WO2007134375A1

WO2007134375A1 - Correction of orthodontic malocclusions

Info

Publication number: WO2007134375A1
Application number: PCT/AU2007/000680
Authority: WO
Inventors: Paul Taylor; Emma Jane Mckenzie; Ali M. Darendeliler; Charlie Sara; Donn Cannon; Lester Prentice
Original assignee: Darenton Holdings Pty Limited; Macono Orthodontic Laboratories Pty Limited
Priority date: 2006-05-18
Filing date: 2007-05-18
Publication date: 2007-11-29

Abstract

A module (25) or (26) and an appliance (12) for the correction of orthodontic malocclusions. The appliance (12) comprises four modules. Each module (25, 26) is formed of material that is shaped with a cavity to receive and closely fit over respective teeth on the upper or lower jaw (10, 12) of one side of the mouth. Encased within each module (25, 26) is at least one magnet (21, 22, 20, 27). The magnet or magnets in the module are arranged to selectively either attract or repel the magnet, or magnets, within the module to be fitted to the opposing jaw (see Fig. 6). The magnets direct a patient’s jaws into a desired position, even when they are asleep, and this creates greater efficacy in their action. This in turn may reduce the duration over which the appliance is required to be fitted to the teeth, and further increasing its acceptability to patients. It also allows a more physiologic and functional adaptation to an ideal jaw position. The appliance may also produce movement of the dentition, although in adults where growth is completed only dental and minor dento-alveolar movements will occur.

Description

"Correction of Orthodontic Malocclusions"

Technical Field This invention concerns the correction of orthodontic and morphologic malocclusions and other dental or jaw problems, both aesthetic and functional. More particularly the invention concerns problems that can be resolved by stimulating bone growth and altering the lower jaw position relative to the upper jaw, and other dental movements. Aspects of the invention concern a module, an appliance and methods for constructing them.

Background Art

The problem of Class II malocclusions has long been a major part of orthodontic treatment. Class II problems are when the upper teeth are significantly forward of the lower teeth. Such problems are often caused by an underdeveloped lower jaw. Studies suggest that approximately 70% of Class II problems are due to some deficiency in the lower jaw. Many approaches have been made to correct this problem.

In the late 1980s, William Clark developed the idea of using removable plastic plates on the upper and lower teeth. These plates had plastic ramps built into them so that when the patient close their mouth, the jaw was forced to move forward. Clark found that these plates, if worn for extended periods of time, stimulated forward growth of the lower jaw and led to correction of the Class II problem.

These plates have proved to be very successful but they depend upon the cooperation of patients. Studies suggest that not all patients wear the plates for long enough each day and for the several months required to achieve correction.

In the last few years, there have been efforts to develop appliances that are fixed to the teeth and therefore don't require the active co-operation of the patients.

For instance, in 1990 researchers in Switzerland proposed the use of upper and lower plates fixed to the teeth by wires and fitted with bar (rectangular) magnets positioned along the outer surfaces of the upper and lower teeth on each side of the mouth in order to urge correct relative alignment of the upper and lower jaws.

Summary of the Invention

In a first aspect, the invention is a module and an appliance for the correction of orthodontic malocclusions. The appliance comprises two or more modules. Each module is formed of material that is shaped with a cavity to receive and closely fit over teeth on the upper or lower jaw of one side of the mouth. Encased within each module is at least one magnet or ferromagnetic piece. The magnet or ferromagnetic piece in the module is arranged to selectively attract or repel one or more further ferromagnetic piece or magnet respectively that is arranged within a further module or device to be fitted to the opposing jaw.

An advantage of using the appliance is that the magnets direct a patient's jaw into a desired position, even when they are asleep creating greater efficacy in their action. This in turn may reduce the duration over which the appliance is required to be fitted to the teeth, and further increasing its acceptability to patients. It also allows a more physiologic and functional adaptation to an ideal jaw position. The appliance may also produce movement of the dentition, although in adults where growth is completed only dental and minor dento-alveolar movements will occur.

The magnet or ferromagnetic piece may be arranged within the module so that it is positioned above the occlusal surfaces of the teeth. Alternatively the magnet or ferromagnetic piece may be arranged within the module so that they are positioned on the buccal and/or palatal sides of the teeth.

The device may be comprised of material in which is encased the further ferromagnetic piece or magnet and is to be fitted to the opposing jaw using wires. For example, the wires may be suitably shaped to grip the teeth of the opposing jaw. The device may be easily removable from the opposing jaw.

In one arrangement there may be three magnets on each side of the mouth. A first magnet is encased in first module that is to receive upper or lower teeth on one side of the mouth, a second and third magnet are encased in a second module that is to receive teeth of the other of the upper or lower teeth, on the same- side of the mouth. The arrangement is such that the first and second magnets attract each other and the first and third magnets repel each other.

In an alternative arrangement there may be four magnets arranged in pairs. First and second magnet are encased in a first module that is to receive upper or lower teeth on one side of the mouth, and a third and fourth magnet are encased in a second module that is to receive the other of the upper or lower teeth, on the same side of the mouth. The first pair of the first and third magnets attract each other, and the second pair of the second and fourth magnets attract each other. Further, the second and third magnets repel each other.

The magnet or ferromagnetic material may be of any dimension, shape and colour. For instance, the magnets may be 2mm high and 6mm in diameter. Cubiod magnets can also be used that are 7mm x 4mm x 4mm. Further, they may be flat with a north pole at the top and a south pole at the bottom or in any other magnetization direction and/or pattern.

Suitable magnets are neodymium, that is Neodymium-Iron-Boron (NdFeB), with a copper nickel coating. However any other suitable type of magnet, ferromagnetic material, and/or coating material can be used.

The magnets may be hermetically encapsulated before being encased in the modules.

Where two magnets or a magnet and ferromagnetic piece are to be encased in a module they may be mounted in advance on a wafer to space them apart by a preferred distance. This will also serve to hold them in place during the process of encasing them. An effective distance to space the magnets or the magnet and ferromagnetic piece apart may be between 6mm to 9mm. If necessary, different separation distances and/or mechanisms to adjust the distance can be used. The wafer may be made from a variety of materials, including plastics, thermoplastics, metallic, stainless steel, or ceramic material. The magnets or the magnet and ferromagnetic piece may be mounted at opposite ends of the same side of the wafer.

The assembly of the magnets or the magnet and ferromagnetic piece and the wafer may be arranged in the module so that, when it is fitted to the teeth, the wafer protects the magnets from wear by the opposing teeth and seals them from saliva. To achieve these advantages the coating material should be hard enough to resist the forces generated by normal function, but thin enough to not decrease the magnetic force between magnets. The coating material can also be a ferro-magnetic material.

The magnets and/or ferromagnetic pieces may be arranged in the modules such that they may be moved between different positions. In particular the magnets and/or ferromagnetic pieces in the upper and lower modules may be arranged in a first position in which they exert magnetic attraction or repulsion between the upper and lower jaws that will cause a modification of the alignment of the jaw. Following some correction of the alignment or for adjustment for individual needs, the magnets and/or ferromagnetic pieces may be repositioned to positions in which they are re-activated to apply different forces of magnetic attraction or repulsion, or both, between the upper and lower jaws to cause further modification of the alignment. This arrangement also allows adjustment of the magnetic intensity or pattern during the course of treatment, as well as to find more efficient or comfortable positions.

The modules may be made of a number of materials that are suitable for the oral environment, including resin, acrylic, magnetic or non-magnetic stainless steel. A combination of different materials can also be used. Currently an acrylic material is preferred, such as methyl methacrylate. The modules may be bonded directly to the teeth so that the bulk is minimized, and so that co-operation of the patient in putting the appliance on and off is avoided. Further, the material of the module may completely encase all inclusions in the module, such as the magnet and the reinforcement wire. That way the entire outer surface of the module is of the material that can be shaped and smoothed for patient comfort. Modules may also be incorporated and/or engaged in any removable or fixed orthodontic or medical appliance or device system.

The modules may be attached to two or more teeth, for example four teeth, to gain retention. Good retention enables the elimination of any bar running behind the front teeth, and so may increase comfort and reduces any effect of wearing the appliance on the patient's speech and swallowing patterns. However, different wire, acrylic or other connection materials can be used if necessary.

Modules may have flat facing surfaces or they can be ramped. Alternatively, a surface of the module facing an opposed further module or device may be shaped to provide mechanical reinforcement of the attraction or repulsion of the magnet. The shape of the surface will depend on the need to provide a mechanical reinforcement of the desired correction. For example, the modules can be arranged with ramped facing ends, or incorporate complementary interengaging formations; possibly a gentle wave shape or a V or W shape to cause the upper and lower plates to come together in a way that simulates normal masticatory function. Other possible formations include a step or a V shaped protrusion or recess. By generating a new functional pattern the modules that will bring the jaw into a desired position will result in favourable growth modification. Inner and outer surfaces of the modules may have any type of treatment to increase or decrease retention. A single loop of wire strengthener may. be incorporated into the modules following the contours of the buccal and lingual gum margins. This provides strength to the modules during wear and keeps the modules intact upon removal post treatment.

The inner surfaces of the modules may be surface treated, such as sandblasted, so that when they are removed, the adhesive material that glues them to the teeth comes off with them and is not left attached to the patient's teeth. Surface treating also helps to increase the retention of the appliance.

To correct Class II malocclusions, that is protrusion of the upper teeth relative to the lower, a first module fitted with one magnet is attached to the lower teeth, and a second module with two magnets is attached to the upper teeth. The upper front magnet is attracted to the lower magnet while the upper rear magnet repels the lower magnet. The upper and lower modules (on each side of the mouth) are located so that the lower jaw is brought forward. A module / attachment combination can also be used. Attachments can be magnetic or ferromagnetic.

Magnetic units may be incorporated in any other existing or future orthodontic or orthopaedic appliance that can be either fixed or removable. Besides correction of Class II problems, and other sagittal (antero-posterior) problems, the appliance may be used to treat open bites, particularly if a second repulsive magnet is incorporated into the lower module. Also the appliance may be used to correct midline shifts, asymmetries and narrowness of the jaws. Expansion or sagittal screws may be incorporated between the modules, for instance on the upper right and left hand side of the arches. The modules, because they can be small in size, can also promote the eruption of posterior teeth to help correct deep bite problems. It is also possible that the appliance may be useful in stimulating implanted bone growth for the correction of hemifacial microsomia, which is severe skeletal underdevelopment of one side of the face. Another area of application is for the treatment of Sleep Apnoea as the magnets are capable of maintaining the lower jaw in a forward position even when the patient is asleep.

Yet others areas of application include temporomandibular joint problems and grinding teeth. Application can also be found in relation to respiratory or functional problems where the lower jaw needs to be kept in a forward, separated or alternate position in relation to the upper jaw.

Yet another area is in the treatment of temporomandibular joint problems where the incorrect position of the mandibular condyle within the Glenoid Fossa was causing pain or discomfort. The magnetic forces are used to relocate the condyles into a position of comfort or therapy.

Any conventional and/or future preparatory, construction, clinical and laboratory technique may be used in making and using the appliances with the magnetic unit(s).

In a further aspect the invention is a method of fabricating the appliance described above. The method comprising the steps of: taking an impression of the patient's teeth; taking a record of the patient's bite, both in a original undesired position and in a position approximating the ideal position; preparing stone castings of the patient's maxilla and mandible, articulated on an articulator with reference to the bite record to position the castings in a protruded and open manner to accommodate the magnets; placing the magnets and/or ferromagnetic material on the cast teeth; pouring, curing and trimming the lower modules to follow the contours of the gingival margin on both the buccal and lingual and trimming the occlusal surface; pouring the upper modules using the attractive force between magnets and/or ferromagnetic piece in order to position the magnets and/or ferromagnetic piece for the upper module; and curing and trimming the upper modules to follow the contours of the gingival margin on both the buccal and lingual and trimming the occlusal surface.

The method may further comprise the step of mounting magnet pairs with opposite polarity and/or ferromagnetic material at opposite ends of the same side of a thermoplastic wafer with a predetermined space between them.

It is an advantage of at least one embodiments of the invention that: it allows gradual adaptation to the protrusive bite and thereby reduces unwanted side effects; allows normal function and thereby hopefully stimulates growth ; maximizes patient comfort, including unembarrassed clear speech, normal chewing function, unaffected social confidence and orthodontic treatment in the background not the foreground of the patient's life.

Brief Description of the Drawings

Examples of the invention will now be described with reference to the accompanying drawings, in which:

Fig. 1 is a side view of the teeth along the upper and lower jaws fitted with a first example of the appliance having three magnets; Fig. 2 is a side view of the teeth along the upper and lower jaws fitted with a second example of the appliance;

Fig. 3 (a) is a side view, Fig. 3(b) is a front view, Fig. 3(c) is an upper occlusal view and Fig. 3(d) is a lower occlusal view_of the teeth fitted with a third example of the appliance; Fig. 4 is a side view of the teeth along the upper and lower jaws fitted with a fourth example of the appliance;

Fig. 5 is a modification of the appliance of Fig. 4 with square magnets on the occlusal surfaces incorporated into upper modules that are connected across the palate by an expansion plate; Fig. 6(a) and 6(b) is a schematic side view of the magnetic forces between magnets of an upper and lower module; and Fig. 7(a) is a side view and Fig. 7(b) is a top view, of modules containing magnets arranged in a first position in which the magnets are not activated. Figs. 7(c) and (d) show the same views but in this case the magnets are repositioned to be activated.

Best Modes of the Invention

Throughout this description, the same reference numerals have been used to refer to the same features of the appliance.

Referring first to Fig. 1, the appliance 10 will be described with reference to its preferred mode of construction.

In order to make the appliance, the patient visits an orthodontist who takes an impression of the teeth, both upper 12 and lower 14. A record is then taken of the patient's bite, both in their original undesired position and in a position approximating the ideal position. The necessary records are forwarded to a laboratory for construction as follows.

Stone castings of a patient's maxilla and mandible are prepared and articulated on an articulator with a wax bite to position the castings in a protruded and open manner as would normally be done in the production of Class II correctors.

The wax (or other material) bite must produce an opening of the bite which allows enough room for the accommodation of the magnets 20, 21 and 22, which have a thickness of approximately 1 to 3 mm each and are encased in acrylic modules 25 and

26 for protection from the corrosive oral environment. If the magnets are placed on the buccal and/or palatal side there may be no need for inter-occlusal opening, provided there is sufficient opening to allow minimal occlusal coverage over the maxilla, and mandible, with a V shape for the mechanical sliding of the jaw. The encasing requires extra space in the bite to accommodate the magnets. With a magnet thickness of 1-2 mm and occlusal coating of 0.25 mm. This will result in a 1.5-2.5 mm upper ad 1.5-2.5 mm lower unit height and the resulting interoclusal distance will be about 4-6 mm.

The upper 25 and lower 26 modules will be weakly interconnected for ease of the construction. Once the three modules are placed and the acrylic is cured the upper

25 and lower 26 modules should be separated easily. The interconnection can be an extension of the coating material on the mesial and distal aspects. Alternatively, attractive magnetic forces may be enough to keep them together.

Once the articulation is complete, the lab technician determines the exact location for the placement of the attractive magnets, for instance the occlusal surface of the upper first pre-molar or the D (deciduous dentition) region. This becomes a landmark and the area directly below this on the either side of the corresponding lower jaw is where the first attractive magnets are placed.

The acrylic modules 25 on the upper will usually extend from the mesial of the upper first pre-molar or D' s to the distal of the upper first molar or the distal of the second molar, depending on whether the second molars are present, or to be left uncovered if further eruption is required. The lower components may vary by extending from the mesial of the canines or Cs to the distal of the second molars depending on retention requirements or to allow for the eruption of various lower posterior teeth which is common in Class II correction treatment. Once the teeth to be covered by acrylic on the upper is established, a wire strengthener 30 of 0.7 mm. gauge thickness is designed to be incorporated into each acrylic module. This wire strengthener is bent in a single loop that follows the contours of the buccal and lingual cusp aspects of the posteriors. The wire strengtheners 30 provide strength to the modules 25 and 26 during wear and keep the modules 25 and 26 intact upon removal of the appliance post treatment by avoiding fragmentation.

The casts are then coated by a separating medium to prevent the acrylic from bonding to the stone casts during the acrylic processing.

The wire strengthener loops 30 are then positioned on to the prospective quadrants to be covered by acrylic and secured with a drop of hot wax on the most anterior and most posterior regions of where the wire strengtheners 30 are to be placed in order to secure the wire to avoid it dislocating during the acrylic processing.

A very small portion of a soft, sticky type of wax is rolled into balls of approximately 4mms in diameter and placed on to the designation spots on the lower casts bilaterally in the areas where the magnets are to be placed. One magnet 20 is placed on each side on top of the sticky wax and is manipulated until it is as close as possible to the occlusal surface of the lower, ensuring that the top flat side of the magnet 20 is level and parallel to the occlusal plane. A dimple on one side indicates polarity of the magnets, making it easier to place the magnets in the correct way up. On both sides, the magnets should both be facing up or both be facing down. Once the wire strengtheners 30 and magnets 20 are secured, the casts are then allowed to soak in water to prevent porosity forming during the acrylic processing. Once it is visible that the casts have absorbed sufficient water, the lower modules 26 are then poured up using the 'salt and pepper' technique. Once a sufficient amount of acrylic has been poured, the lower cast is then placed in a pressure pot and allowed to cure for ten minutes. After ten minutes, the lower cast is removed from the pressure pot and the two acrylic sections are removed for trimming. The trimming of the lower modules 26 is crucial to the overall success of the entire appliance. The modules are trimmed to follow the contours of the gingival margin 40 on both the buccal (shown) and lingual. The occlusal surface 42 of the module is trimmed flat to follow a direction parallel to the occlusal plane. Due to the opening of the bite being greater in the anterior region and lesser in the posterior region, the occlusal surface of the lower modules 26 is also trimmed so that they have a gradual slope being thicker in the anterior section of the module and thinner in the posterior region. The thicker area is where the lower attractive magnet 20 is housed. Another reason for the posterior of the module 26 being thinner is to allow for more space in the upper module 25 to accommodate the opposing repelling magnet 21. The thickness of the acrylic over the lower magnet 20 is trimmed to be just less than 1 mm. thick.

Once satisfied with the shape and dimensions, the lower modules 26 are then polished. The polished modules 26 are then placed back on to the lower casting and a thin strip of adhesive tape is placed over the top surface of the modules 26. The excess adhesive tape is wrapped around the periphery of the modules 26 and secured with wax, effectively acting as a barrier to prevent the opposing modules 25 adhering to the lowers 26 during the upper acrylic processing phase. The upper modules 25 contain both attractive 21 and repelling 22 magnets.

These two magnets 21 and 22 are mounted with opposite polarity at opposite ends of the same side of a thermoplastic wafer 50 with a predetermined space between the two magnets, around 6 mm. This spacing provides the necessary attractive and repelling forces which maintain the mandible of the patient in a protruded position. The two magnets 21 and 22 are positioned with the magnet 21 that is attracted to the lower magnet 20 forward. This magnet 20 helps to deflect the occlusion away from a returned position. The adjoined repelling magnet 22 is always positioned distal to the attractive magnets 21 and in line with the length of the module 25.

The upper acrylic pouring technique is much the same as for the lower, the difference being that the upper magnets 21 and 22 are not secured to the stone cast with wax, but utilise the attractive force from the lower magnets 20 to position the forward upper magnets 21. It is essential that a layer of acrylic be poured up underneath the occlusal surface of the upper magnets 21 and 22 to ensure that they become totally encased in acrylic and are not exposed to the external environment. Once poured up, the upper modules 25 are cured in the same fashion as the lower modules 26. The occlusal surface of the upper modules 25 is determined by the contouring of the lower modules 26.

The upper modules 25 may also have on either side an expansion device placed between them in order to provide maxillary expansion, and is often in the form of a rapid midline expansion screw.

Once the upper modules 25 have been trimmed and polished with contours similar to that of the lower modules 26, holes may be drilled from the inside surface from the cusp tips to the immediate external surface, allowing for excess cement to escape allowing for a closer fitting device.

Steam cleaning is performed on the fitting surface of the modules 25 and 26 to remove any excess wax and the final treatment is sandblasting of the fitting surface to enhance the bond between the cement and the modules 25 and 26. Steam cleaning should not heat the magnets up to close 100⁰C (the maximum working temperature for NdFeB type of magnets) since this will cause the magnets to lose their magnetization.

The modules are now ready to be cemented in the teeth of the patient.

Figs 2 to 5 show alternative arrangement of magnets within modules of the appliance.

Appliance 11 of Fig 2 includes a second magnet 27 on the lower module 26 that is attracted to the magnet of 22 of the upper module 25. All magnets are positioned on the buccal sides of the teeth. The appliance further includes a V shaped mechanical interlock 28 where the upper module 25 includes a V shaped protrusion of acrylic positioned between magnets 21 and 22, and a complementary V shaped groove in the acrylic of the lower module 26 between magnets 20 and 27. A mechanical interlock assists the action of the magnets 20, 21, 22 and 27.

Similarly to appliance 11, appliance 12 of Fig. 3 also includes four magnets 20, 21, 22 and 27 positioned on the buccal sides of the teeth. In this embodiment, the mechanical interlock is a step 29 formed on the upper module 25 and a complementary step formed on the lower module 26. To maximize vertical development the 7s are left free to erupt. However, to minimize vertical eruption the of the acrylic of the upper is extended to over all 7s.

Referring now to Fig 4, a side view of appliance 13 is shown with magnets positioned in a V-shaped configuration on the buccal sides of the teeth. This arrangement includes mechanical repositioning means 40 as well as magnetic forces between the magnets. This arrangement allows for minimal space between the upper

12 and lower 14 teeth. The appliance 14 of Fig. 5 is a modification of Fig. 4 with square magnets 52 and 54, either 7mm x 7mm x 2mm or 7mm x 7mm x 3mm, placed on the occlusal surfaces of the teeth incorporated into upper acrylic modules that are connected across the palate by an expansion plate 60. This modification can be employed when the upper arch needs broadening.

The magnetic forces of the magnets 20, 21, 22 and 27 will now be described with reference to Fig. 6. Fig. 6(a) shows the upper 25 and lower 26 module in alignment when initially placed into patients mouth. An attraction force 70 operates between the magnets 22 and 27 and magnets 21 and 20. A repulsion force 72 also operates between magnets 20 and 22. Overtime these forces 70 and 72 will encourage the lower jaw 14 to move in a desired position to meet the upper jaw 12. Once the desired position is achieved the modules 25 and 26 are aligned as shown in Fig. 6(b). This results in a better relative alignment of the upper and lower jaw, such as a sagittal correction of the jaw. Referring now to Fig. 7, a module 90 is fitted to the upper teeth on one side of the mouth and another module 92 is fitted to the lower teeth. Two magnets 94 and 96 are positioned in upper module 90, and two further magnets 98 and 100 are positioned in lower module 92. In Figs. 7(a) and (b) the magnets 94 and 96 are positioned directly above 98 and 100 and there is no magnetic attraction or repulsion between the upper and lower magnets that would cause modification of the alignment of the patient's jaw. The magnets may then be reposition within their respective modules, by activating some mechanism accessible outside the modules (not shown), such as screwing the magnets on a thread to move them, in order to position them as shown in Figs. 8(c) and (d). In this new position the magnets are activated and exert attraction or repulsion, or both, between the upper and lower jaws. By being able to move the magnets in this way, treatment of a patient wearing the modules can be amended over time as required by changing the degree of attraction or repulsion and the direction of the attraction or repulsion. For example, once some correction is achieved, the magnets can be moved so that they exert a greater attraction or repulsion action. The movements between the positions shown in Fig. 8 can be gradual and over a period of time to increase the patient's comfort.

Although the invention has been described with reference to examples of its construction it should be appreciated that many alternatives and variations are possible.

For instance, it is envisaged that a standard housing could be developed that avoids the necessity of laboratory manipulation. These housings could be attached directly to standard fixed orthodontic appliances so that the correction of the patient's mandibular retrusion could be combined with the correction of other aspects of the malocclusion such as the alignment of teeth.

It should also be appreciated that the different magnets may have different dimensions, and the lower magnets can be placed excentric or incentric with respect to the upper.

A magnet that has applies attraction force to a magnet included in an opposing module or device can be replaced with ferromagnetic material.

The magnets may be positioned in the modules on the palatal sides of the patient's teeth. Modules containing two magnets may make use of attractive magnetic forces, weak material bridges or extra connection material to hold the magnets in the desired relationship with each other.

The design for traditional (vertically normal) Class II cases could be modified for correction of openbite, deepbite and transversally deficient maxilla cases.

Claims

CLAIMS DEFINING THE INVENTION ARE AS FOLLOWS:

1. A module for the correction of orthodontic malocclusions formed of material shaped with a cavity to receive and closely fit over teeth on an upper or lower jaw of one side of a mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to an opposing jaw.

2. A module according to claim 1, wherein the magnet or ferromagnetic piece is arranged within the module so that it is positioned above the occlusal surfaces of the teeth.

3. A module according to claim 1, wherein the magnet or ferromagnetic piece is arranged within the module so that it is positioned on the buccal and/or palatal sides of the teeth.

4. A module according to any one of claims 1, 2 or 3, wherein the magnet or ferromagnetic piece is a cuboid, such as a cubiod having the dimensions 7mm x 4mm x

4mm.

5. A module according to any one of the preceding claims, wherein the magnet is neodymium with a copper nickel coating.

6. A module according to any one of the preceding claims, wherein the magnet or ferromagnetic piece is hermetically encapsulated before being encased in the module.

7. A module according to any one of the preceding claims, wherein the magnet or ferromagnetic piece is arranged to move between two or more positions.

8. A module according to claim 7, wherein in a first position the magnet or ferromagnetic piece is arranged to apply a different magnetic attraction or repulsion than in a second position.

9. A module according to any one of the preceding claims, wherein the device is comprised of material in which the further ferromagnetic piece or magnet is encased and is to be fitted to the opposing jaw using wires.

10. A module according to of any one of the preceding claims, wherein the module is made of any one or more of resin, acrylic, magnetic or non-magnetic stainless steel.

11. A modules according to any one of the preceding claims, wherein the module is shaped to be bonded directly to the teeth.

12. A module according to any one of the preceding claims, wherein the module is incorporated and/or engaged in a removable or fixed orthodontic or mouth device.

13. A module according to claim 12, wherein the module is incorporated with an expansion or sagittal screws.

14. A module according to any one of the preceding claims, wherein the module is shaped to receive two or more adjacent teeth on one side of the mouth.

15. A module according to any one of the preceding claims, wherein the cavity receives the whole of the exposed part of the teeth.

16. A module according to any one of the preceding claims, wherein a loop of wire strengthener is incorporated into the module and follows the contours of the buccal and lingual gum margins.

17. A module according to any one of the preceding claims, wherein a surface of the cavity is surface treated, such as sandblasted.

18. A module according to any one of the preceding claims, wherein a surface of the module facing the opposed further module or device is shaped to provide mechanical reinforcement to the attraction or repulsion forces.

19. A module according to claim 18, wherein the surface is ramped.

20. A module according to claim 18, wherein the surface incorporates an interengaging and complementary formations with a surface of the module or device to be fitted to the opposing jaw.

21. A module according to claim 20, wherein the interengaging formations include any one or more of: a gentle wave shape of a V or W; a V shaped protrusion or recess; and a step.

22. A module according to any one of the preceding claims, wherein an outer surface of the module is of the material.

23. An appliance for the correction of orthodontic malocclusions comprised of two or more modules according to any one of the preceding claims.

24. A appliance according to claim 23, wherein a first module is separate from a second module.

25. An appliance according to claim 23 or 24, wherein there are three magnets on each side of the mouth, a first magnet is encased in a first module that is to receive upper or lower teeth on one side of the mouth, and a second and third magnet are encased in a second module that is to receive the other of the upper or lower teeth, on the same side of the mouth.

26. An appliance according to claim 25, wherein first and second magnets attract each other and the first and third magnets repel each other.

27. An appliance according to claim 23, 25 or 26, wherein there are four magnets on each side of the mouth, a first and second magnet are encased in a first module that is to receive upper or lower teeth on one side of the mouth, and a third and fourth magnet are encased in a second module of material that is to receive the other of the upper or lower teeth, on the same side of the mouth.

28. An appliance according to claim 27, wherein the first and third magnets attract each other, the second and fourth magnets attract each other and the second that third magnets repel each other.

29. An appliance according to any one of claims 23 to 28, wherein two magnets or one magnet and one ferromagnetic piece are encased within one module of the appliance, and the two magnets or the one magnet and one ferromagnetic piece are mounted on a wafer to space them apart by a preferred distance.

30. An appliance according to claims 29, wherein the two magnets or the one magnet and ferromagnetic piece, and wafer are arranged so that the wafer protects the magnets and/or ferromagnetic piece from wear by the opposing teeth.

31. An appliance according to any one of claims 23 to 30, wherein two magnets or one magnet and one ferromagnetic piece are encased within one module of the appliance, and the distance between the two magnets or the one magnet and ferromagnetic piece is between 6mm to 9mm.

32. A method for fabricating the appliance as described in any one of claims 23 to 31.

33. A method of claim 32, comprising the steps of: taking an impression of the patient's teeth; taking a record of the patient's bite, both in a original undesired position and in a position approximating the ideal position; preparing stone castings of the patient's maxilla and mandible, articulated on an articulator with reference to the bite record to position the castings in a protruded and open manner to accommodate the magnets; placing the magnets and/or ferromagnetic material on the cast teeth; pouring, curing and trimming the lower modules to follow the contours of the gingival margin on both the buccal and lingual and trimming the occlusal surface; pouring the upper modules using the attractive force between magnets and/or ferromagnetic piece in order to position the magnets and/or ferromagnetic piece for the upper module; and curing and trimming the upper modules to follow the contours of the gingival margin on both the buccal and lingual and trimming the occlusal surface.

34. A method according to claim 33, wherein the method further comprises the step of mounting magnet pairs with opposite polarity and/or ferromagnetic material at opposite ends of the same side of a thermoplastic wafer with a predetermined space between them.

35. A module for the correction of orthodontic bite problems formed of material shaped with a cavity to receive and closely fit over teeth on an upper or lower jaw of one side of a mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to an opposing jaw.

36. A module according to claim 35, wherein the bite problems include open bites, closed bites or cross bites.

37. A module for the correction of midline shifts, asymmetries or narrowness of jaws formed of material shaped with a cavity to receive and closely fit over teeth on an upper or lower jaw of one side of a mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to a opposing jaw.

38. A module for the correction of hemifacial microsomia formed of material shaped with a cavity to receive and closely fit over teeth on an upper or lower jaw of one side of a mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to an opposing jaw.

39. A module for the treatment of sleep apnoea formed of material shaped with a cavity to receive and closely fit over teeth on an upper or lower jaw of one side of an mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to an opposing jaw.

40. A module for the treatment of temporomandibular joint problems formed of material shaped with a cavity to receive and closely fit over teeth on an upper or lower jaw of one side of a mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to the opposing jaw.

41. A module according to claim 40, wherein the temporomandibular joint problems includes teeth grinding.

42. A module for keeping a lower jaw in a forward and separated position in relation to an upper jaw formed of material shaped with a cavity to receive and closely fit over teeth on the upper or lower jaw of one side of a mouth, and encased within the module is one magnet or ferromagnetic piece arranged to attract or repel one further ferromagnetic piece or magnet respectively which is arranged within a further module or device to be fitted to the opposing jaw.