Orthodontic appliances and treatment methods

Abstract

An orthodontic appliance and assembly for distal movement of segments in the posterior jawbone region is disclosed. The orthodontic appliance comprises a mesial element having a mesial base surface configured for attachment to a premolar or canine, an arm having a pivot at the distal end of the arm, and a distal element having a distal base surface configured for attachment to a molar. The distal element or distal portion of the arm comprises a distal anchoring structure for connecting a first distal movement force element. The mesial element may have a projection defining a groove for fitting an elastic band, the groove being positioned along a rounded convex surface of the projection having a diameter of at least 3 mm. A method of treatment is also provided.

Description

Technical Field

[0001] This application claims priority to U.S. Provisional Application 63 / 460, filed on April 18, 2023, and European Patent Application No. 23186722.7, filed on July 20, 2023.

[0002] This disclosure relates to orthodontic devices, and more particularly to orthodontic devices for segmental distal movement of posterior jaw sectors. This disclosure further relates to methods of treatment using such devices.

Background Art

[0003] Depending on the patient's malocclusion, various orthodontic treatments are available. In some of these treatments, it may be necessary to extract teeth to create space for the remaining teeth. In some treatments, distal movement elements can be used in combination with, in some cases, extracting one or more teeth. This disclosure particularly relates to distal movement elements for distally moving a segment of teeth.

[0004] A segment of teeth is defined herein as a group of adjacent teeth, i.e., two or more adjacent teeth. Distal movement of a segment of teeth relates to moving the group of teeth together. In particular, in this disclosure, distal movement refers to moving the group of teeth in the distal direction of the oral cavity. The group of teeth can be located in the upper jawbone (maxilla) or the lower jawbone (mandible).

[0005] Certain distal movement elements are known, for example, from EP1433435 and EP1649824. These distalisers are particularly adapted for segmental distal movement in the posterior maxillary region from the canine to the molar teeth. The distalisers of these documents comprise a mesial element that can be fixed to the upper canine by its base, and further comprise a distal element that can be fixed to the upper molar, particularly the first molar, by its base.

[0006] The mesial element in these designs comprises both a base and an arm connecting the base to the distal element. The arm may be substantially arched and may have a ball-shaped member at one of its ends. This ball-shaped member is received within a receptacle of the distal element having a shape complementary to the ball-shaped member.

[0007] The mesial element may have a substantially forward-extending blunt projection that can function as a hook element. When in use, a bracket with the hook can be attached to the mandibular molar, and a (orthodontic) rubber band can be suspended around this hook and the hook element on the mesial element.

[0008] In this way, a force is provided that pulls the maxillary canine tooth backward. If the patient is wearing a splint (or other fixation device) that acts as a solid anchor to fix the teeth in the mandible in place, for example, it can be ensured that the teeth in the mandible do not move forward and the maxillary canine tooth is pulled backward.

[0009] Due to the joint between the mesial and distal elements of the distalizer, the maxillary molars can also be pushed backward. Simultaneously, a rotational force is applied to the molars due to the shape of the arm between the canine and molars and the position of the distal element on the molars. This rotational force can cause the maxillary molars to pivot around the palatal root. Furthermore, distal rotation (uprighting) of the molars can occur. Therefore, both a backward force and a rotational force can be applied to the molars simultaneously.

[0010] To prevent excessive distal rotation of the maxillary molars (i.e., assuming a posterior tilt orientation), the shape of the receptacle and ball member is such that a predetermined rotation of the ball member relative to the upper molar causes the ball member to touch the inside of the receptacle and prevent further rotation. For this purpose, both the mesial and distal elements are mounted at the appropriate height over the molars and canines and are mounted substantially straight along the mandibular-maxillary (straight up and down) direction on locally defined tooth surfaces. The arms are positioned at a predetermined angle relative to the ball member. If both the canines and molars are actually straight, this angle ensures that the arms of the ball member or mesial element touch the boundary of the receptacle and prevent further rotation.

[0011] Similarly, the shape of the ball member and the boundary of the receptacle may be designed to restrict the rotation of the upper molar around its palatal root. Once a predetermined rotation is reached, the arm can touch the boundary of the receptacle, and the ball member cannot rotate further.

[0012] Therefore, it can be ensured that distal movement of the canine-molar segment can be combined with appropriate (re)orientation of the tooth set in the posterior maxillary region.

[0013] U.S. Patent Application Publication 2011 / 0244414 provides a further distal repositioning device with reduced height compared to the devices described in EP1433435 and EP1649824. The distal repositioning device of U.S. Patent Application Publication 2011 / 0244414 consists of a single element coupled to the canine / premolar and molar. Coupling with a ball member and receptacle is absent in this device. This allows for reduced height and makes the device usable in the treatment of many patients in the mandible, but the functionality of the distal repositioning device is limited because rotation of the mesial element relative to the distal element and the corresponding collision point between the ball member or arm and the receptacle are eliminated. These devices therefore have limited ability to adjust the position of the molars in both "alignment" and twisting.

[0014] Another distal movement device is known from WO2018 / 219858. This prior art document discloses an orthodontic device for segmental distal movement in the posterior mandibular region comprising an arm and a mesial element including a projection for coupling with a traction element, the arm having an elongated transverse pivot at its distal end. The elongated transverse pin is received within a receptacle at the distal base. The elongated transverse pin is pivotable relative to the distal base, thus enabling segmental distal movement that combines alignment and rotation around the palatal root of the molar. The interior of the receptacle restricts the pivotal movement of the elongated transverse pin. In the example, the elongated transverse pin is substantially condylar. These devices can provide effective segmental distal movement and have a reduced height, thereby facilitating use, particularly in the mandible of patients.

[0015] WO2018 / 219858 describes a process for assembling a distal transfer device, according to which the distal base receptacle is made slightly larger than the pin, so that the pin can be introduced without deforming it. After the introduction of the pin, the opening of the receptacle can be reduced, which may involve, for example, local deformation or complete boundary deformation. Local deformation with coining is a particularly preferred example.

[0016] U.S. Patent Application Publication No. 2020 / 0146782 discloses a segment distal movement device comprising an elongated rod having a distal end and a mesial end, a distal base on the distal end of the elongated rod, a mesial base on the mesial end of the elongated rod, and a mounting member attached to at least one of the elongated rod, the distal base, and the mesial base. In some embodiments, the mounting member is operable to connect the segment distal movement device to an anchor via an elastic connector.

[0017] This disclosure provides further improvements to distal transfer devices and methods of treatment using distal transfer devices. [Overview of the project]

[0018] According to a first embodiment, an orthodontic appliance for distal movement of segments in the posterior jawbone region is provided. The appliance comprises a mesial element having a mesial base surface configured for attachment to a premolar or canine, an arm having a pivot at the distal end of the arm, and a distal element having a distal base surface configured for attachment to a molar, the distal element comprising a receptacle. The pivot of the arm is located within the receptacle, and the distal element or the distal portion of the arm comprises a distal anchoring structure for connecting a first distal movement force element.

[0019] The appliance according to the first embodiment can provide segment distal movement, with the distal movement force being provided closer to the molars. In certain malocclusions and / or in certain patients, providing traction or tensile force to the mesial elements (typically attached to the canines, and sometimes to the premolars) can be complex. In these scenarios, the orthodontic appliance according to the first embodiment can be used for segment distal movement, with the tensile or pushing force being provided directly to or near the molars.

[0020] In some cases, providing distal movement force in or near the molars can reduce canine extrusion. In some cases, providing distal movement force in or near the molars can be more easily provided depending on the patient's malocclusion.

[0021] In some examples, the proximal portion of the mesial element or arm may be provided with a projection for coupling with a second distal moving force element. The second distal moving force element may be an elastic band in particular. In these examples, the distal moving force may be provided in the mesial element, in the distal element, in its vicinity, or both.

[0022] In some examples, the arm may be formed integrally with the mesial element or fixedly attached to the mesial element. In examples, the pivot may be substantially granular or ball-shaped, or the pivot may be ball-shaped with diametrically opposed flat surfaces. Although destabilizers having substantially granular pivots are generally shown in this disclosure and drawings, it should be made clear that the methods illustrated and described for assembly are generally applicable to other pivots, particularly pivot elements such as those described in EP1433435 and EP1649824 and WO2018 / 219858. In particular, the pivot may be substantially ball-shaped, or may be formed as a ball with diametrically opposed flat surfaces, or may be substantially elongated pins.

[0023] In some examples, the distal anchoring structure may include an orifice for receiving and holding a portion of the first distal mobility element. Throughout this disclosure, the orifice may be considered as a hole or loop through which a portion of the first distal mobility element can be guided in order to connect the first distal mobility element to an orthodontic appliance. The orifice may be configured as an eye or eyelet, or as a hole or opening. The orifice may be formed integrally with the distal pad.

[0024] In some examples, the anchoring structure may be provided on the distal portion of the arm. In this disclosure, the distal portion of the arm may be considered as the most distal 33%, preferably the most distal 25% of the arm. In some examples, the anchoring structure may comprise one or more projections on the arm.

[0025] A second aspect of this disclosure provides a method for treating malocclusion in a patient. The method comprises providing an orthodontic appliance according to any example of the first aspect. The method further comprises attaching the mesial base surface of the orthodontic appliance to the patient's premolar or canine, and attaching the distal base surface of the orthodontic appliance to the patient's molar. The method further comprises providing a first distal force element, coupling the first distal force element to a distal anchoring structure, and actinguating the first distal force element.

[0026] According to this embodiment, a treatment method is provided for moving a tooth segment distally, wherein the distal movement force is applied in or near a molar.

[0027] In some examples, the method further includes attaching elastic bands around projections on the arm or mesial element and around anchors fitted in the patient's oral cavity. The anchors may be hooks, pins, screws, or any other anchor suitable for holding elastic bands on brackets or molar tubes, or on temporary anchorage devices (TADs) or buttons fitted on teeth (e.g., Carriere Motion 3D sidekick®).

[0028] In an example, particularly for treating Class II malocclusion, the orthodontic device is disposed on the patient's maxilla. In an example, the first distal movement force element can be a Class II correction device. Suitable Class II correction devices include, for example, the Herbst appliance, Forsus appliance, Jasper Jumper or Powerscope™, Twin Force® Bite Corrector, TruEase™ Bite Corrector, CS® 5, commercially available from American Orthodontics, Twin Force® Bite Corrector, TruEase™ Bite Corrector, Dynaflex® CS® 5, commercially available from Ortho Technology. Most or all of these devices can be intermaxillary devices.

[0029] In a further example, the first distal movement force element can be an intraoral device. The first distal movement force can be an elastic (rubber) ligature, a nitinol ligature, a coil spring, etc.

[0030] In another example, the orthodontic device can be disposed on the patient's mandible, for example, to correct Class III malocclusion. In such an example, a Class III correction device, particularly an intermaxillary Class III correction device, can function as the first distal movement force element. The aforementioned Class II devices can also generally be used as Class III devices.

[0031] In a further aspect, a kit is provided that includes an orthodontic device of the first aspect and an adapter for coupling to the first distal movement force element. Such an adapter can function to couple a particular orthodontic appliance (such as Herbst, Forsus, etc.) to the orthodontic device. This enables different brands of orthodontic appliances to be used in combination with the orthodontic device. In some examples, such a kit can include a plurality of adapters for coupling to various first distal movement force elements.

[0032] In a further embodiment, an orthodontic assembly is provided for distal movement of segments in the posterior jawbone region. The orthodontic assembly comprises a mesial element having a mesial base surface configured for attachment to a premolar or canine, an arm having a pivot at the distal end of the arm, and a distal element having a distal base surface and a receptacle configured for attachment to a molar. The pivot of the arm is located within the receptacle. The mesial element has a projection, and the assembly further comprises an anchor, thereby enabling an elastic band to be fitted around the projection and anchor to provide distal movement force. The projection is shaped such that, when the mesial portion of the elastic band is positioned around the projection, the first portion of the elastic band adjacent to the mesial portion on the first side of the mesial portion and the second portion of the elastic band adjacent to the mesial portion on the second side of the mesial portion are not parallel to each other.

[0033] In this embodiment, the projection around which the elastic band is fitted can be wider than in the prior art device. The projection may be such that the portions of the elastic band extending from it directly to intermaxillary anchors (such as motion 3D sidekicks or hooks on molar tubes or brackets) are not parallel to each other. The force distribution around the projection can be more uniform than in the prior art, and friction can be reduced compared to the prior art device. This can make the initial stages of orthodontic treatment, particularly the treatment of Class II or Class III malocclusion, more efficient. Results can be obtained more quickly than in the prior art.

[0034] In some examples, the projection may have a rounded groove for receiving the mesial portion of the elastic band. The groove may be formed between the base of the mesial element and the edge of the projection. In some examples, the projection may have a substantially circular cross-section passing through the plane of the groove. In other examples, the cross-section passing through the plane of the groove may be substantially oval.

[0035] In some examples, the mesial edge of the projection may substantially coincide with the mesial edge of the mesial base surface. In other examples, the mesial edge of the projection is positioned anterior to the mesial edge of the mesial base surface.

[0036] In a further embodiment, an orthodontic appliance is provided for distal movement of segments in the posterior jawbone region. The orthodontic appliance comprises a mesial element having a mesial base surface configured for attachment to a premolar or canine, an arm having a pivot at the distal end of the arm, and a distal element having a distal base surface and a receptacle configured for attachment to a molar. The pivot of the arm is located within the receptacle, and the mesial element has a projection defining a groove for fitting an elastic band. The groove is located along a rounded convex surface of the projection (the cross section passing through the projection is convex), and the rounded convex surface has a diameter of at least 3 mm, specifically 5 mm or more.

[0037] Orthodontic appliances of this embodiment can provide more efficient treatment for Class II or Class III malocclusion.

[0038] In some examples, the distal element may have an anchoring structure for coupling with a distal mobile force device. In some examples, the proximal portion of the arm has a hole for coupling with an auxiliary arm.

[0039] In some examples, the pivot has a mesial surface and a distal surface, and the internal geometry of the receptacle allows the pivot to rotate around a first axis over an angle of 1° to 45°. Optionally, in this specification, rotation around the first axis is limited by the mesial and / or distal surfaces that contact the inside of the receptacle. That is, the internal geometry of the receptacle is designed to allow the given range of rotation.

[0040] A pivot having mesial and distal surfaces that enter and contact the inside of the receptacle and restrict rotation around the first axis provides the function of restricting the alignment of the molars.

[0041] In some examples, the pivot can be rotated around the first axis over an angle of 5° to 20°, specifically 8° to 12°.

[0042] In some examples, the pivot may be substantially cylindrical. In further examples, the cross-sectional dimensions of the pivot may decrease gradually from the central point of attachment to the arm toward both ends of the pivot. A form of gradual decrease is such that smoothly increasing contact between the distal and mesial surfaces of the transverse pivot and the inside of the receptacle is provided as a transverse pivot rotating around a first axis.

[0043] In some cases, the pivot may have a longitudinal axis, and the receptacle may be capable of being rotated around the longitudinal axis over an angle of 0° to 60°, specifically 15° to 45°, with the transverse pivot. The angle of rotation enabled along the longitudinal axis may be limited by an arm that strikes the inside of the receptacle. The angle of rotation enabled determines the rotation of the molar around its palatal root. Rotation around the first and second axes, combined with the reduced height of the device, allows for the treatment of patients with different dental scenarios and different malocclusions.

[0044] In some examples, the pivot may have an upper and lower surface, and the internal shape of the receptacle may be such that the transverse pivot can be rotated around a second axis over an angle of 1° to 30°, specifically 5° to 15°. Optionally, rotation around the second axis may be restricted by the upper and / or lower surfaces that contact the inside of the distal cap and / or the distal base. In these examples, the moments and forces caused by torsional forces along the arms of the orthodontic appliance can be well absorbed by the receptacle.

[0045] In some examples, the central plane is defined by a first and second axis (at the height of the arm of the mesial element), and the pivot is symmetrical with respect to the central plane. In some examples, the central plane is defined by a first and second axis, and the receptacle may be asymmetrical with respect to the central plane. Asymmetry can be introduced into the device to allow more rotation in one direction than in the other. Asymmetry may exist in the transverse pivot and / or inside the distal cap.

[0046] In some examples, the third axis is positioned perpendicular to the first and second axes, and the angle between the third axis and the longitudinal axis of the transverse pivot can be between 0° and 15°.

[0047] Precisely defined collision points can be provided to limit the range of rotation around the first axis, the second axis, and / or the third axis. The collision points may be defined in particular by contact between the pivot and the inside of the receptacle, or by contact between the arm and the edge of the receptacle, for example, the apex or lateral edge on the entry side of the receptacle. In some examples, the arm 33 may have a specific curvature for determining the collision points.

[0048] Various embodiments can be combined with one another. Various examples of different embodiments can be combined with one another.

[0049] Additional objects, advantages, and features of embodiments of the present invention may become apparent to those skilled in the art when examining this specification, or may be learned through the practice of the present invention.

[0050] Specific embodiments of the present invention are described below as non-limiting examples with reference to the accompanying drawings. [Brief explanation of the drawing]

[0051] [Figure 1A-1B] This figure shows some of the terms used in this specification. [Figure 2A-2C] This is a diagram showing prior art orthodontic devices. [Figure 3A-3C] This figure shows an example of an orthodontic appliance according to the present disclosure. [Figure 4A-4B] This diagram schematically illustrates examples of the use of orthodontic appliances and treatment methods. [Figure 5] This figure shows an example of a combination of an orthodontic appliance with the first distal movement force element. [Figure 6A-6C] This diagram schematically illustrates different examples of orthodontic appliances, which include an anchoring structure for the distal element to connect with the first distal movement element. [Figures 7A-7D] This diagram schematically illustrates different examples of orthodontic appliances, showing that the distal portion of the arm of the orthodontic appliance has an anchoring structure. [Figures 8A-8C] This is a schematic diagram illustrating an example of an orthodontic appliance. [Figure 8D] This figure schematically shows a comparison of the force applied to an example of an orthodontic appliance (Figure 8) and an orthodontic appliance of prior art. [Figure 9] This diagram schematically shows a side view of an orthodontic appliance as an example. [Figure 10A-10C] This diagram schematically illustrates yet another example of an orthodontic appliance incorporating a distal anchoring structure. [Modes for carrying out the invention]

[0052] Figure 1A schematically shows the arrangement of teeth in the mandible (mandible). The anterior portion of the oral cavity 110 may be referred to as the mesial region. The posterior portion of the oral cavity 120 may be referred to as the distal region. The internal portion of the oral cavity behind the teeth 130 may be referred to as the lingual region. The external portion of the oral cavity 140 may be referred to as the labial region. The mesial-distal direction 115 for a specific tooth (first molar) is schematically shown in Figure 1A. The lingual-labial direction 135 for the same tooth is also shown in Figure 1A. This terminology is observed throughout this disclosure.

[0053] Figure 1B schematically shows a molar. The mesial side of the molar is indicated by reference symbol 110, while the distal side is indicated by reference symbol 120. Reference symbols 130 and 140 indicate the lingual and labial sides of the molar, respectively.

[0054] In this disclosure, the first axis is defined as an axis substantially perpendicular to the base surface of a distal element attached to the lingual surface of a molar. In Figure 1B, the first axis is indicated by reference numeral 1. The second axis may be defined as extending along a mesial-distal direction substantially parallel to the base surface of the distal element. The second axis 2 is perpendicular to the first axis 1.

[0055] Figures 2A to 2C schematically show prior art orthodontic appliances used for segment distal movement. The orthodontic appliance comprises a mesial element 10 and a distal element 20. The mesial element 10 has a base 11 which can be configured to be attached to the canine. The distal element 20 may be configured to be attached to the molar.

[0056] In this example, the mesial element may be attached to the maxillary canine, and the distal element may be attached to the maxillary molar or premolar. An anchor for attaching a traction device, such as a rubber band, may then be attached to the mandible.

[0057] The mesial element may be attached to the canine tooth in the maxilla, and the distal element may be attached to the molar tooth in the maxilla. In this scenario, the anchor may be attached to the mandible.

[0058] In this example, the projection or hook 15 is provided at the mesial end of the device. In other examples, the projection of the hook may be provided at another location, for example, along the arm 13.

[0059] The mesial element has a mesial base 11 having a mesial base surface 12 configured for attachment to a canine or premolar. The mesial base surface 12 may include a number of projections or some form of roughness for attachment to the canine. This base surface may be slightly recessed to fit the specific tooth to which it is designed to be attached.

[0060] Before installation, the tooth surface may be cleaned, possibly etched, and then dried. Adhesive may then be applied to the tooth surface. It is known to use adhesives that can be activated with light. Orthodontic appliances, sometimes also having adhesive on their base surface, can then be attached to the tooth surface. Adhesive may be applied to grooves formed between projections on the mesial base surface.

[0061] For example, after activating the adhesive using light, orthodontic appliances can be firmly fixed to the teeth. Different types of adhesives can be used, such as composite resin or glass ionomer cement. This process is also called "bonding" or, depending on the adhesive used, "cement bonding." Improved mechanical retention can be achieved due to the widening of the lateral grooves towards the edges.

[0062] Figures 2B and 2C also show a distal element 20 having a distal base surface 22 adapted to be fixed to the molar surface. The distal base surface 22 may also have some roughness or protrusions to aid in cementation to the molar. In the example shown, the protrusions may be smaller than those on the mesial base surface. The space between the protrusions may be filled with adhesive to mechanically retain the distal base surface on the molar.

[0063] The anchor (for example, attached to the mandible) can be a TAD, bracket, molar tube, or any other device capable of holding a traction element. In the case of an elastic band, the elastic band can be held on the hook of the anchor.

[0064] The mesial element 10 generally extends in the mesilateral-distal direction and comprises an arm 13 terminating at a substantially ball-shaped pivot 14. In this example, the pivot may be substantially ball-shaped having two opposing flat surfaces.

[0065] As schematically shown in Figure 2B, the pivot 14 may be positioned within the receptacle of the distal element 20.

[0066] This provides a force that pulls the canine teeth in the mandible posteriorly (i.e., distally). If the patient is wearing a splint (or other fixation device) that acts as a solid anchor to fix the teeth in the maxilla in place, for example, it can be ensured that the teeth in the maxilla do not move forward and the canine teeth in the mandible are pulled posteriorly. As mentioned above, the distal movement force is applied to the tooth segment in the maxilla, rather than to the tooth segment in the mandible.

[0067] Due to the connection between the mesial element 10 and the distal element 20 of the orthodontic appliance, the molars can also be pushed backward. Simultaneously, a rotational force is applied to the molars due to the shape of the arm between the canine and molars and the position of the distal element on the molars. This rotational force can cause pivotal movement of the maxillary molars around the palatal root. It can also cause rotation ("orientation") of the molars in the distal direction. Therefore, both a backward force and a rotational force can be applied to the molars simultaneously.

[0068] Figures 3A to 3C illustrate examples of orthodontic appliances according to the present disclosure. According to a first embodiment, an orthodontic appliance 50 is provided for distal movement of segments in the posterior jawbone region. The appliance 50 comprises a mesial element 30 having a mesial base surface 31 configured for attachment to a premolar or canine, and an arm 33 having a pivot 34 at the distal end of the arm 33. The appliance 50 comprises a distal element 40 having a distal base surface 41 and a receptacle configured for attachment to a molar. The pivot 34 of the arm 33 is located within the receptacle, and the distal portion of the distal element 40 or arm 33 comprises a distal anchoring structure 48 for connecting a first distal movement force element.

[0069] In the example shown in Figure 3, the mesial element 30 is provided with a projection 35 for coupling with a second distal moving force element. The second distal moving force element may be an elastic band that can function in the same manner as described above.

[0070] In other examples, the proximal portion of the arm may be provided with a projection for connecting with an elastic band.

[0071] In the example shown in Figure 3, the arm is formed integrally with the mesial element 30. In further examples, the arm may be attached to the mesial element 30, and in particular, may be fixedly attached.

[0072] The pivot 34 may be substantially granular or ball-shaped, or the pivot may be ball-shaped with diametrically opposed flat surfaces. The shape of the pivot 34 and the receptacle may be designed so that the rotation of the pivot around one or more axes is restricted, in particular by the pivot 34 touching the inside or boundary of the receptacle.

[0073] In some examples, such as the example in Figure 3, the distal anchoring structure includes an orifice 48 for receiving and holding a portion of the first distal moving force element. In this example, the orifice 48 is located within the distal element. The orifice 48 may be a through-hole passing through the distal element in the occlusal-gingival direction.

[0074] In this example, the distal element 40 comprises a distal base 42 and a distal cap 44 attached to the distal base 42. The receptacle of the distal element 40 may be positioned between the distal base 42 and the cap 44. The distal cap 44 may be attached to the distal base 42 by welding, mechanical fastening, or other means.

[0075] In some examples, the proximal portion of the arm 33 is provided with a hole 39 for connecting an auxiliary arm. Such an auxiliary arm may be used to introduce additional force into the device 50.

[0076] The first axis can be defined as substantially perpendicular to the distal base surface (as shown in Figure 1b), and the second axis can be defined as a mesicentric-distal direction substantially parallel to the distal base surface and substantially perpendicular to the first axis.

[0077] The pivot 34 has a mesial surface and a distal surface. The internal shape of the receptacle (in this case, the internal shape of the distal cap 44) allows the pivot to rotate around a first axis over an angle of 1° to 45°, specifically 5° to 20°, and more specifically 8° to 15°. The rotation around the first axis can be restricted by the mesial and / or distal surfaces that touch the inside of the distal cap.

[0078] The pivot 34 has an upper and a lower surface. The internal shape of the receptacle of the distal element 40 is such that the pivot 34 can be rotated around a second axis by an angle of 1° to 30°, specifically 5° to 15°. The rotation around the second axis can be restricted by the upper surface (in this case, the distal cap 44) that touches the inside of the receptacle and the lower surface that touches the distal base 42.

[0079] The pivot 34 may have a longitudinal axis, and the receptacle is configured such that the pivot can rotate around the longitudinal axis at an angle of 0° to 60°, specifically from 15° to 45°.

[0080] Figures 4A and 4B schematically illustrate two methods of treatment with the appliance 50 shown in Figure 3. In this particular case, the malocclusion may be a Class II malocclusion. Class II malocclusion is generally characterized by upper molars that protrude too far forward compared to the lower molars. Class II malocclusion is sometimes also known as an "overbite." In contrast to Class II, Class III malocclusion is generally characterized by lower molars that protrude too far forward compared to the upper molars. This is sometimes known as an "underbite."

[0081] A method for treating malocclusion in a patient is provided according to further aspects of this disclosure. The method includes providing an orthodontic appliance 50 or any example thereof shown herein. The mesial base surface 31 of the orthodontic appliance 50 can be attached to the patient's premolar, or in this example, the canine 212.

[0082] The distal base surface 42 of the orthodontic appliance 50 can be attached to the patient's molars 214. The method further includes providing a first distal movement force element and coupling the first distal movement force element to a distal anchoring structure 48, and acting the first distal movement force element.

[0083] In this example, the first distal movement force element may be an elastic band, (nitinol) ligature, coil spring, or other intraoral appliance that can be attached to the anchoring structure 48 of the distal element 40 of the TAD60 and the orthodontic appliance 50. The TAD60 may be a small screw or mini-implant, which may be made of titanium, for example.

[0084] The first distal movement force element may extend at one end through the orifice 48 of the distal element 40 of the orthodontic appliance 50 and be attached to the TAD at the other end. In some examples, the first distal movement force element may be stretched during wear, thereby tending to pull the TAD and the orthodontic appliance 50 closer to each other. The result may be a distal tensile force on the distal element 40. Since the distal element 40 is joined to the mesial element, the entire segment of teeth extending from the molar 214 to the canine 212 may be pulled distally to correct a class II malocclusion.

[0085] In the example shown in Figure 4A, the first distal mobility element is the ligature 63.

[0086] Additionally, further traction devices, particularly elastic bands, may be positioned around the projection 35 on the mesial element and around the hook on the anchor 70. The anchor 70 in this case may be a lingual button, such as a Carriere 3D Motion sidekick. In this configuration, further distal forces are thus provided to the orthodontic appliance 50.

[0087] In some other examples, the anchor may be a hook on a bracket, on a molar tube, or on a temporary anchorage device (TAD).

[0088] In the example shown, the orthodontic appliance 50 is placed on the patient's maxilla 210. The orthodontic appliance 50 may be used to move tooth segments in the maxilla, for example, to correct an overbite. An anchor 70 for further traction devices (e.g., elastic bands) may, in this case, be attached to the mandible 220.

[0089] Figure 4B shows different methods of treatment using the same orthodontic appliance 50. Figure 4B can also show different stages of the same treatment, i.e., a certain period of time, where the configuration of Figure 4A may be used, while the configuration of Figure 4B may be used during a different period.

[0090] In the configuration shown in Figure 4B, only a single distal movement force is provided. No elastic band is positioned around the projection 35. Only the first distal movement force element may extend between the TAD 60 and the orthose 48 of the orthodontic appliance. In this particular example, another possibility for the first distal movement force element, namely a coil spring 67, is shown.

[0091] In alternative configurations, the same or similar orthodontic appliance 50 may be used as shown in Figure 5. Figure 5 shows an example of a combination of orthodontic appliances having another first distal movement element. In the example, the first distal movement element may be a Class II orthodontic appliance. In particular, a Class II orthodontic appliance may be an intermaxillary appliance.

[0092] In the example shown in Figure 5, the first distal movement force element in this example is the Twin Force® Bite Corrector. One end 81 of the appliance 80 can be bonded to a tooth in the mandible, such as a canine tooth. The other end 89 can be bonded to the distal element 40 of the orthodontic appliance 50. In particular, the end 89 can be bonded to a suitable anchoring structure on the distal element 40.

[0093] In one example, the end 89 may be directly connected to an anchoring structure. In another example, an adapter may be positioned between the end 89 and the anchoring structure on the distal element 40. Between the first end 81 and the second end 86, the tube joins the mandible to the maxilla. In this particular example, the central tube 84 is joined to tubes 82 and 86 at both ends. Tubes 82 and 86 have expansion and contraction biasing forces toward both sides of the central tube 84. Tube 82 can therefore push the maxilla mesially, and tube 86 can push the mandible distally.

[0094] In the example, the first distal movement element may be a Class II orthodontic appliance. Suitable Class II orthodontic appliances include, for example, Herbst appliances, Forsus appliances, Jasper Jumper or Powerscope®, commercially available from American Orthodontics, Inc., Twin Force® Bite Corrector and TruEase® Bite Corrector, commercially available from Ortho Technology, Inc., and CS® 5, commercially available from Dynaflex®. These appliances can be used as standalone appliances for various orthodontic treatments, particularly Class II orthodontics. However, within the scope of this disclosure, these appliances can be combined with examples of orthodontic appliances 50 described herein to provide a more efficient treatment (depending on the patient's malocclusion and specific needs) than would be possible using any of these appliances alone.

[0095] In further examples, extraoral devices such as headgear may also be used.

[0096] Although not further shown herein, in other examples the orthodontic appliance 50 may be positioned on the patient's mandible. In these examples, a TAD or other anchor may be positioned on the maxilla. The elastic band can therefore pull the orthodontic appliance distally in the mandible. As shown in Figures 4A and 5, throughout the treatment or during a particular stage of treatment, the action of the elastic band may be combined with the action of a first distal movement force element coupled to the anchoring structure of the orthodontic appliance 50.

[0097] In such examples, the first distal movement element may be a Class III orthodontic appliance. The Class III orthodontic appliance may be an intermaxillary appliance. Class III versions of the aforementioned appliances may be used in these examples, for example, the Class III TruEase® Bite Corrector, the inverted (and possibly mini-screw and anchored) Forsus appliance, the CS® 5 Class III orthodontic appliance, etc.

[0098] Alternatively, or during a particular stage of treatment, the first distal mobility element may be a device selected from an elastic band, elastic ligature, nitinol ligature, or coil spring.

[0099] In the example of the method (for both Class II and Class III orthodontics), for a certain period the distal movement force is provided solely by the first distal movement force element, and for another period the distal movement force is provided by an elastic band in the mesial element.

[0100] Figures 6A–6C schematically illustrate further examples of orthodontic appliances according to this disclosure, in which an alternative anchoring structure is provided for coupling with a first distal mobility element.

[0101] In the example in Figure 3, orifice 48 is shown to generally extend along the occlusal-gingival direction. It should be made clear that the orifice does not necessarily need to be aligned in this direction.

[0102] In the example shown in Figure 6, the distal element 40 comprises a distal base 42 to which a distal cap 44 is attached. The pivot of the arm 33 is held within a receptacle formed between the distal base 42 and the distal cap 44. In this example, the distal element comprises two orifices 52, 54, which generally extend along the lingual-labial direction.

[0103] Orifices 52 and 54 are formed on the distal cap 44 in this example. The orifices may be closed and completely surrounded by an annular portion or ring 53 formed as a projection on the outer surface of the distal cap 44. In this example, the ring 53 may be provided on the gingival side.

[0104] The occlusal orifice 54 of the distal element 40 may be partially open. In this case, the annular structure 56 is obstructed and provides an opening for the introduction of the adapter or a portion of the first distal movable force element. Once introduced into the orifice 54, the first distal movable force element can be held within the orifice, and a distal force is applied to the distal inner surface of the annular structures 52, 56.

[0105] In the example in Figure 6, the orifices 52 and 54 are partially formed by the distal element, particularly the recess on either side of the distal cap 44.

[0106] It should be made clear that in some examples, orifices 52, 54 may be the same on both the occlusal and gingival sides. In other examples, a single orifice may be provided on either the occlusal or gingival side. That is, the distal element may be provided with a ring to form an orifice on the occlusal surface of the distal element and / or on the gingival surface of the distal element.

[0107] The distal anchoring structure may comprise one or more recesses formed on the outer surface of the distal element, configured to hold a portion of the first distal mobility element. In the example shown in Figure 6C, recesses 49 are formed on both the occlusal and gingival sides of the distal element. A well-formed portion of the first distal mobility element may be introduced into and held within the recesses 49. Figure 6B shows how the ring and recesses can be combined to provide an anchoring structure.

[0108] In the example, the anchoring structure may be provided in the distal portion of the arm 33, for example, as shown in Figures 7A and 7B. In particular, the anchoring structure may be provided at the most distal 33%, and especially at the most distal 25%, of the length of the arm 33. An appropriate clearance between the anchoring structure and the distal element may be selected so that the first distal moving force element does not obstruct any movement of the distal element 40 or the arm 33.

[0109] In this example, the anchoring structure on the device 50 includes one or more protrusions on the arm.

[0110] In the example shown in Figure 7A, two hooks 39 are provided on the distal portion of the arm 33.

[0111] In further examples, the arm 33 may include one or more rings, such as the ring 37 shown in Figure 7B.

[0112] In further examples, similar to the example in Figure 7C, the arm may have different projections or sets of projections 48, which may be polygonal, for example, quadrilateral. A ligature or other distal mobility element may be attached to one or both of the projections 48.

[0113] In a further example, the arm 33 may have one or more recesses 39, as shown in Figure 7D. The recesses 39 can hold a portion of a first distal movement element coupled to the orthodontic appliance 50.

[0114] In some examples, a portion of the distal moving force element can be crimped onto the bar 33 and the provided anchoring structure.

[0115] Figures 8A to 8C schematically show examples of orthodontic appliances. Figure 8D schematically shows a comparison of forces between the example orthodontic appliance in Figure 8 and an orthodontic appliance of the prior art. Figures 8A to 8D and Figure 9 are used to illustrate specific versions of the projections 35 that may be incorporated into the orthodontic appliance according to this disclosure. The projections 35 shown in these figures may be incorporated into an orthodontic appliance 50 as shown in any of the examples in Figures 3 to 7.

[0116] Figure 8A shows an orthodontic appliance for distal movement of a segment in the posterior jawbone region, comprising a mesial element 30 having a mesial base surface 32 configured for attachment to a premolar or canine. The appliance further comprises an arm 33 having a pivot 34 at the distal end of the arm.

[0117] The device further comprises a distal element having a distal base surface and a receptacle configured for attachment to a molar, with the arm pivot positioned within the receptacle. The distal element is not shown in Figure 8, but may be the same as or similar to the distal element shown in Figures 2-7.

[0118] The mesial element 30 is provided with a projection 35 that defines a groove 35B for fitting an elastic band (see, for example, Figure 8C), the groove being positioned along a rounded convex surface of the projection 35, the rounded convex surface having a diameter of at least 3 mm.

[0119] In this example, the diameter of the rounded convex surface may be 5 mm or more. The groove 35B may be formed between the base 32 of the mesial element and the edge of the projection. Figure 8A shows the location of section AA, which is further shown in Figure 8B and shown in more detail in Figure 8C.

[0120] The orthodontic appliance in Figure 8 typically uses very small hooks and has a larger surface area of ​​contact with the elastic band than in prior art appliances, which may have rounded or polygonal (square, quadrilateral) cross-sections. In other words, the hooks are much wider than those in prior art appliances.

[0121] Even the use of small hooks or "as small as possible" hooks is generally widely extended in orthodontics, particularly to avoid the hooks rubbing against the patient's tissues. The oral mucosa, in particular, is sensitive to rubbing. This disclosure provides examples of orthodontic appliances that deviate from this idea. The curved, wider hooks presented herein have been found to be more efficient in treatment.

[0122] While it's undesirable to be bound by a specific theory, one possible explanation is that when an elastic band is pulled around a hook with a smaller diameter, the average amount of friction between the elastic material (rubber) and the hook is greater than when the elastic band is pulled around a hook with a larger diameter. The smaller the diameter of the hook, the smaller the contact surface area with the elastic material, which may mean that there is greater pressure at each contact point between the elastic material and the hook. Conversely, when an elastic material is pulled around a hook with a larger diameter, the average amount of friction between the elastic material and the hook is lower because there is a larger surface area in contact with the elastic material.

[0123] Therefore, the force applied to the elastic band is smaller at each contact point, and the force is distributed over a larger surface area along the axis of direct application, causing the elastic band to degrade more slowly over time. This effect is particularly pronounced when the corners of the square hook are sharp. In such cases, the elastic band functions less efficiently, as the higher applied force is distributed over a smaller surface area along the axis of direct application, causing the elastic material to degrade more quickly over a period of time.

[0124] It should be noted that all latex and non-latex elastomers typically degrade over time when subjected to the pressure at which they are applied.

[0125] Furthermore, if the elastic band is stretched along the same distance but across a hook of a larger diameter, as shown in Figure 8, the elastic band will impart greater tension compared to the smaller hook diameters known from the prior art.

[0126] For example, as can be seen in the top view of Figure 3C, the projection 35 of the mesial element 30 may be substantially teardrop-shaped to follow the natural tension of the elastic material around the cross section toward the paired orthodontic mounting anchor (i.e., sidekick, buccal tube, etc.). The teardrop shape reduces stress concentration points in the elastic material and increases the contact area with the elastic band.

[0127] As a result of its teardrop-shaped design and its engagement interface with the elastic material, a lower applied force degrades the elastic material more slowly over a period of time, allowing the elastic material to function more efficiently.

[0128] In a further embodiment, an orthodontic assembly is provided for distal movement of segments in the posterior jawbone region. The assembly comprises a mesial element 30 having a mesial base surface 31 configured for attachment to a premolar or canine, an arm 33 having a pivot 34 at the distal end of the arm, and a distal element having a distal base surface and a receptacle configured for attachment to a molar. The pivot 34 of the arm 33 is located within the receptacle. The mesial element 30 is provided with a projection 35, and the assembly further comprises anchors (e.g., buttons, sidekicks, molar tubes, TADs, etc.) so that elastic bands can be fitted around the projection 35 and anchors to provide distal movement force.

[0129] In this embodiment, when the mesial portion 91 of the elastic band is positioned around the projection 35, the projection 35 is formed such that the first portion 92 of the elastic band adjacent to the mesial portion 91 on the first side of the mesial portion and the second portion 93 of the elastic band adjacent to the mesial portion on the second side of the mesial portion are not parallel to each other.

[0130] This effect is shown in the upper diagram of Figure 8D and can be compared to the situation in the case of a small prior art hook shown in the lower diagram of Figure 8D. Due to its small size, parts 92 and 93 adjacent to the portion wound around the hook are substantially parallel to each other. In the case of the upper diagram, due to the width of the projection 35, parts 92 and 93 adjacent to part 91 (the portion of the elastic band in contact with the hook / projection) are not parallel to each other. Instead of a single force vector, two different force vectors are thus generated, also resulting in a more uniform distribution of force.

[0131] As shown in Figures 8A to 8C, the projection may have a rounded groove for receiving the mesial portion of the elastic band. The projection may have a substantially circular cross-section passing through the plane of the groove, for example. The diameter of the circular cross-section may be 3 mm or more, more specifically 4 mm or more, and more specifically 5 mm or more.

[0132] In other examples, the cross-section passing through the plane of the groove may be substantially oval. The distance between the first portion 92 of the elastic band and the second portion 93 of the elastic band is 3 mm or more, specifically 4 mm or more, and more specifically 5 mm or more.

[0133] In one example, as shown in Figure 9, the mesial edge of the projection 35 may substantially coincide with the mesial edge of the mesial base surface 32. In another example, the mesial edge of the projection may be positioned anterior to the mesial edge of the mesial base surface. That is, the mesial edge of the projection does not extend beyond the edge of the base surface. For example, 10% to 40% of the length of the distal element may be "free," i.e., not overhanging by the projection 35. The risk of irritation to the patient's tissue can be reduced in such examples.

[0134] The outer surface of the projection is substantially smooth and rounded to avoid contact with the patient's tissue. The apical surface of the projection may be substantially teardrop-shaped, as noted above.

[0135] It should be noted that user-friendliness is further improved. The elastic band can be fitted around the protrusion and removed when necessary, making it easier and quicker to do so.

[0136] Although not further shown in Figures 8 and 9, in these examples as well, the distal element of the orthodontic appliance 50 may be provided with an anchoring structure for coupling with a distal movement device. All other features noted with respect to the pivot, distal element, first distal movement device, etc., may be combined with a broad, rounded projection 35.

[0137] For example, the arm may be formed integrally with the mesial element or fixedly attached to the mesial element. The pivot may be substantially granular or ball-shaped, or the pivot may be ball-shaped with diametrically opposed flat surfaces. The anchoring structure may have a through-hole in the distal element. The through-hole may be substantially aligned along the occlusal-gingival direction.

[0138] Furthermore, as shown in Figure 8A, the proximal portion of the arm 33 (the most proximal 33% or 25% of the length of the arm 33) may be provided with a hole for connecting an auxiliary arm.

[0139] The range of movement enabled by the pivot within the receptacle may also be the same as disclosed above herein. For example, the pivot can be rotated around a first axis over an angle of 1° to 45°, specifically 5° to 20°, and more specifically 8° to 15°. For example, the pivot can be rotated around a second axis over an angle of 1° to 30°, specifically 5° to 15°. For example, the pivot has a longitudinal axis, and the receptacle is configured such that the pivot can be rotated around the longitudinal axis over an angle of 0° to 60°, specifically 15° to 45°.

[0140] The different components of orthodontic appliances described herein can be manufactured in a variety of ways, including molding, additive manufacturing such as 3D printing, and cutting. The different components can be made from a variety of suitable materials, including metals (e.g., stainless steel or titanium), ceramics, plastics (e.g., PEEK, polysulfone, etc.), or composites (e.g., fiber-reinforced polymers).

[0141] In certain cases, placing the distal cap on top of the pivot may involve 3D printing the distal cap on top of the distal base if the pivot is already positioned on top of the distal cap.

[0142] In further embodiments of the present disclosure, an anchor is provided which can be mounted in the oral cavity of a patient, particularly on the patient's teeth or molars. Such an anchor may include a base surface configured for attachment to a tooth, specifically a molar. Such a base surface may be configured for cementing onto the patient's tooth and may include roughness, or protrusions or recesses, to improve the mechanical retention of the tooth.

[0143] The anchor can be configured for distal movement therapy as generally described herein, i.e., an elastic band or similar can be positioned on or around the anchor and around projections on the mesial element of the distal movement device.

[0144] The anchor may have the same or very similar structure as those described with respect to the projection in relation to Figures 8A to 8D. In this embodiment, the anchor may have a projection, which is shaped such that, when the distal portion of the elastic band is positioned around the projection, the first portion of the elastic band adjacent to the distal portion on the first side of the mesial portion and the second portion of the elastic band adjacent to the distal portion on the second side of the mesial portion are not parallel to each other.

[0145] Due to the width of the projection, the portions of the elastic band adjacent to the portion in contact with the hook / projection are not parallel to each other. Instead of a single force vector, two different force vectors are thus generated, resulting in a more uniform distribution of force. The relatively wide projection on the anchor is also user-friendly, meaning it has been found to be easier for the patient to position the elastic band around the anchor and remove it when necessary.

[0146] Surprisingly, an improvement in user-friendliness was also found despite the increased size. There is no significant discomfort added due to the increased size, and at the same time, fitting and removing the elastic band around the protrusion is easier and quicker when necessary. This is an advantage, especially for younger patients.

[0147] In the example, the projection of the anchor may have a rounded groove for receiving the distal portion of the elastic band. The projection may have a substantially circular cross-section passing through the plane of the groove, for example. The diameter of the circular cross-section may be 3 mm or more, more specifically 4 mm or more, and more specifically 5 mm or more.

[0148] In other examples, the cross-section passing through the plane of the groove may be substantially oval.

[0149] According to an aspect of the present disclosure, the anchor is provided with a projection that defines a groove for fitting an elastic band, the groove being positioned along a rounded convex surface of the projection, the rounded convex surface having a diameter of at least 3 mm.

[0150] In the example, the diameter of the rounded convex surface may be 5 mm or more. The groove may be formed between the base of the anchor and the edge of the projection.

[0151] Figures 10A to 10C schematically show further examples of orthodontic appliances 50 incorporating distal anchoring structures. An orthodontic appliance 50 for distal movement of a segment in the posterior mandibular region is shown, and the orthodontic appliance 50 comprises a mesial element 30 having a mesial base surface 31 configured for attachment to a premolar or canine. The appliance 50 further comprises an arm 33 having a pivot 34 at the distal end of the arm. The appliance 50 further comprises a distal element 40 having a distal base surface 41 and a receptacle configured for attachment to a molar.

[0152] In this example, the distal element 40 comprises a distal base 42 and a distal cap 44. A receptacle is formed between the distal base 42 and the distal cap 44. The pivot 34 of the arm is located within this receptacle.

[0153] In this example as well, the distal element 40 includes a distal anchoring structure for connecting to the first distal moving force element. In this example as well, the mesial portion of the arm 33 includes a hole 39 for connecting an auxiliary arm. Such an auxiliary arm may be used to introduce further force into the device 50.

[0154] A distal anchoring structure may be incorporated into the distal cap 44. In this particular case, the distal cap 44 comprises an orifice 120 extending in the occlusal-gingival direction through the distal element 40. The orifice 120 is demarcated by an upper surface. The distal cap 44 comprises two cleat hooks 62, 64, and a ligature may be positioned around the two cleat hooks 62, 64. In this example, the distal cap 44 comprises a distal cleat hook 62 and a mesial cleat hook 64.

[0155] A cleat hook can be considered a T-shaped hook, that is, a hook extending in opposite directions. A cleat hook 62 has hooks 62A and 62B on the occlusal side and the gingival side. Similarly, a cleat hook 64 has hooks 64A and 64B on the occlusal side and the gingival side.

[0156] In this example, the first distal moving force element may be, for example, an elastic band, a rubber band, or a ligature. In this example, the ligature may be a nitinol ligature. In this particular example, for example, a stainless steel ligature may be wrapped around one of the cleat hooks, especially the distal cleat hook.

[0157] As can be seen more clearly in Figure 10C, the occlusal-gingival orifice 120 can also be used as a distal anchoring structure to connect the first distal force element. In this particular example, different options are therefore provided to the orthodontist to provide distal force. Depending on the patient and malocclusion, a cleat hook or orifice may be used, and different distal force elements may be used. During (part of) treatment, the first distal force element may be combined with the second distal force element. Alternatively, the use of the first and second distal force elements may be alternated.

[0158] The features shown in Figure 10 may also be used in the distal element instead of a separate distal base and cap, and the distal element may be formed integrally.

[0159] For completeness, several aspects of this disclosure are described in the following numbered clauses.

[0160] Clause 1. An orthodontic appliance for distal movement of a segment in the posterior jawbone region, wherein the orthodontic appliance is A mesial element having a mesial base surface configured for attachment to a premolar or canine, An arm having a pivot at its distal end, and It comprises a distal element having a distal base surface and a receptacle configured for attachment to a molar, The arm's pivot is located inside the receptacle. The distal element or the distal portion of the arm is provided with a distal anchoring structure for connecting to a first distal moving force element. Orthodontic appliance.

[0161] Clause 2. The orthodontic appliance according to Clause 1, wherein the proximal portion of the mesial element or arm has a projection for coupling with a second distal movement element.

[0162] Clause 3. The orthodontic appliance described in Clause 2, wherein the second distal movement force element is an elastic band.

[0163] Clause 4. An orthodontic appliance according to any one of Clauses 1 to 3, wherein the arm is formed integrally with the mesial element or fixedly attached to the mesial element.

[0164] Clause 5. An orthodontic appliance according to any one of Clauses 1 to 4, wherein the pivot is substantially granular or ball-shaped, or the pivot is ball-shaped with diametrically opposed flat surfaces.

[0165] Clause 6. An orthodontic appliance according to any one of Clauses 1 to 5, wherein the distal anchoring structure comprises an orifice for receiving and holding a portion of the first distal moving force element.

[0166] Clause 7. The orthodontic appliance according to Clause 6, wherein the orifice is located within the distal element, and in particular the orifice is formed integrally with or within the distal element.

[0167] Clause 8. The orthodontic appliance described in Clause 7, wherein the orifice is a through-hole passing through the distal element in the occlusal-gingival direction.

[0168] Clause 9. An orthodontic appliance as described in Clause 7, wherein the orifice extends along the lingual-labial direction.

[0169] Clause 10. The orthodontic appliance according to Clause 9, wherein the distal element comprises a ring so as to form an orifice on the occlusal surface of the distal element and / or a ring on the gingival surface of the distal element.

[0170] Clause 11. An orthodontic appliance according to any one of Clauses 1 to 10, wherein the distal anchoring structure comprises one or more recesses formed on the outer surface of a distal element configured to hold a portion of a first distal mobility element.

[0171] Clause 12. The orthodontic appliance according to Clause 11, wherein the distal element has a recess on the occlusal side of the distal element and / or a recess on the gingival side of the distal element.

[0172] Clause 13. An orthodontic appliance according to any one of Clauses 1 to 12, wherein the anchoring structure comprises one or more protrusions on the arm.

[0173] Clause 14. The orthodontic appliance described in Clause 13, wherein the arm comprises one or more hooks or one or more rings.

[0174] Clause 15. The orthodontic appliance according to Clause 13, wherein the arm comprises one or more recesses.

[0175] Clause 16. An orthodontic appliance according to any one of Clauses 1 to 15, wherein the proximal portion of the arm has a hole for connecting an auxiliary arm.

[0176] Clause 17. The first axis is defined to be substantially perpendicular to the distal base surface, and the second axis is defined to be substantially parallel to the distal base surface in the mesial-distal direction and substantially perpendicular to the first axis. An orthodontic appliance according to any one of Clauses 1 to 16, wherein the pivot has a mesial surface and a distal surface, and the internal shape of the distal cap allows the pivot to rotate around a first axis over an angle of 1° to 45°, specifically 5° to 20°, more specifically 8° to 15°, and optionally the rotation around the first axis is restricted by the mesial surface and / or distal surface that touch the inside of the distal cap.

[0177] Clause 18. The orthodontic appliance according to Clause 17, wherein the pivot has an upper and lower surface, and the internal shape of the receptacle of the distal element allows the pivot to rotate around a second axis over an angle of 1° to 30°, specifically 5° to 15°, and the rotation around the second axis is limited by the upper surface that touches the inside of the distal cap and the lower surface that touches the distal base.

[0178] Clause 19. An orthodontic appliance as described in any one of Clauses 1 to 18, wherein the pivot has a longitudinal axis and the receptacle is such that the pivot can be rotated around the longitudinal axis over an angle of 0° to 60°, specifically 15° to 45°.

[0179] Article 20. A method for treating malocclusion in a patient, the method being: To provide an orthodontic appliance as specified in any one of clauses 1 to 19, Attaching the mesial base surface of the orthodontic appliance to the patient's premolar or canine tooth. Attaching the distal base surface of the orthodontic appliance to the patient's molars, To provide a first distal mobility element and to connect the first distal mobility element to a distal anchoring structure, and This includes activating a first distal moving force element, method.

[0180] Clause 21. The method of Clause 20, further comprising attaching elastic bands around projections on the arm or mesial element and around anchors fitted in the patient's oral cavity.

[0181] Clause 22. The method according to Clause 21, wherein the anchor is a bracket mounted on a tooth, a molar tube, a temporary anchorage device (TAD), or a hook on a button.

[0182] Clause 23. The method according to any one of Clauses 20 to 22, wherein an orthodontic appliance is placed on the maxilla of the patient.

[0183] Clause 24. The method according to Clause 23, wherein the first distal movement force element is a Class II orthodontic appliance.

[0184] Clause 25. The method according to Clause 24, wherein the Class II orthodontic appliance is an intermaxillary appliance.

[0185] Clause 26. The method of Clause 25, wherein the Class II orthodontic appliance is a Herbst appliance or a Forsus appliance.

[0186] Clause 27. The method according to any one of Clauses 20 to 26, wherein the first distal mobility element is one or more of an elastic band, an elastic ligature, a nitinol ligature, or a coil spring, and optionally the first distal mobility element is attached to an anchor, specifically an anchor in the maxilla.

[0187] Clause 28. The method according to any one of Clauses 20 to 22, wherein an orthodontic appliance is placed on the mandible of the patient.

[0188] Clause 29. The method according to Clause 28, wherein the first distal movement element is a Class III orthodontic appliance.

[0189] Clause 30. The method described in Clause 29, wherein the Class III orthodontic appliance is an intermaxillary appliance.

[0190] Clause 31. The method according to Clause 28, wherein the first distal mobility element is one or more of an elastic band, an elastic ligature, a nitinol ligature, or a coil spring, and optionally the first distal mobility element is attached to an anchor, specifically an anchor in the mandible.

[0191] Clause 32. The method according to any one of Clauses 20 to 31, wherein for one period the distal moving force is provided solely by a first distal moving force element, and for another period the distal moving force is provided by an elastic band.

[0192] Clause 33. The method according to any one of Clauses 20 to 32, wherein a distal anchoring structure is coupled to an adapter, and the adapter is attached to a first distal mobile force element.

[0193] Clause 34. A kit comprising an orthodontic appliance as described in any one of Clauses 1 to 19 and an adapter for coupling with a first distal movement element.

[0194] Clause 35. The kit according to Clause 34, comprising a plurality of adapters for coupling to various first distal mobility elements.

[0195] Clause 36. An orthodontic assembly for distal movement of a segment in the posterior jawbone region, wherein the orthodontic assembly is A mesial element having a mesial base surface configured for attachment to a premolar or canine, An arm having a pivot at its distal end, and It comprises a distal element having a distal base surface and a receptacle configured for attachment to a molar, The arm's pivot is located inside the receptacle. The mesial element has a projection, and the assembly further includes an anchor, thereby allowing an elastic band to be fitted around the projection and the anchor to provide distal movement force. When the projection is positioned around the mesial portion of the elastic band, the first portion of the elastic band adjacent to the mesial portion on the first side of the mesial portion and the second portion of the elastic band adjacent to the mesial portion on the second side of the mesial portion are formed so as not to be parallel to each other. Orthodontic assembly.

[0196] Clause 37. The orthodontic assembly according to Clause 36, wherein the projection has a rounded groove for receiving the mesial portion of an elastic band.

[0197] Clause 38. An orthodontic assembly according to Clause 36 or 37, wherein the projection has a substantially circular cross-section passing through the plane of the groove.

[0198] Clause 39. An orthodontic assembly as described in Clause 38, having a circular cross-section diameter of 3 mm or more, specifically 4 mm or more, and more than 5 mm or more.

[0199] Clause 40. An orthodontic assembly according to Clause 36 or 37, wherein the cross-section passing through the plane of the groove is substantially oval-shaped.

[0200] Clause 41. An orthodontic assembly as described in any one of Clauses 36 to 40, wherein the distance between the first part of the elastic band and the second part of the elastic band is 3 mm or more, specifically 4 mm or more, and more specifically 5 mm or more.

[0201] Clause 42. An orthodontic assembly according to any one of Clauses 36 to 41, wherein the mesial margin of the projection substantially coincides with the mesial margin of the mesial base surface.

[0202] Clause 43. An orthodontic assembly according to any one of Clauses 36 to 41, wherein the mesial margin of the projection is positioned anterior to the mesial margin of the mesial base surface.

[0203] Clause 44. An orthodontic assembly as described in any one of Clauses 36 to 43, wherein the outer surface of the projection is substantially smooth and rounded.

[0204] Clause 45. An orthodontic assembly according to any one of Clauses 36 to 44, wherein the top surface of the projection is substantially teardrop-shaped.

[0205] Clause 46. An orthodontic appliance assembly according to any one of Clauses 36 to 45, wherein the distal element or the distal portion of the arm comprises a distal anchoring structure for connecting a further distal moving force element.

[0206] Clause 47. An orthodontic appliance for distal movement of a segment in the posterior jawbone region, wherein the orthodontic appliance is A mesial element having a mesial base surface configured for attachment to a premolar or canine, An arm having a pivot at its distal end, and It comprises a distal element having a distal base surface and a receptacle configured for attachment to a molar, The arm's pivot is located inside the receptacle. The mesial element has a projection that defines a groove for fitting an elastic band, The groove is positioned along the rounded convex surface of the projection, and the rounded convex surface has a diameter of at least 3 mm. Orthodontic appliance.

[0207] Clause 48. An orthodontic appliance as described in Clause 47, wherein the diameter of the rounded convex surface is 5 mm or more.

[0208] Clause 49. The orthodontic appliance according to Clause 47 or 48, wherein a groove is formed between the base of the mesial element and the edge of the projection.

[0209] Clause 50. An orthodontic appliance according to any one of Clauses 47 to 49, comprising an anchoring structure for coupling with a distal moving force device, wherein optionally the anchoring structure comprises a through hole in the distal element.

[0210] Clause 51. The orthodontic appliance described in Clause 50, wherein the through-hole is substantially aligned along the occlusal-gingival direction.

[0211] Clause 52. An orthodontic appliance according to any one of Clauses 46 to 51, wherein the arm is formed integrally with or fixedly attached to the mesial element.

[0212] Clause 53. An orthodontic appliance according to any one of Clauses 46 to 52, wherein the pivot is substantially granular or ball-shaped, or ball-shaped having diametrically opposed flat surfaces.

[0213] Clause 54. An orthodontic appliance according to any one of Clauses 46 to 53, wherein the proximal portion of the arm is provided with a hole for connecting an auxiliary arm.

[0214] Clause 55. The first axis is defined to be substantially perpendicular to the distal base surface, and the second axis is defined to be substantially parallel to the distal base surface in the mesial-distal direction and substantially perpendicular to the first axis, An orthodontic appliance according to any one of Clauses 46 to 54, wherein the pivot has a mesial surface and a distal surface, and the internal shape of the distal cap allows the pivot to rotate around a first axis over an angle of 1° to 45°, specifically 5° to 20°, more specifically 8° to 15°, and optionally the rotation around the first axis is restricted by the mesial surface and / or distal surface that touch the inside of the distal cap.

[0215] Clause 56. The orthodontic appliance according to Clause 55, wherein the pivot has an upper and lower surface, and the internal shape of the receptacle of the distal element allows the pivot to rotate around a second axis over an angle of 1° to 30°, specifically 5° to 15°, and the rotation around the second axis is limited by the upper surface that contacts the inside of the distal cap and the lower surface that contacts the distal base.

[0216] Clause 57. An orthodontic appliance as described in any one of Clauses 46 to 56, wherein the pivot has a longitudinal axis and the receptacle is such that the pivot can be rotated around the longitudinal axis over an angle of 0° to 60°, specifically 15° to 45°.

[0217] Clause 58. An anchor configured to be mounted in the patient's oral cavity, particularly on the patient's teeth or molars, for use in combination with any one of the orthodontic appliances described in Clauses 1 to 19 or 47 to 56, in the distal movement of a segment in the posterior jawbone region, wherein the anchor is It is equipped with protrusions around the projection for receiving an elastic band, When the projection is positioned around the mesial portion of the elastic band, the first portion of the elastic band adjacent to the mesial portion on the first side of the mesial portion and the second portion of the elastic band adjacent to the mesial portion on the second side of the mesial portion are formed so as not to be parallel to each other. anchor.

[0218] Clause 59. The anchor according to Clause 58, wherein the projection has a rounded groove for receiving the mesial portion of an elastic band.

[0219] Clause 60. The anchor according to Clause 58 or 59, wherein the projection has a substantially circular cross-section passing through the plane of the groove.

[0220] Clause 61. An anchor as described in Clause 60, having a circular cross-section with a diameter of 3 mm or more, specifically 4 mm or more, and more specifically 5 mm or more.

[0221] Clause 62. An anchor according to Clause 58 or 59, wherein the cross-section passing through the plane of the groove is substantially oval.

[0222] Clause 63. An anchor as described in any one of Clauses 58 to 62, wherein the distance between the first part of the elastic band and the second part of the elastic band is 3 mm or more, specifically 4 mm or more, and more specifically 5 mm or more.

[0223] Clause 64. An anchor as described in any one of Clauses 58 to 63, wherein the outer surface of the projection is substantially smooth and rounded.

[0224] Clause 65. An anchor as described in any one of Clauses 58 to 64, wherein the top surface of the projection is substantially teardrop-shaped.

[0225] Clause 66. An anchor configured to be mounted in the patient's oral cavity, particularly on the patient's teeth or molars, for use in combination with any one of the orthodontic appliances described in Clauses 1 to 19 or 47 to 56, wherein the anchor comprises a projection defining a groove for fitting an elastic band. The groove is positioned along the rounded convex surface of the projection, and the rounded convex surface has a diameter of at least 3 mm. anchor.

[0226] Clause 67. An anchor as described in Clause 66, having a rounded convex surface with a diameter of 5 mm or more.

[0227] Clause 68. The anchor according to Clause 66 or 67, wherein the groove is formed between the base of the mesial element and the edge of the projection.

[0228] Clause 69. An anchor as described in any one of Clauses 58 to 56, having a base surface configured for attachment to a tooth, particularly a molar.

[0229] While only certain specific embodiments and examples of the present invention are disclosed herein, it will be understood by those skilled in the art that other alternative embodiments and / or uses of the present invention, as well as obvious modifications and their equivalents, are possible. Furthermore, the present invention covers all possible combinations of the specific embodiments described. Therefore, the scope of the present invention should not be limited by any particular embodiment, but should be determined solely by a fair reading of the following claims.

Claims

1. An orthodontic appliance for distal movement of a segment in the posterior jawbone region, wherein the orthodontic appliance is A mesial element having a mesial base surface configured for attachment to a premolar or canine, An arm having a pivot at its distal end, and It comprises a distal element having a distal base surface and a receptacle configured for attachment to a molar, The pivot of the arm is located within the receptacle. The distal element includes an orifice as a distal anchoring structure for receiving and holding the first distal moving force element. Orthodontic appliance.

2. The orthodontic appliance according to claim 1, wherein the mesial element or the proximal portion of the arm is provided with a projection for coupling with a second distal moving force element.

3. The orthodontic appliance according to claim 2, wherein the second distal movement force element is an elastic band.

4. The orthodontic appliance according to any one of claims 1 to 3, wherein the first distal movement force element is a Class II orthodontic appliance, and in particular the Class II orthodontic appliance is an intermaxillary appliance.

5. The orthodontic appliance according to any one of claims 1 to 3, wherein the first distal movement force element is one or more of an elastic ligature, a nitinol ligature, and a coil spring, and optionally the first distal movement force element is attached to an anchor, specifically an anchor in the maxilla.

6. The orthodontic appliance according to any one of claims 1 to 5, wherein the arm is formed integrally with the mesial element or is fixedly attached to the mesial element.

7. The orthodontic appliance according to any one of claims 1 to 6, wherein the pivot is substantially granular or ball-shaped, or the pivot is ball-shaped having flat surfaces facing each other in the diametrical direction.

8. The orthodontic appliance according to any one of claims 1 to 7, wherein the orifice is a through-hole passing through the distal element in the occlusal-gingival direction.

9. The orthodontic appliance according to any one of claims 1 to 7, wherein the orifice extends along the lingual-labial direction.

10. The orthodontic appliance according to any one of claims 1 to 7, wherein the distal element is provided with a ring so as to form the orifice on the occlusal surface of the distal element and / or is provided with a ring on the gingival surface of the distal element.

11. The orthodontic appliance according to any one of claims 1 to 10, wherein the distal anchoring structure has a recess on the occlusal side of the distal element and / or a recess on the gingival side of the distal element.

12. The orthodontic appliance according to any one of claims 1 to 11, wherein the distal element comprises the distal base and a distal cap attached to the distal base, and the receptacle of the distal element is formed between the distal cap and the distal base.

13. The orthodontic appliance according to claim 12, wherein the distal cap comprises the distal anchoring structure.

14. The orthodontic appliance according to claim 13, wherein the distal anchoring structure is an orifice extending in the occlusal-gingival direction, separated by an upper surface.

15. The orthodontic appliance according to claim 14, wherein the distal cap comprises two cleat hooks suitable for positioning a ligature.

Images