Automatic treatment planning

Abstract

An orthodontic and / or dental treatment planning method and apparatus. In particular, methods of generating a plurality of potential treatment plan variants for simultaneous and interactive viewing of treatment plan variants are described herein. Each variant may be optimized to optimally address the user's treatment goals and as close as possible to the ideal or target final location. Also described herein are orthodontic and / or dental treatment planning methods and devices that allow a user to form, modify, and select a treatment plan from a plurality of different treatment plans in real time.

Description

[0001] This application is a divisional application of the invention patent application with application date of November 1, 2018, application number 2022109337123, and invention name “Automatic treatment planning”. Application No. 2022109337123 is a divisional application of the invention patent application with Chinese application number 2018800718780 (corresponding to PCT international application number PCT / US2018 / 058791), application date of November 1, 2018, and invention name “Automatic treatment planning”.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] This patent application claims priority to U.S. Provisional Patent Application Serial No. 62 / 580,432 filed on November 1, 2017 (entitled “REAL-TIME, INTERACTIVE DENTALTREATMENT PLANNING”), U.S. Provisional Patent Application Serial No. 62 / 580,427 filed on November 1, 2017 (entitled “AUTOMATIC TREATMENT PLANNING”), and U.S. Provisional Patent Application Serial No. 62 / 692,551 filed on June 29, 2018 (entitled “AUTOMATICTREATMENT PLANNING”), the entire contents of each of which are incorporated herein by reference.

[0004] Incorporated by Reference

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

[0006] Treatment planning for orthodontic treatment using a series of patient-removable appliances to reposition the teeth. Background Art

[0007] Orthodontic and dental treatment using a series of patient-removable appliances (e.g., "aligners") are very useful for treating patients, particularly for treating malocclusion. Typically, treatment planning is performed in conjunction with a dental professional (e.g., a dentist, orthodontist, dental technician, etc.) by generating a model of the patient's teeth in a final configuration and then dividing the treatment plan into a number of intermediate stages (steps) corresponding to the individual appliances worn in sequence. The process can be interactive, with the staging and, in some cases, the final target position being adjusted based on the constraints on tooth movement and the dental professional's preferences. Once the final treatment plan is finalized, a series of aligners can be manufactured that correspond to the treatment plan.

[0008] The treatment planning process can include many complex manual steps and may require a high level of knowledge of orthodontic specifications. In addition, because the steps are performed sequentially, the process can require a significant amount of time. The manual steps may include preparing models for digital planning, reviewing and modifying the proposed treatment plan (including phasing), and aligner feature placement (including features placed on the teeth or on the aligners themselves). These steps may be performed before an initial treatment plan is provided to a dental professional, who may then further modify the plan and send it back for additional processing to adjust the treatment plan, repeating (iterating) this process until a final treatment plan is completed and then provided to the patient.

[0009] The methods and devices described herein may improve treatment planning, including potentially increasing the speed at which a treatment plan can be completed, as well as providing dental professionals with more choice and control and allowing for improved patient involvement in the treatment planning process. Summary of the invention

[0010] Orthodontic and / or dental treatment planning methods and apparatus are described herein. In particular, methods of planning dental and / or orthodontic treatment are described herein. Any of the methods and apparatus described herein can pre-compute multiple potential treatment plan variations, including all phases and various possible alternative final configurations, and display them in parallel. A large number of such plans can be quickly generated at one time (e.g., as a large collection or array), and can be reviewed in real time or near real time. The treatment plan can include multiple different stages during which the patient's teeth are moved from an initial position to a final position; dental aligners (e.g., shell aligners) or other orthodontic devices can be caused to correspond to each stage and worn in an order defined by the treatment plan to move the patient's teeth from their initial position to the final position.

[0011] Methods and apparatus described herein allow for the simultaneous generation of a large number of treatment plan variations, wherein each variation is optimized to best address the dental professional's (and in some cases, the patient's) treatment goals, as well as to get as close as possible to an ideal or target final position. Also described herein are orthodontic and / or dental treatment planning methods and apparatus that allow a dental professional (e.g., a "user") and / or a patient to create, modify, and select a treatment plan from a plurality of different treatment plans in real time.

[0012] For example, a dental professional may make a model (e.g., a digital model or scan, and / or a physical model, which may subsequently be digitized) and send it to a remote site (e.g., a laboratory) where multiple options for a treatment plan may be generated. The model may be sent along with one or more of: patient-specific treatment preferences from the dental professional, treatment preferences specific to a particular dental professional (which may apply to all patients associated with that dental professional), and / or an indication of what clinical products (e.g., orthodontic products) should be used to move the patient's teeth. This data may be used as input to generate multiple optional treatment plans, as described in more detail below. The resulting multiple treatment plans (which may be collectively referred to as an array of treatment plans, a collection of treatment plans, or a set of treatment plans or treatment plan variations) may then be sent back to the dental professional for interactive display, selection, and / or modification by the dental professional and / or patient. Note that each treatment plan can have multiple phases, wherein in each phase of the treatment plan, the aligners may be worn for a predetermined period of time; alternatively or additionally, in some variations one or more phases may include orthodontic / dental manipulation of the patient's teeth (e.g., tooth movement, interproximal reduction, etc.).

[0013] The methods and devices described herein allow for the rapid creation of a large number of complete treatment plans that are specific and customized to a patient, which set forth orthodontic and / or dental plans for beneficially modifying the dentition of a subject, specifically including moving (e.g., aligning, straightening, etc.) the patient's teeth and / or solving patient-specific orthodontic problems. Traditionally, only a single orthodontic treatment plan is provided to a user and / or patient, in which the patient's dentition is modified from the patient's initial tooth position to the final tooth position, typically the comprehensive final position of the patient's teeth. Typically, a treatment plan may include a series of patient-removable appliances that reposition the teeth, as well as some indications of the duration for which each appliance ("aligner") will be worn. At each stage of the treatment plan, one or more (or all) of the patient's teeth may be moved relative to the previous stage until the teeth are in the target configuration; once in the target configuration, the final stage may optionally be a retainer (or multiple retainers) that maintains the target configuration for a certain retention duration. Any number of stages may be used. In some variations, the treatment plan may also indicate one or more dental / orthodontic procedures (e.g., interproximal removal, tooth extraction, etc.) to be performed at that stage.

[0014] The devices (e.g., systems, devices, etc. including software, firmware, and hardware) and methods described herein that may include treatment plan solvers can quickly generate multiple different treatment plans, each of which is customized for the patient. These methods and devices can take into account the treatment preferences of dental professionals and / or patients, and / or the types and constraints of available appliances (aligners) when generating these treatment plans. Alternative plans in which one or more of these parameters are different can be generated, thereby allowing direct comparison between a large number of alternative plans. Typically, even generating a single treatment plan has proven to be complex and time-consuming. Manual techniques have been used for treatment planning and may take hours or days to complete. Automation has also proven to be difficult, especially when estimating or preventing collisions between teeth during treatment. The methods and devices described herein can provide extremely fast and efficient methods to generate (and in some cases generate simultaneously or almost simultaneously) a large number of different and therapeutically feasible treatment plans. Treatment plans can be generated without the need for technicians or dental professionals to supervise or with very little technicians or dental professionals to supervise. In some variations of the methods and devices described herein, there are greater than 3 (e.g., greater than 4, 5, 6, 7, 8, 9, 10, 12, 14, 16, 18, 20, 25, 30, 35, 40, 45, 50, 60, 70, 80, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 500, etc.) complete treatment plans, each plan comprising multiple stages and corresponding tooth positions and / or appliance (e.g., aligner) configurations (in some variations, the tooth positions at each stage can be used to generate a dental appliance).

[0015] For example, described herein are automated methods for creating multiple dental / orthodontic treatment plans and apparatus (e.g., a treatment plan solver) for executing them. An automated method for creating multiple variations of a treatment plan for aligning a patient's teeth using multiple removable aligners to be worn in sequential stages may include: (a) specifying a set of treatment preferences and a set of treatment details (the treatment preferences and treatment details may be specified automatically or manually); (b) automatically determining a treatment plan based on the specified treatment preferences and treatment details by: collecting (e.g., receiving, forming, assembling, downloading, and / or accessing) a digital model of the patient's teeth in a processor that has access to the set of treatment preferences, the overall final position of the patient's teeth, and the set of treatment details; and (c) automatically determining a treatment plan based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth. The method further comprises: (a) selecting a plurality of numerically represented treatment objectives from a memory accessible to a processor; combining the plurality of numerically represented treatment objectives to form a single numerical function; selecting a plurality of numerical constraints on the single numerical function based on a set of treatment preferences; minimizing the single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages for forming a treatment plan; mapping the solution vector to a treatment plan, wherein the treatment plan includes a final tooth position different from the overall final position of the patient's teeth; (c) adding the treatment plan to an array of treatment plans; and (d) modifying one or more treatment details or treatment preferences, and repeating steps (b)-(d) at least once. The method may further comprise adding metadata identifying the treatment details or treatment preferences to each treatment plan, such that the array of treatment plans includes the identifying metadata. The metadata need not indicate all treatment details or treatment preference information, but may include only a subset thereof, such as only those parameters that differ from other treatment plans (e.g., number of stages, use of IPR, etc.).

[0016] In any of the methods and apparatus described herein, minimizing a single numerical function subject to multiple numerical constraints to obtain a solution vector that includes all stages of forming a treatment plan may include estimating collisions between adjacent teeth. Accordingly, any of these apparatus may include a collision detector, and in particular, a collision detector that determines the magnitude and / or speed of collisions (or separations, which are negative collisions) between teeth. The use of very fast collision detection / detectors can increase the speed and efficiency of the methods and apparatus for treatment planning described herein; automatic collision detection methods and systems (collision detectors) are also described in more detail herein.

[0017] In some variations, the method may also include automatic analysis of the final stage tooth positions to determine the amount or level of correction of the patient's malocclusion achieved. This treatment outcome information may be added to the array of treatment plans, for example as metadata.

[0018] Also described herein are methods and devices for generating or converting user-specific treatment preferences. Dental professionals (e.g., users) can provide comments, requests, and feedback on treatment plans for many cases. The methods and devices described herein can interpret these comments, requests, and feedback as treatment preferences. For example, these treatment preferences can include preferences for modifying patient teeth (e.g., IPR, including which teeth to perform IPR on, at which treatment stage to perform IPR, etc.), the use of attachments (use / not use, where to place them, when to use them), etc. The methods and devices described herein can establish and use a database of such user-specific treatment preferences. As users perform other cases, the database can be updated and modified. In addition, as described herein, the database can be accessed to generate a treatment plan (or an array of treatment plans).

[0019] For example, an automated and customized method for creating an orthodontic treatment plan for a patient's teeth for a designated dental professional may include: in a treatment plan optimization engine (e.g., a processor), collecting (e.g., receiving, forming, compiling, downloading, and / or accessing) a set of combined treatment preferences specific to the designated dental professional, wherein the set of combined treatment preferences includes a first set of rules and a second set of rules, the first set of rules converted from a set of text instructions from the designated dental professional into a domain-specific language specific to the designated dental professional, wherein the text instructions include unscripted instructions, and the second set of rules converted from a set of scripted instructions from the designated dental professional, wherein the scripted instructions include responses from a script of predetermined options; in the treatment plan optimization engine, receiving a digital model of the patient's teeth; and generating a treatment plan for the patient's teeth using the combined set of treatment preferences and the digital model of the patient's teeth with the treatment plan optimization engine. The different treatment characteristics may include one or more of: interproximal removal (IRR), extraction, and aligner attachment.

[0020] The scripted instructions from the designated dental professional may be specific to the patient's teeth. The textual instructions may be specific to the patient's teeth, and / or the textual instructions may be extracted by the designated dental professional from a plurality of different previous cases.

[0021] The text instructions may include instructions regarding, for example, one or more of the staging of interproximal removal and the location of adnexa.Any other treatment preferences may be included as text instructions.

[0022] Generally, any of the methods may include updating the domain specific language specific to the designated dental professional, and / or storing the domain specific language specific to the designated dental professional in a remote database accessible to the treatment plan optimization engine. Any of these methods may include automatically generating the domain specific language specific to the designated dental professional, or manually converting the text instructions into the domain specific language specific to the designated dental professional.

[0023] Any of these methods may include a designated dental professional to the treatment plan optimization engine; for example, the dental professional may be identified by an identifier (dental professional identifier) ​​such as name (last name, first name, etc.), clinic name, number, etc. The identifier described herein may uniquely identify the dental professional.

[0024] As described in greater detail herein, generating a treatment plan generally includes determining a final position of the patient's teeth, and determining each of a plurality of stages of tooth movement based on the combined treatment preferences, wherein each stage includes a dental aligner.

[0025] For example, the present invention describes an automated and customized method for creating an orthodontic treatment plan for a patient's teeth for a designated dental professional, the method comprising: receiving a set of scripted instructions from the designated dental professional in a processor, wherein the scripted instructions include responses from a script of predetermined options; receiving a set of textual instructions from the designated dental professional in the processor, wherein the textual instructions include unscripted instructions; converting the set of textual instructions into a domain-specific language specific to the designated dental professional, wherein the domain-specific language includes a first set of rules; converting the set of scripted instructions into a second set of rules; combining the first set of rules and the second set of rules into a combined set of treatment preferences; and passing the combined set of treatment preferences to a treatment plan optimization engine, wherein the treatment plan optimization engine uses the combined treatment preferences to generate a treatment plan.

[0026] Any of these methods may further include accessing, by the processor, a database in a domain specific language corresponding to the designated dental professional.

[0027] Any of the methods described herein may be performed by a device configured and / or adapted to perform them. For example, a non-transitory computer-readable storage medium having computer-executable instructions stored thereon is also described herein, which, when executed by a computer, causes the computer to automatically create an orthodontic treatment plan for a patient's teeth customized for a specified dental professional by: receiving, in a treatment plan optimization engine, a set of combined treatment preferences specific to the specified dental professional, wherein the set of combined treatment preferences includes a first set of rules and a second set of rules, the first set of rules being converted from a set of text instructions from the specified dental professional into a domain-specific language specific to the specified dental professional, wherein the text instructions include unscripted instructions, and the second set of rules being converted from a set of scripted instructions from the specified dental professional, wherein the scripted instructions include responses from a script of predetermined options; receiving, in the treatment plan optimization engine, a digital model of the patient's teeth; and generating, using the treatment plan optimization engine, a treatment plan for the patient's teeth using the set of combined treatment preferences and the digital model of the patient's teeth.

[0028] As described above, methods and apparatus (e.g., systems, apparatus, etc. including software) for automatically detecting and / or estimating collisions between teeth are also described herein. These methods and apparatus can provide an approximation of the magnitude and / or velocity of a collision between teeth. The magnitude and velocity of a collision can be represented as a vector or one or more scalar values. The velocity can be the velocity on each of a plurality of axes, such as three translation axes (x, y, z) and three rotation axes (pitch, roll, yaw). In some embodiments, the magnitude and velocity of a collision between all adjacent pairs of teeth can be determined. The magnitude of a collision can be positive (e.g., indicating the depth of a collision) or negative (indicating the spacing or spacing between teeth).

[0029] Although the automatic collision detection systems and methods described herein may be particularly useful as part of an automatic method for generating a treatment plan (e.g., as part of a treatment plan solver), they are not limited thereto. It should be understood that the methods and apparatus described herein may also be used independently or as part of any other method or apparatus that may benefit from automatic and rapid detection of collisions between two or more teeth.

[0030] For example, a method for automatically determining collisions between adjacent teeth may include: forming a digital model of the surface of each tooth by automatically packing multiple 3D shapes to approximate the surface of each tooth of a patient's multiple teeth, wherein each 3D shape has a core that is a line segment or a closed plane figure, and an outer surface that is a constant radius from the core; for the digital model of the surface of each tooth, forming a hierarchy of bounding boxes that enclose the multiple 3D shapes; measuring the magnitude and speed of the collision between adjacent teeth when the patient's multiple teeth are in a set of tooth positions in a collision detector by identifying the colliding bounding boxes and determining the spacing or overlap between the 3D shapes defined by the colliding bounding boxes; and outputting the magnitude and speed of the collision between adjacent teeth corresponding to the set of tooth positions.

[0031] Any method for automatically determining collisions may also include collecting (e.g., receiving, downloading, accessing, etc.) a set of tooth positions. The positions of the teeth may correspond to the positions of the teeth in space. In some variations, the teeth may be arranged in a coordinate system (e.g., x, y, z) such that the relative positions of the teeth are understood.

[0032] Typically, in any of the methods and devices (e.g., collision detectors) described herein for automatically determining collisions, one or more surfaces of a patient's teeth can be filled with a 3D shape. As used herein, a 3D shape can refer to a shape having a core and an outer 3D surface, the core being a line or plane (including a closed plane) figure, the outer 3D surface surrounding the core and extending from the core to a set radius r. In some variations, the 3D shape is a capsule having a core that is a line segment extending a length L. The body of the 3D shape (capsule body) is elongated, but rounded at the end, with a hemispherical end. Any appropriate 3D shape or combination of 3D shapes can be used. These 3D shapes can exclude spheres, which usually have a point at the core and are surrounded by a surface at the outer radius. When filling a tooth surface, a 3D shape having a core that is a line or plane figure, especially a closed plane figure (e.g., rectangle, circle, etc.) that forms a shape with a linear and convex outer surface, can work better than a simple sphere, and the tooth surface can be concave, convex, and flat in some areas.

[0033] Typically, when automatically determining a collision between two teeth, each of the two teeth being processed can be divided into parts so that only those surfaces of the parts of the teeth that face each other need to be filled / modeled using a 3D shape (e.g., a capsule). In some variations, the tooth can first be divided into two halves, into a left half and a right half, and only those sides of the teeth that face each other need to be processed. Thus, forming a digital model of the surface of each tooth can include forming the left and right sides of each tooth separately. Thus, measuring the magnitude and speed of a collision between adjacent teeth can include identifying a collision between adjacent left and right sides of adjacent teeth.

[0034] In any of the collision detection methods and devices described herein, forming a digital surface of the surface of each tooth may include automatically packing multiple 3D shapes to approximate the surface. In some variations, the surface (and / or the entire tooth volume, or a portion of the tooth volume, such as the left / right side) can be modeled by packing with multiple 3D shapes (e.g., capsules), all of which are the same shape and size, or 3D shapes of different shapes and / or different sizes can be used. In the process of determining the collision (and / or spacing) between adjacent teeth, the closed capsule between each of the two teeth can be determined by a bounding box, and one or more numerical methods can be used to solve the collision amplitude (which can be overlap / collision and can be a positive value, or can be a spacing and a negative collision amplitude).

[0035] Therefore, any method and apparatus for collision detection described herein may also include forming a hierarchy of bounding boxes around a 3D shape (e.g., a capsule) forming a first tooth surface, and a second hierarchy of bounding boxes around a 3D shape (e.g., a capsule) forming a surface of a second tooth adjacent to the first tooth may be determined. Using a hierarchical hierarchy of bounding boxes around 3D shapes forming surfaces, it is computationally fast to determine which bounding boxes in the hierarchy overlap / collide and which bounding boxes do not overlap / collide. At the lowest level of the hierarchy, each bounding box encloses a single 3D shape, and each subsequent level defines two adjacent bounding boxes until the highest level, which defines all bounding boxes around all 3D shapes. Forming a hierarchy of bounding boxes may include, for example, forming a hierarchy in which the bounding boxes of the lowest level of the hierarchy each enclose a single 3D shape, the subsequent levels of the hierarchy each enclose adjacent bounding boxes or groups of bounding boxes, and the highest level of the hierarchy encloses all bounding boxes around 3D shapes forming surfaces. When comparing the hierarchy of bounding boxes, the comparison may start from the top of the hierarchy; if the top level hierarchy of each adjacent tooth surface does not collide, then no bounding boxes in the hierarchy collide. Starting at the highest level and working down the hierarchy, each branch of the first hierarchy (e.g., corresponding to the first tooth surface) can be compared to each branch of the second hierarchy (e.g., corresponding to the second tooth surface); at any level where there is no overlap between two branches (e.g., a collision can be detected by measuring the shortest distance between bounding boxes at that level), there is no need to check further lower level branches. Once the lowest level is reached, the 3D shape in the bounding box of the collision can be used to determine the collision magnitude and speed.

[0036] For example, the magnitude of a collision between adjacent teeth can be measured by determining the spacing or overlap between 3D shapes defined by the colliding bounding boxes to obtain the magnitude of the collision. As just mentioned, measuring the magnitude and speed of a collision between adjacent teeth can include starting from the top level of the hierarchy of bounding boxes and proceeding down the layers to the lowest level of the hierarchy of bounding boxes corresponding to each adjacent tooth, comparing the branches at each level between two adjacent teeth to identify the colliding bounding box at the lowest level of the hierarchy of bounding boxes. Once the colliding bounding box is determined, the shortest distance (maximum overlap) between two 3D shapes (e.g., capsules) can be determined by calculation.

[0037] The velocity of a collision between adjacent teeth can be measured by "jittering" one or both teeth that are colliding with each other relative to the other tooth; for example, one of the teeth (or a portion of a tooth) populated by a 3D shape can be moved very slightly (e.g., between 0.001-0.0001 inches) in each of the spatial axes (e.g., x, y, z, pitch, roll, yaw), and the change in the collision after each sequential movement is determined. For example, by sequentially adjusting the position of a first 3D shape of adjacent teeth by a small predetermined amount in each of the multiple axes of the first tooth, and determining the change in the spacing or overlap between the 3D shapes defined by the bounding boxes, the velocity of the collision for each of the corresponding axes is obtained. For that axis, the change in the magnitude of the collision / spacing after each change can be expressed as a velocity (the time to achieve the change can be assumed to be a set value, such as 1).

[0038] Velocity can be expressed as a single vector (e.g., x, y, z directions) and / or rotation; in some variations, velocity can be expressed on each axis (three spatial axes and three rotational axes). Alternatively, in some variations, only three spatial (or three rotational) axes are examined. The magnitude and velocity of the resulting collision can be output, for example, by outputting the magnitude and velocity for each of the three spatial axes and the three rotational axes. The output (magnitude, velocity, or both) can be passed to a treatment plan solver, or to any other system of which the collision detector is a part, and / or it can be output (e.g., displayed, stored, transmitted, etc.) for independent use.

[0039] Also described herein are systems for automatically detecting collisions between teeth. These systems may be referred to as collision detectors and may include, for example: one or more processors; and a memory coupled to the one or more processors, the memory being configured to store computer program instructions that, when executed by the one or more processors, perform a computer-implemented method comprising: forming a digital model of the surface of each of a plurality of teeth of a patient by automatically packing a plurality of 3D shapes to approximate the surface of each of the plurality of teeth of the patient, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, and the outer surface having a constant radius from the core; for the digital model of the surface of each tooth, forming a hierarchy of bounding boxes that enclose the plurality of 3D shapes; measuring in the collision detector the magnitude and velocity of collisions between adjacent teeth when the plurality of teeth of the patient are in a set of tooth positions by identifying collision bounding boxes and determining the spacing or overlap between the 3D shapes bounded by the collision bounding boxes; and outputting the magnitude and velocity of collisions between adjacent teeth corresponding to the set of tooth positions.

[0040] As described above, any of these methods for detecting collisions and / or collision detectors can be included as part of a system or method for automatically creating an orthodontic treatment plan for a patient. For example, a method for automatically creating an orthodontic treatment plan for a patient may include: forming a digital model of the surface of each tooth of a plurality of teeth of the patient by packing a plurality of 3D shapes to approximate the surface of each tooth, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed plane figure, and the outer surface having a constant radius from the core; for the surface of each tooth of the plurality of teeth of the patient, forming a hierarchy of bounding boxes that enclose the plurality of 3D shapes; passing a set of tooth positions of the plurality of teeth of the patient from a treatment plan solver to a collision detector; measuring in the collision detector the magnitude and velocity of collisions between adjacent teeth when the plurality of teeth of the patient are in the set of tooth positions by identifying collision bounding boxes and determining the spacing or overlap between the 3D shapes defined by the collision bounding boxes; and passing the magnitude and velocity of collisions between adjacent teeth corresponding to the set of tooth positions to a treatment plan solver; and outputting from the treatment plan solver one or more orthodontic treatment plans, the one or more orthodontic treatment plans comprising a series of dental appliances for moving the patient's teeth.

[0041] A method for automatically creating an orthodontic treatment plan for a patient may include: collecting a digital model of a plurality of teeth of the patient, wherein each tooth of the digital model is segmented; automatically packing a plurality of 3D shapes to approximate a surface of each tooth of the digital model, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed plane figure, and the outer surface having a constant radius from the core; for the surface of each tooth of the digital model, forming a hierarchy of bounding boxes surrounding the plurality of 3D shapes, wherein, for the surface of each tooth of the digital model, each of the bounding boxes of the lowest level of the hierarchy surrounds a single 3D shape, each of the subsequent levels of the hierarchy surrounds adjacent bounding boxes or groups of bounding boxes, and the highest level of the hierarchy surrounds all bounding boxes surrounding the 3D shapes forming the surface; passing the set of tooth positions of the plurality of teeth of the patient from a treatment plan solver to a collision solver; A detector; measuring in a collision detector the magnitude and velocity of a collision between adjacent teeth when a plurality of teeth of a patient are in a set of tooth positions by: identifying a collision bounding box at the lowest level of a hierarchy of each of the adjacent teeth, determining a spacing or overlap between 3D shapes defined by the collision bounding box to obtain a magnitude of the collision, and sequentially adjusting a position of a first tooth among the adjacent teeth by a small predetermined amount on each of a plurality of axes of the first tooth and determining a change in the spacing or overlap between the 3D shapes defined by the bounding box to obtain a velocity of the collision for each of the corresponding axes; and outputting the magnitude and velocity of the collision between adjacent teeth corresponding to the set of tooth positions to a solver; and outputting from the solver one or more orthodontic treatment plans, the one or more orthodontic treatment plans comprising a series of dental appliances for moving the patient's teeth.

[0042] A system for automatically creating an orthodontic treatment plan for a patient may include: one or more processors; a treatment plan solver running on the one or more processors; a collision detector running on the one or more processors; and a memory coupled to the one or more processors, the memory configured to store computer program instructions that, when executed by the one or more processors, perform a computer-implemented method, the method comprising: forming a digital model of a surface of each tooth of a plurality of teeth of the patient by packing a plurality of 3D shapes to approximate the surface of each tooth, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, the outer surface having a constant radius from the core; For the surface of each tooth of the patient's multiple teeth, a hierarchy of bounding boxes enclosing multiple 3D shapes is formed; a set of tooth positions of the patient's multiple teeth is passed from a treatment plan solver to a collision detector; the magnitude and speed of collisions between adjacent teeth when the patient's multiple teeth are in the set of tooth positions are measured in the collision detector by identifying collision bounding boxes and determining the spacing or overlap between the 3D shapes defined by the collision bounding boxes; and the magnitude and speed of collisions between adjacent teeth corresponding to the set of tooth positions are passed to the treatment plan solver; and one or more orthodontic treatment plans are output from the treatment plan solver, the one or more orthodontic treatment plans including a series of dental appliances for moving the patient's teeth.

[0043] In any of these methods and systems, the collision detector may be called repeatedly (including iteratively). For example, in any of these methods and apparatuses, before outputting the one or more treatment plans, the steps of transmitting a set of tooth positions of a plurality of teeth of the patient to the collision detector, measuring the magnitude and velocity of collisions between adjacent teeth, and transmitting the magnitude and velocity of collisions are repeated for a plurality of different sets of tooth positions, wherein the treatment plan solver generates the different sets of tooth positions.

[0044] In any of the methods and systems for generating treatment plans described herein, a treatment plan solver can generate different sets of tooth positions while minimizing a numerical function subject to a plurality of numerical constraints to obtain a solution vector that includes all phases of the one or more orthodontic treatment plans.

[0045] Also described herein are methods and apparatus for quickly viewing and selecting a treatment plan in real time from a large number of alternative treatment plans, including plans with different characteristics, durations, and ultimate endpoints for the patient's dentition. Once selected / approved, the selected treatment plan, including all phased information, can be sent for manufacture and delivery to a dental professional and / or patient. In particular, the methods and apparatus described herein can allow for the presentation of various treatment plans with different treatment times (e.g., phases) and costs.

[0046] The array of treatment plans can include alternative variations of the treatment plan presented to a user (e.g., a dental professional, or in some cases, a patient) in parallel and in real time. As mentioned, the treatment plan variations can include a variety of different stages, where each stage corresponds to a different aligner to be worn (e.g., for a predetermined period of time, such as one day, one week, two weeks, etc.). The user can display side-by-side views of the different variations on a video device (computer, tablet, smartphone, etc.) for real-time comparison, and / or can switch between different variations. The display can show the final position of the teeth expected to result from the treatment, and / or can allow the user to view all different stages (including animations). The user can use one or more controls (e.g., buttons, sliders, tabs, etc.) that can be on the display to switch between treatment plans, including applying a "filter" to show variations with or without specific tooth modifications (e.g., interproximal removal, tooth extraction, and aligner attachments, etc.). Alternatively, the controls can be off the display (e.g., on a keyboard, mouse, trackball, etc.).

[0047] As used herein, an array of treatment plans may refer to a set of treatment plans.The array of treatment plans may be unsorted or sorted, and / or may be part of a single data structure, or individual treatment plans may be maintained in separate data structures.

[0048] The methods and apparatus may also allow a user to modify any treatment plan. Many of the modifications made by the user may include variations of treatment plans that have been pre-calculated and included in the array of treatment plans, and thus may be modified in real time by switching between different treatment plan variations. The modifications may change one or more characteristics of the treatment and, therefore, the treatment plan. If the modifications exceed the changes included in the array of treatment plans, the user may be notified, and the modified treatment plan may be sent back to the remote site to recalculate the plurality of treatment plans (or add new treatment plans to the array) to incorporate the changes, and the interactive method of forming and / or producing treatment plans may continue with the array of new or expanded treatment plan variations that include the modifications requested by the user.

[0049] At the beginning of any of the methods described herein, a dental professional can provide input, including patient-specific preferences or preferences specific to the dental professional (which can apply to all patients of the dental professional). Such preferences can include tooth movement restrictions (e.g., indicating which teeth should not be moved as part of treatment), whether interproximal removal (IPR) should be used and / or how, when or where during treatment the IPR should be performed, whether attachments should be used, where the attachments should be placed if used (e.g., on which teeth), and the like. In some variations, the method or apparatus may require only the name of the dental professional in order to call up a predetermined set of dental professional-specific preferences (e.g., to look up the dental professional's predetermined preferences). The dental professional and / or patient can also specify which dental / orthodontic product to use (e.g., which type of orthodontic product to use), which may correspond to characteristics that affect treatment, including the number of stages to be used, the speed of tooth movement, and the like. As with the dental professional-specific preferences, the method or apparatus can include a memory that stores a database (e.g., a lookup table) of characteristics specific to each dental product.

[0050] In any of these methods and devices, another input is typically a digital model of the patient's teeth. The digital model of the patient's teeth and any user's patient-specific or user-specific preferences and / or dental products to be used can be used as input (e.g., sent to a remote site) to generate an array of treatment plans. The process of generating treatment plans can be automatic and can be fast (e.g., within seconds, minutes, or hours). Each treatment plan generated may include a final position, a stage (e.g., a description of the direction of tooth movement and the speed associated with each stage), and (optionally) a set of aligner features placed on each tooth to improve the predictability of treatment and ensure that tooth movement occurs. When generating each of these treatment plans, the final position of the teeth can be determined so as to address all or part of the patient's clinical condition (e.g., malocclusion), such as crowding, bite problems, etc., and / or can be as close as possible to the ideal tooth position that can be achieved by the patient's teeth. Each treatment plan in the array can be specific to a set of characteristics that are associated with the treatment plan and used to pre-calculate the treatment plan. For example, each treatment plan can be generated using a set of specific treatment characteristics ("characteristics"). Characteristics can refer to modifications of the patient's teeth. For example, treatment plans may be pre-calculated for a specific number of treatment phases / treatment times, with or without attachments on teeth, with attachments at specific locations, with specific types of attachments, with or without IPR, with IPR on a specific subset of teeth, with IPR at specific phases, with or without extraction, etc., including all possible combinations of these characteristics. Each treatment plan is patient-specific and may be independently generated for each set of characteristics using any of the techniques described herein. Thus, each treatment plan may be unique and may have different tooth positions at any different phases, and importantly, may have different final phases. Although treatment plans may have some substantially similar or nearly identical tooth positions for some phases, they are typically generated independently of one another. For this reason, these treatment plans may be referred to as partial treatment plans, because the final position of the treatment plan, especially those treatment plans where the maximum number of phases (and therefore the duration of treatment) may not be the same as a comprehensive treatment plan that solves almost all of the patient's orthodontic problems; rather, a partial treatment plan may partially solve an orthodontic problem, or may only solve or partially solve some of these orthodontic problems.

[0051] The collection (e.g., array) of treatment plans can include a matrix of different treatment plan variations. For example, various treatment plans can include variations with different treatment times (e.g., number of stages, corresponding to the number of aligners in treatment), and for each different treatment time, the final position can be optimized to address the treatment goal and to approximate as closely as possible one or both of the ideal or target final position. The array of treatment plans can also include treatment plans that are variations of each plan with different treatment numbers, including one or more specific treatment characteristics (including modifications to the patient's teeth) (e.g., with or without IPR, with or without extractions, etc.).

[0052] The methods and devices described herein may include a display that provides a simple interface for treatment planning. A user may modify any plan using a collection of tools provided as controls (buttons, etc.) that may appear on a screen or any other input. A user may switch between different pre-calculated complete treatment plans already in an array of treatment plans (e.g., by applying an on / off filter to display variations, e.g., with / without IPR, with / without extraction, with / without attachments, which attachments are placed on which teeth, which teeth use IPR, change the spacing between teeth, change the leveling strategy from "incisal edge alignment" to "gingival edge alignment", etc.). As mentioned, in some cases, modifications not covered by the pre-calculated treatment plan variants in the array of treatment plans may cause the method or device to trigger the generation of a new treatment plan that replaces or is added to the array of existing treatment plans and includes the new modifications. In any of these methods and devices, a treatment plan may be generated in a manner that ensures the manufacturability of the plan defined by the ability to manufacture an aligner based on the treatment plan without manual intervention. In addition, all treatment plans described herein may be generated so as not to exacerbate any orthodontic problems (e.g., malocclusion).

[0053] For example, described herein are apparatus (e.g., systems) and methods for treatment planning that provide interactive treatment planning with a user (and / or subject). In general, the apparatus and methods can provide multiple pre-calculated complete treatment plans, wherein at least some of the plans have different numbers of stages (e.g., different completion times, wherein each stage is an aligner that can be worn for a predetermined and continuous amount of time), and many (if not all) of the treatment plans may have different final tooth positions that address some or all of the treatment goals. The plans can be annotated to include a description of the treatment plan, which can indicate the number of stages, options that are present / absent, and treatment goals that are met, improved, or left as is. As described herein, these methods and apparatus can take into account the preferences of a dental professional in order to maximize the proposed treatment plan. For example, a treatment plan initially presented from an array of treatment plans can be selected so that it has a higher likelihood of being accepted by a dental professional (user) without additional modifications. For example, when generating a treatment plan, a user's preferences for treatment of a particular patient (which may be based on a questionnaire and / or annotations provided by the user, as will be discussed in more detail below, and / or based on treatment goals, weights of treatment goals, etc.) and / or general user preferences that may apply to all of the user's patients (e.g., standard user practices, etc.) may be used with a model of the patient's teeth (and in some variations, products to be used and / or characteristics of the products to be used) to generate a collection of treatment plans that form an array. Thus, each array may be customized and patient-specific for each individual user (e.g., dental professional). Additionally, the method and apparatus may select which treatment plans to initially present based on predetermined or set user preferences.

[0054] Methods and apparatus for displaying and selecting multiple treatment plans with different endpoints and numbers of treatment stages are described herein. For example, a method of manufacturing a series of aligners for a patient's teeth may include: collecting (e.g., receiving, forming, assembling, downloading, and / or accessing from a remote site or a local site, and may be collected, for example, in a processor to be accessed by a user) an array of treatment plans specific to the patient's teeth, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages including a final stage, further wherein at least three of the treatment plans have a different number of sequential stages, further wherein the array of treatment plans includes two or more treatment plans with different treatment characteristics; displaying on a screen an image of the teeth at the final stage of each treatment plan from a subset of treatment plans from the array of treatment plans; switching in real time between images of the teeth at the final stages of different treatment plans within the array of treatment plans based on one or more user-selected controls on the screen; and after a user has selected a selected treatment plan from the treatment plans displayed on the screen, sending the selected treatment plan from the treatment plans for production.

[0055] The methods and apparatus described herein may be directed to sending and / or receiving from a remote site from which an array of treatment plans specific to the patient's teeth may be generated, the remote site may be remote from the user, and may be accessed via a network (e.g., cloud) server, etc. In some variations, the treatment plan is generated locally, such as on software running on a user's computer / processor, which is the same processor containing instructions (e.g., code) for performing interactive treatment planning (including receiving the array of treatment plans).

[0056] As mentioned, each treatment plan in the array can describe a set of sequential stages for orthodontic movement of a patient's teeth, the set of sequential stages including a final stage. The treatment plan can include the final position of the patient's teeth, the staging of the patient's tooth movement (e.g., a description of the direction of tooth movement and the speed associated with each stage, which can be a keyframe showing the relative movement of the teeth with treatment), and a set of aligner features placed on each tooth to improve the predictability of treatment and ensure that tooth movement occurs. The treatment plan can also include metadata (e.g., annotations) regarding the number of stages, the presence / absence of tooth modifications, the impact on the patient's treatment goals, etc.

[0057] As used herein, the phrase "real-time" may refer to an immediate (or perception of immediate or simultaneous) response, e.g., a response within a few milliseconds so that when observed by a user, it is effectively immediately available. Near real-time may refer to simultaneous occurrence within a few seconds to a few minutes.

[0058] The screen for displaying and interacting with the user can be any suitable screen or monitor, including touch screens and non-touch screens. The screen can be part of the screen of a laptop, desktop computer or other computer, including handheld (e.g., smart phones, tablet computers, etc.). The screen can include flat panel displays as well as other displays, including virtual reality (e.g., glasses, goggles, etc.) and projection (e.g., surface projection).

[0059] Different treatment features that can be used to generate various treatment plans may include one or more of the following: interproximal removal (IRR) / changing the spacing distance between teeth, extraction and aligner attachments (one or more, at various locations), changing the leveling strategy from "incisal edge alignment" to "gingival margin alignment", etc.

[0060] As will be described in more detail below, any of the methods described herein may include generating a plurality of treatment plans, such as generating an array of complete treatment plans including variations of different treatment characteristics. These treatment plans may be pre-computed. Any number of treatment plans may be included in the array of treatment plans, typically 3 or more (e.g., 4 or more, 5 or more, 6 or more, 7 or more, 8 or more, 9 or more, 10 or more, 11 or more, 12 or more, 13 or more, 14 or more, 15 or more, 16 or more, 17 or more, 18 or more, 19 or more, 20 or more, 22 or more, 24 or more, 26 or more, 28 or more, 30 or more, 35 or more, 40 or more, 45 or more, 50 or more, 55 or more, 60 or more, 65 or more, 70 or more, 80 or more, 90 or more, 100 or more, 110 or more, 120 or more, etc.). In fact, any of these methods may include sending a patient's dental model to a remote site holding a treatment plan generator, which may be referred to as a treatment plan optimization engine or a treatment plan optimization generator. The treatment plan generator may be located at the remote site, for example, as part of a processor or other system. Therefore, any of these methods may include generating an array of treatment plans specific to the patient's teeth at the remote site. The model of the patient's teeth (upper dental arch, lower dental arch, or upper dental arch and lower dental arch) may be sent to the remote site and may be received there as a digital file, or it may be digitized at the remote site. The remote site may be a dental laboratory. In addition, the user may send a list of tooth movement prescription information (e.g., patient-specific treatment preferences), wherein the tooth movement prescription information list includes tooth movement limitations, retraction limitations, and interproximal removal limitations. In any of these variations, the remote site may also receive a user identity and may look up stored (e.g., stored in a database) user-specific preferences, which may be applied to any case associated with the user (e.g., user-specific treatment preferences). The user may also (optionally) send treatment details or a reference to a collection of treatment details, including product details specific to one or more types of dental / orthodontic products to be used, which may be defaulted if not included. For example, a user may send as input to the treatment plan generator the name or indicator of a specific dental / orthodontic treatment plan, such as "OrthoGO." The treatment plan generator may then use the name or indicator to look up details specific to that treatment plan, such as a maximum number of aligners (e.g., maximum treatment duration), etc., from a memory accessible to or included in the treatment plan generator.

[0061] One or more preferably multiple treatment plans may be displayed to a user for review (in real time or near real time). When displaying a treatment plan, the final stage of the treatment plan may be displayed to the user (showing the final position of the patient's teeth, as achieved by the treatment plan), and / or metadata about the treatment plan (e.g., number of stages, components processed / unprocessed, etc.). Displaying an image of the teeth at the final stage of each treatment plan of a subset of treatment plans from an array of treatment plans may include simultaneously displaying an image of the teeth at the final stage of treatment plans having different numbers of sequential stages. The treatment plans may be displayed side by side for comparison. In some variations, a user may toggle between "filters" or switches that display different treatment plans (e.g., plans with or without IPR, etc.). Because the treatment plans have been pre-calculated and in an array, they may be displayed in real time, and the user may easily toggle between different versions, allowing the user to pick the best treatment for the patient.

[0062] As mentioned, switching between images of teeth at the final stages of different treatment plans within an array of treatment plans can be based on one or more user-selected (optional) controls on the screen, for example, switching a treatment plan having a first number of sequential stages with a treatment plan having the same number of sequential stages but having different treatment characteristics when the user changes one or more user-selected controls on the screen.

[0063] For example, different filters / switches may toggle between treatment plans that display one or more tooth / treatment modifications. In practice, any modification may be used, including, for example, one or more of: extraction (of one or more teeth), adjusting tooth overjet, adjusting overbite, adjusting crossbite, interproximal removal (IPR), including one or more aligner attachments on teeth, and anterior to posterior (AP) correction. These filters may correspond to treatment preferences.

[0064] The methods and devices described herein may include one or more tools that allow a user to modify one or more treatment plans. The tools may be display tools for modifying the display of the teeth displayed by the treatment plan (e.g., allowing rotation, sectioning, etc.), or they may modify the treatment plan itself, for example, modifying the position and / or orientation of the teeth in the final stage (or any intermediate stage) of the treatment plan. The tools may include adding / removing attachments to the teeth. The tools may include removing (e.g., reducing) material from one or more tooth sides, and / or removing (e.g., extracting) teeth.

[0065] Any of these methods may include sending the modified one or more treatment plans to a treatment plan optimization generator (e.g., a remote site where the treatment plan optimization generator is located) to recalculate the array of treatment plans based on the modification of the one or more treatment plans.

[0066] Any of these methods may also allow the user to step through the entire treatment plan, as a keyframe display and / or as a more intuitive display of a model (e.g., a 3D model or projection) of the user's teeth at each stage. Thus, any of these methods may include displaying a plurality of sequential stages on a screen (e.g., an image of the teeth at each stage) when the user selects a stage selection control. These displays may be animated, showing the movement of the teeth.

[0067] Any of the methods and apparatus described herein may allow a user to select a subset of treatment plans from a larger array (set) of treatment plans. The subset may be used for presentation to a patient, as described below (e.g., in a "consulting mode") or for further modification or refinement, including for side-by-side comparison. In some variations, the method or apparatus may automatically select one or more treatment plans for display to a user based on predetermined user preferences. For example, any of these methods and apparatus may include selecting a subset of treatment plans for display from an array of treatment plans based on user preferences.

[0068] As described above, the display may be switched between treatment plans by turning one or more "filters" or toggles on / off. For example, any of these methods and apparatus may be configured to filter one or more of the displayed images of teeth at the final stage of a subset of treatment plans from an array of treatment plans when a user selects a filter control.

[0069] For example, a method for manufacturing a series of aligners for a patient's teeth may include: sending a model of the patient's teeth to a remote site; sending a list of tooth movement prescription information to the remote site; collecting (e.g., receiving, assembling, downloading and / or accessing) an array of treatment plans specific to the patient's teeth from the remote site, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages including a final stage, further wherein at least three of the treatment plans have a different number of sequential stages, further wherein, for each number of sequential stages, the array includes two or more treatment plans having the same number of sequential stages but different treatment characteristics; displaying on a screen an image of the teeth at the final stage of each treatment plan from a subset of treatment plans from the array of treatment plans; switching in real time between images of the teeth at the final stage of different treatment plans within the array of treatment plans based on one or more user-selected controls on the screen; and after a user has selected a selected treatment plan from the treatment plans displayed on the screen, sending the selected treatment plan from the treatment plans for fabrication.

[0070] Any of the methods described herein may be performed by an apparatus configured to perform the method steps. In particular, an apparatus (e.g., system) configured to execute instructions (code) to control an apparatus having a processor, a display, an input, etc. to interactively allow a user to design and manufacture a series of aligners for correcting malocclusion of a patient's teeth is described herein. Any of these apparatuses may be configured as a non-transitory computer-readable medium (e.g., software, firmware, hardware, or some combination thereof) that includes instructions for controlling an apparatus as described herein, and may be part of a system or subsystem.

[0071] For example, a non-transitory computer-readable medium containing program instructions is described herein for causing a computer to: receive an array of treatment plans specific to a patient's teeth from a remote site, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages including a final stage, further wherein at least three of the treatment plans have a different number of sequential stages, further wherein the array of treatment plans includes two or more treatment plans with different treatment characteristics; display on a screen an image of the teeth at the final stage of each treatment plan from a subset of treatment plans from the array of treatment plans; switch in real time between images of the teeth at the final stage of different treatment plans within the array of treatment plans based on one or more user-selected controls on the screen; and after a user has selected a selected treatment plan from the treatment plans displayed on the screen, send the selected treatment plan from the treatment plans for production. A system is also described herein, which includes one or more processors configured to execute the program instructions. These systems may be referred to herein as treatment plan comparators (or interactive real-time treatment plan comparators) and may optionally or additionally include one or more displays, one or more user-selectable controls, and one or more communication circuits (e.g., communication modules, such as wireless circuits, etc.).

[0072] Different treatment characteristics that may vary between different treatment plans may include treatment preferences, such as one or more of: allowing or limiting interproximal removal (IRR), allowing or limiting extractions, and allowing or limiting aligner attachments (e.g., attachments on teeth coupled to aligners). The program instructions may also be configured to send a model of the patient's teeth to a remote site. The program instructions may also be configured to generate an array of treatment plans specific to the patient's teeth at the remote site.

[0073] The program instructions may be configured to send a tooth movement prescription information list (eg, to a remote site containing a treatment plan optimization generator), wherein the tooth movement prescription information list includes tooth movement restrictions, retraction restrictions, and interproximal removal restrictions.

[0074] The program instructions may be configured to display an image of the teeth at a final stage for each treatment plan of a subset of treatment plans from the array of treatment plans by simultaneously displaying images of the teeth at a final stage for treatment plans having a different number of sequential stages.

[0075] The program instructions may be configured to switch between images of teeth at final stages of different treatment plans within an array of treatment plans based on one or more user-selected controls on the screen by switching a treatment plan having a first number of sequential stages to a treatment plan having the same number of sequential stages but having different treatment characteristics based on the one or more user-selected controls on the screen. The different treatment characteristics may include one or more of: extraction, overbite, overbite, crossbite, interproximal removal, attachment, and anterior to posterior (AP) correction. The program instructions may also be configured to provide one or more tools that allow a user to modify one or more treatment plans.

[0076] The program instructions may also be configured to send the modified one or more treatment plans to a remote site to recalculate the array of treatment plans based on the modification of the one or more treatment plans. The program instructions may also be configured to display a plurality of sequential stages on a screen when a user selects a stage selection control. The stage selection control may allow a user to dynamically view different stages (e.g., the position of teeth in each stage) in real time.

[0077] The program instructions may also be configured to select a subset of treatment plans from the array of treatment plans for display based on a user preference. The program instructions may also be configured to filter one or more of the displayed images of teeth at a final stage of the subset of treatment plans from the array of treatment plans when a user selects a filter control.

[0078] As mentioned, any of these methods and apparatus may include a consultation mode that presents multiple treatment plans to a patient or physician, including treatment plans with different numbers of stages and different final tooth positions. A user (e.g., a dental professional) may select these displayed treatment plans as a subset of the treatment plans in the array. The displayed treatment plans (and any corresponding metadata about them) may be displayed sequentially or simultaneously (e.g., side by side) for the patient to view. Pricing information corresponding to each treatment plan may also be displayed, as well as a graphical display that allows the patient (and / or user) to view the final tooth positions and allows the user to select the desired results. Multiple treatment plans with different numbers of stages and different final tooth positions may be presented to the patient, and the patient (either by themselves or in consultation with a dental professional) may decide which treatment plan to select.

[0079] Once a treatment plan is selected, it can be used to generate a series of aligners. For example, the treatment plan can be sent to a manufacturing facility that can directly print (e.g., by 3D printing) each aligner in the series, or the treatment plan can be used to generate positive molds of the patient's teeth at each stage used to form the aligners (e.g., by thermoforming).

[0080] Thus, in consultation mode, the patient is presented with a plurality of treatment plans having different numbers of stages and is allowed to select which treatment plan to make and use.

[0081] For example, a method of manufacturing a series of aligners for a patient's teeth may include a consultation mode. For example, the method may include: collecting (e.g., receiving, forming, compiling, downloading and / or accessing) in a processor an array of treatment plans specific to the patient's teeth, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages including a final stage, further wherein at least three of the treatment plans have a different number of sequential stages, further wherein the final stages of the treatment plans within the array of treatment plans are different; displaying on a screen an image of the teeth at the final stage of a subset of treatment plans from the array of treatment plans; selecting, by a user using one or more controls on the screen, two or more treatment plans from the subset of treatment plans; and displaying to the patient two or more treatment plans from the subset of treatment plans; and after the patient has selected the selected treatment plan from the treatment plans, sending the selected treatment plan from the two or more treatment plans for production.

[0082] As described, any of these methods may include sending a model of the patient's teeth to a remote site (e.g., a location of a treatment plan optimization generator). Displaying the two or more treatment plans may include displaying annotations describing changes in the final stage of each of the two or more treatment plans compared to the model of the patient's teeth. The annotations (which may be "metadata" about the treatment plans) may include one or more of: changes in malocclusion, changes in the patient's bite, and changes in upper and / or lower crowding.

[0083] Displaying two or more treatment plans from the subset of treatment plans to the patient may include displaying the number of stages of the sequence.

[0084] Any of these methods may include switching, in real time, one or more of the images of the tooth at the final stage of the subset of different treatment plans with images of the final stage of one or more other treatment plans from the array of treatment plans based on one or more user-selected controls on the screen. The two or more treatment plans from the subset of treatment plans may include two or more treatment plans having different numbers of sequential stages.

[0085] For example, a method for manufacturing a series of aligners for a patient's teeth may include: sending a model of the patient's teeth to a remote site; collecting (e.g., receiving, forming, assembling, downloading and / or accessing) an array of treatment plans specific to the patient's teeth from the remote site, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages including a final stage, further wherein at least three of the treatment plans have a different number of sequential stages, further wherein the final stages of the treatment plans within the array of treatment plans are different; displaying on a screen an image of the teeth at the final stage of a first subset of treatment plans from the array of treatment plans; selecting, by a user using one or more controls on the screen, two or more treatment plans from the first subset of treatment plans; and displaying to the patient the two or more treatment plans and annotations describing changes in the final stage of each of the two or more treatment plans compared to the model of the patient's teeth; and after the patient has selected a selected one of the treatment plans, sending the selected one of the two or more treatment plans for fabrication.

[0086] Also described herein is a non-transitory computer-readable medium containing program instructions for causing a computer to: receive in a processor an array of treatment plans specific to teeth of a patient, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of teeth of the patient, the set of sequential stages including a final stage, further wherein at least three of the treatment plans have a different number of sequential stages, further wherein the final stages of the treatment plans within the array of treatment plans are different; display on a screen an image of teeth at the final stage of a first subset of treatment plans from the array of treatment plans; select, by a user using one or more controls on the screen, two or more treatment plans from the first subset of treatment plans; and display the two or more treatment plans to the patient; and after the patient has selected the selected treatment plan from the treatment plans, send the selected treatment plan from the two or more treatment plans for production.

[0087] Generally, the methods and apparatus described herein provide interactive treatment planning and can present multiple, complete and pre-computed treatment plans to a user (e.g., a dental professional) and allow the user to switch between views of different pre-computed treatment plans and modify one or more treatment plans. The systems and methods described herein can also allow the physician to change the final position and recompute the new final position in real time without sending it to a technician.

[0088] Also described herein are methods and apparatus (eg, non-transitory computer-readable media containing program instructions for causing a computer to perform steps) for creating one or more (eg, arrays) of treatment plans to align, including partially align, a patient's teeth.

[0089] For example, the present document describes an automatic method for creating a treatment plan to align a patient's teeth using a plurality of removable aligners to be worn in sequential stages, the method comprising: collecting (e.g., receiving, forming, compiling, downloading and / or accessing) in a processor: a digital model of the patient's teeth, a set of treatment preferences and / or a reference to a set of treatment preferences, an overall final position of the patient's teeth, and (optionally) a set of treatment details or an identifier identifying the set of treatment details; selecting a plurality of numerically represented treatment goals and constraints from a memory accessible to the processor based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; combining the plurality of numerically represented treatment goals to form a single numerical function; selecting a plurality of numerical restrictions on the treatment constraint function based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; minimizing the single numerical merit function subject to the plurality of restrictions on the numerical treatment constraints to obtain a solution vector including all stages of forming the treatment plan; and mapping the solution vector to a treatment plan, wherein the treatment plan includes a final tooth position that is different from the overall final position of the patient's teeth.

[0090] Generally, treatment details may refer to product definitions, which may be parameters set by the characteristics of the aligner product to be used for treatment, e.g., the number of stages, the speed at which teeth move, etc. Treatment preferences may refer to the dentist's treatment preferences (e.g., which teeth do not move, etc.), and may be patient-specific, or may be user-specific and applicable to all patients of the user. Thus, treatment details may include details about the products that can be used to achieve the treatment, including the number and type of aligners, and any characteristics of the aligners themselves. In some variations, treatment details are not provided separately to the method or apparatus, but are available (e.g., as a default) when generating one or more treatment plans. The method or apparatus may default to a single set of treatment details corresponding to a single dental / orthodontic product, or may select from a list of predetermined products with specified characteristics. Alternatively, a user may provide details specific to a specific product or products to form treatment details. Note that when multiple different treatment plans are to be generated, an array of treatment plans is formed, and different variations may be generated using various sets of treatment details corresponding to different dental / orthodontic products.

[0091] Examples of treatment preferences are described in detail herein. For example, the treatment preferences may include one or more of: an indicator of which teeth are not allowed to move, an indicator of which teeth should not have attachments, an indicator of which teeth are to be treated, an indicator of the amount of correction for the tooth class, an indicator of interproximal removal to be used, an indicator of arch expansion to be used, an indicator of spacing between teeth, an indicator of tooth leveling. An identifier identifying treatment details may identify a product having a defined set of treatment details accessible to a processor.

[0092] Examples of treatment details are also provided below (corresponding to characteristics of different products that may be used), but may include one or more of: maximum allowed number of stages, whether attachments to the patient's teeth are allowed, maximum allowed root movement, maximum allowed crown movement, and maximum allowed tooth rotation.

[0093] Combining numerically represented treatment goals may mean: weighting each of the numerically represented treatment goals in a single numerical function. A weighting factor may be used for any of a plurality of numerically represented treatment goals; a different weighting factor may be used for each or a subset of the numerically represented treatment goals. The weighting factors may be set empirically or may be adjusted by the device.

[0094] For a set of teeth, a single numerical function may include the sum of at least the following: a difference in tooth position compared to the global final position of the patient's teeth, a measure of misalignment of the teeth in the x-direction, a measure of misalignment of the teeth in the z-direction, a measure of misalignment of the dental arches of the teeth, a measure of gaps between adjacent teeth, a measure of overjet of the teeth, a measure of overbite of the teeth, a measure of collision between the teeth, a measure of the difference between the dental arches of the teeth and the global final position of the patient's teeth, a measure of the difference in leveling between the teeth and the global final position of the patient's teeth, a measure of the amount of bite between the patient's maxillary and mandibular teeth, a measure of the difference in the amount of bite between the teeth and the global final position of the patient's teeth, a measure of the amount of mesial to distal reciprocation of the teeth, a measure of the amount of buccal to lingual reciprocation of the teeth, and a measure of the number of aligner stages compared to a target number of aligner stages from the set of treatment details. For example, for a set of teeth, a single numerical function may include the sum of at least: the difference in tooth position compared to the global final position of the patient's teeth, a measure of misalignment of the teeth, and a measure of the number of aligner stages compared to a target number of aligner stages from the set of treatment details.

[0095] The method described herein may also include adjusting multiple numerically represented treatment goals into multiple adjusted numerically represented treatment goals based on: a set of treatment details, a set of treatment preferences, and an overall final position of the patient's teeth, further wherein combining the multiple numerically represented treatment goals includes combining the multiple adjusted numerically represented treatment goals.

[0096] The plurality of numerical limits may include one or more of: a maximum rate of tooth movement, a maximum amount of collision between teeth, a limit on tooth movement, a maximum number of aligner stages, a maximum amount of bite, a maximum amount of underbite, a maximum amount of overbite, a maximum amount of overjet, and a maximum midline position.

[0097] Generally, minimizing a single numerical function subject to multiple numerical constraints includes using a constrained optimization method to obtain a solution vector. The constrained optimization method may include an interior point method (eg, interior point method variants such as SQP and Active Set).

[0098] Mapping the solution vector to the treatment plan may include converting the solution vector to a set of keyframes for each tooth corresponding to the stage number and position information for each tooth, the position information including x-coordinates, y-coordinates, z-coordinates, and angles, inclinations, and rotations. When mapping the solution vector to form a key function, the solution vector may include many key function components that may be combined to form a complete set of key functions for the treatment plan. Thus, mapping the solution vector to the treatment plan may include, for some teeth, mapping a single variable in the solution vector to a single coordinate or angle in the keyframe, while for some teeth, the mapping may include mapping a linear combination of multiple variables from the solution vector to a single coordinate or angle in the keyframe.

[0099] The method may further comprise displaying the final tooth positions of the treatment plan and / or sending the treatment plan to be displayed.

[0100] For example, an automatic method for creating a treatment plan to align a patient's teeth using a plurality of removable aligners to be worn in sequential stages may include: collecting (e.g., receiving, forming, compiling, downloading, and / or accessing) in a processor: a digital model of the patient's teeth; accessing (by the processor): a set of treatment preferences, an overall final position of the patient's teeth, and a set of treatment details; selecting a plurality of numerically represented treatment goals from a memory accessible to the processor based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; adjusting the plurality of numerically represented treatment goals into a plurality of adjusted numerically represented treatment goals based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; combining the plurality of adjusted numerically represented treatment goals to form a single numerical function; setting a plurality of numerical constraints on the single numerical function based on the set treatment preferences; minimizing (e.g., iteratively) the single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages of forming the treatment plan; and mapping the solution vector to a treatment plan, wherein the treatment plan includes a final tooth position that is different from the overall final position of the patient's teeth.

[0101] Accessing a set of treatment preferences may include collecting (e.g., receiving, forming, assembling, downloading and / or accessing in a processor) a set of treatment preferences, or collecting a reference to a set of treatment preferences, which the processor may use to look up the set of (e.g., one or more) treatment preferences from a memory accessible to the processor that holds, for example, a preference lookup table indexed by the reference. Accessing a comprehensive final position of the patient's teeth may include receiving the comprehensive final position (e.g., as a digital model or representation of the position of the patient's teeth), or may include generating the comprehensive final position using the processor. The comprehensive final position may be generated manually or semi-manually, and a digital copy sent to the processor. If the processor has generated the comprehensive final position, the processor may store it in the memory and access it later (e.g., in an additional cycle). Accessing a set of treatment details may include accessing a stored set of treatment details (in memory), including accessing a "default" set of treatment details, receiving the set of treatment details, or may include receiving an identifier identifying the set of treatment details and using the identifier to look up the set of treatment details from a memory (e.g., holding a lookup table). The identifier may be a product name / model number, etc.

[0102] Also described herein is an apparatus for performing any of these methods as a non-transitory computer-readable medium containing program instructions for creating a treatment plan to align a patient's teeth using a plurality of removable aligners. For example, the program instructions may cause a processor to: receive in the processor: a digital model of the patient's teeth, a set of treatment preferences or a reference to a set of treatment preferences, an overall final position of the patient's teeth, and a set of treatment details or an identifier identifying the set of treatment details; based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth, select a plurality of numerically represented treatment goals from a processor-accessible memory; combine the plurality of numerically represented treatment goals to form a single numerical function; based on the set of treatment preferences, select a plurality of numerical constraints on the single numerical function; minimize the single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages of forming the treatment plan; and map the solution vector to a treatment plan, wherein the treatment plan includes a final tooth position that is different from the overall final position of the patient's teeth.

[0103] As described above, the treatment preferences may include one or more of: an indicator of which teeth are not allowed to move, an indicator of which teeth should not have attachments, an indicator of which teeth are to be treated, an indicator of the amount of correction for the tooth class, an indicator of interproximal removal to be used, an indicator of arch expansion to be used, an indicator of spacing between teeth, an indicator of tooth leveling. An identifier identifying treatment details may identify a product having a defined set of treatment details accessible to the processor.

[0104] The set of treatment details may include one or more of: a maximum allowed number of stages, whether attachments to the patient's teeth are allowed, a maximum allowed root movement, a maximum allowed crown movement, and a maximum allowed tooth rotation. Combining the numerically represented treatment goals may also include weighting each of the numerically represented treatment goals in a single numerical function.

[0105] For a set of teeth, a single numerical function may include the sum of at least: a difference in tooth position compared to an overall final position of the patient's teeth, a measure of misalignment of the teeth in the x-direction, a measure of misalignment of the teeth in the z-direction, a measure of misalignment of the dental arches of the teeth, a measure of gaps between adjacent teeth, a measure of overjet of the teeth, a measure of overbite of the teeth, a measure of collision between the teeth, a measure of the difference between the dental arches of the teeth and the overall final position of the patient's teeth, a measure of the difference in leveling between the teeth and the overall final position of the teeth, a measure of the amount of bite between the patient's maxillary and mandibular teeth, a measure of the difference in the amount of bite between the teeth and the overall final position of the patient's teeth, a measure of the amount of mesial to distal reciprocation of the teeth, a measure of the amount of buccal to lingual reciprocation of the teeth, and a measure of the number of aligner stages compared to a target number of aligner stages from the set of treatment details.

[0106] For the set of teeth, the single numerical function comprises the sum of at least: a difference in tooth position compared to an overall final position of the patient's teeth, a measure of misalignment of the teeth, and a measure of the number of aligner stages compared to a target number of aligner stages from the set of treatment details.

[0107] The program instructions may also be configured to adjust the multiple numerically represented treatment goals into a plurality of adjusted numerically represented treatment goals based on: a set of treatment details, a set of treatment preferences, and an overall final position of the patient's teeth. In addition, the program instructions may also be configured to combine the multiple numerically represented treatment goals by combining the plurality of adjusted numerically represented treatment goals.

[0108] The plurality of numerical constraints may include one or more of: a maximum speed of tooth movement, a maximum amount of collision between teeth, a tooth movement limit, a maximum number of aligner stages, a maximum amount of bite, a maximum amount of overbite, a maximum amount of overbite, a maximum amount of overjet, and a maximum midline position. The program instructions may also be configured to minimize a single numerical function subject to the plurality of numerical constraints using a constrained optimization method to obtain a solution vector.

[0109] The program instructions can also be configured to map the solution vector to a treatment plan by converting the solution vector into a set of key frames for each tooth corresponding to a stage number and position information for each tooth, the position information including x-coordinates, y-coordinates, z-coordinates, and angles, inclinations, and rotations.

[0110] The program instructions may be configured to provide the final tooth positions of the treatment plan for display.

[0111] Any of the methods and apparatus described herein may be configured to generate an array of treatment plan variations. This may be accomplished, for example, by automatically or manually modifying treatment preferences and / or treatment details. For example, the maximum number of stages (corresponding to the number of aligners to be used in treatment) may be modified to generate treatment plan variations with different treatment durations, since the duration of treatment is typically related to the number of aligners to be worn. Although generally speaking, the more stages / aligners used, the greater the overall amount of correction that can be achieved, as described herein (e.g., a near-full final position of the teeth may be considered an optimal treatment option), in some cases, a patient and / or dental professional may prefer to limit the duration of treatment and accept an improved but less than fully corrected alignment.

[0112] Also described herein is a method of modifying a treatment plan for a series of aligners and / or manufacturing a series of aligners for a patient's teeth. For example, a method may include: sending a model of the patient's teeth to a remote site; sending a list of tooth movement prescription information to the remote site; using the ideal final position of the patient's teeth and the model of the patient's teeth to collect a plurality of treatment plans specific to the patient's teeth, wherein each of the plurality of treatment plans describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages having a final stage, and further wherein, for each treatment plan, the final stage is different from the ideal final position of each treatment plan for different treatment characteristics of the patient's teeth; ranking the plurality of treatment plans based on the comprehensiveness of the comparison with the ideal final position; and displaying on a screen an image of the patient's teeth at the final stage of a first treatment plan or a first treatment plan and a second treatment plan from an array of treatment plans; switching in real time between images of the teeth at the final stages of different treatment plans within the array of treatment plans based on one or more user-selected controls on the screen; and after a user has selected a selected treatment plan from the treatment plans displayed on the screen, sending the selected treatment plan from the treatment plans for production.

[0113] Different treatment characteristics may include one or more of: interproximal removal (IRR), extraction, and aligner attachments. For example, tooth movement prescription information may include tooth movement restrictions, retraction restrictions, and interproximal removal restrictions.

[0114] Any of these methods may include switching between images of teeth at final stages of different treatment plans within an array of treatment plans based on one or more user-selected controls on the screen by switching a treatment plan having a first number of sequential stages to a treatment plan having the same number of sequential stages but having different treatment characteristics.

[0115] Ranking based on the comprehensiveness of the treatment plans may include looking up a score from a database of rankings indexed by two or more of: interproximal removal, accessories, dental aligner products, extractions, overlays, overbites, crossbites, and anterior-to-posterior (AP) correction. Alternatively or additionally, ranking based on the comprehensiveness of the treatment plans may include scoring the treatment plans based on three or more of: interproximal removal, accessories, dental aligner products, extractions, overlays, overbites, crossbites, and anterior-to-posterior (AP) correction.

[0116] The method may further include modifying the one or more treatment plans using the user interface and sending the modified one or more treatment plans to the remote site to recalculate the array of treatment plans based on the modification of the one or more treatment plans. BRIEF DESCRIPTION OF THE DRAWINGS

[0117] The novel features of the present invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description which sets forth illustrative embodiments in which the principles of the invention are utilized, and the accompanying drawings in which:

[0118] Figure 1A is a tooth repositioning appliance, shown in this example as an aligner or shell aligner.

[0119] Figure 1B Shown is a series of tooth repositioning appliances (aligners) configured to be worn sequentially (over the course of days or weeks) to reposition a patient's teeth.

[0120] Figure 2A is an illustrative example of a treatment plan solver (eg, an automated orthodontic treatment planning system).

[0121] Figure 2B is an illustrative example of a collision detector (eg, an automatic collision detection system).

[0122] Figure 2C One example of an automated method of creating one or more treatment plans to align a patient's teeth (eg, using a series of removable aligners to be worn in sequence) is schematically illustrated.

[0123] Figure 2D An example of an automatic collision detection method is schematically shown, which may be used, for example, by a treatment plan solver to perform an automatic treatment planning method. The automatic collision detection method shown may be performed, for example, by a collision detector.

[0124] Figure 3 An example of a method for manufacturing a series of aligners for a patient's teeth is shown, wherein a plurality of treatment plans for the patient's teeth having a fixed number of different stages representing portions of the treatment plan and variations of the fixed number of stages are pre-computed and included and displayed in real time to allow a user to interactively select and / or modify the treatment plan for orthodontic treatment. The method for manufacturing a series of aligners may include an automated method for creating one or more treatment plans or a treatment plan solver configured to perform an automated method for creating one or more treatment plans, and / or an automated collision detection method or a collision detector configured to perform an automated collision detection method.

[0125] Figure 4 is an illustration of a method for counseling a patient by interactively presenting a subset of treatment plans (eg, selected by a user) to the patient.

[0126] Figure 5 is an example of a detailed process diagram for designing, selecting and / or modifying a treatment plan and for producing a selected treatment plan.

[0127] Figure 6 is another example of a detailed process map for designing, selecting and / or modifying a treatment plan and for manufacturing a selected treatment plan.

[0128] Fig. 7A is an example of a display for simultaneously displaying multiple treatment plans in real time, the display including filters for switching between treatment plans that are variations of fixed-length (eg, "portions") treatment plans having a preset / predetermined number of stages.

[0129] Figure 7B is another example of a display for simultaneously displaying multiple treatment plans in real time.

[0130] Figure 7C is a schematic example of an interactive real-time treatment plan comparator.

[0131] Fig.7D An example of a method for interactive real-time treatment plan comparison, which may be part of a method of manufacturing a series of aligners for a patient's teeth, is schematically illustrated.

[0132] Fig. 8Ais a user interface for a user (e.g., clinician, orthodontist, dentist, etc.) that can be executed as a non-transitory computer-readable medium containing program instructions for causing a computer to execute controls to interactively display, select and / or modify a treatment plan.

[0133] Figure 8B is another example of a user interface configured as an interactive prescription interface.

[0134] Fig.9A is an example of a user interface showing simultaneous, real-time display of multiple treatment plans showing treatment fixed at 26, 14, and 7 stages, respectively. Fig.9A , the final tooth configuration achieved by each treatment plan is shown for comparison, and switches (filter controls) are included to show alternative treatment plans calculated with / without IPR and with / without accessories. Additional filters may be included.

[0135] Fig. 9B Shows the results after selecting (turning on) both filters. Fig.9A 's user interface, so that the treatment plan on the right (fixed at 26 stages) is a treatment plan that includes IPR and accessories, and so that the patient's crowding treatment goal is addressed and the patient's open bite is partially addressed.

[0136] Fig. 9C , 9D 9E are examples of user interfaces that interactively display and allow a user to modify (and resubmit) one or more treatment plans. Fig. 9C is an example of a user interface showing an interactive treatment planning screen in which a model (3D digital model) of the patient's dentition is included in a large display window. Fig.9D is an example of a user interface that includes a window for displaying one or both of a patient's dental arches at any stage of a proposed treatment plan. Fig.9E is similar to Fig.9D Another example of a user interface is shown.

[0137] Fig.9F is an example of a user interface configured for side-by-side comparison of one or more variables that may be considered in generating multiple treatment plans.

[0138] Figure 9G is an example of a user interface configured to display "before" and "after" images of a patient's dentition, wherein the pre-treatment image is displayed on the left and the suggested / predicted results of a given treatment plan are displayed on the right.

[0139] Figure 9His an example of a patient presented user interface that may be provided to a patient to illustrate the predicted outcome of a treatment and / or to allow comparisons between different treatment plans.

[0140] Fig. 10A A user interface (display) is shown showing a 26-stage treatment plan including an IPR and aligner attachment; on-screen controls (eg, sliders) allow the user to view predicted tooth positions for each stage.

[0141] Fig. 10B Shows Fig. 10A The user interface (display) includes adjustments to spacing (shown by a + symbol) and / or leveling. Other tools may be included to modify the treatment plan.

[0142] Fig. 10C A user interface for confirming submission of a modified treatment plan to recalculate one or more treatment plans (which may be added to an array for further display, selection and / or modification).

[0143] Fig.11A Such as Fig. 10A Another example of a user interface is shown in , where a user can comment (eg, via text) to make additional modifications.

[0144] Fig. 11B A user interface for confirming submission of a modified treatment plan to recalculate one or more treatment plans (which may be added to an array for further display, selection and / or modification).

[0145] Fig.12 is an example of a user interface configured as a consultation summary screen for use in a consultation mode to display a subset of treatment plans to a subject (e.g., a patient) to allow them to select between treatment options. Fig.12 In FIG. 1 , a patient (Joe Smith) is shown two options, a treatment plan with 26 phases with IPR and aligner attachments, and a second treatment plan with 14 phases without IPR or aligners. The user interface (display) also indicates that the 26 phase treatment plan addresses the treatment goals of reducing crowding and open bite; the 14 phase treatment plan addresses crowding (but not open bite). The user interface also indicates the treatment goals (upper and lower crowding and open bite) as a malocclusion analysis.

[0146] Fig.13 is another example of a user interface configured to provide consultation to a patient. Fig.13In the figure, the user interface shows the patient's current dentition ("now") and identifies two malocclusion issues, and displays a 26-stage treatment plan (center) and a 14-stage treatment plan (right). The 26-stage treatment plan addresses upper and lower crowding and an open bite. The 14-stage treatment plan addresses upper and lower crowding and partially addresses the open bite.

[0147] Fig.14 is an example of a user interface showing a 3D model of a patient's teeth as they move during an exemplary 26-stage treatment plan. The display includes controls that allow the user to animate the display (moving from an initial, untreated state to a final position, or manually selecting any treatment stage).

[0148] Fig.15 A display showing the progression of a patient's malocclusion over time, from 2005 to 2011, is shown.The user interface may allow a user to select and display images from the patient's dental record in addition to selecting one or more treatment plans from an array of treatment plans.

[0149] Fig.16A is a front view of a digital model (eg, scan) of a patient's dental arch in an untreated configuration.

[0150] Figure 16B-16M An array of treatment plans is graphically illustrated showing the final stage positions of the patient's teeth for each of the 12 treatment plans. FIGS. 16B, 16C, and 16D illustrate the final stage tooth positions of treatment plans generated assuming that no appliance attachments will be used and no IPR will be performed on the patient's teeth; in FIG. 16B, the treatment is limited to 26 stages, in FIG. 16C, the treatment plan is limited to 14 stages, and in FIG. 16D, the treatment plan is limited to 7 stages. FIGS. 16E, 16F, and 16G illustrate the final stage tooth positions of treatment plans generated assuming that an aligner attachment will be used and no IPR will be performed on the patient's teeth; in FIG. 16E, the treatment is limited to 26 stages, in FIG. 16F, the treatment plan is limited to 14 stages, and in FIG. 16G, the treatment plan is limited to 7 stages. Figures 16H, 16I, and 16J show the final stage tooth positions of a treatment plan generated assuming that no aligner attachment will be used but that IPR will be performed on the patient's teeth; in Figure 16H, the treatment is limited to 26 stages, in Figure 16I, the treatment plan is limited to 14 stages, and in Figure 16J, the treatment plan is limited to 7 stages. Figures 16K, 16L, and 16M show the final stage tooth positions of a treatment plan generated assuming that an aligner attachment will be used and that IPR will be performed on the patient's teeth; in Figure 16K, the treatment is limited to 26 stages, in Figure 16L, the treatment plan is limited to 14 stages, and in Figure 16M, the treatment plan is limited to 7 stages.

[0151] Fig.17 is another example of a user interface that shows a real-time display of multiple treatment plans with a limited number of stages. Fig.17 , the left panel shows the final position of the teeth according to a treatment plan that was generated by limiting the number of stages to 26 stages. User controls ("Filters") on the right side of the user interface can be used to select one or more different treatment plans that include different numbers of stages ("Products"), different treatment characteristics (e.g., IPR, accessories). The user interface can also display preferences ("Apply Templates") by instantly switching between different treatment plans and can display any of these changes in real time. Controls at the bottom of the left panel allow the user to select and display the position of the teeth at any stage. As in any user interface, the currently displayed treatment plan can be selected for comparison as part of the consultation screen. Additional controls can allow modification of the treatment plan or immediate manufacture / ordering of a series of aligners corresponding to the selected treatment plan.

[0152] Fig.18 A sequence of a linear treatment planning method using the global final position as the final position for the planned treatment is shown.

[0153] Fig.19 is a graphical illustration of a method for automatically generating an optimized treatment plan described herein.

[0154] Fig. 20A A sequence of a partial optimization-based treatment planning method (eg, an automated method of creating a treatment plan to align a patient's teeth using a plurality of removable aligners to be worn in sequential stages) as described herein is shown.

[0155] Fig. 20B is another schematic diagram of a method of creating a treatment plan to align a patient's teeth using multiple removable aligners to be worn in sequential stages.

[0156] Fig. 20C is an alternative illustration of a method of creating a treatment plan to align a patient's teeth using multiple removable aligners to be worn in sequential stages.

[0157] Fig.21 The use of a nonlinear constrained optimization method to generate a treatment plan is shown.

[0158] Fig.22A A method of quantifying the occlusion between the maxilla and mandible so that it can be represented as a numerical expression is shown.

[0159] Figures 22B-22D The use of a complete treatment plan ( Fig. 22C ) and partially optimized treatment plans ( Fig.22D ) from the starting position ( Fig.22A ) for cross bite correction of patients.

[0160] Fig.23 The quantization of x is shown to be unaligned so that it can be expressed as a numerical expression.

[0161] Fig.24 The quantization of the z misalignment is shown so that it can be expressed as a numerical expression.

[0162] Fig.25 The alignment to the dental arch is shown quantified so that it can be expressed as a numerical expression.

[0163] Fig.26 An annotation of tooth movement is shown, which shows a trajectory with four keyframes.

[0164] Fig. 27 One method of generating treatment preferences (eg, user-specific / dental professional-specific treatment preferences) that may be used to automatically generate a treatment plan or a set of treatment plans is shown.

[0165] Fig.28 Another example of a method of generating a treatment plan is shown in which a treatment plan generator (engine) accesses a set of user-specific treatment preferences.

[0166] Fig.29A An example of a triangular mesh surface approximation is shown.

[0167] Fig.29B An example of surface approximation of some or all of the surface and interior volume of a three-dimensional object (or a portion of an object adjacent to a second object) by packing with a 3D shape (shown as a capsule) is shown.

[0168] Fig.29C is an example of a comparison of a tooth having its surface approximated both by a triangle mesh (right) and by packing with a 3D shape (left, shown as a capsule).

[0169] FIG. 30A to FIG. 30C A cross section through an example of a 3D shape having a core at a constant radius from the core is shown. Fig. 30A In , the 3D shape is a sphere, showing the point as the core. Fig. 30B In , the 3D shape is a capsule with a line and an outer surface with a constant radius from the line. Fig. 30C An example of a rectangular core with a constant radius from a square is shown.

[0170] Figures 31A-31C The corresponding Figures 30A-30C Exemplary 3D shapes of those shown in . Fig.31A In , the 3D shape is a sphere. Fig.31B In , the 3D shape is a capsule. Fig.31C In the example, the 3D shape is a rounded rectangle.

[0171] Fig.32A and 32B Shown are a top view and a side perspective view, respectively, of a digital model of a molar having an outer surface that has been modeled using the capsule packaging outer surface.

[0172] Figures 33A-33B Shown are left and right perspective views, respectively, of a digital model of a portion of a dental device (shown as a precision wing) having an exterior surface that has been modeled using the capsule packaging exterior surface.

[0173] Fig.34A Another example of a tooth is shown having a first (left) side surface formed from a digital model of the tooth by packing multiple 3D shapes (capsules in this example) to approximate the surface.

[0174] Fig.34B A digital model of multiple patient teeth (here shown as the patient's maxillary arch) is shown, where each tooth is divided into regions (e.g., left, right or left, right, and middle regions) so that the surface of the tooth in each region can be modeled (e.g., formed) by packing multiple 3D shapes (e.g., capsules) to approximate the surface.

[0175] Fig.35A An example showing the formation of a hierarchy of bounding boxes around a capsule is shown.

[0176] Fig.35B It shows the tree-like hierarchical structure Fig.35A An example of layers of an exemplary hierarchy.

[0177] Fig.36 is an example of pseudocode for traversing the bounding box hierarchy to skip distance calculations between capsules that do not affect the final value of the collision between two surfaces.

[0178] Fig.37A A method of determining a collision distance (in this example, a negative collision distance or separation) between two capsules from each of two separate surfaces being checked for collision is shown.

[0179] Fig.37B is an example of pseudocode for finding the approximate distance between the surfaces of two shapes (eg, shape A and shape B) packed with a capsule.

[0180] Fig.38is an example of a digital model of a tooth set including pairs of teeth shown colliding.

[0181] Fig.39 yes Fig.38 An enlarged view of the collision area between two collision teeth is shown.

[0182] Fig.40 is Fig.38 A magnified view of one of the colliding teeth shown in FIG. 1 shows the six axes by which the collision velocity can be determined.

[0183] Fig.41A An example of the shape of a tooth pair is shown, showing regions with closed (enclosed) curvature.

[0184] Fig.41B is a 3D model of a patient's teeth showing regions with closed (enclosed) curvature.

[0185] Fig.41C Comparison between medium accuracy (left) and high accuracy (right) estimation of tooth volume using different "capsule filling" techniques described in this article for collision estimation.

[0186] Fig.42 One example of a mock-up of a user interface display configured for simultaneous (side-by-side) display of treatment plan "cards," also referred to herein as a multi-card view, is shown.

[0187] Fig.43A is a table (Table 1) showing the ranking of treatment plans indexed by attachment (all, posterior only, none) and interproximal removal (with IPR, without IPR) for single arch treatment plans. The values ​​represent the relative level of comprehensiveness (1 being the highest).

[0188] Fig.43B is a table (Table 2) showing the ranking of treatment plans indexed by attachment (all, posterior only, none) and interproximal removal (with IPR, without IPR) for both arch treatment plans. The values ​​represent the relative level of comprehensiveness (1 being the highest).

[0189] Fig.44 is another example of a user interface display that illustrates the use of a treatment plan filter to allow a user to switch or transition between different treatment plans for display. Fig.44 In the example, a control configured as a drop-down menu or filter allows a user to switch between types of attachments (e.g., all attachments, no attachments, or rear attachments only).

[0190] Fig.45is another example of a user interface display illustrating the use of a treatment plan filter to allow a user to switch or transition between different treatment plans for display.

[0191] Fig.46 An example of a detailed view of a single treatment plan is shown, showing the teeth (and any modifications to the teeth, including attachments, IPR, etc.) at a selected stage of the treatment plan.

[0192] Fig.47 is similar to the above Fig.42 , 44 Another example of a multiple treatment plan (MTP) user interface is shown in and 45 .

[0193] Fig.48 is similar to Fig.46 An example of a single treatment plan (STP) user interface is shown, which allows detailed viewing of a treatment plan and switching between other treatment plans.

[0194] Fig.49 is another example of an STP user interface. DETAILED DESCRIPTION

[0195] In general, methods and apparatus for manufacturing a series of aligners for a patient's teeth are described herein, which may include generating a plurality of treatment plans that are various specified stages of limitation (e.g., 5 stages, 6 stages, 7 stages, 8 stages, 9 stages, 10 stages, 10 stages, 12 stages, 14 stages, 15 stages, 16 stages, 17 stages, 18 stages, 19 stages, 20 stages, 21 stages, 22 stages, 23 stages, 24 stages, 25 stages, 26 stages, 27 stages, 28 stages, 29 stages, 30 stages, etc.), and generating variations of these fixed-stage treatment plans that include one or more features to a predetermined degree (e.g., interproximal removal, use of a certain number of aligner attachments, etc.). These methods and apparatus may also include interactively displaying the plurality of treatment plans and allowing a user, such as a dental professional (e.g., a doctor, dentist, orthodontist, etc.), to view, select and / or modify the plurality of treatment plans. Multiple treatment plans can be labeled to indicate which treatment goals they do or do not address. The user can also select a subset of multiple treatment plans to be included as part of the patient consultation, with the treatment plans displayed for comparison and selection by the patient.

[0196] The treatment plan optimization generator, which will be described in more detail below, can be used to generate multiple treatment plans that are variations of each other. Typically, the input to the treatment plan optimization generator is a digital scan of the patient's teeth, along with constraints (e.g., number of stages, tooth modification features, etc.) and preferences, and an "ideal" alignment of the patient's teeth (which can be generated manually, automatically, or semi-automatically). The treatment plan optimization generator can then automatically generate a treatment plan that is subject to those constraints and that both addresses one or more treatment goals (which can also be identified or automatically identified) and is as close to the ideal alignment as possible. The treatment plan optimization generator can be used multiple times to automatically generate multiple treatment plan variations that can be collected into an array (or group) of treatment plans.

[0197] As will be described in more detail herein, the results generated by multiple treatment plans can be presented to the user. Multiple treatment plans can be collected as an array of multiple treatment plans, which can include metadata identifying each treatment plan and / or the treatment goals it solves or does not solve. Each treatment plan can represent a clinically feasible treatment plan. In addition, for each plan, there may be several options that can be used to modify the plan. The plan may be limited to the number of stages, and the number of stages may be related to the commercial product. The product may include restrictions (product restrictions), which can be included in the treatment plan. For example, the treatment plan may correspond to a low-stage plan (e.g., between 5 and 13 stages), an intermediate stage plan (between 14 and 25 stages), and a high intermediate stage plan (26 and more stages). Other tooth modification features can also be included as restrictions to modify the treatment plan, such as including or excluding the placement of aligner accessories. If accessories are not allowed, a restricted clinical protocol can be applied to avoid unpredictable movement. Another example of a tooth modification feature that can be included in the treatment plan is to include IPR or not include IPR. If IPR is not allowed, the best plan in the case where IPR is not allowed during the treatment period can be presented.

[0198] Additionally, template selection can select clinical scenarios to be applied to plan generation. Given the constraints provided, the user can select any combination of options to determine which treatment plan is optimal. All possible combinations of plans are pre-calculated, so the user can see the available options in real time by changing to different clinical filters without having to re-make the treatment plan. The user can also modify any treatment plan using the 3D controls, where each change made using the tool modifies the plan, but is configured to maintain the ability to transfer the selected (and modified) treatment plan directly to manufacturing (e.g., without further human intervention).

[0199] In general, the methods described herein are directed to the manufacture of a series or sequence of orthodontic aligner appliances that can be worn sequentially to correct malocclusion. For example, FIG. 1 shows an exemplary tooth repositioning appliance or aligner 100 that can be worn by a patient to achieve incremental repositioning of individual teeth 121 in a jaw. The appliance may include a housing 110 (e.g., a continuous polymer shell or a segmented shell) having a tooth-receiving cavity 111 that accommodates and elastically repositions the teeth 121. The appliance or a portion thereof may be manufactured indirectly using a physical model of the teeth. For example, an appliance (e.g., a polymer appliance) may be formed using a physical model of the teeth and a sheet of a suitable layer of polymer material. In some embodiments, a physical appliance is directly manufactured from a digital model of the appliance, for example using additive manufacturing techniques. The appliance may fit on all teeth present in the upper or lower jaw, or on less than all teeth. The appliance may be specifically designed to accommodate the patient's teeth (e.g., the topology of the tooth-receiving cavity matches the topology of the patient's teeth) and may be manufactured based on a positive or negative model of the patient's teeth generated by molding, scanning, etc. Alternatively, the appliance may be a general appliance configured to accommodate teeth, rather than necessarily being shaped to match the topology of the patient's teeth. In some cases, only certain teeth accommodated by the appliance may be repositioned by the appliance, while other teeth may provide a base or anchor area to hold the appliance in place while the appliance applies force against the teeth targeted for repositioning. In some cases, some, most, or even all of the teeth may be repositioned at some point during treatment. The moved teeth may also serve as a base or anchor to hold the appliance while it is worn by the patient. Wires or other devices for holding the appliance in place over the teeth may not be required. However, in some cases, it may be desirable or necessary to provide separate attachments or other aligner features to control the transfer and distribution of forces. Example appliances, including in Appliances such as those used in the System are described in numerous patents and patent applications assigned to Align Technology, Inc., and on the company's website, including, for example, U.S. Patent Nos. 6,450,807 and 5,975,893, which is accessible on the Internet (e.g., see link "invisalign.com"). Examples of tooth-mounted attachments suitable for use with orthodontic appliances are also described in patents and patent applications assigned to Align Technology, Inc., including, for example, U.S. Patent Nos. 6,309,215 and 6,830,450.

[0200] Alternatively, in situations involving more complex movements or treatment plans, it may be beneficial to utilize auxiliary components (e.g., features, accessories, structures, devices, components, etc.) in conjunction with the orthodontic appliance. Examples of such accessories include, but are not limited to, elastics, wires, springs, bars, arch expanders, palatal expanders, twin blocks, occlusal blocks, bite ramps, mandibular advancement splints, bite plates, pontics, hooks, brackets, headgear tubes, springs, bumper tubes, palatal bars, frameworks, pin-and-tube apparatuses, buccal shields, buccinator bows, wire shields, lingual flanges and pads, lip pads or bumper bars. Other examples of accessories include, but are not limited to, relative arch features, occlusal features, torsional stiffness features, occlusal cusps, and bridges. In some embodiments, the appliances, systems, and methods described herein include improved orthodontic appliances having integrally formed features that are shaped to couple to or replace such ancillary components.

[0201] Figure 1BA tooth repositioning system 110 is shown that includes a plurality of appliances 112, 114, 116. Any appliance described herein may be designed and / or provided as part of a set of a plurality of appliances for use in a tooth repositioning system. Each appliance may be configured such that a tooth receiving cavity has a geometry corresponding to an intermediate or final tooth arrangement intended for the appliance. By placing a series of progressive position adjustment devices on the patient's teeth, the patient's teeth may be gradually repositioned from an initial tooth arrangement toward a target tooth arrangement. For example, the tooth repositioning system 110 may include a first appliance 112 corresponding to an initial tooth arrangement, one or more intermediate appliances 114 corresponding to one or more intermediate arrangements, and a final appliance 116 corresponding to a target arrangement. The target tooth arrangement may be a planned final tooth arrangement selected for the patient's teeth at the end of all planned orthodontic treatment. Alternatively, the target arrangement can be one of a number of intermediate arrangements of the patient's teeth during orthodontic treatment, which can include a variety of different treatment scenarios, including but not limited to situations where surgery is recommended, where interproximal surface removal (IPR) is appropriate, where a progress check is scheduled, where anchor placement is optimal, where palate expansion is desired, where restorative dentistry (e.g., inlays, onlays, crowns, bridges, implants, veneers, etc.) is involved, etc. Thus, it will be appreciated that the target tooth arrangement can be any planned resulting arrangement of the patient's teeth following one or more progressive repositioning stages. Likewise, the initial tooth arrangement can be any initial arrangement of the patient's teeth followed by one or more progressive repositioning stages.

[0202] The method of orthodontic treatment using multiple appliances according to an embodiment can be practiced using any appliance or appliance group described herein. In a first step, a first orthodontic appliance is applied to the patient's teeth so as to reposition the teeth from a first tooth arrangement to a second tooth arrangement. In a second step, a second orthodontic appliance is applied to the patient's teeth so as to reposition the teeth from a second tooth arrangement to a third tooth arrangement. The method can be repeated as needed using any suitable number and combination of sequential appliances so as to progressively reposition the patient's teeth from an initial arrangement to a target arrangement. These appliances can be manufactured all at the same stage or in groups or batches (e.g., at the beginning of a treatment stage), or one appliance can be manufactured at a time, and the patient can wear each appliance until the pressure of each appliance on the teeth is no longer felt or until the maximum amount of tooth movement for the given stage is reached. Before the patient wears any of the multiple appliances, multiple different appliances (e.g., a set) can be designed or even manufactured. 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. The appliance is typically not fixed to the teeth, and the patient can place and replace the appliance at any time during treatment (e.g., a patient-removable appliance). The final appliance or appliances in the series may have one or more geometries selected to overcorrect the tooth arrangement. For example, one or more appliances may have a geometry that, if fully implemented, would move each tooth beyond the tooth arrangement that has been selected as the "final". This overcorrection may be necessary to offset potential relapse after the repositioning method has ended (e.g., allowing each tooth to move back toward its pre-corrected position). Overcorrection can also be beneficial for speeding up the correction (e.g., an appliance with a geometry that is placed beyond the desired intermediate or final position can move each tooth toward that position at a greater rate). In this case, use of the appliance may be terminated before the teeth reach the position determined by the appliance. In addition, overcorrection may be intentionally performed to compensate for any inaccuracies or limitations of the appliance.

[0203] Various embodiments of orthodontic appliances presented herein can be manufactured in a variety of ways. In some embodiments, the orthodontic appliances (or a portion thereof) herein can be produced using direct manufacturing, such as additive manufacturing techniques (also referred to herein as "3D printing") or subtractive manufacturing techniques (e.g., milling). In some embodiments, direct manufacturing involves forming an object (e.g., an orthodontic appliance or a portion thereof) without using a physical template (e.g., a mold, a mask, etc.) to define the geometry of the object. For example, stereolithography can be used to directly manufacture one or more appliances herein. In some embodiments, stereolithography involves selectively polymerizing a photosensitive resin (e.g., a photosensitive polymer) using light (e.g., ultraviolet light) according to an expected cross-sectional shape. By sequentially polymerizing multiple object cross sections, the object geometry can be established in a layer-by-layer manner. As another example, the appliances herein can be directly manufactured using selective laser sintering. In some embodiments, selective laser sintering involves selectively melting and fusing layers of powdered material using a laser beam according to an expected cross-sectional shape in order to establish the object geometry. As yet another example, the appliances herein can be directly manufactured by fused deposition molding. In some embodiments, fused deposition modeling includes melting and selectively depositing filaments of thermoplastic polymers in a layer-by-layer manner to form an object. In yet another example, material spraying can be used to directly manufacture the apparatus herein. In some embodiments, material spraying involves spraying or extruding one or more materials onto a build surface to form successive layers of the object geometry.

[0204] In some embodiments, the direct manufacturing methods provided herein build up object geometry in a layer-by-layer manner, forming continuous layers in discrete building steps. Alternatively or in combination, direct manufacturing methods that allow continuous building of object geometry can be used, referred to herein as "continuous direct manufacturing". Various types of continuous direct manufacturing methods can be used. Continuous liquid interphase printing is described in U.S. Patent Publication Nos. 2015 / 0097315, 2015 / 0097316, and 2015 / 0102532, the disclosures of each of which are incorporated herein by reference in their entirety.

[0205] As another example, a continuous direct manufacturing method can achieve continuous construction of object geometry by continuously moving the build platform during irradiation (e.g., along the vertical direction or Z direction) so that the hardening depth of the irradiated photosensitive polymer is controlled by the movement speed. Therefore, continuous polymerization of the material on the build surface can be achieved. Such a method is described in U.S. Patent No. 7,892,474, the disclosure of which is incorporated herein by reference in its entirety.

[0206] In another example, a continuous direct manufacturing method can involve extruding a composite material consisting of a curable liquid material around a solid strand. The composite material can be extruded along a continuous three-dimensional path to form an object. Such a method is described in U.S. Patent Publication No. 2014 / 0061974, the disclosure of which is incorporated herein by reference in its entirety.

[0207] In another example, a continuous direct manufacturing method utilizes a "spiral lithography" method, in which a liquid photopolymer is cured using focused radiation while the build platform is continuously rotated and raised. Thus, object geometries can be continuously built along a spiral construction path. Such methods are described in U.S. Patent Publication No. 2014 / 0265034, the disclosure of which is incorporated herein by reference in its entirety.

[0208] In some embodiments, the relatively rigid portions of the orthodontic appliance can be formed by direct manufacturing using one or more of the following materials: polyester, copolyester, polycarbonate, thermoplastic polyurethane, polypropylene, polyethylene, polypropylene and polyethylene copolymers, acrylic, cyclic block copolymers, polyetherketone, polyamide, polyethylene terephthalate, polybutylene terephthalate, polyetheramide, polyethersulfone and / or polytrimethylene terephthalate.

[0209] In some embodiments, relatively elastic portions of an orthodontic appliance may be formed by direct manufacturing using one or more of the following materials: styrene block copolymers (SBCs), silicone rubber, elastomeric alloys, thermoplastic elastomers (TPEs), thermoplastic vulcanizates (TPV) elastomers, polyurethane elastomers, block copolymer elastomers, polyolefin blend elastomers, thermoplastic copolyester elastomers, and / or thermoplastic polyamide elastomers.

[0210] Optionally, the direct manufacturing methods described herein allow for the manufacture of appliances comprising multiple materials, referred to herein as "multi-material direct manufacturing". In some embodiments, the multi-material direct manufacturing method includes forming an object from multiple materials simultaneously in a single manufacturing step using the same manufacturing machine and method. For example, a multi-tip extrusion device can be used to selectively dispense multiple types of materials (e.g., resins, liquids, solids, or combinations thereof) from different material supply sources in order to manufacture an object from a variety of different materials. Such a method is described in U.S. Patent No. 6,749,414, the disclosure of which is incorporated herein by reference in its entirety. Alternatively or in combination, the multi-material direct manufacturing method may include forming an object from multiple materials in multiple sequential manufacturing steps. For example, a first portion of an object may be formed from a first material according to any direct manufacturing method herein, and then a second portion of the object may be formed from a second material according to the method herein, and so on, until the entirety of the object is formed.

[0211] In many embodiments, the post-processing of the utensil includes cleaning, post-curing and / or support removal processes. Related post-processing parameters can include the purity of the cleaning agent, cleaning pressure and / or temperature, cleaning time, post-curing energy and / or time, and / or the consistency of the support removal process. These parameters can be measured and adjusted as a part of the process control scheme. In addition, the physical properties of the utensil can be changed by modifying the post-processing parameters. Adjusting the post-processing machine parameters can provide another way to compensate for the variability of material properties and / or machine characteristics.

[0212] Although various embodiments are described herein with respect to direct manufacturing techniques, it should be understood that other techniques, such as indirect manufacturing techniques, may also be used. In some embodiments, the appliances (or portions thereof) herein may be manufactured using indirect manufacturing techniques, such as by thermoforming on a male or female mold. The indirect manufacture of an orthodontic appliance may involve one or more of the following steps: producing a male or female mold of the patient's dentition in a target arrangement (e.g., by additive manufacturing, milling, etc.), thermoforming one or more sheets of material on the mold to produce an appliance housing, forming one or more structures in the housing (e.g., by cutting, etching, etc.), and / or coupling one or more components to the housing (e.g., by extrusion, additive manufacturing, spraying, thermoforming, adhesives, bonding, fasteners, etc.). Optionally, one or more of the auxiliary device components described herein (e.g., elastics, wires, springs, bars, arch expanders, palatal expanders, twin blocks, occlusal blocks, bite ramps, mandibular advancement splints, bite plates, pontics, hooks, brackets, headgear tubes, bumper tubes, palatal bars, frameworks, pin-and-tube apparatuses, buccal shields, buccinator bows, wire shields, lingual flanges and pads, lip pads or bumper bars) are used. Orbumpers, protrusions, divots, etc.) are formed separately from the appliance housing and coupled to the appliance housing (e.g., by adhesives, bonding, fasteners, mounting features, etc.) after the housing is manufactured.

[0213] The orthodontic appliances described herein may be manufactured using a combination of direct and indirect manufacturing techniques, such that different parts of the appliance may be manufactured using different manufacturing techniques and assembled to form the final appliance. For example, the appliance housing may be formed by indirect manufacturing (e.g., thermoforming), and one or more structures or components described herein (e.g., auxiliary components, power arms, etc.) may be added to the housing by direct manufacturing (e.g., printing onto the housing).

[0214] The configuration of the orthodontic appliances herein can be determined based on a treatment plan for the patient, for example, a treatment plan involving the sequential application of multiple appliances to progressively reposition the teeth. Computer-based treatment planning and / or appliance manufacturing methods can be used to facilitate the design and manufacture of appliances. For example, one or more appliance assemblies described herein can be digitally designed and manufactured with the aid of computer-controlled manufacturing equipment (e.g., computer numerical control (CNC) milling, computer-controlled additive manufacturing (e.g., 3D printing), etc.). The computer-based methods proposed herein can improve the accuracy, flexibility, and convenience of appliance manufacturing.

[0215] The methods and apparatus described herein may be formed or incorporated into a computer-based 3D planning / design tool and may be used to design and manufacture the orthodontic appliances described herein.

[0216] Figure 2A One example of a treatment plan solver (eg, an automated orthodontic treatment planning system or solver) 101 is shown that may be used to automatically generate a series of treatment plans, and thereby manufacture a series of aligners based on one of the series of treatment plans.

[0217] Solver 101 may include various modules, including engines, processors on which engines can run, and / or one or more data stores (datastores). The computer system may be implemented as an engine, implemented as a part of an engine, or implemented by multiple engines. As used herein, an engine may include one or more processors or a part thereof. A part of one or more processors may include some parts of hardware that are less than all the hardware including any given one or more processors, such as a subset of registers, a part of a processor dedicated to one or more threads of a multithreaded processor, a time slice of a processor dedicated entirely or partially to executing a portion of the functions of an engine, etc. In this way, the first engine and the second engine may have one or more dedicated processors, or the first engine and the second engine may share one or more processors with each other or with other engines. Alternatively or additionally, different engines may share the same processor. Depending on implementation-specific or other considerations, the engine may be centralized or its functions may be distributed. The engine may include hardware, firmware, or software contained in a computer-readable medium for execution by a processor. The processor uses the implemented data structures and methods to convert data into new data, such as described with reference to the accompanying drawings of this article.

[0218] The engine described herein or the engine by which the systems and devices described herein can be implemented can be a cloud-based engine. As used herein, a cloud-based engine is an engine that can run applications and / or functions using a cloud-based computing system. All or part of an application and / or function can be distributed between multiple computing devices and is not necessarily limited to only one computing device. In some embodiments, a cloud-based engine can execute functions and / or modules accessed by an end user through a web browser or a container application without having to install the functions and / or modules locally on the end user's computing device.

[0219] As used herein, a data repository is intended to include a repository having any applicable data organization, including tables, comma-separated value (CSV) files, traditional databases (e.g., SQL), or other applicable known or convenient organizational formats. A data repository may be implemented, for example, as software embodied in a physical computer-readable medium on a dedicated machine, in firmware, hardware, a combination thereof, or an applicable known or convenient device or system. Data repository-related components such as database interfaces may be considered to be "part" of a data repository, a part of some other system component, or a combination thereof, although the physical location and other characteristics of data repository-related components are not critical to understanding the techniques described herein.

[0220] A data repository may include a data structure. As used herein, a data structure is associated with a specific way of storing and organizing data in a computer so that it can be used efficiently in a given context. A data structure is typically based on the ability of a computer to obtain and store data at any location in its memory, the location being specified by an address, which is a bit string that can itself be stored in memory and manipulated by a program. Therefore, some data structures are based on calculating the addresses of data items using arithmetic operations; while other data structures are based on storing the addresses of data items within the structure itself. Many data structures use these two principles, sometimes combined in a non-general way. The implementation of a data structure typically requires writing a set of processes that create and manipulate instances of the structure. The data repository described herein may be a cloud-based data repository. A cloud-based data repository is a data repository compatible with cloud-based computing systems and engines.

[0221] exist Figure 2AIn, a system for automatically creating an orthodontic treatment plan for a patient may include one or more processors 102. A treatment plan solver instruction set may run on the one or more processors. The system may also include a collision detector 106, which may also run on the one or more processors. The system may also include a memory that is part of or coupled to the one or more processors, and the memory stores computer program instructions that, when executed by the one or more processors, perform a computer-implemented method, which may include: collecting (e.g., forming, reading, receiving, etc.) a digital model of the surface of each tooth in a plurality of teeth of the patient by packing a plurality of 3D shapes to approximate (e.g., modeling, forming, etc.) the surface of each tooth, wherein each 3D shape has a core that is a line segment or a closed plane figure, and an outer surface that is a constant radius from the core. As will be described in more detail below, the collision detector 106 may include hardware, software, and / or firmware for packing teeth or other features and modeling the surface with a 3D shape such as a capsule. The system may also be configured to collect (e.g., receive, read, etc.) treatment preferences. The preferences may be collected in a treatment preference data repository 115. The preferences may also include a treatment detail data repository 117. The system can form a hierarchy of bounding boxes that enclose the plurality of 3D shapes for the surface of each of the plurality of teeth of the patient. This can be performed using a processor and / or as part of a collision detector. The tooth positions of the plurality of teeth of the patient can be passed from the treatment plan solver 101 to the collision detector (e.g., see Figure 2B ). The solver may collect a digital model of the patient's teeth to be modified by the treatment plan (collecting may include receiving / loading from an external source, from a memory, including retrieving from a patient teeth data repository 123 or other memory, etc.).

[0222] One or more processors 102 or any other elements (e.g., numerical function engine 107, numerical function building engine 109, comprehensive final position engine 111, collision detector 106, solution vector mapping engine 113, etc.) can be connected in any appropriate manner, and any of these elements can also be connected to a data repository (e.g., patient tooth data repository 123, treatment goal data repository 119, treatment details data repository 117, treatment preference data repository 115, and numerical limitation data repository 121, etc.).

[0223] The numerical function building engine 109 can be used to select a plurality of numerically represented treatment goals (e.g., from a treatment goal data store 119 or other memory or input accessible to one or more processors) based on a set of treatment details (accessible from a treatment details data store 117 or other accessible memory / input), a set of treatment preferences (provided by a treatment preferences data store 115 or other memory / input), and a global final position of the patient's teeth. The global final position of the patient's teeth can be provided by the global final position engine 111 or from a memory storing the global final position.

[0224] The solver may also include a numerical function minimization engine 107 that may combine multiple numerically represented treatment objectives to form a single numerical function. The single numerical function may then be minimized to solve one or more solution vectors using a collision detector 106 and a set of numerical constraints that may be provided, for example, from a numerical constraint data repository 121 or other memory / input. Numerical constraints may be selected for the single numerical function based on a set of treatment preferences (e.g., from a treatment preference data repository 115 or other memory / input).

[0225] The solution vector generally includes all stages of forming a treatment plan and may be stored in a memory and / or displayed and / or transmitted. In some variations, the solution vector may be converted to a treatment plan using a solution vector mapping engine 113 to map the solution vector to the treatment plan, wherein the treatment plan includes final tooth positions that are different than the overall final positions of the patient's teeth.

[0226] Figure 2C A method of creating a treatment plan to align a patient's teeth using a plurality of removable aligners to be worn in sequential stages is schematically illustrated. In this example, a first step is to collect a digital model of the patient's teeth (e.g., an upper dental arch or a lower dental arch or both an upper dental arch and a lower dental arch) 250. This can include, for example, receiving a digital model of the patient's teeth in a processor. The method can also include selecting a plurality of numerically represented treatment goals (e.g., based on a selected set of treatment details, a set of treatment preferences, and an overall final position of the teeth) 252. The plurality of numerically represented goals can then be combined into a single numerical function 254, and a plurality of numerical constraints on the single numerical function can be selected (e.g., based on a set of treatment preferences) 256. The single numerical function subject to the plurality of numerical constraints can be minimized to obtain a solution vector (including all stages of forming a treatment plan, using automatic collision detection) 258. The process of solving (minimizing) the solution vector can implement a collision detection method ( Figure 2D , described in more detail below). The solution vector may then be mapped to a treatment plan 260.

[0227] Method of manufacturing a series of aligners

[0228] Figure 3 is an overview of a method for manufacturing a series of aligners for a "partial treatment" plan. A partial treatment plan is a plan to treat a patient using only a limited series of aligners; this limited number of aligners may be a predetermined number (e.g., 7, 10, 12, 16, 26, etc.) that is less than the total number required to optimally fully correct the patient's malocclusion, addressing all clinically addressable conditions (also referred to as treatment goals). In a partial treatment plan, the fixed number of aligners in the series may be configured (by configuring the treatment plan) to address some treatment goal in a defined, limited number of stages and to get as close as possible to the ideal realignment configuration without creating new malocclusions or exacerbating existing malocclusions.

[0229] exist Figure 3 In the method, the method begins by collecting a model 303 of the patient's teeth and any conditions (e.g., tooth movement restrictions) or preferences for treatment 301 from the patient (and by a user, such as a dental professional); optionally, the method or device can also identify any general preferences 302 that are specific to the dental professional and can be applied to all patients of the dental professional. In addition (and optionally), the method or device can also provide an indication 304 of the type of dental product (e.g., the type of dental / orthodontic product to be used to treat the patient). All of this information, especially the prescription information, can be completed in a relatively short form (e.g., 2-25 lines, 2-20 lines, 2-15 lines, etc.) or a virtual questionnaire. The user can submit this information to a treatment plan optimization generator, which can be located at a remote location. The treatment plan optimization generator, which will be described in detail below, can use this information to generate multiple treatment plans. For example, the treatment plan optimization generator can first prepare a model 305 by, for example, digitizing it if it is not already a digital model, and segmenting the digital model into individual teeth, gums, etc. Once prepared, automated treatment planning 307 can be executed to automatically generate multiple treatment plans using, for example, different numbers of stages; for each stage, multiple variations 311 can also be generated including different treatment characteristics (e.g., IPR, accessories, etc.). Each treatment plan is complete and can be used to build a family of aligners. For example, each treatment plan can include a new (and potentially unique) final position of the patient's teeth at the end of treatment, a staged display of tooth movement and movement speed for each stage (e.g., keyframes), and a set of aligner features 313. The corresponding aligner features can include the location of accessories, etc.

[0230] Thus, the automated treatment planning may use the treatment plan optimization generator multiple times, each time providing slightly different treatment details and / or goals, while annotating each treatment plan with indicators of which constraints and / or treatment goals were used to generate the treatment plan, including, for example, a fixed number of stages. The resulting multiple treatment plans may be collected into a single collection (e.g., an array), and all of these treatment plans are presented back to the user, for example, via a user interface, to provide a meaningful and interactive display, selection, and / or manipulation of treatment plans 315. The user (e.g., a dental professional) may then use the interactive display to switch between the multiple plans in real time and select a treatment plan or subset of treatment plans 319. Optionally, the user may modify one or more plans 319; if the user modifies the treatment plan in a manner that exceeds the pre-computed multiple treatment plans 321, these modifications may be sent back to the automated treatment planning subsystem (including the treatment plan optimization generator) to generate additional treatment plans 337 that include the user's modifications. These new treatment plans may replace or supplement the already pre-computed plans.

[0231] Optionally, once a subset of treatment plans has been selected from the larger array of treatment plans, the user can present the subset of treatment plans to the subject 323. The subject can be provided with a consultation to provide an indication of the orthodontic results that can be achieved with each treatment plan (e.g., by showing the final stage / tooth position). The user or the subject (or both) can decide which treatment plan to select, and as described above, the selected treatment plan can be forwarded for production / manufacturing 325.

[0232] Figure 4 Additional details are provided regarding an example of a consultation mode of operation of the system described herein. In this example, after the dental professional selects two or more dental plans 419 (see also Figure 3 , 319), two or more of these dental plans may be presented to the patient 433, allowing the patient to select between them. In some examples, in addition to the image of the teeth (including at least the final position of the treatment plan), metadata may also be displayed indicating the number / length of stages of the treatment and / or the treatment characteristics used to generate the particular treatment, etc. The display may be side-by-side 435 or may be sequential, etc. The patient may then select between the presented plans 435. Finally, optionally, the user may finalize the treatment, and the selected treatment plan may be submitted for manufacture 437.

[0233] Figure 5 and Figure 6 A more detailed example of a possible method for manufacturing a series of aligners for a patient is provided. Figure 5In the example, although the user can be any dental professional, it is assumed that the user is a doctor. The user can first open the patient record, including any photos, using a user interface (IDS, where the user can log in to access the account entrance). A preliminary (automatic or manual) assessment can be performed to determine whether the patient is a good candidate for the procedure ("case assessment"), and the user can review the case assessment. Thereafter, the user can submit a minimal patient prescription (e.g., indicating treatment goals, constraints, etc.). The user can also submit the patient's dental model to a remote site for processing as described above to generate a digital model sufficient for automatic treatment plan generation. In some cases, the technician can digitally "detail process" the digital model to prepare it for processing. Then, as described above, an array of alternative treatment plans (MTPs) can be automatically generated using a treatment plan optimization generator. Thereafter, a user interface ("CCWeb") configured to allow interactive display of multiple different alternative treatment plans can be used to review and select a treatment plan in the treatment plan array, and in some variations, modify the treatment plan in the treatment plan array. As described above, a consultation can be provided to the patient. Once the user has selected a single treatment plan, and is satisfied with the treatment plan, the user can send the selected treatment plan to the manufacturer (technician), who can (optionally) review and send a final version of the treatment plan for final approval. Once approved, the treatment plan can be made using it directly or converted to a manufacturing format to include all stages of the appliance. If the user is not satisfied with the treatment plan, it can be modified.

[0234] Figure 6 Shown with Figure 5 Similar workflow as shown in Figure 6 In the example, it is assumed that the user initially provides a digital model of the patient's teeth (eg, by digitally scanning the patient's teeth).

[0235] Fig. 7A and 7B An example of an interactive display of multiple treatment plans is shown to allow a user to select between treatment plans and / or modify a treatment plan as quickly and efficiently as possible. Fig. 7A In FIG. 1 , the final stage (final configuration) of each of the multiple treatment plans is shown. In this example, the final configuration is determined according to the number of stages (n1, n2, ... n x ) to arrange the plans side by side. Each of these plans also includes optional variations (option 1, option 2, etc.) that can be displayed when the user control (box) is selected, which can be indicated by checking, such as Fig. 7A shown.

[0236] Figure 7B Similar to Fig. 7A, but lists each treatment plan as part of a strip that can be moved by, for example, swiping left or right. Any of these user interfaces may show additional representations of the stages, as keyframes and / or tooth representations.

[0237] Figure 7C An example of a system is shown. The system 701 is configured to provide interactive, real-time and dynamic comparisons between different treatment plans. Figure 7C In the system 701, a plurality of modules may be run together in any combination to provide a real-time (or near real-time) interactive dynamic display for comparison between multiple complete orthodontic treatment plans, including rapid switching between different complete treatment plans to illustrate the differences between treatment plans with modified inputs (e.g., with / without IPR, extraction, etc.). For example, in Figure 7C In the embodiment of the present invention, the system may include a user interface 711 for displaying different treatment plans (side by side and / or sequentially). As described herein, a variety of different treatment preferences and / or treatment details may be used to calculate the treatment plan. The treatment plans may be arranged into any type of grouping (e.g., an array), and the treatment plans may be generated by the system from the treatment plan generation system (e.g., the above Figure 2A The treatment plans may be collected (e.g., received, etc.) from a treatment plan data repository 717 (shown) and may be stored in a treatment plan data repository 717 for use by the system 701. Each of the plurality of treatment plans may include a set of sequential stages for orthodontic movement of the patient's teeth, including a final stage. The final stage may represent a final position of the patient's teeth. In particular, these systems may be used when at least three treatment plans have different numbers of sequential stages, and further, wherein the array of treatment plans includes two or more treatment plans with different treatment characteristics. The different treatment characteristics may be stored in a treatment characteristics data repository 715 for later use by the system.

[0238] In operation, the system may operate a user interface module 711 in conjunction with user selectable controls 705 to allow a user to dynamically switch (convert) between different treatment plans, which may be displayed on a screen or other display 703 of the system by displaying one or more stages including a final (final) stage (which may be represented by a digital model of the patient's teeth in that final position) and / or characteristics of the treatment plan (e.g., number of steps / stages, duration of treatment, duration of stages, rate of tooth movement, movement of teeth over time (e.g., via animation or static demonstration), etc.). The system may display on the screen an image of the teeth in the final stage for each treatment plan of a subset of treatment plans from the array of treatment plans. The treatment characteristics switching 709 module may provide real-time (or near real-time) switching between images of different treatment plans within the array of treatment plans, including switching between various images based on one or more user-selected controls on the screen.

[0239] The system may also include a communication module 713 (e.g., a wireless module such as Wi-Fi, Bluetooth, etc.) The communication module may allow the system to receive input and send output, for example, after a user selects a selected treatment plan from among the treatment plans displayed on the screen, sending the selected treatment plan for manufacturing.

[0240] Any of these systems may also be configured to allow the user to modify one or more treatment plans during display, including modifying tooth positions, phase timing, etc. Figure 7C In the present invention, the system includes an optional treatment plan modification engine 713, which can be configured to allow a user to directly modify the treatment plan.

[0241] Fig.7DAn example of a method of manufacturing a series of aligners for a patient's teeth is shown. In particular, the method can allow for real-time analysis and verification of a large number of treatment plans, selection of one of the treatment plans, and manufacturing a series or sequence of aligners based on the treatment plans. For example, the method can include: assembling (e.g., collecting, including collecting from a remote site) an array of treatment plans specific to the patient's teeth, wherein each treatment plan in the array describes a set of sequential stages for orthodontic movement of the patient's teeth including a final stage, further wherein at least three treatment plans have a different number of sequential stages, and further wherein the array of treatment plans includes two or more treatment plans with different treatment characteristics 721. An image of the teeth after the final stage of each treatment plan from a subset of treatment plans from the array of treatment plans can then be displayed on the screen 723. The method can then switch between images of the teeth at the final stage of different treatment plans in the array of treatment plans in real-time based on one or more user-selected controls on the screen 725. Finally, the selected one of the treatment plans that the user has selected for manufacturing can be displayed on the screen and sent for manufacturing. Once produced, it can then be sent to the patient or the patient's dental / orthodontic provider for distribution to the patient.

[0242] Fig. 8A Another example of a user interface that can be used to interactively view, modify, and / or select a treatment plan is shown. Fig. 8A In the example, the user interface can be used to select and monitor patient records. For example, the user interface can allow a user to interactively view multiple treatment plans generated; for example, Fig. 8A The illustrated user interface shows an example in which a patient's dental model has been submitted along with the user's preferences, constraints, etc., and an array including multiple (eg, 12 or more) treatment plan variations has been generated using treatment plan optimization.

[0243] Figure 8B is another example of a user interface that can be used at the beginning of a patient treatment plan. Figure 8B In some embodiments, the user interface is configured as an interactive prescription form that can allow a user (e.g., a clinician, dentist, orthodontist, dental technician, etc.) to select a patient type (e.g., child, adolescent, adult) and enter information about the patient (e.g., name, age, image, etc.), and / or enter treatment / regimen preferences (e.g., eruption compensation, interproximal removal preferences, attachment preferences, etc.). The user interface can also suggest one or more preferences from a library or database of preferences. In some variations, the prescription form can also allow a user to manually enter treatment preferences. Figure 8BIn, the prescription form also allows the user to select the type of input of the patient's dentition, such as selecting from an intraoral scan and / or a scan of a mold or an impression of the patient's teeth.

[0244] Figures 9A-9B (Similar to Figure 7A-7B ) shows a user display showing three (in this example) variations of a treatment plan for a patient ("Joe Smith") side by side. As shown on the right side of the user interface, the patient has upper and lower crowding and an open bite ("Malocclusion Analysis"). Treatment can be configured to address these goals. Fig.9A , three sets of treatment plans are shown with user controls allowing selection of variations (to be exchanged with the variation treatment plan). A 26-stage treatment plan is shown on the left; a 14-stage treatment plan is shown in the middle; and a 7-stage treatment plan is shown on the right. For each treatment plan, the variations include: with / without IPR, and with / without aligner accessories. By selecting user controls on the screen (or on an input such as a keypad, mouse, etc.), the user can see the effect that adding / removing these features has. In addition, any of these treatment plans can be selected and placed into a subset to be displayed to the subject as part of the consultation mode. Finally, below the image of the final stage position of the teeth for each variation is a textual description of the malocclusion analysis specific to that treatment plan. In FIG8 , all three basic parameters address upper and lower crowding, and both the 26 and 14-stage treatment plans address (partially address) open bite malocclusion. Fig. 9B Shown with Fig.9A Same basic user interface, but showing a 26-stage treatment plan as a variation that includes both the IPR and aligner accessories.

[0245] Fig. 9C is an example of a user interface showing an interactive treatment planning screen, wherein a model (3D digital model) of the patient's dentition is included in a larger display window. In some variations, one or both of the upper and lower dental arches show the selected (one or more) stages of the treatment plan, and allow the user to select and apply various digital tools to modify the treatment plan (e.g., change the number of teeth, add / remove or move attachments, add / remove / modify IPRs between selected teeth, add / remove bridges to selected teeth, etc.), manipulate the 3D model of the teeth (e.g., rotate, scale, show only the upper portion, show only the lower portion, show both upper and lower, change the display angle of the teeth to one or more predetermined angles, etc.), manipulate the display, including selecting different stages of the treatment plan and / or displaying an image of the patient's smile predicted for any stage (or just the final stage) of the treatment plan, display a grid, and / or display one or more analyses (e.g., Bolton ratio, occlusal analysis, etc.).

[0246] exist Fig. 9C In the user interface, the user may also allow the user to see and modify the options applied in generating the treatment plan, including the names of products with different characteristics for the proposed treatment plan (e.g., comprehensive, rapid, juvenile, etc.). Characteristics such as duration of treatment / number of stages, minimum root movement, extraction, attachment restrictions, pre-restoration spacers, IPR, expansion (including which teeth to use for each, all or some subset of these), elastic or surgical simulation, distalization, etc. As described above, Fig. 9C The user interface allows Figures 9A-9B any feature of a, including selecting / deselecting one or more parameters.

[0247] Figures 9D-9F In general, the term "user interface" may refer to an interface seen by a user (doctor, dentist, dental technician, etc.), although as described below, in some variations, any of these user interfaces or similar structures may be presented to a patient, including by a user, as part of a treatment selection and / or design process and / or during a treatment procedure. For example, in Fig.9D In the embodiment of the present invention, the user interface includes a window for displaying one or both dental arches of the patient at any stage of the proposed treatment plan (e.g., when a single treatment plan is selected or when only a single treatment plan is generated). The user interface can display features and / or user preferences used in designing the treatment plan, such as the number or range of stages (e.g., a comprehensive plan with >21 stages), the amount of tooth movement (whether minimal), a description of the clinical goals (e.g., improving overbite, crossbite, etc.), and aligner / stage features (e.g., spacers, IPR, expansion, tilting, extraction, elastic or surgical, distal movement, attachments, etc. before restoration). The user interface may also provide 3D tools for manipulating teeth and / or tools for modifying the treatment plan and / or resubmitting to generate a new / revised treatment plan or series of plans. Finally, the user interface can allow the user to select / accept the treatment plan so that a series of aligners can be sent for manufacturing (e.g., which may include one or more additional quality control steps).

[0248] Fig.9E is another example of a user interface similar to Fig.9D as shown, but includes additional "tabs" that allow the user to select between suggested treatment plans for direct comparison; the functionality of the user interface may otherwise be the same as described above. Each treatment plan may be reviewed individually or in combination. Fig.9EIn some embodiments, a user can switch between treatment plans; in some embodiments, as described above, a side-by-side window can be displayed to the user, allowing for simultaneous comparison between two (or more) treatment plans, such as Fig.9F In this example, pairs of different treatment plans generated for the same patient are displayed side by side; the user can select one or both for rotation, and in some variations, the user interface can be configured to allow individual rotation of the 3D models of the patient's teeth as the stages of the treatment plans are displayed, or the user interface can be configured so that moving one of the 3D models of the patient's teeth in a particular treatment plan can automatically move another 3D model of the patient's teeth according to a second treatment plan.

[0249] In some variations, the user interface may be configured to display a modified image of the patient's smile (eg, the patient's teeth in a front-facing image of the patient's face) at the end of the treatment plan (or at any stage). Figure 9G An image of an initial malocclusion (left) is shown for direct side-by-side comparison with a simulated image of a patient's smile after a particular treatment plan (right); details of the treatment plan are listed on the user interface (right). In this example, the user can switch between different treatment plans by toggling (in the right controls) various features on or off (e.g., overbite correction, crossbite correction, molar class correction, overbite correction, IPR, attachment position, number of stages (e.g., products), etc.).

[0250] As mentioned, in some variations, specific outputs (including specific user interfaces) for presenting one or more treatment plans to a patient may be used. Figure 9H is an example of a patient presented user interface that may be provided to a patient to illustrate the predicted outcome of a treatment and / or to allow comparisons between different treatment plans. Figure 9H The user interface in is a simplified version of the above user interface, showing a smile (face) image and / or an image of the patient's teeth with simulated patient tooth positions. The user interface in FIG. Figure 9H The user interface in the figure is shown at the top, including zoom, rotation, arch view / angle, etc. to manipulate the image. Figure 9H , the "Smile" view is selected and the final tooth arrangement for each of the two treatment plans is shown.

[0251] Figures 10A-10C A user display screen is shown including controls for displaying a treatment plan in detail and / or for modifying a treatment plan. Fig. 10A, a treatment plan with 26 stages is shown. A display of the teeth at each stage is shown in the middle of the screen, and this display can be changed by moving the slider (control 1005). One or more controls can also be used to change the view of the teeth shown 1007. Patient information 1009 can be displayed, as well as product information 1011. Treatment details and / or treatment preferences 1013 corresponding to the treatment plan being displayed can also be shown. Fig. 10A In the figure, the display indicates the creation of a treatment plan that allows for interproximal resection (IPR) and adnexa. Fig. 10A The exemplary display shown in also indicates that the treatment plan addresses the treatment concerns 1015; specifically, the treatment plan addresses upper and lower crowding and open bite. In addition, the display also includes controls 1019 that allow the treatment plan to be added to a subset of plans for consultation and / or selected for subscription. Figures 7A-9B In any other display of the treatment plan shown, select Fig. 10A Displays such as the one shown.

[0252] Fig. 10B Shows Fig. 10A 1021, as shown by the + sign on the teeth. Additionally, the amount of leveling may be adjusted. Other tools to modify and control them may also be included. Other controls on the screen may allow the user to communicate directly with the technician 1025, or order a series of aligners based on the treatment plan 1027, and / or enter a consultation mode 1031. For example, selecting a control to order a plan may result in a confirmation screen such as Fig. 10C shown.

[0253] Fig.11A Shows Fig. 10A An exemplary screen of FIG. 10 is configured to communicate with a technician, as described above. In this example, a user can add instructions or preferences to annotate the treatment plan for modification. These text comments / instructions can be typed by the user or can be selected from a notes menu. Fig.11A In the example, instructions / notes 1105 include treatment preferences stating: "Do not move the upper and lower third molars" and "Do not retract the upper teeth." Additional comments may allow the user to submit 1107 or abandon 1109 the comments. When submitting the treatment preferences, the device may indicate a confirmation screen 1111, such as Fig. 11B shown.

[0254] As described above, methods and apparatus (eg, software, firmware, hardware, or some combination of these) may be configured to include an advisory mode. Fig.12An example of a consultation summary screen is shown. This screen may be used by the user prior to entering consultation mode, or may be used as part of consultation mode. In general, consultation mode may display a subset of an array of treatment plans; treatment plans included in the subset may be selected by the user, or in some variations may be automatically selected, e.g., based on known user preferences. These selected treatment plans may then be presented to the subject using consultation mode. Fig.12 , the consultation summary screen displays the two treatment plans 1201, 1203 as dental images (at the selected treatment stage to be displayed) and treatment details or treatment preferences 1215 (e.g., allow / disallow IPR, allow / disallow attachments, etc.). The display may also show the treatment concerns addressed by each treatment plan 1217 (e.g., upper and lower crowding resolved, open bite resolved, etc.). This may allow the patient to make a direct comparison, including a side-by-side comparison. Fig.12 The screen in also shows patient information, including name 1220 ("Joe Smith"), initial position of teeth 1221, image of the patient 1223, and analysis of initial malocclusion 1225. Controls on the display may allow the user to enter a consultation mode in which a simplified display of a treatment plan that may correspond to various treatments may be displayed to the patient.

[0255] Fig.13 A "counseling mode" display screen is shown for displaying to a patient a subset of treatment plans based on a user selection. Fig.13 , the consultation mode screen shows two selected treatment plans 1303, 1305 for comparison with the patient's current dentition 1301. In this example, the first treatment plan is a 26-stage plan 1303, and the second treatment plan is a 14-stage treatment plan. Any subset of treatment plans may be displayed. In this example, the various treatment plans are displayed with annotations indicating the extent to which they address the patient's identified malocclusion 1307. For example, the 26-stage treatment plan (which may correspond to the first product) addresses upper and lower crowding as well as an open bite 1309. The 14-stage treatment plan (which may correspond to the second product) addresses upper and lower crowding and partially addresses the open bite 1312.

[0256] In the consultation mode, the user and / or patient can review various selected treatment plans in a sequential display or a side-by-side display and can select between them. The consultation mode can also include information about the cost and / or time schedule (including the number of stages, etc.) of the treatment plan.

[0257] Fig.14 is an example of a display showing details of a specific treatment plan (including animation). Individual stages can be selected.

[0258] Typically, patient information including dental record information may also be displayed. For example, as a reference, the methods and apparatus may include a display of the patient's upper and lower dental arches (e.g., see Fig.15 ).exist Fig.15 In , the display shows images of the patient's upper and lower jaws at two times (e.g., 2005 and 2011). This type of display shows the progression of malocclusion over time. Fig.15 In the case of malocclusion, there is sliding contact and mesial drift.

[0259] As described above, the array of treatment plans may typically include three or more (more preferably 12 or more) treatment plans. Fig.16A Figures 16 through 16M show one example of an array of treatment plans for a patient. Fig.16A An example of a patient's actual dentition is shown, shown as a digital model. As described above, the model can be generated from a direct digital scan of the patient's teeth or from an impression. Figures 16B to 16M show 12 alternative treatment plans generated for the patient, which are combined into an array of treatment plans from which a user can select or further modify. For convenience, Figures 16B to 16M are arranged as a grid and show a model of the final tooth positions after completing the treatment plan. The actual treatment plan may include an indicator of the position and / or orientation of each tooth, as well as a description of how to move from an initial position (e.g., Fig.16A ) to the final position ( Figure 16B-16M ) keyframes. In Figures 16B to 16D, as shown on the horizontal axis, each of the three treatment plans calculated using treatment details or treatment preferences that are set to not allow attachments and not allow IPR is shown. These figures also show that 26, 15 or 7 stages are used for Figures 16B-16D, respectively. Figures 16E to 16G show a series of treatment plans that allow attachments but do not allow IPR (also 26, 15 or 7 stages, respectively). Figures 16H, 16I and 16J (26, 15 or 7 stages, respectively) show examples of the final stages of a treatment plan that does not allow attachments but allows IPR. Finally, Figures 16K, 16L and 16M (26, 15 or 7 stages, respectively) show examples of treatment plans generated by allowing both attachments and IPR.

[0260] exist Fig.17 An alternative treatment plan display and modification screen is shown in FIG. In this example, the treatment plan is a 26-stage plan. The initial display is a 26-stage device that does not allow IPR and does not allow attachments. Fig.17, the right half of the screen shows controls configured as filters that can be selected to switch between different treatment plans. Since all treatment plans are pre-calculated and included in the array of treatment plans, it is easy and fast to switch between treatment plans, even in very large or complex treatment plans. Fig.17 A control is shown that allows the display to switch between treatment plans that allow IPR / do not allow IPR 1703 and treatment plans that allow or do not allow attachments 1705. Additional controls may allow the user to switch between different products 1707 with different treatment durations (phases). Fig.17 In the embodiment of the present invention, the device may also allow the user to select different treatment details 1709.

[0261] Treatment Plan Optimizer

[0262] Also described herein are methods and apparatus for automatically creating a treatment plan to align a patient's teeth using a plurality of removable aligners to be worn in sequential stages. The methods and apparatus may include multiple variations of creating a treatment plan to align a patient's teeth using a plurality of removable aligners to be worn in sequential stages. The method may be referred to herein as a method for automatically generating an optimized treatment plan, and the apparatus (e.g., software including a non-transitory computer-readable medium, a computer-readable medium containing program instructions for creating a treatment plan to align a patient's teeth using a plurality of removable aligners) may be referred to as a treatment plan optimization generator.

[0263] The methods described herein for automatically generating an optimized treatment plan can optimize both the final position and the intermediate tooth positions (e.g., in stages) simultaneously. This can allow the apparatus to generate a treatment plan with a final position that is achievable within an allowed number of stages (and therefore, treatment duration) of a product corresponding to a set number (or range) of aligners.

[0264] The comprehensive treatment plan constructed using the method for automatically generating an optimized treatment plan described herein also incorporates an optimized or idealized treatment plan (referred to herein as a comprehensive treatment plan) that is generated without regard to the amount of time or number of stages it will take to achieve. This can enable the method to improve orthodontic measurements that are not explicitly defined as optimization targets. Measurements that represent potential orthodontic problems can be limited to a range between the initial position (or value) of the patient's teeth and the position (or value) planned in the comprehensive treatment. This ensures that partial final positions do not unnecessarily introduce or worsen orthodontic problems.

[0265] As an alternative to the methods and apparatus described herein, a treatment plan can be created by first constructing a comprehensive treatment plan (manually or automatically or a combination of manual and automatic), and then dividing the plan into a series of stages with restricted movement. In this approach, the number of stages depends on the final position of the teeth. The stages are determined by, for example, iteratively simplifying the dominant tooth movement. Fig.18 An example of a processing flow of the method is shown, wherein initial positions of teeth and a user's (e.g., a dental professional's) prescription and preferences are provided as input to generate a final position of teeth (e.g., a comprehensive treatment plan). Due to inaccuracies in treatment length estimates, the final positions generated by this method may not always meet product constraints. In addition, the straightforward simplification of tooth movement required to divide the steps of the plan may unnecessarily compromise the quality of the final positions. Finally, the treatment plan may not prioritize aesthetic goals over orthodontic specifications and rules, achieving suboptimal solutions to possible patients' primary concerns. Although these issues can be alleviated through the technician's personal judgment, such manual adjustments can take a significant amount of time and the generated plans may lack consistent quality.

[0266] Fig.18 The method in involves sequentially solving for an overall final position ("final position generation"), which is then divided into a series of aligners ("stage generation"), and ultimately outputting a treatment plan ("output") including the final position and stages, the method being a linear process, although iterations may be included to adjust the final position and / or stages. As described above, there are often situations where it is desired to plan treatments in which parameters such as treatment duration are constrained. In addition, it would be beneficial to provide methods and apparatus for treatment planning in which the entire treatment plan (e.g., each stage) is determined simultaneously rather than sequentially.

[0267] Described herein are methods and apparatus for generating orthodontic treatment plans by expressing target treatment objectives for tooth movement as numerical expressions and constraining these target treatment objectives by numerical constraints corresponding to treatment limits. Given the constraints and target objectives, once the treatment objectives and limits are numerically defined, the resulting numerical expressions (e.g., equations) can be treated as nonlinear optimization problems and solved to generate an optimal treatment plan. These methods can result in treatment plans that can be referred to as "partial plans" because these plans are not intended to fully address all of the patient's clinical orthodontic conditions, but rather to best address these conditions within given product constraints (e.g., within a limited number of treatment times / stages, etc.).

[0268] Fig.19 A simplified overview of the basic concepts of the method described herein for automatically generating an optimized treatment plan is schematically shown. Fig.19, the area within circle 1903 represents all treatment plans and final positions that can be achieved from the patient's starting tooth configuration (shown as center circle 1905 in the upper left). Thus, the circle contains all final tooth positions and treatment plans for achieving these final positions when the treatment plan is subject to the limitations of the aligner system (e.g., limitations on the number of stages, limitations on the amount and speed of movement of each tooth, etc.) and the limitations required by the dental professional (e.g., limiting the movement of some teeth, etc.). These limitations can be referred to as treatment preferences and treatment details. Fig.19 The circles shown are highly simplified; the space defined by the constraints can be multidimensional, but the underlying concepts are the same. Fig.19 Same as shown.

[0269] Typically, the overall treatment plan is determined without considering all or most of the constraints that form the boundary 1903. Fig.19 In FIG. 1 , the overall treatment plan (“ideal final”) 1907 is shown as being outside the space defined by boundary 1903, although in theory it could be inside or outside. An image of the final tooth positions corresponding to the overall treatment plan is shown in FIG. Fig.19 Because this orthodontically ideal final position may not be achievable within the boundaries, the space contained within the boundaries must be examined to identify a suboptimal treatment plan that satisfies as many treatment concerns while providing an aesthetically pleasing outcome.

[0270] One possible approach could be to find a treatment plan within the boundaries that is close to the desired final position. Fig.19 In FIG. 1 , the closest position 1909 results in an unsatisfactory final position of the teeth. Fig.19 As shown in the upper right corner of the figure, the treatment plan that is closest to the ideal final position within the boundary, while addressing other concerns (e.g., alignment, etc.), does not address the primary concern (e.g., crowding) and instead creates or exacerbates other issues, such as tooth spacing. Although all but one tooth achieve a final position that is nearly identical to the ideal final position, the resulting final position is not orthodontically or aesthetically satisfactory.

[0271] On the contrary, Fig.19 The bottom left of shows an optimal position 1911 that both addresses major concerns (e.g., tooth crowding) and results in an aesthetically pleasing result. Although fewer teeth achieve the same final position as the optimal position, the resulting final position is better than the closest position shown.

[0272] In practice, the ideal fit can be found by expressing the constraints as a set of numerical expressions and restrictions on these numerical expressions, and solving the resulting expressions as an optimization problem. Specifically, the method can include identifying a set of treatment preferences and treatment details for a specific patient, expressing these treatment preferences and treatment constraints as nonlinear expressions, and solving the optimization problem. Fig. 20A A schematic diagram of the method is shown. Fig. 20A In the method (or the device performing the method), the inputs to the method (or the device performing the method) are the initial position of the patient's teeth, the dental professional's prescription and preferences, and the product's definition. The product's definition can be considered as a set of treatment preferences. For example, this can include the number of stages, the characteristics of the aligner including the speed at which the aligner moves the teeth, etc. The user's prescription and preferences can correspond to the treatment details.

[0273] In any of the methods and apparatus described herein, it may be beneficial to have an ideal tooth position (e.g., a global final tooth position) for use in treatment planning. However, it should be clear that the global final tooth position is not used as the actual final tooth position. Rather, the methods described herein simultaneously determine the actual final tooth position and the stages required to reach that tooth position within the constraints required by the treatment preferences and treatment details. Software for determining the global final position (which may also be referred to as "FiPos" software) may be used, or the final position may be manually or semi-manually / semi-automatically determined and digitized digitally or manually (e.g., using a model of the patient's teeth).

[0274] Once the comprehensive final tooth positions have been identified ("Complete Final Position Generation"), this final position, along with the initial positions, treatment preferences, and treatment details, can be used to determine the best treatment plan using "Optimized Treatment Planning". This optimized treatment planning is described in detail below. The optimized treatment plan can include results in a vector description, including staged, keyframes (showing tooth movement between stages), and a proposed final position of the teeth, which can be output by the system ("Output").

[0275] Fig. 20B The method is shown in slightly more detail, showing examples of rules and problems to be solved for determining an overall final position, as well as rules and constraints for determining an optimization problem that can be solved for an optimized treatment plan.

[0276] exist Fig. 20C, the same four inputs (product definitions / treatment details 2003, preferences (treatment preferences, user-specific and / or patient-specific) 2005, initial tooth positions 2007, and global tooth positions 2009) are used by the treatment plan optimization generator to select a plurality of numerically represented treatment goals from a memory accessible to a processor 2011. The memory may typically include a set of predetermined general expressions ("merit functions" or merit function components, or "objective functions") that describe the numerically represented treatment goals. Typically, each of these goals is a numerical function whose value is closest to zero under ideal circumstances. For example, as described below, if the treatment goal is alignment in the x-direction, the numerical function may represent the deviation from alignment in the x-direction as a numerical value (e.g., from 0, which means alignment, to some distance, e.g., in millimeters, for misalignment).

[0277] Similarly, treatment preferences can be expressed as constraints on an objective function. The treatment preferences and, in some variations, the treatment details, the initial position, and the overall position can be used to select numerical constraints from a set of stored predetermined general constraints. Once the numerical constraints and the objective function (e.g., based on a set of treatment details, a set of treatment preferences, and an overall final position of the patient's teeth) are selected 2015, specialized constraints (constraints) 2017 and specialized numerically represented treatment goals (objective functions) 2019 are obtained, which can then be represented as a nonlinear optimization problem 2021 by first combining multiple numerically represented treatment goals (objective functions) to form a single numerical function (single numerical evaluation function). Each numerically represented treatment goal can be multiplied by a scaling factor. The resulting nonlinear optimization problem is a single numerical function 2023 subject to multiple numerical constraints.

[0278] Thereafter, the optimization problem may be solved using conventional techniques such as interior point methods. Such nonlinear constrained optimization solving techniques 2025 may minimize a single numerical function subject to multiple numerical constraints to obtain a solution vector 2027 that includes all stages of forming a treatment plan. The solution vector may be mapped to a treatment plan 2029, wherein an "optimized" treatment plan 2033 includes final tooth positions that differ from the overall final positions of the patient's teeth.

[0279] Once the constraints on the patient's teeth (e.g., product limitations / treatment details and treatment preferences) are expressed as numerical functions and restrictions, the optimal treatment plan can be identified by solving an optimization problem. An optimization problem with nonlinear constraints can be represented by a set of merit functions and inequality constraints:

[0280] Minimize f0(x)

[0281] Limited by f i (x)≤0,i=1,...,m,

[0282]

[0283] See e.g. Fig.21 To generate a treatment plan by solving an optimization problem, the treatment plan is described in terms of different values ​​that are mapped to the x in the problem statement. j variables. One possible mapping used in a first implementation of the method is described below. The position of each tooth in the final stage is described in terms of six coordinates (orientation, e.g. rotation and translation from the center of the mandible) and mapped to six variables. The stage (i.e. intermediate position) of each tooth is described as a linear combination of several function components. Each component describes the deviation from the linear movement at a certain stage and is parameterized by the six coordinate deviations and the stage number. Therefore, each function component of each tooth is mapped to seven variables in the optimization space.

[0284] The numerical limits of the individual numerical functions are understood as qualities of the treatment plan, which must not be violated, and can be defined as inequality constraints fi. Constraints enforce limitations imposed by mechanical, biomechanical, clinical and aesthetic rules and product limitations. Implemented constraints include, but are not limited to: amount of reproximation, maximum speed of tooth movement, depth of inner arch collision, cusp to sulcus occlusion. Examples of constraints also include "no damage" constraints, which ensure that the movement of teeth does not result in poor alignment or overcorrection, such as: centerline, overjet, overbite, occlusion, malposition, spacing, rotation, etc. Other constraints may include: amount of collision, speed of movement, and separation of movement, etc.

[0285] The quality of the treatment plan, which must be improved as much as possible within the constraints, is defined as a numerically expressed treatment goal, i.e., a component f0 of the merit function. The goal is typically the feature to be improved or modified by treatment. Goals may include, but are not limited to, the length of the resulting treatment, the amount of space, misalignment between teeth, etc. For example, potential major concerns may include: misalignment (x and z), de-rotation, occlusion, interdental spaces and spaces, inter-arch collisions, etc. Other goals may include: near full setup and round trip. The merit function is defined as a non-linear combination of objective functions weighted by predetermined coefficients. All objective functions may be summed (and weighted) to form a single numerical function (single numerical merit function).

[0286] For example, objective functions that may be weighted, summed, and minimized as described herein may include: minimum difference from an ideal final position (with a goal of trying to achieve the ideal final position); misalignment, such as by minimizing the difference between the x-misalignment and z-misalignment in the value final position and the x-misalignment and z-misalignment in the ideal position; teeth to be aligned to the dental arch (e.g., minimizing the angle between the x-axis values ​​of the value final position and the ideal position); minimum interdental spacing (e.g., minimizing the space between adjacent teeth); occlusion (e.g., applicable to the case of two jaws, pulling the corresponding cusps from one jaw to the groove of the opposite jaw); reciprocating (e.g., minimizing mesial-distal and buccolingual reciprocating); inter-arch collisions in the value position (applicable only to the case of two jaws, for example, trying to create inter-arch collisions at the posterior teeth that are as close to the ideal final position as possible); arch collisions during stages, etc.

[0287] Typically, measurements can be functions implemented in software that can be used as objectives or constraints in optimization problems. The inputs to each measurement can be: a 3D model of all teeth (constants), six coordinates per tooth that define the position of the tooth relative to the jaw. The output of each measurement can be a single numerical value, such as a distance in millimeters, an angle in radians, or a fraction from 0 to 5.

[0288] exist Figure 22A-25 The examples of objectives shown in show examples of objectives and constraints expressed as numerical functions and restrictions. For example, Fig.22A A method of quantifying occlusion (e.g., between the upper and lower jaws) is shown. Fig.22A In , the occlusal metric is the cumulative distance between all corresponding cusps from one jaw and the sulcus spline of the opposite jaw. For the maxilla, the lingual cusps are used; for the mandible, the buccal cusps are used. Therefore, the quality of the occlusion is measured as a function of the distance between the occlusal sulcus and the cusps. The constraints of the optimization problem ensure that the quality of the occlusion in the partial setup is not worse than the patient's initial position. Therefore, if the patient's cross bite cannot be fully resolved with good occlusion in the low-stage product, it will not be corrected. This is in Figures 22B-22D Shown in. Fig. 22B A view of the patient's initial dental configuration (cross bite) is shown. Fig. 22C Correction using the global final position for correction is shown. Fig.22D A comparable correction using a "partial" optimization setup as described herein is shown.

[0289] Fig.23 An example of quantification of x-misalignment is shown. X-misalignment is the projection 2303 (yellow line) of the line between the buccal ridge endpoints of two adjacent teeth onto the dental arch normal at a given stage. Similarly, Fig.24Quantification of z misalignment is shown. Z misalignment is the projection 2403 of the difference in tooth cusp points onto the normal to the jaw occlusal plane at a given stage.

[0290] Fig.25 Quantification of alignment to the dental arch is shown. As shown, for a given tooth the alignment to the dental arch is the angle between the X-axis projection in the value final position and the X-axis projection in the ideal final position.

[0291] Examples of constraints include tooth movement limits, which typically require limiting the range of movement allowed for each tooth type according to product definitions. These limits may be clinically defined to ensure that the proposed treatment plan is achievable in practice with the device to be used. Each product (e.g., aligner) may have a different set of values, which may be stored in a lookup table or other memory accessible to the processor.

[0292] Tooth movement restrictions may include rotation (e.g., rotation of the tooth along the z-axis); flip (e.g., rotation of the tooth along the x-axis), twist (e.g., rotation of the tooth along the y-axis); crown movement, including horizontal crown movement (e.g., translation along the z-axis is ignored); buccal-lingual crown movement (crown center translation along the x-axis); mesio-distal crown movement (e.g., crown center translation along the y-axis); mesio-distal apical movement (e.g., apical translation along the y-axis); buccal-lingual apical movement (e.g., apical translation along the x-axis); extension / depression (e.g., translation of the tooth along the z-axis); and relative extension.

[0293] Collision constraints can also be used to limit collisions between teeth. In addition, staged constraints can be applied to intermediate stages (e.g., keyframes) to ensure that the treatment plan is consistent and clinically predictable. Collision constraints can include inter-arch collisions (applicable only to the two-jaw case), which prohibit deep collisions on the posterior teeth with a depth greater than, for example, 0.05 mm, and can prohibit collisions of smaller or equal depths in the anterior teeth in the value final position. Collision constraints can also prohibit one-arch collisions (e.g., so that collisions between adjacent teeth in the value final position do not exceed the maximum collision in the initial, ideal final, or values ​​corresponding to close contact).

[0294] Phased constraints may also be used. For example, phased constraints may include synchronous completion of final position of values ​​(e.g., each tooth must complete the move at the same phase number); fixed phase constraints (e.g., each tooth starts moving at phase 0); "no more phases" (e.g., the final phase number, treatment length must not be greater than the product allows (i.e., 20 phases, etc.); "no triggering of stairs pattern" (no more than the mesiodistal movement on each tooth that can be expected to be achieved in practice without long continuous tooth movement, which is called stairs pattern); constraints such that no Z rotation and depression / extrusion round trip occurs on any tooth; and speed rules (e.g., tooth movement on a single phase (e.g., aligner) must not exceed 0.25 mm).

[0295] Other examples of constraints include "do no harm" constraints, which ensure that the planned final position does not cause or worsen orthodontic problems. In the optimized final position, each measurement corresponding to the orthodontic condition must be within the value measured in the initial position and the value measured in the comprehensive (ideal) final position. For example, overjet can be restricted by requiring that there should be at least one incisor on each side of each jaw (only applicable to the case of two jaws). Overbite can be restricted (only applicable to the case of two jaws); there should be at least one incisor on each side of each jaw. Midline can be restricted (only applicable to the case of two jaws); each jaw should have more than two anterior teeth. Occlusion can be restricted (only applicable to the case of two jaws). X and Z misalignment can be restricted (applicable to each pair of adjacent teeth where at least one tooth is movable); the dental arch and jaw occlusal planes can be calculated once in the initial position. Spacing (applicable to each pair of adjacent teeth where at least one tooth is movable) can be restricted; the crown spacing between adjacent teeth should not exceed the maximum spacing in the initial position and the ideal final position. The angle can be limited by maintaining the tooth axis between the initial position and the desired final position (for alignment of the x, y and z axes to the dental arch measurements).

[0296] Once the problem has been stated in this way, it can be solved by any constrained optimization algorithm of sufficient power (e.g., an interior point method). The result is a solution vector. This vector will include the position and orientation values ​​for each tooth, as well as the stage number corresponding to each tooth. The vector can describe a large number of such values, such as x j variables.

[0297] Through the above reference Fig. 20C The mapping of variables described can generate x j The solution vector of optimal values ​​of the variables is converted into a treatment plan.

[0298] In general, these methods can be used to generate partial treatment plans, which are characterized by addressing the patient's concerns as closely as possible within the product constraints. Compared to a comprehensive or complete treatment plan that ends with an ideal comprehensive tooth position, these partial treatment plans may not fully address all of the dental professional's concerns, nor may they address all orthodontic issues. To generate such partial plans, the treatment lengths and tooth constraints allowed in the product are implemented as inequality constraints. This forces the optimization algorithm to find a solution within the product constraints, i.e., a treatment plan that improves the merit function as much as possible, but not to the full extent.

[0299] Typically, to improve the quality of the plan, an optimization goal (e.g., global tooth position) can be added to minimize the distance between the partial plan and the global treatment. The distance can be measured by the length of the secondary treatment starting from the partial final position to reach the global final position. As described above, the complete final position of the global treatment plan can be generated manually, automatically or semi-automatically and stored separately in the device. Once the partial treatment plan is ready, the complete final position will be abandoned.

[0300] In order to ensure that the partial treatment plan (optimized treatment plan) generated as described herein does not introduce or worsen orthodontic problems, additional inequality constraints can be introduced. As described above, each identified orthodontic problem, such as a deep bite or class, can be measured as a single numerical value. Next, two inequalities constrain this measurement in the partial setting to a range between the initial value and the full treatment. The first inequality ensures that the partial setting does not make the problem worse than the initial position. The second (optional) inequality can ensure that the partial setting does not unnecessarily overcorrect the problem.

[0301] By including the comprehensive final position and incorporating it into the merit function and constraints of the nonlinear optimization problem and solving the problem using a general optimization algorithm, the method described herein can generate a treatment plan that fully satisfies the constraints from product and user preferences while optimally addressing the primary concerns and improving and maintaining other orthodontic measurements.

[0302] The methods described herein can be directly applied to all products that have restrictions on the number of stages or the amount of tooth movement. As described above, by automatically building such plans, they can enable dental professionals to review multiple plans for a range of products, or customize a product while reviewing an updated treatment plan. The restrictions on the number of stages can be replaced or supplemented with other restrictions and goals; this can allow the method to also incorporate primary concerns, physician preferences, and predictability models into the comprehensive treatment plan.

[0303] The methods and devices described herein are also fully compatible with the use of biomechanical protocols, which can potentially be combined with optimization of final and intermediate tooth positions to generate a treatment plan with movements fully supported by the appliance (e.g., aligner) design.

[0304] Collision Detection

[0305] The construction of an orthodontic treatment for a patient must take into account constraints on the relative positions of the teeth, including the amount of spacing and interproximal removal. Calculating the exact amount of collisions and spacings between teeth can be a computationally intensive operation that affects the cost and quality of automated treatment planning. This article describes methods and devices (e.g., such as a system for automatically detecting collisions between teeth, which may be referred to as a collision detector) for constructing an approximate tooth shape by wrapping the surface of a tooth using multiple three-dimensional (3D) shapes (e.g., capsules) or in some variations wrapping other structures (e.g., accessories, brackets, etc.), the three-dimensional (3D) shape having a planar figure (e.g., a line, a rectangle, etc.) in a core and having an outer surface extending from the core at a constant radius in x, y, and z. Collisions (e.g., overlaps) between teeth can be analytically determined from the 3D shapes with high accuracy. These systems and methods can also be applied to only adjacent portions of teeth (rather than entire teeth) and can be combined with a hierarchy of bounding boxes to speed up calculations. The methods and apparatus described herein can be two or more orders of magnitude faster than accurate general-purpose techniques or estimated collisions, and can allow the above-described systems and methods for calculating one or more treatment plans (e.g., solvers or treatment plan solvers) to incorporate these collision detectors. In addition, any of the methods and apparatus described herein can determine the magnitude of overlap (or in some cases, the closest separation) between teeth, but can also be configured to determine the velocity of overlap (e.g., in three or more spatial directions, e.g., x, y, z and / or yaw, pitch, roll).

[0306] Fig.29A The surface of a shape such as teeth is shown modeled using a triangular mesh 2905. Surface modeling using a triangular mesh can be used to model adjacent teeth, and the modeled surface can be used to estimate distances between objects such as teeth. Fig.29B An example of a set of three-dimensional (3D) shapes displayed as capsules is shown, where each 3D shape has a core that is a line or a plane figure and an outer surface that is a constant radius from the core. Fig.29B In FIG. 2 , capsule 2907 is formed by a core that is a wire. As will be described in more detail below, modeling the surface of adjacent teeth by encapsulating the surface (and interior regions) of adjacent teeth as described herein can be used to model the surface of adjacent teeth more efficiently than other methods (including modeling by triangular meshes, such as Fig.29AAs shown, collisions between shapes can be determined much faster using 3D shapes (as shown in Figure 1). For example, a tooth surface can be modeled with high accuracy using 2000-8000 triangles; the same surface can be modeled with approximately equal accuracy using 50-200 capsules. Because capsules have flat areas and raised areas, they may be particularly suitable for modeling shapes such as surfaces of teeth. Using 3D shapes with a constant radius from a plane figure (e.g., a line, rectangle, etc.) can be used to calculate distances between surfaces more than five times faster than modeling with equal accuracy using triangles. 3D shapes such as capsules are typically solid and therefore can be used for fast penetration depth calculations.

[0307] Fig.29C A side-by-side comparison of a tooth modeled with a capsule 2917 (entire tooth) and a tooth modeled with a triangular mesh (right 2915) is shown. In practice, the patient's teeth need only be modeled once by packaging with a three-dimensional shape such as a capsule; thereafter, the position of the entire tooth can be changed, but the same surface modeled by the 3D shape is used to check collision / spacing for multiple different arrangements of the teeth.

[0308] Although it has been found that using shapes with at least partially linear cores (e.g., capsules, rounded rectangles, etc.) can be particularly beneficial for modeling tooth surfaces and estimating distances (including collisions and collision depths), any suitable 3D shape having a core and an outer surface with a constant radius from the core may be used. For example, FIG. 30A to FIG. 30C shows a cross section through a 3D shape having a core and an outer surface at a constant radius from the core; Figures 31A-31C The corresponding figures shown are shown in perspective view. Fig. 30A and 31A , the shape is a sphere with a core 3001, which is the point from which the radius r 3003 originates. Using a sphere with only concave outer surfaces to pack complex shapes such as the surface of a tooth may be non-optimal, in part because the surface of a tooth includes areas that are not concave. Fig. 30B and 31B Using spheres may require a greater number of smaller spheres to be packed to approximate the tooth surface than other shapes such as the capsules shown in FIG. Fig. 30B and 31B , the capsule has a core that is a line segment 3005 and an outer surface of constant radius r 3007 on all sides of the line in x, y, and z space. Similarly, Fig. 30C and 31C An example of a core having a closed planar shape is shown, shown as a rectangle 3009 having a constant length radius 3011 extending from the surface. Figures 31A-31C The outer surface is shown in a perspective view.

[0309] When using 3D shapes such as capsules to model teeth, a variety of different capsule sizes can be used; for example, the capsules can have different core segment lengths, and / or the radius at which each capsule extends from the core can be different (although typically the radius lengths in a single capsule are the same). Alternatively or additionally, different 3D shapes can be used.

[0310] Fig.32A and 32B A top perspective view and a side perspective view of a patient's molar 3201 that have been modeled using multiple capsules are shown, respectively. In this example, the entire outer surface of the portion of the tooth above the gums has been modeled by packaging with capsules. In practice, one or more teeth can be modeled from a digital model of one or more teeth of the patient. For example, a digital scan of the patient's teeth (e.g., from an intraoral scan, a scan of a dental impression, etc.) can be provided, and the surface of the tooth can be modeled by packaging the tooth surface (and all tooth volumes or their peripheral areas) with multiple 3D shapes (e.g., capsules). An optimization algorithm can be used to automatically position a small number of capsules to approximate the tooth surface as closely as possible. The matching accuracy with the tooth surface can be set as a parameter so that the minimum number of capsules (or maximum capsule size) required to model the surface within the set accuracy range can be determined.

[0311] In variations where a digital scan of the patient's teeth is taken, the digital scan may be divided into individual teeth (or groups of teeth), and each divided region (e.g., tooth) may be modeled using a 3D shape (e.g., a capsule). In some variations, the tooth(s) may have been modeled in another manner (e.g., by Fig.29A ) and existing models can be modeled using 3D shapes.

[0312] In order to model a single tooth (or group of teeth), the teeth can be packaged with a capsule so that the difference between the tooth surface and the outer surface of the capsule is as small as possible. In this model, only 3D shapes (such as capsules) are used for approximation; these 3D shapes can be quickly constructed and can be quickly analyzed. As will be described in more detail below, in some variations, only a portion of the tooth can be approximated. For example, only the IP area, the incisor area, the crown, etc. can be modeled; for example, only the side of the tooth facing the adjacent teeth can be modeled. Alternatively, the entire tooth shape can be modeled. In some variations, the tooth shape can be reduced (decimate) before approximation. For example, the tooth shape can be simplified by filtering (e.g., smoothing, etc.). Alternatively or additionally, the original shape can be used to obtain a more accurate approximation. In some variations, all teeth (or a subset of teeth) can be modeled simultaneously, for example in parallel. Alternatively, the teeth can be modeled one by one, for example sequentially.

[0313] Modeling the teeth can be iterative. Initially, the surface can be filled with non-overlapping 3D shapes (e.g., capsules) as an initial configuration. Each iteration can include finding the region of the shape that is worst approximated by the capsule (e.g., comparing the digital tooth surface or "real surface" to the 3D shape-filled surface). An optimization problem can be constructed to approximate the region with one capsule object. For example, the following relationship can be minimized, subject to the constraints that the endpoints of each capsule must lie inside the convex hull of the tooth shape, and that the vertex closest to each least squares line (LSS) of the tooth shape should not exceed some small limit:

[0314]

[0315] In this relationship, w k is the vertex v of the original shape k For the interproximal (IP, the area between adjacent teeth) area approximation:

[0316] ω k =f({vertex k} y 2 )

[0317] This can be solved with an optimization solver, and newly discovered surfaces can be added to the approximation, while obsolete surfaces can be removed from the approximation. The total approximation can then be refined. This process can be repeated (iterated) as many times as necessary until the desired accuracy is achieved.

[0318] For example, in some variations, the systems and methods described herein may select a subset of vertices from a digital model (e.g., a scan) of a tooth surface, and the subset of vertices may be approximated with a capsule. An optimization solver may be used to minimize the distance between the capsule and the selected subset of points. If the approximation is poor (e.g., below a certain threshold for approximation), the point set is inappropriate, and the subset of vertices may be modified to find points within the vertices that can be better approximated, or to find a new set of points that can be more closely approximated within the desired range (e.g., another capsule may be identified to approximate a smaller subset of points). Once the initial packing of capsules is completed, each capsule approximating a smaller subset of points on the tooth, the optimization process may be repeated with some of the capsules being rearranged to achieve greater accuracy. The process may stop when the maximum number of capsules required is reached. For example, a threshold number of capsules may be set to, for example, 15 capsules (10 capsules, 12 capsules, 15 capsules, 20 capsules, 25 capsules, 30 capsules, 35 capsules, etc.). Alternatively, in some variations, the process may be repeated until a precision limit or threshold is reached, without limiting the number of capsules (and therefore the size of the capsules). For example, a precision limit may be set to require that all spaces greater than 0.001 mm be filled. Alternatively, a combination or balance of the two (number of capsules and / or minimum precision limit) may be used, for example to increase the number of capsules if the precision is within a predetermined range.

[0319] although Figures 32A-32B An example of an entire tooth modeled using multiple capsules is shown, but other structures may also be modeled, including other tooth structures that may be present on or associated with the tooth. Figures 33A-33B A perspective view of a portion of a dental appliance (precision wing portion 3301) is shown that has been modeled by packaging with multiple 3D shapes (e.g., capsules). In some variations, this may be beneficial for detecting collisions between teeth and orthodontic devices or between multiple orthodontic devices.

[0320] Fig.34A An example of a tooth with surfaces (interproximal surfaces) modeled using multiple capsules is shown. Fig.34A , the left interproximal surface 3405 is approximated by packing the surface with multiple capsules of various sizes. Other regions of the tooth (e.g., the crown region) are not modeled, or are not modeled to similar accuracy. In some variations, multiple regions associated with the same tooth may be modeled separately, such as the left and right interproximal regions, the crown region, etc. Fig.34BA dental arch including a plurality of individual teeth is shown. Each tooth is divided into a left side and a right side, and in some teeth (e.g., molars, premolars), into a separate middle region; the left and right regions can be modeled separately. For example, the framed incisor 3408 includes a left side 3410 and a right side 3412 shown in different shades, and similar distinctions can be made for all teeth.

[0321] Once one or more surfaces of a tooth have been digitally modeled by packing 3D shapes, a hierarchy of bounding boxes can be formed around all 3D shapes of each modeled surface of each tooth and adjacent shape sets. Establishing a hierarchy of bounding boxes can provide a fast and efficient way to determine which capsules between two adjacent teeth may be closest to each other and / or may overlap. The use of bounding boxes, especially the use of an organized hierarchy of bounding boxes, can greatly reduce the time to find the closest capsule pair. Bounding boxes allow approximate values ​​of collision / separation in space to be quickly determined, rather than exact values. The approximate value can be calculated as the minimum distance between all possible capsule pairs of two shapes. For example, approximate collisions can be used in the optimization process of treatment plan generation to provide a good initial guess for tooth position, which meets almost all requirements, except for some small collision / space rule violations caused by the inaccuracy of the approximate calculation. These violations can be resolved by switching back to exact calculations (e.g., using capsule distances). This combination of bounding boxes and 3D shapes that allows rough and more accurate determination of spacing has been found to improve substantial performance by up to 150 times or more compared to using only more accurate collision depth / space calculations.

[0322] Using a hierarchy of bounding boxes that provide approximate collision information with more precise collision information provided by 3D shapes (eg, capsules), particularly by increasing the number of capsules, may allow for fast accurate collision / distance information.

[0323] The hierarchy of bounding boxes can be organized so that each capsule fits tightly into its bounding box. Each bounding box that contains one or more capsules is considered a leaf of the hierarchy. Each box from a higher level of the hierarchy bounds several boxes from lower levels of the hierarchy. Fig.35A An example of a hierarchy of bounding boxes for four capsules is shown. In this example, capsules A, B, C, D are each bounded in a bounding box, forming the lowest level of the hierarchy. Bounding boxes A and B are merged into bounding box AB, and bounding boxes C and D are merged into bounding box CD. Finally, at the top of the hierarchy, bounding boxes AB and CD are merged into bounding box ABCD. Fig.35A The entire hierarchy arranged as a tree is shown, with boxes corresponding to individual capsules at the lowest level.

[0324] Any suitable algorithm for constructing a bounding box hierarchy can be used. Using tighter bounding boxes (e.g., having smaller volumes) can result in more efficient use of the hierarchy in collision calculations, and thus, the methods and apparatus described herein can construct a hierarchy while minimizing the volume of the resulting bounding boxes at each level of the hierarchy. Each tooth can have a single hierarchy or multiple hierarchies, e.g., a hierarchy corresponding to a left interproximal side and a right interproximal side, etc. When checking for collisions of adjacent teeth, the hierarchy can be traversed to avoid calculating distances between pairs of capsules that cannot affect the resulting collision / spatial values. For example, Fig.36 An example of a method for traversing a bounding box hierarchy to skip distance calculations between capsules that cannot affect the final value of collision / space is shown (e.g., shown here as pseudo code). The method can start at the highest level and check to see if there is any collision (e.g., overlap) between the top levels of the hierarchy by, for example, measuring the distance between the largest (top-level) bounding boxes of each adjacent tooth or two adjacent tooth regions. If there is no overlap at the top level, there is no collision at all. However, if there is a collision, the next level down the hierarchy can be compared to determine which branches in the hierarchy include a collision; for each branch that includes a collision, the process can continue down to the next level / branch until the lowest level (capsule or other 3D shape) is reached; therefore, the final level on the two teeth or tooth regions represents the area where the collision occurred, which can be checked to determine the depth (magnitude) of the collision. Fig.37A Methods for analytically determining the distance between two capsules of different hierarchical structures are shown. In general, the apparatus and method can measure the distance d between the cores of a 3D shape, and in this example, the minimum separation between capsules is equal to the shortest distance between two line segments minus the radius of the first capsule and the radius of the second capsule. Fig.37B Also included are functions for finding two shapes (e.g., using Figures 35A-35B An example of a pseudo-code instruction set for approximating the distance between the capsule-enclosed shape A and shape B shown. Although the examples described herein include bounding boxes, other simplified bounding geometries may be used, for example, a bounding sphere or a bounding capsule hierarchy may be used.

[0325] In addition to detecting the magnitude of any collision that occurs when the teeth are in a specified position, the methods and apparatus described herein can be used to determine the velocity of any collision. In making velocity measurements, one or both teeth can be moved in one or more axes (x, y, z axes, roll, pitch, and yaw) by very small increments (e.g., less than 0.001 mm, less than 0.01 mm, etc.), and the resulting change in overlap is determined for each axis. The final velocity can be measured for each of the six axes, and / or the final velocities can be combined into a single indicator (e.g., vector) sum or relationship.

[0326] During any process of determining collision velocity, where the tooth may "jitter" in one or more of its axes, the collision with any positional change in shape / closest capsule pair in space is small. This can be used to calculate gradients faster in optimization algorithms for determining the final position of the tooth after treatment, and for staged construction. For example, a tooth may move a small amount (e.g., less than 0.001 mm translation, less than 0.01 degree rotation, etc.) in each of the six axes (e.g., three translation axes x, y, and z and three rotation axes: pitch, yaw, and roll). This is useful, for example, in Fig.40 , an axis around one tooth is shown. Thus, the same capsule identified as a collision can be re-examined after a small movement to determine the collision velocity. When solving one or more treatment plans using a solver / engine, the solver can avoid collisions between teeth. In order for the solver to estimate the best solution when planning treatment, the solver can be provided not only by the magnitude of the collision (e.g., depth), but also by the velocity of the collision (e.g., how the collision depth reacts to small changes in position relative to adjacent teeth). If one tooth is fixed, but the other tooth moves around its original position, such as a dither, the same pair (or pairs) of capsules can be used for very fast calculations. The depth can be defined as the proximity of a tooth to another tooth, such as in mm of overlap. In some variations, alternatively, the method and / or device can measure the space between the two closest capsules (e.g., even when there is no collision).

[0327] In use, methods for solving for magnitude and velocity of collisions may be integrated into methods for solving one or more treatment plans. For example, a treatment plan solver may call a collision detector to identify collisions and rotations between each tooth. The treatment plan solver may initially have identified a digital model of the patient's teeth, where one or more surfaces are modeled by 3D graphics (e.g., capsules). See, e.g. Fig.38 and 39The patient's teeth, such as along the interproximal areas, can be modeled as a single tooth (or collection of teeth) and overlap can be determined 3509. There is no need to remodel the teeth when making additional collision determinations. The collision detector (collision engine) can measure the change in magnitude as a collision depth and can also determine the speed of the change in magnitude for each of the multiple axes.

[0328] A special variation of this method is used during the construction of orthodontic treatments using algorithms based on nonlinear optimization. For example, in order to calculate the gradient of the change in the amount of collision or space, each step of the nonlinear optimization algorithm can be calculated into thousands of values ​​of small changes in the position of the teeth. If the changes in position are limited by small constant bounds, the results of the previous calculations can be used to select a smaller number of capsules that must be considered to find the amount of collision or space. This additional pruning reduces the computational complexity from O(N 2 ) to O(1) and allows increasing the number of capsules used in the tooth approximation without a corresponding increase in computation time, thus improving accuracy.

[0329] In examples where the capsule has a core that is a planar figure (e.g., a line, rectangle, etc.) and has an outer surface that extends from the core at a constant radius in x, y, and z, collisions (e.g., overlaps) between teeth can be analytically determined from the 3D shape with high accuracy. As described above, these systems and methods can also be applied to only adjacent portions of teeth (rather than entire teeth) and can be combined with a hierarchy of bounding boxes to speed up calculations.

[0330] Any of the methods and apparatus described herein, including subassemblies or subsystems (e.g., such as a system or subsystem for automatically detecting collisions between teeth, which may be referred to as a collision detector), may be configured to construct an approximate shape of a tooth by encapsulating the surface of a tooth, or in some variations encapsulating other structures (e.g., accessories, brackets, etc.), using a plurality of three-dimensional (3D) shapes (e.g., capsules) as described above, which may be selected based on the shape of the product to be modeled (including teeth and / or other structures, such as retainers, accessories, etc.). As described above, generally, the use of capsules for shape approximation can significantly reduce the time required for collision calculations, which can be a bottleneck in treatment plan construction. However, even if the accuracy of the approximation is not high, filling (e.g., capsule-based) techniques are still useful in eliminating residual collisions when modeling. In some variations, the construction of a high-precision approximation can result in significant time savings, even without the need for precise calculations to improve treatment plans.

[0331] For example, in some variations, topological information about the face(s) of a tooth or other object being modeled can be used to select the size, shape, and / or location of a capsule. In some variations, topological information about the face (e.g., curvature) is used to find regions that are best approximated using a single capsule. This can be done by identifying one or more regions on a shape that is closed in curvature; in some variations, when capsules are composed of fixed-radius spheres or shapes based on fixed radii, they may not be able to effectively approximate regions with different curvatures. Fig.41A An example of a pair of tooth shapes is shown, showing regions with closed (enclosed) curvatures that can be approximated using a single capsule. Fig.41A In , each different region (shown by different shading), such as 4101, 4103, has a closed curvature. A quadratic error metric is used to measure the distance from the shape to the approximation. The curvature of the surface can be determined using any suitable method.

[0332] Once identified, the curvature can be used to determine the shape, size, and / or position of the capsule. The capsule approximation can be refined on the fly. For example, if a request is made to approximate a capsule in a particular area (e.g., a "bad" area or a high error area, such as Fig.41B If there are collisions in the same region as shown in FIG. 1 , information about the quality of the approximation in different regions can be determined, stored, and used to interactively refine the approximation. Fig.41B In the figure, the shaded dots of different sizes show the areas with approximation errors (e.g., Fig.41B The relative sizes of points 4109, 4109' in FIG. 4 reflect the approximate error at the position of each point).

[0333] For example, the present invention describes a method for determining / detecting collisions as described above, wherein the initial division of a three-dimensional shape (e.g., a tooth) can be based on the curvature of the surface of the outer shape. Thus, the method or any device configured to perform the method can identify close faces of the outer surface. For each face, the method or device can construct a vector with coordinates (x1, ..., x7), wherein x1 ... x3 are the coordinates of the center of the face, x4 ... x6 are the coordinates of the vector (k1*d1+k2*d2)^n (k1, k2 are the principal curvatures of the face, d1, d2 are the principal directions, n is perpendicular to the face), and x7 is the average curvature of the face defined as k1+k2.

[0334] A clustering algorithm can then be used with the constructed set of vectors, and the number of clusters should be equal to the desired number of capsules. In this technique, the center of each cluster can be used to construct a capsule to be used as an initial guess by the optimization algorithm. A quadratic error metric can be used to control the sticking of the approximation from the 3D shape; to measure the distance between the capsule and the plane, the following definition can be used:

[0335] distance(capsule, plane) = min(quadraticerrormetric(s(t,r),plane))

[0336] In this technique, t belongs to [0,1], s(t) is a sphere centered at p0+t*(p1-p0), p0 and p1 represent the endpoints of the capsule, and r is the radius of the capsule. This metric is different from the distance from an unoriented point p (relative to the plane {p,n}) to the capsule; it also takes into account the direction of the normal and naturally distinguishes between convex and concave regions.

[0337] As described above, any of these methods can include refining capsules on the fly. For example, after calculating the approximation, the device or method can include marking areas of poor approximation with a marker (e.g., a flag). The collision calculation can check whether there are any areas of poor approximation near the potential collision area; if so, the method or device can perform capsule construction on the affected areas (areas near the potential collision; other areas that have a low probability of collision that may be ignored even if the approximation is poor). The newly constructed capsules can then be added to the approximation, and the collision results can be recalculated using the newly constructed capsules.

[0338] The above methods can be used to significantly increase the speed and / or efficiency of these techniques. For example, Fig.41C An example of comparison between collision detection using capsule approximation at different accuracy levels is shown. Fig.41C , the right side 4133 is an approximation of a tooth where 70 capsules are used to approximate the tooth surface (e.g., 70 capsules per tooth), while the right side 4135 is an approximation using 300 capsules per tooth. Compared to an exact collision detection method (e.g., using a triangle mesh), the approximation using 70 capsules per tooth is over 20x faster (e.g., reconstruction takes 10-15 seconds), while the approximation with 300 capsules per tooth is between 3x-7x faster (e.g., reconstruction takes >1 minute). The example of 70 capsules per tooth 4133 can be considered a "medium accuracy" technique, with a difference of approximately 0.1 mm compared to the exact model, while the example of 300 capsules per tooth 4135 is a higher accuracy model, with a difference of approximately 0.03 mm compared to the exact model.

[0339] Example

[0340] Examples of methods for generating an optimal partial treatment plan can include, for example, determining (in a computer processor) an initial position (position and orientation, in six variables) of each of the patient's teeth from a digital model of the patient's teeth. The digital model can be maxillary, mandibular, or both. The software typically separates the model into individual teeth and places them in the patient's occlusal relationship. The step of determining the position of the patient's teeth can be performed in the same processor (or as part of the same device) as the rest of the method (e.g., solving for the solution vector), or can be a different, separate processor. Any of these methods can then determine the overall (e.g., "optimal") final position of the patient's teeth.

[0341] The processor executing the method may then receive product definitions specific to the patient's treatment (e.g., the number of stages to be used). Other product information may include: the maximum number of stages allowed, whether attachments are allowed, the maximum allowed root movement, crown movement and rotation, etc.

[0342] Thereafter, the processor may receive preferences specific to the patient's treatment (e.g., interproximal removal, attachments, teeth that do not move, etc.) Preferences may include: indicating which tooth(s) do not move, individual teeth where attachments should not be placed, arches to be treated (both jaws, mandibular only, or maxillary only), category correction amount and method, IPR, arch expansion, spacing, leveling preferences, etc.

[0343] The processor can then represent multiple treatment goals of the treatment plan as numerical functions ("objective functions") based on product definitions and preferences, weight each numerical function, and sum them to form a single numerical function. The single numerical function may include, for example, a weighted sum of at least the following: tooth position compared to the overall final position of the patient's teeth, misalignment (x and z misalignment, alignment with the dental arch), interdental space (spacing between adjacent teeth), collisions (inter-arch collisions), and treatment length (number of stages). Therefore, a single numerical function (e.g., an evaluation function) is a non-linear combination of treatment goals (objective functions) weighted by predetermined coefficients. Typically, the key components of the evaluation function are objective (independent of overall position) measurements of aesthetic concerns: misalignment between teeth, spacing between teeth, overjet, and overbite. The components related to the overall final position primarily describe the orthodontic goals (arch type, occlusion, leveling, alignment, etc.).

[0344] The predetermined coefficients may be set or determined empirically, for example by expert opinion, or may be solved for. For example, starting from an initial guess with approximately equal weights, a set may be prepared for each case and checked against an existing database. Additionally, some adjustments may be made for technical reasons (i.e., to improve convergence to a solution, which may be delayed if the weights are inconsistent).

[0345] Constraints on tooth movement can then be expressed as numerical limits based on: product limitations, preferences, and overall final position, including at least: maximum speed of tooth movement, maximum amount of collision, limits on tooth movement, staged limits, and maximum amount of bite. As described above, other constraints can include: maximum speed of tooth movement, maximum amount of collision and space, limits on tooth movement, staged limits, maximum amount of bite, overbite, overjet, and midline position.

[0346] A constrained optimization algorithm can then be used to solve (e.g., minimize) a single numerical function subject to the constraints on tooth movement to obtain a solution vector and map that vector to a treatment plan. An example of a constrained optimization algorithm is an interior point method, including interior point variants SQP and active sets. Other methods may alternatively or also be used.

[0347] The solution vector is generated as a result of an optimization algorithm that solves the constraints. The optimization problem is defined as finding the solution that minimizes the merit function f0(x1…x N ) and does not violate the inequality constraint f i (x1…x N ) of variables x1…x N The solution vector is the x1…x generated as output by the optimization algorithm. N The variables map to the tooth positions, and for each keyframe on each tooth, there are seven variables: x, y, z coordinates, angles, tilts and rotations, and the stage number of the keyframe. For example, x1, x2, x3, x4, x5, x6 could be the initial position of the molars, x7 is the constant stage 0 (initial), and then x8 ... x 14 can be the stage number to add to the position, angle, and intermediate keyframes for the staged molars, and then x 15 …x 21 is the final position of the molar and the final stage number (treatment length). Then x 22 …x 43 are the initial, intermediate, and final positions of the premolar and the stage number, and so on for each tooth. There may be a varying number of intermediate, staged keyframes on each tooth, so there is a minimum of 14 variables per tooth, up to 42 or more variables for teeth with many staged keyframes. If there are multiple intermediate keyframes on a single tooth, and their order is not fixed, then each coordinate (e.g., angle) of the tooth at each keyframe may instead be computed as the sum of a piecewise function parameterized by the stage number and the coordinate variables. The piecewise function may be defined so that if the x values ​​corresponding to the six coordinates at the keyframe are i ..x i+6 If the variable is equal to zero, the tooth movement through that keyframe is linear, which is equivalent to the absence of a keyframe.

[0348] Fig.26 An example of a set of keyframes is shown. Keyframes are described in more detail in US8038444 and US6729876, which are hereby incorporated by reference in their entirety. The number of keyframes used may be predetermined, or may be determined by the apparatus or method. Each tooth may have a different number of keyframes.

[0349] Keyframes can be used to simplify treatment planning. For example, a treatment plan can be stored as keyframe positions for each tooth. A keyframe is essentially an animation of the movement of a tooth from an initial stage position through all keyframe positions to a final stage position. Therefore, the treatment plan does not need to store positions for each stage. Defined positions can be at the initial, final, and one or more intermediate stages called keyframes. Tooth positions at stages that are not keyframes are inserted between two adjacent keyframes. Therefore, as described above, the staged, i.e., intermediate position of each tooth can be a linear combination of several function components. Each component describes the deviation from linear movement at a certain stage and is parameterized by six coordinate deviations and a stage number.

[0350] User-specific treatment preferences

[0351] The methods and apparatus described herein generally use treatment preferences to partially define an objective function (and therefore a merit function) and constraints, which are then used to automatically pre-compute one or more treatment plans. Each user (e.g., a dental professional) can use the same general treatment preferences when treating different patients. Customizing treatment plan generation (and display) for a user would be very helpful, especially when the same user may have many patients.

[0352] For example, it would be beneficial to automate personalized treatment planning for all users (e.g., dental professionals). This can be accomplished using a domain specific language that can be integrated into the methods and apparatus described herein. For example, the start of any treatment (including a patient consultation) can include a questionnaire or template that the user completes. A treatment planning optimization engine can use treatment templates described using a domain specific language in order to control the case processing flow to create treatments based on the user's individual needs.

[0353] There can be two sources of preferences of dental professionals regarding how to prepare treatment plans. One source of treatment preferences can essentially be structured input where, for a set of questions, the user provides answers where each answer is selected from a set of predetermined answers. The second source of information can be represented as text-based annotations that define the user's personal rules to be followed when preparing treatment plans for the practitioner. A domain-specific language can be used to store the user's unstructured input (e.g., text annotations describing their treatment preferences), which can enable full automation of treatment planning and aggregation of rules from multiple sources (e.g., structured preferences and unstructured treatment preferences).

[0354] Structured treatment preferences may only cover a small portion of a user's personal treatment plan. In contrast, many treatment plan details may be provided by the user in an unstructured text form. When setting up a treatment plan, technicians use both structured and unstructured treatment preferences. If this information is used manually, misunderstandings and inconsistent treatment plan quality may result when technicians apply text-based user preferences, and the resulting treatment plan may depend on the technician. As described herein, text-based annotations expressing a physician's treatment planning style may be converted (manually or automatically) into a domain-specific language, and a method or device (e.g., software) may interpret the domain-specific language to automatically apply the physician's preferences to treatment plan preparation.

[0355] From the user's perspective, the user fills out two sections describing their preferences for treatment style, for example on a website. One section may be represented as questions each with a predetermined set of answers, and the other section may be represented as a note in text form. The user may then save their preferences, and both types of preferences may then be applied to cases associated with the user (e.g., cases submitted by the user).

[0356] The user's text-based preferences can be converted into a domain-specific language that defines the clinical rules applied to the treatment plan in a formal manner that can also be interpreted by the treatment planning software. Initially, this can be performed manually or semi-automatically, and initially may include manual verification and checking (including verification with the user). However, once the domain-specific language is built for the user, it can be used without human intervention unless modified at the request of the user (e.g., as described herein, when displaying the resulting treatment plan). Each user can be associated with a rule file, which may be unique to the user and can be updated independently of other users.

[0357] When a user submits a case (e.g., requests a treatment plan), the user preferences expressed in a domain-specific language can be accessed from the stored database, aggregated with other user preferences (e.g., patient-specific goal preferences or other structured input provided by the user), and can be used to perform the fully automated treatment planning described above.

[0358] Fig. 27 A method for defining user-specific treatment preferences based on both structured and unstructured input is shown. Fig. 27 In, the method (or any device configured to perform this method, which may be a treatment plan optimization engine or treatment plan optimization generator) may first obtain a set of text instructions (e.g., non-script instructions) from a user (e.g., a dental professional, such as a dentist, orthodontist, etc.) 2701. These may be input or handwritten (and converted to machine-readable form) and then converted to a user-specific domain-specific language; this represents a first set of rules (treatment preferences). As described above, this step may first be performed semi-automatically or manually to build the domain-specific language. Once built, it may be fully automated 2705.

[0359] Simultaneously or sequentially, the method may obtain a set of scripted instructions from a user. The scripted instructions may include responses to a script from a predetermined selection (e.g., a survey, a questionnaire, etc.) 2703. The responses to the set of scripted instructions may be automatically converted into a second set of rules (treatment preferences) 2707. Thereafter, the method may include: accessing, by the automatic treatment planning engine, the first set of treatment preferences and the second set of treatment preferences, and forming a combined set of treatment preferences therefrom 2709. The automatic treatment planning engine may then access (e.g., receive, search, etc.) a digital model of the patient's teeth 2711, and any other inputs, a digital model of the patient's teeth, a comprehensive model of the patient's teeth, and / or treatment details (e.g., product details) 2713 required to automatically generate a treatment plan for the patient's teeth using the combined set of treatment preferences, as described above.

[0360] Fig.28Another example of this is shown. In this example, a treatment plan optimization engine or treatment plan optimization generator 2813 includes a rule aggregator 2815 that combines treatment preferences from user-specific treatment preferences stored in a database 2805 indexed by the user and converted into a first set of treatment rules via a domain-specific language, which can also be converted into rules via a domain-specific language 2819, with the user's patient-specific treatment preferences (specific to this case) 2811, which can be combined 2815 and then converted into treatment preferences using a language interpretation module 2817. The interpretation of these rules into treatment preferences may depend in part on the product (e.g., aligner features 2821) and can provide for determining staged 2823 and optimal stage (e.g., comprehensive) final position 2825.

[0361] Thus, a collection of rules can be expressed in a domain specific language and associated with each user in the clinical database. A module can convert structured input (e.g., answers given by a physician to a set of questions) into another set of rules. These rules can be combined by a rule aggregation module, which combines rules from multiple sources into a single rule list. A language interpretation module can take any of these rule files as input and interpret them to control the flow of the FiPos, Phasing, and Aligner feature modules to fully automatically create a treatment plan, as described above.

[0362] Automatic selection of treatment plans

[0363] The methods and apparatus described herein may provide multiple treatment plans and may allow a user (e.g., a dentist, orthodontist, dental professional) and / or in some variations a patient to view all or a subset of these treatment plans and select one or more treatment plans from which a series of dental appliances are to be manufactured. As described above, a very large number of treatment plans (e.g., 12, 18, 24, 30, 36, 40, 48, 50, 55, 60, 65, 70, 75, 100, 125, etc.) may be generated simultaneously. Therefore, it may be helpful to sort or organize the treatment plans, and in particular to determine the order in which treatment plans are displayed and / or how a user switches or selects between these different treatment plans.

[0364] In any of these variations, the treatment plans may be categorized or organized by assigning a weight to each treatment plan based on one or more criteria. For example, if 24 different treatment plans are generated, it would be helpful to automatically sort the treatment plans using one or more criteria and display them in that order. For example, the treatment plans may be sorted (weighted) and displayed based on how comprehensive they are. The degree of comprehensiveness may be based on, for example, how similar the predicted end position of the teeth is to the ideal end position (or arbitrary end position) of the patient's teeth, which was calculated as part of the process of generating the plurality of treatment plans, as described above.

[0365] In some variations, different categories of treatment plans may be displayed simultaneously, e.g., the most comprehensive treatment plans among treatment plans having a first characteristic (e.g., those limited to a first number of stages, such as 16 stages) may be displayed side by side with the most comprehensive treatment plans having a second characteristic (e.g., those limited to a second number of stages, such as 24 stages or unlimited stages). The methods and systems described herein may determine how comprehensive each treatment plan is by comparison to an ideal end position and / or by applying a ranking logic in which each of the one or more characteristics (also referred to herein as criteria) is used to determine a weight. For example, a treatment plan with interproximal removal (IPR) may be weighted more than a treatment plan without IPR; a treatment plan with extractions may be weighted higher; a treatment plan with all attachments (e.g., anterior and posterior) may be weighted higher than a plan with no attachments, plans with only anterior attachments may be ranked higher than those with only posterior attachments, treatment plans that include both upper and lower arches may be ranked higher than those with only one of the arches; upper arch only treatment plans may be ranked higher than lower arch only treatment plans, etc. Each of these features may provide a number of points (weights), and the final ranking may be determined by the sum of these points for each treatment plan.

[0366] In addition to or instead of sorting multiple treatment plans based on the comprehensiveness of each treatment plan, the methods and devices described herein can sort the treatment plans based on one or more alternative or additional criteria, such as: duration of the treatment plan, number of phases, amount of tooth movement achieved, etc. The criteria can be selected by the user or automatically. In some variations, the criteria can include, for example, a prediction of a user's preferences; the user's preferences can be determined by machine learning and can be specific to the user (e.g., based on the user's previous / past preferences or selections), or can be generic.

[0367] For example, in any of these variations, the system may select two categorized treatment plans for side-by-side (simultaneous) display; in some variations, displayed together with the original tooth positions and / or the calculated ideal tooth positions. As described above, the system may select the highest ranked treatment plan in two (or more) categories for simultaneous display. The ranked treatment plans may be displayed in an initial user interface screen, from which the user may then switch between other treatment plans using one or more controls on the user interface, as described herein. In some variations, the system selects the two most comprehensive treatment plans and displays them to the user in an initial display for user review (e.g., using a treatment review system or subsystem). The system may weight each treatment plan based on one or more criteria. For example, the system may weight each treatment plan based on attributes such as: IPR, use of attachments (and the type of attachments, and / or the number of attachments, and / or where the attachments are used), presence of a treatment plan or single or double arch treatment, etc. As described above, these criteria may also be used to select categories for simultaneous display. The device may classify the case and return the most comprehensive.

[0368] Fig.42 An example of a display is shown showing a side-by-side (simultaneous) display of categorized (using ranking criteria based on, for example, clinical efficiency versus comprehensiveness) treatment plans. In this example, a first display screen shows the final tooth positions for the plan with the highest ranking in each of two categories: a first product, "Invisalign GO Plus," and a second category, "Invisalign Go" products. A user can begin reviewing plans without having to spend time browsing through them and finding the best plan. Thus, the systems and methods can default to displaying the highest ranked treatment plans first, where the treatment plans are ranked as described herein. Fig.42, the left image 4201 shows the initial position of the patient's teeth. The right image can be an image of the final tooth position of the highest ranked treatment plan in the two categories. For example, the middle image 4203 can be the highest ranked treatment plan among those treatment plans that qualify as the first product ("Invisalign GO Plus", for example, limited to 12 or fewer stages). The right image 4205 can be the highest ranked treatment plan among those treatment plans that qualify as the second product (for example, the "Invisalign GO" product, limited to 20 or fewer stages). This display view can be referred to as a multi-card view. The display can also indicate features used as part of the calculations performed on each treatment plan, such as the use / type of attachments 4211, the use / non-use of IPRs 4201, the movement of the two dental arches 4213, the products used 4215, etc. The display can also indicate the number of stages in the treatment plan 4217. As described below, in some variations, these indicators can be selectable controls, such as drop-down menus, buttons, etc., which can allow the user to switch between treatment plans.

[0369] In practice, when one or more treatment plans are generated, the system can set how to rank the treatment plans for initial display, such as displaying them in multiple cards. For example, the system can view all or a subset of parameters used in calculating multiple different treatment plans, including but not limited to: information about IPR (e.g., using IPR / not using IPR); information about accessory sets (e.g., accessories: yes / accessories: posterior only / accessories: no); dental arches to be treated (single arch treatment / double arch treatment); treatment type ("Invisalign Go" / "Invisalign Go Plus"), etc.

[0370] In some variations, if only one product type is available to the practitioner, then by default only one treatment plan should be displayed in the multi-card view. Alternatively, in some variations, the multi-card display may be used to display single arch / two arch views or other parameters. For a single arch treatment submitted by a user, the most comprehensive single arch treatment plan may be selected and displayed in the multi-card view for each available product type.

[0371] As described above, each treatment plan generated can be ranked (e.g., scored). For example, Table 1 ( Fig.43A ) shows an example of a ranking of priorities, which can be used to select the most comprehensive single arch treatment plan within a treatment type to be displayed to the user. In this example, the lower the number, the higher the ranking (e.g., 1 is the highest priority and 11 is the lowest priority). Fig.43AThe simplified representation shows the relationship between two categories (IPR and Attachment) that can have two or more different states; other categories can be included, adding multiple dimensions. Fig.43B is a table showing another example of a ranking set for a two-arch treatment; the same categories apply. Thus, when determining the ranking score for each treatment plan, the system may use something like Figures 43A-43B (One or more) lookup tables of the table shown, or a scoring system could be applied where each parameter state could be assigned a specific number of "points" (note, however, that this could result in "ties" that could be allowed or reconciled using a second set of preferences).

[0372] In use Fig.43A and 43B In an example of scoring, when determining the initial display, the treatment plan with the lowest value score may be displayed. In variations where one or more options are not available to the user (e.g., only one product type is available to the physician, the user is unable / unwilling to provide an IPR, etc.), if a treatment plan is generated, the treatment plan may be scored lower or removed. In some cases, even if not selected by the user (e.g., if the user indicates "no IPR"), a treatment plan may still be generated that includes these options so that the user can directly compare the use / non-use of these options.

[0373] From the initial view, the user can select one or more treatment plans for side-by-side comparison with other selected treatment plans, and can control the options / criteria to begin viewing other (lower ranked) treatment plans. For example, the screen may include a "compare" or "save" control (e.g., a button) that can allow the user to store the case for analysis. In some variations, the control can be used to move the selected treatment plan to the side of the display (e.g., in some variations, replacing the initial view of the patient's teeth) so that it can be directly compared with the other treatment plans.

[0374] In addition to directly switching between options on the user interface, a control may be provided to allow the user to view the next ranked treatment plan (e.g., a button or other control on the user interface, etc.). For example, in a two-arch treatment scenario, selecting a "Compare" button in the multi-card view may be used to display the treatment plans that are scaled / ranked according to the above priorities (e.g., in Fig.43B For a single arch treatment situation, clicking the same control (e.g., the "Compare" button in a multi-card view) will compare the treatment plans according to the priorities described in both Tables 1 and 2 (e.g., Fig.43A and 43B) to select the next treatment plan. In one example, both treatment types are available to the user (e.g., Invisalign Go and Invisalign Go Plus), and then clicking the “Compare” button in the multi-card view, the system can compare the treatment plans for a single arch. Fig.43A and for two-arch treatments use, for example, Table 2 to select the most comprehensive treatment plan with product types not in this view. In some variations, if two treatment types are displayed, an "Invisalign Go Plus" plan may generate a treatment plan that may be displayed by default in a multi-card view (e.g., on the left). In some variations, an Invisalign Go treatment plan may be displayed by default on the right side of a multi-card view (e.g., if two treatment types are present).

[0375] Treatment Plan Filters

[0376] As described above, any of the methods and devices described herein can be configured to display one or more treatment plans, typically by showing one or more models of the patient's dental arch at one or more stages of the treatment plan and allowing the user to switch or convert between treatment plans by changing the parameters or constraints specified when generating the treatment plan. Thus, the user can select an appropriate treatment plan in real time by using filters, switches or switches for clinical parameters such as one or more of the following: interproximal removal (no IPR / no, IPR), attachments (all attachments, no attachments, anterior attachments only, posterior attachments only, etc.), etc. These controls may be referred to as clinical filters, and the user can use these clinical filters to select the most appropriate treatment plan for a particular patient to quickly compare treatment plans. The use of clinical filters can also allow the user to fine-tune the selected treatment plan. For example, in some variations, the user can use a filter to select another value for IPR or attachments, and then the modified treatment plan can be immediately submitted to generate a new series of modified treatment plans that can be viewed immediately or soon after.

[0377] Thus, by switching between treatment plans, the user can automatically and quickly navigate between multiple treatment plans by selecting key features that may affect the final position, such as the use and placement of accessories, IPR, treatment of one or both arches, etc. Each filter may display one or more notifications or prompts if a feature is not available for a particular case.

[0378] For example, Fig.44is a model of a multi-card view showing three panels. The first panel shows an image of the patient's current teeth (from the scanned 3D model) 4401. The middle panel shows an image 4403 of the patient's teeth from a first treatment plan (e.g., a treatment plan with 9 stages, using the constraints of the "Invisalign Go Plus" product, which has a limited number of stages allowed, in which no IPR is used, no accessories are used, and aligners are used on both dental arches). Similarly, the third panel shows an image 4405 of the patient's teeth from a second treatment plan (e.g., a treatment plan with 11 stages, using the constraints of the "Invisalign Go Plus" product, in which no IPR is used, but only posterior accessories are selected by the user using a control or filter (shown here as a button on the user interface that pulls up a drop-down menu allowing the user to specify which type of accessory to use (e.g., no accessory, yes accessory, or posterior only accessory)); Fig.44 , the user is about to select "Rear attachment only" to toggle the third card to show this change.

[0379] Typically, the display showing the initial malocclusion 4401 and the different treatment plans 4403 and 4405 may show a plan view or static view of the teeth based on the simulated movement of each treatment plan; alternatively, animation may be used to show the movement of the teeth between multiple treatment stages. In some variations, the stage shown may be the final stage (showing all movement); other stages may also be shown. In some variations, the 3D model showing the tooth positions may be rotated (or may automatically rotate) to show different angles.

[0380] As described above, a filter can indicate one or more notifications or prompts if a feature is not available for a particular case. For example, Fig.45 Shows something like Fig.44 4504. A display is shown showing a side-by-side comparison of the original tooth positions and two treatment plans. In this example, although the display includes an indicator / control for the number of arches (e.g., two arches, single arch), only treatment plans with a single arch have been generated, so if the user attempts to switch to view the "single arch" treatment plan, as shown in the middle image, a notification 4505 may be provided indicating that only dual treatments are available. In some variations, the indicator may be grayed out, preventing it from being selected.

[0381] Typically, any of these displays may also include an indication of the cost or price associated with the treatment plan. For example, one of the filters may allow the doctor to compare two different product types with different prices. The higher priced product may have, for example, more stages of treatment and a wider range of clinical conditions. Thus, in any of these examples, the doctor may use filters to provide an overview of what treatment (e.g., what treatment outcome) may be best for the patient, and for a specific patient, as described above, it may be automatically suggested by the system. In some variations, the doctor may use these filters to examine specific clinical feature usage (e.g., comparing a plan with an IPR to another plan without an IPR, etc.) and compare the results. The use of filters may also allow the user to view the clinical details of the selected plan.

[0382] like Fig.46 As shown, filters can also be applied when reviewing a single plan in more detail. This view may be referred to as a "single treatment plan" view (STP view). Fig.44 and Fig.45 The view shown may be referred to as a "multiple treatment plan view" (MTP view). Fig.46 In the example shown, the same controls may be included (e.g., configured as filters); in addition, the user may select which stages 4603 to review or animate between them. In addition, the user interface may include one or more controls 4613 for modifying the treatment plan. For example, the user may select "Modify" and may use tools to add / remove attachments 4607 and / or bridges, move attachments, indicate IPRs 4605, etc. Finally, if the treatment plan looks good, the user may indicate approval 4615.

[0383] Typically, the user can also switch between multiple treatment plan views and a single treatment plan view. For example, Fig.47 Another example of a multiple treatment plan view similar to the above is shown, showing a side-by-side comparison between two (or more) treatment plans and the patient's original dental configuration ("initial malocclusion"). The MTP view can display important high-level information about the expected results of multiple alternative treatments and the initial malocclusion. Conversely, the STP view can show how the selected treatment plan will be achieved. Switching between these different views can help the user verify the selected plan and maximize to the full screen. In Fig.47 , the user can select one of the displayed treatment plans by activating a control (shown as buttons 4705, 4705' labeled "View" on the user interface). To open a single treatment plan view (also referred to herein as a single card view) from multiple cards (multiple treatment plan views), the user can select the control, such as Fig.47This opens a single treatment plan view for that treatment plan, such as Fig.48 The STP may include features not found in the MPT display, such as: playback staging, free-form commentary, editing / modification of treatment plans, etc. The user may also switch back to the multi-view by, for example, selecting the MTP control 4805 or "Back".

[0384] A single treatment plan display (eg, user interface) may allow a user to view the stages, features available at each stage of treatment, and the positions of the teeth at each stage. Fig.49 As shown, in some variations, the STP view may allow the user to approve the selected plan and send it for manufacturing or add free-form comments 4905, request that the manufacturing technician modify (e.g., improve or change) anything in the treatment plan, and send the treatment plan back to the technician for a treatment plan update 4907, which may be performed manually, automatically, or semi-automatically. In some variations, the user may view the details of any plan in the MTP view by clicking a "view" control (e.g., a button). In some variations, the STP view may allow the physician to view detailed staged information at the bottom of the screen, such as: treatment lengths for the upper and lower arches, which type of aligner (active or passive) will be manufactured for each stage, the overcorrection stage for treatment (if any), animated controls to play / pause treatment animations, etc.

[0385] In any of these views, tools (e.g., on a toolbar) are available to allow the user to view and / or modify features (attachments, IPRs, bridges, etc.) related to any phase, as described above with reference to Fig.46 For example, a user may click an "Approve" control (e.g., button) to send the selected treatment plan directly to manufacturing. Alternatively, clicking an "Edit" control (e.g., button) may add / edit free-form comments and send the case to the technician for updates after initiating a "Submit" control 4907.

[0386] Any method described herein (including user interface) may be implemented as software, hardware, or firmware, and may be described as a non-transitory computer-readable storage medium storing a set of instructions that can be executed by a processor (e.g., a computer, tablet, smartphone, etc.), which, when executed by the processor, causes the processor to control the execution of any of the following steps, including but not limited to: displaying, communicating with a user, analyzing, modifying parameters (including timing, frequency, intensity, etc.), determining, issuing an alarm, etc.

[0387] When a feature or element is referred to as "on" another feature or element in this article, it can be directly located on the other feature or element, and / or there may also be intermediate features and / or elements. On the contrary, when a feature or element is referred to as "directly on" another feature or element, there is no intermediate feature or element. It should also be understood that when a feature or element is referred to as "connected", "attached" or "coupled" to another feature or element, it can be directly connected, attached or coupled to the other feature or element, or there may be intermediate features or elements. On the contrary, when a feature or element is referred to as "directly connected", "directly attached" or "directly coupled" to another feature or element, there is no intermediate feature or element. Although described or shown relative to an embodiment, the features and elements described or shown in this way can be applied to other embodiments. Those skilled in the art will also recognize that the reference to the structure or feature set for "adjacent" another feature can have a part overlapping with adjacent features or located below adjacent features.

[0388] The terms used herein are only used for the purpose of describing specific embodiments and are not intended to limit the present invention. For example, unless the context clearly indicates, as used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well. It should be further understood that the terms "comprises" and / or "comprising" when used in this specification specify the presence of stated features, steps, operations, elements and / or components, but do not exclude the presence or addition of one or more other features, steps, operations, elements, components and / or groups thereof. As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items and may be abbreviated as " / ".

[0389] For ease of description, spatially related terms such as "under", "below", "lower", "over", and "upper" may be used herein to describe the relationship between an element or feature and another (or multiple) element or feature as shown in the accompanying drawings. It will be understood that spatially related terms are intended to include different orientations of the device in use or operation in addition to the orientation depicted in the accompanying drawings. For example, if the device in the accompanying drawings is inverted, the element described as "under" or "beneath" of other elements or features will be oriented to be "over" other elements or features. Therefore, the exemplary term "under" may include both the above and below orientations. The device may be oriented otherwise (rotated 90 degrees or in other orientations), and the spatially relative descriptors used herein are interpreted accordingly. Similarly, unless otherwise specifically stated, the terms "upwardly", "downwardly", "vertical", "horizontal", etc. are used herein for illustrative purposes only.

[0390] Although the terms "first" and "second" may be used herein to describe various features / elements (including steps), these features / elements should not be limited by these terms unless the context indicates otherwise. These terms may be used to distinguish one feature / element from another feature / element. Therefore, without departing from the teachings of the present invention, the first feature / element discussed below may be referred to as the second feature / element, and similarly, the second feature element discussed below may be referred to as the first feature / element.

[0391] In this specification and the appended claims, unless the context requires otherwise, the word "comprise" and variations such as "comprises" and "comprising" mean that various components can be used together in methods and articles (e.g., compositions and devices including apparatus and methods). For example, the term "comprising" will be understood to imply the inclusion of any stated elements or steps but not the exclusion of any other elements or steps.

[0392] In general, any apparatus and method described herein should be understood to be inclusive, but all or a subset of components and / or steps may optionally be exclusive and may be expressed as "consisting of." or alternatively "consisting essentially of" the various components, steps, subcomponents or sub-steps.

[0393] As used herein in the specification and claims, including in the examples, unless otherwise expressly stated, all numbers may be understood as if preceded by the word "about" or "approximately", even if the term does not explicitly appear. The phrase "about" or "approximately" may be used when describing an amplitude and / or position to indicate that the value and / or position described is within a reasonably expected range of values ​​and / or positions. For example, a numerical value may have a value of + / -0.1% of the value (or range of values), + / -1% of the value (or range of values), + / -2% of the value (or range of values), + / -5% of the value (or range of values), + / -10% of the value (or range of values), etc. Any numerical value given herein should also be understood to include about that value or approximately that value, unless the context indicates otherwise. For example, if the value "10" is disclosed, "about 10" is also disclosed. Any numerical range recited herein is intended to include all subranges contained therein. It should also be understood that when a value is disclosed, "less than or equal to" the value, "greater than or equal to the value," and possible ranges between values ​​are also disclosed, as appropriately understood by those skilled in the art. For example, if a value "X" is disclosed, "less than or equal to X" and "greater than or equal to X" (e.g., where X is a numerical value) are also disclosed. It should also be understood that throughout the application, data is provided in a variety of different formats, and that the data represents end points and starting points and ranges for any combination of data points. For example, if a specific data point "10" and a specific data point "15" are disclosed, it should be understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15, and between 10 and 15 are considered disclosed. It should also be understood that every unit between two specific units is also disclosed. For example, if 10 and 15 are disclosed, 11, 12, 13, and 14 are also disclosed.

[0394] Although various illustrative embodiments are described above, any of several changes may be made to the various embodiments without departing from the scope of the invention as described in the claims. For example, in optional embodiments, the order in which the various described method steps are performed may generally be changed, and in other optional embodiments, one or more method steps may be skipped altogether. Optional features of the various device and system embodiments may be included in some embodiments and not included in other embodiments. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be construed as limiting the scope of the present disclosure as set forth in the claims.

[0395] The examples and descriptions included herein show specific embodiments in which the subject matter can be practiced by way of illustration and not limitation. As mentioned, other embodiments can be utilized and derived therefrom, so that structural and logical replacements and changes can be made without departing from the scope of the present disclosure. Only for convenience, the term "invention" can be used herein individually or collectively to refer to these embodiments of the subject matter of the present invention, and it is not intended that the scope of the present application is actively limited to any single invention or inventive concept, if in fact more than one invention or inventive concept is disclosed. Therefore, although specific embodiments have been illustrated and described herein, it is expected that any arrangement for achieving the same purpose can replace the specific embodiments shown. The present disclosure is intended to cover any and all modifications or variations of various embodiments. By reading the above description, the combination of the above embodiments and other embodiments not specifically described herein will be apparent to those skilled in the art.

Claims

1. An automated method of creating a treatment plan for aligning a patient's teeth using a plurality of removable aligners to be worn in sequential stages, the method comprising: receiving, in a processor, a digital model of the patient's teeth; accessing, by the processor, a set of treatment preferences, an overall final position of the patient's teeth, and a set of treatment details; selecting a plurality of numerically represented treatment goals from a memory accessible to the processor based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; combining the plurality of numerically represented treatment objectives to form a single numerical function; selecting a plurality of numerical constraints on the single numerical function based on a set of treatment preferences; minimizing the single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages of forming a treatment plan; as well as The solution vector is mapped to a treatment plan, wherein the treatment plan includes a final tooth position that is different than an overall final position of the patient's teeth.

2. An automated method of creating a treatment plan for aligning a patient's teeth using a plurality of removable aligners to be worn in sequential stages, the method comprising: receiving, in a processor, a digital model of the patient's teeth; accessing, by the processor, a set of treatment preferences, an overall final position of the patient's teeth, and a set of treatment details; selecting a plurality of numerically represented treatment goals from a memory accessible to the processor based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; adjusting the plurality of numerically represented treatment goals into a plurality of adjusted numerically represented treatment goals based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; combining the plurality of adjusted numerical representations of the treatment goals to form a single numerical function; setting a plurality of numerical limits on the single numerical function based on the set of treatment preferences; iteratively minimizing the single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages of forming a treatment plan; as well as The solution vector is mapped to a treatment plan, wherein the treatment plan includes a final tooth position that is different than an overall final position of the patient's teeth.

3. A non-transitory computer readable medium containing program instructions for creating a treatment plan to align a patient's teeth using a plurality of removable aligners, the method program instructions causing a processor to: receiving, in the processor, a digital model of the patient's teeth; accessing, by the processor, a set of treatment preferences, an overall final position of the patient's teeth, and a set of treatment details; selecting a plurality of numerically represented treatment goals from a memory accessible to the processor based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; combining the plurality of numerically represented treatment objectives to form a single numerical function; selecting a plurality of numerical constraints on the single numerical function based on a set of treatment preferences; minimizing the single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages of forming a treatment plan; as well as The solution vector is mapped to a treatment plan, wherein the treatment plan includes a final tooth position that is different than an overall final position of the patient's teeth.

4. An automated method of creating multiple variations of a treatment plan for aligning a patient's teeth using a plurality of removable aligners to be worn in sequential stages, the method comprising: (a) specifying a set of treatment preferences and a set of treatment details; (b) automatically determining a treatment plan based on the specified treatment preferences and treatment details by: receiving a digital model of the patient's teeth in a processor; Access a collection of treatment preferences, the comprehensive final position of the patient's teeth, and a collection of treatment details; selecting a plurality of numerically represented treatment goals from a memory accessible to the processor based on the set of treatment details, the set of treatment preferences, and the overall final position of the patient's teeth; combining the plurality of numerically represented treatment objectives to form a single numerical function; Selecting multiple numerical restrictions on a single numerical function based on a set of treatment preferences; minimizing a single numerical function subject to the plurality of numerical constraints to obtain a solution vector including all stages of forming a treatment plan; as well as mapping the solution vector to a treatment plan, wherein the treatment plan includes a final tooth position that is different than an overall final position of the patient's teeth; (c) adding the treatment plan to an array of treatment plans; and (d) modifying one or more of the treatment details or treatment preferences, and repeating steps (b)-(d) at least once.

5. An automated and customized method of creating an orthodontic treatment plan for a patient's teeth for a designated dental professional, the method comprising: In a treatment plan optimization engine, receiving a set of combined treatment preferences specific to a specified dental professional, wherein the set of combined treatment preferences includes a first set of rules and a second set of rules, the first set of rules being converted from a set of text instructions from the specified dental professional into a domain specific language specific to the specified dental professional, further wherein the text instructions include non-scripted instructions and the second set of rules being converted from a set of scripted instructions from the specified dental professional, wherein the scripted instructions include scripted responses from predetermined options; receiving a digital model of the patient's teeth in a treatment planning optimization engine; and A treatment plan for the patient's teeth is generated using the combined set of treatment preferences and the digital model of the patient's teeth using a treatment plan optimization engine.

6. An automated and customized method of creating an orthodontic treatment plan for a patient's teeth for a designated dental professional, the method comprising: In a processor, receiving a set of scripted instructions from a designated dental professional, wherein the scripted instructions include scripted responses from predetermined options; receiving, in a processor, a set of text instructions from a designated dental professional, wherein the text instructions include non-script instructions; converting the set of text instructions into a domain specific language specific to the designated dental professional, wherein the domain specific language comprises a first set of rules; converting the set of script instructions into a second set of rules; combining the first set of rules and the second set of rules into a set of combined treatment preferences; and The set of combined treatment preferences is passed to a treatment plan optimization engine, where the treatment plan optimization engine generates a treatment plan using the combined treatment preferences.

7. A non-transitory computer-readable storage medium having computer-executable instructions stored thereon, which, when executed by a computer, cause the computer to automatically create an orthodontic treatment plan for a patient's teeth customized for a designated dental professional by: In a treatment plan optimization engine, a set of treatment preferences specific to a specified combination of dental professionals is received, wherein: the combined set of treatment preferences comprises a first set of rules and a second set of rules, the first set of rules being converted from a set of text instructions from a designated dental professional into a domain specific language specific to the designated dental professional, further wherein the text instructions comprise non-scripted instructions and the second set of rules being converted from a set of scripted instructions from the designated dental professional, wherein the scripted instructions comprise responses from a script of predetermined options; receiving a digital model of the patient's teeth in a treatment planning optimization engine; and A treatment plan for the patient's teeth is generated using the combined set of treatment preferences and the digital model of the patient's teeth using a treatment plan optimization engine.

8. A method for automatically creating an orthodontic treatment plan for a patient, the method comprising: forming a digital model of a surface of each tooth of a plurality of teeth of the patient by packing a plurality of 3D shapes to model the surface of each tooth, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, the outer surface having a constant radius from the core; For a surface of each of a plurality of teeth of the patient, forming a hierarchy of bounding boxes surrounding the plurality of 3D shapes; passing a set of tooth positions for a plurality of teeth of a patient from a treatment plan solver to a collision detector; determining, using a collision detector, a magnitude and velocity of collisions between adjacent teeth when the plurality of teeth of the patient are in a set of tooth positions by identifying bounding boxes of collision and determining a separation or overlap between 3D shapes defined by the bounding boxes of collision; and transmitting the magnitude and velocity of collisions between adjacent teeth corresponding to the set of tooth positions to a treatment planning solver; One or more orthodontic treatment plans are output from the treatment plan solver, the one or more orthodontic treatment plans comprising a series of dental appliances for moving the patient's teeth.

9. A method for automatically creating an orthodontic treatment plan for a patient, the method comprising: collecting a digital representation of a plurality of teeth of a patient, wherein each tooth of the digital representation is segmented; forming a digital model of the surface of each tooth of the digital representation by packing a plurality of 3D shapes to approximate the surface of each tooth of the digital representation, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, the outer surface having a constant radius from the core; for each digital model of the surface of each tooth, forming a hierarchy of bounding boxes surrounding the plurality of 3D shapes, wherein, for each digital model of the surface of each tooth, each of the bounding boxes at a lowest level of the hierarchy surrounds a single 3D shape, each of the subsequent levels of the hierarchy surrounds an adjacent bounding box or group of bounding boxes, and a highest level of the hierarchy surrounds all of the bounding boxes surrounding the 3D shapes forming the digital model of the surface of each tooth; passing a set of tooth positions for a plurality of teeth of a patient from a treatment plan solver to a collision detector; Measuring, in a collision detector, a magnitude and a velocity of a collision between adjacent teeth when a plurality of teeth of a patient are in a set of tooth positions by: identifying a bounding box of the collision at a lowest level of a hierarchy of each of the adjacent teeth, determining a spacing or overlap between 3D shapes defined by the bounding box to obtain a magnitude of the collision, and sequentially adjusting a position of a first tooth of the adjacent teeth by a small predetermined amount on each of a plurality of axes of the first tooth and determining a change in the spacing or overlap between the 3D shapes defined by the bounding box to obtain a velocity of the collision for each of the corresponding axes; and outputting to a solver the magnitude and velocity of collisions between adjacent teeth corresponding to the set of tooth positions; One or more orthodontic treatment plans are output from the solver, the one or more orthodontic treatment plans comprising a series of dental appliances for moving the patient's teeth.

10. A system for automatically creating an orthodontic treatment plan for a patient, the system comprising: one or more processors; a treatment plan solver, running on the one or more processors; a collision detector, running on the one or more processors; as well as a memory coupled to the one or more processors, the memory being configured to store computer program instructions that, when executed by the one or more processors, perform a computer-implemented method comprising: forming a digital model of a surface of each of the plurality of teeth of the patient by packing a plurality of 3D shapes to approximate the surface of each of the plurality of teeth of the patient, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, the outer surface having a constant radius from the core; For a surface of each of a plurality of teeth of the patient, forming a hierarchy of bounding boxes surrounding the plurality of 3D shapes; passing a set of tooth positions for a plurality of teeth of a patient from a treatment plan solver to a collision detector; determining, using a collision detector, a magnitude and velocity of collisions between adjacent teeth when the plurality of teeth of the patient are in a set of tooth positions by identifying bounding boxes of collision and determining a separation or overlap between 3D shapes defined by the bounding boxes of collision; and transmitting the magnitude and velocity of collisions between adjacent teeth corresponding to the set of tooth positions to a treatment planning solver; One or more orthodontic treatment plans are output from the treatment plan solver, the one or more orthodontic treatment plans comprising a series of dental appliances for moving the patient's teeth.

11. A method for automatically determining collisions between adjacent teeth, the method comprising: forming a digital model of a surface of each of the plurality of teeth of the patient by automatically packing a plurality of 3D shapes to approximate the surface of each of the plurality of teeth of the patient, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, the outer surface having a constant radius from the core; For the digital model of the surface of each tooth, forming a hierarchy of bounding boxes surrounding the plurality of 3D shapes; measuring, in a collision detector, a magnitude and velocity of collisions between adjacent teeth of a patient when the plurality of teeth are in a set of tooth positions by identifying bounding boxes of collision and determining a separation or overlap between 3D shapes defined by the bounding boxes of collision; and The magnitude and speed of collisions between adjacent teeth corresponding to the set of tooth positions are output.

12. A system for automatically detecting collisions between teeth, the system comprising: one or more processors; as well as a memory coupled to the one or more processors, the memory being configured to store computer program instructions that, when executed by the one or more processors, perform a computer-implemented method comprising: forming a digital model of a surface of each of the plurality of teeth of the patient by automatically packing a plurality of 3D shapes to approximate the surface of each of the plurality of teeth of the patient, wherein each 3D shape has a core and an outer surface, the core being a line segment or a closed planar figure, the outer surface having a constant radius from the core; For the digital model of the surface of each tooth, forming a hierarchy of bounding boxes surrounding the plurality of 3D shapes; measuring in a collision detector the magnitude and velocity of collisions between adjacent teeth of a patient when the plurality of teeth are in a set of tooth positions by identifying bounding boxes of collision and determining separation or overlap between 3D shapes defined by the bounding boxes of collision: and The magnitude and speed of collisions between adjacent teeth corresponding to the set of tooth positions are output.

13. A method of manufacturing a series of aligners for use with teeth of a patient, the method comprising: Sending a model of the patient's teeth to a remote site; sending a list of tooth movement prescription information to a remote site; collecting a plurality of treatment plans specific to the patient's teeth using the desired final positions of the patient's teeth and a model of the patient's teeth, wherein each treatment plan of the plurality of treatment plans describes a set of sequential stages for orthodontic movement of the patient's teeth, the set of sequential stages having a final stage, and further wherein, for each treatment plan, the final stage is different from the desired final position for each different treatment characteristic of the patient's teeth; ranking the plurality of treatment plans based on how well they compare to the ideal final position; and displaying on a screen an image of the patient's teeth at a final stage of a first treatment plan from the array of treatment plans or an image of the patient's teeth at a final stage of a first treatment plan and a second treatment plan from the array of treatment plans; switching in real time between images of the tooth at final stages of different treatment plans within the array of treatment plans based on one or more user-selected controls on the screen; and After the user has selected a selected treatment plan among the treatment plans displayed on the screen, the selected treatment plan among the treatment plans is sent for production.

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