Dental repair mold comprising integral mold body

Abstract

A custom tool for forming a dental restoration in an oral cavity of a patient, the custom tool comprising an integrally formed mold body providing a custom fit with at least one tooth of the patient, the integrally formed mold body comprising: an occlusal portion, the occlusal part forms an occlusal surface corresponding to the occlusal surface of the teeth; a mesial proximal portion forming a mesial proximal surface corresponding to the mesial proximal surface of the tooth; and a distal proximal portion forming a distal proximal surface corresponding to the distal proximal surface of the tooth. The mold body is configured to combine with a tooth of a patient to form a mold cavity that encompasses a missing tooth structure of the tooth. The bite portion, the mesial proximal portion, and the distal proximal portion are based on three-dimensional scan data of the patient's oral cavity.

Description

Technical Field

[0001] This disclosure relates to dental restoration. Background Technology

[0002] Dental restorations or fillings utilize dental restorative materials designed to improve the function, integrity, and morphology of missing or irregularly shaped teeth. For example, dental restorations can be used to repair missing tooth structures due to congenital defects or external trauma, or as part of restorative treatment for caries or cavities.

[0003] Restorative dentistry typically involves drilling away cavities from the infected tooth (often referred to as "preparing" the tooth), followed by isolating, retracting, filling, and shaping the finished restoration using simple tools and skillful techniques. High-quality isolation achieved via rubber dams is cumbersome and is often omitted in favor of less efficient isolation via cotton rolls, which increases the risk of contamination and reduces the restoration's lifespan. Retraction of soft and hard tissues involves manipulating cords, wedges, and shaping strips, and imperfect techniques can lead to contamination, difficulties in finishing and / or polishing adjacent areas, and poor contact point adaptation.

[0004] While "overall filling" materials and high-intensity curing lamps facilitate relatively rapid filling of deep cavities (e.g., 4mm-5mm), many restorations are completed with a single shade because practitioners may be unsure of the correct layering scheme for multiple shades or types of restorative materials. Finally, with little geometric guidance available on the prepared tooth, the final fill level and occlusal surface geometry can involve an iterative process of overfilling with dental restorative material, followed by grinding and checking the anesthetized patient's tooth contact and occlusal function. This process can be the most time-consuming for dental restorations, and errors here can lead to tooth sensitivity and follow-up visits for adjustments.

[0005] The jointly assigned patents and patent applications include U.S. Patent Nos. 10,722,331, 11,123,165, and 11,185,392; U.S. Patent Application Publication Nos. 2019 / 0298489, 2019 / 0083208, 2021 / 0290349, 2021 / 0298882, 2021 / 0378789, 2021 / 0386528, 2022 / 0047357, and 2022 / 0117699. All disclosed dental restoration techniques involve directly molding dental restoration materials onto teeth located in the patient's oral cavity. Summary of the Invention

[0006] This disclosure relates to dental restoration techniques that include directly molding dental restoration materials onto teeth located within a patient's oral cavity. The disclosed techniques include methods for dental restoration, custom-made tools for dental restoration, and techniques for producing custom-made tools for dental restoration. The disclosed techniques include tools for providing mold cavities customized for individual patients. In some examples, 3D printing technology can be used to produce such custom-made tools.

[0007] Adding facial veneers to the anterior teeth as part of dental restorations can lead to so-called buccal corridor collapse, i.e., shadowing of the posterior teeth. This can be aesthetically unpleasant and may stem at least in part from the additional facial lateral volume added by the veneer-based restoration. Shadowing of the buccal corridor can be reduced by adding facial veneers to at least the first premolars.

[0008] Clinicians typically perform these facial veneer restorations on premolars by manually placing the composite material. Manually performing such restorations can make creating the correct profile of the restoration difficult and time-consuming, requiring a high level of skill. These premolar restorations in the posterior region are even more challenging due to limited access from the patient's cheek. Because of this restricted access to the oral cavity, standard existing dental restoration molds cannot be used for posterior restorations. For example, dental restoration molds that include gates or ports for placing the restorative material may not be accessible in the posterior region of the oral cavity or may be obstructed there.

[0009] In one example, this disclosure relates to a custom tool for forming a dental restoration in a patient's oral cavity. The custom tool includes: a mold body providing a patient-specific, custom fit to at least three teeth of the patient, including a first restorative tooth, a second restorative tooth, and a first supporting tooth adjacent to either the first or second restorative tooth. The mold body defines a restoration portion including a facial-side portion forming a first facial-side surface corresponding to a facial-side surface of the first restorative tooth and a second facial-side surface corresponding to a facial-side surface of the second restorative tooth. The restoration portion also includes at least one finger configured to extend partially over a wedge-shaped gap between the first and second restorative teeth. The tool also includes a registration section comprising a first occlusal strut and a first support body. The first occlusal strut is configured to extend over the incisal ridge or one or more occlusal cusps of the first supporting tooth. The first support body forms a third facial lateral surface corresponding to the facial lateral surface of the first supporting tooth. The mold body is configured to combine with the patient's tooth to form a mold cavity that covers the missing tooth structure of both the first and second restorative teeth.

[0010] In another example, this disclosure relates to a custom tool for forming a dental restoration in a patient's oral cavity, the custom tool comprising a mold body providing a patient-specific custom fit with at least one tooth (typically two teeth) of the patient, with at least one restorative tooth, and typically at least one adjacent supporting tooth. The mold body includes: a restoration portion forming a first facial lateral surface corresponding to a facial lateral surface of the first restorative tooth and a first occlusal surface corresponding to an occlusal surface of the first restorative tooth; a registration portion including a first occlusal strut configured to extend over an incisal ridge or occlusal cusp of the first restorative tooth or the first supporting tooth; and a lingual bar fixed relative to the restoration portion to the registration portion. The mold body is configured to combine with the patient's tooth to form a mold cavity encompassing the missing tooth structure of the first restorative tooth.

[0011] In yet another example, this disclosure relates to a process for manufacturing a custom tool for forming a tooth restoration in a patient's oral cavity, the process comprising: obtaining three-dimensional scan data of the patient's oral cavity; and three-dimensionally printing the custom tool for forming the tooth restoration based on the three-dimensional scan data of the patient's oral cavity. This custom tool conforms to the custom tool described in the preceding paragraphs.

[0012] In yet another example, this disclosure relates to a process for manufacturing a custom tool for forming a dental restoration in a patient's oral cavity, the process comprising: obtaining three-dimensional scan data of the patient's oral cavity; transmitting at least a portion of the three-dimensional scan data to a remote manufacturing facility; and receiving from the remote manufacturing facility a custom tool for forming the dental restoration based on the three-dimensional scan data of the patient's oral cavity. This custom tool conforms to the custom tool described in the preceding paragraphs.

[0013] In yet another example, this disclosure relates to a process for obtaining a custom tool for forming a dental restoration in a patient's oral cavity, the process comprising: obtaining three-dimensional scan data of the patient's oral cavity; transmitting at least a portion of the three-dimensional scan data to a remote manufacturing facility; and receiving from the remote manufacturing facility a design for a custom tool for forming the dental restoration based on the three-dimensional scan data of the patient's oral cavity. This custom tool conforms to the custom tool described in the preceding paragraphs.

[0014] The custom tools and methods described herein can be used in combination with any of the previously described examples to create complete, partial, or sequential restorations in a patient's oral cavity.

[0015] In this application, terms such as “a,” “an,” and “the” are not intended to refer only to a singular entity, but rather to include general categories whose specific examples may be used to illustrate the point. The terms “a,” “an,” and “the” are used interchangeably with the term “at least one.” The phrases “at least one of…” and “including at least one of…” followed by a list refer to any one of the items in the list and any combination of two or more items in the list.

[0016] As used herein, the term "or" is generally used in its usual sense, including "and / or," unless otherwise expressly stated. The term "and / or" means one or all of the listed elements or any combination of two or more of the listed elements.

[0017] Similarly, in this document, it is assumed that all numbers are modified by the term “about,” and preferably by the term “precisely.” As used herein in conjunction with the quantity being measured, the term “about” refers to a variation in the quantity that would be expected by a technician performing the measurement and at a level of care commensurate with the purpose of the measurement and the precision of the measuring equipment used. Also in this document, numerical ranges expressed by endpoints include all numbers within that range as well as the endpoints (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, 5, etc.).

[0018] As used herein as modifiers of properties or attributes, unless otherwise specifically defined, the term "generally" means that the property or attribute will be easily recognized by a person skilled in the art but does not require absolute precision or perfect matching (e.g., within + / - 20% for quantifiable properties). Unless otherwise specifically defined, the term "substantially" means highly approximate (e.g., within + / - 10% for quantifiable properties), but again does not require absolute precision or perfect matching. Terms such as identical, equal, consistent, constant, and rigorous are understood to mean within the usual tolerances or measurement errors applicable to the specific situation, without requiring absolute precision or perfect matching.

[0019] As used herein, the term "occlusal surface" can refer to the chewing surface of any tooth, including posterior teeth, as well as the incisal surface (e.g., incisal edge) of anterior teeth. In this way, as used herein, the term "occlusal surface" does not refer to any particular one or more teeth, and therefore includes the incisal surface.

[0020] As used herein (including the claims), “facial” means the direction toward the patient’s cheek or lips (i.e., buccal and lip sides) and is opposite to the lingual direction. As used herein (including the claims), “lingual” means the direction toward the patient’s tongue and is opposite to the facial direction.

[0021] The foregoing overview of this disclosure is not intended to describe every embodiment or every specific implementation of this disclosure. The following description illustrates exemplary embodiments in more detail. Throughout the application, guidance is provided by a list of examples that may be used in various combinations. In each case, the drawn list is intended only as a representative group and should not be construed as an exclusive list. Attached Figure Description

[0022] Figures 1 to 6 An example of a custom-made tool for forming a tooth restoration in a patient's mouth is shown, the custom-made tool comprising a one-piece mold body that provides a custom fit to at least one of the patient's teeth; Figures 7 to 10 Examples of using Figures 1 to 6 The procedure of using custom-made tools to form dental restorations in the patient's mouth; Figures 11 to 15 An alternative custom tool for forming a dental restoration of two adjacent teeth in a patient's mouth is illustrated, which includes two fitting mold body components; Figure 16 This is a flowchart illustrating an exemplary technique for forming a dental restoration in a patient's oral cavity; Figure 17 An exemplary dental restoration mold 400 is depicted that can be used in combination with or sequentially with the custom tools 10 and 200 disclosed herein; Figure 18 This is a flowchart for forming dental restorations in a patient's mouth; Figure 19 This is a block diagram illustrating an example computer environment in which clinics and manufacturing facilities communicate information throughout the custom tool manufacturing process; Figure 20 This is a flowchart illustrating a procedure performed in a clinic according to an example of this disclosure; and Figure 21 to Figure 21B A custom tool for forming a dental restoration in a patient's mouth is described, comprising a one-piece molded body that provides a custom fit with at least two of the patient's anterior teeth.

[0023] While the foregoing figures illustrate several embodiments of this disclosure, other embodiments are contemplated as indicated in the description. The figures are not necessarily drawn to scale. In all instances, this disclosure is presented by way of example and not limitation. It should be understood that those skilled in the art can devise many other modifications and embodiments that fall within the scope and spirit of the principles of this invention. Detailed Implementation

[0024] While conventional dental restoration techniques typically involve iterative steps and benefit significantly from the skill and experience of the practicing physician, this disclosure includes techniques that utilize custom molds to facilitate more precise and faster intraoral formation of dental restorations than is typically achievable with conventional techniques. In addition to the benefits to practicing physicians and patients, this invention also provides benefits to manufacturers of various elements of digital treatment solutions, as well as to device designers and custom device manufacturers.

[0025] The disclosed techniques involve capturing a patient's three-dimensional dentition using an intraoral scanner or by scanning conventional impressions or models. Customized tools for dental restorations may include molds based on the patient's three-dimensional (3D) dentition. Compared to conventional dental restoration techniques, the disclosed techniques can facilitate high-quality dental restorations, reduce time, and lower skill requirements.

[0026] In some examples, the tools described herein may be digitally designed. For example, the tools may be designed using a three-dimensional (3D) model of the patient's dental structure, e.g., obtained from an intraoral scan of all or part of the patient's dentition or a scan of a conventional impression or model. For example, the tools may be manufactured based on digital data using additive manufacturing techniques (such as 3D printing) or subtractive manufacturing techniques (such as CAD / CAM milling). In some examples, tools for dental restoration may include molds designed based on a 3D model of the patient's dental structure and may include additional features to provide advantages over molds formed solely based on 3D scans, wax models, or other molds based solely on the patient's anatomy and / or the desired shape of the dental structure.

[0027] The customized tools disclosed herein can be designed and manufactured digitally, making them cost-effective to use. Through custom-designed specific criteria and optional additional criteria, such as dentist preferences or tooth position, the customized tools of this invention can achieve highly predictable results in a wide range of clinical cases. Finally, the tools described herein reduce flash and / or allow for increased control over the placement of restorative materials compared to practitioners using more traditional skills, tools, and techniques.

[0028] Custom tools can be made from a full range of 3D printing materials, molding polymer materials, or CAD / CAM forming polymer materials with certain desired strength, flexibility, translucency, or color. For example, mold materials can consist of polymer materials that can be transparent, translucent, or opaque. In some embodiments, transparent or substantially transparent polymer materials may include one or more of, for example, amorphous thermoplastic polymers, semi-crystalline thermoplastic polymers, and transparent thermoplastic polymers, and are selected from polycarbonate, thermoplastic polyurethane, acrylics, polysulfone, polypropylene, polypropylene / ethylene copolymers, cyclic olefin polymers / copolymers, poly-4-methyl-1-pentene or polyester / polycarbonate copolymers, styrene polymer materials, polyamides, polymethylpentene, polyetheretherketone, and combinations thereof. In another embodiment, the mold may be selected from transparent or substantially transparent semi-crystalline thermoplastics, crystalline thermoplastics, and composites, such as polyamides, polyethylene terephthalate, polybutylene terephthalate, polyester / polycarbonate copolymers, polyolefins, cyclic olefin polymers, styrene copolymers, polyetherimides, polyetheretherketones, polyethersulfones, polypropylene terephthalate, and mixtures and combinations thereof. In some embodiments, the mold is a polymeric material selected from polyethylene terephthalate, polyethylene terephthalate diol, polycyclohexyl terephthalate diol, and mixtures and combinations thereof. Custom tools may also be formed from a wide range of thermosetting polymers, including acrylics, methacrylates, polyurethanes, epoxy resins, esters, thioolefins, cyclic olefins, silicones, and rubbers.

[0029] Figures 1 to 6 An example is illustrated by a custom-made tool 10 for forming a dental restoration 102 in a patient's oral cavity. Specifically, Figure 1 The components of the custom tool 10 are illustrated, including a one-piece mold body 12. Figure 2 The components of the custom tool 10 and a portion of the patient's oral cavity before dental restoration are illustrated. Figure 3 Examples include components of a custom-made tool 10 assembled inside a patient's mouth to facilitate dental restoration, and Figure 4 The custom tool is illustrated from a lateral view of the tongue. Figure 5 The illustration shows components of the custom tool 10 and a portion of a patient's oral cavity after dental restoration using the custom tool 10. Figure 6 The underside of the custom tool 10 is illustrated, which includes surfaces corresponding to various sides of the tooth 102. In some examples, the custom tool 10 may represent a single dental veneer mold and / or be used to repair cavities within the tooth 102.

[0030] Although custom tool 10 is constructed to facilitate dental restoration of a single premolar (i.e., premolar), custom tool 10 is merely an example, and the techniques described in custom tool 10 can be readily applied to custom tools that facilitate the restoration of other posterior teeth, other anterior teeth, etc. Figure 21A and Figure 21B Two or more teeth, for example, by including multiple mold bodies within a single mold body component, as further explored herein.

[0031] The custom tool 10 includes a one-piece mold body 12 that provides a custom fit to a tooth 102, hereinafter defined as a restorative tooth, i.e., a tooth awaiting veneer or other missing tooth structure filling. The mold body 12 includes a facial-side portion 14 configured to at least surround the restorative tooth 102 and a lingual bar 30 disposed opposite the facial-side portion 14. The facial-side portion 14 includes: a restorative portion 15 configured to define a mold cavity together with the restorative tooth 102, as described in further detail below; and optional support bodies 20 extending outwardly from the restorative portion 15. The facial-side portion 14 is connected to the lingual bar 30 via a mesial registration post 42 and a distal registration post 44 disposed at the mesial and distal edges of the support bodies 20. The mesial registration post 42 and the distal registration post 44 together define the registration portion 40 of the custom tool 10 and are configured to engage the occlusal surfaces (including portions of the buccal cusps and lingual cusps) of the teeth 104 and 106 adjacent to the restored tooth 102.

[0032] The mold body 12 is combined with the tooth 102 to form a mold cavity, including a customized facial lateral surface 16. This mold cavity encompasses the missing tooth structure and / or veneer of the tooth 102. By positioning the mold body 12 over the tooth 102, dental restorative material can be positioned within the mold cavity and presented in the form of restoring the missing tooth structure and / or veneer of the tooth 102. The missing tooth structure may include any portion of the tooth 102, including any combination of proximal, occlusal, and facial lateral tooth structures. The inner surface of the mold body 12 includes a portion of the mold cavity corresponding to at least one outer surface of the corresponding tooth 102, which may include the facial lateral surface, proximal surface, and / or occlusal surface of the corresponding tooth 102. In some examples, the mold cavity may facilitate dental veneer restoration of the facial lateral surface, proximal surface, and / or occlusal surface of the corresponding tooth 102.

[0033] Any, both, or all of the facial-side portion 14, the lingual bar 30, and the registration portion 40 may include a patient-specific custom surface. Specifically, the restorative portion 15 forms a patient-specific custom facial-side surface 16 for at least the restored tooth 102. The custom facial-side surface 16 includes a custom mesial surface 16a corresponding to the proximal surface of the tooth 102, a custom mesial surface 16b corresponding to the mesial surface of the tooth 102, and a custom occlusal surface (e.g., 16c below the finger 17) optionally corresponding to the occlusal surface of the tooth 102. The restorative portion 15 may also optionally form a custom gingival surface corresponding to the gingival surface within the patient's oral cavity.

[0034] The customized occlusal surface of the restorative portion 15 is typically formed by occlusal fingers 17. Occlusal fingers 17 surround the buccal cusps 110 of the restorative tooth 102, but do not necessarily extend across the central developmental groove 112 and / or into the lingual surface 120. Occlusal fingers 17 can facilitate the shaping of the restorative material on the tooth 102, thereby allowing for better integration of the restorative material with the existing tooth structure in some cases. Occlusal fingers 17 extend along an arcuate path from the occlusal margin 15a of the restorative portion 15 at the tip of the buccal cusps 110 and generally have a width smaller than the width of the restorative tooth 102. In some embodiments, the width of the finger 17 is no greater than 80% of the mesial-distal width of the restored tooth 102, in some embodiments no greater than 70% of the mesial-distal width of the restored tooth, in some embodiments no greater than 65% of the mesial-distal width of the restored tooth, in some embodiments no greater than 60% of the mesial-distal width of the restored tooth, in some embodiments no greater than 55% of the mesial-distal width of the restored tooth, and in some embodiments no greater than 50% of the mesial-distal width of the restored tooth.

[0035] The facial portion 14 may also include an adjacent portion 18 corresponding to the adjacent surface of the tooth 102. As depicted, the adjacent portion 18a corresponds to the adjacent surface of the tooth 102 to also provide a custom fit with the tooth 102a, and the adjacent portion 18b of the mold body 12b corresponds to the adjacent surface of the tooth 102b to also provide a custom fit with the tooth 102. Each of the adjacent portions 18 has an integral construction because the custom tool 10 does not include any seams in its components within the adjacent space corresponding to the adjacent portions 18a, 18b. For example, each of the adjacent portions 18 may extend partially through the adjacent space between the tooth 102 receiving the restoration and adjacent teeth 104, 106. Typically, the adjacent portions do not extend completely through the adjacent space because the engagement between the lingual surface 120 of the tooth 102 and the adjacent portions 18a, 18b may make it more difficult to remove the custom tool 10 after the missing tooth structure has been restored.

[0036] In some embodiments, the proximal portions are selected to provide a specific proximal tooth structure between adjacent selected teeth. Therefore, the mold body may include patient-specific, custom-fitted proximal portions. At least some of the proximal portions may be specifically engineered, rather than simply replicas of proximal structures previously present in a pre-restoration patient oral scan or digital wax model. Instead, they are digitally engineered to provide a specific, selected proximal tooth structure in the proximal space. In some embodiments, the mold body 12 may include naturally occurring proximal contacts in certain areas provided by a 3D scan of the patient's oral cavity, as well as specifically engineered proximal contacts in other areas. Considerations and designs for specifically engineered proximal contacts can be found in International Publications WO / 2023 / 031761, WO / 2023 / 031766 and WO / 2023 / 031771, all of which are commonly owned and incorporated herein by reference in their entirety.

[0037] The facial portion 14 may also include markings, coloring, or other markings to identify the designated prosthetic tooth, patient, target prosthetic material, and any other information relevant to the practitioner. The markings discussed herein may be integrated into the respective mold components or may be applied separately to the mold components. For example, patient and prosthetic tooth identification markings may be 3D components integrated into the mold design, or the markings may be applied to the surface of the mold component using ink or any suitable material. Orientation markings (e.g., coloring markings on the distal end of each tool component) may also be applied to or incorporated into the custom tool to facilitate placement in the patient's mouth.

[0038] The facial side portion 14 includes a first mesial support body 21 and a second distal support body 22 (collectively, “support body 20”) located on either side of the restorative portion 15. The support bodies 21 and 22 may not provide any part of the mold cavity, but rather simply help to secure the mold body 12 in place. Specifically, the facial side portion 14 of the mold body 12 includes: an optional mesial support portion 21 having a custom surface 21a providing a custom fit with the supporting tooth 104; and an optional distal support portion 22 having a custom surface 22a providing a custom fit with the supporting tooth 106. The custom surfaces 21a and 22a also secure and align the mold body 12 in the appropriate position within the patient's oral cavity to facilitate precise custom dental restoration of the tooth 102. The mold body 12 may also be aligned with the patient's gingiva 115. The support body 20 may be part of a monolithic, one-piece unit having the facial side portion 14. Alternatively, the support body 20 may be attached to the facial side portion via snap-fit ​​or other interlocking connections.

[0039] Although the support body 20 is described as not forming any part of the mold cavity, in other examples, the support body 20 can be easily modified to combine with the mold body 12 to form one or more mold cavities. In such examples, the modified support body 20 should also be considered as part of the repair portion 15.

[0040] In an alternative embodiment, the mold body 12 is configured to be registered with an adjacent supporting tooth (104 or 106), or only with the restorative tooth 102. For example, the facial side portion 14 may extend beyond the proximal surfaces on the mesial and distal margins of the restorative tooth 102. As an alternative or additional example, one or both of the mesial registration post 42 and the distal registration post 44 may extend along the wedge-shaped gap between the restorative tooth and the supporting teeth 104, 106, as appropriate. In such cases, custom-made tools may be more difficult to remove from the restored tooth without damaging the finished restoration, and placement errors may be more likely to occur when placing dental restoration materials. However, such custom-made tools remain feasible in creating dental restorations.

[0041] Turn to Figure 1 A reinforcing band 50 protrudes from the facial side portion 14 of the mold body 12 toward the face in a generally orthogonal orientation. This facial side band 50 serves as a reinforcing rib of the mold body 12 and typically extends along the contour of the gingival margin of the patient's dental arch. The facial side band 50 may extend along a generally sinusoidal path, with the crest adjacent to the proximal region between teeth 102, 104, or 106. The facial side height of the band 50 is relatively short to avoid patient discomfort during dental restoration, typically approximately 2mm-5mm. The occlusal-gingival thickness of the band 50 is also relatively thin, typically approximately 1mm-2mm. Both the height and thickness are variable and can be adapted to the desired conditions in the patient's oral cavity.

[0042] Hole 54 is located near the gingival margin 15a of the restorative portion 15 and provides an unfilled space between the facial-side surface of the mold body 12 and the band 50. The size and shape of hole 54 are configured to receive the tip of a dental hand instrument or restorative material dispenser. Thus, hole 54 provides a point of leverage to aid in the removal of the mold from the restorative tooth. Custom tool 10 may include additional holes between the band and the mold body 12 to provide multiple pry points. Holes 54 may be discrete and adjacent to each tooth represented in the mold body 12. Alternatively, custom tool 10 may have a channel (i.e., a hole providing a continuous opening between two or more teeth) between the band 50 and the facial-side surface 13 of the mold body 12. Another function of hole 54 is to receive dental floss to aid in the retrieval of the tool 10 when it is removed from its original position in the mouth.

[0043] The facial side portion 14 of the mold body 12 may also include protrusions 46, 48 adjacent to wedge-shaped gaps 113, 114 on both sides of the restored tooth 102. By achieving limited flexibility between the mold portions, the protrusions 46, 48 facilitate the registration and placement of the custom tool 10 on the restored tooth 102. The occlusal-gingival depth of the protrusions 46, 48 is typically approximately 1 mm, but the patient's dental anatomy may require adaptation to other dimensions within the scope of this disclosure.

[0044] The registration portion 40 facilitates the alignment of the custom tool 10 in the patient's mouth and provides visual confirmation that the tool is correctly positioned in the desired location. In some embodiments, one or both of the mesial registration post 42 and the distal registration post 44 provide custom occlusal surfaces 42a, 44a corresponding to the occlusal surfaces of teeth 104, 106. Typically, the custom occlusal surfaces 42a, 44a correspond only to a portion of the occlusal surfaces of teeth 104, 106, as they do not cover the entire crown. As an example, the custom occlusal surfaces 42a, 44a correspond to approximately 30% to 70% of the mesial-distal width of tooth 104 or 106, where the area adjacent to the corresponding wedge-shaped gaps 113, 114 of the restored tooth 102 is not covered. In a typical but non-exclusive case, the registration portion 40 is sufficiently spaced from the restoration of tooth 102 to avoid contact with any dental restorative material introduced into the mold cavity of the mold body 12. Other configurations are possible and are envisioned below.

[0045] The lingual bar 30 may include various cross-sectional shapes, including circular, oval, rectangular (including square), triangular, and combinations thereof. Although not present in the depicted embodiment, the lingual bar 30 may also include custom distal surfaces corresponding to the distal surfaces of the lingual side of the tooth, and custom mesial surfaces corresponding to the mesial surfaces of the lingual side of the tooth. This correspondence is not strictly necessary because the lingual bar 30 provides stability to the custom tool 10 and provides a mechanism for disengaging the tool 10 from the patient's oral cavity; the lingual bar typically does not form part of the mold cavity responsible for forming the restoration. The lingual bar 30 may also include patient identification markings or instructions for sequencing methods of the dental restoration, as further discussed below.

[0046] The markings discussed herein can be integrated into the corresponding mold components, or they can be applied separately to the mold components. For example, a tooth-shaped marking can be a 3D component that is an integrated feature of the mold design, coloring can be the color of the material used to form the part of the mold component, and / or the marking and / or coloring can be applied to the surface of the mold component using ink or any suitable material.

[0047] By positioning the custom tool 10 above the tooth 102, dental restorative material can be positioned in the mold and presented in the form of the missing tooth structure of tooth 102. In some examples, the dental restorative material may be placed on the restorative tooth 102 before the custom tool 10 is assembled onto it. In the same or different examples, the dental restorative material may be placed on the surface 16 of the facial side portion 14 before the custom tool 10 is assembled onto the tooth 102. In another example, the custom tool 10 may be assembled onto the tooth 102 first, and then the dental restorative material may be injected into the mold cavity. For example, the facial side portion 12 may include a port configured to receive the injection of dental restorative material once the custom tool 10 is positioned above the tooth 102 to form the mold cavity.

[0048] Compared to Figure 5 Further description of the custom fit provided by the mold body 12. For example... Figure 5 As shown, the integrally molded mold body 12 includes customized surfaces for each of teeth 102, 104, and 106. Specifically, surface 21a is customized to mate with tooth 104, restoration portion 16 is customized to mate with tooth 102, and surface 22a is customized to mate with tooth 106. Restoration portion 16 provides customized fit for more than one surface of tooth 102. Specifically, restoration portion 16 includes a distal-mesial surface 16a corresponding to the distal-mesial aspect of tooth 102, a mesial-mesial surface 16b corresponding to the mesial-mesial aspect of tooth 102, and a facial-side surface 15 corresponding to the facial-side surface of tooth 102. Occlusal surfaces are provided by registration portion 40 and occlusal fingers 17.

[0049] The custom fit of the mold body 12 can also be used to isolate teeth 102 from blood, gingival crevicular fluid, or saliva during dental restoration procedures. For example, portions of the mold body 12 can fit against the surfaces of teeth 102, 104, 106, and gingiva 115 to protect the mold cavity from bodily fluids such as blood, gingival crevicular fluid, and saliva. Furthermore, the mold body 12 can also be used to forcibly retract gingiva 115 and / or assist in separating teeth 102, 104, 106 when the mold body 12 is inserted into the patient's oral cavity. For example, adjacent portions (e.g., sheet-like pieces) 18a, 18b of the mold body 12 can be used to forcibly separate adjacent teeth 102, 104, 106. In this way, although the custom tool 10 can be based on a three-dimensional model of the patient's oral cavity, various features of the custom tool 10 can be selected for temporary modification of the position of gingiva 115 and / or teeth 102, 104, 106 during the restoration procedure.

[0050] Optionally, the mold body 12 may also be configured to provide features including a customized gingival surface representing an isolating matrix for dental restoration. In this way, the mold body 12 may contain features extending subgingivally or into hidden proximal spaces. Data for these extensions may be based on anatomical averages or patient-specific data such as X-rays, ultrasound, or MRI. The tool may incorporate an elastomeric material designed for a slightly smaller fit to form a tight seal within the actual geometry of the patient's dentition. The materials used may also vary in hydrophilicity to draw away water, saliva, and other fluids from the tooth structure being restored. Microfluidic channels, vacuum line attachments, and occlusal blocks may also be incorporated. Hemostatic agents and fluid cores, blocking, or guiding features may be used in conjunction with the tool.

[0051] Figures 7 to 10 The steps for forming a dental restoration of tooth 102 in a patient's mouth using a custom tool 10 are illustrated. Figure 7 A portion of a patient's oral cavity is illustrated, including teeth 102, 1014, and 106, and gingiva 115. As shown, tooth 102 may have been previously prepared for dental restoration by removing unhealthy tooth structures, for example, by removing damaged tooth material through drilling or other preparations to facilitate dental restoration using tool 10. In some examples, a 3D image of the patient's oral cavity may be taken before removing decayed material from tooth 102, as the shape of the decayed material can help customize the design of tool 10, or the restoration procedure can be shortened by utilizing scan data obtained before tooth preparation. In various examples, the scan data may be recent (e.g., within the past twelve months) or may be from a previous period (e.g., more than a year, more than five years, or even more than ten years ago). Such older scan data can indicate tooth wear over time and may facilitate restoration to repair this tooth wear. Scan data from multiple scans over time can also be used to detect tooth wear and facilitate appropriate restoration.

[0052] An exemplary restoration procedure for tooth 102 using custom tool 10 is described below. Figure 7 In the best example, the dental restorative material 80 is positioned within a mold cavity formed by the tooth 102 and the mold body 12. A currently preferred dental restorative material is Filtek, commercially available from Solventum US. ™ Supreme Universal A2 ™The dentist may apply restorative material 80 to the teeth to be restored or to the mold body 12 before applying the mold body 12 to the patient's teeth 102, 104, 106. In some examples, the dentist may use various tools to place the restorative material into the mold cavity. In some examples, the restorative material 80 may be placed into the mold cavity through one or more holes or filling ports.

[0053] like Figure 8 As shown, the mold body 12 is positioned at an appropriate location above the teeth 102, such that the adjacent portions 18a and 18b ( Figure 8 (Not shown) Extends between teeth 102, 104, and 106. The mold body 12 provides a customized and secure placement within the patient's oral cavity. In various examples, depending on the design of the customized tool 10, the mold body 12 can be positioned on the lingual, occlusal, and / or facial side of the teeth 102.

[0054] Because tooth preparations can be made at depths greater than the recommended maximum curing depth of the restorative material, or because different shades, viscosities, or other properties of restorative materials are required in deeper parts of the cavity, a base layer of restorative material can optionally be laid in the deeper portion of the preparation, and for example, using Elipare... ™ The DeepCure-S curing lamp light-cures dental restorative materials. Components of tool 10 (including mold body 12) can be transparent or translucent to facilitate light curing. In this example, dental restorative material 80 represents more than one layer of dental restorative material.

[0055] Customized facial and occlusal surfaces of the mold body can be used to shape one or more layers of restorative material 80 on the facial, occlusal, and proximal surfaces of the tooth 102, to press the restorative material 80 into the mold cavity, or any combination thereof. For example, a lingual bar 30 can be used to press the restorative material 80 onto the facial, occlusal, and proximal surfaces of the tooth. Excess restorative material on the occlusal or wedge-shaped surfaces can be removed before proceeding.

[0056] In some examples, the practicing physician can solidify the repair material 80 ( ) within the mold cavity. Figure 9 For example, if the restorative material is photocurable, the physician can expose the restorative material to curing light (e.g., blue light) through a mold body 12, which may be formed of a material transparent to the curing light. The physician can also cure at least a portion of the restorative material through an exposed occlusal window 118 formed between the occlusal finger 17 and the registration portion 40.

[0057] In any case, after the dental restoration material 80 has been formed within the mold cavity formed by the tooth 102 and the mold body 12, the mold body 12 is removed from the patient's mouth. In some embodiments, the practitioner may use the tip and hole 54 of a tool to pry the mold body 12 off the teeth 102, 104, 106. The restored tooth 102 now has a restorative structure defined by the restoration material. In this way, the mold body 12 not only provides a customized fit to the patient's mouth but also provides a customized mold cavity to facilitate the application of veneers to the restored tooth 102 and / or the repair of missing tooth structures in the restored tooth 102. In some examples, the practitioner may trim the tooth (which now includes the restored tooth structure defined by the restoration material), such as by polishing, to remove burrs or other undesirable surface defects.

[0058] In some embodiments, the custom tool 10 can be used in combination with other dental restoration molds known in the art. For example, the custom tool 10 can be deployed in combination with any of the tools described in the following documents: U.S. Patent Nos. 10,722,331, 11,123,165, 11,185,392; U.S. Patent Application Publication Nos. 2019 / 0298489, 2019 / 0083208, 2021 / 0290349, 2021 / 0298882, 2021 / 0378789, 2021 / 0386528, 2022 / 0047357, and 2022 / 0117699. The custom tool 10 can be deployed sequentially or nearly simultaneously with other dental restoration molds, such that both the custom tool 10 and additional tools are simultaneously deployed in the patient's oral cavity. The following... Figure 17 An exemplary implementation of such a method is described.

[0059] While a custom tool 10 comprising a monolithically formed mold body 12 is described relative to a single mold cavity for repairing a single premolar 102, the techniques described relative to custom tool 10 can be readily applied to custom tools configured to facilitate the repair of more than one tooth (e.g., a first premolar and a second premolar) by forming more than one mold cavity. The monolithically formed mold body of the modified custom tool 10 can be configured to be combined with two adjacent teeth (e.g., 102 and 104) to form a separate mold cavity covering the missing tooth structure of each of the adjacent teeth.

[0060] Figures 11 to 15 An alternative custom tool 210 is illustrated for forming dental restorations of two adjacent teeth 120 and 122 in a patient's oral cavity. Specifically, Figure 11 The components of the custom tool 210 are illustrated, including a one-piece mold body 212 and support bodies 221, 222. Figure 12The illustration shows a component of the custom tool 210 and a portion of the patient's oral cavity. Figure 13 The following is an example of a component of a custom-made tool 210 that is assembled inside a patient's mouth to facilitate dental restoration. Figure 14 Custom tool 210 is illustrated from a lingual perspective. Figure 15 The underside of the custom tool 210 is illustrated, and this underside includes surfaces corresponding to the respective sides of teeth 120, 122, 124, and 126. Although the custom tool 210 is configured to facilitate the restoration of two adjacent teeth, the custom tool 210 is merely an example, and the techniques described with respect to the custom tool 210 can be readily applied to custom tools that facilitate the restoration of a single tooth or more than two teeth.

[0061] The custom tool 210 includes a one-piece mold body 212. The mold body 212 provides a custom fit for at least two of the patient's teeth (typically the first and second premolars, e.g., the first and second premolars)). Figure 12 As shown, mold body component 212a provides a custom fit with premolar 120, and mold body component 212b provides a custom fit with premolar 122. The custom tool 210 also includes two support bodies 221, 222 on either side of the mold body 212. Support body 221 may include an optional custom surface 221a providing a custom fit with supporting tooth 124, and support body 222 may include an optional custom surface 222a providing a custom fit with tooth 126. Custom surfaces 221a, 222a also secure and align the custom tool 210 in the appropriate position within the patient's oral cavity to facilitate precise custom dental restoration of teeth 120, 122. The mold body 212 may also be aligned with the patient's gingiva. For example, support bodies 221, 222 may not provide any part of the mold cavity, but may simply help secure the mold body 212 in place (i.e., provide some level of support).

[0062] Custom tool 210 may include any one of the features present in custom tool 10 or any combination of such features. For example, custom tool 210 may include a band 250, a pry hole 254, a tongue-and-groove bar 230, an adjacent portion 218, and a registration portion 240. Considerations of these features in custom tool 10 are applied to custom tool 210 with necessary modifications.

[0063] Similar to custom tool 10, the custom occlusal surface of the restorative portion 215 of custom tool 210 is typically formed by one or more occlusal fingers 217. The restorative portion 215 also includes wedge-shaped gap fingers 219a, 219b, and 219c (collectively referred to as wedge-shaped gap fingers 219). The wedge-shaped gap fingers extend partially over wedge-shaped gaps 133 and 134 between adjacent teeth in the mold body (specifically, the wedge-shaped gap between teeth 120 and 122, and the wedge-shaped gap between teeth 120 and 124; extending along the wedge-shaped gap between teeth 122 and 126). The wedge-shaped gap fingers 219 extend from the occlusal edge 215a of the restorative portion 215 along an arcuate path, extending partially (but not completely) over the respective wedge-shaped gap. Occlusal fingers 217a and 217b (collectively referred to as occlusal fingers 217) surround the buccal cusps 130 of the restorative teeth 120 and 122, but do not necessarily extend through the central developmental groove 132 and / or extend to the lingual surface. Occlusal fingers 217 and wedge-shaped gap fingers 219 may facilitate the shaping of the restorative material on the restorative teeth 120 and 122, thereby allowing the restorative material to integrate better with the existing tooth structure in some cases.

[0064] Both the mold body 212 and the support bodies 221 and 222 may include surfaces that mate with the patient's teeth and gingiva. For example, as described above, mold body component 212a may include features that mate with tooth 120, while mold body component 212b may include features that mate with tooth 122. Similarly, support body 221 may include features that mate with tooth 124, while support body 222 may include features that mate with tooth 126. Support bodies 221 and 222 also include optional custom surfaces 221a and 222a that provide a custom fit with tooth 124 and tooth 126, respectively. Custom surfaces 221a and 222a may also secure and mate the mold body 212 in the appropriate position within the patient's oral cavity to facilitate precise custom tooth restoration of tooth 120. The support bodies may also mate with the patient's gingiva. In this way, the mold body 212 and the support bodies 221, 222 can provide multiple customized surfaces that conform to the corresponding surfaces of teeth 120, 122, 124, 126 and the patient's gingiva. The combination of the mold body 212 and the support bodies provides a secure fit within the patient's oral cavity to precisely align the mold body components 212a, 212b with the teeth, thereby facilitating dental restoration.

[0065] Although support bodies 221 and 222 are described as not forming any part of the mold cavity, in other examples, support bodies 221 and 222 can be easily modified to combine with mold body 212 to form one or more mold cavities. In such examples, the modified support body 220 should also be considered as the mold body.

[0066] Optionally, the mold body 212 may also be configured to provide features including a customized gingival surface representing an isolation molding sheet for dental restoration. In this way, the mold body 212 may contain features extending subgingivally or into hidden proximal spaces. Data for these extensions may be based on anatomical averages or patient X-ray data. The tool may incorporate an elastomeric material designed for a slightly smaller fit to form a tight seal within the actual geometry of the patient's dentition. The materials used may also vary in hydrophilicity to draw away water, saliva, and other fluids from the tooth structure being restored. Microfluidic channels, vacuum line attachments, and occlusal blocks may also be incorporated.

[0067] Custom tool 210 is combined with teeth 120, 122 to form two distinct mold cavities of mold body 212. The mold cavity of mold body 212 encompasses the missing tooth structure of teeth 120, 122 and / or a veneer for one or both of teeth 120, 122. By positioning mold body components 212a, 212b above teeth 120, 122, dental restorative material can be positioned within the mold cavity and conform to the form of the tooth structure and / or provide veneers on the surfaces of teeth 120, 122.

[0068] Repairs to the prosthetic teeth 120 and 122 are performed by filling the mold cavity with dental restorative material after the mold body 212 has been positioned to align with the tooth 120. Optionally, the filling material may be applied to the tooth and / or mold cavity before the mold body 212 has been positioned to align with the tooth 120. In such examples, the process of positioning the mold body shapes the restorative material into the desired shape. The missing tooth structure 121 may include any portion of the tooth 120, including any combination of proximal, occlusal, facial, and / or lingual tooth structures. The inner surfaces of the mold body components 212a and 212b each include a portion of the mold cavity corresponding to at least one outer surface of the corresponding tooth 120 or 122, which may include the facial, lingual, proximal, and / or occlusal surfaces of the corresponding tooth 120 or 122. In some examples, the mold cavity may facilitate dental veneer restorations of the facial, lingual, proximal, and / or occlusal surfaces of the corresponding tooth 120 or 122.

[0069] Custom tool 210 can be formed based on a digital model of the patient's teeth and oral cavity, which can be generated by intraoral 3D scanning (such as a multichannel scanner). In a specific example, custom tool 210 can be digitally designed using computer-aided design (CAD) software (such as solid modeling software based on digital models). Custom tool 210 is designed to fit onto a portion of teeth 120, 122 (for example, which may represent adjacent incisors) and adjacent teeth 124, 126. Subsequently, the tooth structure of teeth 120, 122, 124, 126 can be digitally subtracted from the mold block. Alternatively, the reverse morphology of the tooth structure can be reversed within the software to define the mold block. Optional filling ports or vents can be located in areas of the occlusal surface segments that correspond to areas of the teeth that will ultimately be removed during preparation (e.g., adjacent to the mold cavity of teeth 120, 122). The size of the filling port can be set to receive the tip of a commercially available dental restoration material filling device to allow injection of dental restoration material during filling. The vent port can be set to be smaller in diameter than the filling port.

[0070] Within the digital model, the mold block design can be divided into two parts (mold body 212 and support bodies 220, 221) to facilitate the final assembly of the tool components on the tooth without geometric interference. Within the digital model, handle features can be included and added to the mold body 212 and support bodies 220, 221 to facilitate holding these parts with hemostatic forceps or cotton forceps during dental restoration using tool 210.

[0071] Parts within CAD software can be converted into 3D point mesh files or other formats to facilitate production using 3D printers, CNC milling machines, CAD / CAM milling processes, or other methods. Orientation markings (e.g., colored markings on the distal ends of each tool part) can be applied to the tool parts to facilitate assembly. Production may optionally include additional steps such as curing (e.g., in a UV oven), cleaning (e.g., in an ethanol solution), and / or assembly of various parts, polishing of tooth surfaces, and coatings (e.g., with a clear acrylic coating to enhance the visibility of the restoration area during injection of dental restorative material). Furthermore, the surfaces of tool parts intended to come into contact with the dental restorative material may optionally be coated with a release agent layer (e.g., a thin layer of petroleum jelly).

[0072] Figure 16This is a flowchart illustrating an exemplary technique 300 for forming a dental restoration in a patient's oral cavity. First, the practitioner positions a mold (such as mold body 12 or mold body 212) over a portion of the patient's tooth (302). The tooth contains missing tooth structures or has been prepared to generate missing tooth structures, as is typically done during caries removal. The mold is combined with the tooth to form a mold cavity that encompasses the missing tooth structure and / or veneer of the tooth. Next, the practitioner introduces dental restoration material into the mold cavity (304). The practitioner causes or induces the dental restoration material to harden within the mold cavity to reshape the tooth; this may include applying photochemical radiation to harden the dental restoration material (306). The practitioner removes the mold from the patient's tooth, leaving a dental restoration on the patient's tooth with a shape defined by the mold cavity (308).

[0073] Figure 17 An exemplary dental restoration mold 400 is depicted that can be used in combination with or sequentially with the custom tools 10 and 210 of this disclosure. The dental restoration mold 400 includes a facial-side mold body 412, which can be configured to provide a personalized, unique, and customized fit with at least one tooth of a patient. For example, the facial-side mold body 412 can be specifically designed to fit adjacently to, conform to, and provide a restorative structure for at least one tooth. Figure 17 In the example shown, the facial mold body 412 includes a repair portion 416 and an engagement portion 418, wherein the repair portion 416 is used to repair at least one tooth in the patient's oral cavity. The engagement portion 418 is structured to engage or interlock with an engagement portion on the lingual mold body 414, as explained in more detail below.

[0074] In the illustrated embodiment, the size and shape of the restorative portion 416 of the mold body are configured to fit the patient's anterior teeth. The size and shape of the mating portion 418 are configured to be adjacent to the posterior teeth.

[0075] The face-side body 412 includes one or more holes (in) Figure 17Each hole (covered by a door 440) can be configured to align with a portion of the facial lateral surface of the corresponding tooth to be restored in the patient. For example, a hole can be configured to align with a portion of the facial lateral surface of one tooth, and a hole can be configured to align with a portion of the facial lateral surface of another tooth. Each hole has a suitable configuration (e.g., shape and / or size) for introducing restorative material into a mold cavity defined by the inner surface of the door 440 and the inner mold surface (not shown) of the lingual mold body 414 to cover a portion of the surface of the tooth to be restored. When the door 440 engages with the corresponding hole, the surface of the door 440 and the patient's tooth structure help to shape the restorative material placed in the mold cavity, for example, to define the surface of the tooth to be restored. In the illustrated embodiment, the door body 440 and the facial mold body 412 are mechanically connected to each other using hinges 446 and hinge pins 448.

[0076] The dental restoration mold 400 may include a lingual mold body 414, which may also be configured to provide a personalized, unique, and customized fit with at least one of the patient's teeth. The facial mold body 412 and the lingual mold body 414 may be configured to combine with at least one of the patient's teeth to form a mold cavity. For example, the facial mold body 412 and the lingual mold body 414 may be configured to fit together and / or attach to at least one tooth to form a mold cavity. In some examples, the lingual mold body 414 may be separable from and engaged with the facial mold body 412 while maintaining the integrity of the respective mold body through the use of their engagement portions 418, 419. Similar to the facial mold body 412, the lingual mold body 414 includes a restoration portion 417 and an engagement portion 419. The engagement portion 419 of the lingual mold body 414 may include multiple engagement surfaces configured to suitably fit with engagement surfaces on the facial mold body 412.

[0077] The dental restoration mold 400 is designed to ensure a relatively tight fit between the mold bodies 412 and 414 to help reduce or eliminate flash that occurs along the edges where they fit together. Any flash that does occur may be very thin along the incisal edge and may be relatively easy to remove with dental instruments.

[0078] Figure 18This is a flowchart of forming a dental restoration in a patient's oral cavity using the custom tools and dental restoration mold 400 (or other similar dental restoration molds) disclosed herein. The method includes: positioning a patient-specific facial mold body adjacent to at least one tooth of the patient to be restored (502); positioning a patient-specific lingual mold body adjacent to the at least one tooth to be restored (504); interlocking the facial mold body and the lingual mold body to combine with the patient's tooth to form a mold cavity that covers the missing tooth structure of the at least one tooth to be restored (506); introducing restorative material into the mold cavity (508); curing the restorative material (510); and removing the facial mold body and the lingual mold body from the at least one tooth (512).

[0079] The method further includes: a practitioner positioning a portion of a one-piece custom-made tool (such as mold body 12 or mold body 212) over a portion of the patient's tooth (514). This tooth contains a missing tooth structure or has been prepared for generating a missing tooth structure. This tooth is typically not the tooth to be restored according to steps 502-512 described above. The mold is combined with the tooth to form a mold cavity that encompasses the missing tooth structure and / or veneers of the tooth. Next, the practitioner introduces dental restoration material into the mold cavity (514). The practitioner causes or induces the dental restoration material to harden within the mold cavity to reshape the tooth; this may include applying photochemical radiation to harden the dental restoration material. The practitioner removes the mold from the patient's tooth, leaving a dental restoration (516) on the patient's tooth with a shape defined by the mold cavity.

[0080] This method can be followed Figure 16 The processes described herein may be executed sequentially, or nearly simultaneously. In other alternative methods, step 514 may be executed prior to steps 502-512. As another alternative, the two tools may be executed sequentially... Figure 18 The teeth are placed on the tooth to be restored in the order specified in the instructions, but undergo curing and / or removal steps at the same time or almost simultaneously.

[0081] Figure 19 This is a block diagram illustrating an exemplary system 600 for designing and manufacturing dental instruments (e.g., custom tools 10 or 210) for restoring a patient's dental anatomy, according to various aspects of this disclosure. Figure 17 In the example, system 600 includes clinic 604, appliance design facility 608, and manufacturing facility 610.

[0082] Physician 606 may treat patient 602 in clinic 604. For example, physician 606 may create a digital model of patient 602's current dental anatomy. Dental anatomy may include any portion of the crown or root of one or more teeth in the dental arch, gingiva, periodontal ligament, alveolar bone, cortical bone, implants, artificial crowns, bridges, veneers, dentures, orthodontic appliances, or any structure that may be considered part of the dentition before, during, or after treatment. In one example, the digital model of the current dental anatomy includes a three-dimensional (3D) model of the patient's current dental anatomy. The 3D model may be generated using an intraoral scanner, cone-beam computed tomography (CBCT) scan (i.e., 3D X-ray), optical coherence tomography (OCT), magnetic resonance imaging (MRI), or any other 3D image capture system. In some examples, computing device 690 stores the digital model of patient 602's current dental anatomy.

[0083] The computing device 690 of clinic 604 can store a digital model of the patient's future dental anatomy. The future dental anatomy represents the intended shape of the dental anatomy that will be achieved through the application of dental instruments (such as dental instrument 601). In one example, the practitioner 606 can create a physical model of the future dental anatomy and can utilize an image capture system (e.g., as described above) to generate a digital model of the future dental anatomy. In another example, the practitioner 606 can modify the digital model of the patient 602's current anatomy (e.g., by adding material to the surface of one or more teeth of the dental anatomy) to generate a digital model of the future dental anatomy. In yet another example, the computing device 690 can modify the digital model of the current dental anatomy to generate a model of the future dental anatomy. In yet another example, modifications to the patient's dental anatomy can be made remotely by a third-party provider. Such modifications can be prescribed, reviewed, and modified by the practitioner 606, or made under the guidance of the practitioner. The dental anatomy can be designed in a digital environment or physically rendered using conventional dental laboratory techniques (e.g., applying wax) to physically modify the initial dentition. This physical model of the teeth can be digitized via a 3D scanner.

[0084] In one scenario, computing device 690 outputs a digital model representing the (e.g., current and / or future) dental anatomy of patient 602 to another computing device, such as computing device 650 and / or computing device 692. Figure 19 As illustrated, in some examples, the computing device 650 of design facility 608, the computing device 690 of clinic 604, and the computing device 692 of manufacturing facility 610 may be communicatively coupled to each other via network 614. Network 614 may include wired or wireless networks, such as via WIFI. ® BLUETOOTH® 3G, 4G LTE, 5G, etc.

[0085] exist Figure 19 In one example, design facility 608 includes computing device 650 configured to automatically design dental appliances for orthodontic treatment of the dental anatomy of patient 602. In one example, computing device 650 includes one or more processors 672, one or more user interface (UI) devices 674, one or more communication units 676, and one or more storage devices 678.

[0086] UI device 674 may be configured to receive user input and / or output information (also referred to as data) to the user of computing device 650. One or more input components of UI device 674 may receive input. Examples of input are haptic input, audio input, dynamic input, and optical input (to name just a few). For example, UI device 674 may include a mouse, keyboard, voice response system, camera, button, control panel, microphone, or any other type of device for detecting input from a person or machine. In some examples, UI device 674 may be a presence-aware input component, which may include a presence-aware screen, touch-sensitive screen, etc.

[0087] One or more output components of UI device 674 can generate output. Examples of output are data output, haptic output, audio output, and video output. In some examples, the output components of UI device 674 include display devices (e.g., presence-sensing screens, touchscreens, liquid crystal displays (LCDs), light-emitting diode (LED) displays, optical head-mounted displays (HMDs), etc.), light-emitting diodes, speakers, or any other type of device for generating output for people or machines.

[0088] Processor 672 represents one or more processors, such as a general-purpose microprocessor, a specially designed processor, an application-specific integrated circuit (ASIC), a field-programmable gate array (FPGA), a collection of discrete logic, or any type of processing device capable of performing the techniques described herein. In one example, storage device 678 may store program instructions (e.g., software instructions or modules) executed by processor 672 to perform the techniques described herein. In other examples, these techniques may be executed by specially programmed circuitry of processor 672. In these or other ways, processor 672 may be configured to perform the techniques described herein.

[0089] In some examples, storage device 678 may also include one or more computer-readable storage media. Storage device 678 may be configured to store a larger amount of data than volatile memory. Storage device 678 may be further configured to serve as long-term storage of data as non-volatile memory space and to retain data after an activation / deactivation cycle. Examples of non-volatile memory include solid-state drives (SSDs), hard disk drives (HDDs), flash memory, or electrically programmable memory (EPROM) or electrically erasable programmable memory (EEPROM). Storage device 678 may store program instructions and / or data associated with software components 682-689 and / or operating system 680.

[0090] The system receives a preoperative scan. A wax model is then generated to create an outline of the future tooth anatomy. The wax model can be physically generated and scanned into a computer, or it can be generated digitally. Preferably, the wax model is scaled and oriented in digital 3D space to correspond to the preoperative scan, which facilitates tool design by selectively utilizing the surfaces from both the preoperative and future tooth anatomy models.

[0091] exist Figure 19 In the example, storage device 678 includes an appliance feature library 664, a model library 666, and a physician preference library 668. Libraries 664, 666, and 668 may include relational databases, multidimensional databases, mapping graphs, hash tables, or any data structure for storing data. In one example, model library 666 includes 3D models of a patient's current and / or future dental anatomy. As described in more detail below, libraries 664, 666, and 668 may include representations of adjacent 3D geometry. In some instances, libraries 664, 666, and 668 may be stored locally on computing device 650 or accessible via networked file sharing, cloud storage, or other remote data repositories.

[0092] Computing device 650 may utilize one or more processors 672 to execute software components 682-689. Computing device 650 may execute any of components 682-689 as a virtual machine executing on the underlying hardware or within that virtual machine. In one example, any of components 682-689 may be implemented as part of operating system 680.

[0093] According to the technology disclosed herein, computing device 650 automatically or semi-automatically generates a digital model of dental appliance 601 for restoring the dental anatomy of patient 602 based on a digital model of the patient's future dental anatomy and a preoperative model. Preprocessor 681 can preprocess the digital model of the patient 602's future dental anatomy. In one example, preprocessor 681 performs preprocessing to identify one or more teeth in the patient 602's future dental anatomy. In some instances, preprocessor 681 identifies a local coordinate system for each individual tooth and can identify a global coordinate system encompassing each tooth of the future dental anatomy. As another example, preprocessor 681 can preprocess the digital model of the future dental anatomy to identify the root structure of that anatomy. In another example, preprocessor 681 can identify the gingiva. Thus, preprocessor 681 can determine the portion of the future dental anatomy that includes the gingiva and the portion of the future dental anatomy that includes the teeth.

[0094] Landmark identifier 682 identifies one or more landmarks for the future dental anatomy and preoperative model. Example landmarks include slices, midpoints, gingival boundaries, the nearest point between two adjacent teeth (e.g., the contact point or closest point (or most closely proximal point) between adjacent teeth), convex hulls, centroids, or other landmarks. A slice refers to a cross-section of the dental anatomy. The midpoint of a tooth refers to the geometric center of the tooth within a given slice (also known as the geometric midpoint). The gingival boundary is the boundary between the gingiva and one or more teeth of the dental anatomy. A convex hull is a polygon whose vertices include a subgroup of vertices from a given set of vertices, where the boundary of the subgroup of vertices circumscribes the entire set of vertices. The centroid of a tooth refers to the midpoint, center point, centroid, or geometric center of the tooth. In some instances, landmark identifier 682 identifies landmarks in a local coordinate system for each tooth.

[0095] In some examples, the landmark identifier 682 identifies multiple slices of the patient's future dental anatomy. In one example, each slice has the same thickness. In some instances, the thickness of one or more slices differs from the thickness of another slice. The thickness of a given slice can be predetermined. In one instance, the landmark identifier 682 automatically determines the thickness of each slice. In another instance, the thickness of each slice can be user-defined.

[0096] In some examples, the landmark identifier 682 determines the midpoint of each tooth. In one example, the landmark identifier 682 determines the midpoint of a particular tooth by calculating the extreme value of the geometry of that particular tooth based on the tooth as a whole (e.g., without dividing the tooth anatomy into slices), and determining the midpoint of that particular tooth based on that extreme value of the tooth geometry.

[0097] In some examples, the landmark identifier 682 determines the midpoint of each tooth for each slice. The landmark identifier 682 can determine the midpoint of a specific tooth for a specific slice by calculating the centroids of a series of vertices around the edge of the specific tooth for that specific slice. In some instances, the midpoint of a specific tooth for a specific slice may be biased toward one edge of the tooth (e.g., in cases where one edge has more points than another).

[0098] In another example, the landmark identifier 682 may determine the midpoint of a specific tooth in a particular slice based on the convex hull of that tooth for that particular slice. For example, the landmark identifier 682 may determine the convex hull of a set of edge points of a tooth for a given slice. In some instances, the landmark identifier 682 determines the geometric center from the convex hull by performing a flooding fill operation on the region circumscribed by the convex hull and calculating the centroid of the flooded convex hull.

[0099] In some examples, the landmark identification module 682 determines the closest point between two adjacent teeth. The closest point between two adjacent teeth can be a contact point or a point of closest proximity. In one example, the landmark identification module 682 determines the closest point between two adjacent teeth for each slice. In another example, the landmark identification module 682 determines the closest point between two adjacent teeth based on the overall structure of the adjacent teeth (e.g., without dividing the tooth anatomy into slices).

[0100] A spline is a curve that passes through multiple points or vertices, such as a piecewise polynomial parametric curve. A mold parting surface is a 3D mesh that bisects one or more teeth (e.g., separating the facial side of one or more teeth from the lingual side of one or more teeth). A gingival trimming surface is a 3D mesh trimmed along the gingival margin that surrounds the housing. The housing is a body of nominal thickness. In some examples, the inner surface of the housing matches the surface of the dental arch, and the outer surface of the housing is a nominal offset of the inner surface. A facial side band is a reinforcing rib with nominal thickness that is offset towards the face from the housing. An incisal edge ridge provides reinforcement at the incisal edge of the dental appliance 601 and can be obtained from the dental arch morphology. A housing frame strut is a connecting material that attaches parts of the dental appliance 601 (e.g., the facial side portion of the dental appliance 601, the lingual bar of the dental appliance 601, and its sub-components) to the manufacturing housing frame. In this way, the housing frame strut can fasten the parts of the dental appliance 601 to the housing frame during manufacturing, protect the individual parts from damage or wear, and / or reduce the risk of parts becoming entangled.

[0101] In some examples, the custom feature generator 684 generates one or more splines based on landmarks. The custom feature generator 684 may generate splines based on multiple tooth midpoints and / or the closest points between adjacent teeth (e.g., contact points or closest points between adjacent teeth). In some instances, the custom feature generator 684 generates one spline for each slice. In one instance, the custom feature generator 684 generates multiple splines for a given slice. For example, the custom feature generator 684 may generate a first spline for a first subgroup of teeth (e.g., right posterior teeth), a second spline for a second subgroup of teeth (e.g., left posterior teeth), and a third spline for a third subgroup of teeth (e.g., anterior teeth).

[0102] The instrument feature library 664 includes a set of predetermined instrument features that may be included in the dental appliance 601. The instrument feature library 664 may include a set of predetermined instrument features that define one or more functional characteristics of the dental appliance 601. Examples of predetermined instrument features include vents, occlusal registration features, custom labels, fabricated housing frames, interdental shaping piece handles, etc. Each vent is configured to allow excess dental composite material to drain from the dental appliance 601. In some examples, the incisal registration feature includes a pair of convex and concave tabs (e.g., along the midsagittal plane) situated on the incisal edge of the dental appliance 601. In one example, the incisal registration feature is used to maintain the vertical alignment of the facial portion of the dental appliance 601. Each custom label includes data identifying a part of the dental appliance 601 and / or data identifying a patient or a specific tooth to be restored. The fabricated housing frame is configured to support one or more parts of the dental appliance 601. For example, the outer shell frame can be detachably connected to the facial side portion of the dental appliance 601 to safely dispose of the dental appliance 601 and transport it from the manufacturing facility 610 to the clinic 606.

[0103] According to other embodiments, the instrument feature library 664 may be configured to include one or more abutment geometries inserted between adjacent teeth. The predetermined geometry may include library parts, scaled geometries, and / or parametric shapes (to name just a few examples). For instance, the instrument feature library 664 may include 3D sheet-like parts with a uniform thickness. As another example, the instrument feature library 664 may include subdivided 3D sheet-like parts, each subdivided having a corresponding thickness, and this corresponding thickness may be varied to better conform to the spacing and orientation of adjacent teeth. Generally, depending on a particular embodiment, the sheet-like parts may have an initial thickness between 100 micrometers and 500 micrometers. For example, in one embodiment, a sheet-like part with a uniform thickness of 650 micrometers is stored in the instrument feature library 664. Moreover, in yet another example, the instrument feature library 664 may include an oval cylinder that can be placed within the abutment space between adjacent teeth. Techniques for placing and refining abutment geometries are described in WO2023 / 031716 (Hansen et al.).

[0104] Feature manager 686 determines parameters of one or more predetermined appliance features included in predetermined appliance feature library 664. In one example, the predetermined appliance features are configured to perform the functionality of dental appliance 601. Parameters of the predetermined appliance features may include the size, shape, proportion, position, and / or orientation of the predetermined appliance features. Feature manager 686 may determine the parameters of the predetermined appliance features based on one or more rules. Rules may be pre-programmed or machine-generated (e.g., via machine learning). Exemplary methods for using neural networks to determine and design dental appliances can be found in International Publication No. WO2021 / 240290 (Fabbri et al.).

[0105] In some examples, feature manager 686 can determine the initial placement, orientation, and thickness of one or more adjacent geometries according to this disclosure.

[0106] Feature manager 686 can determine parameters of predetermined instrument features based on the preferences of physician 602. Physician preference library 668 may include data indicating the preferences of individual physicians 602. In one example, physician preferences directly affect the parameters of one or more instrument features. For example, physician preference library 668 may include data indicating preferred sizes for various instrument features (such as the size of registration features). In other examples, physician preference library 668 may include data indicating preferred initial sizes or shapes of adjacent geometries.

[0107] As another example, physician preferences indirectly influence the parameters of appliance features. For instance, a physician preference library 668 may include data indicating the preferred stiffness of the appliance. Such preference choices may also influence more complex design changes to the cross-sectional thickness of the molding piece. The feature manager 686 can determine the parameters of the appliance features by applying physician preferences to one or more rules, simulations (e.g., Monte Carlo), or finite element analyses. Feature parameters can also be derived from the properties of the materials used with the molding piece, such as the type of composite material preferred by dentists for use with appliances.

[0108] Model assembler 688 generates a digital 3D model of a dental appliance 601 for orthodontic purposes (e.g., to orthodontically reshape the tooth anatomy) in response to determining parameters of customized and predetermined appliance features. The digital model of the dental appliance 601 may include point clouds, 3D meshes, NURBS, or other digital representations of the dental appliance 601. In some instances, model assembler 688 stores the digital model of the dental appliance 601 in a model library 666.

[0109] Model assembler 688 can output a digital model of dental appliance 601. For example, model assembler 688 can output the digital model of dental appliance 601 to computing device 692 of manufacturing facility 610 (e.g., via network 614) for manufacturing dental appliance 601. In another example, computing device 650 transmits the digital model of dental appliance 601 to computing device 690 of clinic 604 for manufacturing in clinic 604. In some implementations, model assembler 688 generates a computer-readable file that includes data describing the digital model of dental appliance 601. This file can be stored in storage device 666 and can be referenced by system 600 in the future to refine previous digital models, or by manufacturing system 694 to manufacture the physical substrate of the digital model.

[0110] The refinement module 689 can be used to refine the digital model of the dental appliance 601. For example, the refinement module 689 can be used to modify one or more parameters of the digital model. In some implementations, modifications to the digital model include modifying one or more parameters of the inserted adjacent geometry. The refinement module 689 can be configured to progressively modify the digital model in response to received user input (e.g., from a practitioner 606), or it can be configured to automatically refine the digital geometry using predetermined rules or machine learning techniques.

[0111] In some implementations, the refinement module 689 can also graphically present the progressive refinement in real time as the parameters of the digital model are changed. For example, when the thickness or position of an adjacent sheet is modified based on received user input, the refinement module 689 can update the modified parameters of the adjacent sheet and display any changes in the adjacent sheet relative to the digital model in real time via the UI device 674. In other implementations, the refinement module 689 can graphically present the final refinement calculated automatically using predetermined rules or machine learning.

[0112] The advantage of presenting the finishing process graphically (step-by-step or upon completion) is that the user of system 600 (e.g., a practicing physician 606) can visually inspect the digital model of the dental appliance 601 before providing the model to the manufacturing system 694. In some embodiments, one or more aspects of the digital model of the dental appliance 601 may be provided to the finishing module 689 before system 600 provides the digital model to the model assembler 688.

[0113] The computing device 692 can transmit a digital model of the dental appliance 601 to the manufacturing system 694. The manufacturing system 694 manufactures the dental appliance 601 based on the digital model. The manufacturing system 694 can use any number of manufacturing techniques, such as 3D printing, chemical vapor deposition (CVD), thermoforming, injection molding, lost-wax casting, milling, machining, laser cutting, etc., to form the dental appliance 601.

[0114] A dentist 606 may receive and utilize dental instrument 601 to orthodontically treat one or more teeth of patient 602. For example, dentist 606 may apply dental composite material to the surface of one or more teeth of patient 602 through one or more gates of dental instrument 601. Excess dental composite material may be removed through one or more vents. In some cases, the presence of adjoint geometry in dental instrument 601 allows dentist 606 to better control the amount of dental composite material or bonding material used in the filling procedure of patient 602. Generally, the advantages of using the techniques described herein include a significant reduction in the need for dentist 606 to remove excess dental composite material. This reduces the time spent treating patient 602 with dental instrument 601 and reduces the need for dentist 606 to use saws, blades, and other tools to separate adjacent dental composite materials after they have cured.

[0115] In some examples, model assembler 688 generates a digital model of dental appliance 601 based on an existing digital model (e.g., one stored in model library 666). In one example, model library 666 may include data indicating appliance success criteria associated with each completed dental appliance 601, which indicate manufacturing output, physician and / or customer feedback or ratings, or a combination thereof. For example, in response to determining that a previous dental appliance 601 meets a threshold criterion for appliance success (e.g., a threshold manufacturing output or a threshold physician rating), model assembler 688 may utilize an existing digital model to generate a new or updated digital model of dental appliance 601. In one example, the existing digital model is a template or reference digital model. In such examples, model assembler 688 may generate a digital model of dental appliance 601 based on a template digital model. For example, the template digital model may be associated with different characteristics of a potential patient's dental anatomy (such as a patient having small teeth or being unable to open their mouth wide).

[0116] In one example, model assembler 688 generates a digital model of dental appliance 601 based on an existing digital model by utilizing one or more deformation algorithms. For example, model assembler 688 may use deformation algorithms to interpolate the geometry of appliance features. In one instance, model assembler 688 may generate a new digital model of dental appliance 601 based on the design of an existing digital model. In one instance, the design features of the existing digital model may include windows embedded from the periphery, allowing model assembler 688 to deform the geometry of the existing digital model based on landmarks of different dental anatomy structures.

[0117] The technology disclosed herein enables computing devices to automatically determine the shape of a dental appliance 601 and the placement of various appliance features. This allows the computing device to generate a digital model of the dental appliance 601 more accurately and quickly. More accurate determination of the shape and placement of the appliance features of the dental appliance 601 increases the effectiveness of both the dental appliance 601 and the dental restoration. Faster determination of the shape and placement of the appliance features allows practitioners to orthodontists to correct patients' teeth more quickly, potentially improving the appearance and / or function of the patient's teeth and thus enhancing the patient experience. Furthermore, reducing the time required to generate a digital model of the dental appliance 601 lowers production costs and makes treatment more affordable and accessible to a wider range of patients.

[0118] While the computing device 650 is described as automatically generating a digital model of the dental appliance 601 based on a digital model of the patient's future dental anatomy, in some examples, the computing device 650 may utilize a digital model of the patient's current unrepaired dental anatomy to generate the entirety or a portion of the digital model of the dental appliance 601. For example, the computing device 650 may utilize a digital model of the current dental anatomy to generate facial lateral bands (e.g., because the gingival margin may not change during restoration) and / or registration portions (e.g., because the mesial and distal pillars may be registered with teeth that are not to be restored).

[0119] Figure 20 This is a flowchart illustrating example techniques for generating digital models of dental appliances according to various aspects of this disclosure. Figure 20 In the following text Figure 19 It is described in the context of System 600.

[0120] Computing device 650 receives a digital 3D model of the future (i.e., desired) dental anatomy of patient 602 (step 702). In one example, computing device 650 receives the digital model of the future dental anatomy from another computing device (such as computing device 690 of clinic 604). The digital model of the patient's future dental anatomy may include a point cloud or 3D mesh of the future dental anatomy. A point cloud includes a set of points that represent or define an object in three-dimensional space. A 3D mesh includes multiple vertices (also referred to as points) and geometric faces (e.g., triangles) defined by the vertices. In one example, practitioner 606 creates a physical model of the future dental anatomy and uses an image capture system to generate a digital model of the future dental anatomy. In another example, practitioner 606 modifies the digital model of the patient 602's current anatomy (e.g., by adding material to the surface of one or more teeth of the dental anatomy) to generate a digital model of the future dental anatomy. In yet another example, computing device 690 may modify the digital model of the current dental anatomy to generate a model of the future dental anatomy.

[0121] In some examples, preprocessor 684 preprocesses the 3D model of the future tooth anatomy to generate a modified model by digitally extending the roots of the initial digital model of the future tooth anatomy according to the expected root extension determined by preprocessor 684, thereby more accurately modeling the complete anatomy of the patient's teeth (step 704). In some examples, because the tops of the roots (e.g., the region furthest from the gingival eruption point) may be at different heights, preprocessor 684 may detect vertices corresponding to the tops of the roots and then project those vertices along normal vectors, thereby digitally extending the roots. In one example, preprocessor 684 (e.g., using a k-means algorithm) groups the vertices into clusters. Preprocessor 684 may compute an average normal vector for each vertex cluster. For each vertex cluster, preprocessor 684 may determine the sum of the residual angular differences between the average normal vector for that cluster and the vectors associated with each vertex in that cluster. In one example, preprocessor 684 determines which vertex cluster is the top surface of the root based on the sum of the residual angular differences for each cluster. For example, preprocessor 684 can determine the top surface of the cluster-defined root with the lowest sum of residual angle differences.

[0122] Furthermore, the landmark identifier 682 processes the 3D model of the future dental anatomy to automatically detect a set of one or more landmarks of the future dental anatomy, wherein each landmark represents an identifiable geometry within the 3D model that can be used to determine position and orientation relative to one or more tooth surfaces. In some examples, the landmarks calculated by the landmark identifier 682 include multiple slices of the dental anatomy, and each slice of the dental anatomy may include one or more additional landmarks. For example, the landmark identifier 682 may divide the 3D mesh of the future dental anatomy into multiple slices. In response to dividing the digital model of the dental anatomy into slices, in one example, the landmark identifier 682 calculates one or more landmarks for each slice, such as the midpoint of each tooth in the slice, the nearest point between two adjacent teeth (e.g., the contact point between two adjacent teeth or the closest point between two adjacent teeth), the convex hull of each tooth in the slice, etc. (step 706).

[0123] Custom feature generator 684 automatically generates design files that include specific sizes, shapes, locations, and / or orientations of one or more custom appliance features of dental appliance 601 determined based on landmarks. Each "feature" represents a digital 3D mesh defining a specific geometry that will be used as a part (i.e., a sub-mesh) within a 3D model defining the entire dental appliance (step 708). Examples of custom appliance features include 3D meshes for splines, mold parting surfaces, gingival trimming surfaces, housings, facial sidebands, adjacent sheet pieces, lingual bars, occlusal registration portions, and so on. In one example, custom feature generator 684 generates one or more digital meshes of splines representing each slice of dental anatomy. Custom feature generator 684 can generate splines for a given slice based on multiple tooth midpoints within the slice and / or the nearest points between adjacent teeth within the slice (e.g., contact points between adjacent teeth within the slice or the closest proximity points between adjacent teeth within the slice). In other words, in this example, the custom feature generator 684 accumulates a set of points (e.g., tooth midpoints, contact points between adjacent teeth, closest points between adjacent teeth, or combinations thereof) for each slice to generate a feature representing a spline for each digital slice.

[0124] In some examples, the custom feature generator 684 automatically generates a mold parting surface as an example feature to be incorporated into the entire 3D model of the dental prosthesis. The custom feature generator 684 can generate the mold parting surface based on multiple midpoints and / or the nearest points between adjacent teeth. For example, the custom feature generator 684 can accumulate multiple points for each spline of each slice to generate the mold parting surface. In an example where the custom feature generator 684 divides the dental anatomy into four slices and generates a single spline for each slice, the custom feature generator 684 aggregates the points of each of the four splines to generate the mold parting surface.

[0125] In one scenario, feature manager 686 receives data indicating physician preferences (step 710). For example, feature manager 686 may query physician preference database 668 to determine the preferences of physician 606. Examples of data stored in physician preference database 686 include preferred sizes or orientations of predetermined instrument features for a particular physician.

[0126] Feature manager 686 receives data indicating predetermined appliance features, such as by accessing and retrieving data from one or more libraries (e.g., data repositories or other electronic databases) representing 3D meshes used to incorporate predetermined features throughout the 3D model (step 712). For example, feature manager 686 may receive data by querying appliance feature library 664. Appliance feature library 664 stores data defining 3D meshes for multiple predetermined appliance features (such as markings, protrusions, engagement registration features, and engagement fingers, etc.).

[0127] In one example, feature manager 686 selects one or more predetermined instrument features from a plurality of predetermined instrument features stored in instrument feature library 686. For example, instrument feature library 686 may include data defining a plurality of different predetermined instrument features belonging to a given type. As an example, instrument feature library 664 may include data defining different characteristics (e.g., size, shape, proportion, orientation) of predetermined instrument features of a given type (e.g., data for fingers, holes, etc. of different sizes and / or shapes). In other words, instrument feature library 664 may determine the characteristics of predetermined instrument features and select features from the predetermined instrument library corresponding to the determined characteristics. In some cases, feature manager 686 selects predetermined instrument features from instrument feature library 686 based on the landmark of the corresponding tooth, the characteristics of the corresponding tooth (e.g., the tooth to be restored using the instrument feature when the dental appliance is applied to the patient) (e.g., size, type, location), practitioner preference, or both (e.g., facial sidebands).

[0128] In another example, the appliance feature library 664 includes data defining a desired set of predetermined appliance features, such that the feature manager 686 retrieves data for a 3D mesh representing each of the desired predetermined features. In such examples, the feature manager 664 can transform the 3D mesh for inclusion in a patient-specific dental appliance. For example, the feature manager 664 can rotate or scale (e.g., resize) the 3D mesh for a particular feature based on landmarks of the corresponding tooth, tooth characteristics, and / or practitioner preferences.

[0129] Model assembler 688 is used to construct the entire 3D mesh for a dental appliance by, for example, determining the characteristics of one or more custom appliance features and one or more predetermined dental appliance features, at least in part, based on patient-specific landmarks (step 714). For example, based on patient-specific landmarks, model assembler 688 can determine example characteristics, such as size, position, and / or orientation, of each 3D mesh corresponding to each appliance feature (including custom or predetermined appliance features) for the entire appliance. In some instances, model assembler 688 determines the position of predetermined appliance features based on the position of the custom appliance features. For example, model assembler 688 can align perforations with the centerline of the mold body. Furthermore, model assembler 688 can adjust the geometry, scale, or position of features based on analysis of the entire model. Model assembler 688 can also make adjustments based on subsequent anticipated manufacturing tolerances, such as providing appropriate gaps between features. Similarly, the model assembler 688 can be adjusted based on the properties of the materials used to generate physical devices, such as increasing the thickness when using more flexible materials.

[0130] Model assembler 688 generates a complete digital 3D model of dental appliance 601 based on custom dental appliance features and predetermined dental appliance features and their determined properties (step 716). The digital model of dental appliance 604 may include point clouds, 3D meshes, or other digital representations of dental appliance 604.

[0131] Computing device 650 stores, sends, and / or outputs a digital 3D model of dental appliance 604 (step 718). For example, computing device 650 may output the digital 3D model of dental appliance 604 to computing device 692 of manufacturing facility 640. Manufacturing system 694 generates dental appliance 604 based on the digital 3D model of dental appliance 604 (step 720). For example, manufacturing system 694 may generate physical dental appliance 604 via 3D printing, CVD, machining, milling, or any other suitable technology.

[0132] In some examples, the computing system 650 receives feedback from the physician 606 regarding the dental appliance 601 (step 722). For example, after the physician 606 receives the physical dental appliance 601, the physician 606 may transmit feedback to the computing device 650 using the computing device 690. As an example, the computing device 650 may receive data indicating a request for adjusting the characteristics (e.g., size, relative position) of predetermined appliance features. In some examples, the computing system 650 updates the physician preference library 668 (724) based on the feedback.

[0133] Various examples have been described. Modifications to the described examples are possible within the substantial scope of this disclosure. For example, a custom tool may be fabricated based on an initial tooth geometry or a digitally optimized tooth geometry (e.g., optimized by filling gaps in data through cavity filling, pulling and scaling data from a tooth database, or testing in a virtual occlusal articulator). The tool may precisely fit an existing structure or may be optimized to selectively move or position tissue. Custom tools may be formed without prior information about where tooth structures will be removed (e.g., when the extent of caries is unknown). Custom tools may be formed to generate a digitally optimized tooth structure that will require removal of the tooth structure by a practitioner before applying the tool. The tool may be printed or milled. The tool may be made from a full range of 3D printing materials (strength, flexibility, translucency, color). The tool may be coated with a range of reagents to optimize release, surface finish, and optical transparency. The tool may include features indicating or defining the infill level (hue, infill level, physical properties) of different restorative materials. The physical properties of the tool (elasticity, roughness, texture, imprint of secondary / tertiary anatomy, transparency, gloss, etc.) can vary across tools, including sealing ability, dimensional fidelity, the texture imparted to the restorative material, and the degree of material curing. The tool and mold portions can interlock with each other or with standard components (e.g., shaping strips). The tool can be used intraorally or externally. The restorative material can be injected through a port in the tool, applied to the tooth structure and / or the tool before application, allowing the material to be shaped during application. The tool can be biodegradable, such as by solvents or heating, to demold from the restorative material or to achieve undercut geometry and / or reduce parting lines. The tool can be foldable (shrinkable, brittle, etc.). Patient-specific kits of tools and associated products and quantities (e.g., adhesives, fillings, and polishing materials selected according to patient needs and / or physician preferences) can be created. A series of tools can be used sequentially during direct filling to control the geometry of multi-layered dental restorations on the tooth. Parts of the tool can be designed to align with the anterior dentition and / or dentition in the middle or final stages of treatment. The tool can be designed to align with or fit into auxiliary devices used in the procedure, such as wedges, shaping strips, and retraction devices. Dental scans can be performed during the diagnostic appointment to facilitate the fabrication of custom tools prior to the dental restoration appointment. Tools can be manufactured locally, or digital scan data can be transmitted to a remote location for production.

[0134] All patents, patent documents, and patent applications cited herein are incorporated by reference in their entirety, as if each were individually incorporated by reference. It will be apparent to those skilled in the art that various changes and modifications can be made without departing from the inventive concept set forth above. Therefore, the scope of this disclosure should not be limited to the structures described herein. Those skilled in the art will understand that many variations can be made to the above embodiments and details of specific implementations without departing from the basic principles. Furthermore, various modifications and alterations to the invention will be apparent to those skilled in the art without departing from the spirit and scope of the invention. Therefore, the scope of this application should be determined solely by the following claims and their equivalents.

Claims

1. A method for forming a dental restoration in a patient's oral cavity, the method comprising: A mold body is provided that provides a patient-specific, custom fit for at least two teeth of the patient, the teeth including a first restorative tooth and a first supporting tooth adjacent to the restorative tooth, wherein the mold body includes a facial side portion and a registration portion, the facial side portion forming a first facial side surface corresponding to the facial side surface of the first restorative tooth, and the registration portion including an occlusal strut configured to extend over the incisal ridge or one or more occlusal cusps of the first supporting tooth; Dental restorative material is applied to the surface of the mold body, the surface of the first restored tooth, or both; The mold is positioned on a portion of the restored tooth, wherein the mold is combined with the restored tooth to form a mold cavity that covers the missing tooth structure of the restored tooth; as well as The dental restorative material is cured within the mold cavity to reshape the tooth.

2. The method of claim 1, wherein the mold body further comprises a reinforcing band extending along the gingival margin of the facial side portion of the mold body.

3. The method of claim 2, wherein the mold body includes at least one hole located between the facial side surface of the facial side portion and the inner surface of the reinforcing strip.

4. The method of claim 1, wherein the mold body further comprises at least a first abutment portion corresponding to a first abutment surface of the first restorative tooth, and wherein the first abutment portion has a patient-specific digitally engineered surface.

5. The method of claim 1, wherein the restoration portion includes at least a first finger configured to extend over a portion of the cusp of the first restored tooth, the finger defining a first occlusal surface.

6. The method of claim 5, wherein the registration portion includes at least a second finger configured to extend over a wedge-shaped gap between the first registration tooth and the supporting tooth.

7. The method of claim 1, wherein the occlusal strut has a patient-specific custom fit with the occlusal cusp of the first restorative tooth or the first supporting tooth.

8. The method according to any one of the preceding claims, wherein the mold body further comprises a support body forming a first facial side surface corresponding to the facial side surface of the first supporting tooth.

9. The method according to any one of the preceding claims, wherein the mold body provides a patient-specific, custom fit for at least three teeth of the patient, the teeth including the first restorative tooth, the first supporting tooth, and the second restorative tooth. The mold body includes a facial side portion, which forms a first facial side surface corresponding to the facial side surface of the first restored tooth and a second facial side surface corresponding to the facial side surface of the second restored tooth. The mold body is configured to combine with the patient's teeth to form a mold cavity that covers the missing tooth structure of both the first and second restored teeth.

10. The custom tool according to any one of the preceding claims, wherein the mold body comprises a dental restoration, The dental restorative material is cured within the mold cavity to reshape the tooth.

11. A method for forming a dental restoration in a patient's oral cavity, the method comprising: A patient-specific facial mold body is positioned adjacent to at least one tooth of the patient to be restored, wherein the facial mold body has a custom fit with the facial side of at least one tooth of the patient, the at least one tooth defining the first restoring tooth; The patient-specific lingual mold body is positioned adjacent to the first restored tooth, wherein the lingual mold body has a customized fit with the lingual side of the first restored tooth; The facial mold body is connected to the lingual mold body to be combined with the first restored tooth, thereby forming a mold cavity that covers the missing tooth structure of at least one tooth to be restored; The repair material is introduced into the mold cavity; Solidify the repair material; as well as A second integral mold body is provided, which provides a patient-specific, custom fit with at least two additional teeth of the patient, the teeth including a second restorative tooth and a first supporting tooth adjacent to the second restorative tooth, wherein the integral mold body includes a facial side portion and a registration portion, the facial side portion forming a first facial side surface corresponding to the facial side surface of the first restorative tooth, and the registration portion including an occlusal strut configured to extend over the incisal ridge or one or more occlusal cusps of the first supporting tooth; Dental restorative material is applied to the surface of the mold body, the surface of the first restored tooth, or both; The mold is positioned on a portion of the restored tooth, wherein the mold is combined with the restored tooth to form a mold cavity that covers the missing tooth structure of the restored tooth; as well as The dental restorative material is cured within the mold cavity to reshape the tooth.

12. The method of claim 11, wherein the second restored tooth is a first premolar or a second premolar.

13. The method of claim 12, wherein providing the second integral mold body occurs after the restorative material has been cured on the first restorative tooth.

14. The method of claim 11, wherein the second integral mold body includes at least a first abutment portion corresponding to a first abutment surface of the first restorative tooth, and wherein the first abutment portion has a patient-specific digitally engineered surface.

15. The method of claim 11, wherein the restoration portion includes at least a first finger configured to extend over a portion of the cusp of the first restored tooth, the finger defining a first occlusal surface.

16. The method of claim 15, wherein the registration portion includes at least a second finger configured to extend over a wedge-shaped gap between the first registration tooth and the supporting tooth.

17. The method of claim 11, wherein the occlusal strut has a patient-specific, custom fit with the occlusal cusp of the first supporting tooth or the first restorative tooth.

18. A method of manufacturing a custom-made tool for forming a dental restoration in a patient's oral cavity, the method comprising: Obtain three-dimensional scan data of the patient's oral cavity; as well as A first custom-made tool for forming a dental restoration for the tooth is printed in three dimensions based on the three-dimensional scan data of the patient's oral cavity. The first custom tool includes a mold body that provides a patient-specific custom fit for at least two teeth of the patient, including a first restorative tooth and a first supporting tooth adjacent to the restorative tooth. The mold body includes a facial side portion and a registration portion. The facial side portion forms a first facial side surface corresponding to the facial side surface of the first restorative tooth. The registration portion includes an occlusal strut configured to extend over the incisal ridge or one or more occlusal cusps of the first supporting tooth.

19. The method of claim 18, further comprising: A second custom tool is 3D printed based on the 3D scan data of the patient's oral cavity. The second custom tool includes: a patient-specific facial mold body that has a custom fit with the facial side of at least one tooth of the patient, the at least one tooth defining a second restorative tooth; and a patient-specific lingual mold body that has a custom fit with the lingual side of the second restorative tooth.

20. The method of claim 18, wherein the mold body of the first custom tool provides a patient-specific custom fit for at least three teeth of the patient, the teeth including the first restorative tooth, the first supporting tooth, and the second restorative tooth. The mold body includes a facial side portion, which forms a first facial side surface corresponding to the facial side surface of the first restored tooth and a second facial side surface corresponding to the facial side surface of the second restored tooth. The mold body is configured to combine with the patient's teeth to form a mold cavity that covers the missing tooth structure of both the first and second restored teeth.

Images