Prefabricated attachments for clear aligner with their special holders to increase fitness and effectiveness of aligners

Abstract

It is a 3D printed piece, consists of the attachment, and its special holder, which consists of a base takes the shape of the opposite surface, and an arm that connects between the base of the holder and the attachment in the form of part of a ring connected at one end to the base of the holder, and at the other end it contains one or more cones whose base is integrated with the arm of the holder and its head is integrated with the attachment. And with the use of our new shapes of attachments; they can transfer the required forces from the aligner to the tooth in the optimum way and give the aligner a good, thus giving the possibility to perform multiple movements at the same time, which results in shortening for the time of orthodontic treatment.

Description

Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners

[0001] Attachment material:liquid resin for 3D printers, after curing, it has a solid texture and high transparency.

[0002] Design:It is computer-designed to suit each case individually so that it is applied to a single tooth or to a group of teeth, and the following is the full explanation of the parts of the invention.

[0003] Parts:The invention consists of the attachment, which is computer-designed and printed with 3D printers so that it fits perfectly on the surface of the tooth, and its holder, which is also computer-designed and printed with the attachment as a single block and consists of a base that applies to the surface opposite the place of the attachment, and an arm that connects the attachment body and the base;

[0004] 1.The attachment:It is the final attachment that will remain attached to the surface of the tooth, and it takes any form of known attachments so that it is computer-designed within the treatment plan (-2 and 10).

[0005] This mechanism allows the doctor to clearly see the location of the attachment and completely remove excess composite from its surroundings, as is done when posing brackets, thus obtaining a precise, well-defined attachment that conforms to the computer design.

[0006] In the following we will explain the new attachments shapes and their work:(1)Rhomboid shape ():It is the first shape of the new shapes presented, which was designed to achieve what the previous designs for attachment failed to do, which in most cases calls for a lengthening of the treatment period and sometimes imposes complications that require the use of more than one attachment for the same tooth, and therefore, we have to put an attachment for the first stage and then remove it in the middle of the treatment to replace it with another attachment that allows to continue the required movements.

[0007] This new attachment is in the shape of a rhombus, its side active surfaces are inclined, and it has four inclined surfaces called “active surfaces”; and they are the surfaces on which the aligner applies force.

[0008] The dimensions of the attachment indicated in Figure (1-f) and Figure (1-e):The long dimension (1) is between 1 mm and 4 mm.The short dimension (2) is between 0.5mm and 2.5mmThe ratio between the two dimensions (1) to (2) is from 1 to 8.Thickness (3) is from 0.3 mm to 3 mm.The slope angles (4) indicated in Figure (1-e) From 100 degrees to 160 degrees.Note: The active surface slope angles are not required to be equal.

[0009] Inclined surfaces allow better insertion of the aligner plate and ease of removal.

[0010] This attachment allows the tipping movement to be accomplished by applying forces at four simultaneous points, by applying two couple of force as in(the blue shape represents the aligner that applies tipping forces to the attachment), where it is shown how the four application points form two couples of force , the first couple is formed by forces 4-1 and 4-2, and the second couple is formed by forces 4-3 and 4-4, thus ensuring the desired result.

[0011] This attachment also controls the intrusion and tipping movements that occur as a side effect for the mesio-distal movement and significantly helps in obtaining bodily movement. It corrects the vertical axis of the tooth at each stage of treatment. As shown in Figures 5-b and 8; the forces coming out from mesial push of the upper right canine and the resulting forces at the center of resistance; where we notice the effect of tipping and intrusion resulting from the mesial pushing forces, and the final result expected movement is shown in-a.

[0012] shows the forces applied by the plate to the attachment, where we notice how the applied forces produce rotational movements at the level of the center of resistance opposite to the rotations that result from the application of mesial pushing forces at the level of the canine crown, and as shown in; it explains how the attachment controls vertically to prevent the intrusion of the canine.

[0013] Common movements that we can apply using this attachment:Mesio-distal with tipping for bodily movementRotation with tip with control of the intrusive effect, especially for the canines.(2)L-shaped and inverted L ():These are the second and the third shape of the new shapes presented, which were designed to obtain what previous designs for attachments were unable to achieve, which in most cases calls for a prolongation of the treatment period and sometimes imposes complications that require the use of more than one attachment for the same tooth, and therefore we have to put an attachment for the first stage and then remove it in the middle of the treatment to replace it with another attachment that allows to continue the required movements.

[0014] It is in the form of the English letter L and horizontally inverted from the English letter L.

[0015] It has 6 active surfaces and is mainly intended to be applied on incisors.

[0016] It allows to achieve rotation, tipping and extrusion movements at the same time, as shown in-a, where the active surfaces 2, 4 and 6 accomplish and control the tipping movements, notice that the blue shape represents the aligner that applies tipping forces to the attachment.

[0017] Where the active surfaces 1and 5 carry out and control the extrusion movements as shown in-d and-e, and intrusion as shown in-f.

[0018] For the completion of rotation movements, one of the inverted L and L control links is chosen so that its vertical section (the long arm of the letter L) is towards the side where the treatment requires rotation, as shown in Figures 9-b and 9-c.

[0019] Therefore, if we want to distinguish the ways of applying the previous two forms, they will be:

[0020] 1-L shape:For the left upper anterior segment in order to induce a mesio-palatal rotation.For the right upper anterior segment in order to induce a disto-palatal rotation.For the left lower anterior segment in order to induce a mesio-palatal rotation noticing that it must be vertically inverted (the base of the letter L towards the incisive border).For the right lower anterior segment in order to induce a disto-palatal rotation noticing that it must be vertically inverted (the base of the letter L towards the incisive border).2- Inverted L shape:For the left upper anterior segment in order to induce a disto-palatal rotation.For the right upper anterior segment in order to induce a mesio-palatal rotation.For the left lower anterior segment in order to induce a disto-palatal rotation, noticing that it must be also inverted vertically (the base of the inverted L towards the incisive border).For the right lower anterior segment in order to induce a mesio-palatal rotation, noticing that it must be also inverted vertically (the base of the inverted L towards the incisive border).

[0021] The dimensions of the attachments referred to in:The long dimension (1) is between 1 mm and 4 mm.Short dimension (2) is between 0.5mm and 2.5mmThe ratio between the two dimensions (1) to (2) is from 1 to 8.Dimension (3) is between 0.5 mm and 2 mm.Dimension (4) is between 0.5 mm and 2 mm.The ratio between the two dimensions (1) to (3) is from 1.6 to 8.The ratio between the two dimensions (2) to (4) is from 1.6 to 8.Thickness (5) is from 0.3 mm to 3 mm.The slope angles (6) indicated in Figure (3-c) are from 100 degrees to 160 degrees.Note: The active surface slope angles are not required to be equal

[0022] -d shows the ability of the attachment design to control a number of dental movements simultaneously.

[0023] Common movements that we can apply:Mesio-distal with tipping for bodily movement.Rotation with tipping with intrusive effect control.Rotation with tipping and extrusion.

[0024] 2.Holder base:firmly applies to the tooth surface opposite to the attachment; It is the vestibular or palatal surface for the front teeth, and the palatal cusps with the palatal surface or the vestibular cusps with the vestibular surface for the back teeth, and it can extend over an area of two teeth to increase its stability ().

[0025] 3.The arm of the holder:It is the part that connects the attachment to the base of the holder. It is in the form of part of a ring with a circular or oval cross-section (). As shown in the longitudinal section image (), it connects the body of the connector to the base, as shown by the cross-section of the arm (-a) So that it has a diameter between 1 and 3 mm, and is in its middle part away from the surface of the tooth to allow the doctor to ensure the complete fit of the attachment on the surface of the tooth without obstructing the view of the surrounding of the attachment in order to remove the excess adhesive composite. At its end, on the side of the attachment, there are elongations in the form of cones (one or two depending on the size of the attachment), with its base on the side of the holder arm and its head entering the body of the attachment at the point that is most prominent from it (vestibular or palatal). The diameter of the area of overlap between the head of the cone and the attachment body is between 0.4 to 0.7 mm (-b), so that it provides easy separation of the arm from the attachment body.

[0026] Clinical application mechanism:As it’s shown in the:The surface of the tooth is first prepared for bonding in the same manner used for bonding brackets such as etching and bonding.The adhesive composite is placed on the inner surface of the attachment opposite the tooth surface.Start applying the entire block (the attachment and its holder) by placing the attachment in its approximate location and moving the block in a semi-circular manner so that the base applies to the surface opposite the location of the attachment.The base of the holder and the attachment are pressed gently against the surface of the tooth so that the attachment takes its exact position.Remove excess adhesive composite from the surrounding of the attachment.The adhesive composite is cured (the composite is firmly bonded to the printed resin and the attachment surface does not need any preparation)Disconnect the attachment from the cone at the end of the holder arm by cutting the tip of the cone exactly at the point where it meets the attachment.Ensure that any remnants of the cone head of the holder arm are removed from the attachment.As a result, the required attachment stays attached to its place on the tooth surface exactly as it was computer-designed during the development of the treatment plan.

[0027] In orthodontic treatment, attachments are added on the surface of the teeth to increase the control of their movement, and to help the clear orthodontic plates (clear aligners) by applying forces in specific directions that serve the orthodontic treatment plan.

[0028] These attachments have specific shapes that serve specific goals in the treatment plan, allowing forces to be applied to the teeth in certain directions.

[0029] All attachments shapes used in all clear aligners systems now adays can’t achieve the desired movements easily and needs in almost all cases a refinement stage.

[0030] Earlier shapes problems:Its vertical edges hinder the insertion of the plates and thus obtaining forces in undesirable directions.The forces resulting from the earlier designs allow the forces to be applied in one or two directions.Weakness in controlling some movements, such as extrusion and tipping, resulting in some unwanted movements.Unwanted movements cause a prolongation of the treatment time.Sometimes it is necessary to divide the movements to ensure the desired results and thus prolong the treatment time.

[0031] Besides, precision in transferring the computational attachment design to the tooth surface is extremely important to the success of the treatment.

[0032] Till now, the common technic followed to apply these attachments on the teeth; depending on 3D printing, a transparent plate (transfer key) is made which covers the teeth and leaves a space between the surface of the teeth and the plate in the shape and location of the joints as designed in the software, in which the doctor fills the composite (light cured filling dental material) and applies the plate to the teeth after preparing their surface then curing it with special light, and after removing the plate, we will obtain the required attachment according to the software design.

[0033] There is no known technic to have these attachments prepared and transmitted to the surface of the teeth other than this explained in the previous paragraph.

[0034] Problems with the earlier transfer traditional method:It often requires making a plate for the entire arch and ensuring that it fits very well.Uncertainty and inaccuracy may occurs when the plate is compressed which reduces; therefor, the accuracy of the attachment.The doctor needs to press firmly on the plate in the place of the attachment for the best fit of the plate to the surface of the toothExcess composites create an excessive thickness on the tooth surface around the attachment (Called flush) that prevents the correct insertion of the treatment plates (aligners) and thus inaccurate transfer of forces which leads, as result, to not obtain the desired results.If the attachment is broken during treatment, it will be difficult to make a new key plate because of the movement of the teeth, and the solution is usually using the last aligner applied as a key plate, which reduces the accuracy of the attachment location.

[0035] The invention consists of :

[0036] Three new shapes of attachments for clear aligners ortho treatment (Rhomboid, inverted L and L) with multiple active surfaces and slope angles for those surfaces that ensure easy placement and removal of the aligner and allow control of simultaneous tip, extrusion and rotation movements, which is computer-designed and printed with 3D printers so that it fits perfectly on the surface of the tooth.

[0037] The holder, which is also computer-designed and printed with the attachment as a single block and consists of a base that applies to the surface opposite the place of the attachment, and an arm that connects the attachment body and the base

[0038] All the cited parts will be printed with a 3D printing technics as one piece for accurate application of the place and the form of the attachments, then the practician will cut off the holder and threw it away where the desired attachment will stay attached to the surface of the teeth

[0039] New attachments shapes edges have sloping bevels that allow better plate entry and thus apply forces in the right direction.

[0040] New attachments shapes have multiple active surfaces which produce a combination of forces that direct the tooth in the desired direction.

[0041] New attachments shapes Increase control of tooth movements, especially tipping and extrusion.

[0042] New attachments shapes can combine multiple tooth movements and shortens treatment time.

[0043] It allows to make a special attachment and its holder for each tooth separately, depending on its anatomical shape, thus enabling us to put the attachment back in its place even if it was broken during treatment. Also, more than one attachment and their holders can be made in one base.

[0044] It gives high accuracy to the shape of the attachment because it is printed directly and does not require a pressed key plate.

[0045] Based on precise 3D printing, the attachment and its holder fit perfectly on the crown of the tooth and there is no need to apply heavy compressive forces.

[0046] Since the attachment is prefabricated, it is directly affixed to the surface of the tooth in a manner similar to fix brackets. Therefore, the excess adhesive composite around the attachment can simply be removed, thereby eliminating the presence of the thin layer on the surface of the tooth in the area surrounding the attachment (called flush).

[0047] If the attachment is broken, it can be reprinted and posed at any stage of the treatment.

[0048] : Different viewing angles for the rhomboid attachment form and measurements indicators

[0049] : Different viewing angles for the L and inverted L shape attachments

[0050] : Measurements indicators for the L and inverted L shape attachments

[0051] : Shows how the rhomboid attachment achieves tipping movement by applying two couple of forces

[0052] : While trying to get a mesial movement of the canine, these are the forces applied by the aligner and the resulting position ignoring the existence and the controlling forces of the attachment

[0053] : The way that the attachment controls the loss of tipping of the canine while the aligner applies mesiodistal movement

[0054] : How the attachment controls vertically the ingression force as an aside effect of the mesiodistal movement force.

[0055] : Proximal forces applied by the aligner in the mesiodistal movement.

[0056] : Shows the ability of the attachment design to control a number of dental movements simultaneously.

[0057] : Indicates the three main parts of the invention

[0058] : lingo vestibular cross-section of the invention

[0059] : Cross-section in the arm of the holder and contacting points with the body of the attachment

[0060] : Photos of the invention after 3D printing and a clinical applicationExamples

[0061] First example, if we want to extrude an upper central with correction of its longitudinal axis, first we will have to install a special attachment for extrusion with an active surface towards the gingiva to allow the application of vertical forces, and then we will have to remove this attachment and replace it with axis correction attachments, which are usually two attachments with active lateral surfaces allow the application of a couple of force for axis correction, while the new Rhomboid attachment performs all these the tasks.

[0062] Second example, if we want to extrude an upper lateral with correction for its longitudinal axis and rotation, as in most cases of the class 2 division 2, we will first have to put a special attachment for extrusion with an active surface towards the gingival to allow the application of vertical forces, and then we will have to remove this joint and replace it with an attachment to correct The axis and the rotation, which are two attachments with active side surfaces to allow the application of a couple of force to correct the axis, taking into account the place of their application to allow the lateral to rotate in the desired direction, while the L and inverted L attachments perform all the functions of the mentioned attachments.

[0063] Industrial Applicability: It can be easily printed using 3D printer using biocompatible clear resin

[0064] Non-Patent Literature: NPL1: no patent literature yet

Claims

Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners; contain the following parts:-The attachment-Holder base- Holder armPrefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners as mentioned in the first claim, with three new orthodontic clear aligner attachment shapes:- Rhomboid shape- L shape- inverted L shapeNew orthodontic clear aligner attachment shape as mentioned in the first or second claim; where is The first one takes the shape of arhombuswith a pointed or bevelled upper surface, where the long dimension is between 1 mm and 4 mm, the short dimension is between 0.5 mm and 2.5 mm, the ratio between the two dimensions is from 1 to 8, the thickness is from 0.3 mm to 3 mm and the Lateral incline is from 100° to 160°.New orthodontic clear aligner attachment shape as mentioned in the first or second claim; where is the second is in the shape of the letter(L)has a pointed or bevelled upper surface has a pointed or bevelled upper surface where the vertical long dimension is between 1 mm and 4 mm, the horizontal long dimension is between 0.5 mm and 2.5 mm, the ratio between the previous two dimensions from 1 to 8, the vertical short dimension between 0.5 mm and 2 mm, the horizontal short dimension between 0.5 mm and 2 mm, the ratio between the vertical long dimension to the horizontal short one is from 1.6 to 8, the ratio between the long horizontal dimension to the short vertical one is from 1.6 to 8, the thickness is from 0.3 mm to 3 mm, the lateral slope angle is from 100 ° to 160 °.New orthodontic clear aligner attachment shape as mentioned in the first or second claim; where is the third is in the form of the letter(L) invertedhas a pointed or bevelled upper surface where the vertical long dimension is between 1 mm and 4 mm, the horizontal long dimension is between 0.5 mm and 2.5 mm, the ratio between the previous two dimensions from 1 to 8, the vertical short dimension between 0.5 mm and 2 mm, the horizontal short dimension between 0.5 mm and 2 mm, the ratio between the vertical long dimension to the horizontal short one is from 1.6 to 8, the ratio between the long horizontal dimension to the short vertical one is from 1.6 to 8, the thickness is from 0.3 mm to 3 mm, the lateral slope angle is from 100 ° to 160 °.New orthodontic clear aligner attachment shape as mentioned in the second or third or forth or fifth claim where is: the constituent substance is made of composite material that is applied directly to the patient’s teeth.New orthodontic clear aligner attachment shape as mentioned in the second or third or forth or fifth claim where is: the constituent substance is applied directly to the patient’s teeth using any transfer key.Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners as mentioned in the first claim, where is the base of the holder fits closely on the surface of the tooth opposite the surface on which we want to place the attachment and covers more than half of this surface.Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners as mentioned in the first claim, where is the holder arm is a piece that connects the prefabricated attachment to the holder base, and is in the form of part of a ring with a circular or semi-circular cross-section and a cross-sectional diameter between 1 and 3 mm.Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners as mentioned in the first or the ninth claim, where is the arm of the holder contains one or more cones at its end, this cone has its base toward the holder and its apex is in contact with the attachment; where is the area where the apex meets the attachment has a diameter between 0.4 and 0.7 mm To facilitate its disengagement from the attachment, the holder is then separated and removed, leaving the attachment attached to the tooth surface.Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners where it manufactured by means of 3D printers.Prefabricated attachments for clear Aligner with their special holders to increase fitness and effectiveness of aligners where the manufacturing material is 3D printer-specific resin, metal, medical acrylic (resin), or any of the materials for applications and devices used in dentistry.

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