Mandibular repositioning device, occlusal block and system, orthodontic treatment system and method

Abstract

An apparatus for mandibular repositioning, the apparatus comprising: a first appliance comprising a first engagement structure, the first engagement structure comprising a first engagement surface, the first engagement surface generally facing forward and inclined relative to a first centerline of the first engagement structure; and a second brace comprising a second engagement structure, the second engagement structure comprising a second engagement surface, the second engagement surface generally facing rearward and inclined relative to a midline of the second engagement structure; wherein one or more of the first engagement surface or the second engagement surface is curved to form a joint line in a lingual-cheek direction in the event of engagement between the first engagement surface and the second engagement surface.

Description

[0001] This application is a divisional application of the application whose applicant is "Alleyne Technology Co., Ltd.", whose application date is December 8, 2020, whose application number is 202080085500.3, and whose invention name is "Bite block design for lateral locking". Background Art

[0002] The present disclosure relates generally to treatment of malocclusion using oral appliances, such as devices for mandibular repositioning and methods of use.

[0003] Dental treatment can involve a procedure for repositioning misaligned teeth and changing the bite configuration to improve the aesthetic appearance and / or dental function. For example, repositioning can be achieved by applying a controlled force to one or more teeth over a period of time.

[0004] As an example, orthodontic repositioning can be provided through a dental procedure using positioning braces for repositioning teeth. The braces can utilize a thin shell of material with elastic properties, called an "appliance," which generally conforms to the patient's teeth and applies tooth repositioning forces to gradually reposition the patient's teeth.

[0005] Such an appliance placed on the teeth can provide controlled forces in specific locations to gradually move the teeth to a new configuration. Repeating this process with successive appliances in a progressive configuration can move the teeth through a series of intermediate arrangements toward a final arrangement.

[0006] Such systems typically utilize lightweight and / or transparent materials to provide a set of aligners that can be used sequentially in multiple stages so that as the teeth move in response to treatment, new aligners for the new treatment state can be implemented to further move the teeth without having to take new impressions of the patient's teeth at each increment of tooth movement in order to manufacture successive aligners.

[0007] In various situations, the teeth of a patient's upper jaw and the teeth of the patient's lower jaw may contact in an incorrect or undesirable manner (e.g., crowding, crossbite, deep bite). Proper fit of the occlusal surfaces of the teeth facilitates proper bite and chewing and is ideal for an aesthetic appearance. Otherwise, the patient may experience premature wear of the teeth, undesirable flexion of the teeth, and / or undesirable forces on the dental restoration. For example, proper fit may vary with the relative position of the teeth to the mandible and maxilla, either of which may retract or protrude relative to the ideal position. The maxilla (e.g., upper jaw) is a bone fixed to the skull. The mandible (e.g., lower jaw) is a bone attached to the skull by many muscles that direct its movement. The mandible is connected to the temporal bone at its posterior upward end to form the jaw joint. The jaw joint is a loosely connected joint that accommodates various movements of the mandible relative to the maxilla during biting and chewing movements. The many muscles that attach the mandible to the skull control and drive the complex movements involved in biting and chewing. Because the condylar relationship provides some flexibility in the positioning of the jaw, the jaw can be intentionally repositioned, for example, by using an oral appliance, depending on the fit of the teeth.

[0008] Existing methods of mandibular repositioning may be less than ideal in at least some respects. For example, at least some of the existing devices that extend between the teeth or to the sides of the teeth may be slightly larger than ideal and less comfortable for the patient. For example, oral appliances that rely on jaw closure to reposition the mandible may less than allow for ideal jaw closure. Moreover, work related to the present disclosure has shown that the contact surfaces of existing oral appliances may be less than ideally suited to accommodate variability in the patient's mouth. Existing structures that rely on transferring force between the maxilla and mandible to reposition the mandible can provide a degree of indirect force that can be associated with undesirable mandibular movement. Moreover, the manufacture of at least some of the existing oral appliances used for mandibular repositioning may be slightly more complicated in design and manufacture than is ideal.

[0009] In view of the foregoing, it would be helpful to have an improved mandibular repositioning device that overcomes at least some of the above-mentioned limitations of existing devices. Summary of the invention

[0010] According to a first aspect of the present application, a device for mandibular repositioning is provided, the device comprising: a first corrector, the first corrector comprising a first engagement structure, the first engagement structure comprising a first engagement surface, the first engagement surface generally facing forward and inclined relative to a first midline of the first engagement structure; and a second corrector, the second corrector comprising a second engagement structure, the second engagement structure comprising a second engagement surface, the second engagement surface generally facing backward and inclined relative to the midline of the second engagement structure; wherein one or more of the first engagement surface or the second engagement surface is curved to form an engagement line in the tongue-buccal direction when the first engagement surface is engaged with the second engagement surface.

[0011] According to a second aspect of the present application, a device for mandibular repositioning is provided, the device comprising: a first corrector, the first corrector comprising: a first plurality of tooth receiving cavities, a first engaging structure, the first engaging structure comprising a first engaging surface, and a second engaging structure, the second engaging structure comprising a second engaging surface; and a second corrector, the second corrector comprising: a second plurality of tooth receiving cavities, a third engaging structure, the third engaging structure comprising a third engaging surface for engaging with the first engaging surface, and a fourth engaging structure, the fourth engaging structure comprising a fourth engaging surface for engaging with the second engaging surface; wherein the first engaging surface and the second engaging surface are inclined relative to the third engaging surface and the fourth engaging surface, respectively, to generate a mandibular repositioning force and limit lateral movement of the mandible.

[0012] According to a third aspect of the present application, a plurality of bite blocks for mandibular repositioning are provided, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engaging surface and a first side surface; a first keyway, the first keyway being formed in the first side surface of the first bite block; a second bite block, the second bite block comprising a second side surface and a second engaging surface for engaging with the first engaging surface; and a second keyway, the second keyway being formed in the second side surface of the first bite block.

[0013] According to the fourth aspect of the present application, an orthodontic treatment system is provided, which includes: multiple groups of orthodontic braces, each of the multiple groups of orthodontic braces has: a first brace, the first brace includes: a first plurality of tooth receiving cavities, a first bonding structure, the first bonding structure includes a first bonding surface, and a second bonding structure, the second bonding structure includes a second bonding surface; and a second brace, the second brace includes: a second plurality of tooth receiving cavities, a third bonding structure, the third bonding structure includes a third bonding surface for bonding with the first bonding surface, and a fourth bonding structure, the fourth bonding structure includes a fourth bonding surface for bonding with the second bonding surface, wherein the first bonding surface and the second bonding surface are inclined relative to the third bonding surface and the fourth bonding surface, respectively, to generate a mandibular repositioning force and limit lateral movement of the mandible.

[0014] According to a fifth aspect of the present application, a plurality of bite blocks for mandibular repositioning are provided, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engaging surface and a first side surface; a first undercut, the first undercut being formed in the first side surface of the first bite block; a first keyway, the first keyway being formed in the first side surface of the first bite block; a second bite block, the second bite block comprising a second side surface and a second engaging surface for engaging with the first engaging surface; and a second keyway, the second keyway being formed in the second side surface of the second bite block.

[0015] According to the sixth aspect of the present application, a system is provided, comprising: a plurality of first orthodontic appliances and a plurality of second orthodontic appliances for multiple treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity, the tooth receiving cavity being used to gradually reposition the patient's teeth from an initial position toward a final position; the plurality of first orthodontic appliances having: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut, the first undercut being formed in the first side surface of the first bite block; a first keyway, the first keyway being formed in the first side surface of the first bite block; the plurality of second orthodontic appliances having: a second bite block, the second bite block comprising a second side surface and a second engagement surface for engaging with the first engagement surface; and a second keyway, the second keyway being formed in the second side surface of the second bite block.

[0016] According to the seventh aspect of the present application, a bite block system for mandibular repositioning is provided, the bite block system comprising: a first bite block, the first bite block comprising an occlusal surface, a first engagement surface configured to engage with a surface of a second bite block, a lingual surface, and a buccal surface; a first undercut, the first undercut is formed in the lingual surface of the first bite block and extends from the base of the first bite block toward the occlusal surface of the first bite block at a first draft angle; a second undercut, the second undercut is formed in the buccal surface of the first bite block and extends from the base of the first bite block toward the occlusal surface of the first bite block at a second draft angle.

[0017] According to the eighth aspect of the present application, a system is provided, comprising: a plurality of first orthodontic appliances and a plurality of second orthodontic appliances for multiple treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity, the tooth receiving cavity being used to gradually reposition the patient's teeth from an initial position toward a final position; the plurality of first orthodontic appliances having: a first bite block, the first bite block comprising an occlusal surface, a first engagement surface configured to engage with a surface of a second bite block on the plurality of second orthodontic appliances, a lingual surface, and a buccal surface; a first undercut, the first undercut being formed in the lingual surface of the first bite block and extending from the base of the first bite block toward the occlusal surface of the first bite block at a first draft angle; a second undercut, the second undercut being formed in the buccal surface of the first bite block and extending from the base of the first bite block toward the occlusal surface of the first bite block at a second draft angle.

[0018] According to the ninth aspect of the present application, a plurality of bite blocks for mandibular repositioning are provided, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut, the first undercut being formed in the first side surface of the first bite block; a second bite block, the second bite block comprising a second side surface and a second engagement surface for engaging with the first engagement surface; and a second undercut, the second undercut being formed in the second side surface of the second bite block.

[0019] According to the tenth aspect of the present application, a system is provided, comprising: a plurality of first orthodontic appliances and a plurality of second orthodontic appliances for multiple treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity, the tooth receiving cavity being used to gradually reposition the patient's teeth from an initial position toward a final position, wherein the plurality of first orthodontic appliances have any combination of the bite blocks as described above.

[0020] According to an eleventh aspect of the present application, a method is provided, the method comprising: using the aforementioned plurality of bite blocks, systems, devices, or correctors.

[0021] According to the twelfth aspect of the present application, a system is provided, comprising: a plurality of orthodontic appliances, each of the plurality of orthodontic appliances having: a tooth receiving cavity for gradually repositioning the patient's teeth from an initial position toward a final position; and a coupling structure for gradually repositioning the patient's mandible, and comprising a bite block as described above.

[0022] Embodiments of the present disclosure provide an improved oral appliance for mandibular repositioning, which has an improved engagement that can allow improved jaw closure, less undesired jaw movement, and reduced complexity. In some embodiments, the first and second appliances of the first treatment stage include engagement surfaces that provide a mandibular repositioning force and a force that limits lateral movement of the jaw, such as relatively inclined surfaces on opposite sides of the mouth. In some embodiments, the engagement surfaces between the oral appliances include a curvature difference that allows engagement at different angles and positions. Because the engagement surfaces can be engaged at various angles relative to each other, the curvature difference can also facilitate the design and manufacture of the oral appliance. In some embodiments, the engagement between the first and second appliances occurs at an engagement site that can change across the engagement surface when the jaws are pulled toward each other, which can provide more continuous movement and changes in the mandibular repositioning force when the jaws are pulled toward each other. Moreover, the curvature difference can allow the engagement structure to have a reduced height within the patient's mouth, which can provide a more direct engagement between the patient's upper and lower jaws.

[0023] In some embodiments, the first and second appliances include a plurality of replicated bite blocks, which can facilitate the design and manufacture of oral appliances. The plurality of replicated bite blocks can include a curvature difference that allows the replicated blocks to engage with each other at various angles to accommodate individual variability in a patient's mouth, such as variability associated with the Curve of Spee. In some embodiments, each of the plurality of replicated bite blocks includes a curvature difference across an engagement surface, which allows the bite blocks to engage with each other when in a flipped orientation. The plurality of replicated bite blocks can be placed at multiple locations on the appliance to engage with each other, which can facilitate design and manufacture at multiple locations. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] A better understanding of the features, advantages, and principles of the present disclosure will be obtained by referring to the following detailed description and accompanying drawings which set forth illustrative embodiments, in which:

[0025] Figure 1An oral appliance and engagement structure are shown according to some embodiments;

[0026] Figure 2A illustrates a pair of engagement structures associated with an upper dental appliance according to some embodiments;

[0027] Figure 2B illustrates a pair of engagement structures associated with a lower dental appliance according to some embodiments;

[0028] Figure 2C A schematic diagram illustrating example relative positioning of an upper engagement structure and a lower engagement structure according to some embodiments;

[0029] Figure 3 A pair of engagement structures for repositioning the mandible and reducing lateral movement according to some embodiments is shown;

[0030] Figure 4A A pair of engagement structures for repositioning a mandible is shown, wherein a gap is formed between the teeth and the engagement structures, according to some embodiments;

[0031] Figure 4B A pair of engagement structures for repositioning a mandible using curved engagement surfaces to allow the engagement structures to follow the Spee curve while providing an engagement site is shown in accordance with some embodiments;

[0032] Figure 5 illustrates a pair of engagement structures associated with an upper aligner and a lower aligner according to some embodiments;

[0033] Figure 6 illustrates a pair of engagement structures associated with an upper aligner and a lower aligner utilizing a keyed positioning system according to some embodiments;

[0034] Figure 7 shows an engagement structure having a geometry that allows it to be located in any quadrant of the dentition according to some embodiments;

[0035] Figure 8 illustrates a pair of engagement structures in an engaged position according to some embodiments;

[0036] Fig. 9 illustrates an engagement structure with a retention feature according to some embodiments; and

[0037] Fig.10 illustrates an engagement structure with a retention feature according to some embodiments;

[0038] Fig.11 shows a junction site according to some embodiments;

[0039] Fig.12shows a top view of a bonding structure according to some embodiments;

[0040] Fig.13 shows a cross-sectional view of an orthotic device including one or more layers of thermoformed material on a bite block;

[0041] Fig.14 illustrates a side view of a pair of engagement structures for repositioning the mandible and reducing lateral movement according to some embodiments;

[0042] Fig.15 shows a top view of an engagement structure for repositioning the mandible and reducing lateral movement according to some embodiments;

[0043] Fig.16 shows a side view of an engagement structure for repositioning the mandible and reducing lateral movement according to some embodiments;

[0044] Fig.17 illustrates a side view of a pair of engagement structures for repositioning the mandible and reducing lateral movement according to some embodiments;

[0045] Fig.18 shows a side view of an engagement structure for repositioning the mandible and reducing lateral movement according to some embodiments;

[0046] Fig.19 shows a side view of an engagement structure for repositioning the mandible and reducing lateral movement according to some embodiments;

[0047] Fig. 20 shows a side view of an engagement structure for repositioning the mandible and reducing lateral movement according to some embodiments;

[0048] Fig.21 shows a side view of an engagement structure for repositioning the mandible and reducing lateral movement according to some embodiments; and

[0049] Fig. 22 An orthodontic aligner including an engagement structure for repositioning the mandible and reducing lateral movement is shown in accordance with some embodiments. DETAILED DESCRIPTION

[0050] The following detailed description provides a better understanding of the features and advantages of the invention described in this disclosure according to the embodiments disclosed herein. Although the detailed description includes many specific embodiments, these embodiments are provided by way of example only and should not be interpreted as limiting the scope of the invention disclosed herein.

[0051] The methods, apparatus, oral appliances, and bite blocks disclosed herein are well suited for use in combination with existing devices such as braces to reposition teeth, such as Invisalign, commercially available from Align Technology, Inc. TM The presently disclosed engagement structures and bite blocks are well suited for incorporation into existing devices for mandibular repositioning to provide reduced size and improved engagement. For example, the presently disclosed engagement structures can be combined with one or more features of the Precision Wings.

[0052] The presently disclosed methods and apparatus are well suited for combination with existing methods of manufacturing appliances, such as with direct manufacturing and overmolding (such as thermoforming). For example, the presently disclosed bite block can be placed on a positive mold of the patient's dentition, and one or more layers of polymer material are thermoformed onto the bite block. Moreover, the bite block is well suited for additive manufacturing (such as 3D printing). Multiple bite blocks as described herein can be repeatedly placed on a computer model of the patient's mouth to facilitate the design of a mandibular repositioning appliance. Moreover, the repeated placement and reduced size can reduce the amount of additive manufacturing material and reduce manufacturing time, for example when the appliance is manufactured directly as a single component with a thin polymer shell and bite block, or when the bite block is manufactured separately and thermoformed.

[0053] The present disclosure describes appliances and structures for mandibular repositioning, including treatment of Class II malocclusion, Class III malocclusion, and sleep apnea correction. An oral appliance for insertion into a patient's mouth may include a plurality of bite blocks and engagement structures for generating mandibular repositioning forces and positioning. The appliance may include a tooth receiving cavity for fitting over the patient's teeth (such as via an orthodontic appliance). A plurality of bite blocks are provided with the appliance and facilitate mandibular repositioning, such as by facilitating mandibular advancement, retraction, lateral correction, or a combination.

[0054] According to the treatment profile, the bite blocks cooperate to align the mandible with the maxilla. For example, a first bite block can be associated with an appliance coupled to the patient's upper teeth, and a second bite block can be associated with an appliance coupled to the patient's lower teeth. The first bite block and the second bite block can be positioned to interfere with each other to maintain the mandible in a desired position, such as to interfere with retraction, advancement, or lateral movement of the mandible once the mandible is properly positioned.

[0055] The bite block may have an engagement surface in which a first bite block on a first appliance engages a second bite block on a second appliance. The engagement surface applies a force on the mandible to correct a Class II malocclusion, a Class III malocclusion, or other type of misalignment of the mandible.

[0056] The bite block can have the same geometry and can be configured to fit in any portion of a patient's mouth to provide the features and benefits described herein. An appliance formed with a bite block can include engagement surfaces for contacting each other, wherein the engagement surfaces are similar to the surfaces of the bite block as described herein.

[0057] Figure 1 An oral appliance 100 and one or more engagement structures 110 carried by the appliance 100 are shown. The appliance 100 can be configured to fit over an entire dental arch 120. In other embodiments, the oral appliance can be designed to fit over some or all of the teeth in the upper or lower jaw. For example, the dental appliance 100 can be formed with a plurality of tooth receiving cavities that allow the oral appliance 100 to fit securely to the dental arch. The oral appliance 100 can be made of a polymer shell, or formed of another material and include a plurality of tooth receiving cavities shaped to receive corresponding teeth. Appliances for positioning teeth are commercially available from Alleyne Technologies, Inc.

[0058] One or more engagement structures 110 may be placed at any suitable location on the oral appliance 100, but according to some embodiments, corresponding pairs of engagement structures 110 are placed on the appliance 100 associated with the patient's upper jaw and on the appliance associated with the patient's lower jaw. In some embodiments, the corresponding pairs of engagement structures 110 reposition the lower jaw relative to the upper jaw. For example, the lower jaw can be repositioned forward (e.g., to correct retrognathism), backward (e.g., to correct prognathism), or laterally relative to the upper jaw. Thus, the corresponding pairs of engagement structures can be used with the oral appliance to address a patient's Class 1, Class 2, or Class 3 malocclusion.

[0059] The oral appliance includes suitable materials for use with the oral appliance. The oral appliance can be made of any suitable material that will be understood by a person of ordinary skill in the art. In some embodiments, for example, the engagement structure 110 can be formed into the oral appliance, such as by overmolding. As an example, one or more engagement structures 110 can be formed by placing a bite block as described herein on a positive mold of the patient's dentition, and an overmolding material (which can be any of a variety of suitable polymers) is molded over the one or more engagement structures 110 and the positive mold. The result is an oral appliance 100 that includes a plurality of tooth receiving cavities and one or more engagement structures 110, wherein, for example, a bite block as described herein is embedded within the oral appliance 100.

[0060] Although the present description may refer to a first appliance and a second appliance, it should be understood that referring to the appliances using this nomenclature is not intended to indicate the location of the appliances within the patient's mouth. For example, the first appliance may be configured to fit on the patient's upper dental arch, or may be configured to fit on the patient's lower dental arch. Similarly, reference to a first engagement structure, a second engagement structure, a third engagement structure, or a fourth engagement structure does not, by itself, indicate a location within the patient's mouth or a location on a particular oral appliance, unless otherwise specified.

[0061] Figure 2A , Figure 2B and Figure 2C A mating pair of engagement structures associated with an upper dental brace 100a along an upper dental arch 120a and a lower dental brace 100b along a lower dental arch 120b according to some embodiments is shown. The upper dental brace 100a defines a plurality of tooth cavities, the size and shape of the plurality of tooth cavities being set to fit on the patient's teeth. A pair of engagement structures 110a can be formed, embedded, attached, attached or otherwise carried by the upper dental brace 100a, and may include a bite block as described herein. In some embodiments, the engagement structure 110a and the corresponding bite block have a midline 104 that divides the engagement structure into a left side and a right side. The engagement structure has an occlusal surface that is generally facing away from the dentition on which the brace is placed. When in use, the occlusal surface 116a of the engagement structure associated with the upper brace will be generally oriented toward the lower brace. Similarly, when used by a patient, the occlusal surface of the engagement structure associated with the lower brace will generally face the engagement structure of the upper brace.

[0062] In some embodiments, the engagement structure 110a and the corresponding bite block have an engagement surface 112a that is generally inclined relative to the bite surface. It should be understood that the engagement surface can be sized and shaped in many ways and can be, for example, curved, wavy, shaped, or inclined. In some embodiments, as shown in FIG. Figure 2AAs shown, where the engagement structure is assembled to an upper oral appliance for placement over the maxillary teeth, the engagement surface can face generally forward (e.g., toward the front of the mouth where the incisors are located).

[0063] In some embodiments, Figure 2B As shown, where the engagement structure 110b is associated with a lower oral appliance 100b for placement on the mandibular teeth, the engagement surface 112b can face generally rearward. Figure 2A and Figure 2B When arranged as shown, the engagement surfaces 112a, 112b can cooperate to help reposition the mandible. For example, as shown in the figure, the first engagement structure 110a can be located on the upper corrector 100a (such as Figure 2A ), and the second engagement structure 110b may be located on the lower orthotic device 100b (as shown Figure 2B ). In use, with the appliance 100 fitted to the patient's dentition, when the patient bites down, the mandible is moved forward (e.g., the mandible is advanced), and the engagement surfaces 112 associated with the engagement structures of the upper and lower appliances contact and interfere with each other to provide mandibular repositioning. In some embodiments, the mandible is pushed to a more forward position, which helps correct the patient's overbite. Additionally, the engagement surfaces can also help reduce lateral movement, e.g., side-to-side movement of the mandible, which can facilitate mandibular repositioning.

[0064] In some embodiments, the engagement structure is positioned and oriented to promote the mandible to a more posterior position. That is, for example, the engagement structure can help retract the mandible to help correct the patient's crossbite.

[0065] Figure 3 A schematic diagram showing example relative positioning of upper and lower engagement structures according to some embodiments is shown. In some embodiments, the engagement structure can be positioned and configured to correct a retracted jaw (e.g., a crossbite), or can be positioned and configured to correct a protrusive jaw (e.g., an overbite). By way of example, the configuration will be described as promoting mandibular advancement, although the engagement structure can be interchanged to provide mandibular retraction.

[0066] As shown, a pair of first engagement structures are associated with the lower brace and can be placed on the patient's lower dentition. A pair of second engagement structures can be associated with the upper brace and can be placed on the patient's upper dentition. In use, once the upper and lower braces are placed on the patient's dentition, the engagement structures contact each other as the braces are brought together. When the mandible is moved forward, the patient is able to bite down and bring the upper and lower braces together. Once the patient bites down, the first engagement structure and the second engagement structure reduce the ability of the mandible to retract from the forward position.

[0067] As shown, the first engagement structure has a center line, which separates the first engagement structure into a first side and a second side, such as a left side and a right side. In some embodiments, the first engagement surface is inclined at an angle relative to the center line. In some embodiments, the angle of inclination α is about 5 degrees, 10 degrees, 15 degrees, 20 degrees, 30 degrees, 40 degrees or 45 degrees, or in the range defined by any two of the aforementioned values. In some embodiments, angle α is in the range of about 10 degrees to about 25 degrees.

[0068] In some embodiments, the inclination angle α provides support to help position the mandible in a forward position, and in addition, provides support to limit lateral movement when the first engagement surface contacts the second engagement surface at the engagement site. For example, the left and right sides of the corrector may include opposing engagement structures to limit lateral jaw movement while providing a mandibular advancement force. For example, a first engagement structure and a second engagement structure on a first side of the corrector on a first side of the mouth may contact each other at corresponding inclination angles to generate a first lateral force associated with a first mandibular advancement force. The first engagement structure and the second engagement structure on the second side of the corrector on the second side of the mouth may contact each other at corresponding inclination angles to generate a second lateral force associated with a second mandibular advancement force. In some embodiments, the first force and the second force are oppositely oriented and can help maintain the mandible in place and reduce lateral movement to facilitate mandibular repositioning.

[0069] Figure 3 A pair of engagement structures 110 for repositioning the mandible and reducing lateral movement are shown, which can be incorporated into an upper and lower brace as described herein. In the configuration shown, a first engagement structure 110a is associated with the mandible on the mandibular brace, and a second engagement structure 110b is associated with the maxilla on the maxillary brace. The first engagement structure has an occlusal portion 120 and a cheek portion 118. The occlusal portion of the first engagement structure 110b is located on the brace as described herein so as to be positioned approximately adjacent to the occlusal surface of one or more lower teeth when the brace has been placed on the lower teeth. When the brace has been placed on the lower teeth, the occlusal portion of the first engagement structure 110a is between the upper and lower dentition. The cheek portion 118 is positioned adjacent to the buccal surface of one or more teeth and is located between the teeth and the cheek, for example when located near a molar or premolar. Although reference is made to the cheek portion, the brace may include a lingual portion extending from the occlusal portion to the lingual side of the patient's teeth.

[0070] The occlusal portion 120 and the cheek portion 118 each define an engagement structure 110 including an engagement surface 112, which is configured to engage with a corresponding engagement surface 112 on a mating engagement structure 110 (such as a second engagement structure 110a). The engagement surface can be as described herein and can be inclined relative to the midline of the engagement structure. In some embodiments, the engagement surface is substantially perpendicular to the midline of the engagement structure, and limitation to lateral movement can be provided only by the cheek. As shown, the first engagement structure can be associated with the mandible, that is, the first engagement structure can be attached or embedded in the first aligner to be placed on the lower dentition, and the cheek extends close to and engages the buccal surface of one or more teeth of the maxilla. The second engagement structure can be associated with the maxilla, that is, the second engagement structure can be attached or embedded in the second aligner to be placed on the upper dentition, and the cheek extends close to and engages the buccal surface of one or more teeth of the mandible. In this configuration, lateral movement of the mandible relative to the maxilla is reduced.

[0071] Figure 4A A pair of engagement structures 110 for repositioning a mandible are shown, wherein a gap 130 is formed between the teeth and the engagement structures 110. A first bite block 111a can be secured to the first appliance 111a for placement on the dentition of a patient. As described herein, the first bite block 111a can be carried by the first oral appliance 100a for placement on the teeth. For example, the first appliance 100a can be coupled to the first bite block 111a during appliance manufacturing, such as by overmolding (e.g., thermoforming) a thin layer of appliance material onto the first bite block to form the first engagement structure. As described herein, the first bite block 111a can be secured to the first appliance 100a for placement on the teeth. Figure 4A As can be seen in the figure, there may be a gap 130 between the patient's maxilla and the first engagement structure 110a. This may be at least partially related to the shape of the first engagement structure 110a and the second engagement structure 110b. For example, for flat surfaces, the engagement between the surfaces is generally intended to provide contact along the flat surface. This engagement between the flat surfaces may be related to the constraints of the angles of the bite blocks relative to each other, such as when the biting surfaces of the teeth correspond to curved surfaces.

[0072] During manufacture of the appliance, a first base may be provided on a positive mold of a first tooth, and a first bite block is received on the first base. The appliance may be overmolded (e.g., thermoformed) on the first positive mold, the first base, and the first bite block to form the first appliance. The first appliance is removed from the positive mold and the base along with the first bite block attached thereto. When placed on the patient's teeth, a gap 130 may extend between the first appliance and the first bite block. A second appliance may be similarly manufactured using a second positive mold, a second base, and a second bite block.

[0073] In at least some cases, the dentition exhibits curvature in at least two dimensions, such as along the occlusal surface, such that the occlusal surface does not extend along the occlusal plane. For example, the upper and lower dentition may follow the dental arch, and in addition, one or more of these may be curved along the occlusal surface, having a curve known as the Spee curve 124, such as Figure 4A In some embodiments, the engagement structures will have a tendency to align with each other, such as where they are in face-to-face contact along a flat engagement surface. Although one or more of the bite blocks may be angled relative to the occlusal surfaces of the teeth, this may, for example, create a gap 130 between the upper engagement structure and the upper dentition, as shown. Figure 4A Work related to the present disclosure has shown that a reinforcing structure can be provided on the aligner near the gap to reinforce the aligner near the gap.

[0074] Work related to the present disclosure has shown that flat surface contact can apply forces to the first engagement structure and / or the second engagement structure, which may bias one or more of the engagement structures away from the dentition. This bias can be addressed by changing the contact surface of the engagement structure to reduce the applied force that tends to pull one or more of the engagement structures away from the dentition, and this solution can rely on the engagement structure being individually designed for each application and for an individual patient. For example, a custom bite block can be manufactured as described herein to fill Figure 4A The gap is shown so that the aligner extends from the occlusal surface of the tooth or teeth on which the aligner is placed, thereby filling the gap.

[0075] Figure 4B A pair of engagement structures for repositioning a mandible having one or more curved engagement surfaces is shown. According to some embodiments, providing one or more curved engagement surfaces allows for variation in the engagement angle between the engagement structures and may allow the engagement structures to follow a Spee curve 124. This may allow a bite block 111 to be placed adjacent one or more underlying teeth. In some embodiments, for example, the one or more curved surfaces provide an engagement site 132 that reduces forces on the engagement structure that may tend to bias the engagement structure away from the dentition. The one or more curved surfaces 134 may include a curved surface of a first bite block and a flat surface 136 of a second bite block that engage one another at the engagement site.

[0076] In some embodiments, the appliance worn by the patient is formed by overmolding, such as thermoforming. For example, a first appliance can be manufactured by placing a first bite block on a first base on a first positive mold of a first tooth of the patient, and thermoforming a thin layer of polymer material over the first positive mold of the tooth, the first base, and the first bite block. The first appliance can be removed along with the first bite block attached thereto and undergo additional manufacturing steps as described herein. A second appliance can be similarly manufactured. The first appliance and the second appliance can be placed on the first tooth and the second tooth to provide engagement, such as Figure 4B shown.

[0077] In some embodiments, the engagement site approximates a contact line extending between the first engagement structure and the second engagement structure. Depending on the material used for the bite block and the aligner material (such as a thermoformed material), the engagement structure can deform in response to contact therebetween, which can change the engagement site. The one or more curved engagement surfaces can allow the engagement structures to slide relative to each other so that the engagement site moves when the jaws are drawn together.

[0078] Although the joint site can approximate and extend along the contact line, it should be understood that the joint site can include one or more of many shapes, such as a rectangle, an ellipse, or a butterfly shape. In some embodiments, the joint site is defined by a rectangle with a higher aspect ratio of width to height, such as 3:1, 5:1, 8:1, 10:1 or greater. In other words, the joint site can approximate a rectangle whose width is substantially greater than its height.

[0079] In embodiments where one of a pair of engagement structures includes a curved engagement surface, it can be positioned based on the patient's oral geometry. For example, in some patients, the Spey curve 124 is generally convex, which can facilitate positioning of an engagement structure having a curved engagement surface on the maxilla. In some cases, for example, the Spey curve 124 can be concave, which can facilitate positioning of an engagement block having a curved engagement surface on the mandible. In some embodiments, a pair of mating engagement structures (e.g., one engagement structure associated with the maxilla, and one engagement structure associated with the mandible) have different geometries. The different geometries can aid in proper placement. In some cases, a pair of mating engagement structures have similar or even identical geometries. In some embodiments, the engagement surfaces of the mating engagement structures are different, such as Figure 4B shown.

[0080] Figure 5A pair of engagement structures 110 associated with an upper appliance 100a for a maxillary arch 109 and a lower appliance 100b for a mandibular arch 106 are shown according to some embodiments. A first engagement structure 110a can be associated with the first appliance 100a. In some embodiments, the first appliance 110a includes the first engagement structure 110a, and the first engagement structure 110a includes a first bite block 111a and a layer of appliance material covering the first bite block. In some embodiments, the second appliance 100b includes the second engagement structure 110b, and the second engagement structure 110b includes a second bite block 111b and a layer of appliance material covering the second bite block. For example, the engagement structure 110a of the first brace may include a portion of brace material covering the first bite block 111a, and the engagement structure of the second brace 110b may include a portion of brace material covering the second bite block 111a, wherein contact between the first brace surface and the second brace surface at the engagement site 132 transmits force to the underlying bite block 111 and teeth.

[0081] The first and second aligners 100 can be manufactured as described herein. In some embodiments, the first base 136a is positioned on a positive mold of one or more maxillary teeth of the patient, such as one or more molars, premolars, or a combination, by any suitable method or technique. The first bite block 111a can be coupled to the first base 136a in any suitable manner, such as by an interference fit, a key and keyhole fit, a boss and notch, or any other suitable type of connection. For example, the second bite block 111b can be similarly coupled to the second base 136a.

[0082] The first and second engagement structures 110 can have different shapes and can have different engagement surfaces. In some embodiments, the first engagement structure 110a has a first engagement surface 112a, which is wavy (e.g., curved, shaped, contoured, or other surfaces other than a flat surface). The second engagement structure 110b has a second engagement surface 112b, which cooperates with the first engagement surface to help align the mandible. The second engagement surface 112b can be substantially flat, or can be wavy and configured to cooperate with the first engagement surface. Where the curved surface meets the flat surface, the engagement site can be approximated to a line. In some embodiments, the engagement structure includes a bite block embedded in an associated corrector, which can be formed of a material as described herein. Therefore, when the first corrector contacts the second corrector, the corrector can be elastically deformed and change the engagement site, which can depend on the force between the engagement structures. For example, as the force between the engagement structures increases, the area of ​​the engagement site can increase as the corresponding corrector elastically deforms in response to the contact force. The bite block of each aligner is capable of transmitting forces from the other aligner to the tooth or teeth in contact with each bite block.

[0083] In some embodiments, configuring the engagement structures to have smaller engagement sites (such as engagement sites that approximate a line) allows one or more of the first engagement structure or the second engagement structure to be positioned closer to the associated teeth. This allows for a reduction in the height of each engagement structure and a reduction in possible gaps between the engagement structure and the associated teeth, which can result in improved force transfer between the jaws having smaller height structures on each bite block. In some embodiments, this can allow the jaws to be drawn closer together and can result in improved patient comfort and experience.

[0084] Figure 6A pair of engagement structures 110 associated with an upper and lower appliance utilizing a keyed positioning system are shown in accordance with some embodiments. A first base 136a can be attached to a positive mold of one or more maxillary teeth of the patient. The first key 138a can include a boss, or a key, or other structure that helps determine the position of the first bite block and the corresponding first engagement structure. For example, the first base 136a can be attached to the positive mold of the maxillary teeth by any suitable attachment structure or method (such as deposition manufacturing of the positive mold and the first base together). The first bite block including the first engagement structure 110a may include a recess, a key hole, or other structure configured to fit on a protrusion of the first base. As described herein, the first appliance can be manufactured by thermoforming on the first positive mold of the first tooth, the first base, and the first bite block. In some embodiments, the keyed positioning system ensures that the first engagement structure is properly positioned within the patient's mouth according to the mandibular repositioning treatment contour. The first base 136a may include an intrusion for receiving a protrusion extending from the first engagement structure, and any type or arrangement of positioning systems may be utilized to facilitate proper positioning, placement, and orientation of the first engagement structure. For example, a protrusion of the first bite block received in the intrusion of the first base may be removed prior to placing the first appliance on one or more teeth of the patient.

[0085] The second bite block 111b of the second engagement structure may include a keyed positioning system that cooperates with the second base 136b of the positive mold attached to one or more mandibular teeth of the patient. In some embodiments, the keyed positioning system of the second engagement structure is different from the keyed positioning system of the first engagement structure to reduce the chance of positioning the first engagement structure and the second engagement structure in an incorrect position.

[0086] Figure 7 An engagement structure 110 is shown that includes a bite block 111 having a shape profile geometry that can be used and repeated at multiple locations so that a similar bite block is engaged at each of the multiple locations. For example, the bite block 111 can be located in any quadrant of the dentition. The bite block 111 may include a wavy engagement surface 112. In some embodiments, the engagement surface 112 extends to a substantially flat first edge 140 (e.g., having an approximately zero curvature) and to a substantially convexly curved second edge 142. The engagement surface 112 can define a smooth transition between the flat first edge 140 and the curved second edge 142. Thus, the engagement surface 112 defines a first portion 144 having a first curvature on a first side of the midline 104, the first curvature being different from a second curvature on a second portion 146 of the engagement surface on a second side of the midline 104.

[0087] The bite block may include a recess 148, such as a slot, a channel groove, or other components of a key mechanism as described herein (such as a keyway). For example, the recess 148 may be located along the midline 104 of the bite block.

[0088] like Figure 7 The illustrated engagement surfaces 112 allow a pair of mating snap blocks 111 to include engagement structures 110 configured to have substantially identical engagement surfaces 112. In some embodiments, a plurality of snap blocks include substantially identical three-dimensional shape profiles across the entire outer surface of each of the plurality of snap blocks. In some embodiments, the engagement structures are used in pairs, with a flat edge of a first engagement structure engaging a curved edge of a second engagement structure, and similarly, a curved edge of a first engagement structure engaging a flat edge of a second engagement structure.

[0089] Figure 8 It shows that Figure 7 The two mating engagement structures 110 shown meet at an engagement site that approximates the engagement line. As shown, the curved edge of the first engagement structure 110a is matched with the flat edge 140b of the second engagement structure 110b. In some cases, the engagement surface 112 is inclined relative to the midline of the engagement structure. In other words, the engagement surface may not be perpendicular to the midline of the engagement structure, but may be inclined at an angle such as 10°, or 12°, or 15°, or 20° or greater, or within the range defined by any two of the aforementioned values. In some cases, the inclination angle is in the range of 5° to 15°. The inclination angle can be selected so that the lateral movement of the mandible relative to the maxilla is reduced by contact between the first engagement structure and the second engagement structure (e.g., by a pair of engagement structures located on each side of the jaw) and the multiple correctors described herein.

[0090] In some embodiments, the overall shape of the engagement structure is selected so that multiple bite blocks, including multiple engagement structures all having substantially the same shape, can be used anywhere on the dentition to provide the advantages described herein. For example, multiple engagement structures can be manufactured on multiple aligners by any suitable manufacturing technique, such as a thermoforming process, molding, machining, or some other technique. Multiple bite blocks, including multiple engagement structures, can all be substantially identical in size and shape and can be positioned on the patient's dentition at any suitable location within the patient's mouth. For example, engagement structures sharing substantially the same shape can be positioned in the lower left quadrant, upper left quadrant, lower right quadrant, and upper right quadrant within the patient's mouth to provide mandibular repositioning. As described herein, the engagement structures can be oriented and rotated as needed to provide mandibular repositioning forces.

[0091] The plurality of bite blocks may include features such as slots, recesses, or keyways 138a, 138b to aid in the positioning of each engagement structure. In some cases, the keyway features extend a portion of the path through the thickness of the bite block and a portion of the engagement structure. In some embodiments, the keyways extend so that the engagement structures can be rotated and flipped to fit in any quadrant of the patient's mouth while utilizing a single geometry and three-dimensional outer surface profile of the plurality of engagement structures for repositioning of the patient's mandible.

[0092] As described herein, a bite block generally includes a material structure that generally extends away from the biting surface of one or more teeth. An engagement structure may include an engagement structure of the bite block or oral appliance that extends away from the biting surface of the patient's teeth to engage with an opposing engagement structure. Thus, when properly positioned within the patient's mouth, the engagement structures engage each other to generate a mandibular repositioning force when the patient bites down.

[0093] In some embodiments, a bite block including an engagement structure is positioned on a positive mold corresponding to the dentition, and a layer of thermoforming material is placed on the bite block to form an appliance including an engagement structure as described herein. The engagement structure may include the same material as the thermoforming material or a different material. In some embodiments, the thermoforming material includes a polymeric material. The engagement structure may include a hardness similar to or different from that of the thermoforming material (e.g., softer or harder).

[0094] Fig. 9 According to some embodiments Figure 7 and Figure 8 Another view of a bite block 111 of a device that may include a retention feature 152. The bite block may include additional features, such as retention features, to facilitate retention of an engagement structure with a corresponding aligner. As shown, the bite block 111 may include one or more undercuts 152 on the engagement surface 112, the occlusal surface 116, and the side surface 150. The one or more undercuts 152 may define a draft angle and be configured such that the undercut becomes larger or deeper toward the occlusal surface 160. Other retention features, such as protrusions, grooves, notches, chamfers, draft angles, etc., may be provided to allow for additional mechanical connection between the bite block 111 and the thermoformed material of the aligner. The one or more retention features on the bite block 111 are well suited for use with a thermoformed aligner including one or more layers of polymeric material as described herein to facilitate retention of the bite block 111 with the one or more layers of thermoformed material.

[0095] An undercut 152 can be formed on one or more side surfaces 150 of the engagement structure. During thermoforming, the thermoforming material can flow into the undercut 152 to provide a more secure assembly of the engagement structure within the aligner.

[0096] Fig.10 Another view of a joint structure 110 is shown, according to some embodiments, the joint structure includes a bite block 110 having retention features such as Fig. 9 The retention feature may include an undercut 152 formed by a draft 154 in the side surface 150 of the engagement structure. The draft angle may be approximately or about 10° relative to a vertical axis of the engagement structure extending perpendicular to the occlusal surface 116. Other angles may be used, and for example, the angle may be in the range of about 1° to about 45° to provide the benefits of the retention feature.

[0097] According to some embodiments, the bite block 111 is retained in the thermoformed aligner 100 by a retaining feature, and additional chemical or mechanical fastening means are optional. In some embodiments, the retaining feature is sufficient to retain the engagement structure within the aligner.

[0098] Additional fastening mechanisms may be used with or without the retention features, such as any of a variety of adhesives that promote chemical bonding, mechanical bonding, or a combination. In some cases, the aligner is manufactured by laminating a thermoformable material onto the engagement structure, and the thermoformable material is able to flow in a softened state to fill in the retention features, thereby providing a mechanical connection between the engagement structure and the aligner.

[0099] The side surfaces of the engagement structure may additionally have a draft angle such that the engagement structure as a whole is narrower at its base and wider as it extends away from the tooth to provide additional attachment security between the engagement structure and the aligner. The draft angle may be approximately or about 10°, and may be any suitable angle within the range of about 1° to about 30°.

[0100] Fig.11 The engagement structure 110 of the engagement site 134 is shown according to some embodiments. The bite block 111 may include a reference Figures 6 to 11Any structure of a bite block in the. As described herein, where the engagement surfaces 112 of two mating engagement structures include one or more curved surfaces, the engagement site 134 can extend along a line. However, in some embodiments, the engagement site can approximate other shapes associated with the contact area as described herein. As shown, the engagement site 134 can be wider near the center of the engagement surface and become thinner toward the sides of the engagement surface. The engagement site can include an outer surface of an oral brace that contacts an outer surface of another brace. Alternatively or in combination, the engagement site can include a force receiving surface of the bite block through which the engagement force is transmitted through one or more layers of polymer material placed on the bite block. In some embodiments, the engagement site of the bite block corresponds to a surface contact area of ​​the engagement structure on the outer surface of the braces that contact each other.

[0101] In some embodiments, the engagement site can be substantially parallel to one or more surfaces (such as the occlusal surface) of the engagement structure. However, as shown in the figure, in some embodiments, the engagement site is not parallel to the occlusal surface, and can be inclined relative to the occlusal surface, for example, due to changes in the engagement surface or asymmetric curvature. Other shapes and sizes of the engagement site are contemplated and described herein, and the engagement site can follow a curve in one, two or three dimensions. That is, when viewed from the top, front or side of the mating engagement structure, the engagement site can follow a curve. In addition, the engagement site can include an area less than the engagement surface area. For example, the engagement site can include about 10% of the engagement surface area. In some embodiments, the engagement site can include less than about 10%, 20%, 30%, 40%, 50%, 60%, 70% or 80% of the engagement surface area. In some embodiments, when the jaws are pulled toward each other and the mandible protrudes or retracts and the contact surfaces slide relative to each other, the engagement site moves. Because the amount of force applied to the mandible gradually increases when the jaws are pulled toward each other, the movable engagement site can provide improved comfort for the patient.

[0102] Fig.12 FIG. 1 is a top view of a bite block 111 of a joint structure 110 according to some embodiments. The bite block 111 may include Figures 6 to 11 In some embodiments, Figures 6 to 11 The bite block includes Fig.12The same bite block as shown. The bite block 111 includes an occlusal surface 116 and an engagement surface 112. The surface 113 opposite the engagement surface 112 can be round, square, or include some other shape. In some embodiments, the engagement surface 112 includes a curved profile, a flat profile, or a profile of varying curvature, and combinations thereof. The engagement surface 112 can include multiple profiles, such as a combination of a flat profile 172 and one or more curved profiles 170. As shown, the engagement structure includes a relatively flat profile 172 near one edge of the engagement surface, a curved profile 170 adjacent to the opposite edge of the engagement surface, and a smooth grid transition between the relatively flat profile 172 and the curved profile 170.

[0103] As shown, the engagement surface 112 can be wedge-shaped when viewed from above. For example, the engagement surface can include an angle of inclination 162 relative to the midline 104. The angle of inclination 162 or α can include the angle between a transverse line extending along the engagement surface and a transverse line extending perpendicular to the midline. The angle of inclination α can be configured to provide a mandibular repositioning force and reduce lateral movement, as described herein, for example with reference to Figure 2C Each of the plurality of engagement structures may include, for example Fig.12 In some embodiments, the angle of inclination α can be zero and the midline 104 of the engagement structure can be tangent to the dental arch of the aligner at the location where the engagement structure is located on the aligner.

[0104] In some cases, the engagement surface may define a curve when viewed from the top. According to some embodiments, the mating engagement structures define an engagement surface configured to cooperate to provide a mandibular repositioning force and reduce lateral movement of the mandible. According to some embodiments, the engagement surface may be flat and define a surface-to-surface engagement site.

[0105] although Figures 2A to 12The bite block and associated engagement structures are shown in isolation, but one of ordinary skill in the art will readily recognize that the figure also shows how these blocks can be integrally formed into an oral brace (such as a thermoformed brace). For example, a first block can be placed on a positive mold of the patient's dentition and thermoformed with a material (such as a sheet of material) as described herein. The thin sheet of material will be thermoformed over the bite block and the positive mold of the patient's teeth. The surface contour of the thermoformed brace will generally conform to the outer surface of the positive mold of the patient's teeth, with the bite block placed thereon. The thermoformed brace with the bite block can be removed from the positive mold with the bite block attached to the brace, and excess material removed for placement on the patient's teeth. The upper brace can be similarly formed with a positive mold of the patient's upper teeth and a second bite block. In some embodiments, the thin layer of polymer material above the bite block includes a shape profile similar to the shape profile of the bite block, and the thin layers of material on each brace are bonded to each other and transmit forces similar to those described with respect to the bite block described herein.

[0106] In some embodiments, one or more of the coupled engagement surfaces may be curved and define an engagement point that is substantially smaller than the engagement surface area, for example, to allow movement of the engagement point. Also, for example, an engagement point that is smaller than the engagement surface area allows the engagement surfaces to engage each other when tilted relative to the bite block.

[0107] Fig.13 A cross-sectional view of an appliance 100 is shown, the appliance comprising one or more layers 102, 103, 106 of thermoformed material above a bite block 111. For example, the one or more layers 102, 103, 106 of thermoformed material may comprise a single layer of thermoformed material or multiple layers of thermoformed material. Although one bite block is shown, each appliance may comprise multiple bite blocks as described herein, and a pair of appliances may be configured to engage with each other to produce a mandibular repositioning force as described herein. The one or more layers of thermoformed material may comprise a first layer 102, a second layer 103, and a third layer 106, wherein one or more layers are shaped to the surface contour of an underlying bite block. In some embodiments, a contact surface of an engagement structure of an engagement appliance for mandibular repositioning comprises substantially the surface shape contour of an underlying bite block as described herein.

[0108] In some embodiments, the first layer of thermoformed material on the first bite block is shaped to form an outer surface of a first engagement structure of the first mandibular repositioning brace, and the second layer of thermoformed material on the second bite block is shaped to form an outer surface of a second engagement structure of the second mandibular repositioning brace. The first block and the second block can be arranged to engage with each other, wherein the first layer and the second layer are located between the first block and the second block. The first layer and the second layer can include a type of polymer material, and the first bite block and the second bite block include the type of polymer material, such as a copolyester or a polyurethane.

[0109] In some embodiments, the one or more layers above the bite block include multiple layers. For example, a first plurality of layers of thermoformed material of a first brace may cover the first block, and a second plurality of layers of thermoformed material of a second brace may cover the second block. The first plurality of layers may include a layer of harder material between two layers of softer material, and the second plurality of layers may include a layer of harder material between two layers of softer material. For example, the harder layer may include a copolyester, and the softer material layer may include a thermoplastic polyurethane. For example, the first and third layers may include thermoplastic polyurethane, and the second layer may include a copolyester.

[0110] Figure 14-Figure 21 Engagement structures 1411 , 1511 are depicted that may share features and benefits of the engagement structure 110 discussed herein.

[0111] Fig.14 A side view of a pair of engagement structures 1411, 1511 for repositioning the mandible and reducing lateral movement is shown. The engagement structure 1410 may include a bite block 1411 on which the appliance portion is located. For clarity, the Fig.14 The tooth receiving cavity is omitted in Fig. 22 An appliance including a tooth receiving cavity and an engagement structure is shown in FIG. The bite block 1411 may include an engagement surface 1430. Fig.14In the illustrated embodiment, the engagement surface 1430 is a planar surface that faces the engagement surface of an opposing engagement structure, such as the engagement structure 1510. The angle of the engagement surface 1430 relative to the occlusal plane can match the angle of the engagement surface 1530 relative to the occlusal plane. For example, when the aligner is worn by the patient, the engagement surface 1430 can be parallel to the engagement surface 1530. The side 1421 of the bite block 1411 can include: an upper or first portion 1422, which is closer to the occlusal surface 1428 of the bite block 1411; and a lower or second portion 1420, which is farther away from the occlusal surface 1428 of the bite block 1411 than the first portion 1422. The lower portion 1420 can be shaped to form an undercut, such as the undercut 152 discussed above. The undercut can define a draft angle and can be configured so that the lower portion 1420 becomes wider toward the occlusal surface 1428. Other retention features, such as protrusions, grooves, notches, chamfers, draft angles, etc., may be provided to allow for additional mechanical connection between the bite block 1411 and the thermoformed material of the aligner 1412. The one or more retention features on the bite block 1411 are well suited for use with a thermoformed aligner including one or more layers of polymeric material as described herein. The draft angles facilitate retention of the bite block 1411 to the aligner.

[0112] The undercut can be formed by one or more side surfaces of the bite block. The undercut can be formed by a side surface having a draft angle relative to a vertical axis (such as a line perpendicular to the occlusal surface or occlusal plane of the appliance). The draft angle can be about 5 degrees relative to a vertical axis extending perpendicular to the occlusal surface of the engagement structure. Other angles can be used, and for example the angle can be in the range of about 1 degree to about 45 degrees to provide the benefit of retaining the feature. In some embodiments, the draft angle can be between 1 degree and 10 degrees. More preferably, it can be between about 3 degrees and about 7 degrees.

[0113] The side surface of the appliance material may additionally have a draft angle so that the engagement structure as a whole is narrower at the base and wider as it extends away from the teeth toward the upper portion 1422 to provide additional attachment security between the engagement structure and the appliance. The draft angle may be about 10 degrees, and may be any suitable angle in the range of about 1 degree to about 45 degrees. In some embodiments, the draft angle may be about 5 degrees, or between about 1 degree and about 10 degrees, more preferably between about 8 degrees and about 12 degrees, or between about 3 degrees and about 7 degrees.

[0114] The upper portion 1422 may include a bevel between the occlusal surface 1428 and the lower portion 1420 of the bite block 1411. The bevel may be formed in or by the surface of the side 1421 of the bite block 1411. The bevel may be formed by one or more side surfaces of another portion of the bite block. The bevel may be formed by a side surface having a bevel angle relative to a vertical axis, such as a line perpendicular to the occlusal surface. The bevel angle may be about 20 degrees relative to the vertical axis of the engagement structure, which extends perpendicular to the occlusal surface or occlusal plane of the appliance. Other angles may be used, and the angle may be in the range of, for example, about 1 degree to about 45 degrees. In some embodiments, the bevel may preferably be between about 15 degrees and about 25 degrees, more preferably between about 18 degrees and about 22 degrees.

[0115] The bite block 1411 may have a height 1412 extending from the base of the bite block to the bite surface 1428 of the bite block 1411. The height of the bite block may be between 2 mm and 15 mm, more preferably between 3 mm and 12 mm, and most preferably between 5 mm and 7 mm, inclusive.

[0116] In some embodiments, bite block 1411 may have a height of 5 mm. In such embodiments, upper portion 1422 may have a height 1416 of about 2.5 mm extending from bite surface 1428 to where the bevel of upper portion 1422 meets the undercut of lower portion 1420. In such embodiments, lower portion may have a height 1418 of about 2.5 mm extending from the base of bite block 1411 to where the bevel of upper portion 1422 meets the undercut of lower portion 1420.

[0117] In some embodiments, the height of the upper portion and the height of the lower portion are approximately 50% of the total height 1412. In some embodiments, the height of the lower portion and the height of the upper portion are between 20% and 80% of the total height 1412 of the bite block 1411.

[0118] The side surfaces of the appliance material may additionally have a bevel angle so that the engagement structure as a whole is narrower at its occlusal surface and wider as it extends inferiorly away from the occlusal surface. The draft angle may be about 10°, and may be any suitable angle within the range of about 1° to about 45°.

[0119] The bite block 1411 and the corresponding appliance 1412 can have an occlusal surface (such as occlusal surface 1428) that is substantially parallel to the occlusal plane of the patient's dentition or the occlusal plane of the appliance 1412. The bite block 1411 can include a rear surface 1424 opposite the engagement surface 1430. The rear surface can be formed at an angle 1426 relative to the vertical axis of the engagement structure. The angle 1426 can be about 20 degrees relative to the vertical axis of the engagement structure extending perpendicular to the occlusal surface. Other angles can be used, and for example, the angle can be in the range of about 0 degrees to about 45 degrees. In some embodiments, the angle is between about 15 degrees and about 25 degrees, more preferably between about 18 degrees and about 22 degrees.

[0120] In some embodiments, the bite block 1411 may include one or more alignment structures 1432 to assist in alignment of the bite block 1411 in the appliance housing 1412. The alignment structure 1432 may be an elongated keyway formed in the side 1421 of the bite block 1411. The alignment structure 1432 of the bite block may be aligned in a direction perpendicular to the occlusal surface 1428 of the bite block 1411. In some embodiments, the alignment structure 1432 is aligned with a corresponding alignment structure on the appliance 1412. For example, the appliance may include a key shaped to mate with the keyway 1432. In some embodiments, the alignment structure may be an etching or other visual indicator on the bite block 1411 that aligns with an etching or visual indicator on the appliance 1412 when the bite block is properly positioned within the appliance.

[0121] Similar to engagement structure 1410, engagement structure 1510 may include a bite block 1511 on which the appliance is located. Engagement structure 1410 may be shaped and positioned on the appliance to be placed on the patient's lower dental arch, while engagement structure 1510 is shaped and formed on the appliance to be placed on the patient's upper dental arch. Engagement structure 1510 may have similar features as engagement structure 1410. Bite block 1511 may include engagement surface 1530. In Fig.14In the illustrated embodiment, the engagement surface 1530 is a planar surface that faces the engagement surface 1430 of the opposing engagement structure, such as the engagement structure 1410. The angle of the engagement surface 1530 relative to the occlusal plane can match the angle of the engagement surface 1430 relative to the occlusal plane. For example, when the aligner is worn by the patient, the engagement surface 1430 can be parallel to the engagement surface 1530. The side 1521 of the bite block 1511 can be divided into: an upper or first portion 1522, which is closer to the occlusal surface 1528 of the bite block 1511; and a lower or second portion 1520, which is farther away from the occlusal surface 1528 of the bite block 1511 than the first portion 1522. The lower portion 1520, which can be positioned more gingivally than the upper portion, can be shaped to form an undercut, such as the undercut 152 discussed above. The undercut can define a draft angle and can be configured so that the lower portion of the undercut becomes wider toward the occlusal surface 1528. Other retention features, such as protrusions, grooves, notches, chamfers, draft angles, etc., may be provided to allow for additional mechanical connection between the bite block 1511 and the thermoformed material of the aligner 1512. The one or more retention features on the bite block 1511 are well suited for use with a thermoformed aligner including one or more layers of polymeric material as described herein to facilitate retention of the bite block 1511 and the one or more layers of thermoformed material.

[0122] The undercut can be formed by one or more side surfaces of the bite block. The undercut can be formed by a side surface having a draft angle relative to a vertical axis (such as a line perpendicular to the occlusal surface). The draft angle can be about 5 degrees relative to a vertical axis of the engagement structure extending perpendicular to the occlusal surface. Other angles can be used, and for example, the angle can be in the range of about 1 degree to about 45 degrees to provide the benefit of retaining the feature. In some embodiments, the draft angle can be between about 1 degree and about 10 degrees, more preferably between about 3 degrees and about 7 degrees. The side surface of the appliance material can additionally have a draft angle so that the engagement structure as a whole is narrower at its base and wider as it extends away from the teeth toward the upper portion 1522 to provide additional attachment security between the engagement structure and the appliance. The draft angle can be about 5 degrees, and can be any suitable angle in the range of about 1 degree to about 45 degrees.

[0123] The upper portion 1522 may include a bevel between the occlusal surface 1428 and the lower portion 1520 of the bite block 1511. The bevel may be formed in the surface of the side 1521 of the bite block 1511. The bevel may be formed by one or more side surfaces of another portion of the bite block. The bevel may be formed by a side surface having a bevel angle relative to a vertical axis (such as a line perpendicular to the occlusal surface). The bevel angle may be about 20 degrees relative to the vertical axis of the engagement structure (extending perpendicular to the occlusal surface). Other angles may be used, and for example the angle may be in the range of about 1 degree to about 45 degrees. In some embodiments, the angle may preferably be between about 15 degrees and about 25 degrees, more preferably between about 18 degrees and about 22 degrees.

[0124] The bite block 1511 may have a height 1512 extending from the base of the bite block to the bite surface 1528 of the bite block 1511. The height of the bite block may be between 2 mm and 15 mm, more preferably between 3 mm and 10 mm, and most preferably between 5 mm and 7 mm, inclusive.

[0125] In some embodiments, bite block 1511 may have a height of 5 mm. In such embodiments, upper portion 1522 may have a height of about 2.5 mm extending from bite surface 1528 to where the bevel of upper portion 1522 meets the undercut of lower portion 1520. In such embodiments, the lower portion may have a height 1519 of about 2.5 mm extending from the base of bite block 1511 to where the bevel of upper portion 1522 meets the undercut of lower portion 1520.

[0126] In some embodiments, the height of the upper portion and the height of the lower portion are approximately 50% of the total height 1515. In some embodiments, the height of the lower portion and the height of the upper portion are between 25% and 75% of the total height 1515 of the bite block 1511.

[0127] The side surfaces of the appliance material may additionally have a bevel angle so that the engagement structure as a whole is narrower at its occlusal surface and wider as it extends inferiorly away from the occlusal surface. The draft angle may be about 5°, and may be any suitable angle within the range of about 1° to about 45°.

[0128] The bite block 1511, the corresponding appliance 1512, can have an occlusal surface 1528 that is angled 1529 relative to the occlusal plane of the patient's dentition or the occlusal plane of the appliance 1512. In some embodiments, the occlusal surface of the bite block 1511 is at an angle 1529 between 3 and 15 degrees relative to the occlusal plane. Preferably, the angle 1529 is between 5 and 10 degrees. In some embodiments, the angle matches the Spey curve of the patient's dentition at the location of the engagement structure 1510. The occlusal surface can be angled relative to the occlusal plane or matched to the Spey curve to provide space between the occlusal surfaces of the opposing jaws. In some embodiments, the angle and / or height of the bite block, such as the distal height of the block, can be provided to form a gap or clearance with the tooth surface of the opposing jaw. For example, during occlusion of the patient's jaw, the occlusal surface can have a clearance of about 1 mm, 2 mm, 3 mm, 4 mm, 5 mm, 6 mm, 7 mm, 8 mm, 9 mm, or 10 mm. In some embodiments, the gap may be between about 1 mm and 10 mm, or between about 2 mm and about 5 mm.

[0129] The bite block 1511 may include a rear surface 1524 opposite the engagement surface 1530. The rear surface may be formed at an angle relative to the vertical axis of the engagement structure. The angle may be about 10 degrees relative to the vertical axis of the engagement structure extending perpendicular to the engagement surface. Other angles may be used, and for example, the angle may be in the range of about 1 degree to about 45 degrees. In some embodiments, the angle may be between about 5 degrees and about 15 degrees, more preferably between about 8 degrees and about 12 degrees.

[0130] In some embodiments, the bite block 1511 may include one or more alignment structures 1532 to assist in alignment of the bite block 1511 in the appliance housing 1512. The alignment structure 1532 may be an elongated keyway formed in the side 1521 of the bite block 1511. The alignment structure 1532 of the bite block may be aligned in a direction perpendicular to the occlusal surface 1528 of the bite block 1511. In some embodiments, the alignment structure 1532 is aligned with a corresponding alignment structure on the appliance 1512. For example, the appliance may include a key shaped to mate with the keyway 1532. In some embodiments, the alignment structure may be an etching or other visual indicator on the bite block 1511 that aligns with an etching or visual indicator on the appliance 1512 when the bite block is properly positioned within the appliance.

[0131] Fig.15 A top view of the bonding structure 1410 is shown. Fig.15As shown, the bite block 1411 may include an alignment structure 1432 located on one or both of the buccal and lingual sides of the engagement structure. Although depicted as having a single alignment structure 1432 on each of the buccal and lingual sides of the engagement structure 1410, in some embodiments, the engagement structure may include one or more, more than 1, more than 2, or 1, 2, 3, or 4 alignment structures on each side. Although depicted as having similar cross-sectional shapes, such as circular cross-sectional shapes, in some embodiments, the alignment structures may have different shapes. For example, the alignment structure on the first side of the engagement structure may have a circular cross-section, while the alignment structure on the second side may have an elliptical shape. Other cross-sectional shapes of the alignment structures include rectangular, triangular, asymmetric shapes. In some embodiments, the first alignment structure and the associated key and keyway may be located in a more proximal position on the engagement structure, while the second alignment structure is located in a more distal position on the engagement structure.

[0132] The bite block 1411 can have a width 1413 extending between the buccal-most portion and the lingual-most portion of the bite block. The width can be between 5 mm and 10 mm. In some embodiments, the base and the biting surface of the bite block can also have a width. The width of the base can be the same as the width of the biting surface. In some embodiments, the width of the biting surface is less than the width of the base.

[0133] Despite Fig.15 14. A lower engagement structure 1410 and corresponding features are depicted in , but similar features and dimensions apply to other engagement structures, such as upper engagement structure 1510.

[0134] Fig.16 A rear view looking toward the rear surface 1424 of the bite block shows the side of the engagement structure 1410. The side 1421 of the bite block 1411 can be divided into: an upper or first portion 1422, which is closer to the bite surface 1428 of the bite block 1411; and a lower or second portion 1420, which is farther away from the bite surface 1428 of the bite block 1411 than the first portion 1422. The lower portion 1420 can be shaped to form an undercut. The undercut can define a draft angle 1602 and is configured so that the undercut becomes wider toward the bite surface 1428. The draft angle can be about 5 degrees relative to a vertical axis of the engagement structure extending perpendicular to the bite surface. Other angles can be used, and for example, the angle can be in the range of about 1 degree to about 45 degrees to provide the benefit of retaining features. In some embodiments, the draft angle can be between about 1 degree and about 10 degrees, more preferably between about 3 degrees and about 7 degrees.

[0135] The side surfaces of the appliance material may additionally have a draft angle so that the engagement structure as a whole is narrower at the base and wider as it extends away from the teeth toward the upper portion 1422 to provide additional attachment security between the engagement structure and the appliance. The draft angle may be about 10 degrees, and may be any suitable angle within the range of about 1 degree to about 45 degrees. Both the lingual and buccal sides of the bite block may include undercuts on their respective undersides. In some embodiments, the underside does not include an undercut or draft angle.

[0136] The upper portion 1422 may include a bevel located between the occlusal surface 1428 and the lower portion 1420 of the bite block 1411. The bevel may be formed in the surface of the side 1421 of the bite block 1411. The bevel may be formed by one or more side surfaces of another portion of the bite block. The bevel may be formed by a side surface having a bevel angle relative to a vertical axis (such as a line perpendicular to the occlusal surface). The bevel angle may be about 20 degrees relative to the vertical axis of the engagement structure (extending perpendicular to the occlusal surface). Other angles may be used, and for example, the angle may be in the range of about 1 degree to about 45 degrees, for example, the lingual and buccal sides of the bite block may both include a bevel on their respective upper sides. In some embodiments, the upper portion does not include a bevel or a bevel angle.

[0137] Fig.17 A side view of a pair of engagement structures is shown. In some embodiments, the bite block 1411 can have a height of 7 mm. In such an embodiment, the upper portion 1422 can have a height 1716 of about 2.5 mm, extending from the bite surface 1428 to where the bevel of the upper portion 1422 meets the undercut of the lower portion 1420. In such an embodiment, the lower portion can have a height 1718 of about 4.5 mm, extending from the base of the bite block 1411 to where the bevel of the upper portion 1422 meets the undercut of the lower portion 1420.

[0138] In some embodiments, the height of the upper portion and the height of the lower portion are about 50% of the total height 1412. In some embodiments, the height of the lower portion and the height of the upper portion are between 5% and 80% of the total height 1412 of the bite block 1411, more preferably between about 20% and about 40%.

[0139] In some embodiments, the bite block 1511 may have a height of 7 mm. In such embodiments, the upper portion 1522 may have a height of about 2.5 mm, extending from the bite surface 1528 to where the bevel of the upper portion 1522 meets the undercut of the lower portion 1520. In such embodiments, the lower portion may have a height 1519 of about 4.5 mm, extending from the base of the bite block 1511 to where the bevel of the upper portion 1522 meets the undercut of the lower portion 1520.

[0140] In some embodiments, the height of the upper portion and the height of the lower portion are about 50% of the total height 1515. In some embodiments, the height of the lower portion and the height of the upper portion are between 5% and 80% of the total height 1515 of the bite block 1511, more preferably between about 20% and about 40%.

[0141] Fig.18 A side view of the engagement structure is shown. The position of the bite block 1400 of the engagement structure 1410 within the appliance can be designed so that the lower surface 1434 of the bite block 1411 is located at or above the majority of the occlusal portion of the patient's dentition. For example, Fig.18 The bite block 1411 shown in FIG is positioned above the cusps 1802 of the patient's teeth 1810. In some embodiments, the position of the bite block 1411 is such that the bite block does not interfere with the patient's dentition when the patient is not applying a jaw closing force to the engagement structure 1410. In some embodiments, the bite block can be located less than 0.10 mm above the occlusal surface of the patient's teeth 1810. In some embodiments, the bite block can be between 0 mm and 2 mm above the occlusal surface of the patient's teeth. In some embodiments, the bite block may interfere with the patient's teeth. In some embodiments, the bite block can be located such that it is less than 0.1 mm below the occlusal surface of the patient's teeth 1810.

[0142] Fig.19 A side view of an engagement structure for a lower dental arch is shown. Bite block 1411 can have a length 1414. The length 1414 can be such that the bite block spans a gap between two teeth in the patient's dental arch (which gap may be caused by a missing or erupted tooth). In this way, the patient's teeth adjacent to the gap provide support for bite block 1411, such as when a bite force or repositioning force is applied to the block. In some embodiments, length 1414 can be patient-specific such that the length 1414 of the bite block is between 0.5 mm and 6 mm longer than the width of the gap between two non-adjacent teeth 1910. For example, Fig.19 The bite block 1411 shown in has a length that spans the distance between the patient's first premolar and first molar, which is caused by the missing second premolar. In some embodiments, the bite block 1411 can have a length that spans the distance between the patient's second premolar and second molar, which is caused by the missing first molar. In some embodiments, the length of the bite block can be determined based on the average gap formed by the missing teeth. For example, for a bite block on the lower dental arch, the length can be between 8 mm and 16 mm, more preferably between 10 mm and 14 mm. In some embodiments, the length is about 12 mm.

[0143] Fig. 20A side view of an engagement structure for an upper dental arch is shown. Bite block 1511 can have a length 1514. Length 1514 can be such that the bite block spans a gap between two teeth in a patient's dental arch, which gap may be caused by a missing or erupted tooth. In this way, the patient's teeth adjacent to the gap provide support for bite block 1511, such as when a bite force or repositioning force is applied to the block. In some embodiments, length 1514 can be patient-specific such that the length 1514 of the bite block is between 0.5 mm and 6 mm longer than the width of the gap between two non-adjacent teeth 1910. For example, Fig. 20 The bite block 1511 shown in has a length that spans the distance between the patient's first premolar and first molar, which is caused by the missing second premolar. In some embodiments, the bite block 1511 can have a length that spans the distance between the patient's second premolar and second molar, which is caused by the missing first molar. In some embodiments, the length of the bite block can be determined based on the average gap formed by the missing teeth. For example, for a bite block on the upper dental arch, the length can be between 6 mm and 16 mm, more preferably between 8 mm and 13 mm. In some embodiments, the length is about 11 mm.

[0144] Fig.21 A view is shown looking mesially toward the posterior surface of the engagement structure from a distal position. The bite block 1511 can have a buckle-lingual width 2110 that is less than the width of the patient's teeth on which the bite block is placed. The width is measured between the buckle side of the tooth and the lingual side of the tooth. Developments related to the present disclosure have shown that the width of the bite block or engagement structure is equal to or greater than the width of the tooth on which the bite block is placed because of interference when using accessories (such as accessory 2112). A wide bite block is used to inhibit engagement between the accessory 2112 and the orthodontic appliance. By using a bite block 1511 with a width 2110 that is less than the width of the corresponding tooth, accessories and other devices become more effective compared to wider bite blocks. The width of the bite blocks 1411, 1511 is between 4 mm and 10 mm, more preferably between 5 mm and 7 mm. In some embodiments, the width is about 6 mm.

[0145] Fig. 22An orthodontic appliance 2200 including an engagement structure 2210 is shown. The orthodontic appliance 2200 can be used in an upper or lower dental arch of a patient and can include two engagement structures 2210, one on each of the right and left sides of the dental arch of the appliance. The orthodontic appliance can be one of a plurality of orthodontic appliances provided to the patient and worn continuously to gradually move the patient's teeth and adjust the position of the mandible. The appliance can include a tooth receiving cavity 2202 for gradually repositioning the patient's teeth. The appliance 2200 can also include one or more accessory receiving cavities 2204 for receiving accessories placed on the patient's teeth. The engagement structure 2210 can include a bite block received in a cavity formed by the appliance and extending from the occlusal portion of the appliance.

[0146] In some embodiments, a bite block for a set of appliances may be selected from a set of four bite block shapes and sizes. For example, a bite block may be selected from a set of bite blocks having a height of about 5 mm or 7 mm. In some embodiments, a bite block for the right side of a lower dental arch and a bite block for the left side of the same lower dental arch may have the same size and shape, while bite blocks for the left and right sides of an upper dental arch may have the same size and shape, which is different from the size and shape of the lower bite block. In some embodiments, a bite block for each stage of the gradual repositioning of a patient's mandible may be selected from a set of four bite blocks. The set of four bite blocks may include a lower bite block having a first shape and a height of 5 mm, a lower bite block having a second shape and a height of 7 mm, an upper bite block having a third shape and a height of 5 mm, and a fourth bite block having a fourth shape and a height of 7 mm. In some embodiments, the engagement surface of each of the four bite blocks may be at the same angle relative to the occlusal plane. In some embodiments, the angles of the occlusal surfaces of the upper bite blocks may be the same.

[0147] While the bite block can include many suitable materials, in some embodiments, the first bite block and the second bite block both include a material that is softer than the harder layer. For example, the first bite block and the second bite block can include the softer material of the first layer. Work related to the present disclosure has shown that the bite block including a material similar to a layer of thermoformed material in contact with the bite block can improve the bonding of the bite block to the appliance. For example, the first layer of the one or more layers can include polyurethane, and the bite block can include polyurethane.

[0148] The bite blocks disclosed herein can be manufactured in a number of ways, for example, using computer numerical control (CNC) machining, molding (such as injection molding), and additive manufacturing. The presently disclosed engagement structures and braces are well suited for additive manufacturing. In some embodiments, the engagement structure and brace can be manufactured directly as a single, integrally formed component by additive manufacturing. For example, a formed engagement structure as described herein can be manufactured directly with the brace to form an integrally formed brace, wherein the bite block is manufactured directly as a single component with the polymer shell brace, as will be understood by one of ordinary skill in the art.

[0149] Examples of suitable harder and softer materials that may be combined according to embodiments of the present disclosure are described in U.S. Pat. No. 9,655,693, entitled “Multilayer dental appliances and related systems,” issued May 23, 2017, the entire disclosure of which is incorporated herein by reference. The bite block may include any material disclosed herein, such as a hard material or a soft material, and may include a material similar to that of the appliance or a material different from that of the appliance.

[0150] In some embodiments, the hard polymer layer can be thicker than either soft polymer layer. The soft polymer layers can have the same or different thicknesses. For example, the thickness of the hard polymer layer can be in the range of about 550 microns ("μm") to about 750 microns. The thickness of the soft polymer layer can be in the range of about 25 microns to about 100 microns. The thickness of the multilayer sheet used to make a rectifier having a hard polymer layer disposed between two soft polymer layers can be in the range of about 600 microns to about 1000 microns. In some embodiments, the thickness of the various layers can be customized for a particular stage of treatment for a patient.

[0151] Suitable polymer materials for the hard polymer layer may include polyesters, copolyesters, polycarbonates, thermoplastic polyurethanes, polypropylene, polyethylene, copolymers of polypropylene and polyethylene, acrylic acid, cyclic block copolymers, polyetheretherketones, polyamides, polyethylene terephthalate, polybutylene terephthalate, polyetherimides, polyethersulfones, polytrimethylene terephthalate, or combinations thereof (e.g., mixtures of at least two of the listed hard polymer materials). In some embodiments, the hard polymer layer of the orthotic device may include polymer materials such as polycarbonates, copolyesters, polyesters, and thermoplastic polyurethanes. In some embodiments, the hard layer may be composed of multiple hard layers, for example, two or three hard polymer layers are coextruded to form one hard layer.

[0152] The hard polymer layer of the orthosis of the present invention can have various physical properties, which can, for example, improve the treatment selection of the physician. For example, physical properties such as tensile strength, elongation at yield, elongation at break, tensile modulus, flexural modulus, stress relaxation over time, and light transmittance can be specifically tailored for specific applications. In some embodiments, the hard polymer layer of the orthosis can have at least one of the following physical properties: a tensile strength at yield between about 4000 pounds per square inch (psi) and 6500 psi, an elongation at yield greater than about 4%, an elongation at break greater than about 70%, a tensile modulus greater than about 150,000 psi, a flexural modulus greater than about 150,000 psi, a stress relaxation greater than 10% tested in a humid environment (e.g., at a relative humidity between about 90%-100%) for 24 hours, and a light transmittance greater than about 75% between 400 nm and 800 nm.

[0153] Suitable polymer materials for the soft polymer layer of the orthotic device may include: styrene block copolymer (SBC), silicone rubber, elastic alloy, thermoplastic elastomer (TPE), thermoplastic vulcanizate (TPV) elastomer, polyurethane elastomer, block copolymer elastomer, polyolefin blend elastomer, thermoplastic copolyester elastomer, thermoplastic polyamide elastomer or a combination thereof (e.g., a mixture of at least two of the listed soft polymer materials). The soft polymer layers may be the same material or different materials. In some embodiments, the first soft polymer layer and the second soft polymer layer are the same polymer material.

[0154] The soft polymer layer of the orthotic device can have various physical properties. For example, physical properties such as hardness, ultimate tensile strength, elongation at break, tensile modulus, compression set, flexural modulus, and transmittance can be specifically tailored for specific applications. In some embodiments, the soft polymer layer of the orthotic device can independently have at least one of the following physical properties: a hardness in the range of about 60A to about 85D, an ultimate tensile strength greater than about 5000 psi, an elongation at break greater than about 200%, a compression set greater than 40% after 24 hours at about 70°C, a flexural modulus greater than about 35,000 psi, and a transmittance greater than about 75% between 400nm and 800nm.

[0155] As described herein, the layers of the brace may include a hard polymer layer disposed between two soft polymer layers. In one embodiment, a multilayer brace may include a hard polymer layer of one type of material (e.g., a copolyester), and two soft polymer layers of other types of materials that may be the same or different (e.g., two soft polymer layers of a thermoplastic polyurethane elastomer). In some embodiments, a multilayer brace may also include a hard polymer layer of at least two layers of polymer material. For example, the hard polymer layer may include several polymer layers laminated together to form a hard polymer layer. The laminated hard polymer layer may include at least two layers of any combination of the following polymer materials: polyester, copolyester, polycarbonate, thermoplastic polyurethane, polypropylene, polyethylene, polypropylene and polyethylene copolymers, acrylic acid, cyclic block copolymers, polyetheretherketone, polyamide, polyethylene terephthalate, polybutylene terephthalate, polyetherimide, polyethersulfone, and polytrimethylene terephthalate. Similarly, in some embodiments, a multilayer brace may include a soft polymer layer of at least two layers of polymer material. For example, a soft polymer layer may include a layer of several polymer layers laminated together. The laminated soft polymer layer may include any combination of at least two layers of the following polymer materials: styrene block copolymers (SBC), silicone rubber, elastic alloys, thermoplastic elastomers (TPE), thermoplastic vulcanizate (TPV) elastomers, polyurethane elastomers, block copolymer elastomers, polyolefin blended elastomers, thermoplastic copolyester elastomers and thermoplastic polyamide elastomers.

[0156] A variety of methods can be used to manufacture tooth positioning braces. For example, a method for manufacturing the braces may include thermoforming a multi-layer sheet into the braces by heating the sheet and then forming the sheet into a specific configuration. Methods for manufacturing braces (including Invisalign) are described in a number of patents and patent applications assigned to Align Technologies, Inc. TM The invention discloses exemplary methods of thermoforming an object (such as those used in the system), including, for example, U.S. Patent No. 9,103,338, issued on August 18, 2015, and entitled “Methods and systems thermoforming an object” on the company's website accessible on the World Wide Web (see, for example, the website address “invisalign.com”).

[0157] Unless otherwise indicated, the terms "connected to" and "coupled to" (and their derivatives) used in the specification and claims should be interpreted as allowing both direct and indirect (i.e., via other elements or components) connections. In addition, the terms "a" or "an" used in the specification and claims should be interpreted to mean "at least one". Finally, for ease of use, the terms "including" and "having" (and their derivatives) used in the specification and claims are interchangeable with the word "comprising" and shall have the same meaning as the word "including".

[0158] It should be understood that although the terms "first", "second", "third", etc. may be used herein to describe various layers, elements, components, regions, or portions, no particular order or sequence of matters is involved. These terms are only used to distinguish one layer, element, component, region, or portion from another layer, element, component, region, or portion. Without departing from the teachings of the present disclosure, a first layer, element, component, region, or portion as described herein may be referred to as a second layer, element, component, region, or portion.

[0159] As used herein, the term "or" is used inclusively to refer to items in alternatives and combinations unless otherwise stated.

[0160] As used herein, numerals such as numerals refer to similar elements.

[0161] This disclosure includes the following numbered items.

[0162] Item 1. A plurality of bite blocks for mandibular repositioning, the plurality of bite blocks comprising: a first bite block comprising a first surface; and a second bite block comprising a second surface for engaging with the first surface; wherein the first surface and the second surface are formed to engage with each other by a difference in curvature.

[0163] Item 2. The plurality of bite blocks of Item 1, wherein the first surface and the second surface comprise similarly shaped profiles oriented in opposite directions.

[0164] Item 3. The plurality of bite blocks of Item 1, wherein the first surface and the second surface are shaped to join to each other along a join line.

[0165] Item 4. The plurality of bite blocks of Item 3, wherein the first surface and the second surface are shaped to join one another along a substantially straight line through the curvature difference.

[0166] Item 5. The plurality of bite blocks of Item 3, wherein the first surface and the second surface are shaped to engage with each other at an engagement point, the engagement point extending along the line.

[0167] Item 6. A plurality of bite blocks according to Item 1, wherein the first bite block includes a first midline, and the first surface includes a first portion located on a first side of the midline and a second portion located on a second side of the midline, the first portion including a different curvature than the second portion.

[0168] Item 7. A plurality of bite blocks according to Item 6, wherein the second bite block includes a second midline, and the second surface includes a first portion located on a first side of the second midline and a second portion located on a second side of the second midline, the first portion including a different curvature than the second portion.

[0169] Item 8. A plurality of bite blocks according to Item 7, wherein the first portion of the first surface includes a curvature corresponding to the curvature of the second portion of the second surface, and the curvature of the second portion of the first surface includes a curvature corresponding to the curvature of the first portion of the second surface.

[0170] Item 9. The plurality of bite blocks of Item 8, wherein each of the first and second portions of the first surface and the first and second portions of the second surface comprises a convex surface.

[0171] Item 10. The plurality of bite blocks of Item 8, wherein a curvature of the first portion of the first surface matches a curvature of the second portion of the second surface, and a curvature of the second portion of the first surface matches a curvature of the first portion of the second surface.

[0172] Item 11. A plurality of bite blocks according to Item 8, wherein one or more of the first portion or the second portion of the first surface comprises zero curvature, and wherein one or more of the first portion or the second portion of the second surface comprises zero curvature.

[0173] Item 12. A plurality of bite blocks according to Item 1, wherein a first 3D shape profile of the first surface and a second 3D shape profile of the second surface correspond to each other, and optionally wherein the first 3D shape profile matches the second 3D shape profile.

[0174] Item 13. The plurality of bite blocks of Item 1, wherein the first bite block and the second bite block are replicas of each other.

[0175] Item 14. A plurality of bite blocks according to Item 13, wherein the first bite block includes a first 3D outer surface shape profile and the second bite block includes a second 3D outer surface shape profile, and wherein the first 3D outer surface shape profile matches the second 3D outer surface shape profile to within 90%, and optionally wherein the first bite block includes a first volume and the second bite block includes a second volume, and the second volume matches the first volume to within 90%.

[0176] Item 15. A plurality of bite blocks according to Item 1, wherein the plurality of bite blocks comprises: a first layer of thermoformable material on the first bite block to form a first engagement structure of a first mandibular repositioning brace; and a second layer of thermoformable material on the second bite block to form a second engagement structure of a second mandibular repositioning brace.

[0177] Item 16. The plurality of bite blocks of Item 15, wherein the first block and the second block are arranged to engage one another, with the first layer and the second layer located between the first block and the second block.

[0178] Item 17. The plurality of bite blocks of Item 16, wherein the first layer and the second layer comprise a type of polymer material, and the first bite block and the second bite block comprise the type of polymer material.

[0179] Item 18. The plurality of bite blocks of Item 15, comprising: a first plurality of layers of thermoformed material of the first aligner on the first block; and a second plurality of layers of thermoformed material of the second aligner on the second block.

[0180] Item 19. A plurality of bite blocks according to Item 18, wherein the first plurality of layers comprises a harder material layer between two softer material layers, and the second plurality of layers comprises the harder material layer between the two softer material layers, and optionally wherein the harder material layer comprises a copolyester and the softer material layer comprises a thermoplastic polyurethane.

[0181] Item 20. The plurality of bite blocks of Item 19, wherein the first bite block and the second bite block each comprise a softer material than the harder layer.

[0182] Item 21. A device for mandibular repositioning, the device comprising: a first corrector, the first corrector comprising a first engagement structure, the first engagement structure comprising a first engagement surface, the first engagement surface facing generally forward and inclined relative to a first midline of the first engagement structure; and a second corrector, the second corrector comprising a second engagement structure, the second engagement structure comprising a second engagement surface, the second engagement surface facing generally backward and inclined relative to the midline of the second engagement structure; wherein one or more of the first engagement surface or the second engagement surface is curved to form an engagement line in the tongue-buccal direction when the first engagement surface is engaged with the second engagement surface.

[0183] Item 22. The apparatus of Item 21, further comprising a plurality of bite blocks according to any one of Items 1 to 20.

[0184] Item 23. A device for mandibular repositioning, the device comprising: a first corrector comprising a first plurality of tooth receiving cavities, a first engaging structure comprising a first engaging surface, and a second engaging structure comprising a second engaging surface; and a second corrector comprising a second plurality of tooth receiving cavities, a third engaging structure and a fourth engaging structure, the third engaging structure comprising a third engaging surface for engaging with the first engaging surface, the fourth engaging structure comprising a fourth engaging surface for engaging with the second engaging surface; wherein the first engaging surface and the second engaging surface are inclined relative to the third engaging surface and the fourth engaging surface, respectively, to generate a mandibular repositioning force and limit lateral movement of the mandible.

[0185] Item 24. The apparatus of Item 23, further comprising a plurality of bite blocks according to any one of Items 1 to 20, and wherein the first engagement structure comprises the first bite block and the third engagement structure comprises the second bite block.

[0186] Item 25. The apparatus according to Item 24, further comprising a third bite block corresponding to the first bite block and a fourth bite block corresponding to the second bite block, and wherein the second engagement structure includes the third bite block and the fourth engagement structure includes the fourth bite block.

[0187] Item 26. An apparatus according to Item 23, wherein the first engagement surface is inclined relative to the midline of the first engagement structure and the second engagement surface is oppositely inclined relative to the midline of the second engagement structure to limit lateral movement of the mandible and reposition the mandible.

[0188] Item 27. An apparatus according to Item 23, wherein the third engagement surface is inclined relative to the midline of the third engagement structure and the fourth engagement surface is oppositely inclined relative to the midline of the fourth engagement structure to limit lateral movement of the mandible and reposition the mandible.

[0189] Item 28. An apparatus according to Item 23, wherein the first engagement surface and the second engagement surface face generally forward, and wherein the third engagement surface and the fourth engagement surface face generally rearward to engage with the first engagement surface and the second engagement surface to generate the mandibular repositioning force.

[0190] Item 29. An apparatus according to Item 23, wherein the first engagement surface and the second engagement surface face generally rearward, and wherein the third engagement surface and the fourth engagement surface face generally forward to engage with the first engagement surface and the second engagement surface to generate the mandibular repositioning force.

[0191] Item 30. An apparatus according to Item 23, wherein one or more of the first engagement structure, the second engagement structure, the third engagement structure or the fourth engagement structure extends from an occlusal surface of one or more of the first or second brace, and optionally, wherein one or more of the first engagement surface, the second engagement surface, the third engagement surface or the fourth engagement surface is located between the occlusal surfaces of the first or second brace.

[0192] Item 31. An apparatus according to Item 23, wherein one or more of the first joining surface or the third joining surface includes a curved surface to form a first joining site, and wherein one or more of the second joining surface or the fourth joining surface includes a curved surface to form a second joining site.

[0193] Item 32. An apparatus according to Item 31, wherein the curved surface provides engagement between the first engagement surface and the third engagement surface to accommodate a Spee curve of the mouth, and optionally wherein the position of the engagement site changes with subsequent correctors in response to changes in the Spee curve.

[0194] Item 33. An apparatus according to Item 31, wherein the first engagement surface and the third engagement surface are formed to contact each other at the first engagement site and a sliding engagement site is provided between the first engagement surface and the third engagement surface to generate the mandibular repositioning force and limit lateral movement.

[0195] Item 34. An apparatus according to Item 31, wherein the second engagement surface and the fourth engagement surface are formed to contact each other at the second engagement site and a sliding engagement site is provided between the second engagement surface and the fourth engagement surface to generate the mandibular repositioning force and limit lateral movement.

[0196] Item 35. An apparatus according to Item 31, wherein the first bonding site includes a first bonding area, the first bonding area is smaller than one or more of the first surface area of ​​the first bonding surface or the second surface area of ​​the second bonding surface, and wherein the second bonding site includes a second bonding area, the second bonding area is smaller than one or more of the third surface area of ​​the third bonding surface or the fourth surface area of ​​the fourth bonding surface.

[0197] Item 36. An apparatus according to Item 35, wherein the first bonding area includes a contact area located between the first bonding surface and the second bonding surface, and the second bonding area includes a contact area located between the third bonding surface and the fourth bonding surface.

[0198] Item 37. An apparatus according to Item 23, wherein the mandibular repositioning force includes a mandibular advancement force.

[0199] Item 38. An apparatus according to Item 23, wherein the mandibular repositioning force includes a mandibular retraction force.

[0200] Item 39. The apparatus of any of the preceding items, wherein one or more of the first orthosis or the second orthosis comprises a polymer shell orthosis.

[0201] Item 40. A method comprising using a plurality of bite blocks or appliances according to any one of the preceding items.

[0202] Item 41. A plurality of bite blocks for mandibular repositioning, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first keyway, the first keyway formed in the first side surface of the first bite block; a second bite block, the second bite block comprising a second side surface and a second engagement surface for engaging with the first engagement surface; and a second keyway, the second keyway formed in the second side surface of the first bite block.

[0203] Item 42. The plurality of bite blocks of Item 41, wherein the first side surface has a lower portion and an upper portion.

[0204] Item 43. A plurality of bite blocks according to Item 42, wherein the lower portion extends from the base toward the bite surface.

[0205] Item 44. A plurality of bite blocks according to Item 43, wherein the upper portion extends from the bite surface toward the base.

[0206] Item 45. A plurality of bite blocks according to Item 44, wherein the upper portion meets the lower portion along a mesio-distal line between the occlusal surface and the base.

[0207] Item 46. The plurality of bite blocks of Item 45, wherein the first side surface of the lower portion extends from the base toward the upper portion at a draft angle relative to a line perpendicular to the bite plane.

[0208] Item 47. A plurality of bite blocks according to Item 46, wherein the first side surface is a buccal surface, and the first bite block includes a lingual surface opposite the buccal surface, the lingual surface extending from the base at the draft angle.

[0209] Item 48. The plurality of bite blocks of Item 47, wherein the draft angle is between 1 degree and 10 degrees.

[0210] Item 49. The plurality of bite blocks of Item 47, wherein the draft angle is approximately 5 degrees.

[0211] Item 50. The plurality of bite blocks of Item 45, wherein the first side surface of the upper portion defines a slope extending from the bite surface toward the lower portion at an angle relative to a line perpendicular to the bite plane.

[0212] Item 51. A plurality of bite blocks according to Item 46, wherein the first side surface is a buccal surface, and the first bite block includes a lingual surface opposite the buccal surface, the upper portion of the lingual surface defining a ramp extending from the bite surface at the angle.

[0213] Item 52. A plurality of bite blocks according to Item 50, wherein the angle is between 15 degrees and 25 degrees.

[0214] Item 53. A plurality of bite blocks according to Item 50, wherein the angle is about 20 degrees.

[0215] Item 54. A plurality of bite blocks according to Item 41, wherein the bite blocks have a height of approximately 5 mm.

[0216] Item 55. A plurality of bite blocks according to Item 41, wherein the bite blocks have a height of approximately 7 mm.

[0217] Item 56. A plurality of bite blocks according to Item 41, wherein the first bite block comprises an occlusal surface parallel to an occlusal plane of the patient's dentition.

[0218] Item 57. The plurality of bite blocks of Item 41, wherein the second bite block comprises an occlusal surface that is angled relative to the occlusal plane, the angle being between about 15 degrees and about 25 degrees.

[0219] Item 58. A plurality of bite blocks according to Item 57, wherein the angle is between about 3 degrees and about 15 degrees.

[0220] Item 59. A plurality of bite blocks according to Item 57, wherein the angle is between about 5 degrees and about 10 degrees.

[0221] Item 60. A plurality of bite blocks according to Item 57, wherein the angle corresponds to the angle of the Spee curve at the location of the bite block.

[0222] Item 61. A plurality of bite blocks according to Item 41, wherein the base of the bite block has a length extending from a most medial edge to a most distal edge of the base, the length being between 8 mm and 16 mm.

[0223] Item 62. A plurality of bite blocks according to Item 61, wherein the length is between 10 mm and 14 mm.

[0224] Item 63. A plurality of bite blocks according to Item 61, wherein the length is approximately 14 mm.

[0225] Item 64. A plurality of bite blocks according to Item 41, wherein the base of the bite block has a width extending from a buccal-most edge to a lingual-most edge of the base, the width being between 4 mm and 10 mm.

[0226] Item 65. A plurality of bite blocks according to Item 61, wherein the width is between 5 mm and 7 mm.

[0227] Item 66. A plurality of bite blocks according to Item 61, wherein the width is about 6 mm.

[0228] Item 67. A system comprising: a plurality of orthodontic appliances, each of the plurality of orthodontic appliances having: a tooth receiving cavity for gradually repositioning a patient's teeth from an initial position toward a final position; and an engagement structure for gradually repositioning the patient's mandible and comprising a bite block according to any one of Items 1-66.

[0229] Item 68. The system of Item 67, wherein the height of the bite block for each of the plurality of orthodontic appliances is about 5 mm or about 7 mm.

[0230] Item 69. The system of Item 67, wherein the shape of each bite block of each of the plurality of appliances for the lower dental arch is the same shape.

[0231] Item 70. The system of Item 67, wherein the shape of each bite block of each of the plurality of appliances for the upper dental arch is the same shape.

[0232] Item 71. An orthodontic treatment system, the orthodontic treatment system comprising:

[0233] A plurality of orthodontic appliances, each of the plurality of orthodontic appliances having: a first plurality of tooth receiving cavities, a first engagement structure including a first engagement surface, and a second engagement structure including a second engagement surface; and a second appliance, the second appliance comprising: a second plurality of tooth receiving cavities, a third engagement structure including a third engagement surface for engaging with the first engagement surface, and a fourth engagement structure including a fourth engagement surface for engaging with the second engagement surface, wherein the first engagement surface and the second engagement surface are inclined relative to the third engagement surface and the fourth engagement surface, respectively, to generate a mandibular repositioning force and limit lateral movement of the mandible.

[0234] Item 72. The apparatus of Item 71, further comprising said plurality of bite blocks, and wherein said first engagement structure comprises said first bite block, and said third engagement structure comprises said second bite block.

[0235] Item 73. The apparatus of Item 72, further comprising a third bite block corresponding to the first bite block and a fourth bite block corresponding to the second bite block, and wherein the second engagement structure comprises the third bite block and the fourth engagement structure comprises the fourth bite block.

[0236] Item 74. An apparatus according to Item 71, wherein the first engagement surface is inclined relative to the midline of the first engagement structure and the second engagement surface is oppositely inclined relative to the midline of the second engagement structure to limit lateral movement of the mandible and reposition the mandible.

[0237] Item 75. An apparatus according to Item 71, wherein the third engagement surface is inclined relative to the midline of the third engagement structure and the fourth engagement surface is oppositely inclined relative to the midline of the fourth engagement structure to limit lateral movement of the mandible and reposition the mandible.

[0238] Item 76. A plurality of bite blocks for mandibular repositioning, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut, the first undercut being formed in the first side surface of the first bite block; a first keyway, the first keyway being formed in the first side surface of the first bite block; a second bite block, the second bite block comprising a second side surface and a second engagement surface for engaging with the first engagement surface; and a second keyway, the second keyway being formed in the second side surface of the second bite block.

[0239] Item 77. A plurality of bite blocks according to Item 76, wherein the first side surface has a lower portion and an upper portion.

[0240] Item 78. A plurality of bite blocks according to Item 77, wherein the lower portion extends from the base toward the bite surface.

[0241] Item 79. A plurality of bite blocks according to Item 78, wherein the upper portion extends from the bite surface toward the base.

[0242] Item 80. The plurality of bite blocks of Item 79, wherein the upper portion meets the lower portion along a mesio-distal line between the occlusal surface and the base.

[0243] Item 81. The plurality of bite blocks of Item 80, wherein the first side surface of the lower portion forms the undercut by extending from the base toward the upper portion at a draft angle relative to a line perpendicular to the bite surface.

[0244] Item 82. A plurality of bite blocks according to Item 81, wherein the first side surface is a buccal surface, and the first bite block includes a lingual surface opposite the buccal surface, the lingual surface extending from the base at the draft angle.

[0245] Item 83. The plurality of bite blocks of Item 82, wherein the draft angle is between 1 degree and 45 degrees.

[0246] Item 84. The plurality of bite blocks of Item 82, wherein the draft angle is approximately 5 degrees.

[0247] Item 85. A system, comprising: a plurality of first orthodontic appliances and a plurality of second orthodontic appliances for multiple treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity, the tooth receiving cavity being used to gradually reposition the patient's teeth from an initial position toward a final position; the plurality of first orthodontic appliances having: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut, the first undercut being formed in the first side surface of the first bite block; a first keyway, the first keyway being formed in the first side surface of the first bite block; the plurality of second orthodontic appliances having: a second bite block, the second bite block comprising a second side surface and a second engagement surface for engaging with the first engagement surface; and a second keyway, the second keyway being formed in the second side surface of the second bite block.

[0248] Item 86. The plurality of bite blocks of Item 85, wherein the first side surface has a lower portion and an upper portion.

[0249] Item 87. A plurality of bite blocks according to Item 86, wherein the lower portion extends from the base toward the bite surface.

[0250] Item 88. A plurality of bite blocks according to Item 87, wherein the upper portion extends from the bite surface toward the base.

[0251] Item 89. A plurality of bite blocks according to Item 88, wherein the upper portion meets the lower portion along a mesio-distal line between the occlusal surface and the base.

[0252] Item 90. The plurality of bite blocks of Item 89, wherein the first side surface of the lower portion forms the undercut by extending from the base toward the upper portion at a draft angle relative to a line perpendicular to the bite plane.

[0253] Item 91. A system comprising: a plurality of first orthodontic appliances and a plurality of second orthodontic appliances for multiple treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity for gradually repositioning the patient's teeth from an initial position toward a final position; the plurality of first orthodontic appliances having: any combination of bite blocks according to Items 1-91.

[0254] The embodiments of the present disclosure have been shown and described as set forth herein, and are provided by way of example only. Without departing from the scope of the present disclosure, one of ordinary skill in the art will recognize many adaptations, changes, variations, and substitutions. Without departing from the scope of the present disclosure and the invention disclosed herein, several substitutions and combinations of the embodiments disclosed herein may be utilized. Therefore, the scope of the presently disclosed invention shall be limited only by the scope of the appended claims and their equivalents.

Claims

1. A device for mandibular repositioning, the device comprising: a first orthosis including a first engagement structure including a first engagement surface, the first engagement surface generally facing forward and angled relative to a first midline of the first engagement structure; as well as a second orthosis, the second orthosis comprising a second engagement structure, the second engagement structure comprising a second engagement surface, the second engagement surface generally facing posteriorly and angled relative to a midline of the second engagement structure; Wherein, one or more of the first engagement surface or the second engagement surface is curved to form an engagement line in the tongue-buccal direction when the first engagement surface is engaged with the second engagement surface.

2. A device for mandibular repositioning, the device comprising: A first corrector, the first corrector comprising: a first plurality of tooth receiving cavities, a first engagement structure, the first engagement structure comprising a first engagement surface, and a second engagement structure, the second engagement structure comprising a second engagement surface; and A second corrector, the second corrector comprising: a second plurality of teeth receiving cavities, a third engaging structure, the third engaging structure comprising a third engaging surface for engaging with the first engaging surface, and a fourth engagement structure comprising a fourth engagement surface for engaging with the second engagement surface; Wherein, the first engagement surface and the second engagement surface are inclined relative to the third engagement surface and the fourth engagement surface, respectively, to generate a mandibular repositioning force and limit lateral movement of the mandible.

3. A plurality of bite blocks for mandibular repositioning, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first keyway formed in the first side surface of the first bite block; a second bite block including a second side surface and a second engagement surface for engaging with the first engagement surface; as well as A second keyway is formed in the second side surface of the first bite block.

4. An orthodontic treatment system, comprising: A plurality of sets of orthodontic appliances, each of the plurality of sets of orthodontic appliances having: A first corrector, the first corrector comprising: a first plurality of tooth receiving cavities, a first engagement structure, the first engagement structure comprising a first engagement surface, and a second engagement structure, the second engagement structure comprising a second engagement surface; and A second corrector, the second corrector comprising: a second plurality of teeth receiving cavities, a third engaging structure, the third engaging structure comprising a third engaging surface for engaging with the first engaging surface, and a fourth engagement structure comprising a fourth engagement surface for engaging with the second engagement surface, Wherein, the first engagement surface and the second engagement surface are inclined relative to the third engagement surface and the fourth engagement surface, respectively, to generate a mandibular repositioning force and limit lateral movement of the mandible.

5. A plurality of bite blocks for mandibular repositioning, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut formed in the first side surface of the first bite block; a first keyway formed in the first side surface of the first bite block; a second bite block including a second side surface and a second engagement surface for engaging with the first engagement surface; as well as A second keyway is formed in the second side surface of the second bite block.

6. A system, comprising: A plurality of first orthodontic appliances and a plurality of second orthodontic appliances for a plurality of treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity for incrementally repositioning a patient's teeth from an initial position toward a final position; The plurality of first orthodontic appliances comprises: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut formed in the first side surface of the first bite block; a first keyway formed in the first side surface of the first bite block; and the plurality of second orthodontic appliances having: a second bite block including a second side surface and a second engagement surface for engaging with the first engagement surface; and A second keyway is formed in the second side surface of the second bite block.

7. A bite block system for mandibular repositioning, the bite block system comprising: a first bite block including an occlusal surface, a first engagement surface configured to engage a surface of a second bite block, a lingual surface, and a buccal surface; a first undercut formed in the lingual surface of the first bite block and extending from a base of the first bite block toward the occlusal surface of the first bite block at a first draft angle; A second undercut is formed in the buccal surface of the first bite block and extends from the base of the first bite block toward the occlusal surface of the first bite block at a second draft angle.

8. A system, comprising: A plurality of first orthodontic appliances and a plurality of second orthodontic appliances for a plurality of treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: a tooth receiving cavity for incrementally repositioning a patient's teeth from an initial position toward a final position; The plurality of first orthodontic appliances comprises: a first bite block comprising an occlusal surface, a first engagement surface configured to engage with a surface of a second bite block on the plurality of second orthodontic appliances, a lingual surface, and a buccal surface; a first undercut formed in the lingual surface of the first bite block and extending from a base of the first bite block toward the occlusal surface of the first bite block at a first draft angle; A second undercut is formed in the buccal surface of the first bite block and extends from the base of the first bite block toward the occlusal surface of the first bite block at a second draft angle.

9. A plurality of bite blocks for mandibular repositioning, the plurality of bite blocks comprising: a first bite block, the first bite block comprising a first engagement surface and a first side surface; a first undercut formed in the first side surface of the first bite block; a second bite block including a second side surface and a second engagement surface for engaging with the first engagement surface; as well as A second undercut is formed in the second side surface of the second bite block.

10. A system, comprising: A plurality of first orthodontic appliances and a plurality of second orthodontic appliances for a plurality of treatment stages, each of the plurality of first orthodontic appliances and the plurality of second orthodontic appliances having: A tooth receiving cavity for gradually repositioning a patient's teeth from an initial position toward a final position, wherein the plurality of first orthodontic appliances have any combination of the bite blocks of claims 3, 5, 7, and 9.

11. A method comprising: Use of a plurality of bite blocks, systems, devices, or appliances as claimed in any one of claims 1 to 9.

12. A system, comprising: A plurality of orthodontic appliances, each of the plurality of orthodontic appliances having: a tooth receiving cavity for incrementally repositioning a patient's teeth from an initial position toward a final position; as well as An engagement structure for gradually repositioning a patient's mandible and comprising a bite block as claimed in any one of claims 3, 5, 7 and 9.

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