Dentistry – Orthodontics – Means to transmit or apply force to tooth
Reexamination Certificate
2000-08-25
2002-04-09
O'Connor, Cary E. (Department: 3732)
Dentistry
Orthodontics
Means to transmit or apply force to tooth
Reexamination Certificate
active
06368106
ABSTRACT:
FIELD OF THE INVENTION
The present invention generally relates to the field of the advancement of the mandible or lower jaw in typically an orthodontic treatment setting (e.g., to treat an orthodontic patient with a Class II malocclusion, to treat an orthodontic patient with a Class III malocclusion) and, more particularly, to various mandibular advancement devices which include a mandibular advancement incline for affecting mandibular advancement and which may be fixedly attached to one or more teeth of the patient.
BACKGROUND OF THE INVENTION
Class II malocclusions exist when an individual's upperjaw or maxilla protrudes further out from the individual's face than his/her lowerjaw or mandible. Conversely, Class III malocclusions exist when an individual's lower jaw or mandible protrudes further out from the individual's face than his/her upper jaw or maxilla. Treatment of a Class II malocclusion may entail exerting a functional orthopedic force on the individual's lowerjaw or mandible so as to advance the same in a mesial or “outward” direction.
One way in which orthodontic treatment forces have been applied to address a Class II malocclusion is through a facebow to retract the upper jaw or maxilla to match the position of a retruded mandible. As 70% of Class II malocclusions are due to a deficient mandible, it is more beneficial to the patient to advance the mandible than to retract the maxilla. This results in a better profile, and a more balanced facial appearance, compared to orthodontic techniques which retract the maxillary teeth to match the position of a retrusive mandible. The disadvantage of this approach is that the nose continues to grow, when the maxilla is retracted, and the nose becomes unduly prominent in the profile, while the maxilla and mandible are retracted to a retrusive position. This approach may align the anterior teeth, but at the same time, is detrimental to the patient's facial appearance. The alternative to a functional orthopedic approach to correct a mandibular retrusion would entail a combination of orthodontic and surgical correction to align the teeth and advance the mandible to match the correctly positioned maxilla. Orthopedic correction achieves a similar result by correcting the mandibular position without surgery in many cases. It is important to integrate orthopedic techniques with conventional orthodontic techniques, to allow the simultaneous correction of skeletal and dental abnormalities.
Another option which has been utilized to affect mesially-directed mandibular advancement is through what has been characterized in the orthodontic industry as “bite blocks.” Bite blocks generally include a planar surface which is disposed at an angle relative to an individual's occlusal plane when the bite blocks are installed on the patient. Typically a pair of bite blocks are installed on the occlusal surface of the patient's upper dental arch on opposite sides thereof (i.e., one on the right side of the upper dental arch, and another on the left side of the upper dental arch), while a pair of bite blocks are also installed on the occlusal surface of the patient's lower dental arch on opposite sides thereof (i.e., one on the right side of the lower dental arch, and another on the left side of the lower dental arch). Each of these bite blocks are installed so that there is a camming-like action between the two bite blocks which are occlusally installed on the patient's upper arch and their corresponding bite blocks which are occlusally installed on the patient's lower arch.
Both fixed and removable attachment techniques have been suggested for bite blocks generally of the above-noted type. “Fixed” in the orthodontic treatment sense and also as used herein means that a particular appliance is installed on the orthodontic patient in such a manner so that at least in theory the orthodontic patient will not be able to readily remove the appliance, but so that the appliance may be removed by the orthodontic practitioner utilizing the proper tool(s). “Removable” in the orthodontic treatment sense and also as used herein means that a particular appliance is installed on the orthodontic patient in such a manner so that the appliance may be readily removed by both the orthodontic patient and practitioner.
Since the beginning of the twentieth century, orthopedic appliances have traditionally been removable by the patient, therefore being dependent on patient cooperation to achieve the beneficial effects of treatment. The improvements of the present invention addressed below adapt the principles of orthopedic correction, already proven in removable appliance techniques, to fixed orthopedic appliances, thus allowing better control, and better results to be achieved by the unrestricted full time wear of orthopedic appliances.
BRIEF SUMMARY OF THE INVENTION
The present invention generally relates to the advancement of the mandible in typically an orthodontic treatment setting and, more particularly, to the manner in which one or more components used to affect mandibular advancement are assembled for installation on a patient. Both mesial advancement (i.e., treatment of Class II malocclusions) and distal advancement or retraction (i.e., treatment of Class III malocclusions) of the mandible may be affected utilizing principles of the present invention. Nomenclature which will be used herein to describe the various aspects of the present invention defines the corresponding structure/step in relation to the “installed” position or to the position which is assumed within the patient's mouth, and further conforms to the way in which such terms are commonly used in the dental or orthodontic practice to describe particular surfaces of the teeth and orthodontic appliances used in combination therewith and/or orientations relating thereto.
A first aspect of the present invention is a mandibular advancement system which includes a casting form. Multiple options are provided in relation to the particular manner in which a mandibular advancement incline surface is mounted within a patient's mouth through use of this particular casting form. The casting form of this first aspect includes a casting form occlusal surface (e.g., on the “occlusal” side of the casting form when in the patient's mouth), a casting form buccal surface (e.g., on the “buccal” side of the casting form when in the patient's mouth), a casting form lingual surface (e.g., on the “lingual” side of the casting for m when in the patient's mouth), and a casting form mandibular advancement incline for at least facilitating mandibular advancement. Typically the casting form mandibular advancement incline will be disposed on either the mesial or distal end of the casting form. One of these casting forms may be installed on one or both sides of the patient's upper dental arch, on one or both sides of an patient's lower dental arch, or on one or both sides of both of the patient's upper and lower dental arches. These various options will be discussed in more detail below, as well as the various ways in which the installation may be affected.
The casting form occlusal, buccal, and lingual surfaces, as well as the mandibular advancement incline, collectively define a hollow repository of sorts (e.g., a hollow, three-dimensional generally wedge-shaped structure). Disposed within this repository of the casting form is a material which has been polymerized to provide a desired degree of rigidity thereto. Typically this material will be provided to the casting form in somewhat of a “fluid” or “flowable” state (e.g., a paste), such that one could think of the casting form as a “bathtub” or trough of sorts for retaining this fluid-like or flowable material therein for subsequent polymerization. In any case, the casting form is installed on the desired side of the desired dental arch of the patient such that this now polymerized material at least projects toward at least the occlusal surface of at least two or more teeth in the
Marsh & Fischmann & Breyfogle LLP
O'Connor Cary E.
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