Methods and devices for correcting occlusion during palate dilation

Abstract

Methods and apparatus (devices, systems, etc.) for simultaneously applying palate dilation and forward forces to teeth of a subject. In some embodiments, an orthodontic device may include a palate region extending between two or more tooth engagement regions; and one or more elastic band attachments projecting laterally and / or forward from one or more tooth engaging regions that securely couple the elastic band to the headgear appliance. These methods and devices may be used for non-surgical correction of class III malocclusion during maxillary palate dilation therapy or during retention periods of palate dilation therapy (e.g., after most recent palate dilation).

Description

[0001] Priority requirements This patent application claims priority to U.S. Provisional Patent Application No. 63 / 489177, filed March 8, 2023, entitled "Class III Correction During Palatal Expansion," the entire contents of which are incorporated herein by reference. Background Technology

[0002] Although numerous orthopedic and orthodontic treatments for Class III malocclusion are documented in the literature, treating Class III malocclusion in growing subjects remains challenging. Class III malocclusion may be caused by maxillary defects, and a feasible treatment approach may be through downward and forward extension of the maxilla. Therefore, successful orthodontic correction with growth modification can provide non-surgical correction for patients with growing Class III malocclusion. In particular, maxillary expansion may be necessary to increase the lateral width of the maxilla in the treatment of Class III malocclusion. Palatal expansion in the treatment of Class III malocclusion can enhance orthodontic results by disrupting the maxillary suture system, which may be particularly effective in treating children.

[0003] However, existing non-surgical techniques for palatal expansion and / or treatment of Class III malocclusion are unsatisfactory. There is an urgent need for devices (e.g., systems) that can be conveniently worn for the stepwise treatment of Class III malocclusion and palatal expansion. In particular, it may be beneficial to provide methods and devices for removable palatal expanders (or palatal retainers) that can be used for the stepwise treatment of Class III malocclusion. Summary of the Invention

[0004] This article describes methods and apparatus for simultaneously expanding the palate of a subject (or retaining the expansion of the most recently expanded palate) and applying anterior force. The anterior force may be sufficient to correct Class III malocclusion. For example, the methods and apparatus (devices, systems, etc.) described herein can be used for non-surgical correction of Class III malocclusion by combining palatal expansion and / or retention. Although the methods and apparatus described herein can be used during maxillary palatal expansion treatment or during the retention period of palatal expansion treatment (e.g., after recent palatal expansion to correct Class III malocclusion), these methods and apparatus can also be used to treat patients who do not have Class III malocclusion, including: repositioning or reorienting teeth and / or anteriorly displacing the maxilla within the dental arch along anterior direction (e.g., by applying anterior force to stimulate separation and growth along sutures such as the posterior palatal suture and the maxillary-zygomatic suture).

[0005] Any of these methods and devices may include an elastic band attachment (e.g., hook, button, slot, etc.) included as part of a patient-removable and / or insertable palatal expander and / or palatal expander retention device for attaching one or more elastic materials (such as elastic rubber bands) to a headgear. The combination of a palatal expander and / or palatal retainer, elastic materials, and a headgear can be configured to correct Class III malocclusion while simultaneously and / or sequentially expanding a narrow maxillary dental arch.

[0006] For example, the methods and apparatus described herein include one or more palatal expanders and / or palatal expander retainers (in some examples, a series of palatal expanders and / or palatal expander retainers), one or more elastic band and headgear Class III malocclusion appliances. Generally, these methods and apparatus may include elastic band attachments, such as hooks, buttons, etc., as part of the palatal expander apparatus (specifically, including those integrated into the palatal expander apparatus), configured to be removably coupled to the headgear appliance via an elastic material (e.g., a band or rubber band). The elastic material can connect the palatal expander to the headgear appliance, specifically, a Class III headgear appliance. In some cases, this may allow for simultaneous treatment of both Class III correction and palatal expansion. After palatal expansion, treatment can continue during the retention period by including one or more elastic band attachments on the palatal retainer.

[0007] These methods and devices may be particularly advantageous compared to using palatal expanders and / or palatal retainers alone. Furthermore, palatal expanders and / or palatal retainers configured for use with one or more elastic bands and headbands can be specifically configured to apply two anterior forces without compromising palatal expansion (e.g., to correct Class III malocclusion) or, in some cases, further assist palatal expansion. Surprisingly, these devices may be patient-removable palatal expanders (and / or palatal retainers) that can apply significant anterior forces without removing the expander and / or retainer from the teeth, while still allowing the user relatively easy removal of the expander and / or retainer.

[0008] Any of the devices described herein may include one or more tooth attachment regions configured to engage with one or more dental attachments on a subject's teeth (e.g., bonded to a subject's teeth). In some examples, devices including elastic band attachments may be configured to apply forces that aid in engagement between the tooth attachment region and the dental attachment (e.g., pushing anterior portions of the engagement region against the dental attachment) to help retain the device on the subject's teeth when the elastic band is engaged with the headgear appliance.

[0009] Any of these devices can be configured to pull the maxilla (maxillary region) anteriorly around the midline suture of the subject from either side of the jawbone in a manner that enhances or maintains palatal expansion of the suture. In any of these devices, the elastic band attachment and / or headgear appliance can be configured such that the direction of the force applied to either side of the maxilla by the elastic element (e.g., elastic band) is guided parallel or anteriorly at a diverging angle. The net direction of the anterior force can be (or can approximate) in the direction of the zero moment line (ZML) passing through the center of resistance of the patient's dentition, thereby causing anterior translation of the maxilla. One or more elastic band attachments can be located on the buccal side of the palatal expander such that they can be coupled to the headgear appliance so that the elastic band extending from the palatal expander engages with the headgear appliance.

[0010] This document describes an orthodontic appliance comprising a left occlusal region configured to be removably worn on a subject's teeth in the left maxillary region, a right occlusal region configured to be removably worn on a subject's teeth in the right maxillary region, a palatal region between the left and right occlusal regions, a first elastic band attachment on the left occlusal region, and a second elastic band attachment on the right occlusal region. Any of these appliances may include multiple dental attachments configured to engage with one or more attachments on the subject's teeth to secure the left and right occlusal regions to the subject's teeth. Any of these appliances may optionally include a headgear configured to be worn on the subject's head. The headgear may include an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band and to the second elastic band attachment via a second elastic band.

[0011] The palatal region can be configured to apply an expansion force between the left and right occlusal regions to expand the subject's palate. The device can be configured such that the first and second elastic bands extend parallel to each other, or form a forward diverging angle when coupled to orthodontic appliances and headgear. The first and second elastic band attachments can include one of the following: hooks or buttons.

[0012] The first and second elastic band attachments may be located on the anterior buccal side of the left and right dental regions, respectively. In some examples, the first and second elastic band attachments are located on the posterior buccal side of the left and right dental regions, respectively. The first and second elastic band attachments may also be located on the buccal side of the left and right dental regions adjacent to the buccal occlusal interface, respectively.

[0013] The right elastic band attachment and the left elastic band attachment can be configured to push multiple tooth attachment regions against the tooth attachments on the subject's teeth when the first elastic band attachment and the second elastic band attachment are coupled to the elastic band attachment bridge via the first elastic band and the second elastic band.

[0014] Orthodontic appliances can be configured to be removable by the subject.

[0015] For example, this article describes a series of orthodontic appliances that are sequentially arranged and configured for sequential wear by a subject to expand the subject's palate and forward drag the subject's maxillary region. The series of orthodontic appliances includes, for each appliance in the series: a left occlusal region configured to be removably worn over the subject's teeth in the left maxillary region; a right occlusal region configured to be removably worn over the subject's teeth in the right maxillary region; a palatal region between the left and right occlusal regions; and left teeth. The first elastic band attachment on the junction area; a right elastic band attachment on the right junction area; a plurality of tooth attachment areas configured to engage with one or more attachments on the subject's teeth to secure the left and right junction areas to the subject's teeth; and a headgear appliance configured to be worn on the subject's head, wherein the headgear appliance includes an elastic band attachment bridge configured to be coupled to a first elastic band attachment via a first elastic band and to a second elastic band attachment via a second elastic band for each orthodontic appliance in the series.

[0016] Methods for manufacturing these devices are also described herein. For example, any of these methods and devices can be designed and configured as part of a series of patient-removable palatal expanders (in some examples, including or specifically designed for one or more retainers to be worn after palatal expansion). For example, methods for manufacturing a series of palatal expanders are described herein, wherein one or more palatal expanders in this series include an elastic band attachment configured to be fixed to an elastic material (e.g., a band) and a headgear to which the elastic material can be attached.

[0017] For example, the orthodontic device described herein includes a first dental engagement region configured to be removably worn over a first subset of the maxillary teeth of a subject; a second dental engagement region configured to be removably worn over a second subset of the maxillary teeth of a subject; a palatal region extending between the first and second dental engagement regions; and a first elastic band attachment projecting laterally and / or anteriorly from a buccal region (e.g., a first region) of the first dental engagement region, the elastic band attachment including an engagement surface configured to retain the elastic band extending anteriorly and protruding outside the subject's oral cavity.

[0018] These devices can be configured such that the connection between the elastic band attachment and the headgear appliance via the elastic band generates a net force direction that is approximately in line with the patient's ZML (zone of malposition) direction. Generally, this may mean that the elastic band attachment is positioned in a more forward direction (on the forward-to-back axis of the device) and closer to the gingiva (on the buccal gingival-occlusal axis of the device). For example, the first elastic band attachment may laterally protrude from the forward region on the buccal side of the first tooth engagement area. The buccal region of the first elastic band attachment protruding from the first tooth engagement area may be closer to the gingiva on the buccal gingival-occlusal axis, so that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially above the subject's gingiva.

[0019] The first elastic band attachment may include a groove formed (e.g., cut, manufactured, etc.) in a buccal region of the first tooth engagement area. In some examples, the groove is formed in the anterior region of a removal tab that extends away from the occlusal side of the device in a direction opposite to the buccal side of the device. In some examples, the groove includes a channel region leading to a retention region, wherein the diameter of the channel region is smaller than the diameter of the retention region.

[0020] The elastic band attachment can be any suitable configuration. For example, a first elastic band attachment may include a button, hook, slot, etc.

[0021] Generally, when the first tooth engagement region can be configured as a tangential tooth engagement region, the elastic band attachment can extend from the buccal side of the first tooth engagement region. For example, the first tooth engagement region can be part of a tangential region of the first tooth engagement region that is configured to hold the subject's tangential tooth.

[0022] In any of these devices, the first region on the buccal side of the first tooth engagement region may be located within a threshold distance of the generated lever arm and the center of resistance of the subject. The threshold distance may be, for example, approximately 1 mm, approximately 2 mm, approximately 3 mm, approximately 4 mm, approximately 5 mm, approximately 6 mm, approximately 7 mm, approximately 8 mm, approximately 9 mm, approximately 10 mm, etc.

[0023] Any of these devices may include a buccal extension that extends laterally from a first or second dental occlusal region, and when the device is worn on a subject's teeth, the buccal extension is configured to extend at least partially over the subject's gums, wherein a first region is located on the buccal extension.

[0024] Any of these devices may include a cut-out region extending near the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the buccal region of the first tooth engagement area. Generally, the term "cut-out" region refers to a space (e.g., negative space, notch, opening, gap, etc.) formed in the device (e.g., adjacent to the posterior side of the elastic band attachment in this example). As used herein, the "cut-out" region can be formed by any suitable technique, including: directly fabricating the region, cutting with a tool (knife, laser, etc.), ablation, etching, etc.

[0025] Generally, these devices may include a pair of elastic band attachments. For example, these devices may include a second elastic band attachment that protrudes laterally and / or anteriorly from the buccal region of the second tooth engagement area.

[0026] Any of these devices may include an auxiliary elastic band attachment that protrudes laterally and / or anteriorly from the buccal side of the first tooth engagement region, adjacent to the first elastic band attachment. The first elastic band attachment may be closer to the gingiva and more posteriorly than the auxiliary elastic band attachment, wherein the auxiliary elastic band attachment is configured such that the elastic band can engage the first and second elastic band attachments and can extend anteriorly out of the subject's oral cavity to apply a counter-torque to the orthodontic appliance.

[0027] Generally, the palatal region can be configured to apply an expansion force between the first and second dental occlusal regions to expand the subject's palate.

[0028] The engagement surface may include a plurality of contact points along the length of the engagement surface, the plurality of contact points being configured to redirect forces from the elastic band to an axis relative to the long axis extending from the dental device when worn. For example, a first elastic band attachment may include a polygonal engagement surface.

[0029] Generally speaking, orthodontic devices can be configured to be removably worn by the subject.

[0030] As mentioned, any of these devices may include a headgear orthodontic device configured to be worn on the subject's head. The headgear orthodontic device may be configured as an elastic band attachment bridge, which is configured to be coupled to a first elastic band accessory via a first elastic band.

[0031] For example, an orthodontic appliance may include a first dental occlusion region configured to be removably worn over a first subset of the maxillary teeth of a subject; a second dental occlusion region configured to be removably worn over a second subset of the maxillary teeth of a subject; a palatal region extending between the first and second dental occlusion regions; a first elastic band attachment projecting laterally and / or anteriorly from a first region on the buccal side of the first dental occlusion region; a second elastic band attachment projecting laterally and / or anteriorly from a second region on the buccal side of the first dental occlusion region, the elastic band attachment including an engagement surface configured to retain the elastic band; and a headgear configured to be worn on the head of a subject, wherein the headgear includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via the first elastic band.

[0032] Any device and method described herein can be configured such that the profile of the elastic band attachment is low, thereby improving the comfort and effectiveness of the elastic band attachment. For example, any device in these devices can include a cutout region in the posterior region of the elastic band attachment so that the profile (e.g., width) of the engagement surface to which the elastic band can engage can include the thickness of the buccal region. For example, an orthodontic device described herein includes a first dental engagement region configured to be removably worn over a first subset of the maxillary teeth of a subject; a second dental engagement region configured to be removably worn over a second subset of the maxillary teeth of a subject; a palatal region extending between the first and second dental engagement regions; a first elastic band attachment laterally projecting from the buccal region of the first dental engagement region, the elastic band attachment including an engagement surface configured to retain the elastic band; and a cutout region extending to the vicinity of the posterior side of the first elastic band attachment such that at least a portion of the engagement surface includes the thickness of the buccal region of the first dental engagement region.

[0033] The first elastic band attachment may laterally protrude from the anterior region on the buccal side of the first tooth engagement region and / or the buccal region of the first elastic band attachment protruding from the first tooth engagement region may be closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

[0034] The first elastic band attachment can be configured as a button.

[0035] In some examples, the buccal region of the first tooth engagement area may be part of the tangential region of the first tooth engagement area, which is configured to hold the subject's tangential teeth.

[0036] Any of these devices may include a second elastic band attachment that protrudes laterally and / or anteriorly from the buccal region of the second dental occlusion area. The palatal region may be configured to apply an expansion force between the first and second dental occlusion areas to expand the subject's palate. The orthodontic appliance may be configured to be removably worn by the subject.

[0037] The device described herein also includes multiple contact points for each elastic band, which can redirect the force applied by the elastic band. The multiple contact points may be located on the same elastic band attachment, on different elastic band attachments adjacent to each other, or both. For example, the orthodontic device may include a first dental engagement region configured to be removably worn over a first subset of the maxillary teeth of a subject; a second dental engagement region configured to be removably worn over a second subset of the maxillary teeth of a subject; a palatal region extending between the first and second dental engagement regions; a first elastic band attachment laterally projecting from a first region on the buccal side of the first dental engagement region; and an auxiliary elastic band attachment laterally projecting from a second region on the buccal side of the first dental engagement region, the auxiliary elastic band attachment being offset from the first elastic band attachment in the occlusal-gingival axis and the anterior-posterior axis.

[0038] The auxiliary elastic band attachment can be configured such that the first elastic band attachment is closer to the gingiva and further back than the auxiliary elastic band attachment. The first elastic band attachment can laterally protrude from the anterior region on the buccal side of the first tooth engagement region. The buccal region of the first elastic band attachment protruding from the first tooth engagement region may be closer to the gingiva on the buccal gingival-occlusal axis, so the first elastic band attachment is configured to be at least partially located above the subject's gingiva when the device is worn on the subject's teeth.

[0039] The first elastic band attachment may include a button. The buccal region of the first dental engagement region may be part of the tangential region of the first dental engagement region configured to fix the subject's tangential teeth. As mentioned, any of these devices may include a cut area extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the buccal region of the first dental engagement region.

[0040] Any of these devices may include a second elastic band attachment that protrudes laterally and / or anteriorly from a buccal region of the second dental engagement region; and a second auxiliary elastic band attachment that protrudes laterally from a second buccal region of the second dental engagement region, the second auxiliary elastic band attachment being offset from the second elastic band attachment.

[0041] The palatal region can be configured to apply an expansion force between the first and second occlusal regions to expand the subject's palate. The orthodontic appliance can be configured to be removably worn by the subject.

[0042] This document also describes devices in which one or more (preferably a pair) elastic band attachments are located on a tangential region of the device (e.g., configured to retain incisors). For example, an orthodontic device may include a first dental engagement region configured to be removably worn over a first subset of a subject's maxillary teeth, including the subject's incisors; a second dental engagement region configured to be removably worn over a second subset of a subject's maxillary teeth; a third dental engagement region configured to be removably worn over a third subset of a subject's maxillary teeth; a palatal region extending between the first, second, and third dental engagement regions; and a first elastic band attachment projecting laterally and / or anteriorly from a buccal region of the first dental engagement region, the elastic band attachment including an engagement surface configured to retain the elastic band such that the elastic band can extend anteriorly.

[0043] The first elastic band attachment may laterally protrude from the buccal anterior region of the first tooth engagement region. The buccal region of the first elastic band attachment protruding from the first tooth engagement region may be closer to the gingiva on the buccal gingival-occlusal axis, so that when the device is worn on a subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva. The first elastic band attachment may include a button. The first elastic band attachment may include a hook. Any of these devices may include a cutout region extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the buccal region of the first tooth engagement region.

[0044] The device may include a second elastic band attachment that protrudes laterally and / or anteriorly from a second region on the buccal side of the first tooth engagement region.

[0045] The palatal region can be configured to apply an expansion force between the first and second occlusal regions to expand the subject's palate. The orthodontic appliance can be configured to be removably worn by the subject.

[0046] This document also describes methods of using any of these devices. In some examples, the method may include providing a subject (e.g., a patient) with any of the devices described herein to treat the subject, including (but not limited to) treating Class III malocclusion by expanding the subject's palate. The method may include providing the subject with instructions for attaching the device, connecting the elastic band, wearing the device, and removing the device. Optionally, the subject may be instructed to apply an additional device for an additional treatment phase.

[0047] For example, a treatment method for a subject may include: providing an orthodontic appliance configured for wear by the subject to expand the subject's palate and advance the subject's maxillary region forward, wherein the orthodontic appliance includes a pair of occlusal regions configured to be removably worn over the subject's teeth and a palatal region between the occlusal regions, wherein each occlusal region includes an elastic band attachment projecting laterally and / or forwardly from a buccal region of each occlusal region, each elastic band attachment including an engagement surface configured to retain the elastic band; wherein the orthodontic appliance is configured to be coupled to a headband appliance by connecting an elastic band between each elastic band attachment and an elastic band attachment bridge of a headband appliance worn on the subject's head, such that an anterior force is applied from the elastic band to the subject's maxillary region. Any of these methods may be a treatment for Class III malocclusion.

[0048] Orthodontic appliances used in these methods may include any of the orthodontic appliances described herein, configured to be coupled to a headband appliance and apply a forward force from the elastic band in a direction approximating the zero torque line. The method may include an orthodontic appliance configured to apply a reaction force to the subject's teeth by coupling each elastic band to a plurality of contact points on the appliance to counteract rotational torque resulting from displacement of the elastic band relative to the zero torque line. The orthodontic appliance may be configured to be preloaded by mounting the elastic band to an elastic band attachment, wherein the elastic band attachment is configured to hold the elastic band within a channel when the elastic band is in an untensioned configuration. Any method described herein may include preloading the elastic band into the appliance.

[0049] Orthodontic appliances can be configured to be worn for 1 day to 4 weeks (e.g., 1 day to 3 weeks, 1 day to 2 weeks, etc.). As mentioned, each elastic band attachment may laterally protrude from the buccal anterior region of the occlusal area. Each elastic band attachment may protrude from the buccal region of the occlusal area, and when the orthodontic appliance is worn over the subject's teeth, the elastic band attachment is configured to be at least partially located above the gum line. One or both elastic band attachments may include a groove cut out in the buccal region of the first occlusal area.

[0050] The groove can be formed in the anterior region of the removed flap, which extends laterally away from the buccal side in a direction opposite to the occlusal side of the device. One or both elastic band attachments include a button. One or both elastic band attachments can include a hook. The buccal region of the first tooth engagement area can be part of the tangential region of the first tooth engagement area, which is configured to retain the subject's tangential teeth.

[0051] In some examples, treatment for Class III malocclusion may include: applying an orthodontic appliance to the maxillary teeth of a subject to expand the subject's palate and advance the subject's maxillary region forward, wherein applying the orthodontic appliance includes: attaching a first dental occlusal region over a first subset of the subject's teeth and attaching a second dental occlusal region over a second subset of the subject's teeth such that an expansion force is applied between the first and second dental occlusal regions to the palatal region; and coupling the orthodontic appliance to a headband appliance by connecting an elastic band between each elastic band attachment of one or more elastic band attachments protruding from the orthodontic appliance and an elastic band attachment bridge of a headband appliance worn on the subject's head such that an forward force is applied from the elastic band to the subject's maxillary region.

[0052] For example, coupling an orthodontic device to a headband appliance may include: coupling a first elastic band attachment to an elastic band bridge of the headband appliance via the elastic band, the first elastic band attachment projecting laterally and / or anteriorly from the buccal side of the first dental occlusion region. In some examples, coupling an orthodontic device to a headband appliance includes: coupling a first elastic band attachment and a second elastic band attachment to an elastic band bridge of the headband appliance via the elastic band, the first elastic band attachment and the second elastic band attachment each projecting laterally and / or anteriorly from the buccal side of the first dental occlusion region. Coupling an orthodontic device to a headband appliance may include: coupling a first elastic band attachment to an elastic band bridge of the headband appliance via a first elastic band, the first elastic band attachment projecting laterally and / or anteriorly from the buccal side of the first dental occlusion region; and coupling a second elastic band attachment to an elastic band bridge of the headband appliance via a second elastic band, the second elastic band attachment projecting laterally and / or anteriorly from the buccal side of the second dental occlusion region. In some cases, coupling an orthodontic device to a headband aligner includes coupling the elastic band between the headband aligner's elastic band attachment bridge and each of one or more elastic band attachments, wherein the one or more elastic band attachments include a slot. Coupling an orthodontic device to a headband aligner may include coupling the elastic band between the headband aligner's elastic band attachment bridge and each of one or more elastic band attachments, wherein the one or more elastic band attachments include a hook. In some examples, coupling an orthodontic device to a headband aligner includes coupling the elastic band between the headband aligner's elastic band attachment bridge and each of one or more elastic band attachments, wherein the one or more elastic band attachments include a button. Coupling an orthodontic device to a headband aligner may include coupling a first elastic band between the headband aligner's elastic band attachment bridge and one or more elastic band attachments including a plurality of contact points to apply a counter-rotational torque to the subject. In some examples, coupling an orthodontic device to a headband aligner includes coupling a preloaded elastic band to an elastic band attachment bridge of the headband aligner, wherein the elastic band is preloaded and secured in an elastic band attachment. Any of these methods may include: the subject removing the orthodontic device and applying a second orthodontic device.

[0053] This article also describes a treatment method for Class III malocclusion, comprising: applying an orthodontic approach to the maxillary teeth of a subject to expand the subject's palate and advance the subject's maxillary region forward, wherein applying the orthodontic approach comprises: attaching a first dental occlusal region over a first subset of the subject's teeth and attaching a second dental occlusal region over a second subset of the subject's teeth, such that an expansion force is applied between the first dental occlusal region and the second dental occlusal region to the palatal region; and coupling the orthodontic approach to the headband appliance by connecting an elastic band between each of one or more elastic band attachments protruding from the orthodontic approach and an elastic band attachment bridge of a headband appliance worn on the subject's head, such that an forward force is applied from the elastic band to the subject's maxillary region.

[0054] Any of these methods may include: coupling an orthodontic device to a headband appliance by coupling a first elastic band attachment, which protrudes laterally and / or anteriorly from the buccal side of the first dental occlusion region, to an elastic band attachment bridge of the headband appliance via the elastic band. Coupling an orthodontic device to a headband appliance may include: coupling a first elastic band attachment and a second elastic band attachment to an elastic band attachment bridge of the headband appliance via the elastic band, each protruding laterally and / or anteriorly from the buccal side of the first dental occlusion region. In some examples, coupling an orthodontic device to a headband appliance includes: coupling a first elastic band attachment to an elastic band attachment bridge of the headband appliance via a first elastic band, which protrudes laterally and / or anteriorly from the buccal side of the first dental occlusion region; and coupling a second elastic band attachment to an elastic band attachment bridge of the headband appliance via a second elastic band, which protrudes laterally and / or anteriorly from the buccal side of the second dental occlusion region. For example, coupling an orthodontic device to a headband aligner may include: coupling the elastic band between the headband aligner's elastic band attachment bridge and each of one or more elastic band attachments, wherein the one or more elastic band attachments include a slot. Coupling an orthodontic device to a headband aligner may include: coupling the elastic band between the headband aligner's elastic band attachment bridge and each of one or more elastic band attachments, wherein the one or more elastic band attachments include a hook. In some examples, coupling an orthodontic device to a headband aligner includes: coupling the elastic band between the headband aligner's elastic band attachment bridge and each of one or more elastic band attachments, wherein the one or more elastic band attachments include a button. Coupling an orthodontic device to a headband aligner may include: coupling a first elastic band between the headband aligner's elastic band attachment bridge and one or more elastic band attachments including a plurality of contact points to apply a counter-rotational torque to the subject. In some cases, coupling an orthodontic device to a headband includes coupling a preloaded elastic band to an elastic band attachment bridge of the headband, wherein the elastic band is preloaded and secured in an elastic band attachment.

[0055] Any of these methods may include: removing the orthodontic appliance from the subject and applying a second orthodontic appliance.

[0056] For example, this article describes a treatment method for Class III malocclusion, which includes: providing a series of orthodontic appliances configured for sequential wearing by a subject to sequentially expand the subject's palate and forward drag the subject's maxillary region, wherein each appliance includes a pair of dental occlusal regions configured to be removably worn over the subject's teeth; a palatal region between the dental occlusal regions; a pair of elastic band attachments; and a plurality of dental attachments configured to engage with one or more attachments on the subject's teeth to secure the dental occlusal regions to the subject's teeth, wherein each orthodontic appliance is configured to be coupled to a headgear appliance worn on the subject's head, wherein the headgear appliance includes an elastic band attachment bridge configured to be coupled to the elastic band attachments via two or more elastic bands. Any of these methods may include: sequentially and removably applying orthodontic appliances to expand the subject's palate while applying force to the maxillary region by means of two or more elastic bands (e.g., rubber bands) attached to the elastic bands of the headgear.

[0057] In any of these methods and apparatuses, the methods described herein may include: fabricating one or more palatal expanders and / or retainers using direct fabrication techniques. Any of these methods may include: providing a variety of elastic band attachments (e.g., hooks, buttons, slots, etc.) at any location. Methods for fabricating these apparatuses and methods for using these apparatuses are also described herein. For example, any of these methods may include methods that use these apparatuses simultaneously to expand the palate of a subject and correct Class III malocclusion.

[0058] All methods and apparatuses described herein, in whatever combination, are considered herein and can be used to achieve the benefits described herein. Attached Figure Description

[0059] A better understanding of the features and advantages of the methods and apparatus described herein will be obtained by referring to the following detailed description and accompanying drawings, in which illustrative embodiments are set forth: Figure 1 The illustration shows an example of a patient-removable palatal expander and a variety of different elastic band attachment features (“elastic band attachments”).

[0060] Figure 2A and Figure 2B An example of a patient-removable palatal expander that can be configured as part of a system for both palatal expanders and Class III adjustments, as described herein, is illustrated.

[0061] Figure 3The illustration shows an example of a palatal expander that includes dental attachments that can assist in retention within the oral cavity and an elastic band attachment for coupling a palatal expander to a headgear appliance to treat Class III malocclusion.

[0062] Figure 4 Examples of palatal expanders include dental attachments for retention and force application, as well as elastic band attachments for coupling a palatal expander to a headgear appliance for treating Class III malocclusion.

[0063] Figure 5A An example of a palatal expander is shown, comprising a dental attachment and an incision area (here shown as a slit in an open attachment) and an elastic band attachment for coupling a palatal expander to a headgear appliance to treat Class III malocclusion.

[0064] Figure 5B It includes, for example, Figure 5A Examples of palatal expanders, such as palatal expanders, and devices consisting of a pair of elastic bands and a headgear are shown.

[0065] Figure 5C Another example of a device including a palatal dilator with an elastic band attachment configured as a hook is shown.

[0066] Figure 6 Examples of headgear correctors that can be adapted to be used as part of the apparatus described herein.

[0067] Figure 7A and Figure 7B An example of a headgear orthotics that can be adapted as part of a device as described herein is illustrated.

[0068] Figure 8A Examples of headgear correctors that can be adapted to be used as part of a device as described herein.

[0069] Figure 8B An example of a headgear orthotics that can be adapted as part of a device as described herein is illustrated schematically.

[0070] Figure 9 An example of estimating the zero moment line (ZML) is illustrated schematically.

[0071] Figure 10 This is an example of a palatal expander device configured to apply forward force.

[0072] Figures 11A to 11B An example of an elastic band attachment with a low profile is illustrated.

[0073] Figure 11C and Figure 11D It shows including Figures 11A to 11B Side perspective view of the device with the elastic band attachment shown.

[0074] Figures 12A to 12B An example of a device (e.g., a palatal expander device) is illustrated, which includes an elastic band attachment configured to apply forward force when used with a headgear orthodontic appliance.

[0075] Figures 13A to 13C Examples are shown of devices including elastic band attachments configured to apply forward force when used with a headgear orthodontic appliance (e.g., a palatal expander device).

[0076] Figures 14A to 14B An example of a hook that can be used with any of the devices described herein is illustrated.

[0077] Figures 15A to 15B An example of a device is shown, including an elastic band attachment configured as a notch to apply forward force when used with a headgear orthodontic device.

[0078] Figures 16A to 16B An example of a variation of the notched elastic band attachment is shown.

[0079] Figures 17A to 17C An example of a device (e.g., a palatal expander device) comprising multiple elastic band attachments adjacent to each other and configured to provide rotational counter-torque (as described herein) is illustrated.

[0080] Figures 18A to 18B Another example of a device comprising multiple elastic band attachments adjacent to each other is illustrated.

[0081] Figures 19A to 19B The illustration shows an example of an elastic band attachment that includes multiple discrete contact points for the elastic band.

[0082] Figure 19C It shows including with Figures 19A to 19B An example of an apparatus with an elastic band attachment similar to the one shown.

[0083] Figure 20 Examples include devices (e.g., palatal expanders or palatal retainer devices) that include a pair of elastic band attachments projecting forward from the tangential tooth engagement area. Detailed Implementation

[0084] Generally, the methods and apparatus described herein can be used to apply anterior force to a subject undergoing or immediately following palatal expansion. In some cases, this anterior force can be used to correct Class III malocclusion. Alternatively or additionally, this anterior force can be used to align one or more teeth. Generally, the methods and apparatus described herein can include dental appliances configured as palatal expanders, or a series of such palatal expanders (e.g., a series of palatal expanders configured to be worn sequentially) and / or palatal retainers for use when expanding the palate of a subject. These dental appliances can be configured to be releasably or removably worn by the subject over the upper teeth and palatal region. These dental appliances can advantageously be removed by the subject and / or the subject's caregivers (e.g., parents, legal guardians, etc.). Dental appliances may be palatal expanders configured to engage with a headband appliance via one or more elastic bands. The headband appliance is configured to couple with an elastic band in front of the maxillary region to apply force from the elastic band to advance the maxillary region forward, while expanding the subject's palate or retaining previous expansion of the subject's palate.

[0085] Therefore, these devices can be configured as palatal dilators and / or palatal retainers, configured to retain previously dilated areas, and may include one or more elastic band attachments for coupling dental appliances (e.g., palatal dilators and / or retainers) to headgear appliances. For example, Figure 1 An example of device 161 is illustrated, which includes a first tooth receiving portion 163 and a second tooth receiving portion 163' separated by a palatal region 168. The tooth receiving portions may include one or more elastic band attachments that may be coupled to the buccal side of the device at a predetermined location 165 (or, in some examples, to the lingual side). Figure 1 The image shows four examples of elastic band attachments, including three types of hooks 163, 163', 163'' and a button 163'''. The elastic band attachment can be coupled to the device at a predetermined position 165, which can be selected to optimize the direction and / or amplitude of the force applied by the elastic band that couples the elastic band attachment to the headgear orthodontic device.

[0086] Because palatal expansion promotes skeletal changes along the anterior direction, applying anterior forces to correct Class III malocclusion is particularly advantageous when the subject's palate is undergoing expansion (or during a window after the palate has been expanded and is being retained in an expanded configuration). For example, lateral forces applied during palatal expansion (e.g., to separate the mid-palatal suture) may have a synergistic effect in stimulating separation and growth along suture lines such as the posterior palatal suture and the maxillary-zygomatic suture when combined with the anterior forces described herein (e.g., using a headgear appliance and elastic elements). Thus, anterior displacement of the maxilla can be enhanced by combining palatal expansion with the Class III orthodontic techniques disclosed herein. However, while this disclosure focuses on palatal expanders, the device can also be other dental appliances (mandibular arch expanders, aligners, retainers, etc.), and Class III orthodontic techniques and concepts can be similarly adapted to these other devices without the need for a palatal expander.

[0087] Figure 2A and Figure 2B The illustrations show alternative examples of devices configured as palatal expanders 261, 261'. These examples may include two or more elastic band attachments located in any suitable position, including on the anterior or posterior buccal region. The elastic band attachments may be positioned near the upper region (e.g., adjacent to the buccal / occlusal region, buccal) or further toward the gingival margin region of the device. In some cases, the elastic band attachments may be located on a reinforced buccal region of the palatal expander / retainer.

[0088] These devices can be manufactured using any suitable technology. For example, the device can be printed directly using 3D printing, and these features (e.g., one or more elastic band attachments) can be integrated into the device.

[0089] Generally, these palatal expanders can be configured for use with an appropriate headband appliance. For example, any of these palatal expanders can be attached to the headband appliance via one or more elastic bands (e.g., rubber bands). Any appropriate elastic band can be used, such as 1 / 4 inch, 5 / 16 inch, 3 / 8 inch, and / or 1 / 2 inch elastic bands. The elastic band can have any appropriate tensile strength, such as the force exerted by the elastic element when stretched, such as 8 ounces, 14 ounces, and 16 ounces. For example, 3 / 8 inch 8 ounce, 1 / 2 inch 14 ounce, 5 / 16 inch 14 ounce, 5 / 16 inch 16 ounce, and / or 1 / 2 inch 16 ounce bands can be used. If less correction is required, a smaller elastic element and lower tensile strength can be used.

[0090] Orthodontic appliances described herein (e.g., palatal expanders) may include tooth engagement regions for engaging at least a portion of the teeth (particularly molars) in the maxilla of a subject, and a palatal region extending between the tooth engagement regions, the palatal region being configured to be adjacent to and relatively positioned relative to the subject's palate when the subject wears the device. For example, Figure 3 An example of a palatal expander 100 is shown, which includes a pair of tooth engagement regions 103, 103' on either side of the device, connected by a palatal region 105. The palatal expander also includes a pair of elastic band attachments 150, 150' (shown as "buttons"). In this example, the device (which may be a palatal expander) also includes a pair of tooth attachment regions 107, each of which can (e.g., on either side of the device (on the buccal side of the subject's teeth; only one pair is visible)) surround a tooth attachment bonded to the subject's teeth. The tooth attachment can be secured (e.g., glued) to the teeth, its secured position allowing it to be removably coupled to one or more tooth attachment regions on the device. The tooth attachment can be used to assist in securing the device to the subject's teeth. As part of an initial step before wearing a series of devices, the tooth attachment can be glued (adhesive, etc.) to the teeth. Figure 3 In the example shown, the palatal region has a convex upper surface 127 opposite to the concave lower surface 108. The lower surface is the tongue surface (the surface facing the tongue); the upper surface faces the palate.

[0091] The dental engagement regions may be formed of one or more of the same materials as the palatal regions, or they may include different materials. The thicknesses of the dental engagement regions and the palatal regions may differ or be the same. In particular, the palatal regions may be thicker than the dental engagement regions. The thickness of the dental engagement regions may be thicker on the lateral sides of the device (e.g., buccal and / or lingual sides), and thinner (or partially or completely removed from the top of the dental engagement regions) across the apex. The thickness of the palatal regions may be uneven. For example, a palatal expander may be thicker near the midline of the device. Any palatal expander may include ribs or other supports (e.g., extending laterally between and / or perpendicular to the dental engagement regions). These ribs may be formed of the same material as the rest of the palatal regions (e.g., but thicker and / or shaped to have a cylindrical cross-sectional profile).

[0092] The internal (cavity) portion of the dental engagement area is typically configured to fit the outer contour of the subject's teeth and abuts directly against (or avoids) a portion of the teeth and / or gums to apply force. When worn by the subject, the contour of the upper surface of the palatal region, positioned adjacent to the palate, can match the actual or predicted shape of the subject's palate. As mentioned above, all or most of the palatal region can be separated from or isolated from the subject's palate when worn, thereby improving comfort and minimizing interference with speech.

[0093] In some variations, a portion of the palatal region extending between the opposing tooth engagement areas on either side of the device (e.g., a portion of approximately z% of the distance between the tooth engagement areas, where z is greater than approximately 30%, 40%, 50%, 60%, 70%, 80%, 90%, etc.) may be flat or straight, rather than curved, so that it does not necessarily follow the contours of the subject's oral cavity. This portion may be one or more transverse ribs, struts, or supports, or it may be a flat plate. Such a flat or straight portion can provide increased force. Alternatively or additionally, the palatal region (e.g., one or more ribs, plates, etc.) may be curved into an arc similar to the arc of the subject's palate, but may have a much larger radius of curvature (manifested as a smaller concavity) than the subject's palate.

[0094] As mentioned above, any device described herein may include one or more tooth attachment regions or sites (also referred to herein as attachment openings, attachment couplers, etc.) for coupling to dental attachments on the subject's teeth. In particular, it may be helpful to use one or more (e.g., a pair) tooth attachment regions on each buccal side of the device. Furthermore, the tooth attachment region may be an opening through the expander. Open structures (attachment sites) on orthodontic expanders can interact with dental attachments located on the teeth to improve the overall retention of the appliance and, in some cases, can be used to generate force features that facilitate tooth alignment, including limiting or preventing teeth from rolling toward the cheek when the palate is expanded. These features can be helpful, especially when included as part of a device that is directly fabricated (e.g., 3D printed) for rapid (e.g., stage 1) palatal expansion. Furthermore, although dental attachments are typically bonded to one or more teeth and protrude into complementary openings or cavities on the device, this configuration may be reversed in some or all of these features; for example, the protruding dental attachment may be a portion of an expander that can be inserted into an opening / cavity bonded to the user's tooth.

[0095] Any suitable tooth attachment area can be used; in particular, any suitable size and / or shape can be used. As mentioned, in some examples, the tooth attachment area can be an open structure 117 on the device, thereby improving the retention of the appliance above the tooth attachment, and may include force features for tooth alignment, such as... Figure 4 As shown. For example, the tooth attachment region 117 may include circular, elliptical, square, rectangular, triangular, or other openings through the expander (e.g., on the lateral side (e.g., buccal side) of the tooth restoration region of the expander). The tooth attachment region may be keyed relative to the tooth attachment; generally, the tooth attachment may be configured to mate with the tooth attachment region in one orientation or a specific orientation. An open tooth attachment region may also reduce the appliance's incompatibility with poorly cured attachments.

[0096] Alternatively, such as Figure 3 As shown, the tooth attachment region can be closed. Generally, any of these tooth attachment regions can introduce biomechanical forces in the device between the tooth attachment region and the tooth attachment, which, for example, includes a keyed region, as described above, that transmits rotational forces in an open plane (e.g., abutting against a tooth surface). In some variations, the tooth attachment can be snapped or coupled to the tooth attachment region in a manner requiring force to disengage.

[0097] like Figure 3 As shown, a device may include a tooth attachment region that surrounds the tooth attachment and helps maintain its retention in the oral cavity. Alternatively, as... Figure 4 As shown, the tooth attachment area can have an open structure.

[0098] Figure 5A Another example of an orthodontic appliance as described herein is illustrated, configured as a palatal expander comprising a pair of elastic band attachments 150, 150'. In this example, the elastic band attachments are located on the anterior region of the buccal side of the appliance (although in some examples they may be positioned toward the posterior part of the mouth, e.g., in the posterior region). In any of the appliances described herein, the device may also include one or more incision regions, wherein the incision regions (e.g., grooves, slits, etc.) open toward the sides or edges of the appliance. Incision features such as these incision regions can increase flexibility in adjacent regions, such as the buccal surface. When connected to or adjacent to an attachment region opening, as Figure 5A As shown, this configuration can increase or decrease the retention of tooth attachments in the tooth attachment area. Figure 5AIn this design, an incision area (slit 305) has been added to the open structure 307 to increase the flexibility of the appliance above the dental attachment. As described below, in some cases, the device may include an incision area behind the elastic band attachment.

[0099] Figure 5B The illustration shows an orthodontic appliance 401 (such as a headgear aligner 555) coupled to a headgear aligner 555 via a pair of elastic bands 557, 557'. Figure 5A Example of an orthodontic appliance shown. A pair of elastic band attachments 550, 550' are shown coupled to a pair of elastic bands 557, 557', and schematically coupled to a headgear appliance 555. The device is configured such that the bands are substantially parallel. In some examples, the bands may diverge (such that the bands are angled forward relative to each other). In this example, the dental attachments and coupled dental attachment areas are connected to secure the expander 401 to the subject's tooth 404 (model).

[0100] Figure 5C Another example of an orthodontic device 401' coupled to a headgear (not shown) via a pair of elastic bands 557' is illustrated. In this example, the elastic band attachments 551 are shown as hooks, which can be formed by creating spaces or notches (e.g., by cutting, directly making notches, etc.) and optionally reinforcing (e.g., by thickening, etc.) the area of ​​the appliance.

[0101] Figure 6 An example of a headband orthodontic appliance 601 suitable for use is shown, which includes a headband orthodontic elastic band attachment bridge 607 that extends in front of the subject's mouth when worn. The elastic band attachment bridge can be configured to be coupled to an elastic band attachment on an orthodontic appliance via one or more elastic bands. To control the angle between the elastic bands connecting the elastic band attachment bridge to the orthodontic appliance, the length of the elastic band attachment bridge can extend away from the midsagittal plane of the head (e.g., to the left and right) to the outer corner of the mouth. The device may include a monolithic elastic band attachment bridge, or the elastic band attachment bridge may have two or more sections that can be connected / coupled together.

[0102] Figures 7A to 7B and Figures 8A to 8B Other examples of headgear calipers 701, 701' that can be adapted for use with the devices described herein are illustrated. For example, Figure 8A An example of a headgear 801 is shown, which includes an elastic band attachment bridge 807 to which an elastic band can be coupled and to an elastic band attachment on a patient-removable palatal expander, as described herein. The headgear can be attached to the head of a subject and may include a frame and one or more support pads. Figure 8B schematically shown Figure 8A Another example of a cap-and-arm orthodontic appliance includes an elastic band attachment bridge 807. The methods and apparatus described herein can be used with any reverse-pulling cap-and-arm orthodontic appliance and / or other external dental appliances that utilize elastic elements.

[0103] Generally, the force applied by one or more elastic bands of a connecting device (e.g., a palatal expander device) can be configured to be primarily anterior, to drive the maxilla and / or move the maxillary teeth anteriorly within the dental arch, for example, to correct Class III malocclusion, while minimizing or avoiding rotational torques on the maxilla (e.g., torques that may unintentionally cause the maxilla to rotate about an axis orthogonal to the sagittal plane). This can be achieved, for example, by coordinating the position of the elastic band attachments such that the connection between the elastic band attachments and the headgear appliance is aligned with the patient's zero-torque line (referred to herein as the "zero-torque line" or "ZML"). Figure 9 The diagram illustrates the zero-torque line. Generally, the zero-torque line is a force line that passes through the center of resistance (CR) and results in pure translation (not rotation). Therefore, applying a force along the zero-torque line may result in translation of the maxilla without rotation, which is desirable in most cases.

[0104] For any given subject, the ZML can be estimated based on the subject's center of impedance (CR) of the dentofacial complex and also on the location of external anchors (e.g., the elastic band attachment bridge of a headcap appliance). In some examples, the center of impedance of the subject's dentofacial complex can be estimated on the bedside based on the determination of the subject's functional occlusal plane (FOP), the subject's Frankfurt horizontal (FH) plane (or, in some cases, the subject's orbital line), and a vertical line through the distal root of the first permanent maxillary molar region. Although some adjustments can be made to the location of the external anchors to alter the ZML, the level of adjustment is practically limited by the subject's anatomy (e.g., the location must allow one or more elastic bands to enter the subject's oral cavity through the lips). Therefore, as described herein, the ability to precisely control the location of the contact points at the device (e.g., the elastic band attachment of a palatal expander) for better alignment with the ZML has significant benefits.

[0105] Figure 9The diagram schematically illustrates these landmarks, including the elastic band attachment bridge 907, relative to the worn headgear appliance 901, and the resulting ZML. Generally, the position of one or more elastic band attachments on the palatal expander device can be configured such that the resultant force exerted by the elastic band is primarily located on the ZML. Therefore, in some cases, it may be advantageous to position the elastic band attachments further forward of the device, particularly further forward of the buccal surface, and / or further gingival (e.g., towards the gingival margin on the occlusal-gingival axis). The position of the elastic band attachments on the device can be optimized by selecting a location close to the ZML, in some cases with the goal of reducing rotational torque. Any variation from the ZML may produce a lever arm with respect to the CR, which is the perpendicular distance between the line of action of the force (at the point of contact of the respective elastic band attachment) and the CR. A larger lever arm implies a greater tendency to cause rotation. Therefore, the methods disclosed herein include minimizing the lever arm, which, in the standard context of Class III orthodontic treatment using a palatal expander, positions the elastic band attachments in a more anterior and / or more gingival region of the palatal expander. Positioning this location may involve determining (e.g., through iterative adjustment) a position where the lever arm is below a threshold distance (e.g., within approximately 1 mm, approximately 2 mm, approximately 3 mm, approximately 4 mm, approximately 5 mm, etc.). Generally, the geometry of the palatal expander device when worn dictates that placing the elastic band attachments more anteriorly and / or more gingivally will bring them closer to the ZML (Zero-Mill-Low) positioning.

[0106] Figure 10 An example of a device 1000 (e.g., a palatal expander or retainer device) including elastic band attachments 1050, 1050' is illustrated. In this example, the device includes a palatal region 1035 extending between a first dental occlusal region 1003 and a second dental occlusal region 1003', the first dental occlusal region 1003 being configured to be removably worn over a first subset of the maxillary teeth of a subject, and the second dental occlusal region 1003' being configured to be removably worn over a second subset of the maxillary teeth of a subject. The first and second dental occlusal regions each include a lingual side 1057, an occlusal side 1033, and a buccal side 1031, as well as an anterior-posterior axis 1064 and an occlusal-gingival axis 1063. At least one of the tooth engagement regions includes a removal flap 1044 that extends from the buccal side (e.g., from the buccal side on the gingival side outward, which can be used to assist in the removal of an instrument).

[0107] exist Figure 10The device also includes a pair of elastic band attachments 1050, 1050' that project laterally from the buccal side 1031 of the first dental occlusal region 1003 and the second dental occlusal region 1003'. Each elastic band attachment 1050 includes an engagement surface 1046 configured to retain the elastic band, which extends forward and out of the subject's oral cavity, to apply force in a forward direction 1042, 1042'. This force is applied to the device, which then applies the force to the teeth and maxilla of the subject wearing the device.

[0108] exist Figure 10 In this design, the elastic band attachment is shown as a button-shaped attachment having a post extending from the buccal side of the mating surface 1046. Other attachments, including hooks and notches, may be used. The elastic band attachment may be positioned anteriorly and may be on the gingival side of the buccal surface. In some cases, the device may be configured such that when the device is worn, the elastic band attachment is at least partially located above the gingiva.

[0109] Of any of these devices, it may be particularly advantageous to reduce the amount of the elastic band attachment extending laterally from the buccal side (referred to as the overall protrusion of the elastic band attachment). The smaller the protrusion of the elastic band attachment, for example, the less the elastic band attachment protrudes from the buccal side, the less likely it is to cause discomfort and interfere with the anatomy of the subject's mouth.

[0110] Therefore, in some cases, it is particularly advantageous to reduce the protrusion of the elastic band attachment, preferably without reducing the engagement surface configured to retain the elastic band. For example, Figures 11A to 11D An example of an elastic band attachment is illustrated, which can be configured to reduce the protrusion while minimizing the width of the elastic band attachment engagement surface. Figure 11A An example of an elastic band attachment 1150 configured as a button is shown. In this example, the elastic band attachment includes a cap region 1135 and a post 1131, the outer surface of which forms an elastic band that can abut against a mating surface 1133 (e.g., as shown). Figure 11B As shown, the elastic band 1139 surrounds the column 1133. Figure 11A In the middle, the elastic band attachment 1150 extends laterally from the buccal side 1157 of the palatal expander 1137.

[0111] Generally, any of these devices may include a buccal extension from which an elastic band attachment extends. When the device is worn, the buccal extension allows the elastic band attachment to extend laterally away from the buccal side of the device, which helps to minimize contact between the elastic band attachment and / or the attached elastic band and the gums (and thus minimize irritation). The buccal extension also helps to position the elastic band attachment more linearly with the ZML (Zygomatic Alveolar Marrow).

[0112] The elastic band attachment in this example includes a cutout region 1141 on the rearward side of the post 1131. The cutout region extends to the base of the post 1131, such that the effective width 1147 of the engagement surface 1133 on the rearward side of the post 1131 is greater than the width of the engagement surface 1133' on the front side. This is because the width of the engagement surface on the rearward side includes the thickness of the cheek side 1142 in that region (e.g., Figure 11B (As shown), this thickness has been removed by the incision area 1141. On the anterior side, because the engagement surface 1133' extends only to the buccal surface of the dental appliance, its width is smaller.

[0113] like Figure 11B As shown, the elastic band 1139 typically surrounds a region of the engagement surface on the rearward side of the elastic band attachment. Furthermore, as... Figure 11B As illustrated, because the elastic element contacts the elastic band attachment at a certain angle, the cut-out area behind the elastic band attachment increases the cheek-side width of the effective engagement area of ​​the elastic band attachment without increasing the protrusion of the button.

[0114] Figure 11C and Figure 11D They respectively showed the same as Figures 11A to 11B The device shown is similar to a rear view and a front view of a device 1100. In these examples, the elastic band attachments 1150, 1150' each include a rearward cutout region 1141, which is used to increase the thickness of the buccal side 1131 to maintain an effective engagement surface of the elastic element. The device in this example also includes a removal tab 1144 on the buccal side. Although Figure 10 and Figures 11A to 11D Examples are shown in which the device includes an elastic band attachment configured as a button, but in some cases, the elastic band attachment may be configured as a hook, notch and / or other engagement mechanism that can retain the elastic band.

[0115] For example, Figures 12A to 12B It shows the relationship with Figure 10 and Figures 11A to 11B Another example of a device similar to the one shown (e.g., a palatal dilator / retainer) where the elastic band attachment is configured as an offset hook or extension formed by a notched region. Figure 12AIn this device (e.g., a palatal expander configured to apply lateral expansion force and also configured to engage with one or more elastic bands and headgear appliances to provide forward force) 1200 includes a first tooth engagement region 1203 and a second tooth engagement region 1203', each including a buccal side 1231, an occlusal side 1233, and a lingual side. Each tooth engagement region also has an anterior-to-posterior axis 1264 and an occlusal-to-gingival axis. Figure 12A In this process, elastic band attachments 1250, 1250' on each tooth engagement region are formed as extensions (e.g., hook-shaped extensions), which include a proximal engagement surface 1233 formed by cutting a region 1241 on the proximal side; the resulting elastic band attachments 1250 extend laterally away from the buccal side, such as... Figure 12B As shown in more detail. The device also includes a removal tab 1244 and a tooth attachment region for coupling to one or more tooth attachments on the tooth.

[0116] exist Figures 12A to 12B In the illustrated elastic band attachment, the engagement surface is perpendicular to the cheek surface and can be formed by a cutout area on the cheek surface. The elastic band attachment may also include a rearwardly extending bent-over area (e.g., forming a hook), which helps secure the elastic band. In some examples, this area may be reinforced. Generally, the cheek surface area forming or supporting the elastic band attachment can be reinforced, for example, by increasing the size (thickness) of the area or by supporting the area using one or more additional materials or reinforcing structures. Figures 12A to 12B The elastic band attachments are sufficiently offset to allow for the use of thicker elastic elements while maintaining a relatively low convexity. In some examples, such as... Figures 12A to 12B The overall projection of the hook shown may be smaller than the projection of a button with the same engagement surface width. Although in Figures 12A to 12B In this context, the mating surface is shown as a plane that is substantially perpendicular to the buccal side, but in some cases, the mating surface may be at an angle relative to the buccal side plane (e.g., between 30 and 90 degrees, between 40 and 90 degrees, between 25 and 90 degrees, between 50 and 90 degrees, between 60 and 90 degrees, etc.).

[0117] In some examples, the elastic band attachment can be configured to extend forward from the cheek side of the device. For example, Figures 13A to 13C The illustration shows a device in which the elastic band attachment is configured as a forward-extending hook. Figure 13AIn this embodiment, the device 1300 is configured as a palatal expander or retainer, comprising a palatal region 1335 extending between a first occlusal region and a second occlusal region. Each occlusal region has an anterior-posterior axis 1364. In the illustrated example, the device also includes a pair of pull tabs 1344 to assist in the removal of the device. Figures 13A to 13B As shown, a pair of hooks 1350, 1350' extend forward from the buccal side of the first tooth engagement region. In this example, the hooks are cane-shaped and each hook includes a proximal engagement surface 1333 that can engage with an elastic band.

[0118] exist Figures 13A to 13C In the example devices shown, the contact point (contact point) of the elastic band attachment (e.g., a hook) is shown to be more forward relative to the body of the device, including the buccal side, and (in this configuration) this forward position allows the elastic band attachment to be more closely aligned with the ZML for the subject. In any of these devices, the size and relative position and orientation (e.g., relative to the buccal side) of the elastic band attachment can be adjusted and / or optimized to align the force from the elastic band with the ZML.

[0119] For example, Figures 14A to 14B An example of an elastic band attachment 1450 is illustrated, wherein the elastic band attachment 1450 is configured to have a forwardly extending hook for a rearward engagement surface 1433 for the elastic band. In this example, the dimensions shown are intended for a single example only and can be adjusted based on the subject's anatomy and / or headgear, including a zero-torque line specifically for the subject. In any of these examples, the dimensions of the elastic band attachment for the hook-like extension can be varied based on patient-specific needs and physician preferences, such as the type of elastic element to be used. The length of the hook's axis, the radius of curvature of the hook, the cross-sectional diameter of the hook, etc., can be adjusted and / or selected.

[0120] In some examples, a forward protrusion including the incision area can be used instead. Figures 13A to 13C and Figures 14A to 14B A cane-shaped hook. For example, the buccal surface of the device can protrude further forward (e.g., the buccal geometry of one or more teeth in front of the conformal tooth engagement area), and a cut area can be set along this protrusion (with...). Figures 12A to 12B (Similar to the incision area 1241). In other examples, buttons may be placed on the anterior protrusion instead of using the incision area. In some examples, the anterior protrusion may not only cover the buccal surface but may also cover the occlusal and lingual surfaces of one or more additional anterior teeth. Such protrusions may have the added advantage of being less prone to breakage during manufacturing or use. (Similar to...) Figures 13A to 13C and Figures 14A to 14BSimilar to a hook, securing the elastic band to the forward protrusion allows for a more forward placement of the contact point, thus bringing it closer to the ZML.

[0121] The elastic band attachment may be formed as a notch cut from the buccal side in the lateral extension. In some cases, the elastic band attachment is formed as a notch cut in (or immediately adjacent to) the removal flap; in other cases, the elastic band attachment is cut into the buccal side and / or into the buccal extension located anterior to the removal flap.

[0122] For example, Figures 15A to 15B An example of a device 1500 configured as a palatal expander or retainer is shown, comprising a first tooth engagement region 1503 and a second tooth engagement region 1503', wherein a palatal region 1535 extends between the first and second tooth engagement regions. Each tooth engagement region includes a lingual side 1557, an occlusal side 1553, and a buccal side 1531. In this example, elastic band attachments 1550, 1550' are formed as notches in a region extending from the gingival margin of the buccal side 1531. In this example, the elastic band attachments are formed as notched regions in a laterally offset removal tab region. This can take full advantage of an existing removal tab 1544, which is offset from the device when the device is worn on the subject's teeth.

[0123] In any of these examples, the notched area can be configured to retain the elastic band. Figures 15A to 15B In the notch, the notch includes an engagement surface 1533 on the forward side. In any of the devices described herein, the elastic band attachment can be configured to securely hold the elastic band in a preloaded state. For example, the elastic band attachment may include a channel or neck region whose diameter is smaller than the outer diameter of the elastic band to be used when the elastic band is in a relaxed (unstretched) configuration, but whose diameter may be smaller than the diameter of the elastic band when the elastic band is stretched (e.g., thereby tightening the band diameter). The diameter of the channel can be set based on the intended type / size of the elastic band to be used.

[0124] In some examples, the device may include a buccal extension that extends above the gum line to allow the elastic band attachment to be placed closer to the gum line, thereby allowing for a reduced lever arm. The buccal extension may project laterally outward from the buccal side of the occlusal region. For example, the upper buccal extension on the left side may be angled outward from the buccal side of the left occlusal region. A gap may be provided between the buccal extension and the soft tissue of the gum line (e.g., to prevent tissue damage, discomfort, etc.).

[0125] Figures 16A to 16B An example of an elastic band attachment is illustrated (in this example, it is shown as a notched hook). Figures 16A to 16BAn example of the region of the cheek side 1631 of the device as described herein is shown. Figure 16A In this embodiment, the device includes an elastic band attachment area configured as a notch 1650, formed by cutting into the gingival margin of the buccal side 1631 of the device. In this example, the notch is configured to securely hold the elastic band before coupling it to the headgear appliance, allowing the elastic band to be preloaded into the device. Alternatively, the elastic band can be first secured to both the headgear appliance and the device, and then the device can be worn in the mouth, stretching the elastic band in the process. This may facilitate securing the elastic band compared to a scenario where the subject must fix the elastic band in their mouth after wearing the device. Figure 16A In this design, the elastic band attachment has a notch in a channel region 1644 with a first notch 1647, wherein the channel region opens into a retention region 1646, which has a notch 1649 larger than the channel region. Therefore, the elastic band attachment can be preloaded to securely retain the elastic band within the retention region of the elastic band attachment, thereby allowing it to be coupled to the subject's upper dentition (maxilla), and the preloaded elastic band can be attached to a headgear appliance. When attached to the headgear appliance, the elastic band can be pulled against the engagement surface 1633 within the retention region 1646. Figure 16B Another example of an elastic band attachment configured as slot 1650' is shown, which also includes a narrow channel region 1644 that opens to a larger retaining region 1646 including a forward engagement surface 1633. The width of the channel region 1647 is smaller than the width of the retaining region 1649 and can be configured to be smaller than the outer diameter of the elastic band. Therefore, the elastic element can only slide out of the notch in a stretched state, which helps maintain the position of the elastic element while the device is attached to the teeth.

[0126] Any of these devices may include two or more elastic band attachments. Using multiple elastic band attachments allows for adjustment of the direction of the force applied by the elastic band. For example, in some cases, the tension in the elastic band may not be straight along the zero moment line (ZML). In addition to forward translation, this may result in a change in the impedance center (CR) of the subject's maxilla. M Undesirable torques can occur relative to the anchor point of the headgear (e.g., the elastic band attachment bridge of the headgear). This can lead to undesirable rotation or tooth movement, especially when the headgear and elastic band are designed solely to provide forward translation. To address this possibility, in some cases, a second elastic band attachment (or in others, a second elastic band contact point or more additional elastic band contacts) can provide an anti-rotational torque that prevents or reduces maxillary rotation. Examples of two button-type elastic band attachments are shown in [the image / description]. Figures 17A to 17CThe diagram is shown in the image.

[0127] exist Figure 17A The image shows the buccal side 1731 of the device, which includes a first elastic band attachment 1750 and a second (e.g., auxiliary) elastic band attachment 1732. In some examples, the auxiliary elastic band attachment may be positioned more posteriorly and more gingivally (on the occlusal-gingival axis) than the first elastic band attachment. Alternatively, in some examples, the auxiliary elastic band attachment may be positioned more posteriorly and more occlusally. In some cases, such as Figure 17B As shown, the same elastic band can be used with both the first elastic band attachment 1750 and the auxiliary elastic band attachment 1732. In this example, the elastic element is coupled to the headgear (e.g., at the elastic band attachment bridge of the headgear), and the force applied by the elastic band is F. kx As discussed above, coupling the elastic element to the elastic band attachment may result in an undesirable torque M. f This is especially true when the elastic band deviates from ZML. Figure 17B As illustrated, by using an elastic band attachment system (e.g., where the elastic band first wraps around the first attachment 1750 and then extends backward to wrap around the auxiliary elastic band attachment 1732 before extending to the headgear), the direction of the force applied by the rubber band can be adjusted by one or more auxiliary attachments. More complex wrapping around two or more posts can provide precise adjustments to apply a counter-moment force, which can be useful for clinicians to achieve slight rotations. Generally, the elastic band can be attached to the first attachment and redirected by one or more auxiliary attachments to change the direction of the force applied to the dental appliance. Figure 17B In the process, using auxiliary accessory 1732 to redirect the elastic band may result in the application of force around the CR. M The generated reaction torque M kx ,like Figure 17B The illustration is schematic. Therefore, redirecting the elastic band by combining multiple contact points (including auxiliary elastic band attachments) may generate a counter-torque that can prevent or reduce rotation of the maxilla (or prevent other undesirable movements). Figure 17B In the middle, F kx The main force is generated by the stretching of the elastic band. M f M is the undesirable torque around the elastic band attachment. kx The resistance center (CR) of the maxilla is caused by the elastic tension from the elastic element. M The surrounding reaction torque. Any suitable number of elastic band attachments can be used, not limited to two. For example, three, four, or five elastic band attachments can be used to make additional fine adjustments to the torque and force direction as needed.

[0128] Alternatively, in some cases, multiple elastic bands can be used on the same side of a palatal expander device configured to apply forward force. Such an example is... Figure 17C The diagram illustrates the use of the same configuration of a first elastic band attachment 1750 and an auxiliary elastic band attachment 1732. In this example, another elastic element is attached to each elastic band attachment, thereby providing two independent force vectors on each side of the subject's dentition. This allows for further adjustment of the magnitude and direction of the applied force (e.g., for each elastic element, the applied force can be Fkx1 and Fkx2). Any number of elastic band attachments can be used, not limited to two. For example, three, four, or five elastic band attachments can be used for additional fine-tuning control of the force. In some cases, asymmetrical pulling can be used on the left side compared to the right side, for example, by using different numbers of elastic bands on different sides to advance one side more forward relative to the other. The device 1700 also includes a pull-type removal tab 1744 for easy removal of the device.

[0129] Different types of elastic band attachments can be used on the same side (in variations that include two or more elastic band attachments). Figures 17A to 17C In this case, both the elastic band attachment and the auxiliary elastic band attachment are button-type attachments. Figures 18A to 18B The illustration shows an example where the first elastic band attachment is a button-type elastic band attachment 1850 and the auxiliary elastic band attachment is configured as a notch / hook-type elastic band attachment 1832. The auxiliary elastic band attachment 1832 includes an engagement surface 1833 as described above. It can be preloaded into the elastic band attachment when the elastic band is present. Once the device is coupled to the headgear (e.g., ) via the elastic element... Figure 18B The elastic band attachment bridge of the headgear (illustrated in the diagram) generates a force Fkx that can provide sufficient forward force to propel the maxilla forward and / or can be used to apply a counter-torque (not shown), for example, with Figure 17B Similar. The device also includes a pull-out removal tab 1844 for easy removal of the device.

[0130] In some cases, the same elastic band attachment may include multiple contact points that can alter one or more forces applied by the elastic element, including guiding the force in one direction to counteract any rotational torque that may occur, for example, when the force direction deviates from the ZML. For example, the elastic band attachment has a shape configured to have multiple (e.g., two or more) sides that provide multiple discrete contact points for the elastic band when attached to a headgear orthosis. In some examples, the elastic band attachment includes a post that, for example, forms a mating surface (as described above). Figures 11A to 11B(As described), and may include multiple discrete contact points for the elastic band. In one example, the elastic band attachment has a polygonal cross-section forming the engagement path. Figures 19A to 19C An example of an elastic band attachment with a hexagonal cross-section is illustrated, which includes multiple contact points 1983, 1983', etc. Figure 19A and Figure 19B As shown, the edges of the polygon can be used to create unique contact surfaces for the elastic band, thereby creating two distinct force vectors (e.g., one force vector on each side of the elastic band), which can be angled relative to the ZML. That is, the contact point can be deliberately selected by positioning and orienting this elastic band attachment, thus determining the angle at which the elastic band engages with the elastic band attachment. By optimizing the contact point, the engagement can be made closer to the ZML, thereby reducing undesirable forces and moments, and enhancing forward translation as previously discussed. Figure 19A A top view of an elastic band attachment 1950 is shown, which has a mating surface 1933 with a plurality of discrete contact points 1983 formed in a polygonal (e.g., hexagonal) cross-section of the elastic band attachment. Figure 19B Shown in side perspective view Figure 19A Elastic band accessories. Figure 19C It shows having, as Figures 19A to 19B An example of a device (e.g., a palatal expander or retainer device) 1900 comprising a pair of elastic band attachments 1950, 1950' is shown. The post forming the engagement surface of the attachment for contacting the elastic band can be any suitable shape (e.g., triangular, rectangular, octagonal) that allows for control of the contact point with the elastic band. In some examples, the post need not be polygonal, but may have a curved surface that still allows for discrete contact points (e.g., a surface with one or more peaks and valleys).

[0131] In any of these devices, one or more tooth engagement regions can be configured to receive an incisor, and an elastic band attachment can be coupled to the tangential tooth engagement region, and... Figure 2B and Figure 20 The similarity is shown. For example, in Figure 2BThe device (e.g., a palatal expander 261') includes a first dental engagement region 2005 configured to be removably worn over a first subset of the maxillary teeth of a subject, including the subject's incisors; a second dental engagement region 2003 configured to be removably worn over a second subset of the maxillary teeth of the subject; and a third dental engagement region configured to be removably worn over a third subset of the maxillary teeth 2003' of the subject. The device also includes a palatal region 2035 extending between the first, second, and third dental engagement regions. Two forward elastic band attachments are both shown extending from opposite ends of the first dental engagement region. Figure 20 In this design, a first elastic band attachment 2050 is configured as a button projecting laterally and anteriorly from the buccal region of the first tooth engagement area. The first elastic band attachment 2050 includes an engagement surface configured to retain the elastic band, allowing it to extend anteriorly. Figure 20 In the middle, the second elastic band attachment 2050' is configured to be with Figures 13A to 13C and Figures 14A to 14B The hook shown is similar to the one depicted. Figure 20 The configuration shown assists in pulling the elastic band along the zero-torque line by positioning the elastic band attachment at the foremost section of the device. Center or side incisors can be used. Any type of elastic band attachment can be used.

[0132] As discussed above, the device can be other dental appliances (mandibular arch expanders, braces, retainers, etc.) and can be applied by analogy to Class III orthodontic techniques and concepts. For example, to correct Class II malocclusion (e.g., overbite), a headband appliance and elastic elements can be used to advance the mandible (i.e., the lower jaw) and / or mandibular teeth. In this example, the elastic band attachment can be positioned on an appliance (e.g., a mandibular arch expander, brace) worn above the teeth of the mandible. The elastic band attachment can be positioned as described above by considering the ZML (e.g., minimizing the distance between the ZML and the elastic band attachment by positioning it closer to the gum or more forward). Moreover, auxiliary elastic band attachments can be used to generate appropriate reaction torque.

[0133] In any of the devices described herein, different elastic bands may be used, for example, elastic bands of different sizes and / or properties (elasticity). In use, any of these devices may be provided to attach to the patient's teeth to allow simultaneous and / or sequential palatal expansion and Class III orthodontic treatment.

[0134] Any of the devices described herein can be configured to apply force from the elastic band attachments to advance the maxilla forward. In some examples, this force can be balanced such that the net force exerted by one or more elastic band attachments acting on the headgear and dental appliance is a forward pulling force. For example, the elastic band between one or more attachments on each side of the dental appliance and the headgear can be balanced. However, in some cases, it may be desirable and / or beneficial to apply unequal forces between one or more elastic band attachments on the opposite side of the dental appliance and the headgear compared to one or more forces applied between one or more elastic band attachments on one side of the dental appliance and the headgear. For example, if the patient needs more advance on the left than the right (and vice versa), asymmetrical pulling can be used. This can be achieved by changing the position and / or orientation of one or more elastic band attachments on the left side of the dental appliance (compared to the right side) and / or by adjusting the attachment site of the elastic element on the headgear (e.g., an elastic band attachment bridge). For example, positioning the elastic band attachment on the left side further back than the elastic band attachment on the right side alters the force vector, potentially causing the maxilla to be pulled more to the left. Alternatively or additionally, asymmetrical pulling can be achieved by adjusting the type, size, or number of elastic bands connecting the elastic band attachments on the left side (compared to the right side of the dental appliance).

[0135] All publications and patent applications mentioned in this specification are incorporated herein by reference to the same extent as if each individual publication or patent application were specifically and individually indicated to be incorporated herein by reference. Furthermore, it should be understood that all combinations of the foregoing concepts and the additional concepts discussed in more detail below (provided these concepts do not contradict each other) are considered part of the inventive subject matter disclosed herein and can be used to achieve the benefits described herein.

[0136] Any method described herein (including the user interface) 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, tablet, smartphone, etc.), which, when executed by the processor, cause the processor to control any step of the execution process, including but not limited to: display, communicate with the user, analyze, modify parameters (including timing, frequency, intensity, etc.), determine, and issue warnings. For example, any method described herein can be executed 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 one or more processes of the method.

[0137] When a feature or element is referred to herein as being “on” another feature or element, it may be directly on the other feature or element, or there may be intermediate features and / or elements present. In contrast, when a feature or element is referred to as being “directly on” another feature or element, there are no intermediate features or elements. 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 may be directly connected, attached, or coupled to the other feature or element, or there may be intermediate features or elements 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, there are no intermediate features or elements. Although one embodiment has been described or illustrated, the features and elements thus described or illustrated can be applied to other embodiments. Those skilled in the art will also appreciate that a structure or feature mentioned as being “adjacent” to another feature may have portions overlapping with or below the adjacent feature.

[0138] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the invention. For example, as described herein, the singular forms “a,” “an,” and “described” are also intended to include the plural forms unless the context clearly indicates otherwise. It should also be understood that the terms “comprises” and / or “comprising,” when used in this specification, indicate the presence of the stated features, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term “and / or” includes any and all combinations of one or more of the listed items and may be abbreviated to “ / ”.

[0139] For ease of description, spatial relative terms such as “below,” “under,” “lower,” “above,” and “upper” are used herein to describe the relationship of an element or feature to other elements or features as illustrated in the accompanying drawings. It should be understood that, in addition to the orientations depicted in the drawings, spatial relative terms are also intended to cover different orientations of the device during use or operation. For example, if the device in the drawings is inverted, an element described as “below” or “under” other elements or features may be oriented “above” other elements or features. Thus, the exemplary term “below” can encompass both above and below orientations. The device may be oriented in other ways (rotated 90 degrees or in other orientations), and the spatial relative descriptors used herein shall be interpreted accordingly. Similarly, unless otherwise specifically indicated, the terms “up,” “down,” “vertical,” “horizontal,” etc., are used herein for illustrative purposes only.

[0140] 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 otherwise indicates. These terms may be used to distinguish one feature / element from another. Therefore, without departing from the teachings of the invention, the first feature / element discussed below may be referred to as the second feature / element, and similarly, the second feature / element discussed below may be referred to as the first feature / element.

[0141] In general, any apparatus and method described herein should be understood as inclusive, but all or a subset of components and / or steps may alternatively be exclusive and may be expressed as “consisting of various components, steps, sub-components or sub-steps” or alternatively “consisting substantially of various components, steps, sub-components or sub-steps”.

[0142] As used herein in the specification and claims, including as in the examples, and unless explicitly stated otherwise, all figures may be read as if they begin with the words “about” or “approximately”, even if the term is not explicitly stated. The phrase “about” or “approximately” may be used when describing magnitude and / or location to indicate that the described value and / or location is within a reasonably expected range of the value and / or location. For example, a numerical value may have values ​​as + / -0.1% of a set value (or range of values), + / -1% of a set value (or range of values), + / -2% of a set value (or range of values), + / -5% of a set value (or range of values), + / -10% of a set value (or range of values), etc. Unless the context otherwise indicates, any numerical value given herein should also be understood to include approximately or approximate that value. For example, if the value “10” is disclosed, “about 10” is also disclosed. Any numerical range described herein is intended to include all subranges contained therein. It should also be understood that, as should be properly understood by those skilled in the art, when a value is disclosed as "less than or equal to" that value, "greater than or equal to" that value and the possible range between the value are also disclosed. For example, if the value "X" is disclosed, then "less than or equal to X" and "greater than or equal to X" (e.g., where X is a numerical value) are also disclosed. It should also be understood that throughout the application, data is provided in several different formats, and this data represents the end and beginning points and ranges for any combination of data points. For example, if a specific data point "10" and a specific data point "15" are disclosed, 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 are considered to be disclosed in the same way as between 10 and 15. It should also be understood that each unit between two specific units is also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0143] Although various illustrative embodiments have been described above, any of several changes may be made to the various embodiments without departing from the scope of the invention as described in the claims. Optional features of the various device and system embodiments may be included in some embodiments but not in others. Therefore, the foregoing description is provided primarily for illustrative purposes and should not be construed as limiting the scope of the invention as set forth in the claims.

[0144] This disclosure includes the following numbered terms.

[0145] Clause 1. An orthodontic device comprising: a first dental occlusion region configured to be removably worn over a first subset of maxillary teeth of a subject; a second dental occlusion region configured to be removably worn over a second subset of maxillary teeth of the subject; a palatal region extending between the first dental occlusion region and the second dental occlusion region; and a first elastic band attachment projecting laterally and / or anteriorly from a first region on the buccal side of the first dental occlusion region, the elastic band attachment including an engagement surface configured to retain an elastic band extending anteriorly and protruding outside the oral cavity of the subject.

[0146] Clause 2. The device according to Clause 1, wherein the first elastic band attachment protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

[0147] Clause 3. The apparatus according to any one of Clauses 1 to 2, wherein the first region is located within a threshold distance of the generated lever arm from the impedance center of the subject.

[0148] Clause 4. The device according to any one of Clauses 1 to 3 further includes a buccal extension that extends laterally from the first or second dental engagement region and is configured such that when the device is worn on the subject's teeth, the buccal extension extends at least partially above the subject's gums, wherein the first region is located on the buccal extension.

[0149] Clause 5. The device according to any one of Clauses 1 to 4, wherein the first elastic band attachment includes a groove in the region cut into the buccal side of the first dental engagement region.

[0150] Clause 6. The device according to Clause 5, wherein the groove is formed in the anterior region of the removal flap, the removal flap extending away from the buccal side of the device in a direction opposite to the occlusal side of the device and laterally to the buccal side.

[0151] Clause 7. The apparatus according to Clause 5, wherein the groove includes a channel region leading to a retaining region, wherein the diameter of the channel region is smaller than the diameter of the retaining region.

[0152] Clause 8. The device according to any one of Clauses 1 to 7, wherein the first elastic band accessory comprises a button, a notch, or a hook.

[0153] Clause 9. The device according to any one of Clauses 1 to 8, wherein the buccal region of the first tooth engagement region is part of a tangential region of the first tooth engagement region, the tangential region being configured to retain the subject's tangential teeth.

[0154] Clause 10. The device according to any one of Clauses 1 to 9 further includes a cut area extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the region on the buccal side of the first tooth engagement region.

[0155] Clause 11. The device according to any one of Clauses 1 to 10 further comprises a second elastic band attachment, the second elastic band attachment projecting laterally and / or anteriorly from the buccal region of the second dental engagement area.

[0156] Clause 12. The device according to any one of Clauses 1 to 11 further includes an auxiliary elastic band attachment that protrudes laterally and / or anteriorly from a region adjacent to the first elastic band attachment on the buccal side of the first tooth engagement region.

[0157] Clause 13. The device according to Clause 12, wherein the first elastic band attachment is closer to the gum and more posterior than the auxiliary elastic band attachment, wherein the auxiliary elastic band attachment is configured such that the elastic band can engage the first elastic band attachment and the second elastic band attachment, and can extend anteriorly out of the subject's oral cavity to apply a counter-torque to the orthodontic device.

[0158] Clause 14. The apparatus according to any one of Clauses 1 to 13 further includes a headgear orthodontic device configured to be worn on the head of the subject, wherein the headgear orthodontic device includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band.

[0159] Clause 15. The device according to any one of claims 1 to 14, wherein the palatal region is configured to apply an expansion force between the first dental engagement region and the second dental engagement region to expand the palate of the subject.

[0160] Clause 16. The device according to any one of Clauses 1 to 15, wherein the engagement surface includes a plurality of contact points along the length of the engagement surface, the contact points being configured to, when worn, redirect forces from the elastic band to an axis relative to the long axis of the elastic band extending from the dental device.

[0161] Clause 17. The device according to any one of Clauses 1 to 16, wherein the first elastic band attachment comprises a polygonal engagement surface.

[0162] Clause 18. The device according to any one of Clauses 1 to 17, wherein the orthodontic device is configured to be removably worn by the subject.

[0163] Clause 19. An orthodontic appliance comprising: a first dental occlusion region configured to be removably worn over a first subset of maxillary teeth of a subject; a second dental occlusion region configured to be removably worn over a second subset of maxillary teeth of a subject; a palatal region extending between the first and second dental occlusion regions; a first elastic band attachment projecting laterally and / or anteriorly from a first region buccal to the first dental occlusion region; a second elastic band attachment projecting laterally and / or anteriorly from a second region buccal to the first dental occlusion region, the elastic band attachment including an engagement surface configured to retain the elastic band; and a Class III malocclusion headgear configured to be worn on the head of the subject, wherein the headgear includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via the first elastic band.

[0164] Clause 20. An orthodontic device comprising: a first dental engagement region configured to be removably worn over a first subset of maxillary teeth of a subject; a second dental engagement region configured to be removably worn over a second subset of maxillary teeth of a subject; a palatal region extending between the first and second dental engagement regions; a first elastic band attachment laterally projecting from a buccal region of the first dental engagement region, the elastic band attachment including an engagement surface configured to retain the elastic band; and an incision region extending to a posterior periphery of the first elastic band attachment such that at least a portion of the engagement surface includes the thickness of the buccal region of the first dental engagement region.

[0165] Clause 21. The device according to Clause 20, wherein the first elastic band attachment protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

[0166] Clause 22. The device according to any one of Clauses 20 to 21, wherein the region of the first elastic band attachment protruding from the buccal side of the first tooth engagement region is closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

[0167] Clause 23. The device according to any one of Clauses 20 to 22, wherein the first elastic band accessory includes a button.

[0168] Clause 24. The device according to any one of Clauses 20 to 23, wherein the buccal region of the first tooth engagement region is part of a tangential region of the first tooth engagement region configured to retain the subject's tangential teeth.

[0169] Clause 25. The device according to any one of Clauses 20 to 24 further comprises a second elastic band attachment that protrudes laterally and / or anteriorly from the buccal region of the second dental engagement area.

[0170] Clause 26. The apparatus according to any one of Clauses 20 to 25 further includes a headgear orthodontic device configured to be worn on the head of the subject, wherein the headgear orthodontic device includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band.

[0171] Clause 27. The apparatus according to any one of Clauses 20 to 26, wherein the palatal region is configured to apply an expansion force between the first dental engagement region and the second dental engagement region to expand the palate of the subject.

[0172] Clause 28. The device according to any one of Clauses 20 to 27, wherein the orthodontic device is configured to be removably worn by the subject.

[0173] Clause 29. An orthodontic device, said device comprising: A first tooth occlusal region, configured to be removably worn over a first subset of the maxillary teeth of the subject; A second tooth occlusal region is configured to be removably worn over a second subset of the maxillary teeth of the subject. The palatal region extends between the first dental engagement region and the second dental engagement region; A first elastic band attachment, the first elastic band attachment protruding laterally from a first region on the buccal side of the first tooth engagement region; An auxiliary elastic band attachment, the auxiliary elastic band attachment protruding laterally from a second region on the buccal side of the first tooth engagement region, the auxiliary elastic band attachment being offset from the first elastic band attachment on the occlusal-gingival axis and the anterior-posterior axis.

[0174] Clause 30. The apparatus of Clause 29, wherein the auxiliary elastic band attachment is configured such that the first elastic band attachment is closer to the gingiva and more posterior than the auxiliary elastic band attachment.

[0175] Clause 31. The device according to any one of Clauses 29 to 30, wherein the first elastic band attachment protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

[0176] Clause 32. The device according to any one of Clauses 29 to 31, wherein the region of the first elastic band attachment protruding from the buccal side of the first tooth engagement region is closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

[0177] Clause 33. The device according to any one of Clauses 29 to 32, wherein the first elastic band accessory includes a button.

[0178] Clause 34. The device according to any one of Clauses 29 to 33, wherein the buccal region of the first tooth engagement region is part of a tangential region of the first tooth engagement region configured to retain the subject's tangential teeth.

[0179] Clause 35. The device according to any one of Clauses 29 to 34 further includes a cut area extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the buccal side of the first tooth engagement area.

[0180] Clause 36. The device according to any one of Clauses 29 to 35 further comprises a second elastic band attachment that projectes laterally and / or forwardly from a buccal region of the second dental engagement region; and a second auxiliary elastic band attachment that projectes laterally from a second buccal region of the second dental engagement region, the second auxiliary elastic band attachment being offset from the second elastic band attachment.

[0181] Clause 37. The apparatus according to any one of Clauses 29 to 36 further includes a headgear orthodontic device configured to be worn on the head of the subject, wherein the headgear orthodontic device includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band.

[0182] Clause 38. The device according to any one of Clauses 29 to 37, wherein the palatal region is configured to apply an expansion force between the first dental engagement region and the second dental engagement region to expand the palate of the subject.

[0183] Clause 39. The device according to any one of Clauses 29 to 38, wherein the orthodontic device is configured to be removably worn by the subject.

[0184] Clause 40. An orthodontic device, said device comprising: A first tooth occlusal region is configured to be removably worn over a first subset of the maxillary teeth of the subject, the maxillary teeth of the subject including the subject's incisal teeth; A second tooth engagement region is configured to be removably worn over a second subset of the maxillary teeth of the subject. A third tooth occlusal region, which is configured to be removably worn over a third subset of the maxillary teeth of the subject; A palatal region extending between the first dental occlusion region, the second dental occlusion region, and the third dental occlusion region; and A first elastic band attachment, the first elastic band attachment projecting laterally and / or anteriorly from a buccal region of the first tooth engagement area, the elastic band attachment including an engagement surface configured to retain the elastic band such that the elastic band can extend anteriorly.

[0185] Clause 41. The device according to Clause 40, wherein the first elastic band attachment protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

[0186] Clause 42. The device according to any one of Clauses 40 to 41, wherein the region of the first elastic band attachment protruding from the buccal side of the first tooth engagement region is closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

[0187] Clause 43. The device according to any one of Clauses 40 to 42, wherein the first elastic band accessory includes a button.

[0188] Clause 44. The device according to any one of Clauses 40 to 43, wherein the first elastic band accessory includes a hook.

[0189] Clause 45. The device according to any one of Clauses 40 to 44 further includes a cut area extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the region on the buccal side of the first tooth engagement region.

[0190] Clause 46. The device according to any one of Clauses 40 to 45 further comprises a second elastic band attachment that protrudes laterally and / or anteriorly from a second region on the buccal side of the first tooth engagement region.

[0191] Clause 47. The apparatus according to any one of Clauses 40 to 46 further includes a headgear orthodontic device configured to be worn on the head of the subject, wherein the headgear orthodontic device includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band.

[0192] Clause 48. The apparatus according to any one of Clauses 40 to 47, wherein the palatal region is configured to apply an expansion force between the first dental engagement region and the second dental engagement region to expand the palate of the subject.

[0193] Clause 49. The device according to any one of Clauses 40 to 48, wherein the orthodontic device is configured to be removably worn by the subject.

[0194] Clause 50. A treatment method for Class III malocclusion, said method comprising: An orthodontic appliance is provided, the orthodontic appliance being configured to be worn by a subject to expand the subject's palate and advance the subject's maxillary region forward, wherein the orthodontic appliance includes a pair of occlusal regions and a palatal region between the occlusal regions, the pair of occlusal regions being configured to be removably worn over the subject's teeth, wherein each occlusal region includes an elastic band attachment that protrudes laterally and / or forwardly from a buccal region of each occlusal region, each elastic band attachment including an engagement surface configured to retain the elastic band; The orthodontic device is configured to be coupled to the headband via an elastic band connecting an elastic band attachment bridge between each elastic band attachment and the elastic band attachment bridge of the headband worn on the subject's head, such that an anterior force is applied from the elastic band to the maxillary region of the subject.

[0195] Clause 51. The method according to Clause 50, wherein the orthodontic device is configured to be coupled to the headgear by applying the forward force from the elastic band in a direction approximating the zero torque line.

[0196] Clause 52. The method according to any one of Clauses 50 to 51, wherein the orthodontic appliance is further configured to apply a reaction force to the subject's teeth by coupling each elastic band to a plurality of contact points on the orthodontic appliance to counteract the rotational torque generated due to displacement of the elastic band relative to the zero torque line.

[0197] Clause 53. The method according to any one of Clauses 50 to 52, wherein the orthodontic appliance is configured to preload the elastic band into the elastic band attachment, wherein the elastic band attachment is configured to secure the elastic band within the channel when the elastic band is in an untensioned configuration.

[0198] Clause 54. The method according to any one of Clauses 50 to 53, wherein the orthodontic appliance is further configured to be worn for 1 day to 2 weeks.

[0199] Clause 55. The method according to any one of Clauses 50 to 54, wherein each of the elastic band attachments protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

[0200] Clause 56. The method according to any one of Clauses 50 to 55, wherein each of the elastic band attachments protrudes from the buccal region of the dental engagement area, and the elastic band attachments are configured to be at least partially above the gingiva when the orthodontic method is worn on the subject's teeth.

[0201] Clause 57. The method according to any one of Clauses 50 to 56, wherein one or both of the elastic band attachments include a groove cut out in the region on the buccal side of the first dental engagement region.

[0202] Clause 58. The device according to Clause 57, wherein the groove is formed in the anterior region of the removal flap, the anterior region extending laterally away from the buccal side in a direction opposite to the occlusal side of the device.

[0203] Clause 59. The method according to any one of Clauses 50 to 58, wherein one or both of the elastic band attachments include a button.

[0204] Clause 60. The method according to any one of Clauses 50 to 58, wherein one or both of the elastic band attachments include a hook.

[0205] Clause 61. The method according to any one of Clauses 50 to 60, wherein the buccal region of the first tooth engagement region is part of a tangential region of the first tooth engagement region, the tangential region being configured to retain the subject's tangential teeth.

[0206] Clause 62. The method according to any one of Clauses 50 to 61 further includes an incision region extending to the vicinity of the posterior side of each elastic band attachment, such that at least a portion of each engagement surface includes the thickness of the region on the buccal side of the first tooth engagement region.

[0207] Clause 63. The method according to any one of Clauses 50 to 62, wherein each tooth engagement region further includes an auxiliary elastic band attachment that protrudes from the buccal side of the tooth engagement region.

[0208] Clause 64. The method according to any one of Clauses 50 to 63, wherein the palatal region is configured to apply an expansion force between the first dental engagement region and the second dental engagement region to expand the palate of the subject.

[0209] Clause 65. A treatment method for Class III malocclusion, said method comprising: An orthodontic approach is applied to the maxillary teeth of a subject to expand the subject's palate and advance the subject's maxillary region anteriorly, wherein applying the orthodontic approach includes: attaching a first dental occlusal region over a first subset of the subject's teeth and attaching a second dental occlusal region over a second subset of the subject's teeth, such that an expansion force is applied between the first dental occlusal region and the second dental occlusal region to a palatal region extending between them; and The orthodontic method is coupled to the headgear by connecting an elastic band between each of one or more elastic band attachments protruding from the orthodontic method and an elastic band attachment bridge of the headgear worn on the subject's head, such that an anterior force is applied from the elastic band to the maxillary region of the subject.

[0210] Clause 66. The method according to Clause 65, wherein coupling the orthodontic device to the headgear includes: coupling a first elastic band attachment to the elastic band attachment bridge of the headgear via the elastic band, the first elastic band attachment projecting laterally and / or anteriorly from a region on the buccal side of the first tooth engagement area.

[0211] Clause 67. The method according to any one of Clauses 65 to 66, wherein coupling the orthodontic device to the headgear comprises: coupling a first elastic band attachment and a second elastic band attachment to the elastic band attachment bridge of the headgear via the elastic band, the first elastic band attachment and the second elastic band attachment each projecting laterally and / or anteriorly from the buccal side of the first tooth engagement region.

[0212] Clause 68. The method according to any one of Clauses 65 to 67, wherein coupling the orthodontic device to the headgear includes: coupling a first elastic band attachment to the elastic band attachment bridge of the headgear via a first elastic band, the first elastic band attachment projecting laterally and / or anteriorly from the buccal side of the first tooth engagement region; and coupling a second elastic band attachment to the elastic band attachment bridge of the headgear via a second elastic band, the second elastic band attachment projecting laterally and / or anteriorly from the buccal side of the second tooth engagement region.

[0213] Clause 69. The method according to any one of Clauses 65 to 68, wherein coupling the orthodontic device to the headgear comprises: coupling the elastic band between the elastic band attachment bridge of the headgear and each of the one or more elastic band attachments, wherein the one or more elastic band attachments includes a slot.

[0214] Clause 70. The method according to any one of Clauses 65 to 69, wherein coupling the orthodontic device to the headgear comprises: coupling the elastic band between the elastic band attachment bridge of the headgear and each of the one or more elastic band attachments, wherein the one or more elastic band attachments comprises a hook.

[0215] Clause 71. The method according to any one of Clauses 65 to 70, wherein coupling the orthodontic device to the headgear comprises: coupling the elastic band between the elastic band attachment bridge of the headgear and each of the one or more elastic band attachments, wherein the one or more elastic band attachments includes a button.

[0216] Clause 72. The method according to any one of Clauses 65 to 71, wherein coupling the orthodontic device to the headgear comprises: coupling a first elastic band between the elastic band attachment bridge of the headgear and one or more elastic band attachments including a plurality of contact points to apply a counter-rotational torque to the subject.

[0217] Clause 73. The method according to any one of Clauses 65 to 72, wherein coupling the orthodontic device to the headgear comprises: coupling a preloaded elastic band to the elastic band attachment bridge of the headgear, wherein the elastic band is preloaded and secured in the elastic band attachment.

[0218] Clause 74. The method according to any one of Clauses 65 to 73 further comprises: the subject removing the orthodontic device and applying a second orthodontic device.

[0219] The examples and illustrations included herein are shown by way of illustration, not limitation, of specific embodiments in which the subject matter may be practiced. As mentioned, other embodiments may be utilized and derived therefrom, allowing for structural and logical substitutions and changes without departing from the scope of this disclosure. Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term "invention," merely for convenience and not intended to actively limit the scope of this application to any single invention or inventive concept (if actually more than one is disclosed). Therefore, although specific embodiments have been illustrated and described herein, any arrangement contemplated to achieve the same purpose may substitute for the specific embodiments shown. This disclosure is intended to cover any and all modifications or variations of the various embodiments. Upon review of the foregoing description, combinations of the above embodiments, as well as other embodiments not specifically described herein, will be apparent to those skilled in the art.

Claims

1. An orthodontic device, the device comprising: a first tooth-engaging region configured to be removably worn over a first subset of the subject's maxillary teeth; a second tooth-engaging region configured to be removably worn over a second subset of the subject's maxillary teeth; a palatal region extending between the first tooth-engaging region and the second tooth-engaging region; and a first elastic band attachment protruding laterally and / or anteriorly from a first region of a buccal side of the first tooth-engaging region, the elastic band attachment comprising an engagement surface configured to hold an elastic band, the elastic band extending anteriorly and out of the subject's mouth.

2. The device of claim 1, wherein the first elastic band attachment protrudes laterally from an anterior region of the buccal side of the first tooth-engaging region.

3. The device of any one of claims 1-2, wherein the first region is located at a position within a threshold distance from a center of impedance of the subject of a resulting moment arm.

4. The device of any one of claims 1-3, further comprising a buccal extension extending laterally from the first tooth-engaging region or the second tooth-engaging region and configured to extend at least partially over the subject's gums when the device is worn on the subject's teeth, wherein the first region is located on the buccal extension.

5. The device of any one of claims 1-4, wherein the first elastic band attachment comprises a slot cut into the region of the buccal side of the first tooth-engaging region.

6. The device of claim 5, wherein the slot is formed in an anterior region of a removal tab extending away from the buccal side of the device in a direction opposite an occlusal side of the device and lateral to the buccal side.

7. The device of claim 5, wherein the slot comprises a channel region leading to a retention region, wherein a diameter of the channel region is less than a diameter of the retention region.

8. The device of any one of claims 1-7, wherein the first elastic band attachment comprises a button, a notch, or a hook.

9. The device of any one of claims 1-8, wherein the region of the buccal side of the first tooth-engaging region is part of a incisal region of the first tooth-engaging region configured to hold incisal teeth of the subject.

10. The device of any one of claims 1-9, further comprising a cutout region extending proximate to a posterior side of the first elastic band attachment such that at least a portion of the engagement surface comprises a thickness of the region of the buccal side of the first tooth-engaging region.

11. The device of any one of claims 1-10, further comprising a second elastic band attachment protruding laterally and / or anteriorly from a region of a buccal side of the second tooth-engaging region. ​ 12. The device according to any one of claims 1 to 11, further comprising an auxiliary elastic band attachment, the auxiliary elastic band attachment projecting laterally and / or forwardly from a region adjacent to the first elastic band attachment on the buccal side of the first tooth engagement region.

13. The apparatus of any one of claims 1 to 12, further comprising a headgear orthodontic device configured to be worn on the head of the subject, wherein the headgear orthodontic device includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band.

14. The apparatus of any one of claims 1 to 13, wherein the palatal region is configured to apply an expansion force between the first dental engagement region and the second dental engagement region to expand the palate of the subject.

15. An orthodontic device, the device comprising: A first tooth occlusal region, configured to be removably worn over a first subset of the maxillary teeth of the subject; A second tooth occlusal region is configured to be removably worn over a second subset of the maxillary teeth of the subject. The palatal region extends between the first dental engagement region and the second dental engagement region; A first elastic band attachment, the first elastic band attachment protruding laterally and / or anteriorly from a first region on the buccal side of the first tooth engagement region; A second elastic band attachment, the second elastic band attachment projecting laterally and / or anteriorly from a second region on the buccal side of the first tooth engagement region, the elastic band attachment including an engagement surface configured to retain the elastic band; as well as Class III malocclusion headgear, the Class III malocclusion headgear being configured to be worn on the head of the subject, wherein the headgear includes an elastic band attachment bridge configured to be coupled to a first elastic band attachment via a first elastic band.

16. An orthodontic device, the device comprising: A first tooth occlusal region, configured to be removably worn over a first subset of the maxillary teeth of the subject; A second tooth occlusal region is configured to be removably worn over a second subset of the maxillary teeth of the subject. The palatal region extends between the first dental engagement region and the second dental engagement region; A first elastic band attachment, the first elastic band attachment projecting laterally and / or anteriorly from a region on the buccal side of the first tooth engagement area, the elastic band attachment including an engagement surface configured to retain the elastic band; as well as The incision area extends to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the buccal side of the first tooth engagement area.

17. The device of claim 16, wherein the first elastic band attachment protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

18. The device according to any one of claims 16 to 17, wherein the region of the first elastic band attachment protruding from the buccal side of the first tooth engagement region is closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

19. The apparatus of any one of claims 16 to 18 further comprises a headgear orthodontic device configured to be worn on the head of the subject, wherein the headgear orthodontic device includes an elastic band attachment bridge configured to be coupled to the first elastic band attachment via a first elastic band.

20. An orthodontic device, the device comprising: A first tooth occlusal region, configured to be removably worn over a first subset of the maxillary teeth of the subject; A second tooth occlusal region is configured to be removably worn over a second subset of the maxillary teeth of the subject. The palatal region extends between the first dental engagement region and the second dental engagement region; A first elastic band attachment, the first elastic band attachment protruding laterally from a first region on the buccal side of the first tooth engagement region; An auxiliary elastic band attachment, the auxiliary elastic band attachment protruding laterally from a second region on the buccal side of the first tooth engagement region, the auxiliary elastic band attachment being offset from the first elastic band attachment on the occlusal-gingival axis and the anterior-posterior axis.

21. The apparatus of claim 20, wherein the auxiliary elastic band attachment is configured such that the first elastic band attachment is closer to the gingiva and more posterior than the auxiliary elastic band attachment.

22. The device according to any one of claims 20 to 21, wherein the region of the first elastic band attachment protruding from the buccal side of the first tooth engagement region is closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

23. The device according to any one of claims 20 to 22, further comprising a cut region extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the region on the buccal side of the first tooth engagement region.

24. An orthodontic appliance, the appliance comprising: A first tooth occlusal region is configured to be removably worn over a first subset of the maxillary teeth of the subject, the maxillary teeth of the subject including the subject's incisal teeth; A second tooth engagement region is configured to be removably worn over a second subset of the maxillary teeth of the subject. A third tooth occlusal region, which is configured to be removably worn over a third subset of the maxillary teeth of the subject; The palatal region extends between the first dental engagement region, the second dental engagement region, and the third dental engagement region; as well as A first elastic band attachment, the first elastic band attachment projecting laterally and / or anteriorly from a buccal region of the first tooth engagement area, the elastic band attachment including an engagement surface configured to retain the elastic band such that the elastic band can extend anteriorly.

25. The device of claim 24, wherein the first elastic band attachment protrudes laterally from the anterior region on the buccal side of the first dental engagement region.

26. The device according to any one of claims 24 to 25, wherein the region of the first elastic band attachment protruding from the buccal side of the first tooth engagement region is closer to the gingiva on the buccal gingival-occlusal axis, such that when the device is worn on the subject's teeth, the first elastic band attachment is configured to be at least partially located above the subject's gingiva.

27. The device according to any one of claims 24 to 26, wherein the first elastic band accessory comprises a button or a hook.

28. The device according to any one of claims 24 to 27, further comprising a cut area extending to the vicinity of the posterior side of the first elastic band attachment, such that at least a portion of the engagement surface includes the thickness of the region on the buccal side of the first tooth engagement region.

29. A treatment method for Class III malocclusion, the method comprising: An orthodontic appliance is provided, the orthodontic appliance being configured to be worn by a subject to expand the subject's palate and advance the subject's maxillary region forward, wherein the orthodontic appliance includes a pair of occlusal regions and a palatal region between the occlusal regions, the pair of occlusal regions being configured to be removably worn over the subject's teeth, wherein each occlusal region includes an elastic band attachment that protrudes laterally and / or forwardly from a buccal region of each occlusal region, each elastic band attachment including an engagement surface configured to retain the elastic band; The orthodontic device is configured to be coupled to the headband via an elastic band connecting an elastic band attachment bridge between each elastic band attachment and the elastic band attachment bridge of the headband worn on the subject's head, such that an anterior force is applied from the elastic band to the maxillary region of the subject.

30. A treatment method for Class III malocclusion, the method comprising: An orthodontic approach is applied to the maxillary teeth of a subject to expand the subject's palate and advance the subject's maxillary region anteriorly, wherein applying the orthodontic approach includes: attaching a first dental occlusal region over a first subset of the subject's teeth and attaching a second dental occlusal region over a second subset of the subject's teeth, such that an expansion force is applied between the first dental occlusal region and the second dental occlusal region to a palatal region extending between them; and The orthodontic method is coupled to the headgear by connecting an elastic band between each of one or more elastic band attachments protruding from the orthodontic method and an elastic band attachment bridge of the headgear worn on the subject's head, such that an anterior force is applied from the elastic band to the maxillary region of the subject.

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