Complete system of expanders for early orthodontic treatment in patients with deciduous or mixed teeth and production method

Abstract

The present invention relates to a method for producing orthodontic expanders (1) and to said orthodontic expanders (1), in patients with deciduous or mixed teeth, which enables expanders to be produced by means of digitisation using an intraoral scan (100). This information is imported (200) into specialised software that enables the sequencing (400) of tooth movements necessary to achieve the desired correction. After planning and designing (300) the sequencing (400) of the orthodontic expander (1), the expanders are 3D printed (500) directly for orthodontic treatment.

Description

[0001] DESCRIPTION

[0002] Complete system of expanders for early orthodontic treatment in patients with primary or mixed dentition and manufacturing method

[0003] OBJECT OF THE INVENTION

[0004] The present invention, as its title indicates, relates to expanders and a method for manufacturing expanders for use in patients with primary or mixed dentition. This innovation offers advantages previously unknown within current techniques.

[0005] The present invention is characterized by the special functional and constructive features of the elements that make up the device, such that they all contribute to achieving a method for manufacturing expanders for patients with primary or mixed dentition. This method optimizes the experience for both the dental professional and the patient during orthodontic treatment in children, through the implementation of a new dental appliance technology that not only equals the results obtained with conventional orthodontics but even surpasses them, minimizing discomfort, emergencies, and associated problems. Furthermore, this innovation will reduce and simplify the manufacturing process, representing a significant advance in the efficiency and effectiveness of the treatment.This approach represents a major advance in pediatric dentistry, as it seeks to improve the quality of life of patients and facilitate the work of professionals, offering superior results with fewer inconveniences.

[0006] TECHNICAL SECTOR

[0007] Therefore, the present invention falls within the field of dentistry, and in particular among those for orthodontic expander prostheses.

[0008] BACKGROUND OF THE INVENTION

[0009] The present invention details the use of devices for early treatment

[0010] 2 orthodontic treatments that replace conventional methods, representing a significant innovation for the experience of both the doctor and the patient.

[0011] Currently, orthodontic treatment in childhood is of paramount importance, as it creates space for all teeth, preventing crowding. It also corrects bite problems that could lead to future dental and temporomandibular joint issues, and significantly improves breathing, balance, and overall oral health.

[0012] The basis of these devices consists of direct impression transparent upper and lower expanders, which gradually widen the dental arches.

[0013] The prior art invention ES2599310T3 provides a system and method for designing and producing dental prostheses, such as crowns and bridges, where the service center is equipped to generate a virtual 3D model of a patient's teeth from data obtained either by scanning the teeth directly or by scanning a physical model of the teeth, the process being initiated at least at the dental clinic. The service center is also equipped to use the computer model to design a dental treatment and to select or design and manufacture dental prostheses, or at least a part thereof, using conventional material removal methods. However, the method of the present invention allows the prostheses to be manufactured using additive manufacturing techniques.

[0014] In invention ES2814181T3, an orthodontic tooth repositioning device is defined, comprising heterogeneous properties to improve force control and / or torque application on different tooth subsets. For example, different portions of a device may comprise different material compositions to produce different localized stiffnesses. These different localized stiffnesses can be used to exert localized forces and / or torques tailored to the particular underlying teeth. The process of the present invention, however, enables the production of palatal expanders with different attributes.

[0015] In general, the palatal expansion appliances described in ES2845198T3 are worn as a set of expanders that can be configured to apply force within the patient's mouth, thereby expanding the patient's upper jaw. During use, the patient can apply and / or remove the set of palatal expanders, which can be adapted to fit securely onto the patient's teeth, providing sufficient resistance to move the teeth, yet allowing for easy removal without excessive force. The appliance can be attached to the patient's last three teeth. However, these expanders are manufactured using different methods than the invention proposed herein.

[0016] The proposed invention differs from a conventional aligner by virtue of its ability to move not only the teeth, but also the dentoalveolar bone and palate. While an aligner is limited to repositioning the teeth, this device has the capacity to influence the position of additional bone structures and soft tissues, making it a more versatile and comprehensive tool for treating malocclusions and other dental conditions.

[0017] The conventional expander or expander is distinguished by its ability to produce movement in the teeth, dentoalveolar bone, and palate. However, the manufacturing of this device is completely different, making it unique in its function and application.

[0018] With reference to the current state of the art, it should be noted that, although various designs of palatal expanders are known, the existence of any other that presents structural and constitutive technical characteristics equal or similar to those presented by the invention claimed herein is unknown.

[0019] EXPLANATION OF THE INVENTION

[0020] The invention relates to an orthodontic expander and its method of implementation which saves time and facilitates treatment by manufacturing orthodontic expanders.

[0021] Specifically, the invention proposes, as previously mentioned, an orthodontic expander and a method of implementation consisting of several phases. The first phase, once the treatment plan has been determined, is digitization through intraoral scanning, which obtains detailed images of the patient's teeth, gums, and soft palate. These three-dimensional images provide a digital three-dimensional model upon which to develop the future expanders.

[0022] Next, the d3 model is imported into software where a set of sequenced expanders are designed, in which the shape is varied to force the movement of the teeth in a gradual way.

[0023] The information is then processed and imported into specialized software that allows us to carry out the sequence of tooth movements necessary to achieve the desired correction in orthodontic treatment. Using this software, the three-dimensional sequence of the orthodontic expander is planned and designed. This expander consists of a set of upper and a set of lower expanders. These sets are composed of multiple expanders, which are customized according to each patient's needs. The number of expanders used will depend on the individual needs of each patient and will be used sequentially throughout the treatment.

[0024] Specialized software is used to design the devices that establish the cutting line, the differential thickness of the expander assembly by zone, and the necessary attachments, and these are then printed directly. This feature represents a significant advancement compared to conventional aligners, which require the fabrication of dental models with a single thickness for stamping onto the aligner. This approach allows for precise and personalized planning, ensuring that the treatment is effective and tailored to each patient's specific needs.

[0025] The expanders are then manufactured using 3D printing, a process that allows for precise and personalized production for each patient. 3D printing is performed directly on a specialized printer, such as an SLA, DLP, or LCD printer, using a resin specifically designed for direct printing. The choice of resin depends on the properties required for the expander, such as strength and biocompatibility with oral tissues.

[0026] Once the printing phase is complete, the cleaning and post-curing process begins.

[0027] 5. Place the expander according to the instructions provided by the resin manufacturer. This process is crucial to ensure the removal of any resin residue and to guarantee that the expander is ready for implementation in the patient's orthodontic treatment.

[0028] Finally, the treatment phase begins. During this phase, it is crucial that the patient consistently follows the instructions for using the aligners. This means that the aligners must be worn 24 hours a day, even during meals, and should only be removed for cleaning. It is important that the patient understands the importance of adhering to this routine to achieve the desired results within the expected timeframe.

[0029] Furthermore, it is essential that the patient follow a specific routine for changing the expanders. It is recommended that the expander be changed daily or, failing that, every other day. This means that if the patient starts with one expander on Monday night, the change to the next expander will be made on Wednesday night. This routine should be repeated until the planned series of expanders is completed.

[0030] It is important for the patient to understand that following these instructions precisely will significantly contribute to the success of the treatment. Failure to comply with these instructions could negatively affect the final results of the orthodontic treatment. Therefore, the patient is strongly advised to be committed to following these instructions to ensure the success of the expansion process and achieve the desired results.

[0031] Unless otherwise stated, all technical and scientific terms used herein have the meanings commonly understood by a person skilled in the art to which this invention pertains. Similar or equivalent procedures and materials to those described herein may be used in the practice of this invention.

[0032] BRIEF DESCRIPTION OF THE DRAWINGS

[0033] To complete the description being made and in order to help in the better understanding of the characteristics of the invention, this descriptive specification 6 is accompanied, as an integral part thereof, by figures in which, for illustrative and non-limiting purposes, the following has been represented:

[0034] Figure 1 is a schematic representation of the method of making orthodontic expanders.

[0035] Figure 2 is a lower representation of the upper expander (2.1).

[0036] Figure 3 is a side view of the upper expander (2.1).

[0037] Figure 4 is a front view of the upper expander (2.1).

[0038] Figure 5 is a top representation of the lower expander (3.1).

[0039] Figure 6 is a rear view of the lower expander (3.1).

[0040] Figure 7 is a side view of the lower expander (3.1).

[0041] Figure 8 is a perspective representation of the upper expander assembly

[0042] (2).

[0043] Figure 9 is a perspective representation of the lower expander assembly

[0044] (3)

[0045] Figure 10 is a perspective representation of the attachment (5.1)

[0046] Figure 11 is a perspective representation of the attachment (5.2).

[0047] Figure 12 is a perspective representation of the attachment (5.3).

[0048] Figure 13 is a perspective representation of the containment expanders (2.2) and (3.2).

[0049] Figure 14 is a perspective view of the attachments as a button (6.1). Figure 15 is a cross-sectional view of the attachments as a button (6.1).

[0050] Figure 16 is a perspective representation of attachments such as hooks (6.2).

[0051] Figure 17 is a cross-sectional representation of attachments such as hooks (6.2).

[0052] Figure 18 is a representation of the upper expander (2.1) and the lower expander (3.1) comprising attachments such as occlusal blocks (7.1, 7.2, 7.3 and 7.4) and the guide structures (8.1) located on the lingual and palatal face.

[0053] Figure 19 is a perspective representation of the upper expander (2.1) and the lower expander (3.1) comprising attachments such as occlusal blocks (7.1, 7.2, 7.3 and 7.4) viewed from the inside and the guide structures (8.1) located on the lingual and palatal face.

[0054] Figure 20 is a perspective representation of the upper expander (2.1) and the lower expander (3.1) comprising attachments such as occlusal blocks (7.1, 7.2, 7.3 and 7.4) viewed from the outside and the guide structures (8.1) located on the lingual and palatal face.

[0055] Figure 21 is a representation of the upper expander (2.1) and the lower expander (3.1) comprising attachments such as occlusal blocks (7.1, 7.2, 7.3 and 7.4) and the guide structures (8.1) located on the vestibular face.

[0056] Figure 22 is a lateral representation of the upper expander (2.1) and the lower expander (3.1) comprising attachments such as occlusal blocks (7.1, 7.2, 7.3 and 7.4), with the marked inclination axes of the distal inclination (7.6) and the sagittal inclination (7.5) and the guide structures (8.1) located on the vestibular face.

[0057] Figure 23 is a frontal representation of the upper expander (2.1) and the lower expander (3.1) comprising attachments such as occlusal blocks (7.1, 7.2, 7.3 and 7.4) and the guide structures (8.1) located on the vestibular face.

[0058] 8 PREFERRED EMBODIMENT OF THE INVENTION

[0059] In view of the figures, a preferred, though not limiting, embodiment of the proposed invention is described below, which consists of an orthodontic expander and its method of embodiment.

[0060] Once the treatment plan has been determined, the procedure involves digitization using an intraoral scan (100). This technique allows us to obtain a highly accurate three-dimensional digital model of the patient's oral cavity. This technique enables us to record both the upper and lower dental arches, which is essential for making a precise diagnosis and planning dental treatments efficiently.

[0061] During the intraoral scan (100), detailed images of the patient's teeth, gums, and soft palate are captured. These three-dimensional images provide us with a complete view of the oral structure, allowing us to identify any abnormalities or problems that may be present.

[0062] This information is imported (200) into specialized software in which we can carry out the sequence (400) of tooth movements necessary to achieve the desired correction. Planning and designing (300) the sequence (400) of the orthodontic expander (1) in 3D, for orthodontic treatment. The orthodontic expander (1) comprises a set of upper expanders (2) and a set of lower expanders (3). These sets of expanders (2) and (3) are composed of a plurality of expanders (2.1) and (3.1) which are defined according to the treatment, and the number of said expanders (2.1) and (3.1) will depend on the individual needs of each patient. They are sequenced sequentially and will be used by the patient in an orderly fashion throughout the treatment.

[0063] The software allows us to design (300) the shape of the upper and lower expander set (2) and (3), establish the cut line (4), vary the thickness, add attachments, and simulate the process. This functionality is crucial to ensure that each orthodontic expander (1) is perfectly suited to the patient's specific needs.

[0064] 9. The upper expander set (2) covers the entire posterior dentition, from the first primary molar to the last permanent molar, and the palatal portion of the primary canines and permanent incisors. The upper expanders (2.1) have individualized thicknesses to enhance the potential and quality of expansion. The mid-palatal portion, which includes an increased thickness (1.1), is of particular importance. This area covers the palatal surface with the mesial anterior border of the first primary molar and the distal posterior border of the second primary molar. At the dental level, it covers the gingival third of the palatal area of ​​the first and second molars.

[0065] The upper expanders (2.1) fit precisely to all dental and palatal surfaces, with the exception of the palatal vault. The upper expanders (2.1) comprise a palatal space (1.2) with an individualized separation from the most concave part of the palatal vault.

[0066] The cut line (4) is designed with the distal of the first permanent molars or the second deciduous molars if the permanent molars are not yet erupted. The buccal cut is made at the level of the primary molars and the first permanent molar, extending 2 mm gingivally above the gingival margin. The palatal cut is made at the level of the first permanent molars, at the gingival margin. Posteriorly, the transpalatal cut extends from the distal of the second right primary molar to the distal of the second left molar, creating a slight concave relief mesial to the central palatal portion. Anteriorly, the palatal cut passes just above the cingula of the primary canines and the permanent maxillary incisors.

[0067] The lower expander (3) encompasses the entire posterior dentition, from the first primary molar to the last permanent molar, as well as the palatal portion of the primary canines and permanent incisors, and the translingual area. The cut line (4) circumscribes the distal portion of the first permanent molars or the second primary molars if the permanent molars are not yet erupted. It extends buccally from the primary molars and the first permanent molar, 2 mm above the gingival margin. The lingual portion extends from the gingival margin to the first permanent molars. Posteriorly and lingually, the cut extends from the distal portion of the second primary right molar to the distal portion of the second primary left molar, creating a slight concave relief mesial to the central portion. Anteriorly and lingually, the cut passes just above the cingula of the primary canines and the lower permanent incisors.

[0068] 10. The design takes into account the thickness, with the upper expander set (2) measuring 0.7 mm and 0.9 mm across the entire surface, except for the mid-palatal portion. Mid-palatal area: This area encompasses the palatal surface with the mesial anterior limit of the first primary molar and the distal posterior limit of the second primary molar. At the dental level, it will cover the gingival third of the palatal area of ​​the first and second molars. The thickness (1.1) of the palatal portion is significantly increased to optimize expansion. The palatal recess (1.2) of the device adapts precisely to all dental and palatal surfaces, except for the palatal vault.

[0069] In design (300), thickness is taken into account, with the lower expander (3.1) measuring 0.7 mm and 0.9 mm across its entire surface, except for the translingual palatal portion. This translingual zone covers the lingual surface, extending from the mesial anterior border of the first primary molar to the distal posterior border of the second primary molar. At the dental level, it will cover the gingival half of the lingual area of ​​the first and second molars. The thickness of the translingual portion is significantly increased to optimize expansion.

[0070] The orthodontic expander (1) comprises a plurality of attachments (5) distributed on the tooth surfaces consisting of bulges made of composite resins that are placed on the vestibular or palatal face of the teeth by means of a conventional process of adhesion and photopolymerization just like dental fillings.

[0071] The software also designs the attachments (5) that may be necessary for retention in the mouth during the patient's treatment. The need for and design of the attachments (5) may vary slightly depending on the height and retention of the tooth.

[0072] In the design of the attachments (5), the following will be taken into account: attachment (5.1) located on the first primary molar, the horizontal attachment or horizontal attachment beveled to the occlusal surface; attachment (5.2) on the second primary molar, the horizontal attachment or horizontal attachment beveled to the occlusal surface; and attachment (5.3) on the first permanent molar, the horizontal attachment beveled to the gingival surface.

[0073] The orthodontic expander (1) comprises a plurality of attachments distributed on the tooth surfaces, designed to treat a wide range of malocclusions. These attachments have different shapes and functions, such as the buttons (6.1) for elastics.

[0074] 11 intraoral elastics, comprising a specially configured protrusion to ensure correct positioning of the intraoral elastic. Also included are the hooks (6.2) for extraoral elastics, which are used in combination with a face mask and are designed in a hook shape to secure the rubber of the extraoral elastics.

[0075] Depending on the mode of implementation, the attachments can also be occlusal blocks: the upper right occlusal block (7.1), the upper left occlusal block (7.2), the lower right occlusal block (7.3) and the lower left occlusal block (7.4).

[0076] These occlusal blocks (7.1, 7.2, 7.3 and 7.4) comprise a sagittal inclination (7.5) of between 10° and 15° with respect to the transverse plane (T) in the superior direction, and have a variable height that will depend on the amount of anterior interference that the overbite generates in the mandibular advancement.

[0077] The appliances can also be presented as guide structures (8.1), allowing a combination that interferes with the patient's occlusion to move the mandible to a more anterior position. This controlled interference is essential for the success of the treatment.

[0078] These guide structures (8.1) comprise a distal inclination (8.2) of between 8 o and 12° with respect to the coronal plane (C) in the posterior direction, which prevent the patient's jaw from moving backward when opening the mouth, thus helping to maintain the desired position during mandibular advancement.

[0079] It is important to mention that the location of these guide structures (8.1) can vary according to the patient's needs and the professional's preference. The choice can be made whether to place them in the vestibular region or in the palatal and lingual region, as deemed most appropriate for the particular case.

[0080] These components offer a comprehensive solution to address different types of malocclusions and provide personalized treatment for each patient.

[0081] Once all the treatment stages of the corresponding upper (2) and lower (3) expander sequence have been designed (300), they are exported in a 3D printer-compatible file format (500). This allows for the direct 3D printing (500) of the various upper (2) and lower (3) expanders and attachments (5), resulting in a highly precise and customized solution for each patient. This offers a time advantage. This sequence of movements is recommended for predictable expansion.

[0082] The orthodontic expander (1) will perform exclusively vestibular stimulation movements, both in the posterior and anterior sectors, allowing for the programming of posterior expansion, anterior alignment only with proclination, and correction of rotations with vestibularization.

[0083] For predictable expansion of the orthodontic expander (1), expansions of 0.20 mm to 0.25 mm are performed with each change of expander sets (2) and (3), resulting in a movement of 0.10 mm to 0.125 mm per side. Simultaneous movements during expansion of the anterior teeth will be performed at a rate that produces a maximum of 0.10 mm per aligner. The sequence of expanders (2) and (3) concludes with a non-moving, passive orthodontic expander (2.1) and (3.1). This last expander (2.1) and (3.1) will only be removed for eating until proceeding to the next phase of treatment.

[0084] The orthodontic expanders (1) are 3D printed (500) directly. This is done using an SLA, DLP, or LCD printer with direct printing resin, the type of which will depend on the required properties and biocompatibility. Once the printing phase is complete, the final cleaning and post-curing phases are carried out according to the resin manufacturer's instructions.

[0085] During the expansion or treatment phase (600), the patient must wear the orthodontic expanders (1) 24 hours a day, including during meals, and should only be removed for cleaning. The routine for changing expanders (2.1) and (3.1) should be daily or, failing that, every other day.

[0086] Finally, the last of the expander sets (2) and (3) to be used in the treatment are retention expanders (2.2) and (3.2). These upper retention expanders (2.2) and lower retention expanders (3.2) are passive, immobile, and maintain the trans-palatal and trans-lingual structure. This ensures the retention of the expansion previously performed on the patient, and their use will continue, removing them only for eating, until the next phase of treatment begins.

[0087] Having sufficiently described the nature of the present invention, as well as the manner of putting it into practice, it is not considered necessary to make its explanation more extensive so that any expert in the field may understand its scope and the advantages that derive from it, it being noted that, within its essentiality, it may be put into practice in other modes of embodiment that differ in detail from the one indicated as an example, and which will also achieve the protection sought provided that its fundamental principle is not altered, changed or modified.

[0088] 14

Claims

CLAIMS 1. A method for making orthodontic expanders, characterized in that it comprises: an intraoral scanning phase (100) in which a three-dimensional model of the patient's oral cavity is obtained; a data import phase (200) to specialized software; a design phase (300) of the orthodontic expanders (1); a sequencing phase (400) of the different expanders (2.1) and (3.1); an impression (500) or manufacturing phase in which the orthodontic expanders (1) are materialized; a treatment phase (600) in which the patient uses the orthodontic expanders (1) and is monitored and controlled.

2. Orthodontic expander (1), according to the process described in claim 1, characterized in that it comprises a set of upper expanders (2) and a set of lower expanders (3) composed of a plurality of expanders (2.1) and (3.1) whose quantity is defined according to the treatment, which are sequenced correlatively and are used by the patient in an orderly manner throughout the treatment.

3. Orthodontic expander (1), according to the previous claim, characterized in that it comprises a plurality of attachments (5) distributed on the tooth surfaces, consisting of bulges made of composite resins that are placed on the vestibular or palatal face of the teeth by means of a conventional process of adhesion and photopolymerization.

4. Orthodontic expander (1), according to any of claims 2 and 3, characterized in that the upper expanders (2.1) cover the entirety of the posterior dentition including the first deciduous molar to the last permanent molar and the palatal part of the deciduous canine teeth and permanent incisors.

5. Orthodontic expander (1), according to any of claims 2 to 4, characterized in that the upper expanders (2.1) have a thickness of between 0.7mm and 0.9mm, except in the mid-palatal part, which covers the palatal surface with the mesial anterior limit of the first deciduous molar and the distal posterior limit of the second deciduous molar, which comprises an increase in thickness (1.1).

6. Orthodontic expander (1), according to any of claims 2 to 5, characterized in that the upper expanders (2.1) are precisely fitted to all dental and palatal surfaces, with the exception of the palatal vault where they comprise a palatal space (1.2) with an individualized separation from the most concave part of the user's palatal vault.

7. Orthodontic expander (1), according to any of claims 2 to 6, characterized in that the lower expanders (3.1) cover the entire posterior dentition including the first deciduous molar to the last permanent molar, as well as the palatal part of the deciduous canine and permanent incisor teeth and the trans-lingual area.

8. Orthodontic expander (1), according to any of claims 2 to 7, characterized in that the predictability of the expansion depends on performing exclusively vestibular stimulation movements.

9. Orthodontic expander (1), according to any of claims 2 to 8, characterized in that the last device of expander sets (2) and (3) used in treatment, are upper retention expanders (2.2) and lower retention expanders (3.2) that are passive, without movement and maintain the trans-palatal and trans-lingual structure.

10. Orthodontic expander (1), according to any of claims 2 to 9, characterized in that it comprises a plurality of attachments distributed on the tooth surfaces configured to treat any malocclusion.

11. Orthodontic expander (1), according to any of claims 2 to 10, characterized in that the attachment is a button (6.1) for intraoral elastics, which They include a protrusion configured to ensure the correct positioning of the intraoral elastic.

12. Orthodontic expander (1), according to any of claims 2 to 10, characterized in that the attachment is a hook (6.2) for extraoral elastics, which are used in combination with a face mask and are configured in a hook shape to secure the rubber of the extraoral elastics.

13. Orthodontic expander (1), according to any of claims 2 to 10, characterized in that the attachments are occlusal blocks configured as: an upper right occlusal block (7.1), an upper left occlusal block (7.2), a lower right occlusal block (7.3) and a lower left occlusal block (7.4).

14. Orthodontic expander (1), according to the previous claim, characterized in that the attachments, such as occlusal blocks, have a sagittal inclination (7.5) with respect to the transverse plane (T).

15. Orthodontic expander (1), according to the preceding claim, characterized in that the sagittal inclination (7.5) is between 10° and 15° degrees.

16. Orthodontic expander (1), according to claim 13, characterized in that the attachments such as occlusal blocks have a variable height.

17. Orthodontic expander (1), according to any of claims 2 to 16, characterized in that the attachments are guide structures (8.1), which interfere with the patient's occlusion.

18. Orthodontic expander (1), according to the previous claim, characterized in that the guide structures (8.1) comprise a distal inclination (8.2) with respect to the coronal plane (C).

19. Orthodontic expander (1), according to the preceding claim, characterized in that the distal inclination (8.2) is between 8 o and 12° with respect to the coronal plane (C).

20. Orthodontic expander (1), according to claim 17, characterized in that the guide structures (8.1) are located in the vestibular region.

21. Orthodontic expander (1), according to claim 17, characterized in that the guide structures (8.1) are located in the palatal and lingual region. 18

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