Lower dental arch dilation

Abstract

A dental appliance and a method for expanding a lower dental arch. The appliance may be a removable mandibular dilator device for efficient dental arch dilation while being comfortable to wear and easy to use. The appliance may include a lingual portion shaped and sized to apply an expansion force to a lingual surface of one or more teeth. The lingual portion may be shaped and sized to distribute forces between the posterior teeth and / or anterior teeth. A series of dilator devices may be designed to provide a dilation force in a stepwise manner toward a target inferior arch configuration according to a treatment plan.

Description

Priority Claim

[0001] This patent application claims priority to U.S. Provisional Patent Application No. 63 / 412,349, filed on September 30, 2022, entitled "APPARATUSES FOR LOWER ARCH EXPANSION", which is hereby incorporated by reference in its entirety. Incorporation by Reference

[0002] All publications and patent applications mentioned in this specification are hereby incorporated by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference. Background of the Invention

[0003] Arch expansion devices are used to widen a narrow jaw. These devices can be used to correct or prevent tooth overcrowding, correct malocclusions, and / or treat sleep apnea. Devices for expanding the upper jaw (maxilla) are commonly referred to as palatal expanders because they are designed to expand a narrow palate. In some cases, the teeth of the lower jaw can alternatively or additionally be expanded using a lower arch expander. When the jaws are closed together in occlusion, an upper arch expander and / or a lower arch expander can be used to properly align the upper and lower teeth or the upper and lower dental arches.

[0004] Traditionally, arch expansion devices include screws or other mechanisms to transmit horizontal forces to posterior teeth (e.g., molars, premolars, etc.) to stretch cartilage and / or move the molars outward. In many cases, orthodontists apply large horizontal forces during placement. This can cause extreme discomfort, including headaches, nasal discomfort, and pain. In other cases, screws or other mechanisms are used to incrementally adjust once or more per day. While this incremental approach may relieve some discomfort, the incidence of discomfort remains high. Additionally, the device is cumbersome and bulky, mainly due to the expansion mechanism. This bulkiness can cause difficulty speaking, swallowing, and breathing. Screws or other mechanisms can be difficult to operate and typically require the use of a key, which may be accidentally lost or swallowed. Moreover, screws or other expansion mechanisms tend to have many crevices where plaque can accumulate.

[0005] Accordingly, there is a need for lower arch expansion devices that can address these and other problems associated with traditional arch expansion devices. Summary of the Invention

[0006] This document describes expander appliances, which can be part of a series of ordered expanders to incrementally expand the lower dental arch. For example, the devices (e.g., apparatuses and systems) and methods described herein can relate to orthodontic treatment planning that involves expanding the width and / or length of the lower dental arch. The treatment planning can include using one or a series of removable lower dental arch (e.g., mandibular) expander devices that are designed for effective arch expansion while being reasonably comfortable to wear and easy to use. The expander devices can be configured to apply a customized force distribution on the teeth in an outward direction to expand the width and / or length of the lower dental arch. A series of expander devices can be designed to provide a customized force in a stepwise manner towards a target lower dental arch width and / or length according to the orthodontic treatment plan.

[0007] Generally, systems for expanding a patient's lower dental arch are described herein. These lower dental arch expanders can be referred to as mandibular expanders, mandibular expansion devices, mandibular expansion systems, mandibular expansion apparatuses, lower dental arch expansion devices, lower dental arch expansion apparatuses, and / or lower arch expansion systems. A system including a mandibular expander can include a series of mandibular expander appliances, including a polymeric housing configured to apply an expansion force for widening (and in some examples, lengthening) the patient's mandibular arch. The series of appliances can have a progressively increasing expansion width (and in some examples, a progressively increasing expansion length). For example, the expansion width of each sequential appliance in the series can be the same or greater and can generally increase across the series of appliances. Thus, a single appliance configured to apply an expansion (and in some examples, lengthening) force for mandibular (lower jaw) expansion is described; any one of these appliances can be arranged as part of a series of appliances configured to be worn in sequence to expand (and in some cases lengthen) the lower dental arch.

[0008] For example, the present disclosure describes a system for expanding a patient's lower dental arch, the system including: a series of expander devices, each of the series of expander devices being configured to incrementally expand the patient's lower dental arch toward a desired arch configuration based on a treatment plan, wherein each expander device of the series of expander devices includes a polymeric housing that includes: a first tooth receiving portion shaped to receive one or more first teeth, the first tooth receiving portion having a first lingual side, a first buccal side, and a first occlusal side; a second tooth receiving portion shaped to receive one or more second teeth, the second tooth receiving portion having a second lingual side, a second buccal side, and a second occlusal side; and a bridging region coupling the first lingual side to the second lingual side, wherein the bridging region is configured to maintain an expansion width between the first lingual side and the second lingual side, the expansion width applying an expansion force between the one or more first teeth and the one or more second teeth to expand the patient's lower dental arch when the device is worn on the patient's lower dental arch, wherein the first lingual side and the second lingual side are configured to receive the expansion force and apply it to the teeth, and further wherein the expansion width of the expander devices of the series of expander devices increases over the course of the series. In some examples, the first lingual side and the second lingual side are stiffer than the first buccal side and the second buccal side or the first occlusal side and the second occlusal side. For example, the first lingual side and the second lingual side may be thicker than the first occlusal side and the second occlusal side or the first buccal side and the second buccal side.

[0009] As used herein, the phrase "expansion width" may refer to the target width to which the mandible is incrementally expanded during treatment. The expansion width may refer to the width between molars and / or premolars and / or canines on opposite sides of the patient's mandible. The expansion width may be estimated as part of a treatment plan.

[0010] In any of these systems and devices, the polymeric housing of each expander device may be made of a single polymeric material. The single polymer may be processed to increase or decrease the stiffness in the regions described herein (e.g., increasing the stiffness of the lingual region).

[0011] Generally, each of these devices may be generally U-shaped such that there is a channel or opening between the first lingual side and the second lingual side for the patient's tongue to reside comfortably.

[0012] The width between the first lingual side and the second lingual side of each subsequent expander device in the series of expander devices is wider than that of the previous expander device in the series. In particular, the width between the first lingual side and the second lingual side can be the expansion width to which the mandible is to be expanded (or a part of the total expansion width). The expansion width in a more distal (rear part of the mouth) region can be greater than that in a more anterior (front part of the mouth) region. For example, the change in the mandibular width caused by the expansion width can be greater in a more distal (e.g., molar) region compared to a more proximal (e.g., premolar, canine, incisor) region / tooth. In some examples, the change in the mandibular width caused by the expansion width can be the same between the premolars and the molars.

[0013] Each expander device in the series of expander devices can be configured to apply an expansion force having a magnitude and direction according to the stages of the dental arch expansion treatment plan.

[0014] When the device is worn on the teeth, the expansion force of each expander device in the series of expander devices can be between approximately 1 Newton (N) and approximately 25 N. The bridging region of at least one of the expander devices in the series of expander devices can be configured to contact one or more anterior teeth when the device is worn on the patient's lower dental arch. For example, the bridging region of at least one of the expander devices in the series of expander devices can be configured to apply a second expansion force on one or more anterior teeth. The second expansion force can be between about 1 Newton (N) and about 5 N, but is not limited thereto.

[0015] In any of these devices, the bridging region can be configured to conform to the lingual surface of the patient's lower dental arch when the device is worn by the patient. For example, the bridging region can be configured to conform to the lingual surface of one or more anterior teeth when the device is worn by the patient.

[0016] For all or some of the expander devices in the series of expander devices, the first lingual side can be thicker than the first buccal side, and the second lingual side can be thicker than the second buccal side. For example, the first lingual side can be thicker than the first buccal side by about 5% or more, 10% or more, 15% or more, 20% or more, 25% or more, 30% or more, 35% or more, 40% or more, 45% or more, 50% or more, 55% or more, 60% or more, 70% or more, 75% or more, etc.; similarly, the second lingual side can be thicker than the second buccal side by about 5% or more, 10% or more, 15% or more, 20% or more, 25% or more, 30% or more, 35% or more, 40% or more, 45% or more, 50% or more, 55% or more, 60% or more, 70% or more, 75% or more, etc.

[0017] The first tooth receiving portion and the second tooth receiving portion of each expander device in the series of expander devices can be shaped to receive only molars, only premolars, or to receive molars and premolars and / or include canines. The first tooth receiving portion and the second tooth receiving portion of at least one of the expander devices in the series of expander devices can include one or more openings arranged to allow the shedding of one or more deciduous teeth of the patient's lower dental arch. One or both of the first tooth receiving portion and the second tooth receiving portion of each expander device in the series of expander devices can include one or more occlusal adjustment structures configured to facilitate mandibular advancement, wherein the one or more occlusal adjustment structures are shaped and arranged to contact the patient's upper dental arch or a dental device on the patient's upper dental arch.

[0018] One or more occlusal adjustment structures can be shaped and arranged to contact corresponding one or more occlusal adjustment structures of a dental device on the patient's upper dental arch. One or both of the first occlusal side and the second occlusal side of at least one expander device in the series of expander devices can have a thickness configured to disocclude the anterior and / or posterior teeth of the patient's lower dental arch. Also described herein is a system for expanding a patient's lower dental arch, the system comprising: a series of expander devices, each of the series of expander devices configured to incrementally expand the patient's lower dental arch towards a desired arch configuration based on a treatment plan, wherein each expander device in the series of expander devices includes a polymeric housing that includes: at least one tooth receiving portion shaped to receive one or more first teeth on a first side of the patient's lower dental arch, the at least one tooth receiving portion including a buccal side and an occlusal side; a lingual portion coupled to the at least one tooth receiving portion and arranged to contact the lingual surfaces of one or more second teeth on an opposite side of the patient's lower dental arch when the device is worn on the patient's lower dental arch; and a bridging portion shaped and sized to transmit an arch expansion force to the lingual portion according to a corresponding stage of the treatment plan. The bridge can have a width between a first side of the patient's lower dental arch and an opposite side of the patient's lower dental arch that is greater than the width between the first side of the patient's lower dental arch and the opposite side of the patient's lower dental arch at the start of the corresponding stage of the treatment plan. In any of these examples, the at least one tooth receiving portion can include one or more first tooth receiving cavities shaped to apply a tooth alignment force to correct one or more first teeth or to prevent or limit the tilting of one or more first teeth.

[0019] Any one of these appliances (e.g., a single appliance, or an appliance that forms part of a system or series of appliances) may include a lingual portion (also referred to as the lingual or bridging region) configured to apply an arch expansion force on the teeth to effectively elongate and / or widen the lower dental arch. The lingual portion may be arranged to contact the lingual surfaces of one or more teeth when the device is worn on the patient's lower dental arch. The lingual portion may have dimensions (e.g., width and / or length) greater than the corresponding dimensions of the lower dental arch, such that the lingual portion applies pressure to the teeth when the appliance is worn on the arch. The lingual portion may be configured to engage and apply pressure to one or more posterior teeth (e.g., molars and / or premolars) and / or one or more anterior teeth (e.g., incisors and / or canines). The lingual portion may have sufficient stiffness to apply an expansion force on the teeth to expand the width and / or length of the arch. In some cases, at least a portion of the lingual portion has a notched (e.g., scalloped) engagement surface to match the curved lingual surface of the teeth and maximize engagement with the lingual surfaces of the teeth.

[0020] The appliance may include at least one tooth-receiving portion that anchors the appliance to the dental arch. The at least one tooth-receiving portion may include coverage of the buccal, occlusal, and / or lingual sides of one or more teeth of the dental arch. The tooth-receiving portion may have an external shape that provides a desired occlusal interaction with the upper dental arch. For example, the tooth-receiving portion may have a pointed shape outer surface corresponding to the pointed shape outer surfaces of the one / more teeth it covers, which allows the tooth-receiving portion to naturally engage with the tooth cusps of the upper dentition or a dental device on the upper dentition. In other cases, the tooth-receiving portion may have a flat surface. In some examples, the tooth-receiving portion may include one or more occlusal blocks to adjust the patient's bite (e.g., provide mandibular advancement).

[0021] In some examples, arch expansion involves using a series of expansion appliances configured to push the teeth from an initial configuration to a target configuration in a stepwise manner. Each expansion appliance may be a removable polymeric shell shaped to achieve a corresponding stage of the treatment plan.

[0022] The appliance may include a polymeric shell shaped and sized to engage at least some of the teeth. The polymeric shell may have a smooth and continuous outer surface that has no corners and crevices that would otherwise accumulate plaque or particles in the patient's mouth. In some cases, each appliance is made of a single polymeric material. This can provide the appliance with a seamless feel and appearance, which may be more comfortable to wear and less likely to delaminate. Additionally, manufacturing an appliance made of a single material (e.g., using additive manufacturing) may be more efficient and / or cost-effective.

[0023] In some cases, the appliance may include an opening and / or cutout area that provides space for deciduous teeth to shed and / or allows permanent teeth to erupt. The opening and / or cutout may be arranged such that the appliance does not contact at least some of the occlusal and / or buccal sides of the deciduous teeth, such that the deciduous teeth may shed or be removed.

[0024] The appliance may have a varying thickness to provide desired functionality and / or aesthetic qualities. For example, the walls / portions of the appliance configured to support pressure and apply an arch expansion force on the teeth may have a greater thickness than the walls / portions of the appliance not configured to support such pressure. For example, the lingual portion of the appliance may be thicker than the occlusal and / or buccal sides of the tooth-receiving portion. In some cases, different regions of the lingual portion may be thicker than other regions of the lingual portion. In examples where the appliance includes an opening and / or cutout area, these areas may have thicker walls to provide lateral stiffness to the appliance. In some cases, for aesthetic purposes and / or for comfort, the buccal and / or labial walls of the appliance may be relatively thin.

[0025] In some examples, in addition to increasing the width and / or length of the lower dental arch, the appliance may also be configured to correct the patient's lower dental arch. For example, in addition to arch expansion, the expansion force may be distributed among various teeth to align the positions / orientations of the teeth relative to each other. In some cases, the tooth-receiving portion defines a tooth-receiving cavity having walls that apply a tooth alignment force to urge the teeth toward alignment. For example, the buccal, lingual, and / or occlusal sides of the tooth-receiving portion may be shaped to apply pressure to the teeth, sometimes in a direction unrelated to (or opposite to) widening or lengthening the arch.

[0026] These and other features and aspects are described herein.

[0027] All methods and devices of any combination described herein are contemplated herein and may be used to achieve the benefits described herein. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] A better understanding of the features and advantages of the methods and devices described herein will be obtained by reference to the following detailed description taken in conjunction with the accompanying drawings, in which:

[0029] Figures 1A to 1D An example of the shape of the lower dental arch (mandible) is shown. Figure 1A An example of a generally U-shaped lower dental arch is shown. Figure 1B An example of a V-shaped lower dental arch is shown. Figure 1C An example of a generally square lower dental arch is shown. Figure 1D An example of an Ω-shaped lower dental arch is shown.

[0030] Figure 2A A top view of an exemplary lower dental arch is shown, which shows an exemplary expansion force.

[0031] Figure 2B A contour diagram of an exemplary expansion device on the lower dental arch is shown; the expansion device can be part of a series of expansion devices as described herein.

[0032] Figure 3A A contour diagram of an example of an expansion device on the lower dental arch is shown, where the device is configured to expose some molars / premolars to allow the exfoliation of primary molars / premolars and / or the eruption of permanent molars / premolars.

[0033] Figure 3B A contour diagram of an example of an expansion device on the lower dental arch is shown, where the device is configured to expose some molars / premolars to allow the exfoliation of primary molars / premolars and / or the eruption of permanent molars / premolars.

[0034] Figure 4 A top view of another exemplary expansion device on the lower dental arch is shown, where the device is configured to cover all the teeth of the lower dental arch.

[0035] Figure 5A A top view of a lower dental arch expander is shown, where the device includes an opening that allows the exfoliation of primary teeth.

[0036] Figure 5B A bottom view of another exemplary lower dental arch expander is shown, where the device includes a wall thickness and a tooth accommodation arrangement different from that of the Figure 5A device.

[0037] Figures 6A to 6B An example of a lower dental arch expander that includes an occlusal area but has cutout areas on the buccal and lingual sides ( Figure 6A ) or on the buccal side ( Figure 6B ) is shown.

[0038] Figures 7A to 7B An example of a lower dental arch expander that includes an occlusal area but has various cutout areas on the buccal and lingual sides is shown.

[0039] Figures 8A to 8B An example of a lower dental arch expander that includes a cutout area on the occlusal side is shown. Figure 8A A lower dental arch expander device with buccal and occlusal side cutout areas is shown. Figure 8B An example of a lower dental arch expander with occlusal and lingual side cutout areas is shown.

[0040] Figure 9A and Figure 9B Another exemplary expansion device is shown, where the device is configured to disocclude the patient's anterior teeth: Figure 9AShows a top view of the device on the lower dental arch; and Figure 9B Shows a side view of the device on the lower dental arch.

[0041] Figure 10A And Figure 10B Respectively show top and front cross-sectional views of an example of a lower dental arch expander that includes palatal struts that extend upward toward the upper dental arch (e.g., the palatal region).

[0042] Figure 11 Is a flowchart showing an example method of forming a lower dental arch expansion device.

[0043] Figure 12 Is a diagram showing an example data structure system for forming a lower dental arch expansion device. Detailed Description

[0044] Devices (e.g., systems and devices) and methods for expanding a patient's lower dental arch are described herein. The system can include a series of expansion appliances, each of which is configured to incrementally and progressively expand the patient's lower dental arch toward a desired arch configuration based on a treatment plan. Any of the expansion devices described herein can be part of a system that includes a series of expansion devices for expanding a patient's lower (mandibular) dental arch. The methods can include methods for using and manufacturing the expansion appliances.

[0045] In some cases, it may be desirable to expand the patient's mandible to allow space for tooth alignment, to assist in occlusion alignment, and / or for aesthetic reasons.

[0046] A patient's dentition is typically arcuate, but varies in the form of the arc. The arc form can be described by overall shape characteristics, and some forms are superior to others. For example, arch forms such as V-shaped, square, and Ω-shaped may be associated with crowding of the teeth. In contrast, in most cases, a U-shaped arch form can be considered ideal. For example, Figure 1A Shows a top (occlusal side) view of a lower dental arch having a generally U-shaped form. Figure 1B Shows an example of a top (occlusal side) view of a lower dental arch having a generally V-shaped form. Figure 1C And Figure 1D Respectively show examples of square and Ω-shaped lower dental arch forms. In some cases, it may be desirable to expand the mandible to provide additional space between the teeth. The details of the expansion can vary based on the patient's current arch form. For example, the methods and devices described herein can be configured to widen a U-shaped mandible, for example, by symmetrically expanding. In some examples, a V-shaped mandible (as Figure 1BAs shown, it can be generally narrower at the front; in some cases, a mandibular expander as described herein can be used to reshape a V-shaped mandible to a more U-shaped configuration and allow more space to permit better alignment of the teeth. As Figure 1C shown, a square lower dental arch shape can have a more flattened anterior dental arch shape, and expansion of this type of arch form can involve applying forces to round the anterior portion of the arch to a more U-shaped configuration. As Figure 1D shown, an Ω-shaped lower dental arch can be widened as described herein by, for example, applying expansion forces on teeth on opposite sides of the middle region of the mandible to a more U-shaped configuration. In some cases, a patient may have an asymmetric arch form, in which case expansion will involve applying forces to make the arch symmetric (e.g., a U-shaped arch).

[0047] The methods and devices described herein can modify a patient's lower dental arch, including modifying the lower dental arch such that it assumes a more regular and U-shaped configuration. In particular, methods for determining a modified lower dental arch form for a patient are described, which can include comparing the patient's current lower dental arch form to a target (e.g., U-shaped) lower dental arch form to determine the deviation between the patient's current lower dental arch form and the target lower dental arch form, and formulating a treatment plan, typically including a plurality of treatment phases to modify the patient's current lower dental arch form such that it approximates or matches the target lower dental arch form. The method can include dividing the treatment plan into a plurality of phases, estimating the forces required to effect tooth or jaw movement at each phase by applying expansion forces between teeth on opposite sides of the arch, and designing an expander configured to apply the estimated forces at the determined locations. The plurality of phases can be determined based on the amount of force that can be applied between the teeth.

[0048] The target lower dental arch form can be selected based on the patient's current dental arch or can be modeled based on the patient's current dental arch. For example, a target lower (e.g., U-shaped) dental arch form can be selected from a library of target lower dental arch forms based on one or more patient characteristics such as age, gender, initial arch shape, jaw dimensions, etc. Alternatively, a trained neural network can be used to model the target lower arch form. For example, the patient's current lower arch form can be used as an input to a trained neural network, and the neural network can output one or more target lower dental arch forms; the neural network can be trained from historical treatment data that includes initial arch forms and expanded arch forms, e.g., arch forms expanded using one or more expander devices as described herein. Although the above examples include a U-shaped target dental arch form, the same techniques can be applied to any other target dental arch form.

[0049] For example, a method of modifying a patient's lower dental arch may include: receiving a digital model of the patient's lower dental arch, wherein the patient's lower dental arch has a current lower dental arch form; identifying a target lower dental arch form; comparing the patient's current lower dental arch form with the target lower dental arch form to identify a deviation between the patient's current lower dental arch form and the target lower dental arch form; and formulating a treatment plan including a plurality of treatment phases to modify the patient's current lower dental arch form such that it approximates or matches the target lower dental arch form. In any of these methods, identifying the target lower dental arch form may include identifying a target U-shaped lower dental arch form.

[0050] Any of these methods may include designing a lower dental arch expander for each of a plurality of phases, wherein the lower dental arch expander for each phase is configured to apply an estimated force between teeth on opposite sides of the patient's lower dental arch.

[0051] Any method described herein may include fabricating a lower dental arch expander, and / or fabricating at least one of a lower dental arch expander (e.g., of a series of lower dental arch expanders). For example, these methods may include fabricating at least one of the lower dental arch expanders by forming a digital file including a design of at least one lower dental arch expander and transmitting the designed digital file to a manufacturing system. The manufacturing system may be a direct manufacturing system.

[0052] In some examples, the method may include: dividing the treatment plan into a plurality of phases by applying an expansion force between teeth on opposite sides of the patient's lower dental arch to estimate the force required to achieve tooth and / or jaw movement in each phase, and designing a lower dental arch expander for each phase, the lower dental arch expander being configured to apply an estimated force between teeth on opposite sides of the patient's lower dental arch. For example, dividing the treatment plan into a plurality of phases may include: dividing the treatment plan into a plurality of phases based at least in part on the magnitude of the force applied between the teeth.

[0053] Identifying the target lower dental arch form may include selecting the target lower dental arch form from a library of target lower dental arch forms based on the patient's current lower dental arch form. Identifying the target lower dental arch form may include using a trained neural network to provide one or more target lower dental arches based on the patient's current lower dental arch form.

[0054] Although the present disclosure focuses on an expansion appliance for the lower dental arch that expands the mandible, the present disclosure also contemplates using a device with the same features to maintain the current dental arch in the mandible (or maxilla). For example, in the case of a patient with missing teeth or with teeth that are erupting or unerupted, the surrounding teeth may tend to move inward or tilt to block the missing / erupting / unerupted teeth. These surrounding teeth may then impede or prevent the placement of an implant at the missing site or may impede or prevent the proper eruption of the erupting / unerupted teeth. Thus, the devices disclosed herein can be placed on the patient's dentition to maintain the current dental arch. In such a case, the device can be conformed to the patient's current tooth alignment such that no expansion force is applied.

[0055] The lower dental arch has anatomical differences compared to the upper dental arch, and these differences need to be considered when performing lower dental arch expansion treatment. For example, the maxilla includes the median palatal suture, which is the junction between two bones at the top of the oral cavity and extends from the front teeth to the back of the oral cavity. In children (e.g., under 18 years old), the median palatal suture may not be fully fused together, so an upper dental arch expander can be used to open the median palatal suture and widen the upper dental arch. In contrast, the lower dental arch includes a medial suture located along the midline of the front portion of the lower dental arch, and it is typically limited to the front region of the lower dental arch and fuses earlier than the median palatal suture. Thus, compared to the upper dental arch, lower dental arch expansion may involve a different set of forces at different regions relative to the dental arch midline. Additionally, the tongue is positioned at the base of the mouth in the mandible, which should be considered in the design of lower dental arch devices. Generally, widening of the dental arch (including the lower dental arch) can include expanding the distance between corresponding lingual points on the teeth within the same dental arch. The width of the dental arch can be quantified by measuring the distance between these corresponding lingual points. For example, one measure of the lower dental arch width can be determined as the width between the patient's second molars.

[0056] By controlling the applied force, the width of the patient's lower dental arch can be expanded by a predetermined amount and at a predetermined rate. The dental arch expansion device described herein is configured to provide a dental arch expansion force to the teeth of the lower dental arch, and the dental arch expansion force can be customized for the patient's lower dental arch. As used herein, lower dental arch (mandibular arch) expansion can include symmetric (or in some examples, asymmetric) lateral widening of the lower dental arch. The widening can be achieved by applying a force between opposite sides of the mandible, for example, between teeth on opposite sides of the right and left mandibular quadrants, between lower molars (e.g., 17, 18, and / or 19 and 32, 31, and / or 30), between lower bicuspids (e.g., 29 and / or 28 and 20 and / or 21), between canines (27 and 22). Optionally, the expansion can include applying a force between a second and / or third molar on one side and a first molar and / or second bicuspid on the opposing jaw. For example, an expansion force can be applied to separate or widen the lateral distance between third molars and / or between second molars and / or between first molars, etc.

[0057] Generally, the expansion force can be applied by configuring a mandibular expander device such that the lateral width of the device (e.g., the arch width) is greater than the patient's current arch width between the lingual sides of the mandible. For example, the distance between the left tooth receiving portion and the right tooth receiving portion is greater than the distance between the lingual sides of the patient's current mandibular form, and the region between the widening regions (e.g., along the mandibular arch) can be strengthened to apply a force therebetween.

[0058] Figure 2A An example of the lower dental arch is shown. As used herein, the arch length 101 can refer to the length measured from the most posterior molar 103a (in this case, the first molar) on one side of the dental arch 102 to the most posterior molar 103b (in this case, the first molar) on the opposite side of the dental arch 102, as measured along a imaginary line through points on the intervening teeth. In some cases, as measured in a top (from above) view, the points are located at the centers of the teeth. The arch width 124 can refer to the distance between corresponding first molars 103a / 103b, corresponding premolars 105a / 105b, and / or corresponding canines 107a / 107b. In some cases, the arch width 124 can refer to the average distance between corresponding molars, premolars, and canines. The expansion width can refer to the changed arch width 124, which can be selected and / or calculated as part of a treatment plan, as described herein. The change in the expansion width (e.g., an increase) achieved as described herein can refer to the difference between the initial (or previous) arch width and the target arch width for one or more stages of a treatment plan or for the entire treatment, as indicated by the context herein.

[0059] The outward force applied to the teeth (e.g., by Figure 2AThe outward-facing arrows (shown in ) can effectively expand the arch length 101 and / or the arch width 124 of the dental arch 102. Note that Figure 2A the direction of the arrow indicating the outward force in is merely exemplary, and the direction (and magnitude) of the outward force can vary according to the patient's specific dentition and treatment plan. The outward force applied to each tooth can be in the lateral direction (e.g., buccal direction), in the forward direction (e.g., labial direction), or in a combination of the lateral and forward directions. Expanding the arch length 101 and / or the arch width 124 can increase the space between one or more pairs of adjacent teeth to provide space for the eruption of permanent teeth or for crowded teeth. These adjustments can also correct malocclusions with the upper teeth and / or improve the patient's smile. Generally, the expansion of the lower dental arch 102 is achieved together with the expansion of the patient's upper dental arch.

[0060] The dental arch expansion device described herein can be configured to apply a customized expansion force on the lower arch 102. The customized expansion force can include a specific combination of outward forces applied to one or more teeth of the lower dental arch 102. For example, the dental arch expansion device can be configured to apply an outward force to the lingual side of one or both of the first molars 103a and 103b, one or both of the premolars 105a and 105b, one or both of the canines 107a and 107b, and / or one or more of the incisors 109. In the presence of second molars and / or third molars, the dental arch expansion device can additionally or alternatively be configured to apply an outward force to the lingual side of one or more second molars and / or one or more third molars. The outward force applied to each tooth can be applied in a specified direction and / or with a specified magnitude according to the stage of the treatment plan. In one example, the dental arch expansion device can be configured to apply an outward force on the molars 103a / 103b, premolars 105a / 105b, and canines 107a / 107b, but not apply any outward force on the incisors 109. In another example, the dental arch expansion device can be configured to apply an outward force on the molars 103a / 103b, premolars 105a / 105b, canines 107a / 107b, and incisors 109. In some cases, the dental arch expansion device can be configured to apply a greater outward force on one or more teeth (e.g., a group of teeth) compared to one or more other teeth (e.g., other groups of teeth). For example, the dental arch expansion device can be configured to apply a specific outward force between the corresponding canines 107a / 107b and / or incisors 109 to cause a lateral displacement of the soft tissue along the medial suture, and this outward force can be different from the outward force applied between the corresponding premolars 105a / 105b and molars 103a / 103b where the medial suture extends posteriorly.

[0061] In some examples, applying a force to expand the dental arch using any of the lower dental arch expanders described herein can be performed concurrently with the alignment of one or more teeth. In some examples, the lower dental arch expander can also apply a counter-tipping force that is configured to rotate the tooth crown lingually. This may be necessary in at least some cases because when the mandible expands laterally outwards by pushing against the teeth on the opposite side, the teeth may tend to "tilt" outwards such that the crowns of the teeth rotate buccally. By applying a counter-tipping force with the lower dental arch expander, this tilting of the teeth can be counteracted such that the teeth do not tilt or such that the amount of tilting is below an acceptable threshold. The mandibular expanders described herein can apply an outward expansion force between the teeth of the mandible on opposite sides of the mandible to expand the lower dental arch while applying one or more additional counter-tipping forces. For example, the counter-tipping force can be applied to the buccal side of the area of the tooth that is closer to the crown of the tooth (e.g., by increasing the stiffness or thickness of the appliance in that area). Generally, when designing one or more mandibular expanders, the methods and devices (e.g., software) described herein can take into account and include additional tooth movement, including anti-tipping.

[0062] The dental arch expansion device can be part of a series of dental arch expansion devices that are configured to gradually expand the dental arch towards a target tooth alignment, dental arch length, and / or dental arch width. Treatment planning can be determined based on, for example, three-dimensional (3D) virtual models of the patient's dental arch (e.g., prior to treatment) and the target dental arch. The target dental arch can have a desired tooth alignment, dental arch length, and dental arch width. The treatment plan can be divided into multiple incremental stages, typically each stage being associated with a dental arch expansion device. For example, a treatment plan that includes 25 stages can involve the use of 25 dental arch expansion devices. The dental arch expansion device associated with a particular stage of the treatment plan can be configured to move the teeth from a first alignment at the start of the particular stage towards a second alignment at the end of the particular stage. Treatment planning software can be used to calculate the 3D model of the dental arch for each stage of the treatment plan. In some cases, for example, if it is determined that the patient's dentition is not progressing as expected during a particular stage of implementing the treatment plan, the treatment plan can be modified. The virtual model of each dental arch expansion device can also be presented in 3D and used as a basis for forming the actual dental arch expansion device.

[0063] Each arch expansion device of the system (series) of the device can be associated with an arch expansion force customized according to the corresponding stage of the treatment plan. For example, a first arch expansion device associated with the first stage of the treatment plan can be configured to apply a first expansion force (e.g., having a first magnitude) on the molars 103a / 103b and premolars 105a / 105b, and a second expansion force (e.g., having a second magnitude) on the canines 107a / 107b. A second arch expansion device associated with the subsequent second stage of the treatment plan can be configured to apply a third expansion force (e.g., having a third magnitude) greater than or less than the first expansion force on the molars 103a / 103b and premolars 105a / 105b, and a fourth expansion force (e.g., having a fourth magnitude) greater than or less than the second expansion force on the canines 107a / 107b. In this way, a series of arch expansion devices can be customized based on aspects of the lower dental arch and specific conditions of the patient's lower dental arch condition.

[0064] Any arch expansion device described herein can be configured to apply an expansion force having a value within a range from 1 Newton (N) to 25 N (e.g., up to about 1 N, 3 N, 8.5 N, 10 N, 15 N, 20 N, 22 N, etc.) to the patient's lower dental arch. Any arch expansion device described herein can be configured to apply an expansion force having a value within a range from 10 N to 25 N. In certain regions of the lower dental arch (such as the anterior teeth), the expansion force can be less than the expansion force applied to the posterior teeth. For example, the arch expansion device can be configured to apply an expansion force having a value within a range from 1 N to 5 N (e.g., 1 N, 2 N, 2.5 N, 3 N, or 5 N) on the anterior teeth.

[0065] As described above, any arch expansion device described herein can also be configured to align (e.g., correct) a patient's teeth. For example, in addition to the arch expansion force, the device can be configured to apply an alignment force on one or more teeth to align the one or more teeth relative to other teeth in the lower arch and / or upper arch. The tooth alignment force for correcting teeth can be incorporated into the arch expansion treatment plan. The tooth alignment force can cooperate with the arch expansion force to expand the lower arch (e.g., width and / or length) and correct the teeth of the lower arch. For example, the arch expansion force can also participate in correcting teeth. Generally, a tooth alignment force can be applied to translate (antero-posterior, lingual-buccal), rotate, and / or tilt one or more teeth. Similarly, the tooth alignment force can also participate in expanding the arch. For example, the arch expansion force and / or alignment force can cause one or more types of tooth movement, such as translation (e.g., both the crown and root move in the same direction), tipping (e.g., the crown has a greater movement compared to the root), intrusion (axial movement along the axis towards the apex of the root), extrusion (axial movement along the axis towards the crown), torque (labial-lingual movement of the root compared to the tooth), uprighting (movement to correct mesially or distally inclined teeth), and / or rotation (rotating the tooth along its own long axis).

[0066] Figure 2B The profile of an exemplary lower arch expansion device 200 on the lower arch 202 is shown. The device 200 includes a first tooth receiving portion 206 and a second tooth receiving portion 208. The first tooth receiving portion 206 is shaped to receive one or more first teeth 210, and the second tooth receiving portion 208 is shaped to receive one or more second teeth 212. In this case, each of the first tooth receiving portion 206 and the second tooth receiving portion 208 is shaped to receive three teeth (molars / premolars). The first tooth receiving portion 206 has a first lingual side 214 shaped to cover at least a portion of the lingual side of the one or more first teeth 210, and a first buccal side 218 shaped to cover at least a portion of the buccal side of the one or more first teeth 210. The second tooth receiving portion 208 has a second lingual side 216 shaped to cover at least a portion of the lingual side of the one or more second teeth 212, and a second buccal side 220 shaped to cover at least a portion of the buccal side of the one or more second teeth 212. In some cases, the first tooth receiving portion 206 includes an occlusal side 207 shaped to cover at least a portion of the occlusal side of the one or more first teeth 210, and the second tooth receiving portion 208 includes an occlusal side 209 shaped to cover at least a portion of the occlusal side of the one or more second teeth 212. Generally, a device (or series of devices) such as that shown in Figure 2B can be configured to cover only molars or can cover any other teeth.

[0067] Typically, these devices can be configured to apply force directly to the teeth, for example, within the tooth-receiving regions of a mandibular expander, and / or to one or more accessories on the teeth, such as attachments, hooks, etc. Any of these devices can be configured to extend to prevent or minimize contact with the patient's gums. Alternatively, they can be configured to contact the patient's gums and, in some cases, apply force to the patient's gums. In any of these devices, the mandibular expander can be configured to extend over the gums with substantially no contact with the gums. In some examples, the mandibular expander can be configured to contact the gums at one or more locations. Thus, the mandibular expanders described herein can be configured to apply force to the teeth rather than to the gums, or to apply force to the gums to a minimal extent.

[0068] In Figure 2B Device 200 also includes a bridging region 222 that couples at least a portion of the first tooth-receiving portion 206 to at least a portion of the second tooth-receiving portion 208. For example, the bridging region 222 can couple the first lingual side 214 to the second lingual side 216. The bridging region 222 can be configured to maintain a width 224 between the first lingual side 214 and the second lingual side 216 such that when the device 200 is worn on the lower dental arch 202, the device 200 provides an expansion force between one or more first teeth 210 and one or more second teeth 212 (e.g., in a corresponding buccal direction). In some examples, the first lingual side 214 (and / or the bridging region 222) is stiffer and / or thicker than the first buccal side 218 (and / or the first occlusal side 207). Similarly, the second lingual side 216 (and / or the bridging region 222) can be stiffer and / or thicker than the second buccal side 220 (and / or the second occlusal side 209). The stiffer / thicker lingual sides 214 / 216 (and / or the bridging region 222) can support the outward force required to expand the lower dental arch 202 applied to the lingual surfaces of one or more teeth 210 / 212.

[0069] The width 224 between the first lingual side 214 and the second lingual side 216 can be wider than the arch width (also referred to as the inter-molar width) between the first lingual side of one or more first teeth 210 and the second lingual side of one or more second teeth 212. Thus, when the device 200 is placed on the lower dental arch 202, the expansion force can push one or more first teeth 210 in a corresponding outward / buccal direction and push one or more second teeth 212 in a corresponding outward / buccal direction. Thus, the expansion force can expand the lower dental arch 202 by increasing the arch width between the first lingual side of one or more first teeth 210 and the second lingual side of one or more second teeth 212. The expansion force can additionally increase the arch length of the lower dental arch 202.

[0070] In the case where the device 200 is for use in children, the increased arch width and / or arch length can provide space for the erupting permanent teeth, which in turn can allow the permanent teeth to be straighter, reducing or eliminating the need for orthodontic treatment in adolescents or adults.

[0071] The expansion force can have a magnitude corresponding to a respective stage of a treatment plan. For example, the device 200 can be one device in a series of arch expansion devices configured to incrementally expand the lower dental arch 202 towards a desired arch configuration according to multiple stages of a treatment plan. In such a case, the width 224 of each device can increase incrementally as treatment progresses. For example, a first arch expansion device for a first stage of a treatment plan can have a first width, and a second arch expansion device for a subsequent second stage of the treatment plan can have a second width that is greater than the first width. In this way, each of the series of arch expansion devices can have a fixed width 224.

[0072] Each arch expansion device 200 (e.g., each arch expansion device in a series of arch expansion devices) can be configured to apply an expansion force in one direction and have a magnitude according to a planned stage of a treatment plan. In some examples, each arch expansion device 200 (and any arch expansion device described herein) can be configured to apply an expansion force having a magnitude with a value in the range from 1 Newton (N) to 25 N (e.g., to 1 N, 5 N, 8.5 N, 10 N, 15 N, 20 N, 22 N, 25 N, etc.). This expansion force is greater than some conventional lower arch expansion devices, thus allowing for faster and more effective lower arch expansion compared to such conventional devices.

[0073] The first lingual side 214, the second lingual side 216, and the bridging region 222 cooperate to form an arch shape that defines a recessed region 226, the shape and size of which are adapted to receive the patient's tongue. The recessed region 226 can allow the tongue to be positioned at the base of the mouth without interference from the device 200.

[0074] The device 200 may include a polymeric housing 204 that defines a first tooth receiving portion 206, a second tooth receiving portion 208, and a bridging region 222. For example, the first lingual side 214, buccal side 216, and occlusal side 207 of the first tooth receiving portion 206 and the second lingual side 216, buccal side 220, and occlusal side 209 of the second tooth receiving portion 208 may be formed of a polymeric material. In some cases, the device 200 (e.g., the polymeric housing 204) is made of a single polymeric material. The device 200 (e.g., the polymeric housing 204) may have a smooth and continuous plastic outer surface that does not have screws or other mechanisms for expanding the width 224 (e.g., as compared to conventional arch expansion devices). These features may make the device 200 more comfortable for the patient to wear and easier for the patient to manipulate as compared to arch expansion devices having screws or other expansion mechanisms. Additionally, there is no need to turn screws or other expansion mechanisms, making the device 100 easier to use.

[0075] In some examples, the first tooth receiving portion 206 and / or the second tooth receiving portion 208 may be configured to additionally apply orthodontic repositioning forces to correct one or more teeth according to a stage of a treatment plan. For example, one or more of the first lingual side 214, buccal side 216, and occlusal side 207 and / or one or more of the second lingual side 216, buccal side 220, and occlusal side 209 may be shaped to apply a force to one or more first teeth 210 and / or one or more second teeth 212 in a direction toward a target position according to a treatment plan that includes correcting the position of one or more teeth relative to a target dental arch. Such repositioning forces may cooperate with arch expansion forces to expand the dental arch and correct the teeth.

[0076] In some cases, the first tooth receiving portion 206 and / or the second tooth receiving portion 208 may include one or more attachment receiving cavities that are configured to receive corresponding dental attachments that are adhered to one or more teeth of a patient. The dental attachments may be adhered to specific locations on one or more teeth and have a specific shape to facilitate prescribed movement of the one or more teeth (e.g., according to a stage of a treatment plan).

[0077] Figure 3AAnother example of a lower dental arch expansion device 300 on the lower dental arch 302 is shown. The device 300 is similar to the device 200, except that the first tooth receiving portion 306 and the second tooth receiving portion 308 are configured to cover only a portion of the molars and / or premolars of the lower dental arch 302. In this case, the first tooth receiving portion 306 is configured to cover a single tooth 310a on one side of the dental arch 302, and the second tooth receiving portion 308 is configured to cover a single tooth 312a on the opposite side of the dental arch 302. This configuration leaves the occlusal surfaces of the teeth 310b, 310c, 312b, and 312c uncovered, for example, to allow these teeth to exfoliate (if they are primary teeth) and / or to provide space for the eruption of permanent teeth. This configuration may also be more aesthetically desirable because when worn in the patient's mouth, the device 300 does not cover the buccal and labial sides of the teeth that may be visible.

[0078] The first tooth receiving portion 306 has a first lingual side 314, a first buccal side 318, and an occlusal side 307. Similarly, the second tooth receiving portion 308 has a second lingual side 316, a second buccal side 320, and an occlusal side 309. A bridging region 322 couples the first lingual side 314 to the second lingual side 316 and maintains a width 324 between the first tooth 310a and the second tooth 312a. The bridging region 322 of the device 300 is longer and extends further in the posterior direction compared to the bridging region 322 of the device 300. Additionally, the surfaces 328 and 330 of the bridging region 322 that are arranged to contact the lingual surfaces of the teeth 310b, 310c, 312b, and 312c have a fan shape to increase the engagement with the teeth 310b, 310c, 312b, and 312c, thereby allowing the device 300 to also apply sufficient dental arch expansion force between the first teeth 310b and 310c and the second teeth 312b and 312c. The first lingual side 314 (and / or the bridging region 322) may be stiffer and / or thicker than the first buccal side 318 (and / or the first occlusal side 307). Similarly, the second lingual side 316 (and / or the bridging region 322) may be stiffer and / or thicker than the second buccal side 320 (and / or the second occlusal side 309). The stiffer / thicker lingual sides 314 / 316 (and / or the bridging region 322) may support the outward force applied to the lingual surfaces of one or more of the teeth 310a, 310b, 310c, and 312a, 312b, 312c, which is required to expand the width of the lower dental arch 302 according to the corresponding phase of the treatment plan.

[0079] In some examples, the arch expansion device described herein may include a bridging region having a shape configured to increase the arch depth of the lower dental arch (in the front-to-back direction). For example, the bridging region (e.g., 222 or 322) may be configured to engage the lingual surfaces of the anterior teeth, and its shape and dimensions are designed to apply a force in the forward direction to increase the arch depth. In some examples, such as in Figure 3A device 300 of Figure 3B Similar to Figure 3A the device shown in

[0080] Figure 4 Another example of a lower dental arch expansion device 400 on the lower dental arch 402 is shown. Similar to devices 200 and 300, device 400 may be a polymeric housing. Device 400 includes a tooth-receiving portion 404 that defines a plurality of tooth-receiving cavities shaped to receive a corresponding number of teeth. The tooth-receiving portion 404 includes a lingual side 406, a buccal side 408, and an occlusal side 410. In this case, the tooth-receiving portion 404 is configured to cover all the teeth of the dental arch 402. The lingual portion of the lingual side of device 400 (which corresponds to the lingual side 406 of the tooth-receiving portion 404) is arranged to contact the lingual surfaces of the teeth when device 400 is worn on the patient's lower dental arch. The shape and dimensions of the lingual portion 406 are designed to apply an arch expansion force (e.g., an outward force) on the teeth to elongate and / or widen the dental arch 402.

[0081] For example, the lingual portion 406 may have an arch width 424 between opposing teeth (e.g., opposing molars, premolars, canines, and / or incisors) that is wider than the width of the lower dental arch 402 (e.g., at the start of the corresponding phase of treatment planning). At least a portion of the lingual portion 406 may be stiffer and / or thicker than the buccal side 408 and / or the occlusal side 410 such that the lingual portion 406 can apply an expansion force between opposing posterior teeth, for example, according to the phase of treatment planning.

[0082] In some cases, the device 400 may alternatively be configured to increase the depth 425 of the lower dental arch 402 by applying a force to the anterior teeth in the buccal direction. For example, the depth 425 of the device 400 may be greater than the depth of the lower dental arch 402 (e.g., at the start of the corresponding phase of treatment planning), thereby creating an outward force on the anterior teeth. Alternatively or additionally, the device may include one or more auxiliaries (e.g., buttons, attachments, etc.) or be configured to be used in conjunction with the one or more auxiliaries. For example, the device may be configured to include one or more buttons, hooks, etc. and / or elastics (e.g., bands) between the first, second, or third molars of the mandible and the canines or bicuspids (or first molars) or optionally on the maxilla or a device worn on the maxilla and / or operate in conjunction with one or more buttons, hooks, etc. and / or elastics (e.g., bands).

[0083] As described above, any of the lower dental arch expansion devices described herein may be configured to apply orthodontic alignment forces, for example, according to the phase of treatment planning, to correct one or more teeth. For example, in the example of the device 400, the tooth receiving cavity 404 (e.g., one or more of the lingual / portion 406, buccal 408, and occlusal side 410) may be shaped to apply orthodontic alignment forces to correct one or more teeth of the lower dental arch 402. In some cases, the device 400 (e.g., the buccal side 408) includes one or more attachment cavities shaped to receive one or more corresponding attachments bonded to one or more teeth such that the attachments may provide leverage and enhance the orthodontic alignment forces.

[0084] Generally, the devices and methods described herein can accommodate tooth exfoliation and / or eruption, which can be particularly helpful when treating young patients with a mixed dentition having both permanent and primary teeth, and expansion of the mandible (and / or maxilla) can be highly beneficial for young patients. For example, any of the mandibular expanders described herein can include one or more incised regions on any of the buccal region, lingual region, and / or occlusal region of the mandibular expander. In any of these methods and devices, a clinician (e.g., a doctor or other dental practitioner) can select incised regions for all or some of the teeth (including all or some of the patient's primary teeth and / or erupting teeth), and can determine whether incised regions and / or enhanced regions are needed. For example, the method and / or device (e.g., software, etc.) can be configured to allow dental professionals to select incised regions (e.g., buccal, lingual, and / or occlusal sides) for each tooth based on the patient's tooth eruption status (such as erupting from the buccal or lingual side) and / or based on treatment purposes (such as avoiding eruption interference, avoiding over-eruption, guiding tooth eruption, etc.). The same techniques can be applied to both mandibular expanders and maxillary expansion devices. For example, a dental professional can select incised regions for the mandibular and maxillary arch expansion devices based on the patient's needs. The dental professional can customize the expansion device for each patient according to the patient's treatment needs.

[0085] Generally, one or more incised regions can be included in areas where eruption occurs or may occur to avoid interfering with eruption. In some examples, the incised region can include an occlusal overhang along the occlusal side, where the vertical height of the occlusal overhang is set to prevent over-eruption. The incised region can form a window through the device, for example, it can be enclosed along its perimeter, or it can be continuous with the edge of the device. In any of these devices, the incised region can include a thicker marginal region.

[0086] Generally, the mandibular arch expansion device can provide a large arch expansion force as needed. The first molars can be stable for treatment. Other permanent teeth may still be erupting, or primary teeth may not have exfoliated yet, and can be treated differently from permanent teeth. One or more incised regions can be included to address various situations when treating a patient. For example, in some cases, it may be desirable to avoid interfering with tooth eruption. Teeth can erupt on the midline of the arch or off the midline of the arch. Therefore, one or more incised regions can be included on the buccal and / or lingual sides of the mandibular expander to accommodate the erupting teeth. In some cases, it may be desirable to avoid over-eruption of the teeth, so the mandibular expander can have an occlusal overhang on the erupting teeth, which can contact the inside of the mandibular expander opposite the occlusal surface; this contact can slow down or directly inhibit the eruption of the teeth.

[0087] In some cases, it may be desirable to guide an erupting tooth, e.g., such that it erupts into a desired position. Thus, in any of these examples, a lower arch expander may be configured to guide tooth eruption by constraining the erupting tooth from the buccal and / or lingual sides; thus, the lower arch expander may include a buccal and / or lingual side. For example, the guidance may be performed to guide the eruption of the tooth such that the tooth erupts perpendicular to the dental arch.

[0088] Generally, it may be desirable to enhance the stiffness of any lower arch expander described herein, as mentioned in more detail below, which may include increasing the thickness in the continuous line where the lower arch expander extends between teeth, and the lower arch expands between teeth (e.g., between the left and right molars). Thus, even in cases where the device includes one or more incised regions, the lower arch expander may be configured to apply a force between a pair or more pairs (or paired regions) of teeth by including a force transmission path, which may be formed by a path of thicker material and / or reinforcing material. In any of these devices, the cutting line of the lower arch expander (one or more edges of the device extending toward the gingiva) may be extended and / or reinforced.

[0089] The devices described herein may have enhanced device integrity (e.g., overall integrity) and / or regions of enhanced integrity. For example, these devices may be configured to have a continuous surface, e.g., buccal, lingual, occlusal, and / or an extended cutting line extending between two or more adjacent teeth, which is thicker and / or reinforced. Any of these devices may be enhanced by including one or more additional materials and / or layers, which may enhance the strength and / or stiffness of the material forming that region of the lower arch expander.

[0090] In some examples, the lower arch expander may be configured to allow exfoliation and / or prevent interference with tooth eruption, e.g., by including an occlusal overhang on the area where the tooth is erupting and / or on the tooth that is to be exfoliated.

[0091] Thus, a dental practitioner (e.g., doctor, technician, etc.) may customize any lower arch expander described herein, as well as the methods of manufacturing and using them, to include one or more incised regions and / or enhanced regions with a suitable occlusal overhang to achieve any of these objectives. As described in more detail below with reference to Figures 5A to 5B 、 Figures 6A to 6B 、 Figures 7A to 7B and Figures 8A to 8B A dental professional may customize a lower arch expander for a single treatment (e.g., a single lower arch expander), or more preferably, customize the lower arch expander over a series of lower arch expanders, by including one or more incised regions.

[0092] Typically, when including one or more incision regions, the lower dental arch expander described herein can be configured to continue to apply an expansion force between teeth to expand the teeth of the lower dental arch; thus, any expander described herein can adjust the applied force to maintain the expansion force in order to accommodate the removal of all or part of the lingual, occlusal, and / or buccal sides. In any of these examples, the force transmission path between the two sides of the lower dental arch expander can be thickened and / or strengthened in order to maintain the applied expansion force. The force transmission path can follow the curvature of the dental arch, including along the lingual, buccal, and / or occlusal sides. For example, in some variations (e.g., see Figure 6A , Figure 6B , Figure 7A , Figure 7B and Figure 8B ), all or a portion of the lingual wall can be excised. The device (e.g., system) described herein for designing and / or manufacturing a lower dental arch expander can configure the lower dental arch expander to add additional force to the left and / or right side, e.g., by making the remaining portion of the lingual wall thicker, and / or including a force transmission path (which can also be thickened and / or strengthened) to transmit the expansion force between the left and right sides of the lower dental arch.

[0093] The reinforcement can include adding a selected material that is capable of transmitting the expansion force without permanent deformation. For example, the reinforcement can include a reinforcing material (e.g., a metal and / or polymer material, and in particular, a material having a relatively high stiffness k or flexural and / or tensile modulus, e.g., sufficient to transmit an expansion force of about 1 Newton (N) to 25 N or between 10 N and 25 N between teeth without permanent deformation). The force transmission path can be continuous. In some examples, the force transmission path can be configured as a thickened region that continuously extends along one or more of the buccal, lingual, and / or occlusal sides of the lower dental arch expander, but terminates at the lingual surface (or lingual and occlusal sides) configured to contact the patient's teeth to apply the expansion force. In some cases, the expansion force transmission path terminates in a region of the device configured to hold the molars.

[0094] Typically, the lower dental arch expander can be configured by one or more of the design tools described herein, including the lower dental arch expander tool (see Figure 12 below), to transmit the expansion force, including modeling the forces acting on the teeth based on one or more digital models of the patient's teeth and one or more digital models of the lower dental arch expander, which can be virtually designed, modified, tested, and revised before final determination and manufacturing. In some cases, the expansion force transmission path can be simulated and adjusted manually, semi-automatically, or automatically to adjust the location and magnitude of the applied expansion force.

[0095] Figure 5A andFigure 5B An example of a lower dental arch expander device is shown, which includes an opening on the occlusal side to allow for exfoliation and / or eruption of teeth. Figure 5A An example of a lower dental arch expansion device 500 is shown, which includes an opening 503 on the occlusal side 510. The opening 503 is arranged to allow for exfoliation and / or eruption of one or more deciduous teeth of the patient's lower dental arch. In this case, the opening 503 is formed in the occlusal side of six tooth receiving cavities (three on each side). As shown, the tooth receiving cavities with the opening 503 include a buccal side 508 and a lingual side / portion 506, which can increase the lateral stiffness of the device 500.

[0096] In addition, two of the tooth receiving cavities 512a and 512b for posterior teeth (molars) have an occlusal side 510 without perforations, thereby providing greater lateral stiffness to the device 500 in this area. In addition, the tooth receiving cavities 512a and 512b can have an undercut geometry, where the edges of the tooth receiving cavities 512a and 512b near the gingiva point slightly inward and follow the curvature of the molars near the gingiva. This undercut feature can distribute the force applied to the teeth closer to the tooth roots, thereby reducing or preventing tooth tilting.

[0097] Figure 5B Another example of a lower dental arch expansion device 550 is shown. The lower dental arch expansion device 550 is similar to the device 500, except that the device 550 has a varying wall thickness and a different arrangement of tooth receiving cavities. Specifically, the walls of the tooth receiving cavities 562a, 562b, 562c, 562d, 562e, and 562f (for canines and premolars) including the opening 553 have a greater thickness than the walls of the tooth receiving cavities 562g, 562h, 562i, and 562j (for first and second molars) and / or the walls of the tooth receiving cavities 562k, 562l, 562m, and 562n (for central and lateral incisors). The greater thickness of the walls of the tooth receiving cavities 562a, 562b, 562c, 562d, 562e, and 562f can compensate for the presence of the opening 553 to maintain the lateral stiffness of the device 550. The wall thickness can be adjusted based on the desired lateral stiffness of the device 550. Additionally, the device 550 includes four tooth receiving cavities 562g, 562h, 562i, and 562j, which are configured to cover the occlusal side surfaces of the corresponding first and second molars of the patient's lower dental arch (compared to the two tooth receiving cavities in the device 500 that are configured to cover the occlusal side surfaces of the corresponding first molars). The entire tooth receiving portion 560 can include all the tooth receiving cavities. In Figure 5A and Figure 5BIn [the device], the region of the device between the tooth receiving cavities 562g, 562h, 562i, and 562j (for the first and second molars) can be referred to as the bridging region and can be configured to transmit the expansion force, as described.

[0098] Any arch expander device described herein can include walls of different thicknesses (i.e., not limited to Figure 5B the example device 550). The varying thicknesses in different regions of the device can be used to provide varying stiffness to different regions. In the example of device 550, the greater thickness of the wall surrounding the opening 553 enhances the lateral stiffness of the device 550. In the examples of devices 200, 300, 400, and 500, the lingual portion (e.g., the lingual and / or bridging region) can have a greater thickness to provide sufficient stiffness to apply an expansion (e.g., outward) force. Other regions of the device can have a smaller thickness to provide other functions, such as greater flexibility, increased comfort, and to provide appropriate elastic alignment forces on the teeth.

[0099] Thus, any lower arch expander described herein can include one or more incised regions that form a window through the expander. In some cases, the lower arch expander can be customized, for example, by a dental professional, to include a bite region that serves as a bridging region (and includes an expansion force transmission path) between two tooth receiving cavities at either end of the arch, the tooth receiving cavities being configured to hold molars 556 (e.g., the first and / or second and / or third molars), where all or a portion of the more anterior buccal and lingual sides are absent. For example, Figure 6A an example of a lower arch expander 750 is shown that includes tooth receiving cavities 752, 752' for receiving the patient's molars and an anterior cavity region 753 for receiving the anterior teeth; a pair of bite bridging regions 754, 754' that connect the cavities. The bite bridging regions and the anterior cavity region form a bridging region for transmitting the expansion force between the tooth receiving regions. There are two incised regions on the lingual sides 756, 756' and two incised regions on the buccal sides 758, 758'. Figure 6A The lower arch expander in [the reference] can prevent interference with the eruption and / or exfoliation of teeth that deviate laterally from the central dental arch of the mandible.

[0100] Figure 6BShows another variant of the lower dental arch expander 750', which includes incisional regions 756, 756' on the lingual side, but includes intact buccal sides 759, 759' and occlusal sides 754, 754'. In this example, the expansion force transmission path can extend between two posterior tooth receiving cavities 752, 752' at either end of the device along either or both of the occlusal regions 754, 754' and / or the buccal sides 759, 759' (and through all or a portion of the anterior tooth receiving cavity 753). This variation can prevent interference with the lingual inward eruption and / or exfoliation of teeth from the central dental arch of the mandible.

[0101] Figure 7A Shows another example of a lower dental arch expander 770 that includes an incisional region, similar to Figures 6A to 6B the incisional region shown in Figure 7A In Figure 7B the expander includes a pair of occlusal bridging regions 754, 754' and partial incisions 766 in both the buccal and lingual sides. Figure 7A Shows a lower dental arch expander 780 that includes an incisional region in both the buccal and lingual sides, which is different in position along the dental arch from the example shown in

[0102] Figure 8A and Figure 8B Shows examples of lower dental arch expanders that include an incisional region in the buccal portion of the expander. For example, Figure 8A shows a lower dental arch expander 850, in which large bilateral portions of the buccal and occlusal sides are removed, leaving an expansion force path along the lingual side. Alternatively, Figure 8B shows a lower dental arch expander 860, in which large bilateral portions of the lingual and occlusal sides are removed, and the expansion force path passes through the buccal side.

[0103] In any series of lower dental arch expanders, some or all of the lower dental arch expanders can include an incisional region. Thus, depending on the treatment objective, different lower dental arch expanders in a series can have different incisional regions. For example, the incisional region can be arranged on any lower arch expander to prevent it from interfering with the movement, eruption, and / or exfoliation of one or more teeth. Auxiliary

[0104] Any of the lower dental arch expander devices and methods described herein can include one or more auxiliary structures ("auxiliaries") for use with the lower dental arch expander. Generally, the auxiliaries can change the force applied by the lower dental arch expander and / or can change the connection between the lower dental arch expander and the teeth. The auxiliaries can include attachments, buttons, hooks, occlusal blocks, ramps, elastics, etc.

[0105] In some examples, the lower arch expander devices described herein can be used with one or more attachments. The attachments can be adhered to the patient's teeth and can engage with attachment receiving sites (e.g., cavities, pockets, etc.) on the lower arch expander device. The attachments can include one or more attachment surfaces for engaging with the lower arch expander device; for example, the lower arch expander device can include attachment receiving sites, each of which can be coupled to an attachment adhered to the patient's teeth to help secure the lower arch expander device to the teeth and can apply a force to the teeth and / or can transfer a force between the lower arch expander device and the teeth. The attachments can be adhered to any suitable tooth or tooth region, including the buccal surface and / or the lingual surface of the tooth.

[0106] Alternatively or additionally, the lower arch expander devices described herein can include one or more buttons or hooks formed on an outer surface of the lower arch expander device. In some examples, the buttons or hooks can be configured to apply a distal force and / or a force to pull one or more teeth proximally or forward. The buttons or hooks can be configured to be used with an elastic member (e.g., a band) or a wire, rod, etc.

[0107] Any device or system described herein can include one or more occlusal adjustment structures (e.g., occlusal blocks) configured to adjust the patient's occlusion. The occlusal adjustment structures can project from one or more of the buccal, labial, occlusal, and / or lingual sides of the device. The occlusal adjustment structures can be shaped and arranged to contact the patient's upper dental arch or a dental device on the patient's upper dental arch to affect the relative maxillary and mandibular positions when the patient occludes. In some specific examples, the occlusal adjustment structures are configured to provide a mandibular advancement relative to the maxilla.

[0108] Figure 9A and Figure 9B Another variant of the lower arch expansion device 600 is shown, which is configured to disocclude the anterior teeth of the patient's upper and lower dental arches by separating the anterior teeth of the patient's upper and lower dental arches from each other. The disocclusion of the jaws can be particularly useful for helping to correct certain malocclusions, such as overbite or underbite, where one jaw needs to advance relative to the other jaw. For example, one or more protrusions (e.g., occlusal ramps) can be included on the lower arch expander device (e.g., along one or more posterior teeth) such that when the patient bites down, the anterior teeth separate vertically. In some examples, the protrusions can be formed of the same material as the remainder of the lower arch expander and can be formed by increasing the thickness of a portion of the lower arch expander (e.g., along a portion configured to be placed on the posterior teeth). The disocclusion using any of these devices can also or alternatively be used to treat crossbite. In any of these examples, the lower arch expander device can include a disocclusion member on the occlusal side of the lower arch expander device. For example, in Figure 9AAnd Figure 9B In, apparatus 600 includes a first tooth receiving portion 606 and a second tooth receiving portion 608 shaped to receive opposing posterior teeth; in this case, the opposing posterior teeth are the first molars and the first and second premolars. The occlusal sides 610 and 611 of the first tooth receiving portion 606 and the second tooth receiving portion 608 have a thickness large enough to prevent the anterior teeth 630 of the lower dental arch 602 from contacting the anterior teeth 633 of the upper dental arch 603, as Figure 9B shown. In this example, the patient may have an overbite or an underbite, which requires treatment involving the advancement of one jaw relative to the other. As Figure 9B shown, the anterior teeth of the upper and lower dental arches are vertically separated from each other. By introducing this vertical separation and preventing contact between the anterior teeth of the upper and lower jaws, it becomes easier to advance one jaw relative to the other using a dental appliance (e.g., advancing the lower jaw relative to the upper jaw, or vice versa). In some examples, the projection can be an occlusal bevel on the anterior teeth to disocclude the posterior teeth and effect corrective movement of the posterior teeth during orthodontic treatment. In other variations, the tooth receiving portion on the anterior teeth can have an increased thickness along the occlusal (incisal) side to disocclude the posterior teeth.

[0109] In some examples, the outer occlusal surfaces of the occlusal sides 610 and 611 are pointed, e.g., corresponding to the pointed occlusal surfaces of the underlying teeth. This can allow the occlusal sides 610 and 611 to mate with the matching pointed surface of the posterior teeth of the upper dental arch 603 and / or a second dental appliance on the upper dental arch 603. In other cases, the outer occlusal surfaces of the occlusal sides 610 and 611 are flat. Any of the apparatuses described herein (e.g., apparatus 200, 300, 400, 500, or 550) can have a tooth receiving portion having an occlusal side with a pointed outer surface or a flat outer surface.

[0110] Any of the apparatuses described herein can include one or more features to facilitate removal and / or placement of the apparatus on the patient's dental arch. In some examples, the apparatus includes one or more tabs that a user can grasp, pull, and / or push to provide leverage for removing and / or placing the apparatus. In some cases, the tabs extend from the edge (e.g., the buccal edge) of the apparatus at or near the gingiva. In some cases, the apparatus can include one or more hinges that predictably bend the apparatus in a manner that provides space to more easily remove the apparatus and / or place the apparatus on the teeth.

[0111] Figures 10A to 10BAnother example of a mandibular expander is shown, where when the device is worn, additional leverage for expansion is provided by one or more palatal struts extending inwardly and vertically upward from the body of the lower dental arch (e.g., lingual side) toward the palate. The palatal struts can be configured to arch over the oral cavity to allow space (e.g., a passage or tunnel) for the tongue such that the tongue can pass through unobstructed. The palatal struts can provide additional expansion force against the mandible such that direct lateral forces can be applied on opposite sides of the dental arch for lateral expansion. The palatal struts can at least partially cover the area extending from the occlusal / lingual interconnect point to avoid contact with the tongue and the maxilla. In some examples, the struts can be configured to provide a clearance from at least a portion of the palatal surface to prevent direct contact with some or all of the palatal surface. In some examples, the struts can contact the palatal surface.

[0112] For example, Figure 10A A top view of a lower dental arch expander 1000 including a palatal strut 1030 is shown, the palatal strut 1030 connecting the lingual sides of a pair of tooth engaging portions 1020, 1021 having tooth receiving cavities configured to fit over the patient's molars and / or premolars. Figure 10B A cross-sectional front view is shown. As shown, the lower dental arch expander can be worn with an upper dental arch appliance or expander 1045. Although Figure 10A and Figure 10B a single wide strut 1030 is shown, in some examples, multiple struts (e.g., narrow rods) can be used to apply a similar expansion force.

[0113] In some examples, the palatal strut 1030 can be integrally formed with the tooth engaging portions 1020, 1021. For example, the palatal strut 1030 and the tooth engaging portions 1020, 1021 can be directly manufactured (e.g., by 3D printing) as a single unitary part. In some examples, the palatal strut 1030 can be formed separately and can subsequently be attached to the tooth engaging portions 1020, 1021. In some examples, the palatal strut 1030 can have a different stiffness or thickness than the tooth engaging portions 1020, 1021. For example, the palatal strut 1030 can be more rigid or thicker than the tooth engaging portions 1020, 1021 in order to be able to apply a higher amount of expansion force. In some examples, the palatal strut 1030 can be made of a different material than the tooth engaging portions 1020, 1021 such that they have different force application characteristics. For example, the tooth engaging portions 1020, 1021 can be made of a polymeric material while the palatal strut 1030 can be made of a metal (e.g., a shape memory metal such as nitinol). Generally, the characteristics of the palatal strut 1030 can be customized based on patient characteristics (e.g., age) and / or treatment (e.g., the amount of expansion force required). Having such a separate source of expansion force not only provides a greater amount of expansion force; it also provides greater flexibility in terms of how the force is applied during treatment.

[0114] In some examples, a dental appliance such as the lower arch expander disclosed herein can include features for correcting specific oral habits. For example, a barrier structure can be placed on the lingual side of the dental appliance (e.g., the lower arch expander) to reduce or prevent tongue thrust. The barrier structure can project vertically and / or lingually from the gingival-lingual margin of the dental appliance or in the vicinity thereof and can thus block or prevent the tongue from being pushed outwards. As another example, a barrier structure can be placed on the lingual side of an upper or lower dental appliance to block or prevent a patient's thumb from being inserted into the mouth to reduce or prevent thumb sucking. In some examples, the barrier structure can be laterally continuous. In some examples, the barrier structure can have perforations or surface modifications such as channels or ridges. The barrier structure can be integrally formed with the dental appliance (e.g., directly manufactured by 3D printing, sintering, or other means, thermoforming, etc.) or can be formed separately and then subsequently attached to the dental appliance. More information regarding structures (e.g., barriers) on dental appliances for habit correction can be found in U.S. Patent No. 11,026,831, which is incorporated herein by reference in its entirety.

[0115] The devices described herein can be fabricated using any of a variety of manufacturing techniques. For example, the devices can be fabricated using one or more of additive manufacturing (e.g., 3D printing), molding, and / or etching processes. Due to the customizability of additive manufacturing, additive manufacturing techniques may be well-suited for fabricating the devices. For example, a series of devices according to incremental treatment planning can be virtually presented as 3D objects, as described herein, which can be used as a basis for forming the actual devices via additive manufacturing programming instructions. Thus, the devices can have the exact shape and dimensions of the virtual model. A series of virtual devices according to a treatment plan can be virtually generated using one or more treatment planning programs, and a series of actual / physical devices can be formed (e.g., printed) based on the series of virtual devices.

[0116] The arch expansion devices described herein can be made of any of a variety of materials. In some examples, the devices are made of one or more polymeric materials (e.g., thermoplastics, nylon, etc.). In some cases, the polymeric material can be visibly transparent / translucent such that the underlying teeth are visible through the polymeric material. In some cases, the device is formed of a single type of polymeric material, which may be more advantageous for some types of additive manufacturing processes. In other cases, the arch expansion device can be made of more than one type of polymeric material. Different types of polymeric materials can have different stiffness characteristics and can thus be used to fabricate different portions of the arch expansion device. For example, a stiffer polymeric material can be used to form at least some of the lingual portion compared to some portions of the tooth-engaging portion.

[0117] Figure 11 A flowchart depicting an example method for forming a mandibular expander device is shown. A 3D model (e.g., virtual / digital model) of a patient's lower dental arch is collected 701. The 3D model can be based on one or more dental scans within the patient's oral cavity (e.g., extracted from one or more dental scans within the patient's oral cavity). A 3D model of a target-expanded lower dental arch is generated 703. The target lower dental arch has a desired tooth configuration, where the lower dental arch has a desired arch width and / or arch length. For example, the target lower dental arch can widen and / or elongate the lower dental arch to create space for erupting permanent teeth or to uncrowd crowded teeth. These target lower dental arches can also align the teeth of the lower dental arch with the teeth of the upper dental arch. In some cases, expansion of the upper dental arch is performed in conjunction with expansion of the lower dental arch.

[0118] A 705 arch expansion treatment plan can be generated. This can involve determining the expansion force to be applied to the lower dental arch required to achieve the target lower dental arch. The direction and magnitude of the expansion force applied to the teeth can be calculated based on simulating the expansion force on a virtual model of the lower dental arch. The treatment plan can include a series of arch expansion phases, in which the expansion force is incrementally applied to the lower dental arch towards the target arch configuration. In some examples, in addition to expanding the lower dental arch, the arch expansion treatment plan can include aligning the positions / orientations of the teeth relative to each other and the lower dental arch. Steps 703 and 705 can be interchanged.

[0119] At 707, a series of virtual arch expansion devices are generated based on the series of arch expansion phases of the treatment plan. For example, each of the arch expansion phases can be associated with a corresponding arch expansion device configured to apply the necessary force on the teeth from the configuration at the start of a particular phase of the treatment plan towards the configuration at the end of the particular phase. At 709, one or more arch expansion devices are manufactured based on one or more of the virtual arch expansion devices. In some examples, the arch expansion devices are manufactured using additive manufacturing based on a virtual version of the arch expansion device (e.g., a 3D model).

[0120] The methods for treatment planning can be performed using software, hardware, and / or firmware, including forming and using one or more dental appliances (e.g., a series of lower arch expander devices). These processes can be performed as part of treatment planning software or can be separate modules (remote or local modules) or tools (e.g., lower arch expander planning tools) accessible by (or receivable of input from) a treatment planning tool.

[0121] Figure 12 is a diagram showing an example system for forming a lower arch expansion appliance. The lower arch expansion tool 800 can be incorporated as part of one or more treatment planning systems (e.g., an arch expansion planning system and / or a tooth alignment planning system) and can thus also be referred to as a subsystem. In some cases, the lower arch expansion tool 800 can be an add-on (e.g., a plug-in) to one or more treatment planning systems. In any of the methods and devices described herein, the lower arch expansion tool 800 can be invoked by a user control (such as a tab, button, etc.) that is part of the treatment planning system or can be invoked separately. In Figure 12In [the context], the lower dental arch expansion tool 800 may include an engine and a data store. As used herein, an engine includes one or more processors or portions thereof. A portion of one or more processors may include some part of the hardware that is less than all of the hardware that includes any given one or more processors, such as a subset of registers, a portion of a processor dedicated to one or more threads of a multi-threaded processor, a time slice of a processor dedicated entirely or in part to performing a portion of the functions of the engine, etc. The lower dental arch expansion tool 800 may include a computer-readable medium or be a part of a computer-readable medium, and may include an input engine 802 that allows access to patient-related data and / or databases. Such data may include the patient's dental scan data and / or 3D models related to the patient's treatment plan. All or some of the data may be stored in one or more data stores 814.

[0122] In any of these methods and devices (e.g., systems), the computer system may be implemented as an engine, a portion of an engine, or through multiple engines. As used herein, an engine includes one or more processors or portions thereof. A portion of one or more processors may include some part of the hardware that is less than all of the hardware that includes any given one or more processors, such as a subset of registers, a portion of a processor dedicated to one or more threads of a multi-threaded processor, a time slice of a processor dedicated entirely or in part to performing a portion of the functions of the engine, etc. Thus, the first engine and the second engine may have one or more dedicated processors, or the first engine and the second engine may share one or more processors with each other or with other engines. Depending on implementation-specific or other considerations, the engine may be centralized, or its functions may be distributed. The engine may include hardware, firmware, or software implemented in a computer-readable medium for execution by a processor. The processor uses the implemented data structures and methods to transform data into new data, such as described with reference to the figures herein.

[0123] The engines described herein or the engines through which the systems and devices described herein may be implemented may be cloud-based engines. As used herein, a cloud-based engine is an engine that can use a cloud-based computing system to run applications and / or functions. All or part of the applications and / or functions may be distributed across multiple computing devices and need not be limited to one computing device. In some embodiments, the cloud-based engine may execute functions and / or modules accessed by an end user through a web browser or a container application without locally installing the functions and / or modules on the end user's computing device.

[0124] The lower dental arch expansion tool 800 may include a computer-readable medium. The modules / engines may be coupled to each other (e.g., example coupling shown by interconnect lines in Figure 12 or coupled toFigure 12 Modules / engines not explicitly shown in the figure. The computer-readable medium can include any computer-readable medium, including but not limited to a bus, a wired network, a wireless network, or some combination thereof. The engines described herein can implement one or more automated agents, including machine learning agents.

[0125] As used herein, data store 814 is intended to include a repository having any suitable data organization, including tables, comma-separated value (CSV) files, traditional databases (e.g., SQL), or other suitable known or convenient organizational formats. For example, data store 1016 can be implemented as software, firmware, hardware, a combination thereof, or a suitable known or convenient device or system implemented in a physical computer-readable medium on a dedicated machine. Components associated with the data store (such as a database interface) can be considered part of the data store, part of some other system component, or a combination thereof, although the physical location and other characteristics of the components associated with the data store are not important for understanding the techniques described herein.

[0126] Data store 814 can include data structures. As used herein, a data structure is associated with a particular way of storing and organizing data in a computer such that it can be effectively used in a given context. Data structures are generally based on the ability of a computer to retrieve and store data at any location in its memory, the data being specified by an address, e.g., a bit string that can itself be stored in memory and manipulated by a program. Thus, some data structures are based on calculating the address of a data item with arithmetic operations; while other data structures are based on storing the address of a data item within the structure itself. Many data structures use both principles, sometimes in non-trivial combinations. Implementing a data structure typically requires writing a set of procedures that create and manipulate examples of the structure. Data store 814 described herein can be cloud-based data storage. Cloud-based data storage is a data storage that is compatible with cloud-based computing systems and engines.

[0127] The arch expansion engine 804 can calculate the expansion force for expanding the lower dental arch based on the patient's current lower dental arch (e.g., based on an oral scan) and the target lower dental arch. As described herein, the target lower dental arch configuration typically has a longer and / or wider arch than the patient's current condition. The expansion force can be calculated based on applying an outward force on the lingual side of one or more teeth. The arch expansion engine 804 can determine the direction and magnitude of the force applied to each tooth to achieve the target lower dental arch configuration.

[0128] As described above, generally, any of these methods and devices can include aligning teeth while expanding, and / or preventing or restricting tipping. Thus, the methods and devices (including treatment planning software) described herein can be configured to move teeth in addition to expanding the lower dental arch. Generally, expansion and / or movement of the mandible can cause movement of the teeth relative to the maxilla (although in some cases, the maxilla can be expanded and moved concurrently with the expansion of the mandible). In any of these methods and devices, the software can be configured to account for movement of the teeth of the mandible relative to the maxilla during expansion of the mandible. Thus, in some of these examples, the method can modify the position of one or more teeth on the maxilla, and / or can modify the occlusal surface of the maxilla such that the occlusion between the maxilla and the mandible is minimally affected (if at all) during treatment with a mandibular expander.

[0129] A tooth alignment engine 806 can optionally be used to manage aspects related to repositioning one or more teeth for alignment purposes. The tooth alignment engine 806 can be configured to account for arch expansion forces and calculate additional forces on the teeth to align and correct the teeth. The tooth alignment forces can be applied to the buccal, labial, lingual, and / or occlusal sides of one or more teeth of the lower dental arch.

[0130] A treatment planning engine 808 can determine a comprehensive treatment plan based on the patient's current lower dental arch configuration (e.g., prior to treatment) and a target lower dental arch configuration (e.g., a desired final tooth configuration). The treatment planning engine 808 can integrate the arch expansion forces determined by the arch expansion engine 804 and, in some cases, the tooth alignment forces determined by the tooth alignment engine 806 to generate a plan that achieves the target lower dental arch configuration in a stepwise manner through multiple stages. The treatment planning engine 808 can be configured to generate intermediate dentition models corresponding to intermediate stages of the treatment plan.

[0131] An arch expansion device engine 810 can be configured to generate one or more virtual arch expansion device models that are configured to apply arch expansion forces (and in some cases also tooth alignment forces) to one or more teeth according to the stages of an arch expansion treatment plan. In some cases, the arch expansion device models can be virtually placed on a model of the patient's lower dental arch to ensure proper fit. For example, the arch expansion device engine 810 can be used to modify the expansion device model by changing the shape of certain portions of the expansion device model. For example, the expansion device model can be changed to modify the arch expansion forces and / or achieve the comfort desired by the patient.

[0132] The output engine 812 can be configured to generate one or more outputs, such as data for manufacturing one or more arch expansion devices. The output engine 812 can access data stored in the data store 814, such as 3D model data for an arch expansion device. In some cases, the output includes a virtual 3D model of the arch expansion device in a format readable by an additive manufacturing machine (e.g., a 3D printer) to manufacture a physical arch expansion device. In some cases, the output can include instructions for manufacturing the arch expansion device. In some cases, the output can be in a form suitable for forming the arch expansion device or a portion thereof using one or more manufacturing processes other than additive manufacturing, such as a molding process or an etching process.

[0133] It should be understood that all combinations of the foregoing concepts and additional concepts discussed in greater detail below (assuming these concepts are not mutually inconsistent) are considered to be part of the inventive subject matter disclosed herein and can be used to achieve the benefits described herein.

[0134] Any method described herein (including user interfaces) can be implemented as software, hardware, or firmware and can be described as a non-transitory computer-readable storage medium storing a set of instructions executable by a processor (e.g., a computer, a tablet, a smartphone, etc.), which, when executed by the processor, causes the processor to control the execution of any steps, including but not limited to: displaying, communicating with a user, analyzing, modifying parameters (including timing, frequency, intensity, etc.), determining, warning, etc. For example, any method described herein can be performed at least in part by a device including one or more processors having a memory storing a non-transitory computer-readable storage medium storing a set of instructions for the processing of the method.

[0135] Although various embodiments have been described and / or illustrated herein in the context of a full-featured computing system, one or more of these example embodiments can be distributed in various forms as a program product, regardless of the specific type of computer-readable medium used for the actual distribution. The embodiments disclosed herein can also be implemented using software modules that perform certain tasks. These software modules can include scripts, batch files, or other executable files that can be stored on a computer-readable storage medium or in a computing system. In some embodiments, these software modules can configure the computing system to perform one or more of the example embodiments disclosed herein.

[0136] 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 the computer-readable instructions included within the modules described herein. In their most basic configuration, these computing devices can each include at least one memory device and at least one physical processor.

[0137] As used herein, the terms "memory" or "memory device" generally refer 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 may 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 disk drive, cache, variations or combinations of one or more thereof, or any other suitable storage memory.

[0138] Additionally, as used herein, the term "processor" or "physical processor" generally refers to any type or form of hardware-implemented processing unit capable of interpreting and / or executing computer-readable instructions. In one example, a physical processor may access and / or modify one or more of the modules stored in the memory devices described above. 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), portions of one or more thereof, variations or combinations of one or more thereof, or any other suitable physical processor.

[0139] Although shown as separate elements, the method steps described and / or shown herein may represent parts of a single application. Additionally, 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 the method steps.

[0140] Additionally, one or more of the devices described herein may convert data, physical devices, and / or representations of physical devices from one form to another. Additionally or alternatively, one or more of the modules described herein may convert a processor, volatile memory, non-volatile memory, and / or any other part of a physical computing device from one form of computing device to another by executing on the computing device, storing data on the computing device, and / or otherwise interacting with the computing device.

[0141] 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 types of 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 distribution systems).

[0142] One of ordinary skill in the art will recognize that any process or method disclosed herein can be modified in many ways. The process parameters and step sequences described and / or illustrated herein are given by way of example only and can be varied as needed. For example, while the steps shown and / or discussed herein may be shown or discussed in a particular order, these steps do not necessarily need to be performed in the order shown or discussed.

[0143] The various exemplary methods described and / or illustrated herein may also omit one or more of the steps described or illustrated herein, or may include additional steps in addition to those disclosed. Further, the steps of any method disclosed herein may be combined with any one or more steps of any other method disclosed herein.

[0144] 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 disclosed herein.

[0145] When a feature or element is referred to herein as being "on" another feature or element, it can be directly on the other feature or element, or intervening features and / or elements may also be present. In contrast, when a feature or element is referred to as being "directly on" another feature or element, no intervening features or elements are present. It should also be understood that when a feature or element is referred to as being "connected", "attached", or "coupled" to another feature or element, it can be directly connected, attached, or coupled to the other feature or element, or intervening features or elements may be present. In contrast, when a feature or element is referred to as being "directly connected", "directly attached", or "directly coupled" to another feature or element, no intervening features or elements are present. Although described or illustrated with respect to one embodiment, the features and elements so described or illustrated can be applied to other embodiments. Those skilled in the art will also understand that references to a structure or feature being "adjacent" to another feature can have portions that overlap or are located beneath the adjacent feature.

[0146] The terms used herein are for the purpose of describing particular embodiments only and are not intended to limit the present invention. For example, as used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly dictates otherwise. It will be further understood that when the terms "comprises" and / or "comprising" are used in this specification, they specify the presence of the stated features, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items and may be abbreviated as " / ".

[0147] For ease of description, spatial relative terms such as "below", "beneath", "lower", "above", "upper", etc. may be used herein to describe the relationship of one element or feature to another element or feature as shown in the figures. It should be understood that the spatial relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation shown in the figures. For example, if the device in the figures is inverted, an element described as "below" or "beneath" another element or feature would then be oriented "above" the other element or feature. Thus, the exemplary term "below" can encompass both an orientation above and below. The device may be otherwise oriented (rotated 90 degrees or at other orientations), and the spatial relative descriptors used herein are to be interpreted accordingly. Similarly, the terms "upward", "downward", "vertical", "horizontal", etc. are used herein for purposes of explanation only unless specifically stated otherwise.

[0148] Although the terms "first" and "second" may be used herein to describe various features / elements (including steps), these features / elements should not be limited by these terms unless the context dictates otherwise. These terms may be used to distinguish one feature / element from another. Thus, without departing from the teachings of the present invention, a first feature / element discussed below may be termed a second feature / element, and similarly, a second feature / element discussed below may be termed a first feature / element.

[0149] Throughout the specification and the following claims, unless the context requires otherwise, the word "comprises", and variations such as "comprising" and "containing", will be understood to imply the inclusion of various components (e.g., a composition and an apparatus including devices and methods) that may be used in a method and an article. For example, the term "comprises" will be understood to imply the inclusion of any stated element or step but not the exclusion of any other element or step.

[0150] Generally, any devices and methods described herein should be understood as inclusive, but all or subsets of components and / or steps may alternatively be exclusive and may be expressed as "comprising various components, steps, subcomponents or substeps" or alternatively "consisting essentially of various components, steps, subcomponents or substeps".

[0151] As used herein in the specification and claims, including as used in the examples, and unless otherwise expressly specified, all numbers may be read as if prefaced by the word "about" or "approximately", even if the term does not expressly appear. The phrase "about" or "approximately" may be used when describing size and / or position to indicate that the described values and / or positions are within a reasonable expectation of the value and / or position. For example, a numerical value may have a value of + / −0.1% of the stated value (or range of values), + / −1% of the stated value (or range of values), + / −2% of the stated value (or range of values), + / −5% of the stated value (or range of values), + / −10% of the stated value (or range of values), etc. Any numerical value given herein should also be understood to include about or approximately that value, unless the context otherwise indicates. For example, if the value "10" is disclosed, then "about 10" is also disclosed. Any numerical range described herein is intended to include all subranges subsumed therein. It should also be understood that when a value is disclosed, "less than or equal to" that value, "greater than or equal to" that value, and the possible ranges between values are also disclosed, as would be understood by a person skilled in the art. For example, if the value "X" is disclosed, then "less than or equal to X" and "greater than or equal to X" are also disclosed (e.g., where X is a numerical value). It should also be understood that throughout the application, data is provided in a variety of different formats, and that this data represents endpoints and starting points, as well as ranges for any combination of data points. For example, if a particular data point "10" and a particular data point "15" are disclosed, then it should be understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15, as well as between 10 and 15 are considered disclosed. It should also be understood that each unit between two particular units is also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0152] Although various illustrative embodiments have been described above, many changes of any kind may be made to the various embodiments without departing from the scope of the invention as described by the claims. For example, in alternative embodiments, the order in which the various described method steps are performed may generally be altered, and in other alternative embodiments, one or more method steps may be entirely skipped. Optional features of the various apparatus and system embodiments may be included in some embodiments and not in others. Accordingly, the foregoing description has been provided primarily for exemplary purposes and should not be construed as limiting the scope of the invention as set forth in the claims.

[0153] The examples and figures included in this document illustrate, by way of illustration and not limitation, specific embodiments in which the subject matter may be practiced. As described above, other embodiments may be utilized and other embodiments may be derived therefrom, such that structural and logical substitutions and changes may be made without departing from the scope of the present disclosure. These embodiments of the subject matter of the present invention may be referred to herein individually or collectively by the term "invention" merely for convenience and not intended to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is actually disclosed. Thus, although specific embodiments have been shown and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. The present disclosure is intended to cover any and all adaptations or variations of various embodiments. After reading the above description, combinations of the above embodiments and other embodiments not specifically described herein will be apparent to those skilled in the art.

Claims

1. A system for expanding a patient's lower dental arch, the system comprising: A series of expander devices, each of the series of expander devices being configured to incrementally expand the patient's lower dental arch towards a desired arch configuration based on a treatment plan, wherein each expander device of the series of expander devices includes a polymer housing, the polymer housing comprising: A first tooth receiving portion shaped to receive one or more first teeth, the first tooth receiving portion having a first lingual side, a first buccal side, and a first occlusal side; A second tooth receiving portion shaped to receive one or more second teeth, the second tooth receiving portion having a second lingual side, a second buccal side, and a second occlusal side; and A bridging region coupling the first lingual side to the second lingual side, wherein the bridging region is configured to maintain an expansion width between the first lingual side and the second lingual side, and when the device is worn on the patient's lower dental arch, the expansion width applies an expansion force between the one or more first teeth and the one or more second teeth to expand the patient's lower dental arch, wherein the first lingual side and the second lingual side are configured to transmit all or some of the expansion force; Further, wherein the expansion width of the expander devices in the series of expander devices increases over the course of the series.

2. The system according to claim 1, wherein, The first lingual side and the second lingual side are stiffer than the first buccal side and the second buccal side or the first occlusal side and the second occlusal side.

3. The system according to any one of claims 1 to 2, wherein, The first lingual side and the second lingual side are thicker than the first occlusal side and the second occlusal side or the first buccal side and the second buccal side.

4. The system according to any one of claims 1 to 3, wherein, The polymer housing of each expander device is made of a single polymer material.

5. The system according to any one of claims 1 to 4, wherein, The width between the first lingual side and the second lingual side of each subsequent expander device in the series of expander devices is wider than that of the previous expander device in the series.

6. The system according to any one of claims 1 to 5, wherein, Each expander device in the series of expander devices is configured to apply an expansion force having a magnitude and direction according to the stage of a dental arch expansion treatment plan.

7. The system according to any one of claims 1 to 6, wherein, The expansion force of each expander device in the series of expander devices is between 1 Newton (N) and 25 N.

8. The system according to any one of claims 1 to 7, wherein, The bridging region of at least one of the expander devices in the series of expander devices is configured to contact one or more anterior teeth when the device is worn on the patient's lower dental arch.

9. The system according to claim 8, wherein, The bridging region of at least one of the expander devices in the series of expander devices is configured to apply a second expansion force on the one or more anterior teeth.

10. The system according to any one of claims 1 to 9, wherein, For each expander device in the series of expander devices, the first lingual side is thicker than the first buccal side, and the second lingual side is thicker than the second buccal side.

11. The system according to any one of claims 1 to 10, wherein, The first tooth receiving portion and the second tooth receiving portion of each expander device in the series of expander devices are shaped to receive only molars, only premolars, or both molars and premolars.

12. The system according to any one of claims 1 to 11, wherein, The bridging region is configured to conform to the lingual surface of the patient's lower dental arch when the device is worn by the patient.

13. The system according to any one of claims 1 to 12, wherein, The bridging region is configured to conform to the lingual surface of one or more anterior teeth when the device is worn by the patient.

14. The system according to any one of claims 1 to 13, wherein, The bridging region includes a tooth-receiving portion having one or more of a buccal side, a lingual side, and an occlusal side.

15. The system according to any one of claims 1 to 14, wherein, The bridging region for at least one of the expander devices in the series of expander devices includes one or more openings arranged to permit exfoliation of one or more deciduous teeth of the patient's lower dental arch.

16. The system according to any one of claims 1 to 15, wherein, Each expander device includes a plurality of attachment cavities, each attachment cavity being configured to be coupled to an attachment that adheres to one or more of the patient's teeth.

17. The system according to any one of claims 1 to 16, further comprising one or more occlusal adjustment structures configured to facilitate mandibular advancement, wherein, The one or more occlusal adjustment structures are shaped and arranged to contact the patient's upper dental arch or a dental device on the patient's upper dental arch.

18. The system according to claim 17, wherein The one or more occlusal adjustment structures are shaped and arranged to contact corresponding one or more occlusal adjustment structures of the dental device on the patient's upper dental arch.

19. The system according to any one of claims 1 to 18, wherein, One or both of the first occlusal side and the second occlusal side of at least one expander device in the series of expander devices has a thickness configured to disocclude the anterior teeth of the patient's lower dental arch.

20. A mandibular expander device, comprising: A polymeric housing, comprising: A first tooth-receiving portion shaped to receive one or more first teeth, the first tooth-receiving portion having a first lingual side, a first buccal side, and a first occlusal side; A second tooth-receiving portion shaped to receive one or more second teeth, the second tooth-receiving portion having a second lingual side, a second buccal side, and a second occlusal side; and A bridging region coupling the first lingual side to the second lingual side, wherein the bridging region is configured to maintain a width between the first lingual side and the second lingual side that, when the device is worn on the patient's lower dental arch, exerts an expansion force between the one or more first teeth and the one or more second teeth to expand the patient's lower dental arch, wherein the first lingual side and the second lingual side are configured to transmit all or some of the expansion force.

21. The device according to claim 20, wherein, The first lingual side and the second lingual side are stiffer than the first buccal side and the second buccal side or the first occlusal side and the second occlusal side.

22. The apparatus according to any one of claims 20 to 21, wherein, The first lingual side and the second lingual side are thicker than the first occlusal side and the second occlusal side or the first buccal side and the second buccal side.

23. The apparatus according to any one of claims 20 to 22, wherein, The polymeric housing is made of a single polymeric material.

24. The apparatus according to any one of claims 20 to 23, wherein, The width between the first lingual side and the second lingual side is wider than the width between the first lingual side of the one or more first teeth and the second lingual side of the one or more second teeth.

25. The device according to any one of claims 20 to 24, wherein, The device is configured to exert an expansion force having a magnitude and direction according to the stage of a dental arch expansion treatment plan.

26. The device according to any one of claims 20 to 25, wherein, The expansion force is between 1 Newton (N) and 25 N.

27. The apparatus according to any one of claims 20 to 26, wherein The bridging region is configured to contact one or more anterior teeth when the device is worn on the patient's lower dental arch.

28. The apparatus according to claim 27, wherein, The bridging region is configured to exert a second expansion force on the one or more anterior teeth.

29. The device according to claim 28, wherein, The second expansion force is between 1 Newton (N) and 5 N.

30. The apparatus according to any one of claims 20 to 29, wherein, The bridging area, the first lingual side, and the second lingual side define a recessed area that is shaped to provide space for the patient's tongue.

31. The device according to any one of claims 20 to 30, wherein, The first lingual side is thicker than the first buccal side, and the second lingual side is thicker than the second buccal side.

32. The apparatus according to any one of claims 20 to 31, wherein, The first tooth receiving portion and the second tooth receiving portion are shaped to receive only molars, only premolars, or both molars and premolars.

33. The apparatus according to claim 32, wherein, Each of the first tooth receiving portion and the second tooth receiving portion is shaped to receive only one molar or premolar.

34. The apparatus according to any one of claims 20 to 33, wherein, The first tooth receiving portion and the second tooth receiving portion are shaped to receive molars, premolars, canines, and incisors.

35. The apparatus according to any one of claims 20 to 34, wherein, The first tooth receiving portion and the second tooth receiving portion include one or more openings that are arranged to allow exfoliation of one or more deciduous teeth of the patient's lower dental arch.

36. The device according to any one of claims 20 to 35, wherein, The first occlusal side of the first tooth receiving portion includes a first pointed-shaped outer surface, and the second occlusal side of the second tooth receiving portion includes a second pointed-shaped outer surface.

37. The apparatus according to claim 36, wherein, The first pointed-shaped outer surface matches the pointed shape of the one or more first teeth, and the second pointed-shaped outer surface matches the pointed shape of the one or more second teeth.

38. The apparatus according to any one of claims 20 to 37, wherein The first occlusal side of the first tooth receiving portion has a first flat outer surface, and the second occlusal side of the second tooth receiving portion has a second flat outer surface.

39. The apparatus according to any one of claims 20 to 38, further comprising one or more occlusal adjustment structures configured to facilitate mandibular advancement, wherein, The one or more occlusal adjustment structures are shaped and arranged to contact the patient's upper dental arch or a dental device on the patient's upper dental arch.

40. The apparatus according to claim 39, wherein, The one or more occlusal adjustment structures are shaped and arranged to contact corresponding one or more occlusal adjustment structures of the dental device on the patient's upper dental arch.

41. The apparatus according to any one of claims 20 to 40, wherein, One or both of the first occlusal side and the second occlusal side have a thickness configured to de-occlude the anterior teeth of the patient's lower dental arch.

42. The device according to any one of claims 20 to 41, wherein One or more of the bridging area, the first tooth receiving portion, and the second tooth receiving portion have a fan-shaped lingual surface that is shaped to engage the lingual surface of the corresponding tooth when the device is worn on the patient's lower dental arch.

43. The apparatus according to any one of claims 20 to 42, wherein, The bridging area is configured to conform to the lingual surface of the patient's lower dental arch when the device is worn by the patient.

44. The apparatus according to any one of claims 20 to 43, wherein, The bridging area is configured to conform to the lingual surface of one or more anterior teeth when the device is worn by the patient.

45. The apparatus according to any one of claims 20 to 44, wherein, The first tooth receiving portion includes one or more first tooth receiving cavities that are shaped to apply tooth alignment forces to correct the one or more first teeth, and the second tooth receiving portion includes one or more second tooth receiving cavities that are shaped to apply tooth alignment forces to correct the one or more second teeth.

46. A system for expanding a patient's lower dental arch, the system comprising: A series of expander devices, each of the series of expander devices being configured to incrementally expand the patient's lower dental arch towards a desired arch configuration based on a treatment plan, wherein each expander device of the series of expander devices includes a polymeric housing, the polymeric housing comprising: At least one tooth receiving portion shaped to receive one or more first teeth on a first side of the patient's lower dental arch, the at least one tooth receiving portion including a buccal side and an occlusal side; A lingual portion coupled to the at least one tooth receiving portion and arranged to contact the lingual surfaces of one or more second teeth on an opposite side of the patient's lower dental arch when the device is worn on the patient's lower dental arch; and A bridging portion, the shape and size of the bridging portion being designed to transmit an arch expansion force to the lingual portion according to a corresponding stage of the treatment plan.

47. The system according to claim 46, wherein, The width between the first side of the patient's lower dental arch and the opposite side of the patient's lower dental arch of the bridge is greater than the width between the first side of the patient's lower dental arch and the opposite side of the patient's lower dental arch at the start of the corresponding stage of the treatment plan.

48. The system according to any one of claims 46 to 47, wherein, The at least one tooth receiving portion includes one or more first tooth receiving cavities shaped to apply a tooth alignment force to correct the one or more first teeth or to prevent or limit the inclination of the one or more first teeth.

49. The system according to any one of claims 46 to 48, wherein, The bridging area is configured to conform to the lingual surface of the patient's lower dental arch when the device is worn by the patient.

50. The system according to any one of claims 46 to 49, wherein, The bridging area is configured to conform to the lingual surfaces of one or more anterior teeth when the device is worn by the patient.

51. A system for expanding a patient's lower dental arch, the system comprising: A series of expander devices, each of the series of expander devices being configured to incrementally expand the patient's lower dental arch towards a desired arch configuration based on a treatment plan, wherein each expander device of the series of expander devices includes a polymeric housing, comprising: A polymeric housing defining a plurality of tooth receiving cavities shaped to receive a plurality of teeth of the patient's lower dental arch, the polymeric housing having a lingual side, a buccal side and an occlusal side, wherein: The plurality of tooth receiving cavities are shaped to apply a tooth alignment force to correct one or more of the plurality of teeth according to a stage of a treatment plan when the polymeric housing is worn on the patient's lower dental arch; and At least a portion of the lingual side is harder than the buccal or occlusal side of the plurality of tooth receiving cavities and has an expansion width, wherein the lingual side is configured to apply an expansion force between opposing teeth according to a stage of the treatment plan when the polymeric housing is worn on the patient's lower dental arch, Further, wherein the expansion width of the expander devices of the series of expander devices increases over the course of the series.

52. The system according to claim 51, wherein, Each of the plurality of tooth receiving cavities of each expander device of the series of expander devices includes one or more openings arranged to permit exfoliation of one or more deciduous teeth of the patient's lower dental arch.

53. The system according to claim 52, wherein, The one or more openings are located on the occlusal side of the plurality of tooth receiving cavities.

54. The system according to claim 52, wherein, At least one of the plurality of tooth receiving cavities does not have the one or more openings.

55. The system according to any one of claims 51 to 54, wherein At least a portion of the lingual side of each expander device of the series of expander devices has a thicker wall than the walls of the buccal side or the occlusal side.

56. The system according to any one of claims 51 to 55, wherein, For each expander device of the series of expander devices, one or more of the lingual side, the buccal side, and the occlusal side have different thicknesses.

57. The system according to any one of claims 51 to 56, wherein, The plurality of tooth receiving cavities of each expander device of the series of expander devices are shaped to receive all of the teeth of the patient's lower dental arch.

58. The system according to any one of claims 51 to 57, wherein, One or both of the buccal side and the lingual side of each expander device of the series of expander devices include one or more attachment cavities configured to engage an attachment bonded to one or more of the plurality of teeth.

59. The system according to any one of claims 51 to 58, wherein The lingual side of each expander device of the series of expander devices is configured to distribute the expansion force between opposing teeth and anterior teeth of the patient's lower dental arch.

60. The system according to any one of claims 51 to 59, wherein, The lingual side of the polymeric housing is configured to conform to the lingual surface of the patient's lower dental arch when the device is worn by the patient.

61. The system according to any one of claims 51 to 60, wherein, The lingual side of the polymeric housing is configured to conform to the lingual surface of one or more anterior teeth when the device is worn by the patient.

62. A method of forming a mandibular expander device, the method comprising: generating an arch expansion treatment plan based on a patient's pre-treatment lower dental arch and a target lower dental arch configuration, wherein the arch expansion treatment plan includes a plurality of phases, each phase being configured to incrementally expand the patient's lower dental arch toward the target lower dental arch configuration; generating a series of virtual mandibular expander devices, wherein each of the virtual mandibular expander devices has a shape for implementing a corresponding phase of the arch expansion treatment plan, wherein at least one of the virtual mandibular expander devices includes a lingual side configured to apply an expansion force between opposing teeth of the patient's lower dental arch according to the corresponding phase of the arch expansion treatment plan; and manufacturing the mandibular expander device based on at least one of the virtual mandibular expander devices.

63. The method according to claim 62, wherein, Generating the series of virtual mandibular expander devices includes configuring a bridging region between the opposing teeth that transmits the expansion force between the opposing teeth.

64. The method according to any one of claims 62 to 63, wherein, Manufacturing the mandibular expander device includes 3D printing the mandibular expander device using a polymeric material.

65. The method according to any one of claims 62 to 64, wherein, Generating the arch expansion treatment plan includes integrating a tooth alignment force for aligning one or more teeth of the patient's lower dental arch with an arch expansion force for expanding the patient's lower dental arch.

66. The method according to any one of claims 62 to 65, wherein, Generating the arch expansion treatment plan includes applying an outward force on one or more anterior teeth of the patient's lower dental arch.

67. The method according to any one of claims 62 to 66, wherein At least one of the virtual mandibular distractor devices includes a tooth receiving portion configured to anchor at least one of the virtual mandibular distractor devices to the lower dental arch of the patient, wherein the tooth receiving portion includes a buccal side and an occlusal side.

68. The method according to any one of claims 62 to 67, wherein, At least one of the virtual mandibular distractor devices and the mandibular distractor device have walls of different thicknesses.

69. The method according to any one of claims 62 to 68, wherein, At least one of the virtual mandibular distractor devices and the mandibular distractor device have at least one opening to allow exfoliation of deciduous teeth or eruption of permanent teeth.

70. The method according to any one of claims 62 to 69, wherein, The lingual sides of at least one of the virtual mandibular distractor devices and the mandibular distractor device have a fan-shaped engagement surface configured to engage with the curved lingual surface of the opposing teeth.

71. A method of modifying a patient's lower dental arch, the method comprising: Receiving a digital model of the patient's lower dental arch, wherein the patient's lower dental arch has a current lower dental arch form; Identifying a target lower dental arch form; Comparing the patient's current lower dental arch form with the target lower dental arch form to identify a deviation between the patient's current lower dental arch form and the target lower dental arch form; and Formulating a treatment plan including a plurality of treatment phases to modify the patient's current lower dental arch form such that the patient's current lower dental arch form approximates or matches the target lower dental arch form.

72. The method according to claim 71, wherein, Identifying the target lower dental arch form includes identifying a target U-shaped lower dental arch form.

73. The method according to any one of claims 71 to 72, further comprising designing a lower arch expander for each of the plurality of stages, wherein, The lower dental arch distractor for each phase is configured to apply an estimated force between teeth on opposite sides of the patient's lower dental arch.

74. The method according to claim 73, further comprising manufacturing at least one of the lower dental arch distractors.

75. The method according to claim 73, wherein, Manufacturing at least one of the lower dental arch distractors includes transmitting a digital file of the design of at least one of the lower dental arch distractors to a manufacturing system.

76. The method according to any one of claims 71 to 75, further comprising: Dividing the treatment plan into a plurality of phases by applying a distractive force between teeth on opposite sides of the patient's lower dental arch to estimate the force required to achieve tooth and / or jaw movement in each phase, and designing a lower dental arch distractor for each phase, the lower dental arch distractor being configured to apply an estimated force between teeth on opposite sides of the patient's lower dental arch.

77. The method according to any one of claims 71 to 76, wherein, Dividing the treatment plan into a plurality of phases includes: dividing the treatment plan into a plurality of phases at least partially based on the magnitude of the force applied between the teeth.

78. The method according to any one of claims 71 to 77, wherein Identifying the target lower dental arch form includes selecting the target lower dental arch form from a library of target lower dental arch forms based on the patient's current lower dental arch form.

79. The method according to any one of claims 71 to 78, wherein, Identifying the target lower dental arch form includes using a trained neural network to provide one or more target lower dental arches based on the patient's current lower dental arch form.

80. A mandibular distractor device, comprising: A first tooth receiving portion shaped to receive one or more first teeth of the patient's mandible, the first tooth receiving portion having a first lingual side, a first buccal side, and a first occlusal side; A second tooth receiving portion, shaped to receive one or more second teeth of the patient's mandible, the second tooth receiving portion having a second lingual side, a second buccal side, and a second occlusal side; and a palatal strut coupling the first lingual side to the second lingual side, wherein the palatal strut is configured to maintain a width between the first lingual side and the second lingual side, and when the device is worn on the patient's lower dental arch, the width applies an expansion force between the one or more first teeth and the one or more second teeth to expand the patient's lower dental arch.

81. The apparatus according to claim 80, wherein, The palatal strut forms a passage between the first tooth receiving portion and the second tooth receiving portion for the patient's tongue to pass through.

82. The apparatus according to any one of claims 80 to 81, wherein, The palatal strut includes a single strut.

83. The apparatus according to any one of claims 80 to 82, wherein, The palatal strut includes a plurality of struts.

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