Dentistry – Apparatus – Having gauge or guide
Reexamination Certificate
2000-11-03
2001-11-27
Lewis, Ralph A. (Department: 3732)
Dentistry
Apparatus
Having gauge or guide
Reexamination Certificate
active
06322359
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to dental articulation. More particularly, the present invention pertains to methods for use in dental articulation which use digital data that corresponds to images of a patient's upper and lower dental arches.
DESCRIPTION OF THE RELATED ART
Dentists, orthodontists, prosthodontists and others engaged in various fields of dentistry often have use for a model or replica of selected areas of a patient's oral cavity. For example, a dentist or prosthodontist may desire to have a model of an area of a patient's oral cavity where one or more teeth are missing or damaged, so that suitable replacement teeth may be made in the lab using the model as a guide. In practice, the replacement teeth may be fitted by trial and error on the model and adjusted in size and shape as needed until a satisfactory size and shape are attained.
As another example, orthodontists often use models of a patient's teeth to study malformations of the teeth and jaws and plan a course of treatment. In some instances, the orthodontist may use models to trial fit one or more orthodontic appliances that will be used in the oral cavity to move teeth to desired positions. In other instances, models may be used to pre-position a set of orthodontic brackets and associated archwires that are later affixed to the patient's actual dental arches by a technique known as indirect bonding. Models are also used by orthodontists as well as other dental practitioners to serve as a permanent record of a patient's teeth before and after treatment, and in some instances at selected intervals during the treatment program.
The use of dental models provides significant advantages for both the dental practitioner and the patient. Models enable the dental practitioner to adjust the shape and size of replacement teeth and tooth restorations, to fabricate custom appliances, to adjust the position of standard appliances (e.g., indirect bonding), to diagnose patient cases, to plan for oral surgery, and for other like purposes, in the practitioner's laboratory or in an outside laboratory as desired and during a time that is most convenient for the dentist or lab personnel. Moreover, such work can be carried out without requiring the patient to wait in the dental chair. For example, once a satisfactory fitting of replacement teeth, restoration or orthodontic appliances is obtained on a patient model, the replacement teeth, restoration or orthodontic appliances can be readily installed in the patient's oral cavity with few or no additional adjustments.
Oftentimes, it has been advantageous to use a mechanical device called an articulator in conjunction with the models to replicate movement of the patient's lower jaw, i.e., mandible, about the temporal mandibular joint or oral hinge axis. Such articulators include, among others, the SAM II brand articulator from Great Lakes Orthodontics, LTD, Buffalo, N.Y.; Hanau articulator available from Henry Shein, Port Washington, N.Y.; articulators available from Whip-Mix Corp. of Louisville, Ky.; articulators available from Panadent of Grand Terrace, Calif.; as well as the articulator described in U.S. Pat. No. 5,320,528. Articulators are useful for the dental practitioner in the study and correction of the patient's occlusion, with the aim of developing the optimal harmonious occlusal relationship of the patient's dentition. The articulator assists in establishing the optimal occlusal relationship by assisting the practitioner in the determination of proper occlusal contacts and optimum cusp-fossa relationships between the teeth of the patient's upper and lower jaws.
In general, conventional articulators use a model of the patient's upper dental arch and a model of the patient's lower dental arch. To obtain the models, an impression of the patient's upper dental arch and lower dental arch is first obtained. To prepare an impression of the upper arch, a quantity of curable dental impression material is placed in an impression tray, and the tray is then positioned in the patient's oral cavity such that the impression material fills and surrounds the teeth vestibule, and adjacent gingival, i.e., gum, regions of the upper arch. Once the impression material has cured to a sufficient degree, the impression material along with the tray is removed from the oral cavity. An impression of the patient's lower dental arch is obtained in a similar manner.
To make a dental model from each impression, a second curable material is poured or otherwise placed in the cured impression material. After the second material has sufficiently cured, the impression material is removed from the resulting models. When made properly, the models provide an accurate physical replica of the patient's upper and lower teeth as well as adjacent portions of the patient's gingiva and attachment mucosa.
In addition to the two dental models, a bite impression of the patient's upper and lower dental arches is obtained. The bite impression is often obtained using a wax bite plate. As the patient's dental arches are closed, an impression of the cusps of the upper and lower dental arches is simultaneously formed on the wax bite plate which serves to record the relative position between the upper and lower dental arch when the jaws are closed.
In addition, a facebow with a bite fork is used to provide a record of the spatial orientation of the patient's upper dental arch to the ear canals, the latter of which are located a certain distance from the patient's mandibular condyles. One method of using a facebow involves placing a compound material such as dental wax or impression material onto all or a portion of one side of a bite fork. Next, the bite fork is positioned in the patient's oral cavity such that the impression compound is in secure contact with some or all of the cusps of the patient's upper teeth to make an impression of such teeth. Next, a facebow is placed into position such that ear pieces of the facebow fit snugly into the patient's outer ear canals. A nasal support connected to the facebow is then adjusted so that the facebow lies parallel to the Frankfort horizontal plane at the same time that the nasal support is resting in the Nasian notch with the nasal support extending along an axis thereof that lies in the patient's sagittal plane.
Next, the patient's jaws are closed onto the bite fork with supporting material such that the impression on the upper side of the bite fork is in snug, complemental engagement with the cusps of the patient's upper teeth. A jig is then connected between the facebow and an arm of the bite fork that extends outwardly from the patient's mouth. The jig includes adjustable connecting arms and couplers which are tightened once the impression on the bite fork is in snug contact with the cusps of the patient's upper teeth and the facebow has not been inadvertently moved from its previous position in parallel relationship to the Frankfort horizontal plane. The bite fork is placed relative to the upper teeth such that it is used to render an imprint of tooth anatomy for relocating the facebow and jig in a mechanical articulator as described below.
The facebow with the jig provide a mechanical record of the spatial orientation of the patient's upper dental arch to the patient's ear canals and thus to the patient's mandibular condyles. The facebow and jig can then be used to properly position the model that replicates the patient's upper dental arch on the dental mechanical articulator. In some cases, the articulator may be provided with mounting adapters so that only the jig and not the facebow is needed to properly position and mount the model of the patient's upper dental arch on the mechanical articulator.
In brief overview, many mechanical articulators include an upper member and a lower member that are connected together by a pair of pivotal couplings (such as ball and socke
Caruso Joseph M.
Dufour Patrick B.
Hansen James D.
Jordan Russell A.
Nissenbaum Baruch
3M Innovative Properties Company
Christoff James D.
Lewis Ralph A.
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