CN101677841B - 带突出部的牙齿矫治器 - Google Patents
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Abstract
本发明公开包括牙齿矫治器、牙齿矫治器系统、以及制造和使用该牙齿矫治器的方法在内的实施例。在一个实施例中，牙齿矫治器包括：多个牙齿孔，在其内部布置牙齿；以及突出部，其位于未完全长出的牙齿的位置并且定向成被接纳在未完全长出的牙齿的位置的上方。
Description
技术领域
本发明整体涉及口腔正畸领域。更具体地，本发明涉及可以在牙齿还未完全长出的情况下进行牙齿矫正的领域。
背景技术
许多口腔正畸治疗涉及对未对准的牙齿进行重新定位并改变咬合构造以改善整形外观和牙齿功能。例如可以通过在一段时间内向一颗或多颗牙齿施加受控力来进行重新定位。
一些口腔正畸处理使用使牙齿重新对准的牙齿定位矫治器。该矫治器可以使用具有弹性特性的薄材料壳(被称为“矫正器”)，该矫治器基本上符合患者的牙齿但是稍微与最初的牙齿构造不对准。
将这种矫治器布置在牙齿上就可以在特定位置上提供受控力，以逐渐地将牙齿移动为新的构造。连续地用提供渐进构造的矫治器重复执行该处理，最终使牙齿经过一系列中间布局移动到最终需要的布局。在美国专利No.5,975,893中描述了该系统的实例。
这种系统通常依赖于在治疗的开始阶段设计和制造患者将要配戴的一些、大部分或所有的矫治器。在一些处理中，矫治器的设计依赖于对一系列连续的牙齿布局进行计算机建模，将各个矫治器设计为配戴在牙齿上，并且通过从第一矫治器经过各个中间矫治器至最后矫治器连续依次地使用矫治器而将牙齿重新定位。
然而，在一些情况下，患者的牙齿并未完全长出(即，未竖直定位)。在这些情况下，因这些牙齿未被包含在治疗计划中，因此这些牙齿的过度生长(supra-erupt)会对相对的齿弓造成干扰，或者造成其它矫正问题。因为在许多情况下，在治疗的初期这些牙齿比其它牙齿低很多，因此，没有设计矫治器来容纳这些牙齿。
附图说明
图1示出根据本发明实施例的带突出部的位置调整矫治器的实例以及作为治疗对象的颚。
图2A示出根据本发明实施例的设置有小突出部的矫治器端部的实例。
图2B示出根据本发明实施例的各自设置有小突出部的上矫治器端部和下矫治器端部的实例。
图3A示出根据本发明实施例的设置有小突出部的矫治器端部的另一个实例。
图3B示出根据本发明实施例的设置有中等尺寸突出部的矫治器端部的实例。
图3C示出根据本发明实施例的设置有大尺寸突出部的矫治器端部的实例。
图4示出计算系统，该系统用于与本发明实施例的制造相关联的牙齿矫治器设计。
具体实施方式
实施例包括牙齿矫治器、牙齿矫治器系统、和制造并使用该矫治器和系统的方法。在一些实施例中，例如，牙齿矫治器包括：一个或多个牙齿孔，其用于在内部布置牙齿；以及突出部，其位于未完全长出的牙齿的位置。
该突出部可以例如定向为被接纳在未完全长出的牙齿的位置之上。以这样的方式，除了其它优点之外，即使牙齿未完全到位，突出部也可以为被调整的一颗或多颗其它牙齿提供力和/或支撑。这在调整与未完全长出的牙齿邻接(例如，位于上方或附近)的牙齿时是尤其有用的。该矫治器的另一个优点是可以向正在长出的一颗或多颗牙齿施加力，以便防止牙齿过度长出(over erupting)(例如，过度生长)。
在一些实施例中，突出部的长度使其能够跨越(即，延伸)牙齿在完全长出时将要占据的水平位置(例如在多颗牙齿的中间、或者在多颗牙齿的端部处)的一部分。附图中的图3A-图3C示出具有这种构造的实施例。例如，如图3B所示，突出部的长度使其能够跨越牙齿在完全长出时将要占据的水平位置的一半。
本发明的实施例还包括多个方法实施例。例如，在一些实施例中，方法可以包括：通过将成形为使牙齿移动的多个矫治器中的第一牙齿矫治器插入到患者的口中来应用第一牙齿矫治器，其中，第一牙齿矫治器包括具有第一长度的突出部，该突出部位于还未完全长出的牙齿的位置；以及应用多个矫治器中的第二牙齿矫治器，其中，第二牙齿矫治器包括具有第二长度的突出部，该突出部位于还未完全长出的牙齿的位置，并且具有第二长度的突出部比具有第一长度的突出部长。
在一些实施例中，第一矫正器可以包括小尺寸突出部，随后的矫正器可以包括尺寸更大的突出部。可能出于多种不同原因而使用不同尺寸的矫正器。这些实施例是有利的，例如可以为患者提供比全尺寸矫正器更佳的舒适度。
例如，如果臼齿还未完全长出，则配戴设置有臼齿矫正器部分的全尺寸矫正器是不舒适的，这是因为该臼齿矫正器部分突出并超过完全长出的牙齿。在一些情况下，比全长度短的带突出部的矫正器是有益的，这是因为除了其它优点之外，如果在使用带突出部的矫正器期间牙齿长成与突出部接触，则突出部还可以减缓或防止过度生长。
除了其它优点和功能之外，这些实施例还具有如下益处，即较长的突出部长度可以提供更大的刚性和/或可以成形为接纳正在长出的牙齿的一个或多个表面。在一些实施例中，可以使突出部的长度从一个矫正器至随后的矫正器保持为相同的，或者使突出部从一个矫正器至随后的矫正器由大变小。
如上所述，这些实施例可以包括在插入第二矫治器之前移除第一矫治器。这对于实施如下实施例是有益的：即，利用连续的多个布局阶段来调整一颗或多颗牙齿的位置。
在一些这样的实施例中，可以应用一个或多个牙齿矫治器。在这些实施例中，例如，第三牙齿矫治器可以包括具有一定长度的突出部，该突出部位于未完全长出的牙齿的位置并且长于具有第一长度和第二长度的突出部。
这些实施例还有利于例如正在长出的牙齿的继续长出，并且在一些情况下，除了其它优点之外，还可以开始用于支撑安装有突出部的矫治器的其它部分和/或其它矫治器、施加力、和/或可以开始进行调整。例如，矫正器的突出部可以用于向被该矫正器或相邻矫正器移动的一颗或多颗牙齿施加力。
突出部还可以设计为向正在长出的牙齿提供一些初始调整。这些实施例对于如下情况是有益的：即，牙齿可能在错误的位置上长出，并且如果正在长出的牙齿的长出方式影响到其它牙齿的定位，则能够避免这种影响。
在一些实施例中，第三牙齿矫治器可以包括具有一定长度的突出部，该突出部位于完全长出的牙齿位置。在这些实施例中，具有该长度的突出部可能长于具有第一长度和第二长度的突出部。在该情况下，突出部可以利用已长出的牙齿的一个或多个表面来帮助提供支撑和力、和/或调整位置。
在一些实施例中，第一矫治器可以在未完全长出的牙齿达到生长临界点时被移除。生长的临界点可以是任意合适的临界点，并且可以由制造商或治疗专家来决定。
例如，移除第一矫治器的临界点可以是牙齿的顶端从齿龈表面长出时。移除第二矫治器的临界点可以是例如牙齿长出至超过由治疗专家决定的中间点时。
在一些实施例中，多个矫治器中的第一牙齿矫治器可以通过查看患者口腔内患者牙齿的定位来设计，其中，第一牙齿矫治器可以包括具有第一长度的突出部，该突出部位于未完全长出的牙齿的位置。这种实施例还可以包括多个矫治器中的第二牙齿矫治器，第二牙齿矫治器设计为包括具有第二长度的突出部，该突出部位于未完全长出的牙齿的位置，并且具有第二长度的突出部长于具有第一长度的突出部。
在这些实施例中，可以例如通过由治疗专家人工收集一个或多个数据点组并将数据点输入到计算装置中来完成查看患者口腔内患者牙齿的定位。
还可以借助自动或半自动处理来获得数据。此外，例如使用关于患者其它牙齿的牙齿尺寸和/或形状和/或信息的资料库来推测正在长出的牙齿的尺寸和/形状。在多个实施例中，该信息可以由治疗专家来人工提供，或者由自动或半自动处理来提供。
下面参考图1，图1示出作为治疗对象的颚以及根据本发明实施例的带突出部的位置调整矫治器的实例。在多个实施例中，如以上概括所述，这种矫治器可以用于影响一颗或多颗牙齿的递增式重新定位。
本发明的方法或系统可以使用与口腔正畸治疗相关联的用于完成或保持牙齿位置的任意定位器、保持器、和/或其它可移除的矫治器。如本文所述，本发明实施例所用的系统可以利用例如由患者连续配戴的多个这样的矫治器，以便逐渐地对牙齿进行重新定位。
矫治器(例如，矫治器100)可以由例如聚合物壳制成、或由具有腔体的其它材料形成，该腔体成形为接受和施加力以将牙齿从一个牙齿布局重新定位为接续的牙齿布局。壳可以设计为配合在上颚或下颚101的多个(在许多情况下为所有)牙齿上。
在一些情况下，某颗或一小组牙齿被重新定位，而其余牙齿将用于在重新定位矫治器向待重新定位的一颗或多颗牙齿施加弹性重新定位力时提供将重新定位矫治器保持在适当位置上的基座或支撑区域。在这种情况下，被移动的一颗或多颗牙齿也可以作为用于保持重新定位矫治器的基座或支撑装置。
此外，牙龈和/或颚部(palette)可以用作支撑区域，因而如果需要的话，允许对所有或几乎所有的牙齿同时进行重新定位。
图2A示出根据本发明实施例的设置有小突出部的矫治器端部的实例。在图2A中，矫治器实施例已经定位在牙齿上并且该附图重点示出矫治器的包括小尺寸突出部的一端的定位。
例如，在图2A的实施例中，突出部210延伸到正在长出的牙齿212的被颚201的齿龈覆盖的近中牙尖(mesial cusp)上方。突出部延伸的量可以是任意长度(即，将牙齿表面的顶部或侧面的一部分覆盖的水平延伸量)。
此外，突出部还可以具有不同的深度(即，突出部的沿着牙齿的一个或多个侧面竖直地延伸的部分)和/或厚度(即，形成突出部的水平或竖直表面的材料的厚度)。例如，突出部的深度可以是任意深度，从几乎无深度(即，形成水平突出部的材料的厚度)至牙齿侧面的底部的深度(即，牙龈上方或下方的深度)。
在一些实施例中，可以增加突出部的一个表面或多个表面的厚度而使得这些表面与正在长出的牙齿接触。在一些实施例中，可以将突出部的表面定向为与牙齿接触地布置。例如，如果突出部的底面设置为与牙齿的上表面接触，则形成突出部底面的水平表面可以设置成低于形成矫正器的其它部分的那些水平表面(例如，从矫正器的一个或多个其它表面向下成阶梯状)，所述其它部分定向为与完全长出的牙齿的顶面接触。在一些实施例中，第一牙齿矫治器的表面的深度和厚度中至少一者可以大于第二牙齿矫治器的对应表面的深度和/或厚度。在将矫正器用于帮助对正在长出的牙齿进行定位的情况下，这种加厚或成阶梯状的实施例是有利的。
在一些实施例中，从一个矫正器至随后的矫正器，可以调整突出部的深度或厚度。例如，矫正器的第一厚度和/或深度可以比随后的矫正器的厚度和/或深度大。这可能是由于牙齿已经长出一定量，或者是为了使矫正器相对于与正在长出的牙齿相邻的牙龈进行定位。
虽然在图2A中示出突出部定向成抵靠在正在长出的牙齿的上表面上，但是一个或多个突出部可以设置于抵靠在正在长出的牙齿的一个或多个侧面上的矫治器上。还可以提供如下突出部：即，该突出部设计成使多个表面抵靠在正在长出的牙齿上。例如，在一些实施例中，突出部可以具有抵靠在牙齿顶面上的底面、以及抵靠在牙齿侧面上的侧面。
如上所述，一个或多个突出部可以如下设计：即，设置成在牙齿从目前位置进一步长出时抵靠牙齿表面；或者可以如下设计：即，设置在将要抵靠在完全长出的牙齿上的位置上，但是在最初设置时不会抵靠任何牙齿表面。此外，如本文所述，可以提供具有形状和长度各异的突出部的多个矫治器，以提供支撑和力、和/或对正在长出的牙齿和/或其余牙齿进行矫正，例如对安装有突出部的矫治器或其它矫治器的抵靠表面进行支撑。
图2B示出根据本发明实施例的各自设置有小突出部的上矫治器端部和下矫治器端部的实例。在图2B的实施例中，第一矫治器200-1和第二矫治器200-2设计为进行配合接合，从而施加适当的力来矫正多颗牙齿。
在如图2B所示的实施例中，第二矫治器具有带底面214、侧面216、和顶面218的突出部。底面214成形为如下的形状：即容纳颚201的齿龈中正在长出的牙齿212的顶部。侧面216成形为如下的形状：即容纳正在长出的牙齿212的一个侧面。
在一些实施例中，突出部包括如下表面，该表面成形为与另一个矫治器的设置成与该突出部的表面相邻的一个或多个表面配合。除了其它优点，这些表面可以用于提供支撑和力、和/或对由第一矫治器和/或第二矫治器调整的一颗或多颗牙齿进行调整。
例如，在各个实施例中，突出部可以包括如下表面，该表面成形为与第二矫治器的设置成与该突出部的表面相邻的第二突出部的表面配合。如上所述，除了其它优点，这些表面可以用于提供支撑和力、和/或对由第一矫治器和/或第二矫治器调整的一颗或多颗牙齿进行调整。
例如，在图2B的实施例中，顶面218成形为与矫治器200-2的表面(例如，突出部部分)配合。本文所用的术语“顶”和“底”是为了帮助读者理解，而不应该认为是限制本发明的实施例。
本发明的实施例还包括多个牙齿矫治器系统实施例。例如，在一些实施例中，该系统可以包括成形为使牙齿移动的多个矫治器中的第一牙齿矫治器。
第一矫治器可以例如包括具有第一长度的突出部，该突出部位于未完全长出的牙齿的位置。该系统还可以包括多个矫治器中的第二牙齿矫治器，其中，第二牙齿矫治器包括具有第二长度的突出部，该突出部位于牙齿的位置。
在这种实施例中，第一矫治器可以是用于调整患者上牙的矫治器，在一些实施例中，第二矫治器可以是用于调整患者下牙的矫治器。在不同实施例中，矫治器可以用于患者口腔中上部或下部的不同牙齿。
此外，在一些实施例中，可以接续地将矫治器应用于患者口腔中(即，将一个矫治器从患者口中移除并将另一个矫治器设置在患者口腔中)。这些实施例可以连续地用作例如调整系统的一部分，该系统使一颗或多颗牙齿移动并连续地经过多个的布局阶段，例如递增地使牙齿从初始位置经过多个中间位置然后移动至最终位置上。
例如，在如图3A、图3B、和图3C所示的实施例中，该矫治器可以用作系统。图3A示出根据本发明实施例的设置有小突出部的矫治器端部的实例，该突出部与图2A的实施例中所提供的突出部类似。
图3B示出根据本发明实施例的设置有中等尺寸突出部的矫治器端部的实例。在图3B的实施例中，例如，突出部可以跨越正在长出的牙齿的区域的一半。中等尺寸突出部可以具有介于小突出部和大突出部之间的任何尺寸和形状。
例如，在一些实施例中，中等突出部长度可以设计为将远中牙尖(distal cusp)的一部分(例如一半)以及近中牙尖覆盖。此外，在一些实施例中，在小突出部矫治器与大突出部矫治器之间还存在多个不同尺寸的中等突出部矫治器。在一些实施例中，突出部可以具有多个中等尺寸的表面。例如，突出部可以包括尺寸介于小突出部和大突出部矫治器之间的一个或多个侧面。
在一些实施例中，突出部可以具有跨越牙齿完全长出时要占据的整个水平位置的长度。在一些这样的实施例中，突出部可以具有构造为与部分和/或完全长出的牙齿的表面相互作用的多个表面。
例如，图3C示出根据本发明实施例的设置有大尺寸突出部的矫治器端部的实例。例如，在不同的实施例中，突出部包括成形为与牙齿顶面配合的底面。在图3C的实施例中，突出部延伸越过正在长出/已长出的牙齿的整个咬合面。
在一些实施例中，突出部包括成形为与完全长出的牙齿的顶面配合的底面。在这些实施例中，牙齿可能生长到突出部的形状内的位置上，因此，突出部可以用于提供支撑和力、和/或对由一个或多个矫治器调整的正在长出/已长出的牙齿和/或其余牙齿进行调整。
在不同的实施例中，突出部可以具有成形为与牙齿侧面配合的侧面。如上所述，该侧面还可以是突出部的一部分。
图4提供一种计算系统，其用于与本发明实施例的制造相关联的牙齿矫治器的设计。在如图4所示的系统中，该系统包括计算装置438，该计算装置具有处理器420和存储器422。存储器可以存储各种类型的信息，包括本文所述的数据424和可执行指令426。
此外，如图4的实施例所示，该系统可以包括网络接口436。该接口可以允许在另一个联网计算装置上进行处理，或该装置可以用于获取关于患者的信息或可执行指令以用于本文所提供的各种实施例。
如图4的实施例所示，该系统可以包括一个或多个输入和/或输出接口428。这种接口可以用于将计算装置与一个或多个输入或输出装置进行连接。例如，在如图4所示的实施例中，该系统包括与扫描装置430、照相装置(camera dock)432和键盘434的连接。
这种连接允许输入图像信息(例如，扫描图像或数字图片等)或指令(例如，经由键盘的输入)以及其它类型的信息。虽然一些实施例可以分布在一个或多个网络内的各个计算装置之间，但是如图4所示的这种系统可以有利于允许捕捉、计算和分析本文所述的各种信息。
虽然本文已经示出和描述了具体的实施例，但是本领域的普通技术人员将理解，设计为获得相同技术的任意布局都可以替代所示的具体实施例。本发明意图在于涵盖本发明各个实施例的任意和所有修改和变型。
应该理解到，所使用的术语“一”、“一个”、“一个或多个”、“多个”、或“至少一个”均应该理解为存在一个或多个项。此外，应该理解到，以上描述仅为是示例性的而不是限制性的。本领域的技术人员在阅读以上的描述后能够容易地将以上实施例和未具体描述的其它实施例进行组合。
本发明的各个实施例的范围包括使用以上结构和方法的任意其它应用。因此，本发明的各个实施例的范围应该参考所附权利要求书以及该权利要求书的等同内容的全部范围来确定。
在以上的详细描述中，为了使本发明叙述流畅而将多种特征组合在单个实施例中。不应该将这种公开方法理解为本发明的实施例需要比各个权利要求项所述的特征更多。
当然，如以下权利要求书所反映，本发明的主题少于所披露的单个实施例的所有特征。因此，以下的权利要求书并入该详细描述中，各个权利要求项本身作为独立的实施例。
Claims (16)
1.一种牙齿矫治器，包括：
壳，其具有多个牙齿孔，所述多个牙齿孔构造成接受和施加力以将牙齿从一个牙齿布局重新定位为连续的牙齿布局且包括构造为大致延伸至患者牙龈线的侧面，所述多个牙齿孔构造为接纳患者的上颚或下颚上的多个牙齿，所述壳包括：
突出部，其长度使其朝远中方向跨越完全长出时的牙齿的顶面的仅仅一部分，
所述突出部包括成形为与牙齿顶面的所述部分配合的牙齿接触表面、以及成形为与牙齿顶面的所述部分配合的所述牙齿接触表面的相反表面，
所述突出部的牙齿接触表面被定位为接纳牙齿完全长出时的牙齿的所述部分，并且，
所述突出部包括如下的侧面：所述侧面构造为不是大致延伸到牙齿完全长出时的患者牙龈线。
2.根据权利要求1所述的牙齿矫治器，其中，
所述突出部的长度使其在使用时跨越所述牙齿在完全长出时将要占据的水平位置的一半。
3.根据权利要求1所述的牙齿矫治器，其中，所述突出部的牙齿接触表面的所述相反表面成形为与待定位的第二矫治器的在使用时与所述突出部的所述相反表面相邻的表面配合。
4.根据权利要求3所述的牙齿矫治器，其中，
所述突出部的牙齿接触表面的所述相反表面成形为与所述待定位的第二矫治器的在使用时与所述突出部的所述相反表面相邻的第二突出部的表面配合。
5.根据权利要求1所述的牙齿矫治器，其中，
所述突出部的被构造为不是大致延伸到牙齿完全长出时的患者牙龈线的所述侧面成形为在使用时与所述牙齿的侧面配合。
6.一种牙齿矫治器系统，包括：
成形为使牙齿移动的第一牙齿矫治器，其是根据权利要求1至5中任一项所述的牙齿矫治器，所述第一牙齿矫治器包括具有第一长度的突出部，所述具有第一长度的突出部位于未完全长出的牙齿的位置；以及
另一个牙齿矫治器，其是据权利要求1至5中任一项所述的牙齿矫治器，所述另一个牙齿矫治器包括具有第二长度的突出部，所述具有第二长度的突出部位于牙齿的位置上。
7.根据权利要求6所述的牙齿矫治器系统，其中，
所述第一长度和所述第二长度是相等的。
8.根据权利要求6所述的牙齿矫治器系统，其中，
所述第一牙齿矫治器形成为在使用时设置在患者的一颗或多颗上牙上，并且／或者所述另一个牙齿矫治器形成为在使用时设置在患者的一颗或多颗下牙上。
9.根据权利要求6所述的牙齿矫治器系统，其中，
所述具有第一长度的突出部包括成形为与牙齿顶面的所述部分配合的牙齿接触表面，并且所述突出部的至少一个表面的厚度设定为使所述表面与正在长出的牙齿接触。
10.根据权利要求6所述的牙齿矫治器系统，其中，
所述具有第二长度的突出部包括成形为与牙齿顶面的所述部分配合的牙齿接触表面，并且所述突出部的至少一个表面的厚度设定为使所述表面与正在长出的牙齿接触。
11.根据权利要求6所述的牙齿矫治器系统，其中，
所述具有第一长度的突出部的牙齿接触表面设计成可被定位成在使用时与正在长出的牙齿的顶面接触，形成所述具有第一长度的突出部的牙齿接触表面的水平表面设置成从形成所述第一牙齿矫治器的其它部分的那些水平表面降低，所述其它部分定向为在使用时与完全长出的牙齿的顶面接触。
12.根据权利要求6所述的牙齿矫治器系统，其中，
就深度或厚度中的至少一者而言，所述第一牙齿矫治器的表面大于所述另一个牙齿矫治器的对应表面。
13.根据权利要求6和8至12中任一项所述的牙齿矫治器系统，其中，
所述具有第二长度的突出部比所述具有第一长度的突出部长。
14.根据权利要求6至12中任一项所述的牙齿矫治器系统，还包括：
第三牙齿矫治器，其中，所述第三牙齿矫治器包括具有第三长度的突出部，所述具有第三长度的突出部位于未完全长出的牙齿的位置，并且所述具有第三长度的突出部比所述具有第一长度的突出部和所述具有第二长度的突出部长。
15.根据权利要求6至12中任一项所述的牙齿矫治器系统，其中，
所述第一牙齿矫治器形成为在使用时当所述未完全长出的牙齿到达第一生长临界点时可被移除。
16.一种用于实现如权利要求6至15中任一项所述的牙齿矫治器系统的计算机实施方法，包括：
通过查看患者口腔中患者牙齿的定位来设计成形为使牙齿移动的所述第一牙齿矫治器，所述具有第一长度的突出部朝远中方向跨越完全长出时的牙齿的顶面的仅仅一部分；以及
设计所述另一个牙齿矫治器，所述具有第二长度的突出部朝远中方向跨越完全长出时的牙齿的顶面的仅仅一部分。
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| EP3649979B1 (en) | 2021-09-01 |
| EP3175818A1 (en) | 2017-06-07 |
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