WO2012168301A1

WO2012168301A1 - Orthodontic alignment rail, orthodontic alignment system, and use of the orthodontic alignment system in an orthognathic treatment method

Info

Publication number: WO2012168301A1
Application number: PCT/EP2012/060702
Authority: WO
Inventors: Katrin LEYGRAF
Original assignee: Leygraf Katrin
Priority date: 2011-06-10
Filing date: 2012-06-06
Publication date: 2012-12-13
Also published as: DE102011077391A1

Abstract

The invention relates to an orthodontic alignment rail, to an orthodontic alignment system, and to the use of the orthodontic alignment system in an orthognathic treatment method. The orthodontic alignment rail (SCU; SCU'; SCU"; SCO; SCU1; SC01; SCU2; SC02) has the shape of a shell, which comprises a cavity (KU; KO) for accommodating a plurality of teeth of a row of teeth of a jaw on the inside and a top surface (OSU; OSO), an inside surface (ISU; ISO), and an outside surface (ASU; ASO) on the outside. At least one orientation coding element (S1, S2, S3; S4, L1, C4; S5, S6; L5, L6; S1a, S1b, S2', C1, C2, C3; P1, P2, P3) for coding an orthognathic displacement is provided on the outside. At least one fastening element (BZ1; BZ2) for fastening during the orthognathic displacement is provided on the inside surface (ISU; ISO) and/or the outside surface (ASU; ASO).

Description

description

title

Orthodontic alignment rail. orthodontic alignment and use of the orthodontic alignment device in an orthognathic treatment procedure

The invention relates to an orthodontic alignment machine, an orthodontic alignment system and a use of the orthodontic alignment system in an orthognathic treatment procedure.

State of the art

The repositioning of rows of teeth with malpositions of the individual teeth for aesthetic or pathological reasons is usually achieved by wearing a so-called braces. Such braces have a variety of elements, such. As holders, archwires, ligatures, O-rings, etc., on. The attachment or readjustment of the braces is time consuming and tedious.

For some time, there have been orthodontic alignment rails in shell form of thin transparent plastic for largely invisible treatment of malocclusions, the healing success is achieved by applying a sequence of custom-made rails.

Fig. 6 is a perspective view of a lower jaw orthodontic alignment bar known from US 7,192,275 B2, and Figs. 7a), b), c) are schematic plan views of a lower jaw for explaining a treatment course in orthodontic treatment with a sequence of mandibular orthodontic alignment rails known from US 7,192,275 B2.

In Fig. 6, reference character UK denotes a human mandible, and reference S denotes an orthodontic alignment splint, which is commonly referred to as an orthodontic aligner. The alignment rail S has the shape of a shell having on the inside a cavity K for receiving a plurality of teeth of a row of teeth of the lower jaw UK. On the outside, an upper side surface OS, an inner side surface IS and an outer side surface AS are provided. When worn, the alignment rail S is slipped over the teeth of the lower jaw UK and forms a tooth shape corresponding to the plurality of teeth so as to aid in correcting the malformation by the bite during wear. The majority of teeth here is the entire lower jaw, but may be limited to a partial sequence in certain applications.

In many applications, an alignment rail for the lower jaw and a further alignment rail for the upper jaw are carried simultaneously. The teeth of the respective rows of teeth are clamped under pressure in the alignment rails, so that separate holding means are usually unnecessary. The alignment rails are usually formed of a thin film of a suitable elastomeric polymer.

In order to adapt the alignment rails, the actual state of the rows of teeth is recorded in a three-dimensional model by means of a special computer graphics method. Following on from this, a treatment target is defined as the target state and a series of treatment phases between the actual state and the target state. For each of these phases, the individual individual alignment rails are then produced and each carried over a certain period of time until the goal of the respective treatment phase is reached. Such phases usually last for several weeks. In the period of the treatment phase, the teeth are moved by applying pressure continuously in the predetermined direction. Once the goal of the treatment phase is achieved, an alignment splint is applied for the subsequent treatment phase until the next desired treatment goal is achieved, etc. The duration of the total treatment is usually between 9 and 15 months, depending on the degree of maldistribution.

As shown in FIGS. 7a), b), c), the row of teeth of the lower jaw UK of FIG. 7a develops from a faulted actual state UK1 via one or more intermediate states UK2 to a correctly set desired state UK3. In practice, the number of treatment stages is typically between 5 and 25 stages. Although good results can be achieved with a purely orthodontic treatment using such plastic alignment rails, it is inadequate in a number of patients, as the skeletal relationship between the maxilla and mandible is incorrect and therefore an orthognathic surgical procedure for dislocation one or both jaws is necessary.

In such an orthognathic surgical procedure usually splints are used, and an intra-operative and postoperative intermediate fixation between the lower jaw and upper jaw is usually realized with a so-called Schuchardt wire rail, which runs through the jaw tissue. In particular, the postoperative removal of such Schuchardt wire rail proves to be extremely painful in many patients.

US 2003/0065259 A1 discloses a method and apparatus for producing surgical splints used in such jaw surgery, and US 7,936,911 1 B2 discloses a planning method for optimizing skeletal symmetry in orthognathic surgical procedures.

Disclosure of the invention

The invention provides an orthodontic alignment rail according to claim 1.

Preferred developments are the subject of the respective subclaims. According to a preferred development, at least one pin and / or a receiving hole for receiving a pin is provided as the orientation coding element on the upper side surface.

According to a further preferred development, at least one symbol element and / or at least one pattern element is provided as the orientation coding element.

According to a further preferred development, the symbol element and / or the pattern element is assigned to a further orientation coding element in the form of a pin or a receiving hole for receiving a pin. According to a further preferred development, at least one replaceable pin is provided as the orientation coding element on the top surface.

According to a further preferred development, the fastening element has a mushroom-like shape with a collar-shaped widening for fixing a band or wire.

The invention also provides an orthodontic alignment system according to claim 7. According to a preferred development, at least one pin and / or a receiving hole for receiving a pin is provided as the orientation coding element of the alignment system on the first and / or second top surface.

According to a further preferred development, at least one symbol element and / or at least one pattern element is provided as the orientation coding element of the alignment system.

According to a further preferred development, the symbol element and / or the pattern element of the alignment system is assigned to a further orientation coding element in the form of a pin or a receiving hole for receiving a pin.

According to a further preferred development, one of the first and second alignment rails has a pin as the orientation coding element, the other of the first and second alignment rails having, as the orientation coding element, a receiving hole for receiving the pin and the pin and the receiving hole corresponding thereto inserted alignment system are engageable with each other.

According to a further preferred development, at least one exchangeable pin is provided as the orientation coding element on the first and / or second top side surface.

According to a further preferred development, the first and second fastening element have a mushroom-like shape with a collar-shaped widening for fixing a band or wire. The invention also provides a use of an orthodontic alignment system according to the invention in an orthognathic treatment method according to claim 14.

According to a further preferred refinement, after the first connection has been released and before the second connection has been formed, at least one orientation coding element is modified and / or removed and / or added

Advantages of the invention

Typically, the alignment of the rows of teeth of the two jaws is orthodontic before a separate orthognathic surgical step is performed to align the jaw or jaws. The idea underlying the present invention is to combine an orthodontic treatment technique with an orthognathic treatment technique, for which purpose a special modification of the hitherto customary alignment rails with orientation coding elements is carried out. The two jaws can be positioned in the ideal position for orthognathic surgery prior to surgery, using the orthodontic alignment splints and eliminating the need for additional attachment mechanisms. A sequence of several operation steps is possible, in which different ideal orientations are required, if the orientation of the two alignment rails is modifiable by modifying the orientation coding elements between the operation steps, wherein the respectively optimal orientations for the surgeon by changing or removing the pins and the fixation position is possible.

All this makes it possible to increase the well-being of the patient, to shorten the operation time and to save surgical material.

Finally, the inventive treatment method in conjunction with the alignment rail according to the invention, the planning time or simulation time is shortened because no different models for the orthodontic treatment and orthognathic treatment must be created.

Brief description of the drawings

Further features and advantages of the present invention will be explained below with reference to embodiments with reference to the figures. 1 is a partial cross-sectional view perpendicular to a row of mandibular teeth of an orthodontic alignment rail according to a first embodiment of the present invention; a partial cross-sectional view perpendicular to a mandibular tooth row of an orthodontic alignment system according to a second embodiment of the present invention; a partial cross-sectional view parallel to a mandibular tooth row of an orthodontic alignment system according to a third embodiment of the present invention; Fig. 4a), b) partial cross-sectional views parallel to a lower jaw row of an orthodontic alignment system according to a fourth embodiment of the present invention, wherein Fig. 4a) a first fixed state before a first jaw operation step and Fig. 4b) a first fixed state after the first and showing a second jaw operation step;

Fig. 5a), b) partial views perpendicular to a row of mandibular teeth of an orthodontic alignment rail according to a fifth and sixth embodiment of the present invention;

Fig. 6 is a perspective view of an orthodontic alignment splint for a mandible known from US 7,192,275 B2; and

Fig. 7a), b), c) are schematic plan views of a lower jaw to explain a

Course of treatment in an orthodontic treatment with a

Sequence of orthodontic alignment splints for a mandible, known from US 7,192,275 B2. Embodiments of the invention

In the figures, like reference numerals designate the same or functionally identical elements.

Fig. 1 is a partial cross-sectional view perpendicular to a lower jaw row of an orthodontic alignment rail according to a first embodiment of the present invention. In Fig. 1, reference numeral SCU denotes an orthodontic alignment rail made of plastic, which is provided for the lower jaw of a patient, wherein reference numeral ZU schematically a tooth of a row of teeth of the lower jaw is indicated. Although the alignment rail SCU extends over a plurality of teeth of the row of teeth of the lower jaw, the schematic partial cross-sectional view of the alignment rail SCU shows only the overlap of a single tooth CL for reasons of simplicity.

The cup-shaped alignment rail SCU has a cavity KU on the inside for accommodating the plurality of teeth of the row of teeth of the mandible and on the outside a surface side OSU, an inside surface ISU and an outside surface ASU forming a tooth sequential shape corresponding to the plurality of teeth. In particular, the top surface OSU is a bite support surface with a tooth shape when the alignment rail SCU is installed. The preparation of the alignment rails according to the embodiment is carried out by CAD technology, such as stereolithographic or three-dimensional printing, or casting processes or milling processes.

On the surface side OSU three pins S1, S2, S3 of different shape are provided as Orientierungskodierelemente, which also serve as spacers and placemarks. On the outer side surface ASU, a fastening element BZ1 is provided, which has a collar-shaped widening K1, which adjoins a cylindrical part Z1.

The pins S1, S2, S3 are fixed in the present case and provided from the same material as the alignment rail SCU, but can be interchangeable or shortened by a cutting step or removed, so modified, or be made of a different material if necessary , The fastener BZ1 is for fixed connection with another alignment rail SCO provided for the upper jaw, as will be explained below with reference to FIG.

2 is a partial cross-sectional view perpendicular to a lower jaw row of an orthodontic alignment system according to a second embodiment of the present invention.

In Fig. 2, in addition to the reference numerals already introduced, reference numeral SCO denotes an orthodontic alignment rail for the patient's upper jaw, which together with the orthodontic alignment rail SCU for the lower jaw constitutes an orthodontic alignment system according to the second embodiment of the present invention.

The alignment rail SCO has, analogous to the alignment rail SCU, a cavity KO on the inside for accommodating a plurality of teeth of a row of teeth of the patient's upper jaw and on the outside a top surface OSO, an inside surface ISO, and an outside surface ASO, which in the worn state one of the plurality of teeth of the Make mandible corresponding tooth shape.

Just as for the alignment rail SCU, the alignment rail SCO is shown only in partial cross-section with the overlap of a single tooth of the upper jaw row to simplify the illustration, but the alignment rail SCO, like the alignment rail SCU, actually extends over a plurality of teeth of the row of teeth of the upper jaw, which lies above the corresponding row of teeth of the lower jaw.

The alignment rail SCO also has on its outer side surface ASO a fastening element BZ2, which comprises a cylindrical part, which is adjoined by a collar-shaped widening K2. In the illustration of Fig. 2, an elastic fastening strip B1 is provided, which connects the fastening elements BZ1 and BZ2. On the surface side OSO of the alignment rail SCO, there is shown a stylus S4 as orientation coding element, which in the completely found state rests on the orientation coding element in the form of the stylus S3 of the alignment rail SCU. Further, on the surface side OSO of the alignment rail SCO, an orientation coding element in the form of a receiving hole L1 for receiving the pin is provided. - S2 of the alignment rail SCU is provided. In the fully oriented and aligned state, the pin S2 engages the receiving hole L1. The cohesion is ensured by the elasticity of the band B1 and prevents unintentional displacement by the engagement.

Once the fully aligned and tightly connected state between the alignment rails SCU and SCO is established, this condition forms the ideal starting point for an orthognathic jaw surgical procedure in which there is a spatial orientation change of at least one of the mandible and maxilla, as discussed later with reference to FIG. 4a ), b) will be explained.

3 is a partial cross-sectional view in parallel with a lower jaw row of an orthodontic alignment system according to a third embodiment of the present invention.

The orthodontic alignment system shown in Fig. 3 comprises an alignment rail SCU1 for the lower jaw, which has on the upper surface OSU as the orientation encoding two pins S5, S6 in corresponding receiving holes L5, L6 as Orientierungskodierelemente in the surface side OSO of the alignment rail SC01 for engage the upper jaw when the band B1 firmly connects the fasteners BZ1, BZ2 and exerts a pressure P on the alignment rails SCU1, SC01, which provides a firm cohesion. As previously explained, this is the ideal initial state for a jaw surgical procedure in which there is a spatial orientation change of at least one of the mandible and maxilla.

4 a), b) are partial cross-sectional views parallel to a lower jaw row of an orthodontic alignment system according to a fourth embodiment of the present invention, FIG. 4 a) showing a first fixed state before a first jaw operation step, and FIG. 4 b) showing a first fixed state after the first and second before a second jaw operation step.

In Figs. 4a), b), the mandibular alignment track is labeled SCU2 and the maxillary alignment track is SC02. In contrast to the previous embodiments, the alignment rail SCU2 has, as orientation coding elements, a permanently attached pin S2 'and a detachable pin S1a, wherein the latter is mounted in a locking element H1 for releasably locking the pin S1 a, for example a threaded sleeve.

In this example! For example, the upper jaw alignment rail SC02 has no pins and the pins S1 a, S2 'of the lower jaw alignment rail SCU2 rest only on the upper surface OSO of the alignment rail SC02.

In the locked state according to FIG. 4 a), a first jaw operating step takes place in which a first spatial orientation change takes place at least one of the upper jaw and lower jaw,

Subsequently, the fixed connection between the alignment rails SCU2 and SC02 is removed by releasing the elastic band B1, and the pin S1a of the alignment rail SCU2 for the lower jaw is replaced with the shorter pin S1b. Subsequently, the alignment rails SCU2, SC02 are in turn firmly connected to each other by attaching the band, and there is carried out a second jaw operation step in which a second spatial orientation change takes place at least one of the lower jaw and upper jaw.

In this type of treatment, it is possible to provide different initial orientations for successive jaw operation steps, which, for example, first target a translation of at least one of the jaws and then a rotation of at least one of the jaws.

Advantageously, between or after the individual jaw operation steps, the firm connection between the alignment rail SCU2 and SC02 can be removed easily and painlessly by releasing the elastic band B1, which contributes to the well-being of the patient.

5 a), b) are partial cross-sectional views perpendicular to a row of mandibular teeth of an orthodontic alignment rail according to a fifth and sixth embodiment of the present invention.

In the fifth embodiment according to FIG. 5 a), the alignment rail is denoted by the reference symbol SCU 'via the lower jaw, and in comparison with the alignment Management bar SCU the first embodiment in addition to the pins S1, S2 and S3 in addition to a respective the relevant pin S1, S2, S3 associated Orientärerungskodie- ing element C1, C2, C3, which contains instructions to the surgeon, for example in the form of characters and / or other symbols.

In the sixth embodiment shown in FIG. 5b), the lower alignment rail is designated by reference character SCU "and, unlike the alignment rail SCU of the first embodiment, has respective patterns P1, P2, P3 associated with the pins S1, S2 and S3, respectively For example, a grid-exact alignment or alignment change, if necessary, to perform.

Although the present invention has been described with reference to preferred embodiments, it is not limited thereto, but variously modifiable. The orientation coding elements pins can be provided on the outside of the shell of the upper row of teeth and / or the lower row of teeth and in principle assume any shape.

They can be made of the same material as the shell or made of a different material. The fastening mechanism may comprise any fastening elements which may be arranged both on the inner side surface and on the outer side surface or on both surfaces. The attachment between the fasteners can be realized not only by elastic bands, but also by screws, wires or other fasteners. In order to ensure a firm cohesion during the jaw operation steps, the alignment rails can be additionally fixed on the rows of teeth, for example by gluing, screws, clamps or other fastening mechanisms.

The coding of the various positions or orientations for the individual Kie feroperationsschritte can be achieved not only by the Orientierungskodierelemente shown, but by any shapes, colors, patterns, scripts or other representations. The alignment rails may have a homogeneous thickness and elasticity or have different thickness ranges or areas of different strength or elasticity.

Claims

claims

1. An orthodontic alignment rail (SCU; SCU ^1; SCU ";SCO;SCU1;SC01;SCU2; SC02), comprising: the shape of a shell which on the inside a cavity (KU; KO) for receiving a plurality of teeth of a dental arch of a jaw and an outside surface (OSU; OSO), an inside surface (ISU; ISO), and an outside surface (ASU; ASO); outside, at least one orientation encoder (S1, S2, S3, S4, L1, C4, S5, S6, L5 , L6; S1a, S1b, S2'C1, C2, C3; P1, P2, P3) for encoding an orthogonal dislocation, and wherein on the inner side surface (ISU; ISO) and / or the outer side surface (ASU; ASO) at least one fastener (BZ1; BZ2) is provided for attachment during orthognathic displacement.

2. Orthodontic alignment rail (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) according to claim 1, wherein as the orientation coding element (S1, S2, S3, S4, L1,

C4; S5, S6; L5, L6; S1a, S1b, S2'C1, C2, C3; P1, P2, P3) on the upper side surface (OSU) at least one pin (S1, S2, S3, S4, S5, S6, S1a, S1b, S2 ') and / or a receiving hole (L1, L5, L6) for receiving a pin (S1, S5, S6) is provided.

3. Orthodontic alignment rail (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) according to claim 1 or 2, wherein as the orientation coding element (S1, S2, S3, S4, L1, C4, S5, S6; L5, L6, S1a, Slb, S2'C1, C2, C3, P1, P2, P3) at least one symbol element (C1, C2, C3) and / or at least one pattern element (P1, P2, P3) is provided.

4. Orthodontic alignment bar (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) according to claim 3, wherein the symbol element (C1, C2, C3) and / or the pattern element (P1, P2, P3) corresponds to a further orientation coding element (S1, S2, S3, S4, L1, C4, S5, S6, L5, L6, S1a, S1b, S2'C1, C2, C3, P1, P2, P3) in the form of a pin (S1, S2 , S3) or a receiving hole (L1; L5, L6) for receiving a pin (S1, S5, S6).

5. Orthodontic alignment bar (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) according to any one of the preceding claims, wherein as the orientation coding element (S1, S2, S3; S4 ₍ L1, C4; S5, S6; L5, L6; S1a, S1b, S2'C1, C2, C3; P1, P2, P3) on the top surface (OSU; OSO) at least one exchangeable pin (S1, S2, S3; S4; S5, S6; S1a , S1 b, S2 ¹ ) is provided.

6. Orthodontic alignment rail (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) according to one of the preceding claims, wherein the fastening element (BZ1; BZ2) has a mushroom-like shape with a collar-shaped widening (K1; K2) Fixing a band (B1) or wire has.

7. An orthodontic alignment system comprising: a first alignment channel (SCU; SCU; SCU1; SCU2) having the shape of a shell having on the inside a first cavity (KU) for receiving a plurality of teeth of a row of teeth of the lower jaw and externally one first upper side surface (OSU), a first inner side surface (ISU) and a first outer side surface (ASU; ASO); a second alignment rail (SCO; SC01; SC02) having the shape of a shell internally having a second cavity (KO) for receiving a A plurality of teeth of a row of teeth of the upper jaw and externally a second Oberseitenfiäche (OSO), an inner side surface (ISO) and an outer side surface (ASO), wherein on the first and / or second alignment rail (SCU ';SCU';SCO; SCU1 SC01; SCU2; SC02) have at least one orientation coding element (S1, S2, S3; S4, L1, C4; S5, S6; L5, L6; S1a, S1b, S2 ^! C1, C2, C3; P1, P2; P3) for coding an orthognomic transfer is envisaged; and on the first and second alignment rails (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) on the first and second inside surfaces (ISU; ISO) and / or the first and second outside surfaces (ASU; ) at least one first and second fastening element (BZ1; BZ2) is provided for fastening during the orthognathic displacement; wherein the fasteners (BZ1, BZ2) are arranged such that when the alignment system is in place, a connection between the first and second alignment rails (SCU; SCU; SCO; SCU1; SC01; SCU2; SC02) is formed therethrough.

8. An orthodontic alignment system according to claim 7, wherein as said orientation coding element (S1, S2, S3, S4, L1, C4, S5, S6, L5, L6, S1a, S1b, S2'C1, 02, 03; P2, P3) on the first and / or second top surface (OSO) at least one pin (S1, S2, S3, S4, S5, S6, S1a, S1b, S2 ") and / or a receiving hole (L1, L5, L6) is provided for receiving a pin (S1, S5, S6).

The orthodontic alignment system according to claim 7 or 8, wherein as said orientation coding element (S1, S2, S3; S4, L1, 04; S5, S6; L5, L6; S1a, S1b, S2'C1, 02, 03; P1 , P2, P3) at least one symbol element (C1, 02, 03) and / or at least one outer element (P1, P2, P3) is provided.

10. The orthodontic alignment system according to claim 9, wherein the symbol element (01, 02, 03) and / or the pattern element (P1, P2, P3) is another orientation code element (S1, S2, S3, S4, L1, 04; S6; L5, L6; S1a, S1b, S2'C1, 02, 03; P1, P2, P3) in the form of a pin (S1, S2, S3) or a receiving hole (L1; L5, L6) for receiving a pin (S1, S5, S6) is assigned.

The orthodontic alignment system according to any one of claims 7 to 10, wherein the one of the first and second alignment rails (SCU, SCU1, SCO, SC01) is used as the orientation encoding element (S1, S2, S3, S4, L1, 04, S5, S6, L5 , L6; Sla, S1b, S2'C1, C2, 03; P1, P2, P3) has one pin (S2; S5, S6), the other one of the first and second alignment rails (SCU, SCU1; SCO; SC01) as the orientation coding element (S1, S2, S3, S4, L1, C4, S5, S6, L5, L6, S1a, S1b, S2'C1, C2, C3, P1, P2, P3) has a receiving hole (L1, L5 , L6) for receiving the pin (S; S5, S6) and wherein the pin (S2; S5, S6) and the corresponding receiving hole (L1; L5, L6) are engageable with each other when the alignment system is inserted.

The orthodontic alignment system according to any one of claims 7 to 11, wherein as the orientation coding element (S1, S2, S3, S4, L1, 04, S5, S6, L5, L6, S1a, S1b, S2'C1, C2, C3 P1, P2, P3) on the first and / or second top surface (OSU) at least one replaceable pin (S1, S2, S3, S4, S5, S6, S1a, S1b, S2 ') is provided.

The orthodontic alignment system according to any one of claims 7 to 12, wherein said first and second attachment members (B21; BZ2) have a mushroom-like shape with a collar-shaped widening (K1; K2) for fixing a band (B1) or wire.

14. Use of the orthodontic alignment system according to any one of claims 7 to 13 in an orthognathic treatment method.