Dental prosthesis support device

Abstract

The present invention relates to a dental prosthesis support device comprising: a support strip (201) integrated with a dental prosthesis (DP); a connector (203) adapted, in use, to be fixed to a patient's teeth sandwiching a tooth gap on either side, with the support strip releasably engaging with the connector so that the dental prosthesis fills said gap; a support strip having a contour such that it completely covers only the lingual surface of the tooth, leaving the other surfaces of the tooth free; a connector configured for fixing against the lingual surface of the tooth; a support strip comprising a recess into which the connector elastically fits.

Description

[Technical Field]

[0001] The present invention relates to a dental prosthesis support device.

[0002] The technical field of the invention is that of devices that allow dental prostheses to be kept in place in a patient's mouth. [Background technology]

[0003] Dental implants, or dental anchors, are used to replace missing teeth. Implants typically contain a screw (made of titanium, zirconia, or a polymer) that is inserted into the maxilla or mandible to create an anchor that can receive a dental prosthesis. Implant installation is performed in multiple steps and is usually performed under anesthesia. During the primary surgical step, the surgeon installs the implant by screwing it into the bone. During a healing period of several months, the bone reforms around the implant, securing it in place. Once the implant is secured to the bone, an abutment is attached to prepare the gums for a retraction that will serve as a support for the prosthesis. Finally, the prosthesis is attached to the abutment and finally cemented.

[0004] Unless the dental prosthesis is placed on an abutment, the patient will end up with a gap in the dental arch at the implant site. This gap is particularly unsightly and can lead to undesirable movement of other teeth. In this case, dental malocclusion, diastema, or diastema may appear, which can interfere with the action of the jaw muscles or disrupt the functional relationship between the teeth. Summary of the Invention [Problem to be solved by the invention]

[0005] The present invention aims to solve these problems.

[0006] Another object of the invention is to propose a dental appliance that is particularly aesthetic, hygienic and comfortable for the patient. [Means for solving the problem]

[0007] The solution proposed by the present invention is a dental prosthesis support device comprising: - a support strip integrated with a dental prosthesis; - a connector which, in use, is adapted to be fixed to a patient's teeth sandwiching a tooth gap on either side, with the support strip removably engaging with the connector so that the dental prosthesis fills the gap; - a support strip which has a contour such that it completely covers only the lingual surface of the tooth, leaving other surfaces of the tooth free; - a connector which is configured to be fixed against the lingual surface of the tooth; - a support strip which includes a recess into which the connector elastically fits.

[0008] Because the support strip is only in a lingual position, it is always invisible and, in fact, is particularly aesthetic. It is not unsightly even if it comes into contact with cigarette smoke or coffee and becomes discolored. Furthermore, because the strip and connector leave the occlusal and incisal surfaces of the teeth completely free, the patient can cut, chew, and eat perfectly without having to remove the strip. Moreover, because of its lingual position, the connector is no longer a source of discomfort and / or irritation at the patient's lips and / or cheeks. Finally, the strip can be easily removed and replaced by the patient themselves, without relying on a doctor.

[0009] Other advantageous features of the present invention are listed below, each of which may be considered alone or in combination with the notable features defined above and may, if necessary, be the subject of one or more divisional patent applications.

[0010] According to one embodiment, the dental prosthesis is fixed to the support strip by gluing, brazing or fitting.

[0011] According to one embodiment, the dental prosthesis has a lingual surface that adheres to the support strip.

[0012] According to one embodiment, the dental prosthesis and support strip are a single piece consisting of one molded, machined or 3D printed element.

[0013] According to one embodiment, each connector has a spherically shaped connection head.

[0014] According to one embodiment, each connector has the following: - a base having a fixing surface adapted to be fixed against the lingual surface of the tooth; - a connection head located on an extension of the base and into which one of the recesses of the support strip fits.

[0015] According to one embodiment, the connection head is separate from the base and a flange connects said head to said base.

[0016] According to one embodiment, each connector has the following: - a connection head into which one of the recesses of the support strip fits; - a fixing surface adapted to be fixed against the lingual surface of the tooth; - a fixing surface consisting of a flat portion arranged on the connection head.

[0017] According to one embodiment, the connection head has one of the following shapes: oval, prolate spheroid, sphere, cube, parallelepiped, polyhedron, prism, cone, pyramid, cylinder, or a combination of two or more of these various shapes.

[0018] According to one embodiment, the support strip is flexible.

[0019] According to one embodiment, the support strip is rigid.

[0020] According to one embodiment, the support strip has portions or regions with distinctly different moduli of elasticity.

[0021] Another aspect not addressed by the present invention relates to a maxillary expansion appliance comprising: a maxillary expansion plate configured to cooperate with a plurality of teeth in a patient's maxillary dental arch to expand the patient's palate; a connector adapted to be secured to the teeth, with the maxillary expansion plate being releasably engaged with the connector; a connector and a plate that cooperate to apply at least one stress that tends to expand the palate when the patient is wearing the dental appliance; a maxillary expansion plate that has a contour that completely covers only the hard palate and the lingual surfaces of the teeth, leaving other surfaces of the teeth free; a connector configured to be secured against the lingual surfaces of the teeth; and a maxillary expansion plate that includes a recess into which the connector resiliently fits.

[0022] Yet another aspect not addressed by the present invention relates to a dental appliance including: a dental aligner configured to cooperate with at least one tooth in a patient's dental arch to move the tooth toward a desired position; a connector adapted to be secured to a tooth in the dental arch, the connector being releasably engaged by the dental aligner; and the connector and aligner cooperating to apply at least one therapeutic stress to at least the tooth when the patient is wearing the dental appliance. The dental aligner is formed of a flexible strip and has a contour that completely covers only the lingual surfaces of the teeth, leaving other surfaces of the teeth free. The connector is further configured to be secured against the lingual surfaces of the teeth. The flexible strip also includes a recess into which the connector resiliently fits.

[0023] Other advantages and features of the present invention will become better apparent from reading the following description of preferred embodiments, with reference to the accompanying drawings, made as non-limiting and indicative examples, in which: [Brief explanation of the drawings]

[0024] [Figure 1] FIG. 1 is a cross-sectional schematic view of a dental appliance worn by a patient. [Figure 2a] 1 is a cross-sectional schematic view of a dental aligner adapted for positioning on a patient's upper dental arch. [Figure 2b] 1 is a cross-sectional schematic view of a dental aligner adapted for positioning on a patient's mandibular dental arch. [Figure 3a] 1 shows a schematic front view of a connector used in the present invention. [Figure 3b] 1 shows a side view of a connector used in the present invention. [Figure 3c] 1 shows a plan view of a connector used in the present invention. [Figure 4a] 1 shows a schematic front view of a connector used in the present invention, showing various stress areas on the connector. [Figure 4b] 1 shows a side view of a connector used in the present invention, showing various stress areas on the connector. [Figure 4c] 1 shows a top view of a connector used in the present invention, showing various stress areas on the connector. [Figure 5] 1 illustrates the placement of dental appliances at the patient's lower and upper dental arches. [Figure 6] FIG. 1 is a cross-sectional schematic view of a dental appliance worn by a patient, with an aligner placed on the maxillary dental arch showing a palatal extension connected to an anchor screw. [Figure 7] FIG. 7 is a cross-sectional schematic view of a dental aligner used in the appliance of FIG. 6. [Figure 8] FIG. 10 is a cross-sectional schematic view of a dental appliance positioned on a patient's mandibular dental arch, according to another embodiment. [Figure 9] FIG. 9 is a cross-sectional schematic view of a removable mouthpiece used in the device of FIG. 8. [Figure 10]10 illustrates the placement of a dental appliance at a patient's upper dental arch, according to another embodiment. [Figure 11] FIG. 11 is a schematic cross-sectional view taken along line AA in FIG. [Figure 12a] 1 illustrates the use of a dental appliance as a support for a temporary tooth. [Figure 12b] 1 illustrates the use of a dental appliance as a support for a temporary tooth. [Figure 13a] FIG. 10 is a schematic side view of a connector according to a modified embodiment. [Figure 13b] FIG. 10 is a schematic plan view of a connector according to a modified example. [Figure 14] FIG. 10 is a cross-sectional schematic view of a dental appliance positioned on a patient's mandibular dental arch, according to another embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0025] For clarity, the following detailed explanations are given to certain terms used in the specification and claims. "Lingual surface" means the surface of the tooth that faces the tongue (for teeth in the mandibular dental arch) or the surface of the tooth that faces the palate (for teeth in the maxillary dental arch); - As used herein, unless otherwise indicated, the use of ordinal adjectives such as "first," "second," etc. to describe objects merely indicates that various instances of similar objects are being referred to and does not imply that the objects so described must be in a given order, whether in time, space, classification, or in any other manner; - Similarly, the use of adjectives such as "right / left", "front / back", "top / bottom", etc., merely makes it possible to describe the position of objects in the composition of the accompanying drawings, and does not necessarily imply that similar objects are in the same position in reality; - "X and / or Y" means X alone, or Y alone, or X and Y; - It will generally be appreciated that the various drawings are not drawn to exact scale from one drawing to another, or even within a given drawing, and that, inter alia, objects may be drawn freely in order to facilitate the interpretation of the drawings.

[0026] FIG. 1 shows a first dental aligner 101 cooperating with a first tooth 102 in an upper dental arch 100 and a second dental aligner 201 cooperating with a second tooth 202 in a lower dental arch 200. In practice, each aligner 101, 201 cooperating with multiple teeth, e.g., 2-16 teeth. Depending on the nature of the treatment, only one of the two dental arches 100 or 200 may be equipped with an aligner. An aligner 101, 201 can be used to move only one tooth or multiple teeth in one dental arch.

[0027] The teeth 102, 202 have a vestibular surface 102a, 202a (the surface facing the cheek or lip), a lingual surface 102b, 202b, an occlusal or incisal surface (upper surface), a mesial surface (front-facing surface), and a distal surface (back-facing surface). According to one feature, the aligner 101, 201 is formed of a flexible strip contoured to completely cover only the lingual surfaces 102b, 202b of the teeth. All other surfaces of the teeth 102, 202, especially the occlusal or incisal surfaces, are left free, which allows the patient to eat while holding the aligner 101, 201 in their mouth.

[0028] According to one embodiment, the flexible strip completely covers and contacts the entire lingual surface 102b, 202b (except at the connectors 103, 203) so that food cannot get trapped between them. According to another embodiment, the flexible strip only completely covers and contacts a portion of the lingual surface 102b, 202b, for example the portion located between the connectors 103, 203 and the occlusal or incisal surface.

[0029] According to one preferred embodiment, the aligner 101, 201 is made in one piece. However, it can be made in multiple distinct sections, each section used to specifically address one or more tooth movements.

[0030] The aligners 101, 201 are advantageously made of a transparent or translucent polymer material and are therefore invisible when worn. The polymer material used can, for example, belong to the following groups: (meth)acrylate polymers, silicones, polyesters, polyurethanes, polycarbonates, polyethylene terephthalate glycol (PETG), polypropylene, ethylene vinyl acetate, or any other suitable polymer.

[0031] According to one embodiment, the aligners 101, 201 are obtained by molding, thermoforming, 3D printing, or any other method convenient to one skilled in the art.

[0032] In a manner known to those skilled in the art, determining the tooth movement with the aligners 101, 201 can begin with creating a model of the initial position of the teeth, for example using impressions or, preferably, an intraoral scan that allows obtaining a digital model of the dental arch. A treatment plan defining the sequence of tooth movement to the desired final position can be determined by the doctor and / or by dedicated software, such as the DeltaFace® software sold by Coruo. This sequence will determine the configuration of the aligners for each stage of the treatment plan. In each stage, the teeth move gradually in different planes of space, for example, by 0.1 mm to 0.2 mm. There can be 10 to 100 stages and therefore 10 to 100 different models of aligners. At the beginning of each treatment stage, when the aligners are placed on the teeth, they are adjusted to the intermediate (or final) alignment that the teeth must achieve at the end of that stage, so that each model of aligner applies one or more stresses to the teeth to be moved. The flexibility of the aligner allows it to elastically deform to the alignment the teeth had at the beginning of the treatment phase. The aligner exerts one or more stresses on the teeth by trying to return to its initial shape (shape memory). The teeth then gradually adjust to the shape of the aligner. When the teeth have fully adjusted to the shape of the aligner, i.e., when the teeth have moved to their planned position, the deformation of the aligner, and therefore the associated treatment forces, becomes smaller or even zero. The aligner is then replaced and the next treatment phase begins. In practice, the patient is provided with a set of aligners and uses them sequentially at each stage of treatment without the need for a doctor's appointment. At the end of treatment, the last aligner (or another aligner adjusted to the final alignment) can be used for retention purposes; the aligner is then passive, i.e., it does not constrain any teeth.

[0033] The flexibility of the aligner 101, 201 is determined primarily by its shape, its material, and its thickness. This flexibility corresponds to the aligner's ability to deform in an elastic and controlled manner to apply therapeutic stresses to one or more teeth to move the tooth or teeth.

[0034] According to one embodiment, the thickness of the aligner 101, 201 is between 0.1 mm and 2 mm, advantageously between 0.5 mm and 1 mm, and preferably between 0.6 mm and 0.8 mm. This thickness can be constant or, rather, varied so that the aligner 101, 201 has various portions or regions of distinct thicknesses with different elastic moduli. In this way, the strength of the stress to be applied to a particular tooth to be treated can be adapted. Similar results can be obtained by using an aligner formed of multiple portions or regions composed of materials with distinct elastic moduli. Each portion or region can thus generate stresses with its own specific strength.

[0035] The aligners 101, 201 are maintained in place by connectors 103, 203 configured to secure against the lingual surfaces 102b, 202b of the teeth 102, 202. The aligners 101, 201 releasably engage (manually and without tools) with the connectors 103, 203 as described earlier in this specification.

[0036] The connectors 103 can be secured to all or some of the teeth in the dental arch. In the example of Figure 5, in the maxillary dental arch 100, the connectors 103 are secured to the lingual surfaces of the central incisors, lateral incisors, and canines, and the aligner 101 is positioned only on these teeth. In the dental arch 200, the connectors 203 are secured to the lingual surfaces of the central incisors, lateral incisors, canines, first premolars, second premolars, and first molars, and the aligner 201 is positioned only on these teeth.

[0037] The connectors 103, 203 can be made of the same polymer material as the aligners 101, 201, or they can be made of a distinctly different material, for example metallic or ceramic. The connectors 103, 203 can be obtained by molding, machining, 3D printing, etc. They are rigid in the sense that they do not deform when constrained by the aligners.

[0038] All connectors 103, 203 are advantageously identical in size and shape, regardless of the tooth to which they are secured and the dental arch in which they are positioned, in order to simplify their design and their installation. However, different connector sizes and / or shapes can be provided depending on the tooth and / or dental arch and / or the type and / or strength of the stress to be applied.

[0039] According to one embodiment, the aligner 101, 201 includes a gripping mechanism that allows the patient to easily grasp the aligner to disengage it from the connector 103, 203. In FIG. 5, this gripping mechanism 2012 is in the form of a notch formed at one or more folded edges or at each (or only one) distal end of the aligner 201. This notch 2012 allows the patient to slip a fingernail or finger into it to disengage the aligner 201. The gripping mechanism 2012 may also be in other forms, such as a raised component. The gripping mechanism 2012 may be formed simultaneously with the aligner 101, 201 or added to the aligner.

[0040] 3a, 3b and 3c show a preferred embodiment of connector 103 that can be used universally on any tooth, any dental arch and whatever the type and / or strength of stress to be applied.

[0041] The connector 103 includes a seat 1030 having a fixing surface 1030b adapted to be fixed against the lingual surface 102b, 202b of the tooth. According to one embodiment, the seat 1030 has a rectangular or approximately rectangular shape, with a length of 2 mm to 6 mm, a width of 1 mm to 3 mm, and a thickness of 0.5 mm to 2 mm. However, the seat 1030 may have other shapes, such as a circular, oval, or polygonal shape. The fixing surface 1030b may be flat, but preferably has a curvature that matches the curvature of the lingual surface 102b, 202b. According to one embodiment, the seat 1030 is fixed to the tooth by bonding, for example, using a light-curing adhesive. The position of the connectors 103, 203 is maintained throughout the duration of treatment, eliminating the need to replace them at each stage.

[0042] The connector 103 also includes a connection head 1301 that is an extension of the base 1030. In Figures 3a, 3b, and 3c, the connection head 1301 is spaced from the base 1030 by a distance of, for example, 0.5 to 2 mm, so that the connector 103 has a flange 1032 that connects the head to the base. This flange 1032 can, among other things, receive a power chain or elastic, allowing the connector 103 to be stressed when the power chain or elastic is fastened to another connector, an anchor screw, or an orthodontic button. This technique can be used, for example, to retract an impacted tooth.

[0043] In Figures 3a, 3b and 3c, the connection head 1031 has an oval (or drop of water or egg) shape with a longitudinal axis of symmetry XX, i.e. the main axis. By way of example, this oval is contained in a parallelepiped enclosure with a length of 2 mm to 6 mm, a width of 1 mm to 6 mm and a height of 1 mm to 6 mm.

[0044] 3b, the longitudinal axis of symmetry XX and the normal YY to the fixing surface 1030b of the seat 1030 advantageously form an angle α of between 10° and 90°, advantageously between 45° and 90° and preferably between 55° and 65°. This angulation of the oval connecting head 1031 allows very precise control of the tooth movement, and more particularly of the tilt movement and torque.

[0045] The oval-shaped connecting head 1031 has an end 10310 that is sharper than the other opposite end 10311. For optimal precision in controlling tooth movements (especially tipping and torque), this "pointed" end 10310 is preferably oriented toward the root of the tooth when the connector 103 is secured to the tooth. However, good results may be obtained when the pointed end 10310 is oriented toward the occlusal or incisal surface of the tooth. For tooth movements such as rotation, the pointed end 10310 may be oriented toward the distal or mesial surface of the tooth.

[0046] After much experimentation, the inventors have determined that such a connector 103, in particular a connector having an oval connecting head 1031 angled relative to the seat 1030 and with a pointed end 10310 directed towards the root of the tooth, not only makes it possible to move the tooth along any selected trajectory, with very precise control of the tooth movement according to a cubic order, but also makes it possible to precisely adjust the intensity of the stress applied to the tooth. Such a connector 103 can be called universal insofar as only one shape and one orientation allows for precise control of six tooth movements (tipping or tipping, extrusion, impaction, rotation, torque, and tooth body movement).

[0047] Good results in terms of precision of tooth movement and adjustment of stress intensity are also obtained when the connecting head 1031 has a prolate ellipsoid shape whose major axis is the aforementioned longitudinal axis of symmetry XX. In this case, the two ends 10310 and 10311 are identical and symmetrical.

[0048] According to other embodiments, in particular in the applications described above in the description with reference to Figures 10, 11 and 12a-12b, the connection head 1031 can have an ovoid or prolate spheroidal shape or other shapes, in particular the shape of a sphere, cube, parallelepiped, polyhedron, prism, cone, pyramid, cylinder, etc. It can also consist of a combination of two or more of these various shapes.

[0049] In the embodiment variant of Figures 13a and 13b, the fixing surface 1030b consists of a flat surface that is directly aligned with the connection head 1031, which is then positioned as close as possible to the lingual surface of the tooth. This design provides more comfort to the patient, insofar as the external dimensions (especially the thickness and / or height) of the connector 103 are smaller compared to the external dimensions of Figures 3a, 3b and 3c. Furthermore, since the connection head 1031 protrudes less compared to the connection heads of Figures 3a, 3b and 3c, the nature and / or strength of the stresses applied to the tooth are not the same.

[0050] 1, 2a, and 2b, each aligner 101, 201 includes a recess 1013, 2013 into which the connector 103, 203, more specifically the head 1031, 2031, resiliently fits. To install the aligner 101, 201, simply place the recess 1013, 2013 in front of the head 1031, 2031 and manually (using your fingers) press the recess onto the head. The recess 1013, 2013 forms a hollow (not open) into which the head 1031, 2031 fits. The recess 1013, 2013 has a peripheral lip 10131, 20131 or another undercut shape that deforms upon insertion and removal of the connector 103, 203. After insertion of the connector 103, 203, the peripheral lip 10131, 20131 engages with the head 1031, 2031. It is noted here that the oval or ellipsoidal shape of the head 1031, 2031 ensures easy and painless removal of the aligner 101, 201 by hand without the risk of tearing off the connector 103, 203.

[0051] When the recesses 1013, 2013 are fitted to the connectors 103, 203 and the aligner 101, 201 is in place, the aligner will exert one or more stresses on the head 1031, 2031 and possibly on the lingual surfaces of the teeth.

[0052] 4a, 4b, and 4c show various stress areas of the connector 103, indicated by black dots. These stress areas correspond to points or surfaces of the head 1031 against which the aligner applies pressure and / or force. These pressures are caused by the elastic deformation of the aligner during the relevant treatment phase. In other words, the aligner presses against one or more localized areas of the head 1031. The exact location of the stress areas can be determined by the specific configuration of the recesses 1013, 2013 and / or by the creation of bosses made by adding material (e.g., resin) into the recesses or shaped by molding. As long as the recesses 1013, 2013 surround and clamp the head 1031, 2031 in three dimensions, three-dimensional control can be easily obtained and each area of ​​the head can be constrained.

[0053] The impaction movement is achieved by applying pressure along the long axis of the tooth in region I (FIG. 4a) at the end 10311 (close to the occlusal or incisal surface of the tooth). This pressure will generate an apical axial force that tends to sink the tooth into its socket.

[0054] Conversely, an extrusion movement is achieved by applying pressure along the long axis of the tooth in region E (FIG. 4a) at the end 10310 (closer to the root of the tooth), which will generate an axial force in the occlusal direction that tends to move the tooth out of its socket.

[0055] Tipping movements are achieved by applying pressure in areas V11 and / or V12 (FIG. 4a). This pressure will cause a mesial-distal rotation of the crown about the vestibulo-lingual axis of rotation. Pressure applied in areas V21 and / or V22 will cause a counter-rotation of the crown about the vestibulo-lingual axis in the distal-mesial direction.

[0056] Torque movement is achieved by applying pressure in areas T11 and / or T12 (FIG. 4b). This pressure will cause a vestibular-lingual rotation of the crown about the mesial-distal axis. Pressure applied in areas T21 and / or T22 will cause a counter rotation of the crown about the mesial-distal axis in the lingual-vestibular direction.

[0057] Rotational movement is achieved by applying pressure in regions R11 and / or R12 (FIG. 4c), which will cause a distal-to-mesial rotation of the tooth about its long axis, and pressure applied in regions R21 and / or R22 will cause a mesial-to-distal rotation of the tooth about its long axis.

[0058] A tooth-moving movement is obtained by applying pressure in region L (FIGS. 4b and 4c). This pressure will cause translation of the tooth crown in the lingual-vestibular direction. A similar tooth-moving movement is obtained by simultaneously applying pressure in regions R21 and R12 (either as a supplement to or instead of the pressure applied in region L). Simultaneous pressure applied in regions R11 and R22 will also cause an opposite translation of the tooth in the lingual-vestibular direction.

[0059] These various movements can be combined by simultaneously applying pressure in various areas of the head 1031. For example, a tooth movement movement can be combined with a rotation movement by simultaneously applying pressure in areas L, R11, and R12. Similarly, an extrusion movement can be combined with a tipping movement by simultaneously applying pressure in areas E and V11. Furthermore, all of these various tooth movements can be amplified and / or adjusted by the aligner applying stress directly to the lingual surfaces of the teeth, resulting in distinctly different stress areas on the connectors and the lingual surfaces of the teeth at the same time.

[0060] The oval or ellipsoid shape of the head 1031, combined with the specific orientation of the head, provides numerous stress areas (or pressure areas) that help precisely direct the treatment force applied by the aligner to induce the desired tooth movement or movements. The positioning of the stress areas selected by the practitioner further allows the strength of the treatment force applied by the aligner to be adjusted. The tooth movement according to third orders can thus be adjusted and controlled with high precision.

[0061] Such connectors allow the treatment forces generated by the aligners to be accurately transmitted to the teeth. The connectors are like a kind of adjustment lever or joystick, allowing the movement of the teeth to which the connectors are attached to be controlled. Another analogy is that the connecting head is an avatar of the tooth to which the connectors are attached, and the effects of the stress applied to the head are directly reflected on the teeth.

[0062] The connectors 103, 203 are secured to multiple teeth in one dental arch, but the aligner 101, 201 will not necessarily apply therapeutic stresses to all of these teeth. In fact, only some of these teeth need to be repositioned, while other teeth will serve as anchors to hold the aligner 101, 201 in place as the aligner applies stresses to the tooth or teeth to be repositioned.

[0063] The aligner 101, 201 must press on a surface to apply sufficient therapeutic stress to the connector 103, 203 and / or teeth to which it is mated (the law of action and reaction). The surfaces in contact with the aligner are the surfaces of the lingual surfaces 102b, 202b and the surfaces of the connection heads 1031, 2031. The connectors 103, 203 thus increase the total contact area. However, this total contact area is much smaller than that of a conventional aligner of the Invisalign® mouthpiece type, which completely covers the occlusal, incisal, and vestibular surfaces of the teeth in addition to the lingual surfaces 102b, 202b. Therefore, with a comparable modulus of elasticity, the aligner 101, 201 may apply less therapeutic stress to the connector 103, 203 and / or teeth than an Invisalign® mouthpiece. This may be problematic depending on the nature of the tooth movement to be performed, such as a corporal movement or a rotational movement.

[0064] One solution to solve this problem is to use aligners 101, 201 with an increased modulus of elasticity, for example by using a stiffer material and / or by increasing the thickness of said aligners. This solution, however, has the disadvantage of being particularly painful and uncomfortable for the patient, insofar as the localized stress intensity can become relatively high.

[0065] Therefore, a preferred solution is to shape the aligner 101, 201 so that it has an additional pressing area. This additional pressing area acts as a lever, which will increase the strength of the stress applied by the aligner 101, 201. In Figures 1, 2a, 2b and 5, the aligner 101 has a palatal extension 1010 configured to press against all or part of the patient's hard palate VP when in use. According to one embodiment, the palatal extension 1010 extends beyond the gingival area, for example, by 0.5 cm to 2 cm, to completely cover all or part of the palatal ridge (e.g., the width between the canines). By way of example, the area of ​​the palatal extension 1010 may be 1 cm or more. 2 ~3cm 2 Similarly, the aligner 201 has a gingival extension 2010 configured to press against the patient's gingival region ZG during use. According to one embodiment, the gingival extension 1010 completely covers the gingival region up to the mucogingival junction on an arch (e.g., intercanine arch) that is 1 cm to 4 cm in length. The area of ​​this gingival extension 2010 is, for example, 0.5 cm 2 ~2cm 2 is.

[0066] This solution has the advantage of keeping the aligners 101, 201 relatively thin and flexible, not causing excessive stress, and indeed being particularly comfortable for the patient.

[0067] According to one embodiment shown in Fig. 6, the palatal extension 1010 is connected to an anchor screw VA placed in the patient's palate. For this purpose, the palatal extension 1010 has a recess 10100 (Fig. 7) into which the head of the screw VA fits. The aligner 101 thus enjoys an additional anchor point, allowing for even greater stress intensity. A similar configuration can be considered for the gingival extension 2010.

[0068] The embodiment shown in Figures 8 and 9 allows for further amplification of the stress applied by the aligner 201 to the connecting head 2031 and / or the lingual surfaces 202b of the teeth to be moved. In this embodiment, the removable mouthpiece 3 is contoured to completely cover the patient's teeth. The mouthpiece 3 has a portion 30 that engages at least a portion of the aligner 201 and applies at least one force to the aligner 201 that tends to restrain the aligner toward the lingual surfaces 202b of the teeth 202 that must be completely covered and moved. The mouthpiece 3 is advantageously made of the same material as the aligner 201 and has the same or nearly the same thickness, making the mouthpiece flexible. The mouthpiece 3 can be placed on the mandibular dental arch to completely cover the aligner 201, or on the maxillary dental arch to completely cover the aligner 101. Because the mouthpieces 3 are shaped to fit the shape of the aligners 201, there are as many mouthpieces as there are aligners in a treatment sequence.

[0069] Similar to Invisalign®-type mouthpieces, mouthpiece 3 has receiving cavities 300 that fit teeth, e.g., all of the teeth in the dental arch where the mouthpiece is positioned. Mouthpiece 3 can thus fully cover the vestibular and occlusal / incisal surfaces of these teeth. For those teeth that do not cooperate with aligner 201, mouthpiece 3 also fully covers their lingual surfaces. For those teeth that do cooperate with aligner 201, portion 30 fully covers at least a portion of the aligner. In FIG. 8 , portion 30 fully covers aligner 201 up to connector 203. However, this portion may extend beyond that and down to the gums. Due to the flexibility of mouthpiece 3, portion 30 acts like a clip on aligner 201, which amplifies the stress on connection head 2031 and / or lingual surface 202b of the tooth to be moved.

[0070] In FIG. 14 , part 30 complements aligner 201 without completely covering it. Thus, the teeth with which aligner 201 cooperate—with the majority of their lingual surfaces (e.g., 80% to 95%) completely covered by the aligner—and the remaining portions of their lingual surfaces, their occlusal / incisal surfaces, and their vestibular surfaces completely covered by mouthpiece 3—can be covered by part 30, forming a lingual burr extending several millimeters (e.g., 1 mm to 5 mm) from the occlusal / incisal edge of the tooth. Mouthpiece 3 thus acts on the tooth (by applying vestibular stress to the tooth) but not on aligner 201. This design is particularly advantageous from a manufacturing standpoint. Indeed, it is possible to design aligner 201 and mouthpiece 3 as a monoblock, single piece (e.g., by thermoforming), and then simply cut the aligner (e.g., by laser cutting) to separate it from the mouthpiece. These two components are thus obtained very simply and at little expense.

[0071] It should be noted that this mouthpiece 3 is not essential, insofar as the lingual aligners 101, 201 provide very good results when used alone. The mouthpiece 3 is merely an accessory and is essentially used at night. It can also be used in a passive manner (without constraining the aligners and / or teeth) as a retention accessory at the end of treatment.

[0072] Orthodontic appliances such as rapid expansion devices and quad helices are commonly used to widen jaws that are too narrow. The force exerted by these appliances allows the palate to expand so that all teeth undergo precise, step-by-step changes. These appliances are generally restrictive insofar as their installation can be relatively complicated. Also, in the case of quad helices, initiation and adjustment are performed by the doctor at each visit. Only the doctor can change the appliance, which is particularly restrictive. A dental appliance according to one embodiment not covered by the present invention makes it possible to solve these problems.

[0073] 10 and 11, the connectors 103 are secured to the lingual surfaces of the molars and premolars to ensure optimal stability to the teeth. However, the connectors can be secured exclusively to molars or other teeth.

[0074] The aligner is now in the form of a palate plate 101, which completely covers the palate and releasably engages (manually and without tools) with connector 103 as previously described. The role of plate 101 (the maxillary expansion plate) is no longer to align the teeth, but to widen the palate. In effect, connector 103 and plate 101 work together to apply at least one stress to the teeth that tends to open the palate laterally.

[0075] Plate 101 is a flexible plate that is contoured to completely cover only the lingual surfaces 102b, 202b of the teeth, leaving the other surfaces of the teeth free, similar to the aligners previously described. It also completely covers the hard palate VP. Plate 101 includes recesses into which connectors 103 resiliently fit.

[0076] 9, the flexible plate 101 presses against the hard palate VP, acting like a spring or jack. The force (shown diagrammatically by arrows) exerted by the flexible plate 101 on the hard palate VP and on the connectors 103 and teeth 102 is directed in the lingual-vestibular direction, which allows the palate to open.

[0077] According to one embodiment, the flexible plate 101 presses against the lingual surfaces of multiple teeth in a quadrant or half arch. In some cases, such as the incisors and canines in FIG. 10, some teeth do not have connectors 103. As a result, the flexible plate 101 allows for palate opening in the sagittal direction as well as the transverse direction, i.e., a curved or fan-like opening. This is particularly advantageous when the appliance is worn by a growing child whose normal maxillary growth occurs in all directions, not just the transverse direction. If palate opening in the transverse direction only is desired, the flexible plate 101 can be configured to constrain only the molars.

[0078] Because the plates 101 are easily manually mated and disassembled with the connectors 103, patients can manage their own treatment independently. Apart from the attachment of the connectors 103, no medical intervention is required. The patient has a series of plates 101, each stage allowing the palate to open gradually, e.g., 0.1 mm to 0.2 mm. Each plate is progressively larger to widen the palate. There may be 10 to 100 stages, and therefore 10 to 100 different models of plates 101. At the beginning of each stage, when the plates are placed on the palate and mated with the connectors, the plates 101 are adjusted to the intermediate (or final) configuration that the maxillary dental arch should have at the end of that stage, so that each model of plate 101 applies stresses to the teeth that tend to widen the palate. The flexibility of the plates 101 allows them to elastically deform to the configuration the dental arch has at the beginning of the treatment stage. Plate 101 applies stress to the maxillary dental arch by returning to its original shape (shape memory). The maxillary dental arch and palate then gradually adjust to the shape of plate 101. Once the maxillary dental arch and palate have completely adjusted to the shape of plate 101, the plate is replaced and treatment moves to the next stage. Treatment can last from one to six months, with plate 101 being replaced once or twice a month.

[0079] In Figure 12a, connectors 203 are secured to the lingual surfaces of teeth 202 that flank a gap E that will be left open at the implant site. By way of example, if an implant is to be placed at the second premolar, connectors 203 are secured to the lingual surfaces of the first premolar and first molar. It is also possible that gap E will be left open by a missing tooth. Connectors 203 are similar to connector 103 described above.

[0080] 12b, the device according to the invention comprises a support strip 201 on which a dental prosthesis DP is fixed. As is conventional, this prosthesis DP is made of resin and / or ceramic. It is obtained by molding, machining or 3D printing.

[0081] The fixing of the prosthesis DP to the support strip 201 can be done by gluing, brazing, fitting or any other method convenient to a person skilled in the art. According to the embodiment of Fig. 12b, the lingual side of the prosthesis DP is glued to the support strip 201. According to one variant, the prosthesis DP and the support strip 201 are a single part consisting of one element obtained by molding, machining or 3D printing.

[0082] As with the previously described aligner, the support strip 201 fits into the connector 203. It takes the form of a flexible or rigid plate, contoured to completely cover only the lingual surfaces of the teeth, leaving the other surfaces of the teeth free. It includes recesses into which the connector 203 fits resiliently. The features of this support strip 201 are similar to those of the previously described aligner 101.

[0083] When the support strip 201 is engaged with the connector 203, the prosthesis DP fills the gap E. The role of the strip 201 is no longer to align the teeth, but to support the prosthesis DP. It also makes it possible to avoid tooth movement, which would maintain the gap E, for example, due to later implantation or the eruption of a child's permanent teeth. It also makes it possible to maintain the occlusion by keeping the opposing teeth in a vertical position while avoiding relapse. This solution is particularly aesthetic, as the support strip 201 remains hidden behind the teeth and the prosthesis DP. Furthermore, since the support strip 201 removably engages with the connector 203 (manually and without tools), the installation and removal of the prosthesis DP is very easy. The prosthesis DP can simply be temporary and, in particular, can be removed upon installation of the abutment and final prosthesis as soon as the healing period is over. The prosthesis DP can also be kept in place for a longer period of time and can serve as a substitute for a definitive prosthesis (at less cost) if, for example, the patient does not wish to proceed with surgery after the installation of the implant.

[0084] Insofar as the role of the strip 201 is no longer to align the teeth, it is advantageous for the strip to be passive when placed on the connector 203. "Passive" means that the strip 201 does not (or as little as possible) impose moving stresses on the teeth 202 that sandwich the gap E. To achieve this result, it has proven advantageous to use connectors 203 whose connecting heads are spherical in shape. The three-dimensional stresses exerted on the teeth 202 by such connectors are then zero, or at least greatly reduced.

[0085] In the above-described embodiments, the arrangement of the various components and / or means and / or steps of the present invention should not be understood as requiring such an arrangement in all implementations. Other variations may be provided. In particular, the support strip 201 may be associated with multiple adjacent or non-adjacent dental prostheses.

[0086] Moreover, one or more features disclosed in only one embodiment may be combined with one or more other features disclosed in only other embodiments. Similarly, one or more features disclosed in only one embodiment may be generalized to other embodiments, even if this or those features are described only in combination with other features. [Explanation of symbols]

[0087] 101 Support Strip 102 teeth 102b Lingual surface of tooth 103 Connector 1013 Depression 201 Support Strip 202 teeth 202b Lingual surface of tooth 203 Connector 2013 Depression

Claims

1. below, - a support strip (101, 201) integrated with the dental prosthesis (DP), a connector (103, 203) adapted to be fixed, in use, to the patient's teeth (102, 202) that sandwich the dental cavity (E) on either side, with which the support strips (101, 201) are releasably engaged, so that the dental prosthesis (DP) fills said cavity; - a support strip (101, 201) having a contour so as to completely cover only the lingual surfaces (102b, 202b) of said teeth, leaving the other surfaces of said teeth free; - a connector (103, 203) adapted to be fixed against the lingual surface (102b, 202b) of said tooth; a support strip (101, 201) comprising recesses (1013, 2013) into which the connectors (103, 203) fit elastically; A dental prosthesis (DP) support device comprising:

2. 2. The device according to claim 1, wherein the dental prosthesis (DP) is fixed to the support strip (101, 201) by gluing, brazing or fitting.

3. 2. The device according to claim 1, wherein the dental prosthesis (DP) has a lingual surface that adheres to the support strip (101, 201).

4. 2. The device according to claim 1, wherein the dental prosthesis (DP) and the support strip (101, 201) are a single part consisting of one molded, machined or 3D printed element.

5. 5. A device according to any one of claims 1 to 4, wherein each connector (103, 203) has a spherically shaped connection head (1301).

6. Each connector (103, 203) has the following: a seat (1030, 2030) having a fixing surface (1030b) adapted to be fixed against the lingual surface (102b, 202b) of the tooth; a connection head (1031, 2031) in the extension of the base (1030, 2030) and into which one of the recesses (1013, 2013) of the support strip (101, 201) fits; 10. The apparatus of claim 1, comprising:

7. 7. The device of claim 6, wherein a connection head (1301) is spaced from a base (1030), and a flange (1032) connects the head to the base.

8. Each connector (103, 203) has the following: a connection head (1031, 2031) into which one of the recesses of the support strip (101, 201) fits; a fixing surface (1030b) adapted to fix against the lingual surface of the tooth (102b, 202b); a fixing surface (1030b) consisting of a flat surface arranged on the connection head (1031, 2031); 5. The device according to claim 1, further comprising:

9. 7. The device according to claim 6, wherein the connection head (1031, 2031) has one of the following shapes: oval, prolate spheroid, sphere, cube, parallelepiped, polyhedron, prism, cone, pyramid, cylinder, or a combination of two or more of these various shapes.

10. 2. The device of claim 1, wherein the support strip (101, 201) is flexible.

11. 2. The device of claim 1, wherein the support strip (101, 201) is rigid.

12. 2. The device of claim 1, wherein the support strip (101, 201) has portions or regions with distinctly different moduli of elasticity.

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