Orthodontic appliance with elastic body

Abstract

An improved orthodontic appliance, and related systems and methods are provided. In one aspect, the appliance includes a housing having a plurality of cavities formed to receive teeth, and a discontinuity formed in the housing. The appliance also includes a resilient member having a first portion directly coupled to the housing at a first attachment point, and a second portion directly coupled to the housing at a second attachment point. The resilient member can be positioned to interact with the discontinuity.

Description

[0001] This application is a divisional application based on patent application number 201580006795.X (PCT / IB2015 / 000112) filed on January 30, 2015 and entitled “ORTHONTONIC APPLIANCE WITH ELASTOMER” (date of entry into the Chinese national phase: August 1, 2016).

[0002] Cross-references

[0003] This application claims the benefit of U.S. Provisional Application No. 61 / 934,657, filed January 31, 2014, which is hereby incorporated by reference in its entirety. Background Art

[0004] In order to correct malocclusion and / or improve aesthetics, the orthodontic process generally involves repositioning the patient's teeth to a predetermined arrangement. To achieve these goals, orthodontic appliances such as braces, retainers, shell-shaped appliances, etc. can be applied to the patient's teeth by an orthodontist. Specifically, the appliance is configured to apply a force to one or more teeth in order to produce the desired tooth movement. In order to incrementally reposition the teeth to the desired arrangement, the application of force can be periodically adjusted by the practitioner (e.g., by changing the appliance or using a different type of appliance).

[0005] However, in some cases, current orthodontic appliances may not be able to effectively generate the forces required to achieve the desired tooth repositioning, or may not provide adequate control over the forces applied to the teeth. In addition, the stiffness of some existing appliances may interfere with the ability of the appliance to attach to the patient's teeth and may increase the patient's discomfort. Summary of the invention

[0006] An improved orthodontic appliance and related systems and methods are provided. In many embodiments, an orthodontic appliance configured to be worn on a patient's teeth includes a discontinuity and an elastic member that interacts with the discontinuity or is configured to interact with the discontinuity. The appliance described herein provides enhanced control of the forces applied to the teeth, thereby enabling improved orthodontic treatment.

[0007] Thus, in one aspect, an orthodontic appliance is provided. The orthodontic appliance comprises: a housing including a plurality of cavities formed to receive teeth; and a discontinuity formed in the housing. In many embodiments, the resilient member is directly attached to the housing at a first attachment point and a second attachment point and is positioned to interact with the discontinuity.

[0008] Other objects and features of the present invention will become apparent from a thorough reading of the specification, claims and accompanying drawings.

[0009] Incorporation by Reference

[0010] All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantageous effects of the invention will be obtained by reference to the following detailed description setting forth an illustrative embodiment in which the principles of the invention are implemented, and the accompanying drawings which are as follows:

[0012] Figure 1A A tooth repositioning appliance according to many embodiments is illustrated;

[0013] Figure 1B illustrates a tooth repositioning system according to many embodiments;

[0014] Figure 1C A method of orthodontic treatment utilizing multiple appliances is illustrated in accordance with many embodiments;

[0015] Figure 2A illustrates an exemplary orthodontic appliance having attached elastic members and interruptions according to many embodiments;

[0016] Figure 2B The diagram shows the Figure 2A Orthodontic appliances;

[0017] Figure 2C illustrates an exemplary orthodontic appliance having attached elastic members and interruptions according to many embodiments;

[0018] Figure 2D The diagram shows the Figure 2C Orthodontic appliances;

[0019] Figure 2E Another example of an orthodontic appliance having attached elastic members and interruptions is illustrated in accordance with many embodiments;

[0020] Figure 2F The diagram shows the Figure 2E Orthodontic appliances;

[0021] Figure 2G An example of an orthodontic appliance having multiple elastic members and interruptions according to many embodiments is illustrated;

[0022] Figure 2H The diagram shows the Figure 2G Orthodontic appliances;

[0023] Fig.2I illustrates additional exemplary geometries for interruptions in orthodontic appliances according to many embodiments;

[0024] Figure 3A An orthodontic appliance for repositioning teeth according to many embodiments is illustrated;

[0025] Figure 3B The diagram shows the Figure 3A Orthodontic appliances;

[0026] Figure 4A An orthodontic appliance for repositioning teeth according to many embodiments is illustrated;

[0027] Figure 4B Another orthodontic appliance for repositioning teeth is illustrated in accordance with many embodiments;

[0028] Figure 5A An orthodontic appliance for repositioning teeth according to many embodiments is illustrated;

[0029] Figure 5B The diagram shows the Figure 5A Orthodontic appliances;

[0030] Figure 5C Illustration of the tooth after repositioning has occurred Figure 5B Orthodontic appliances;

[0031] Figure 6 An orthodontic appliance including a channel for receiving an attachment on a tooth is illustrated according to many embodiments;

[0032] Fig. 7A Another example of an orthodontic appliance for repositioning teeth according to many embodiments is illustrated;

[0033] Figure 7B The diagram shows the Fig. 7A Orthodontic appliances;

[0034] Figure 7C Pictured Fig. 7A The occlusal surface of the appliance;

[0035] Fig.7D Illustration of the tooth after repositioning has occurred Figure 7B Orthodontic appliances;

[0036] Fig. 8A An orthodontic appliance having an elastomeric body and associated guiding features is illustrated in accordance with many embodiments;

[0037] Figure 8B The diagram shows the Fig. 8A Orthodontic appliances;

[0038] Figure 8C Illustration of the tooth after repositioning has occurred Figure 8B Orthodontic appliances;

[0039] Fig.8D illustrates an orthodontic appliance having a telescoping housing segment according to many embodiments;

[0040] Fig. 8E The diagram shows the Fig.8D Orthodontic appliances;

[0041] Fig.8F Illustration of the tooth after repositioning has occurred Fig. 8E Orthodontic appliances;

[0042] Figure 8G yes Figure 8C A cross-sectional view of a segment of an appliance;

[0043] Figure 8H is a top view of a retractable guide feature according to many embodiments;

[0044] Fig.8I yes Figure 8H A side view of a retractable guide feature;

[0045] Fig. 9 An orthodontic appliance for maintaining the current position of a patient's teeth is illustrated in accordance with many embodiments;

[0046] Fig. 10A An orthodontic appliance having a protrusion according to many embodiments is illustrated;

[0047] Fig. 10B The diagram shows the Fig. 10A Orthodontic appliances;

[0048] Fig. 10C Illustration of the tooth after repositioning has occurred Fig. 10B Orthodontic appliances;

[0049] Fig. 10D illustrates an appliance divided into separate shell sections according to many embodiments;

[0050] Fig.10E The diagram shows the Fig. 10D Orthodontic appliances;

[0051] Fig.10F Illustration of the tooth after repositioning has occurred Fig.10E Orthodontic appliances;

[0052] Figure 10G yes Fig. 10C A perspective view of the appliance;

[0053] Fig.11A An orthodontic appliance configured to engage an attachment is illustrated according to many embodiments;

[0054] Fig. 11B The diagram shows the Fig.11A Orthodontic appliances;

[0055] Fig. 12A Another exemplary orthodontic appliance configured to engage an attachment is illustrated in accordance with many embodiments;

[0056] Fig. 12B The diagram shows the Fig. 12A Orthodontic appliances;

[0057] Fig.13A Still another orthodontic appliance configured to engage an attachment is illustrated in accordance with many embodiments;

[0058] Fig. 13B The diagram shows the Fig.13A Orthodontic appliances;

[0059] Fig.14A An orthodontic appliance configured to engage an attachment is illustrated according to many embodiments;

[0060] Fig. 14B The diagram shows the Fig.14A Orthodontic appliances;

[0061] Fig. 14C An orthodontic appliance including features for securing an elastic member according to many embodiments is illustrated;

[0062] Fig.14D Another orthodontic appliance including features for securing an elastic member according to many embodiments is illustrated;

[0063] Figures 15A to 15D illustrates an exemplary flap geometry of an orthodontic appliance configured to engage an attachment according to many embodiments;

[0064] Fig.15E An orthodontic appliance including a plurality of flaps for engaging attachments on a plurality of teeth is illustrated in accordance with many embodiments;

[0065] Fig.15F Illustration of the tooth after repositioning has occurred Fig.15E Orthodontic appliances;

[0066] Fig.16A is a cross-sectional view of an inner surface profile of an orthodontic appliance including a protrusion according to many embodiments;

[0067] Fig. 16B yes Fig.16A A cross-sectional view of a housing of an appliance;

[0068] Fig. 16C The diagram shows the Fig. 16B Shell;

[0069] Fig.17A is a cross-sectional view of an inner surface profile of another exemplary orthodontic appliance including a protrusion according to many embodiments;

[0070] Fig. 17B yes Fig.17A A cross-sectional view of a housing of an appliance;

[0071] Fig. 17C The diagram shows the Fig. 17B Shell;

[0072] Figures 18A to 18C illustrates an exemplary orthodontic appliance including a protrusion and an elastic body according to many embodiments;

[0073] Fig.19 Another exemplary orthodontic appliance having a protrusion according to many embodiments is illustrated;

[0074] Fig. 20A An orthodontic appliance housing having an elastic member and an attachment is illustrated according to many embodiments;

[0075] Fig. 20B An elastic member with an attachment body according to many embodiments is illustrated;

[0076] Fig. 20C The diagram shows the link to Fig. 20A of the appliance Fig. 20B elastic components;

[0077] Figures 21A to 21F An orthodontic appliance having multiple interruptions is illustrated according to many embodiments;

[0078] Figures 22A to 22D illustrates the direction of a resilient member that affects the force applied to a tooth according to many embodiments;

[0079] Figures 23A to 23D An orthodontic appliance configured to produce tooth rotation is illustrated in accordance with many embodiments;

[0080] Figures 24A to 24D An orthodontic appliance configured to produce tooth rotation is illustrated in accordance with many embodiments;

[0081] Fig.25A and 25BAn orthodontic appliance with a retractable guide feature is illustrated according to many embodiments;

[0082] Figures 26A to 26D An orthodontic appliance having a biasing feature according to many embodiments is illustrated;

[0083] Fig. 27 is a schematic illustration in the form of a block diagram of a method for orthodontic treatment according to many embodiments;

[0084] Fig.28 is a schematic illustration in the form of a block diagram of a method for designing an orthodontic appliance according to many embodiments;

[0085] Fig.29 illustrates a method for digitally planning an orthodontic treatment according to many embodiments; and

[0086] Fig.30 is a simplified block diagram of a data processing system in accordance with many embodiments. DETAILED DESCRIPTION

[0087] In order to reset more than one tooth, maintain the current position of more than one tooth, or a suitable combination of the two, the orthodontic appliance described herein and its related systems and methods can be used as part of the orthodontic treatment measures. Such an appliance can include a shell, which is formed to accommodate the patient's teeth, and in order to achieve the desired positioning of the teeth, the geometry of the shell is selected to apply appropriate forces to the teeth. In many embodiments, the orthodontic appliance described herein utilizes more than one elastic component (also referred to herein as "elastic body"), which works together with more than one discontinuity formed in the shell to apply orthodontic force to the teeth. The geometry and construction of more than one discontinuity and / or more than one elastic component can be selected to control the magnitude and direction of the applied force. In existing methods, more than one elastic body is fastened to the teeth or to more than one attachment mounted on the teeth. Compared to the existing method, the appliance disclosed herein uses more than one elastic component that is directly connected to the shell and applies force to the teeth via interaction with the discontinuity. Such an appliance can be used to generate a larger force and / or a more precisely controlled force for orthodontic applications. Furthermore, the geometry and configuration of one or more discontinuities and / or one or more elastomers can be used to adjust the local compliance of the appliance, thereby improving device fit and reducing patient discomfort. Additionally, by locally controlling the compliance of the shell, the techniques described herein can be used to ensure that some or all points on the appliance that are intended to apply force to the teeth (also known as "action points") maintain adequate contact with the teeth throughout the treatment process, thereby improving the accuracy and efficiency of the repositioning. The amount of force applied to the teeth at each action point can be varied based on the compliance of the shell, and the configuration of the discontinuities and / or elastomers.

[0088] Thus, in one aspect, an orthodontic appliance can include: a housing having a plurality of cavities formed to receive teeth; and a discontinuity formed in the housing. The appliance also includes a resilient member having: a first portion directly attached to the housing at a first attachment point, and a second portion directly attached to the housing at a second attachment point. The resilient member can be positioned to interact with the discontinuity. For example, the resilient member can interact with an area of ​​the housing on an opposite side of the discontinuity to accommodate changes in the configuration and / or size of the discontinuity during installation of the appliance onto the teeth and / or during repositioning of one or more teeth.

[0089] The orthodontic appliance can be configured to receive an attachment coupled to a tooth. A portion of the resilient member between the first attachment point and the second attachment point can engage with the attachment or be engageable to the attachment.

[0090] The orthodontic appliance can be configured to reduce one or more spaces between teeth. For example, the orthodontic appliance can include one or more elastic members and one or more interruptions configured to cause movement of the teeth when the appliance is worn on the teeth, which movement reduces the size of the interproximal space between the teeth.

[0091] Any suitable configuration and / or number of discontinuities can be employed.For example, the discontinuity can be or include an aperture in the housing, a cutout in the housing, or a deformation of the housing.

[0092] In many embodiments, a portion of the resilient member between the first attachment point and the second attachment point extends along the surface of the housing such that the portion spans across a plurality of cavities. The discontinuity can include a plurality of openings disposed in the housing between the first attachment point and the second attachment point. When the appliance is worn on the tooth, each of the plurality of openings can be adjacent to or proximal to an interproximal region of the tooth.

[0093] In many embodiments, when the appliance is not worn on the teeth, the mesial-distal dental arch length of the shell is shorter or adapted to be shorter, and when the appliance is worn on the teeth, the length is longer or adapted to be longer. For example, an orthodontic appliance can include one or more interruptions and one or more elastomers such that the dental arch length of the shell depends on whether the appliance is worn on the teeth. As another example, the interruptions can divide the shell into separate segments, and one or more elastomers connect the segments so that the segments can move relative to each other so that the dental arch length of the shell can change depending on whether the appliance is worn on the teeth.

[0094] The orthodontic appliance may include one or more elastic members spanning the discontinuity.For example, the orthodontic appliance can include a discontinuity in the form of an elongated opening in the housing, with a portion of the elastic member between the first and second attachment points spanning the elongated opening.

[0095] In many embodiments, the first attachment point and the second attachment point are disposed on the housing so that when the appliance is worn on the teeth, the portion of the elastic member between the first attachment point and the second attachment point is adjacent to or close to the interproximal region of the teeth. For example, the first attachment point can be disposed on the lingual surface of the housing, and the second attachment point can be disposed on the buccal surface of the housing. In another example, the first attachment point and the second attachment point can be disposed on the lingual surface of the housing, respectively. Also as an example, the first attachment point and the second attachment point can be disposed on the buccal surface of the housing, respectively.

[0096] In many embodiments, the appliance includes one or more guide features formed in the housing and configured to guide relative movement between portions of the housing, wherein the relative movement is caused by a force applied by the resilient member. The one or more guide features can affect at least one of a direction and a magnitude of the force applied by the resilient member. In some cases, the one or more features can include a retractable feature formed in the housing.

[0097] The appliance may include one or more retaining features formed in the housing, and the retaining features are configured to retain a portion of the elastic component at a specific position relative to the housing. One or more retaining features can include a slot formed in the housing, and a portion of the elastic component is retained in the slot.

[0098] In many embodiments, at least one of the first attachment point and the second attachment point includes a hook formed in the housing, the hook being configured to secure the resilient member to the housing. A portion of the resilient member can extend between the first attachment point and the second attachment point.

[0099] In many embodiments, the discontinuity forms a flap at a location of the housing configured to accommodate an attachment that is mounted on a tooth that can be received within a cavity of the housing. The portion of the resilient member between the first attachment point and the second attachment point extends around the flap to engage the attachment so that the resilient member applies force directly to the attachment. As another example, the portion of the resilient member between the first attachment point and the second attachment point can span the flap so that the resilient member applies force to the attachment through the flap.

[0100] In another aspect, an orthodontic treatment method includes providing an orthodontic appliance, the orthodontic appliance including: a housing including a plurality of cavities formed to receive teeth; and a discontinuity formed in the housing. The resilient member can be directly attached to the housing at a location where the resilient member and the discontinuity interact, wherein at a first attachment point, a first portion of the resilient member is directly attached to the housing, and at a second attachment point, a second portion of the resilient member is directly attached to the housing. The appliance is placed on a patient's teeth. A force can be applied to the teeth via the interaction of the resilient member and the discontinuity.

[0101] In many embodiments, the resilient member and the discontinuity are configured to cause movement of the teeth to reduce the size of the interproximal space between the teeth. The discontinuity may be a hole in the shell, a cutout in the shell, or a deformation of the shell. In some cases, a portion of the resilient member between the first attachment point and the second attachment point extends along a surface of the shell such that the portion spans across a plurality of the cavities.

[0102] In many embodiments, when the appliance is not worn on the teeth, the mesiodistal length of the housing is shorter or adapted to be shorter, and when the appliance is worn on the teeth, the mesiodistal length of the housing is longer or adapted to be longer. One or more guide features can be formed in the housing and configured to guide movement of a portion of the housing, wherein the movement is caused by a force applied to the portion by the elastic member.

[0103] In another aspect, an orthodontic system includes: a plurality of orthodontic appliances, each of the orthodontic appliances including a housing including a plurality of cavities formed to receive teeth. The appliances can be adapted to be worn sequentially by a patient to move one or more teeth from a first arrangement to a second arrangement. At least one of the appliances includes: a discontinuity formed in the housing; and a resilient member positioned to interact with the discontinuity. The resilient member can have: a first portion directly attached to the housing at a first attachment point, and a second portion directly attached to the housing at a second attachment point.

[0104] In many embodiments, the interruption comprises an elongated opening in the housing, and a portion of the elastic member between the first attachment point and the second attachment point spans the elongated opening. The first attachment point and the second attachment point can be positioned on the housing so that when the braces are worn on the teeth, the portion of the elastic member between the first attachment point and the second attachment point is adjacent to or close to the interproximal area of ​​the teeth.

[0105] In many embodiments, one or more retaining features are formed in the housing and are configured to retain a portion of the resilient member at a specific position relative to the housing. In some cases, at least one of the first attachment point and the second attachment point includes a hook formed in the housing, the hook being configured to secure the resilient member to the housing.

[0106] In many embodiments, a portion of the resilient member extends between the first attachment point and the second attachment point. The interruption can form a flap at a location of the housing configured to receive an attachment mounted on a tooth that can be received in a cavity of the housing.

[0107] Turning now to the drawings, wherein like numerals represent like elements throughout the various views, Figure 1AAn exemplary tooth repositioning appliance or aligner 100 that can be worn by a patient in order to achieve incremental repositioning of individual teeth 102 in the mandible is shown. The appliance can include a housing (e.g., a polymeric housing) having a tooth receiving cavity that receives and resiliently repositions the teeth. In many embodiments, the polymeric appliance can be formed by a polymeric material plate of an appropriate layer. The appliance can fit on all teeth present in the upper or lower jaw, or less than all teeth. The appliance can be specifically directed to accommodating the patient's teeth (e.g., the morphology of the tooth receiving cavity matches the morphology of the patient's teeth), and can be manufactured based on a positive or negative mold of the patient's teeth generated by an impression, a scan, etc. Alternatively, the appliance can be a common appliance that is constructed to receive teeth, and does not necessarily have to be molded to match the morphology of the patient's teeth. In some cases, only certain teeth received by the appliance will be repositioned by the appliance, while other teeth can be provided for holding the base or anchoring area of ​​the appliance in a suitable position while applying force to more than one tooth intended to be repositioned. In some cases, at some point during the treatment, many, most, or even all of the teeth will be repositioned. The teeth that are moved can also serve as a base or anchor for holding the appliance while it is worn by the patient. Specifically, no wires or other devices will be provided on the teeth to hold the appliance in place. However, in some cases, it is desirable or necessary to provide corresponding receptacles or apertures 106 in the appliance 100 for attachments 104 or other anchoring elements on the teeth 102 so that the appliance can apply a selected force to the teeth. Exemplary aligners for use in the Invisalign® System are described in a number of patents and patent applications assigned to Align Technology, Inc., including, for example, in U.S. Pat. Nos. 6,450,807 and 5,975,893, as well as on the company's website accessible on the World Wide Web (see, for example, the website "invisalign.com").

[0108] exist Figure 1A In the illustrated embodiment, the appliance 100 is designed to fit over a single dental arch of a patient's dentition 102, which is represented by a positive model of the dentition. The appliance 100 includes a receptacle 106 formed in a housing and configured to receive an attachment 104, such as a bracket mounted to the patient's teeth (capable of corresponding with the same attachment on the teeth of the positive model). When engaged by the appliance 100 (e.g., via the receptacle 106), the attachment 104 is capable of transmitting a repositioning force applied by the housing to the teeth. Other examples of brackets and other dental attachments suitable for use with orthodontic appliances are described in U.S. Patent Nos. 6,309,215 and 6,830,450.

[0109] Figure 1B A tooth repositioning system 110 including a plurality of appliances 112, 114, 116 is illustrated. Any of the appliances described herein can be designed and / or arranged as part of a set of a plurality of appliances. In such an embodiment, each appliance can be constructed so that the tooth receiving cavity has a geometry corresponding to an intermediate tooth arrangement or a final tooth arrangement to be achieved using the appliance. By placing a series of incremental position adjustment appliances on the patient's teeth, the patient's teeth can be gradually repositioned from an initial tooth arrangement to a target tooth arrangement. For example, the tooth repositioning system 110 can include: a first appliance 112, which corresponds to an initial tooth arrangement; one or more intermediate appliances 114, which correspond to one or more intermediate arrangements; and a final appliance 116, which corresponds to a target arrangement. The target tooth arrangement can be a planned final tooth arrangement, which is the final tooth arrangement selected for the patient's teeth at the end of all planned orthodontic treatments. Alternatively, the target arrangement can be one of many intermediate arrangements of the patient's teeth during the course of orthodontic treatment, which may include where surgery is recommended, where interproximal removal (IPR) is appropriate, where further examination is planned, where anchor placement is optimal, where jaw expansion is desired, etc. Thus, it is understood that the target tooth arrangement can be any planned final arrangement of the patient's teeth after one or more incremental repositioning stages. Similarly, the initial tooth arrangement can be any initial arrangement of the patient's teeth followed by one or more incremental repositioning stages.

[0110] Figure 1CA method 150 of orthodontic treatment using multiple appliances according to many embodiments is illustrated. The method 150 can be implemented using any appliance or set of appliances described herein. In step 160, a first orthodontic appliance is applied to the patient's teeth in order to reposition the teeth from a first tooth arrangement to a second tooth arrangement. In step 170, a second orthodontic appliance is applied to the patient's teeth in order to reposition the teeth from the second tooth arrangement to a third tooth arrangement. The method 150 can be repeated as needed using any suitable number and combination of sequential appliances in order to incrementally reposition the patient's teeth from an initial arrangement to a target arrangement. The appliances can be produced in the same stage or in groups or batches (e.g., at the beginning of a stage of treatment), or the appliances can be manufactured one at a time, and the patient can wear each appliance until the pressure of the individual appliances on the teeth is no longer felt, or until the maximum amount of tooth movement effected for that given stage has been reached. Multiple different appliances (e.g., a set) can be designed and even manufactured before the patient wears any of the multiple appliances. After wearing the appliance for an appropriate period of time, the patient can replace the current appliance with the next appliance in the series until there is no appliance left. The appliance is usually not attached to the teeth, and the patient can place and replace the appliance at any time point during the process (e.g., the patient can remove the appliance). The final appliance or the final few appliances in the series can have a geometry selected to overcorrect the tooth arrangement. For example, more than one appliance can have such a geometry: it will (if fully realized) move each tooth across the tooth arrangement that has been selected as the "final". In order to offset the potential rebound after the resetting method has been terminated (e.g., allowing each tooth to move toward their pre-corrected position), such overcorrection is desired. Overcorrection can also be beneficial to accelerate correction (e.g., an appliance with a geometry positioned to exceed the desired intermediate or final position can cause each tooth to shift toward the position at a faster speed). In such a case, before the tooth reaches the position defined by the appliance, the use of the appliance can be terminated. Furthermore, overcorrection may be intentionally applied to compensate for errors or limitations of the appliance.

[0111] In many cases, orthodontic appliances include more than one elastic component. The elastic component can be a band, a rope, a strip, a ring, a line, a spring, a mesh, a film, a bracket, a layer or any other suitable elastic connecting element, and can be made of materials such as one or more polymers, one or more metals or composite materials. In many embodiments, the elastic component can be manufactured by extrusion, rapid prototyping, injection, thermoforming or their appropriate combination. The elastic component can be manufactured by a single type of elastic material or a variety of different types of elastic materials. The properties of the elastic material (e.g., length, width, thickness, area, shape, cross-section, stiffness, etc.) can be selected based on the desired performance of the elastic component, for example, the size and / or direction of the force to be applied by the elastic material.

[0112] The orthodontic appliance can include: a housing having a tooth receiving cavity as previously described herein; and one or more elastic members, which are connected to the housing. Various configurations for connecting the elastic member to the housing are possible. At an appropriate number (e.g., one, two, three, four or more) of attachment points, one or more portions of the elastic member (e.g., portions at or near each end of the elastic member) can be connected to the housing. As an alternative or in addition, one or more portions of the elastic member can be connected to the housing over a continuous attachment area. Any description of the attachment point herein can also be applied to the attachment area, and vice versa. Each attachment point can be located at any appropriate portion of the housing, such as a buccal surface, a lingual surface, an occlusal surface, a gingival surface, an inner surface (e.g., a surface adjacent to or close to a tooth), an outer surface (e.g., a surface away from a tooth), or an appropriate combination thereof. In order to control the force applied to the tooth (e.g., the magnitude and / or trajectory of the force), the position of the attachment point can be selected. In many embodiments, the elastic component is directly connected to the attachment point on the shell without the use of an intervening attachment element or fastener. For example, the elastic component can be directly connected to the shell using an adhesive and / or bonding. As another example, the attachment point on the shell can be formed with or formed as one or more hooks, protrusions, apertures, ridges or other such features suitable for directly fastening the elastic component to the shell (for example, integrally formed as a single piece or a whole piece). In an alternative embodiment, the elastic component can be indirectly connected to the shell (for example, via an attachment element or fastener that is not integrally formed as a single piece or a whole piece with the shell). In some cases, the elastic component is permanently attached to the shell. On the contrary, the elastic component can be removably connected or can be detached from the shell. In many embodiments, the elastic component is only connected to the shell and is not connected to the patient's teeth or attachments mounted on the teeth.

[0113] The orthodontic appliance described herein can include one or more interruptions formed in the shell. One or more interruptions can include one or more incisions, flaps, pores (e.g., openings, windows, gaps, notches) and / or deformations formed in any appropriate portion of the shell (e.g., on the buccal, lingual, occlusal and / or gingival surfaces). The exemplary geometric structure of such interruptions will be further described in detail herein. The interruptions provided herein can be used to control the force applied to the patient's teeth through the orthodontic appliance. In many embodiments, in order to generate the desired force, one or more interruptions are used in combination with one or more elastic components. In an alternative embodiment, the orthodontic appliance can include one or more interruptions without using any elastic components, so that the force applied to the teeth is adjusted by using the interruptions alone.

[0114] In many embodiments, one or more elastic members are positioned to interact with one or more discontinuities in the housing of the appliance. In some cases, the discontinuity is positioned between two or more attachment points for the elastic member, such that the portion of the elastic member extending between the attachment points spans the discontinuity (or at least a portion of the discontinuity). Alternatively or additionally, the portion of the elastic member between the attachment points can extend around the discontinuity (e.g., around the aperture or petal of the discontinuity). The elastic member can interact with the discontinuity by applying force directly to the discontinuity (e.g., pressing or pulling on the petal, deformation, etc.) and by applying force to a portion of the housing adjacent to the discontinuity (e.g., applying force to a portion of the housing around the cutout, aperture). Such interaction can include, for example, the elastic member applying force on the discontinuity or in the region of the discontinuity when the appliance is worn (e.g., such that the resultant force is in a direction suitable for changing the shape of the discontinuity), and / or the elastic member applying force on the discontinuity when the appliance is not worn. In many embodiments, the applied force is at least partially caused by deformation (e.g., expansion, compression, bending, flexion) of the elastic member. In some cases, the deformation of the elastic member can be caused by deformation of the corresponding discontinuity and / or the shell, such as the deformation caused when the aligner is placed on the teeth, which will be further described below.

[0115] The interaction of the elastic member with the interruption can cause a force to be applied to a portion of the appliance housing. The corresponding resultant force can be transmitted to the teeth below via the housing, causing tooth movement (e.g., extrusion, inward push, rotation, twisting, tilting and / or translation) toward a specific tooth arrangement. As the teeth move toward a specific arrangement, the deformation of the interruption may decrease until the teeth reach the arrangement and the interruption is fully restored to its undeformed state (also known as the "fully expressed" state). In many embodiments, the housing includes a predetermined amount of internal space (e.g., in a tooth receiving cavity of the housing) to accommodate tooth movement from one arrangement to a subsequently specified arrangement. The size of the internal space can be used to control the extent of tooth movement. For example, once the available internal space has been passed and contact has been made with the inner surface of the housing (i.e., the wall of the tooth receiving cavity), further movement of the tooth can be prevented. In addition, the geometric structure (e.g., size) of the interruption can also affect the extent of tooth movement, in that once the interruption has fully acted, no more tooth movement is produced. In some cases, one or more portions of the internal space can be made of a material that is more rigid than the remainder of the housing to ensure that the teeth are maintained in a desired configuration.

[0116] The magnitude and / or size of the force applied to the tooth can be at least partially controlled, influenced by or based on the geometry of the discontinuity and its positioning relative to the resilient member. For example, the size (e.g., length, width, depth, surface area, etc.) and / or shape of the discontinuity can be calculated to achieve a specified degree of compliance of the appliance. For example, a portion of the shell adjacent to the discontinuity can be more compliant, while a portion of the shell away from the discontinuity can be more rigid. In many embodiments, the discontinuity is configured to be deformable (e.g., change size, shape) and / or replaceable, thereby increasing the local compliance of the appliance. The local compliance of various portions of the shell can be used to control the resultant force applied to the underlying teeth.

[0117] The force applied to the teeth can also be affected by the characteristics of the elastic component (e.g., length, width, thickness, area, shape, cross-section, quantity, elastic coefficient and other material properties, etc.). In order to produce the desired tooth movement, a combination of appropriate characteristics can be used, and such characteristics can be homogeneous or variable in the elastomer. In many embodiments, the elastic force of the elastic component can vary based on the direction of deformation of the elastic component (anisotropic elasticity). For example, when deformed along one or more specified directions (e.g., longitudinal, transverse, etc.), the elastic component can be constructed to be more compliant, and when deformed along all other directions, the elastic component is less compliant (non-compliant), or vice versa. The direction of the elastic force can be used to control the composite force applied to the teeth.

[0118] Optionally, the elastic member can be deformed (e.g., due to the placement of attachment points and / or discontinuities) prior to attachment to the appliance and / or prior to the appliance being worn by the patient, such that there is an initial "preload" or tension in the elastic member. The use of a preload can be used to produce a substantially constant force on the tooth throughout the treatment period. In addition, the use of a preload can ensure that sufficient force is applied to the tooth, for example, according to a desired treatment plan. Alternatively, the elastic member can be relaxed prior to attachment to the appliance and / or wearing the appliance, such that there is no preload force prior to placing the appliance on the tooth.

[0119] Figure 2A and 2B An orthodontic appliance 200 is illustrated having an attached elastic member 202 according to many embodiments. The elastic member 202 is depicted as an elongated band or strip having two opposing ends. The ends of the elastic member 202 are attached to the exterior of a housing 204 that is shaped to receive the teeth of a single dental arch. Figure 2A and Figure 2B , the elastic member 202 spans the discontinuity 206 formed in the shell 204 with the ends of the elastic member 202 attached to the shell 204 on each of the two sides of the discontinuity 206. The discontinuity 206 includes an elongated cutout 208 that selectively terminates at both ends in a circular aperture 210. The circular aperture 210 can be used to prevent undesired extension of the cutout 208 when force is applied to the shell 204. In alternative embodiments, other types of aperture shapes (e.g., elliptical apertures) can be used in place of the circular apertures. In many embodiments, when the appliance 200 is placed on the teeth of the patient's dental arch 212 (e.g., Figure 2B 200), the intentionally designed mismatch between the patient's current tooth structure and the tooth arrangement specified by the geometric structure of the appliance 200 generates forces, and at least a portion of the shell 204 is deformed due to the above-mentioned forces, resulting in a corresponding deformation of the interruption 206. For example, the expansion of the shell 204 can cause the elongated incision 208 to widen into an elongated aperture 214. The deformation of the interruption causes the geometric structure of the appliance to more easily conform to the current position of the patient's teeth, thereby reducing the discomfort felt by the patient when wearing the appliance. In addition, the deformation of the interruption can make it possible for the appliance to accommodate the patient's teeth even when the teeth are not in an ideal arrangement relative to the structure of the appliance (for example, due to errors in the manufacture of the appliance, inaccurate measurement data of the initial tooth arrangement, tooth movement lagging behind or not in accordance with the treatment plan, etc.). In addition, the deformation enables the appliance to cause greater tooth movement, thereby enabling the appliance to be used for a longer period of time.

[0120] Deformation of the discontinuity 206 and / or the housing 204 generally results in deformation of the elastic member 202. For example, the elastic member 202 can stretch due to the widening of the discontinuity 206. In many embodiments, the tension of the elastic member 202 generated by such deformation can be acted as a continuous force by a portion of the housing 204, such as a portion of the housing 204 adjacent to the discontinuity 206. The corresponding resultant force can be transmitted by the housing 204 to the underlying teeth, thereby causing tooth movement that repositions the teeth to a desired predetermined arrangement. For example, since the discontinuity 206 is located near the tooth 216, the appliance 200 can apply a force to the tooth 216 and its adjacent area 218, causing them to move toward each other (see, for example, arrow 220). This movement can reduce the interproximal space between the teeth 216, 218, thereby shortening the mesiodistal length of the dental arch 212 (see, for example, arrow 222). As the teeth are repositioned to reduce the mismatch between the tooth arrangement and the appliance geometry, deformation of the shell 204, discontinuity 206, and / or resilient member 202 can be reduced, thereby reducing the amount of force exerted by the appliance 200 on the teeth.

[0121] Figure 2C and Figure 2D The orthodontic appliance 230 is illustrated with a coupled elastic member 232 and a discontinuity 234 formed in a housing 236 according to many embodiments. Figure 2A The discontinuity 206 is similar to that of the embodiment of the present invention, except that the cutout 208 is replaced by a narrow elongated aperture, which can be formed in any suitable manner, such as by removing material from the housing 236. As used herein, narrow can mean, for example, that the aperture has an extension in one direction that is more than two times, for example, more than four times, longer than its dimension in a second, such as a perpendicular direction. When placed on the patient's dental arch 238, such as Figure 2D As described, the interruption 234 and the elastic member 232 are positioned adjacent to the teeth 239. When worn, the elongated aperture of the interruption 234 can be deformed (e.g., the size of the aperture increases), generating tension in the elastic member 232 and causing force to be applied to the portions of the housing 236 disposed on both sides of the interruption 234. The corresponding resultant force can be applied to the underlying teeth to close the interproximal space (see, e.g., arrow 240) and thereby reduce the overall dental arch length (see, e.g., arrow 242).

[0122] Figure 2E and Figure 2F An orthodontic appliance 250 is illustrated having a connected elastic member 252 and a discontinuity 254 according to many embodiments. Similar to the discontinuity 206 of the appliance 200, the discontinuity 254 can be formed as an elongated cutout in the housing 256. When the appliance 250 is worn ( Figure 2F254 can be positioned adjacent to the interproximal space between the teeth 258 and 260. When the appliance 250 is worn, the elastic member 252 can be attached to the housing 256 at an attachment point adjacent to the teeth 258, 260. The operating principle of the appliance 250 is the same as the operating principle of the appliances 200 and 230, wherein the elastic member 252 interacts with the interruption 254 to cause tooth movement that reduces the interproximal space between the teeth 258, 260 (see, e.g., arrow 262).

[0123] Figure 2G and Figure 2H An example of an orthodontic appliance 270 having a plurality of elastic members 272 and a plurality of interruptions 274 formed in a housing 276 is illustrated. Each elastic member 272 is positioned to span one of the plurality of interruptions 274 depicted as cutouts in the housing 276. When the appliance 270 is worn on a dental arch 278, the interruptions 274 are positioned adjacent to the interproximal region (see Figure 2H ). The interaction between the elastic member 272 and the interruption 274 can generate a force for repositioning the teeth to reduce the interproximal space (see, for example, arrow 280). Figure 2G and Figure 2H Although depicted as being positioned only on the buccal surface of the appliance, they can also be positioned on other surfaces, such as on the lingual surface or on the occlusal surface, and any combination of these surfaces. For example, the appliance can include some interruptions and elastomers positioned on the lingual surface, and some interruptions and elastomers positioned on the buccal surface. In this construction, force is applied to the underlying teeth via both surfaces of the shell, thereby improving the resetting efficiency. One, two, three or more interruptions can be additionally or alternatively placed in other areas besides the area adjacent to the interproximal area, and each interruption can be selectively spanned by zero, one, or more elastic components.

[0124] Fig.2IThe diagram shows additional exemplary geometric structures of more than one discontinuity in an orthodontic appliance according to many embodiments. As described above, the discontinuity can have any appropriate structure, for example, such as an incision, a flap, a pore, a deformation, etc. For example, the discontinuity can include an incision in the shell, and the incision can include a linear portion and / or a curved portion (see, curved incision 290). As another example, the discontinuity can include a pore formed into an appropriate shape, such as a circle, an ellipse (e.g., an elliptical pore 292, 294), a triangle, a square, a rectangle (e.g., a rectangular pore 296) or other polygonal shapes and / or their appropriate combination. The discontinuity and / or the elastomer can be positioned in any appropriate orientation. For example, the elastic component can extend vertically (along the direction of gingival occlusion), horizontally or longitudinally (along the proximal and distal directions) or in any other appropriate direction. Similarly, the interruptions can extend vertically (e.g., interruptions 290, 294, 296), horizontally or longitudinally (e.g., interruption 292), or in any other suitable orientation. The orientation of the elastic member and / or interruption can be selected based on the desired tooth movement. In some cases, different orientations can be used to produce different types of movement.

[0125] In many embodiments, the interruptions can be composed of a plurality of individual elements arranged in an appropriate configuration (e.g., a plurality of circular apertures 298). The appliance can incorporate any appropriate number and type of interruptions, and the interruptions can interact with an appropriate number of elastic components. For example, a single elastic component can be paired with a single interruption. Alternatively, multiple elastic components can interact with a single interruption. Conversely or in addition, a single elastic component can interact with multiple interruptions. The interruptions described herein and their corresponding elastic components can be arranged on the housing in any appropriate manner relative to the underlying dentition (e.g., adjacent to more than one tooth, more than one interproximal region, etc.) and relative to each other.

[0126] Figure 3A and Figure 3B An orthodontic appliance 300 for repositioning teeth 310 is illustrated in accordance with many embodiments. For example, the appliance 300 can be used to reduce interproximal spaces between teeth 310. The orthodontic appliance 300 includes a housing 304 and a resilient member 302 coupled to the housing 304. The housing 304 has a plurality of discontinuities 308 formed therein. The length of the resilient member 302 extends along a surface of the housing 304 spanning across a plurality of tooth receiving cavities 306. The resilient member 302 spans the discontinuities 308 described herein as cutouts, although other geometries can also be used. When such as Figure 3BWhen placed on the patient's teeth 310 as shown, the interruption 308 can be deformed to form a plurality of openings. The orthodontic appliance 300 can be configured so that each opening of the interruption 308 is positioned above or adjacent to each interproximal region of the teeth 310. The elastic member 302 can apply a force to the housing 304 so that a corresponding resultant force is applied to the teeth 310, thereby causing the teeth to move to reduce the size of the interproximal space between the teeth 310.

[0127] In many embodiments, the appliance includes one or more retaining features (e.g., grooves, ridges, protrusions, indentations, etc.) formed in the housing to retain the elastic member (or appropriate portion thereof) at a particular position relative to the housing. The retaining feature is beneficial in situations where the elastic member is relatively long and therefore more prone to sliding relative to the housing 304. For example, the housing 304 of the appliance 300 can include a groove (not shown) that is configured to constrain the elastic member to a configuration that spans the tooth receiving cavity 306 and the discontinuity 308. Such a retaining feature can be used to prevent the elastic member from being accidentally displaced or released from a desired position, thereby ensuring that the appropriate treatment force is maintained.

[0128] Figure 4A The configuration of an orthodontic appliance 400 for repositioning teeth according to many embodiments is illustrated. For example, the appliance 400 can be used to reduce interproximal spaces between teeth. The appliance 400 includes: a housing 406; a plurality of elastic members 402, each of which spans one of a plurality of discontinuities 404 (described as cutouts terminating in circular apertures) formed in the housing 406. The elastic members 402 and the discontinuities 404 are positioned on the occlusal surface of the housing 406 near the interproximal region between teeth 408 and 410. The appliance 400 is configured to reduce the size of the interproximal space between teeth 408, 410. In many embodiments, the mesiodistal length of the housing 406 when the patient is not wearing the appliance (configuration 412) is shorter by an amount 415 than the mesiodistal length when the appliance is worn (configuration 414) due to the increased interproximal space produced by the patient's initial tooth arrangement relative to the tooth position of the anti-appliance 400. The interruption 404 can be deformed to aid in the compliance of the appliance 400 and to relieve some of the initial forces generated due to the mismatch between the geometry of the patient's teeth and the geometry of the appliance 400. Similar to other embodiments described herein, the resilient member 402 can apply a sustained force between portions of the housing 406 to induce tooth movement (see, e.g., arrow 416) that reduces and can eliminate interproximal spacing between the teeth 408, 410.

[0129] Figure 4BThe configuration of an orthodontic appliance 450 for reducing interproximal spaces between teeth according to many embodiments is illustrated. The appliance 450 includes: a shell 456; and a plurality of elastic members 452, which span a single discontinuity 454 (described as a separate cutout) formed in the shell 456. The discontinuity 454 can be a complete cutout in the shell 456 that divides the shell 456 into separate segments, or the discontinuity 456 can be a partial cutout such that the shell 456 remains as a single segment. Similar to the appliance 400, when the appliance 450 is placed on the patient's teeth, the discontinuity 454 can be deformed (e.g., widened from a cutout to an elongated aperture) such that the mesiodistal dental arch length of the shell 456 in the unworn configuration 458 is shorter than the dental arch length in the worn configuration 460, such as a shortening amount 461. As described above, the elastic members 452 apply a resetting force that closes the interproximal space (see, e.g., arrow 462).

[0130] FIG. 5A to FIG. 5C An orthodontic appliance 500 for repositioning teeth of a dental arch is illustrated in accordance with many embodiments. Although the concepts presented herein can also be applied to space enlargement in the upper dental arch, in Figures 5A to 5C In the description, the appliance 500 is constructed to increase the space between the teeth of the lower dental arch. Space expansion (which can involve the expansion of the interproximal space between adjacent teeth, as well as the expansion of the space caused by tooth removal) can be beneficial for various dental treatments (e.g., implants, compact tooth treatments). However, the technology disclosed herein can also be used for other applications, such as reducing the space between teeth, moving teeth, tilting teeth, rotating teeth, etc.). Any description herein involving space expansion can be applied to other types of orthodontic repositioning, and vice versa. The appliance 500 includes a shell 501 and a first elastic component 502 and a second elastic component 504, which interact with a first discontinuity 506 and a second discontinuity 508 formed in the shell 501, respectively. In an alternative embodiment, instead of one elastic component for each discontinuity, more than two elastic components can be used for each discontinuity. When the appliance 500 is placed on the patient's lower dental arch 516 ( Figure 5B As described above, the elastic members 502, 504 and the associated respective interruptions 506, 508 can be positioned above the teeth 510, 512 adjacent to the space 514. The elastic members and interruptions can be configured in any manner suitable for producing spatially expanded tooth movement. For example, Figures 5A to 5CAs shown, the interruptions 506, 508 can be respectively constructed as pores positioned above the tooth surface adjacent to the space 514. Each pore extends toward the crown of each tooth and is spanned by an elastic member. Each elastic member can extend around the entire circumference of the tooth and can be attached to the shell on the same tooth (see, for example, elastic member 502), or extend partially around the circumference of the tooth and attached to the shell above an adjacent tooth (see, for example, elastic member 504). In either case, the ends of the elastic member 504 can be respectively attached to the buccal and lingual sides of the shell 501 so that the teeth 510, 512 move to increase the space between the teeth 510, 512 (e.g., in the direction indicated by arrow 518). For example, tooth 512 can move to reduce and generally eliminate the interproximal space 519 between the tooth 512 and the adjacent tooth, thereby repositioning the tooth, such as Figure 5C shown.

[0131] When the appliance 500 is placed over the dental arch 516, the resilient members 502, 504 interact with the interruptions 506, 508 to apply a force to the teeth 510, 512, thereby moving the teeth 510, 512 in a desired direction (see, e.g., arrow 518) to expand the space 514. In many embodiments, the degree of movement can be varied based on the size of the interruptions 506, 508. Figure 5C The dental configuration of the lower dental arch 516 after repositioning with an expanded space 514 is shown. The repositioning of the teeth 510, 512 reduces the mismatch between the patient's dental arrangement and the geometry of the appliance, thereby reducing the deformation of the discontinuities 506, 508 relative to Figure 5B The previous construction described in is reduced.

[0132] Figure 6An orthodontic appliance 600 is illustrated that includes a channel 602 that accommodates an attachment 604 mounted on a tooth 606 according to many embodiments. The channel 602 can be formed within an internal cavity of a housing 608 of the appliance 600 such that the attachment 604 is received within the channel 602 when the appliance 600 is placed over a dental arch 610 of a patient. The channel 602 can be configured to guide movement of the tooth 606 as the tooth 606 is repositioned due to a force applied by an elastic member 612 on and / or near a discontinuity 614. For example, the geometry of the channel 602 can be used to restrict movement of the tooth 606 along a predetermined trajectory (e.g., substantially parallel to the trajectory of the channel 602). Additionally, the channel 602 can be used to create inward or outward displacement of the tooth as the tooth moves along the trajectory. Although the channel 602 is described herein as extending in a mesiodistal direction, other orientations can also be used, such as an occlusal-gingival direction (e.g., to create inward displacement, outward displacement, alignment, etc.). In many embodiments, the appliance can include multiple channels to accommodate multiple corresponding attachments, such as buccal channels and lingual channels that respectively accommodate buccal attachments and lingual attachments on the lower teeth. The use of multiple channel-attachment pairs can be used to improve the efficiency and accuracy of tooth repositioning. In addition, the materials of the channels and attachments can be selected to optimize the application of forces and tooth repositioning. For example, the channels and attachments can be made of different materials, respectively. In many embodiments, the materials can be selected to minimize the coefficient of friction between the channels and the attachments so that the attachments can move freely within the channels.

[0133] 7A to 7D An orthodontic appliance 700 for repositioning teeth of a dental arch is illustrated in accordance with many embodiments. The appliance 700 includes a housing 710 and a first pair of elastic members 702 and a second pair of elastic members 704 that interact with a first discontinuity 706 and a second discontinuity 708, respectively, formed in the housing 710. In alternative embodiments, a different number of elastic members can be used for each discontinuity, for example, a single elastic member, or more than two elastic members. When the appliance 700 is placed on the dental arch 712 (e.g., Figure 7B As shown in FIG. 1 , the elastic member pairs 702, 704 and the discontinuities 706, 708 are positioned on the teeth 714, 716 just to the side of the space 718. Figure 7CAs shown, when the orthodontic appliance 700 is worn, the interruptions 706, 708 are deformed to form a gap in the housing 710 that extends above the occlusal surfaces of the teeth 714, 716, and the elastic members 702, 704 extend from the lingual surface to the buccal surface of the teeth 714, 716. The interaction between the elastic members 702, 704 and the interruptions 706, 708 results in tooth movement (see, e.g., arrow 720) that expands the size of the space 718. As described above, the magnitude of the tooth movement can be affected by the size of the interruptions 706, 708. Fig.7D The repositioned dental arch 712 is shown wherein the space 718 has been expanded and the discontinuities 706, 708 have returned to their respective undeformed configurations (fully functional state).

[0134] In many embodiments, the orthodontic appliance provided herein can include a shell divided into two or more separate sections, which can be referred to as a "segmented orthodontic appliance". The shell can be divided into any appropriate number of sections, for example, two, three, four, five or more. The shell can be divided into two or more horizontal (mesiodistal) sections. Alternatively or in addition, the shell can be divided into two or more vertical (occlusal gingival) sections. Each shell section can accommodate a different subset of the patient's teeth. Different sections can accommodate different numbers of teeth. Alternatively, some or all of the sections can accommodate the same number of teeth. The shell sections can be engaged with each other via one or more elastic components to form a single orthodontic appliance. The elastic components can allow the shell sections to move relative to each other, and can determine the direction of the allowed movement based on the desired tooth movement to be achieved (e.g., extrusion, inward push, translation, etc.). In many embodiments, the sections can move relative to each other in multiple different directions. Alternatively, the sections can be restricted from moving in a single direction. For example, the housing segments can be moved relative to each other only in the horizontal (mesiodistal) direction, only in the vertical (occlusal-gingival) direction, or any suitable intermediate angle. The limited movement can be achieved using various techniques, such as guide features that limit the permissible directions of movement. In many embodiments, such guide features include: a first element (e.g., a channel or slot) located in the first housing segment; and a second element (e.g., a protrusion that fits into the channel or slot) located on the second housing segment, so that when the two elements are engaged with each other, the housing segments are only allowed to move in a certain direction (e.g., along the length of the channel). In addition, the guide feature can include a resilient element (e.g., a spring element) that exerts a force on the segments to cause them to shift relative to each other (e.g., toward each other or away from each other).

[0135] Figures 8A to 8C and Figure 8GAn orthodontic appliance 800 is illustrated that includes a first housing segment 806 and a second housing segment 808 that can be viewed as being separated by a discontinuity 804 (e.g., a gap between the two segments 806, 808). As described herein, the segments 806, 808 of the appliance 800 are horizontal (mesiodistal) segments. The first housing segment 806 and the second housing segment 808 have guide features 802. The first housing segment 806 and the second body segment 808 are movable relative to each other. A plurality of elastic members 810 span the discontinuity 804 and are coupled to the first segment 806 and the second segment 808. In many embodiments, the first segment 806 and the second segment 808 are configured to overlap in a state where a portion of the first segment 806 is located above a portion of the second segment 808, so that the two segments 806, 808 can slide telescopically relative to each other.

[0136] The guide features 802 formed in the segments 806, 808 are configured to guide the movement of the segments 806, 808 relative to each other. For example, the guide features can include mating retractable features (e.g., protrusions 812 that slide within channels 814) that limit relative movement between the segments 806, 808 along a specified direction. Figure 8H and Fig.8I A top view and a side view of an exemplary retractable guide feature 870 according to many embodiments are illustrated, respectively, and the guide feature 870 includes a piston element 872 and a spring element 874. The piston 872 can slide telescopically within a channel 876. The spring 874 can be any suitable elastic sheet or element. In many embodiments, the spring 874 is disposed within the channel 876 with the ends of the spring 874 respectively attached to the interior of the channel 876 and one end of the piston 872, so that the elastic force of the spring 874 controls the amount of force required to displace the piston 872 relative to the channel 876 (e.g., inwardly and / or outwardly).

[0137] The guide features described herein can be integrally formed with the appliance housing, or provided as separate elements attached to the housing. In many embodiments, the guide feature 870 can be mounted within the channel 814 of the appliance 800. Alternatively or additionally, the guide feature 870 can be mounted on the housing sections 806, 808 of the appliance 800 without the channel 814. For example, the guide feature 870 can be provided as a separate element and fastened to the appliance 800 using one or more fasteners 878 (e.g., rivets, bolts, pins, etc.). Any suitable configuration and / or number of retractable features (or other guide features) can be used in conjunction with any suitable configuration and / or number of elastic members and interruptions. Figure 8GA cross section of segment 806 is shown wherein telescoping channels 814 and resilient members 810 interpenetrate one another. The guide features and resilient members can be located on any suitable portion of the appliance, such as the lingual, occlusal, and / or buccal surfaces of the appliance.

[0138] When the appliance 800 is placed on the dental arch 816 (eg Figure 8B 806, 808 can be displaced relative to each other (e.g., moved apart). Resilient member 810 can exert a force on segments 806, 808 that resists displacement and pulls segments 806, 808 toward each other. The corresponding resultant force applied to the teeth causes repositioning of the teeth of dental arch 816 (see, e.g., arrow 818), thereby reducing the dental arch length (e.g., by closing interproximal space 820). Guide feature 802 can act in parallel with resilient member 810 to control the magnitude and / or direction of the force acting on the teeth. Figure 8C The teeth of the dental arch 816 are shown after repositioning, with the space 820 closed and the two sections 806, 808 returned to Fig. 8A The original structure.

[0139] FIG. 8D to FIG. 8F An orthodontic appliance 850 having telescopic shell sections 852, 854 is illustrated in accordance with many embodiments. The shell sections 852, 854 described herein are vertical (occlusal-gingival) sections. The first shell section 852 and the second shell section 854, which can be viewed as being separated by a discontinuity 856, are movable relative to each other such that the first section 852 telescopically overlaps and slides over the second section 854. A plurality of resilient members 858 span the discontinuity 856 and are attached to the first section 852 and the second section 854. When the appliance 850 is placed over the dental arch 860 (e.g., Fig. 8E ), segments 852, 854 can be displaced relative to each other (e.g., moved apart). Resilient member 858 can resist displacement and pull segments 852, 854 toward each other, resulting in repositioning of teeth of dental arch 860 (e.g., pushing inward of teeth, as shown). Fig.8F In many embodiments, in order to more precisely guide the relative movement of the segments 852, 854, the orthodontic appliance 850 can include one or more of the guiding features described herein.

[0140] Fig.25AAn orthodontic appliance 2500 with a retractable guide feature 2502 is illustrated in accordance with many embodiments. The appliance 2500 includes a housing 2504 that is divided into separate segments 2506, 2508 with the guide feature 2502 engaging the two segments 2506, 2508. The two segments 2506, 2508 can be configured to move relative to each other without telescopically sliding over each other. In an alternative embodiment, the segments 2506, 2508 can be configured for telescopic movement, with Figures 8A to 8F The guide feature 2502 can be used to limit the relative movement of the housing segments 2506, 2508 along a specified direction of motion. In many embodiments, the guide feature 2502 includes a resilient member (e.g., a spring element) that provides a force to cause tooth movement. For example, the guide feature 2502 can include a slidable piston element 2510 coupled to a resilient spring element 2512, similar to that previously described herein. Figure 8H and 8I The guide feature 2502 can be arranged such that when the appliance 2500 is placed on the teeth 2514, the spring element 2512 is pressed by the piston 2510 and thereby applies a force (indicated by the arrows) to displace the housing segments 2506, 2508 away from each other. The resultant force applied to the teeth 2514 can be used to move the teeth apart, for example, to increase the space between the teeth.

[0141] Fig.25B An orthodontic appliance 2550 having a retractable guide feature 2552 is illustrated in accordance with many embodiments. Similar to appliance 2500, appliance 2550 includes a housing 2554 having separate sections 2556, 2558 engaged by guide features 2552. The guide features can include a slidable piston element 2560 coupled to a spring element 2562. The guide features 2552 can be arranged such that when appliance 2550 is placed on teeth 2564, the spring element 2562 is stretched by the piston 2560 and thereby applies a force (indicated by arrows) to displace the housing sections 2556, 2558 toward each other. The resultant force applied to the teeth 2564 can be used to move the teeth together, for example, to reduce the space between the teeth.

[0142] In many embodiments, the orthodontic appliance described herein can be configured to maintain the current position of the patient's teeth, rather than repositioning the teeth. Such a tooth-retaining appliance, also known as a retainer, is generally similar to the tooth-repositioning appliance described herein, except that the appliance geometry is selected to apply force to the teeth without repositioning the teeth. In such an embodiment, the tooth arrangement specified by the appliance geometry can be roughly similar to the patient's current tooth arrangement. In order to reduce or prevent the teeth from moving away from the corrected configuration, the retaining appliance can be worn by the patient, for example, after the orthodontic treatment is completed. Any description herein about a tooth-repositioning appliance can be applied to a tooth-retaining appliance, and vice versa.

[0143] Fig. 9 An orthodontic appliance 900 is illustrated that is configured to maintain the current position of a patient's teeth according to many embodiments. The appliance 900 includes a housing 906 and one or more resilient members 902 that interact with a discontinuity 904 formed in the housing 906. For example, the discontinuity 904 can include one or more cutouts in the housing 906. The discontinuity 904, such as a cutout, can extend toward a periphery (e.g., a gingival margin) of the housing 906. Fig. 9 As shown, the elastic member 902 can be attached to the lingual and buccal surfaces of the housing 906 and span the interruption 904. When worn on the dental arch 908, the appliance 900 can apply a continuous force to one or more teeth to prevent the teeth from moving from their current arrangement. The magnitude of such force can be less than the magnitude of the force that causes the teeth to move. In addition, the elastic member 902 can act as a clasp to prevent the appliance 900 from moving or becoming disengaged from the teeth. The configuration of the housing, elastic member and / or interruption can be selected to prevent unintentional repositioning of the teeth.

[0144] In many embodiments, to improve control of the forces applied to the teeth by the orthodontic appliance, the appliance housing can include features such as dimples, ridges, protrusions, etc. that contact the teeth at specified points or areas to selectively apply forces to the points or areas. This approach can improve control of the magnitude and / or direction of the forces applied to the teeth, resulting in more controlled tooth movement and enabling the application of more complex force systems.

[0145] FIG. 10A to FIG. 10C An orthodontic appliance 1000 having a lingual protrusion 1002 and a buccal protrusion 1004 is illustrated in accordance with many embodiments. The lingual protrusion 1002 and the buccal protrusion 1004 are formed as curved surfaces on the lingual and buccal surfaces of a shell 1006, respectively, and protrude into an internal cavity of the shell 1006. The shell 1006 can include a pair of interruptions 1008 formed on the lingual and buccal surfaces, respectively. Each interruption 1008 can be formed as a cutout in the shell 1006, which defines a space surrounding a corresponding protrusion (e.g., Figure 10G ) and each discontinuity 1008 can be spanned by a pair of elastic members 1010. When placed on a patient's dental arch 1012 (as shown in FIG. Fig. 10B ), the projections 1002, 1004 are deflected outwardly by the underlying teeth 1014. The resilient member 1010 can resist the deflection by the applied force applied inwardly by the projections 1002, 1004 against the teeth 1014, thereby producing tooth movement (see, e.g., arrow 1016). Fig. 10C The appliance 1000 and dental arch 1012 are illustrated after repositioning of the teeth 1014 has occurred.

[0146] FIG. 10D to FIG. 10F An orthodontic appliance 1050 is illustrated as being divided into separate housing sections 1052, 1054 in accordance with many embodiments. The appliance 1050 can be used to increase the size of the space between teeth, for example, to accommodate the installation of a prosthesis such as an implant 1056. The housing sections 1052, 1054 are interconnected by elastic members 1058, 1060 that span discontinuities 1062, 1064, respectively. When placed on a dental arch 1066 (e.g., Fig.10E 1060). In some embodiments, the housing segments, interruptions, and elastic members can be configured to reposition tooth 1068 in multiple stages. In a first stage, tooth 1068 can translate in a medial direction (see, e.g., arrow 1070). In a second stage, tooth 1068 can rotate (see, e.g., arrow 1072). The stages can occur sequentially, such that tooth 1068 translates first and then rotates, or vice versa. Alternatively, in some cases, the first and second stages can overlap or occur simultaneously, such that tooth 1068 translates and rotates simultaneously. Fig.10F The dental arch 1066 is illustrated after repositioning, wherein the teeth 1068 have been moved to widen the space available for the implant 1056 .

[0147] FIG. 16A to FIG. 16C An orthodontic appliance 1600 including protrusions 1602 for applying force to teeth is illustrated in accordance with many embodiments. Fig.16A As shown, the inner surface profile of the aligner 1600 has a curved surface that forms a protrusion 1602 that extends into the interior of the aligner. Fig. 16BA cross-sectional view of a housing 1604 of an appliance 1600 is illustrated, wherein the protrusion 1602 is implemented as a curved portion 1606 of the housing 1604. The curved portion 1606 is positioned adjacent to or near a discontinuity 1608 in the housing 1604, which is described herein as a cutout formed in the housing 1604. An elastic member 1610 is coupled to the housing 1604 across the discontinuity 1608 such that one end of the elastic member 1610 is attached to the curved portion 1606, or is located near the curved portion 1606. Fig. 16C The tooth 1612 is shown housed within the housing 1604 and having the curved portion 1606 displaced outwardly relative to its initial configuration. The resilient member 1610 can exert a force on the curved portion 1606 to resist displacement (see, e.g., arrow 1614). In many embodiments, the applied force causes the associated force to be transmitted from the curved portion 1606 to the tooth 1612 at the contact point. Applying a force at the contact point can be utilized, for example, to cause a tilting movement of the tooth 1612.

[0148] FIG. 17A to FIG. 17C An orthodontic appliance 1700 is illustrated that includes protrusions 1702 for applying force to teeth, in accordance with many embodiments. Fig.17A The inner surface profile of the appliance 1700 is shown, and the appliance 1700 includes a curved protrusion 1702 and is connected to the Fig.16A The embodiments are similar. Fig. 17B A cross-sectional view of a housing 1704 of an appliance 1700 is illustrated, wherein the protrusion 1702 is implemented as a knob or button 1706 formed on the interior of the housing 1704. Similar to the appliance 1600, the appliance 1700 includes a discontinuity 1708 (e.g., a cutout) adjacent to or proximate to the knob 1706, and an elastic member 1710 spanning the discontinuity 1708 and attached at one end to or proximate to the knob 1706. When the appliance receives a tooth 1712, the elastic member 1710 is capable of applying a force to the tooth 1712 at a contact point via the knob 1706 (see, e.g., arrow 1714).

[0149] 18A to 18C and Fig.19 An orthodontic appliance including a protrusion for applying force to a tooth is illustrated according to many embodiments. The protrusion can be any suitable feature extending from a shell surface to apply force to the tooth via contact between the protrusion and the tooth, such as the embodiments described previously herein (e.g., curved surface 1606, mass 1706). Fig.18AAn appliance 1800 is illustrated that includes a pair of protrusions 1802 positioned on teeth 1804. Each protrusion 1802 is positioned proximate a discontinuity, described herein as a cutout that forms a curved flap 1806 in a housing 1808, such that the protrusion is disposed on the underside of the flap 1806 (extending to the interior of the housing 1808 toward the teeth 1804). An elastic member, described herein as a band or strip 1810, is attached to the housing 1808 on the opposite side of the flap 1806 and extends over the flap 1806. Fig.18B An alternative construction for the appliance 1800 is illustrated in which the elastic component is implemented as an elastic film or elastic mesh 1812 that connects the edge of the petal 1806 to the adjacent edge of the shell 1804. Fig. 18C Another exemplary configuration for the appliance 1800 is illustrated in which the resilient member comprises a resilient film or mesh 1814 positioned around the flap 1806 and over a portion 1804 of the housing adjacent the flap 1806. In each of the previous examples, the resilient member can generate forces applied to the flap 1806 and thereby generate forces applied by the protrusions 1802 against the teeth 1804. The positioning of the protrusions 1802 can be configured to control tooth movement resulting from the application of these forces. For example, as Fig.19 As shown, the appliance 1900 can include a pair of protrusions 1902 positioned on different sides of a tooth 1904 (e.g., on the buccal and lingual surfaces, respectively). When combined with an appropriate set of elastic members and interruptions (not shown), the positioning of the protrusions 1902 can be used, for example, to cause rotational tooth movement (see, e.g., arrow 1906). The elastomers described herein can be attached to the housing and / or flaps using any suitable method. For example, the elastomer can be extruded, sprayed, or directly attached to the housing and / or flaps.

[0150] FIG. 20A to FIG. 20CAn orthodontic appliance 2000 including a resilient member having an attachment 2002 is illustrated in accordance with many embodiments. The resilient member, described herein as a mesh or film 2004, is formed with or attached to the attachment 2002. The attachment 2002 (e.g., a protrusion, a post, a stud, a button, etc.) is configured to engage with a tooth 2006 and apply a force to the tooth 2006. In many embodiments, the attachment 2002 contacts the tooth 2006 through a discontinuity formed in a housing 2008 of the appliance 2000, which is described herein as an aperture 2010. The attachment 2002 can contact the tooth 2006 directly or indirectly (e.g., via an attachment mounted on the tooth). The resilient member can be attached to the housing 2008 at a location that spans the discontinuity such that the attachment 2002 extends through the discontinuity into the interior of the housing 2008. For example, the mesh 2004 is formed to cover the aperture 2010 and includes an adhesive perimeter 2012 that enables the mesh 2004 to be directly attached to the shell 2008. When the mesh 2004 is attached to the shell 2008, the attachment 2002 protrudes through the aperture 2010 toward the tooth 2006.

[0151] In many embodiments, an orthodontic appliance is configured to apply forces to a tooth via one or more attachments mounted to the tooth. As previously described herein, an attachment can be attached to the surface of one or more teeth to transfer the forces applied by the appliance to the tooth. The geometry of the attachment and its location on the tooth can affect the magnitude and / or direction of the force applied to the tooth. In many embodiments, the attachment is configured to cause tooth movement that may be difficult to achieve using an appliance (e.g., a protrusion) alone.

[0152] The interaction between the appliance (e.g., elastic member, housing, flap formed in the housing, etc.), the attachment (e.g., mounted on the tooth), and the tooth can be affected by the friction between these elements. In many embodiments, the coefficient of friction between the appliance and the attachment is configured to be smaller than the coefficient of friction between the appliance and the tooth. This arrangement enables the attachment to move freely relative to the appliance while increasing the force applied to the tooth by the appliance. The coefficient of friction can be a function of material and / or surface properties. In many embodiments, different types of materials are used to manufacture the appliance and attachment, and such materials can be selected based on their material and / or surface properties. In addition, the coefficient of friction can be increased or decreased by applying appropriate coatings, coatings, surface textures, etc.

[0153] FIG. 11A to FIG. 11B1 shows an orthodontic appliance 1100 configured to engage an attachment 1102 on a tooth 1106 according to many embodiments. The appliance 1100 includes a receiving portion 1104 configured to receive the attachment 1102 coupled to the tooth 1106. For example, the receiving portion 1104 can be a protrusion extending outwardly from a surface of a housing 1108, having an interior space shaped to receive the attachment 1102. In many embodiments, the receiving portion 1104 is also shaped to accommodate and / or guide movement of the attachment relative to the housing 1108, such as movement corresponding to repositioning of an underlying tooth. The receiving portion 1104 can include, for example, an inclined transverse wall 1112 along which the attachment 1102 slides as the tooth 1106 moves upward or downward (along the gingival-occlusal axis).

[0154] The appliance 1100 also includes a discontinuity formed in the housing 1108, for example, to form a flap 1114 that can be positioned over and / or against the open upper surface of the receiving portion 1104. The resilient member 1116 is attached to the housing 1108, for example, at attachment points on either side of the receiving portion 1104, and can extend across the top of the receiving portion 1104 to hold the flap 1114 in place. When the appliance 1110 is placed over the teeth (e.g., Fig. 11B 1104, and can at least partially protrude from the open upper surface, so that the flap 1114 is displaced from its initial configuration. The elastic member 1116 can abut the flap 1114, thereby transmitting a downward force (see, for example, arrow 1118) to the underlying tooth 1106 on the attachment 1102, causing the tooth movement to push inward.

[0155] FIG. 12A to FIG. 12BAn orthodontic appliance 1200 configured to engage an attachment 1202 is illustrated according to many embodiments. The appliance 1200 includes a housing 1206 and a receptacle 1204 formed within the housing 1206 and shaped to receive the attachment 1202. The receptacle 1204 can include an open lateral surface from which the attachment 1202 can protrude. In many embodiments, the appliance 1200 includes a discontinuity forming a flap 1208 that can be positioned above the open lateral surface of the receptacle 1204. A resilient member 1210 is coupled to the housing 1206 at an attachment point located on an opposite side of the receptacle 1204 and extends across the lateral surface of the receptacle 1204 to hold the flap 1208 in place. Similar to the appliance 1100, when the appliance 1200 is placed over the teeth, the attachment 1202 protrudes from the lateral surface of the receiving portion 1204, displacing the flap 1208. The elastic member 1210 applies a force against the flap 1208 to push the flap 1208 toward its closed configuration (see, e.g., arrow 1212), thereby applying a force to the attachment 1202 to cause movement of the underlying tooth 1214.

[0156] Fig.13A and Fig. 13B An orthodontic appliance 1300 is shown that is constructed to engage an attachment 1302 according to many embodiments. Similar to the appliance 1100, the appliance 1300 includes a receptacle 1304 having an open upper surface for accommodating the attachment 1302. The discontinuity of the appliance 1300 can form a flap 1306 positioned above the upper surface of the receptacle 1304. The flap 1306 is vertically offset from the receptacle 1304 so that when the appliance 1300 is not placed on the tooth, only the end edge 1308 of the flap 1306 contacts the receptacle 1304. The elastic member 1310 is similar to the elastic member 1116 in that it extends across the top of the receptacle 1304 to hold the flap 1306 in place. When the appliance 1300 is placed on the tooth (such as Fig. 13B As shown in FIG. 1 , the attachment 1302 is received in the receiving portion 1304 and protrudes from the upper surface of the receiving portion 1304 to displace the flap 1306. The elastic member 1310 applies a downward force (see, for example, arrow 1312) to the flap 1306, thereby applying a downward force to the attachment 1302 to reposition the tooth 1314.

[0157] Fig.14A and Fig. 14BAn orthodontic appliance 1400 configured to engage an attachment 1402 according to many embodiments is illustrated. Similar to the appliance 1200, the appliance 1400 includes a receiving portion 1404 having an open lateral surface for accommodating the attachment 1402. The appliance 1400 includes a discontinuity that forms a flap 1406 positioned above the open lateral surface of the receiving portion 1404. The elastic member 1408 of the appliance 1400 is configured as an elastic film or an elastic mesh that engages the edge of the flap 1406 to the corresponding edge of the lateral surface of the receiving portion 1404. When the appliance 1400 is worn by a patient (e.g., Fig. 14B As shown in FIG. 14 , the attachment 1404 protrudes through the lateral surface of the receiving portion 1404 to displace the flap 1406. The obtained stretching of the elastic member 1408 generated by the displacement of the flap 1406 generates a tooth resetting force, which is applied to the tooth 1410 via the attachment 1404.

[0158] Fig. 14C An orthodontic appliance 1420 is illustrated that includes features for securing an elastic member 1422 according to many embodiments. The appliance 1420 includes a fastening feature for attaching the elastic member 1422 to a housing 1424, exemplarily described herein as a pair of posts 1426. The elastic member 1422 can be engaged and secured to the posts 1426 using a ring 1428. The posts 1426 can be formed with the housing 1424 so that the elastic member 1422 is directly attached to the housing 1424 through the posts 1426. The ring 1428 can be located at any suitable position of the elastic member 1422, such as at an end. In addition, the appliance 1420 includes a retaining feature for the elastic member 1422, described herein as a pair of ridges or protrusions 1430 located on a petal 1432. As described above, the retaining feature can secure the elastic member 1422 at a specific position relative to the housing 1424. For example, protrusion 1430 can engage resilient member 1422 to ensure that at least a portion of its length passes over flap 1432 such that an appropriate force (see, eg, arrow 1434 ) is exerted on underlying tooth 1436 via attachment 1438 . Fig.14D An orthodontic appliance 1440 is illustrated that includes features for securing an elastic member 1442 in accordance with many embodiments. The elastic member 1442, described herein as an elastic ring, is coupled to the housing 1444 by a hook 1446 formed in the housing 1444. Similar to the appliance 1420, the appliance 1440 includes a pair of protrusions 1148 configured to retain the elastic member 1442 in a position across the petal 1450 to ensure that a desired force is applied (see, e.g., arrow 1452).

[0159] FIG. 15A to FIG. 15D Examples of flap geometries for orthodontic appliances according to many embodiments are illustrated. FIG. 11A to FIG. 14B Similar to the embodiments discussed above, the flap described herein can be formed via a discontinuity in the housing and positioned over the attachment. The flap can include one or more features that engage the attachment. For example, Fig.15A In the embodiment, the flap 1500 includes a protrusion 1502 extending toward the interior of the housing 1504 to contact the attachment 1506 mounted on the tooth 1508. The elastic member 1510 is held against the flap 1500 by the retaining feature 1514 so that the reset force (see, for example, arrow 1512) is applied to the attachment 1506 via the flap 1500. As another example, in Fig. 15B , the flap 1520 includes a protrusion 1522 that is shaped to receive a corresponding protrusion 1524 on an attachment 1526 of a tooth 1528. The end of the elastic member 1530 can be positioned higher than the protrusion 1524 so that the middle portion of the elastic member 1530 engages with the underside of the protrusion 1522 to apply a force (see force arrow 1532) to the attachment 1526 via the flap 1520. In yet another example, in Fig. 15C , the flap 1540 includes an aperture 1542 into which a protrusion 1544 on an attachment 1546 of a tooth 1548 can extend. Similar to the elastic member 1530, the end of the elastic member 1550 can be positioned so that the middle portion of the elastic member 1550 engages with the protrusion 1544 of the attachment 1546, generating a corresponding force directly against the attachment 1546 (see, e.g., arrow 1552). Similar to other embodiments of the flap described herein, the appliance can include any suitable number and configuration of flaps. For example, Fig.15D As described, a single appliance can include a variety of different valve geometries that interact with various types of attachments.

[0160] Fig.15E and Fig.15FAn orthodontic appliance 1570 is illustrated that includes a plurality of flaps 1572 for engaging a plurality of attachments 1574 mounted on teeth 1576. Each flap 1572 can include a protrusion 1578 that is shaped to receive a projection 1580 on a corresponding attachment 1574. In some cases, the projection 1580 is sized to fit tightly within the projection 1578, leaving little or no room for movement. Alternatively, the projection 1578 can be larger than the projection 1580, such that the projection 1578 includes sufficient room to accommodate movement of the projection 1580 within the projection 1578 (e.g., due to movement of an underlying tooth 1584). Each of the plurality of resilient members 1582 is angled upward to pull the projection 1578 upward, thereby applying a force to the attachment 1574 via the flap 1572. In many embodiments, the portion of the elastic member 1582 that engages the projection 1578 can be secured to the flap 1572 by adhesives, bonding, retaining features, etc. The configuration of the flap, attachments, and elastics can be customized to each tooth so that the forces applied and / or tooth movement achieved are different for each tooth. For example, the appliance 1570 can be configured to cause extrusion movement of the tooth 1584 relative to the other teeth. Similar to a conventional wire-bracket system, after the tooth 1576 has been repositioned (e.g., Fig.15F ), attachments 1582 can be positioned to be co-linear (or nearly co-linear) with each other along the proximal-distal direction.

[0161] Although the embodiments described in FIGS. 11 to 15 illustrate tooth movement that causes introversion, it should be understood that the configurations described herein can be modified as needed to produce other types of tooth movement in different directions (e.g., occlusal-gingival, mesiodistal, buccal-lingual). Such configurations can involve changing the orientation, position, size, and / or shape of various features provided herein. For example, again referring to Fig.11A and 11B The orientation of the attachment 1102, the receiving portion 1104, or the flap portion 1114 can be rotated any amount (e.g., 180°) to produce tooth movement in other directions (e.g., tooth extrusion instead of introversion).

[0162] Figures 21A to 21F An orthodontic appliance 2100 having multiple interruptions is illustrated in accordance with many embodiments. Fig.21A and 21B Describes the side view, Fig. 21C and 21D describes a top view, and Fig.21E and 21FA perspective view is depicted. The appliance 2100 includes a housing 2102 having a first plurality of elongated cutouts 2104a and a second plurality of elongated cutouts 2104b. The cutouts 2104a, 2104b can be substantially parallel to each other. In many embodiments, the cutouts 2104a are primarily located on the occlusal surface of the appliance 2100, and the cutouts 2104b are primarily located on the lingual or buccal surface of the appliance 2100. Optionally, portions of the cutouts 2104a and / or 2104b can also extend to other surfaces of the appliance 2100, for example, portions of each cutout 2104a can extend to the buccal and / or lingual surfaces, and portions of each cutout 2104b can extend to the occlusal surface. The positioning of the cutouts 2104a, 2104b relative to the teeth 2106 housed by the housing 2102 can vary as desired. In the depicted embodiment, the cutout 2104a is positioned adjacent to the occlusal region of the tooth 2106, while the cutout 2104b is positioned adjacent to the interproximal region of the tooth 2106. The cutout 2104a can be interlaced with the cutout 2104b along the mesiodistal axis of the appliance 2100, thereby forming a stretchable "folded" configuration such that when placed on the tooth 2106 (e.g., Fig. 21B , 21D 21F), allowing for mesiodistal extension of the housing 2102. The deformation of the cutouts 2104a, 2104b when worn over the teeth 2106 can generate forces (e.g., a pair of opposing mesiodistal forces represented by arrows) to cause tooth movement that reduces the space between the teeth. Figures 21A to 21F The appliance 2100 is described without any elastic components, but it should be understood that in order to adjust the force applied to the teeth 2106, alternative embodiments can include one or more elastic components that interact with (e.g., span) the cutouts 2104a and / or 2104b, as previously described herein.

[0163] In many embodiments, the orientation of the elastic member affects the direction of the resultant force applied to the tooth. For example, in embodiments where the elastic member is elongated (e.g., a band or strip), the force applied by the elastic member to the appliance and / or underlying teeth can be aligned with (e.g., substantially parallel to) the length of the elastic member. Additionally, the orientation of the elastic member relative to the discontinuity can affect the force applied to the tooth via the interaction of the elastic member with the discontinuity. In order to influence the direction of tooth movement while controlling the portion of the tooth upon which the force is applied, the orientation of the elastic member can be varied as desired. For example, in some cases, it may be desirable to apply the force close to the top of the crown of the tooth (e.g., to produce tilting), while in other cases, it may be desirable to apply the force close to the center of the root of the tooth (e.g., to avoid tilting).

[0164] Figures 22A to 22DThe illustration shows the direction of the elastic member that affects the force applied to the teeth according to many embodiments. The appliance 2200 includes a housing 2202 and at least one discontinuity 2204a-b formed in the housing 2202, the discontinuity being described herein as an elongated cutout spanning at least the occlusal and buccal surfaces of the appliance 2200. The elastic member 2206, described herein as an elongated band, is attached to the buccal surface of the housing 2202 at a location spanning the discontinuity 2204a. Fig.22A and 22B In an embodiment of the present invention, the elastic member 2206 includes: a medial end 2208, which is close to the gingival margin of the housing 2202; and a distal end 2210, which is close to the occlusal surface of the housing 2202, so that the length of the elastic member 2206 is at an angle relative to the proximal-distal axis of the housing 2202 (e.g., not parallel to the proximal-distal axis). The elastic member 2206 can be arranged so that the length of the elastic member 2206 is not orthogonal to the length of the interruption 2204. Therefore, when the orthodontic appliance 2200 is placed on the patient's tooth 2212, the force (indicated by the arrow) applied to the tooth 2212 is applied near the center of the root of the tooth 2214 and near the top of the crown of the tooth 2216.

[0165] Fig. 22C and 22D An orthodontic appliance 2250 is illustrated having a housing 2252, interruptions 2254a-b formed in the housing, and an elastic member 2256 spanning the interruption 2254a. The elements of the appliance 2250 are substantially similar to those of the appliance 2200, except that the intermediate end 2258 of the elastic member 2256 is closer to the occlusal surface of the housing 2252, while the distal end 2260 is closer to the gingival margin. Thus, when the appliance 2250 is placed on the tooth 2262, the resultant force (indicated by the arrow) is applied near the crown tip of the tooth 2264 and near the root center of the tooth 2266.

[0166] In many embodiments, more than two elastic members can be used together to apply multiple forces with different magnitudes and / or directions. For example, a pair of elastic members attached to opposite sides of a housing can be used to create a force couple that causes tooth rotation. The use of multiple elastic members can allow for a more complex force system to be created to improve control of tooth movement and / or create more complex tooth movement.

[0167] Figures 23A to 23DAn orthodontic appliance 2300 configured to produce tooth rotation according to many embodiments is illustrated. The appliance 2300 includes a housing 2302 that is divided into a plurality of separate segments 2304a-c. The segments 2304a-c can be interconnected by a first pair of elastic members 2306a-b and a second pair of elastic members 2308a-b to form a single appliance, wherein the segments 2304a-c can move relative to each other. In many embodiments, segment 2304a is connected to segment 2304b by elastic members 2306a, 2308a, and segment 2304b is connected to segment 2304c by elastic members 2306b, 2308b. The properties (e.g., stiffness, thickness, material type, etc.) of the elastic members 2306a-b can be different from the properties of the elastic members 2308a-b. For example, the stiffness (elastic modulus) of the elastic components 2306a-b can be smaller than the stiffness (elastic modulus) of the elastic components 2308a-b. Fig. 23B , 23D 2308a-b), the magnitude of the force applied to the tooth by the elastic members 2308a-b can be greater than the force applied by the elastic members 2306a-b. In many embodiments, the difference in the magnitude of the force applied by each pair of elastic members produces the application of a force couple on the tooth 2312, thereby causing the tooth 2312 to rotate.

[0168] Figures 24A to 24D An orthodontic appliance 2400 configured to produce tooth rotation according to many embodiments is illustrated. Similar to the appliance 2300, the appliance 2400 includes a housing 2402 that is divided into a plurality of separate segments 2404a-c. To form a single appliance 2400 and allow for relative movement of the segments 2404a-c, the segments 2404a-c are joined by a first elastic member 2406 described herein as a mesh or plate. In addition, the appliance 2400 includes: a second elastic member 2408 that is attached to a first side (e.g., a buccal surface) of the appliance 2400; and a third elastic member 2410 that is attached to a second, opposite side (e.g., a lingual surface) of the appliance 2400. The second elastic member 2406 and the third elastic member 2408 can be arranged such that when the appliance 2400 is placed on the tooth 2412 , the second elastic member 2406 and the third elastic member 2408 apply a force couple to the tooth 2414 , thereby causing rotation of the tooth 2414 .

[0169] In order to improve the control of the deformation of the orthodontic appliance (for example, when worn by a patient), in order to define the specific location where the desired deformation (for example, bending, flexion, stretching, compression) should occur, biasing features such as perforations, grooves, parallel lines, engraved shapes, etc. can be formed in the shell. The biasing feature can only partially penetrate the thickness of the shell (for example, the groove), or can penetrate the entire thickness (for example, the cutout or pore). Such a feature can improve the local compliance of the shell to reduce its resistance to deformation at specific locations, and enable preferential deformation at those locations when appropriate forces are applied. In many embodiments, when the appliance is placed on the patient's teeth, in order to adjust the deformation of the discontinuity, one or more biasing features are used in combination with one or more discontinuities (for example, flaps, cutouts, pores, etc.). For example, perforation lines or engraved lines can be used to define hinges for forming flaps in the appliance. As another example, multiple parallel perforation lines or engraved lines can be used to define a compliant area in the shell that adapts to the deformation of the shell (for example, as the elastic member applies force).

[0170] Figures 26A to 26D An orthodontic appliance having an offset feature according to many embodiments is illustrated. Although the offset feature described herein is a perforation line, it should be understood that the various alternative embodiments provided herein of the offset feature can also be used. Fig.26A An orthodontic appliance 2600 is illustrated having a receiving portion 2602 and a flap portion 2604. To ensure that the flap portion 2602 will preferentially bend at this location, a biasing feature 2606 is formed at the hinge of the flap portion 2604. Similarly, Fig.26B An orthodontic appliance 2610 is illustrated having a pair of petals 2612 with respective biasing features 2614 defining a hinge for each petal 2612 . Fig.26C An appliance 2620 is illustrated wherein a biasing feature 2622 contacts and extends from one end of a discontinuity 2624 (described herein as a cutout). The biasing feature 2622 can be aligned with the length of the discontinuity 2624 to facilitate deformation (e.g., widening) of the discontinuity 2624 when the appliance 2620 is placed on the teeth. Fig.26D An orthodontic appliance 2630 is illustrated in which a plurality of biasing features 2632 are used to define an area of ​​increased compliance near a discontinuity 2634 (described herein as an aperture). Thus, when an elastic member 2636 applies a force to the appliance near the discontinuity 2634, the appliance 2630 is able to bend preferentially at the area of ​​increased compliance in order to apply the force to the teeth, rather than at other locations where it is not desirable to apply the force.

[0171] The various embodiments of the orthodontic appliances described herein can be manufactured in a wide variety of ways. The configuration of the orthodontic appliance can be determined based on a treatment plan for the patient, for example, a treatment plan involving sequential administration of multiple appliances for incrementally repositioning teeth. To facilitate the design and manufacture of the appliance, a computer-based treatment planning and / or appliance manufacturing method can be used.

[0172] Fig. 27 is a schematic illustration in the form of a block diagram of a method 2700 of orthodontic treatment according to many embodiments. The method 2700 can be applied to repositioning one or more patient's teeth, maintaining one or more patient's teeth in a current configuration, or a suitable combination thereof. The method 2700 can be practiced using any suitable orthodontic appliance, such as the suitable orthodontic appliances described herein.

[0173] In step 2710, an orthodontic appliance having a discontinuity formed in a shell is provided. The discontinuity can include any of the various types of embodiments of the discontinuity described herein. In many embodiments, the discontinuity can be formed in the shell after the shell has been manufactured (e.g., by cutting, removal of material, deformation of a portion of the shell, etc.). Alternatively, the discontinuity can be formed simultaneously with the manufacture of the shell.

[0174] In step 2720, the elastic component is directly connected to the shell at a position that interacts with the discontinuity. Any embodiment of the elastic component described herein can be combined with any appropriate discontinuity. As described above, the elastic component can be directly connected to the shell without using an intermediate attachment element (e.g., a fastener provided separately and connected to the shell, such as a hook, bolt, stator, pin, etc.). The elastic component can be connected using an orthodontic appliance before the appliance is applied to the teeth. Alternatively, the connection is performed by the manufacturer of the appliance so that the appliance is provided to the physician together with the connected elastic component. In many embodiments, step 2720 is optional, such as when the orthodontic appliance is already provided with a connected elastic component.

[0175] In step 2730, the appliance is placed on the teeth of the patient's dental arch. In many embodiments, the appliance is designed to accommodate the teeth of a single dental arch. More than one tooth can be attached to a pre-installed attachment (e.g., FIG. 11A to FIG. 15D). Alternatively, the appliance can be placed on a tooth without any attachments. As previously described herein, placement of the appliance can involve deformation of one or more of the shell, the discontinuity, and the elastic member in order to accommodate the tooth. In some cases, the discontinuity and / or a portion of the shell near the discontinuity is displaced when the appliance is worn. For example, the discontinuity can form a flap (e.g., Figures 11-19) that is pushed outward when the appliance is placed on the tooth. As another example, the appliance includes separate shell sections (e.g., Figures 8 and 10) that can move relative to each other when the appliance is placed on the tooth. In some cases, step 2730 can be performed earlier than step 2720 so that the appliance is placed on the tooth before the elastic member is attached to the shell.

[0176] In step 2740, a force is applied to the tooth via the interaction of the elastic member and the discontinuity. As described elsewhere herein, the elastic member can apply a continuous force on the housing, and the force can be transmitted to the underlying teeth via the housing. In many embodiments, the force is applied to the tooth via an attachment mounted on one or more teeth (e.g., Figures 11-15). The applied force can result in the repositioning of one or more teeth, as previously described herein. Alternatively, the force can be applied to maintain the current arrangement of the teeth so that tooth movement does not occur.

[0177] Fig.28 is a schematic illustration in block diagram form of a method 2800 of designing an orthodontic appliance according to many embodiments. The steps of the method 2800 can be performed by a suitable system, such as a data processing system described elsewhere herein.

[0178] In step 2810, a first position of the patient's teeth is determined. The first position can be, for example, an initial position of the teeth (e.g., a current position of the teeth within the patient's dental arch). The position can be determined based on measurement data of the patient's current tooth arrangement, such as the measurement data obtained by scanning the patient's teeth or a model of the patient's teeth. The measurement data can be used to generate a digital representation of the dentition (e.g., a digital model), and the first position of the teeth can be determined based on the digital representation.

[0179] In step 2820, a second position of the teeth is determined. In many embodiments, the second position represents an intermediate or final position of the teeth after orthodontic treatment (e.g., repositioning) has occurred. For example, the second position can be selected based on an intermediate or final tooth arrangement specified by an orthodontist to correct more than one malocclusion.

[0180] In step 2830, the movement path of the tooth from the first position to the second position is calculated. In many embodiments, the movement path is calculated using one or more appropriate computer programs that can take digital representations of the first position and the second position as input and provide a digital representation of the movement path as output. The movement path can also be calculated based on the position and / or movement path of other teeth in the patient's dentition, and such information can also be provided as a digital representation. For example, the movement path can be optimized based on minimizing the total distance moved, preventing collisions with other teeth, avoiding more difficult tooth movements, or any other appropriate criteria. In some cases, the movement path can be set as a series of incremental tooth movements that, when performed sequentially, result in the tooth being repositioned from the first position to the second position.

[0181] In step 2840, a geometry of an appliance housing having a discontinuity is determined based on the movement path such that the elastic member can be coupled to the housing at a location that interacts with the discontinuity in order to cause tooth movement along the movement path. The geometry can be determined using one or more suitable computer programs, such as a computer program configured to receive as input a digital representation of the movement path and provide as output (e.g., as a digital model) a digital representation of the housing, discontinuity, and / or elastic member geometry. In some cases, the output can be provided to a manufacturing system, such as a suitable computer-aided manufacturing system, in order to manufacture a physical model of the housing having the discontinuity.

[0182] The geometry of the housing, interruptions, and resilient members can be configured in any manner suitable for producing tooth movement, such as any of the embodiments described herein. In many embodiments, one or more portions of the housing (e.g., a tooth receiving cavity of the housing) can be adapted to include an appropriate amount of additional space to accommodate tooth movement, as previously described herein. In some cases, step 2840 also includes calculating the geometry of an attachment to be coupled to the tooth such that the resilient member interacts with the attachment to affect movement of the underlying tooth.

[0183] Fig.29 Illustrated is a method 2900 of digitally planning an orthodontic treatment and / or designing or manufacturing an appliance in accordance with many embodiments. The method 2900 can be applied to any of the processes described herein and can be performed using any suitable data processing system.

[0184] In step 2910, a digital representation of the patient's teeth is received. The digital representation can include surface topography data for the patient's oral cavity (including teeth, gum tissue, etc.). The surface topography data is generated by directly scanning the oral cavity, a physical model (positive or negative) of the oral cavity, or an impression of the oral cavity using an appropriate scanning device (e.g., a handheld scanner, a desktop scanner, etc.).

[0185] In step 2920, one or more treatment stages are generated based on the digital representation of the teeth. The treatment stages can be incremental repositioning stages of an orthodontic treatment process designed to move one or more patient teeth from an initial tooth arrangement to a target tooth arrangement. For example, the treatment stages can be generated by determining an initial tooth arrangement indicated by the digital representation, determining a target tooth arrangement, and determining a movement path of one or more teeth in the initial arrangement required to achieve the target tooth arrangement. The movement path can be optimized based on minimizing the total distance moved, preventing collisions between teeth, avoiding more difficult tooth movements, or any appropriate criteria.

[0186] In step 2930, at least one orthodontic appliance is manufactured based on the generated target stage. For example, a set of appliances can be manufactured, each of which is formed to accommodate the tooth arrangement specified by a processing stage, so that the appliances can be worn sequentially by the patient to incrementally reset the teeth from the initial arrangement to the target arrangement. The appliance group can include more than one orthodontic appliance having at least one interruption and / or at least one elastic component described herein. The configuration (e.g., quantity, geometry, construction, material properties, etc.) of the interruption and / or elastic component of such an appliance can be selected to cause the tooth movement specified by the corresponding processing stage. At least some of these properties can be determined via appropriate computer software or other digital-based methods. The manufacture of the appliance can involve establishing a digital model of the appliance to be used as an input to a computer-controlled manufacturing system.

[0187] In some cases, various stages of arrangement or processing may be unnecessary for the design and / or manufacture of the appliance. Fig.29 As shown in dashed lines, the design and / or manufacture of an orthodontic appliance and perhaps a particular orthodontic appliance may include the use of a representation of a patient's teeth (e.g., receiving a digital representation of the patient's teeth 2910), followed by the design and / or manufacture of the orthodontic appliance based on the representation of the patient's teeth in the arrangement indicated by the received representation. For example, a shell may be generated based on the representation of the patient's teeth (e.g., as in step 2910), followed by the application of discontinuities and / or elastic components to generate the appliance described in various embodiments herein.

[0188] Fig.303000 is a simplified block diagram of a data processing system 3000 that can be used in the execution methods and processes described herein. The data processing system 3000 specifically includes at least one processor 3002, which communicates with one or more peripheral devices via a bus subsystem 3004. These peripheral devices typically include: a storage subsystem 3006 (a memory subsystem 3008 and a file storage subsystem 3014), a set of user interface input and output devices 3018, and an interface 3016 to an external network. The interface is schematically shown as a "network interface" block 3016, and is connected to corresponding interface devices in other data processing systems via a communication network interface 3024. The data processing system 3000 can include, for example, one or more computers, such as personal computers, workstations, mainframes, laptops, etc.

[0189] The user interface input device 3018 is not limited to any particular device, and typically includes, for example, a keyboard, a pointing device, a mouse, a scanner, an interactive display, a touch pad, a joystick, etc. Similarly, a variety of user interface output devices can be employed in the system of the present invention, and can include, for example, one or more of a printer, a display (e.g., visual, non-visual) system / subsystem, a controller, a projection device, a sound output, etc.

[0190] The storage subsystem 3006 maintains the basic required programming, including computer readable media with instructions (e.g., operating instructions, etc.) and data structures. The program modules discussed herein are generally stored in the storage subsystem 3006. The storage subsystem 3006 generally includes a memory subsystem 3008 and a file storage subsystem 3014.

[0191] The memory subsystem 3008 typically includes a plurality of memories (e.g., RAM 3010, ROM 3012, etc.), including: a computer-readable memory for storing fixed instructions, instructions and data during program execution, and a basic input / output system, etc. The file storage subsystem 3014 provides persistent (non-volatile) storage for program and data files, and can include one or more removable or fixed drives or media, hard disks, floppy disks, CD-ROMs, DVDs, optical drives, etc. One or more storage systems, drives, etc. can be located at a remote location, connected via a server on a network or via the Internet / global network. In the context, the term "bus subsystem" is generally used to include any mechanism for making various elements and subsystems communicate with each other as desired, and can include various appropriate elements / systems that should be known or considered suitable for use therein. It is believed that the various elements of the system can be, but not necessarily, in the same physical location, and can be connected via various local area network or wide area network media, transmission systems, etc.

[0192] The scanner 3020 includes means for obtaining a digital representation (e.g., image, surface topography data, etc.) of the patient's teeth (by scanning a physical model of the teeth such as a cast 3021, by scanning an impression taken of the teeth, or by directly scanning the intraoral cavity), which data representation can be obtained either from the patient or from a processing person such as an orthodontist, and includes means for providing the digital representation to the data processing system 3000 for further processing. The scanner 3020 can be located at a remote location relative to the other elements of the system and can communicate image data and / or information to the data processing system 3000, for example, via a network interface 3024. The manufacturing system 3022 manufactures the aligner 3023 based on a processing plan that includes data set information received from the data processing system 3000. The manufacturing machine 3022 can, for example, be located at a remote location and receive the data set information from the data processing system 3000 via a network interface 3024.

[0193] The data processing aspects of the methods described herein (e.g., method 2700) can be implemented in digital electronic circuits, or in computer hardware, firmware, software, or a suitable combination thereof. The data processing apparatus can be implemented in a computer program product that is tangibly embedded in a machine-readable storage device for execution by a programmable processor. The data processing steps can be performed by a programmable processor that executes computer instructions to perform functions by operating on input data and generating outputs. The data processing aspects can be implemented in one or more computer programs that can execute a programmable system, the system including one or more programmable processors operably connected to a data storage system. Typically, the processor will accept instructions and data from a read-only memory and / or a random access memory. Storage devices suitable for physically embedding computer program instructions and data include all forms of non-volatile memory, for example, semiconductor storage devices such as EPROM, EPROM, and flash memory devices, magnetic disks such as internal hard disks and removable disks, magneto-optical disks, and CD-ROM optical disks.

[0194] A and / or B as used herein includes more than one of A or B and combinations such as A and B.

[0195] Although preferred embodiments of the present invention have been shown and described herein, it will be clear to those skilled in the art that such embodiments are provided by way of example only. Without departing from the present invention, those skilled in the art will now be able to make numerous variations, changes, and substitutions. It should be understood that various alternative embodiments of the embodiments of the present invention described herein may be employed in the practice of the present invention. Numerous different combinations of the embodiments described herein are also possible, and such combinations are also considered to be part of the present invention. In addition, the features discussed in connection with any one embodiment of the present invention can be readily applied to other embodiments herein. It is expected that the following claims define the scope of the present invention, and methods and structures within the scope of these claims and their equivalents are also included thereby.

Claims

1. An orthodontic appliance comprising: an integrally formed housing including a plurality of tooth receiving cavities formed to receive the dentition of a patient; a discontinuity disposed on a surface of the housing, wherein the discontinuity is configured to have a closed configuration when the plurality of tooth-receiving cavities have not yet received the dentition of the patient, and wherein the discontinuity is configured to expand into a deformed configuration when the dentition of the patient is received in the plurality of tooth-receiving cavities; a resilient member secured to a surface of the housing at a first attachment point and a second attachment point, wherein the first attachment point and the second attachment point are positioned on opposite sides of the discontinuity such that the resilient member spans the discontinuity; wherein the elastic member is configured to exert an elastic force on the region of the discontinuity, thereby causing the discontinuity to transition from the deformed configuration to the closed configuration, Wherein the shell and the interruption are generated based on a digital representation of the patient's teeth.

2. The orthodontic appliance according to claim 1, wherein: As part of an orthodontic treatment plan, causing the interruption to transition from the deformed configuration to the closed configuration generates a tooth moving force to reposition at least one of the patient's teeth toward a target position.

3. The orthodontic appliance according to claim 1, wherein: The elastic member spans over the discontinuity in a direction substantially orthogonal to the length of the discontinuity.

4. The orthodontic appliance according to claim 1, wherein: The elastic force is in a direction between the first attachment point and the second attachment point.

5. The orthodontic appliance according to claim 1, wherein: The discontinuity comprises an aperture in the integrally formed housing.

6. The orthodontic appliance according to claim 1, wherein: The discontinuity comprises a cutout in the integrally formed housing.

7. The orthodontic appliance according to claim 1, wherein: The discontinuity comprises a discontinuity in the integrally formed housing.

8. The orthodontic appliance according to claim 1, wherein: The discontinuity is disposed at or near an interproximal region of the patient's dentition.

9. The orthodontic appliance according to claim 1, wherein: The discontinuity is disposed on an occlusal surface of the patient's dentition.

10. The orthodontic appliance according to claim 1, wherein: The discontinuity is disposed on a buccal surface of the patient's dentition.

11. The orthodontic appliance according to claim 1, wherein: The integrally formed housing includes a telescoping feature, and wherein the discontinuity is disposed on the telescoping feature.

12. The orthodontic appliance according to claim 11, wherein: The discontinuity forms a petal on the retractable feature.

13. The orthodontic appliance according to claim 1, wherein: The dental arch length of the orthodontic appliance changes depending on whether the interruption is in the deformed configuration or in the closed configuration.

14. The orthodontic appliance according to claim 1, wherein: The discontinuity includes a plurality of separate cutouts.

15. The orthodontic appliance according to claim 1, wherein: The elastic member is fixed to the first attachment point and the second attachment point along a gingival occlusal direction.

16. The orthodontic appliance according to claim 1, wherein: The elastic member is fixed to the first attachment point and the second attachment point along the proximal-distal direction.

17. The orthodontic appliance according to claim 1, wherein: The first attachment point and the second attachment point are disposed on adjacent teeth of the patient's dentition.

18. The orthodontic appliance according to claim 1, wherein: At least one of the first attachment point and the second attachment point includes a hook portion.

19. The orthodontic appliance according to claim 1, wherein: The resilient member is secured to the first attachment point and the second attachment point such that the resilient member spans across a plurality of teeth of the patient's dentition.

20. The orthodontic appliance according to claim 1, wherein: Prompting the discontinuity to transition from the deformed configuration to the closed configuration facilitates reducing the size of the interproximal space of the patient's dentition.

21. A method for designing an orthodontic appliance according to claim 1 for moving at least one tooth of a patient according to an orthodontic treatment plan, the method comprising: determining a geometry of an orthodontic appliance housing, wherein the geometry is shaped to receive a plurality of the patient's teeth; determining a location of a discontinuity formed on a housing of the orthodontic appliance; determining the positions of a first attachment point and a second attachment point on the orthodontic appliance housing, wherein the first attachment point and the second attachment point are configured to couple with a resilient member, and wherein coupling of the resilient member to the first attachment point and the second attachment point applies a force to or in the region of the discontinuity when the orthodontic appliance is worn; generating instructions for manufacturing the orthodontic appliance; and manufacturing the orthodontic appliance according to the instruction, Wherein the orthodontic appliance housing and the interruption are generated based on a digital representation of the patient's teeth.

22. The method according to claim 21, wherein: The geometry of the orthodontic appliance housing is determined based on a digital representation of the patient's dentition.

23. The method according to claim 21, wherein: The discontinuity comprises one or more of an aperture, a cutout, a flap, a window or a notch.

24. The method according to claim 21, wherein: A force on or in the region of the discontinuity causes movement of the at least one tooth thereby reducing the size of the interproximal space.

25. The method according to claim 21, wherein: The discontinuity is located between the first attachment point and the second attachment point such that the elastic member spans the discontinuity when coupled to the first attachment point and the second attachment point.

26. The method of claim 21, wherein: The orthodontic appliance is one of a plurality of orthodontic appliances used to move the patient's teeth through a plurality of corresponding stages of the orthodontic treatment plan.

27. The method of claim 21, wherein: The orthodontic appliance housing comprises two or more separate housing sections.

28. The method of claim 21, wherein: The first attachment point and the second attachment point are located on separate split housing sections.

29. The method of claim 21 further comprising generating a digital model of the orthodontic appliance.

30. The method of claim 21, wherein: Manufacturing the orthodontic appliance occurs at a location remote from the generation of the instructions.

31. The method of claim 21, wherein: Manufacturing the orthodontic appliance includes extrusion of a polymeric material.

32. The method of claim 21, wherein: Manufacturing the orthodontic appliance includes forming the interruption integrally with the orthodontic appliance.

33. The method of claim 21, wherein: Manufacturing the orthodontic appliance includes forming the geometry of the orthodontic appliance housing from multiple sheets of polymeric material.

34. The method of claim 21, wherein: Manufacturing the orthodontic appliance includes forming the discontinuity on the orthodontic appliance by cutting.

35. The method of claim 21, wherein: Manufacturing the orthodontic appliance includes forming the first attachment point and the second attachment point integrally with the orthodontic appliance.

36. The method of claim 21, wherein: As part of the orthodontic treatment planning, fabrication of the orthodontic appliances occurs before the patient wears any appliances.

37. The method of claim 21, wherein: The force is configured to urge the discontinuity to transition from a deformed configuration to a closed configuration when the orthodontic appliance is received around the plurality of teeth of the patient.

38. The method of claim 37, wherein: As part of an orthodontic treatment plan, causing the interruption to transition from the deformed configuration to the closed configuration generates a tooth moving force to reposition at least one of the patient's teeth toward a target position.

39. The method of claim 21, wherein: The first attachment point and the second attachment point are arranged relative to each other along the gingival occlusal direction.

40. The method of claim 21, wherein: The first attachment point and the second attachment point are disposed relative to each other along a proximal-distal direction.

41. An orthodontic appliance comprising: an integrally formed housing including a plurality of tooth-receiving cavities shaped to receive a dentition of a patient, wherein the plurality of tooth-receiving cavities include a first portion configured to receive at least a first tooth and a second portion configured to receive at least a second tooth, wherein the second tooth is adjacent to the first tooth; a first discontinuity disposed on a surface of the first portion; a first elastic member fixed to the surface of the first portion so as to span the first discontinuity and to exert a first elastic force in the region of the first discontinuity; a second discontinuity disposed on a surface of the second portion; a second elastic member fixed to the surface of the second portion so as to span the second discontinuity and exert a second elastic force in the region of the second discontinuity; wherein the first elastic force and the second elastic force are configured to increase a distance separating the first teeth and the second teeth when the patient's dentition is received in the plurality of tooth receiving cavities, Wherein the shell and the first and second interruptions are generated based on a digital representation of a patient's teeth.

42. The orthodontic appliance according to claim 41, wherein: As part of an orthodontic treatment plan, the first elastic force is configured to cause the first discontinuity to transition from a deformed configuration to a closed configuration, thereby generating a tooth moving force to reposition at least the first tooth toward a target position.

43. The orthodontic appliance of claim 41, wherein: As part of an orthodontic treatment plan, the second elastic force is configured to urge the second discontinuity to transition from a deformed configuration to a closed configuration, thereby generating a tooth moving force to reposition at least the second tooth toward a target position.

44. The orthodontic appliance of claim 41, wherein: At least one of the first discontinuity or the second discontinuity comprises an aperture in the integrally formed housing.

45. The orthodontic appliance of claim 41, wherein: At least one of the first discontinuity or the second discontinuity comprises a cutout in the integrally formed housing.

46. ​​The orthodontic appliance of claim 41, wherein: At least one of the first discontinuity or the second discontinuity comprises a discontinuity in the integrally formed housing.

47. The orthodontic appliance of claim 41, wherein: Each of the first discontinuity and the second discontinuity is disposed on respective buccal surfaces of the first portion and the second portion.

48. The orthodontic appliance of claim 41, wherein: The first elastic member is fixed to the surface of the first portion in a manner spanning two opposing buccal surfaces and a mesial or distal surface therebetween.

49. The orthodontic appliance of claim 41, further comprising: a third elastic member fixed to the surface of the first portion so as to span the first discontinuity in the region of the first discontinuity; and A fourth elastic member is fixed to the surface of the second portion so as to span the second discontinuity in the region of the second discontinuity.

50. The orthodontic appliance of claim 41, further comprising: a third discontinuity disposed on the first portion; and Wherein, the first interruption portion and the third interruption portion are arranged on the opposite buccal surface and lingual surface of the first portion.

51. A method for designing an orthodontic appliance according to claim 41 for moving at least one tooth of a patient according to an orthodontic treatment plan, the method comprising: determining a geometry of an orthodontic appliance housing, wherein the geometry includes a plurality of tooth-receiving cavities shaped to receive a dentition of a patient, wherein the plurality of tooth-receiving cavities includes a first portion configured to receive at least a first tooth and a second portion configured to receive at least a second tooth, wherein the second tooth is adjacent to the first tooth; determining a location of a first discontinuity formed on a surface of the first portion; determining a position of a first mounting point, wherein the first mounting point is configured to couple with a first elastic component, and wherein coupling of the first elastic component to the first mounting point applies a first elastic force to or in the region of the first discontinuity when the orthodontic appliance is worn; determining a location of a second discontinuity formed on a surface of the second portion; determining a position of a second pair of mounting points, wherein the second pair of mounting points is configured to couple with a second elastic component, and wherein coupling of the second elastic component to the second pair of mounting points applies a second elastic force to or in the region of the second discontinuity when the orthodontic appliance is worn; generating instructions for manufacturing the orthodontic appliance; and manufacturing the orthodontic appliance according to the instruction, Wherein the orthodontic appliance housing and the first interruption and the second interruption are generated based on a digital representation of the patient's teeth.

52. The method of claim 51, wherein: The first elastic force and the second elastic force are configured to increase the distance between the first tooth and the second tooth when the patient's dentition is received in the plurality of tooth receiving cavities.

53. The method of claim 51, wherein: The first resilient force is configured to urge the first discontinuity to transition from a deformed configuration to a closed configuration, thereby generating a tooth moving force to reposition at least the first tooth toward a target position as part of an orthodontic treatment plan.

54. The method of claim 51, wherein: The geometry of the orthodontic appliance housing is determined based on the digital representation of the patient's dentition.

55. The method of claim 51, wherein: Each of the first interruption and the second interruption includes one or more of an aperture, a cutout, a flap, a window, or a notch.

56. The method of claim 51, wherein: The orthodontic appliance is one of a plurality of orthodontic appliances used to move the patient's teeth through a plurality of corresponding stages of the orthodontic treatment plan.

57. The method of claim 51 further comprising generating a digital model of the orthodontic appliance.

58. The method of claim 51, wherein: Manufacturing the orthodontic appliance occurs at a location remote from the generation of the instructions.

59. The method of claim 51, wherein: Manufacturing the orthodontic appliance includes extrusion of a polymeric material.

60. The method of claim 51, wherein: Manufacturing the orthodontic appliance includes forming the geometry of the orthodontic appliance housing from multiple sheets of polymeric material.

61. The method of claim 51, wherein: Manufacturing the orthodontic appliance includes forming the first interruption and the second interruption on the orthodontic appliance by cutting.

62. The method of claim 51, wherein: Manufacturing the orthodontic appliance includes separating the first portion from the second portion by cutting.

63. The method of claim 51, wherein: As part of the orthodontic treatment planning, fabrication of the orthodontic appliances occurs before the patient wears any appliances.

64. The method of claim 51, wherein: Each of the first interruption and the second interruption is disposed on a respective buccal surface of the first portion and the second portion.

65. The method of claim 51, wherein: The first elastic member is configured to be attached to the surface of the first portion in a manner spanning two opposing buccal surfaces and a mesial or distal surface therebetween.

66. An orthodontic appliance comprising: an integrally formed housing including a plurality of tooth receiving cavities formed to receive the dentition of a patient; a receiving portion disposed at a buccal surface of the housing, wherein the receiving portion protrudes from the buccal surface, and wherein the receiving portion includes a flap hingedly connected to a body of the receiving portion; an elastic member fixed to the buccal surface of the shell so as to span the receiving portion and engage with the flap portion; The elastic component is configured to apply force to the petal portion, thereby causing the petal portion to change from an open configuration to a closed configuration. Wherein the shell and the receiving portion are generated based on a digital representation of the patient's teeth.

67. The orthodontic appliance of claim 66, wherein: The flap portion includes a buccal surface of the receptacle, and wherein the force exerted on the flap portion is in a generally buccolingual direction.

68. The orthodontic appliance of claim 66, wherein: The petal portion includes an upper surface of the receiving portion, and wherein the force exerted on the petal portion is in a generally downward direction.

69. The orthodontic appliance of claim 66, wherein: As part of an orthodontic treatment plan, urging the flap to transition from the open configuration toward the closed configuration generates a tooth moving force to reposition at least one of the patient's teeth toward a target position.

70. The orthodontic appliance of claim 66, wherein: The receiving portion includes an inclined transverse wall.

71. The orthodontic appliance of claim 66, wherein: The elastic member is fixed to the buccal surface of the housing via a first attachment point and a second attachment point, wherein the first attachment point and the second attachment point are arranged on opposite sides of the receiving portion.

72. The orthodontic appliance of claim 70, wherein: At least one of the first attachment point and the second attachment point includes a hook portion.

73. The orthodontic appliance of claim 66, wherein: The elastic member is fixed to the buccal surface of the housing along a gingival occlusal direction.

74. The orthodontic appliance of claim 66, wherein: The elastic member is fixed to the buccal surface of the shell in the proximal-distal direction.

75. The orthodontic appliance of claim 66, wherein: The resilient member is secured to the buccal surface of the shell such that the resilient member spans across a plurality of teeth of the patient's dentition.

76. A method for designing an orthodontic appliance according to claim 66 for moving at least one tooth of a patient according to an orthodontic treatment plan, the method comprising: determining a geometry of an orthodontic appliance housing, wherein the geometry is shaped to receive a plurality of the patient's teeth; determining a location and geometry of a receptacle formed on a buccal surface of the housing, wherein the receptacle protrudes from the buccal surface, and wherein the receptacle includes a flap hingedly connected to a body of the receptacle; determining positions of a first attachment point and a second attachment point on the orthodontic appliance housing, wherein the first attachment point and the second attachment point are configured to couple with an elastic member, and wherein coupling of the elastic member to the first attachment point and the second attachment point applies a force to the flap portion when the orthodontic appliance is worn, thereby causing the flap portion to transition from an open configuration toward a closed configuration; generating instructions for manufacturing the orthodontic appliance; and manufacturing the orthodontic appliance according to the instruction, Wherein, the orthodontic appliance housing and the receiving portion are generated based on a digital representation of the patient's teeth.

77. The method of claim 76, wherein: As part of an orthodontic treatment plan, urging the flap to transition from the open configuration toward the closed configuration generates a tooth moving force to reposition at least one of the patient's teeth toward a target position.

78. The method of claim 76, wherein: The geometry of the orthodontic appliance housing is determined based on the digital representation of the patient's dentition.

79. The method of claim 76, wherein: The orthodontic brace is one of a plurality of orthodontic appliances used to move the patient's teeth through a plurality of corresponding stages of the orthodontic treatment plan.

80. The method of claim 76, further comprising generating a digital model of the orthodontic appliance.

81. The method of claim 76, wherein: Manufacturing the orthodontic appliance occurs at a location remote from the generation of the instructions.

82. The method of claim 76, wherein: Manufacturing the orthodontic appliance includes extrusion of a polymeric material.

83. The method of claim 76, wherein: Manufacturing the orthodontic appliance includes forming the geometry of the orthodontic appliance housing from multiple sheets of polymeric material.

84. The method of claim 76, wherein: Manufacturing the orthodontic appliance includes forming the flap by cutting.

85. The method of claim 76, wherein: Manufacturing the orthodontic appliance includes forming the receiving portion integrally with the housing.

86. The method of claim 76, wherein: As part of the orthodontic treatment planning, fabrication of the orthodontic appliances occurs before the patient wears any appliances.

87. The method of claim 76, wherein: The flap portion includes a buccal surface of the receptacle, and wherein the force exerted on the flap portion is in a generally buccolingual direction.

88. The method of claim 76, wherein: The petal portion includes an upper surface of the receiving portion, and wherein the force exerted on the petal portion is in a generally downward direction.

89. The method of claim 76, wherein: The geometry of the housing includes inclined transverse walls.

90. The method of claim 76, wherein: The first and second attachment points are positioned such that the resilient member coupled thereto spans across a plurality of teeth of the patient.

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