System, method and devices for orthodontic treatment using directly bonded orthodontic wires

Abstract

A system for mounting an orthodontic wire directly to surfaces of a patient's teeth includes a tray configured to temporarily mount the orthodontic wire thereon, an attachment mechanism associated with the tray and an adhesive. The tray designed and configured to conform to a shape of the patient's teeth. The attachment mechanism designed and configured to temporarily secure the orthodontic wire to the tray before the wire is secured to the patient's teeth. The tray configured to position the wire against the patient's teeth when the tray is engaged with the patient's teeth such that the adhesive bonds the wire to the patient's teeth and the tray and attachment mechanism are removed from the patient's teeth once the wire is bonded to the patient's teeth.

Description

Attorney Docket No.: 689346.0060 / 45WOTITLE OF THE INVENTIONSystem, Method and Devices for Orthodontic Treatment Using Directly Bonded Orthodontic WiresCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims the benefit of U.S. Provisional Patent Application No. 63 / 639,905, filed April 29, 2024 and titled, “System, Method and Devices for Orthodontic Treatment Using Directly Bonded Orthodontic Wires,” the entire contents of which is incorporated herein by reference in its entirety.BACKGROUND OF THE INVENTION

[0002] Directly bonded orthodontic wires are typically positioned on the patient’s teeth based on the expertise and experience of an orthodontist. It would be useful and novel to place a flexible orthodontic wire directly to the surface of multiple teeth that are not well aligned using a custom transfer tray. Use of the custom transfer tray to position and bond the wire directly to the patient’s teeth results in preferred positioning of the wire, which may be determined via a digital, 3D treatment planning process and then be precision placed in the patient’s mouth. The wire would be pre-placed in the transfer tray and then, once bonded to the teeth, the tray is removed, leaving the wire directly bonded to surfaces of the teeth to promote straightening or other desired movement of the teeth.

[0003] During treatment with directly bonded orthodontic wires, a clinician may want to detach the wire from a tooth and reposition the wire at a different height, location or orientation on the tooth surface or they may also want to more fully engage the bonding of the wire to the tooth surface, such as by applying more adhesive to a tooth, thereby covering more of the wire and enhancing bonding strength. This repositioning of the wire and / or adhesive allows for deflection forces to be applied in a different manner than previously. Removing the wire typically requires removing the adhesive or composite from the tooth. An effective way to remove composite is to use a high-speed rotary device, however, the tool can be difficult to effectively operate when there is a wire held within the adhesive or composite since the wire is in close contact to the tooth. Becauseof the close contact of the wire embedded within the adhesive or composite, the tool may cut the wire and / or damage the tooth while trying to avoid damaging the wire. It would be desirable to design, develop and deploy a system and method to remove a directly bonded wire to a patient’s tooth without utilizing a high-speed rotary tool that may damage the wire or tooth. A wire lifter may be useful to bend a wire away from the tooth surface while using a composite removal tool such as a burr to remove the adhesive bonding or composite bonding material from the patient’s teeth and the wire to expose or free the wire from the tooth.

[0004] A patient has a wire bonded to the teeth. The clinician wants to apply a new wire and remove the existing wire. The new wire may need to be placed in the same height (location) on a tooth or may need to be positioned differently. It would be desirable to design, develop and deploy a system and method for efficiently directing the placement of the replacement wire on the patient’s teeth.

[0005] An orthodontic system that corrects a common malocclusion called a Class II is generally known. A Class II malocclusion is characterized by upper molars that are too far forward compared to the lower molars. This overbite can be caused by an overly prominent upper jaw or an underdeveloped lower jaw. It would be desirable to design, develop and deploy a Class II corrective system that is more aesthetically pleasing to users and corrects the malocclusion compared to known systems and constructions. The preferred present invention addresses this prior art shortcoming for correcting Class II malocclusions.BRIEF SUMMARY OF THE INVENTION

[0006] Briefly stated, use of the custom transfer tray to position and bond an orthodontic wire directly to the patient’s teeth results in preferred and consistent positioning of the orthodontic wire, which is preferably determined via a digital, 3D treatment planning process and then be precision placed in the patient’s mouth. The orthodontic wire is pre-placed in the transfer tray and then bonded to the target teeth. Once the orthodontic wire is bonded to the target teeth, the tray is removed from the patient’s mouth and the wire remains in the desired position on the target teeth.

[0007] In another aspect, a preferred embodiment of the invention is directed to a wire lifter tool that may be used to bend a directly bonded orthodontic wire away from the tooth surface while using a composite removal tool, such as a burr, to remove the remaining adhesive or composite from the patient’s teeth.

[0008] In an additional aspect, a preferred embodiment of the invention is directed to a system and method for reapplying a wire or applying a new wire after removal of an original wire. The objective with this innovation is to provide a better means of efficiently guiding the placement of the new wire in an orthodontic treatment. The system and devices involve removal of the existing wire and a portion of the composite or adhesive in such a manner that the remaining composite on the tooth provides a ledge, guide or channel upon which the next wire is placed for subsequent bonding.

[0009] In a further aspect, a Class II corrective system may be used as a pre-treatment prior to aligner therapy or traditional braces, although the Class II system can be used in conjunction with wires affixed to the lower teeth. Such wires can be directly bonded or attached via traditional brackets. The preferred Class II corrective system, distalizer, retention device, an inter-arch elastic and flexible orthodontic wires simultaneously may be utilized to impact tooth alignment and Class II malocclusion. The elastic may be comprised of first and second elastics that are mounted on opposite sides of the patient’s jaw extending from a first prong to the hardware and from a second prong to the hardware, respectively. The hardware may also include first and second hardware that are mounted to opposite sides of the patient’s jaw, respectively.

[0010] In an additional aspect, a preferred embodiment of the invention is directed to a kit for correcting a Class II malocclusion of a patient’s teeth. The kit includes a tray configured for positioning on a mandibular portion of the patient’s teeth, an orthodontic wire, a prong configured for mounting to a mandibular molar of the patient’s teeth, hardware configured for mounting to a maxillary portion of the patient’s teeth and an elastic configured for connection between the prong and the hardware in a working configuration. The tray includes a relief window at a front portion and a side relief feature on a rear portion.

[0011] In a further aspect, a preferred embodiment of the invention may be directed to a system for removing and then re-attaching an orthodontic wire to a patient’s teeth.The system may include a core wire lifter tool or jig designed and configured to apply a force to the orthodontic wire away from the patient’s teeth, a dental tool having a bunattachment designed and configured to remove a cured adhesive away from the wire and the patient’s teeth to expose a portion of the wire, a dissolvable wire coating designed and configured for application to the portion of the wire and an adhesive designed and configured for application to the coated portion of the wire and the patient’s teeth to bond the portion of the wire to the patient’s teeth. The dissolvable wire coating is configured to dissolve from the wire after a predetermined amount of time, thereby forming a channel in the cured adhesive. The predetermined amount of time for dissolving the wire coating may be one minute to seven hundred twenty-eight (728) hours, for example twenty-four hours.

[0012] In an additional aspect, a preferred embodiment of the invention may be directed to a custom tray for guiding removal of cured adhesive that bonds an orthodontic wire directly to surfaces of a patient’s teeth. The custom tray may include a body having first and second molar legs and an incisal portion between the first and second molar legs and a guidance surface formed in the body. The body is configured for mounting to the patient’s teeth. The guidance surface is designed and configured to guide a dental tool in removing portions of the cured adhesive to release the orthodontic wire from connection with the patient’s teeth and to leave a guide portion of adhesive on the patient’s teeth. The custom tray may also include a replacement wire configured for mounting to the patient’s teeth by placing the replacement wire on the guide portion of adhesive.BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

[0013] The foregoing summary, as well as the following detailed description of preferred embodiments of the instrument, implant and method of the present application, will be better understood when read in conjunction with the appended drawings. For the purposes of illustrating the preferred orthodontic systems and methods, there are shown in the drawings preferred embodiments. It should be understood, however, that the application is not limited to the precise arrangements and instrumentalities shown. In the drawings:

[0014] Fig. 1 illustrates a top perspective view of an orthodontic tray with an orthodontic wire held therein by an attachment mechanism in accordance with a first preferred embodiment of the present invention;

[0015] Fig. 1 A illustrates a bottom perspective view of the orthodontic tray with the orthodontic wire held therein by the attachment mechanism of Fig. 1;

[0016] Fig. IB illustrates an additional top perspective view of the orthodontic tray of Fig. 1 mounted to a patient’s teeth;

[0017] Fig. 2 illustrates a side perspective view of a wire lifter jig in accordance with a second preferred embodiment of the present invention;

[0018] Fig. 3A illustrates a side elevational view of an orthodontic tray, a prong and orthodontic hardware mounted to a patient’s teeth in accordance with a third preferred embodiment of the present invention; and

[0019] Fig. 3B illustrates a top perspective view of a lingually, directly bonded wire and prongs mounted to a patient’s teeth in accordance with the third preferred embodiment of the present invention.DETAILED DESCRIPTION OF THE INVENTION

[0020] Certain terminology is used in the following description for convenience only and is not limiting. Unless specifically set forth herein, the terms “a”, “an” and “the” are not limited to one element but instead should be read as meaning “at least one”. The words "right", "left", "lower" and "upper" designate directions in the drawings to which reference is made. The words "inwardly" or “distally” and "outwardly" or “proximally” refer to directions toward and away from, respectively, the patient’s body, or the geometric center of the preferred orthodontic treatment systems, components and related parts thereof. The words, “anterior”, “posterior”, “superior,” “inferior”, “lateral” and related words and / or phrases designate preferred positions, directions and / or orientations in the human body to which reference is made and are not meant to be limiting. The terminology includes the above-listed words, derivatives thereof and words of similar import.

[0021] It should also be understood that the terms “about,” “approximately,” “generally,” “substantially” and like terms, used herein when referring to a dimension orcharacteristic of a component of the preferred invention, indicate that the described dimension / characteristic is not a strict boundary or parameter and does not exclude minor variations therefrom that are functionally the same or similar, as would be understood by one having ordinary skill in the art. At a minimum, such references that include a numerical parameter would include variations that, using mathematical and industrial principles accepted in the art (e.g., rounding, measurement or other systematic errors, manufacturing tolerances, etc.), would not vary the least significant digit.

[0022] Referring to Figs. 1-1B, in a first preferred embodiment, a tray 10 for directly bonding an orthodontic wire 12 to a patient’s teeth is used to place the orthodontic wire 12 precisely and consistently onto the patient’s teeth for direct bonding. The system includes the tray 10 that is custom fit to the morphology and anatomy of the patient’s teeth and / or arch for positioning the wire 12 and bonding the wire 12 to at least one of the patient’s teeth. The system also includes the flexible wire 12, which may be comprised of a “memory” wire 12. The wire 12 is temporarily attached to the tray 10, preferably positioned in a channel 10a formed in the tray 10, and is deflected from its static position within the tray 10 so that the wire 12 is under pressure to shift back to a relaxed shape or configuration, which is preferably in the preferred positioning of the patient’s teeth or closer to the preferred positioning of the patient’s teeth than the current or original positioning of the teeth. When the tray 10 is removed from the patient’s mouth after the wire 12 is bonded to the patient’s teeth, the wire 12 applies pressure and forces the teeth to move toward a desired alignment and configuration. In the preferred system and method, forces are applied to at least two teeth to reposition / move at least one of the two teeth such that the two teeth and additional teeth of the patient’s arch are shifted into or toward a desired orientation and configuration. The flexible memory wires 12 are typically arch shaped nitinol wires 12 but are not so limited and may be otherwise shaped and constructed as long as the wires 12 are designed to perform the preferred functions described herein, withstand the normal operating conditions of the wires 12, are biocompatible and can take on the general size and shape of the wire 12, as described herein. The nitinol wires 12 may be heat activated so that at higher temperatures the wires 12 revert to their pre-formed shape. The wires 12 may be straight or curved and may be formed in any cross-sectional shape of wire (round, rectangular, etc ).

[0023] An attachment mechanism 14, which may be comprised of a temporary attachment mechanism 14, holds the wire 12 inter-proximally in the tray 10 and preferably in the channel 10a so that adhesive can be placed on the tooth surface or the wire 12, while the wire 12 is being held by the attachment mechanism 14 in the tray 10. The wire 12 may be threaded through the channel 10a in the tray 10 that is preferably formed in or attached to the tray 10.

[0024] The attachment mechanism 14 may be comprised of a variety of systems and structures, including but not limited to (i) a structure formed within the monolithic tray 10 structure, (ii) the channel 10a through which the wire 12 is threaded, (iii) attachment holes 10b through which ligatures or flexible bands 14 are placed and secured around the wire 12, (iv) a “plug” comprising the attachment mechanism 14 or (v) other structures, straps, clamps or features that secure the wire 12 in the preferred position on the tray 10 and relative to the teeth for bonding. The plug 14 may be threaded through or is pressed through the tray 10 to temporarily hold the wire 12.

[0025] The plug or attachment mechanism 14 may be constructed of one or multiple materials and may extend through a hook or the attachment hole 10b in the tray 10 that is sufficiently malleable and enables the wire 12 to be released from the tray 10 once the wire 12 is bonded to the teeth. In the first preferred embodiment the plug 14 may be pressed through the attachment hole 10b and may be shaped in a T-like shape so that the wire 12 is temporarily locked or held in place in the tray 10. Alternatively, a thin piece of flexible material (like a thin piece of rubber, dental floss or string) may be threaded through the attachment holes 10b in the tray 10 with the wire 12 pressed into the channel 10a or onto an inside of the tray 10 by the attachment mechanism 10. The flexible material of the attachment mechanism 14 is preferably stretched away from the wire 12 to create tension and then the material is tied off or otherwise blocked from pulling through the tray 10 toward the wire 12 and preferably to hold the wire in the channel 10a. The attachment mechanism 14 may be comprised of floss or a flexible biocompatible string material that is threaded through the attachment holes 10b in the tray 10 to temporarily hold the wire 12 in a predetermined position for placement of the wire 12. The attachment mechanism 14 may alternatively include the channel 10a, reservoirs orgrooves in the tray 10 that temporarily engage and secure the wire 12 to the tray 10 prior to bonding to the patient’s teeth.

[0026] The tray 10 may be constructed by three dimensional (“3D”) manufacturing methods such as 3D printing using resins that, once cured, are either flexible or rigid, vacuum formed over a model of the teeth and other construction systems and / or methods. The vacuum formed tray 10 may be constructed from one to five (1-5) layers using thermoplastic materials or resins. In embodiments where the tray 10 is constructed as a multi-layer tray 10, each layer may allow for one or more teeth to be bonded so that different layers allow for the bonding of different teeth. The tray 10 may include “candy cane” shaped or hook-shaped supports mounted into the tray 10. The supports may hold the temporary attachment mechanism 14 to temporarily secure the wire 12 to the tray 10 until the wire 12 is bonded to the patient’s teeth and the tray 10 and attachment mechanisms 14 are removed from the patient’s mouth with the wire 10 adhesively bonded directly to the patient’s teeth.

[0027] In use, the adhesive may be applied to the patient’s teeth to bond the wire 12 to the teeth. The tray 10 may be fabricated to include reservoirs 16 with reservoir holes 16a that permit introduction of the adhesive into the reservoir 16 to fill the reservoirs 16 with adhesive either before the tray 10 is placed in the patient’s mouth or while the tray 10 is in the patient’s mouth. The reservoirs 16 may enable direct application of adhesive to the wire 12 and to the patient’s teeth to secure and bond the wire 12 to the teeth. The adhesive may be positioned in the reservoirs 16 in the tray 10 and only activated when the tray 10 is mounted on the patient’s teeth, such as by ultraviolet light, heat or other cure promoting systems or methods. Alternatively, the adhesive may be introduced into the reservoirs 16 through the reservoir holes 16a when the tray is mounted to the patient’s teeth.

[0028] In operation, an impression of the patient’s teeth may be created by direct molding, based on a digital scan of the teeth and creation of a 3D model, traditional vinyl polysiloxane impression material (“VPS”) impression or other related impression creation systems or methods. A clinician (lab tech, doctor, etc.) or other dental personnel may evaluate the patient’s teeth and determine an optimal position on which to place the orthodontic wire 12 to impact the desired tooth movements. In the preferred embodimenta digital software planning may be used to determine desired locations and orientations of the patient’s teeth.

[0029] In a preferred method after the patient’s teeth are modelled, the tray 10 is manufactured, the wire 12 is inserted into the tray 10 and temporarily held in the channel 10a and / or the attachment mechanisms 14, the patient’s teeth are prepared using etching and / or a priming process, the tray 10 is placed in the patient’s mouth, adhesive is applied over the wire 12 and onto the teeth so that the wire 12 is bonded to each of the desired teeth such as by introducing the adhesive into the reservoirs 16 through the reservoir holes 16a, the adhesive is cured, such as by light activation, the tray 10 is removed from the patient’s mouth once the adhesive is cured and the cured adhesive or composite is smoothed out in the mouth using a burr or comparable device so that the cured adhesive and wire 12 are comfortable for the patient.

[0030] The first preferred embodiment of the tray 10 and wire 12 may be comprised of a single layer tray 10 that is 3D printed into its final shape and form. The tray 12 may be relatively translucent or transparent such that the clinician is able to visually confirm placement of the wire 12 in the desired location or may be relatively opaque. The tray 10 have the attachment holes 10b for receipt of the plugs or attachment mechanisms 14 that hold the wire 12 in place in the tray 10 or may include only the channel 10a to temporarily hold the wire 12 in the tray 10. The plugs or attachment mechanisms 14 are sufficiently rigid to hold the wire 12 in place in the tray 10 but are thin enough or weak enough to be readily separated from the wire 12 prior to or at time of removal of the tray 10 from the patient’s teeth when the plug can be cut away or torn away from the wire 12. The attachment mechanism 14 is designed to not damage the surface of the wire 12 or remove a coating on the wire 12 while held in the tray 10 or while being applied to the teeth.

[0031] The nitinol wire 12 may be heat activated to apply preferred forces to the teeth once mounted to the teeth. The wire 12 may have a temporary coating on an outer surface that, once dissolved, converts the bonding adhesive into a tube or aperture through which the wire 12 may slide or move but continue to apply forces to the teeth.

[0032] The tray 10 may include the voids or reservoirs 16 so that adhesive can be placed on the tooth surface while the tray 10 is in the patient’s mouth, thus fullysurrounding the wire 12 when the adhesive is introduced into the voids or reservoirs 16. The tray 10 may be designed to allow for application of the wire 12 to four or more teeth at one time, may alternatively be designed and configured such that the wire 12 contacts two teeth or may be designed and configured for mounting multiple wires 12 being positioned on and relative to the patient’s teeth. The tray 10 may be designed and configured for applying the wire 12 facially, occlusally and / or lingually to the patient’s teeth.

[0033] The tray 10 may include a relief window or groove 11 to accommodate the wire 12 and subsequent trays 10 for the patient’s treatment plan may also include relief windows 11, such as those described in International Patent Application No. PCT / US23 / 85354 (“354-APP”), International Patent Application Publication No. WO2024 / 137942, filed December 21, 2023. The 354-APP is incorporated herein by reference in its entirety.

[0034] The various tray systems described herein may also be used to place the wires 12, which may be comprised of retention or retainer wires 12, at the conclusion of treatment. The trays 10 may be designed and fabricated at the end of treatment using a model of the patient’s arch / teeth (either digital model or traditional VPS impression model). The model may be based on the expected final tooth position determined from an aligner treatment plan or from actual final tooth position based on an updated scan of the patient’s teeth.

[0035] Referring to Fig. 2, a second preferred embodiment of the present invention is directed to a wire lifter tool or a wire lifter jig 220. The wire lifter tool and jig 220 is designed and configured to apply pressure on the orthodontic wire 12 that is bonded directly to the patient’s teeth away from the tooth surface by using one or two points of contact on the wire 12. The two points of contact of the wire lifter jig 220 are preferably on either side of bonding composite or adhesive that attaches the wire 12 to the tooth surface. The wire lifter tool and jig 220 preferably wedges under the wire 12 on both sides of a section of the composite or adhesive, which covers the wire 12 on the tooth and then enables the clinician to apply pressure away from the tooth surface so that the adhesive already on the wire 12 can be safely removed.

[0036] The wire lifter tool 220 of the second preferred embodiment includes a pointed lifter or prongs 221, 222, a rounded nose 225 and a handle 223. The wire lifter tool 220 is used by pushing the pointed lifter or prongs 221, 222 under the directly bonded wire 12 proximate one or both sides of the adhesive, pressing the nose 225 against the surface of the patient’s tooth and pivoting the handle 223 such that the pointed lifter or prongs 221, 222 raises the wire 12 away from the patient’s tooth. The prongs 221, 222 include a first prong 221 with a first prong end 221a and a second prong 222 with a second prong end 222a. In use, the first prong end 221a is positioned under the wire 12 on one side of the adhesive and the second prong end 222a is positioned under the wire on an opposite side of the adhesive between the wire 12 and the surface of the patient’s teeth and the wire lifter tool or core wire jig 220 is pivoted on the nose 225 to apply an outward force on the wire 12 to remove the wire from the adhesive. The clinician may then remove the adhesive adjacent to the wire lifter tool 200 using a rotating dental tool or other removal tool or method and repeats the process on an opposite side of the adhesive or for another portion of the wire 12.

[0037] The wire lifter jig or tool 220 of the second preferred embodiment may include the multiple prongs 221, 222, preferably the first and second prongs 221, 222, which can be tapered or straight. The prongs 221, 222 are spaced so that they can be placed on either side of the bonded composite or adhesive in a working configuration and may be positioned at a fixed distance relative to each other or may be flexible or configured for different spacings relative to each other. Multiple different sized wire lifter jigs or tools 220 may be provided to the clinician in a kit for manipulation of different sized adhesive or composite bonds. In addition, the clinician may utilize a device (now shown) that is able to trim the adhesive to a size that fits between the first and second prongs 221, 222.

[0038] The wire lifter jig or tool 220 may provide torque to move the wire 12 away from the tooth surface. The wire lifter tool and / or jig 220 may be weighted to apply hands-free torque once properly positioned.

[0039] The first and second prongs 221, 222 may be shaped so that once the pressure is applied to the wire 12, the prongs 221, 222 wedge into the teeth and force the wire 12 outwardly without the need hold the wire lifter jig or tool 220. The wire lifter jig or tool220 is less likely to cut the wire 12 or remove enamel or otherwise damage the tooth during use when compared to directly machining the adhesive with a rotating or mechanical dental tool. The first and second prongs 221, 222 are preferably positioned immediately on either side of the adhesive to immediately lift the portions of the wire 12 that extend out of the adhesive. The wire lifter jig or tool 220 may also be designed and configured to have an angle such that the wire lifter jig or tool 220 does not require the clinician to hold the wire lifter jig or tool 220 throughout the procedure, such as being configured to wrap over peaks of the teeth to hold the wire lifter jig or tool 220 in place and apply outward forces to the wire 12 adjacent the adhesive.

[0040] The wire lifter jig or tool 220 may have adjustable width prongs 221, 222 that may be used to apply pressure on the wire 12. A width W may be defined between the first prong end 221a and the second prong end 222a and the width maybe be adjusted or changed to change the distance between the first and second prong ends 221a, 222a or to change the width W. The second preferred embodiment may also include a mechanism or system for adjusting the width of the prongs 221, 222 or the separation of the prongs 221, 222 from each other and then applying a locking or securing feature so that the prongs 221, 222 are fixed in a position relative to each other when locked so that the clinician does not need to maintain pressure on the wire lifter jig 220 to maintain the separation distance or width between the prongs 221, 222 during use. The locking mechanism (not shown) could be a clip, clamp, lock or caliper or any other systems or methods that facilitate securing the positioning of the prongs 221, 222 relative to each other during use.

[0041] The wire lifter tool or jig 220 comprises a system for removing a directly bonded wire 12 from the patient’s teeth by applying an outward force to the wire 12 adjacent portions of the wire 12 that exit the adhesive. The wire 12 may then be rebonded or re-attached to the patient’s tooth after being de-bonded using the wire lifter tool and / or jig 220. The clinician may apply a temporary coating to the wire 12 once it is de-bonded from the teeth using the wire lifter tool and / or jig 220 and re-attach the wire 12 to the teeth, wherein the temporary coating may dissolve under normal conditions, thereby leaving a channel in the adhesive that permits limited movement of the wire 12 relative to the adhesive.

[0042] The wire lifter tool or jig 220 is particularly preferred when applying a recoat of material on the surface of the wire 12, at least on portions of the wire 12 that are exposed from the removed adhesive. The exposure of the portion of the wire 12 enables the recoat material to be placed around the entire perimeter of the exposed portion of the wire 12. The recoat material may dissolve beneath the re-applied adhesive, within a predetermined amount of time, such as twenty -four hours (24 hrs) from application of the adhesive, and forms the channel or aperture in the composite or adhesive to achieve slidability of the wire 12 within the channel. The predetermined amount of time is not limited to twenty-four hours (24 hrs) and may be otherwise designed and configured based on designer preferences or application or clinically specific requirements or preferences. The predetermined amount of time may be one minute (1 min) to seven hundred twenty-eight hours (728 hrs) or other times desired or required for a specific patient or application. For example, the predetermined time may be approximately twenty -four to ninety-six hours (24-96 hrs) or preferably less than or equal to seventy- two hours (72 hrs).

[0043] The exposed portion of the wire 12 may be coated with a temporary, dissolvable coating but the coating is spot placed on the wire 12 in the oral cavity. The coating may be comprised of a liquid, solid or gelatinous material. The coating may be brushed onto the wire 12, applied with a syringe or otherwise coated onto the wire 12 in the exposed portion. After application of the coating material, compressed air may be applied to the newly coated wire 12 so that the coating will stay bonded to the wire 12 long enough to allow for bonding of the wire 12 to a tooth using the adhesive.

[0044] The clinician may use a rotary device to remove the adhesive to disengage a previously mounted wire 12 and to remove some but not all of the composite or adhesive. The remaining composite or adhesive is used to create a ledge or channel in the composite or adhesive. The ledge or channel serves as a placement guide for applying a new wire 12. Once placed against the remaining composite comprised of the ledge or channel, the wire 12 is affixed to the teeth by applying additional composite or adhesive over the remaining composite and wire 12.

[0045] This method of re-applying the wire or applying a new wire 12 using the remaining ledge or channel may be employed by first using a digital model of thepatient’s teeth to fabricate a custom tray 10 that can be placed over the teeth. The tray 10 may be formed such that it provides a guidance surface against which the rotary tool can make contact and then be manipulated laterally while removing the composite or adhesive. The guidance surface is preferably fabricated so that the composite or adhesive is removed in a preferred position. The custom tray 10 may also have coloration proximate to the guidance surface to provide better visibility as to the contours of the guidance surface. This preferred system may be utilized to place new flexible orthodontic wires 12, place rigid or semi-rigid retention wires 12 or for other related purposes.

[0046] Referring to Figs. 3A and 3B, the preferred Class II (commonly referred to as overbite) corrective system may include directly bonded wires 12 which can be facial or lingual on either the upper or lower teeth. The wires 12 may be coated or segmented, different gauges, flexible, nitinol, stainless, and other materials and configuration and are secured to the patient’s teeth by bonding adhesive. The wires 12 may be applied to the patient’s teeth using the tray 10.

[0047] The preferred Class II corrective system, such as a Carriere distalizer in combination with an alternative orthodontic tray 20 having a relief window 20a. The alternative orthodontic tray 20 allows for placement of the flexible orthodontic wire 12 on the lower teeth near the gingival surface. This enables alignment of the teeth to occur simultaneously with correction of the Class II condition. The lower tooth retention system or alternative orthodontic tray 20 can be one or more in a series of retainers as the case progresses. In addition to the wire 12, the alternative orthodontic tray 20 may include opposing side relief features 22 that accommodate opposing prong 24 that are mounted on the facial side of the patient’s lower molars. The prongs 24 may be utilized with hardware 30 on the facial sides of the patient’s upper teeth and an elastic 32 to correct the Class II malocclusion while simultaneously stabilizing the correcting the alignment of the patient’s lower teeth.

[0048] In operation, a dental professional creates a treatment plan, the Class II system, including the hardware 30 and the prongs 24, is bonded to the patient’s teeth, the wire 12 is bonded to the patient’s teeth, the patient wears the orthodontic tray 20 on the lower teeth, which in the preferred embodiment is clear and removable and accommodated the wire 12 with the relief window 20a and the prongs 24 with the siderelief feature 22, but which also may be a fixed wire retainer and the patient wears an elastic 32 attached to the Class II system spanning from the prongs 24 to the hardware 30.

[0049] The preferred Class II distilization appliance distalizes the maxillary buccal segments all at once using an elastic 32 that extend from the upper arch to the lower arch or from the hardware 30 to the prongs 24. The lower arch is stabilized with the alternative preferred orthodontic tray 20 and the wire 12. The primary effect of the elastic 32 is to correct the patient’s overbite condition, which can be utilized simultaneously with the alternative preferred tray 20 to reduce the amount of time the patient spends in the treatment protocol. This device is particularly popular as a pre-aligner.

[0050] So that the wire 12 can be worn on the lower teeth simultaneously with the tray 20, the tray 20 of the alternative preferred embodiment is trimmed near the gingival edge and may not cover the occlusal surface of at least two of the teeth so that the teeth may not be locked into position by the tray 20. The alternative preferred tray 20 may be fabricated to enable it to fit near or around the elastic attachment buttons or prongs 24 so that the patient may wear the elastic 32 spanning from the prongs 24 to the hardware 30. Alternatively, the tray 20 may include a button, hook or other feature for connection of the elastics 32.

[0051] It will be appreciated by those skilled in the art that changes could be made to the embodiments described above without departing from the broad inventive concept thereof. It is understood, therefore, that this invention is not limited to the particular embodiments disclosed, but it is intended to cover modifications within the spirit and scope of the present invention as defined by the appended claims.

Claims

CLAIMSWe claim:

1. A system for mounting an orthodontic wire directly to surfaces of a patient’ s teeth, the system comprising: a tray configured to temporarily mount the orthodontic wire thereon, the tray designed and configured to conform to a shape of the patient’s teeth; an attachment mechanism associated with the tray, the attachment mechanism designed and configured to temporarily secure the orthodontic wire to the tray before the wire is secured to the patient’s teeth; and an adhesive, the tray configured to position the wire against the patient’s teeth when the tray is engaged with the patient’s teeth such that the adhesive bonds the wire to the patient’s teeth and the tray and attachment mechanism are removed from the patient’s teeth once the wire is bonded to the patient’s teeth.

2. The system of claim 1, wherein the attachment mechanism is comprised of a plurality of plugs connected to the tray.

3. The system of claim 1, wherein the attachment mechanism is comprised a flexible string that extends through attachment holes in the tray and wraps around the orthodontic wire to secure the wire to the tray before the tray is removed from the patient’s teeth.

4. The system of claim 1, wherein the tray includes a hole therein for introduction of the adhesive onto the wire and the patient’s teeth after the tray is mounted to the patient’s teeth.

5. The system of claim 4, wherein the tray includes a reservoir formed therein, the hole in fluid communication with the reservoir.

6. The system of claim 1, wherein the tray includes reservoirs formed therein configured to receive the adhesive for bonding the wire to the patient’s teeth.

7. The system of claim 1, wherein the tray includes a relief window.

8. The system of claim 1 , wherein an end of the wire extends proximate to the relief window when the wire is temporarily secured to the tray by the attachment mechanism.

9. The system of claim 1, wherein the tray includes attachment holes and a reservoir formed therein, the attachment holes spaced from the reservoir.

10. An orthodontic kit for urging an orthodontic wire that is directly bonded to a patient’s teeth away from the patient’s teeth, the orthodontic kit comprising: a core wire jig including a first prong having a first prong end, a second prong having a second prong end and a handle connecting the first and second prongs, the first and second prong ends spaced for positioning adjacent sides of the adhesive and between the orthodontic wire and a surface of the patient’s teeth to apply a force to the orthodontic wire away from the surface of the patient’s teeth.

11. The orthodontic kit of claim 10, wherein the first prong end and the second prong end may be relatively adjusted to change a width between the first prong end and the second prong end.

12. The orthodontic kit of claim 10, wherein the core wire jig includes a rounded nose and the handle, the rounded nose configured for positioning against the patient’s teeth.

13. The orthodontic kit of claim 10, wherein a width between the first and second prong ends is adjustable for positioning relative to opposing sides of a plurality of differently sized adhesives.

14. The orthodontic kit of claim 10, wherein the handle is spaced from the first and second prong ends.

15. A kit for correcting a Class II malocclusion of a patient’s teeth, the kit comprising:a tray configured for positioning on a mandibular portion of the patient’s teeth, the tray including a relief window at a front portion and a side relief feature on a rear portion; an orthodontic wire configured for mounting to the patient’s teeth; a prong configured for mounting to a mandibular molar of the patient’s teeth; hardware configured for mounting to a maxillary portion of the patient’s teeth; and an elastic configured for connection between the prong and the hardware in a working configuration.

16. The kit of claim 15, further comprising: an adhesive configured for application to the orthodontic wire and the patient’s teeth, the orthodontic wire configured for bonding to a lingual side of incisors of the patient’s teeth with the adhesive.

17. The kit of claim 15, wherein the prong includes a first prong and a second prong, the first prong configured for mounting to a facial side of a first mandibular molar and the second prong configured for mounting to a facial side of a second mandibular molar.

18. The kit of claim 17, wherein the side relief feature includes a first side relief feature and a second side relief feature, the first prong positioned proximate the first side relief feature and the second prong positioned proximate the second side relief feature in the working configuration.

19. The kit of claim 15, wherein the orthodontic wire is positioned adjacent the relief window in the working configuration.

20. The kit of claim 15, wherein the orthodontic wire is bonded directly to a lingual side of the patient’s teeth in the working configuration within the relief window.

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