Dental restoration molds including unitary mold body

Abstract

A custom tool for forming a dental restoration in a mouth of a patient includes a one-piece mold body providing for a customized fit with at least one tooth of the patient, the one-piece mold body including an occlusal portion forming an occlusal surface corresponding with an occlusal surface of the tooth, a mesial proximal portion forming a mesial proximal surface corresponding with a mesial proximal surface of the tooth, and a distal proximal portion forming a distal proximal surface corresponding with a distal proximal surface of the tooth. The mold body is configured to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of the tooth. The occlusal portion, the mesial proximal portion, and the distal proximal portion are based on three-dimensional scan data of the mouth of the patient.

Description

[0001] DENTAL RESTORATION MOLDS INCLUDING UNITARY MOLD BODY

[0002] TECHNICAL FIELD

[0003] This disclosure relates to dental restorations.

[0004] BACKGROUND

[0005] A dental restoration, or a dental filling, utilizes a restorative dental material used to improve the function, integrity, and morphology of missing or irregular tooth structure. For example, a dental restoration may be used to restore missing tooth structure due to congenital discrepancies, following external trauma, or as part of a restorative treatment for dental caries, or tooth decay.

[0006] Restorative dentistry often includes drilling decay from an infected tooth (commonly referred to as “preparing” the tooth) and then using simple tools and a high level of craftsmanship to isolate, retract, fill and contour the finished restoration. Quality isolation via a rubber dam is cumbersome and often skipped for less effective isolation via cotton rolls - increasing the risk of contamination which reduces longevity of the restoration. Retraction of soft and hard tissue includes manipulation of cords, wedges and matrix bands, and imperfect technique may result in contamination, difficulty in finishing and / or polishing in interproximal areas, and poorly adapted contacts.

[0007] While ‘bulk fill’ restorative materials and high intensity curing lights facilitate relatively fast filling of deep cavities (e.g., 4-5 mm), many restorations are completed in a single shade as practitioners may be uncertain of the correct layering protocol for multiple shades or types of restorative material. Last, with little geometrical guidance available on a prepared tooth, creation of the final filling level and occlusal surface geometry may include overfilling with restorative dental material, followed by an iterative process of grinding and checking tooth contact and biting function on an anesthetized patient. This process may be the most time consuming for dental restorations and errors here may result in tooth sensitivity and return visits for adjustment.

[0008] Commonly assigned patents and patent applications include United States Patent Nos. 10,722,331; 11,123,165; 11,185,392; United States Patent Application Publ. Nos. 2019 / 0298489; 2019 / 0083208; 2021 / 0290349; 2021 / 0298882; 2021 / 0378789; 2021 / 0386528; 2022 / 0047357; and 2022 / 0117699, all disclosing dental restoration techniques incorporating the molding of dental restorative material directly on a tooth located within the mouth of a patient. SUMMARY

[0009] This disclosure relates to dental restoration techniques incorporating the molding of restorative dental material directly on a tooth located within the mouth of a patient. Disclosed techniques include methods for dental restoration, custom tools used for dental restoration and techniques for producing custom tools for dental restoration. Disclosed techniques include tools providing mold cavities customized for an individual patient. In some examples, such custom tools may be produced using 3D printing techniques.

[0010] Adding facial veneers to the anterior teeth as a part of a dental restoration can result in a so-called collapsed buccal corridor, which is the shadowing of the posterior teeth. This can be aesthetically displeasing and may result at least partially from the additional facial bulk added via the veneer-based restoration. The shadowing of the buccal corridor can be reduced by adding a facial veneer to at least the first bicuspids.

[0011] Clinicians typically will complete these facial veneer restorations on the bicuspids by hand placing composite. Performing such restorations by hand can be a difficult and time-consuming process to create the correct contours of the restoration and require a high degree of skill to perform the procedure. These bicuspid restorations in the posterior are made even more challenging due to the limited access from the patient’s cheek. The limited access in this area of the mouth does not allow for the common prior art dental restoration molds to be used for posterior restorations. For instance, dental restoration molds that include doors or ports for dental restorative material placement may be inaccessible or blocked in the posterior of the mouth.

[0012] In one example, this disclosure is directed a custom tool for forming a dental restoration in a mouth of a patient, the custom tool comprising: a mold body providing for a patient-specific, customized fit with at least three teeth of the patient, the teeth including a first restoration tooth, a second restoration tooth and a first support tooth adjacent to the first or second restoration tooth. The mold body defines a restoration portion including a facial portion forming a first facial surface corresponding with a facial surface of the first restoration tooth and a second facial surface corresponding with a facial surface of the second restoration tooth, the restoration portion further including at least one finger configured to extend partially over the embrasure between the first restoration tooth and the second restoration tooth. The tool further comprises a registration portion including a first occlusal strut configured to extend over an incisal ridge or one or more occlusal cusps the first support tooth and a first support body forming a third facial surface corresponding with a facial surface of the first support tooth, wherein the mold body is configured to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of both the first and second restoration tooth. In another example, this disclosure is directed a custom tool for forming a dental restoration in a mouth of a patient, the custom tool comprising a mold body providing for a patient-specific, customized fit with at least one typically two teeth of the patient, with at least one restored tooth and generally at least one adjacent support tooth. The mold body includes a restoration portion forming a first facial surface corresponding with a facial surface of the first restoration tooth and a first occlusal surface corresponding to an occlusal surface of the first restoration tooth, a registration portion including a first occlusal strut configured to extend over an incisal ridge or occlusal cusps of the first restoration tooth or the first support tooth, and a lingual bar fixed to the registration portion opposite the restoration portion. The mold body is configured to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of the first restoration tooth.

[0013] In further example, this disclosure is directed to a process of making a custom tool for forming a dental restoration of a tooth within a mouth of a patient, the process comprising obtaining three-dimensional scan data of a patient’s mouth, and three -dimensionally printing a custom tool for forming the dental restoration of the tooth based on the three-dimensional scan data of the mouth of the patient. The custom tool conforms to the custom tools described in the preceding paragraphs.

[0014] In further example, this disclosure is directed to a process of obtaining a custom tool for forming a dental restoration of a tooth within a mouth of a patient, the process comprising obtaining three-dimensional scan data of a patient’s mouth, transmitting at least a portion of the three-dimensional scan data to a remote manufacturing facility, receiving, from the remote manufacturing facility, a custom tool for forming the dental restoration of the tooth based on the three dimensional scan data of the mouth of the patient. The custom tool conforms to the custom tools described in the preceding paragraphs.

[0015] In further example, this disclosure is directed to a process of obtaining a custom tool for forming a dental restoration of a tooth within a mouth of a patient, the process comprising obtaining three-dimensional scan data of a patient’s mouth, transmitting at least a portion of the three dimensional scan data to a remote manufacturing facility, receiving, from the remote manufacturing facility, a design for a custom tool for forming the dental restoration of the tooth based on the three dimensional scan data of the mouth of the patient. The custom tool conforms to the custom tools described in the preceding paragraphs.

[0016] The custom tools and methods described herein may be used in combination with any of the previously described examples to create full, partial, or sequential restorations in the mouth of a patient. In this application, terms such as “a”, “an”, and “the” are not intended to refer to only a singular entity but include the general class of which a specific example may be used for illustration. The terms “a”, “an”, and “the” are used interchangeably with the term “at least one.” The phrases “at least one of’ and “comprises at least one of’ followed by a list refers to any one of the items in the list and any combination of two or more items in the list.

[0017] As used herein, the term “or” is generally employed in its usual sense including “and / or” unless the content clearly dictates otherwise. The term “and / or” means one or all of the listed elements or a combination of any two or more of the listed elements.

[0018] Also herein, all numbers are assumed to be modified by the term “about” and preferably by the term “exactly.” As used herein in connection with a measured quantity, the term “about” refers to that variation in the measured quantity as would be expected by the skilled artisan making the measurement and exercising a level of care commensurate with the objective of the measurement and the precision of the measuring equipment used. Also herein, the recitations of numerical ranges by endpoints include all numbers subsumed 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.).

[0019] As used herein as a modifier to a property or attribute, the term “generally”, unless otherwise specifically defined, means that the property or attribute would be readily recognizable by a person of ordinary skill but without requiring absolute precision or a perfect match (e.g., within + / - 20 % for quantifiable properties). The term “substantially”, unless otherwise specifically defined, means to a high degree of approximation (e.g., within + / - 10% for quantifiable properties) but again without requiring absolute precision or a perfect match. Terms such as same, equal, uniform, constant, strictly, and the like, are understood to be within the usual tolerances or measuring error applicable to the particular circumstance rather than requiring absolute precision or a perfect match.

[0020] As used herein, the term “occlusal surface” may refer to the chewing surface of any teeth, including the posterior teeth, as well as incisal surfaces (e.g., incisal edges) of anterior teeth. In this manner, as used herein, the term occlusal surface is not indicative of any particular tooth or teeth and is thus inclusive of incisal surface(s).

[0021] “Facial” as used herein, including the claims, refers to the direction directed toward the cheeks or lips (i.e., the buccal and labial) of the patient, and opposite the lingual direction. “Lingual” as used herein, including the claims, refers to the direction directed toward the tongue of the patient, and opposite the facial direction.

[0022] The above summary of the present disclosure is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The description that follows more particularly exemplifies illustrative embodiments. In several places throughout the application, guidance is provided through lists of examples, which examples can be used in various combinations. In each instance, the recited list serves only as a representative group and should not be interpreted as an exclusive list.

[0023] BRIEF DESCRIPTION OF DRAWINGS SHOWING

[0024] SOME EXAMPLES OF THIS DISCLOSURE

[0025] FIGS. 1 - 6 illustrate a custom tool for forming dental restorations of a tooth in a mouth of a patient, the custom tool including a one-piece, unitary mold body providing for a customized fit with at least one tooth of the patient;

[0026] FIGS. 7 - 10 illustrate a procedure for forming a dental restoration of a tooth in the mouth of a patient using the custom tool of FIGS. 1-6;

[0027] FIGS. 11 - 15 illustrate an alternative custom tool for forming dental restorations of two adjacent teeth in a mouth of a patient, the custom tool including two mating mold body components;

[0028] FIG. 16 is a flowchart illustrating an example technique for forming a dental restoration in the mouth of a patient;

[0029] FIG. 17 depicts an exemplary dental restoration mold 400 that can be used in combination or in series with the custom tools 10 and 200 of the present disclosure;

[0030] FIG. 18 is a flowchart for forming a dental restoration in the mouth of patient;

[0031] FIG. 19 is a block diagram illustrating an example computer environment in which a clinic and manufacturing facility communicate information throughout a custom tool manufacturing process; FIG. 20 is a flow diagram illustrating a process conducted at the clinic in accordance with one example of this disclosure; and

[0032] FIGS. 21-2 IB depict a custom tool for forming dental restorations of a tooth in a mouth of a patient, the custom tool including a one-piece, unitary mold body providing for a customized fit with at least two anterior teeth of the patient.

[0033] While the above-identified figures set forth several embodiments of the disclosure, other embodiments are also contemplated, as noted in the description. The figures are not necessarily drawn to scale. In all cases, this disclosure presents the invention by way of representation and not limitation. It should be understood that numerous other modifications and embodiments can be devised by those skilled in the art, which fall within the scope and spirit of the principles of the invention. DETAILED DESCRIPTION

[0034] While conventional dental restoration techniques often include iterative steps and benefit from significant practitioner skill and experience, this disclosure includes techniques that may utilize custom molds to facilitate forming dental restorations within the mouth of a patient more precisely and quickly than generally possible using conventional dental restoration techniques. In addition to benefits to the practitioner and patient, the current invention also provides benefit to the manufacturer(s) of various elements of the digital treatment plan, device design and custom device manufacturer.

[0035] Disclosed techniques include capturing a three-dimensional dentition of a patient with an intraoral scanner or scanning of a conventional impression or model. The custom tool for a dental restoration may include a mold based on the three-dimensional (3D) dentition of the patient. The disclosed techniques may facilitate high quality dental restorations with reduced time and skill requirements as compared to conventional dental restoration techniques.

[0036] In some examples, a tool described herein may be digitally designed. For example, a tool may be designed using a three-dimensional (3D) model of the patient’s tooth structure (e.g., obtained from an intraoral scan of all or part of the patient’s dentition or scanning of a conventional impression or model). The tool can be, for example, manufactured from digital data using an additive manufacturing technique, such as 3D printing, or a subtractive manufacturing technique, such as CAD / CAM milling. In some examples, the tool for a dental restoration may include a mold designed based on the 3D model of the patient’s tooth structure, and may include additional features to provide advantages over molds that are formed based simply on the 3D scan, a wax-up model, or other molds based simply on the shape of the anatomy and / or desired tooth structure of the patient.

[0037] The custom tools of the present disclosure can be digitally designed and fabricated, making them economical to use. By tailoring the specific design criteria and by optionally additional criteria such as a dentist preference or tooth position, the custom tools of the present invention enable highly predictable results across a wide range of clinical cases. Lastly, the tools described herein may reduce flash and / or allow increased control of the placement of restorative material compared to practitioners using more traditional skills, tools and techniques.

[0038] Custom tools can be made from the full range of 3D printed materials, molded polymeric material or CAD / CAM shaped polymeric materials having certain desired strength, flexibility, translucency, or color. For example, mold material can be comprised of polymeric material that may be transparent, translucent, or opaque. In some embodiments, clear or substantially transparent polymeric material that may include, for example, one or more of amorphous thermoplastic polymers, semi-crystalline thermoplastic polymers and transparent thermoplastic polymers chosen from polycarbonate, thermoplastic polyurethane, acrylic, polysulfone, polyprolylene, polypropylene / ethylene copolymer, cyclic olefin polymer / copolymer, poly-4- methyl-1 -pentene or polyester / polycarbonate copolymer, styrenic polymeric materials, polyamide, polymethylpentene, polyetheretherketone and combinations thereof. In another embodiment, the mold may be chosen from clear or substantially transparent semi-crystalline thermoplastic, crystalline thermoplastics and composites, such as polyamide, polyethylene terephthalate, polybutylene terephthalate, polyester / polycarbonate copolymer, polyolefin, cyclic olefin polymer, styrenic copolymer, polyetherimide, polyetheretherketone, polyethersulfone, polytrimethylene terephthalate, and mixtures and combinations thereof. In some embodiments, the mold is a polymeric material chosen from polyethylene terephthalate, polyethylene terephthalate glycol, polycyclohexylenedimethylene terephthalate glycol, and mixtures and combinations thereof. The custom tool may be formed as well from a wide range of thermoset polymers including acrylics, methacrylates, urethanes, epoxies, esters, thiolenes, cyclic olefins, silicones, and rubbers.

[0039] FIGS. 1 - 6 illustrate custom tool 10 for forming a dental restoration of tooth 102 in the mouth of a patient. In particular, FIG. 1 illustrates the components of custom tool 10, including one-piece, unitary mold body 12. FIG. 2 illustrates the components of custom tool 10 as well as a portion of the mouth of a patient prior to a dental restoration. FIG. 3 illustrates the components of custom tool 10 assembled within the mouth of a patient to facilitate a dental restoration, and FIG. 4 illustrates the custom tool from a lingual perspective. FIG. 5 illustrates the components of custom tool 10 as well as a portion of the mouth of a patient after dental restoration with custom tool 10. FIG. 6 illustrates the underside of custom tool 10, which includes surfaces that correspond to various sides of tooth 102. In some examples, custom tool 10 may represent a single tooth veneer mold and / or may be used to repair caries within tooth 102.

[0040] While custom tool 10 is configured to facilitate dental restorations of a single premolar tooth (i.e., a bicuspid), custom tool 10 is merely one example, and the techniques described with respect to custom tool 10 can readily be applied to custom tools that facilitate repair of other posterior teeth, other anterior teeth (Fig. 21A & 21B), of two teeth or more than two teeth, e.g., by including multiple mold bodies within a single mold body component as explored further herein.

[0041] Custom tool 10 includes a one-piece, unitary mold body 12, which provides a customized fit with tooth 102, which is hereinafter defined as a restoration tooth, i.e., one awaiting a veneer or build-up of other missing tooth structure. The mold body 12 includes a facial portion 14 configured to surround at least the restoration tooth 102 and a lingual bar 30 disposed opposite the facial portion 14. The facial portion 14 includes a restoration portion 15, configured to define a mold cavity with restoration tooth 102 as described in further detail below, and optional support bodies 20 extending outward from the restoration portion 15. The facial portion 14 is coupled to the lingual bar 30 via mesial and distal registration struts 42, 44 disposed at the mesial and distal edges of the support bodies 20. Mesial and distal registration struts 42, 44 collectively define a registration portion 40 of the custom tool 10 and are configured to engage with occlusal surfaces, including portions of the buccal and lingual cusps, of teeth 104 and 106 adjacent to the restoration tooth 102.

[0042] The mold body 12 combines with tooth 102 to form a mold cavity, including the customized facial surface 16. The mold cavity encompasses missing tooth structure and / or a veneer of tooth 102. By positioning mold body 12 over tooth 102, restorative dental material may be positioned into the mold cavities and take the form of the missing tooth structure and / or a veneer of restoration tooth 102. The missing tooth structure may include any portion of tooth 102, including any combination of interproximal, occlusal, facial tooth structure. An inner surface of mold body 12 includes a portion of a mold cavity corresponding with at least one exterior surface of the corresponding tooth 102, the at least exterior surface may include facial, interproximal and / or occlusal surfaces of the corresponding tooth 102. In some examples, the mold cavities may facilitate a dental veneer restoration of facial, interproximal and / or occlusal surfaces of the corresponding tooth 102.

[0043] Any one, two, or all of facial portion 14, lingual bar 30, and registration portion 40 may include patient-specific, customized surfaces. In particular, restoration portion 15 forms a patientspecific customized facial surface 16 of at least the restoration tooth 102. Customized facial surface 16 include customized proximal surfaces 16a, corresponding to proximal surfaces of the tooth 102, customized mesial surfaces 16b, corresponding to mesial surfaces of the tooth 102, and optionally custom occlusal surfaces (e.g., 16c beneath finger 17), corresponding to the occlusal surfaces of the tooth 102. Restoration portion 15 can also optionally form customized gingival surfaces corresponding to gingival surfaces within the mouth of the patient.

[0044] Customized occlusal surfaces of the restoration portion 15 are typically formed by an occlusal finger 17. The occlusal finger 17 wraps around a buccal cusp 110 of the restoration tooth 102 but does not necessarily extend past the central development groove 112 and / or to lingual surfaces 120. The occlusal finger 17 can aid in the shaping of the restorative material on tooth 102, permitting, in certain circumstances, the restorative material to better blend with the existing tooth structure. The occlusal finger 17 follows an arcuate path from an occlusal edge 15a of the restoration portion 15 over the tip of the buccal cusp 110, and has a width generally smaller than the width of the restoration tooth 102. In some embodiments, the finger 17 has a width of no greater than 80%, in some embodiments no greater than 70%, in some embodiments no greater than 65%, in some embodiments no greater than 60%, in some embodiments no greater than 55%, and in some embodiments no greater than 50% of the mesial-distal width of the restoration tooth 102.

[0045] The facial portion 14 can further include interproximal portions 18 corresponding with interproximal surfaces of teeth 102. As depicted, interproximal portion 18a corresponds to an interproximal surface of tooth 102 to also provide a customized fit with tooth 102a, and interproximal portion 18b of mold body 12b corresponds to an interproximal surface of tooth 102b to also provide a customized fit with tooth 102. Interproximal portions 18 are each of unitary construction in that custom tool 10 does not include any seams within its components within the interproximal spaces corresponding to interproximal portions 18a, 18b. For example, interproximal portions 18 may each extend partially through the interproximal space between the tooth 102 receiving the restoration and an adjacent tooth 104, 106. Typically, the interproximal portion does not extend entirely through the interproximal space, as engagement between the lingual surfaces 120 of the tooth 102 and the interproximal portions 18a, 18b can make removal of the custom tool 10 more difficult after the missing tooth structure is restored.

[0046] In some embodiments, the interproximal portions are selected to provide certain interproximal tooth structure between adjacent selected teeth. As such, the mold body may include patient-specific, customized fitted interproximal portions. At least some of the interproximal portions may be specifically engineered and are not mere replications of the interproximal structure that was previously present in the scan of the patient’s mouth before restoration or in the digitized wax-up. Instead, they are digitally engineered to provide a specific, selected interproximal tooth structure in the interproximal spaces. In some embodiments, the mold body 12 may include naturally occurring interproximal contacts provided by the 3D scan of the patient’s mouth in certain areas, in combination with specifically engineered interproximal contacts, in other areas. Considerations and design of specifically engineered interproximal contacts can be found in International Publication Nos. WO / 2023 / 031761, WO / 2023 / 031766, and WO / 2023 / 031771, all commonly owned and incorporated by reference in their entirety herein.

[0047] The facial portion 14 can also include markings, coloring, or other indicia to identify the prescribed restoration tooth, the patient, the target restorative material, and any other information relevant to the practitioner. The indicia discussed herein may be integrated into the respective mold components or may be a separate form applied to a mold component. For example, the patient and restoration tooth identifying indicia may be 3D components that are an integrated feature of the mold design, or the markings may be applied to a surface of the mold component using ink or any suitable material. Orientation marks (e.g., a colored mark on the distal ends of each tool component) may also be applied to or incorporated in the custom tool to facilitate placement in the patient’s mouth. The facial portion 14 includes a first, mesial support body 21 and a second, distal support body 22 (collectively, “support bodies 20”) on either side of the restoration portion 15. Support bodies 21, 22 may not provide any portion of the mold cavity but may instead simply help secure mold body 12 in place. In particular, the facial portion 14 of mold body 12 includes optional mesial support portion 21 with customized surface 21a, which provides a customized fit with supporting tooth 104 and optional distal support portion 22 with customized surface 22a, which provides a customized fit with supporting tooth 106. Customized surfaces 21a, 22a may further secure and register mold body 12 in place within a patient’s mouth to facilitate precise customized dental restorations of tooth 102. Mold body 12 may further register with gingiva 115 of the patient. Support bodies 20 can be part of a unitary and monolithic whole with facial portion 14. Alternatively, the support bodies can 20 can be coupled to the facial portion through snap-fit or other interlocking connection.

[0048] While support bodies 20 are described as not forming any portion of mold cavity, in other examples, the support bodies 20 may be readily modified to combine with mold bodies 12 to form one or more mold cavities. In such examples, the modified support bodies 20 should also be considered part of the restoration portion 15.

[0049] In alternative embodiments, the mold body 12 is configured to register with one adjacent support tooth (104 or 106), or exclusively on the restoration tooth 102. For instance, the facial portion 14 can extend no further than the interproximal surfaces on the mesial and distal edges of the restoration tooth 102. As an alternative or additional example, one or both of the mesial and distal registration struts 42, 44 can follow an embrasure between restoration tooth and support tooth 104, 106, as appropriate. In such circumstances, the custom tool may be more difficult to remove from the restored tooth without damaging the finished restoration and may be more susceptible to placement error when seating the dental restorative material. Nevertheless, such a custom tool will still be viable in creating a dental restoration.

[0050] Turning again to Fig. 1, a reinforcement ribbon 50 projects facially at a generally orthogonal orientation from the facial portion 14 of mold body 12. This facial ribbon 50 acts as a stiffening rib for mold body 12, and generally follows the contour of a gingival margin of the patient’s dental arch. The facial ribbon 50 can follow a generally sinusoidal path, with wave peaks adjacent interproximal areas between the teeth, 102, 104, or 106. The facial height of the ribbon 50 is relatively short to avoid patient discomfort during tooth restoration, typically on the order of 2-5 mm. The occlusal-gingival thickness of the ribbon 50 is also relatively thin, typically on the order of 1-2 mm. Both the height and thickness are variable and adaptable to expected conditions in the patient’s mouth. An aperture 54 resides proximate to the gingival margin 15a of restoration portion 15 and provides unfilled space between the facial surface of the mold body 12 and the ribbon 50. The aperture 54 is sized and shaped to accept the tip of a dental hand instrument or restorative material dispenser. The aperture 54 accordingly provides a purchase point to aid in removal of the mold from the restoration tooth. The custom tool 10 can include additional apertures between the ribbon and mold body 12 to provide multiple pry points. The aperture(s) 54 can be discrete and adjacent to each tooth reflected in the mold body 12. Alternatively, the custom tool 10 can be provided with a channel (i.e., an aperture offering continuous opening between two or more teeth) between the ribbon 50 and facial surfaces 13 of the mold body 12. An additional function of an aperture 54 is to receive dental floss to assist in retrieving the tool 10 should it become dislodged in the mouth.

[0051] The facial portion 14 of the mold body 12 may further include reliefs 46, 48 adjacent the embrasures 113, 114 on either side of the restoration tooth 102. Reliefs 46, 48 aid in the registration and seating of the custom tool 10 on the restoration tooth 102 by allowing limited flexibility between the mold portions. The occlusal-gingival depth of the reliefs 46, 48 is generally on the order of 1 mm, but the patient’s tooth anatomy may need to accommodate other dimensions within the scope of the present disclosure.

[0052] The registration portion 40 helps align custom tool 10 in the patient’s mouth and can provide visual confirmation that the tool is properly seated at the desired location. In some embodiments, one or both of the mesial and distal registration struts 42, 44 provide customized occlusal surfaces 42a, 44a corresponding to occlusal surfaces of teeth 104, 106. Typically, the customized occlusal surfaces 42a, 44a correspond to only a portion of the occlusal surfaces of teeth 104, 106, in that they do not cover the entire tooth crown. As an example, the customized occlusal surfaces 42a, 44a correspond to about 30% to 70% of the mesial-distal width of the tooth 104 or 106, with the areas proximate a respective embrasure 113, 114 with restoration tooth 102 left uncovered. In typical but not exclusive circumstances, 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 mold body 12. Other configurations are possible and contemplated hereunder.

[0053] The lingual bar 30 can include a variety of cross-sectional shapes, including circular, ovular, rectangular (including square), triangular, and combinations thereof. Though not present in the depicted embodiment, the lingual bar 30 may also include customized distal surfaces, respectively, corresponding to distal surfaces of the lingual side of the tooth, as well as customized mesial surfaces, respectively, corresponding to mesial surfaces of the lingual side of the tooth. Such correspondence is not strictly necessary, as the lingual bar 30 provides stability to the custom tool 10 and a mechanism to disengage tool 10 from the mouth of the patient; it does not typically form a portion of the mold cavity tasked with forming the restoration. The lingual bar 30 can also include patient identifying indicia, or instructions for sequencing methods for dental restorations, as explored further below.

[0054] The indicia discussed herein may be integrated into the respective mold components or may be a separate form applied to a mold component. For example, the tooth identification markings may be 3D components that are an integrated feature of the mold design, the colorings may be a color of the material used to form portions the mold component, and / or the markings and / or coloring may be applied to a surface of the mold component using ink or any suitable material.

[0055] By positioning custom tool 10 over tooth 102, restorative dental material may be positioned in the mold and take the form of the missing tooth structure of tooth 102. In some examples, restorative dental material may be placed on restoration tooth 102 prior to assembling custom tool 10 over the tooth 102. In the same or different examples, restorative dental material may be placed on surface 16 of facial portion 14 prior to assembling custom tool 10 over tooth 102. In another example, custom tool 10 may be first assembled over tooth 102 and then restorative dental material may be injected into the mold cavity. For example, facial portion 12 may include a port configured to receive an injection of restorative dental material once custom tool 10 is positioned over tooth 102 to form the mold cavity.

[0056] The customized fit provided by mold body 12 is further described with respect to FIG. 5. As shown in FIG. 5, one-piece mold body 12 includes customized surfaces for each of teeth 102, 104, 106. In particular, surface 21a is customized to fit with tooth 104 restoration portion 16 is customized to fit with tooth 102, and surface 22a is customized to fit with tooth 106. Restoration portion 16 provides a customized fit for more than one surface of tooth 102. In particular, restoration portion 16 includes distal proximal surface 16a corresponding with a distal proximal of tooth 102, mesial proximal surface 16b corresponding with a mesial proximal of tooth 102, and facial surface 15 corresponding with a facial surface of tooth 102. The occlusal surfaces are provided by registration portion 40 and the occlusal fingers 17.

[0057] The customized fit of mold body 12 may further serve to isolate tooth 102 from blood, gingival crevicular fluid, or saliva during a dental restoration material. For example, portions of mold body 12 may mate with surfaces of teeth 102, 104, 106 as well as gingiva 115 to shield the mold cavity from bodily fluids such as blood, gingival crevicular fluid, and saliva. In addition, mold body 12 may further serve to forcibly retract gingiva 115 and / or assisting in separating teeth 102, 104, 106 upon insertion of mold body 12 within the mouth of the patient. For example, interproximal portions (e.g., fins) 18a, 18b of mold body 12 may serve to forcibly separate adjacent teeth 102, 104, 106. In this manner, while custom tool 10 may be based on a three- dimensional model of the mouth of a patient, various features of custom tool 10 may be selected to temporarily modify the positions of gingiva 115 and / or teeth 102, 104, 106 during a restoration procedure.

[0058] Optionally, mold body 12 may be further configured to provide features, including customized gingival surfaces representing an isolation matrix for a dental restoration. In this manner, mold body 12 may contain features that extend subgingivally or into a hidden interproximal space. The data for these extensions can be based off anatomical averages, or patient specific data, such as x-ray, ultrasound, or MRI. The tool may incorporate elastomeric material which can be designed for an undersized fit to create a tight seal against varying actual geometry of the patient’s dentition. The materials used may also vary in hydrophilicity to draw water, saliva, and other fluids away from the tooth structure being restored. Microfluidic channels, vacuum line attachments and bite blocks can be incorporated as well. Hemostatic agents and fluid wicking, blocking, or directing features may be used in conjunction with the tool.

[0059] FIGS. 7-10 illustrate steps for using custom tool 10 to form dental restorations of tooth 102 in the mouth of a patient. FIG. 7 illustrates a portion of the mouth of the patient that includes teeth 102, 1014, and 106 as well as gingiva 115. As shown, tooth 102 may have previously prepared for the dental restoration by removing unhealthy tooth structure, e.g., by drilling or other preparation to remove damaged dental material to facilitate dental restoration using tool 10. In some examples a 3D image of the mouth of the patient may be taken prior to the removal of decayed material from tooth 102 as the shape of the decayed material may help in the design of custom tool 10 or the restorative procedure may be shortened by utilizing scan data obtained at a time prior to preparation of the tooth. In different examples, the scan data may be obtained recently, such as within the past twelve months, or may be obtained a prior time, such as a period of greater than one year, greater than 5 years or even greater than 10 years ago. Such old scan data may demonstrate tooth wear over time and may facilitate restoration to repair such tooth wear. The scan data from multiple scans over time may also be used to detect tooth wear and facilitate an appropriate restoration.

[0060] An example restoration process for tooth 102 using custom tool 10 is described as follows. As best illustrated in FIG. 7, restorative dental material 80 is positioned within the mold cavity formed by tooth 102 and mold body 12. One presently preferable dental restorative material is Filtek™ Supreme Universal A2™, commercially available from Solventum US. The practitioner may apply the restorative material 80 to the tooth to be restored or to mold body 12 before applying mold body 12 over teeth 102, 104, 106 of the patient. In some examples, the practitioner may use various tools to place the restorative material into the mold cavity. In some examples, restorative material 80 may be placed in the mold cavity through one or more apertures or fill ports.

[0061] As shown in FIG. 8, mold body 12 is positioned in place over tooth 102 such that interproximal portions 18a, 18b (not shown in Fig. 8) extend between teeth 102, 104, 106. Mold body 12 provides a customized and secure placement within the mouth of the patient. In various examples, depending on the design of custom tool 10, mold body 12 may be positioned on the lingual, occlusal and / or facial sides of tooth 102.

[0062] Because the tooth preparations may prepared at a depth greater than the recommended maximum cure depth for the restorative dental material, or a different shade, viscosity or other property of restorative material is desired at deeper layers of the cavity, a base layer of restorative dental material can optionally be layered into the deep portions of the preparation and restorative dental material photocured, e.g., with an Elipar™ DeepCure-S curing light. The components of tool 10, including mold body 12, may be transparent or translucent to facilitate photocuring. In such examples, restorative dental material 80 represents more than one layer of restorative dental material.

[0063] The customized facial, and occlusal surfaces of the mold body may be used to shape one or more layers of restorative material 80 on the facial, occlusal, interproximal surfaces of the tooth 102, to compress restorative material 80 within the mold cavity, or any combination thereof. For instance, the lingual bar 30 may be used to compress the restorative material 80 against the facial, occlusal, and interproximal surfaces of the teeth. Excess restorative material on occlusal or embrasure surfaces can be removed prior to proceeding.

[0064] In some examples, the practitioner may cure the restorative material 80 within the mold cavity (Fig. 9). For example, if the restorative material is light curable, the practitioner may expose the restorative material to the curing light (e.g., a blue light) through mold body 12, which may be formed of a material transparent to the curing light. The practitioner may also cure at least a portion of the restorative material through exposed occlusal window 118, formed between the occlusal finger(s) 17 and registration portion 40.

[0065] In any event, following the formation of the restorative dental material 80 within mold cavities formed by tooth 102 and mold body 12, mold body 12 is removed from the mouth of the patient. In some embodiments, the practitioner may pry the mold body 12 from the teeth 102, 104, 106 using the tip of a tool and the aperture(s) 54. The restoration tooth 102 now has a restored structure defined by the restorative material. In this manner, mold body 12 not only provides a customized fit with the mouth of the patient, but also provides a customized mold cavity to facilitate application of a veneer to the restoration tooth 102 and / or repair of missing tooth structure of tooth 102. In some examples, the practitioner may finish the teeth, which now include restored dental structure defined by the restorative material, such as by polishing, to remove flash or other undesired surface imperfections.

[0066] In certain embodiments, custom tool 10 may be used in combination with other dental restoration molds known in the art. For instance, the custom tool 10 may be deployed in combination with any of the tools described in United States Patent Nos. 10,722,331; 11,123,165; 11,185,392; United States Patent Application Publ. Nos. 2019 / 0298489; 2019 / 0083208; 2021 / 0290349; 2021 / 0298882; 2021 / 0378789; 2021 / 0386528; 2022 / 0047357; and 2022 / 0117699. Custom tool 10 may be deployed in seriatim with other dental restoration molds or near simultaneously, such that both custom tool 10 and the additional tool are deployed in the patient’s mouth at the same time. Fig. 17 below depicts one exemplary embodiment of such methods.

[0067] While custom tool 10, including one-piece mold body 12 is described with respect to a single mold cavity for repair of a single premolar tooth 102, the techniques described with respect to custom tool 10 may easily be applied to a custom tool configured to facilitate repair of more than one tooth (e.g., the first and second bicuspid) by forming more than one mold cavity. The one-piece mold body of the modified custom tool 10 may be configured to combine with the two adjacent teeth, (e.g., 102 and 104) to form separate mold cavities encompassing missing tooth structure for each of the adjacent teeth.

[0068] FIGS. 11-15 illustrate an alternative custom tool 210 for forming dental restorations of two adjacent teeth 120, 122 in the mouth of a patient. In particular, FIG. 11 illustrates the components of custom tool 210, including one-piece mold body 212 and support bodies 221, 222. FIG. 12 illustrates the components of custom tool 210 as well as a portion of the mouth of a patient. FIG. 13 illustrates the components of custom tool 210 assembled within the mouth of a patient to facilitate a dental restoration. FIG. 14 illustrates the custom tool 210 from a lingual perspective. FIG. 15 illustrates the underside of custom tool 210, which includes surfaces that correspond to various sides of teeth 120, 122, 124, 126. While custom tool 210 is configured to facilitate dental restorations of two adjacent teeth, custom tool 210 is merely one example, and the techniques described with respect to custom tool 210 can readily be applied to custom tools that facilitate repair of a single tooth or more than two teeth.

[0069] Custom tool 210 includes one-piece, unitary mold body 212. Mold body 212 provides a customized fit with at least two teeth of the patient, typically the first and second premolar (e.g., the first and second bicuspid). As shown in FIG. 12, mold body component 212a provides a customized fit with premolar tooth 120, and mold body component 212b provides a customized fit with premolar tooth 122. Custom tool 210 further includes two support bodies 221, 222 on either side of the mold body 212. The support body 221 can include an optional customized surface 221a, which provides a customized fit with support tooth 124 and the support body 222 can include optional customized surface 222a, which provides a customized fit with tooth 126. Customized surfaces 221a, 222a may further secure and register custom tool 210 in place within a patient’s mouth to facilitate precise customized dental restorations of teeth 120, 122. Mold body 212 may further register with gingiva of the patient. For example, support bodies 221, 222 may not provide any portion of the mold cavities but may instead simply help secure mold body 212 in place (i.e., provide some level of support).

[0070] Custom tool 210 can include any one or any combination of features present in custom tool 10. For instance, the custom tool 210 can include a ribbon 250, pry aperture 254, a lingual bar 230, interproximal potions 218, and a registration portion 240. Considerations for these features in conjunction with custom tool 10 apply mutatis mutandis with custom tool 210.

[0071] Like custom tool 10, customized occlusal surfaces of the restoration portion 215 of custom tool 210 are typically formed by one or more occlusal fingers 217. The restoration portion 215 further includes embrasure fingers 219a, 219b, and 219c (collectively, embrasure fingers 219). The embrasure fingers extend partially over the embrasures 133, 134 between adjacent teeth in the mold body, in particular between restoration teeth 120 and 122, as well as between tooth 120 and tooth 124, along the embrasure located between tooth 122 and tooth 126. Embrasure fingers 219 follow an arcuate path from an occlusal edge 215a of the restoration portion 215, partially (but not completely) extending over the corresponding embrasure. The occlusal fingers 217a, 217b (collectively, occlusal fingers 217) wrap around a buccal cusp 130 of the restoration teeth 120, 122 but does not necessarily extend past the central development groove 132 and / or to lingual surfaces. The occlusal fingers 217 and embrasure fingers 219 can aid in the shaping of the restorative material on the restoration teeth 120, 122, permitting, in certain circumstances, the restorative material to better blend with the existing tooth structure.

[0072] Both mold body 212 and support bodies 221, 222 may include surfaces that register with the teeth of the patient, as well as gingiva of the patient. For example, as described above mold body component 212a may include features that register with tooth 120, whereas mold body component 212b may include features that register with tooth 122. Likewise, support body 221 may include features that register with tooth 124, whereas support body 222 may include features that register with tooth 126. Support bodies 221, 222 further includes optional customized surface 221a, which provides a customized fit with tooth 124 and optional customized surface 222a, which provides a customized fit with tooth 126. Customized surfaces 221a, 222a may further secure and register mold bodies 212 in place within a patient’s mouth to facilitate precise customized dental restorations of teeth 120. Support bodies may further register with gingiva of the patient. In this manner, mold body 212 and support bodies 221, 222 may provide multiple customized surfaces that mate with corresponding surfaces of teeth 120, 122, 124, 126 as well as gingiva of the patient. The combination of mold body 212 and support bodies provides a secure fit within the mouth of the patient to precisely align mold bodies components 212a, 212b with teeth in order to facilitate dental restorations of teeth.

[0073] While support bodies 221, 222 are described as not forming any portion of mold cavity, in other examples, the support bodies 221, 222 may be readily modified to combine with mold bodies 212 to form one or more mold cavities. In such examples, the modified support bodies 220 should also be considered mold bodies.

[0074] Optionally, mold body 212 may be further configured to provide features, including customized gingival surfaces representing an isolation matrix for a dental restoration. In this manner, mold body 212 may contain features that extend subgingivally or into hidden interproximal space. The data for these extensions can be based off anatomical averages, or patient x-ray data. The tool may incorporate elastomeric material which can be designed for an undersized fit to create a tight seal against varying actual geometry of the patient’s dentition. The materials used may also vary in hydrophilicity to draw water, saliva, and other fluids away from the tooth structure being restored. Microfluidic channels, vacuum line attachments and bite blocks can be incorporated as well.

[0075] Custom tool 210 combines with teeth 120, 122 to form two distinct mold cavities of mold bodies 212. Mold cavities of mold body 212 encompass missing tooth structures of teeth 120, 122 and / or a veneer for one or both of teeth 120, 122. By positioning mold body components 212a, 212b over teeth 120, 122 restorative dental material may be positioned into the mold cavities and take the form of tooth structures and / or provide a veneer on the surfaces of teeth 120, 122.

[0076] Repair of restoration teeth 120, 122 occurs by filling the mold cavities with dental restoration material after positioning mold body 212 to register with teeth 120. Optionally, the filling material may be applied to the tooth and / or mold cavity prior to positioning mold body 212 to register with teeth 120. In such examples, the process of seating the mold body shapes the restorative material into the desired shape. Missing tooth structures 121 may include any portion of teeth 120, including any combination of interproximal, occlusal, facial and / or lingual tooth structure. An inner surface of mold body components 212a, 212b each include a portion of a mold cavity corresponding with at least one exterior surface of the corresponding tooth 120, 122 the at least exterior surface may include facial, lingual, interproximal and / or occlusal surfaces of the corresponding teeth 120, 122. In some examples, the mold cavities may facilitate dental veneer restoration of facial, lingual, interproximal and / or occlusal surfaces of the corresponding teeth 120, 122.

[0077] Custom tool 210 may be formed based on a digital model of the teeth and mouth of a patient, which can be produced an intra-oral 3D scan, such as a multi-channel scanner. In one particular example, custom tool 210 may be digitally designed using Computer Aided Design (CAD) software, such as solid modeling software based on the digital model. Custom tool 210 was designed to fit over teeth 120, 122 (which may represent, by way of example, adjacent incisors) and a portion of the neighboring teeth 124, 126. Subsequently, the tooth structure of teeth 120, 122, 124, 126 may be digitally subtracted from a mold block. Alternatively, an inverse of the tooth structure may be inverted within software to define the mold block. Optional filling ports or vents may be located in regions of the occlusal section which correspond to regions of the teeth which would ultimately be removed in the preparation process, e.g., adjacent to the mold cavities of teeth 120, 122. Filling ports may be sized to receive a tip of a commercially available restorative dental material compule, to permit injection of the restorative dental material during filling. Vent ports may be sized smaller in diameter than filling ports.

[0078] Within the digital model, the mold block design may be segmented into two sections (mold body 212 and support bodies 220, 221) to facilitate eventual assembly of the tool components on the teeth without geometric interference. Within the digital model, handle features may be included and added to mold body 212 and support bodies 220, 221 to facilitate holding of the portions with a hemostat or cotton pliers during dental restoration using tool 210.

[0079] The components within the CAD software may be converted into a 3D point mesh file or other format to facilitate production with a 3D printer, CNC mill, CAD / CAM milling processes, or otherwise. Orientation marks (e.g., a colored mark on the distal ends of each tool component) may be applied to the tool components to facilitate assembly. Production may optionally include other steps such as, curing (e.g., in a UV oven), cleaning, e.g., in alcohol solution, and / or assembly of various components, polishing of tooth surfaces, coating, such as with a clear acrylic to enhance visibility of the restoration area during injection of the restorative dental material. In addition, surfaces of tool components expected to be in contact with the restorative dental material could optionally be coated with a layer of release agent (e.g., a thin layer of petroleum jelly).

[0080] FIG. 16 is a flowchart illustrating an example technique 300 for forming a dental restoration in the mouth of a patient. First, a practitioner positions a mold, such as mold body 12 or mold body 212, over a portion of a tooth of the patient (302). The tooth either contains missing tooth structure or has been prepared to create missing tooth structure, such as is commonly done in the caries removal process. The mold combines with the tooth to form a mold cavity encompassing missing tooth structure of the tooth and / or a veneer. Next a practitioner introduces a restorative dental material within the mold cavity (304). The practitioner allows or causes the restorative dental material to cure within the mold cavity to reform the tooth, which may include application of actinic radiation to cure the restorative dental material (306). The practitioner removes the mold from the tooth of the patient leaving the dental restoration with a shape defined by the mold cavity on the tooth of the patient (308).

[0081] FIG. 17 depicts an exemplary dental restoration mold 400 that can be used in combination or in series with the custom tools 10 and 210 of the present disclosure. Dental restoration mold 400 includes a facial mold body 412, which may be configured to provide a personalized, unique, and customized fit with at least one tooth of a patient. For example, facial mold body 412 may be specifically designed to fit next to, mate with, and provide restorative structure to at least one tooth. In the example shown in FIG. 17, the facial mold body 412 includes a restorative portion 416 and an engagement portion 418, with the restorative portion 416 used to restore at least one tooth in the mouth of the patient. The engagement portions 418 are structured to engage with or interlock with the engagement portions on a lingual mold body 414, as explained in more detail below.

[0082] In the illustrated embodiment, the restorative portion of mold body 416 is sized and shaped to mate with the anterior teeth of a patient. The engagement portions 418 are sized and shaped to be adjacent to the posterior teeth.

[0083] Facial body 412 includes one or more apertures (covered by a door 440 in FIG. 17), which may each be configured to align with a portion of a facial surface of a respective tooth of the patient to be restored. For example, aperture may be configured to align with a portion comprising a majority of a facial surface of one tooth and aperture may be configured to align with a portion comprising a majority of a facial surface of another tooth. Each of the apertures has a suitable configuration (e.g., shape and / or size) for introducing restorative material into a mold cavity defined by an interior surface of door 440 and the interior mold surface of the lingual mold body 414 (not shown) to cover the portion of the surface of the tooth to be restored. When door 440 is mated with a respective aperture, the surface of the door 440 and the tooth structure of a patient may help shape the restorative material that is placed in the mold cavity, e.g., in order to define the surface of the tooth to be restored. In the illustrated embodiment, the door body 440 and facial mold body 412 are mechanically connected to each other by using a hinge 446 and hinge pin 448.

[0084] 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 tooth of the patient. Facial mold body 412 and lingual mold body 414 may be configured to combine with at least one tooth of the patient to form the mold cavity. For example, facial mold body 412 and lingual mold body 414 may be configured to mate with one another and / or to be attached to at least one tooth to form the mold cavity. In some examples, lingual mold body 414 is separable from and engageable with the facial mold body 412, while maintaining the integrity of the respective mold bodies, through use of their engagement portions 418, 419. Like facial mold body 412, the lingual mold body 414 includes a restorative portion 417 and an engagement portion 419. The engagement portions 419 of the lingual mold body 414 may include a variety of engagement surfaces configured to mate appropriately with engagement surfaces on the facial mold body 412.

[0085] Dental restoration mold 400 is designed to ensure a relatively tight fit between the mold bodies 412, 414 to help reduce or eliminate the flash that occurs along the edge where the two mate together. Any flash that does occur may be very thin along the incisal edge and may be relatively easily removed with a dental instrument.

[0086] FIG. 18 is a flowchart for forming a dental restoration in the mouth of patient, using the custom tools of the present disclosure and a dental restoration mold 400 (or other similar dental restoration mold). The method includes positioning a patient-specific a facial mold body adjacent at least one tooth to be restored of a patient (502); positioning a patient-specific lingual mold body adjacent the least one tooth to be restored (504); interlocking the facial mold body with the lingual mold body to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of 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, lingual mold body from the at least one tooth (512).

[0087] The method further includes a practitioner positioning a part of a unitary custom tool, such as mold body 12 or mold body 212, over a portion of a tooth of the patient (514). The tooth either contains missing tooth structure or has been prepared to create missing tooth structure. The tooth is typically not the tooth to be restored from steps 502-512 above. The mold combines with the tooth to form a mold cavity encompassing missing tooth structure of the tooth and / or a veneer. Next a practitioner introduces a restorative dental material within the mold cavity (514). The practitioner allows or causes the restorative dental material to cure within the mold cavity to reform the tooth, which may include application of actinic radiation to cure the restorative dental material. The practitioner removes the mold from the tooth of the patient leaving the dental restoration with a shape defined by the mold cavity on the tooth of the patient (516).

[0088] The method may be performed in the sequence depicted in FIG. 16 or may be performed near simultaneously. In other alternative methods, the step 514 may be performed prior to steps 502-512. As another alternative, both tools may be seated on the teeth to be restored in the sequence prescribed in FIG. 18 but subjected to curing and / or removal steps at the same or near simultaneous time.

[0089] FIG. 19 is a block diagram illustrating an example system 600 for designing and manufacturing a dental appliance (e.g., custom tool 10 or 210) for restoring the dental anatomy of a patient, in accordance with various aspects of this disclosure. In the example of FIG. 17, system 600 includes clinic 604, appliance design facility 608, and manufacturing facility 610. Practitioner 606 may treat patient 602 at clinic 604. For example, practitioner 606 may create a digital model of the current dental anatomy of patient 602. The dental anatomy may include any portion of crowns or roots of one or more teeth of a dental archform, gingiva, periodontal ligaments, alveolar bone, cortical bone, implants, artificial crowns, bridges, veneers, dentures, orthodontic appliances, or any structure that could 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 current dental anatomy of the patient. The 3D model may be generated using an intra-oral scanner, Cone Beam Computed Tomography (CBCT) scanning (i.e., 3D X-ray), Optical Coherence Tomography (OCT), Magnetic Resonance Imaging (MRI), or any other 3D image capturing system. In some examples, computing device 690 stores a digital model of a current dental anatomy of patient 602.

[0090] Computing device 690 of clinic 604 may store a digital model of a future dental anatomy for the patient. The future dental anatomy represents the intended shape of the dental anatomy to be achieved by application of a dental appliance, such as dental appliance 601. In one example, practitioner 606 may create a physical model of the future dental anatomy and may utilize an image capturing system (e.g., as described above) to generate the digital model of the future dental anatomy. In another example, practitioner 606 may modify the digital model of the current anatomy of patient 602 (e.g., by adding material to the surface of one or more teeth of the dental anatomy) to generate the 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. In another example, the modification of the dental anatomy of the patient may occur offsite by a 3rd party provider. Such modifications may be prescribed, reviewed, and modified by, or under the direction of, the practitioner 606. The dental anatomy may be designed in a digital environment, alternatively a physical rendering of the initial dentition may be physically modified using conventional dental laboratory techniques (e.g., application of wax). This physical model of the teeth may be digitized via a 3D scanner.

[0091] In one scenario, computing device 690 outputs the digital model representing the dental anatomy (e.g., current and / or future) of patient 602 to another computing device, such as computing device 650 and / or computing device 692. As illustrated in FIG. 19 in some examples, computing device 650 of design facility 608, computing device 690 of clinic 604, and computing device 692 of manufacturing facility 610 may be communicatively coupled to one another via network 614. Network 614 may include a wired or wireless network, such as via WIFI®, BLUETOOTH®, 3G, 4G LTE, 5G, and the like.

[0092] In the example of FIG. 19, design facility 608 includes computing device 650 configured to automatically design a dental appliance for re-shaping 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.

[0093] UI device 674 may be configured to receive user input and / or output information, also referred to as data, to a user of computing device 650. One or more input components of UI device 674 may receive input. Examples of input are tactile, audio, kinetic, and optical input, to name only a few examples. For example, UI device 674 may include a mouse, keyboard, voice responsive system, video camera, buttons, control pad, microphone, or any other type of device for detecting input from a human or machine. In some examples, UI device 674 may be a presencesensitive input component, which may include a presence-sensitive screen, touch-sensitive screen, etc.

[0094] One or more output components of UI device 674 may generate output. Examples of output are data, tactile, audio, and video output. Output components of UI device 674, in some examples, include a display device (e.g., a presence-sensitive screen, a touch-screen, a liquid crystal display (LCD) display, a Light-Emitting Diode (LED) display, an optical head-mounted display (HMD), among others), a light-emitting diode, a speaker, or any other type of device for generating output to a human or machine.

[0095] 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 executing the techniques described herein. In one example, storage device 678 may store program instructions (e.g., software instructions or modules) that are executed by processor 672 to carry out the techniques described herein. In other examples, the techniques may be executed by specifically programmed circuitry of processor 672. In these or other ways, processor 672 may be configured to execute the techniques described herein.

[0096] Storage device 678 may, in some examples, also include one or more computer-readable storage media. Storage device 678 may be configured to store larger amounts of data than volatile memory. Storage device 678 may further be configured for long-term storage of data as nonvolatile memory space and retain data after activate / off cycles. Examples of non-volatile memories include solid state drives (SSDs), hard disk drives (HDDs), flash memories, or forms of electrically programmable memories (EPROM) or electrically erasable and programmable (EEPROM) memories. Storage device 678 may store program instructions and / or data associated with software components 682-689 and / or operating system 680.

[0097] The system receives a pre-operative scan. A wax-up is then created to produce the contours of the future dental anatomy. The wax-up can be created physically and scanned into the computer, or it may be created digitally. Preferably the wax-up is scaled and oriented in digital 3d space to correspond with the pre -operative scan such that design of the tool is facilitated by selectively utilizing surfaces from the pre-operative and future dental anatomy models.

[0098] In the example of FIG. 19, storage device 678 includes appliance feature library 664, models library 666, and practitioner preferences library 668. Libraries 664, 666, and 668 may include relational databases, multi-dimensional databases, maps, and hash tables, or any data structure that stores data. In one example, models library 666 includes 3D models of the patient’s current and / or future dental anatomy. As described in more detail below, the libraries 664, 666, and 668, may include representations of interproximal 3D geometries. In some instances, libraries 664, 666, and 668 may be stored locally at computing device 650 or may be accessed via a networked file share, cloud storage, or other remote datastore.

[0099] Computing device 650 may execute software components 682-689 with one or more processors 672. Computing device 650 may execute any of components 682-689 as or within a virtual machine executing on underlying hardware. In one example, any of components 682-689 may be implemented as part of operating system 680.

[0100] In accordance with the techniques of this disclosure, 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 the preoperative model. Pre-processor 681 may pre-process the digital model of the future dental anatomy of patient 602. In one example, pre-processor 681 performs pre-processing to identify one or more teeth in the future dental anatomy of patient 602. In some instances, pre-processor 681 identifies a local coordinate system for each individual tooth and may identify a global coordinate system that includes each tooth of the future dental anatomy. As another example, preprocessor 681 may pre-process the digital model of the future dental anatomy to identify the root structure of the dental anatomy. In another example, pre-processor 681 may identify the gingiva. In this way, pre-processor 681 may determine portions of the future dental anatomy that include gingiva and portions of the future dental anatomy that include tooth.

[0101] Landmark identifier 682 may determine one or more landmarks of the future dental anatomy and pre-operative models. Example landmarks include a slice, a midpoint, a gingival boundary, a closest point between two adjacent teeth (e.g., a point of contact between adjacent teeth or a point of closest approach (or closest proximity), a convex hull, a center of mass, or another landmark. A slice refers to a cross section of the dental anatomy. The midpoint of a tooth refers to a geometric center (also referred to as a geometrical midpoint) of the tooth within a given slice. The gingival boundary refers to a boundary between the gingiva and one or more teeth of the dental anatomy. A convex hull refers to a polygon whose vertices include a subset of the vertices in a given set of vertices, where the boundary of the subset of vertices circumscribes the entire set of vertices. The center of mass of a tooth refers to a midpoint, center point, centroid, or geometric center of the tooth. In some instances, landmark identifier 682 determines the landmarks in the local coordinate system for each tooth.

[0102] In some examples, landmark identifier 682 determines a plurality of slices of the patient’s future dental anatomy. In one example, the thickness of each slice is the same. In some instances, the thickness of one or more slices is different than the thickness of another slice. The thickness of a given slice may be pre-defined. In one instance, landmark identifier 682 automatically determines the thickness of each slice. In another instance, the thickness of each slice may be user-defined.

[0103] Landmark identifier 682 determines, in some examples, a midpoint for each tooth. In one example, landmark identifier 682 determines a midpoint of a particular tooth by computing the extrema of the particular tooth’s geometry based on the entirety of the particular tooth (e.g., without dividing the dental anatomy into slices) and determine the midpoint of the particular tooth based on the extrema of the tooth geometry.

[0104] In some examples, landmark identifier 682 determines a midpoint for each tooth for each slice. Landmark identifier 682 may determine the midpoint for a particular slice of a particular tooth by calculating the center of mass of a constellation of vertices around the edge of the particular tooth for that particular slice. In some instances, the midpoint of the particular tooth for the particular slice may be biased toward one edge of the tooth (e.g., in the case that one edge has more points than another edge).

[0105] In another example, landmark identifier 682 may determine the midpoint of a particular tooth in a particular slice based on a convex hull of the particular tooth for the particular slice. For example, landmark identifier 682 may determine a convex hull of a set of edge points of the tooth for a given slice. Landmark identifier 682 determines, in some instances, a geometric center from the convex hull by performing a flood-fill operation on the region circumscribed by the convex hull and computing a center of mass of the flood-filled convex hull.

[0106] In some examples, landmark identification module 682 determines the closest point between two adjacent teeth. The closest point between two adjacent teeth may be a point of contact or a point of closest approach. In one example, landmark identification module 682 determines the closest point between two adjacent teeth for each slice. In another example, landmark identification module 682 determines the closest point between two adjacent teeth based on the entirety of the adjacent teeth (e.g., without dividing the dental anatomy into slices).

[0107] A spline refers to a curve that passes through a plurality of points or vertices, such as a piecewise polynomial parametric curve. A mold parting surface refers to a 3D mesh that bisects two sides of one or more teeth (e.g., separates the facial side of one or more teeth from the lingual side of the one or more teeth). A gingival trim surface refers to a 3D mesh that trims an encompassing shell along the gingival margin. A shell refers to a body of nominal thickness. In some examples, an inner surface of the shell matches the surface of the dental arch, and an outer surface of the shell is a nominal offset of the inner surface. The facial ribbon refers to a stiffening rib of nominal thickness that is offset facially from the shell. An incisal ridge provides reinforcement at the incisal edge of dental appliance 601 and may be derived from the archform. The case frame sparing refers to connective material that couples parts of dental appliance 601 (e.g., the facial portion of dental appliance 601, the lingual bar of dental appliance 601, and subcomponents thereof) to the manufacturing case frame. In this way, the case frame sparing may tie the parts of dental appliance 601 to the case frame during manufacturing, protect the various parts from damage or loss, and / or reduce the risk of mixing-up parts.

[0108] In some examples, custom feature generator 684 generates one or more splines based on the landmarks. Custom feature generator 684 may generate a spline based on a plurality of tooth midpoints and / or closest points between adjacent teeth (e.g., points of contact between adjacent teeth or points of closest proximity between adjacent teeth). In some instances, custom feature generator 684 generates one spline for each slice. In one instance, custom feature generator 684 generates a plurality of splines for a given slice. For instance, custom feature generator 684 may generate a first spline for a first subset of teeth (e.g., right posterior teeth), a second spline for a second subset of teeth (e.g., left posterior teeth), and a third spline for a third subset of teeth (e.g., anterior teeth).

[0109] Appliance feature library 664 includes a set of pre-defined appliance features that may be included in dental appliance 601. Appliance feature library 664 may include a set of pre-defined appliance features that define one or more functional characteristics of dental appliance 601. Examples of pre-defined appliance features include vents, occlusal registration features, custom labels, a manufacturing case frame, a diastema matrix handle, among others. Each vent is configured to enable excess dental composite to flow out of dental appliance 601. In some examples, an incisal registration feature comprises a male and female tab pair that falls on the incisal edge of dental appliance 601 (e.g., along the midsagittal). In one example, the incisal registration feature is used to maintain vertical alignment of a facial portion of dental appliance 601. Each custom label includes data identifying a part of dental appliance 601 and / or data identifying the patient or the particular tooth to be restored. The manufacturing case frame is configured to support one or more parts of dental appliance 601. For example, the manufacturing case frame may detachably couple to a facial portion of dental appliance 601 to one another for safe handling and transportation of dental appliance 601 from manufacturing facility 610 to clinic 606. According to other implementations, appliance feature library 664 can be configured to include one or more interproximal geometries that are inserted between adjacent teeth. This predefined geometry may include a library part, scaled geometry, and / or parametric shapes, to name a few examples. For instance, the appliance feature library 664 may include 3D fins of a uniform thickness. As another example, appliance feature library 664 may include 3D fins that are subdivided with each subdivision having a respective thickness, and the respective thickness can be altered to better conform with the spacing and orientation of the adjacent teeth. In general, the fins can have an initial thickness between 100 and 500 microns, according to particular implementations. For example, in one implementation, fins having a uniform thickness of 650 microns are stored in the appliance feature library 664. And in yet another example, appliance feature library 664 may include ovoid cylinders that can be placed within interproximal spaces between adjacent teeth. Techniques for placing and refining interproximal geometries are described in WO2023 / 031716 (Hansen et al.).

[0110] Feature manager 686 determines the parameters of one or more pre-defined appliance features that are included in pre-defined appliance feature library 664. In one example, the predefined appliance features are configured to perform functionality of dental appliance 601. The parameters of the pre-defined appliance features may include the size, shape, scale, position, and / or orientation of the pre-defined appliance features. Feature manager 686 may determine the parameters of the pre-defined appliance features based on one or more rules. The rules may be pre-programmed or machine generated, for instance, via machine learning. An exemplary method for determining and designing dental appliances using neural networks can be found in International Publication No. W02021 / 240290 (Fabbri et al.).

[0111] In some examples, feature manager 686 may determine an initial placement, orientation, and thickness of one or more interproximal geometries in accordance with this disclosure.

[0112] Feature manager 686 may determine the parameters of a pre-defined appliance feature based on preferences of practitioner 602. Practitioner preferences library 668 may include data indicative of preferences of various practitioner 602. In one example, practitioner preferences directly affect the parameters of one or more appliance features. For example, practitioner preferences library 668 may include data indicating a preferred size of various appliance features, such as the size of the registration features. In other examples, practitioner preferences library 668 may include data indicating a preferred initial size or shape of the interproximal geometries.

[0113] As another example, practitioner preferences indirectly affect the parameters of appliance features. For example, practitioner preferences library 668 may include data indicating a preferred stiffness of the appliance. Such preference selections may also affect more complex design changes to section thickness of the matrix. Feature manager 686 may determine the parameters of the appliance features by applying the practitioner preferences to one or more rules, a simulation (e.g., Monte Carlo) or finite element analysis. Feature parameters also may be derived from properties in the materials to be used with the matrix, such as the type of composite that the dentist prefers to use with the appliance.

[0114] Model assembler 688 generates a digital 3D model of dental appliance 601 used to reshape the dental anatomy (e.g., to the future dental anatomy) in response to determining the parameters of the custom and pre-defined appliance features. The digital model of dental appliance 601 may include a point cloud, 3D mesh, NURBS or other digital representation of dental appliance 601. In some instances, model assembler 688 stores the digital model of dental appliance 601 in models library 666.

[0115] Model assembler 688 may output the digital model of dental appliance 601. For example, model assembler 688 may output the digital model of dental appliance 601 to computing device 692 of manufacturing facility 610 (e.g., via network 614) to manufacture dental appliance 601. In another example, computing device 650 sends the digital model of dental appliance 601 to computing device 690 of clinic 604 for manufacturing at clinic 604. In some implementations, the model assembler 688 generates a computer-readable file that includes data describing the digital model of dental appliance 601. This file may be stored in storage devices 666 and the file may be referenced by the system 600 in the future to refine the previous digital model or by the manufacturing system 694 to manufacture a physical matrix of the digital model.

[0116] Refinement module 689 can be used to refine the digital model of dental appliance 601. For instance, the refinement module 689 can be used to modify one or more parameters of the digital model. In some implementations, the modification to the digital model includes modifying one or more parameters of the inserted interproximal geometries. Refinement module 689 can be configured to incrementally modify the digital model in response to received user input (e.g., from practitioner 606) or may be configured to automatically refine the digital geometry using predefined rules or based on machine learning techniques.

[0117] In some implementations, the refinement module 689 may also graphically present the incremental refinements in real-time as the parameters of the digital model are being changed. For example, as the thickness or position of an interproximal fin is being modified in accordance with received user input, the refinement module 689 can update the parameters of the modified interproximal fin and demonstrate via UI devices 674 any changes to the interproximal fins relative to the digital model in real-time. In other implementations, the refinement module 689 can graphically present final refinements that are automatically computed using predefined rules or machine learning. An advantage of graphically presenting the refinements (either incrementally or upon completion of the refinements) is that a user of system 600 (e.g., the practitioner 606) can visually inspect the digital model of dental appliance 601 before the model is provided to the manufacturing system 694. In some implementations, one or more aspects of the digital model of dental appliance 601 can be provided to the refinement module 689 before the system 600 provides the digital model to the model assembler 688.

[0118] Computing device 692 may send the digital model of dental appliance 601 to manufacturing system 694. Manufacturing system 694 manufactures dental appliance 601 according to the digital model of dental appliance 601. Manufacturing system 694 may form dental appliance 601 using any number of manufacturing techniques, such as 3D printing, chemical vapor deposition (CVD), thermoforming, injection molding, lost wax casting, milling, machining, laser cutting, among others.

[0119] Practitioner 606 may receive dental appliance 601 and may utilize dental appliance 601 to re-shape one or more teeth of patient 602. For example, practitioner 606 may apply a dental composite to the surface of one or more teeth of patient 602 via one or more doors of dental appliance 601. Excess dental composite may be removed via one or more vents. In some situations, the presence of interproximal geometries in the dental appliance 601 gives practitioner 606 better control of the amount dental composite, or bonding material, used during a filling procedure with patient 602. In general, advantages of using the techniques described herein include greatly reducing the need of practitioner 606 to remove excess dental composite. That can result in decreasing the time to treat patient 602 using the dental appliance 601 and limiting the practitioner’s 606 to use saws, blades, and other tools to separate interproximal dental composite after it has cured.

[0120] In some examples, model assembler 688 generates a digital model of dental appliance 601 based on an existing digital model (e.g., stored in models library 666). In one example, models library 666 may include data indicative of appliance success criteria associated with each completed dental appliance 601, the appliance success criteria indicating a manufacturing print yield, practitioner and / or customer feedback or ratings, or a combination thereof. For example, model assembler 688 may utilize an existing digital model to generate a new or updated digital model of a dental appliance 601 in response to determining the appliance success criteria for the previous dental appliance 601 satisfy threshold criteria (e.g., a threshold manufacturing yield, or a threshold practitioner rating). 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 a dental appliance 601 based on the template digital model. For example, the template digital model may be associated with different characteristics of a potential patient’s dental anatomy, such as the patient having small teeth or being unable to open the mouth widely.

[0121] In one example, model assembler 688 generates a digital model of a dental appliance 601 based on an existing digital model by utilizing one or more morphing algorithms. For example, model assembler 688 may utilize morphing algorithms to interpolate appliance feature geometries. In one instance, model assembler 688 may generate a new digital model of a dental appliance 601 based on the design of the existing digital model. In one instance, the design feature of an existing digital model may include a window inset from the perimeter, such that model assembler 688 may morph the geometry of the existing digital model based on landmarks for a different dental anatomy.

[0122] The techniques of this disclosure may enable a computing device to automatically determine the shape of dental appliance 601 and the placement of various appliance features. In this way, the computing device may more accurately and more quickly generate a digital model of a dental appliance 601. More accurately determining the shape of dental appliance 601 and the placement of the appliance features may increase the efficacy of dental appliance 601 and the tooth restoration. Determining the shape of dental appliance 601 and placement of the appliance features more quickly may enable the practitioner to correct a patient’s teeth more quickly, which may improve the appearance and / or functionality of the patient’s teeth, thereby potentially improving the patient experience. Additionally, reducing the time required to generate the digital model of a dental appliance 601 may reduce the cost of production and make treatment affordable and accessible for a wider set of patients.

[0123] While computing device 650 is described as automatically generating a digital model of dental appliance 601 based on a digital model of a future dental anatomy of the patient, in some examples, computing device 650 may utilize a digital model of the current, unrestored state of the dental anatomy of the patient to generate all or part of the digital model of dental appliance 601. For example, computing device 650 may utilize a digital model of the current dental anatomy to generate the facial ribbon (e.g., as the gingival margin may not change during restoration) and / or the registration portion (e.g., as the mesial and distal struts can register with teeth that are not to be restored).

[0124] FIG. 20 is a flow diagram illustrating an example technique for generating a digital model of a dental appliance, in accordance with various aspects of this disclosure. FIG. 20 is described below in the context of system 600 of FIG. 19.

[0125] Computing device 650 receives a digital 3D model of a future (i.e., desired) dental anatomy for a 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 future dental anatomy of the patient may include a point cloud or 3D mesh of the future dental anatomy. A point cloud includes a collection of points that represent or define an object in 3-dimensional space. A 3D mesh includes a plurality of 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 utilizes an image capturing system to generate the digital model of the future dental anatomy. In another example, practitioner 606 modifies the digital model of the current anatomy of patient 602 (e.g., by adding material to the surface of one or more teeth of the dental anatomy) to generate the 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.

[0126] In some examples, pre-processor 684 pre-processes the 3D model of the future dental anatomy to generate a modified model by digitally extending the roots of the initial digital model of the future dental anatomy according to the projected root extension determined by pre-processor 684, thereby more accurately modeling the complete anatomy of the patient’s teeth (Step 704). In some examples, because the tops (e.g., the area furthest the gingival emergence) of the roots may be at different heights, pre-processor 684 may detect the vertices corresponding to the tops of the roots and then project those vertices along a normal vector, thereby digitally extending the roots. In one example, pre-processor 684 groups vertices into clusters (e.g., using a k-means algorithm). Pre-processor 684 may compute the average normal vector for each cluster of vertices. For each cluster of vertices, pre-processor 684 may determine a sum of residual angular differences between the average normal vector for the cluster and the vector associated with each of the vertices in the cluster. In one example, pre-processor 684 determines which cluster of vertices is the top surface of the roots based on the sum of the residual angular differences for each cluster. For example, pre-processor 684 may determine that the cluster with the lowest sum of residual angular differences defines the top surface of the roots.

[0127] Further, 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, where each landmark represents an identifiable geometric construct within the 3D model that is useful for determining the position and orientation with respect to one or more tooth surfaces. In some examples, the landmarks computed by landmark identifier 682 include a plurality of slices of the dental anatomy and each slice of the dental anatomy may include one or more additional landmarks. For example, landmark identifier 682 may divide the 3D mesh of the future dental anatomy into a plurality of slices. Responsive to dividing the digital model of the dental anatomy into slices, in one example, landmark identifier 682 computes one or more landmarks for each slice, such as a midpoint for each tooth in the slice, a closest point between two adjacent teeth (e.g., a point of contact between two adjacent teeth or a point of closest approach between two adjacent teeth), a convex hull for each tooth in the slice, among others (Step 706).

[0128] Custom feature generator 684 automatically generates the design fdes, including determining the particular size, shape, position, and / or orientation of one or more custom appliance features for dental appliance 601 based on the landmarks, where each “feature” represents a digital 3D mesh defining a particular geometric shape to be utilized as one portion (i.e., a sub-mesh) within a 3D model defining overall dental appliance (Step 708). Examples of custom appliance features include a 3D mesh for a spline, a mold parting surface, a gingival trim surface, a shell, a facial ribbon, an interproximal fin, a lingual bar, an occlusal registration portion, among others. In one example, custom feature generator 684 generates one or more digital meshes representing splines for each slice of the dental anatomy. Custom feature generator 684 may generate a spline for a given slice based on a plurality of tooth midpoints of teeth within the slice and / or closest points between adjacent teeth within the slice (e.g., points of contact between adjacent teeth within the slice or points of closest proximity between adjacent teeth within the slice). In other words, in this example, custom feature generator 684 accumulates a set of points (e.g., tooth midpoints, points of contact between adjacent teeth, points of closest approach between adjacent teeth, or a combination thereof) for each slice to generate features representing a spline for each digital slice.

[0129] In some examples, custom feature generator 684 automatically generates a mold parting surface as one example feature to be incorporated within an overall 3D model of a dental restoration appliance. Custom feature generator 684 may generate the mold parting surface based on the plurality of midpoints and / or closest points between adjacent teeth. For example, custom feature generator 684 may accumulate a plurality of the points for each spline for each slice to generate the mold parting surface. In an example where custom feature generator 684 divides the dental anatomy into four slices and generates a single spline for each slice, custom feature generator 684 aggregates the points of each of the four splines to generate the mold parting surface.

[0130] In one scenario, feature manager 686 receives data indicative of practitioner preferences (Step 710). For instance, feature manager 686 may query practitioner preferences library 668 to determine preferences for practitioner 606. Examples of data stored within practitioner preferences library 686 include a preferred size or orientation of a pre-defined appliance feature for a particular practitioner.

[0131] Feature manager 686 receives data indicative of pre-defined appliance features, such as by accessing and retrieving the data from one or more libraries (e.g., datastore or other electronic repository) of 3D meshes representing pre-defined features for incorporation within an overall 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 a plurality of pre-defined appliance features, such as indicia, reliefs, occlusal registration features, and occlusal fingers, among others.

[0132] In one example, feature manager 686 selects one or more pre-defined appliance features from a plurality of pre-defined appliance features stored within appliance feature library 686. For example, appliance feature library 686 may include data defining a plurality of different predefined appliance features of a given type of pre-defined appliance feature. As one example, appliance feature library 664 may include data defining different characteristics (e.g., size, shape, scale, orientation) for a given type of pre-defined appliance feature (e.g., data for differently sized and / or differently shaped fingers, apertures, etc.). In other words, appliance feature library 664 may determine the characteristics of a pre-defined appliance feature and select a feature from the pre-defined appliance library that corresponds to the determined characteristics. In some scenarios, feature manager 686 selects a pre-defined appliance feature (e.g., a particularly facial ribbon) from appliance feature library 686 based on landmarks for a corresponding tooth, characteristics (e.g., size, type, location) of the corresponding tooth (e.g., a tooth for which the appliance feature will be used to restore when the dental appliance is applied to the patient), practitioner preferences, or both.

[0133] In another example, appliance feature library 664 includes data defining a set of required pre-defined appliance features, such that feature manager 686 retrieves data for the 3D meshes representing the pre-defined features for each of the required pre-defined features. In such examples, feature manager 664 may transform the 3D mesh for including in the patient specific dental appliance. For example, feature manager 664 may rotate or scale (e.g., re-size) a 3D mesh for a particular feature based on the landmarks for a corresponding tooth, characteristics of the tooth, and / or practitioner preferences.

[0134] Model assembler 688 operates to construct an overall 3D mesh for the dental appliance by, for example, determining the characteristics of one or more custom appliance features and one or more pre-defined dental appliance features based at least in part on the patient-specific landmarks (Step 714). For example, based on the landmarks for the particular patient, model assembler 688 may determine example characteristics such as size, position, and / or orientation of each 3D mesh corresponding to each of the appliance features (including custom or pre-defined appliance features) for the overall appliance. In some instances, modeler assembler 688 determines the position of a pre-defined appliance feature based on the position of a custom appliance feature. For instance, modeler assembler 688 may align a ribbon aperture a midline of a mold body. Further, the model assembler 688 may adjust the feature geometry, scale or position based on analysis of the overall model. The model assembler 688 may also make adjustments based on subsequent expected manufacturing tolerances, such as providing suitable clearance between features. Similarly, the model assembler 688 may make adjustments based on the properties of the material used in the creation of the physical appliance, such as increasing thicknesses when using more flexible materials.

[0135] Model assembler 688 generates the full digital 3D model of the dental appliance 601 based on the custom dental appliance features and the pre-defined dental appliance features and their determined characteristics (Step 716). The digital model of dental appliance 604 may include a point cloud, 3D mesh, or other digital representation of dental appliance 604.

[0136] Computing device 650 stores, transmits and / or outputs the 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 (Step 720) based on the digital 3D model of dental appliance 604. For example, manufacturing system 694 may generate the physical dental appliance 604 via 3D printing, CVD, machining, milling, or any other suitable technique.

[0137] In some examples, computing system 650 receives feedback on dental appliance 601 from practitioner 606 (Step 722). For example, after practitioner 606 receives the physical dental appliance 601, practitioner 606 may utilize computing device 690 to send feedback to computing device 650. As one example, computing device 650 may receive data indicating a request to adjust a characteristic (e.g., size, relative position) of a pre-defined appliance feature. In some examples, computing system 650 updates the practitioner preferences library 668 based on the feedback (724).

[0138] Various examples have been described. Modifications to the examples described may be made within the spirit of this disclosure. For example, custom tools can be fabricated off of initial tooth geometry or digitally optimized tooth geometry (for example hole filling close gaps in the data, pulling and scaling data from tooth libraries, testing in a virtual articulator). Tools can fit precisely to the existing structure or can be optimized to selectively move or position tissue. Custom tools can be formed without prior information of where the tooth structure will be removed, such as when the extent of caries is not known. Custom tools may be formed to generate a digitally optimized tooth structure that will require the practitioner to remove tooth structure prior to application of the tool. Tools can be printed or milled. Tools can be made from the full range of 3D printed materials (strength, flexibility, translucency, color). Tools can be coated with a range of agents to optimize release, surface finish and optical transparency. Tools can contain features to indicate or define the fill level of different restorative materials (shade, fill level, physical properties). Physical characteristics (elasticity, roughness, texture, imprint of secondary / tertiary anatomy, transparency, gloss, etc.) of tools can vary across the tool including sealing capability, dimensional fidelity, texture imparted to restorative material, degree of cure of material, etc. Tools and mold sections can interlock with each other or with standard components (for example matrix bands). Tools can be used inside or outside of the mouth. Restorative material can be injected through ports in tools, applied to tooth structure and / or tool prior to the application of the tool, such that application shapes the material. Tools can be degradable such as with solvent or heat to release from the restorative material or enable undercut geometries and / or reduce parting lines. Tools could be collapsible (deflated, frangible, etc.) Kits can be created of the patient specific tools and associated products and quantities, (such as adhesives, filling, and polishing materials selected for the patient’s needs and / or doctor's preferences). A series of tools can be used sequentially in the direct filling process in order to control the geometries of multiple layers of a dental restoration on a tooth. Portions of the tool may be designed to register with pre-treatment dentition and / or dentition at an intermediate or finished stage of treatment. Tools may be designed to register or mate with auxiliary devices used in the procedure such as wedges, matrix bands, and retraction devices. Dental scans may be taken at a diagnostic appointment to facilitate custom tools fabrication prior to a dental restoration appointment. Tools may be manufactured locally, or digital scan data may be sent to a remote location for production.

[0139] The 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 of ordinary skill in the art that various changes and modifications may be made without deviating from the inventing concepts set from above. Thus, the scope of the present disclosure should not be limited to the structures described herein. Those having skill in the art will appreciate that many changes may be made to the details of the above -described embodiments and implementations without departing from the underlying principles thereof. Further, various modifications and alterations of the present invention will become apparent to those skilled in the art without departing from the spirit and scope of the invention. The scope of the present application should, therefore, be determined only by the following claims and equivalents thereof.

Claims

What is claimed is:

1. A method for forming a dental restoration in a mouth of a patient, the method comprising: providing a mold body providing for a patient-specific, customized fit with at least two teeth of the patient, the teeth including a first restoration tooth and a first support tooth adjacent to the restoration tooth, where the mold body includes a facial portion forming a first facial surface corresponding with a facial surface of the first restoration tooth, a registration portion including an occlusal strut configured to extend over an incisal ridge or one or more occlusal cusps of the first support tooth; applying a dental restorative material to a surface of the mold body, a surface of the first restoration tooth, or both; positioning the mold on a portion of the restoration tooth, wherein the mold combines with the restoration tooth to form a mold cavity encompassing missing tooth structure of the restoration tooth; and allowing the dental restorative material to cure within the mold cavity to reform the tooth.

2. The method of claim 1, and the mold body further including a reinforcement ribbon extending along the gingival edge of the facial portion of the mold body.

3. The method of claim 2, wherein the mold body includes at least one aperture between a facial surface of the facial portion and an interior surface of the reinforcement ribbon.

4. The method of claim 1 , wherein the mold body further includes at least a first interproximal portion corresponding with a first interproximal surface of the first restoration tooth, and wherein the first interproximal 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 cusps of the first restoration tooth, the finger defining the first occlusal surface.

6. The method of claim 5, wherein the registration portion includes at least a second finger configured to extend over an embrasure between the first registration tooth and the support tooth.

7. The method of claim 1, wherein the occlusal strut has a patient-specific, customized fit with the occlusal cusps of the first support tooth or the first restoration tooth.

8. The method of any of the previous claims, and wherein the mold body further comprises a support body forming a first facial surface corresponding with a facial surface of the first support tooth.

9. The method of any of the previous claims, wherein the mold body provides for a patientspecific, customized fit with at least three teeth of the patient, the teeth including the first restoration tooth, the first support tooth and a second restoration tooth, wherein the mold body includes a facial portion forming a first facial surface corresponding with a facial surface of the first restoration tooth and a second facial surface corresponding with a facial surface of the second restoration tooth, wherein the mold body is configured to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of both the first and second restoration tooth.

10. The custom tool of any of the previous claims, wherein mold body includes a dental restorative. allowing the dental restorative material to cure within the mold cavity to reform the tooth.

11. A method for forming a dental restoration in a mouth of a patient, the method comprising; positioning a patient-specific a facial mold body adjacent at least one tooth to be restored of a patient, wherein the facial mold body has a customized fit with the facial side of at least one tooth of the patient, the at least one tooth defining a first restoration tooth; positioning a patient-specific lingual mold body adjacent the first restoration tooth, wherein the lingual mold body has customized fit with the lingual side of the first restoration tooth; coupling the facial mold body with the lingual mold body to combine with the first restoration tooth form a mold cavity encompassing missing tooth structure of at least one tooth to be restored; introducing restorative material into the mold cavity; curing the restorative material; and providing a second, unitary mold body providing for a patient-specific, customized fit with at least two additional teeth of the patient, the teeth including a second restoration tooth and a first support tooth adjacent to the second restoration tooth, where the unitary mold body includes a facial portion forming a first facial surface corresponding with a facial surface of the first restoration tooth, and a registration portion including an occlusal strut configured to extend over an incisal ridge or one or more occlusal cusps of the first support tooth;applying a dental restorative material to a surface of the mold body, a surface of the first restoration tooth, or both; positioning the mold on a portion of the restoration tooth, wherein the mold combines with the restoration tooth to form a mold cavity encompassing missing tooth structure of the restoration tooth; and allowing the dental restorative material to cure within the mold cavity to reform the tooth.

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

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

14. The method of claim 11, wherein the second, unitary mold body comprise at least a first interproximal portion corresponding with a first interproximal surface of the first restoration tooth, and wherein the first interproximal 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 cusps of the first restoration tooth, the finger defining the first occlusal surface.

16. The method of claim 15, wherein the registration portion includes at least a second finger configured to extend over an embrasure between the first registration tooth and the support tooth.

17. The method of claim 11, wherein the occlusal strut has a patient-specific, customized fit with the occlusal cusps of the first support tooth or the first restoration tooth.

18. A process of making a custom tool for forming a dental restoration of a tooth within a mouth of a patient, the process comprising: obtaining three-dimensional scan data of a patient’s mouth; and three-dimensionally printing a first custom tool for forming the dental restoration of the tooth based on the three-dimensional scan data of the mouth of the patient, wherein the first custom tool comprises a mold body providing for a patient-specific, customized fit with at least two teeth of the patient, the teeth including a first restoration tooth and a first support tooth adjacent to the restoration tooth, where the mold body includes a facial portionforming a first facial surface corresponding with a facial surface of the first restoration tooth, a registration portion including an occlusal strut configured to extend over an incisal ridge or one or more occlusal cusps of the first support tooth.

19. The process of claim 18, and further comprising three-dimensionally printing a second custom tool based on the three-dimensional scan data of the mouth of the patient, the second custom tool comprising a patient-specific a facial mold body having a customized fit with the facial side of at least one tooth of the patient, the at least one tooth defining a second restoration tooth; and a patient-specific lingual mold body having a customized fit with the lingual side of the second restoration tooth.

20. The process of claim 18, wherein the mold body of the first custom tool provides for a patient-specific, customized fit with at least three teeth of the patient, the teeth including the first restoration tooth, the first support tooth and a second restoration tooth, wherein the mold body includes a facial portion forming a first facial surface corresponding with a facial surface of the first restoration tooth and a second facial surface corresponding with a facial surface of the second restoration tooth, wherein the mold body is configured to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of both the first and second restoration tooth.

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