Computer system and computer-implemented method for orthodontic treatment planning

Abstract

Described herein are methods and computer devices for interpreting human input upon reviewing an orthodontic treatment plan and making requested changes to the plan or providing requested information on the plan A multi-modal user interface processes the inputs, classifying them as either requests for information or requests for changes to the proposed treatment plan. When changes are requested, the user interface passes appropriate parameters to one or more modules to implement those changes. In handling requests for changes, the computer device involves determining whether the inputs are intended as: (1) modifications, adjustments, or refinements to the target dentition associated with the treatment plan, directing these to a refinement module that implements these adjustments to the current target dentition while minimising the non-requested changes effected to the target dentition in order to ensure clinical validity; or (2) major changes, such as alterations to clinical treatment parameters and preferences, which are directed to an automated treatment planning module that re-computes a new treatment plan, including a new target dentition, based on the original dentition using updated criteria.

Description

COMPUTER SYSTEM AND COMPUTER-IMPLEMENTED METHOD FOR ORTHODONTIC TREATMENT PLANNINGTECHNICAL FIELD

[0001] The present invention relates to the field of orthodontic treatment planning, and more specifically, to automated planning of orthodontic treatment using a series of patientremovable appliances to reposition teeth.BACKGROUND OF THE INVENTION

[0002] Clear aligner orthodontic treatment planning involves creating a detailed treatment plan for repositioning teeth to achieve a target dentition that aligns with patient-specific clinical preferences and the principles of good occlusion. For any given patient, there may be a range of clinically valid target dentitions possible, each emphasizing different clinical or aesthetic aspects.

[0003] The process of modifying the proposed treatment plan typically requires a technician to interpret the person's (e.g. clinician’s) feedback which is typically communicated by text over software platforms. The person determines if the request involves (1) minor adjustments to the proposed plan, such as minor adjustments to one or more tooth positions, which can be effected on the target dentition, or (2) significant changes, such as alterations to the clinical treatment parameters (e.g., introducing IPR or opting for tooth extractions), requiring a whole new treatment plan to be crafted or generated from the initial patient dentition.

[0004] In the prior art, for changes, the technician typically reverts to the initial patient dentition and generate a new plan that incorporates updated clinical parameters. This manual process typically encounters a number of challenges:• Manual Iterative Adjustments: Each requested change can result in multiple manual adjustments and arriving or converging to a suitable treatment plan may require repeated review and modification cycles, i.e., back and forth between clinician and technician.• Loss of Clinical Intent: Translating clinician input into constraints can be challenging, potentially leading to unintended changes in non-target teeth.• Recalculation Needs: When a request requires a new target dentition, the process of recomputing a plan from the original patient dentition can be lengthy and may not always align with the clinician’s expectations.SUMMARY OF THE INVENTION

[0005] At its most general, the present invention provides a technique for automating the adjustment of an orthodontic treatment plan, in which consequential changes to a targetdentition, which are required as a result of implementing a requested change, are automatically determined in a manner that ensures the resulting adjusted target dentition still complies with all applicable clinical and aesthetic requirements and / or preferences. In particular, the invention may determine the consequential changes in a way that minimises the requires adjustment to the target dentition, whilst remaining compliant with the relevant clinical and aesthetic requirements and / or preferences.

[0006] According to a first aspect of the invention, there is provided a computer- implemented method for creating an orthodontic treatment plan, the method comprising: generating an initial orthodontic treatment plan that maps a transition for a set of teeth from a current dentition to a target dentition, wherein the target dentition complies with a dentition specification indicating one or more clinical and aesthetic requirements and / or preferences; receiving a change request that identifies an adjustment of a parameter of the target dentition; automatically determining an additional change to the target dentition required as a consequence of implementing the change request in order to remain compliant with the dentition specification, wherein the additional change comprises an adjustment to a parameter of the target dentition not identified in the change request; obtaining an adjusted target dentition that incorporates the change request and the additional change; and generating a revised orthodontic treatment plan that maps a transition for the set of teeth from the current dentition to the adjusted target dentition. The method provides a solution that avoids the manual processing required in the prior art, which is time-consuming, prone to delays due to remote communication, and requires specialized training.

[0007] Herein, the term “dentition” means the configuration, e.g. relative position and orientation, or a set of teeth. The term “dentition specification” is used to mean a collection of rules and preferences that govern how the target dentition is derived or selected. The dentition specification may reflect clinical norms (principles of good occlusion) and may define to clinical preferences, anatomical constraints, and patient-specific considerations, such as jaw shape and periodontal health. The dentition specification may be predefined or predetermined, e.g. through instructions communicated to a technician or automated treatment plan module, as is known.

[0008] The target dentition may be one of a plurality of solutions that comply with the dentition specification. In other words, there is not necessarily a unique configuration of teeth that will satisfy the requirements and preferences set forth in the dentition specification. On the contrary, it is more likely that there will be a set of possible solutions. The step of generating the initial orthodontic treatment plan may comprises selecting one of those possible solutions. That is, the target dentition may be a selected one of a plurality of dentition solutions, each of which comply with the dentition specification.

[0009] The present invention addresses a scenario in which implementation of a requested change to the target dentition causes the changed target dentition no longer to comply with the dentition specification, i.e., it no longer falls within the set of possible solutions. Toaddress this scenario, the invention automatically determines one or more additional changes that required to bring the changed target dentition back within the set of possible solutions. A particular advantage of the invention is that the additional change(s) can be determined in a way that minimizes the overall adjustment to the target dentition. In other words, the method is predisposed to keeping the adjusted target dentition as close as possible to the original target dentition.

[0010] The identified parameter in the change request may be a position or orientation of a tooth specified in the change request. Alternatively or additionally, the identified parameter may be an interproximal reduction, IPR, value. For example, the method may include introducing and / or changing interproximal reduction (IPR) to the target dentition by adding or increasing IPR to the current dentition in order to accommodate for changes in position and / or orientation of one or more teeth. IPR may be added or increased if two teeth would overlap. The additional change may comprise an adjustment to a position or orientation of a tooth not specified in the change request.

[0011] To illustrate, consider an example in which the change request is “incline teeth X, Y and Z by 5 degrees”. In principle, this request is straightforward to execute by moving only the specific (target) teeth by the requested amount. However, this alone will almost certainly introduce issues that need to be resolved. For example, following an inclination is highly likely that the target tooth will either overlap / collide with neighbouring teeth or create a gap between them. These consequences will conflict with the dentition specification, either because they introduce a physically impossible or undesirable outcome. Solving these issues is what necessitates the additional change(s), typically to teeth that not specified in the change request. The invention provides a way to do this efficiently and automatically.

[0012] One way in which the adjusted target dentition can be kept as close as possible to the original target dentition is use the target dentition as the starting point for the adjusted target dentition. In other words, the adjusted target dentition may be obtained by adjusting the target dentition. This differs, for example, from a solution in which the adjusted target dentition in determined de novo from the current dentition. Unlike known systems that recompute the entire treatment plan, the invention may focus on adjusting only what is necessary to ensure minimal disruption to the target dentition. It may thus accommodate the requested change while minimising the re-positioning of other teeth.

[0013] There may also be a plurality of possible solutions for the adjusted target dentition, i.e. a number of ways of adapting the target dentition to implement the change request and remain compliant with the dentition specification. The adjusted target dentition may thus be a selected one of a plurality of adjusted dentition solutions that each incorporate the change request and remain compliant with the dentition specification.

[0014] In a preferred embodiment, the selected adjusted dentition solution minimises the additional change needed to the target dentition. The method may automatically select this solution. For example, the step of determining the additional change may compriseminimising a magnitude of adjustment to the parameter of the target dentition not identified in the change request.

[0015] Alternatively, the method may propose a number of alternative solutions to allow one to be selected by a user. For example, the step of generating the revised orthodontic treatment plan may comprise: generating a plurality of options for the adjusted target dentition; and receiving, by the user interface, a selection of one of the plurality of options, wherein the revised orthodontic treatment plan is based on the selected one of the plurality of options. This may permit the method to run iteratively, to allow fine tuning of the change request and additional change until a satisfactory adjusted target dentition is obtained.

[0016] The step of minimising the magnitude of adjustment may use (i.e. may seek to minimise the magnitude of) one or more of the following metrics: (i) a difference in position and / or orientation of a tooth relative to the target dentition; (ii) a difference in one or more components of tooth movement, optionally including inclination, angulation, rotation, bucco- lingual translation, mesio-distal translation, or intrusion / extrusion; (iii) the number of teeth whose positions and / or orientations remain identical between the target dentition and the adjusted target dentition; and (iv) difference in one or more dental metrics between the target dentition and the adjusted target dentition, optionally including crowding, Bolton ratio, or inter-canine width.

[0017] There may be circumstances in which the change request is so significant that is not possible to find a solution that complies with the dentition specification. In this scenario, the method may include generating a notification that the change request cannot be implemented, and / or generating a new orthodontic treatment plan de novo starting from the current dentition.

[0018] The change request may be input by a user. The change request may directly identify one or more teeth to be adjusted, i.e. it may explicitly identify the parameter to be adjusted, and the adjustment required. In other example, however, the parameter and the required adjustment may be derived from an input change request. The change request may identify a change to the target dentition. Alternatively or additionally, the change request may identify an alteration to the dentition specification.

[0019] The initial orthodontic treatment plan may be generated in any conventional manner. For example, the initial orthodontic treatment plan may be crafted either by a technician or generated automatically, for example using an automated treatment planning module based on the current dentition and / or guided by clinical and aesthetic preferences and treatment parameters selected by the person (e.g. the patient and / or the clinician) as well as pre-defined orthodontic norms of good occlusion. In one example, generating the initial orthodontic treatment plan may comprise: obtaining, e.g. via a suitable data interface, a virtual three- dimensional, 3D, model representing the current dentition; receiving, via a user interface, the dentition specification indicating the one or more clinical and aesthetic requirements and / orpreferences; and using the virtual 3D model and the dentition specification to determine the target dentition.

[0020] Each tooth of the person may be represented in the virtual 3D model, which may be in a computer-readable format. The 3D model may include a virtual 3D representation of each tooth such that the 3D model can be processed by a computer or the computer device described herein. The 3D model may be considered 3D data of the teeth and their position and / or orientation. The 3D model of the teeth may be in the form of surface meshes. The 3D model may include surface information about the relative position of teeth on the upper and / or the lower jaw.

[0021] For example, a piece of data of the 3D model may correspond to a pixel of a scan of the teeth (e.g. a pixel of a scanned surface of a tooth), and describes the position, orientation, colour, material / tissue, etc of the tooth corresponding to this pixel. Alternatively or additionally, the 3D model may correspond to a point cloud, including of 3D vertices (points) plus, optionally, any associated attributes such as orientation (e.g. normals), colour, curvature etc. A connected set of points can also be used - for example a triangular (or other polygon) mesh. Mathematical functions (such as Radial Basis functions) may also represent small regions of a scan (or the 3D model).

[0022] The 3D model may describe, show, and / or include dental features of the teeth. The dental features may relate to any feature in the mouth of the patient / person that is visible to the human eye and / or can be recorded using optical measurement techniques. For example, the dental features may include buccal / facial surfaces of the teeth, lingual / palatal surfaces of the teeth, occlusal surfaces of the teeth, distal surfaces of the teeth (if visible), and / or mesial surfaces of the teeth. The dental features may also include buccal / facial surfaces of portions of the dental soft tissue (e.g. gum / gingiva, oral mucous membrane, etc) and / or portions of the patient’s dental soft tissue.

[0023] The 3D model may be considered a virtual representation of the current dentition, i.e. the dentition of the person / patient on which the orthodontic treatment is based, e.g. before the orthodontic treatment has started. As such, the 3D model may include all necessary information for the orthodontic treatment. The 3D model may be in a data format that can be processed to be visualised on a display of the computer device and / or on any other computer. The 3D model may be used for virtually modelling the orthodontic treatment. Alternatively or additionally, the 3D model may be used for producing a physical 3D model of the teeth, for example by milling a blank.

[0024] The 3D model may be obtained by directly scanning the patient’s mouth using an intraoral dental scanner or obtaining an impression of the teeth, forming a model based on the impression, and scanning the model using a dental scanner.

[0025] For example, the dental scanner may be wireless coupled to the computer device and / or connected to the computer device via the data interface such that the 3D surfaceprofile information can be transmitted from the dental scanner to the computer device. Alternatively or additionally, the 3D model may be downloaded from a databank.

[0026] The term “data interface” is used herein to mean any interface which provides for the gathering or obtaining of the 3D model. This data interface may be an interface of the computer device for receiving data, e.g. from the intraoral scanner or a databank.

[0027] The teeth and / or dental features of the teeth may be represented in the 3D model as a set of parameters. For example, a first set of parameters is used to specify the outer surface of each teeth and a second set of parameters specifies the position and / or the orientation of each teeth. In other words, the first set of parameters may be considered specifying the shape of an individual tooth and / or the second parameter may be considered specifying the spatial relationship of one tooth to the other teeth. For example, the orthodontic treatment plan may include spatially moving one or more teeth and / or changing the orientation of one or more teeth. As such, the orthodontic treatment plan may include information on how the second set of parameters needs to be changed from an initial position (current dentition) to a desired position (target dentition). The target dentition may thus comprise a target position and orientation for each tooth.

[0028] The change request and additional change(s) discussed herein may relate to any of the parameters in the 3D model. The parameters may be changed directly, e.g. by changing position or orientation of a tooth. The parameter may be changed indirectly, e.g. by adjusting an interproximal reduction (IPR) value.

[0029] The method may include presenting the initial orthodontic treatment plan for review by the patient and / or clinician. The method may include providing a user interface that permits the patient and / or clinician to (i) accept the orthodontic treatment plan, (ii) request more information about it, or (iii) request changes to it based on specific aesthetic or functional considerations that have become apparent upon reviewing the treatment plan and target dentition. Any requested change form the basis of the change request discussed above.

[0030] The user interface may include an input device (such as a keyboard, mouse and / or touchscreen) and / or a chatbot device. The input device may be used to directly and / or indirectly change the parameters in the 3D model. For example, a command for changing the parameter of a tooth can be input (an example for a direct change of the parameter) and / or the tooth can be moved and / or re-oriented in a virtual model of the teeth (e.g. on a screen). In this case, the movement of the tooth in the virtually displayed model may be automatically transferred in a command to change one or more parameters of the tooth or teeth.

[0031] In some examples, the initial treatment plan may include information on the configuration of one or more aligners. Optionally, the method further comprises manufacturing one or more aligners in line with the revised orthodontic treatment plan.

[0032] The method may be implemented on any suitable computing device, e.g. a computer including a processor and a memory which is configured to store an algorithm or program that can execute the steps of the methods described herein.

[0033] The step of receiving the change request may comprise: receiving a qualitative request identifying a target clinical or aesthetic outcome; and translating the qualitative request into the change request that that identifies the parameter of the target dentition to be adjusted. For example, the method may include a natural language processor configured to output the change request in response to receive a natural language input. In other words, the step of receiving the change request may include: receiving a natural language input, and converting the natural language input into one or more commands for changing the identified parameter.

[0034] The method may also operate to produce a natural language output that explains the adjustment(s) to the target dentition. For example, the step of generating the revised orthodontic treatment plan may further comprise expressing the adjustments of the change request and the additional change in natural language.

[0035] The natural language functionality may be an independent second aspect of the invention. According to this second aspect, there is provided computer-implemented method for creating an orthodontic treatment plan for a person, the method comprising: generating an initial orthodontic treatment plan that maps a transition for a set of teeth from a current dentition to a target dentition; receiving a natural language input that requests a change to the target dentition; converting the natural language input into a command that identifies an adjustment of a parameter of the target dentition; and generating a revised orthodontic treatment plan that maps a transition for the set of teeth from the current dentition to an adjusted target dentition that incorporates the change request.

[0036] With this aspect, tasks previously done by a technician can be automated by using the user interface which can be considered a module for converting natural language input into commands for changing the position and / or orientation of one or more teeth, e.g. according to the method of the first aspect set out above.

[0037] The natural language functionality may be provided by a chatbot interface or device. The chatbot device may include a receiving device and a processing device. The receiving device is configured to receive the natural language input. For example, the receiving device includes a microphone. Alternatively or additionally, the receiving device may be provided as part of the user interface, e.g. as an input device. For example, the input device may be used to type in text as a natural language input. The processing device may be provided by the processor of the computer device. The processing device may be configured to convert the natural language input into commands for changing one or more parameters of the teeth or tooth in the 3D model

[0038] The chatbot device may include a computer program or an artificial intelligence agent, e.g. leveraging a large language model (LLM), that is programmed to conduct a conversation in natural language either in text or spoken format.

[0039] The chatbot device may be designed to act as a virtual assistant, interpreting clinician inputs in natural language into actionable categories. This may include requests for information, request for refinements (e.g. a change request as set out above), and requests forre-computation. The requests for information may include providing feedback on the distance between upper and lower canines. Thus, the chatbot device may generate command to retrieve the corresponding data from the 3D model.

[0040] The chatbot may output a command corresponds to the change request, e.g. relating to modifications like adjusting a tooth's inclination or reducing oveijet, intended to be applied to the target dentition.

[0041] The chatbot may output a command for re-computation if significant changes are needed, such as altering clinical treatment parameters (e.g., allowing for interproximal reduction). The chatbot device may decide that a new treatment plan should be generated with updated preferences.

[0042] The natural language input may include text command and / or a voice command.

[0043] A third aspect of the invention provide a system for implementing the method of the first aspect. The system may comprise a computer device equipped with functional modules for executing the steps of the method. For example, the computer device may comprise a treatment plan module, a user interface (such a chatbot), and a refinement module.

[0044] According to this aspect, there may be provided a computer device for creating an orthodontic treatment plan, the computer device comprising: a treatment plan module configured to generate an initial orthodontic treatment plan that maps a transition for a set of teeth from a current dentition to a target dentition, wherein the target dentition complies with a dentition specification indicating one or more clinical and aesthetic requirements and / or preferences; a user interface configured to receive a change request relating to the target dentition; a refinement module configured to: identify, from the change request, an adjustment of a parameter of the target dentition; automatically determine an additional change to the target dentition required as a consequence of implementing the change request in order to remain compliant with the dentition specification, wherein the additional change comprises an adjustment to a parameter of the target dentition not identified in the change request; obtain an adjusted target dentition that incorporates the change request and the additional change; and generate a revised orthodontic treatment plan that maps a transition for the set of teeth from the current dentition to the adjusted target dentition.

[0045] As discussed in relation to the second aspect, the user interface may include a multimodal chatbot configured to configured to receive a natural language input and convert the natural language input into a command to change the identified parameter. The chatbot may be configured to issue commands to both the refinement module and the treatment plan module. For example, the chatbot device may be configured to translate a clinician’s input into suitable parameters and directs them to the appropriate modules (e.g. the refinement module or the treatment plan module), enabling either refinements / adjustments to the target dentition or the creation of a new treatment plan with a new target dentition.

[0046] The user interface may automatically manage a variety of typical requests (e.g. by a person, such as a patient or a clinician) upon review of a treatment plan, such as: providinginformation about the plan; making direct adjustments or refinements to the target dentition (using the refinement module); and / or generating a new treatment plan based on revised preferences and parameters (using the treatment plan module).

[0047] The treatment module may comprise a data interface configured to receive or otherwise obtain a virtual three-dimensional (3D) model representing teeth of the person.

[0048] The refinement module may be configured to directly adjust the target dentition based on clinician input without reverting to the current dentition (e.g. without reverting to the original 3D model on which the target dentition is based).

[0049] The refinement module may employ strategies that implement the requested change while minimizing adjustments to non-target teeth, maintaining clinical validity and original preferences. The refinement process can be iterative, allowing fine-tuning until the clinician is satisfied.

[0050] The refinement module may deal with requests to change the position and / or orientation of one tooth or a few teeth. The refinement module may not deal with requests to change the position and / or orientation of all teeth. For example, the refinement module may deal with requests to change the position and / or orientation of 1 tooth, 2 teeth, 3 teeth, 4 teeth, 5 teeth, 6 teeth, 7 teeth, 8 teeth, 9 teeth, 10 teeth, 11 teeth, 12 teeth, 13 teeth, or 14 teeth.

[0051] The tooth or teeth whose position and / or orientation is requested to be changed may be considered as a target tooth or target teeth. The teeth that are not requested to be changed may be considered non-target teeth. Where multiple target teeth are identified, they may be adjacent to each other or non-adjacent, i.e. may have any number (including zero) non-target teeth therebetween. For example, a change request may relate to inclining both upper canines by a certain degree. In this case, four non-target teeth may be arranged between the target teeth (the canines).

[0052] The refinement module may aim to change only the position and / or orientation of the target teeth. However, as discussed above, this may not be possible in practice. Thus, the refinement module may change the position and / or orientation of non-target teeth. The changed non-target teeth may be adjacent or non-adjacent to the one or more target teeth. The refinement module may be configured to change up to 1 adjacent non-target tooth, 2 adjacent non-target teeth, 3 adjacent non-target teeth, 4 adjacent non-target teeth, or 5 adjacent non- target teeth (e.g. on one or both sides in ajaw) and / or up to 1 adjacent non-target tooth, 2 adjacent non-target teeth, 3 adjacent non-target teeth, 4 adjacent non-target teeth, or 5 adjacent non-target teeth in the opposing jaw.

[0053] In practice, the number of non-target teeth to be adjusted may depend on the difficulty of resolving the issues that arise in the process of implementing the change request.

[0054] Movement of non-target teeth may be necessary in order to ensure that the revised orthodontic treatment plan continues to adhere to the dentition specification. However, it may be desirable to minimise the movement of non-target teeth in order to ensure highresemblance between the initial orthodontic treatment plan and the revised orthodontic treatment plan. This minimisation may be necessary to ensure that the outcome of performing a refinement is predictable to the user. The target dentition generation method may inherently generate treatment plans where movement of non-target teeth is limited.

[0055] The movement to be minimised may be quantified using one or more metrics, for example: a. Difference in position and / or orientation of each non-target tooth (relative to the initial orthodontic treatment plan) to be as close to 0 as possible. These may be broken down into individual movements, e.g. difference in inclination, difference in angulation, difference in rotation, difference in bucco-lingual translation, difference in mesio-distal translation, difference in intrusion / extrusion. b. Number of teeth whose position and / or orientation is identical between the refined and the initial treatment plan. c. Difference in dental metrics (well established in dental literature) , such as crowding, Bolton ratio or inter-canine width (compared to the initial orthodontic treatment plan) to be as close to 0 as possible, unless implied in the request (e.g. a request to incline canines implies expectation that inter-canine width will change).

[0056] This minimisation may be achieved by comparing multiple alternative refined treatment plans, obtained e.g. with the use of different heuristics, with the use of a cost function. Such a cost function may e.g. calculate a singular score, using e.g. an arithmetic average, geometric average, maximum of the individual metrics or other mathematical function. Derived metrics may be used, e.g. a square root of a given metric, or a score assigned based on a metric falling within a certain range (e.g. a particular movement of 0.1 to 0.2 mm may be assigned a score of 1, while 0.2 to 0.3 mm a score of 2 etc.).

[0057] The one or more clinical and aesthetic requirements and / or preferences in the dentition specification may include a plurality of restrictions which provide ranges (within which the target position and / or orientation can be moved) and / or limitations for the position and / or orientation of each tooth. For example, the restrictions include ranges and / or limitations for providing a clinically valid dentition. The restriction may also include ranges and / or limitations that reflect preferences of the user. For example, a limitation may refer to a position and / or orientation of one or more teeth that should not be changed or only to a certain extent.

[0058] A clinically valid dentition may require that the teeth are within certain ranges and / or comply with certain limitations for providing good occlusion. The restrictions may not refer to physical restrictions (e.g. a virtual overlap of teeth). Rather, the restrictions may be based on clinical and / or aesthetic considerations.

[0059] Some of the one or more clinical and aesthetic requirements and / or preferences may be automatically generated when generating the initial orthodontic treatment plan. Some orall of the one or more clinical and aesthetic requirements and / or preferences may be manually selected by a user, e.g. a clinician, prior to generating the initial orthodontic treatment plan.

[0060] For example, the one or more clinical and aesthetic requirements and / or preferences may provide ranges and / or limitation for obtaining a good occlusion. Further, the one or more clinical and aesthetic requirements and / or preferences may be selected with regard to aesthetic considerations. The generation of the one or more clinical and aesthetic requirements and / or preferences may be an iterative process. For example, the automated treatment module may generate the initial dentition with ranges and / or limitation that are clinically valid. Upon user input, aesthetic preferences and / or changes are input which prompt the automated treatment module to generate an updated dentition with ranges and / or limitation that are clinically valid and fulfil the preferences.

[0061] The one or more clinical and aesthetic requirements and / or preferences may include physical constraints on the target position and / or orientation of teeth which may need to be imposed to ensure treatment feasibility, and thus the treatment plan to be (clinically) valid. The one or more clinical and aesthetic requirements and / or preferences may comprise the requirement that no two teeth should overlap / collide with one another. This constraint may be applied to adjacent teeth within the same jaw. It may also be applied to teeth in opposing jaws. In addition to these physical constraints, other clinical and aesthetic requirements and / or preferences may be defined.

[0062] The one or more clinical and aesthetic requirements and / or preferences may comprise one or more metrics or criteria, for example:1. Oveijet and / or overbite to be within a certain range.2. Dental metrics, such as crowding, Bolton ratio or inter-canine width (these metrics, and the method of measuring them, are well known in the art) width to be within a certain range.3. Tooth inclinations and angulations to be within a certain range.4. Tooth displacement, e.g. bucco-lingual movement (relative to their initial position) to be within a certain range.5. Occlusion to fall within Class I, as defined in Angle’s Classification of Malocclusion.6. All, or a subset, of the criteria of ‘Andrews' six keys to occlusion’ to be met.7. Incisal edges of teeth (or other axes derived from the teeth’s geometry) to not deviate from the tangent of a curve defining the target arch shape by more than a certain amount.8. Certain landmarks on adjacent teeth to he within a certain distance of one another (e.g. mesial landmark on one tooth to be within a certain distance of the distal landmark on the tooth mesial of it).9. Index of Orthodontic Treatment Need (IOTN) score or Peer Assessment Rating (PAR) Index, or computer-derived approximation of these scores, or their subset to be within a certain range.

[0063] These one or more clinical and aesthetic requirements and / or preferences may be predefined and / or specified by the user.

[0064] The user may be able to specify that one or more teeth is to be allowed to deviate from these metrics / criteria, and / or introduce additional / stricter requirements for one or more teeth.

[0065] It is possible to maintain, modify, and / or supplement the one or more clinical and aesthetic requirements and / or preferences during the refinement of the initial treatment plan. For example, a user, such as a clinician, may change one or more of the aesthetic preferences before and / or during the refinement of the initial treatment plan. The modified aesthetic preference may relate to the requested change in the position and / or orientation of the target teeth.

[0066] If the refinement module determines that a clinically valid dentition and / or clinically valid target position of all teeth cannot be generated using the above defined constraint on how many targeted and / or non-target teeth are changed, the refinement module may decide that it cannot execute the request. In this case, the request may be handled by the treatment plan module.

[0067] The adjusted target dentition may describe the position and / orientation of all target teeth and / or all non-target teeth (e.g. the non-target teeth that are changed by the refinement module). The adjusted target dentition may refer to the position and / orientation of all teeth after the revised orthodontic treatment plan has been completed. The difference between the (adjusted) target dentition and the current dentition may correspond to the spatial movement and / or re-orientation of each tooth that is achieved by the initial or revised orthodontic treatment plan. This change in the position and / or the orientation of a tooth may be implemented by wearing one or more aligners.

[0068] The chatbot device may be able to differentiate between requests for information, modifications to the current target dentition, and requests for complete re-computation, ensuring the appropriate response to each clinician request.

[0069] For example, an indirect request may include a user input to “broaden the arch”, which can be re-interpreted as a request to adjust transverse tooth positions or rotations; a request to “reduce oveijet”, which may correspond to adjusting inclinations of anterior teeth; or a request to “reduce black triangles”, which may correspond to adjusting angulations of central incisors and / or introducing or increasing interproximal reduction (IPR) between those teeth.

[0070] An indirect request may not relate to individual target teeth. Rather, the indirect request may relate to a group of target teeth that are requested to change together.

[0071] Exemplary advantages of the present disclosure may include any one or more of the following:• Enhanced clinician control: Clinicians can provide real-time feedback through the chatbot device, allowing iterative adjustments to the treatment plan until it meets their objectives.• Improved refinement workflow: When the clinician requests a change to the target dentition, the request is expressed in terms of the target dentition rather than the current dentition. Re-framing these requests into suitable constraints or preferences for an ab initio re-computation of a new target dentition, starting from the current dentition, can be complex and may lead to unwanted changes to non-target teeth. As the clinician moves through different iterations, stacking up requested changes, the process of translating these refinement requests into parameters for the treatment plan module becomes increasingly challenging.• Minimized unintended changes: The refinement module limits changes to non-target teeth, ensuring the treatment plan aligns with the clinician's intent while maintaining clinical validity. Adjustments to the current target dentition are directly applied.• Adaptable workflow: The system efficiently handles both minor adjustments and significant changes, dynamically transitioning between refinement and recomputation as needed.

[0072] The optional step of iterating changes to the non-target teeth until the clinically valid target position and / or orientation for each tooth is achieved may refer to changing the position and / or orientation of one or more teeth until the target dentition is achieved. However, if this target dentition is not clinically valid, the generation of the target dentition is repeated by changing the position and / or orientation in a different way.

[0073] The optional step of generating a notification that the change request cannot be fully achieved may be displayed on a screen of the computer device. The chatbot device may convert the parameters that cause the clinical validity into a verbal output.

[0074] The present disclosure encompasses the combination of the aspects and optional features described herein except where such a combination is clearly impermissible or expressly avoided.BRIEF DESCRIPTION OF THE DRAWINGS:

[0075] FIG. 1: A block diagram showing an embodiment of a computer device for obtaining an orthodontic treatment plan for a person

[0076] FIG. 2: A flowchart showing an embodiment of a method of orthodontic treatment planning, comprising a chatbot device, a refinement module and a treatment plan module.

[0077] FIG. 3: A flowchart showing an embodiment of a method of orthodontic treatment planning, comprising a chatbot device and an automated system (either a refinement module or a treatment plan module).

[0078] FIG. 4: A flowchart showing an embodiment of a method of orthodontic treatment planning, comprising a chatbot device and an automated system (either a refinement module or a treatment plan module).

[0079] FIG. 5: An image illustrating an example graphical user interface of the system during interaction of the user (clinician) with the chatbot device.

[0080] FIG. 6: A flowchart illustrating an example interaction between a user (clinician), the chatbot device and the computer device (refinement module).

[0081] FIG. 7: A flowchart illustrating another example interaction between a user (clinician), a chatbot device and the computer device (refinement module).DETAILED DESCRIPTION OF THE INVENTION:Definitions

[0082] The term “chatbot” is used herein to mean a chatbot with a multi-modal interface that allows clinicians to interact using natural language inputs (e.g., typing or voice commands) to request treatment plan changes (e.g. using the refinement module or the automated treatment plan module) or information. The chatbot device may be configured to interpret requests and classify them, converting them into suitable parameters according to predefined rules, and communicates these parameters to one or more modules (such as a refinement module and a treatment plan module).

[0083] The term “orthodontic treatment plan” may refer to a clear aligner orthodontic treatment plan based on orthodontic clinical and aesthetic norms of good occlusion and the patient and clinician’s preferences and typically comprises a target dentition.

[0084] The “target dentition” may relate to the final, desired configuration of the patient's teeth that the treatment aims to achieve. The target dentition may be a clinically valid target configuration teeth (e.g. the position and / or orientation) of teeth generated by the treatment plan module, output from the refinement module or generated by a technician. The target dentition may reflect clinical norms (principles of good occlusion) and adheres to clinical preferences, anatomical constraints, and / or patient-specific considerations, such as jaw shape and periodontal health as communicated to the technician or automated treatment plan module through both selected and pre-defined treatment parameters and preferences.

[0085] The term “staging” refers to the sequencing of tooth movements throughout the treatment. It involves breaking down the overall treatment plan into a series of incremental steps or stages, where teeth are moved gradually towards the target dentition. An aligner may be produced for each stage.

[0086] The term “interproximal reduction (IPR)” refers to a technique used to create space between teeth by removing small amounts of enamel from the proximal surfaces. This is often required to resolve crowding or to make certain movements possible. The treatment plan may specify the position and amount of IPR needed at each stage of the treatment.

[0087] The term “attachments” refers to small, tooth-coloured composite bumps that are bonded to certain teeth to aid in the movement of the teeth. These attachments provide additional force or rotational control, helping to achieve movements that might otherwise be difficult with clear aligners alone. The placement, shape, and purpose of each attachment can be detailed in the treatment plan.

[0088] An “aligner wear schedule” details the duration for which each set of aligners must be worn by the patient before moving on to the next set. It typically involves wearing each aligner for one to two weeks, depending on the treatment plan and the patient's progress. The aligner wear schedule may also be part of the orthodontic treatment plan

[0089] The term “current dentition” (or “initial dentition”) is used herein to mean the original configuration of a patient's teeth (e.g. the position and / or orientation) before any orthodontic treatment planning or modifications have been applied.

[0090] The “treatment plan module” referred to herein may be part of the computer device and / or may be an automated system module that takes the current dentition as input and generates a treatment plan and associated target dentition based on predefined rules for good occlusion and clinician (or patient) specified preferences and treatment parameters. It can be re-invoked with modified preferences and parameters based on clinician’s input after their review of a treatment plan. The treatment plan module uses the 3D model and / or the current dentition as input and / or the target dentition in case the refinement module is not able to generate an adjusted target dentition.

[0091] The “refinement module” may be part of the computer device and / or may be a system module that (only) takes a target dentition as input and generates an adjusted target dentition based on clinician’s input after their review of a treatment plan and / or the target dentition (e.g. produced by the treatment plan module). The refinement module may use input from the clinician after reviewing the target dentition to effect modifications on the target dentition itself, rather than the current dentition, where this has been determined to be (i) the intent / expectation of the clinician (request may imply tacit acceptance of the target dentition as the starting point for the requested modifications) and / or (ii) the best approach to making the requested modifications. It uses strategies and algorithms to ensure that refinements maintain a valid target dentition, potentially making non-requested adjustments to nearby teeth when necessary. These strategies aim to minimize unintended changes while adhering to clinician inputs. The refinement module can involve a sequence of modifications using the refinement module whereby the output from one refinement step is reviewed by the clinician, and new change requests are input, repeating the process until the clinician is satisfied with the target dentition configuration.

[0092] The term “constraints” is used herein to mean parameters or limitations applied during the adjustment process, such as occlusion, spacing, angulation, rotation, and interproximal reduction (IPR).

[0093] The term “partial adjustment” refers to a modification that achieves as much of the requested change as possible within system constraints, even if the full request cannot be met.

[0094] The term “orientation” is used herein to refer to the inclination, the angulation, and / or the rotational position of a tooth. The position and / or orientation may also refer to the intrusion / extrusion of a tooth.Computer Device Overview

[0095] Fig. 1 shows a computer device 100 that may also be considered a system. The computer device 100 comprises of several components, such as a refinement module 102, an automated treatment plan module 104, a data interface 106, and / or a user interface 108. These components work together to allow clinicians to make changes to a proposed target dentition, either through modifications directly on the target dentition using the refinement module or by triggering re-computation using the treatment plan module based on initial patient dentition and revised / modified preferences passed on by the user interface 108.

[0096] The data interface 106 may provide for data-communi cation with an intra-oral scanner and / or is configured to receive a 3D model of the patent’s teeth and / or an initial dentition of the patient that has been recorded with the intra-oral scanner. The data interface 106 may provide for data-communication with the intra-oral scanner and / or with a databank on which the 3D model of the patent’s teeth and / or an initial dentition of the patient are stored. For example, the user selects files containing the 3D-model (previously generated using the intra-oral scanner). These files may have been obtained via the data interface 106.

[0097] The user interface 108 may include an input interface, such as a keyboard, a mouse and / or a touchscreen, for inputting non-verbal requests. The user interface 108 may also include a chatbot device.

[0098] The chatbot device may be configured to (i) receive clinician inputs in natural language, (ii) classify these inputs into requests for information, localized modifications or minor refinements, or requests for full re-computation, and / or (iii) translate the inputs into parameters for either the refinement module or the automated treatment plan module.

[0099] In an example, if the clinician requests “Incline the upper left canine by 5 degrees,” the chatbot device interprets this as a request for an adjustment to be effected on the target dentition, which is then passed to the refinement module. Alternatively, if the clinician requests a more substantial change (e.g., eliminating the need for IPR), the chatbot device interprets this as a request for new treatment plan and new associated target dentition which is passed to the treatment plan module.

[0100] The chatbot device may (i) serves as the primary communication channel between the clinician and the system, (ii) accepts inputs through typing (e.g. typing language text) or voice commands and provides real-time feedback on requested changes and information requests, (iii) present multiple strategies for accommodating clinician requests and allows theclinician to select preferred options, and / or provides information on treatment plan and feedback on changes effected by the computer device 100.

[0101] The refinement module 102 is configured to take the current target dentition and the clinician’s request as input (e.g. from the user interface 108). The refinement module 102 is configured to adjust the relevant teeth (e.g. the target teeth) while applying strategies that ensure clinical validity and minimize unintended changes to non-target teeth. This process allows for incremental refinements, replicating the approach that a human technician would take for such requests.

[0102] In an example, a clinician requests the retroclination of a canine. The refinement module 102 is configured to adjust this tooth while making minimal changes to adjacent teeth, broadly preserving the rest of the initial input target dentition.

[0103] The automated treatment planning module 104 may be used for requests that require more significant changes. The computer device 100 may trigger the automated treatment planning module 104, which generates a new treatment plan including associated target dentition based on updated clinical preferences. Unlike localized modifications using the refinement module 102, this process treats all teeth as variables and generates an optimal new configuration.Chatbot device and method for obtaining an orthodontic treatment plan for a person / patient

[0104] Fig. 2 illustrates an example embodiment of a method for identifying a treatment plan for a patient using the chatbot device.

[0105] The method starts with obtaining a digital model of the patient's teeth (1) which is an example of a 3D model of each tooth of the patient. This would typically be in the form of a surface mesh representing that patient's dentition, obtained e.g. with the use of an intraoral scanner. The digital model may be obtained using the data interface 106.

[0106] This is followed by preparing said model for digital planning (2). This may be considered a step of obtaining a virtual 3D model of each tooth of the person. This step of model preparation may be executed if the 3D model and / or the digital are the raw data from the intra-oral scanner.

[0107] The step of model preparation may involve: identifying and / or separating teeth in the model from gums and / or other objects present in the model and identifying the type of / labelling each tooth (e.g. identifying a particular tooth as being the upper left canine). Model preparation may involve other steps which may be later used to inform treatment planning, e.g. identifying dental landmarks, occlusal and midsagittal planes, determining dental metrics (e.g. inter-canine width), identifying dental issues (e.g. gum recession), etc. Model preparation may be fully automatic, partly automated (involving some user interaction) or fully manual (e.g. requiring the user to label each tooth).

[0108] The method may involve collecting clinical and aesthetic preferences (3) which will be used to inform treatment planning. This may be an example of the step of receiving a natural language input including requests on the orthodontic treatment plan. Of course, collecting clinical and aesthetic preferences may be input using the input interface.

[0109] The clinical and aesthetic preferences may input using the command device 108 and / or relate to a variety of different aspects of a treatment plan, e.g. whether interproximal reduction (IPR) should be used, which teeth should be treated, whether to address certain issues present in the patient's dentition (e.g. midline discrepancy, excessive overjet, tooth crowding). These preferences may be patient-specific, typically collected from the user (the user typically being a clinician) e.g. by filling out a form. Alternatively, or additionally, the preferences may be user-specific, e.g. collected from the user once, and re-used across different patients (e.g. a specific clinician may indicate they wish never to perform any IPR). The preferences may also be predefined and not user-specific, e.g. reflecting generally accepted dental practices (e.g. the shape of the arch curve that teeth would be aligned to). A combination of preferences originating from the different sources may be used in conjunction with one another. Collecting the preferences does not necessarily involve any user interaction.

[0110] Once the digital model of the patient's teeth has been prepared, and clinical and aesthetic preferences collected, a treatment plan is generated (4) e.g. using the automated treatment plan module, specific to that patient and reflecting the preferences. A treatment plan would typically comprise the desired (final) tooth positions and / or orientation (e.g. the final teeth configuration). It may also comprise e.g. the location and amount of IPR to perform (if any), the shape and placement of attachment to use (if any), the number of stages required to complete the treatment and / or expected tooth positions at each stage of the treatment.[OHl] Some components of the treatment plan may not be computed and / or presented to the user at this stage, and instead only computed / presented at a later stage (e.g. at or after stage 16). Generation of a treatment plan may be automatic (e.g. performed by the treatment plan module) or manual (either partially or fully). In the latter case, it would typically be performed by a person other than the user, e.g. by an off-site technician, and would typically involve a delay in the treatment planning process (e.g. one or more days).

[0112] Once a treatment plan has been generated, it is presented to the person / patient / user (5). Typically, a 3D visualisation of the desired (final) tooth positions would be displayed. Various treatment plan details may be displayed in graphical (3D or 2D), textual and / or other form. Based on the information presented, the person / patient / user decides whether they wish to proceed with the presented treatment plan, or whether they require any additional information / feedback about the treatment plan or require any changes to it (6). If the person / patient / user is satisfied with the presented treatment plan and has no requests, they have the option to accept it and proceed with the treatment (16). This would typicallycomprise manufacturing of a series of aligners, each corresponding to tooth positions at each stage of the selected treatment plan.

[0113] An Al chatbot functionality is provided to the user (e.g. by the chatbot device) in case they wish to make any changes to the treatment plan presented to them or have any queries about the treatment plan (7). The user may communicate, in natural language (e.g. using text or voice commands), any desired changes to the treatment plan or requests for requests on the treatment plan. These requests may be related to various dental metrics (e.g. the amount of overjet) before and / or after treatment, and / or various treatment plan properties (e.g. the number of treatment stages required).

[0114] The chatbot device may be suitably trained and configured to interpret these user requests and distinguish between, and appropriately classify, requests for information from requests for changes to be made to the treatment plan (8, 9, 11). In addition to these, the chatbot device may be trained and configured to process other types of user requests (12). Furthermore, the chatbot device may be configured to distinguish between, and appropriately classify, requests for small adjustments (e.g. to rotate a certain tooth by a certain amount), which imply that the user expects the treatment plan to remain substantially unchanged, from requests for substantial changes to the previously indicated clinical and / or aesthetic preferences (e.g. a request to generate a treatment plan with IPR, where the user has previously indicated, they do not wish to use IPR) (13).

[0115] The chatbot device may be trained and configured to convert these user requests from natural language into a format which can be algorithmically processed by an automated system module (e.g. the automated treatment plan module and / or the refinement module), and to relay these user requests to the appropriate module in order to fulfil these requests (e.g. by generating a new treatment plan or retrieving any requested information).

[0116] Small adjustments may be performed by the refinement module, using the existing or initial treatment plan as the starting point, in a way that minimises (or completely avoids) changes to the initial treatment plan other than those requested by the user (e.g. it may be possible to fulfil a request to rotate a tooth without affecting other teeth, or it may be necessary to also move other teeth e.g. in order to gain additional space or close new space created as a result of this rotation) (14).

[0117] Requests for substantial changes, e.g. to the previously indicated clinical and / or aesthetic preferences, may be actioned by the treatment plan module; treatment plans generated in response to these requests may be generated from scratch, and consequently may not resemble the previous treatment plan, and instead may represent an optimal treatment plan for the given preferences (e.g. one with fewest treatment stages) (15).

[0118] The communication between the chatbot device and the automated system module(s) (e.g. the automated treatment plan module and / or the refinement module) may have the form of one or more predefined function calls forming an API of the system module(s). These function calls would be generated by the chatbot device and received by the systemmodule(s). Optionally, in response to the request generated by the chatbot device, the system module(s) may generate (in addition to, or instead of, the new treatment plan) a textual response (either in natural language or using a predefined API) e.g. indicating whether that particular request could or could not be processed, e.g. due to constraints arising due to issues present in the initial dentition (e.g. a request to eliminate IPR could be rejected on the basis of the patient having severe tooth crowding). This response may be processed by the chatbot device and adapted into a format appropriate for display to the user.

[0119] The chatbot device may provide feedback to the user about the requested changes (e.g. whether they have been successfully applied) and / or the effected changes (e.g. if the user requested a change in overjet, what specific actions, e.g. tooth inclination or IPR, have been performed to address this request).

[0120] The chatbot device may be suitably trained and configured to allow a variety of different user requests, which may vary in complexity and the level of explicitness. Requests communicated by the user may fully and unambiguously describe the required change (e.g. "Please incline tooth X by 5 degrees"). In some cases, the request may not be fully explicit (e.g. "Please incline tooth X a bit more."), but the chatbot device may be configured to infer the missing information e.g. from previous communication or from its predefined instructions. The chatbot device may also be configured to request additional information from the user in order to clarify an ambiguous request.

[0121] A request may require some additional changes to the treatment plan in order to accommodate the user request while ensuring that the treatment plan remains valid (e.g. a request to "Please reduce the amount of IPR between teeth X and Y from 0.5 mm to 0.1 mm" implies that the two teeth need to be moved away from each other to reflect the reduced IPR, and other changes in the jaw may be required to accommodate their movement, e.g. all other teeth may need to be inclined or IPR may need to be introduced elsewhere). Where additional changes are required to accommodate the user's request, the chatbot device may be configured to identify the appropriate strategy and / or the automated system module may contain algorithmic rules for identifying this strategy.

[0122] The chatbot device may be configured to communicate to the user that multiple strategies are available and process the user's response in order to select the strategy to apply. The chatbot device may be configured to interpret requests which do not directly correspond to the system module's API (e.g. if the system module's API does not contain a function for reducing overbite, the chatbot device may be configured to translate a request to "Please reduce the overbite" into a function call which e.g. intrudes upper incisors, which is likely to reduce the overbite).

[0123] In addition to processing requests for modifications to the treatment plan, the chatbot device may be trained and configured to provide additional functions, e.g. to provide diagnostic and / or other information about the patient's dentition and / or the treatment plan (e.g. what dental issues are present in the patient's dentition, what the overjet is before andafter treatment, etc.), to provide general information and / or advice related to dental treatment planning (e.g. what IPR is, when it is recommended or not recommended, etc.), and / or to provide information / guidance about the use of the software into which the chatbot is embedded (e.g. what functions are available in the software, how to use them, etc.).

[0124] Examples of user requests which the chatbot may be able to process may include e.g.:• change in overjet (e.g. increase or decrease),• change in overbite (e.g. increase or decrease),• change in arch shape (e.g. square / tapered / ovoid arch shape, a request for a "broader” or "wider” smile, etc.),• change in position of one or more teeth (e.g. to incline, tip, angulate, rotate, translate, extrude or intrude a tooth, to apply torque, etc.)• change in the amount or location of interproximal reduction (IPR),• change in midline position,• change in the location or shape of attachments, placement or removal of attachments.

[0125] Once the user request has been interpreted by the chatbot device and converted into the appropriate format, a new or refined treatment plan is generated reflecting that request (4) and presented to the user (5). The user may then either issue additional requests, repeating the process described above, or accept the refined treatment plan, and proceed with treatment (16).

[0126] Another possible embodiment of a method for identifying a treatment plan for a patient using the chatbot device is illustrated in Fig. 3. The method in this embodiment is substantially identical to that illustrated in Fig. 2 and described above. In this embodiment, whereas the chatbot refined is trained and configured to distinguish between requests for information and requests for changes to the treatment plan, it is not configured to distinguish between minor adjustments and substantial changes to the treatment plan. In this embodiment, the chatbot refined only communicates with one automated system module, which may be functionally equivalent to the refinement module or the automated treatment plan module (11, 12, 13) or may in fact combine the functionality of both these modules.

[0127] Yet another possible embodiment is illustrated in Fig. 4. The method in this embodiment is substantially identical to that illustrated in Fig. 3 and described above. In this embodiment, the functionality provided by the chatbot refined is further limited to only processing user requests for changes to the treatment plan. In particular, it does not provide any information / feedback about the presented treatment plan (8, 9).Chatbot configuration

[0128] An example of chatbot configuration of the chatbot device is shown below. The chatbot may be a computer program or an artificial intelligence agent, e.g. leveraging a large language model (LLM), that is programmed to conduct a conversation in natural languageeither in text or spoken format. This configuration may be submitted to the chatbot as the initial message before any user interaction begins.You are a chatbot embedded in a dental (tooth alignment) treatment planning software. Your task is to assist the user, who is a dental professional, in generating an appropriate treatment plan for their patient. Treatment plans are generated algorithmically by an external automated system, with which you can communicate using the API specified below. If the user asks to make a change in the treatment plan, you should attempt to find a corresponding function among those specified in the API and submit it to the automated system. If the reguest is ambiguous, you should ask the user for clarification. Once you submit a reguest to the automated system, you will receive a response indicating whether the change has been successfully actioned. If successful, the updated treatment plan will be visible to the user. If not successful, the treatment plan will not have been modified, and you will receive additional details about the reason for this failure, which you should communicate back to the user.All messages from the user will be prefixed: "USER:" and all messages from the automated system will be prefixed: "SYSTEM:". All your responses to the user and the automated system must be prefixed as "USER:" and "SYSTEM:" respectively. The user will not see your communication with the automated system and vice versa.## CURRENT TREATMENT PLAN INFORMATION ##An initial treatment plan has already been generated and is currently being displayed to the user. Current treatment plan details: 11 stages reguired, both jaws treated (upper and lower), IPR: 0.2mm between upper left central incisors and upper left lateral incisor, [...], initial overjet was: 4.7 mm, now: 3.2 mm, [...], the patient is missing the left lower canine, [...] ## AUTOMATED SYSTEM API ##The automated system for generating / updating the treatment plan can only be communicated with using the following API function calls. Submit any reguests in the following format: "functionNamejparameterl, parameter2, ...)". You can submit a seguence of function calls by separating each function call with a semicolon, e.g. "functionNameljparameterl, ...); functionName2(parameterl, ...); ...".Function: rotateToothftooth, amount) description: Allows a single tooth to be rotated (around its long axis) by the specified amount. The automated system may adjust other tooth positions slightly to accommodate this movement. parameters:tooth: The tooth to rotate (use FDI notation). amount: Amount in degrees. Positive values denote mesial rotation. Negative values denote distal rotation. If there is any ambiguity which direction the user wishes to rotate the tooth, please ask for clarification. If the user does not specify the amount, use 5 degrees as the default increment.Function: rotateTeethftoothl, amountl, tooth2, amount2, ...) description: Allows multiple teeth to be rotated (around their long axes) by the specified amounts. The automated system may adjust other tooth positions slightly to accommodate these movements. parameters: toothl / tooth2 / tooth3 / ...: The first / second / third / ... tooth to rotate (use FDI notation). amountl / amount2 / amount3 / ...: The first / second / third / ... amount in degrees.Positive values denote mesial rotation. Negative values denote distal rotation. If there is any ambiguity which direction the user wishes to rotate the tooth, please ask for clarification. If the user does not specify the amount, use 5 degrees as the default increment.Function: angulateTooth(tooth, amount) description: Allows a single tooth to be angulated by the specified amount. The automated system may adjust other tooth positions slightly to accommodate this movement. parameters: tooth: The tooth to ungulate (use FDI notation). amount: Amount in degrees. Positive values denote mesial angulation. Negative values denote distal ungulate. If there is any ambiguity which direction the user wishes to ungulate the tooth, please ask for clarification. If the user does not specify the amount, use 2 degrees as the default increment.[...]amount: The new IPR amount in millimetres. Only values between 0 and 0.5 [mm] are allowed. A value of 0 indicates no IPR.[...]Function: reduceOverjetfa mount) description: The automated system will attempt to reduce the overjet by the specified amount. This may involve changes to tooth inclination, rotation and / or IPR. parameters: amount: The relative amount in millimetres by which to reduce the overjet.[...]Interaction with chatbot device

[0129] Figure 5 illustrates an example conversation between the user and the chatbot device, from the point of view of the user. In the course of this conversation, the user makes two requests to change the target dentition, which are processed by the chatbot device and actioned by the refinement module.

[0130] Figures 6 and 7 illustrate two examples of conversations between the user and the chatbot device. In both examples, the flow of information is shown: between the user and the chatbot, as well as between the chatbot and the refinement module.

[0131] In Fig. 6, a request for tooth inclination issued by the user is received by the chatbot device, which interprets the request, generates a corresponding API function call and submits it to the refinement module. The refinement module performs the change and communicates to the chatbot that the request has been successfully processed. The chatbot acknowledges this to the user. This is followed by another user request for inclination, which is processed in the same manner.

[0132] In Fig. 7, a similar conversation is illustrated. However, in this example, the user’s initial request to reduce IPR cannot be actioned (the resulting target dentition would not be valid) without making additional modifications to the target dentition. The refinement module identifies two alternative strategies for achieving a valid dentition which are communicated, via the chatbot device, to the user. The user then selects one of them. The chatbot device interprets the user’s response and issues a new request to the refinement module, which incorporates the additional modifications required and which belong to one of the two previously identified strategies. This request is successfully processed by the refinement module, of which the user is informed via the chatbot.Refinement module

[0133] The following description presents an example embodiment of the refinement module. The refinement module receives an initial target dentition, which may have been generated automatically (e.g. by the Treatment Plan Module) or manually by a technician (e.g. via the data interface 106 and / or the automated treatment plan module 104). This initial target dentition may represent, in digital form, a proposed final tooth arrangement (after treatment) for the given patient. This initial target dentition may be deemed clinically valid, i.e. free of any issues that would make it impossible to achieve in the course of a treatment or contrary to established orthodontic practices (this may the case e.g. if some teeth are in collision / overlapping and / or excessive movement is required).

[0134] However, this initial target dentition may not fulfill certain goals or wishes of the clinician and / or patient (which they may not have expressed prior to obtaining the initial target dentition) and therefore may require one or more refinements. These refinements may be requested by the clinician using a suitable graphical user interface, e.g. sliders, (examples of the input interface) or using the chatbot device, which interprets the clinician's input and converts it into a format which can be processed by the refinement module (e.g. a function call with parameters).

[0135] A target dentition (both the one initially received by the refinement module and any refined target dentition that will be generated by the refinement module) may comprise the following components:1) a 3D representation of each of the patient’s teeth (e.g. in the form of surface meshes, one per tooth);2) information about the position and / or orientation of each tooth in the target dentition, e.g. relative to the patient’s original dentition (e.g. as defined in the 3D model), e.g. in the form of transformation matrices;3) one or more landmarks / points (e.g. points marking the distal and mesial extremities of each tooth), axes / lines (e.g. the long axis and / or the facial axis of clinical crown [FACC] of each tooth), reference frames and / or other geometrical constructs, whose purpose may be, among others, to identify the mesial / distal / facial / lingual surfaces of each tooth; these geometrical constructs may have been identified manually (e.g. by the user) or automatically (e.g. with the use of a computer algorithm or an appropriately trained Al system);4) the occlusal plane and the midsagittal plane, which may have been identified manually (e.g. by the user) or automatically (e.g. with the use of a computer algorithm or an appropriately trained Al system);5) information about any prescribed interproximal reduction (IPR), including the amount of IPR required (e.g. 0.3 mm) and location (e.g. contact between the upper left lateral incisor and the upper left canine).

[0136] Components (1), (3) and (4) may be generally identical across all target dentitions (initial and refined) for a given patient, whereas (2) and (5) may be generally different for each target dentition.Change requests handled by the refinement module

[0137] The refinement module, given a particular change request (e.g. to incline a specific tooth by a certain amount), may be able to generate a new (refined) target dentition which incorporates the requested change into the existing target dentition, while ensuring that it remains substantially unchanged (e.g. by minimizing changes to teeth not explicitly mentioned in the change request) and that it remains clinically valid. In some cases, the refinement module may be able to action the request without any other changes to the target dentition, however, in practice, some other changes may be unavoidable, e.g. in order to resolve collisions / overlaps between teeth (introduced as a direct result of the requested change) and / or to close gaps between them. The objective of the refinement module is to minimize these additional changes, reflecting the implicit expectation of the user when issuing the request, that no (or few) other changes in the target dentition will occur.

[0138] Examples of changes that the refinement module may be able to perform:• To incline or retrocline one or more teeth. The amount of inclination may or may not be specified in the request. If not specified, a certain predefined amount may be used (e.g. 0.1°, 0.5°, 0.75°, 1°, 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, or 10°).• To angulate one or more teeth distally or mesially. The amount of angulation may or may not be specified in the request. If not specified, a certain predefined amount may be used (e.g. less than 0.1°, 0.5°, 0.75°, 1°, 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, or 10°).• To rotate one or more teeth distally or mesially. The amount of rotation may or may not be specified in the request. If not specified, a certain predefined amount may be used (e.g. less than 0.1°, 0.5°, 0.75°, 1°, 2°, 3°, 4°, 5°, 6°, 7°, 8°, 9°, or 10°).• To translate one or more teeth distally, mesially, bucally or lingually. The amount of translation may or may not be specified in the request. If not specified, a certain predefined amount may be used (e.g. less than 0.01 mm, 0.05 mm, 0.075 mm, 0.1 mm, 0.15mm, 0.2 mm, or 0.3 mm).• To intrude or extrude one or more teeth. The amount of intrusion / extrusion may or may not be specified. If not specified, a certain predefined amount may be used (e.g. less than 0.01 mm, 0.05 mm, 0.075 mm, 0.1 mm, 0.15mm, 0.2 mm, or 0.3 mm). The request may not specify the amount directly, but instead ask for one or more teeth to be extruded / intruded so as to align their incisal edges or gingival margin, relative to one another or to another tooth.• To increase or reduce the amount of IPR at one or more contacts. An increase in the amount of IPR at a specific contact would typically imply that the two neighboringteeth should be moved closer together (either by mesial / distal translation or angulation), while a decrease that they should be moved away from one another.• To introduce / increase / reduce / remove a gap between two neighboring teeth.• To shift the midline in one or both jaws by a certain amount, or to align them.• To change the overall dentition shape in one or both jaws to be either broader (more square) or narrower (more tapered).• To reduce or increase oveijet or overbite. The amount may be specified. If not, the refinement module may identify an appropriate amount based on a predefined ideal range or value.• To improve canine guidance.

[0139] The refinement module may be configured to decide whether the change request can be fully achieved if the change in the parameters (for moving the respective one or more teeth from the initial position and / or orientation of the initial dentition to the target position and / or orientation of the target dentition) may be within a predetermined range. The predetermined ranges may be set for each parameter, e.g. there may be a threshold or range for rotation, inclination, spatial movement, and the like.Target dentition generation

[0140] In one embodiment, a target dentition may be defined by two target arch curves (one per jaw), parallel or almost parallel to the occlusal plane and to one another, e.g. in the form of splines defined by several control points. A set of rules may be defined that e.g. each tooth’s FACC must pass through the arch curve, each tooth’s mesiodistal axis must be tangential to the arch curve, and that all neighboring teeth must be closely abutted against one another (at contacts where IPR has been prescribed, the rule may instead be that the two teeth must overlap each other by the IPR amount; whereas at contacts where a gap has been prescribed, that the two teeth must be set distance apart).

[0141] Target mi dimes may be specified (independently for each jaw) e.g. with the use of planes intersecting the arch curves (the target midline passing through the point of intersection). This set of rules is sufficient to fully prescribe each tooth’s mesiodistal and buccolingual translation, as well as rotation (though not inclination, angulation nor intrusion / extrusion, all of which are independent of the arch curve). Optionally, the rotation of each tooth may be made independent of the arch curve, by allowing an offset to be specified (for each tooth) from the default rotation (tangential to the arch curve). Optionally, the mesiodistal translation of each tooth may be made independent of the arch curve, by allowing an offset to be specified (for each tooth) between an FACC and the arch curve.

[0142] Thus, an example target dentition may be fully defined by the following parameters:• a target arch curve (for each jaw), defined by a set of control points,• a target midline (for each jaw), defined by a plane,• an IPR / gap prescription, e.g.:and a set of prescribed tooth positions, e.g.:Simple change requests

[0143] The initial target dentition received by the refinement module may be defined using the parameters described above. Refinements performed by the refinement module may involve altering one or more of these parameters and then generating a refined target dentition corresponding to these updated parameters, according to the rules described above. Most change requests could be executed by altering only a small number of these parameters (often, only one). For example, a request to incline a specific tooth by 5° would only require the inclination parameter for that tooth to be updated, a request to reduce IPR at a specific contact would only require the corresponding entry in the IPR / gap prescription to be updated, and a request for a broader smile could only require the arch curve control points to be appropriately adjusted.

[0144] In most circumstances, the vast majority of these parameters would remain unchanged, and therefore the resulting (refined) target dentition would bear close resemblance to the previous target dentition. However, it must be noted that a change to one parameter, ostensibly only affecting one tooth, may also involve some (minor) changes to other teeth in the same jaw, typically in the form of mesiodistal translation (i.e. mesialization and / or distalization). This is because any tooth movement, however small, would typically either spawn a small gap or create an overlap at the contacts with the neighboring teeth. Some changes may only require changes to be made in one of the jaws (e.g. a request to incline a specific tooth may only require that tooth to be inclined and, likely, other teeth in that jaw to be mesialized and / or distalized). However, in practice, both jaws may need to be modified. This is because an important task of the refinement module is to ensure that the whole targetdentition remains valid, which may involve, among other things, ensuring that teeth in the upper jaw do not collide / overlap with teeth in the lower jaw. Even small changes in one jaw may lead to collisions / overlaps between teeth in opposite jaws and / or other issues which would render a target dentition invalid. Therefore, when the refinement module processes a change request, it may, in addition to performing the changes as described above, employ an additional strategy to ensure the target dentition remains valid. These strategies are described in more detail in “Ensuring validity of refined target dentition” below.Complex change requests

[0145] Certain change requests may not directly correspond to any parameters which define the target dentition, and therefore may require a more complex strategy. An example of such a change request may be to “reduce overjet by 0.5 mm”. Reduction of oveijet may be achieved by e.g.: reducing inclination of upper incisors, increasing inclination of lower incisors, allocating additional IPR in the upper jaw, reducing any previously allocated IPR in the lower jaw, allocating gaps in the lower jaw, using a broader (more square) arch shape for the upper jaw, using a narrower (more tapered) arch shape for the lower jaw, or any combination of these techniques.

[0146] Regardless of the technique used, it may be difficult to accurately predict the amount of overjet reduction achieved by each of these techniques, as well as whether the resulting target dentition will be valid, without generating the corresponding target dentition. For this reason, the refinement module may process requests to reduce the overjet e.g. by generating a range of different target dentitions, e.g. using each of the different techniques and / or using a range of different parameters (e.g. reducing upper incisor inclination by 2°, 3°, 4° and / or other amounts), and then select one which both results in a valid target dentition and is as close as possible to achieving the requested overjet reduction.

[0147] A similar approach may be used by the refinement module to process other requests, e.g. to increase oveijet, increase / reduce overbite, increase / reduce interincisal angle etc. The range of strategies employed may vary depending on the nature of the request. For example, a request to increase / reduce overbite may be fulfillable by intrusion / extrusion of incisors, while a request to improve canine guidance may be fulfillable by angulating the targeted canines.Ensuring validity of refined target dentition

[0148] It is possible that the target dentition generated in response to a change request would not be valid. This may be the case e.g. if any of the teeth would require an excessive amount of movement to reach the proposed final positions, or if any teeth in the upper jaw were positioned in a way that collides / overlaps any teeth in the lower jaw. The refinement module may employ different strategies to mitigate this, generally requiring some additionalmodifications to the target dentition, in order to ensure that the refined target dentition presented to the user is always valid.

[0149] If the target dentition was to be invalid due to issues in the same jaw(s) as the one modified (e.g. if following a request to incline a particular tooth, that tooth, or any other tooth in that jaw, was positioned in a way that requires an excessive movement), the refinement module may attempt to mitigate these issues by generating one or more alternative target dentitions using one or more techniques which may achieve a reduced amount of movement of that tooth and select one among these target dentitions to be presented to the user.

[0150] These techniques may include e.g.: inclination / angulation / rotation or buccolingual translation of the tooth in question and / or of other teeth, allocation / deallocation of IPR, allocation / deallocation of a gap and / or mesiodistal translation of all teeth (involving a midline shift). The refinement module may avoid employing techniques which would directly counteract the change request and / or any previous change requests. For example, if the user has requested for a tooth to be inclined, the refinement module may avoid using inclination as the mitigation technique, and instead attempt buccolingual translation. If none of the available strategies allow a valid target dentition to be obtained, the refinement module may instead attempt to perform the requested change, but with a smaller magnitude, accepting that the change request may only be partly fulfilled. For example, if following a request to incline a tooth by 5°, the resulting target dentition is invalid, the refinement module may instead attempt to incline said tooth by 4°, 3° and / or any other amount, with the aim of obtaining a valid target dentition, while only partially achieving the requested adjustment. If a valid target dentition is identified using this technique, appropriate feedback may be provided to the user.

[0151] If the target dentition was to be invalid due to issues involving both jaws, e.g. if teeth in the upper jaw collide / overlap with teeth in the lower jaw, or if excessive overjet or overbite is introduced, the refinement module may attempt additional changes in one or both jaws in order to obtain a valid target dentition, while also ensuring that dentition in each jaw individually remains valid.

[0152] Techniques which the refinement module may employ in order to obtain a valid target dentition may include e.g. inclination / angulation / rotation change or buccolingual translation of certain teeth, allocation / deallocation of IPR and / or allocation / deallocation of a gap. The refinement module may avoid employing techniques which would directly counteract the change request and / or any previous change requests. For example, if the user has requested for upper incisors to be inclined, the refinement module may avoid using inclination of the upper incisors as the mitigation technique, and instead attempt inclination of the lower incisors.

[0153] The refinement module may select the technique based on the issue in need of resolving. For example, if the upper and lower left canines are in collision, the refinement module may attempt to increase inclination of the upper canine and / or to reduce inclination ofthe lower canine. The refinement module may generate one or more target dentitions using different techniques and / or different parameter values (e.g. multiple target dentitions may be generated which incline incisors, but each by a different amount) and select one to be presented to the user. Alternatively, it may present multiple of these target dentitions to the user, allowing them to select one to be applied.

[0154] In certain circumstances (e.g. if the refinement module is unable to generate a valid target dentition using the strategies described above) the refinement module may identify that the change request could be addressed by generating a new target dentition using the treatment plan module with different constraints.

[0155] This disclosure may be summarised and / or defined by the following aspects.Aspects regarding the chatbot / interface

[0156] 1. A method for making changes to an orthodontic treatment plan, comprising a chatbot configured to: receive natural language inputs from a clinician; interpret the clinician input; and communicate with one or more system modules to perform requested actions, including passing parameters to perform requested changes.

[0157] 2. The method of aspect 1, wherein the treatment plan is received from a technician.

[0158] 3. The method of aspect 1, wherein the treatment plan is generated from an automatedTreatment Plan Module.

[0159] 4. The method of aspect 1, wherein the natural language input is a text command.

[0160] 5. The method of aspect 1, wherein the natural language input is a voice command.

[0161] 6. The method of aspect 1, wherein the clinician is substituted by a suitably trained person such as a technician.

[0162] 7. The method of aspect 1, wherein the chatbot provides feedback to the clinician on the changes requested

[0163] 8. The method of aspect 1, wherein the chatbot provides feedback to the clinician on the changes effected.

[0164] 9. The method of aspect 1, wherein the chatbot requests additional clarification of the clinician on the changes requested.

[0165] 10. The method of aspect 1, wherein the chatbot classifies clinician’s input as either a request to provide information on the treatment plan or as a request for a change to the treatment plan.

[0166] 11. The method of aspect 1, wherein the chatbot is configured to automatically select between two or more modules to call and pass parameters on to based on the classification of the type of change requested.

[0167] 12. The method of aspect 11, wherein the chatbot classifies whether a clinician’s change request is best interpreted as a request for modification of the current target dentitionor as a request for a new treatment plan based on the initial dentition with additional or modified treatment parameters and preferences.

[0168] 13. The method of aspect 11, wherein the chatbot classifies whether a clinician’s change request is best effected by modification of the current target dentition or recomputation of the treatment plan starting from the initial dentition using additional or modified treatment parameters and preferences.

[0169] 14. The method of aspects 12 or 13 wherein the chatbot passes appropriate parameters to either a refinement module or an automated treatment plan module.

[0170] 15. The method of aspect 1, wherein the Chatbot Interface is configured to convert qualitative clinician inputs regarding the magnitude of changes into quantitative values for the parameters sent to the modules, such that inputs like “incline the tooth a bit” are interpreted as specific numeric adjustments, for example, a 2-degree inclination, based on predefined values associated with qualitative terms.

[0171] 16. The method of aspect 1, wherein the chatbot is configured to pass appropriate parameters to a module to indicate a requested change in occlusal parameters such as overjet, overbite, arch shape, position (6 degrees of freedom) of one or more teeth, the amount and location of any interproximal reduction (IPR), the position of upper and / or lower mi dimes and the type and location of any attachments. Both the nature of the requested change and the amount of change requested are passed to the module.Aspects regarding the refinement module

[0172] 1. A method comprising a refinement module, the method including: receiving clinician change requests to adjust a target dentition; applying the requested adjustments to the target dentition using one or more strategies that accommodate the requested changes, minimize modifications to non-target teeth, and ensure that the adjusted target dentition remains clinically valid.

[0173] 2. The refinement module of aspect 1, wherein clinician change requests are received as parameters from a configured chatbot interpretation of a clinician’s input.

[0174] 3. The refinement module of aspect 1, wherein the clinician’s change requests are received from the clinician through a suitable graphical user interface such as sliders.

[0175] 4. The method of aspect 1, wherein the strategy for maintaining a clinically desirable and valid target dentition involves modifying the positions of one or more non-target teeth.

[0176] 5. The method of aspect 1, wherein the strategy for maintaining a clinically desirable and valid target dentition involves introducing additional IPR to either target teeth or one or more non-target teeth.

[0177] 6. The method of aspects 4 and 5, wherein the changes to non-target teeth are iterated until a valid target dentition is achieved, for example, IPR is applied incrementally or across a number of teeth until suitable retro-clination is achieved.

[0178] 7. The method of aspect 1, wherein, upon determining that a requested modification cannot be fully achieved, the refinement module automatically computes and applies the maximum feasible partial adjustment and communicates the partial adjustment to the clinician for approval.

[0179] 8. The method of aspect 1, wherein the Refinement Module is configured to automatically identify when a clinician’s request is best addressed by generating a new target dentition from the initial dentition using the Automated Treatment Planning Module with new or modified constraints.

[0180] 9. The refinement module of aspect 1, wherein the refinement module supports iterative modifications based on clinician feedback until the final treatment plan is approved.

[0181] 10. The method of aspect 1, further comprising: generating and presenting to the clinician multiple valid modification strategies for addressing the request, each strategy involving different adjustments to the target dentition that partially or wholly achieve requested change; receiving a selection from the clinician of a preferred strategy; applying the selected strategy to the proposed target dentition.

[0182] 11. The method of aspect 1, wherein a clinician request is for modifications to a global occlusal metric rather than directly specifying a tooth movement

[0183] 12. The method of aspect 11 whereby the global occlusal metric is one of oveijet, overbite, canine guidance.

[0184] 13. The method of aspect 11 whereby requested target occlusal metric is achieved using one or more heuristic strategies.

[0185] 14. The method of aspect 13 wherein the clinician request is for a change in overjet, and this requested change is achieved using a heuristic strategy of reducing or increasing the inclination of upper incisors.

[0186] 15. The method of aspect 13 wherein the clinician request is for a change in overjet, and this requested change is achieved using a heuristic strategy of reducing or increasing the inclination of lower incisors.

[0187] 16. The method of aspect 13 wherein the clinician request is for reduction of oveijet, and this requested reduction is achieved using a heuristic strategy comprising prescription of inter-proximal reduction (IPR) in the upper jaw.

[0188] 17. The method of aspect 13 wherein the clinician request is for reduction of oveijet, and this requested reduction is achieved using a heuristic strategy comprising reduction of or elimination of previously prescribed inter-proximal reduction (IPR) in the lower jaw.

[0189] 18. The method of aspect 13 wherein the clinician request is for reduction of overbite, and this requested reduction is achieved using a strategy comprising intrusion of incisors.

[0190] 19. The method of aspect 13 wherein the clinician request is for reduction of overbite, and this requested reduction is achieved using a strategy comprising increased inclination of incisors.

[0191] 20. The method of aspect 13 wherein the clinician request is for improved canine guidance, and this requested reduction is achieved using a strategy comprising angulation of canines.

[0192] 21. The method of aspect 1, wherein the refinement module computes different refined target dentitions using various adjustment strategies for accommodating clinician requests.Aspects regarding the combination of chatbot / interface with the refinement module

[0193] 1. A method for modifying a target dentition, comprising: a chatbot configured to receive clinician inputs in natural language, interpret these inputs into suitable parameters, and communicate these parameters to a refinement module configured to modify the target dentition based on the parameters received from the chatbot interface, while maintaining clinical validity.

[0194] 2. The method of aspect 1, further comprising a fallback mechanism wherein the chatbot triggers an automated Treatment Planning Module to generate a new treatment plan when requested changes cannot be accommodated by adjustments on the current target dentition.

[0195] 3. The method of aspect 1, whereby maintaining clinical validity is effected in a manner which minimizes changes to non-target teeth.

[0196] 4. A method for generating and refining an orthodontic treatment plan, comprising the steps of: receiving, via a Chatbot Interface, a clinician's request for modifying a target dentition; modifying the proposed target dentition using a Refinement Module, including applying constraints and validating the refined target dentition; automatically adjusting one or more teeth in the proposed target dentition to accommodate the clinician's request, without reverting to the initial dentition; and, if the requested modification cannot be fully achieved, computing a partial adjustment and communicating it to the clinician for approval.

[0197] 5. A system for automated refinement of orthodontic target dentitions, comprising: an automated Treatment Planning Module for generating a target dentition; a Refinement Module for modifying the initial target dentition iteratively based on clinician inputs; a Chatbot Interface for facilitating clinician interaction with the system and for providing realtime feedback on requested refinements, wherein the system supports iterative modifications and presents multiple strategies for clinician approval.

Claims

CLAIMS1. A computer-implemented method for creating an orthodontic treatment plan, the method comprising: generating an initial orthodontic treatment plan that maps a transition for a set of teeth from a current dentition to a target dentition, wherein the target dentition complies with a dentition specification indicating one or more clinical and aesthetic requirements and / or preferences; receiving a change request that identifies an adjustment of a parameter of the target dentition; automatically determining an additional change to the target dentition required as a consequence of implementing the change request in order to remain compliant with the dentition specification, wherein the additional change comprises an adjustment to a parameter of the target dentition not identified in the change request; obtaining an adjusted target dentition that incorporates the change request and the additional change; and generating a revised orthodontic treatment plan that maps a transition for the set of teeth from the current dentition to the adjusted target dentition.

2. The computer-implemented method of claim 1, wherein the target dentition is a selected one of a plurality of dentition solutions, each of which comply with the dentition specification.

3. The computer-implemented method of claim 1 or 2, wherein the adjusted target dentition is obtained by adjusting the target dentition.

4. The computer-implemented method of claim 3, wherein the adjusted target dentition is a selected one of a plurality of adjusted dentition solutions that each incorporate the change request and remain compliant with the dentition specification, wherein the selected adjusted dentition solution minimises the additional change needed to the target dentition.

5. The computer-implemented method of any one of claims 1 to 4, wherein the change request results from an alteration of the dentition specification.

6. The computer-implemented method of any one of claims 1 to 5, wherein generating the initial orthodontic treatment plan comprises: obtaining, via a data interface, a virtual three-dimensional, 3D, model representing the current dentition; receiving, via a user interface, the dentition specification indicating the one or more clinical and aesthetic requirements and / or preferences; and using the virtual 3D model and the dentition specification to determine the target dentition.

7. The computer-implemented method of any one of claims 1 to 6, wherein the target dentition comprises a target position and orientation for each tooth.

8. The computer-implemented method of any one of claims 1 to 7, wherein determining the additional change comprises minimising a magnitude of adjustment to the parameter of the target dentition not identified in the change request.

9. The computer-implemented method of claim 8, wherein minimising the magnitude of adjustment uses one or more of the following metrics:(i) a difference in position and / or orientation of a tooth relative to the target dentition;(ii) a difference in one or more components of tooth movement, optionally including inclination, angulation, rotation, bucco-lingual translation, mesio-distal translation, or intrusion / extrusi on;(iii) the number of teeth whose positions and / or orientations remain identical between the target dentition and the adjusted target dentition; and(iv) difference in one or more dental metrics between the target dentition and the adjusted target dentition, optionally including crowding, Bolton ratio, or inter-canine width.

10. The computer-implemented method of any one of claims 1 to 9, wherein the identified parameter is a position or orientation of a tooth specified in the change request.

11. The computer-implemented method of claim 10, wherein the additional change comprises an adjustment to a position or orientation of a tooth not specified in the change request.

12. The computer-implemented method of any one of claims 1 to 11, wherein the identified parameter is an interproximal reduction, IPR, value.

13. The computer-implemented method of any one of claims 1 to 12, wherein receiving a change request comprises: receiving a qualitative request identifying a target clinical or aesthetic outcome; and translating the qualitative request into the change request that that identifies the parameter of the target dentition to be adjusted.

14. The computer-implemented method of any one of claims 1 to 13, wherein receiving the change request includes: receiving a natural language input, converting the natural language input into one or more commands for changing the identified parameter.

15. The computer-implemented method of any one of claims 1 to 14, wherein generating the revised orthodontic treatment plan comprises: generating a plurality of options for the adjusted target dentition; and receiving, by the user interface, a selection of one of the plurality of options, wherein the revised orthodontic treatment plan is based on the selected one of the plurality of options.

16. The computer-implemented method of claim 15, wherein generating the revised orthodontic treatment plan further comprises expressing the adjustments of the change request and the additional change in natural language.

17. A computer-implemented method for creating an orthodontic treatment plan for a person, the method comprising: generating an initial orthodontic treatment plan that maps a transition for a set of teeth from a current dentition to a target dentition; receiving a natural language input that requests a change to the target dentition; converting the natural language input into a command that identifies an adjustment of a parameter of the target dentition; andgenerating a revised orthodontic treatment plan that maps a transition for the set of teeth from the current dentition to an adjusted target dentition that incorporates the change request.

18. The computer-implemented method of claim 17, wherein the identified parameter defines a position and / or orientation of one or more teeth and / or orientation of the one or more teeth.

19. The computer-implemented method of claim 17 or 18, wherein the natural language input includes text command and / or a voice command.

20. The computer-implemented method of any one of claims 17-19, wherein converting the natural language input includes generating an adjusted target dentition.

21. A computer device for creating an orthodontic treatment plan, the computer device comprising: a treatment plan module configured to generate an initial orthodontic treatment plan that maps a transition for a set of teeth from a current dentition to a target dentition, wherein the target dentition complies with a dentition specification indicating one or more clinical and aesthetic requirements and / or preferences; a user interface configured to receive a change request relating to the target dentition; a refinement module configured to: identify, from the change request, an adjustment of a parameter of the target dentition; automatically determine an additional change to the target dentition required as a consequence of implementing the change request in order to remain compliant with the dentition specification, wherein the additional change comprises an adjustment to a parameter of the target dentition not identified in the change request; obtain an adjusted target dentition that incorporates the change request and the additional change; and generate a revised orthodontic treatment plan that maps a transition for the set of teeth from the current dentition to the adjusted target dentition.

22. The computer device of claim 21, wherein the user interface is configured to receive a natural language input and convert the natural language input into a command to change the identified parameter.

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