Systems and methods for placing occlusal mandibular advancement blocks

Abstract

A method of treating tooth malocclusion may include receiving a scan of a patient's tooth and generating a treatment plan to move the patient's tooth from a first position toward a second position. The treatment plan may include moving the jaw from the first position toward the second position. The treatment plan may include a series of jaw movement phases to move the jaw from the first position toward the second position. The method may include generating a digital model of an appliance having a mandibular repositioning structure. The position of the mandibular repositioning structure may be based on a set of position constraints. The method may include manufacturing a physical appliance based on a digital model of the appliance.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application No. 63 / 369,850, filed on July 29, 2022, entitled “Systems and Methods for Placing Occlusal Mandibular Advancement Blocks,” the entire contents of which are incorporated herein by reference. Background Art

[0003] Oral appliances, such as braces, can be used for various treatments of a patient's dentition, such as orthodontic treatment. For example, braces are often used to move teeth to the correct position. Oral appliances can also be used for mandibular repositioning (MR) treatments, such as mandibular advancement, by gradually repositioning the patient's mandible to the correct position. In some cases, the teeth of the patient's upper and lower jaws may contact in an incorrect or suboptimal manner, for example, crowding, crossbite, deep bite. Proper fit of the occlusal surfaces of the teeth contributes to chewing and aesthetics. Proper fit can be related to the relative position of the mandible and the upper jaw, either of which can be retracted or protruded relative to the ideal position. Mandibular repositioning treatment can be used to change the relative position of the upper and lower jaws toward a better alignment. Repositioning treatment can utilize a bite block on an oral appliance. A bite block can be a protrusion extending from the occlusal surface of an appliance. Contact between corresponding bite block pairs, such as contact between corresponding bite blocks from an upper appliance and a lower appliance, can apply force to gradually reposition the patient's mandible.

[0004] Oral appliances may be used exclusively for mandibular repositioning treatment or for simultaneous treatment, such as mandibular repositioning treatment with teeth alignment treatment. Teeth alignment treatment may include various stages. Each stage may involve an appliance that is worn by the patient for several weeks and is designed to gradually shift the teeth compared to the previous stage. Mandibular repositioning treatment may be more gradual and may require longer treatment. For example, mandibular repositioning treatment typically relies on several treatment trajectories, each of which includes a series of mandibular repositioning stages.

[0005] The placement of the bite block for each stage of each trajectory can be selected to advance the patient's mandible. Determining feasible positions for the bite block can be a resource intensive process. Determining the position is a time consuming process that often results in a suboptimal bite block position that is only achieved after or during treatment and appliance fitting. Work related to the present disclosure has shown that it may be desirable to iteratively calculate potential bite block positions based on a series of constraints. For example, certain positions may not be feasible due to structural weaknesses, manufacturing constraints, material limitations, etc. Other constraints may include human constraints, such as limitations due to the patient's oral or facial structure, incompatibilities with other orthodontic treatments, etc.

[0006]

[0013] Accordingly, the present disclosure identifies and addresses the need for systems and methods for selecting the position of a bite block on an oral appliance that can reliably advance a patient's jaw while being comfortable for the patient to wear for extended periods of time. Summary of the invention

[0007] As will be described in more detail below, the present disclosure describes various systems and methods for selecting the position of a bite block on an oral appliance. The position for placing a bite block for mandibular repositioning (MR) treatment can be determined by evaluating candidate positions that satisfy a series of constraints. The systems and methods described herein can improve bite block position selection when compared to conventional methods that simply select the first available candidate position for each stage.

[0008] In addition, the systems and methods described herein can improve the operation of a computing device by selectively targeting locations for bite block placement on an appliance, thereby increasing the processing efficiency of the computing device relative to conventional methods. These systems and methods can also improve the field of orthodontic treatment by selecting bite block locations that improve patient comfort and the effectiveness of mandibular repositioning treatment.

[0009] Incorporation by Reference

[0010] All patents, applications, and publications mentioned and identified herein are hereby incorporated by reference in their entirety, and should be deemed to be fully incorporated by reference in this application even if mentioned elsewhere in this application. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The features, advantages and principles of the present disclosure will be better understood by referring to the following detailed description which sets forth illustrative embodiments and the accompanying drawings, in which:

[0012] Figure 1 shows an example of placement of a bite block for an oral appliance according to some embodiments;

[0013] Figure 2A , 2B and 2C illustrate a flow chart of an example method for selecting a position of a bite block on an oral appliance according to some embodiments;

[0014] Figure 3 shows an illustration of a model for evaluating bite block placement according to some embodiments;

[0015] Figure 4 A block diagram illustrating an example system for selecting a position of a bite block on an oral appliance according to some embodiments;

[0016] Figure 5An example of a jaw opening constraint for placing a bite block on an oral appliance is shown according to some embodiments;

[0017] Figure 6 shows an example of collision constraints for placing a bite block on an oral appliance according to some embodiments;

[0018] Figure 7 shows an example of a rotational constraint for placing a bite block on an oral appliance according to some embodiments;

[0019] Figure 8 shows examples of relative positional and rotational constraints for placing a bite block on an oral appliance in accordance with some embodiments;

[0020] Fig. 9 shows an example of a contact plane constraint for placing a bite block on an oral appliance according to some embodiments;

[0021] Fig.10 shows an example of a tooth center constraint for placing a bite block on an oral appliance according to some embodiments;

[0022] Fig.11 shows an example of a bite gap constraint for placing a bite block on an oral appliance according to some embodiments;

[0023] Fig.12 shows an example of a distalization constraint for placing a bite block on an oral appliance according to some embodiments;

[0024] Fig.13 shows an example of dental arch position constraints for placing a bite block on an oral appliance according to some embodiments;

[0025] Fig.14 shows an example of a vertical articulation constraint for placing a bite block on an oral appliance according to some embodiments;

[0026] Fig.15 shows an example of a lateral articulation constraint for placing a bite block on an oral appliance according to some embodiments;

[0027] Fig.16 shows an example of a vertical asymmetric constraint for placing a bite block on an oral appliance according to some embodiments;

[0028] Fig.17 shows an example of a vertical asymmetric constraint for placing a bite block on an oral appliance according to some embodiments;

[0029] Fig.18A and Fig.18Bshows an example of a bridging constraint for placing a bite block on an oral appliance according to some embodiments;

[0030] Fig.19 shows an example of an attachment constraint for placing a bite block on an oral appliance according to some embodiments;

[0031] Fig. 20 shows a block diagram of an example computing system capable of implementing one or more embodiments described and / or illustrated herein, according to some embodiments;

[0032] Fig.21 shows a block diagram of an example computing network capable of implementing one or more embodiments described and / or illustrated herein, according to some embodiments;

[0033] Fig. 22 An exemplary tooth repositioning appliance or device is shown that may be worn by a patient to achieve incremental repositioning of individual teeth in a jaw, according to some embodiments;

[0034] Fig.23 shows a tooth repositioning system according to some embodiments;

[0035] Fig.24 A method of orthodontic treatment using multiple appliances according to an embodiment is shown;

[0036] Fig.25 A method for digitally planning orthodontic treatment according to an embodiment is shown; and

[0037] Fig.26 A simplified block diagram of a data processing system is shown in accordance with an embodiment. DETAILED DESCRIPTION

[0038] The following is a detailed description of the features and advantages of the invention described in this disclosure according to the embodiments disclosed herein, and a better understanding provided. Although the detailed description includes many specific embodiments, these specific embodiments are provided only as examples and should not be interpreted as limiting the scope of the invention disclosed herein.

[0039] Although reference is made to a thermoformed appliance with a bite block, the appliance and bite block may be manufactured together, for example, additive manufacturing such as 3D printing may be used to manufacture the appliance with the bite block in accordance with a treatment plan.

[0040] Figure 1Features of an oral appliance that can be used for mandibular repositioning treatment are shown. The oral appliance can include an upper shell 110 for the upper jaw, which can have one or more tooth receiving cavities for receiving teeth of the upper jaw, and a lower shell 120 for the lower jaw or mandible, which can have one or more tooth receiving cavities for receiving teeth of the lower jaw. The upper shell can include an upper mandibular repositioning feature, such as a bite block 112, which can include a protrusion extending downward (e.g., toward the lower jaw). The lower shell can include a lower mandibular repositioning feature, such as a bite block 122, which can include a protrusion extending upward (e.g., toward the upper jaw). When the patient wears the oral appliance and the upper and lower shells are brought together (e.g., when the patient closes his or her mouth), the upper mandibular repositioning feature 112 can engage the lower mandibular repositioning feature 122 along an engagement region 130. This engagement can generate a forward force that can displace the lower shell forward relative to the upper shell, which can push the patient's mandible in an anterior direction.

[0041] Although the upper mandibular repositioning feature 112 and the lower mandibular repositioning feature 122 are shown as being located on the buccal surface, in some embodiments, the upper mandibular repositioning feature 112 and / or the lower mandibular repositioning feature 122 may be located on other surfaces, such as the lingual surface or the occlusal surface. Figure 1 Two pairs of mandibular repositioning features are depicted, but oral appliance 100 may include more or fewer pairs of mandibular repositioning features. In addition, the shape of upper mandibular repositioning features 112 and / or lower mandibular repositioning features 122 may vary, such as having complementary shapes for mating to improve the stability of engagement region 130.

[0042] The upper mandibular repositioning feature 112 and the lower mandibular repositioning feature 122 may include one or more structures suitable for mandibular repositioning, such as rigid precision wings, curved precision wings, or mandibular advancement blocks, and combinations thereof. In some embodiments, the precision wings include wing-like structures, such as protrusions, that extend to one or more sides of the appliance to engage with each other and generate a mandibular repositioning force at an engagement area 130. The protrusions of the precision wings may include complementary curved engagement surfaces, or substantially flat inclined engagement surfaces, that engage with each other to generate a mandibular relocation (MR) force. The protrusions of the precision wings may include an inflexible structure, such as a rigid structure, so as to transmit the mandibular repositioning force to the appliance. The bite block may include a protrusion extending between the occlusal surfaces of the appliance, the protrusion including surfaces that are sized and shaped to engage with each other to generate a mandibular repositioning force, wherein the engagement area 130 is located between the upper and lower jaws. The upper mandibular repositioning feature 112 and the lower mandibular repositioning feature 122 may include any suitable combination of these structures in order to generate MR forces at the engagement region 130 .

[0043] The upper shell and / or the lower shell can each include a polymer shell device having a thickness suitable for mandibular repositioning treatment. In some embodiments, the polymer shell thickness can be no greater than about 2 mm, and in some embodiments, the polymer shell thickness can range from about 0.2 mm to about 2 mm. For example, the polymer shell can include multiple layers.

[0044] In addition to polymer appliances, many types of oral appliances are also suitable for use in accordance with the present disclosure. For example, the oral appliance may include a retainer, a palate expander, a nightguard, an apnea appliance, or a functional appliance. The appliance and the mandibular repositioning feature may be manufactured in many ways and may include a 3D printed appliance with a mandibular repositioning feature, wherein the appliance and the mandibular repositioning feature have been 3D printed together, or include an appliance formed on a 3D thermoformed mold, wherein the mandibular repositioning feature is placed on the 3D thermoformed mold.

[0045] Figure 2A An example method 300 for orthodontic treatment, including mandibular repositioning, is shown. The method 300 may include generating a model of a patient's teeth at box 310, generating a treatment plan for repositioning the patient's jaw and / or teeth at box 330, identifying jaw movements in the treatment plan at box 330, determining mandibular advancement (MA) block positions at box 340, generating a visualization of mandibular repositioning features at box 350, and manufacturing an orthodontic appliance at box 360. The method 300 is described in more detail below.

[0046] Figure 2A The processes shown may be performed by any suitable computer executable code and / or computing system, including Fig. 20 and Fig.21 In one example, Figure 2A Each step of the illustrated process 300 may represent an algorithm whose structure includes and / or is represented by a plurality of sub-steps, examples of which are described in more detail below.

[0047] Method 300 can start at box 310 by generating a 3D model of the patient's teeth. A scanner, such as an intraoral scanner, can be used to generate scan data by scanning the patient's dentition. During the scanning process, a single frame or image of the patient's teeth can be used to generate a 3D model of the patient's teeth. The 3D model of the patient's teeth can include 3D data representing the surface contours and shapes of the patient's dentition (including teeth and gums), and color data representing the patient's anatomical structures associated with the surfaces of the patient's teeth, gums, and other oral anatomical structures. The scan data can be spliced ​​together to generate a 3D model of the patient's dentition, such as the upper and lower jaws of the patient alone and in bite. The 3D model of the patient's dentition can include the lingual surface, buccal surface, and occlusal surface of the patient's teeth and the buccal surface and lingual surface of the patient's gums. The scan data can include a digital representation of the patient's teeth. A digital representation such as a two-dimensional or three-dimensional model can include surface topography data of the patient's oral cavity (including teeth, gingival tissue, etc.). The surface topography data can be generated by directly scanning the oral cavity using a suitable scanning device (e.g., a handheld scanner).

[0048] At box 320, a treatment plan for treating the patient's teeth is generated. The treatment plan can be a dental treatment plan, such as an orthodontic treatment plan that moves the patient's teeth from a first arrangement toward a second arrangement. The treatment plan can also include jaw repositioning. The treatment plan can move the patient's teeth and / or jaw from a first position toward a second position in a series of stages or steps. During treatment, a first orthodontic appliance is applied to the patient's teeth so as to reposition the teeth from the first tooth arrangement toward the second tooth arrangement. Subsequently, a second orthodontic appliance is applied to the patient's teeth so as to reposition the teeth from the second tooth arrangement to a third tooth arrangement. Any suitable number of sequence appliances and combinations thereof can be used to wear new appliances as needed so as to incrementally reposition the patient's teeth from an initial arrangement toward a target arrangement. Appliances can all be generated in the same stage or in groups or batches (e.g., at the beginning of a treatment stage), or one at a time, and the patient can wear each appliance until the pressure of each appliance on the teeth can no longer be felt or until the maximum amount of tooth movement expressed for that given stage has been achieved. A plurality of different appliances (eg, a set) may be designed and even manufactured before any of the multiple appliances are worn by a patient.

[0049] After wearing the appliance for an appropriate period of time, the patient can replace the current appliance with the next appliance in the series until there is no appliance left. The appliance is usually not fixed to the teeth, and the patient can place and replace the appliance at any time during the procedure (e.g., a patient-removable appliance). The final appliance or several appliances in the series may have one or more geometries selected for overcorrecting the tooth arrangement. For example, one or more appliances may have a geometry that will (if fully realized) move a single tooth beyond the tooth arrangement that has been selected as the "final". In order to compensate for potential recurrence after the repositioning method has been terminated, this overcorrection may be desirable (e.g., allowing a single tooth to move back toward their position before correction). Overcorrection can also be beneficial to speed up the correction rate (e.g., an appliance with a geometry that is positioned beyond the desired intermediate or final position can cause a single tooth to shift toward the position at a greater rate). In such a case, the use of the appliance can be terminated before the tooth reaches the position defined by the appliance. In addition, overcorrection can be deliberately applied to compensate for any inaccuracies or limitations of the appliance.

[0050] One or more treatment stages are generated based on a digital representation of the teeth, such as a 3D model. A treatment stage can be an incremental repositioning stage of a dental treatment procedure designed to move one or more of a patient's teeth or jaw from an initial tooth arrangement to a target arrangement. For example, a treatment stage can be generated by determining an initial tooth arrangement and / or jaw position indicated by a digital representation, determining a target tooth arrangement and / or jaw position, and determining a movement path of one or more teeth in the initial arrangement required to achieve the target tooth arrangement and / or jaw movement amount. The movement path can be optimized based on minimizing the total distance moved, preventing collisions between teeth, avoiding tooth movements that are more difficult to achieve, or any other suitable criteria.

[0051] At block 330, jaw movements are determined based on the treatment plan. A treatment plan may be received, and jaw movements for each phase of the treatment plan, such as mandibular repositioning, may be determined based on the treatment plan. In some embodiments, jaw movements may be extracted from treatment plan data.

[0052] At block 340, the position of the mandibular repositioning feature (such as a bite block, precision wing, and / or other) is determined based on satisfying one or more constraints. In some embodiments, the position may be based on optimization of constraints. Constraints include: jaw opening ( Figure 5 ); Collision Avoidance( Figure 6 ); Block orientation including block tilt, angulation, and / or rotation ( Figure 7 ); the difference between the block orientation and the origin of the two contacting blocks ( Figure 8 ); the distance and angle between the block contact planes of two contact blocks ( Fig. 9 ); proximity of the block center to the tooth center ( Fig.10 ); the size of the gap between the occlusal surface of the tooth and the bite block ( Fig.11 ); the remote location of the block ( Fig.12 ); Arch position of the block ( Fig.13 ); vertical connection of block pairs ( Fig.14 ); lateral joining of block pairs ( Fig.15 ); vertical asymmetry ( Fig.16 ); horizontal asymmetry ( Fig.17 ); and, placement on missing teeth ( FIG. 18 ). Each constraint is discussed in more detail herein.

[0053] Figure 2BAn example method 251 for placing a bite block of an orthodontic appliance is shown, which can occur at box 340. The method can start at box 252. At box 254, the value of the iteration is reset or set to zero. Subsequently, the process can proceed to box 256, where the iteration value is checked. If the iteration value is less than 5, the process proceeds to box 258. In some embodiments, the initial value can be checked to be less than a number other than 5, such as 3, 4, 6, 8, 10 or more. The iteration value can vary based on how much the inter-arch distance increases with each iteration. Before proceeding to box 258, an initial value for the inter-arch distance can be set. The initial value can be between 1 mm and 8 mm, such as 6.2 mm. In some embodiments, the inter-arch distance is set at the height of the bite block. In some embodiments, the inter-arch distance can be set to be greater than the height of the bite block, such as 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm, or 0.5 mm greater than the height of the bite block. In some embodiments, the initial inter-arch distance may be at least 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm, or 0.5 mm greater than the height of the bite block. The inter-arch distance may be the displacement distance between the upper and lower arches from a closed or occluded arch position.

[0054] At block 258, a pair of blocks are placed on the right side of the dental arch, one block is placed on the lower dental arch, and one block is placed on the upper dental arch. In some embodiments, at block 258, the blocks may be placed on the left side. At block 260, the placement of the blocks is checked against constraints such as those described herein. In some embodiments, only one-sided constraints are checked at block 260. If no constraints are violated, the process proceeds to block 262.

[0055] At box 262, a pair of blocks are placed on the left side of the dental arch, one block is placed on the lower dental arch gate, and one block is placed on the upper dental arch. In some embodiments, the blocks can be placed on the right side at box 262. At box 264, the placement of the blocks is checked against constraints such as those described herein. In some embodiments, unilateral constraints and bilateral constraints or symmetric constraints are checked at box 264. If no constraints are violated, the process proceeds to box 266. At box 266, success can be displayed or indicated to the user or otherwise reported.

[0056] If a constraint is violated or more than one constraint is violated at box 260 or 264, the process proceeds to box 268. At box 268, all bite blocks are removed from the model. At box 270, a pair of blocks are placed on opposite sides of the dental arch, such as the left side of the dental arch, one block is placed on the lower dental arch and one block is placed on the upper dental arch, like the blocks placed in box 258. In some embodiments, at box 270, the blocks can be placed on the right side. At box 272, the placement of the blocks is checked against constraints such as those described herein. In some embodiments, only one-sided constraints are checked at box 272. If no constraints are violated, the process proceeds to box 274.

[0057] At block 274, a pair of blocks are placed on opposite sides of the dental arch, such as the right side of the dental arch, one block being placed on the lower dental arch and one block being placed on the upper dental arch, like the blocks placed in block 262. In some embodiments, at block 274, the blocks may be placed on the left side. At block 276, the placement of the blocks is checked against constraints, such as those described herein. If no constraints are violated, the process proceeds to block 266. At block 266, success may be displayed or indicated to the user or otherwise reported.

[0058] If a constraint is violated or more than one constraint is violated at box 272 or 276, the process proceeds to box 278. At box 268, all bite blocks are removed from the model. At box 280, the iteration value is increased by 1. After the iteration value is increased by 1, the inter-arch space can be increased. In some embodiments, the inter-arch space is increased by 0.55mm. In some embodiments, each iteration increases by 0.1mm, 0.25mm, or 0.75mm. In some embodiments, each iteration inter-arch distance can increase by between 0.1mm and 0.7mm. In some embodiments, the inter-arch distance can be determined based on a formula, such as a starting inter-arch distance plus an increment with respect to the number of iterations. In some embodiments, after the inter-arch space is increased, the iteration can be incremented at box 280.

[0059] At box 284, the jaw opening is checked to determine if it matches the inter-arch space set at box 282. In some embodiments, at box 284, the jaw opening is checked to determine if the jaw opening or inter-arch distance has exceeded a threshold, such as 10 mm. In some embodiments, the threshold may be greater or less than 10 mm, for example, a smaller patient such as a child may have a lower threshold, such as 8 mm. If the jaw opening is not correct, the process proceeds to box 286.

[0060] At block 286, a notification may be sent or displayed to the user indicating that the bite block was not placed using the process. If the jaw opening is correct at block 284, the process proceeds to block 256 where the process repeats itself as described herein, or if the iteration value is not less than 5, the process proceeds to block 286 and the block placement has failed.

[0061] At block 286, a notification may be sent or displayed to the user indicating that the bite block was not placed using the process.

[0062] Figure 2B The optimization depicted may be performed for each stage or each jump in the mandibular repositioning treatment. Each jump may reposition the mandible by 1-4 mm, and the total mandibular repositioning treatment may move the mandible by 5-15 mm. Each stage or each jump in the mandibular repositioning treatment may include one or more stages of the orthodontic treatment plan. For example, the first jump in mandibular duplication may move the mandible forward by 2 mm, but this movement may require 4-10 stages of orthodontic treatment.

[0063] Figure 2C An example method 299 for placing bite blocks on an orthodontic appliance is shown. The method 299 for determining block placement may occur at box 340 and may begin at box 290. At box 291, a first pair of blocks is placed on the right side of the dental arch, a second pair of blocks is placed on the left side of the dental arch, and the jaw opening or inter-arch distance is set to an initial value. One block in each pair is placed on the lower dental arch and one block is placed on the upper dental arch.

[0064] At box 292, the jaw opening is checked to determine if it matches the inter-arch space set at box 291. In some embodiments, at box 292, the jaw opening is checked to determine if the jaw opening or inter-arch distance has exceeded a threshold, such as 10 mm. In some embodiments, the threshold can be greater or less than 10 mm, for example, a smaller patient such as a child can have a lower threshold, such as 8 mm. If the jaw opening is not correct, the process proceeds to box 293.

[0065] At box 293, the placement of the block is checked against constraints such as those described herein, and the variables are iterated and the constraints are rechecked. The variables may include jaw opening or inter-arch spacing, which may vary between an upper limit of 10 mm and a lower limit of 1.2 mm. As described herein, the constraints may include unilateral constraints and bilateral constraints or symmetric constraints. In some embodiments, the position of the block may be determined based on optimization of the constraints and variables.

[0066] If block 293 is successful, and the block is placed while the constraints are met and within the allowed range of the variables, the process proceeds to block 294. At block 294, success may be displayed or indicated or otherwise reported to the user.

[0067] If the jaw opening is incorrect at block 292, or a block is not placed without a violation at block 293, the process may proceed to block 295. At block 295, all bite blocks are removed from the model. After block 295, the process may proceed to block 295, where a notification may be sent or displayed to the user indicating that a bite block was not placed using the process.

[0068] The optimization may be run for each phase or each jump of the mandibular repositioning treatment. Each jump may reposition the mandible by 1-4 mm, and the total mandibular repositioning treatment may move the mandible by 5-15 mm. Each phase or each jump of the mandibular repositioning treatment may include one or more phases of the orthodontic treatment plan. For example, the first jump of mandibular duplication may move the mandible forward by 2 mm, but this movement may require 4-10 phases of orthodontic treatment.

[0069] In some embodiments, the placement algorithm may begin by positioning the mandible with a predetermined distance between the teeth at the rear to accommodate the bite block between the jaws. The opening distance may be set at the first and last stage of each jaw transition and at one or more intermediate stages of the transition. Figure 5 , the constraints on the jaw opening include: the minimum inter-arch distance 508 between the three posterior teeth (including the two premolars and the first molar) measured between the occlusal surfaces of the teeth on the mandibular teeth (such as at the maximum bite point on each jaw) should be between 6.2 mm and 6.75 mm; the maximum value 506 of the vertical movement of the mandible measured as a displacement in the gingival occlusal direction can be less than 10 mm; and, the distance between the anterior teeth of the opposing jaws (central incisors and lateral incisors and canines) can be at least less than 1.2 mm to account for the thickness of the orthodontic appliance plus additional spacing to account for the delayed intrusion of teeth during treatment. For example, if the treatment plan includes intrusion of the anterior teeth or intrusion of the anterior teeth is identified in the treatment plan, an additional amount of spacing can be added. For example, for a particular treatment stage, half of the intrusion of the anterior teeth can be added to the jaw opening for that stage.

[0070] After the jaw opening is determined, block positioning can be initiated by positioning two blocks on one side of the patient's dental arch (such as the right side of the upper and lower dental arches with a jaw transition interval on one side of the jaw in an initial starting position and orientation), and then iterating through potential positions and orientations by solving one or more of the unilateral constraints discussed herein.

[0071] After the first set of blocks are placed, a second set of blocks is placed on the other side of the dental arch in an initial position and orientation, followed by iterating through potential positions and orientations by solving one or more unilateral constraints discussed herein. In some embodiments, positioning may include iterating through symmetry constraints that depend on the positions of features on opposite sides of the dental arch.

[0072] In some embodiments, all four blocks may be placed and the one-sided constraints and the symmetric constraints applied to all four blocks in the same iteration.

[0073] If the placement fails, e.g., if the constraints are not met, the algorithm can start again, but with the block placed on the opposite side of the dental arch. For example, if in the first failed attempt, the right block was placed first, followed by an attempt to place the left block, then in the second pass, the left block is placed first, followed by an attempt to place the right block.

[0074] If placement fails again, placement can be attempted again with an increased jaw opening distance. The jaw opening distance can be increased many times. For example, the jaw opening distance can be increased by 0.05mm to 0.4mm per iteration, such as 0.05mm, 0.075mm, 0.1mm, 0.125mm, 0.15mm, 0.175mm, 0.2mm, 0.225mm, 0.25mm, 0.275mm, 0.3mm, 0.325mm, 0.35mm, 0.375mm or 0.4mm. Total jaw opening can be increased by 2mm at most in several iterations (such as 40 iterations).

[0075] Each positioning attempt may begin with the block positioned in the most distal position and be advanced mesially if placement fails.

[0076] In some embodiments, constraints are applied for the first orthodontic stage of the transition and the last orthodontic stage of the transition.In some embodiments, one or more intermediate stages may also be evaluated.

[0077] The placement of the mandibular repositioning feature may use a nonlinear optimization algorithm. The algorithm may include one or a combination of an interior point nonlinear method, an active set sequential quadratic programming method (SLQP), a sparse matrix storage method, a multistart method, and / or a clustering method.

[0078] In some embodiments, when placement of the mandibular repositioning feature fails, the process can proceed back to block 320 where an updated treatment plan can be generated. For example, if the mandibular repositioning feature cannot be placed due to interference or proximity with an attachment placed according to the treatment plan, a revised treatment plan can be generated at block 320 where the attachment position on the teeth is changed, such as moved more gingivally or removed. In some embodiments, tooth or jaw movement can be delayed to allow placement of the mandibular repositioning feature. For example, jaw movement can be delayed until after tooth movement using the attachment is complete so that the attachment can be removed.

[0079] At block 350, a visualization of a mandibular repositioning feature, such as a bite block, is generated. The visualization may include the position of the bite block relative to each dental arch. In some embodiments, the bite block is generated with the appliance in which it resides. The visualization may include a 2D or 3D view of the appliance with the bite block positioned on the patient's teeth. In some embodiments, the visualization may include generating attachments placed on the patient's teeth and / or attachment receiving cavities on the appliance. In some embodiments, the visualization may include the upper and lower dental arches or jaws of the patient in occlusion.

[0080] Generating a visualization and providing or otherwise displaying the visualization to a dental professional (such as a dentist or orthodontist) allows the dental professional to approve, modify, or otherwise provide feedback about the block position. In some embodiments, after receiving the feedback, the constraints can be modified and the optimization can be performed again. For example, the dental professional may reject the block position for one or more treatment stages due to an unsatisfactory position relative to one or more constraints, such as the gap between the occlusal surface of the tooth and the bite block. In this case, the allowed range of the constraints, such as the maximum or minimum gap, can be changed, and the optimization can be performed again for all stages of treatment that were rejected or where the constraints are outside the modified allowed range. In some embodiments, the weight of the constraints can be increased or decreased based on the feedback. Increasing the weight of the constraint can give the optimization a higher priority relative to the constraint over other constraints to give the block position a higher priority.

[0081] At block 360, an orthodontic appliance with a bite block or other mandibular repositioning feature is manufactured. In some embodiments, instructions for manufacturing the appliance based on the block position and tooth position at each stage of treatment may be generated. The instructions may be output for use by a manufacturing machine to manufacture the appliance. The appliance may be manufactured by inputting the output instructions.

[0082] At least one orthodontic appliance is manufactured based on the generated treatment stages and bite block positions. For example, a set of appliances can be manufactured to be worn sequentially by a patient to incrementally reposition the teeth and / or jaws from an initial arrangement and position to a target arrangement and position. Some appliances can be shaped to accommodate a tooth arrangement specified by one of the treatment stages.

[0083] The physical model of the teeth can be used to indirectly manufacture the appliance or part of the appliance. For example, the physical model of the teeth and a suitable layer of polymer material and a bite block can be used to form an appliance (e.g., a polymer appliance). The physical model of the teeth with the bite block (e.g., a physical mold) can be formed by various technologies including 3D printing. The appliance can be formed by thermoforming the appliance on the physical model including the bite block. In some embodiments, the physical appliance is directly manufactured from the digital model of the appliance, for example using additive manufacturing technology. In some embodiments, the physical appliance can be created by various direct forming technologies (such as 3D printing). The appliance can be adapted to all teeth present in the upper or lower jaw, or on part of the teeth. The appliance can be specially designed to accommodate the patient's teeth (e.g., the morphology of the tooth receiving cavity matches the morphology of the patient's teeth), and can be manufactured based on a positive model or a negative model of the patient's teeth generated by an impression, a scan, etc. Alternatively, the appliance can be a common appliance constructed to accommodate teeth, but it does not have to be formed to match the morphology of the patient's teeth. In some cases, only certain teeth received by the appliance will be repositioned by the appliance, while other teeth may provide a base or anchoring area for holding the appliance in place while it applies force to the tooth or teeth that are being targeted for repositioning. In some cases, some or most of the teeth, or even all of the teeth, will be repositioned at some point during treatment. The moved teeth may also serve as a base or anchor for holding the appliance while it is worn by the patient. In some embodiments, no wires or other means will be provided for holding the appliance in place over the teeth. However, in some cases, it may be desirable or necessary to provide separate attachments or other anchoring elements on the teeth, with corresponding receptacles or holes in the appliance so that the appliance can apply a selected force on the teeth. Description of the Prior Art The invention relates to a method of repositioning the appliance in a manner that is consistent with the present invention and is described in a number of patents and patent applications assigned to Align Technology, Inc., including those described herein. Exemplary appliances of those used in the system, such patents and patent applications include, for example, U.S. Patent Nos. 6,450,807 and 5,975,893, and on company web pages accessible on the World Wide Web (see, for example, URL "invisalign.com"). Examples of tooth-mounted attachments suitable for orthodontic appliances are also described in patents and patent applications assigned to Align Technology, Inc., including, for example, U.S. Patent Nos. 6,309,215 and 6,830,450.

[0084] Figure 3 An illustration of a model for evaluating bite block placement is shown. The appliance model 372 is a 3D digital model representing the shape of the mandibular repositioning features of a physical appliance. During manufacturing, the appliance may be formed on a mold having the shape of the bite block. The appliance model 372 represents that shape. The appliance model 372 may represent the outer surface of the appliance formed on the bite block. In some embodiments, the appliance model represents the volume of the appliance on the bite block.

[0085] The block portion model 374 is a 3D digital model that represents the shape of the physical bite block. The physical bite block fits within the cavity formed by the appliance.

[0086] The mold model 376 is a 3D model that represents the shape of a mold used to form an appliance having a mandibular repositioning feature.

[0087] The dual appliance cap model 378 is a 3D digital model that represents the shape of the mandibular repositioning feature of a physical appliance having twice the thickness of the physical appliance. The dual appliance cap model 378 can be used when there is a collision, distance, etc. between a first appliance on a first jaw and a second appliance on a second jaw. Instead of modeling the second appliance on the teeth, a dual thickness appliance is used and the distance, collision, etc. are determined based on the dual thickness appliance and the dental model of the opposing jaw.

[0088] The attachment collision volume model 380 is a 3D digital model used to test the interaction of attachments on the patient's teeth. If the mandibular repositioning features are too close to the attachments, the appliance shape may reduce or otherwise alter the effectiveness of the attachments. The collision volume model 380 extends beyond the occlusal surface of the teeth in the gingival direction.

[0089] Figure 4 A block diagram of an example system for selecting a position of a bite block on an oral appliance and orthodontic treatment is shown.

[0090] As shown in the figure, the example system 200 may include one or more modules 202 for performing one or more tasks. As will be explained in more detail below, the modules 202 may include a scanning module 204, a treatment planning module 206, an occlusal mandibular repositioning feature placement module 408, and a visualization module 410. Although shown as separate elements, Figure 4 One or more of the modules 202 in may represent multiple portions of a single module or an application.

[0091] In certain embodiments, Figure 4The one or more modules 202 in the embodiment of the present invention may represent one or more software applications or programs that, when executed by a computing device, may cause the computing device to perform one or more tasks. For example, and as will be described in more detail below, one or more of the modules 202 may represent modules stored and configured to run on one or more computing devices, such as Fig. 20 (e.g., computing system 1010) and / or Fig.21 The device shown in . Figure 4 The one or more modules 202 in may also represent all or portions of one or more special-purpose computers configured to perform one or more tasks.

[0092] like Figure 4 As shown, the example system 200 may also include one or more memory devices, such as memory 240. Memory 240 generally represents any type or form of volatile or non-volatile storage device or medium capable of storing data and / or computer-readable instructions. In one example, memory 240 may store, load, and / or maintain one or more of modules 202. Examples of memory 240 include, but are not limited to, random access memory (RAM), read-only memory (ROM), flash memory, hard disk drive (HDD), solid-state drive (SSD), optical drive, cache, one or more variations or combinations of the same, and / or any other suitable storage memory.

[0093] like Figure 4 As shown, the example system 200 may also include one or more physical processors, such as physical processor 230. Physical processor 230 generally represents a hardware-implemented processing unit of any type or form capable of interpreting and / or executing computer-readable instructions. In one example, physical processor 230 may access and / or modify one or more of modules 202 stored in memory 240. Additionally or alternatively, physical processor 230 may execute one or more of modules 202 to facilitate the selection of MRF locations. Examples of physical processor 230 include, but are not limited to, a microprocessor, a microcontroller, a central processing unit (CPU), a field programmable gate array (FPGA) implementing a soft-core processor, an application specific integrated circuit (ASIC), a variation or combination of one or more of the same components, and / or any other suitable physical processor.

[0094] like Figure 4 As shown, the example system 200 may also include one or more additional elements 220, such as 3D model data 224, constraint data 226, and position data 228. The additional elements 220 generally represent any type or form of data and its arrangement. The additional elements 220 may correspond to cached or otherwise stored data values ​​used for calculations.

[0095] Figure 4 The example system 200 in FIG. 2 may be implemented in various ways. For example, all or part of the example system 200 may represent Fig. 20 1010 and / or any other suitable computing system. Figure 4 One or more modules 202 of the system 200 can enable the system 200 to select an MRF position when executed by at least one processor (e.g., the physical processor 230) of the system 200. For example, and as will be described in more detail below, one or more of the modules 202 can enable the system 200 and / or the computing device 1010 to determine candidate positions for each stage and select a position from the candidate positions based on reducing the distance between the selected positions.

[0096] like Figure 4 As shown, the example system 200 may also include a scanner 250. The scanner 250 may be an intraoral scanner and may include a probe, such as a handheld probe, for optically capturing a three-dimensional structure from within the oral cavity, such as by confocal focusing of an array of beams. The scanner 250 may also include other components, such as optical components, accelerometers, communication components, gyroscopes, processing devices, etc. An example of an intraoral scanner is manufactured by Align Technology, Inc. Intraoral digital scanner.

[0097] The scanning module 204 of the system 200 can communicate with the scanner 250 to generate an intraoral scan of the patient's dentition. The scanning module 204 can provide a user interface displayed on the display, wherein the user interface enables the dentist to interact with the user interface associated with the scanning module 204 by manipulating graphical elements (such as graphical icons and visual indicators such as buttons, menus, etc.). The scanning module 204 may include multiple modes such as a scanning mode, a processing mode, and a delivery mode.

[0098] The scanning mode allows the dentist to capture images and / or videos of the dental sites of the patient's dentition, such as for the lower dental arch, upper dental arch, occlusal segment and / or prepared teeth. The images and / or videos can be used to generate a virtual 3D model of the dental sites. When in the scanning mode, the scanning module 204 can register and stitch together the intraoral images from the intraoral scanner 250 and generate a digital virtual 3D model of the dental arch or portion of the dental arch that has been scanned so far.

[0099] During the scanning mode, the scanning module 204 may provide the virtual 3D model, or a portion thereof, to a display that includes portions of the dental arch that have been scanned.

[0100] Once the intraoral scan is complete, or in some embodiments, during the scan mode, the scan module 204 may also enter an image processing mode. When in the image processing mode, the scan module 204 may process one or more scanned intraoral scan data from the respective segments to generate a virtual 3D model of the scanned tooth positions.

[0101] Once the scan is complete, the delivery mode allows the dentist to send the scan and / or the virtual 3D model and / or approve the scan for treatment planning and mandibular repositioning. The scan module may perform the steps at block 310 of method 300.

[0102] The treatment planning module 206 may perform orthodontic and / or mandibular repositioning planning. The treatment planning module 206 may generate a treatment plan for treating a patient's teeth. The treatment plan may be a dental treatment plan, such as an orthodontic treatment plan for moving the patient's teeth from a first arrangement toward a second arrangement. The treatment plan may also include mandibular repositioning. The treatment plan may move the patient's teeth and / or mandible from a first position toward a second position in a series of stages or steps. During treatment, a first orthodontic appliance is applied to the patient's teeth to reposition the teeth from a first tooth arrangement toward a second tooth arrangement. Subsequently, a second orthodontic appliance is applied to the patient's teeth to reposition the teeth from the second tooth arrangement to a third tooth arrangement. Any suitable number of sequential appliances and combinations thereof may be used and new appliances may be worn as needed to incrementally reposition the patient's teeth from an initial arrangement toward a target arrangement. The appliances may all be generated in the same stage or in groups or batches (e.g., at the start of a treatment phase), or one at a time, and the patient may wear each appliance until no longer able to feel the pressure of each appliance on the teeth or until the maximum amount of tooth movement expressed for that given stage has been achieved. Multiple different appliances (e.g., a set) may be designed and even manufactured before the patient wears any of the multiple appliances.

[0103] After wearing the appliance for an appropriate period of time, the patient can replace the current appliance with the next appliance in the series until there are no more appliances remaining. Appliances are usually not fixed to the teeth, and patients can place and replace appliances (e.g., patient-removable appliances) at any time during the procedure. The final appliance or several appliances in the series may have one or more geometries selected for overcorrecting the tooth arrangement. For example, one or more appliances may have a geometry that will (if fully realized) move a single tooth beyond the tooth arrangement that has been selected as the "final". In order to compensate for potential recurrence after the repositioning method has been terminated, this overcorrection may be desirable (e.g., allowing a single tooth to move back toward their pre-correction position). Overcorrection can also be beneficial to speed up the correction rate (e.g., an appliance with a geometry positioned outside the desired intermediate or final position can cause a single tooth to shift toward the position at a greater rate). In such a case, the use of the appliance can be terminated before the tooth reaches the position defined by the appliance. In addition, overcorrection can be deliberately applied to compensate for any inaccuracies or limitations of the appliance.

[0104] One or more treatment stages are generated based on a digital representation of the teeth, such as a 3D model. A treatment stage can be an incremental repositioning stage of a dental treatment procedure designed to move one or more of a patient's teeth or jaw from an initial tooth arrangement to a target arrangement. For example, a treatment stage can be generated by determining an initial tooth arrangement and / or jaw position indicated by the digital representation, determining a target tooth arrangement and / or jaw position, and determining a movement path of one or more teeth in the initial arrangement required to achieve the target tooth arrangement and / or jaw movement amount. The movement path can be optimized based on minimizing the total distance moved, preventing collisions between teeth, avoiding tooth movements that are more difficult to achieve, or any other suitable criteria.

[0105] The treatment planning module may perform the actions described in block 320 of method 200 .

[0106] The occlusal MA placement module 208 can determine the placement of the mandibular repositioning features based on the optimization of the constraints. The constraints include: jaw opening ( Figure 5 ); Collision Avoidance( Figure 6 ); Block orientation including block tilt, angulation and / or rotation ( Figure 7 ); the difference between the block orientation and the origin of the two contacting blocks ( Figure 8 ); the distance and angle between the block contact planes of two contact blocks ( Fig. 9 ); proximity of the block center to the tooth center ( Fig.10 ); the size of the gap between the occlusal surface of the tooth and the occlusal surface of the bite block ( Fig.11 ); the remote location of the block ( Fig.12); Arch position of the block ( Fig.13 ); vertical connection of block pairs ( Fig.14 ); lateral joining of block pairs ( Fig.15 ); vertical asymmetry ( Fig.16 ); horizontal asymmetry ( Fig.17 ); and, placement on missing teeth ( FIG. 18 ). Each constraint is discussed in more detail herein.

[0107] Optimization of the placement of the mandibular repositioning features may use a nonlinear optimization algorithm. The algorithm may include one or a combination of an interior point nonlinear method, an active set sequential quadratic programming (SLQP) method, a sparse matrix storage method, a multistart method, and / or a clustering method.

[0108] The occlusal MA placement module 208 may perform the steps of block 340 of the method 300 .

[0109] The visualization module 210 can generate a visualization of a mandibular repositioning feature, such as a bite block. The visualization can include the position of the bite block relative to each dental arch. In some embodiments, the bite block is generated with the appliance in which it resides. The visualization can include a 2D or 3D view of the appliance with the bite block positioned on the patient's teeth. In some embodiments, the visualization can include generating attachments placed on the patient's teeth and / or attachment receiving cavities on the appliance. In some embodiments, the visualization can include the upper and lower dental arches or jaws of the patient in occlusion.

[0110] Generating a visualization and providing or otherwise displaying the visualization to a dental professional (such as a dentist or orthodontist) allows the dental professional to approve, modify, or otherwise provide feedback about the block position. In some embodiments, after receiving the feedback, the constraints can be modified and the optimization can be performed again. For example, the dental professional may reject the block position for one or more treatment stages due to an unsatisfactory position relative to one or more constraints, such as the gap between the occlusal surface of the tooth and the bite block. In this case, the allowed range of the constraints, such as the maximum or minimum gap, can be changed, and the optimization can be performed again for the rejected stage or for all stages of treatment or all stages of treatment where the constraints are outside the modified allowed range. In some embodiments, the weight of the constraint can be increased or decreased based on the feedback. Increasing the weight of the constraint can give the optimization a higher priority relative to the constraint over other constraints, giving the block position a higher priority.

[0111] The visualization module 210 may perform the steps of block 350 .

[0112] 3D model data 224 may include data within the patient's oral cavity, such as a 3D model, including dentition, such as teeth, gums, and associated color data, such as a color texture applied to the model. 3D model data 224 may also include the above-mentioned Figure 3 Digital 3D models of the appliance model 372 , block part model 374 , mold model 376 , dual appliance cap model 378 , and accessory collision body model 380 in question.

[0113] The constraint data 226 may include data related to the constraints discussed herein. Each constraint may have a weight used to prioritize the constraint when determining the position of the bite block. Each constraint may have a measurement determined based on a 3D model having a mandibular repositioning feature or features, such as a bite block at one or more specific locations. The measurement may be a distance, angle, orientation, etc.

[0114] Each constraint may also have one or more thresholds, ranges, or target values ​​used in determining whether the constraint is satisfied. A threshold may be one or both of a minimum threshold or a maximum threshold for a distance, angle, orientation, etc. A target may be a target distance, angle, orientation, etc. A range may be a range of distances, angles, orientations, etc.

[0115] The position data 228 may include the position of a mandibular advancement feature, such as a bite block, relative to the patient's dental arch. The position data 228 may include a three-dimensional position and a three-dimensional orientation.

[0116] Figure 6 An example of a collision constraint for placing a bite block on an oral appliance according to some embodiments is shown. In some embodiments, the collision constraint can prevent collisions between a dual appliance block 604 on a first dental arch 608 and teeth of an opposing dental arch 606. In some embodiments, the collision constraint can prevent collisions between a block portion 602 on a first dental arch 606 and teeth of the first dental arch 606.

[0117] Figure 7 An example of a rotational constraint for placing a bite block on an oral appliance is shown in accordance with some embodiments. The tilt angle 714 is the angle between the occlusal surface normal projected onto a plane orthogonal to the block Y axis and the block Z axis. The block Y axis and the block Z axis may be defined by the lower surface of the block. The block X axis may be perpendicular to the plane. Figure 710 shows an enlarged tilt angle of the upper right block toward the buccal direction.

[0118] Angulation angle 716 is the angle between the occlusal plane normal projected to a plane orthogonal to the block X-axis and the block Z-axis. Image 720 shows an enlarged angulation angle 716 of the upper right block toward the upper jaw.

[0119] The rotation angle 718 is the angle between the palatal arch tangent and the block Y-axis, both projected onto the palatal occlusal plane. Figure 730 shows an enlarged rotation angle 718 of the upper right block toward the buccal direction.

[0120] The tilt angle 714 , the angulation angle 716 , and the rotation angle 718 may be constrained to a range of 0.0 to 5.0 degrees for the tilt angle 714 and the angulation angle 716 , and 0.0 to 7.5 degrees for the rotation angle 718 .

[0121] Although the mandibular repositioning feature 712 is depicted as a dual appliance model and a mold model, the feature 712 may be depicted as any of the models discussed herein.

[0122] Figure 8 An example of relative position and rotational alignment constraints for placing a bite block on an oral appliance according to some embodiments is shown. The constraints can include an angle between an X-axis 826 (extending buccal-lingually) of the upper block 814 and the lower block 824. The constraints can include an angle between a Y-axis 828 (extending mesiodistal) of the upper block 814 and the lower block 824. The constraints can include an angle between a Z-axis 830 (extending occlusally gingivally) of the upper block 814 and the lower block 824.

[0123] The constraint may include a distance between the origin 832 of the upper block 814 and the lower block 824. The origin may be located at the midpoint or center point of the joint surface of the respective upper block 814 and the lower block 824.

[0124] The angle between the x-axes, the y-axes, and the z-axes can be limited to a range of 0.0 to 10 degrees. The distance between the origins can be limited to a range of 0.0 mm to 5.0 mm.

[0125] Although the mandibular repositioning features 814, 824 are depicted as a dual appliance model and a mold model, the feature 712 may be depicted as any model discussed herein.

[0126] Fig. 9 An example of a contact plane constraint for placing a bite block on an oral appliance is shown in accordance with some embodiments. Distance 930 can be determined based on the distance between the center of mass of contact plane 922 of lower block 920 and the center of mass of contact plane 912 of upper block 910. Angle 932 can be determined based on the angle between the normal of contact plane 922 of lower block 920 and the normal of contact plane 912 of upper block 910. Distance 930 can be greater than twice the thickness of the appliance, for example, between 1.13 mm and 1.25 mm. Angle 932 can be between 0.0 degrees and 1.0 degrees.

[0127] Fig.10An example of a tooth center constraint for placing a bite block on an oral appliance is shown in accordance with some embodiments. A signed distance 1040 is from the center of mass of a mold or block model 1042 projected onto the occlusal plane to a line 1036 connecting the centers 1032, 1034 of the teeth beneath the block 1042 projected onto the occlusal plane. The signed distance 1040 is negative if the block is placed lingually to the line 1036 and positive if the block is placed buccal to the line 1036. The signed distance of the tooth center constraint may be between 0.0 mm and 0.5 mm.

[0128] Fig.11 An example of a bite gap constraint for placing a bite block on an oral appliance is shown in accordance with some embodiments. The block gap is determined by finding the minimum distance 1106 between two approximate shapes, namely the block 1104 and the tooth 1102 or the tooth on which the block is placed. The gap is measured as the shortest distance between a location on a tooth and the block 1106 or the jaw Z-component of the distance. Teeth that are not directly "above" or "below" the block (such as locations of teeth that do not overlap the Y-axis of the block) have a gap value of 0.0 approximately along the jaw arch. The block gap constraint can be between 0.0 mm and 1.4 mm.

[0129] Fig.12 An example of a distalization constraint for placing a bite block on an oral appliance according to some embodiments is shown. The distalization constraint can be a signed distance 1206 between the distal-most end point of the block 1202 and a plane 1204 that is orthogonal to the distal-most end point of the jaw dental arch 1208 passing through the distal-most tooth.

[0130] For the most distal block, this point may be the most distal location on the bottom plane 1210 of the block. The plane position and orientation may be determined by finding the most distal tooth that is not unerupted or a pontic, then finding the most distal point of the tooth along the palatal arch spline projected on the occlusal plane, then constructing a plane at that location with the normal being the tangent to the palatal arch spline projected at the most distal point. The signed distance 1206 may be greater than 5.0 mm.

[0131] Fig.13 An example of an arch position constraint for placing a bite block on an oral appliance according to some embodiments is shown. The arch position constraint may be the signed distances 1306, 1316 between the block 1302 and the mesial and distal limiting planes 1314, 1304.

[0132] Finding the distal limiting plane 1304 is similar to plane 1204 except taking the most distal candidate tooth.

[0133] The centric limit plane 1314 is calculated by finding the most centric candidate tooth and its most centric point along the jaw dental arch projected onto the occlusion plane. This point can be moved 2 mm upward along a line tangent to the jaw dental arch projected onto the occlusion plane. If the adjacent tooth is not a pontic or unerupted, this point can be displaced mesially from 0.0 to 2.0 mm.

[0134] The signed distance can be 1306, 1316, which can be greater than 5.0 mm. In some embodiments, the signed distance can be greater than 0 mm.

[0135] Fig.14 An example of a vertical engagement constraint for placing an occlusion block on an oral appliance according to some embodiments is shown. The vertical engagement constraint is the signed distance 1430 between the top block 1420 and the bottom block 1410. This distance can be based on the distance between the position 1412 that is vertically or occlusally farthest from the base of the block 1410 on the engagement surface of the block 1410 and the position 1422 that is vertically or occlusally farthest from the base of the block 142 on the engagement surface of the block 1420.

[0136] The centric point 1422 of the top block 1420 is the most centric position on the top surface of the top block 1420 (the surface farthest from the teeth of the dental arch) that engages with the bottom block 1410. The centric point 1412 of the bottom block 1410 is the most centric position on the top surface of the bottom block 1420 (the surface farthest from the teeth of the dental arch). The signed distance 1430 can be between 3.8 mm and 5.0 mm.

[0137] Fig.15 An example of a lateral engagement constraint for placing an occlusion block on an oral appliance according to some embodiments is shown. The first lateral constraint can be the distance 1540 from the lingual side 1512 of the lower block to the buccal side 1524 of the upper block 1520. The second lateral constraint can be the distance 1530 from the buccal side 1514 of the lower block 1510 to the lingual side 1522 of the upper block 1520.

[0138] For each block, the lingual and buccal edges are used as the lingual and buccal sides. The buccal and lingual edges are the respective intersection lines of the right or left side of the corresponding block with the engagement surface of the block. The distances 1530, 1540 can be between 5.5 mm and 10.0 mm.

[0139] Fig.16An example of a vertical asymmetry constraint for placing a bite block on an oral appliance according to some embodiments is shown. The vertical asymmetry can be determined based on the difference between the distance 1622 between the dual appliance block 1620 and the teeth of the opposing jaw on the first side of the dental arch and the distance 1612 between the second dual appliance block 1610 and the teeth of the opposing jaw on the second side of the dental arch. The constraint is a symmetric constraint. The distances 1622, 1612 are the minimum distances between the corresponding blocks and the corresponding teeth on the opposing jaws. The absolute value of the difference between these distances 1622, 1612 is the vertical asymmetry constraint. The difference between the distances 1622, 1612 can be between 0.0 and 5.0 mm.

[0140] Fig.17 An example of a horizontal asymmetry constraint for placing a bite block on an oral appliance according to some embodiments is shown. The horizontal asymmetry between the block pair locations on the left and right sides of the jaw dental arch can be a measurement of the distance 1708 between the centers 1702, 1704 of the bite block on each side of the dental arch or patient.

[0141] The center of the block can be the center of mass of the block. The vector 1706 between these centers can be projected on the jaw midline 1710, which passes through the central incisor along the distal midline axis. The length of the projection is the measured horizontal asymmetry. The distance 1708 can be between 0.0 mm and 3.0 mm.

[0142] Fig.18A and Fig.18B An example of a bridging constraint for placing a bite block on an oral appliance is shown in accordance with some embodiments. For example, when a bite block is placed on a missing, unerupted tooth, or an incompletely erupted tooth 1810 in a manner such that it is supported by two fully erupted adjacent teeth 1820, 1822, such that there is overlap between these teeth and the block. The constraint may include a distal bridging distance 1816 and a median bridging distance 1806 of the block 1802. The distances 1806 and 1816 describe the length of the block that extends over or is supported by teeth adjacent to a gap location, such as a gap formed by an erupted or missing tooth. The distal bridging distance 1816 is a measurement of the distance between a plane 1812 of the most medial position of a distal tooth 1822 passing through the distal end of the support block 1802 and a distal-most end 1814 of the block 1802. The distance 1816 may be at least 2.0 mm. The median bridge distance 1806 is a measurement of the distance between a plane 1804 passing through the median end 1808 of the support block 1802 at the most distal position of the median tooth 1820 and the median end of the block 1802. The distance 1806 may be at least 2.0 mm. The distance may be measured along the median-distal axis or parallel to the median-distal axis of the tooth.

[0143] Placing the bite block 1802 over an unerupted or missing tooth can include satisfying one of two conditions: the block is supported by two fully erupted teeth, or the center of mass of the block is further away from the missing or unerupted tooth than the closed cusp of the adjacent fully erupted teeth.

[0144] Fig.18A It shows how the block is supported by two fully erupted teeth when distances 1818 and 1806 are greater than 2.0 mm.

[0145] The distance 1806 may be the signed distance between the mesial end of the block 1802 and the plane 1804 passing through the distal-most point of the mesial tooth 1820. For this block, the plane is calculated by first finding the adjacent tooth from the mesial side of the unerupted or missing tooth 1810 that has not erupted or is not a pontic, then finding the distal-most point of the tooth along the palatal arch spline projected on the occlusal plane so as to avoid unwanted vertical components, and constructing there a plane whose normal is the tangent of the palatal arch spline projected at the distal-most point.

[0146] The distance 1806 may be the signed distance between the distal end of the block 1802 and a plane 1812 passing through the distal-most point of the centric tooth 1822. For this block, the plane is calculated by first finding the adjacent tooth from the mesial side of the unerupted or missing tooth 1810 that has not erupted or is not a pontic, then finding the distal-most point of the tooth along a palatal arch spline projected on the occlusal plane so as to avoid unwanted vertical components, and constructing a plane where the normal is the tangent of the palatal arch spline projected at the distal-most point.

[0147] Fig.18B How the block is placed to satisfy the other condition is shown, namely that the center of mass 1824 of block 1802 may be further from the missing or unerupted tooth than the nearest cusp of the adjacent fully erupted tooth. If the fully erupted tooth is a centric tooth, then the distance between the nearest cusp of the centric tooth and the center of mass of block 1830 is determined by the distance 1834 between the center of mass of block 1830 and a plane 1832 passing through the most distal cusp of the centric tooth. The position of plane 1832 is calculated by first finding the adjacent tooth from the centric side that is not erupted or a pontic, then finding the most distal cusp of the tooth, and constructing there a plane whose normal is the tangent of the jaw arch spline projected at the cusp point projected onto the jaw arch spline. Distance 1834 is the distance between plane 1832 and center of mass 1830.

[0148] If the fully erupted tooth is a distal tooth, the distance between the nearest cusp of the distal tooth and the center of mass of block 1830 is determined by the distance 1834 between the center of mass of block 1830 and a plane 1832 passing through the most median cusp of the distal tooth. The position of plane 1832 is calculated by first finding the adjacent tooth from the distal end that has not erupted or is not a pontic, then finding the most median cusp of the tooth, and there constructing a plane whose normal is the tangent of the jaw arch spline projected at the cusp point back-projected onto the jaw arch spline. Distance 1834 is the distance between plane 1832 and center of mass 1830.

[0149] The distance between the center of mass 1830 and the location of the missing or unerupted teeth, such as the pontic 1810, is the distance 1836. The location of the pontic or missing teeth can be based on, for example, a plane that passes through the location on the non-missing teeth 1822 closest to the missing teeth. In some embodiments, the location can be a plane that passes through the location on the pontic close to the non-missing adjacent teeth 1822.

[0150] If distance 1830 is less than distance 1836, block 1802 may be placed.

[0151] Fig.19 An example of an accessory constraint for placing a bite block on an oral appliance is shown in accordance with some embodiments. The geometry and position of the bite block should allow for the placement of accessories on teeth below the block. In some cases, the block and appliances near the block may cause interference with the use of the accessories. The block and accessories 1904 should be placed so that they do not interfere with each other. The constraint on interference between the block 1908 and an accessory 1904 on a tooth 1906 of the same dental arch is a collision between the accessory activator model and the model of the accessory 1904, which is a projection of the plane of the bottom surface of the appliance and the block. The constraint on collision between the bite block and an accessory on a tooth of the opposing jaw is the dual appliance 1902 and the accessory model. The constraint is satisfied if there is no collision.

[0152] Fig. 20 2 is a block diagram of an example computing system 1010 capable of implementing one or more embodiments described and / or illustrated herein. For example, all or a portion of the computing system 1010 may perform and / or be used as a means to perform one or more steps described herein (such as one or more steps illustrated in FIG. 2 ), either alone or in combination with other elements. All or a portion of the computing system 1010 may also perform and / or be used as a means to perform any other steps, methods, or processes described and / or illustrated herein.

[0153] Computing system 1010 broadly represents any single-processor or multi-processor computing device or system capable of executing computer-readable instructions. Examples of computing system 1010 include, but are not limited to, a workstation, a laptop computer, a client-side terminal, a server, a distributed computing system, a handheld device, or any other computing system or device. In its most basic configuration, computing system 1010 may include at least one processor 1014 and system memory 1016.

[0154] The processor 1014 generally represents any type or form of physical processing unit (e.g., a hardware-implemented central processing unit) capable of processing data or interpreting and executing instructions. In some embodiments, the processor 1014 may receive instructions from a software application or module. These instructions may cause the processor 1014 to perform one or more of the functions of the example embodiments described and / or illustrated herein.

[0155] System memory 1016 generally represents any type or form of volatile or non-volatile storage device or medium capable of storing data and / or other computer-readable instructions. Examples of system memory 1016 include, but are not limited to, random access memory (RAM), read-only memory (ROM), flash memory, or any other suitable memory device. Although not required, in some embodiments, computing system 1010 may include both volatile memory units (such as system memory 1016) and non-volatile storage devices (such as main storage device 1032, as described in detail below). In one example, Figure 4 One or more modules 202 may be loaded into the system memory 1016 .

[0156] In some examples, system memory 1016 can store and / or load operating system 1040 for execution by processor 1014. In one example, operating system 1040 can include and / or represent software that manages computer hardware and software resources and / or provides common services to computer programs and / or applications on computing system 1010. Examples of operating system 1040 include, but are not limited to, LINUX, JUNOS, MICROSOFT WINDOWS, WINDOWS MOBILE, MAC OS, APPLE's IOS, UNIX, GOOGLE CHROME OS, GOOGLE's ANDROID, SOLARIS, variations of one or more of the above operating systems, and / or any other suitable operating system.

[0157] In some embodiments, the example computing system 1010 may include one or more components or elements in addition to the processor 1014 and the system memory 1016. For example, Fig. 20As shown, computing system 1010 may include memory controller 1018, input / output (I / O) controller 1020, and communication interface 1022, which may be interconnected via communication infrastructure 1012, respectively. Communication infrastructure 1012 generally represents any type or form of infrastructure capable of facilitating communication between one or more components of a computing device. Examples of communication infrastructure 1012 include, but are not limited to, communication buses (such as Industry Standard Architecture (ISA), Peripheral Component Interconnect (PCI), PCI Express (PCIe), or similar buses) and networks.

[0158] Memory controller 1018 generally represents any type or form of device capable of handling memory or data or controlling communications between one or more components of computing system 1010. For example, in some embodiments, memory controller 1018 may control communications between processor 1014, system memory 1016, and I / O controller 1020 via communication infrastructure 1012.

[0159] I / O controller 1020 generally represents any type or form of module capable of coordinating and / or controlling the input and output functions of a computing device. For example, in some embodiments, I / O controller 1020 may control or facilitate data transfer between one or more elements of computing system 1010, such as processor 1014, system memory 1016, communication interface 1022, display adapter 1026, input interface 1030, and storage interface 1034.

[0160] like Fig. 20 As shown, computing system 1010 may also include at least one display device 1024 coupled to I / O controller 1020 via display adapter 1026. Display device 1024 generally represents any type or form of device capable of visually displaying information forwarded by display adapter 1026. Similarly, display adapter 1026 generally represents any type or form of device configured to forward graphics, text, and other data from communications infrastructure 1012 (or from a frame buffer, as is known in the art) for display on display device 1024.

[0161] like Fig. 20 As shown, the example computing system 1010 may also include at least one input device 1028 coupled to the I / O controller 1020 via an input interface 1030. The input device 1028 generally represents any type or form of input device capable of providing computer or human generated input to the example computing system 1010. Examples of the input device 1028 include, but are not limited to, a keyboard, a pointing device, a voice recognition device, variations or combinations of one or more thereof, and / or any other input device.

[0162] Additionally or alternatively, the example computing system 1010 may include additional I / O devices. For example, the example computing system 1010 may include an I / O device 1036. In this example, the I / O device 1036 may include and / or represent a user interface that facilitates human interaction with the computing system 1010. Examples of I / O devices 1036 include, but are not limited to, a computer mouse, a keyboard, a monitor, a printer, a modem, a camera, a scanner, a microphone, a touch screen device, variations or combinations of one or more thereof, and / or any other I / O device.

[0163] The communication interface 1022 broadly represents any type or form of communication device or adapter that can facilitate communication between the example computing system 1010 and one or more additional devices. For example, in some embodiments, the communication interface 1022 can facilitate communication between the computing system 1010 and a private or public network including additional computing systems. Examples of the communication interface 1022 include, but are not limited to, a wired network interface (such as a network interface card), a wireless network interface (such as a wireless network interface card), a modem, and any other suitable interface. In at least one embodiment, the communication interface 1022 can provide a direct connection to a remote server via a direct link to a network such as the Internet. The communication interface 1022 can also provide such a connection indirectly through, for example, a local area network (such as an Ethernet), a personal area network, a telephone or cable network, a cellular phone connection, a satellite data connection, or any other suitable connection.

[0164] In some embodiments, the communication interface 1022 may also represent a host adapter that is configured to facilitate communication between the computing system 1010 and one or more additional network or storage devices via an external bus or communication channel. Examples of host adapters include, but are not limited to, a Small Computer System Interface (SCSI) host adapter, a Universal Serial Bus (USB) host adapter, an Institute of Electrical and Electronics Engineers (IEEE) 1394 host adapter, an Advanced Technology Attachment (ATA), a Parallel ATA (PATA), a Serial ATA (SATA) and an External SATA (eSATA) host adapter, a Fibre Channel interface adapter, an Ethernet adapter, and the like. The communication interface 1022 may also allow the computing system 1010 to participate in distributed or remote computing. For example, the communication interface 1022 may receive instructions from a remote device or send instructions to a remote device for execution.

[0165] In some examples, system memory 1016 can store and / or load network communication program 1038 for execution by processor 1014. In one example, network communication program 1038 can include and / or represent a program that enables computing system 1010 to communicate with another computing system ( Fig. 201042 and / or software for communicating with the other computing system via the communication interface 1022. In this example, the network communication program 1038 can direct the flow of outgoing traffic sent to the other computing system via the network connection 1042. Additionally or alternatively, the network communication program 1038 can work in conjunction with the processor 1014 to direct the processing of incoming traffic received from the other computing system via the network connection 1042.

[0166] Despite Fig. 20 1022, but the network communication program 1038 may alternatively be stored and / or loaded into the communication interface 1022. For example, the network communication program 1038 may include and / or represent at least a portion of software and / or firmware executed by a processor and / or an application specific integrated circuit (ASIC) incorporated into the communication interface 1022.

[0167] like Fig. 20 As shown, the example computing system 1010 may also include a primary storage device 1032 and a backup storage device 1033 connected to the communication infrastructure 1012 via a storage interface 1034. Storage devices 1032 and 1033 generally represent any type or form of storage device or medium capable of storing data and / or other computer-readable instructions. For example, storage devices 1032 and 1033 may be disk drives (e.g., so-called hard drives), solid-state drives, floppy disk drives, tape drives, optical drives, flash drives, etc. Storage interface 1034 generally represents any type or form of interface or device for transferring data between storage devices 1032 and 1033 and other components of computing system 1010. In one example, Figure 4 The data elements 420 may be stored and / or loaded into the primary storage device 1032 .

[0168] In some embodiments, storage devices 1032 and 1033 may be configured to read from and / or write to a removable storage unit that is configured to store computer software, data, or other computer-readable information. Examples of suitable removable storage units include, but are not limited to, floppy disks, magnetic tapes, optical disks, flash memory devices, and the like. Storage devices 1032 and 1033 may also include other similar structures or devices for allowing computer software, data, or other computer-readable instructions to be loaded into computing system 1010. For example, storage devices 1032 and 1033 may be configured to read and write software, data, or other computer-readable information. Storage devices 1032 and 1033 may also be part of computing system 1010 or may be separate devices accessed through other interface systems.

[0169] Many other devices or subsystems may be connected to computing system 1010. Conversely, it is not necessary to present Fig. 20 all of the components and devices shown in Fig. 20 to practice the embodiments described and / or illustrated herein. The devices and subsystems cited above may also be interconnected in ways different from those shown in

[0170]

[0171] Fig.21

[0172] Computing system 1010 may also adopt any number of software, firmware, and / or hardware configurations. For example, one or more of the example embodiments disclosed herein may be encoded as a computer program (also referred to as computer software, software application, computer-readable instructions, or computer control logic) on a computer-readable medium. As used herein, the term "computer-readable medium" generally refers to any form of device, carrier, or medium capable of storing or carrying computer-readable instructions. Examples of computer-readable media include, but are not limited to, transmission-type media such as carrier waves, and non-transitory media such as magnetic storage media (e.g., hard disk drives, tape drives, and floppy disks), optical storage media (e.g., compact discs (CDs), digital video discs (DVDs), and Blu-ray discs), electronic storage media (e.g., solid state drives and flash media), and other distributed systems. A computer-readable medium containing a computer program may be loaded into computing system 1010. Subsequently, all or a portion of the computer program stored on the computer-readable medium may be stored in various portions of system memory 1016 and / or storage devices 1032 and 1033. When executed by processor 1014, the computer program loaded into computing system 1010 may cause processor 1014 to perform and / or serve as a means for performing the functions of one or more of the example embodiments described and / or illustrated herein. Additionally or alternatively, one or more of the example embodiments described and / or illustrated herein may be implemented in firmware and / or hardware. For example, computing system 1010 may be configured as an application-specific integrated circuit (ASIC) adapted to implement one or more of the example embodiments disclosed herein. FIG. 11 is a block diagram of an example network architecture 1100 in which client systems 1110, 1120, and 1130 and servers 1140 and 1145 may be coupled to network 1150. As described above, all or a portion of network architecture 1100 may perform and / or serve as a means for performing one or more of the steps disclosed herein (such as one or more of the steps shown in FIG. 2) either alone or in combination with other elements. All or a portion of network architecture 1100 may also be used to perform and / or serve as a means for performing other steps and features set forth in this disclosure. Client systems 1110, 1120, and 1130 generally represent any type or form of computing device or system, such as Fig. 20 1100. Similarly, servers 1140 and 1145 generally represent computing devices or systems configured to provide various database services and / or run certain software applications, such as application servers or database servers. Network 1150 generally represents any telecommunications or computer network, including, for example, an intranet, WAN, LAN, PAN, or the Internet. In one example, client systems 1110, 1120, and / or 1130 and / or servers 1140 and / or 1145 may include Figure 4 All or a portion of system 400.

[0173] like Fig.21 As shown, one or more storage devices 1160(1)-1160(N) can be directly attached to server 1140. Similarly, one or more storage devices 1170(1)-1170(N) can be directly attached to server 1145. Storage devices 1160(1)-1160(N) and storage devices 1170(1)-1170(N) generally represent any type or form of storage device or medium capable of storing data and / or other computer-readable instructions. In some embodiments, storage devices 1160(1)-1160(N) and storage devices 1170(1)-1170(N) can represent network attached storage (NAS) devices configured to communicate with servers 1140 and 1145 using various protocols, such as Network File System (NFS), Server Message Box (SMB), or Common Internet File System (CIFS).

[0174] The servers 1140 and 1145 may also be connected to a storage area network (SAN) fabric 1180. The SAN fabric 1180 generally represents any type or form of computer network or architecture capable of facilitating communication between multiple storage devices. The SAN fabric 1180 may facilitate communication between the servers 1140 and 1145 and multiple storage devices 1190(1)-1190(N) and / or an intelligent storage array 1195. The SAN fabric 1180 may also facilitate communication between the client systems 1110, 1120, and 1130 and the storage devices 1190(1)-1190(N) and / or the intelligent storage array 1195 via the network 1150 and the servers 1140 and 1145 in a manner such that the devices 1190(1)-1190(N) and the array 1195 appear as locally attached devices to the client systems 1110, 1120, and 1130. As with storage devices 1160(1)-1160(N) and storage devices 1170(1)-1170(N), storage devices 1190(1)-(1190N) and smart storage array 1195 generally represent any type or form of storage device or medium capable of storing data and / or other computer-readable instructions.

[0175] In certain embodiments, and with reference to Fig.10 An example computing system 1010, a communication interface such as Fig. 20 The communication interface 1022 in the example embodiment may be used to provide connectivity between each client system 1110, 1120, and 1130 and the network 1150. The client systems 1110, 1120, and 1130 may be able to access information on the server 1140 or 1145 using, for example, a web browser or other client software. Such software may allow the client systems 1110, 1120, and 1130 to access data hosted by the server 1140, server 1145, storage devices 1160(1)-1160(N), storage devices 1170(1)-1170(N), storage devices 1190(1)-1190(N), or smart storage array 1195. Although Fig.21 The use of a network, such as the Internet, to exchange data is depicted, but the embodiments described and / or illustrated herein are not limited to the Internet or any particular network-based environment.

[0176] In at least one embodiment, all or part of one or more of the example embodiments disclosed herein may be coded as a computer program and loaded onto and executed by server 1140, server 1145, storage devices 1160(1)-1160(N), storage devices 1170(1)-1170(N), storage devices 1190(1)-1190(N), smart storage array 1195, or any combination thereof. All or part of one or more of the example embodiments disclosed herein may also be coded as a computer program, stored in server 1140, executed by server 1145, and distributed to client systems 1110, 1120, and 1130 via network 1150.

[0177] As described above, one or more components of computing system 1010 and / or network architecture 1100 may perform and / or be a means for performing, alone or in combination with other elements, one or more steps of an example method for selecting an MRF position for an oral appliance for MR treatment.

[0178] Although the foregoing disclosure uses specific block diagrams, flow charts, and examples to illustrate various embodiments, each block diagram component, flow chart step, operation, and / or component described and / or illustrated herein may be implemented individually and / or collectively using a variety of hardware, software, or firmware (or any combination thereof) configurations. In addition, any disclosure of components contained within other components should be considered exemplary in nature, as many other architectures may be implemented to achieve the same functionality.

[0179] In some examples, Figure 4All or part of the example system 200 in the embodiment may represent multiple parts of a cloud computing or network-based environment. A cloud computing environment may provide various services and applications via the Internet. These cloud-based services (e.g., software as a service, platform as a service, infrastructure as a service, etc.) may be accessed through a web browser or other remote interface. The various functions described herein may be provided through a remote desktop environment or any other cloud-based computing environment.

[0180] In various embodiments, Figure 4 All or part of the example system 200 in can facilitate multi-tenancy within a cloud-based computing environment. In other words, the software modules described herein can configure a computing system (e.g., a server) to facilitate multi-tenancy of one or more of the functions described herein. For example, one or more of the software modules described herein can program a server to enable two or more clients (e.g., customers) to share an application running on the server. A server programmed in this manner can share applications, operating systems, processing systems, and / or storage systems between multiple customers (i.e., tenants). One or more modules described herein can also partition the data and / or configuration information of a multi-tenant application for each customer so that one customer cannot access the data and / or configuration information of another customer.

[0181] According to various embodiments, Figure 4 All or part of the example system 200 in can be implemented in a virtual environment. For example, the modules and / or data described herein can reside in a virtual machine and / or execute in a virtual machine. As used herein, the term "virtual machine" generally refers to any operating system environment abstracted from computing hardware by a virtual machine manager (e.g., a hypervisor). Additionally or alternatively, the modules and / or data described herein can reside in a virtualization layer and / or execute in a virtualization layer. As used herein, the term "virtualization layer" generally refers to any data layer and / or application layer covering an operating system environment and / or abstracted from an operating system environment. The virtualization layer can be managed by a software virtualization solution (e.g., a file system filter), which presents the virtualization layer as if it is part of the underlying basic operating system. For example, a software virtualization solution can redirect calls that were originally directed to a location within a basic file system and / or a registry to a location in the virtualization layer.

[0182] In some examples, Figure 4All or part of the example system 200 in can represent multiple parts of a mobile computing environment. The mobile computing environment can be implemented by a variety of mobile computing devices, including mobile phones, tablet computers, e-book readers, personal digital assistants, wearable computing devices (e.g., computing devices with head-mounted displays, smart watches, etc.), etc. In some examples, the mobile computing environment can have one or more different features, including, for example, reliance on battery power, presenting only one foreground application at any given time, remote management features, touch screen features, location and movement data (e.g., provided by global positioning systems, gyroscopes, accelerometers, etc.), a restricted platform that limits modifications to system-level configurations and / or limits the ability of third-party software to inspect the behavior of other applications, controls that limit the installation of applications (e.g., only from approved application stores), etc. The various functions described herein can be used in and / or interact with a mobile computing environment.

[0183] also, Figure 4 All or a portion of the example system 200 in the example may represent multiple parts of one or more systems, interact with, consume data generated by, and / or generate data consumed by them for information management. As used herein, the term "information management" may refer to the protection, organization, and / or storage of data. Examples of systems for information management may include, but are not limited to, storage systems, backup systems, archiving systems, replication systems, high availability systems, data search systems, virtualization systems, etc.

[0184] In some embodiments, Figure 4 All or a portion of the example system 200 in FIG. 1 may represent portions of, generate data protected by, and / or communicate with, one or more information security systems. The term "information security" may refer to the control of access to protected data. Examples of information security systems may include, but are not limited to, systems that provide managed security services, data loss prevention systems, identity authentication systems, access control systems, encryption systems, policy compliance systems, intrusion detection and prevention systems, electronic discovery systems, and the like.

[0185] The process parameters and step sequences described and / or illustrated herein are given by way of example only and may be changed as desired. For example, although the steps illustrated and / or described herein may be illustrated or discussed in a particular order, the steps do not necessarily need to be performed in the order illustrated or discussed. The various example methods described and / or illustrated herein may also omit one or more of the steps described or illustrated herein, or include additional steps in addition to those disclosed.

[0186] Although various embodiments have been described and / or shown herein in the context of a fully functional computing system, one or more of these example embodiments may be distributed in various forms as a program product, regardless of the specific type of computer-readable medium used to actually perform the distribution. The embodiments disclosed herein may also be implemented using software modules that perform certain tasks. These software modules may include scripts, batch processing, or other executable files that may be stored on a computer-readable storage medium or in a computing system. In some embodiments, these software modules may configure a computing system to perform one or more of the example embodiments disclosed herein.

[0187] As described herein, the computing devices and systems described and / or illustrated herein broadly represent any type or form of computing device or system capable of executing computer-readable instructions such as those contained within the modules described herein. In their most basic configuration, these computing devices may each include at least one memory device and at least one physical processor.

[0188] As used herein, the term "memory" or "memory device" generally refers to any type or form of volatile or non-volatile storage device or medium capable of storing data and / or computer-readable instructions. In one example, a memory device can store, load, and / or maintain one or more of the modules described herein. Examples of memory devices include, but are not limited to, random access memory (RAM), read-only memory (ROM), flash memory, hard disk drive (HDD), solid-state drive (SSD), optical drive, cache, variations or combinations of one or more of them, or any other suitable memory.

[0189] In addition, the term "processor" or "physical processor" as used herein generally refers to any type or form of hardware-implemented processing unit capable of interpreting and / or executing computer-readable instructions. In one example, the physical processor can access and / or modify one or more modules stored in the above-mentioned memory device. Examples of physical processors include, but are not limited to, microprocessors, microcontrollers, central processing units (CPUs), field programmable gate arrays (FPGAs) implementing soft-core processors, application specific integrated circuits (ASICs), multiple portions of one or more of them, variations or combinations of one or more of them, or any other suitable physical processor.

[0190] Fig. 22An exemplary tooth repositioning appliance 2200 is shown, such as an appliance that can be worn by a patient to achieve incremental repositioning of a single tooth 1102 in a jaw. The appliance can include a shell (e.g., a continuous polymer shell or a segmented shell) having a tooth receiving cavity that receives the tooth and resiliently repositions the tooth. The appliance or a portion of the appliance can be indirectly manufactured using a physical model of the teeth. For example, an appliance (e.g., a polymer appliance) can be formed using a physical model of the teeth and a layer of a suitable polymer material. The physical model of the teeth (e.g., a physical mold) can be formed by various techniques including 3D printing. The appliance can be formed by thermoforming the appliance on the physical model. In some embodiments, for example, a physical appliance is directly manufactured based on a digital model of the appliance using additive manufacturing technology. In some embodiments, the physical appliance can be created by various direct forming techniques (such as 3D printing). The appliance can be fitted on all teeth or a portion of teeth present in the upper or lower jaw. The appliance can be specially designed to accommodate the patient's teeth (e.g., the topography of the tooth receiving cavity matches the topography of the patient's teeth), and can be manufactured based on a positive or negative model of the patient's teeth generated by an impression, a scan, etc. Alternatively, the appliance can be a common appliance constructed to accommodate teeth, but it does not have to be shaped to match the topography of the patient's teeth. In some cases, only some of the teeth received by the appliance will be repositioned by the appliance, while other teeth can provide a base or anchoring area for holding the appliance in place when it applies force to one or more teeth that are the target of repositioning. In some cases, some or most, or even all of the teeth will be repositioned at a certain point during treatment. The mobile teeth can also be used as a base or anchor to hold the appliance when the patient wears the appliance. In some embodiments, wires or other devices for holding the appliance in place above the teeth will not be provided. However, in some cases, it may be desirable or necessary to provide a separate attachment or other anchoring element 2204 on the tooth 2202 with a corresponding receptacle or hole 2206 in the appliance 2200 so that the appliance can apply a selected force on the tooth. Exemplary appliances of those used in the system, such patents and patent applications include, for example, U.S. Patent Nos. 6,450,807 and 5,975,893, and on company web pages accessible on the World Wide Web (see, for example, URL "invisalign.com"). Examples of tooth-mounted attachments suitable for orthodontic appliances are also described in patents and patent applications assigned to Align Technology, Inc., including, for example, U.S. Patent Nos. 6,309,215 and 6,830,450.

[0191] Fig.23A tooth repositioning system 2300 is shown that includes multiple appliances 2303A, 2303B, 2303C. Any appliance described herein can be designed and / or provided as part of a set of multiple appliances for use in a tooth repositioning system. Each appliance can be constructed so that a tooth receiving cavity has a geometry corresponding to an intermediate or final tooth arrangement intended for the appliance. By placing a series of incremental position adjustment appliances over the patient's teeth, the patient's teeth can be progressively repositioned from an initial tooth arrangement to a target tooth arrangement. For example, the tooth repositioning system 2300 can include a first appliance 2303A corresponding to an initial tooth arrangement, one or more intermediate appliances 2303B corresponding to one or more intermediate arrangements, and a final appliance 2303C corresponding to a target arrangement. The target tooth arrangement can be a planned final tooth arrangement selected for the patient's teeth at the end of all planned orthodontic treatments. Alternatively, the target arrangement can be one of a number of intermediate arrangements for the patient's teeth during the course of orthodontic treatment, which can include a variety of different treatment scenarios, including but not limited to situations where surgery is recommended, situations where interproximal reduction (IPR) is appropriate, situations where a progress check is scheduled, situations where anchor placement is optimal, situations where palate expansion is desired, situations involving restorative dentistry (e.g., inlays, onlays, crowns, bridges, implants, veneers, etc.), etc. As such, it should be understood that the target tooth arrangement can be any planned resulting arrangement of the patient's teeth after one or more incremental repositioning stages. Likewise, the initial tooth arrangement can be any initial arrangement of the patient's teeth after one or more incremental repositioning stages.

[0192] Optionally, in cases involving more complex movements or treatment plans, it may be beneficial to utilize auxiliary components (e.g., features, accessories, structures, devices, components, etc.) in conjunction with the orthodontic appliance. Examples of such accessories include, but are not limited to, elastics, wires, springs, rods, arch expanders, palatal expanders, bimaxillary blocks, bite blocks, bite ramps, mandibular advancement splints, bite plates, bridges, hooks, brackets, headgear tubes, springs, buffer tubes, palatal bars, frames, pin-tube devices, buccal shields, buccal arches, wire shields, lingual flanges and pads, lip pads or buffers, protrusions, divots, etc. In some embodiments, the appliances, systems, and methods described herein include improved orthodontic appliances having integrally formed features that are shaped to couple to, or replace, such auxiliary components.

[0193] Fig.24A method 2400 of orthodontic treatment using multiple appliances according to many embodiments is shown. The method 2400 can be practiced using any appliance or set of appliances described herein. In step 2410, a first orthodontic appliance is applied to the patient's teeth to reposition the teeth from a first tooth arrangement to a second tooth arrangement. In step 2420, a second orthodontic appliance is applied to the patient's teeth to reposition the teeth from the second tooth arrangement to a third tooth arrangement. As desired, the method 2400 can be repeated using any suitable number of sequence appliances and combinations thereof to incrementally reposition the patient's teeth from an initial arrangement to a target arrangement. The appliances can be generated all or in groups or batches (e.g., at the beginning of a treatment phase) at the same stage, or one at a time, and the patient can wear each appliance until the pressure of each appliance on the teeth can no longer be felt, or until the maximum amount of tooth movement expressed for the given stage has been achieved. Multiple different appliances (e.g., a set) can be designed and even manufactured before the patient wears any of the multiple appliances. After wearing the appliance for an appropriate period of time, the patient can replace the current appliance with the next appliance in the series until there are no more appliances remaining. Appliances are usually not fixed to the teeth, and patients can place and replace appliances at any time during the procedure (e.g., patient-removable appliances). The final appliance or several appliances in the series may have one or more geometries selected for overcorrecting the tooth arrangement. For example, one or more appliances may have a geometry that will (if fully realized) move a single tooth beyond the tooth arrangement that has been selected as the "final". In order to compensate for potential recurrence after the repositioning method has been terminated, this overcorrection may be desirable (e.g., allowing a single tooth to move back toward their position before correction). Overcorrection can also be beneficial to speed up the correction rate (e.g., an appliance with a geometry positioned outside the desired intermediate or final position can cause a single tooth to shift toward the position at a greater rate). In such a case, the use of the appliance can be terminated before the tooth reaches the position defined by the appliance. In addition, overcorrection can be deliberately applied to compensate for any inaccuracies or limitations of the appliance.

[0194] Fig.25 A method 2500 for digitally planning orthodontic treatment and / or designing or manufacturing an appliance according to many embodiments is shown. The method 1000 can be applied to any treatment procedure described herein and can be performed by any suitable data processing system. Any embodiment of the appliance described herein can be designed or manufactured using the method 2500.

[0195] In step 2510, a digital representation of the patient's teeth is received. The digital representation may include surface topography data of the patient's oral cavity (including teeth, gum tissue, etc.). The surface topography data may be generated by directly scanning the oral cavity, a physical model (positive or negative) of the oral cavity, or an impression of the oral cavity using a suitable scanning device (e.g., a handheld scanner, a desktop scanner, etc.).

[0196] In step 2520, one or more treatment stages are generated based on the digital representation of the teeth. The treatment stages can be incremental repositioning stages of an orthodontic treatment procedure designed to move one or more of the patient's teeth from an initial tooth arrangement to a target arrangement. For example, the treatment stages can be generated by determining an initial tooth arrangement indicated by the digital representation, determining a target tooth arrangement, and determining a movement path of one or more teeth in the initial arrangement necessary to achieve the target tooth arrangement. The movement path can be optimized based on minimizing the total distance moved, preventing collisions between teeth, avoiding tooth movements that are more difficult to achieve, or any other suitable criteria.

[0197] In step 2530, at least one orthodontic appliance is manufactured based on the generated treatment stages. For example, a set of appliances can be manufactured to be worn sequentially by a patient to incrementally reposition the teeth from an initial arrangement to a target arrangement. Some appliances can be shaped to accommodate a tooth arrangement specified by one of the treatment stages. Alternatively or in combination, some appliances can be shaped to accommodate a tooth arrangement that is different from the target arrangement for the corresponding treatment stage. For example, as previously described herein, an appliance can have a geometry corresponding to an overcorrected tooth arrangement. Such an appliance can be used to ensure that the appropriate amount of force is applied to the teeth as the teeth approach or reach their desired target position for the treatment stage. As another example, an appliance can be designed to apply a specific force system to the teeth, and the appliance may not have a geometry corresponding to any current or planned arrangement of the patient's teeth.

[0198] In some cases, the hierarchical arrangement of various arrangements or treatment phases may not be necessary for the design and / or manufacture of the device. Fig.25 As shown by the dotted lines in , the design and / or manufacture of orthodontic appliances, and possibly specific orthodontic treatments, can include using a representation of a patient's teeth (e.g., receiving a digital representation of the patient's teeth 2510), and subsequently designing and / or manufacturing the orthodontic appliance based on the representation of the patient's teeth in an arrangement represented by the received representation.

[0199] Fig.2626 is a simplified block diagram of a data processing system 2600 that can be used to perform the methods and processes described herein. The data processing system 2600 typically includes at least one processor 2602, which communicates with one or more peripheral devices via a bus subsystem 2604. These peripheral devices typically include a storage subsystem 2606 (a memory subsystem 2608 and a file storage subsystem 2614), a set of user interface input and output devices 2618, and an interface 2616 to an external network. The interface is schematically represented as a "network interface" box 2616 and is connected to corresponding interface devices in other data processing systems via a communication network interface 2624. The data processing system 2600 may include, for example, one or more computers, such as personal computers, workstations, mainframes, laptop computers, etc.

[0200] The user interface input device 2618 is not limited to any particular device, and may generally include, for example, a keyboard, a pointing device, a mouse, a scanner, an interactive display, a touch pad, a joystick, etc. Similarly, a variety of user interface output devices may be used in the system of the present invention, and may include, for example, one or more of a printer, a display (e.g., visual, non-visual) system / subsystem, a controller, a projection device, an audio output, etc.

[0201] The storage subsystem 2606 maintains the basic required programming, including computer-readable media and data structures with instructions (e.g., operating instructions, etc.). The program modules discussed herein are generally stored in the storage subsystem 2606. The storage subsystem 2606 generally includes a memory subsystem 2608 and a file storage subsystem 2614. The memory subsystem 2608 generally includes a plurality of memories (e.g., RAM 2610, ROM 2612, etc.), which include computer-readable memories for storing fixed instructions, instructions and data during program execution, basic input / output systems, etc. One or more storage systems, drives, etc. may be located at a remote location, such as via a server on a network or via the Internet / World Wide Web connection. The file storage subsystem 2614 provides persistent (non-volatile) storage for program and data files, and may include one or more removable or fixed drives or media, hard disks, floppy disks, CD-ROMs, DVDs, optical drives, etc. One or more storage systems, drives, etc. may be located at a remote location, such as via a server on a network or via the Internet / World Wide Web connection. In this context, the term "bus subsystem" is generally used to include any mechanism for enabling the various components and subsystems to communicate with each other as intended, and may include various suitable components / systems that will be known or deemed suitable for use therein. It should be appreciated that the various components of the system may, but need not, be at the same physical location, but may be connected via various local or wide area network media, transmission systems, etc.

[0202] Scanner 2620 includes any means for obtaining a digital representation (e.g., image, surface topography data, etc.) of a patient's teeth (e.g., by scanning a physical model of the teeth, such as a cast 2621, by scanning an impression taken of the teeth, or by scanning directly into the oral cavity), which may be obtained from the patient or from a treating professional such as an orthodontist, and includes means for providing the digital representation to data processing system 2600 for further processing. Scanner 2620 may be located at a remote location relative to the other components of the system, and may communicate image data and / or information to data processing system 2600, for example, via network interface 2624. Manufacturing system 2622 manufactures appliance 2623 based on a treatment plan that includes data set information received from data processing system 2600. Manufacturing machine 2622 may, for example, be located at a remote location and receive data set information from data processing system 2600 via network interface 2624.

[0203] Although shown as separate elements, the method steps described and / or illustrated herein may represent multiple portions of a single application. In addition, in some embodiments, one or more of these steps may represent or correspond to one or more software applications or programs that, when executed by a computing device, may cause the computing device to perform one or more tasks, such as method steps.

[0204] In addition, one or more devices described herein may transform data, physical devices, and / or representations of physical devices from one form to another. Additionally or alternatively, one or more modules described herein may transform a processor, volatile memory, non-volatile memory, and / or any other portion of a physical computing device from one form of computing device to another form of computing device by executing on a computing device, storing data on a computing device, and / or otherwise interacting with a computing device.

[0205] As used herein, the term "computer-readable medium" generally refers to any form of device, carrier or medium capable of storing or executing computer-readable instructions. Examples of computer-readable media include, but are not limited to, transmission-type media such as carrier waves, and non-transitory media such as magnetic storage media (e.g., hard drives, tape drives, and floppy disks), optical storage media (e.g., compact disks (CDs), digital video disks (DVDs), and BLU-RAY disks), electronic storage media (e.g., solid-state drives and flash memory media), and other distribution systems.

[0206] Those of ordinary skill in the art will recognize that any process or method disclosed herein may be modified in many ways. The process parameters and order of steps described and / or illustrated herein are given as examples only and may be changed as desired. For example, although the steps shown and / or described herein may be shown or discussed in a particular order, the steps do not necessarily need to be performed in the order shown or discussed.

[0207] The various exemplary methods described and / or shown herein may also omit one or more steps described or shown herein, or include additional steps in addition to those steps disclosed. In addition, the steps of any method disclosed herein may be combined with any one or more steps of any other method disclosed herein.

[0208] A processor as described herein may be configured to perform one or more steps of any method disclosed herein.Alternatively or in combination, a processor may be configured to combine one or more steps of one or more methods as disclosed herein.

[0209] 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 as "at least one". Finally, for ease of use, the terms "including" and "having" (and their derivatives) used in the specification and claims may be interchangeable with "comprising" and shall have the same meaning as "including".

[0210] The processors disclosed herein may be configured with instructions to perform any one or more steps of any method disclosed herein.

[0211] It should be understood that although the terms "first", "second", "third", etc. may be used herein to describe various layers, elements, components, regions or parts, this does not imply any particular order or sequence of events. These terms are only used to distinguish a layer, an element, a component, a region or a part from another layer, another element, another component, another region or another part. Without departing from the teachings of the present disclosure, the first layer, the first element, the first component, the first region or the first part described herein may be referred to as the second layer, the second element, the second component, the second region or the second part.

[0212] As used herein, the term "or" is used to indicate items in alternatives and combinations in an inclusive manner.

[0213] As used herein, symbols such as numerals refer to the same elements.

[0214] This disclosure includes the following numbered clauses.

[0215] Clause 1. A system for generating an orthodontic appliance having a mandibular repositioning structure, the system comprising: one or more processors; and, a non-transitory computer-readable medium comprising instructions that, when executed by the one or more processors, cause the system to perform a method comprising: generating a treatment plan to move a patient's teeth from a first position toward a second position and comprising moving a jaw from the first position toward the second position, the treatment plan comprising a series of jaw movement stages to move the jaw from the first position toward the second position; placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the mandible, and Placing a second mandibular repositioning structure of a first pair of mandibular repositioning structures on the upper jaw; determining positions of the first pair of mandibular repositioning structures based on a first set of constraints; placing a first mandibular repositioning structure of a second pair of mandibular repositioning structures on the lower jaw, and placing a second mandibular repositioning structure of the second pair of mandibular repositioning structures on the upper jaw; determining positions of the second pair of mandibular repositioning structures based on a second set of constraints; determining positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints; and, providing positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures to implement the series of jaw movement stages.

[0216] Clause 2. The system of clause 1, wherein the method further comprises: generating a digital model of the appliance; and manufacturing the physical appliance based on the digital model of the appliance.

[0217] Clause 3. The system of clause 1, wherein determining the position of the first pair of mandibular repositioning structures based on the first set of constraints comprises optimizing the position based on the first set of constraints.

[0218] Clause 4. The system of clause 1, wherein determining the position of the first pair of mandibular repositioning structures based on the first set of constraints comprises: using a nonlinear optimization algorithm.

[0219] Clause 5. The system of clause 1, wherein the first set of constraints and the second set of constraints include unilateral constraints for each of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures.

[0220] Clause 6. The system of clause 1, wherein the third set of constraints comprises symmetry constraints.

[0221] Clause 7. The system of clause 1, wherein the third set of constraints comprises one-sided constraints and symmetric constraints.

[0222] Clause 8. The system of clause 5, wherein the one-sided constraint comprises a collision constraint that tests for collision between a first mandibular repositioning feature on a first side of the first jaw and a second mandibular repositioning feature on a first side of the second jaw.

[0223] Clause 9. The system of clause 5, wherein the unilateral constraint comprises a rotational constraint that constrains rotation of the mandibular repositioning structure relative to a dental arch of the patient.

[0224] Clause 10. The system of Clause 5, wherein the unilateral constraint comprises a rotational alignment constraint between a first mandibular repositioning feature on a first side of the first jaw and a second mandibular repositioning feature on a first side of the second jaw.

[0225] Clause 11. A system according to clause 5, wherein the one-sided constraint includes a contact plane constraint, which contact plane constraint includes a constraint on the angle between the normal angle of the centroid of the engagement surface of the first mandibular repositioning feature on the first side of the first jaw and the normal angle of the centroid of the engagement surface of the second mandibular repositioning feature on the first side of the second jaw.

[0226] Clause 12. The system of clause 5, wherein the unilateral constraint comprises a post constraint on a distance between a center of the first mandibular repositioning structure and a line extending between centers of two adjacent teeth on which the first mandibular repositioning structure is located.

[0227] Clause 13. A system according to clause 5, wherein the unilateral constraint includes a constraint on a gap between the bite block and the tooth on which the first mandibular repositioning structure is located, wherein the gap is the shortest distance between the bite block of the first mandibular repositioning structure and the occlusal surface of the tooth on which the first mandibular repositioning structure is located.

[0228] Clause 14. A system according to clause 5, wherein the unilateral constraint includes a constraint on a distal arch position of the first mandibular repositioning structure, the distal arch position being greater than a threshold distance from a distal-most point of a distal-most tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

[0229] Clause 15. A system according to clause 5, wherein the unilateral constraint includes a constraint on the dental arch position of the first mandibular repositioning structure that is greater than a threshold distance from the most distal point of the most distal tooth on the same side of the dental arch on which the first mandibular repositioning structure is located, and is greater than 5 mm from the most midpoint of the most midpoint of the most central tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

[0230] Clause 16. A system according to clause 5, wherein the unilateral constraint includes a constraint on vertical articulation, which is the distance between a vertical occlusal position on the articulation surface of the first mandibular repositioning structure and a vertical occlusal position on the articulation surface of the second mandibular repositioning structure.

[0231] Clause 17. The system of Clause 5, wherein the unilateral constraint comprises a constraint on the lateral articulation, the constraint on the lateral articulation comprising a constraint on the distance from the lingual side of the first block to the buccal side of the second block.

[0232] Clause 18. A system according to clause 6, wherein the symmetry constraint includes a vertical asymmetry constraint based on a difference between a distance between a first mandibular repositioning structure and opposing teeth on a first side of the jaw and a distance between a second mandibular repositioning structure and opposing teeth on a second side of the jaw.

[0233] Clause 19. The system of clause 6, wherein the symmetry constraint comprises a horizontal asymmetry constraint between centers of a first pair of mandibular repositioning structures on a first side of the dental arch and centers of a second pair of mandibular repositioning structures on a second side of the dental arch.

[0234] Clause 20. The system of clause 5, wherein the unilateral constraint comprises a bridging constraint, the bridging constraint being a constraint on the distance that the mandibular repositioning structure extends over a supporting tooth adjacent to a gap formed by an erupted tooth or a missing tooth.

[0235] Clause 21. The system of clause 1, wherein the method further comprises: adjusting a jaw opening distance between the upper jaw and the lower jaw.

[0236] Clause 22. A system according to clause 1, wherein placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the mandible and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the mandible occurs before determining the positions of the first pair of mandibular repositioning structures based on a first set of constraints, determining the positions of the second pair of mandibular repositioning structures based on a second set of constraints, and determining the positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints.

[0237] Item 23. A method for treating dental malocclusion, the method comprising: generating a treatment plan to move a patient's teeth from a first position toward a second position, and comprising moving the jaw from the first position toward the second position, the treatment plan comprising a series of jaw movement stages to move the jaw from the first position toward the second position; placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the lower jaw, and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the upper jaw; determining positions of the first pair of mandibular repositioning structures based on a first set of constraints; placing a first mandibular repositioning structure of a second pair of mandibular repositioning structures on the lower jaw, and placing a second mandibular repositioning structure of the second pair of mandibular repositioning structures on the upper jaw; determining positions of the second pair of mandibular repositioning structures based on a second set of constraints; determining positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints; and, providing positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures to implement the series of jaw movement stages.

[0238] Clause 24. The method of clause 22, wherein the method further comprises: generating a digital model of the appliance; and manufacturing the physical appliance based on the digital model of the appliance.

[0239] Clause 25. The method of clause 22, wherein determining the position of the first pair of mandibular repositioning structures based on the first set of constraints comprises optimizing the position based on the first set of constraints.

[0240] Clause 26. The method of clause 22, wherein determining the position of the first pair of mandibular repositioning structures based on the first set of constraints comprises: using a nonlinear optimization algorithm.

[0241] Clause 27. The method of clause 22, wherein the first set of constraints and the second set of constraints include unilateral constraints for each of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures.

[0242] Clause 28. The method of clause 22, wherein the third set of constraints comprises symmetry constraints.

[0243] Clause 29. The method of clause 22, wherein the third set of constraints includes one-sided constraints and symmetric constraints.

[0244] Clause 30. The method of Clause 25, wherein the one-sided constraint comprises a collision constraint that tests for collision between a first mandibular repositioning feature on a first side of the first jaw and a second mandibular repositioning feature on a first side of the second jaw.

[0245] Clause 31. The method of Clause 25, wherein the unilateral constraint comprises a rotational constraint that constrains rotation of the mandibular repositioning structure relative to a dental arch of the patient.

[0246] Clause 32. The method of Clause 25, wherein the unilateral constraint comprises a rotational alignment constraint between a first mandibular repositioning feature on a first side of the first jaw and a second mandibular repositioning feature on a first side of the second jaw.

[0247] Clause 33. A method according to Clause 25, wherein the one-sided constraint includes a contact plane constraint, which contact plane constraint includes a constraint on the angle between the normal angle of the centroid of the engagement surface of the first mandibular repositioning feature on the first side of the first jaw and the normal angle of the centroid of the engagement surface of the second mandibular repositioning feature on the first side of the second jaw.

[0248] Clause 34. The method of Clause 25, wherein the unilateral constraint comprises a post-constraint on a distance between a center of the first mandibular repositioning structure and a line extending between centers of two adjacent teeth on which the first mandibular repositioning structure is located.

[0249] Clause 35. The method of clause 25, wherein the unilateral constraint comprises a constraint on a gap between the bite block and the tooth on which the first mandibular repositioning structure is located, the gap being the shortest distance between the bite block of the first mandibular repositioning structure and the occlusal surface of the tooth on which the first mandibular repositioning structure is located.

[0250] Clause 36. A method according to Clause 25, wherein the unilateral constraint includes a constraint on a distal arch position of the first mandibular repositioning structure, the distal arch position being greater than a threshold distance from the most distal point of the most distal tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

[0251] Clause 37. A method according to clause 25, wherein the unilateral constraint includes a constraint on the dental arch position of the first mandibular repositioning structure that is greater than a threshold distance from the most distal point of the most distal tooth on the same side of the dental arch on which the first mandibular repositioning structure is located, and is greater than 5 mm from the most medial point of the most medial tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

[0252] Clause 38. The method of clause 25, wherein the unilateral constraint comprises a constraint on the vertical articulation, the constraint being the distance between a vertical occlusal position on the articulation surface of the first mandibular repositioning structure and a vertical occlusal position on the articulation surface of the second mandibular repositioning structure.

[0253] Clause 39. The method of Clause 25, wherein the unilateral constraint comprises a constraint on the lateral articulation, the constraint on the lateral articulation comprising a constraint on the distance from the lingual side of the first block to the buccal side of the second block.

[0254] Clause 40. A method according to Clause 26, wherein the symmetry constraint includes a vertical asymmetry constraint based on a difference between a distance between a first mandibular repositioning structure and opposing teeth on a first side of the jaw and a distance between a second mandibular repositioning structure and opposing teeth on a second side of the jaw.

[0255] Clause 41. The method of Clause 26, wherein the symmetry constraint comprises a horizontal asymmetry constraint between centers of a first pair of mandibular repositioning structures on a first side of the dental arch and centers of a second pair of mandibular repositioning structures on a second side of the dental arch.

[0256] Clause 42. The method of Clause 25, wherein the unilateral constraint comprises a bridging constraint, the bridging constraint being a constraint on the distance that the mandibular repositioning structure extends over a supporting tooth adjacent to a gap formed by an erupted tooth or a missing tooth.

[0257] Clause 43. A method according to Clause 22, wherein: placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the mandible and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the mandible occurs before determining the positions of the first pair of mandibular repositioning structures based on a first set of constraints, determining the positions of the second pair of mandibular repositioning structures based on a second set of constraints, and determining the positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints.

[0258] The embodiments of the present disclosure have been shown and described as set forth herein, and are provided as examples only. Without departing from the scope of the present disclosure, those of ordinary skill in the art will recognize many modifications, changes, variations and substitutions. Without departing from the scope of the present disclosure and the invention disclosed herein, several alternatives and combinations of the embodiments disclosed herein may be used. Therefore, the scope of the invention disclosed herein should only be limited by the scope of the attached claims and their equivalents.

Claims

1. A system for generating an orthodontic appliance having a mandibular repositioning structure, the system include: one or more processors; as well as A non-transitory computer-readable medium comprising instructions which, when executed by the one or more processors, enable the system to perform a method comprising: generating a treatment plan to move a patient's teeth from a first position toward a second position and including moving a jaw from the first position toward the second position, the treatment plan including a series of jaw movement stages to move the jaw from the first position toward the second position; placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the lower jaw and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the upper jaw; determining positions of the first pair of mandibular repositioning structures based on the first set of constraints; placing a first mandibular repositioning structure of a second pair of mandibular repositioning structures on the lower jaw and placing a second mandibular repositioning structure of the second pair of mandibular repositioning structures on the upper jaw; determining positions of the second pair of mandibular repositioning structures based on the second set of constraints; determining positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints; and The positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures are provided to implement the series of jaw movement stages.

2. The system according to claim 1, in, The method further comprises: Generate a digital model of the appliance; and A physical appliance is manufactured based on the digital model of the appliance.

3. The system according to claim 1, in, Determining positions of the first pair of mandibular repositioning structures based on a first set of constraints includes optimizing the positions based on the first set of constraints.

4. The system according to claim 1, in, Determining the positions of the first pair of mandibular repositioning structures based on the first set of constraints includes using a non-linear optimization algorithm.

5. The system according to claim 1, in, The first set of constraints and the second set of constraints include unilateral constraints for each of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures.

6. The system according to claim 1, in, The third set of constraints includes symmetry constraints.

7. The system according to claim 1, in, The third set of constraints includes one-sided constraints and symmetric constraints.

8. The system according to claim 5, in, The one-sided constraint includes a collision constraint that tests for collision between a first mandibular repositioning feature on a first side of a first jaw and a second mandibular repositioning feature on a first side of a second jaw.

9. The system according to claim 5, in, The unilateral constraint includes a rotational constraint that constrains rotation of the mandibular repositioning structure relative to a dental arch of the patient.

10. The system according to claim 5, in, The unilateral constraint includes a rotational alignment constraint between a first mandibular repositioning feature on a first side of a first jaw and a second mandibular repositioning feature on a first side of a second jaw.

11. The system according to claim 5, in, The one-sided constraint comprises a contact plane constraint comprising a constraint on the angle between the normal angle of the centroid of the engagement surface of the first mandibular repositioning feature on the first side of the first jaw and the normal angle of the centroid of the engagement surface of the second mandibular repositioning feature on the first side of the second jaw.

12. The system according to claim 5, in, The unilateral constraint includes a post constraint on the distance between a center of a first mandibular repositioning structure and a line extending between centers of two adjacent teeth on which the first mandibular repositioning structure is located.

13. The system according to claim 5, in, The unilateral constraint includes a constraint on a gap between a bite block and a tooth on which the first mandibular repositioning structure is located, the gap being the shortest distance between a bite block of the first mandibular repositioning structure and an occlusal surface of the tooth on which the first mandibular repositioning structure is located.

14. The system according to claim 5, in, The unilateral constraint comprises a constraint on a distal arch position of the first mandibular repositioning structure that is greater than a threshold distance from a distal-most point of a distal-most tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

15. The system according to claim 5, in, The unilateral constraint includes a constraint on the dental arch position of the first mandibular repositioning structure, wherein the dental arch position is greater than a threshold distance from the most distal point of the most distal tooth on the same side of the dental arch on which the first mandibular repositioning structure is located, and is greater than 5 mm from the most medial point of the most medial tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

16. The system according to claim 5, in, The unilateral constraint comprises a constraint on vertical articulation, the constraint being the distance between a vertical occlusal position on an articulation surface of a first mandibular repositioning structure and a vertical occlusal position on an articulation surface of a second mandibular repositioning structure.

17. The system according to claim 5, in, The unilateral constraint includes a constraint on lateral articulation, and the constraint on lateral articulation includes a constraint on a distance from a lingual side of the first block to a buccal side of the second block.

18. The system according to claim 6, in, The symmetry constraint includes a vertical asymmetry constraint based on a difference between a distance between a first mandibular repositioning structure and opposing teeth on a first side of a jaw and a distance between a second mandibular repositioning structure and opposing teeth on a second side of the jaw.

19. The system according to claim 6, in, The symmetry constraint includes a horizontal asymmetry constraint between centers of a first pair of mandibular repositioning structures on a first side of a dental arch and centers of a second pair of mandibular repositioning structures on a second side of the dental arch.

20. The system according to claim 5, in, The unilateral constraint includes a bridging constraint, which is a constraint on the distance a mandibular repositioning structure extends over supporting teeth adjacent to a gap formed by an erupted tooth or a missing tooth.

21. The system according to claim 1, in, The method also includes adjusting a jaw opening distance between the upper jaw and the lower jaw.

22. The system according to claim 1, in: Placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the mandible and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the mandible occurs prior to determining positions of the first pair of mandibular repositioning structures based on a first set of constraints, determining positions of the second pair of mandibular repositioning structures based on a second set of constraints, and determining positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints.

23. A method for treating dental malocclusion, the method include: generating a treatment plan to move a patient's teeth from a first position toward a second position and including moving a jaw from the first position toward the second position, the treatment plan including a series of jaw movement stages to move the jaw from the first position toward the second position; placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the lower jaw and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the upper jaw; determining positions of the first pair of mandibular repositioning structures based on the first set of constraints; placing a first mandibular repositioning structure of a second pair of mandibular repositioning structures on the lower jaw and placing a second mandibular repositioning structure of the second pair of mandibular repositioning structures on the upper jaw; determining positions of the second pair of mandibular repositioning structures based on the second set of constraints; determining positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints; as well as The positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures are provided to implement the series of jaw movement stages.

24. The method according to claim 23, in, The method further comprises: Generate a digital model of the appliance; and A physical appliance is manufactured based on the digital model of the appliance.

25. The method according to claim 23, in, Determining positions of the first pair of mandibular repositioning structures based on a first set of constraints includes optimizing the positions based on the first set of constraints.

26. The method according to claim 23, in, Determining the positions of the first pair of mandibular repositioning structures based on the first set of constraints includes using a non-linear optimization algorithm.

27. The method according to claim 23, in, The first set of constraints and the second set of constraints include unilateral constraints for each of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures.

28. The method according to claim 23, in, The third set of constraints includes symmetry constraints.

29. The method according to claim 23, in, The third set of constraints includes one-sided constraints and symmetric constraints.

30. The method according to claim 27, in, The one-sided constraint includes a collision constraint that tests for collision between a first mandibular repositioning feature on a first side of a first jaw and a second mandibular repositioning feature on a first side of a second jaw.

31. The method according to claim 27, in, The unilateral constraint includes a rotational constraint that constrains rotation of the mandibular repositioning structure relative to a dental arch of the patient.

32. The method according to claim 27, in, The unilateral constraint includes a rotational alignment constraint between a first mandibular repositioning feature on a first side of a first jaw and a second mandibular repositioning feature on a first side of a second jaw.

33. The method according to claim 27, in, The one-sided constraint comprises a contact plane constraint comprising a constraint on the angle between the normal angle of the centroid of the engagement surface of the first mandibular repositioning feature on the first side of the first jaw and the normal angle of the centroid of the engagement surface of the second mandibular repositioning feature on the first side of the second jaw.

34. The method according to claim 27, in, The unilateral constraint includes a post constraint on the distance between a center of a first mandibular repositioning structure and a line extending between centers of two adjacent teeth on which the first mandibular repositioning structure is located.

35. The method according to claim 27, in, The unilateral constraint comprises a constraint on a gap between a bite block and a tooth on which the first mandibular repositioning structure is located, the gap being the shortest distance between the bite block of the first mandibular repositioning structure and an occlusal surface of the tooth on which the first mandibular repositioning structure is located.

36. The method according to claim 27, in, The unilateral constraint comprises a constraint on a distal arch position of the first mandibular repositioning structure that is greater than a threshold distance from a distal-most point of a distal-most tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

37. The method according to claim 27, in, The unilateral constraint includes a constraint on the dental arch position of the first mandibular repositioning structure, wherein the dental arch position is greater than a threshold distance from the most distal point of the most distal tooth on the same side of the dental arch on which the first mandibular repositioning structure is located, and is greater than 5 mm from the most medial point of the most medial tooth on the same side of the dental arch on which the first mandibular repositioning structure is located.

38. The method according to claim 27, in, The unilateral constraint comprises a constraint on vertical articulation, the constraint being the distance between a vertical occlusal position on an articulation surface of a first mandibular repositioning structure and a vertical occlusal position on an articulation surface of a second mandibular repositioning structure.

39. The method according to claim 27, in, The unilateral constraint includes a constraint on lateral articulation, and the constraint on lateral articulation includes a constraint on a distance from a lingual side of the first block to a buccal side of the second block.

40. The method according to claim 28, in, The symmetry constraint includes a vertical asymmetry constraint based on a difference between a distance between a first mandibular repositioning structure and opposing teeth on a first side of a jaw and a distance between a second mandibular repositioning structure and opposing teeth on a second side of the jaw.

41. The method according to claim 28, in, The symmetry constraint includes a horizontal asymmetry constraint between centers of a first pair of mandibular repositioning structures on a first side of a dental arch and centers of a second pair of mandibular repositioning structures on a second side of the dental arch.

42. The method according to claim 27, in, The unilateral constraint includes a bridging constraint, which is a constraint on the distance a mandibular repositioning structure extends over supporting teeth adjacent to a gap formed by an erupted tooth or a missing tooth.

43. The method according to claim 23, in: Placing a first mandibular repositioning structure of a first pair of mandibular repositioning structures on the mandible and placing a second mandibular repositioning structure of the first pair of mandibular repositioning structures on the mandible occurs prior to determining positions of the first pair of mandibular repositioning structures based on a first set of constraints, determining positions of the second pair of mandibular repositioning structures based on a second set of constraints, and determining positions of the first pair of mandibular repositioning structures and the second pair of mandibular repositioning structures based on a third set of constraints.

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