Assistance system for assembling a retaining device, method for producing such a system and use of such a system

Abstract

The invention relates to an assistance system (10) for assembling a retaining device (1), the retaining device (1) comprising: - at least two plates (4), - at least one retaining element (6); the guide (11) comprising at least two guide surfaces (12), each guide surface being shaped to be at least partially complementary to a single plate (4), the guide (11) further comprising at least one guide mark (13) for the retaining element (6), the guide surfaces (12) and the guide mark (13) being positioned relative to one another in a predetermined manner, in order to be at least partially complementary to the retaining device (1) in a retaining configuration.

Description

[0001] DESCRIPTION

[0002] Title: System for assembling a restraint device, method for manufacturing such a system and use of such a system

[0003] FIELD OF INVENTION

[0004]

[0001] The present invention relates to the field of orthodontics, and more particularly to the field of fixed, intraoral orthodontic retention systems intended to be applied, but not exclusively, to the lingual face of the teeth.

[0005] TECHNOLOGICAL BACKGROUND

[0006]

[0002] After orthodontic treatment, aimed for example at restoring alignment of a patient's teeth, it is not uncommon to see after a certain time a partial or total reappearance of the initial dental malpositions. This is then referred to as relapse.

[0007]

[0003] To limit the risk of relapse, it is known to prescribe a retainer to the patient to maintain the position of the teeth. Since the risk of relapse is lifelong, the retainer should preferably be worn for life.

[0008]

[0004] The function of the retainer is to provide sufficient rigidity to hold the teeth in position, while also providing adequate flexibility so that the teeth retain freedom of movement relative to one another. Indeed, physiologically, teeth exhibit a certain degree of natural mobility that allows them to absorb mechanical stresses through elasticity, particularly during chewing. The retainer must therefore allow controlled movement between the teeth.

[0009]

[0005] There are so-called removable restraint devices, worn mainly at night. The effectiveness of removable devices depends on the patient's willingness and diligence, and frequent forgetfulness reduces their effectiveness.

[0010]

[0006] There are also so-called fixed restraint devices, intended to be worn constantly by the patient for a period of several months or even years, and requiring the intervention of a specialist for their placement and / or removal and / or repair.

[0011]

[0007] Fixed retention devices are mainly intraoral, and consist of fixing on the teeth, preferably on their non-visible lingual face, a retention element having the required rigidity characteristics.

[0012]

[0008] When the risk of relapse is high, i.e., when the patient's tooth mobility is high, the retention element may be a splint, particularly a metallic one, for example, cast and bonded to the lingual surface of the teeth. The high rigidity of this solution can cause the metallic splint to detach under the effect of chewing. Furthermore, irreversible tooth mutilation is necessary to create a space on the teeth corresponding to the thickness of the material forming the bar and to limit discomfort in the mouth.

[0013]

[0009] Another solution involves using a wire-type retention element, generally a multi-strand braided steel wire with a circular cross-section, of a length suitable for retaining a specific number of teeth. A specialist then shapes the wire, either directly on the lingual surface of the patient's teeth or in a laboratory on a model of the patient's teeth, so that the wire fits snugly against the lingual surface. The wire is then bonded to the teeth using composite resin pads. The wire can be replaced by a metal chain, a rectangular wire, or a fiberglass strip. Alternatively, the wire can be completely embedded in resin to hold it against the teeth.

[0014]

[0010] The thickness of the resin must be sufficient to encase the retainer, provide adequate mechanical support, and minimize discomfort in the mouth. Therefore, the resin thickness influences, to varying degrees, patient comfort, ease of cleaning, and the risk of chewing difficulties, which could lead to detachment of the retainer and the need for emergency consultation with a specialist.

[0015]

[0011] Furthermore, when the retention element is a wire, its complex folding increases the risk that the wire will not perfectly follow the lingual surface of each tooth, as well as the boundary between two adjacent teeth. More specifically, the wire, being locally straight, may not follow the double convexity of the tooth surfaces and creates a relief that causes discomfort for the patient and makes cleaning difficult.

[0016]

[0012] Other techniques such as cast splints or fiber strips also present this increased disadvantage at the interdental limits, the surface area of ​​their cross-section being greater than that of the wire.

[0017]

[0013] Document FR3005405 proposes a fixed, so-called passive, restraint device comprising a support onto which slats are fixed. More specifically, the slats include a groove forming a recess, and the support, which is typically a wire, is fixed inside the recesses. The support is fixed in the recesses of the slats by gluing.

[0018]

[0014] The assembly between the support and the copings is, however, a delicate operation, as the assembly must be carried out precisely to guarantee patient comfort. Depending on the practitioner's skill, patient comfort may not be optimal. Furthermore, the application of adhesive between the support and the copings can lead to excess adhesive. The precise positioning of the copings and the support in the patient's mouth can then be compromised, causing discomfort for the patient.

[0019]

[0015] In addition, such a retention device makes it possible to increase comfort in the mouth, in particular thanks to the plates, while providing effective and comfortable retention thanks to the retention wire held against the teeth.

[0020]

[0016] However, it frequently happens that the wire is damaged or even breaks. Repair of the retainer must be carried out by a professional practitioner and involves removing at least one retainer from the patient's mouth, or even all of them. Removing a retainer is a delicate operation: the aim is for the retainer to be as close as possible to the tooth for the patient's comfort, with no gap between the retainer and the tooth to prevent food from getting stuck. The tool used to remove the retainer may not have a firm grip. The tool is forced between the tooth and the retainer, with a high risk of slipping and damaging the teeth or even injuring the patient's mouth.

[0021]

[0017] Document W02022 / 200246 proposes a retention device that addresses, in particular, the aforementioned drawbacks. Specifically, it proposes a custom-made retention device that provides sufficient flexibility to allow the teeth the necessary freedom of movement during chewing, while remaining discreet enough to minimize discomfort for the patient. It also proposes a solution to facilitate the placement of the retention device in the mouth, notably through the implementation of a rigid, connected assembly comprising guides for the retention element and guides for the retention elements, called retainers, of the retention element.

[0022]

[0018] However, such a device, while it provides assistance to the practitioner, can be delicate to handle, in particular because it may involve actions on the guides while they are being introduced into the patient's mouth.

[0023]

[0019] The invention thus aims to provide a solution in particular to the aforementioned disadvantages.

[0024]

[0020] A first aspect of the invention is to provide a guide which allows a practitioner to perform a minimum of actions to place a fixed retention device in the mouth.

[0025]

[0021] A second aspect of the invention is to provide a guide for placing a fixed restraint in a patient's mouth with increased precision.

[0026]

[0022] A third aspect of the invention is to provide a guide ensuring good relative positioning of the components of the fixed restraint device.

[0027]

[0023] A fourth aspect of the invention is to provide a guide that can be used to transport the restraint device.

[0024] A fifth aspect of the invention is to provide a guide that reliably maintains the relative positioning of the components of the restraint device during transport.

[0028]

[0025] A sixth aspect of the invention is to provide a guide allowing the assembly of a restraint device with increased precision outside the mouth.

[0029] SUMMARY OF THE INVENTION

[0030]

[0026] Thus, according to a first aspect, the invention relates to an aid system for assembling a restraint device. The restraint device includes, in particular:

[0031] -at least two plates, each plate comprising an inner surface, called intrados, for rigid fixation to one face of a tooth of the patient's dentition and an outer surface, called extrados, opposite the inner surface;

[0032] -at least one restraint element attached and rigidly fixed to each of the plates.

[0033]

[0027] The retention device is intended to be placed in a patient's mouth to provide retention between at least two teeth in a so-called retention configuration. In the retention configuration, the inner surface of each plate is fixed at least partially to a tooth, and preferably a single tooth, and the retention element is fixed to each plate. The retention element then comprises a portion extending between the two successive plates and which is at least partially in contact with the teeth extending between said two successive plates.

[0034]

[0028] The support system comprises at least one guide, which includes at least two guide surfaces, each guide surface being shaped to be at least partially complementary to a single pad. The guide further comprises at least one guide marker for the restraint element. The guide surfaces and the guide marker are positioned relative to each other in a predetermined manner, to be at least partially complementary to the restraint device in the restraint configuration.

[0035]

[0029] The system then allows for precise and reliable assembly between the plates and the retention element outside the patient's mouth, facilitating the placement of the retention device in the mouth and enabling highly effective retention.

[0036]

[0030] Depending on various aspects, it is possible to provide one or both of the features below, taken alone or in combination.

[0031] In one embodiment, the guide of the support system may comprise at least three guide surfaces, each guide surface being shaped to be complementary, at least in part, to a single plate of the retention device. The retention device then comprises at least three successive plates, each intended to be fixed to a different tooth in the patient's dentition. In other words, each tooth is associated with a single plate, and the guide comprises at least one guide surface dedicated to a single plate.

[0037]

[0032] According to one embodiment, the guide can block the translation of the retention element in at least one direction in at least two spatial directions, so as to limit unintentional movement on the guide. Preferably, the blocking is performed in a single direction in each direction, to facilitate the placement on the guide and the removal of the retention element.

[0038]

[0033] According to one embodiment, the support system may include at least one removable retaining device for at least one plate against the corresponding guide surface. The plate 4 is then completely locked, temporarily, onto the guide, at least for the duration of the assembly with the retaining element.

[0039]

[0034] For example, the removable retention device includes an adhesive.

[0040]

[0035] According to one embodiment, at least one guide surface may be complementary to at least a portion of the internal or external surface of the corresponding insert. Alternatively, or in combination, the guide surface may be complementary at least at the edge of the lateral edge of the insert.

[0041]

[0036] According to one embodiment, the guide mark may include at least one recess on the guide. Alternatively, or in combination, the guide mark may include at least one projection on the guide.

[0042]

[0037] According to one embodiment, at least one guide surface may include at least one glue flow groove.

[0043]

[0038] According to a second aspect, the invention relates to a method for manufacturing an aid system for assembling a restraint device as described above, the restraint device comprising:

[0044] -at least two plates, each plate comprising an internal surface for rigid fixation on one face of a tooth of the patient's dentition and an opposing external surface;

[0045] -at least one restraint element attached and rigidly fixed to each of the plates.

[0046]

[0039] The retention device is intended to be placed in a patient's mouth to provide retention between at least two teeth in a so-called retention configuration, in which the inner surface of each plate is fixed to a tooth and the retention element fixed to each plate includes a portion extending between the two plates, at least partially in contact with the teeth concerned by the retention. The method then comprises:

[0047] -determining the restraint configuration of the restraint device for the patient;

[0048] -the determination of at least two guide surfaces;

[0049] -the determination of at least one guide frame;

[0050] -the making of the guide.

[0051]

[0040] According to one embodiment, the guide manufacturing step may include manufacturing by 3D printing.

[0052]

[0041] According to one embodiment, the guide manufacturing step includes making a mold of the patient's teeth and machining at least two guide surfaces and at least one guide relief on the mold.

[0053]

[0042] According to a third aspect, the invention proposes the use of an aid system for positioning a restraint device as described above. The use includes, in particular, placing each plate against a guide surface, applying the restraint element to the guide relief, and fixing the restraint element to each of the plates.

[0054]

[0043] Independently of the system for assembling a retention device, another invention relates to a pad, also called a retainer plate, intended to be rigidly attached to a retention element, such as a retainer wire, of a retention device. Such a retention device is preferably fixed. The pad includes, in particular, an inner face, called the intaglio surface, intended to be rigidly attached to a surface of a patient's tooth. The surface in question is typically the labial or lingual surface. The pad also includes an outer face, called the extrados, opposite the intaglio surface, and a lateral edge forming the junction between the inner and outer faces. The inner face is specifically intended to be attached to at least a portion of the relevant surface of the tooth. The pad further includes at least one notch on the inner face.The notch includes an opening leading to the lateral edge of the plate so as to allow a tool to be inserted into the notch when the inner face of the plate is fixed to the tooth.

[0055]

[0044] The notch thus allows the tool to be inserted between the plate and the tooth to remove the plate safely and with great ease.

[0056]

[0045] Depending on various aspects, it is possible to provide for this other invention one or both of the features below, taken alone or in combination.

[0046] According to one embodiment, the inner face may include a groove intended to house at least part of the retention element, said groove opening at least at one point on the lateral edge of the plate and joining the entrance of the notch. Thus, the additional thickness of the plate possibly caused by the notch is combined with the additional thickness expected from the groove. Since an additional thickness results in a ridge on the extrados, the notch and the groove together form a single ridge, limiting discomfort in the patient's mouth.

[0057]

[0047] According to one embodiment, the notch can be filled with a filling material less resistant than the material of the insert. Thus, when the insert is in the mouth, the risk of objects, particularly food, becoming trapped in the notch is reduced. Since the filling material is less resistant than the rest of the insert, it can be removed if necessary, for example by sandblasting.

[0058]

[0048] In one embodiment, the retainer is made of metal, a metal alloy, or ceramic. The material is in all cases biocompatible. Such a retainer ensures good mechanical stability in the mouth and highly effective retention.

[0059]

[0049] According to another aspect, the invention relates to a restraint device comprising:

[0060] -at least two plates, each plate comprising an internal surface for rigid fixation on one face of a tooth of the patient's dentition and an opposing external surface;

[0061] -at least one restraint element attached and rigidly fixed to each of the plates.

[0062]

[0050] The retention device is intended to be placed in a patient's mouth to provide retention between at least two teeth in a so-called retention configuration, in which the inner surface of each plate is fixed to a tooth and the retention element is fixed to each plate, comprising a portion extending between the two plates, at least partially in contact with the teeth concerned by the retention. The retention device then comprises at least one plate as described above.

[0063]

[0051] Preferably, all the pads of the retention device are as shown above, that is to say, they include, in particular, a notch. Any intervention on the device that requires the removal of one or more pads is thus facilitated.

[0064]

[0052] According to another aspect, the invention relates to a method for manufacturing the restraint device. The method includes in particular: -determining the relative position between the pads and the restraint element in the restraint configuration of the restraint device;

[0065] -determining the position of at least one notch on the plate in question; -manufacturing the plates.

[0066] BRIEF DESCRIPTION OF THE DRAWINGS

[0067]

[0054] Embodiments of the invention will be described below with reference to the drawings, briefly described below:

[0068]

[0055] [Fig. 1] represents a top view of a lower jaw of a human patient;

[0069]

[0056] [Fig. 2] is a diagram representing a restraint device according to one embodiment.

[0070]

[0057] [Fig. 3] is a three-dimensional schematic view of a system for assisting in the assembly of a restraint device, according to a first embodiment of the invention.

[0071]

[0058] [Fig. 4] is a three-dimensional view of a system for assisting in the assembly of a restraint device, according to the first embodiment of the invention, a plate of a restraint device having to be placed on it.

[0072]

[0059] [Fig. 5] is a three-dimensional view of the aid system of Figure 4, an assembled restraint device to be placed on it.

[0073]

[0060] [Fig.6] is a three-dimensional schematic view of a model for an assembly aid system for a restraint device, according to a second embodiment of the invention.

[0074]

[0061] [Fig.7] is a three-dimensional schematic view of a model for an assembly aid system for a restraint device, according to a fourth embodiment of the invention.

[0075]

[0062] [Fig.8] is a view of the model of figure 7, on which a model of plates has been added.

[0076]

[0063] [Fig.9] is a schematic view of a restraint device suitable for use with the model aid system of Figures 7 and 8.

[0077]

[0064] [Fig.10] is an illustration of a tool to be used with the pads of the restraint device of Figure 9.

[0078]

[0065] In the drawings, identical references designate identical or similar objects.

[0079] DETAILED DESCRIPTION

[0080]

[0066] Figure 1 shows a lower jaw 100 of a human patient, intended to receive an orthodontic retention device 1 according to the invention on at least some of the teeth 101. Preferably, the retention device 1 is of the fixed type, that is to say, it is intended to remain in place in the patient's mouth continuously and permanently. In what follows, the device will be described with reference to the example of the lower jaw in Figure 1, it being understood that the device 1 can be applied in the same way to the teeth of an upper jaw.

[0081]

[0067] Each jaw 100 supports a set of teeth comprising at least one tooth 101. Each tooth 101 comprises a face 101a called lingual, i.e. turned towards the inside of the mouth and the tongue, a face 101b called labial, i.e. turned towards the outside of the mouth and the lips or cheeks, a summit face 101c, i.e. oriented towards the other jaw, in this case the upper jaw according to the example in Figure 1, and two lateral edges 101d. Each lateral edge 101d of a tooth 101 can be in contact, or face, a lateral edge 101d of an adjacent tooth, except for a lateral edge 101d of the bottom teeth 101, at the ends of the jaw 100, i.e. the second or third molars, which is free.

[0082]

[0068] Preferably, but not exclusively, the retention device 1 is intended to be fixed on the lingual face 101a of the teeth, for reasons of discretion and aesthetics.

[0083]

[0069] The retention device 1 typically comprises pads 4, also called retainers, which are fixed to the teeth 101 so that each tooth 101 has a single pad 4. Thus, if N teeth are involved in retention, the retention device 1 comprises N pads 4. The number N is a natural number, greater than or equal to two, and preferably greater than or equal to three. Each pad 4 has an inner face 2, called the intaglio, intended to face the face 101a or 101b of the tooth 101 to which it is fixed, and an opposite outer face 3, called the extrados. Each pad 4 also includes a lateral edge 5, or contour, forming the junction between the intaglio and the extrados.

[0084]

[0070] Each plate 4 is typically bonded to a tooth 101 using a fixing adhesive. The intaglio surface 2 may be textured to increase adhesive retention for bonding to the teeth. The face 101a or 101b of the tooth 101 to which the plate 4 is intended to be fixed may be finely hollowed out to accommodate the added thickness created by the plate 4 on the tooth 101.

[0085]

[0071] The pads 4 can be made of any type of biocompatible material. However, in order to ensure high-quality restraint with limited discomfort for the patient, the pads 4 are preferably made of metal, metal alloy, or ceramic.

[0086]

[0072] The restraint device 1 comprises a restraint element 6 attached and fixed to each plate 4.

[0087]

[0073] Preferably, the retention element 6 is of the wire type, meaning that it has a dimension called the length that is very large compared to the other two, which may be very close or even identical. The cross-section of the retention element 6 is generally circular, square, or rectangular, but any other shape is suitable. The retention element 6 is, for example, a multi-strand metal wire, both flexible enough to be shaped by a technician, for example using a tool, to adapt to the teeth being treated and rigid enough to provide the required retention. The elastic properties of the retention element 6 allow it to absorb masticatory stresses and prevent the risk of fracture. As will be discussed later, the retention element 6 can also be custom-shaped and dimensioned to closely fit the lingual or labial surface 101a of the teeth.

[0088]

[0074] The restraint element 6 may comprise a single section extending continuously over all the plates 4 of the restraint device 1, or it may comprise several sections, each section being fixed to two successive and adjacent plates 4, i.e., plates that follow one another along the restraint element 6 without the interposition of another plate or any other element. In what follows, the restraint element 6 is considered to comprise a single continuous section and is referred to hereafter as the restraint wire 6.

[0089]

[0075] The mechanical properties of the pads 4 and the retaining element 6 are generally different, because their functions are different. Thus, the pads 4 and the retaining element 6 are initially separate elements, manufactured separately, and then fixed together in an assembly step.

[0090]

[0076] According to one embodiment, when the retaining plates 4 and wire 6 are metallic, the assembly can be carried out by welding or brazing, outside the patient's mouth. Welding ensures a rigid, high-quality fixation with high mechanical strength and limits discomfort in the mouth.

[0091]

[0077] According to another embodiment, the assembly between the plates 4 and the wire 6 can be achieved by gluing, for example using a resin-type assembly adhesive.

[0092]

[0078] It should be noted here that the dimensions of the brackets 4 and the wire 6 are small, making their assembly delicate and meticulous. For example, the retention wire 6 has a width (or diameter) of approximately 0.5 mm, or even less. Each bracket 4 has dimensions that vary depending on whether it is face 101a or 101b of the tooth 101 to which it is attached. Typically, a bracket 4 has a surface area between 6 mm 2 and 15 mm 2The thickness of a plate 4 is typically less than 1 mm. More precisely, on the same plate 4, the thickness can vary from 0.3 mm in the thinnest areas to approximately 0.9 mm, for example. Furthermore, the assembly must be carried out in such a way that the retention device 1 causes minimal discomfort to the patient; that is, the plates 4 and the wire 6 must be shaped and positioned to fit the patient's dentition as closely as possible. More specifically, when the retention device 1 is placed in a patient's mouth to provide retention between at least two teeth 101, it is in a so-called retention configuration, in which:

[0093] - the intrados 2 of each plate 4 is fixed at least partially to a single tooth 101; and

[0094] - the retention wire 6, fixed to each plate 4, includes a portion 61 extending between two successive plates 4 and which is at least partly in contact with the teeth 101 extending between the two successive plates.

[0095]

[0079] Thus, the assembly of the plates 4 and the wire 6 must in particular take into account the shape of the plates 4, their relative position when they are fixed on the teeth 101, the shape of the portions 61 of the wire 6 shaped to fit the shape of the teeth, the location of the connection between the wire 6 and each plate 4 and finally, where applicable, the presence of glue which can add thickness to that of the plates 4 and / or the wire 6.

[0096]

[0080] Although the use of automated tools is possible, the complex bending of the wire may still largely require manual intervention.

[0097]

[0081] To this end, an assembly aid system 10 for the restraint device 1 is proposed, which includes at least one guide 11. The guide 11 includes:

[0098] - at least two 12-guide surfaces, each 12-guide surface being shaped to be complementary at least in part to a single plate 4 of the restraint device 1,

[0099] - at least one guide marker 13 for the retention element 6,

[0100]

[0082] A guide surface 12 can be complementary, for example, to the intrados 2 and / or the extrados 3 and / or the lateral edge 5 of a plate 4.

[0101]

[0083] The guide surfaces 12 and the guide marker 13 are connected. In one embodiment, the guide 11 is a single piece, meaning that the guide surfaces 12 and the guide marker 13 are machined from a single piece of material. The guide surfaces 12 and the guide marker 13 are shaped and positioned relative to each other in a predetermined manner, to complement the retention device 1 in the retention configuration. The guide 11 thus allows, by complementarity, the fixing of the relative position between the pads 4 and the retention element 6. The positioning of the retention element 6 for assembly with the pads 4 can therefore be carried out precisely and reliably thanks to the guide marker 13.

[0102]

[0084] A guide surface 12 may be continuous, but not necessarily so; that is, it may comprise several portions spaced apart on which the plate 4 can bear simultaneously. Similarly, the guide marker 13 may be continuous, but not necessarily so.

[0085] More precisely, the guide 11 blocks the translation of the retaining element 6 in at least one direction in at least two spatial directions.

[0103]

[0086] In what follows, a containment plane is defined on the guide as the mean plane of the guide marker 13, which is substantially parallel to the mean plane of the containment element 6. The containment plane can, for example, be calculated by the least squares method applied to the distance between the points of the guide marker 13 and the containment plane. Within the containment plane, a longitudinal direction is defined, corresponding to the overall extension direction of the guide marker 13, and a transverse direction, substantially perpendicular to the longitudinal direction. Finally, a vertical direction, substantially perpendicular to the containment plane, is defined. Thus, the three translational directions in space are referred to in what follows as the longitudinal direction, the transverse direction, and the vertical direction.

[0104]

[0087] The translational locking of the retaining element 6 on the guide 11 is ensured along at least the transverse and vertical directions, in at least one direction in each direction. Correct positioning along the longitudinal direction can then result from the coincidence between the retaining element 6 and the guide marker 13.

[0105]

[0088] Preferably, the locking of the wire 6 on the guide 11 is ensured along the three translational degrees of freedom, in at least one direction in each degree of freedom. In order to easily remove the retaining device 1 from the guide, the locking of the wire 6 on the guide 11 is ensured along the three translational degrees of freedom, in only one direction in each degree of freedom.

[0106]

[0089] The guide 11 can be said to be negative, that is to say that each guide surface 12 is shaped to be complementary at least in part with the extrados 3 of a plate 4. In other words, the guide 11 of the aid system 10 forms a negative impression of the restraint device 1 in the restraint configuration.

[0107]

[0090] Alternatively, the guide 11 can be said to be positive, that is to say that each guide surface 12 is shaped to be complementary at least in part with the intrados 2 of a plate 4.

[0108]

[0091] The guide surfaces 12 can also take into account the presence of the retaining wire 6, depending on the face of the plate 4 on which it is fixed, and depending on whether the guide is positive or negative.

[0109]

[0092] We will now describe four embodiments of the support system 10 for a restraint device 1 comprising plates 4.

[0110]

[0093] According to a first embodiment, illustrated in Figures 3 to 5, the guide 11 is negative. Each guide surface 12 is formed by a recess 14, such that each recess 14 can only correspond to a single plate 4, in shape and dimensions. Thus, according to the example shown, the guide 11 comprises five recesses 14, so that the corresponding retaining device 1 comprises five plates 4. More precisely, each recess 14 comprises a bottom 14a and a contour 14b: the bottom 14a may be complementary, at least in part, to the extrados 3 of a single plate 4 and / or the contour 14b may be shaped to fit, at least in part, the lateral edge of the corresponding plate 4.

[0111]

[0094] The guide 11 includes a recessed marker 13 according to the first embodiment, extending between two successive and adjacent recesses 14 of the guide 11, so as to form grooves 15. Each groove 15 opens onto two successive recesses 14 and corresponds to a portion 61 of the retaining wire 6. More precisely, each groove 15 includes a bottom 15a and two rims 15b that define a space or volume in which the retaining wire 6 must be positioned in order to correspond to the retaining device 1 in its restraint configuration.

[0112]

[0095] According to the example shown, the retaining wire 6 is assembled on the intrados 2 of the plates 4. Thus, the intrados 2 of each plate 4 includes a groove 4a to accommodate the wire 6. When the plate 4 in question is intended to be located at one end of the retaining device 1, then the groove 4a is partial, that is to say, it opens at a single point on the lateral edge 5 of the plate 4 and stops substantially in a central area of ​​the plate 4 where the groove 4a forms a stop 4b. When the plate 4 in question is not an end plate of the retaining device 1, the groove 4a is complete, that is to say, it runs the entire length of the plate 4 and opens at two points on the lateral edge 5 of the plate 4.The dimensions of the grooves 4a are adapted so that the wire 6 is completely inserted inside the grooves 4a, possibly taking into account the extra thickness created by the assembly glue between the plates 4 and the wire 6.

[0113]

[0096] Thus, when the retaining wire 6 is placed by complementarity on the guide mark 13, in this case in the grooves 15, its correct positioning relative to the plates 4 is reliably and precisely ensured, and the assembly with the plates 4 can be carried out.

[0114]

[0097] The retaining wire 6 is thus blocked along a first degree of freedom in translation along the transverse direction in one direction and along a second degree of freedom in translation along the vertical direction in both directions by the grooves 15. Preferably, the grooves 15 can be shaped so that one of the edges 15b does not block vertical translation in one direction. The retaining wire 6 is blocked along the third degree of freedom in translation along the longitudinal direction by a stop formed by one end of the wire 6 against the stop formed by the groove 4a on at least one of the end plates 4 of the retaining device 1. Preferably, blocking by a single end plate 4 is sufficient.

[0115]

[0098] According to one embodiment, the system 10 may include a removable retaining device for one or more pads 4. For example, the retaining device may be formed by the contour 14b of the recesses 14 which closely follows the contour of the pads 4, so as to retain them by friction. According to another example, the removable retaining device includes an adhesive applied to the guide surfaces 12 and / or to the marker 13, applied in a thin layer on the order of a few microns. The adhesive is in particular a hot melt adhesive, that is to say, in a solid state at room temperature. Such an adhesive is also pressure-sensitive to achieve bonding, but has a low adhesion value so that the pads 4 can be detached from the guide 11 manually by a deliberate action of a practitioner and / or a technician. The adhesive may in particular be a so-called fugitive adhesive (such as "Post-it" adhesive).The detachment can be reversible, so the 4 pads can be repositioned as many times as necessary on the guide surfaces 12 without damaging the retaining device. Such an adhesive is, for example, resin-based, starch-based, dextrin-based, gelatin-based, or water-based, or is a so-called metallocene adhesive.

[0116]

[0099] A technician can then implement the following procedure using the aid system 10 comprising the negative guide 11.

[0117]

[0100] First, personalized information about the patient can be obtained, for example, to create a model of their teeth, as well as prescriptions concerning, for example, the width 6 of the wire and / or the thickness of the retainers 4. This information makes it possible to determine the retention configuration for the retention device 1. More specifically, the retention configuration includes, for example, an optimal position of the wire 6 on the patient's teeth, as well as contour limits for the retainers 4 on the teeth.

[0118]

[0101] The guide 11 is then designed from the retention configuration of the retention device 1, by transforming the model of the patient's teeth, on which the guide surfaces 12 and the guide marker 13 are added, so as to determine the impression of the retention device 1 in the retention configuration.

[0119]

[0102] The guide 11 can be designed digitally and then manufactured by any known technique.

[0120]

[0103] Once the guide 11 is obtained, and the retaining plates 4 and wire 6 have been previously manufactured, custom-made in particular, the plates 4 are placed on the corresponding guide surfaces 12, so that their upper surface 3 can be in contact with the bottom 14a of the recesses 14 and their lateral edge 5 can be in contact with the contour 14b of the recesses 14, but leaving at least partially the grooves 4a on the lower surface 2 free. If necessary, the plates 4 can be removably retained on the guide 11 by an adhesive as described above. The wire 6 is then placed in the grooves 4a of the plates 4 and the grooves 15 of the guide. The assembly glue between the plates 4 and the wire 6 is applied to the intrados 2 of the plates 4, in the grooves 4a, before or after placing the wire 6 in the grooves 4a of the plates 4. The assembly glue is applied in liquid or viscous form.The assembly glue is then hardened, ensuring the bond between the plates 4 and the wire 6.

[0121]

[0104] If necessary, excess assembly adhesive can be easily identified and removed, since the grooves 4a are visible and accessible. Excess assembly adhesive can, for example, be removed using an ultrasonic insert.

[0122]

[0105] The restraint device 1 is thus ready to be placed in the patient's mouth, the precise assembly between the plates 4 and the restraint element 6 ensuring positioning with minimal discomfort in the patient's mouth.

[0123]

[0106] In order to place the device 1 in the mouth, a mouth guide can be used.

[0124]

[0107] According to a second embodiment, the guide 11 is positive. Figure 6 illustrates a model for defining the guide surfaces 12 and the guide datum 13 of the positive guide. In what follows, the terms and reference numerals guide surface 12 and guide datum 13 will be used to designate the models of these elements in Figure 6.

[0125]

[0108] As in the negative guide 11, each guide surface 12 of the positive guide 11 is formed by a recess 16, such that each recess 16 can only correspond to a single plate 4, in shape and dimensions. Thus, according to the example shown, the guide 11 comprises six recesses 16, so that the corresponding retaining device 1 comprises six plates 4. More specifically, each recess 16 comprises a bottom 16a and a contour 16b: the bottom 16a may be complementary, at least in part, to the intrados 2 of a single plate 4 and / or the contour 16b may be shaped to fit, at least in part, the lateral edge 5 of the corresponding plate 4. The bottom 16a of the recesses 16 may further comprise grooves of small width relative to the wire 6, in particular, which will serve to facilitate the drainage of any excess adhesive between the plates 4 and the wire 6.

[0126]

[0109] The guide further includes a guide reference 13 formed on the one hand by projections 17 in relation to the bottom 16a of the guide surfaces 12 according to the second embodiment, and on the other hand by support portions 18.

[0127]

[0110] The projections 17 thus define a support against which the wire 6 can be placed to determine its position relative to the brackets 4. More precisely, according to the illustrated example, the guide marker 13 comprises a plurality of projections 17, in this case six projections 17, each projection 17 comprising at least one bearing face 17a against which the wire 6 is intended to bear. Preferably, the wire 6 is intended to also be in contact with the teeth 101, or at least to be as close to them as possible, so that the bearing face 17a is preferably a face of the projection 17 that extends substantially perpendicularly to the vertical direction, the set of bearing faces 17a of the projections 17 thus being substantially parallel to the retention plane. The projections 17 thus ensure that the retention wire 6 is held in a position along the vertical direction.Preferably, the vertical locking is achieved in only one direction to facilitate handling. Optionally, the projections 17 may also have a second bearing face to lock the wire 6 in the second direction along the vertical axis. The projections 17 may form a single continuous projection, but preferably they are subtly distinct from one another.

[0128]

[0111] The projections 17 rise, for example, from the bottom 16a of the grooves 16 of the guide, substantially in a median zone along the longitudinal direction. The number of projections 17 and their position along the longitudinal direction can be arbitrary. The projections 17 are, however, arranged along the vertical direction so that their bearing surfaces 17a ensure the correct positioning of the retaining wire 6 relative to the retaining plane.

[0129]

[0112] The bearing portions 18 correspond in particular to the portion of the surface of the teeth 101 against which the retention wire 6 bears, so as to block the translation of the retention wire 6 along the transverse direction in one direction. The bearing surface portions 18 may form a continuous bearing surface, or extend discretely.

[0130]

[0113] At least one projection 17 intended to guide an end portion of the restraint wire 6 can form a stop 17b along the longitudinal direction, in one direction. Preferably, the restraint wire 6 is locked in a single direction along the longitudinal axis to facilitate handling of the device 1 once assembled. However, it is possible to form a longitudinal stop on two projections 17 at the two extreme portions of the restraint wire 6.

[0131]

[0114] When the retaining wire 6 is pressed against the faces 17a of the projections 17, the stop 17b, and the support portions 18, it is thus blocked in translation along at least one direction in all three directions. Reliable and precise positioning of the wire 6 relative to the plates 4, themselves positioned on the guide 11 by means of the guide surfaces 12, is thus guaranteed.

[0132]

[0115] In the same way as in the first embodiment, the system 10 may include a removable locking device for one or more plates 4.

[0116] The aid system 10 including the positive guide 11 then allows a technician to implement the following process.

[0133]

[0117] First, personalized information about the patient can be obtained, for example, to create a model of their teeth, as well as prescriptions concerning, for example, the width 6 of the wire and / or the thickness of the retainers 4. This information then makes it possible to determine the retention configuration for the retention device 1. More specifically, the retention configuration includes an optimal position of the wire 6 on the patient's teeth, as well as contour limits for the retainers 4 on the teeth.

[0134]

[0118] The guide 11 is then designed from the retention configuration of the retention device 1, by transforming the model of the patient's teeth 101 onto which the guide surfaces 12 and the guide marker 13 are added, which is the model illustrated in Figure 6.

[0135]

[0119] Guide 11 can be designed digitally and then manufactured by any known technique, including 3D printing.

[0136]

[0120] Alternatively, in the case of the positive guide 11, the manufacture of the guide 11 may include taking a mold of the patient's teeth and machining the guide surfaces 12 and the guide relief 13 on the mold. The machining may be carried out precisely using numerically controlled tools.

[0137]

[0121] Once the guide 11 is obtained, the retaining wire 6 is manufactured, notably from the patient's personalized information.

[0138]

[0122] According to a first example, the plates 4 are also manufactured in parallel with the manufacture of the wire 6. Then, the wire 6 is applied to the guide 11, bearing against the support surfaces 17a, the stop 17b, and the support portions 18. If necessary, the wire 6 can be retained on the guide 11 by the retention device. The plates 4 are placed against the corresponding support surfaces 12, and over the wire 6, which is housed in the grooves 4a. The plates 4 can then be bonded to the wire 6 to assemble the retention device 1.

[0139]

[0123] According to a second example, the plates 4 are manufactured to account for a margin of error, for example, in the manufacture of the wire 6. Indeed, although the shape and dimensions of the wire 6 were determined based on the patient's information, the actual manufacturing of the wire 6 can introduce play that is not initially taken into account when manufacturing the plates 4. In particular, the complex folding of the wire 6 can lead to discrepancies between the optimal position of the wire determined by calculation and the result obtained after manufacturing. It is therefore proposed to first manufacture the wire 6 and place it on the positive guide 11, following the guide marker 13, and then scan the assembly formed by the guide 11 and the retention wire 6 in place on the guide 11. From this scan, the plates 4, and in particular the grooves 4a, can then be determined to correspond perfectly to the actual retention wire 6.The four pads are manufactured in a second step with increased precision. Patient comfort is improved. The four pads are then positioned on the guide 11, following the guide surfaces 12, and bonding between the pads 4 and the wire 6 can be performed.

[0140]

[0124] To bond the plates 4 and the wire 6, the assembly adhesive is applied in liquid form, and pressure is exerted, for example manually, on the plates 4 to ensure that the plates 4 are correctly positioned by the guide surfaces 12. Once the assembly adhesive has hardened, for example in light, the bond is permanent.

[0141]

[0125] The guide 11 may optionally include openings allowing at least partial access to a contact area between each pad 4 and the wire 6, so as to allow, for example, precise application of the adhesive. The size and position of such openings do not interfere with the correct positioning of the pads and the wire 6 on the guide 11.

[0142]

[0126] The assembled retention device 1 can then be placed in the patient's mouth by bonding the plates 4 to the teeth 101, possibly with the aid of a placement guide. If necessary, before placing the retention device 1 in the mouth, any excess adhesive between the plates 4 and the wire 6 can be cleaned.

[0143]

[0127] According to a third embodiment, the guide 11 is also positive as described in the second embodiment, but does not include projections 17. Instead of projections 17, the guide marker 13 includes a visual marker, for example, a line of a color distinct from that of the rest of the guide, or a fine groove, visually indicating where the wire 6 should be placed. According to this third embodiment, the guide 11 then includes a system for locking the wire 6 onto the visual marker. The locking system is, for example, similar to the retaining device, and may include, in particular, a fugitive hot-melt adhesive.

[0144]

[0128] According to a fourth embodiment, the guide 11 is also positive as described in the second embodiment and comprises projections 17 which are positioned longitudinally in a particular manner to create a notch 7 on the intrados 2 of the plate. For this purpose, the number 17 of projections is at least equal to the number of plates 4 of the retention device. Thus, for each plate 4, at least one projection 17 can be positioned longitudinally so as to come into contact with the wire 6 at at least one point where the wire 6 crosses the lateral edge 5 of the plate 4. The shape of a projection 17 corresponds substantially to the expected shape for a notch 7, in particular conical or truncated conical. Thus, when the plate 4 is manufactured taking into account the projection 17, it has at least one notch 7, that is to say a recess. In other words, the notch 7 is concave in shape, turned towards the inside of the plate 4.The notch 7 opens at least once on the lateral edge 5 of the plate 4, forming an entry 7a of the notch 7.

[0145]

[0129] Such a plate 4 having at least one notch 7 is not known in itself, and may constitute an invention independent of the invention presented here.

[0146]

[0130] According to the fourth embodiment, when the plate 4 is fixed to a tooth 101 by its intrados 2, the notch 7 allows for a localized, intentional, and controlled space between the plate 4 and the face of the tooth 101 to which the plate 4 is fixed. The notch 7 is positioned and sized to allow the insertion, through the opening 7a, of a removal tool 20 between the plate 4 and the face 101a, 101b of the tooth 101 to which the plate 4 is fixed, in order to exert force on the plate 4 and detach it from the tooth 101, while limiting the risk of injuring the patient's mouth.

[0147]

[0131] The notch 7 is, for example, a few millimeters long, for example 1 to 3 mm. The length of the notch 7 here refers to its extension on the intrados 2 of the plate from the opening 7a. The length of the notch 7 may, however, depend on the dimensions of the plate 4 in question. The notch 7 may have a substantially conical, or truncated conical, shape along its length. The maximum width of the notch 7, that is, its opening dimension 7a, on the lateral edge 5 of the plate, is, for example, greater than 0.5 mm, and for example, on the order of 1 mm. However, the dimensions of the opening 7a of the notch 7 may depend on the dimensions of the plate 4.

[0148]

[0132] The inlet 7a of the notch 7 can be positioned at any level on the lateral edge 5 of the bracket. Preferably, the inlet 7a of the notch is positioned substantially in the direction of the interdental line when the bracket 4 is fixed to the tooth 101, that is, substantially in the direction of the lateral edge 101 of the tooth 101 to which the bracket 4 is fixed. In one embodiment, the inlet 7a of the notch is located on the lateral edge 5 at substantially the same level as where the groove 4a opens. Typically, the groove 4a opens at only one point when the bracket 4 is located at one end of the retention device 1; otherwise, the groove 4a opens at two points on the lateral edge 5 for the other brackets 4 of the retention device 5. The notch entry 7a is then located on the lateral edge 5 at approximately the same level as a place where the groove 4a opens onto the lateral edge 5.For example, groove 4a joins the entrance 7a of notch 7 on the lateral edge 5. Notch 7 can extend lengthwise almost directly under groove 4a, or even merge with groove 4a. Thus, the number of raised features on the upper surface 3 of plate 4 is limited: groove 4a and notch 7 form a single ridge on the upper surface 3.

[0149]

[0133] An example of a removal tool 20 is illustrated in Figure 10. According to the example, the tool 20 comprises a handle 21 for being held in the hand by a practitioner, and a shaft 22 fixed to the handle, which has a curved portion 23, substantially at 90° to the rest of the shaft 22. The shaft 22 terminates at its free end with a point 24. Such a tool 20 allows the practitioner to exert a lever arm manually, by holding the tool 20 by the handle 21, by inserting the point 24 into the notch 7 between the plate 4 and the tooth 101, and by taking support by the curved portion 23 on the tooth 101 concerned, and / or on another tooth. Preferably, as the 7a inlet of the notch is turned towards the interdental line, the curved portion 23 rests on another plate 4 of the retention device, in particular plate 4 of a tooth adjacent to the one concerned by the removal of the plate.The length of the rod 22, and / or the angle of curvature of the curved portion 23 can be adapted to provide the appropriate lever arm.

[0150]

[0134] The tool 20 is made of a suitable material, appropriate for use in the patient's mouth. This is, for example, stainless steel.

[0151]

[0135] The notch 7 is filled with a filling material less resistant than the material of the plate 4. This is, for example, a resin, which may be the adhesive used to fix the plate 4 to a tooth 101, and / or the adhesive to glue the wire 6 to the plate 4. The notch 7 may be filled before placing the device in the mouth, or when gluing the plates 4 to the teeth 101. Thus, the risk of food, or any other object, becoming stuck in the notch 7 is virtually nil.

[0152]

[0136] When a insert 4 needs to be removed, for example when the wire 6 needs to be changed, the notch 7 is first released. For this purpose, a sandblasting process can be used, in which a fine jet of a powdered material such as alumina is precisely projected onto the filling material in the notch 7, so as to at least partially expose the notch 7. The tool 20 can then be used as described above to remove the insert 4 with increased ease and safety.

[0153]

[0137] The aid system 10, comprising the guide 11 shown above, allows for the precise assembly of metal, metal alloy, or ceramic retainers 4 and the retention element 6, resulting in highly effective retention. In particular, the retention device 1 is positioned as close as possible to the patient's teeth 101, minimizing discomfort. Furthermore, the use of metal, metal alloy, or ceramic retainers 4 ensures a strong bond between the retention device 1 and the patient's teeth, reducing the risk of detachment.

[0138] The aid device 10 can be made of resin, plastic, or any other material. It may also include means to facilitate its handling by a technician and / or practitioner.

Claims

DEMANDS [Claim 1] System (10) for assisting in the assembly of a restraint device (1), the restraint device (1) comprising: - at least two plates (4), each plate (4) comprising an internal rigid fixing surface (2) on one face (101a, 101b) of a tooth (101) of the patient's dentition and an opposite external surface (3); - at least one restraint element (6) attached and rigidly fixed to each of the plates (4); the retention device (1) being intended to be placed in the mouth of a patient to provide retention between at least two teeth (101) in a so-called retention configuration, in which the inner surface (2) of each plate (4) is fixed at least in part to a tooth (101) and the retention element (6) fixed to each plate (4) comprises a portion (61) extending between two successive plates (4) and which is at least in part in contact with the teeth (101) extending between said two successive plates (4), the aid system (10) comprising at least one guide (11), the guide (11) comprising at least two guide surfaces (12), each guide surface being shaped to be complementary at least in part to a single plate (4), the guide (11) further comprising at least one guide marker (13) for the retention element (6),the guide surfaces (12) and the guide marker (13) being positioned relative to each other in a predetermined manner, so as to be complementary at least in part to the restraint device (1) in the restraint configuration. [Claim 2] System according to claim 1, comprising at least three guide surfaces (12), each guide surface (12) being shaped to be complementary at least in part to a single plate (4) of the retention device, the retention device (1) then comprising at least three successive plates (4) intended to be fixed each on a different tooth (101) of the patient's dentition. [Claim 3] System (10) according to claim 1 or claim 2, wherein the guide (11) blocks the translation of the restraint element (6) in at least one direction in at least two directions of space. [Claim 4] System (10) according to any one of the preceding claims, comprising at least one removable retaining device for at least one plate (4) against the corresponding guide surface (12). [Claim 5] System (10) according to claim 4, wherein the removable retaining device comprises an adhesive. [Claim 6] System (10) according to any one of the preceding claims, wherein at least one guide surface (12) is complementary to at least a portion of the internal surface (2) of the corresponding plate (4). [Claim 7] System (10) according to any one of the preceding claims, wherein at least one guide surface (12) is complementary to at least a portion of the external surface (3) of the corresponding plate (4). [Claim 8] System (10) according to any one of the preceding claims, wherein the guide marker (13) comprises at least one groove (14, 16) on the guide (11). [Claim 9] System (10) according to any one of the preceding claims, wherein the guide marker (13) comprises at least one projection (17) on the guide (11). [Claim 10] System (10) according to any one of the preceding claims, wherein at least one guide surface (12) comprises at least one flow groove for an adhesive. [Claim 11] A method for manufacturing an aid system for assembling a restraint device (1) according to any one of the preceding claims, the restraint device (1) comprising: - at least two plates (4), each plate (4) comprising an internal rigid fixing surface (2) on one face (101a, 101b) of a tooth (101) of the patient's dentition and an opposite external surface (3); - at least one retention element (6) attached and rigidly fixed to each of the plates (4); the retention device (1) being intended to be placed in the mouth of a patient to provide retention between at least two teeth (101) in a so-called retention configuration, in which the inner surface (2) of each plate (4) is fixed to a tooth (101) and the retention element (6) fixed to each plate (4) includes a portion (61) extending between the two plates (4) at least partially in contact with the teeth concerned by the retention, the method comprising: - determining the restraint configuration of the restraint device (1) for the patient; - the determination of at least two surfaces (12) guide; - the determination of at least one reference point (13) guide; - the making of the guide (11). [Claim 12] A method according to the preceding claim, wherein the guide manufacturing step includes manufacturing by 3D printing. [Claim 13] A method according to claim 10, wherein the guide manufacturing step comprises making a mold of the patient's teeth (101) and machining on the mold at least two guide surfaces (12) and at least one guide relief (13). [Claim 14] Use of an aid system (10) for positioning a restraint device (1) according to any one of claims 1 to 10 comprising placing a plate (4) against each guide surface (12), applying a restraint element (6) to the guide relief (13), and fixing the restraint element (6) to each of the plates (4).

Images