of the teeth if preferred by the clinician.

[0119] A separate respective female connector element 700 is secured to each respective tooth. According to the first and second embodiments described herein, the female connector element provides a connection interface to connect one or more aligners to the teeth. Figure 7 The figures in show all teeth in each jaw having female connector elements, but other embodiments may employ separate corresponding female connector elements on some but not all teeth in the upper or lower jaw (eg, at the clinician's option).

[0120] The female connector element 700 can be attached to the tooth by direct or indirect bonding or other suitable means to fix the element fixedly to the surface of the tooth. The bonding material may include an adhesive, such as but not limited to a composite resin. In the case of indirect bonding, the clinician can use a fixture to increase the accuracy of bracket placement. In a specific example, one or more (or all) female connector elements 700 are customized for each tooth in size or shape and are constructed to have a minimum profile (to minimize the dimension extending away from the tooth, i.e., the size in the buccal and lingual direction). Further examples can be constructed to minimize the size along the mesiodistal direction or the occlusal direction or a combination thereof. In an example where the female connector element 700 will be attached to the tooth by direct bonding, an intraoral scan or an impression of the arch can be performed after the female element is attached to the tooth. The impression or scan (or both) includes and therefore provides information that helps identify the position of the female connector element on the tooth. Clinicians, manufacturers, or technicians use this information in the design of the aligner, for example, to help identify the appropriate position on the aligner to place or form one or more male connector elements so as to properly align with one or more female connector elements on the tooth.

[0121] Figure 7 The female connector element 700 is configured to be connected to a Figure 1-Figure 3 , Figure 5 and Figure 6 The male connector element of the configuration shown in the exemplary orthosis 100, 200, 300, 500 and 600 in FIG. Figure 7 Each female connector element 700 in includes a generally wedge-shaped basket structure that is configured to receive a corresponding one of the generally wedge-shaped male elements 104, 204, 304, 504, or 604 when the aligner 100, 200, 300, 500, or 600 is mounted on the patient's teeth. The inner surface of each generally wedge-shaped basket structure has depressions and projections that engage with corresponding projections and depressions on the male connector element, respectively, when the male connector element is received in the generally wedge-shaped basket structure. In this manner, when the male connector element is received in the generally wedge-shaped basket structure, the male connector element (and, therefore, the aligner) is secured to the female connector element (and, therefore, to the tooth to which the female connector element is attached). In other examples, the female connector elements of the aligners 100, 200, 300, 500, and 600 may have other suitable configurations for engaging and securing to associated male connector elements, including but not limited to the configurations described with reference to Fig.13b , Fig.15b , Fig.16b , Fig.17b or Fig.26e Other examples described.

[0122] The orthosis according to the first embodiment and the female connector element associated with the first embodiment can be manufactured in any suitable manner (including but not limited to molding, casting, machining, 3D printing, stamping, extrusion, etc.). However, in a specific example, the orthosis or the female connector element (or both) according to the first embodiment is made by cutting a two-dimensional (2D) form of the orthosis from a 2D sheet and bending the 2D form into a desired 3D shape. As described below, these methods are particularly suitable for manufacturing orthosis according to the examples of the first embodiment described herein.

[0123] By cutting 2D components from flat sheets, rather than from conventional single diameter wire, a wider variety of 3D shapes can be made than shapes made by bending single diameter wire. The cut 2D components can have set or varying widths and lengths, so that when they are bent into the desired shapes, multiple parts of the 3D corrector can have variations in thickness, width, and length dimensions. In this way, when the 2D component is bent into a 3D shaped component of the corrector, it can be cut into a shape with the desired thickness, width, and length of the spring member, arm, or other component of the corrector.

[0124] exist Fig.17a Shown in the Figures are examples of 3D shaped components of a brace formed by bending a 2D component cut from a flat sheet. In a particular example, the sheet is Nitinol (NiTi). In other examples, the sheet can be any suitable material, such as but not limited to stainless steel, beta-titanium, cobalt-chromium or other metal alloys, polymers, or ceramics. In other examples (if practical for the desired brace shape), a brace according to the first embodiment can be constructed from wire that is bent or otherwise formed into a desired 3D shape.

[0125] Fig.17a The orthosis 1700 in the embodiment includes a male connector element 1702 formed as a relatively simple linear member that is configured to engage and secure to a Fig.17b The female connector element 1706 is shown. Fig.17b As shown, each female connector element 1706 includes a linear slot feature that receives a corresponding linear member of the male connector element 1702. In a particular example, the female connector elements 1706 can be a double bracket type connector.

[0126] Each male connector element 1702 is separated from each adjacent male connector element 1702 by a spring member 1704. In other examples, one or more male connector elements may be separated from one or two (or more) adjacent male connector elements by a rigid portion of the orthosis without a spring member. Fig.17aIn the example shown, each spring member 1704 has a generally U-shaped structure, as described herein. In other examples, one or more (or each) spring member 1704 can have another suitable shape, such as, but not limited to, other spring shapes shown and described herein or other shapes that can be cut from a flat sheet and bent into a 3D shape. In other examples, Fig.17a The orthosis 1700 may include other types of male connector elements (such as but not limited to those described herein). Figure 1-Figure 3 , Figure 5 , Figure 6 , Figure 8-12h , Fig.15a , Fig.16a , Fig.17a , Figure 18c-18f , Fig.25 , Fig.27a and Figure 27b The shape and type of spring member can be selected and configured, for example, to provide the desired movement and can be based at least in part on the type and size of the tooth to which the spring is to be connected.

[0127] Second embodiment

[0128] As described above, a system or method according to an example of the second embodiment includes or employs an appliance having a plurality of separate arms configured to be connected to a corresponding plurality of patient teeth, wherein each arm of the appliance is configured to be connected to a corresponding tooth that is different relative to each other arm of the appliance. In other examples of the second embodiment, the appliance may include: an arm configured to be connected to a plurality of teeth; or a plurality of separate arms configured to be connected to a corresponding one of the patient's teeth, or various combinations of arm-to-tooth connections as described herein. In some examples, after rearranging the 3D digital OTA as a 3D digital FTA, an appliance according to the second embodiment may be manufactured, and a shape of the appliance configured to apply forces on the patient's teeth to move the teeth from the OTA to the FTA (or to the ITA, or from the ITA to the FTA or another ITA) may be designed (via computer-aided design or other suitable design techniques).

[0129] Examples of the orthotics 800, 900, 1000 and 1100 according to the second embodiment are respectively Figure 8-Figure 11 The aligners 800, 900, 1000, and 1100 (and components of the aligners) may be made of any suitable material including, but not limited to, nitinol (NiTi), stainless steel, beta-titanium, cobalt-chromium or other metal alloys, polymers, or ceramics, and may be made into a single integrally formed structure, or alternatively may be made into a single structure with multiple separately formed components connected together.

[0130] Figure 8 and Fig.10 Each of the aligners 800 and 1000 can be configured to be mounted on the upper jaw of a patient. In a specific example, the aligner 800 or 1000 can be configured to help close the extraction space or adjust other tooth positions (or both) after the patient's first premolars are extracted. On the other hand, Fig. 9 and Fig.11 Each of the aligners 900 and 1100 may be configured to be mounted on a patient's mandible.

[0131] exist Figure 8 and Fig.10 In the embodiment, exemplary braces 800 and 1000 each include an arch bar 802 or 1002 configured for use in the upper jaw (conforming to the arch of the upper jaw of the patient). Braces 800 and 1000 each include a palatal arch feature 804 or 1004. In other examples, the palatal arch feature 804 or 1004 may be omitted.

[0132] Each of the orthoses 800 and 1000 includes a plurality of separate arms ( Figure 8 Arm 806 and Fig.10 Arm 1006 in. Figure 8 and Fig.10 The example shown includes twelve arms 806 or 1006 that are respectively and individually secured to twelve associated teeth on a one-to-one basis. In other examples, the appliance may have other suitable numbers of arms, including less than or more than twelve arms. The number of arms may be equal to the number of teeth in the jaw to be moved.

[0133] Each arm 806 on the brace 800 (and each arm 1006 on the brace 1000) can have the same configuration (length, shape, width, etc.) as each other arm of the brace, such as Figure 8 and Fig.10 Alternatively, some (or each) arms 806 of the aligner 800 (or some (or each) arms 1006 of the aligner 1000) may have a different configuration (length, shape, width, etc.) than some or each of the other arms of the aligner. In a particular example, the configuration, including the shape and size of each arm, may depend on the desired movement and size of the tooth to which the arm is to be secured (and may be different for different arms and teeth).

[0134] Each arm 806 (or arm 1006) has: one end extending from the rod 802 (or arm 1002) or otherwise connected to the rod 802 (or rod 1002); and a second end, on which a male connector element 808 (or male connector element 1008) is formed or otherwise connected. Thus, a separate corresponding male connector element is formed on each separate corresponding arm or otherwise connected to each separate corresponding arm. When the brace 800 (or 1000) is installed on the patient's teeth, each male connector element 808 is configured to engage with a corresponding female connector element or bracket. In a specific example, the male connector element is configured to be fixed to the female connector element bonded to the patient's teeth and remain fixed to the patient's teeth until the clinician removes the brace.

[0135] Each arm 806 (or arm 1006) has a spring member 810 (or spring member 1010) along its length. Figure 8 and Fig.10 In the examples of the present invention, the spring members 810 and 1010 are located at the ends of the respective arms 806 and 1006 (i.e., corresponding to the ends of the arms extending from or otherwise connected to the rods 802 or 1002, and opposite to the ends of the arms where the male connector elements 808 or 1008 are located). However, in other examples, the spring members 810 (or 1010) may be located at another position along the length of the arms 806 (or 1006), such as, but not limited to, in the middle of the length of the arms 806 (or 1006), or toward the ends of the arms where the male connector elements 808 or 1008 are located.

[0136] Spring members 810 and 1010 can have any suitable configuration and can be designed and manufactured to provide a force or torque (or both) in a desired direction or magnitude (or both). In certain examples, computer-aided design and manufacturing techniques can be used to design or construct (or both) the spring members. Spring members 810 and 1010 can have the same configuration on each arm of the orthosis, such as Figure 8 and Fig.10 Alternatively, the spring members on some (or each) arms 806 of the brace 800 (or some (or each) arms 1006 of the brace 1000) may include a different configuration than some or each other arm of the brace. The spring members 810 (or 1010) may be formed as a single integrally formed structure with the remainder of the arms 806 (or 1006), such as Figure 8 and Fig.10 Alternatively, the spring member 810 (or 1010) can be formed separately from the rest of the arm 806 (or 1006) and then coupled to the arm 806 (or 1006) after formation.

[0137] Figure 8 Each spring member 810 in the exemplary orthosis 800 of FIG. 8 is configured with multiple U-shaped segments along a portion of the length of its associated arm 806. In other examples, each spring member may include a single (no more than one) U-shaped segment, or more than one U-shaped segment. Figure 8 Fewer or larger U-shaped segments are shown in the examples.

[0138] Fig.10 Each spring member 1010 in the exemplary aligner 1000 of is configured with a spiral or annular segment that forms a single loop along a portion of the length of its associated arm 1006. In other examples, each spring member 1010 may include multiple loops along one or more segments of the length of its associated arm 1006. In other examples, other suitable spring configurations may be employed on one or more (or each) of the arms 806 or 1006. In other examples, more than one spring member (having the same or different configurations) may be included in each arm 806 or 1006. The geometry (size, shape, length, etc.) of the spring members and arms may be designed and selected according to and based on a variety of factors, including, but not limited to, the type or size of teeth, facial morphology, the type of malocclusion that needs to be addressed, and other factors unique to each patient.

[0139] As mentioned above, Figure 8 and Fig.10 The example devices 800 and 1000 shown in FIG. 1 include a palatine arch feature ( Figure 8 Palatal arch features 804 and Fig.10 The palatal arch features in 1004). Figure 8 and Fig.10 In the example shown, the palatal arch features 804 and 1004, each include a plurality of retainers 812 or 1012 for a corresponding plurality of anchoring devices, such as but not limited to screws or other temporary anchoring devices (TADs). Figure 8 and Fig.10 804 and 1004. In other examples, one, two, or more than three anchor retainers 812 or 1012 may be included on the palatal arch features 804 or 1004. In other examples, one or more anchor retainers may be disposed at other suitable locations on the appliance. In other examples, the anchor retainers 812 and 1012 may be omitted from the palatal arch features 804 and 1004. In particular examples, the inclusion, number, and location of the anchor retainers 812 and 1012 may depend, at least in part, on the type of malocclusion to be addressed and other factors specific to each patient.

[0140] One or more anchor retainers 812 and 1012 may be employed to receive or otherwise retain a TAD or other anchoring device that is secured to the patient's palate. Thus, if the clinician desires additional anchoring of the appliance, the clinician may decide to use one or more TADs. For example, the clinician may secure one or more implantable screws or other TAD structures to one or more anchor retainers 812 (or 1012) and to the patient's palate before or after the male connector element 808 (or 1008) of the appliance 800 (or 1000) is secured to the female connector element previously bonded to the patient's teeth. Figure 8 and Fig.10 In the example of the present invention, the anchoring device holders 810 and 1010 are in the shape of a ring or annulus with a central opening through which the length of the screw or other suitable TAD structure can extend to anchor the device to the patient's palate when the screw or other TAD structure is implanted in the patient's palate. Prior to implantation, the clinician can anesthetize the patient's palate area in which the TAD is to be implanted.

[0141] exist Fig. 9 and Fig.11 , exemplary appliances 900 and 1100 each include an arched bar 902 or 1102 that is configured for the mandible (to conform to the arch of the patient's mandible). Fig. 9 and Fig.11 The braces 900 and 1100 in do not include lingual arch support features. However, other examples may include lingual arch support features (e.g., but not limited to, similar to Figure 3 feature 302 in ).

[0142] Each of the braces 900 and 1100 includes two anchor retainers 904 or 1104 extending from the arch bar 902 or 1102 on the right and left sides of the brace. Each anchor retainer 904 or 1104 is configured to receive and retain a suitable anchor, such as, but not limited to, an implantable screw or other suitable TAD structure, for securing the brace to the lingual side of the mandible.

[0143] Although in Fig. 9 and Fig.11Two anchor retainers 904 or 1104 are shown in each of the embodiments, but in other examples, one or more than two anchor retainers 904 or 1104 may be included on the orthosis 900 or 110. In other examples, anchor retainers 904 and 1104 may be omitted from the orthosis 900 or 1100. In a particular example, the inclusion, number, type, and location of anchor retainers 904 and 1104 may depend at least in part on the type of malocclusion to be addressed and other factors specific to each patient. Each anchor retainer 904 or 1104 is arranged on the lingual side of the orthosis for receiving an anchor, such as a TAD, fixed to the lingual side of the patient's mandible, otherwise it may have a structure and operation as described herein with respect to anchor retainers 812 or 1012. In other examples, the anchor retainer may be arranged on the buccal side of the patient's jaw. In other examples, other suitable mechanisms or combinations of mechanisms may be used to fix the orthosis to the patient's jaw.

[0144] Fig. 9 and Fig.11 Each of the exemplary aligners 900 and 1100 in the drawings includes a plurality of arms 906 or 1106 having spring members 910 or 1110. Each of the exemplary aligners 900 and 1100 also includes a respective male connector element 908 or 1108 on one end of each respective arm 906 or 1106. The arms 906 and 1106, spring members 910 and 1110, and male connector elements 908 and 1108 may have a construction and operate in a manner similar to the arms 806 and 1006, spring members 810 and 1010, and male connector elements 808 and 1008 described herein, but for use with teeth in a patient's lower jaw.

[0145] As described above, each male connector element 808, 908, 1008, and 1108 is configured to engage with a corresponding female connector element or bracket when the aligner 800, 900, 1000, or 1100 is installed on the patient's teeth. Figure 8-Figure 11In the illustrated example of the corrector, each male connector element 808, 908, 1008, and 1108 can be constructed as a single integrally formed structure, either separately formed from the arm to which it is connected, or integrally formed with the arm. Such an integrally formed structure can be formed by any suitable manufacturing technique (including but not limited to molding, casting, machining, 3D printing, stamping, cutting, extrusion, etc.). In some examples, each male connector element is formed as an integral structure with the other parts of the corrector by cutting a 2D shape member from a piece of suitable material, such as but not limited to nitinol (NiTi), stainless steel, β-titanium, cobalt-chromium alloy or other metal alloys, polymers or ceramics, and bending the 2D shape member into a 3D shape member of the corrector. In other examples, one or more (or each) male connector elements 808, 908, 1008, and 1108 can be formed as a plurality of separate parts connected together by means of an arm to form the arm and male connection structure of the corrector 800, 900, 1000, or 1100.

[0146] Reference Figure 12a-12h An example of a male connector element and arm structure consisting of multiple parts connected together and to an arcuate rod of an orthosis is described. Figure 12a-12h A male connector element is provided having a Figure 8-Figure 11 The exemplary orthotics 800, 900, 1000 and 1100 shown in FIG. Figure 12a-12h The male connector element shown may be used with other orthotics as described herein, including but not limited to Figure 1-Figure 3 , Figure 5 and Figure 6 The aligners are 100, 200, 300, 500 and 600.

[0147] exist Figure 12a-12h The example shown in FIG. 1 includes: an arm structure 1200 ( Fig.12a ), an arcuate structure or rod 1201 having one or more (in the example shown, multiple) first arm connector components 1202 ( Figure 12b ), the second arm connector component 1204 ( Fig.12c ), the first male connector component 1206 (respectively in Fig.12d , Fig.12e and Fig.12f ), and the second male connector element component 1208 (respectively in Figure 12g and Figure 12h1000 and 1100). In certain examples, the arm structure 1200 can correspond to any one or more of the arms 806, 906, 1006, 1106 of the braces 800, 900, 1000, and 1100 described herein. The arm structure 1200 includes a first end segment 1210 that is configured to be attached to a rod (e.g., but not limited to, the rod 802, 902, 1002, or 1102 of the braces 800, 900, 1000, or 1100). Fig.12a In the example shown, the first end segment 1210 of the arm structure 1200 is formed as an annular portion that fits within a corresponding annular groove in one or both of the first connector component 1202 and the second arm connector component 1204 (eg, Figure 12b and Fig.12c shown).

[0148] Additionally, the arm structure 1200 includes a second end segment 1212 that is configured to attach a male connector element. Fig.12a In the example shown, the second end section 1212 of the arm structure 1200 is formed as an annular cross-section that fits into a corresponding annular groove in one or both of the first male connector component 1206 and the second male connector component 1208 (eg, Figure 12d-Figure 12h ). The arm structure 1200 also includes a central segment 1214 located between the first end segment and the second end segment. One or more spring members (such as, but not limited to, spring members as described herein) can be formed or otherwise disposed on the central segment 1214.

[0149] Figure 12b and Fig.12c The first arm connector component 1202 and the second arm connector component 1204 are shown as being configured to be connected together. Figure 12b As shown, each first arm connector component 1202 can be formed as part of (integrally with) the arch structure or rod 1201 of the orthosis. In other examples, each first arm connector component 1202 can be formed separately from the arch structure or rod and then attached to the arch structure or rod by adhesive, welding, or any other suitable attachment mechanism to form Figure 12b The bow-shaped structure or rod 1201 may correspond to the structure shown in the present invention. Figure 8-Figure 11 The arched structures 802, 902, 1002, 1102 described in the examples, or other suitable examples described herein.

[0150] One or both of the first arm connector component 1202 and the second arm connector component 1204 include grooves 1215 and 1217 for receiving the first end 1210 of the arm structure 1200 between the first arm connector component 1202 and the second arm connector component 1204. More specifically, the first end segment 1210 of the arm structure 1200 is placed between the first and second arm connector components 1202 or 1204, and then the arm connector components 1202 and 1204 are brought together to enclose the first end 1210 of the arm structure 1200 within the grooves 1215 and 1217. The grooves 1215 and 1217 extend to the edges of the respective first arm connector component 1202 and the second arm connector component 1204, whereby the central segment 1214 of the arm structure 1200 can extend from the connector components 1202 and 1204 when the connector components 1202 and 1204 are coupled together.

[0151] One of the first arm connector component 1202 and the second arm connector component 1204 (e.g., connector component 1202) includes one or more ( Figure 12b The first arm connector component 1202 and the second arm connector component 1204 may include a plurality of protrusions 1216 (three in the example) that engage with corresponding one or more recesses or holes 1218 in the other of the first arm connector component 1202 and the second arm connector component 1204 (e.g., connector component 1204). During assembly, the protrusions 1216, recesses, and holes 1218 help to properly align the first arm connector component 1202 and the second arm connector component 1204 together with each other and with the arm structure 1200. In addition, the protrusions 1216, recesses, and holes 1218 may be configured to provide a snap-fit ​​or friction-fit connection between the first arm connector component 1202 and the second arm connector component 1204. In other examples, alternative or additional connection mechanisms may be employed, including but not limited to screws, adhesives, welding, etc., to connect the connector components 1202 and 1204 together. For example, one or both of the first arm connector component 1202 and the second arm connector component 1204 may include one or more holes 1220 for receiving one or more screws, bolts, or other threaded connectors (not shown). In such an example, one or more of the holes may be threaded for threaded engagement with a screw, bolt, or other threaded connector (not shown).

[0152] Figure 12d-Figure 12hThe first male connector component 1206 and the second male connector component 1208 are shown to be configured to be connected together. One or both of the first male connector component 1206 and the second male connector component 1208 include grooves 1222 and 1224 for receiving the second end 1212 of the arm structure 1200 between the first male connector component 1206 and the second male connector component 1208. More specifically, the second end segment 1212 of the arm structure 1200 is placed between the first and second male connector component parts 1206 or 1208, and then the male connector component parts 1206 and 1208 are put together to enclose the second end 1212 of the arm structure 1200 within the grooves 1222 and 1224. The grooves 1222 and 1224 extend to the edges of the respective first and second male connector component parts 1206 and 1208, whereby the central section 1214 of the arm structure 1200 can extend from the male connector component parts 1206 and 1208 when the connector components 1206 and 1208 are coupled together.

[0153] One of the first male connector component 1206 and the second male connector component 1208 (e.g., connector component 1208) includes one or more ( Figure 12g 1208) that engages with corresponding one or more recesses or holes 1228 in the other of the first male connector component part 1206 and the second male connector component part 1208 (e.g., connector component 1206). During assembly, the projections 1226, recesses, or holes 1228 help to properly align the first male connector component part 1206 and the second male connector component part 1208 with each other and with the arm structure 1200. In addition, the projections 1226, recesses, or holes 1228 can be configured to provide a snap-fit ​​or friction-fit connection between the first male connector component part 1206 and the second male connector component part 1208. In other examples, alternative or additional connection mechanisms, including but not limited to screws, adhesives, welding, etc., can be used to connect the male connector component parts 1206 and 1208 together. For example, one or both of the first male connector component part 1206 and the second male connector component part 1208 may include one or more holes 1230 for receiving one or more screws, bolts, or other threaded connectors (not shown). In such an example, one or more of the holes may be threaded for threaded engagement with a screw, bolt, or other threaded connector (not shown).

[0154] Thus, first male connector element component 1206 and second male connector element component 1208 can be assembled and connected to one end of arm structure 1200. The other end of arm structure 1200 can be assembled and connected to the arcuate bar of the orthosis. In this example, the orthosis 800, 900, 1000, or 1100 can be composed of multiple separately formed components that are assembled and connected together to form a single unitary orthosis structure.

[0155] In such examples, each component of the orthosis can be formed separately by any suitable manufacturing technology, including but not limited to molding, casting, machining, 3D printing, stamping, extrusion, cutting and bending (e.g., cutting 2D shaped components from sheets and bending 2D shaped components into 3D shaped components as described herein), etc., and then assembled with one or more other components of the orthosis. In such examples, the arm structure 1200 can be formed by any suitable technology (the above-mentioned technologies include but are not limited to those discussed above), or formed by bending technology. For example, automatic or robotically controlled bending technology can be used to form or bend the desired and precise spring and arm structures from suitable materials, such as but not limited to nitinol (NiTi), stainless steel, β-titanium, cobalt-chromium alloy or other metal alloys, polymers or ceramics. In other examples, one or more (or all) components of the orthosis structure can be formed together as a single integrally formed structure.

[0156] As mentioned above, Figure 12a-12h The example shown in FIG. 1 provides a male connector element having a Figure 8-Figure 11 The male connector element is configured to engage and secure to a device having, for example, Fig.13a and Fig.13b Female connector element of the configuration shown.

[0157] For example, Fig.12e and Fig.12f As best shown, male connector component 1206 includes a backing portion 1232 (including portions of apertures 1228 and 1230) and an extension structure 1234. Extension structure 1234 is configured to engage a female connector element, such as Fig.13a and Fig.13b The extension structure 1234 includes a frame-shaped extension portion 1236 extending outwardly from the backing portion 1232. The extension structure 1234 also includes a pair of leg-type members 1238 and 1240, which extend from the frame-shaped extension portion 1236 and are spaced apart from each other by a gap 1242. Fig.12fAs shown, the leg members 1238 and 1240 are also spaced apart from the backing portion 1232 by a gap 1244, by a portion of the extended length of the frame-shaped extension 1236. The free end of each leg member 1238 and 1240 has a flared portion or widened portion 1239 and 1241, respectively. The male connector component 1206 can be made of any suitable material, such as but not limited to nitinol, stainless steel, beta-titanium, cobalt-chromium alloy or other metal alloys, polymers or ceramics, or other materials that allow the leg members 1238 and 1240 to be resiliently flexible and flex inwardly when a force is applied (directed to press the leg members 1238 and 1240 toward each other) to reduce the width of the extension structure 1234. In this state, the extension structure can be inserted into a female connector element (e.g., Fig.13a and Fig.13b 1206 and 1208). Once inserted into the female connector element, the force can be released to allow the leg members 1238 and 1240 to resiliently move outward toward their initial position to secure the male connector element (formed by components 1206 and 1208) to the female connector element. In certain examples, the male connector component 1206 (including the frame-shaped extension structure 1234 and the leg members 1240 and 1238) is formed as an integral, single-formed structure. In other examples, the male connector component 1206 can be formed from multiple separate components connected together.

[0158] Fig.13a A representation of an OTA image of a patient's upper jaw is shown on which an example of a female connector element 1300 is attached to the lingual surface of the teeth of the upper arch. In other examples, the female connector element 1300 can be attached to the buccal surface of the teeth (e.g., if preferred by the clinician). A separate respective female connector element 1300 is secured to each respective tooth. In accordance with the first and second embodiments described herein, the female connector element provides a connection interface to connect one or more aligners to the teeth. Although Fig.13a The figures in show all teeth in each jaw having female connector elements, but other examples may employ separate corresponding female connector elements on some but not all teeth in the upper or lower jaw (eg, as selected by the clinician).

[0159] The female connector element 1300 can be attached to the tooth via direct or indirect bonding or in other suitable ways to fix the element to the surface of the tooth. The bonding material can include an adhesive, such as but not limited to a composite resin. In the case of indirect bonding, the clinician can use a clamp to increase the accuracy of bracket placement. In a specific example, one or more (or all) female connector elements 1300 are customized for each tooth in size or shape and are constructed to have a minimum profile (to minimize the dimension extending away from the tooth (i.e., the buccal and lingual direction), or the mesiodistal direction or the occlusal direction, or any combination thereof).

[0160] Fig.13b Shows Fig.13a An example of a female connector element 1300 in FIG. Fig.13b In the example of FIG. 1 , the female connector element 1300 includes a backing portion 1302 that is configured to be bonded to a surface of a patient's tooth. Fig.13b The female connector element 1300 in FIG. 1 further includes a frame-shaped extension structure 1304 extending outward from the backing portion 1302 . Fig.13b The female connector element 1300 in FIG. 1 also includes a first L-shaped extension structure 1306 and a second L-shaped extension structure 1308 extending outwardly from the backing portion 1302. The extension structures 1304, 1306, and 1308 extend outwardly from the backing portion 1302 in the same direction. However, the frame-shaped extension structure 1304 has a surface with a planar surface dimension, which is in one direction ( Fig.13b The L-shaped extension structures 1304, 1306 and 1308 are arranged such that a gap 1310 is provided between the L-shaped extension structures 1306 and 1308, and an additional gap 1312 is provided between the frame-shaped extension structure 1304 and each of the L-shaped extension structures 1306 and 1308.

[0161] The female connector element 1300 can be made of any suitable material, such as, but not limited to, nitinol, stainless steel, beta-titanium, cobalt chromium or other metal alloys, polymers, ceramics, or other materials that allow the L-shaped extension structures 1306 and 1308 to be elastically flexible and flex outward when a force is applied (pointing the L-shaped extension structures away from each other) to increase the width of the gap 1310. In this state, the extension portion 1234 of the male connector element can be inserted into the gap 1310. Once inserted, the force can be released to allow the L-shaped extension structures 1306 and 1308 to elastically move toward each other toward their initial positions to secure the male connector element to the female connector element. In a specific example, when the extension portion 1234 of the male connector element is received in the gap 1310, the rack-shaped extension 1236 of the male connector component 1206 fits into the gap 1312 of the female connector element 1300. In other examples, the L-shaped extension structure of the female connector element can be relatively rigid (and not configured to flex outwardly much or at all) so that the resilient flexibility of the leg members 1236 and 1238 of the male connector element is sufficient to allow the male connector element to be inserted into the gap 1310 without the L-shaped extension structures 1306 and 1308 of the female connector element flexing outwardly. In a particular example, the female connector element 1300 (including the rack-shaped extension structure 1304 and the L-shaped extension structures 1306 and 1308) is formed as an integral, single-formed structure. In other examples, the female connector element 1300 can be formed from multiple separate components connected together.

[0162] Each of the L-shaped extension structures 1306 and 1308 of the female connector element 1300 includes a free end having a lip or L-shaped extension that extends toward the other of the L-shaped extension structures. When the extension portion 1234 of the male connector element 1200 is received in the gaps 1310 and 1312 of the female connector element 1300, as described above, the lips or L-shaped extensions of the L-shaped extension structures 1306 and 1308 snap back onto the leg members 1238 and 1240 of the male connector element 1200 to retain and secure the male connector element. The flared or widened portions 1239 and 1241 of the leg members 1238 and 1240 and the rack-shaped extension 1236 help to retain the male connector element 1200 in the female connector element 1300 in a properly aligned state when secured and during installation. In this state, the male connector element 1200 can remain secured to the female connector element 1300 until the clinician removes the male connector element (e.g., by applying pressure inwardly to the leg members 1236 and 1238 of the male connector element sufficient to clear the L-shaped extension structures 1306 and 1308 and then pulling the male connector element away from the female connector element.

[0163] In some examples, male connector elements 808, 908, 1008, and 1108 can be configured as described herein. Figure 12a-12g As described herein, for Fig.13a and Fig.13b However, in other examples, the male connector elements 808, 908, 1008, and 1108 according to the second embodiment can be similar to the male connector elements 104, 204, 304, 504, and 604 described herein with respect to the first embodiment. In such examples, the female connector elements can be configured similarly to Figure 7 Similarly, other examples of the first embodiment may include, for example, Figure 12a-12g The male connector element described herein is used for use with Fig.13a and Fig.13b The female connecting element 1300 is described to be engaged.

[0164] In other examples, the male connector element on the orthosis according to the second embodiment (including the orthosis 800, 900, 1000 and 1100) or according to the first embodiment can have other suitable configurations, such as but not limited to: Fig.15a The male connector element example shown is constructed for engagement and fixation to a Fig.15b and Fig.15c The female connector element 1501 is shown. The female connector element 1501 is Fig.15c is shown bonded to a tooth.

[0165] Fig.15a The male connector element 1500 in the embodiment includes a shaped body portion having a first arm segment 1504 and a second arm segment 1506. Each arm segment 1504 and 1506 is connected to another arm segment at a first end 1508 and extends to free ends 1510, 1512 respectively. The arm segments 1504 and 1506 are spaced apart from each other (except at the connection end 1508) to form a gap 1502 between the arm segments and extend along a portion of the length of each arm segment. The male connector element is made of a sufficiently elastic material to allow the free ends of the arm segments 1504 and 1506 to be further separated from each other or moved away from each other by force, and then elastically moved back to its original state when the force is removed. When the arm segments 1504 and 1506 are further separated from each other by force, the width dimension of the gap 1502 between the arm segments 1504 and 1506 increases. In this state, the male connector element 1500 is placed on the female connector element. When placed over the female connector element, the force on the arm segments 1504 and 1506 is released to allow the arm segments to resiliently move toward their non-forced or passive state to lock or secure the male connector element to the female connector element.

[0166] Fig.15b The female connector element shown in the figure includes a backing portion 1514 that is configured to be bonded to the surface of the patient's teeth. An extension portion 1516 consisting of four hook-shaped or L-shaped extension members 1518 extends outward from the backing portion 1514. When the arm segments 1504 and 1506 of the male connector element 1500 are forced apart as described above, the male connector element 1500 can be placed on the female connector element so that the hook-shaped extension members 1518 are received in the gap 1502 between the arm segments 1504 and 1506, and the arm segments 1504 and 1506 are accommodated in the female connector element behind the hook-shaped or L-shaped free ends of the hook-shaped extension members 1518. In this state, the force on the arm segments 1504 and 1506 is released to allow the arm segments to resiliently move toward their non-forced or passive state to lock or secure the arm segments 1504 and 1506 between the backing portion 1514 and the hook-shaped or L-shaped free end of the hook-shaped extension member 1518 of the female connector element 1501, as shown. Fig.15c In this state, male connector element 1500 can remain secured to female connector element 1501 until the clinician removes the male connector element (e.g., by applying an outward force on arm segments 1504 and 1506 sufficient to clear the hook-shaped or L-shaped free end of hook-shaped extension member 1518), and then pulls the male connector element away from the female connector element.

[0167] In other examples, the male connector element on the orthosis according to the second embodiment (including the orthosis 800, 900, 1000 and 1100) or according to the first embodiment can have other suitable configurations, such as but not limited to Fig.16a The male connector shown is configured to engage and secure to a Fig.16b and Fig.16c Female connector element 1601 is shown. Fig.16aThe male connector element 1600 in the embodiment includes a shaped body portion having a first arm segment 1604 and a second arm segment 1606. Each arm segment 1604 and 1606 is connected to another arm segment at a first end 1608 and extends to free ends 1610, 1612, respectively. The free ends 1610 and 1612 include widened portions or L-shaped ends having extensions extending outwardly from each arm segment (in a direction away from the other of the two arm segments). The arm segments 1604 and 1606 are spaced apart from each other (except at the connection end 1608) to form a gap 1602 between the arm segments and extend along a portion of the length of each arm segment. The male connector element is made of a sufficiently elastic material to allow the free ends of the arm segments 1604 and 1606 to be forced to move toward each other and then elastically move back to their original state when the force is removed. When the arm segments 1604 and 1606 are forced toward each other, the width dimension of the gap 1602 between the arm segments 1604 and 1606 is reduced. In this state, the male connector element 1600 is placed in the receiving portion of the female connector element 1601. When placed in the receiving portion of the female connector element, the force on the arm segments 1604 and 1606 is released to allow the arm segments to resiliently move outward toward their unforced or passive state to lock or secure the male connector element to the female connector element.

[0168] Fig.16b The female connector element shown in the figure includes a backing portion 1614, the rear surface of which (the surface facing inward in the figure) is configured to be bonded to the surface of the patient's teeth. An extension portion 1616 consisting of a box-shaped structure with an opening 1618 forming a receiving portion extends outward from the backing portion 1614. The box-shaped structure of the extension portion 1616 includes two side walls 1620 and 1622, each of which has an opening 1621 and 1623, respectively. When the male connector element 1600 is fixed to the female connector element 1601, the openings 1621 and 1623 are configured (in shape and size) to receive the free ends 1610 and 1612, which include widened portions or L-shaped ends on the free ends 1610 and 1612 of the arm segments of the male connector element 1600.

[0169] When the arm segments 1604 and 1606 of the male connector element 1600 are forced toward each other as described above, the male connector element 1600 can be inserted into the opening 1618 of the female connector element 1601 until the widened portions or L-shaped ends on the free ends 1610 and 1612 of the arm segments of the male connector element 1600 are aligned with the openings 1621 and 1623 in the side walls 1620 and 1622 of the female connector element 1601. In this state, the force on the arm segments 1604 and 1606 can be released to allow the arm segments 1604 and 1606 to elastically move outwardly toward each other to engage the widened portions or L-shaped ends on the free ends 1610 and 1612 of the arm segments and insert into the openings 1621 and 1623 in the side walls 1620 and 1622 to lock or secure the male connector element 1600 to the female connector element 1601. In this state, the male connector element 1600 can remain secured to the female connector element 1601 until the clinician removes the male connector element (e.g., by forcing the arm segments 1604 and 1606 inward toward each other sufficiently to withdraw the widened portions or L-shaped ends on the free ends 1610 and 1612 of the arm segments from the openings 1621 and 1623 in the side walls 1620 and 1622, and then pulling the male connector element away from the female connector element).

[0170] In other examples, the male connector element on the orthosis according to the second embodiment (including the orthosis 800, 900, 1000 and 1100) or the first embodiment can have other suitable configurations, such as but not limited to Fig.18e and Fig.18f The construction of the male connector element example shown. Fig.18e and Fig.18f In the exemplary orthotic devices 1810 and 1820 shown, each male connector element 1802 or 1822 has a T-shaped configuration for engaging and fixing to a female connector element. In such an example, the female connector element may have a corresponding T-shaped slot for selectively receiving a T-shaped male connector element.

[0171] Fig.25 An example of a male connector element 2500 having a T-shaped configuration is shown, which may be used with embodiments described herein, including but not limited to Fig.18e or Fig.18f The embodiment shown. Fig.25 The male connector element 2500 in the embodiment has a T-shaped body structure disposed at the end of the arm of the orthosis. The T-shaped body structure has a Fig.25 The first portion 2501 extending in the vertical direction (in the vertical direction) and transverse to (for example, but not limited to, substantially perpendicular to) the first portion 2501 ( Fig.25 A second portion 2502 extending in a horizontal direction (in the horizontal direction).

[0172] An example of a female connector element 2600 is shown in Figure 26a-26d In the embodiment, the female connector element is used to receive and fix a male connector element having a T-shaped structure, such as but not limited to Fig.25 Male connector element 2500. Figure 26a-26d 2600. The male connector element 2500 is received by and fixed to the female connector element 2600 in the drawings of FIG. The female connector element 2600 includes a backing portion 2601 and an extension portion 2602 extending outwardly from the backing portion 2601. The extension portion 2602 has a plurality of hook-shaped extension members 2604 that are separated from each other to form a pair of transverse slots 2606 and 2608. The transverse slots are arranged transversely to each other at an angle that corresponds to the transverse angle of the first portion 2501 and the second portion 2502 of the T-shaped body of the male connector element 2500.

[0173] Thus, the male connector element 2500 can be aligned with and inserted into the transverse slots 2606 and 2608 of the female connector element 2600 to secure the male connector element to the female connector element. In a specific example, one or both of the slots 2606 and 2608 are slightly smaller in width than the width of the first portion 2501 and the second portion 2502 of the T-shaped body of the male connector element. In such an embodiment, the hook-shaped extension member 2604 can have sufficient flexibility and elasticity to receive the T-shaped body and exert a compressive force on the T-shaped body when the T-shaped body is received in the transverse slots 2606 and 2608, for example, to help retain or secure the male connector element 2500 to the female connector element 2600.

[0174] like Fig.26c and Fig.26d As shown, after the T-shaped body of the male connector element 2500 is received in the female connector element, the clinician can add a retaining structure 2605, such as but not limited to an O-ring, a ligature, or other suitable retaining structure, to the plurality of hook-shaped extension members 2604 of the extension portion 2602 of the female connector element 2600. The hook-shaped extension members 2604 can include a hook-shaped or L-shaped end that holds the O-ring, ligature, or other suitable retaining structure in place.

[0175] In another example, the female connector element 2610 can be constructed and operated similarly to the female connector element 2600 described herein, but also includes one or more clamp structures 2612 to function as a self-ligating stent, such as Fig.26e and Figure 26fAs shown. The clamp structure 2612 can be disposed on one (or a pair of) hook-shaped extension members 2604, or clamped on one (or a pair of) hook-shaped extension members 2604. In a specific example, the clamp structure 2612 has a plate portion 2614 and a spring portion 2616, and is arranged so that the spring portion 2616 is bent around one or more hook-shaped extension members 2604, or is otherwise supported on one or more hook-shaped extension members 2604. When the T-shaped body is received in the transverse slot of the female connector element 2610, the plate portion 2614 is supported to cover a portion of one or both transverse slots by a sufficient amount so as to prevent the T-shaped body of the male connector element 2600 from being removed. Spring portion 2616 provides sufficient flexibility and resiliency to allow plate portion 2614 to move outwardly (away from extension member 2604) from extension member 2604 a sufficient amount to allow the T-shaped body of male connector element 2600 to be removed from (or inserted into) the transverse slot of female connector element 2610 once sufficient outward force is applied to plate portion 2616. Upon release of the force, plate portion 2616 resiliently moves back toward its original state (eg, Figure 26f shown).

[0176] Fig.27a Another example of a male connector element 2700 having an annular (e.g., rectangular-annular with rounded corners) shape configuration is shown, which can be used with the embodiments described herein as an alternative to other male connector elements described herein. For patient comfort, the corners of the annular shape of the male connector element 2700 are rounded. In other examples, the shape of the male connector element can include square corners. Fig.27a The male connector element 2700 in the embodiment has a spring portion disposed at the end of the arm of the orthosis (the spring portion of the arm, in Fig.27a and Fig.28 In other examples (consistent with the first embodiment), the male connector element 2700 may be disposed on the arcuate rod of the orthosis (rather than at the end of the arm). Fig.27a In the example shown, the annular body structure 2702 is generally rectangular in shape with a central opening 2704. In other examples, the annular body structure 2702 can be in other suitable shapes, including other polygons, ellipses, circles, or shapes formed as a combination of polygons and portions of ellipses or circles. In other examples, for example but not limited to Figure 27b In the exemplary male connector element 2701 shown in FIG. 1 , the body structure 2703 may be open at a corner, bottom, right side, or left side in the orientation shown (and thus, be partially but not completely annular). Figure 27bIn the example of , the body structure 2703 is open at the corner (upper left corner in the illustrated orientation). Compared with the connector element 2700 having a closed annular shape, the connector element 2701 that is open at the corner, bottom or side can be more easily formed by cutting from a 2D sheet.

[0177] like Fig.27a or Figure 27b The male connector element 2700 or 2701 shown can be configured to engage and secure with a female connector element having a similar configuration to the female connector element 2610 described herein. Alternatively, the male connector element 2700 or 2701 can engage and secure to a female connector element that is configured similarly to the female connector element 2610, but the female connector element need not include a slot (rather than having a slot). Fig.26a The vertical slot between the extension members 2604 in the connector 2604 and thus can be engaged and secured to a female connector element having a conventional structure (or a more conventional structure). Fig.28 An example of a male connector element 2700 engaged and secured with a female connector element 2610 is shown in FIG. Fig.28 As shown, a portion of the annular body structure 2702 of the male connector element 2700 is inserted between the plate portion 2614 of the clamp structure 2612 and the backing portion 2601 of the female connector element 2610. Fig.28 As shown, another portion of the female connector element 2610 is aligned with and partially fits into or passes through the central opening 2704 in the annular body structure 2702 to help align the male connector element with the female connector when the male connector element 2700 is secured (or being secured) to the female connector element 2610. In this manner, the male connector element 2700 can engage and be secured to a self-ligating female connector element or bracket.

[0178] In various examples of the second embodiment described herein (as well as various examples of the first embodiment), various examples and configurations of male connector elements and associated female connector elements may be employed. Some examples of orthotics according to the second embodiment include Figure 1-Figure 3 , Figure 5 and Figure 6 The male connector element shown and described (for securing to a Figure 7 Other exemplary orthotics according to the second embodiment include Figure 8-12h The male connector element described and shown (for fixing to the female connector element as described in Figure 13). Other orthotics according to the second embodiment include Fig.15a The male connector element described and shown (for fixing to a Fig.15b As described, Fig.15c Other orthotics according to the second embodiment include Fig.16a The male connector element described and shown (for fixing to a Fig.16c shown Fig.16b Other orthotics according to the second embodiment include Fig.17a The male connector element described and shown (for fixing to a Fig.17b Other correctors according to the second embodiment include Fig.18e , Fig.18f and Fig.25 The male connector element described and shown (for fixing to a Figure 26a-26f Other exemplary orthotics according to the second embodiment include Fig.27a and Figure 27b The male connector element described and shown (for fixing to a Fig.28 Other orthotics according to the second embodiment include male connector elements having other suitable configurations for securing to female connector elements having other suitable configurations.

[0179] The system or method according to the second embodiment allows the clinician to move each tooth independently by employing one or more aligners having separate arms connected to each tooth to be moved. The arms (including the spring members of the arms) form a force generating element that exerts sufficient force on the teeth to move the teeth from their OTA to the desired FTA. In a particular example, the arms are capable of moving the teeth in one or more (or all three) translational directions. Alternatively or additionally, the arms are capable of moving the teeth in one or more (or all three) rotational directions.

[0180] One or more of the shape, thickness, width, or length of each arm can be designed and constructed to provide the appropriate force or torque (or both) to achieve the desired movement of the tooth. In addition, one or more of the shape, thickness, width, or length of each arm can be designed and constructed to correspond to the size and type of tooth to which the arm is connected. For example, one or more of the shape, thickness, width, or length of the arm can be designed and selected to provide a greater amount of flexibility when the teeth are displaced a greater distance or when the teeth are smaller in size (e.g., but not limited to, lower incisors).

[0181] In a specific example, a processing and software system with finite element analysis capabilities can be used to determine the desired geometry (size, shape, width, thickness, length) of the spring or arm (or both) for applying the desired or ideal force to accelerate the desired tooth movement.

[0182] The cross-sectional form of the brace according to the second embodiment can be configured to connect to some but not all of the teeth in a jaw, for example, to move only a few teeth while keeping other teeth stationary. In this case, the number of arms in the brace can be significantly less than the number of teeth in a given jaw, but the number of arms can be matched to the number of teeth that the clinician desires to move. In other examples, one or more arms can be connected to one or more corresponding teeth for anchoring the brace, and not necessarily for moving those teeth to which those arms are connected. In such examples, the one or more arms to be connected for anchoring but not moving the teeth can be formed to be relatively strong or thick to provide sufficient anchoring support. Some example uses of the cross-sectional form for the brace according to the second embodiment include, but are not limited to, open spaces for implants, alignment of teeth that are tilted in extraction spaces, and non-comprehensive orthodontic treatment for patients with only some tooth misalignments. Another example of the cross-sectional form of the brace according to the second embodiment includes a molar positioner, with reference to Fig.14 .

[0183] Fig.14 The appliance 1400 in is configured as a molar positioner, for example, for the upper molars of a patient having incorrect intra-arch or inter-arch molar relationships. Fig.14 The appliance 1400 in FIG. 1 includes an arcuate bar 1402 forming two arms 1404 and 1406 connected at a central portion of the bar 1402. When the appliance 1400 is mounted on the patient's teeth, the arcuate bar 1402 is configured to span the patient's palate as a transpalatal arch (TPA).

[0184] Each arm 1404 and 1406 extends from a central portion of the rod 1402 to an end segment where a male connector element is located. The brace 1400 includes a first male connector element 1408 formed on or otherwise attached to the end segment of the arm 1404 and a second male connector element 1410 formed on or otherwise attached to the end segment of the arm 1406. Fig.14 In the example shown, the corrector 1400 also includes a first spring structure 1412 and a second spring structure 1414, wherein the spring structure 1412 is formed on the arm 1404 or connected between the end of the arm 1404 and the male connector element 1408, and the spring structure 1414 is formed on the arm 1406 or connected between the end of the arm 1406 and the male connector element 1410.

[0185] The spring structures 1412 and 1414 can be configured similarly to the configuration of the spring elements (or combinations of spring elements) described herein. Fig.14 is shown as having Figure 8-12g The male connector elements 1408 and 1410 may be similarly configured to any one or more of the examples described in the drawings for engaging with female connector elements such as, but not limited to, those described herein with reference to FIG. 13. However, in other examples, the male connector elements 1408 and 1410 may have other suitable configurations such as, but not limited to, those described herein with reference to FIG. Figure 1-Figure 3 , Figure 5 , Figure 6 , Figure 8-12h , Fig.15a , Fig.16a , Fig.17a , Figure 18c-18f , Fig.25 , Fig.27a and Figure 27b Those structures described herein are used to engage and secure to female connector elements, such as but not limited to those described herein. Figure 7 , Fig.13a , Fig.13b , Fig.15b , Fig.15c , Fig.16b , Fig.16c , Fig.17b , Figure 26a-26f and Fig.28 Those female connector elements described.

[0186] Fig.14 The corrector 1400 in the embodiment includes one or more ( Fig.14 Each anchor retainer 1416 may be constructed and operated similarly to the anchor retainers described herein. Figure 8 and Fig.10 The male connector elements 1408 and 1410 may be secured to female connector elements that are pre-bonded to the surfaces of the upper molars on the opposite side of the patient's jaw.

[0187] The appliance 1400 can be configured to apply appropriate forces on the molars to reposition the molars, for example, to obtain a desired or ideal intra-arch and inter-arch molar relationship. The final position of the molars can be determined by selecting the TAD position, which can be precisely implanted using a guide tray.

[0188] In a further example, as referenced Fig.14 The molar locator described can be used in a mixed dentition to gain space for unerupted premolars and canines without involving other teeth in the jaw.

[0189] The corrector according to the second embodiment and the female connector element associated with the first embodiment can be manufactured in any suitable manner, including but not limited to molding, casting, machining, 3D printing, stamping, extrusion, etc. However, in a specific example, the corrector or the female connector element (or both) according to the second embodiment is made by cutting the 2D form of the corrector from a 2D sheet and bending the 2D form into the desired 3D shape of the corrector. As described below, these methods are particularly suitable for manufacturing correctors according to the examples of the first and second embodiments described herein. Compared with the shapes made by bending a single diameter wire, more 3D shapes can be made by cutting 2D members from a flat sheet instead of a traditional single diameter wire. The cut 2D member can have a designed or varied width and length, which, when bent into the desired shape, can cause the portion of the 3D corrector to have a change in thickness, width and length dimensions. In this way, the 2D member can be cut into a shape that provides the desired thickness, width and length of the spring member, arm or other parts of the corrector. Compared with bending a single diameter wire, more shapes can be provided by bending a customized cut 2D member.

[0190] In some examples where the aligner is formed from a cut 2D sheet of material bent into a desired 3D shape, the male connector element may be constructed from a flat sheet of material that is cut or bent (or both) into the desired shape of the male connector element. Fig.18e An example of an orthosis 1800 according to an example of a second embodiment is shown, the orthosis 1800 being formed from a cut 2D sheet that is bent into a desired 3D shape. In a particular example, the 3D formed article may be shaped by any suitable shape setting procedure, including but not limited to heat treatment. Fig.18e The example includes a plurality of male connector elements, each of which has a generally T-shaped configuration as described above. Each T-shaped male connector element is configured to engage and secure with a corresponding female connector element, the female connector element having, for example, but not limited to, Figure 26a-26f The construction shown in .

[0191] However, in other examples, the orthosis according to the second embodiment can be composed of a wire that is bent into a desired 3D shape. In a specific example, the wire is Nitinol. In other examples, the wire can be any suitable material, such as but not limited to stainless steel, beta-titanium, and shape memory alloys.

[0192] Various examples of braces according to the second embodiment may be configured to treat impacted teeth, such as but not limited to canine teeth. For example, a brace according to the second embodiment may be configured to bring an impacted tooth to the oral cavity by configuring the arms of the brace to be fixed to the impacted tooth and apply a force to pull the tooth toward the patient's dental arch. In a specific example, the brace may include one or more anchoring device retainers for connecting to one or more TADs or other anchoring devices implanted in the patient to help apply a desired force or torque (or both) on the impacted tooth to move the impacted tooth to a final desired or ideal position. The brace may be configured to be passive (and not apply further force or torque to the tooth) when the tooth is in its final position, but active (to apply force or torque or both on the tooth) at any other position.

[0193] Therefore, compared to conventional braces, the brace according to the second embodiment can be constructed to apply appropriate force and torque on the impacted tooth from the beginning of exposure, so that the tooth can be pulled toward the patient's dental arch and rotated in the appropriate direction to achieve the final desired or ideal position. In contrast, traditional orthodontic techniques with braces may involve moving the tooth to the dental arch without any torque control, and then performing additional treatment to apply torque to the tooth. Therefore, the brace example according to the second embodiment can be constructed to speed up the treatment time by applying force and torque simultaneously during the treatment process. And, by adopting TAD or TPA in the brace example as described herein, the reaction force (of the force applied to the tooth) is applied to the TAD or TPA, which can minimize the reaction force side effects. The brace according to various examples can reduce the round trip of the teeth (which can reduce the treatment time), root resorption, and provide other benefits.

[0194] Third embodiment

[0195] As described above, the system or method according to the third embodiment includes or employs an appliance having a similar construction to the first embodiment, but is also configured to be selectively removable to allow a patient (or clinician) to selectively install and remove the appliance from the patient's teeth. The appliance according to the third embodiment includes a plurality of covers (such as, but not limited to, aligners, acrylic or polymer covers) in place of the male connector elements described above. However, other features of the appliance according to the third embodiment may be configured and operated as described above with respect to the examples of the first embodiment (including, but not limited to, Figure 1-Figure 3 , Figure 5 , Figure 6 , Figure 16 and Figure 17).

[0196] In an appliance according to the third embodiment, each aligner cap is configured to be secured to a corresponding tooth by fitting over and onto the tooth. For example, the caps may be made of a polymer, acrylic, or other suitable material, such as a material that helps retain each cap to the patient's teeth. In certain examples, additional or alternative connector elements may be provided to help attach one or more (or each) caps to the corresponding teeth.

[0197] In a specific example of the system and method according to the third embodiment, the cap can be constructed to secure and hold the tooth by engaging the natural undercut on the tooth surface, or by an artificial undercut provided by an attachment or button secured to the tooth. These attachments can be made of metal, polymer, ceramic or other suitable material. In some examples, the attachment can be made of the same or similar color as the tooth so as to be less visible and more aesthetically pleasing. Attachments of the same or similar color as the tooth can be made of materials such as, but not limited to, composite resins, polymers or ceramics. In a specific example, the attachment can be secured to the patient's teeth using a tray that helps the clinician install the attachment in the desired position.

[0198] In a third embodiment, each cover can be customized in size and / or shape to correspond to the size and shape of the tooth to which the cover fits. Alternatively, the aligner cover is constructed to be applied to any patient or tooth (or a group of multiple patients or teeth) and is not customized for each tooth or each patient. In certain examples of the third embodiment, each aligner cover can be individually connected to a support rod rather than directly connected to any other cover for adjacent teeth. In other examples, one of the aligner covers (or each of the multiple aligner covers) can be connected to two or more adjacent teeth, for example, to move a group of teeth in unison or to provide additional anchoring. This provides significantly greater flexibility for the braces according to the third embodiment, which can allow clinicians to complete treatment using fewer braces.

[0199] like Fig.19c As shown, an example of a corrector 1920 according to the third embodiment may include an arch structure 1902 (in Fig.19a ) and a plurality of caps 1922. The arch structure 1902 includes a shaped support member that may be made of any suitable material such as, but not limited to, nitinol (NiTi), stainless steel, beta-titanium, cobalt chromium or other metal alloys, polymers, or ceramics. The arch structure 1902 may be formed into a desired shape using any suitable shape forming process, including but not limited to the methods described herein for forming an orthotic device according to the first embodiment. Fig.19c In the example of Fig.17aA configuration similar to that of the aligner shown and described, or other suitable configurations.

[0200] In certain examples, the arch structure 1902 of the brace 1920 is configured to conform to the arch of the patient's upper jaw (e.g., as described with respect to the arch structures of braces 100, 200, and 500). In other examples, the arch structure of the brace is configured to conform to the arch of the patient's lower jaw (e.g., as described with respect to the arch structures of braces 300 and 600). Some or all of the arch structures of the brace according to the third embodiment may be made of any suitable material (including, but not limited to, nitinol, stainless steel, beta-titanium, cobalt-chromium or other metal alloys, polymers, or ceramics) and may be made as a single, integrally formed structure or may be made as multiple separately formed components connected together into a single structure.

[0201] A plurality of cover connector elements 1904 are formed on or attached to the arcuate structure of the orthosis according to the third embodiment at locations spaced apart along the length of the arcuate structure (rather than, and in lieu of, Figure 1-Figure 3 , Figure 5 and Figure 6 ). In a corrector according to the third embodiment, one or more springs 1906 are disposed between adjacent cover connector elements 1904 (and, therefore, between adjacent calibrator covers). In certain examples of the third embodiment, one or more springs are provided between each cover connector element and each adjacent cover connector element. In other examples of the third embodiment, one or more springs are disposed between some pairs, but not all pairs, of adjacent cover connector elements. For example, a rigid portion of the corrector may be disposed between a pair or some pairs of adjacent cover connector elements. In further examples, one or more springs may be disposed between cover connector elements that are not directly adjacent to each other. Each spring is a force generating component of the corrector. In a specific example, each spring is made of a flexible material, such as, but not limited to, a shape memory alloy, such as, but not limited to, nitinol.

[0202] Each cover connector element 1904 is configured to connect to and hold a separate corresponding cover 1922 relative to the cover connector elements of each other. In other examples, multiple covers can be connected to one or more (or each) corresponding cover connector elements and held by one or more (or each) corresponding cover connector elements. In further examples, one or more (or each) cover connector elements can be connected to and hold more than one cover respectively. Therefore, each cover 1922 is connected in the arch member 1902, at a separate and spaced position along the arch member, so that each cover 1922 is separated from the adjacent cover (not directly connected). In this way, the covers on the braces (and the teeth to which these covers are fixed) can be moved separately and independently of other covers on the braces (and the teeth to which these covers are fixed), and there is no need to limit the movement of other covers on the braces (and the teeth to which these covers are fixed). In some examples, the cover does not cover the spring between adjacent covers on the braces. In a specific example, the covers of adjacent teeth can be constructed and installed at a position on the arch structure where they will not contact each other at this position throughout the treatment process. In further examples, the braces can be constructed to have one or more covers that fit over multiple teeth (or have multiple adjacent covers connected together) while one or more other covers in the braces are separate and independent from the other covers in the braces.

[0203] In an example of an orthotic device according to the third embodiment, each cap 1922 may include a calibrator. In such an example, the calibrator may be used. A machine or other suitable thermoforming or vacuum forming machine attaches each calibrator cover to a corresponding cover connector element on the arcuate member.

[0204] In some examples, the calibrator may cover the entire brace, for example, to make the patient more comfortable. In such examples, a space or gap between the spring and the calibrator may be formed. In such examples, the patient may feel additional comfort because the patient's tongue will only contact the smooth surface of the calibrator instead of the metal arm or rod of the brace. The calibrator may be trimmed manually or by other suitable machining or cutting methods (such as, but not limited to, laser cutting, milling, etc.).

[0205] In other examples of an appliance according to the third or fourth embodiment, the appliance may include other mechanisms for engaging and securing to one or more teeth of the patient, instead of or in addition to one or more male connector elements. For example, one or more engagement mechanisms may be configured to pass the lingual surface of the tooth through the incisal or interproximal surface and hold the tooth from the buccal side (e.g., similar to a clasp in a partial denture). In other examples, one or more engagement mechanisms may be configured to pass through the buccal surface of the tooth, through the incisal or interproximal surface, and hold the tooth from the lingual side (e.g., similar to a clasp in a partial denture).

[0206] In various examples of systems and methods according to the third embodiment, the aligner can be configured to move the teeth until a cap of the removable aligner becomes passive and does not apply force to the teeth.

[0207] Similar to the other embodiments described herein, the orthosis according to the third embodiment can be designed and manufactured using computerized design and manufacturing techniques (such as, but not limited to, those described herein). The orthosis according to the third embodiment can be constructed to exhibit resilience over a longer range of motion than conventional removable orthosis. For example, including a spring member between the covers and using separately connected covers (not directly connected to adjacent covers) can allow for a greater range of motion than an orthosis that does not include a spring member or that employs interconnected covers. Thus, compared to conventional removable orthosis having stainless steel springs, or with conventional aligner processes (such as, but not limited to, or ), the exemplary method according to the third embodiment may involve fewer aligners to complete the treatment.

[0208] In other examples of the braces according to the third embodiment, any suitable combination of aligners located on some teeth and clasps located on other teeth may be used. In such embodiments, the braces may include one or more aligners at the location of one or more corresponding teeth, and one or more clasps at the location of one or more other teeth in the patient's jaw. Alternatively or additionally, different types of clasps may be employed at different tooth locations on the braces. For example, the flexibility of clasps made of NiTi on the posterior teeth can increase the retention ability of the braces. This may be helpful if a malocclusion requires that the braces be better retained on the teeth.

[0209] The appliance according to the third embodiment may include one or more palatal arch features or lingual arch features, such as but not limited to Figure 2 and Figure 8 The palatal arch features 202 or 804, respectively, or Figure 3 The lingual arch feature 302 in.

[0210] The appliance according to the third embodiment may include one or more anchoring device holders for anchoring the appliance to the patient's palate or cheek frame, as described herein. Figure 8 and Fig.10 812 or 904 as described in the anchor device holder 812 or 904 in the embodiment. For example, one or more anchor devices (such as but not limited to TADs) can be implanted in the patient's palate or cheek shelf or other suitable location of the patient. The removable aligner according to the third embodiment may include one or more engagement features, which are configured to engage and connect to the implanted anchor device when the aligner is installed on the patient's teeth, and selectively connect from the implanted anchor device to remove the aligner. In such an embodiment, the engagement feature may include one or more snap connectors (for snap connection to the implanted anchor device), sliding connectors (for sliding connection to the implanted anchor device) or other suitable connectors. Alternatively or additionally, the platform can be fixed to the patient's palate or cheek shelf, wherein the platform includes one or more snaps, slides or other suitable engagement features for engaging and connecting with one or more snaps, slides or other suitable engagement features on the removable aligner for selectively connecting and separating the aligner from the platform. In other examples, any suitable bone anchor device can be used instead of or in addition to one or more TADs.

[0211] Fourth embodiment

[0212] As described above, a system or method according to a fourth embodiment includes or employs an aligner having a similar construction to the second embodiment, but is also constructed to be selectively removable to allow a patient (or clinician) to selectively install and remove the aligner from the patient's teeth. Similar to the second embodiment, the aligner according to the fourth embodiment has a plurality of separate arms that are configured to be connected to a corresponding plurality of teeth, respectively, via covers, wherein each arm of the aligner is configured to be connected to a different corresponding tooth relative to each other arm of the aligner. In other examples, one or more aligner covers (or each of a plurality of aligner covers) can be individually connected to two or more adjacent teeth, for example, to move a group of teeth in unison or to provide additional anchoring.

[0213] Therefore, various features of the fourth embodiment of the orthosis can be described as described above with respect to the second embodiment (including but not limited to Figure 8-12g) as described above. However, instead of the male connector element of the second embodiment, the brace according to the fourth embodiment includes a plurality of covers (such as, but not limited to, aligner covers, acrylic covers, or polymer covers). A separate respective cover is formed on or otherwise attached to each respective arm, for example, at the end of each arm opposite to the end of the arm that is attached to the arched rod of the brace. The covers are configured to hold the brace to the patient's teeth and to maintain the brace in a desired position during use.

[0214] The cap of the fourth embodiment can be configured similarly to the cap described herein for the third embodiment to be secured to the patient's teeth by fitting over and onto the teeth. However, the single cap of the fourth embodiment is connected to the ends of separate respective arms rather than being directly connected to the arch structure of the aligner.

[0215] The system or method according to the fourth embodiment (wherein the braces include multiple individual arms configured to be individually connected to corresponding multiple teeth) can provide the following significant advantages: providing and controlling individual tooth movement. These advantages can enable the clinician to reduce tooth round trips, root resorption, and the number of trips the patient needs to the orthodontist, thereby reducing treatment time. Therefore, compared to traditional orthodontic techniques (wherein multiple teeth are connected to a single archwire so that moving one tooth causes unintentional movement of nearby teeth), the specific examples described herein allow the clinician to control the movement of each tooth independently of every other tooth.

[0216] In various examples of systems and methods according to the fourth embodiment, the aligner can be configured to move the teeth until the cap of the removable aligner is passive and does not apply force to the teeth. Similar to other embodiments described herein, the aligner according to the fourth embodiment can be designed and manufactured using computerized design and manufacturing techniques (such as, but not limited to, those described herein).

[0217] Similar to the third embodiment, various examples of the braces according to the fourth embodiment may include any suitable combination of aligners for some teeth and clasps for other teeth in the patient's jaw. In such an embodiment, the braces may include one or more aligners at the location of one or more corresponding teeth and one or more clasps at the location of one or more other teeth in the patient's jaw. Alternatively or additionally, different types of clasps may be employed at different tooth locations on the braces. For example, the flexibility of clasps made of NiTi on the posterior teeth may increase the retention ability of the braces. This may be helpful if a malocclusion requires better retention of the braces on the teeth.

[0218] The appliance according to the fourth embodiment may include one or more palatal arch features or lingual arch features, such as but not limited to: Figure 2 and Figure 8 Palatal arch feature 202 or 804 in, or Figure 3 The lingual arch feature 302 in the embodiment. The brace according to the fourth embodiment may include one or more anchoring device retainers for anchoring the brace to the patient's palate or lingual position, as described herein with respect to Figure 8 and Fig.10 812 or 904 in the anchoring device holder. In such an example, as described in the third embodiment, one or more anchoring devices (such as but not limited to TADs) can be implanted in the patient's palate or lingual region for engagement and disengagement (as well as selective connection and disconnection).

[0219] In a specific example of the system and method according to the fourth embodiment, as described above with respect to the third embodiment, the cap can be constructed to secure and retain the tooth by engaging a natural undercut on the tooth surface, or by an artificial undercut provided by an attachment or button secured to the tooth.

[0220] The arms of the brace according to the fourth embodiment (similar to the brace according to the second embodiment) may include one or more flexible elements, such as springs, that apply force and have a flexibility that can be selected or customized based on the size of the teeth and the desired movement of the teeth to which the arms are connected. In the brace according to the example of the fourth embodiment, a single cover is attached to each arm, and in particular examples, no portion of the flexible element of the arm or rod is covered. In other examples, more than one cover is attached to the arm, or more than one arm is attached to multiple covers or a combination thereof. A cover connector element (e.g., similar to the cover connector element 1804 described above) can be formed or otherwise connected to the end of each respective arm and can be connected to a single respective cover. In other examples, more than one cover connector is connected to one cover, or more than one cover is fixed to multiple cover connectors or a combination thereof.

[0221] In certain examples, the caps are configured to attach to the patient's teeth in such a manner as to avoid contact between caps for adjacent teeth. In this manner, the caps on the appliance (and the teeth to which they are secured) can move individually and independently of other caps on the appliance (and the teeth to which they are secured), and there is no need to restrict the movement of other caps on the appliance (and the teeth to which they are secured).

[0222] In an example of a rectifier according to the fourth embodiment, each cap may include a calibrator. In such an example, the calibrator may be used. A machine or other suitable thermoforming or vacuum forming machine attaches each aligner cover to a corresponding cover connector element on the arm of the orthosis.

[0223] In some examples, the aligner may cover the entire brace, for example, for patient comfort. In such examples, a space or gap between the spring on the arm and the aligner on the arm may be formed. In such examples, the patient may feel additional comfort because the patient's tongue will only contact the smooth surface of the aligner instead of the metal arm or rod of the brace. The aligner may be trimmed manually or with other suitable machining or cutting methods (such as, but not limited to, laser cutting, milling, etc.).

[0224] In other examples, the tooth can be retained by configuring one or more arms to pass through the lingual surface of the tooth via an incisal or interproximal surface and retain the tooth from the buccal side (similar to the different shapes of clasps in a partial denture). In another example, an appliance according to a fourth embodiment includes a rod on the buccal side, and the arms pass lingually on the tooth so that the tips of the arms in the removable appliance are located on the lingual side.

[0225] Systems or methods according to the third and fourth embodiments, wherein the aligner includes a plurality of aligner covers configured to be secured to the patient's teeth by fitting over and onto the teeth, can provide the unique advantage of an aligner that can be easily removed by the patient or clinician in a manner similar to that of conventional clear aligners.

[0226] Methods of Making and Using Embodiments

[0227] Systems and methods according to embodiments described herein may be employed to move or reposition teeth using one appliance or by gradually using several appliances (eg, depending on the complexity of the dental malocclusion).

[0228] According to various examples and embodiments described herein, the appliance may be constructed and used in a technique that enables translational orthodontic tooth movement in one or more (or all three) spaces (i.e., mesiodistal, buccolingual, and occlusal). Alternatively or additionally, such an appliance may be constructed and used in a technique that enables rotational motion such as torque, angle, and rotation (i.e., buccolingual root torque, mesiodistal angle, and mesiolateral rotation).

[0229] refer to Fig. 20 An example of a method 2000 of making and using an orthosis is described in accordance with various examples and embodiments described herein.

[0230] Fig. 20The method 2000 in includes obtaining 3D OTA data representing a patient's jaw (2002). The 3D OTA data may include, for example, digital image data obtained by using an intraoral scanner on the patient or by using an extraoral scanner on a plaster model of the patient's upper and lower dental arches. In other examples, the 3D OTA data may be obtained from other suitable devices and methods, such as, but not limited to, imaging the arrangement of teeth by cone beam computed tomography (CBCT) or magnetic resonance imaging (MRI). In examples using plaster models, the relationship between the teeth in the upper and lower arches (inter-arch relationship) can be obtained by the patient biting wax in a central position. In examples involving intraoral scanning, the inter-arch relationship can be recorded by the scanner.

[0231] The 3D digital image of the teeth obtained by the 3D OTA data is cut into blocks of a single tooth or multiple teeth (2004), that is, cut into one or more digital images of a single tooth. The 3D digital image can be cut and manipulated using a suitable processing and software system (for example, but not limited to a processing device running computer-aided design (CAD) software). The processing device may include any suitable computer system, mainframe, desktop computer, laptop computer, computer network device or system, mobile electronic tablet or communication device, etc. having the operating capabilities described herein.

[0232] The digital images of the various teeth are then moved to a desired or favorable inter-arch and intra-arch arrangement (2006) using a processing device and appropriate software, e.g., based on a clinician's prescription. For example, one or more (or all) teeth from the maxillary or mandibular (or both) are moved until their cusps have good interdigitation and fit. The desired or optimal arrangement of the teeth in the jaws can be identified as the FTA for the patient. In a specific example, a qualified clinician can approve the rearrangement after obtaining the 3D digital FTA from the 3D digital OTA.

[0233] The processing system interpolates the movement of teeth from the 3D digital OTA to the 3D digital FTA (2008). In examples where multiple aligners are used progressively through treatment to reach one or more ITAs before reaching the FTA, the processing system interpolates the movement of teeth from the 3D digital OTA to the one or more ITAs and from ITA to FTA. In other examples, the clinician may select the FTA or ITA, for example, based on the clinician's experience and knowledge, predetermined guidelines, or a combination thereof, without using computerized interpolation.

[0234] The processing system determines a three-dimensional appliance configuration (2010) based on the insertion movement of the teeth between the OTA and the FTA (including any ITA). The processing system calculates the force and torque required to move each tooth from the OTA to the FTA and any ITA (or uses the force and torque calculations required to move each tooth from the OTA to the FTA and any ITA). The processing system also calculates the force and torque provided by the appliance size and configuration (or uses the force and torque calculations provided by the appliance size and configuration), and based on these calculations, designs or otherwise determines the appropriate appliance configuration to provide the force and torque required to move each tooth from the OTA to the FTA and any ITA. By determining the appropriate thickness, width, and configuration of the springs, arms, and other components of the appliance according to one or more of the first, second, third, and fourth embodiments described herein, the appliance configuration that applies force and torque to the appropriate teeth to move the teeth to the FTA or ITA is determined. The appliance configuration for the FTA is determined, and a separate appliance configuration for each ITA is determined. The processing system provides data corresponding to each appliance configuration.

[0235] In a particular example, the design of the aligner can be performed by a clinician, manufacturer, or technician using a processor system and appropriate design software (such as, but not limited to, CAD software such as, but not limited to, Solidworks, Inventor, The springs and arms may be designed using FEA software such as, but not limited to, Abaqus, Ansys, etc., to apply the desired or optimal force to the teeth. For example, with reference to the first and third embodiments, such software and processing systems may be used to design and vary the thickness, cutting width, length, and overall configuration of each inter-tooth spring, depending on the desired movement of the tooth to which the spring is connected.

[0236] With reference to the second and fourth embodiments, software and processing systems based on the movement of the teeth to which the arms are connected can be used to design and change the thickness, cutting width, length, and overall design of each arm. For example, if the teeth need to be displaced a longer distance or the teeth are smaller (e.g., lower incisors), the springs or arms can be designed to be more flexible. Moreover, if necessary, the springs / arms can be designed to apply less force on some or all teeth due to periodontal problems such as bone resorption, root resorption, or attachment loss. The ability to customize the force or torque (or both) applied to each tooth can provide significant advantages over traditional orthodontics.

[0237] One or more aligners are manufactured based on data provided by the processing system (2012). The processing system can be connected to provide design data corresponding to the aligner configuration to one or more production or manufacturing systems for controlling the one or more production or manufacturing systems to manufacture one or more aligners (or components of one or more aligners) that are configured to provide forces and torques to move each tooth from the OTA to the FTA and any ITA. The connection of the processing system to the one or more production or manufacturing systems can be direct, for example, through an electronic network or other digital connection, or indirect, for example, by storing data from the processing system on a non-transitory storage medium and transporting the storage medium to the one or more production or manufacturing systems.

[0238] according to Fig. 20 The process can be adopted to manufacture one or more aligners according to the embodiments described herein. As described herein, each aligner can be installed on the patient's teeth to move the teeth from OTA to FTA (or to ITA, or from ITA to FTA or another ITA). The aligner can be designed to treat various tooth bites that can be treated with traditional orthodontics. In addition, the system and method including the aligner according to the embodiments described herein can be constructed to reduce the usual treatment time, reduce the clinic time, reduce the number of visits to the clinician, and reduce the complexity of the work performed by the clinician. Another advantage that can be obtained by the embodiments described herein is that the aligner according to such an embodiment can be configured to be installed behind the teeth (if necessary), for example, to minimize visibility. The embodiments described herein are suitable for changes in the patient's teeth that may occur as part of the treatment process. For example, as part of the treatment, due to the lack of space for all teeth to fit the dental arch (or other reasons), the clinician can extract one or more teeth of the patient. In that case, the extracted teeth can be erased from the 3D digital image used in the above calculation. If the clinician decides that the teeth need to be made smaller due to lack of space, the patient can undergo interproximal reduction (IPR). In this case, stripping and reducing the size of the tooth in the 3D digital image may be performed to match the IPR done by the clinician.

[0239] In the first and second embodiments described herein, the manufactured braces are configured to be mounted on the patient's teeth by engaging the male connector elements on the braces with the female connector elements bonded to the teeth. In such embodiments, the clinician can use 3D digital OTA when selecting the position and size of the female connector elements (brackets). In some examples, the female connector elements can be selected or customized according to the geometry of the tooth surface so that they fit precisely on the surface of the teeth. One option is to bond the female connector elements behind the teeth (to the lingual side of the teeth), for example, to make the braces more aesthetically attractive. Another option is to bond the female elements to the front of the teeth (the buccal side of the teeth). In the case of orthognathic surgery, the buccal version may be preferred, where the surgeon will benefit from easy access to the braces during surgery. However, even in the case of orthognathic surgery, the lingual version can be used. In this case, the female connector element can be installed on the buccal side before surgery and then removed, for example, within a few weeks after surgery.

[0240] A custom tray can be fabricated using 3D digital OTA, which is used to indirectly bond the female connector element on the tooth surface. The clinician can use the custom tray to attach the female connector element to the tooth surface using a composite resin or other bonding material. The tray can help the clinician bond the bracket in the optimal location on the tooth. If necessary, another custom tray can be fabricated using OTA to help the clinician implant a temporary anchor device (TAD) in the optimal location. Prior to using the tray as a guide for inserting the TAD, the clinician can anesthetize the desired insertion location for the patient's comfort. If additional anchoring is required for tooth movement, the TAD is placed. The decision whether to use a TAD can be made by the clinician and the selected treatment plan. If necessary, stability can be increased by including a palatal arch on the appliance for the maxilla or a lingual arch on the appliance for the mandible.

[0241] Alternatively, the clinician can attach the female component directly to the teeth without the aid of a tray. Likewise, the clinician can insert the TAD into the jaw without the use of a guide tray. In that case, after manually placing the female component or one or more TADs, the patient can be subjected to an intraoral scan, cone beam computed tomography (CBCT), or other suitable scan or imaging. The appliance will then be produced or manufactured based on the location of the female component or TAD selected by the clinician.

[0242] For the braces according to the third and fourth embodiments, the clinician can use 3D digital OTA to select the position and size of each cover and attachment element. The covers and attachment elements can be customized according to the geometry of the tooth surface so that they fit precisely on the surface of the tooth. In some examples, the attachment is attached behind the tooth (lingual side of the tooth), which makes the braces more aesthetically attractive. In other examples, the attachment is attached to the front of the tooth (buccal side of the tooth). In the case of orthognathic surgery, the buccal version may be preferred, where the surgeon will benefit from easy access to the braces during surgery. However, even in the case of orthognathic surgery, the lingual version can be used. In this case, the attachment can be installed on the buccal side before surgery and then removed, for example, within a few weeks after surgery.

[0243] Custom trays can be manufactured using 3D digital OTA for indirectly bonding attachments on tooth surfaces. Clinicians can use customized trays to attach attachments to tooth surfaces using composite resins or other bonding materials. The tray can help the clinician bond the attachment in a desired or optimal location. If necessary, another customized tray can be manufactured using OTA to allow the clinician to insert a temporary anchor device (TAD) into the desired or optimal location. Before using the tray as a guide for inserting the TAD, the clinician can anesthetize the desired insertion location for the comfort of the patient. These TADs are placed if additional anchoring is required for tooth movement. The decision whether to use TADs will be made by the clinician and the selected treatment plan. If necessary, stability can be increased by including a palatal arch on the appliance for the maxilla or a lingual arch on the appliance for the mandible.

[0244] Alternatively, the clinician can attach the attachment directly to the teeth without the aid of a tray. Likewise, the clinician can insert the TAD into the jaw without the use of a guide tray. In that case, after manually placing the female element or one or more TADs, the patient can be scanned intraorally, CBCT, or other suitable scan or imaging. The appliance will then be produced or manufactured based on the location of the attachment or TAD selected by the clinician.

[0245] In the first and second embodiments, after each appliance is manufactured and the female connector elements are attached to the teeth, each male element of the appliance will be engaged into its associated female element to install the appliance. Once installed, the appliance will apply force and torque on the teeth to move the teeth to the desired FTA or ITA. After each stage of treatment (OTA to FTA, OTA to ITA, ITA to ITA, or ITA to FTA) is completed, the male element will be passively located in the female element and force will no longer be applied to the teeth. At this stage, the male element can be removed and the next appliance can be installed using the same female connector element. However, if the previous appliance was an FTA-based appliance, then the treatment is complete. Based on the clinician's opinion, one or more appliances can be constructed and installed for finishing, detailing, and final fine positioning of the teeth.

[0246] In the third and fourth embodiments, after each appliance is manufactured, in some examples, each cover of the appliance can be engaged with the appropriate one or more teeth with the aid of attachments. Once installed, the appliance will apply forces and torques on the teeth to move the teeth to the desired FTA or ITA. After completing each stage of treatment (OTA to FTA, OTA to ITA, ITA to ITA, or ITA to FTA), the cover will passively sit on the teeth and forces will no longer be applied to the teeth. At this stage, the cover will be removed and the next appliance will be inserted into the patient's mouth. However, if the previous appliance was an FTA-based appliance, then the treatment is complete. Based on the clinician's opinion, one or more appliances can be constructed and installed for finishing, detailing, and final fine positioning of the teeth.

[0247] The braces according to the first and second embodiments and the female connector elements associated with those embodiments can be manufactured in any suitable manner, including but not limited to molding, casting, machining, 3D printing, stamping, extrusion, etc. For example, a 3D metal printer can be used to print the braces directly from nitinol, steel, beta-titanium, or other suitable metals or alloys. In other examples, the braces are first printed with castable wax, and then the wax pattern is investment cast into nitinol, steel, beta-titanium, and other metals or alloys. In another example, the braces are directly printed with a polymer or elastomeric material.

[0248] However, in certain embodiments, the orthotic device or the female connector element (or both) of the examples of the various embodiments described herein are made by cutting a 2D form of the orthotic device from a 2D sheet and bending the 2D form into the desired 3D shape of the orthotic device. These methods are particularly suitable for making orthotic devices according to the examples of the first and second embodiments described herein. Or for the arched structures or metal parts of orthotic devices according to the examples of the third and fourth embodiments described herein.

[0249] Thus, methods for manufacturing an orthosis according to any suitable example embodiment described herein, and in particular examples, for manufacturing an orthosis according to the embodiments described herein include designing an orthosis structure using a suitable processing system and hardware system, for example, as described herein with reference to method 2000, wherein manufacturing (2012) of one or more orthosis involves cutting a 2D form of the orthosis from a 2D sheet and bending the 2D form into a desired 3D shape of the orthosis.

[0250] More specifically, refer to Fig.21 , an example of manufacturing method 2100 (corresponding to feature 2012 in method 2000) includes forming a 3D image or template (2102) based on the 3D configuration determined at 2010 in method 2000. The image or template of the aligner can be generated by a clinician, manufacturer, or technician using a processor system and appropriate design software (such as, but not limited to, CAD software, such as, but not limited to, Solidworks, Inventor, etc.) to execute. and An example of a 3D template 1800 of an orthotic designed in Inventor is Fig.18a Shown in.

[0251] The method 2100 includes converting the 3D image or template into a 2D image or template (2104). This conversion may be performed using a processor system and appropriate flattening software (such as, but not limited to, or other suitable software). Fig.18b Shows Fig.18a An example of a 2D image or template 1802 of a 3D template.

[0252] Then, using a processor system and appropriate software (such as, but not limited to, CAD software, such as, but not limited to, Solidworks, Inventor, etc.), formed (2106) from a 2D image or template or based on a 2D image or template. Fig.18c Shown based on Fig.18b1804 of a 2D image or template of an orthosis. In certain examples, the 2D representation may include one or more temporary arms 1806 for securing the orthosis to the mandrel during the bending or setting (heat treatment) process. In other examples, the 2D representation may include one or more anchoring device holders, such as, but not limited to, those described herein.

[0253] The data corresponding to the 2D representation of the orthosis is then provided to a suitable manufacturing device (2108), such as, but not limited to, one or more machines that perform cutting, laser cutting, milling, wire cutting, water jetting, punching (stamping), etc., which is used to cut the flat sheet into a member having the 2D shape of the 2D representation of the orthosis. The manufacturing device is controlled by the data to manufacture a 2D member having the shape of the 2D representation of the orthosis. The 2D member (2110) can be cut from any suitable flat sheet, such as, but not limited to, Nitinol, stainless steel, cobalt chromium, or other types of metal. In a specific example, the flat sheet is a Nitinol (NiTi) plate, so that the 2D member Nitinol (NiTi) cut from the flat sheet has the shape of the 2D representation of the orthosis. Fig.18d Shown based on Fig.18c 1804 is an example of a 2D member 1808 manufactured. In the example where a temporary arm 1806 is added, the temporary arm can be omitted from the 2D member (or the temporary arm can be included and subsequently cut or removed from the 2D member).

[0254] After cutting a 2D component from a flat sheet of nitinol (NiTi) or other suitable material, the method includes bending the 2D component into a desired 3D shape (2112) corresponding to a 3D image or template for manufacturing the 2D component. In some examples, one or more mandrels are configured to bend the 2D component into a desired 3D shape configuration. In such an example, after cutting the 2D component, the 2D component is fixed on one or more mandrels or between one or more mandrels. The 2D component is bent on or between the mandrels to form a desired 3D shape. Fig.18e An example of an orthotic device 1810 having a 3D shape is shown by Fig.18d The 2D member 1808 is formed by bending into a desired configuration.

[0255] During or after the bending operation, one or more shape setting procedures 2114 (such as, but not limited to, heat treatment) can be applied to the 3D shape to set the desired 3D shape. Shape setting procedures involving heat treatment can include rapid cooling along with heating the component during or after bending.

[0256] An example of a heat treatment process may include heating the component (during or after it has been bent into the desired 3D shape) to a selected temperature (e.g., but not limited to 550 degrees Celsius) for a selected time (e.g., but not limited to 10 minutes) and then rapidly cooling it. Rapid cooling may be achieved by any suitable cooling procedure (e.g., but not limited to water quenching or air cooling). In other examples, the time and temperature of the heat treatment may be different from those discussed above, for example, based on a specific treatment plan. For example, the heat treatment temperature may be in the range of 200 degrees Celsius to 700 degrees Celsius, and the time of the heat treatment may be a time in the range of up to about 120 minutes. In a specific example, the heat treatment procedure may be performed in an air or vacuum furnace, a salt bath, a fluidized sand bed, or other suitable system. After the heat treatment is completed, the brace has the desired 3D shape and configuration. In other examples, other suitable heat treatment processes may be used, including but not limited to resistive heating or heating by passing an electric current through the metal of the brace structure. One or more additional, for example, post-processing operations may be provided on the 3D formed article, including but not limited to polishing, electrolytic polishing, electroplating, coating, sterilization or other cleaning or purification procedures).

[0257] As mentioned above, Fig.18e An example of an orthotic device 1810 having a 3D shape is shown by Fig.18d Another example of a 3D shaped orthotic device 1820 formed by bending a 2D member 1808 into a desired configuration is shown in Fig.18f Shown in. Fig.18f The exemplary orthosis 1820 in includes a plurality of arms having male connector elements 1822, similar to Fig.18e The male connector element 1802 of the orthosis 1810 in the example of FIG. However, the spring 1824 on the arm of the orthosis 1820 has a different shape than the spring on the arm of the orthosis 1810. In addition, Fig.18e The TAD retainer 1826 of the aligner 1820 has a generally U-shaped or Y-shaped structure, compared to the annular or O-shaped TAD retainer of the aligner 1810 in the illustrated example. Fig.18f The aligner 1820 in can be manufactured in a manner similar to the manner in which the aligner 1810 described herein is manufactured.

[0258] In examples where the brace is made of multiple components, some (or each) of the components of the brace may be made according to the methods described above (including but not limited to methods 2000 and 2100) and then connected together to form the desired 3D brace configuration. In these or other examples, the brace (or some or each of the components of the brace) may be made by other suitable methods, including but not limited to: direct printing of metal, first printing a wax component and then investment casting the wax component into metal or other material, printing an elastomeric material or other polymer, or cutting components from sheet metal and shaping them into the desired 3D configuration.

[0259] As discussed herein, one or more mandrels may be constructed to bend the cut 2D member into a desired 3D shape configuration. In a specific example, one or more mandrels are provided (e.g., but not limited to, customized) for each jaw of the patient. For example, the mandrel may be customized in shape and configuration for each patient, and may be manufactured in any suitable manner (including molding, machining, direct metal printing of stainless steel or other suitable metals, 3D printing of suitable materials (e.g., but not limited to steel / copper mixtures by binder jetting), and first printing the configuration in wax and then investment casting the wax member into various metals). In the various examples described herein, the mandrel may be made of a material sufficient to resist heat treatment temperatures. In a specific example, one or more robots may be used with or without one or more mandrels to bend the cut 2D member into a desired 3D shape configuration.

[0260] By employing cut 2D members rather than conventional single diameter wire, a wider variety of 3D shapes can be manufactured than shapes made by bending a single diameter wire. The cut 2D members can have set or varying widths and lengths, which when bent into the desired shapes can result in portions of the 3D brace having variations in thickness, width, and length dimensions. In this way, the 2D members can be cut into shapes that provide the desired thickness, width, and length of the spring member, arm, or other component of the brace. A wider variety of shapes can be provided by bending customized cut 2D members than by bending a single diameter wire.

[0261] As described above, the method 2100 in which the 3D device construction is made of the cut 2D components may be particularly suitable for manufacturing the metal parts of the corrector according to the first and second embodiments or the corrector according to the third and fourth embodiments. In a specific example, the entire corrector (including the male connector element and the spring) is constructed by bending the cut 2D component into the desired 3D shape component. In other examples, additional components can be attached to the 3D shape, for example, after bending 2112, wherein such additional components may include but are not limited to male connector elements (such as but not limited to those shown in Figure 12), spring components, arms, cover connector elements, TAD holders, etc. These additional components can be attached to the 3D shape component by any suitable attachment mechanism (including but not limited to adhesive materials, welding, friction fit, etc.).

[0262] Similarly, the metal portions of the braces according to the third and fourth embodiments may also be made from cut 2D members using methods 2000 and 2100 as described herein. Once the metal components of the braces are constructed (cut from 2D sheets and bent into the desired 3D shaped members), one or more covers may be attached to attachment elements formed on (or attached to) the metal components. In certain examples, the covers may be constructed and attached to the 3D shaped members so that the covers of adjacent teeth may not contact each other during treatment. In some examples, A TECHNOLOGY INC. machine or other suitable thermoforming or vacuum forming machine may be used to attach each cover to a corresponding cover connector element on the 3D shaped member.

[0263] For example, after bending (2112), additional components may be attached to the 3D shaped member, wherein such additional components may include, but are not limited to, male connector elements (such as, but not limited to, those shown in FIG. 12), spring members, arms, cover connector elements, TAD holders, etc. These additional components may be attached to the 3D shaped member by any suitable attachment mechanism, including, but not limited to, adhesive materials, welding, friction fit, etc.

[0264] The covers can be constructed and connected to the 3D shaped member with sufficient gaps between adjacent covers to provide room for the spring and arm to move. In a further example, the aligner covers are constructed to cover only the teeth, and the aligners can be trimmed manually or using another cutting method described herein.

[0265] Another method of manufacturing the orthosis according to the third embodiment is Figure 19a-Figure 19c Described and shown in Reference Fig.19a, according to the procedures described herein, a 3D printed model or mold 1900 of the patient's ITA or FTA is produced. The model or mold 1900 can be made of any suitable polymer, ceramic, metal, etc. In a further example, the mold may include more than Figure 19a-Figure 19c . In addition, the arch structure 1902 is made of metal or other suitable material according to the procedure for manufacturing the aligner of the first embodiment as described herein. In one example, the arch structure 1902 has the same Fig.17a In other examples, the arched structure 1902 may be placed in a model or mold, or as Fig.19a The depicted embodiment is attached to the model or mold by any suitable attachment mechanism including, but not limited to, adhesives, ligatures, etc.

[0266] Then, for example, use The heat curable material is pressed into the mold or die 1900 by a heat forming machine or other suitable thermoforming or vacuum forming machine while the arcuate structures 1902 are present in the mold or die. As a result, the arcuate structures are embedded in the heat curable material. In a specific example, the heat curable material is a heat curable plastic such as, but not limited to, a 10-mm thick plastic having a thickness of up to about 2 mm. Plastic sheet.

[0267] In other examples, one or more layers of heat-curable material may be pressed onto the model or mold 1900 before the arch 1902 is placed in the model or mold. Then, the arch 1902 may be placed on top of the heat-curable material (before or after the heat-curable material is set to the shape of the model or mold). Then, one or more layers of heat-curable material may be placed on the arch 1902 previously placed with the heat-curable material and set to the shape of the model or mold. Therefore, the arch 1902 may be fixed between two or more layers of heat-curable material to form the shape of the model or mold. In a specific example, the heat-curable material may be cut and removed (before or after heat curing) in the area covering the spring member or other flexible parts of the arch or the arm extending from the arch to minimize or eliminate any obstruction to the movement and flexibility of the spring member or the flexible part.

[0268] When sufficiently cured, the heat-curable material (having the arcuate members) is removed from the model or mold 1900. Fig.19b As shown, when removed from the model or mold, the molded plastic (and the arched structure embedded in the molded plastic) forms a three-dimensional structure 1910 for the cap of the whole jaw teeth. The molded plastic structure 1910 is then cut by forming an incision between each pair of adjacent teeth to form a three-dimensional structure 1910. Fig.19cBraces 1920 are shown. Such cutting can be performed by any suitable cutting procedure, such as, but not limited to, milling, laser cutting, etc. Although a variety of materials can be used for examples of braces according to the embodiments described herein, specific examples are made of a shape memory alloy such as Nitinol (NiTi) containing nickel and titanium. Nitinol can be sufficiently elastic and have shape memory properties. Therefore, by using Nitinol, the force applied to the teeth may decay more slowly than the force generator in traditional braces. Therefore, compared to traditional orthodontic techniques, the systems and methods according to the embodiments described herein can be configured to require fewer braces (therefore, simplifying treatment).

[0269] In some treatment processes, clinicians may extract teeth for various reasons, including crowding of teeth due to large teeth compared to the patient's jaw, damaged teeth that need to be extracted, or other reasons. When extraction is performed, adjacent unextracted teeth tend to move toward each other to close the extraction space. Certain systems and methods (including braces) according to the embodiments described herein can be used to asymmetrically (this is called minimum / maximum anchoring) or symmetrically (this is called medium anchoring) close the extraction space. In a specific example, TADs can also be used to provide anchoring for closing the extraction space. In such an example, one or more TADs can be arranged to hold a passive brace toward one side of the extraction space to asymmetrically close the space. On the other hand, one or more TADs can be arranged in the middle of the passive brace to symmetrically close the space. The closure of the space can be achieved by using a brace according to the embodiments described herein to change the angle of the teeth, or by using a more rigid spring for teeth that move relatively less. Similarly, more flexible springs can be used for teeth that need to move further.

[0270] refer to Fig.22a and Figure 22b An exemplary process for closing an extraction space using an orthotic device according to embodiments described herein is shown and described. Fig.22a and Figure 22b According to a third embodiment, an orthosis 2200 (shown in partial view) includes a plurality of caps 2201. The orthosis 2200 is shown with Fig.22a The teeth in the braces are disengaged and in an untensioned or passive state. The braces 2200 are shown engaged and secured to Figure 22b In the teeth. Figure 22b , an extraction space 2202 is shown, for example, where teeth (such as but not limited to premolars) have been extracted. When the aligner 2200 is installed, the spring member (formed by the interdental ring 2204) is in tension and exerts a force on one or two adjacent teeth (for example, on the upper second premolar 2206 and the upper canine 2208) to move those teeth and close the extraction space 2202.

[0271] Fig.23a and Figure 23b Another exemplary orthotic device according to a fourth embodiment is described and illustrated. Fig.23a In FIG. 2 , an example aligner 2300 (shown in partial view) according to certain embodiments described herein is in a passive state, for example, prior to being placed in a patient's mouth. Figure 23b In, the aligner 2300 is connected to the teeth, for example using a cap as described herein. Figure 23b In the embodiment, the arm 2302 of the aligner 2300 is connected to the canine teeth and is connected to the canine teeth. Fig.23a The arm 2302 is shown stretched due to the pull-out space and the force of the spring on the arm 2302.

[0272] As described, a processing system may be used by a clinician (or other appropriate person) to perform Fig. 20 and Fig.21 A general representation of a processing system 2400 that may employ such a method is shown in Fig.24 , and includes a processor 2401, an input device 2402, a display device 2403, and an imaging or scanning device 2404 (or other suitable device for imaging the OTA of a patient). As described herein, the processor 2401 can be connected to one or more manufacturing systems 2406 (including manufacturing machines) for manufacturing the aligner (and its components and tools). The processor 2401 can be connected to one or more manufacturing systems 2406 via any suitable communication connection 2408 (including but not limited to direct electronic connection, network connection, etc.). Alternatively or additionally, the connection 2408 can be provided by delivering to the manufacturing system 2406 a physical non-transient storage medium that has stored data from the processor. The non-transient storage medium may include but is not limited to one or more of an RSB-connectable memory, a memory chip, a floppy disk, a hard disk, an optical disk, or any other suitable non-transient data storage medium.

[0273] While various embodiments and examples described herein include or employ male connection elements on an appliance that engage and secure to female connection elements on the teeth, other embodiments and examples may be similarly constructed but with female connection elements on the appliance and male connection elements on the teeth.

[0274] The embodiments disclosed herein are considered to be illustrative and non-restrictive in all aspects. The present disclosure is not limited to the above-described embodiments in any way. Various modifications and changes may be made to the embodiments without departing from the spirit and scope of the present disclosure. Various modifications and changes within the meaning and scope of the equivalents of the claims are intended to fall within the scope of the present disclosure.

Claims

1. A method of forming an orthodontic appliance, comprising: providing a two-dimensionally shaped member, the member comprising an arcuate portion and arm portions extending outwardly from the arcuate portion, each of the arm portions being spaced apart from one another along the length of the arcuate portion, at least one of the arm portions comprising a spring portion configured to apply a biasing force to a tooth of the patient when the orthodontic appliance is installed in the patient's mouth; manipulating the member from the two-dimensional shape to a desired three-dimensional shape, wherein when in the three-dimensional shape, the member is configured to be positioned in an oral cavity of a patient such that at least some of the arm portions are positioned adjacent to respective teeth of the patient and the arcuate portion extends along a jaw of the patient; as well as Heat is applied to the component while the component is maintained in the three-dimensional shape such that the component substantially maintains the three-dimensional shape when heat is no longer applied to the component.

2. The method according to claim 1, wherein: Providing the component in a two-dimensional shape includes cutting the component from a material.

3. The method according to claim 1, wherein: Providing the component in a two-dimensional shape includes cutting the component from a generally planar sheet.

4. The method according to claim 1, wherein: The component comprises metal, and optionally, wherein the component comprises a shape memory alloy.

5. The method according to claim 1, wherein: In the two-dimensional shape, the arcuate portion and the arm portion are substantially in the same plane.

6. The method according to claim 1, further comprising: obtaining first data representing a three-dimensional representation of the patient's teeth in an original tooth arrangement (OTA); obtaining second data representing a three-dimensional representation of the patient's teeth in a final tooth arrangement (FTA); as well as Tooth movement data is obtained characterizing a desired movement of at least some of the patient's teeth from the original tooth arrangement to the final tooth arrangement.

7. The method according to claim 6, further comprising: At least one of a thickness, a cutting width, a length or a shape of each of the arm portions is selected based on the tooth movement data.

8. The method according to claim 6, further comprising: The magnitude and direction of the force and the magnitude and direction of the torque required to move each tooth of the patient between the original tooth arrangement and the final tooth arrangement are determined based on the tooth movement data.

9. The method according to claim 1, wherein: Manipulating the member includes securing the member to a fixture of a three-dimensional shape and / or bending the member.

10. The method according to claim 1, wherein: Applying heat includes heating the three-dimensionally shaped member to a temperature between 200°C and 700°C.

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