WO2010091832A1

WO2010091832A1 - Apparatus and method for indirect bonding for orthodontic treatment devices

Info

Publication number: WO2010091832A1
Application number: PCT/EP2010/000764
Authority: WO
Inventors: Markus GUNTENHÖNER
Original assignee: Guntenhoener Markus
Priority date: 2009-02-11
Filing date: 2010-02-08
Publication date: 2010-08-19
Also published as: DE102009008384B4; DE102009008384A1

Abstract

The invention relates to an apparatus and to a method for indirect bonding for orthodontic treatment devices (3) in order to create solutions for different problems and disadvantages of the indirect bonding technique for orthodontic treatment devices. Accordingly, the fields of application of the indirect method are widened and facilitated by providing at least one one-part or multi-part, at least regionally elastic element (4, 4a, 5), which can be applied at least regionally to the surface of at least one tooth (2) and comprises a receptacle for at least one orthodontic treatment device (3), wherein the element partially surrounds the orthodontic treatment device (3) only in the head region (12) or in the region of a temporary gripper attachment and does not necessarily have any contact with the tooth surface in the entire surrounding region of the bonding basis (9) of the orthodontic treatment device (3).

Description

"Device and method for indirect bonding for orthodontic treatment devices"

The invention relates to a device and a method for indirect bonding for orthodontic treatment devices including a method for producing this device including a connecting rail for implementing orthodontic treatment devices by means of devices according to the invention.

The orthodontic treatment devices may be, for example, brackets, tubes, knobs, hooks, other three-dimensional structures, in extreme cases, even just simple splices and the like. Act. Such treatment devices can consist of both metallic and non-metallic materials or be composed of different components.

In such orthodontic treatment devices, the position of individual or all teeth within the oral cavity can be corrected. Thus, inter alia, an improvement of the chewing function and also the aesthetic appearance of a patient can be achieved. In addition to dental and jaw malpositions can be treated. Significant deviations from a proper tooth position and / or jaw position can lead to both aesthetic and functional impairments.

The orthodontic treatment devices exert a directed force on the teeth to be moved. Orthodontic treatment devices for the three-dimensional change of the tooth position include both fixed and removable appliances. The necessary force for the desired tooth movement is provided by elastic ele- ments of the respective treatment apparatus delivered to the attached to the teeth treatment equipment. The latter are more or less complex handles that allow the force to engage the otherwise rather smooth tooth surface.

In the fixed orthodontic treatment technique in particular wire bows, elastic springs, rubber-like rings, chains and similar elements are used, which attack directly on the treatment device.

As removable treatment apparatuses for three-dimensional tooth movements, for example, elastic rails of transparent plastics are used. Even with these, the transmission of the desired force on the rather smooth tooth surface is necessary. For this purpose, one uses additional, if possible transparent or tooth-colored three-dimensional elements, so-called "attachments", which are also glued to the tooth surface. The elastic rails in turn have adapted structures for receiving the corresponding "attachments". In order to secure the orthodontic treatment devices securely on the tooth surfaces, various chemically and / or light-curing materials are used as adhesive. There are again two approaches.

In direct bonding technique, the orthodontist grips a single treatment device with tweezers or other suitable hand instrument and places it directly on the desired position on the tooth. He fixes this on the tooth surface with a certain amount of a suitable adhesive. There is no need for additional dental preparations or measures. However, the procedure must be repeated until all treatment devices are mounted on the teeth. The Precise positioning of the treatment devices is difficult especially in the hard to reach areas of the dental arch, such as in the posterior region or on the inside of the dental arch. The skill, the skill and the experience of the orthodontist as well as the willingness to cooperate and ability of the - often young - patient have a great influence on the process of direct gluing and the achieved precision. In addition, a relatively high amount of time is needed.

For this reason, the indirect bonding technique has already been developed. In this case, the orthodontic treatment devices are first positioned outside the oral cavity of the patient on a physical or virtual model of the dental arch. This is freely visible and accessible without restriction. These preparatory work can be carried out without the presence and involvement of the patient and can be carried out flexibly in terms of time. The subsequent working time on the patient and his physical load is thereby significantly reduced. In order to carry out the indirect bonding technique, transmission systems are used for the placement and fixation of the treatment devices at the desired positions on the tooth surfaces. Typically, these are rails that can be made in a variety of ways and have two different shapes of recesses. These serve once the reproducible placement on the dental arch as well as the reversible recording of the adhered to the teeth treatment devices.

However, the indirect bonding technique leads to a significantly higher laboratory and material costs. In addition, the various methods available to date often more or less restrict the selection of the treatment devices and the preferred adhesive. A particular disadvantage of the known transmission systems for indirect bonding is that there is a large-area and close contact between the tooth surface and the respective transmission system in order to position the treatment devices exactly on the dental arch. In this case act between the transmission system and the tooth surface unwanted capillary forces that can lead to the uncontrolled and large-scale spread of low-viscosity liquids such as saliva and glue. This leads to a greater effort for the dry keeping of the teeth and for the removal of any excess glue. In close contact with the gum cavity, the superfluous glue can also spread into the space between the tooth and the gums, the so-called sulcus. Penetrating adhesive can also reduce or destroy the functionality of composite treatment devices with moving parts, such as are common in self-ligating brackets. The remaining adhesive surplus on the tooth surface must be removed in any case, as they represent roughness, which complicate the oral hygiene and lead to an accumulation of dental plaque.

In this case, tooth surfaces with fixed treatment devices are in any case harder to clean. Teenagers, in particular, tend not to exercise enough care in cleaning their teeth. Therefore, endangered tooth surfaces are increasingly being sealed with thermosetting plastics. These preferably contain fluorides and can also deliver them to the enamel.

Since the sealing plastics are likewise of low viscosity, they can hitherto be applied only to a limited extent in the same working step in the known indirect bonding techniques because of the occurrence of the capillary forces already described. If the sealing is necessary digerweise in a separate step, in particular the subsequent elimination of the adhesive surpluses described involves the risk of mechanical damage to the sealing layer. If, on the other hand, the smooth surface sealing is carried out only after gluing the treatment devices, this leads to a significantly increased expenditure of time, because the treatment devices must be carefully omitted.

A well-known problem in the fixed orthodontic treatment technique is the loosening or even the loss of a treatment device. Most of this happens only after a certain period of time. Then the dental arch has already changed by the therapy-related tooth movements, so that the existing transmission system can not be sufficiently adapted and used for a new, indirect bonding of the treatment device. In such a case, the lost or loosened treatment device usually needs to be re-attached or attached directly, with all the disadvantages already described for direct bonding, especially in the area of difficult-to-access teeth.

Another disadvantage of the known transmission systems for indirect bonding technology is that they completely enclose the orthopedic treatment device to be bonded. As a result, the contact surface between the adhesive base of the treatment device and the tooth surface either no longer or only very limited viewable. It is glued almost "blind". Pass inaccuracies between the treatment device and the tooth surface then fall on only after the completed bonding process. In this case, the faulty glued treatment device must be removed time-consuming again and then replaced, again by way of direct bonding with the already described disadvantages.

In addition to individually manufactured transfer rails for indirect bonding technology, there are both prefabricated and individually adapted setting aids for individual teeth. These are racks that lie more or less exactly on a part of the respective tooth and have an element for reversible recording of the adhesive to be treated treatment equipment. As a rule, such frames can only be used for certain treatment devices, in particular brackets of a single manufacturer. With them also a considerable constructive effort is connected. Sometimes they can not be clearly positioned. The fact that a single element is provided for each treatment device, a relatively high amount of time is associated with its implementation.

However, the indirect bonding technique is preferable due to the achievable thereby precision and the time savings in the immediate work on the patient. It is therefore necessary to overcome the existing problems in order to achieve the breakthrough for the indirect bonding technology and to secure its wider application possibilities and acceptance.

The invention has therefore taken on the task of providing a corresponding device for indirect bonding for orthodontic treatment devices and a method for their preparation and for indirect bonding available.

This object is achieved according to the invention initially in that the device comprises at least one single or multi-part, at least partially elastic element which is at least partially applied to the surface of at least one tooth and a recording for less at least one orthodontic treatment device, wherein the element comprises the orthodontic treatment device only in the head area or in the area of a temporary gripping lug partially and not necessarily has tooth surface contact in the entire surrounding area of the adhesive base of the orthodontic treatment device.

On the one hand, the embodiment according to the invention ensures that the capillary forces described as disadvantageous can not occur. Rather, the circular freedom around the adhesive base of the treatment device prevents the occurrence of such capillary forces outside the actual adhesive surface. This avoids the large-scale and uncontrolled spread of low-viscosity fluids on the tooth surface. With regard to the spread of saliva on and over the tooth surface, the device according to the invention facilitates the necessary dry keeping. The lack of capillary forces outside the adhesive base also prevent the unwanted and uncontrolled spread and distribution of the adhesive over the tooth surface. With a correct dosage of the adhesive quantity eliminates the otherwise necessary and time-consuming post-processing. Due to the configuration of the element according to the invention, which partially covers the orthodontic treatment device only in the head region or in the region of a temporary gripping attachment, and in the entire surrounding region of the adhesive base has no tooth surface contact, any contact with the gums of the patient is avoided. This reduces the risk of spreading the glue into the sulcus, i. also avoid the space between the tooth and the gums.

Furthermore, the device according to the invention also prevents the penetration of adhesive into composite treatment devices with moving parts. Thus, the use of indirect bonding technology is also progressively licher self-ligating bracket systems facilitates or allows.

Because the elastic element encloses the orthodontic treatment device only at the head or gripping attachment, while the entire surrounding area of the adhesive base is exposed, this and the entire tooth surface, in contrast to the known state of the art, can also be viewed freely in the indirect bonding technique. This allows the orthodontist to immediately recognize any fit inaccuracies, unwanted adhesive surplus and the like and react accordingly. This also applies to very flat, in extreme cases only drop-shaped treatment devices or splices, which are e.g. be adhered on the inside of the tooth to maintain the tooth correction achieved, and if necessary, have only a temporary gripping lug, which after attachment e.g. is ground away or milled so as not to stand out as disturbing in the oral cavity.

Particularly noteworthy is also the ability to stick the treatment equipment in the same step and at the same time be able to perform a sealing of the tooth surface with hardening plastic. For this purpose, only the sealing plastic must be applied to the adhering tooth surfaces and the adhesive bases of the treatment devices. The indirect bonding process otherwise remains completely unchanged. Subsequently, the device according to the invention - in the ideal case together with other treatment devices, connected by a connecting rail - placed on the dental arch; These can be easily removed after curing of the adhesive or the sealing plastic. Assuming a reasonably correct dosage of the amount of plastic results in a perfect smooth and closed seal the tooth surface, provided with the Treatment device including a super smooth transition surface from the edge of the adhesive base to the tooth surface.

In this way, a perfect protection against decalcification is achieved as well as a facilitation of proper oral hygiene, while at the same time a clear treatment relief and time savings by the indirect bonding technique is achieved.

Since errors can always occur with every single work step, it is particularly important that the orthodontist can see the contacts between treatment devices and tooth surfaces in the area of the edge zone of the adhesive bases. This can thus visually and quickly check the accuracy of fit and precision of the entire system before the gluing process.

Even in the case of loss or loosening of a treatment device, this can be accurately and precisely stick to the original tooth position with reuse of the device according to the invention. At the same time a renewal of the smooth surface seal and possibly the individual adhesive base without additional time in the same operation is possible. The device according to the invention thereby extends all the advantages of indirect bonding technology to the entire course of the treatment without having to return to direct bonding technology again.

It also means that the elastic elements on a physical and / or virtual mandibular arch model are adaptable to perform all necessary preparatory work independently of the patient and to have an optimal working position.

Preferably, the elements are also temporary or permanent markable, in particular with the usual tooth names, to always ensure a correspondingly unique assignment of the devices according to the invention, in particular the elastic elements, to the individual teeth to be treated.

The elastic elements according to the invention also have a base surface for engagement in a connecting rail in order to be placed together and possibly repositioned.

Particularly advantageously, the elastic element is formed in two or more parts, wherein the elastic region comprises the orthodontic treatment device and the second region is designed as a transfer bracket, which is firmly connected on one side with the elastic region and on the other side of the relief of Having tooth occlusal surfaces adapted structure and / or an additional elastic support element. In this two- or multi-part, the advantages of a relatively elastic element on the one hand and a relatively rigid, although to the extent necessary nevertheless flexible transfer bracket are combined. The latter places itself for optimal stopping with a structure adapted to the respective tooth occlusal surface or optionally has an additional elastic support element, in particular if the corresponding tooth, in particular incisor, does not have a corresponding occlusal surface. In this case, the additional elastic element on the opposite tooth side of the tooth surface to be provided with an orthodontic treatment device can provide a corresponding hold thereof during its application and attachment.

The device may also have an additional gripping and / or repositioning device in order to to improve the handling.

Also provided is an already mentioned connecting rail for the implementation of at least one, but preferably a plurality of orthodontic treatment devices pre-mounted on a Kieferzahnbogenmodell by means of one or preferably several devices according to the invention with an elastic, the orthodontic treatment device only in the head area or in the area of a temporary Greifansatzes partially comprehensive element that the Adhesive base leaves free, wherein the connecting rail to the base surfaces of the elastic elements, in particular the transfer straps, corresponding receptacles for releasably connectable attachment of the devices. If all orthodontic treatment devices are placed in the intended, correct treatment position on the jaw tooth arch model and provided with the device according to the invention, then the connecting rail can be placed on top of it. The base surfaces of the elastic elements, in particular the transfer straps, then latch or snap into the corresponding receptacles of the connecting rail or are connected thereto by a sufficiently strong, but easily releasable adhesive bond. Subsequently, all orthodontic treatment devices for the lower or upper jaw of the patient to be treated can be removed from the model and transferred to the natural teeth in the oral cavity of the patient. After the treatment devices have been glued indirectly on the tooth surfaces in this way (this can also happen on the inside of the teeth in the indirect bonding technique), the transfer rail by a slight sideways or backward or forward movement together with the entire device according to the invention, ie all elastic elements and transfer straps, peeled off. Since all treatment devices are comprised of elastic elements, they are based on the individual treatment. acting forces much lower than usual. Moreover, the connecting rail can first be removed from the elastic elements or transfer straps, these can then be detached individually from the orthodontic treatment devices. This contributes significantly to the fact that it does not come to unwanted loosening or detachment of the freshly glued treatment devices from the tooth surfaces. However, should errors in the manufacture of the devices of the invention or of the connecting rail prevent uniform fit, one or more devices may be easily released from the connecting rail.

In addition, the connecting rail can also be subdivided into smaller segments if desired. In this way, first, the exact fit can be restored by removing one or more defective elements. At the same time, the necessary precision and advantages of the indirect bonding technology are maintained with appropriate fault tolerance. Occurring errors can be immediately isolated and switched off. In addition, individual workflows and special, patient-related features can be taken into account at all times.

It is particularly advantageous that the connecting rail can be detached from the individual devices after the indirect bonding process. This leads to a considerable reduction of the possible extraction and shear forces, which otherwise act on the freshly bonded treatment agents when removing conventional aids for indirect bonding technology. Particularly in the case of distinct tooth misalignments, excessive forces relatively often lead to unintentional detachment of the treatment devices.

The complete system for indirect bonding for orthodontic see treatment devices is thus characterized by at least one single or multi-part elastic element which at least partially to the surface of at least one tooth can be applied and a receptacle for at least one orthodontic treatment device, wherein the element orthodontic treatment device only in the head or in the temporary area Gripping attachment partially covers and in the surrounding area of the base surface of the orthodontic treatment device to be attached has no necessary tooth surface contact, and a connecting rail with corresponding to the base surfaces of a plurality of elastic elements recordings for releasably connectable attachment thereof.

According to the invention protection is simultaneously claimed for a method for producing a system for indirect bonding for orthodontic treatment devices, in which after molding the dental arch of the patient and preparation of a dental arch model and fixation of the orthodontic treatment devices on the dental arch model initially a one or more parts, at least partially elastic element , which is at least partially applied to the surface of at least one tooth and has a receptacle for at least one orthodontic treatment device, is plugged into the orthodontic treatment device that it includes this only in the head or in the area of a temporary gripping approach partially and in the entire surrounding area the adhesive base of the orthodontic treatment device has no tooth surface contact, and wherein subsequently a connecting rail with the base surfaces of the elastic Ele ments, in particular the transfer bracket, is brought into engagement.

In an inventive variant, the invention also encompasses a method for the production of a system for indirect cleavage. for orthodontic treatment devices, in which a virtual set-up model is generated by a scan of the patient's dental arch, an impression of the dental arch or dental arch model, from which a real set-up model, in particular by rapid prototyping or CNC Milling technique is formed, on which the orthodontic treatment devices, the elastic elements and / or the transfer straps and the connecting rail can be fastened. This allows further savings by replacing the real, dental work by a computer-aided process. Such a method further provides that also virtual treatment devices are positioned and constructed and / or virtual elastic elements, in particular transfer bars, constructed and produced in reality, which can be placed on the real dental arch model, connected to a connecting rail and removable from the dental arch model and on the dental arch of the patient can be implemented. Thus, virtually all, so far performed in a dental laboratory real manufacturing processes can be handled computer-assisted, possibly even over long distances, before finally the real treatment equipment, elastic elements, in particular transfer bracket and / or the connecting rail are produced from the data created although this is particularly, but not exclusively, achievable by a rapid prototyping or CNC milling process.

Finally, the invention also includes a method for indirect bonding for orthodontic treatment devices, wherein after taking the dental arch of the patient and preparing a dental arch model and fixing the orthodontic treatment devices, a one-part or multi-part, at least partially elastic element that at least partially to the surface of at least one tooth and a receptacle for at least one orthodontic appliance. Pädisches treatment device, in such a way is placed on the orthodontic treatment device that it includes this at the head area or in the area of a temporary gripping part partially and the entire Umweltbreich the adhesive base of the orthodontic treatment device does not necessarily have tooth surface contact, and in which then a connecting rail with the base surfaces of the elastic elements, in particular the transfer straps engaged, all parts removed from the dental arch model, and after temporary cleaning, disinfecting and sterilization are placed on the natural dental arch of the patient.

In a modification, the invention also encompasses a method in which a therapeutic set-up is produced after impression of the dental arch and fabrication of a dental arch model via a saw model and then fixes the orthodontic treatment devices, then at least one single-part or multi-part, at least partially elastic element , which is at least partially applied to the surface of at least one tooth and has a receptacle for at least one orthodontic treatment device, is plugged into the orthodontic treatment device that it includes this only in the head or in the area of a temporary gripping approach partially and in the entire surrounding area the adhesive base of the orthodontic treatment device does not necessarily have tooth surface contact, and then the orthodontic treatment devices with the elastic elements, in particular the transfer straps, from Set-up model to be removed and implemented on the dental arch model and then wherein a connecting rail with the base surfaces of the elastic elements, in particular the transfer bracket, engaged, removed all parts of the dental arch model and after intermediate maturity cleaning, sanitizing and sterilizing on the patient's natural dental arch.

A further method according to the invention provides that a virtual dental arch model and therefrom a virtual setup model and / or virtual treatment devices are constructed and / or positioned via a scan of the patient's dental arch, an impression of the dental arch or the real dental arch model, virtual elastic elements and / or or transferred virtual transfer devices and transfer straps on a virtual dental arch model and / or a virtual connecting rail are constructed, then subsequently the treatment devices produced according to the virtual data, elastic elements, transfer straps and connecting bars real interconnected, cleaned, disinfected and sterilized and on the Dental arch of the patient to be transferred.

In a further advantageous modification, the virtual set-up model is produced from a scan of the real therapeutic set-up, which was created after the patient has arched the dental arch and made a dental arch model using a saw model.

A production of the real elements is preferably, but not exclusively, by the method of rapid prototyping or the CNC milling technique.

The invention is explained in more detail below by way of example with reference to the drawing. This shows in:

1 shows a perspective view of an upwardly placed maxillary dental arch in misalignment with brackets placed on the outer tooth surfaces and with these elastomers encompassing the head area. see elements and on the occlusal and lingual surfaces of the dental crowns adapted transfer straps and a half connecting rail,

2 shows a cross section through a molar tooth with bracket, elastic element, transfer bracket and connecting rail,

3 shows a cross-section through an anterior tooth with a bracket arranged on the outside, an elastic element, a transfer strap adapted to an incisal surface of the tooth crown, and a connecting rail,

4 shows a cross-section through an anterior tooth with a bracket arranged on the inside, an elastic element comprising its head region, a transfer strap adapted to the incisal surface of the tooth crown, and a connecting rail,

5 shows a cross section through a molar tooth with a bracket on the outside, a one-piece elastic element adapted thereto and to the occlusal surface of the molar, and a connecting bar, FIG.

6 shows a cross-section through an anterior tooth with externally mounted bracket, a one-piece elastic element, which is adapted to the incisal surface, and a connecting rail, and in

7 is a flow chart of various manufacturing and application methods according to the invention.

A system, generally designated 1, for indirect access to for orthodontic treatment devices 3 to natural teeth 2 comprises elastic elements 4, 4a which at least partially surround the orthodontic treatment devices 3 in the head region 12, 16. In a multi-part lift, these transfer straps 5 are connected, which are adapted to the occlusal or incisal surfaces 7 of the dental crowns. The transfer bracket 5 in turn have a base surface 14 for engagement in a connecting rail 8. The elastic receiving element 4 has adapted bulges 15 for the reversible recording of the head portion 12, 16 of the orthodontic treatment device 3. In this case, the receiving element 4 surrounds the head portion 12, 16 of the treatment device 3 as far as it is necessary for a secure fit and a reproducible positioning. Preferably, undergoing parts of the treatment element 3 are detected, wherein the largest possible distance to the surface of the tooth 2 is held in the transfer strap region 6 at the same time.

In the drawing, only brackets are exemplified as orthodontic treatment devices 3, although there are other orthodontic treatment devices 3, which can be glued indirectly with the device according to the invention and the method according to the invention. These are e.g. around tubes, knobs, hooks and any other form of metallic or non-metallic three-dimensional structure which is connected to a tooth 2 to absorb a force to be applied, for example, by an orthodontic arch, an elastic rail, a spring, an elastic chain or comparable means, including their combinations.

The elastic member 4 may be made of various materials and also by using various known per se Techniques are made. A suitable method is, for example, the manual adaptation of light-curing provisional filling material.

The elastic element 4 can, as is apparent in particular from FIGS. 5 and 6, be formed in one piece, without requiring a transfer strap 5 separately and at least partially be applied to the surface of at least one tooth 2 without the entire surrounding area of the adhesive base 9 of Orthodontic treatment device 3 to have a tooth surface contact. Rather, this area should, according to the invention, be kept as free as possible in order to enable a high degree of visibility of the entire adhesive area as well as to avoid capillary forces due to excess adhesive emerging laterally from the adhesive base 9.

Instead of integrally, the elastic element 4 can also be designed in several parts. In this case, it consists of the actual, elastic element 4a, which comprises the head region of the orthodontic treatment device 3, and a transfer strap 5, which is connected thereto and spaced in the region 6 from the tooth surface. This is adapted in the posterior region of the relief of the occlusal surface 7 of the natural tooth 2 and can be made of different materials and also by using various per se known techniques. A suitable method is, for example, the manual adaptation of light-curing material for the production of individual spoons in dental prosthetics, which is then polymerized together with further elements of the invention in a light chamber. This transfer bracket 5 may additionally comprise not shown gripping or repositioning elements, which are formed from the same or a different material. It is also possible to introduce prefabricated Moldings before curing of the plastic.

On teeth with a reduced contact surface, as may be the case with anterior teeth, additional stability can be achieved by means of an extension 10 on the opposite tooth surface (compare FIGS. 3 and 14). As such, e.g. an additional elastic support 10 are created. As the material for this example, the same as for the actual elastic receiving element 4a may be used.

All or several elements of the device 1 according to the invention can each be made of the same material, provided that a sufficient elasticity for the reversible recording of the orthodontic treatment devices 3 and a sufficient strength for the reproducible positioning of the elastic elements 4 and / or the transfer bracket 5 on the occlusal or Inzisalen contact surfaces and the treatment devices 3 is ensured on the respective tooth surface. In addition, after the indirect bonding operation in the oral cavity of the patient, the necessary elasticity for easy and safe removal of the entire system from the treatment devices 3 and the teeth 2 of the patient must be provided. The use of a single material is particularly advantageous if a computer-aided method, such as rapid prototyping or CNC milling, should be used for the production of the individual elements in place of a technical dental procedure.

For ease of handling, the individual elastic elements 4, 4a and / or transfer bracket 5 can be marked with the respective tooth designations, the marking conveniently following the tooth designations. The labeling itself can be different Methods, in particular the marking with a waterproof pen, the sticking of prefabricated labels or embossing a stamp done. The mark can also be covered with a transparent plastic paint for protection. In a computer-aided manufacturing a relief-like marking can also be done during the manufacturing process.

The individual elastic elements 4, 4a and / or transfer bracket 5 are connected to one another with an elastic connecting rail 8. This can also be made of different materials and by using various per se known techniques. A suitable method is e.g. the manual adaptation of an addition-cured silicone.

Frequently, the use of the orthodontic treatment agent 3 is predetermined in a so-called therapeutic set-up. This is a target model that represents the desired end position of the teeth after completion of treatment. In order to produce such a set-up, after molding the patient's dental arch, a second dental arch model is first created, the individual teeth are sawn out, the therapeutic set-up is formed from the saw model, on which the orthodontic treatment devices 3 can be ideally positioned , With the device according to the invention and the method according to the invention, the elastic elements 4, 4a and / or transfer straps 5 can then be fastened to this set-up model in an ideal, completely unrestricted manner without simultaneous presence of the patient. Subsequently, the unit of the respective treatment device 3 and elastic element 4 or 4a and transfer bracket 5 on the non-sawn, first dental arch model, the misalignments of the dental arch of the patient on points, implemented. This results in the required positioning on the tooth surfaces of the unchanged dental arch model or of the original dental arch of the patient. The individual elastic elements 4, 4a and / or transfer bracket 5 are then connected to one another with the connecting rail 8, can then be removed from the unsized, first dental arch model and placed on the original dental arch of the patient in its oral cavity and glued. If individual elastic elements 4, 4a and / or transfer bracket 5 are released, they can easily be returned to the connecting rail 8 and, if necessary, fixed with a small amount of a thin-flowing adhesive. Before use on the patient, all elements 3, 4, 4a, 5 and 8 of the device are cleaned or disinfected and sterilized.

The device according to the invention thus has two advantages:

With it, both the transfer of the treatment devices 3 from the planned target model to the initial state forming tooth model can be performed.

In addition, the elastic elements 4, 4a and / or transfer bracket 5, in combination with the connecting rail 8, permit the simultaneous and precise transfer of the orthodontic treatment devices 3 from the unsized dental arch model to the patient's original dental arch.

Due to the design of the transfer aids, it is possible to use both a wide variety of treatment devices 3 from different manufacturers as well as individual adhesive bases and individually produced treatment devices 3. The system according to the invention leaves the orthodontist the free choice of personally preferred adhesive. The sticky Benden treatment equipment 3 are in the surrounding area of the adhesive base 9, so the contact surface to the tooth, not, as previously customary, enclosed by the system. This does not completely cover the tooth surfaces to be covered. Therefore, in addition to chemically curing adhesives, the use of light-curing or dual-curing adhesive is possible. The freedom around the adhesive base 9 of the treatment device 3 prevents the occurrence of unwanted capillary forces outside the actual adhesive surface. This avoids both the large-scale, as well as uncontrolled spread of low-viscosity fluids on the tooth surface. Also with regard to the spread of saliva on and over the tooth surface, the system according to the invention facilitates the necessary dry keeping.

Due to the lack of capillary forces outside the adhesive base 9, an uncontrolled distribution of the adhesive over the tooth surface is avoided. With correct dosage of the adhesive quantity eliminates the otherwise necessary and time-consuming post-processing. Since in the system according to the invention also no contact with the gums of the patient occurs, the risk of spreading of the adhesive into the sulcus, the space between tooth and Zahnfleich, completely off. At the same time, the system also prevents the penetration of glue into composite treatment devices with moving parts because of the prevention of capillary forces. In this way, the use of indirect bonding technology is facilitated or made possible, in particular when using advanced self-ligating bracket systems.

It should also be emphasized that by using the system according to the invention in the same working step, both the treatment devices stick and, at the same time, a sealing of the tooth surface with hardening plastic to carry out. For this purpose, only the sealing plastic is applied to the adhering tooth surfaces and on the adhesive bases of the treatment equipment. The indirect bonding process otherwise remains completely unchanged. The system is placed on the dental arch and can be easily removed after curing of the adhesive or sealant. As a result, provided a reasonably correct dosage of the quantities of plastic provided, a perfectly smooth and closed seal 17 of the tooth surface provided with the treatment device 3 including a smooth transition surface from the edge of the adhesive base 9 to the tooth surface. In this way, both the claim for protection against decalcification and the relief of important oral hygiene, as well as the claim for treatment relief and time savings by the indirect bonding technology is optimally taken into account.

Should a treatment device 3 become loose or should it become completely lost, this or a replacement device can again be accurately and precisely glued to the original tooth position by reuse of the necessary parts of the device 1 according to the invention, ie the elastic elements 4, 4a and transfer strap 5 , At the same time a renewal of the smooth surface seal and possibly also the individual adhesive base 9 without additional time and in the same operation is possible.

The system according to the invention thereby extends all the advantages of the indirect bonding technique to the entire course of the treatment.

However, with all precision, even in the case of indirect bonding technology, errors can occur in every single work step. However, the construction of the system according to the invention makes it possible to see the contacts between The orthodontist can thus visually easily and quickly visually check the accuracy of fit and precision of the system before the gluing process, which was previously not possible.

Insofar as errors in the manufacturing process of the system prevent uniform fit, its construction allows isolation and elimination of the defect for the indirect bonding process. A single element 4, 4a including the transfer bracket 5 can be easily detached from the composite with the connecting rail 8. In addition, these can also be divided by separation into smaller segments. In this way, the exact fit can be restored by removing one or more defective elements. In this way the system allows the necessary fault tolerance while maintaining the necessary precision and advantages of the indirect bonding technique.

In addition, thanks to the easy subdivision of the connecting rail 8 each orthodontist quick adaptation to individual workflows and special, patient-related requirements is possible.

The system according to the invention offers solutions to various problems and disadvantages of the indirect bonding technique for orthodontic treatment devices 3 while at the same time preserving the outstanding advantages over the direct method. Overall, the possible uses of the indirect method are thus expanded and facilitated.

The individual process steps in a conventional, dental technical production of the individual system components arise in particular from the drawing sequence on the left in Fig. 7. Here shows the alternative route on the Sä- gemodeil the creation of a therapeutic set-up to which the treatment devices 3 are fixed before they are provided with the elastic elements 4, 4a and / or transfer straps 5 and converted to the unsnected dental arch model, to be subsequently reconnected to the connecting rail 8 ,

In contrast, the right-hand part in FIG. 7 shows which working steps can be shifted from the real dental-technical world into the virtual world. Thus, a virtual set-up model can be created by a scan of the dental arch, the impression or the model, a virtual dental arch model and therefrom a virtual set-up model or by a scan of the conventionally produced therapeutic set-up. Conversely, one can also produce a real set-up model from the virtual set-up model. Due to the virtual set-up model but also virtual treatment devices 3 can be constructed and / or positioned. The same applies to virtual transfer straps 5 and elastic elements 4, 4a, from which real treatment devices 3 and transfer straps 5 can be produced as required. Also, virtual treatment devices 3 and transfer straps 5, including elastic elements, may be transferred to a virtual dental arch model and a virtual splint 8 may be constructed so as to be subsequently real, e.g. by rapid prototyping. Also in a computer-assisted system in this manner, in which transfer straps 5 and / or elastic elements 4, 4a are fixed with treatment devices 3 in a connecting rail 8, then a cleaning, disinfection and sterilization is carried out before the entire system is used on the patient.

Of course, the invention is not limited to the illustrated embodiments. Further embodiments are possible without leaving the basic idea.

For example, it is also possible to use the elastic elements 4, 4a and / or transfer straps 5, e.g. to produce by deep drawing and then separate into individual elements.

In addition, it is of course also possible to mix virtual and real design and manufacturing processes, for example, instead of individually manufactured treatment devices to use ready-to-use treatment devices and to simulate these virtually.

Claims

Claims;

1.

Device for indirect bonding for orthodontic treatment devices characterized by at least one single or multi-part, at least partially elastic element (4, 4a, 5) which at least partially to the surface of at least one tooth (2) can be applied and a receptacle for at least one orthodontic treatment device (3), wherein the element partially covers the orthodontic treatment device (3) only in the head region (16) or in the region of a temporary gripping attachment and does not necessarily have tooth surface contact in the entire surrounding region of the adhesive base 9 of the orthodontic treatment device 3.

Second

Device according to claim 1, characterized in that the elastic elements (4, 4a, 5) are adaptable to a physical and / or virtual mandibular arch model.

Third

Apparatus according to claim 1 and / or 2, characterized in that the elements (4, 4a, 5) are temporarily or permanently kennzeichenbar, in particular with the usual tooth designations.

4th

Device according to claim 1 and / or one of the subsequent claims, characterized in that the elastic elements (4, 4a, 5) have a base surface for engagement in a connecting rail (8).

5th

Apparatus according to claim 1 and / or one of the following, characterized in that the elastic element (4, 4a, 5) is formed in two or more parts, wherein the elastic region (4) comprises the orthodontic treatment device (3) and the second region is designed as a transfer bracket (5) which is fixedly connected on one side with the elastic region (4) and on the other side a the relief of Zahnok- klusal- or -inzisalflachen (7) adapted structure and / or an additional having elastic support element (10).

6th

Apparatus according to claim 1 and / or one of the following, characterized in that it has an additional gripping and / or repositioning device.

7th

Apparatus according to claim 1 and / or one of the following, in particular claim 5, characterized in that the transfer bracket (5) in the region of reduced support surfaces shopping, in particular the front teeth, on the orthodontic treatment device (3) opposite tooth surface cross-area.

8th.

Connecting rail for implementing at least one, preferably a plurality of orthodontic treatment devices preassembled on a mandibular arch model by means of one or preferably a plurality of devices according to claim 1 and / or at least one of the following, characterized in that the connecting rail (8) to the base surfaces of the elastic elements (4, 4a, 5), in particular the transfer bracket (5), corresponding receptacles for releasably connectable attachment of the devices.

9th

System for indirect bonding for orthodontic treatment devices, characterized by at least one single or multi-part elastic element (4, 4a, 5) which at least partially to the surface of at least one tooth (2) can be applied and a receptacle (15) for at least one orthodontic Treatment device (3), wherein the element (4, 4a, 5) the orthodontic treatment device (3) only in the head area (16) or in the area of a temporary gripping approach partially includes and in the surrounding area of the base surface of the orthodontic treatment device to be attached (3) is not necessary Has tooth surface contact, and a connecting rail (8) with the base surfaces of a plurality of elastic elements (4, 4a, 5) corresponding receptacles for releasably connectable attachment thereof.

10th

Method for indirect bonding for orthodontic treatment apparatus according to claim 1 and / or one of the following, characterized in that after taking the dental arch of the patient and preparing a dental arch model and fixation of the orthodontic treatment devices (3) on the dental arch model initially a one or more parts, at least partially elastic element (4, 4a, 5), at least partially on the surface of at least one tooth (2) can be applied and a receptacle for at least one orthodontic treatment device (3), in such a way attached to the orthodontic treatment device (3), that this only in the head area (12) or in the area partially encompasses and does not necessarily have tooth surface contact in the entire surrounding area of the adhesive base 9 of the orthodontic treatment device (3), wherein subsequently a connecting rail (8) with the base surfaces of the elastic elements (4, 4a, 5), in particular the transfer strap (5), All parts are removed from the dental arch model and placed on the natural dental arch of the patient after interim cleaning, disinfecting and sterilizing.

11th

Method for indirect bonding for orthodontic treatment devices according to claim 1 and / or one of the following, characterized in that after taking the dental arch of the patient and making a dental arch model on a saw model, a therapeutic set-up made on this fixed the orthodontic treatment devices (3) and subsequently at least one single-part or multi-part, at least partially elastic element (4, 4a, 5) which can be applied at least partially to the surface of at least one tooth (2) and has a receptacle for at least one orthodontic treatment device (3) the manner in which the orthodontic treatment device (3) is plugged in that it only partly covers it in the head region (12) or in the region of a temporary gripping attachment and does not necessarily have tooth surface contact in the entire surrounding region of the adhesive base (9) of the orthodontic treatment device (3) st, and then the orthodontic see treatment devices (3) with the elastic elements (4, 4a, 5), in particular the transfer straps (5), removed from the set-up model and implemented on the dental arch model, wherein then a connecting rail (8) with the base surfaces of the elastic Elements (4, 4a _f 5), in particular the transfer strap (5), brought into engagement, all parts removed from the dental arch model and placed on the natural dental arch of the patient after interim cleaning, disinfecting and sterilizing.

12th

Method for indirect bonding for orthodontic treatment devices, characterized in that constructed via a scan of the patient's dental arch, an impression of the dental arch or the real dental arch model, a virtual dental arch model and a virtual set-up model and / or virtual treatment devices (3) and or virtual elastic elements (4, 4a, 5), virtual transfer straps (5) and / or a virtual connecting rail (8) constructed, and the virtual treatment devices (3), elastic elements (4, 4a) and transfer straps (5) transferred to a virtual dental arch model, and then the treatment devices (3) produced according to the virtual data, elastic elements (4, 4a), transfer bracket (5) and connecting rail (8) real joined, cleaned, disinfected and sterilized and on the dental arch be transmitted to the patient.

13th

A method according to claim 12, characterized in that the virtual set-up model is produced from a scan of the real therapeutic set-up after impression of the patient's dental arch and preparation of a dental arch model using a saw model.

14th

A method according to claim 13, characterized in that the production by rapid prototyping or by CNC

Milling technique takes place.

15th

Method for producing a system for indirect bonding for orthodontic treatment devices according to claim 9, characterized in that after taking the dental arch of the patient and making a dental arch model and fixing the orthodontic treatment devices (3) on the dental arch model first a one or more parts, at least partially elastic Element (4, 4a, 5), which at least partially on the surface of at least one tooth (2) can be applied and a receptacle for at least one orthodontic treatment device (3), in such a way attached to the orthodontic treatment device (3) that it partially covers this only in the head region (12) or in the region of a temporary gripping attachment and does not necessarily have tooth surface contact in the entire surrounding region of the adhesive base 9 of the orthodontic treatment device (3), wherein subsequently a connecting rail (8) with the base surfaces the elastic elements (4, 4a, 5), in particular the transfer strap (5), is brought into engagement.

16th

Method for producing an indirect bonding system for orthodontic treatment apparatus according to claim 9, characterized in that by scanning the dental arch of the patient, an impression of the dental arch or a dental arch model, a virtual set-up model are generated from which a real set-up model, in particular by rapid prototyping, is formed on the the orthodontic treatment devices (3), the elastic elements (4, 4a, 5) and / or the transfer straps (5) and the connecting rail (8) can be fastened.

17th

A method for producing an indirect bonding system for orthodontic treatment apparatus according to claim 9, characterized in that virtual treatment devices (3) positioned and constructed and / or virtual elastic elements (4, 4a, 5), in particular transfer bracket (5) constructed and real can be placed on the real dental arch model, with a connecting rail (8) connectable and removable from the dental arch model and can be applied to the dental arch of the patient.

18th

A method for producing a system for indirect bonding for orthodontic treatment apparatus according to claim 9, characterized by at least one single or multi-part, at least partially elastic element (4, 4a, 5), which at least partially to the surface of at least one tooth (2) can be applied and a receptacle for at least one orthodontic treatment device (3), wherein the element (4, 4a, 5) partially covers the orthodontic treatment device (3) only in the head region (12) or in the region of a temporary gripping attachment and in the entire environment. rich of the adhesive base (9) of the orthodontic treatment device (3) does not necessarily have tooth surface contact,