Orthodontic aligner system for malocclusion correction

Abstract

Disclosed examples generally relate to an orthodontic aligner system for malocclusion correction. In some examples, there is provided an orthodontic aligner system for malocclusion correction comprising: a retainer assembly comprising an upper retainer and a lower retainer, wherein each of the upper and lower retainer comprises a teeth-receiving space defined between a buccal surface, a lingual surface and an occlusal surface, and the buccal surface and the lingual surface comprise one or more accessory-receiving protrusions; and one or more tooth accessories couplable to a buccal or lingual side of a subject's teeth and receivable in corresponding accessory-receiving protrusions when the retainers are engaged over the subject's teeth.

Description

ORTHODONTIC ALIGNER SYSTEM FOR MALOCCLUSION CORRECTION

[0001] The present application claims priority from, and the benefit of, United States Provisional Patent Application No. 63 / 515,988 titled “ORTHODONTIC ALIGNER SYSTEM”, filed on July 27, 2023, the entire contents of which are incorporated herein by reference.FIELD OF THE INVENTION

[0002] Disclosed examples generally relate to orthodontic aligners, and in particular, to an orthodontic aligner system for malocclusion correction.

[0003] In some examples, the disclosed orthodontic aligner system is also useful for correcting other types of dental defects including, by way of non-limiting example, tooth rotation, open and closing spaces between teeth, tooth extrusion, Curve of Spee (COS) defects and active eruption anticipation of teeth, e.g., in mixed dentition treatment.BACKGROUND OF THE INVENTION

[0004] Orthodontic issues such as crooked or crowded teeth, gapped teeth or malocclusion may be corrected using orthodontic braces, which apply mild constant pressure to shift teeth into a desired position over time.

[0005] Metal or ceramic (clear) braces use bands, brackets and wires to gently shift teeth over time. A bracket is bonded onto each tooth, then a thin and flexible arch wire is placedover the brackets. Tiny elastic bands, called ligatures, keep the wire firmly in place. The braces may be placed only on the lingual surfaces of teeth.

[0006] Clear aligners, sometimes called “invisible braces”, are an alternative to braces. Instead of brackets and wires, clear aligners use a series of removable custom-made trays which are iteratively worn over the subject’s teeth. These aligners force the teeth into a desired position over time.

[0007] All known aligner systems, however, do not include sufficient features to enable correction of multiple types of malocclusions. For example, the features included in conventional aligner systems do not effectively support many mechanical principles of dental movements (orthodontic biomechanics) and the laws of physics and Newton's laws. Orthodontic biomechanics are the base of all orthodontic movements. As a result, many cases using clear aligners fail to achieve the desired outcomes due to lack of force systems built into the aligner system itself.

[0008] More generally, conventional aligner systems also suffer drawbacks in major orthodontic areas, and demonstrate a lack of molar control, expansion force and arches coordination, rotational control and weak anchorage, deep bite correction, Curve of Spee (CoS) correction, molar correction, efficient accessories to achieve movements, etc. The lack of force systems to control dental movements leads to various problems, including posterior open bite. Posterior open bite is caused by the buccal flaring effect of aligners when trying to correct anterior crowding, as well as from the inherent tendency of aligners to flare out buccally when seating them on the teeth.

[0009] Another issue with conventional aligner systems is the lack of anchorage control. Anchorage is important in orthodontic mechanic and is the base of all orthodontic movements that rely on Newton's 3rdlaw which stipulates: “for every action force, there is a reactive force equal in strength and opposite in direction”. In dental treatment, the anchorage portion should be made stronger (or heavier) than the portion being moved. If this does not occur, undesirable treatment results may occur.

[0010] In view of the foregoing, there are many disadvantages to existing orthodontic aligner systems. There is therefore a need in the art for alternatives which mitigate at least some of the disadvantages known to those skilled in the art.SUMMARY OF THE INVENTION

[0011] In at least one broad aspect, there is provided an orthodontic aligner system for malocclusion correction comprising: a retainer assembly comprising an upper retainer and a lower retainer, wherein each of the upper and lower retainer comprises a teeth-receiving space defined between a buccal surface, a lingual surface and an occlusal surface, and the buccal surface and the lingual surface comprise one or more accessory -receiving protrusions; and one or more tooth accessories couplable to a buccal or lingual side of a subject’s teeth and receivable in corresponding accessory-receiving protrusions when the retainers are engaged over the subject’s teeth.

[0012] In some examples, each of the upper and lower retainers further comprises a buccal- side and lingual-side trimline.

[0013] In some examples, buccal-side and lingual-side trimline of each retainer extends between an anterior portion and posterior portions, and the trimline height is larger in the posterior portions than the anterior portions.

[0014] In some examples, the rigidity of the posterior portions is greater than the anterior portions.

[0015] In some examples, the occlusal surface of the upper retainer extends farther in an occlusion direction in a posterior portion as compared to an anterior portion, and further extends more in the occlusion direction in the anterior portion compared to the posterior portion in the lower retainer, such that the occlusal portions of each retainer laterally engage each other when the subject’s mouth is closed.

[0016] In some examples, the upper retainer further comprises a palatal coverage segment that extends from the buccal-side trimline and between a posterior and anterior end of one or more of the upper retainer.

[0017] In some examples, the palatal coverage is one of full and partial palatal coverage.

[0018] In some examples, one or more of the retainers comprise additional retainer housing to accommodate tooth movement and repositioning.

[0019] In some examples, the tooth accessories comprise pre-filled accessory templates.

[0020] In some examples, one or more bite ramps extend from the buccal surface of one or more of the retainers.

[0021] In some examples, the bite ramps are reverse bite ramps.

[0022] In another broad aspect, there is provided a retainer assembly used for malocclusion correction comprising: an upper retainer and a lower retainer, wherein each of the upper and lower retainer comprising a teeth-receiving area defined between a buccal surface, a lingual surface and an occlusal surface, and the buccal surface and the lingual surface comprise one or more accessory-receiving protrusions.

[0023] In some examples, each of the upper and lower retainers further comprises a buccal- side and lingual-side trimline.

[0024] In some examples, buccal-side and lingual-side trimline of each retainer extends between an anterior portion and posterior portions, and the trimline height is larger in the posterior portions than the anterior portions.

[0025] In some examples, the rigidity of the posterior portions is greater than the anterior portions.

[0026] In some examples, the occlusal surface of the upper retainer extends farther in an occlusion direction in a posterior portion as compared to an anterior portion, and furtherextends more in the occlusion direction in the anterior portion compared to the posterior portion in the lower retainer, such that the occlusal portions of each retainer laterally engage each other when the subject’s mouth is closed.

[0027] In some examples, the upper retainer further comprises a palatal coverage segment that extends from the buccal-side trimline and between a posterior and anterior end of one or more of the upper retainer.

[0028] In some examples, the palatal coverage is one of full and partial palatal coverage.

[0029] In some examples, one or more of the retainers comprise additional retainer housing to accommodate tooth movement and repositioning.

[0030] In some examples, one or more bite ramps extend from the buccal surface of one or more of the retainers.BRIEF DESCRIPTION OF THE DRAWINGS

[0031] In the drawings, like elements may be assigned like reference numerals. The drawings are not necessarily to scale, with the emphasis instead placed upon the principles of the present invention. Additionally, each of the embodiments depicted are but one of a number of possible arrangements utilizing the fundamental concepts of the present invention.

[0032] FIG. 1 illustrates an example orthodontic aligner system, in accordance with disclosed examples, mounted or fitted over a subject’s teeth.

[0033] FIG. 2 illustrates a perspective view of upper and lower aligner retainers which form part of the orthodontic aligner system.

[0034] FIGs. 3 A - 3B are side elevation views of the upper aligner retainer, showing both a buccal retainer surface (FIG. 3 A) and a lingual retainer surface (FIG. 3B).

[0035] FIGs. 3C - 3D are side elevation views of the lower aligner retainer, showing both a buccal retainer surface (FIG. 3C) and a lingual retainer surface (FIG. 3D).

[0036] FIGs. 4A - 4D show various perspective views of a lower aligner retainer and with varying trimline configurations.

[0037] FIG. 5 shows a sideview of upper and lower retainer aligners, and incorporating a twin block feature.

[0038] FIGs. 6A - 6B illustrate bottom-up views of an example retainer aligner which comprises a palatal coverage feature, including full palatal coverage (FIG. 6A) and partial palatal coverage (FIG. 6B) features.

[0039] FIG. 7 illustrates example teeth expansion using buccal and lingual side teeth accessories, which also form part of the orthodontic aligner system.

[0040] FIGs. 8A - 8C illustrate various configurations for a bite ramp feature (FIGs. 8A - 8B) and a reverse bite ramp feature (FIG. 8C).

[0041] FIGs. 9A - 9B provide a sideview of premolar and molar teeth, and showing buccal and lingual side accessories coupled thereto.

[0042] FIGs. 10A - 10E illustrate various configurations for accessories that can be coupled to teeth as part of the orthodontic aligner system, including accessories with beveled surfaces (FIGs. 10A - 10D), non-beveled surfaces (FIG. 10E) and rounded surfaces (FIGs. 10B andIOC). FIG. 10A shows a sideview of an accessory, while FIGs. 10B to 10E show front views of accessories. These figures also show a combination of buccal accessories (FIG. 10A andIOD) and lingual accessories (FIGs. 10B, 10C and 10E).

[0043] FIG. 11 illustrates side views of further configurations of buccal and lingual side accessories coupled to teeth, as well as in isolated views.

[0044] FIG. 12A illustrates a sideview of an omega-shaped elastic hook extending from an upper aligner retainer.

[0045] FIG. 12B illustrates a front view of different sizes of the omega-shaped elastic hook illustrated in FIG. 12 A.

[0046] FIG. 12C illustrates different sizes of a button-shaped elastic hook.

[0047] FIG. 12D illustrates elastic hooks and an elastic extended therebetween.

[0048] FIGs. 13 A - 13C illustrate an aligner retainer being used for rotational correction of rotated teeth (FIG. 13 A), and further illustrating an example buccal-side accessory used for rotational correction (FIG. 13B) including a sideview of the accessory (left side image) and a front view (right side image), and still further illustrating the accessory coupled to individual teeth (FIG. 13C).

[0049] FIG. 14A illustrates a use application for the orthodontic aligner system for space opening mechanics between teeth, and showing a front view (left side image) and occlusal view (right side image).

[0050] FIG. 14B illustrates a use application for the orthodontic aligner system for space closing mechanics between teeth, and showing a front view (left side image) and occlusal view (right side image).

[0051] FIG. 15A - 15D illustrate a use application for the orthodontic aligner system for tooth extrusion mechanics, including a visualization of various teeth extrusion movements (FIGs. 15A - 15C), and example accessories used for accommodating teeth extrusion movements (FIG. 15D).

[0052] FIGs. 16A - 16B illustrate a use application for the orthodontic aligner system for correcting Curve of Spee (COS) defects.

[0053] FIG. 17 illustrates a use application for the orthodontic aligner system for correcting teeth tilting.

[0054] FIG. 18 illustrates a use application for the orthodontic aligner system for active eruption anticipation of teeth, e.g., in mixed dentition treatment.DETAILED DESCRIPTION OF THE INVENTIONI. DEFINITION(S)

[0055] Any term or expression not expressly defined herein shall have its commonly accepted definition understood by a person skilled in the art.

[0056] Directional references such as "lingual", "buccal", "gingival" shall have their recognized meanings to those skilled in the art of orthodontics.II. GENERAL OVERVIEW

[0057] The present disclosure generally relates to an orthodontic aligner system used for malocclusion correction, as well as correcting other types of dental defects.

[0058] As best shown in FIG. 1, the orthodontic aligner system 100 generally includes: (i) an aligner retainer assembly 102, and (ii) one or more tooth accessories 104.

[0059] Retainer assembly 102 engages to and around, and otherwise covers over, the subject’s teeth. Retainer assembly 102 includes one or more of an upper retainer 102a and a lower retainer 102b. Upper retainer 102a engages over the subject’s upper or maxillary arch 106a. Lower retainer 102b engages over the subject’s lower or mandibular arch 106b.

[0060] Tooth accessories 104 couple, or attach, to the subject’s teeth 150. When the retainer assembly 102 is engaged over the subject’s teeth, the tooth accessories 104 are received into complementary shaped protrusions 214 (also referred to herein as “accessory-receiving protrusions”) that extend from the retainers 102a, 102b.

[0061] As described below, the retainer assembly 102 in combination with the tooth accessories 104 correct various types of dental defects. Similar to other orthodontic alignersystems known in the art, dental defects are treated by asking the subject to iteratively wear and substitute different custom molded retainers 102a, 102b and corresponding tooth accessory 104 sets. Each combination of molded retainers 102a, 102b and tooth accessories 104 are configured to apply different forces to the subject’s teeth, such as to gradually effect the necessary corrections.

[0062] To this end, an appreciated advantage of the orthodontic aligner system 100 - as compared to existing orthodontic alignment systems - is that it provides an enhanced mechanism for treating malocclusions. In at least one example, the aligner system 100 is able to provide enhanced effectiveness for treating antero-posterior correction of class II and class III malocclusions. Orthodontic aligner system 100 may also treat others types of malocclusions with efficiency, predictable result, all the while ameliorating the side effect of posterior open bite, thereby saving time and money for both the clinician and the manufacturer. Patients may experience better comfort, ease-of-use and faster outcomes using the orthodontic aligner system 100.

[0063] Aside from malocclusion correction, orthodontic aligner system 100 can also provide for improved molars torque control, expansion of dental arches and incorporating palatal coverage for added rigidity and control.

[0064] As orthodontic aligner system 100 provides more efficient treatment, dental defects can be corrected with faster treatments that necessitate using and disposing of fewer iterations of plastic retainers 102. In turn, the orthodontic aligner system 100 cuts down on plastic wastage and pollution, and reduces environmental harm and carbon footprint.

[0065] As elaborated herein, the design of the orthodontic aligner system 100 is based on principles of dental biomechanics where the force systems are balanced in proportions for each type of movement, all the while respecting Newton’s third law - “for every action or force, there is an equal and opposite reaction”.

[0066] At a general level, the operating function of the orthodontic aligner system 100 is analogized to rowing a canoe: each aligner retainer 102a, 102b represents a shell (canoe), andthe point of force application is the tooth 150 with or without tooth accessories 104 (i.e., a person rowing the canoe). In this analogy, the tooth accessories 104 represent the paddles. The net movement of the tooth 150 represents the displacement of the canoe, and the anchorage is similar to the resistance of the water exerting against the paddles.

[0067] This specification below describes various features of the orthodontic aligner system 100. Different aspects or embodiments of the invention may comprise at least one such feature, and will preferably comprise at least some of these features in different combinations. All such combinations are within the scope of the described invention even if not explicitly described in combination. In a preferred embodiment, the invention may comprise all of the features described below.III. ORTHODONTIC ALIGNER RETAINER ASSEMBLY

[0068] FIG. 2 illustrates the orthodontic aligner retainer assembly 102 in isolated view, and showing the upper retainer 102a and the lower retainer 102b.

[0069] As exemplified, each retainer 102a, 102b generally extends between an anterior side 202a and a posterior side 202b. When the retainers 102a, 102b engage over the subject’s teeth, the anterior side 202a engages over the subject’s anterior teeth, while the posterior side 202b engages over the subject’s posterior teeth, i.e., as these terms are known in the art.

[0070] Each retainer 102a, 102b also includes a buccal / facial side or surface 204a (referred to herein as the “buccal side” or “buccal surface”) and an opposed lingual side or surface 204b.

[0071] When the retainers 102 engage over the subject’s teeth (i) the buccal side 204a covers over (or engages) the buccal and facial side of the teeth 150, and (ii) the lingual side 204b covers over (or engages) the lingual side of teeth 150.

[0072] In at least one example, the thickness of the retainers 102a, 102b - between the respective buccal and lingual sides 204a, 204b - is approximately 0.15-0.30 mm.

[0073] Retainers 102a, 102b also include a lateral side 204c extending laterally between the buccal side 204a and lingual side 204b. Lateral side 204c covers (engages) over the occlusal or incisor surfaces of the teeth 150. Lateral surface 204c is also referred to herein as the “occlusal” side or surface 204c.

[0074] As further exemplified, each of buccal and lingual sides 204a, 204b of the retainers 102a, 102b includes a respective trimline 206a, 206b. For example, the buccal side 204a of each retainer 102 includes a buccal-side trimline 206a, and the lingual side 204b includes a lingual-side trimline 206b.

[0075] Trimlines 206 define an edge of the retainers 102a, 102b and opposite the occlusal side 204c. In use, these trimlines 206 cover over the subject’s gums and above the gingival zenith. In this manner, each of the buccal and lingual sides 204a, 204b is said to extend between (i) the occlusal side 204c of the retainer 102, and (ii) the corresponding trimline 206. Each trimline 206 extends by a trimline height 210 defined above the gingival zenith line 212 of the subject’s teeth (FIGs. 3 A - 3D).

[0076] A teeth-receiving space 250 is further defined between, and bounded by, the surfaces 204a - 204c. When the user places the retainers 102a, 102b on their respective upper and lower teeth, the subject’s teeth slide into fitting engagement within the teeth-receiving space 250 (FIG. 1). In this position, the retainers 102a, 102b engage over and surround the subject’s teeth.

[0077] As further illustrated, the retainers 102a, 102b are custom modelled to the outer three-dimensional (3D) profile shape of the upper and lower teeth. More particularly, the retainers 102a, 102b each include a plurality of tooth-retaining portions 208. Each toothretaining portion 208 is defined between a respective buccal surface 204a, lingual surface 204b and occlusal surface 204c. Surfaces 204a - 204c surrounding each tooth-retaining portion 208 are custom molded to the outer 3D shape of a given tooth that is received inside that area.

[0078] As further exemplified, each of the buccal-side 204a and lingual-side 204b of the retainers 102a, 102b include one or more protrusions 214 extending outwardly from the buccalor lingual retainer sides 204a, 204b. Each protrusion 214 includes an opening in fluid communication with the teeth-receiving space 250.

[0079] In use, protrusions 214 receive (e.g., in fitting engagement) a tooth accessory 104 coupled to a tooth 150 (FIG. 1). Protrusions 214 are generally shaped and sized to complement the outer 3D shape and size profile of a given tooth accessory 104 that is received in that protrusion 214. This, in turn, allows for the tight fit engagement between the accessory 104 and the protrusion 214 when the retainer assembly 102 is placed over the subject’s teeth. Protrusions 214 are also positionally disposed on the buccal or lingual retainer sides 204a, 204b to align with the positioning of the accessories 104 on the subject’s teeth.

[0080] The purpose of the protrusions 214 is to (i) secure the retainers 102a, 102b to the subject’s teeth, and more importantly (ii) to allow the retainers 102a, 102b to apply different axial forces to the subject’s teeth - via the accessories 104 - in order to effect desired tooth movement.

[0081] As noted, protrusions 214 can include both buccal-side protrusions 214a that extend from the buccal retainer side 204a, and engage with buccal-side tooth accessories. Further, protrusions 214 also include lingual-side protrusions 214b that extend from the lingual retainer side 204b, and engage with lingual-side tooth accessories.

[0082] The protrusions are also referred to herein interchangeably as “accessory-receiving protrusions” 214.

[0083] A number of unique features of the retainer assembly 102 are now described herein. These features allow for the retainer 102 to provide for more effective treatment for malocclusions, as well as other dental defects.

[0084] It will be understood that retainer assembly 102 can include any one of the below described features, or any combination or sub-combination of these features, without limitation. The use of a greater number of these features, in combination, contribute to enhancing the aligner system’s efficacy in treating malocclusions.

[0085] (i.) Differential Trimline Feature.

[0086] In at least one example, the aligner retainer assembly 102 includes a differential trimline feature. As provided below, the differential trimline feature allows for better securing the retainer assembly 102 to the subject’s teeth when correcting malocclusions, which can cause displacement of the retainer assembly 102 and ineffective treatment.

[0087] The differential trimline feature can be provided by itself, or with any combination or sub-combination of other features described in relation to the retainer assembly 102.

[0088] FIGs. 3 A - 3B exemplify a differential trimline 206 for the upper retainer 102a, while FIGs. 3C - 3D exemplify a differential trimline 206 for the lower retainer 102b.

[0089] As exemplified in these figures, the trimline height 210 varies between the anterior end 202a and the posterior end 202b of each retainer 102a, 102b. To this effect, one or both of the upper and lower retainers 102a, 102b can include the differential trimline feature.

[0090] In more detail, as shown for the upper retainer 102a (FIGs. 3 A - 3B) - the buccal surface 204a (FIG. 3A) and the lingual surface 204b (FIG. 3B) may each or both have a differential trimline 206. The configuration of the differential trimline 206 may be the same or different as between the buccal surface 204a (FIG. 3 A) and the lingual surface 204b (FIG. 3B).

[0091] In this example, for the buccal surface 204a of the upper retainer 102a (FIG. 3 A) - the trimline height 210 varies between an anterior region 310a and a posterior region 310b. In this example, the anterior region 310a is the region extending anterior of each of the left and right canine teeth 302a (inclusive thereof). The posterior regions 310b is then defined as the two regions posterior of each of the left and right canine teeth 302a. In this case, the differential trimline is expressed by the posterior region 310b having a larger trimline height 210 than the anterior region 310a. In at least one example, the anterior region 310a has a trimline height 210 of 2 mm, while the posterior regions 310b has a trimline height 210 of 5 mm.

[0092] With respect to the lingual surface 204b of the upper retainer 102a (FIG. 3B) - the trimline height 210 also differentially varies between an anterior region 312a and a posteriorregion 310b. In this example, the anterior and posterior regions 312a, 312b are defined with respect to the right and left second premolar teeth 304a. Again, the posterior region 312b has a larger trimline height than the anterior region 312a. In at least one example, the anterior region 312a has a trimline height 210 of 2 mm, while the posterior regions 312b has a trimline height 210 of 5-10 mm.

[0093] FIGs. 3C - 3D exemplify a similar configuration for the lower retainer 102b, also comprising a differential trimline feature.

[0094] In respect of the buccal surface 204a of the lower retainer 102b (FIG. 3C) - the trimline height 210 may again vary between a posterior region 314a that is forward of the right / left canine teeth 302b. For example, the posterior region 314b may have a greater trimline height 210 than the anterior region 314a. In at least one example, the anterior region 314a has a trimline height 210 of 1-2 mm, and posterior regions 314b has a trimline height 210 of 3-5 mm.

[0095] In respect of the lingual surface 204a of the lower retainer 102b (FIG. 3D) - the trimline height 210 varies between the anterior region 316a and the posterior region 316b. The anterior and posterior regions 316a, 316b may be defined with respect to the right and left second premolar teeth 304b. The posterior region 316b has a larger trimline height than the anterior region 316a. In at least one example, the anterior region 316a has a trimline height 210 of 1-2 mm, and posterior regions 316b has a trimline height 210 of 5-7 mm.

[0096] Accordingly, in some examples, for each trimline 206, the posterior region 310b - 316b may have a greater trimline height than the corresponding anterior region 310a - 316a. Further, the trimline may vary for the buccal-side 204a for each retainer 102a, 102b around the canine teeth 302a, 302b. The trimline may vary for the lingual-side 204b for each retainer 102a, 102b around the second premolar teeth 304a, 304b. In other examples, the trimline may vary with respect to any other tooth.

[0097] FIGs. 4A - 4D show further configurations of the trimline 206, using different shapes of posterior trimlines.

[0098] The use of higher posterior trimlines 310b - 316b offers a number of advantages for malocclusion correction. For example, this includes increasing anchorage of the retainers 102a, 102b to the subject’s teeth during malocclusion correction. This is particularly important as the retainers 102a, 102b may become positionally displaced during intensive malocclusion correction.

[0099] In at least one example, the variation in the heights of the trimline is limited by the soft tissues’ structures. On the buccal side, the trimline can be finished at the junction between the attached gingiva and the mobile gingiva (cheeks), therefore tend to be shorter than the lingual side. On the lingual side, the trimline can be extended longer because the lingual walls of the molars are deeper on the mandible. Similarly on the maxilla, the roof of the mouth is made of attached gingiva (i.e., does not move), therefore the trimline can extend much longer and some cases, can cover the entire roof. Accordingly, the extended trimline and various degrees of roof coverage provide much more control during orthodontic movement using aligners (e.g., during malocclusion correction).

[0100] The differential trimline feature is also useful because human dentition typically presents with tall front teeth (incisors and canines) and very short back / posterior teeth (molars). Short crowns areas typically require tall coverage - via a higher posterior trimlines - to increase the grip and traction and provide anchorage control while the front teeth are being corrected (e.g., for malocclusions). Accordingly, to balance the force and to achieve control of movements, the retainer assembly 102 may be trimmed shorter in the anterior region 310a - 316a with shorter timelines, and taller in the posterior region 310b - 316b to compensate for the height difference between the front and the back teeth.

[0101] Beyond malocclusion correction, the differential trimline feature provides for other more general advantages. For examples, the use of the lower anterior timelines 310a - 316a provides for added comfort and reducing unwanted side effects during orthodontic movements because most of the orthodontic crowding are found in the anterior segment between the canines. This area of low anterior trimlines 310a - 316a also prevents gum irritation as thelatter can cause potential gingival recession. Another reason for low anterior trimline is to avoid irritation of the labial frenum.

[0102] The higher posterior trimlines 310b - 316b also provides advantages for certain types of dental correction. This includes providing increased anchorage for the retainer assembly 102 during the correction of anterior teeth crowding, teeth rotation as well as for retraction of the front teeth. In particular, the higher posterior timelines 310b - 316b add torque control during teeth rotation, thus reducing unwanted side effects. For example, the higher posterior trimline 310b - 316b help increase the efficiency in the correction of molar rotation and up righting mechanics. Additionally, the higher posterior timelines 310b - 316b prevent posterior open bite, which is a significant issue in existing aligner systems. Controlling open bite can increase treatment efficiency, saving time and money for the manufacturer and providers, and reduce plastic wastage incurred through using more plastic retainers to correct dental defects.

[0103] More generally, the timelines having an impact on biomechanics, and controlling of force and the comfort of the patient. The difference between the trimlines helps provide a balance of forces between the front and back teeth to assure that the desired movements are achieved (low anterior trimline regions 310a - 316a) while the unwanted side effects of that movements are brought down to a minimum or suppressed (by the high posterior trimline regions 310b - 316b on both sides of the arch). This is an example where Newton’s third law is respected, e.g., allowing the action of the force to express while suppressing the reaction of that force.

[0104] (ii.) Dual-Rigidity / Dual-Density Feature.

[0105] In at least one example, the retainers 102a, 102b are manufactured of material having dual densities. The use of dual densities, as provided herein, provides for forcedifferentials during the correction class II and class III malocclusions. Use of a dual density feature can also provide for more effective treatment of teeth crowding.

[0106] The dual density or dual rigidity feature can be provided by itself, or with any combination or sub-combination of other features described in relation to the retainer assembly 102.

[0107] In particular, with reference to FIGs. 3 A - 3D, the upper and lower retainers 102a, 102b may have differing densities between the anterior regions 310a - 316a and the posterior regions 310b - 316b.

[0108] For example, with respect to the upper retainer 102a (FIGs. 3A - 3B) - the anterior regions 310a, 312a in each of the buccal and lingual retainer sides 204a, 204b can comprise material having a first density. Further, the posterior regions 310b, 312b in each of buccal and lingual surfaces 204a, 204b can comprise material having a second density, different than the first density. In some examples, the second density is greater than the first density, such that the posterior regions 312b, 312b are more rigid than the anterior regions 310a, 310a.

[0109] Similarly, with respect to the lower retainer 102b (FIGs. 3C - 3D) - the anterior regions 314a, 316a in each of the buccal and lingual retainer sides 204a, 204b can comprise material having a first density. Further, the posterior regions 314b, 316b in each of buccal and lingual surfaces 204a, 204b can comprise material having a second density, different than the first density. In some examples, second density is greater than the first density, such that the posterior regions 314b, 316b are more rigid than the anterior regions 314a, 316a.

[0110] In at least one example, dual density plastic sheets are used in the posterior regions to achieve the desired rigidity, and therefore provide enhanced control during malocclusion correction. This can be achieved by positioning in such a way that the anterior portion is molded with a softer portion of a plastic sheet used to form the retainer aligner. Another option is to double the thickness of the plastic sheets to the posterior molars areas during molding process to achieve the added rigidity. In some examples, the thickness is 0.3mm to 0.5mm for the thinner anterior region, and 0.5mm to 0.75mm thick in the posterior regions.

[0111] More generally, the use of material having different densities has a number of appreciated advantages in the context of enhanced malocclusion correction. For instance, the difference in the stiffness provides stronger support for elastics grooves when needed. In other words, when orthodontic and dental elastics are used as known in the art, the more rigid posterior area supports the use of elastics that extend between the upper and lower retainers 102a, 102b. The stiffer posterior regions also provides better resistance to wear and tear from the occlusal forces exerted by the posterior teeth. This added resistance helps patients with clenching and bruxism habits. In the treatment of several malocclusions where very strong posterior anchorage is required, the stiffness in that area helps reduce the unwanted side effects.

[0112] Furthermore, beyond malocclusion correction - the more rigid posterior regions adds efficiency to arch expansion and arch correction and enhances molar torque control. The softer anterior regions further provide comfort to patients, minimizes irritations and pain, and prevents the risk of root resorption and bone loss. The softer anterior regions also demand less anchorage to achieve the same outcomes compared to existing aligner systems. This is particularly beneficial with adult patients present with existing periodontal issues. The lesser rigid anterior portion also reduce the unwanted side effect during orthodontic correction. Patients with short clinical crowns can also benefit from the stiffness of the posterior segments because the aligners provide a stronger grip on those short teeth, reducing the requirement of multiple accessories.

[0113] Accordingly, the stiffness or rigidity prevents damages from daily use, while the softness enhances comfort and prevents pain and root damages to the anterior teeth. This combination of dual stiffness, in combination with the differential timeline feature, are believed to have a high probability of solving biomechanical issues that other aligner systems cannot.

[0114] (Hi.) Twin Block Feature.

[0115] FIG. 5 exemplifies a twin block feature for the retainer align 102. In some examples, the twin block feature can also assist in malocclusion correction.

[0116] The twin block feature can be provided by itself, or with any combination or subcombination of other features described in relation to the retainer assembly 102.

[0117] As exemplified, the upper and lower retainers 102a, 102b may each include a “raised block platform” 550 that extends, occlusally (i.e., in an occlusal direction), from the occlusal boundary 510 of the teeth to the occlusal surface 204c of each retainer 102. In other words, the raised black platform 550 is defined by the occlusal surface 204c being more distally positioned from the teeth.

[0118] In the exemplified case, the upper retainer 102a includes an upper block platform 550a in a posterior region 504b. The upper block platform portion 550a is configured such that the occlusal distance 512a is larger in the posterior regions 504b behind the canines 506a, as compared to an anterior region 504a, e.g., extending anteriorly between the left and right upper canines 506a. In this manner, the raised block platform 550a extends to cover the molar teeth.

[0119] With respect to the lower retainer 102b - it may also include a lower raised block platform portion 550b. However, the raised block platform 550b in this case extends in the anterior region 504b, between the left and right bottom canines 506b. The lower raised block platform 550b can have a larger occlusal distance 512a as compared to the posterior retainer regions 504b, e.g., rearward of each of the left and right bottom canines 506b.

[0120] In view of the foregoing, the block platforms 550a, 550b are inverted with respect to each other, as between the upper and lower retainers 102a, 102b. In other examples, the block platforms 550a, 550b can be inverted in reverse such that upper block platform 550a extends in the anterior region 504a, while the lower block platform 550b extends in the posterior regions 550a, e.g., to correct Class 3 malocclusions.

[0121] As further exemplified, in each of the upper and lower retainers 102a, 102b - a portion of the occlusal surface 204c defines a transition segment 514. Transition segment 514 transitions between the anterior and posterior regions 504a, 504b. In some examples, transition segments 514a, 514b can slope along a transition interface 502 between the posterior and anterior regions 504a, 504b. In use, the lingual / buccal retainer surfaces abut or engage each other along the left and right transition segments 514 when the mouth is closed, such that block platforms 550a, 550b engage each other side-to-side.

[0122] At least one appreciated advantage of the twin block feature (i.e., one block 550a on the upper arch and the other block 500b on the lower arch) is to efficiently correct class II malocclusions. In particular, the lower jaw is postured forward with two independent blocks 550a, 550b that interlock with each other when the mouth is closed, and the upper and lower arches come together in occlusion. The lower jaw is guided forward constantly to help promote mandibular advancement and promote remodeling of the Temporomandibular Joint (TMJ) processes on growing patients. In adults, the twin block feature helps to correct class II dental malocclusion while reducing the need of additional elastic wear.

[0123] In at least one example, the twin block feature is used in combination with the reverse bite ramp - disclosed further on herein - and elastics (e.g., class II elastics) to further increase the speed of treatment and achieve a more predictable treatment outcome. The twin block feature can be used during mixed dentition stage or phase 1 treatment as a functional appliance to help promote the mandible to move forward. This can greatly contribute to the desirable growth of the mandible thus avoiding the needs of major intervention or surgery. All non-growing patients that require class II dental correction can benefit from the disclosed twin block feature.

[0124] The disclosed twin block feature may also be useful to treat patients with Obstructive Sleep Apnea (OSA) and airway deficiency. In these cases, the lower jaw is being postured forward during sleep allowing more room in the back of the throat for an improved air circulation. Accordingly, the twin block feature can potentially reduce the snoring issues on many patients.

[0125] (iv.) Palatal Coverage.

[0126] FIGs. 6A - 6B exemplify a further palatal coverage feature for the retainer assembly 102. In some examples, the palatal coverage feature can provide enhanced malocclusion correction.

[0127] The palatal coverage features can be provided by itself, or with any combination or sub-combination of other features described in relation to the retainer assembly 102.

[0128] As exemplified in these figures, the upper retainer 102a can include a segment - the “palatal coverage” segment 602 - that extends and couples (e.g., integrally couples) to the buccal side 204b of the upper retainer 102a.

[0129] As shown, the palatal segment 602 can extend between the anterior side 202a and posterior side 202b of the upper retainer 102a by a palatal depth distance 604, and further terminating at a palatal outer edge 606.

[0130] While not explicitly illustrated, the palatal coverage segment 602 can extend from, and couple (e.g., be integrally molded) to the trimline 206b on the buccal retainer surface 204b. It can further arch such as to complement the shape and profile of the subject’s upper mouth palate.

[0131] The palatal coverage segment 602 plays an important part in the biomechanics of dental movements. Existing aligner systems are made in a horseshoe design covering only the teeth. These systems have great difficulty to correct any types of malocclusions because of posterior control. They tend to pop out of the posterior teeth due to weak coverage and short trimline. Their lack of palatal coverage and the lack of extension in the molar areas have led to numerous issues with the control of movements, loss of posterior anchorage and more seriously, posterior open bites and treatment failures.

[0132] In view of the foregoing, and in many cases, clinicians need to repeat the same mechanics several times trying to gain control and move forward with treatment. Often, the unused aligners are discarded at each revision due to the tracking issues. This has led tofrustration, wastages, and treatment delays. Certainly, this inefficiency costs money for the clinicians and the manufacturers alike. More and more patients showed a distrust in the aligner therapy because of the numerous issues mentioned above.

[0133] In disclosed examples, various types of palatal coverage segments 602 can be used, including: full palatal coverage (FIG. 6A) and partial palatal coverage (FIG. 6B).

[0134] The difference between the full and partial coverage relates to the palatal extension distance 604. In the partial coverage (FIG. 6B), the palatal extension distance 604b is less than that in the full coverage (FIG. 6A). In some examples, in the full coverage (FIG. 6A), the palatal coverage segment 602 extends such that the palatal outer edge 606 is aligned, or proximally aligned, with the subject’s posterior-most tooth (e.g., the third molar).

[0135] In some examples, upper retainer aligners 102a with full palatal coverage (FIG. 6 A) provide superior control in tooth movement when the posterior teeth are used as anchors while the front teeth are being corrected. It is also used in arch expansion and for torque control without the need of additional metal or acrylic devices.

[0136] In at least one example, palatal coverage 602 and the extended (high) trimline (FIGs. 3 A - 3D) on the buccal side of the posterior teeth also, in combination, prevent aligners from popping out and maintaining a constant seal and tracking to those teeth. This can be beneficial in malocclusion correction, which can result in the aligner popping out as the teeth arches are being moved and displaced. Additionally, the added coverage helps prevent buccal flaring of the molars, avoiding open bite from happening.

[0137] Full palatal coverage (FIG. 6A) can also be efficient in cross bite correction, arches coordination, dental arch expansion in teens and adults and palatal expansion during the mixed dentition stage (pre-teens). With full palatal coverage, the aligner wear time can be reduced to 16-18 hours per day, without losing efficiency, to help with hygiene and allowing the tissues to “breathe”. This offers significant benefits to the patients and parents. Practically speaking,patients can leave the aligners out longer while enjoying meals, playing a mouth instrument, singing, or delivering a lecture.

[0138] In contrast, retainers aligners 102 with partial palatal coverage (FIG. 6B) provide similar functions as the full coverage type, but with lesser emphasis on the expansion of the dental arch. Partial palatal coverage is beneficial for patients with gag reflex and for those who cannot cope with a full coverage of the roof of the mouth. A longer wear time is recommended to maintain high level of treatment efficiency (at least 18-20 hours per day is recommended). The palatal coverage and the extended (high) trimline (FIGs. 3 A - 3D) on the buccal side of the posterior teeth, in combination, also prevent aligners from popping out and maintain a constant seal and tracking to those teeth The partial coverage comes in different variations depending on the requirement of each malocclusion to be corrected.

[0139] Beyond malocclusion correction, the added palatal coverage also offers various other advantages, including the following:

[0140] (i) Tooth Expansion: Use of palatal coverage assists in biomechanical expansion of teeth, as exemplified in FIG. 7. For instance, as shown, teeth 150 may be expanded from a first separation distance 702 to a second separation distance 704.

[0141] The palatal coverage adds strength and support to the aligners during arch expansion to achieve a faster and more predictable outcome while preventing the side effects of buccal tipping leading to potential posterior open bite. The palatal coverage provides better torque control during expansion movements. Since the point of application of the force is situated away from the center of resistance of each tooth, a minor tipping of the crowns might happen. To prevent the buccal tipping motion of the crowns, a moment of force is added to the root of each tooth in the same direction as the movement of that tooth. This moment of force adds a buccal root torque and the final resultant vector of force produces a translation of the toothduring expansion of the arch. Additionally, lingual accessories (as described below) can be added to increase anchorage, help prevent unwanted side effects and achieve faster result.

[0142] (ii) Arch Correction: Palatal coverage 602 may also provide arch correction. This is similar to expansion but with lesser forces required. Arch correction helps improve the required spaces to relieve mild to moderate crowding. The coordination of the upper and lower arches can be accomplished with arch correction process. Additionally, lingual accessories (as described below) can be added to increase anchorage, help prevent unwanted side effects and achieve faster result.

[0143] (iii) Torque Control: Still further, palatal coverage 602 may provide torque control, as shown in FIG. 7. The torque control is based on the biomechanical principle of tooth movement where the torque control is a key concept in achieving faster results while reducing side effects, thus saving time and money for clinicians and manufacturers and helps the environment (less wastage than other aligner systems). Torque control is as important for the front incisors as it is for the molars. The force and the counterforce should be balanced throughout the treatment to avoid unwanted side effects causing loss of efficiency and treatment delay. The torque control also acts as anchorage when needed.

[0144] The partial palatal coverage (FIG. 6A) provides a more flexible anchorage options and can be adjusted to different depths. The complete palatal coverage provides rigidity to the aligners, enhances expansion movement and torque control. In some cases, it is the best choice for treatment of constricted dental arches. The palatal coverage also helps prevent posterior open bite and add anchorage control.

[0145] (v.) Bite Ramps.

[0146] FIGs. 8 A - 8C exemplify a bite ramp feature for the retainer assembly 102. In some examples, the bite ramp feature can provide enhanced malocclusion correction.

[0147] The bite ramp features can be provided by itself, or with any combination or subcombination of other features described in relation to the retainer assembly 102.

[0148] As exemplified, the lingual retainer side 204b of one or both of the upper and lower retainers 102a, 102b, can include an extending bite ramp portion 802.

[0149] Various types of bite ramps 802 can be provided. In some examples, a horizontal bite ramp 802a may be provided, having a flat or planar surface edge 806 directed in an occlusal direction towards the opposing teeth (FIGs. 8A - 8B).

[0150] In at least one example, the horizontal bite ramps 802a (FIGs. 8A - 8B) may be built into each aligner behind the lingual surfaces 204b of the upper incisors (FIG. 8A) for class II cases and on the lingual surfaces 204b of the lower incisors (FIG. 8B) for class III cases. The horizontal bite ramps can be used in the correction of deep bites and cross bites.

[0151] In some examples, the horizontal table 806 of the horizontal bite ramp 802a (FIGs. 8B and 8C) is at least 5 mm long (along a horizontal axis) to compensate for the horizontal distance between the tips of the lower incisors to the lingual surfaces of the upper incisors. This distance is important when there is a significant overjet to correct. The bigger the overjet, the longer the table of the bite ramp should be.

[0152] In other examples, reverse bite ramps 802b may be provided. The reverse bite ramps 802b may have a hook shape 804 (FIG. 8C), e.g., a U-hook shape. The hook shape 804 may be directed in an occlusal direction towards the opposing teeth. In other examples, the bite ramp 802 may have a flat or planar surface edge 806 (FIGs. 8B - 8C).

[0153] The reverse bite ramp 802b may be built into each upper aligner 102a with a downward and backward slope 808 at approximately 45 degrees angle. The base of the ramp806 may start at mid-crown from the lingual retainer surface 204b and angled posteriorly and occlusally until the lower incisors 150b are engaged.

[0154] To be efficient, the lower incisors’ tips may be positioned and locked anteriorly to the tip of the reverse bite ramps. This mechanism may help positioning the mandible forward, thus helping the correction of severe class II malocclusions in age-appropriate patients. Additionally, the angled slope of the reverse bite ramp 802b helps correct the deep bite cases.

[0155] Reverse bite ramps 802b are important as they are used for the correction of class II malocclusions with retrognathic mandible and deep bite cases. The reverse bite ramps help to reposition the mandible forward with the lower incisors resting in front of the ramp. Growing patients with retrognathic mandible can potentially avoid jaw surgery while using the reverse bite ramps to help advancing the mandible during the growth period of the lower jaw. Patients with class II malocclusion can benefit from this feature to correct the overjet and the discrepancy between the upper and lower teeth. In growing patients, this will help achieve the desired outcomes faster with improved comfort. They will not require any additional appliances (bulky metal or acrylic devices) that would affect the comfort and hygiene. Unlike traditional devices to advance the mandible, the clinician saves time and money as there is no adjustment needed at each visit. In some cases, the reverse bite ramps are customized to each patient’s case from the start of treatment.

[0156] In some examples, reverse bite ramps 802b can be used in combination with the twin block feature (FIG. 5) to correct class II malocclusion and mandibular retrusion in growing patients. This combination may increase the speed and efficiency of treatment which is not available in any other aligner systems.

[0157] (vi.) Additional Retainer Internal Housing Area.

[0158] In at least one example, internal space or housing area 1350 is built into each aligner 102a, 102b in the area(s) where the teeth are anticipated to be moved into next, thus allowing a more predictable outcome and faster result. This is discussed in more detail herein, with reference to FIGs. 13 and 15 - 18.

[0159] In some examples the “housing” reduces the blockage or friction of dental movements, therefore maximizes treatment efficiency. Accessories 104 can be placed on the tooth with the beveled surface facing away from the “housing” space to allow the aligner plastic to push the tooth into the “housing” area. This may provide faster movement with great predictability.

[0160] (vii.) Manufacture Process and Material for Orthodontic Aligner Retainer.

[0161] In some examples, the aligner retainer 102 is manufactured using existing conventional methods, such as plastic molding or additive manufacturing (e.g., 3-D printing).

[0162] In at least one example, the aligner retainer 102 is formed of plastic and / or polyurethane material. In some examples, it is formed of Zendura FLX™.

[0163] The use of polyurethane material (e.g., Zundura FLX™) has a number of appreciated advantages. For example, this includes: (i) clearness - this is beneficial for esthetic reasons and easy to care for; (ii) flexibility - retainer is flexible such that it adapts well to the anatomy of teeth and areas of crowding. It is also easy to insert and remove the aligners; (iii) resilience - material lasts longer while keeping the forces constant on a long range of time; (iv) wear resistance - material is resistant to day-to-day wear, resists the effects of the chemicals and salivary enzymes in oral cavity, remains stable or inert with body temperature fluctuations, and does not rip or crack easily. More generally, this material resists the harsh environment of the oral cavity where multiple chemical and biological enzymes are found at the same time. The ideal plastic needs to survive in the mouth for several weeks before showing signs of fatigue.; (v) stain resistance - stain resistant and easier to perform day-to-day maintenance; an (vi) deformation resistance - resistant to deformations as the shape is maintained for a long period of time.

[0164] (viii.) Combination of Features.

[0165] It will be understood that the above features (i) - (vii) can be combined in any manner. In at least one example, the combination of all, or any one or more, of the features (i) - (viii) provides enhanced malocclusion correction.

[0166] For instance, during malocclusion correction - enhanced anchorage (e.g., posterior anchorage) of the retainer aligners 102 to the subject’s teeth is enabled by a combination or sub combination of the differential trimline, dual rigidity and palatal coverage features. As more of these features are included in the retainer, the retainer exhibits increased levels of anchorage and control and for enhanced malocclusion correction, e.g., to avoid displacement of the retainer aligner. Additionally, guiding the motion of the subject’s arches is enhanced by any combination or sub combination of using the twin block feature and bite ramp feature. Further, as discussed below, the use of buccal and lingual accessories further enhances malocclusion correction.

[0167] As such, the unique combination of features in the aligner retainer 102 provides advantages necessary for malocclusion correction, including posterior anchorage and control, as well as guiding movement of the subject’s mandibular / maxillary arches. It is believed that the a single retainer which is adapted with these combination of features (e.g., the retainer is designed to concurrently accommodate these features in a single retainer design, without conflict in design) is a unique aspect.IV. ORTHODONTIC ALIGNER ACCESSORIES

[0168] The orthodontic aligner system 100 may also include a plurality of tooth accessories 104 (FIG. 1) that are coupled (e.g., attached) to the subject’s teeth.

[0169] Various features of the tooth accessories 104 are now described herein. Each of the disclosed features can be used alone or in any combination, or sub-combination, of any other feature of the orthodontic aligner system 100 disclosed herein.

[0170] (i.) Twin Accessories Feature.

[0171] In at least one example, the disclosed aligner system 100 uses one or more lingual- side and buccal-side tooth accessories 104.

[0172] FIGs. 9A - 9B exemplify buccal and lingual side tooth accessories 104. As shown, one or more of the teeth 150 (e.g., molar and premolar) can include one or both of a buccal- side accessory 104a and a lingual-side 104b accessory, which couple respectively to the tooth’ s buccal and lingual sides. The use of both buccal and lingual accessories is also referred to herein as the “twin accessories” feature.

[0173] As explained previously, in use, the buccal and lingual side accessories fit into corresponding and complementary shaped accessory -receiving protrusions 214a, 214b on the buccal and lingual sides of the retainers 102a, 102b.

[0174] The use of both buccal and lingual accessories provides a number of appreciated advantages, as disclosed herein. For example, the twin accessories enhances the efficiency of tooth movement, thus saving time and money for patients, clinicians, and manufacturers.

[0175] In some examples, the use two accessories on the same tooth (i.e., one on the buccal side and the other on the lingual side) can generate a moment of force to provide a rotational correction. This twin accessories concept achieves faster and predictable results in the numerous orthodontic movements of rotation, arch expansion, torque control, anchorage control, sequential distalization and mesialization of posterior teeth, molar up rightingmechanics, levelling the Curve of Spee (CoS), space opening, space closing and elastic traction.

[0176] More generally, the use of lingual-side accessories 104b can improve the esthetic of the area, add or control anchorage, torque or tip, prevent posterior open bite, help correct rotation, help with levelling the curve of Spee (CoS), help with molars up righting, help with intrusion or extrusion.

[0177] FIGs. 10A - 10E exemplify various configurations for the buccal or lingual side accessories. As provided below, each of the exemplified configurations may have unique advantageous in different contexts and applications.

[0178] As shown, each of the of the accessories 104 includes a tooth-coupling surface 1002, which engages the respective tooth 150, e.g., either at the tooth’s buccal or lingual face, or otherwise the tooth’s enamel. The size, the height (thickness), the shape, the amount and the location of the buccal and lingual accessories have a direct impact on the amount of force delivered by the aligner and the direction of the forces it exerts. For example:

[0179] (i) Height: The height (thickness) 1004 of the accessories provides additional grip and prevent aligners from sliding off the teeth, therefore, enhancing the control of movements.

[0180] (ii) Shape: The shape of the accessories provide comfort, guide the force in the desired direction when aligners are engaged. For example, the accessories can have a square or rectangular cross-sectional shape (FIGs. 10D - 10E). In some examples, the square or rectangular shape can have a beveled surface 1360. In a number of cases, the beloved surface 1360 is opposite to the tooth-coupling surface 1002. The surface may be beveled in the direction of force, such that the retainer aligner 102 applies a force to the tooth by engaging on the beveled surface 1360. In at least one example, the distal surfaces 1370 are rounded (FIGs. 10B and 10C). This configuration can be used for lingual-side accessories 104b, such that the portion that meets the tongue is rounded to prevent irritation (FIG. 11).

[0181] (iii) Size: The size of the accessories provides an important role in the movement of the tooth. In general, large teeth require larger accessories than smaller teeth. There should be a balance between esthetics and comfort. For instance, if square it may have 2 mm x 2 mm with beveled surface parallel to the direction of force. Rectangular shapes may have a 2 mm x 3 mm dimension, with beveled surface parallel to the direction of force. Round shapes may have a 2-3 mm diameter. The thickness can be any desired thickness e.g., 1-1.5 mm wide, 2-3 mm long, 0.75-1.5 mm thick.

[0182] (iv) Location: The location of the accessories on each tooth may be configured to enhance the biomechanics of movements while respecting the law of physics.

[0183] For example, for buccal-side accessories 104a, a mid-crown location is desired to harness the maximum potential of forces (i.e., the area of maximum convexity of each tooth) when the retainer aligners 102 are seated and fitted over the tooth and accessory 104. This allows the buccal-side accessory 104a to be used to push and / or move the tooth, as required.

[0184] For lingual-side accessories 104b, the accessory 104b can be positioned in any suitable location on the lingual-side of the teeth. In some examples, a more occlusal position is desired for posterior teeth to avoid potential gum irritation. Further, a more gingival position is desired for anterior teeth to avoid occlusal interferences. The location may be selected for esthetic areas and for added torque control and anchorage enhancement.

[0185] (v) Orientation: A horizontal position can be used for expansion, torque control, extrusion, intrusion. A vertical position can be used for rotation, opening and closing spaces, sequential movement (distalization and mesialization) of molars and premolars, root tip control. An oblique position can be used for combined rotational and extrusive movements

[0186] (ii.) Pre-Filled Accessory Templates.

[0187] Accessories represent an important component in aligner orthodontics. Presently, existing solutions require that in each treatment, clinician place a dental composite into atemplate / mold to create the accessories before bonding them onto the teeth. This is the first step in the aligner therapy and precision is required.

[0188] However, using existing techniques, templates are often filled with a vast degree of inconsistency; the quantity and quality of the accessories depends on the skill of the operator. If the template is overfilled, the accessories are too large on the teeth, thereby leading to aligners that are not seated properly onto the teeth, and resulting in loss of treatment efficiency. If the template is underfilled, the accessories are too small leading to loss of aligner tracking and resulting in teeth not moving as planned. Additionally, the saliva and dental plaque tend to pool in the gap left by the undersized accessories.

[0189] In view of the foregoing, disclosed examples provide for pre-filled accessory templates. The accessory templates assist in eliminating the chance of errors induced by the operator.

[0190] In some examples, the accessories have the shape, size, position, and location as per the clinician’ s prescription. Being pre-filled means that the templates can provide the clinicians the precision and consistency in the quality of accessories needed. Each template may have accessories in place with the exact precision required for each treatment plan. The templates may be bonded to the teeth via an adhesive, e.g., an enamel primer.

[0191] This process has a number of advantages, including saving time and money while assuring better treatment outcome. Further, the initial bonding step of the accessory to the tooth is quicker and more precise. For the manufacturer, pre-filled templates help increase the overall quality assurance of the product they produce.

[0192] In at least one example, the accessories templates are thin for easy removal during bonding, rigid to maintain shape, non-stick for easy release and efficient transfer of accessories to the teeth.V. ELASTIC HOOKS AND AUXILIARY CUTOUTS

[0193] FIGs. 12A - 12D illustrate exemplary hooks and auxiliary cutouts which can be used as elastic hooks. These types of elastic hooks can be used in conjunction with dental or orthodontic elastics to assist in correcting various types of dental defects.

[0194] FIGs. 12A and 12B exemplify omega-shaped grooves or hooks 1202 that extend or protrude from either the lingual retainer surface 204a or the buccal retainer surface 204b, of a retainer aligner 102. This omega-shaped groove 1202 can be used alone, or in any combination or sub-combination with any other feature of the aligner retainer 102 described previously.

[0195] As used herein, the “omega" shape refers to the rounded shape with a lower cross- sectional diameter than is smaller than the largest diameter around a middle portion of the hook.

[0196] The omega-shaped groove 1202 design has the advantage of facilitating easier and more secure hooking of orthodontic or dental elastics (FIG. 12D). This is because the omegashape flap prevents elastics from slipping off. This design is also more comfortable and less prone to tissue irritation because of the rounded top of the Omega.

[0197] The use an omega-shaped groove 1202 is contrasted with various existing solutions, which rely on either a single groove or double grooves on the edge of the aligners 102 to create hooks for elastics. These grooves or slits, however, cause constant lips and cheeks irritation from their sharp edges and comers. Sometimes, the chronic irritation causes damages to the soft tissues leading to an emergency. The patient is then asked to stop the elastic wear for several weeks and the treatment progress is halted. Additionally, elastics are not securely engaged onto the single slit and often slip off from the aligner.

[0198] In view of the foregoing, the omega-shaped hook 1202 is believed to minimize potential tissue irritation because the round head of the omega has no sharp edge. As well, the corners 1204 located on either side of the omega are beveled and smoothed out to furtherimprove patient’s comfort while wearing elastics. The elastics are securely engaged around the head of the Omega and do not come off easily.

[0199] As exemplified in FIG. 12C, in the case where elastic button 1204 is required on a molar, the button is bonded on the mesial portion of the tooth while the accessory 104 is positioned on the distal portion of the tooth to help counter the mesial tipping of the molar during elastic traction. In some examples, a lingual accessory is also added to prevent lingual tilting of the molar. This design provides a balance of forces that exert around the center of resistance of the tooth, thus increase speed and efficiency and minimal side effects.

[0200] In some examples, cutouts for elastic buttons or hooks have rounded edges for added comfort and minimize tissue irritation, where a half circle shape for low trimline areas or a deep silo-shape for high trimline areas may be provided.

[0201] As shown in FIGs. 12B - 12C, the hook 1202 can be of varying sizes, irrespective the type of hook used. This allows for accommodating different tensions or sizes of elastics being used.

[0202] In at least one example, the Omega-shape slits can be used for the correction of mild to moderate malocclusions. They can be used to control the torque and to move a group of teeth using light forces. The button cutout can be used to correct difficult movements where stronger elastic forces can be applied directly to the intended tooth or teeth.VI. EXAMPLE APPLICATIONS OF ORTHODONTICS ALIGNER SYSTEM

[0203] In addition to malocclusion correction, the disclosed orthodontic aligner system 100 has a number of further advantages for other forms of dental correction.

[0204] (i.) Rotational Correction.

[0205] In at least one example application, the orthodontic aligner system 100 can be used for rotational correction of teeth.

[0206] A drawback of conventional aligner systems is that tooth rotation is primarily effected by the force application of the retainer aligner 102, i.e., rather than the effect of using tooth accessories 104 in combination with the retainer aligner 102. When an accessory is used, often it is small in size and shallow in thickness and does not otherwise provide sufficient leverage to rotate the tooth. The lack of control prolongs the correction of movement and leads to tracking issues which requires multiple revisions of the retainer aligner 102 to complete the correction.

[0207] As disclosed previously, the disclosed retainer aligner 102 includes accessoryreceiving protrusions 214 (FIG. 2). This includes accessory-receiving protrusions 214a on the lingual retainer surface 204a, and accessory-receiving protrusions 214b on the buccal retainer surface 204b. These protrusions 214a, 214b receive corresponding accessories 104a, 104b coupled to the buccal and lingual sides of the teeth (FIGs. 9A - 9B).

[0208] An advantage of using the twin accessories on the buccal and lingual teeth, is that this can mitigate the issue of correct tooth rotation. This is because the retainer 102 - when engaging the accessories 104a, 104b via the retainer protrusions 214a, 214b - can apply force on the tooth from both the front and back. This is exemplified in FIG. 13 A, whereby the twin accessories 104a, 104b provide more controlled rotational force application on the molar or pre-molar teeth 150.

[0209] In some instances, as exemplified in FIGs. 9A - 9B, the two accessories 104a, 104b may be positioned 180 degrees apart (e.g., on opposite sides of the tooth) to increase theleverage of forces to de-rotate a tooth. More generally, the use of twin accessories on each tooth creates a pure moment of substantially equal in value, but opposite in direction (but in the same rotational direction). The tooth de-rotates on its long axis without side effect.

[0210] In at least one example, to enable rotation - rectangular accessories (FIG. 13B) are placed vertically and parallel to the long axis of the tooth with the beveled surfaces 1360 oriented in the same direction of the movement. The left image in FIG. 13B provides a side profile view of the beveled surface 1360. FIG. 13C shows an example of the beveled rectangular accessory on a tooth 150. As shown, the use of a beveled surface 1360 allows the retainer aligner 102 to apply a rotational force in the direction of slanting of the beveled surface.

[0211] As discussed previously, the retainer aligner 102 can also include additional open housing space 1350a, 1350b (FIG. 13 A). The additional housing space 1350 can be situated immediately in front of each accessory 104, and provides space for the tooth to move or rotate into the new rotated position when subjected to the moment of forces by the twin accessories 104a, 104b. For example, on each of the buccal retainer surface 204a and the lingual retainer surface 204b surrounding a tooth 150 - the retainer 102 may not abut the tooth directly, but may be laterally spaced away from the tooth to create the additional housing space 1350a, 1350b. This is additional housing space 1350a, 1350b provides room for the tooth to rotate into.

[0212] The twin “housings” zones 1350a, 1350b (e.g., buccally and lingually) thereby effectively create a path of low resistance for the tooth to move into, reducing the friction to a minimum, thus speeding the correction and with practically minimal side effects. Friction is a physical factor that plays a significant role in orthodontic mechanics. The friction slows down dental movements and sometimes prevents them from happening. Tooth movement follows the laws of physics where an object always moves using the path of least resistance. Themoment of forces works around the center of rotation and the center of resistance of the tooth giving a net resultant vector of pure rotation.

[0213] In some examples, the retainer aligner 102 wraps around the adjacent teeth - i.e., teeth adjacent to the rotating tooth - tightly while the rotated tooth is being corrected. The adjacent teeth do not always necessarily require accessories. However, accessories can be included on the adjacent teeth to function as anchors during the rotation process. In some cases, the adjacent teeth require accessories if the adjacent teeth are smaller than the tooth to be rotated. This addresses the biomechanical principles of tooth movement (the anchor unit should be stronger than the moving unit).

[0214] In view of the foregoing, using the disclosed design, the retainer aligners 102 with twin accessory attachments 104a, 104b can be used to rotate and de-rotate any tooth (e.g., big or small, single-rooted, or multi-rooted) without difficulty. The fast correction and added efficiency are beneficial to patients, clinicians, and manufacturers because the correction only requires a small number of iterations of retainer aligners 102 to achieve the desired outcomes. Lesser aligners 102 results in more freedom for the patients and clinicians, less plastic wastage, and more net revenue for the manufacturer which would be passed on to the clinicians and patients.

[0215] (ii.) Space Opening Mechanics.

[0216] As exemplified in FIG. 14A, the disclosed orthodontic aligner system 100 may also be used to effect space opening mechanics.

[0217] With conventional aligners, opening spaces depends largely on the pressure of the aligners on the mesial and distal walls of the teeth. Some systems incorporate a small accessory to assist in effecting the opening, but otherwise fail to provide efficient movement.

[0218] In most cases, using conventional accessories, the crowns of the teeth move apart, giving the impression that space has been opened - however, the tooth roots still remain very close to each other. This movement is extremely unstable because the center of resistance ofeach tooth has not been moved. Therefore, as the space between teeth becomes more enlarged, the resistance is increasingly strongly, thereby leading to loss of aligner tracking which in turn, results in relapse of space opening. This process is very slow and frustrating for both the patient and the clinician. This inefficiency costs time and money for all parties involved, including the manufacturer.

[0219] The disclosed retainer aligner system 100 allows for a progressive approach to space opening procedures. As exemplified in FIG. 14A, tooth buccal-side accessories 104a are placed on teeth 1404a, 1404b positioned on either side of the space 1402 to be opened. These tooth accessories engage (or fit into) corresponding accessory-receiving protrusions 214 on the retainer aligner 102. By opening the space 1402, an additional tooth 1404c can be moved into, or inserted into the widened space.

[0220] In some examples, rectangular accessories 104 (e.g., FIG. 13B) are positioned vertically and parallel to the tooth long axis of each tooth situated on either side of the space. The beveled surfaces 1360 of the accessories are oriented face to face allowing the aligner to push the teeth apart with the same force but opposite in direction, causing the teeth 1404a, 1404b to move away from each other, thus opening the space between them.

[0221] Since the point of application of the force is situated away from the center of resistance of each tooth, some uncontrolled tipping of the crowns may occur. To prevent the tipping motion of the crowns, a moment of force may be added to the root of each tooth in the same direction as the movement of that tooth. The direction of the root tip faces away from each other. The root tip moment is built into each retainer aligner 102 to help move the center of resistance in the desired direction. The final resultant vector of force produces a translation of the tooth during space opening. Additionally, lingual accessories 104b can be coupled to each tooth to increase traction and anchorage, and to help prevent unwanted side effects and achieve faster result. This space opening mechanics is thought to be extremely predictable, and the chance of relapse is very low.

[0222] To this end, the space opening mechanics applies a concept of translation or bodily movement of the tooth. If the teeth translation does not occur during application of spaceopening mechanics, the results may be unstable, and relapse is imminent. To avoid this from happening, the orthodontic aligner system 100 applies the right forces and counter forces to achieve the desired movements with the least chance of relapse possible. As well, in the case of implant replacement, it is more crucial to ensure that not only the space are ideal, but the roots of the adjacent teeth are spread apart to allow placement of the implant in the bone. This roots movement is possible with disclosed orthodontic aligner system 100 that incorporates the twin accessories in combination with built-in root tip in each aligner. The result is more predictable and are achieved in a shorter time.

[0223] (Hi.) Space Closing Mechanics.

[0224] As exemplified in FIG. 14B, the disclosed orthodontic aligner system 100 may be used to effect space closing mechanics. Contrasted to space opening mechanics (FIG. 14 A), using the space closing mechanics, oppositely directed forces are applied between teeth 1404a, 1404b to close a space.

[0225] Using conventional aligner systems, closing spaces between teeth depends largely on the pressure of the aligners on the mesial and distal walls of the teeth. Some systems incorporate a small accessory to assist in effecting the closing movement, but otherwise fail to provide an efficient movement. In many cases, the crowns of the teeth tip towards each other, giving the impression that the space has been closed but yet the roots remain very far from each other. This movement is extremely unstable because the center of resistance of each tooth has not been moved. Therefore, as the space between teeth is becoming smaller, the resistance is increasingly strong, leading to loss of aligner tracking which in turn, results in relapse of the movement. This process is slow and frustrating for both the patient and the clinician.

[0226] Analogous to the space opening mechanics (FIG. 14 A), in the space closing mechanics - buccal-side accessories 104a can be oriented parallel to the long axis of the teeth on either side of the space to be closed. The buccal accessories are received in accessoryreceiving protrusions 214a on the buccal retainer side 204a.

[0227] The accessories 104 can also comprise rectangular accessories with beveled surfaces 1360 (FIG. 13B). The beveled surfaces 1360 may face towards each other to exert the push force to separate the teeth.

[0228] In some examples, 5 to 10 degrees of the tooth’s root tip are added in the same direction of each tooth to prevent tipping and assure translation of the teeth.

[0229] Lingual-side accessories 104b may be added on each tooth 1404a, 1404b - surrounding the area to be closed - to provide better tracking of the teeth and help control tipping.

[0230] Since the point of application of the force is situated away from the center of resistance of each tooth, some uncontrolled tipping of the crowns may occur. To prevent the tipping motion of the crowns, a moment of force can be added to the root of each tooth in the same direction as the movement of that tooth. The direction of the root tip is facing towards each other. The root tip moment can be built into each aligner to help move the center of resistance in the desired direction. The final resultant vector of force produces a translation of the tooth during space closure. Accordingly, it is preferred to make sure that not only the space should be closed, but the roots of the adjacent teeth should be parallel and closer to each other for long term stability.

[0231] It is believed that the space opening mechanics provided by the orthodontic aligner system 100 is predictable, and the chance of relapse is very low. It is important to understand the force systems of each movement and the reactive forces that are trying to cancel these forces. This is a concept of translation or bodily movement of the tooth. If the translation does not occur during a space closing mechanics, the result may be unstable, and relapse becomes imminent.

[0232] (iv.) Extrusion.

[0233] FIGs. 15A - 15D exemplifies a further use application for the orthodontic aligner system 100, and for extrusion movement.

[0234] As shown, the tooth accessories 104 may be placed on the tooth 1502 to be extruded. For example, these may be buccal-side accessories 104a. In this example, the tooth accessory can be a rectangular accessory with a beveled surface 1360 (FIG. 13B). The beveled surface 1360 can be oriented gingivally allowing the plastic - on the retainer aligner 102 - to push the tooth occlusally, while the adjacent teeth have tooth accessories 104 with the beveled surfaces 1360 oriented occlusally, creating anchorage.

[0235] In some examples, a lingual-side accessory 104b is added to the extruded tooth 1502 to improve grip, increase anchorage strength and ensure a more vertical movement during extrusion. The use of a lingual accessory can also prevent lingual tipping of the extruded tooth 1502. The buccal and lingual-side accessories 104a, 104b are received (e.g., fitted) into corresponding accessory-receiving protrusions 214a, 214b on the retainer aligner 102, when the retainer aligner 102 engages over the subject’s teeth. The use of lingual accessories respects Newton’s third law because the unwanted reactive force must be controlled to achieve a net desired force. This feature is very useful when the clinician needs to bring a tooth into occlusion via extrusion.

[0236] As exemplified previously with respect to FIG. 13A, the retainer aligners 102 can be molded to include additional “housing” space 1350c (FIG. 15 A) around the extruded tooth 1502. The additional housing space 1350c can be molded such that it is positioned in occlusal relationship to the extruded tooth 1502 (e.g., below the tooth).

[0237] The use of the additional housing space 1350c can provide room for the extruded tooth 1502 to move into once the retainer aligner 102 is engaged to the subject’s teeth. This facilitates movement of the extruded tooth 1502 as there is no blockage in the zone immediately occlusal to the tooth. Conventional aligner systems do not typically included theadditional “housing” 1350c required to receive the extruded tooth 1502, nor the use of any accessories 104 required to maintain anchorage of the adjacent teeth 1504.

[0238] In at least one example, an elastic cutout can also be added to the retainer aligner and a button bonded to the tooth to be extruded (FIGs. 12A - 12C). The elastics can be used from the button to the opposite arch, exerting a traction on the tooth to extrude it. The combination of “housing” and elastic button give a much more efficient extrusive movement to the tooth and the result will be achieved much easier and faster.

[0239] In some cases, buccal-side tooth accessories 104a can also be coupled to the teeth 1504 adjacent the extruded tooth 1502. The accessories 104a used on the adjacent teeth 1504 may also have the beveled surfaces 1360 (FIG. 13B), but oriented opposite to the extruded tooth 1502. The adjacent teeth and their accessories can be used as anchors during extrusion.

[0240] Accordingly, it is believed that the disclosed design for the orthodontic aligner system 100 can mitigate patients impacted canines requiring extrusion into the arch. This is especially important because canine traction or extrusion represents one of the most difficult and time-consuming procedures in orthodontics. The incidence and prevalence of canine impaction (or any tooth impaction) are high amongst orthodontic patients.

[0241] (v.) Levelling Deep Curve of Spee.

[0242] FIGs. 16A - 16B exemplifies a use application for the orthodontic aligner system 100, and for corrective Curve of Spee (COS) defects.

[0243] The COS plays a very important role in the treatment of various malocclusions, particularly in class II deep bite patients. The COS is often misdiagnosed by the clinicians, which affects the treatment plan and the outcomes. Conventional aligner systems do not have specific features for the correction of the COS. As a result, the correction is unpredictable, time-consuming and the outcome is mediocre. In traditional orthodontic mechanics, clinicians can bend the arch wires or create a reverse curve to the arch wires to correct the COS. The clinicians keep repeating this process each time until the COS is corrected to the desired level.In contrast, in aligner orthodontics, it is not conventionally possible to follow the same procedure because aligners are prefabricated, and cannot bend at the dental chairside. Accordingly, clinicians need to plan when using orthodontic aligners to correct deep COS. Most malocclusions present with different severity in the COS. Patients with deep bite often present with severe COS. A light to flat COS is often necessary to obtain good occlusion.

[0244] The disclosed orthodontic aligner system 100 is believed to solve the problem of correcting COS using orthodontic aligners, and by incorporating a unique collection of accessories and “housing” features aimed at correcting the COS with ease and efficiency.

[0245] As exemplified in FIG. 16B, the rectangular buccal-side accessories 104a with a beveled surface 1360 (FIG. 13B) can be used. The accessories 104a are fitted into corresponding accessory -receiving protrusions 214 on the retainer aligner 102, when the retainer aligner 102 is fit over the subject’s teeth. The beveled surfaces 1360 can be oriented gingivally (FIG. 15D) to allow the retainer aligner 102 to push the teeth occlusally, thereby gradually levelling the deep Curve of Spee (COS) as illustrated. The accessories 104a may be placed on all the teeth involved in the correction of the COS.

[0246] In some examples, lingual-side accessories 104b can also be coupled to the teeth. The lingual-side accessory 104b can add tip and rotational control during the movement.

[0247] In at least one example, the retainer aligners 102 also further incorporate an additional housing feature 1350d (e.g., similar to the housing feature exemplified in FIGs. 13 A and 15). The housing feature 1350d can comprise additional space in the retainer 102 that is situated above the crown of the teeth. The additional “housing” area 1350d is spread on several teeth. The tooth situated at the lowest part of the COS is aligned with the deepest / highest “housing” space 1350d to allow that tooth to move more than the other teeth in the area. The depth of the “housing” space 1350d may be proportional to the amount of movement required. In other words, the deeper the COS, the more “housing” space is provided.

[0248] (vi.) Up-righting Tipped / Tilted Molars.

[0249] FIG. 17 exemplifies a use application for the orthodontic aligner system 100, and for use in correcting tilted teeth.

[0250] As exemplified, the retainer aligners 102 may again be molded and configured with additional housing space 1350e. In this example, the retainer aligner 102 includes an additional housing area 1350e that is positioned occlusal and adjacent to the tilted tooth 1702, thereby leaving room for the tooth to move into that housing space 1350e, during the up-righting process.

[0251] Similar to the correction of the deep COS, the bigger the movement, the more pronounced the “housing” area 1350e. For example, if a molar 1702 is tilted mesially with the mesial portion sitting close to the gum, the retainer aligner 102 is molded with a deeper “housing” area 1350e in the mesial area and shallower in the distal area of the same tooth. The “housing” built 1350e into each subsequent aligner is gradually shallower as treatment progresses. This design concept allows the tilted tooth to be up righted with minimal restriction.

[0252] In some examples, the additional "housing" area 1350e is more pronounced on the mesial-occlusal portion of the molar to allow crown uprighting while the mesial root tip helps increase speed and efficiency, while avoiding unwanted extrusion of the molar.

[0253] Using the additional housing area 1350e in the retainer aligner 102, the up righting movement is almost friction-free allowing fast correction and more predictable outcome. Furthermore, the “housing” area 1350e occlusal to the tilted molar acts as a stop against the opposing teeth from constantly contacting the molar, thus helping shield the space for the uprighting process.

[0254] In at least one example, a horizontal buccal-side accessory 104a is coupled to the tilted tooth 1702 to assist in upright rotation. The buccal-side accessory 104a may have a rectangular shape with a beveled surface 1360 (FIG. 13B). The beveled surface 1360 may beoriented towards the gum, pushing the tooth occlusally. In some cases, a lingual-side accessory 902b can also be coupled to the tilted tooth 1702, and can help the tracking and to control unwanted side movement of the tooth. For instance, lingual accessories 104b can increase tracking for both sides of the tilted tooth 1702, and to preventing bucco-lingual tipping of teeth. The lingual accessory provide support to the tooth while helping to tip the roots mesially. The net movement is a mesio-distal rotation of the molar around its center of rotation.

[0255] The retainer aligner 102 may be configured with corresponding accessory-receiving protrusions 214 that receive the accessories 104a, 104b and applying the tilting force to the tilted tooth 1702.

[0256] Any patient that has lost posterior teeth in the past and receiving orthodontic treatment to upright any tilted posterior teeth prior to final replacement of the missing teeth. This procedure can be done quickly and safely.

[0257] (vii.) Active Eruption Anticipation of Teeth in Mixed Dentition Treatment.

[0258] FIG. 18 exemplifies a use application for the orthodontic aligner system 100, and for active eruption anticipation of teeth, e.g., in mixed dentition treatment.

[0259] The exemplified feature, of the orthodontic aligner system 100, is crucial in the treatment of mixed dentition where permanent teeth are erupting constantly. Without this feature, many clinicians may not be able to treat young patients with aligners.

[0260] Similar to the above discussion, to accommodate for active eruption anticipation of teeth - the aligner retainer 102 includes built-in housing space 135 Of. The housing space 135 Of is configured to anticipate the position of the newly erupted teeth 1802 during mixed dentition stage. With this design concept, clinicians do not need to worry about constantly adjusting aligners 102 to accommodate the erupting teeth.

[0261] As exemplified, the retainer aligner 102 is molded into the shape of the tooth 1802 to be erupted. Analogous to the correction of the deep Curve of Spee (COS) (FIGs. 16A - 16B)and the up-righting of tilted molars (FIG. 17), the eruption anticipation of teeth uses the “housing” configuration 1350f built into each aligner 102.

[0262] In at least one example, the additional housing space 1350f is located directly occlusal to the erupting tooth 1802. This will allows room for the erupting tooth / teeth 1802 to gain new position without friction or blockage. The housing area 1350f also guides the tooth / teeth into a more desirable position in the tooth arch, and minimizes the need for major correction once the erupting tooth 1802 is disposed inside the subject’s mouth. This process also reduces the need to adjust the aligners during treatment, thus saves time and increases efficiency.VII. INTERPRETATION

[0263] Aspects of the present invention may be described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems) and computer program products according to embodiments of the invention. It will be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions / acts specified in the flowchart and / or block diagram block or blocks.

[0264] The flowchart and block diagrams in the Figures illustrate the architecture, functionality, and operation of possible implementations of systems, methods and computer program products according to various embodiments of the present invention. In this regard, each block in the flowchart or block diagrams may represent a module, segment, or portion of code, which comprises one or more executable instructions for implementing the specified logical function(s). It should also be noted that, in some alternative implementations, thefunctions noted in the block may occur out of the order noted in the figures. For example, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. It will also be noted that each block of the block diagrams and / or flowchart illustration, and combinations of blocks in the block diagrams and / or flowchart illustration, can be implemented by special purpose hardware-based systems that perform the specified functions or acts, or combinations of special purpose hardware and computer instructions.

[0265] The corresponding structures, materials, acts, and equivalents of all means or steps plus function elements in the claims appended to this specification are intended to include any structure, material, or act for performing the function in combination with other claimed elements as specifically claimed.

[0266] References in the specification to “one embodiment”, “an embodiment”, etc., indicate that the embodiment described may include a particular aspect, feature, structure, or characteristic, but not every embodiment necessarily includes that aspect, feature, structure, or characteristic. Moreover, such phrases may, but do not necessarily, refer to the same embodiment referred to in other portions of the specification. Further, when a particular aspect, feature, structure, or characteristic is described in connection with an embodiment, it is within the knowledge of one skilled in the art to affect or connect such module, aspect, feature, structure, or characteristic with other embodiments, whether or not explicitly described. In other words, any module, element or feature may be combined with any other element or feature in different embodiments, unless there is an obvious or inherent incompatibility, or it is specifically excluded.

[0267] It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for the use of exclusive terminology, such as “solely,” “only,” and the like, in connection with the recitation of claim elements or use of a “negative” limitation. The terms “preferably,” “preferred,” “prefer,” “optionally,” “may,” and similar terms are used to indicate that an item, condition or step being referred to is an optional (not required) feature of the invention.

[0268] The singular forms “a,” “an,” and “the” include the plural reference unless the context clearly dictates otherwise. The term “and / or” means any one of the items, any combination of the items, or all of the items with which this term is associated. The phrase “one or more” is readily understood by one of skill in the art, particularly when read in context of its usage.

[0269] The term “about” can refer to a variation of ± 5%, ± 10%, ± 20%, or ± 25% of the value specified. For example, “about 50” percent can in some embodiments carry a variation from 45 to 55 percent. For integer ranges, the term “about” can include one or two integers greater than and / or less than a recited integer at each end of the range. Unless indicated otherwise herein, the term “about” is intended to include values and ranges proximate to the recited range that are equivalent in terms of the functionality of the composition, or the embodiment.

[0270] As will be understood by one skilled in the art, for any and all purposes, particularly in terms of providing a written description, all ranges recited herein also encompass any and all possible sub-ranges and combinations of sub-ranges thereof, as well as the individual values making up the range, particularly integer values. A recited range includes each specific value, integer, decimal, or identity within the range. Any listed range can be easily recognized as sufficiently describing and enabling the same range being broken down into at least equal halves, thirds, quarters, fifths, or tenths. As a non-limiting example, each range discussed herein can be readily broken down into a lower third, middle third and upper third, etc.

[0271] As will also be understood by one skilled in the art, all language such as “up to”, “at least”, “greater than”, “less than”, “more than”, “or more”, and the like, include the number recited and such terms refer to ranges that can be subsequently broken down into sub-ranges as discussed above. In the same manner, all ratios recited herein also include all sub-ratios falling within the broader ratio.

Claims

CLAIMS:

1. An orthodontic aligner system for malocclusion correction comprising: a retainer assembly comprising an upper retainer and a lower retainer, wherein each of the upper and lower retainer comprises a teeth-receiving space defined between a buccal surface, a lingual surface and an occlusal surface, and the buccal surface and the lingual surface comprise one or more accessoryreceiving protrusions; and one or more tooth accessories couplable to a buccal or lingual side of a subj ect’ s teeth and receivable in corresponding accessory-receiving protrusions when the retainers are engaged over the subject’s teeth.

2. The aligner system of claim 1, wherein each of the upper and lower retainers further comprises a buccal-side and lingual-side trimline.

3. The aligner system of claim 2, wherein buccal-side and lingual-side trimline of each retainer extends between an anterior portion and posterior portions, and the trimline height is larger in the posterior portions than the anterior portions.

4. The aligner system of claim 2, wherein the rigidity of the posterior portions is greater than the anterior portions.

5. The aligner system of claim 1, wherein the occlusal surface of the upper retainer extends farther in an occlusion direction in a posterior portion as compared to an anterior portion, and further extends more in the occlusion direction in the anterior portion compared to the posterior portion in the lower retainer, such that the occlusal portions of each retainer laterally engage each other when the subject’s mouth is closed.

6. The aligner system of claim 2, wherein the upper retainer further comprises a palatal coverage segment that extends from the buccal-side trimline and between a posterior and anterior end of one or more of the upper retainer.

7. The aligner system of claim 6, wherein the palatal coverage is one of full and partial palatal coverage.

8. The aligner system of claim 1, wherein one or more of the retainers comprise additional retainer housing to accommodate tooth movement and repositioning.

9. The aligner system of claim 1, wherein the tooth accessories comprise pre-filled accessory templates.

10. The aligner system of claim 1, wherein one or more bite ramps extend from the buccal surface of one or more of the retainers.

11. The aligner system of claim 10, wherein the bite ramps are reverse bite ramps.

12. A retainer assembly used for malocclusion correction comprising: an upper retainer and a lower retainer, wherein each of the upper and lower retainer comprising a teeth-receiving area defined between a buccal surface, a lingual surface and an occlusal surface, and the buccal surface and the lingual surface comprise one or more accessoryreceiving protrusions.

13. The retainer assembly of claim 12, wherein each of the upper and lower retainers further comprises a buccal-side and lingual-side trimline.

14. The retainer assembly of claim 13, wherein buccal-side and lingual-side trimline of each retainer extends between an anterior portion and posterior portions, and the trimline height is larger in the posterior portions than the anterior portions.

15. The retainer assembly of claim 13, wherein the rigidity of the posterior portions is greater than the anterior portions.

16. The retainer assembly of claim 12, wherein the occlusal surface of the upper retainer extends farther in an occlusion direction in a posterior portion as compared to an anterior portion, and further extends more in the occlusion direction in the anterior portion compared to the posterior portion in the lower retainer, such that the occlusal portions of each retainer laterally engage each other when the subject’s mouth is closed.

17. The retainer assembly of claim 12, wherein the upper retainer further comprises a palatal coverage segment that extends from the buccal-side trimline and between a posterior and anterior end of one or more of the upper retainer.

18. The retainer assembly of claim 17, wherein the palatal coverage is one of full and partial palatal coverage.

19. The retainer assembly of claim 12, wherein one or more of the retainers comprise additional retainer housing to accommodate tooth movement and repositioning.

20. The retainer assembly of claim 12, wherein one or more bite ramps extend from the buccal surface of one or more of the retainers.

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