Method for the production of an orthodontic orthopedic functional appliance for the treatment of skeletal class ii malocclusions

Abstract

This invention relates to the technical field comprising the manufacturing methods and the techniques used for producing orthodontic apparatuses. In particular, the invention relates to a method for producing an orthodontic orthopedic functional apparatus for the treatment of skeletal class II malocclusions. The aim of this invention is to develop a method which allows an orthopedic functional apparatus for the treatment of skeletal class II malocclusions classes to be made according to professional standards, without making the operation dependent on the operator. The technical problem arises from the fact that existing orthodontic apparatuses require a constant collaboration of the patient, who must keep the mouth closed for long periods, causing psychological and social discomfort and inducing poor collaboration. Moreover, the quality of these devices is strongly dependent on the experience of the operator, with significant variations in the results.

Description

[0001] METHOD FOR THE PRODUCTION OF AN ORTHODONTIC

[0002] ORTHOPEDIC FUNCTIONAL APPLIANCE FOR THE TREATMENT OF

[0003] SKELETAL CLASS II MALOCCLUSIONS

[0004] DESCRIPTION

[0005] Technical field

[0006] This invention relates to the technical field comprising the manufacturing methods and the techniques used for producing orthodontic apparatuses. In particular, the invention relates to a method for producing an orthodontic orthopedic functional apparatus for the treatment of skeletal class II malocclusions.

[0007] Background art

[0008] The aim of this invention is to develop a method which allows an orthopedic functional apparatus for the treatment of skeletal class II malocclusions classes to be made according to professional standards, without making the operation dependent on the operator. The technical problem arises from the fact that existing orthodontic apparatuses require a constant collaboration of the patient, who must keep the mouth closed for long periods, causing psychological and social discomfort and inducing poor collaboration. Moreover, the quality of these devices is strongly dependent on the experience of the operator, with significant variations in the results.

[0009] The aim of creating a device for the treatment of skeletal class II malocclusions is achieved by means of a tool comprising the features described in the main claim. The dependent claims describe advantageous embodiments of the invention.

[0010] To the best of the knowledge of the current inventor, systems of orthodontic appliances are known in the prior art and commonly used which require a high degree of collaboration of the patient and manual skills of the operator for their production and application. One example is the Sander appliance, an orthodontic device used to expand the upper dental arch and advance the jaw. This appliance consists of a central screw which is activated periodically to apply a lateral expansion force on the upper arch. It is often used in the treatment of malocclusions and dental crowding, providing sufficient space for the alignment of the teeth, but above all its anchors act as mandibular advancement. The Sander appliance requires an active patient collaboration, who must regularly activate the screw as instructed by the orthodontist and wear it for 24 hours a day to ensure the effectiveness of the treatment and to achieve the desired results. Disadvantageously, these systems require the patient to keep the mouth closed for long periods during the day, causing psychological and social discomfort, and strongly depend on the skills of the operator, with variable results in the registration of the construction bite.

[0011] The invention described in patent PCT / 1B2015 / 000277 relates to an orthodontic appliance for treating facial asymmetries. This device consists of a bite which covers the upper arch, having a pronounced thickness at the lateral portion of the asymmetrical side, which starts from the canine and descends proportionally up to the molar. The bite is equipped with a removable anatomical shield in the vestibule, to be applied on the asymmetrical side of the bite, and has the occluded surface inclined by an angle equal to the angle of mandibular asymmetry, with an edge of about one millimetre on the occluded surface of the portion of the asymmetrical side from the canines to the molars at the vestibular cusps of the lower arch.

[0012] Patent PCT / 1B2015 / 000277 specifically addresses the problem of facial asymmetries, but does not solve the problem of skeletal class II malocclusions often associated with them and not. The method proposed by this invention makes it possible to provide a device for the treatment of skeletal class II malocclusions in a more effective and comfortable manner for the patient, significantly reducing the need for constant collaboration. In addition, the proposed method allows a standardization of the production of the device whilst remaining personalized, improving the precision and reducing the variability due to the manual intervention by the operator.

[0013] Advantageously, the system proposed by this invention allows the automated production of standardised and personalised orthodontic appliances without direct contact with the patient. The prior art systems are always dependent on the skill of the operator and require constant patient collaboration. The problem of providing an orthodontic device which overcomes the limits of the prior art devices, and in particular which is precise, standardised and less invasive for the patient, therefore remains unresolved.

[0014] Disclosure of the Invention

[0015] An aim of the invention is to reduce the dependence on the operator for making orthodontic appliances.

[0016] Another aim of the invention is to improve the precision and standardisation of the devices produced.

[0017] A further aim of the invention is to reduce the psychological and social inconvenience for the patient.

[0018] A yet further aim of the invention is to allow the automated production of customised orthodontic devices.

[0019] Brief description of the drawings

[0020] The invention is described below according to a preferred embodiment of it, with reference to the accompanying drawings.

[0021] Other features and advantages of the invention will become clear on reading the description given below, provided as a non-limiting example, with the help of the accompanying drawings,. Anyone in the trade can better understand the invention, from a detailed description of the drawings, as follows:

[0022] Drg. 1 Fig. 1: Perspective view of the device.

[0023] Drg. 2 Fig. 2: Side view of the device in its configuration with the front ramp (3) constrained to the upper bite (1).

[0024] Drg. 2 Fig. 3: Side view of the device in its configuration with the front ramp (3) removed from the upper bite (1).

[0025] Drg. 3 Fig. 4: View of sagittal cephalometric tracing (14) of a patient’s skull.

[0026] Detailed description of preferred embodiments of the invention The invention relates to a method for the production of an orthodontic orthopedic functional appliance for the treatment of skeletal class II malocclusions, characterized by the following steps:

[0027] - Generation of a sagittal cephalometric tracing (14) of the patient's skull using a computerized system Drg. 3 Fig. 4;

[0028] - Tracing of the Sella-Nasion S-N axis (13) on the cephalometric tracing (14), where the Sella point S (20) is located at the center of the sella turcica and the Nasion point N (21) is located at the intersection of the frontonasal suture and the internasal suture Drg. 3 Fig. 4;

[0029] - Tracing of point B (22) supramentale as the most retrusive point of the bony contour of the mandibular symphysis Drg. 3 Fig. 4;

[0030] - Tracing of a first perpendicular line (15) passing through the Nasion point on the S-N axis (13) Drg. 3 Fig. 4;

[0031] - Tracing of a Nasion-B axis (16) that connects the Nasion point N (21) with the supramentale point B (22) Drg. 3 Fig. 4;

[0032] - Tracing of a circular arc (17) centered at the Nasion point N (21) passing through the supramentale point B (22) that intersects the first perpendicular line (15) at point BC (18) Drg. 3 Fig. 4;

[0033] - Measurement of the angle f (12) between the Nasion-B axis (16) and the first perpendicular line (15) passing through the Nasion point N (21) to determine the required inclination of the upper ramp (3) of the device Drg. 3 Fig. 4;

[0034] - Tracing of a second perpendicular line (23), perpendicular to the first perpendicular line (15) passing through the supramentale point B (22), where the intersection with the first perpendicular line (15) determines the construction point BC1 (19) Drg. 3 Fig. 4;

[0035] - Measurement of the distance between point BC (18) and point BC1 (19) to determine the height of the step (8) of the device Drg. 3 Fig. 4;

[0036] - Production of an upper bite (1) that follows the anatomical shape of the upper dental arch, having a step (8) with a height equal to the distance between point BC (18) and point BC1 (19), starting from the molars and extending to the beginning of the canines (9), and having in the center of each side of said upper bite (1), along the entire length of the step (8), a semicircular cross-section bump (6) with a radius between 1 and 3 mm, the cross-section of said bump (6), at the farthest point of its semicircular arc from the upper occlusal base (the term upper occlusal base refers to the plane or the surface of the upper teeth which enter into contact with the lower teeth during the closing of the mouth, that is, during occlusion of the teeth), intersects the line connecting the lower vestibular cusps, and whose said upper bite (1) is provided in the anterior part, starting from the beginning of the canines (9), with a curved upper ramp (3) that follows the internal perimeter of the upper arch, said upper ramp (3) having a height between 10 mm and 20 mm and an inclination angle corresponding to a multiple of the angle f (12) between 1 and 2, measured by tracing a third perpendicular line (24) to the lateral midsection of the upper bite (1) (the term lateral midsection means the portion of the bite which extends laterally with respect to a median line which divides ideally the upper dental arch into two symmetrical halves) and whose said upper bite (1) is equipped on each side with an anatomical shield (7) in the vestibule with a rectangular cross-section and rounded edges, spaced from said upper bite (1) according to the anatomy of the vestibule and not in direct contact with the lower teeth Drg. 1 Fig. 1, Drg. 2 Fig. 2, Drg. 2 Fig. 3 and Drg. 3 Fig. 4;

[0037] - Production of a lower bite (2) that follows the anatomical shape of the lower dental arch, covering the entire dental arch, with a smooth occlusal surface (5) designed to allow the bump (6) of the upper bite (1) to slide during mouth closure, and having in the anterior part, a slope (4) with the same inclination as the upper ramp (3), designed to allow said upper ramp (3) to slide during mouth closure, generating a rotation and advancement of the mandible Drg. 1 Fig. 1, Drg. 2 Fig. 2, Drg. 2 Fig. 3 and Drg. 3 Fig. 4.

[0038] The selection of the height of the upper ramp (3) in the range between 10 and 20 mm is determined on the basis of the desired degree of activation for the device. For a mild activation, the ramp is made with a height of 10 mm; for a more intense activation, a height of 20 mm is chosen. In the same way, the selection of the multiple between 1 and 2 for the inclination of the upper ramp (3) depends on the level of activation required. For a mild activation, an inclination of 1 is selected, corresponding to the angle f (12); for a strong activation, an angle of 2 is chosen, that is to say, twice the angle f (12).

[0039] The side shields (7) allow the soft parts to be moved away, leaving the jaw free Drg. 1 Fig. 1.

[0040] Moreover, the method may be performed by a 3D printing device or by a milling cutter, allowing automatic production of the device based on the data of the computerised cephalometric tracing (14). This approach allows for a standardised and precise production. According to preferred aspects, the invention is particularly suitable for use by means of a computerised system which generates and analyses the cephalometric tracings (14). Thanks to this method, it is possible to use artificial intelligence algorithms to optimise the automatic customisation of the device.

[0041] All the edges which constitute the device are bevelled to prevent cuts and discomfort for the user, with a connecting radius preferably between 1 mm and 5 mm.

[0042] Preferred features of the invention are defined in the dependent claims.

[0043] The upper ramp (3) may be equipped with a constraint which makes it removable from the upper bite (1) Drg. 2 Fig. 3. The removal of the upper ramp (3) allows the user to keep the mouth open and use the device during the day without the upper ramp (3); the device will continue to promote the rotation and the advancement of the mandible thanks to the bump (6) with a semi-circular crosssection which will slide on the smooth occlusal surface (5).

[0044] During the night time, the upper ramp (3) may be inserted to ensure a more intense activation with the mouth closed Drg. 1 Fig. 1 and Drg. 2 Fig. 2.

[0045] The side shields (7) may also have a constraint which makes them removable from the upper bite (1), improving comfort and allowing the user to remove them when necessary, for example to facilitate chewing during a meal.

[0046] A type of removable connection may be made, preferably, but without limiting the scope of the invention, by two metal bar (11) integral on each side with said upper ramp (3), which are inserted in suitable snap-on holes (10) made on the front edge of the step (8) relative to the upper bite (1) Drg. 2 Fig. 2 and Fig. 3. If there are difficulties in keeping the mouth closed during the night, such as snoring or oral breathing, the upper bite (1) and the lower bite (2) may be connected by elastics, making it easier to keep the mouth closed during use.

[0047] This invention offers certain important advantages. The main advantage is that automated production ensures a higher precision and standardisation. Moreover, the device does not force the patient to keep the mouth closed for long periods, reducing psychological and social discomfort.

[0048] The invention as described above refers to a preferred embodiment. It is nevertheless clear that the invention is susceptible to numerous variations falling within the scope of the disclosure, in the context of technical equivalents.

Claims

CLAIMS1. Method for the production of an orthodontic orthopedic functional appliance for the treatment of skeletal class II malocclusions, characterized by the following steps:- Generation of a sagittal cephalometric tracing (14) of the patient's skull using a computerized system;- Tracing of the Sella-Nasion S-N axis (13) on the cephalometric tracing (14), where the Sella point S (20) is located at the center of the sella turcica and the Nasion point N (21) is located at the intersection of the frontonasal suture and the internasal suture;- Tracing of point B (22) supramentale as the most retrusive point of the bony contour of the mandibular symphysis;- Tracing of a first perpendicular line (15) passing through the Nasion point on the S-N axis (13);- Tracing of a Nasion-B axis (16) that connects the Nasion point N (21) with the supramentale point B (22);- Tracing of a circular arc (17) centered at the Nasion point N (21) passing through the supramentale point B (22) that intersects the first perpendicular line (15) at point BC (18);- Measurement of the angle f (12) between the Nasion-B axis (16) and the first perpendicular line (15) passing through the Nasion point N (21) to determine the required inclination of the upper ramp (3) of the device;- Tracing of a second perpendicular line (23), perpendicular to the first perpendicular line (15) passing through the supramentale point B (22), where the intersection with the first perpendicular line (15) determines the construction point BC1 (19);- Measurement of the distance between point BC (18) and point BC1 (19) to determine the height of the step (8) of the device;- Production of an upper bite (1) that follows the anatomical shape of the upper dental arch, having a step (8) with a height equal to the distance between point BC(18) and point BC1 (19), starting from the molars and extending to the beginning of the canines (9), and having in the center of each side of said upper bite (1), along the entire length of the step (8), a semicircular cross-section bump (6) with a radius between 1 and 3 mm, the cross-section of said bump (6) at the farthest point of its semicircular arc from an upper occlusal base intersecting the line connecting the lower vestibular cusps, and whose said upper bite (1) is provided in the anterior part, starting from the beginning of the canines (9), with a curved upper ramp (3) that follows the internal perimeter of the upper arch, said upper ramp (3) has a height between 10 mm and 20 mm and an inclination angle corresponding to a multiple of the angle f (12) between 1 and 2, measured by tracing a third perpendicular line (24) to a lateral midsection of the upper bite (1), and whose said upper bite (1) is equipped on each side with an anatomical shield (7) in the vestibule with a rectangular cross-section and rounded edges, spaced from said upper bite (1) according to the anatomy of the vestibule and not in direct contact with the lower teeth;- Production of a lower bite (2) that follows the anatomical shape of the lower dental arch, covering the entire dental arch, with a smooth occlusal surface (5) designed to allow the bump (6) of the upper bite (1) to slide during mouth closure, and having in the anterior part, a slope (4) with the same inclination as the upper ramp (3), designed to allow said upper ramp (3) to slide during mouth closure, generating a rotation and advancement of the mandible.

2. Orthodontic orthopedic appliance for the treatment of skeletal class II malocclusions, obtained according to the method of claim 1, characterized by comprising:- An upper bite (1) that follows the anatomical shape of the upper dental arch, having a step (8) and having in the center of each side of said upper bite (1), along the entire length of the step (8), a semicircular cross-section bump (6) with a radius between 1 and 3 mm, whose cross-section, at the farthest point of its semicircular arc from the upper occlusal base, intersects the line connecting the lower vestibular cusps, and having in the anterior part, starting from the beginningof the canines (9), an upper ramp (3) contained within the upper arch, with a height between 10 mm and 20 mm;- A lower bite (2) that follows the anatomical shape of the lower dental arch, covering the entire dental arch, with a smooth occlusal surface designed to allow the bump (6) of the upper bite (1) to slide during mouth closure, and having in the anterior part, a slope (4) with the same inclination as the upper ramp (3), designed to allow said upper ramp (3) to slide during mouth closure, generating a rotation and advancement of the mandible.

3. Orthodontic orthopedic appliance for the treatment of skeletal class II malocclusions, according to claim 2, characterized by the fact that the upper ramp (3) is equipped with a removable connection from the upper bite (1).

4. Orthodontic orthopedic appliance for the treatment of skeletal class II malocclusions, according to claim 2, characterized by the fact that the lateral shields (7) are equipped with a removable connection from the upper bite (1).

5. Orthodontic orthopedic appliance for the treatment of skeletal class II malocclusions, according to claim 2, characterized by the fact that the upper bite (1) and the lower bite (2) are connected by elastics, facilitating the maintenance of mouth closure during use.

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