System and method for determining and verifying the anatomical position of palatal arch dental appliances - Patents.com

Abstract

The dental appliance positioning assembly includes a bite assembly and a maxillary arch subassembly. The bite assembly includes an upper jaw tray configured to be formed over the patient's maxillary gums, the upper jaw tray including a bite rim portion. The bite assembly further includes a carriage frame portion constructed of a biocompatible magnetic metallic material secured to the upper jaw tray. The maxillary arch subassembly includes a plurality of artificial upper jaw tooth portions magnetically secured to the bite rim portion. The carriage frame portion is movable relative to the upper jaw tray. The artificial upper jaw tooth portions can be individually moved relative to each other to achieve a desired tooth positioning.

Description

[Technical Field]

[0001] [CROSS-REFERENCE TO RELATED APPLICATIONS] This application claims the benefit of priority to U.S. Provisional Patent Application No. 62 / 931,999, filed November 7, 2019, the entire contents of which are incorporated herein.

[0002] The present disclosure relates generally to locating and verifying the anatomical position of palatal arch dental appliances. The techniques described herein can be used, for example, in designing and fitting implant or tissue-supported dentures for patients. [Background technology]

[0003] Restoring a completely edentulous patient is a time-consuming and involved process in which the dentist provides a patient-specific positioning template to a dental technician to design a denture that meets the patient's functional and aesthetic requirements, including speech phonetics. A traditional positioning template (called a "wax rim," "bite rim," or "bite block") is a block of wax that is adjusted and marked to capture patient-specific prosthetic design considerations for the dentures. The information captured by the positioning template is crucial for designing tooth replacement appliances that restore proper function of the masticatory system, speech, and smile aesthetics. The three-dimensional information required to restore an edentulous patient includes the occlusal plane, midline, incisal edge position, buccal corridor, vertical dimension, lip support and lip dynamics (high and low laugh lines), and canine position ("3D parameters"). However, a traditional wax rim can only provide a subset of these 3D parameters. Traditional wax rims do not capture the occlusal surface, buccal corridor, and possibly vertical dimensions, nor can they aid in the assessment of function or speech phonetics.

[0004] In the traditional method of designing customized dentures, dentists manually place pre-made dentures one by one onto a wax rim. As each tooth is positioned, the dentist checks how the upper teeth fit the 3D parameters mentioned above and adjusts accordingly. This is a highly skilled and time-consuming process. Once all the dentures are placed in wax and the design is complete, the "wax-up" is sent to a dental laboratory for molar positioning and wax temporary denture processing. The wax temporary denture is then returned to the dentist. The dentist then places the wax-up in the patient's mouth to ensure it meets the 3D parameters.

[0005] If the wax-up needs adjustments, the dentist makes the desired changes chairside or documents them with a combination of photos, video, and written instructions. The wax-up is sent back to the dental laboratory with the desired changes. The laboratory adjusts the wax-up and sends the revised wax-up back to the dentist, who evaluates the changes with the patient. This process is repeated until the wax-up is acceptable to both the dentist and the patient, and may take many sessions until it is perfect. Summary of the Invention

[0006] Embodiments of the present invention address and overcome one or more of the above-mentioned shortcomings and problems by providing methods, systems, and devices related to locating and verifying the anatomical position of every individual tooth within a palatal arch dental appliance.

[0007] According to some embodiments, the dental appliance positioning assembly includes a bite assembly and a maxillary arch subassembly. The bite assembly includes an upper jaw tray configured to be formed over the patient's maxillary gums, the upper jaw tray including a bite rim portion. The bite assembly further includes a carriage frame portion constructed of a biocompatible magnetic metallic material secured to the upper jaw tray. The maxillary arch subassembly includes a plurality of artificial maxillary tooth portions magnetically secured to the bite rim portion. The carriage frame portion is movable relative to the upper jaw tray. The artificial maxillary tooth portions can be individually moved relative to each other to achieve a desired tooth positioning.

[0008] According to another aspect of the present invention, in some embodiments, a method for making a dental appliance includes assembling a maxillary arch subassembly and a bite assembly in a patient's mouth. The maxillary arch subassembly and the bite assembly each include multiple movable parts. The method further includes adjusting one or more of the patient's midline, incisal position, lip support, and buccal corridor by repositioning one or more movable parts. The final positions of the maxillary arch subassembly and the bite assembly are fixed to a dental appliance positioning assembly template for manufacturing the dental appliance.

[0009] According to another aspect of the present invention, in some embodiments, a method for manufacturing a denture based on a template includes receiving, by a computer-aided design (CAD) system, one or more digital meshes representing a dental appliance positioning assembly template including a plurality of template upper arch teeth. A library of teeth and arch anatomies corresponding to the upper arch teeth is identified in the dental appliance positioning assembly template. The library of teeth and arch anatomies includes a plurality of library tooth models. The plurality of upper arch teeth from the library of teeth and arch anatomies are aligned (automatically or manually) with the plurality of template upper arch teeth. The plurality of mandibular arch teeth from the library of teeth and arch anatomies are automatically positioned based on predetermined occlusion parameters applied to the plurality of upper arch teeth. The gingival anatomies are automatically positioned based on the positioning of the plurality of upper arch teeth and the plurality of mandibular arch teeth. A digital model of the denture is generated based on the plurality of upper arch teeth, the plurality of mandibular arch teeth, and the gingival anatomies.

[0010] Additional features and advantages of the present invention will be made apparent from the following detailed description of illustrative embodiments that proceeds with reference to the accompanying drawings. [Brief explanation of the drawings]

[0011] The above and other aspects of the present invention are best understood from the following detailed description when read in connection with the accompanying drawings. For purposes of illustration, the invention is shown in the presently preferred illustrative embodiments, it being understood, however, that the invention is not limited to the particular apparatus disclosed. The drawings include the following figures: [Figure 1A] FIG. 1A shows a facial view of the positioning assembly for a square tooth prosthesis. [Figure 1B] FIG. 1B shows a lingual view of the prosthesis positioning assembly shown in FIG. 1A. [Figure 1C] FIG. 1C shows a more detailed view of components used in the prosthesis positioning assembly, according to some embodiments. [Figure 2A]FIG. 2A shows a component of the prosthetic positioning assembly: a prefabricated horseshoe with integrated magnets machined into a custom tray. [Figure 2B] Figure 2B shows the carriage frame, which is held by magnets integrated into the lower custom tray, and the carriage frame can be moved to customize the template to the patient's specific anatomy. [Figure 2C] FIG. 2C shows how a maxillary arch assembly, including one anterior section and left and right posterior quadrants, can be coupled to a custom maxillary tray by magnets. [Figure 2D] FIG. 2D shows how a maxillary arch assembly, including one anterior section and left and right posterior quadrants, can be coupled to a custom maxillary tray by magnets. [Figure 2E] FIG. 2E shows how a maxillary arch assembly, including one anterior portion and left and right posterior quadrants, can be coupled to a custom maxillary tray by magnets. [Figure 3A] FIG. 3A shows examples of different tooth shapes in the shape library. [Figure 3B] FIG. 3B shows examples of different tooth shapes in the shape library. [Figure 4A] FIG. 4A shows further details of how the magnets are held and positioned in the pre-fabricated horseshoe shape, according to some embodiments. [Figure 4B] FIG. 4B shows further details of how the magnets are held and positioned in the pre-fabricated horseshoe shape, according to some embodiments. [Figure 5A] FIG. 5A shows a side view of a carriage frame, according to some embodiments. [Figure 5B] FIG. 5B shows an articulated view of the carriage frame, according to some embodiments. [Figure 6A]FIG. 6A shows how spacers are used to adjust the distance between the carriage frame and the custom maxillary tray, the spacers being either magnetic or magnetically held. [Figure 6B] FIG. 6B shows how spacers are used to adjust the distance between the carriage frame and the custom maxillary tray, the spacers being either magnetic or magnetically held. [Figure 7A] FIG. 7A shows a view of the anterior portion of the maxillary arch assembly. [Figure 7B] FIG. 7B shows a different view of the anterior portion of the maxillary arch assembly. [Figure 7C] FIG. 7C shows how the maxillary anterior section can be coupled to the carriage frame in a manner that allows the position of the maxillary anterior section to be adjusted. [Figure 8A] 8A to 8C show views of the right posterior part of the maxilla. [Figure 8B] 8A to 8C show views of the right posterior part of the maxilla. [Figure 8C] 8A to 8C show views of the right posterior part of the maxilla. [Figure 9A] FIG. 9A shows an exemplary magnetic fixture in the anterior maxilla for connection to both the posterior quadrant and the carriage frame. [Figure 9B] FIG. 9B shows the magnetic fixture in the right posterior portion of the maxilla. [Figure 10A] FIG. 10A shows a view of the anterior mandible, according to some embodiments. [Figure 10B] FIG. 10B shows a view of the anterior mandible, according to some embodiments. [Figure 10C] FIG. 10C shows a view of the anterior mandible, according to some embodiments. [Figure 11A] FIG. 11A shows how a VDO pin connects to the anterior mandible, according to some embodiments. [Figure 11B] FIG. 11B shows how the VDO pin connects to the anterior mandible, according to some embodiments. [Figure 12A] FIG. 12A shows the procedure for connecting the mandibular anterior component to the maxillary anterior component by using a spacer. [Figure 12B] FIG. 12B shows the procedure for connecting the mandibular anterior component to the maxillary anterior component by using a spacer. [Figure 12C] FIG. 12C shows the procedure for connecting the mandibular anterior component to the maxillary anterior component by using a spacer. [Figure 12D] FIG. 12D shows the procedure for connecting the mandibular anterior component to the maxillary anterior component by using a spacer. [Figure 13] FIG. 13 shows a flowchart illustrating the sequence of operations for template customization, according to some embodiments. [Figure 14] FIG. 14 shows a method illustrating how a verified unity template can be turned into a provisional denture, according to some embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0012] The following disclosure describes the invention through several embodiments directed to methods, systems, and devices related to positioning and verifying the anatomical position of a palatal arch prosthesis using a prosthetic positioning assembly. The prosthetic positioning assembly assists clinicians in positioning and verifying 3D parameters, function, and phonetics. As described in further detail below, the prosthetic positioning assembly can be provided to clinicians as a standardized collection of parts intended to be used by clinicians as templates for identifying and verifying the anatomical position of palatal arch dental prostheses. This collection is referred to herein as a "Unity Kit." To cover a range of anatomical mouth sizes and shapes, the kit can be divided into multiple template options. For example, in some embodiments, three palatal arch sizes and five tooth shapes are provided. These arch size and tooth shape combinations, along with the dynamic positioning device described below, allow clinicians to create final prosthetic templates for a wide variety of patients.

[0013] Creating a palatal arch using the Unity System involves a series of discrete steps. First, the clinician uses the Unity Kit template (described above) at the patient's chairside to find the correct 3D position for the prosthesis, as well as the palatal arch shape and tooth geometry. After all 3D parameters are confirmed, the Unity Kit template's 3D position in the mouth represents a "patient-specific" template (also called a "customized template," "template," or "wax-up"). In this context, "chairside" refers to the clinician's office while the patient is being examined. The customized Unity template is then digitized with an optical scanner and used as a template for designing the prosthesis using dental computer-aided design (CAD) software. The shape and size of all analog values in the palatal arch are displayed in a digital anatomical library in CAD, allowing for rapid prosthesis design. This design can be used to achieve several different prosthetic devices, including a temporary soft tissue supported denture, an implant supported temporary denture, a surgical guide for implant implantation, or a definitive restoration.

[0014] FIG. 1A shows a facial view of the prosthetic positioning assembly 100 in a square tooth form. As described in more detail below, various tooth forms can be used as desired to meet the patient's expectations regarding tooth size and shape in the final prosthesis. FIG. 1B shows a lingual view of the prosthetic positioning assembly 100 shown in FIG. 1A. As shown in FIGS. 1A and 1B, the prosthetic positioning assembly 100 consists of two subassemblies: a maxillary arch subassembly 101 and a mandibular anterior and VDO pin subassembly 102.

[0015] Figure 1C shows a more detailed view of the components used in the prosthesis positioning assembly 100, according to some embodiments. Note that the image shown in Figure 1C is oriented "upside down" with respect to the anatomy and orientation shown in Figures 1A and 1B. The maxillary arch subassembly 101 includes a left maxillary arch posterior section 105, an anterior maxillary arch section 115, and a right maxillary arch posterior section 120. These three components function together in the oral cavity to determine the incisal edge position, midline position, occlusal surface, buccal corridor, and lip support.

[0016] The bite assembly 110 holds the maxillary arch subassembly 101 in place. As described in more detail below, the bite assembly 110 is designed so that the components 105, 115, and 120 of the maxillary arch subassembly 101 are movable after being attached to the bite assembly 110. This allows a clinician to adjust the components 105, 115, and 120 as needed to achieve a desired positioning of the maxillary arch subassembly 101. Once these components 105, 115, and 120 are in place, the mandibular anterior and VDO pin subassembly 102 can be positioned to assess overall tooth position. The mandibular anterior and VDO pin subassembly 102 includes a mandibular anterior 125 and a VDO pin 130. The VDO pin 130 allows adjustment of the vertical dimension of the bite ("VDO") to achieve a desired 3D positional relationship (i.e., vertical dimension) between the maxilla and jaw.

[0017] 2A and 2B illustrate how the prosthetic positioning assembly 100 can be used in combination with a bite assembly to customize a template for a patient's unique anatomy. The bite assembly includes an upper tray 200 and a carriage frame portion 210 (shown in FIGS. 2A and 2B, respectively). The two portions are designed to serve as an adjustable base for the prosthetic positioning assembly 100, allowing the clinician to quickly and dynamically adjust the position of the bite surface. The bite surface is an important restoration variable in palatal arch restorations because it determines the upper and lower components of the incisor edge position. The bite assembly can be provided in a unity kit in a variety of sizes (e.g., small, medium, large, etc.) to allow customization to fit the patient's mouth size.

[0018] The maxillary tray 200 is designed to mold to the soft tissue structure of a patient's maxilla. As shown in FIG. 2A, the maxillary tray 200 includes a moldable material 201 and an occlusal rim component 205. The moldable material 201 can be formed in the patient's mouth or can be formed on an impression of the patient's maxillary teeth prior to their setting. FIG. 2B shows how a carriage frame component 210 can be secured to the maxillary tray 200. As described in more detail below, in some embodiments, the carriage frame component 210 is fabricated from a ferromagnetic material and the occlusal rim component 205 includes a plurality of magnets.

[0019] 2C-2E show how the maxillary arch subassembly is coupled to the bite assembly 110. Beginning in FIG. 2C, the maxillary anterior section 215 is secured to the carriage frame section 210. Next, as shown in FIG. 2D, the maxillary left posterior section 220 is secured to the maxillary anterior section 215. The maxillary arch subassembly section 225 is then secured in place as shown in FIG. 2E. Note that the order of the maxillary arch subassembly components varies in different embodiments, and the order shown in FIGS. 2C-2E is merely exemplary. Securement between the various sections may be achieved using, for example, magnetic disks embedded in one or more of the maxillary anterior section 215, maxillary left posterior section 220, and maxillary arch subassembly section 225.

[0020] As is commonly understood by those skilled in the art, the shape and position of the maxillary gums will vary from patient to patient based on their unique anatomy and the length of time they have been without teeth (referred to as "edentulous"). The width of the maxillary gums, also referred to as "ridge size," is provided in the Unity Kit by a number of individually sized bite assemblies. The bite assembly size (small, medium, large, etc.) corresponds to the size of the maxillary arch assembly. Selecting the bite assembly size results in selecting the tooth shape.

[0021] The size and shape of a person's maxillary teeth vary. Facial structure, palatal arch size, and the patient's personal preferences are taken into consideration. Additionally, patients may have personal preferences regarding how their teeth look. In some embodiments, the Unity Kit provides different tooth profiles for each ridge size. For example, for each ridge size, tooth profiles may be provided in oval, square, and round forms. The various shapes may be determined, for example, from a model of natural teeth. The tooth profiles can be quickly attached to and detached from the carriage frame 505 during the patient evaluation phase. Furthermore, these tooth profiles are designed with adjustable posterior components 220 and 225 that function to match the patient's buccal corridor. For illustrative purposes, FIGS. 3A and 3B show exemplary square and round tooth profiles, respectively.

[0022] The ideal position of a person's maxillary teeth relative to the rest of the mouth varies based on many physiological characteristics, including, but not limited to, facial structure, lip dynamics, bony anatomy, and phonetics. By combining the bite positioning assembly and prosthesis positioning assembly, clinicians can quickly position the dental arch in the correct physiological position by adjusting the bite plane position, incisor edge position, midline, buccal corridor, lip support, and VDO. Clinicians can then physiologically verify its position in the mouth using phonetics and lip dynamics and adjust its position accordingly. This allows clinicians to create a validated template of the final prosthesis in a single setup at the patient's chairside.

[0023] 4A and 4B show further details of the bite rim component 205, according to some embodiments. The upper tray 400 is comprised of a rigid bite rim 405 surrounded by a moldable material. The bite rim 405 is designed to resemble the natural dental arch. The bite rim 405 includes multiple embedded magnetic fasteners. In the example shown in FIG. 4A, the fasteners include magnetic fasteners 410A, 410B, 410C, and 410D (i.e., two fasteners in the posterior and two fasteners in the anterior). When attached to the bite rim 405, the magnetic fasteners 410A, 410B, 410C, and 410D attract a ferromagnetic carriage frame (see, e.g., FIG. 2B) into a connected position. The moldable material can be formed around the bite rim, for example, by injection overmolding. 4B, the bite rim 405 includes multiple cutouts 415A, 415B, 415C, and 415D for overmolding material, which serves to secure the magnetic retainers 410A, 410B, 410C, and 410D to the bite rim 405 and conform to the unique contours of the patient's upper gums, serving as a customized final impression and record base.

[0024] FIGS. 5A and 5B show side and occlusal views, respectively, of a carriage frame according to some embodiments. The carriage frame 505 is constructed of a biocompatible magnetic metallic material. The carriage frame 505 is shaped to mirror the natural dental arch shape of the bite rim 405, except for the anterior lingual region, where the shape may be thinner. The carriage frame 505 is designed to overlap the magnetic fixture of the maxillary tray (see FIG. 4A) according to a linear range of positions. This allows the carriage frame 505 to be adjusted and secured in any position, depending on the strength and placement of the magnetic fixture. For example, for the maxillary tray 400 described above with reference to FIGS. 4A and 4B, the fixture can allow for up to 6 mm of adjustment in the anterior direction. This feature allows for "macro-adjustment" of the anterior / posterior portions of the incisal edge position. Micro-adjustments can be performed by adjusting individual components of the prosthetic positioning assembly.

[0025] FIGS. 6A and 6B show how spacers 615A, 615B, 615C, and 615D are used to adjust the distance between the carriage frame 605 and the maxillary tray 600. In this example, the spacers 615A, 615B, 615C, and 615D are attracted to magnetic retainers within the bite rim 610, which serve to position the spacers correctly. The carriage frame 605 can be adjusted up or down (higher or lower) relative to the maxillary tray 600 by adding or removing spacers. Additionally, the carriage frame 605 can be angled by adding additional spacers to the anterior retainers, as shown in FIG. 6B. By individually adjusting the size of the spacers, the angle of the carriage frame 605 can be any desired angle. The angle of the carriage frame 605 corresponds to the restorative bite plane. While the example in FIGS. 6A and 6B uses magnets as spacers, it should be understood that other types of spacers can be used in other embodiments. For example, in one embodiment, the spacers are stackable plastic discs that "fit" together to achieve the desired height. The plastic spacers can also include features that allow for connection with the carriage frame 605 and mating rim 610.

[0026] Figures 7A-7C show additional details of a maxillary arch subassembly, according to some embodiments. Starting with Figures 7A and 7B, two different views of a maxillary anterior section 700 are shown. The maxillary anterior section 700 includes the facial and occlusal contours of the six maxillary anterior teeth, along with crescent-shaped protrusions 705 from the lingual surfaces of the teeth. The crescent-shaped protrusions 705 include space for various sized magnets 710A, 710B, 710C, and 710D (or other connectors) to be positioned. Figure 7C shows how the maxillary anterior section 700 is coupled to a carriage frame 715 in a manner that allows the position of the maxillary anterior section 700 to be adjusted.

[0027] Figures 8A-8C show three views of the maxillary left posterior part 800. Specifically, Figure 8A shows the occlusal and buccal views, while Figures 8B and 8C show the lingual and superior views, respectively. The maxillary right posterior part and maxillary left posterior part are mirror images of each other. The maxillary right posterior part and maxillary left posterior part each include the buccal and occlusal outlines of the four posterior teeth. The lingual side of the part includes flat surfaces, rounded surfaces, and spaces for placement of various sized magnets 805 and 810 (or other connectors).

[0028] In some embodiments, the maxillary right posterior section and maxillary left posterior section connect to the maxillary anterior section using a combination of magnetic anchors located lingually on the first bicuspid of all three sections. The anchors allow the sections to rotate along the occlusal plane. This design feature allows for adjustment of the left and right posterior buccal corridors while maintaining the occlusal plane. The magnetic anchors can also be designed to limit rotation from the baseline arc to a desired range (e.g., + / - 10 degrees). Figure 9A shows exemplary magnetic anchors 905, 910 in the maxillary anterior section 900 for connecting to the posterior assembly. Figure 9B shows a magnetic anchor 920 in the maxillary left posterior section 915. The maxillary right posterior anchor (not shown) is a mirror image of the maxillary left posterior anchor 920.

[0029] The maxillary arch subassembly is designed to be magnetically secured to the carriage frame component of the bite assembly, which serves as the base. A fastener connecting the posterior components can be used to firmly attract the maxillary arch subassembly to the carriage frame in a manner that limits movement. As a result, the maxillary arch subassembly can be adjusted only in the bite plane established by the bite assembly. The maxillary arch subassembly can be translated to a natural midline position and adjusted to advance to ideal incision edge and lip support positions.

[0030] 10A-10C show three views of a mandibular anterior section 1000, according to some embodiments. In this example, the mandibular anterior section 1000 is designed to have the bottom six front teeth. As shown in FIGS. 10B and 10C, the mandibular anterior section 1000 includes an opening 1005 for receiving a VDO pin.

[0031] 11A and 11B show how a VDO pin 1105 connects to the mandibular anterior section, according to some embodiments. The VDO pin 1105 connects to the recess (tissue side) of the mandibular anterior section 1100. This VDO pin 1105 provides the clinician with the ability to adjust the VDO, which is an important restoration variable in full arch restoration. More specifically, the VDO pin 1105 is designed to be shortened in the clinician's chair (e.g., with a dental handpiece) to achieve the correct VDO. In some embodiments, the VDO pin 1105 is marked at predetermined intervals (e.g., 1 mm) to indicate the distance from the occlusal surface.

[0032] In some embodiments, the mandibular anterior section is connected to the maxillary anterior section using a magnetic spacer and corresponding magnetic anchors embedded in both sections. The anchors are located on the lingual sides of the maxillary and mandibular incisors and function to limit all movement of the mandibular anterior section relative to the maxillary anterior section. The spacer connects the mandibular anterior section to the maxillary anterior section, maintains the occlusal distance between the two sections during biting, and positions the entire mandibular arch relative to the teeth in the maxillary arch in ideal occlusal relationship.

[0033] 12A-12D illustrate the process of connecting the mandibular anterior section 1215 to the maxillary anterior section 900, as described above with reference to FIGS. 9A and 9B. The maxillary anterior section 900 is connected to the mandibular anterior section 1215 by inserting the anchor 95 into the space 1220 shown in FIG. 12A. FIG. 12B illustrates the mandibular anterior section 1215 with spacers 1225A and 1225B. FIG. 12C illustrates buccal and lingual views of the spacers 1225A and 1225B on the mandibular anterior section 1215. Finally, FIG. 12D illustrates the position of the anchors 905 and 910 when the mandibular anterior section 1215 and maxillary anterior section 900 are secured together.

[0034] FIG. 13 shows a flowchart illustrating the sequence of operations for template customization, according to some embodiments. Starting in step 1305, a customized patient-specific base plate is inserted into the patient's mouth and evaluated for retention and stability. Multiple base plates may be provided in unity kits of various sizes. In step 1310, the clinician selects the appropriate tooth shape and arch size from a library for the patient's specific condition and preferences. The clinician then assembles the carriage frame and maxillary arch. Next, in step 1315, the clinician adds spacers to the bite assembly as needed to achieve the correct bite surface and incisal edge position. In step 1320, the clinician may also move the carriage frame anteriorly or posteriorly, and the arch assembly may be translated anteriorly or posteriorly and side-to-side relative to the carriage frame to establish the midline, lip support, and buccal corridor. Then, in step 1325, with all parameters set, the clinician verifies the maxillary arch position by having the patient phonetically pronounce "F" and / or "V." If necessary, the clinician adjusts the maxillary arch position.

[0035] Continuing with reference to FIG. 13, in step 1330, mandibular advancement and VDO pins (if necessary) are added. If necessary, the clinician adjusts the VDO. For example, in some embodiments, the VDO is calculated by subtracting the "rest gap" from the vertical dimension of the rest ("VDR"). As commonly understood in the art, when the mandible is in its rest position, there is a gap between the upper and lower teeth. The gap between the occlusal surfaces observed in the bicuspid region is the "rest gap." In other embodiments where the denture is designed for replacement purposes, the VDO may match the VDO of the existing denture. The position of the VDO may also be influenced by the patient's facial aesthetics. In step 1335, the clinician fixes the position of the maxillary arch subassembly relative to the maxillary tray and the mandibular advancement relative to the mandibular tray, for example, using a flowable, hardenable material.

[0036] In step 1340, once the maxillary and mandibular sections are secured in the maxillary and mandibular trays, the clinician removes the spacers to separate the maxillary assembly from the mandibular assembly. The maxillary and mandibular sections are now free to move independently of each other. With the lower anterior secured in place, the clinician then has the patient pronounce the sound "S" to confirm the VDO, upper and lower incisor edge positions. The clinician then has the patient smile in step 1345 to confirm tooth size and selection. Process 1300 can then be restarted if changes to arch shape, tooth form, or intraoral position are desired. Once the desired appearance and fit are achieved, in step 1350, the clinician can capture the positions of the maxillary and mandibular assemblies using a chairside scanner, or alternatively, the complete assemblies can be packaged together and shipped to a manufacturing facility for manufacturing.

[0037] FIG. 14 shows a method 1400 illustrating how a customized unity template can be transformed into a provisional denture, according to some embodiments. Starting in step 1403, the customized unity template is converted into digital meshes using an optical 3D scanner. In step 1405, the digital meshes are uploaded to a computer-aided design (CAD) software system. Examples of CAD software systems include 3Shape Dental System, Exocad DentalCAD, and AvaDent Digital Denture. The digital meshes include digital meshes of the soft tissues of the upper and lower jaws, providing a highly detailed model of the soft tissues, including the denture boundaries. A digital mesh of the entire unity template, including the digital meshes of the bite assembly, maxillary arch subassembly, and the lower tray fastened together, is also uploaded in step 1405. These digital meshes collectively provide the VODtoCAD software. The digital meshes uploaded in step 1405 also include a digital mesh of the bite assembly with the maxillary arch subassembly, providing a relationship between the maxillary soft tissues and the identified tooth positions.

[0038] Continuing with reference to FIG. 14, in steps 1410-1420, the model is prepared for design. First, in step 1410, the user selects the type of denture structure they want to manufacture (e.g., one-piece, two-piece, printed, milled, hybrid, etc.). Next, in step 1415, the CAD software system aligns the mesh and, if necessary, trims and corrects defects in the digital mesh. Then, in step 1420, the CAD software system performs an analysis of the model, including occlusal surfaces and feature points, marks the jaw border, sets the insertion direction, and blocks undercuts. The processing in steps 1415 and 1420 can be performed automatically or based on one or more inputs received from the user.

[0039] In steps 1425-1435, the information provided by the CAD software system is used by the user to design a full-oral prosthetic temporary denture based on the user's input. In step 1425, the user selects the corresponding tooth shape and arch size from the anatomical structure library, as indicated by the analog settings. The arch shape is manually or automatically positioned relative to the customized template, and the teeth are individually adjusted. Next, in step 1430, a denture base (representing the tissue) is created. Denture bases can be generated in different configurations to create dentures (with full palate-based coverage) or implant-supported dentures (with only arch-based coverage). In step 1435, the microanatomical structures are adjusted using digital sculpting tools along with the denture base assembly parameters. At this point, the temporary denture design is finalized and can be used to manufacture the dentures.

[0040] Once the dentition positions have been digitized using the process described in steps 1405-1425, any full-mouth dental prosthesis can be designed, including, but not limited to, dentures, radiographic guides, or implant dentures. The process described in Figures 13 and 14 represents the entire analog and digital workflow for achieving an optimal full mouth reconstruction.

[0041] In some embodiments, the temporary denture is fabricated with cavities along the lingual surface of the maxillary denture base or dental arch. The cavities receive radiopaque material (e.g., gutta-percha or zirconia spheres). The temporary denture with radiopaque markers is used in combination with a cone beam computed tomography ("CBCT") scan to generate a set of data related to the three-dimensional position of the temporary denture relative to the patient's tissue and bone. This data set can then be combined with the data set generated in FIG. 14 to, for example, generate (i) a guide for surgical placement of one or more dental implants and (ii) a temporary implant denture based on the planned implant locations.

[0042] After scanning and digitizing the analog part with CAD software, the corresponding arch shape from the anatomical library is selected. Any differences in the arch shape, particularly the repositioning of the posterior quadrant, are identified, and the posterior quadrant of the digital mesh is adjusted to the new analog position by the CAD software. In some embodiments, the CAD recognizes that changes must be made to fit the CAD position to the analog part. As a result, when adapting the design, the CAD software ensures that the design preserves important relationships, including occlusion versus fossa and general occlusal features. The lower anterior position represents the position of the entire lower arch relative to the teeth of the upper arch in an ideal occlusal relationship.

[0043] The software process illustrated in FIG. 14 and described in further detail throughout this disclosure provides various improvements over conventional software used to design and fit implant- or tissue-supported dentures. For example, some embodiments of the present invention utilize a database of meshes corresponding to physical tooth, arch, and tissue anatomies. The anatomical structure library includes multiple tooth, arch, and tissue anatomies corresponding to multiple physical maxillary and mandibular arch anatomies in the prosthetic positioning assembly. The tooth, arch, and tissue anatomical structure mesh database includes additional anatomical structure metadata such as free gum line, cusp and fossa locations, interdental papilla and attached mucosa contours, and contact point locations.

[0044] The technology described herein facilitates the placement / alignment of maxillary teeth and arch shapes. Multiple tooth anatomical meshes in an anatomical structure library are registered to a customized Unity template digital mesh via a mesh alignment algorithm (e.g., iterative closest point) using single or multiple user-marked reference points. In some embodiments, multiple tooth meshes are aligned into three fixed groups corresponding to the anterior maxilla, the posterior maxilla left, and the posterior maxilla right. Automatic mesh alignment of multiple tooth features quickly replicates the confirmed tooth placement and arch shape of the customized Unity template without significant user input. Conventional software workspaces for tooth placement and alignment, such as 3Shape's Smile Composer feature, require manual dragging, dropping, and rotating individual meshes or groups of mesh teeth into desired 3D positions using on-screen controls. Tooth meshes are aligned relative to a wax rim mesh (which does not contain tooth references) or a wax-up mesh (which contains non-corresponding tooth references). Manual alignment is time-consuming and inaccurate.

[0045] The system described herein also facilitates the identification, location, and characterization of gingival tissue anatomy. The digital mesh representing the customized Unity template includes the gingival tissue anatomy. The free gingival margin metadata packaged in the tooth mesh anatomy library allows for the rapid identification of buccal gingival tissue via a Boolean difference algorithm. Multiple registered tooth meshes are subtracted (via Boolean difference) from the digital mesh of the customized Unity template, leaving a mesh representing the tissue anatomy above the free gingival margin. The tissue mesh in the anatomy library is registered to the tissue mesh remaining after subtraction via a mesh alignment algorithm (such as iterative closest point) using one or more user-marked reference points. The tissue mesh is then lofted to the denture boundary to generate the complete denture base. The automatic identification and location of pre-characterized tissue significantly reduces the skilled input required from the user and allows for the modification of the tissue design if changes are desired. Traditional dental CAD software workspaces for tissue design dynamically generate tissue surfaces by 1) creating lofted surfaces from the denture border to the free gingival margin of the denture library teeth, or 2) lofting from the denture border to the upper edge of the library teeth and tissue arch. Traditional algorithms used in Methods 1 and 2 result in non-aesthetic tissue designs that must be digitally or manually modified after fabrication.

[0046] According to some embodiments, the systems described herein utilize decorative denture designs with cavities along the lingual side of the arch. One or two denture designs with multiple cylindrical cavities are placed along the lingual tissue surface of the denture arch. In other embodiments, the cylindrical cavities may be placed along the denture base or tissue surface of the dental arch (referred to as "intaglio"). As described above, the cylindrical cavities can be incorporated into the denture during CNC milling or 3D printing. After fabrication, a radiopaque material such as zirconia, metal, or gutta-percha is placed into the cylindrical cavities.

[0047] While various aspects and embodiments are disclosed herein, other aspects and embodiments will be apparent to those skilled in the art. The various aspects and embodiments disclosed herein are for purposes of illustration and are not intended to be limiting, with the true scope and spirit being indicated by the following claims.

[0048] The illustrated systems and processes are not exclusive. Other systems, processes, and menus may be derived in accordance with the principles of the present invention to achieve the same objectives. While the present invention has been described with reference to specific embodiments, it should be understood that the embodiments and variations shown and described herein are for illustrative purposes only. Modifications to the current designs may be implemented by those skilled in the art without departing from the scope of the present invention. Claim elements herein shall be construed under 35 U.S.C. §112(f) unless the element is expressly recited using the phrase "means for."

Claims

1. 1. A dental appliance positioning assembly comprising:

1. A mating assembly comprising: an upper tray configured to be formed over the patient's upper gums, the upper tray including an occlusal rim component; a carriage frame portion made of a biocompatible magnetic metallic material fixed to the upper jaw tray; and a maxillary arch subassembly including a plurality of artificial maxillary teeth magnetically secured to the carriage frame; one or more spacers for adjusting the distance between the carriage frame portion and the upper jaw tray; A dental appliance positioning assembly, wherein (i) the carriage frame portion is movable relative to the maxillary tray, and (ii) the maxillary artificial teeth portions are individually movable relative to each other to achieve a desired tooth positioning.

2. The plurality of artificial maxillary tooth portions in the maxillary arch subassembly include: The left posterior part of the maxillary arch and The anterior part of the maxilla, Right posterior part of maxillary arch and The dental appliance positioning assembly of claim 1 , comprising:

3. The dental appliance positioning assembly of claim 2 , wherein the maxillary anterior portion is movable anteriorly and posteriorly along the carriage frame portion to achieve an ideal incisal edge position.

4. The dental prosthesis positioning assembly of claim 2 , wherein the plurality of artificial maxillary teeth are movable laterally along the carriage frame portion to achieve a desired maxillary midline position in the patient's mouth.

5. 3. The dental prosthesis positioning assembly of claim 2, wherein the left maxillary arch posterior portion and the right maxillary arch posterior portion are independently rotatable relative to the maxillary anterior portion of the carriage frame portion to achieve a desired buccal corridor for the patient's mouth.

6. The dental appliance positioning assembly of claim 2 , wherein the posterior maxillary tooth portions of the maxillary arch subassembly are connected to one another using magnetic fasteners.

7. The dental appliance positioning assembly of claim 6 , wherein the magnetic fastener limits all movement of the posterior maxillary dental portion except rotation.

8. The dental appliance positioning assembly of claim 2 , wherein the maxillary anterior portion includes labial, occlusal, and palatal contours of six maxillary anterior teeth.

9. The dental appliance positioning assembly of claim 8 , wherein the left maxillary arch posterior portion and the right maxillary arch posterior portion each include buccal, occlusal, and palatal contours of four posterior teeth.

10. 10. The dental prosthesis positioning assembly of claim 9, wherein the maxillary anterior portion is positioned on a palatal aspect of the maxillary anterior teeth and includes a crescent-shaped protrusion that holds one or more anchors for coupling with the maxillary left posterior arch portion and the maxillary right posterior arch portion.

11. The dental appliance positioning assembly of claim 10 , wherein the one or more fasteners are magnets or ferromagnetic materials.

12. The dental appliance positioning assembly of claim 1 , wherein the interlocking rim component comprises a plurality of embedded magnetic anchors and / or ferromagnetic materials.

13. 13. The dental prosthesis positioning assembly of claim 12, wherein the plurality of embedded magnetic fasteners comprises: (i) a first set of magnetic fasteners positioned anterior to the interlocking rim component; and (ii) a second set of magnetic fasteners positioned posterior to the interlocking rim component.

14. The dental appliance positioning assembly of claim 1 , wherein the spacer is a magnetic disk secured to the ferromagnetic bite rim component.

15. The dental appliance positioning assembly of claim 1 , wherein the distance is adjusted by stacking or unstacking magnetic spacers.

16. The dental appliance positioning assembly of claim 1 , wherein the spacer is cylindrical and magnetically secured to the bite rim component.

17. The dental prosthesis positioning assembly of claim 1 , further comprising a mandibular anterior subassembly that holds a plurality of artificial mandibular teeth.

18. 18. The dental appliance positioning assembly of claim 17, wherein the mandibular advancement sub-assembly includes pins for adjusting a vertical dimension of bite, a three-dimensional positional relationship between the patient's maxilla and the patient's mandible.

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