U.S. patent application number 09/079869 was filed with the patent office on 2002-12-12 for force generating device useful in orthodontic appliances.
Invention is credited to CLARK, WILLIAM J., TRINCO, THOMAS A. JR., WATT, DAVID E..
Application Number | 20020187453 09/079869 |
Document ID | / |
Family ID | 22153320 |
Filed Date | 2002-12-12 |
United States Patent
Application |
20020187453 |
Kind Code |
A1 |
CLARK, WILLIAM J. ; et
al. |
December 12, 2002 |
FORCE GENERATING DEVICE USEFUL IN ORTHODONTIC APPLIANCES
Abstract
A force generating device is described which includes an
elastomeric force generating member. Preferably the elastomeric
member is a elastomeric polymer tube. Each end of the tube can be
fitted over collars. Attached to one collar is a piston and formed
within the other collar is an orifice for slidably receiving the
piston. When compressed, the force generating device will attempt
to return to its original undeformed shape thus exerting a force
along a longitudinal axis. Preferably, the force generating device
is employed in an orthodontic assembly. For example, the force
generating device can be employed in an orthodontic assembly for
developing a patient's arch.
Inventors: |
CLARK, WILLIAM J.; (LUNDIN
LEA, GB) ; TRINCO, THOMAS A. JR.; (EVERGREEN, CO)
; WATT, DAVID E.; (BOULDER, CO) |
Correspondence
Address: |
SHERIDAN ROSS PC
1560 BROADWAY
SUITE 1200
DENVER
CO
80202
|
Family ID: |
22153320 |
Appl. No.: |
09/079869 |
Filed: |
May 15, 1998 |
Current U.S.
Class: |
433/18 |
Current CPC
Class: |
A61C 7/36 20130101; A61C
7/00 20130101; A61C 7/282 20130101 |
Class at
Publication: |
433/18 |
International
Class: |
A61C 003/00 |
Claims
What is claimed is:
1. A force generating device comprising: (a) an elastomeric member;
(b) a first collar for receiving a first end of said elastomeric
member; (c) a second collar for receiving a second end of said
elastomeric member; (d) an orifice for receiving a piston wherein
said orifice is operationally attached to said first collar; and
(e) a piston which is slidably engageable into said orifice wherein
said piston is operationally attached to said second collar;
wherein when said force generating device is assembled, said
elastomeric member operationally connects said first collar and
said second collar and wherein said piston is slidably engaged
within said orifice.
2. The force generating device of claim 1, wherein said force
generating member is an elastomeric polymer tube having one end
which frictionally engages the outer surface of said first collar
and having a second end which frictionally engages the outer
surface of said second collar.
3. The force generating device of claim 2, wherein said first
collar and said second collar have ribbed outer surfaces in order
to enhance the frictional engagement between inner surfaces of said
elastomeric polymer tube and said outer ribbed surfaces of said
collars.
4. The force generating device of claim 1, further comprising a
connector for interconnecting said force generating device with a
tooth of an orthodontic patient, said connector comprising: (i)
means for attaching said connector to a tooth; (ii) a first segment
extending at least distally from said means for attaching; (iii) a
second segment interconnected with said first segment and extending
at least gingivally from said first segment; and (iv) a third
segment interconnected with said second segment and extending at
least mesially from said second segment.
5. The force generating device of claim 1, wherein said force
generating device is part of an appliance selected from the group
consisting of lingual arch developers, labial arch developers and
distallizing appliances.
6. The force generating device of claim 1, wherein said second
collar is operationally attached to an arch wire.
7. The force generating device of claim 2, wherein said first
collar includes a first end stop and said second collar includes a
second end stop and wherein said first end of said elastomeric
polymer tube is limited in axial movement by said first end stop
and wherein said second end of said elastomeric polyer tube is
limited in axial movement by said second end stop.
8. The device of claim 4, wherein said means for attaching said
connector to a tooth comprises: (a) a band attached to a tooth of
an orthodontic patient, said band having a first band tube attached
thereto; (b) a first post slidably interconnectable with said first
band tube.
Description
[0001] This application incorporates by reference in their entirety
U.S. patent application Ser. No. 08/632,682, filed on Apr. 16, 1996
and entitled "LINGUAL ORTHODONTIC ASSEMBLY FOR ARCH DEVELOPMENT AND
COMPONENT PARTS USEFUL THEREWITH", which is a continuation-in-part
of abandoned U.S. patent application Ser. No. 08/438,761, filed on
May 11, 1995 and entitled "LINGUAL ARCH DEVELOPING ORTHODONTIC
ASSEMBLY," which is a continuation-in-part of U.S. Pat. No.
5,443,384, filed Apr. 29, 1994, issued Aug. 22, 1995, and entitled
"ORTHODONTIC ASSEMBLY AND METHOD".
FIELD OF THE INVENTION
[0002] The present invention generally relates to the field of
force generating devices and, more particularly, force generating
devices useful in orthodontic appliances, including appliances
useful in developing the arch of an orthodontic patient.
BACKGROUND OF THE INVENTION
[0003] Force generating devices, such as springs, elastic bands and
archwires, have long been employed in orthodontics. There is a need
for improved forced generating devices which provide for ease of
use, ease of assembly, ease of adjustment and safety.
SUMMARY OF THE INVENTION
[0004] In accordance with the present invention, a force generating
device is provided which includes an elastomeric member; a first
collar for receiving a first end of the elastomeric member; a
second collar for receiving a second end of the elastomeric member;
an orifice, which is part of or operationally attached to the first
collar, for receiving a piston; and a piston which is slidably
engageable into the orifice. The piston is operationally attached
to the second collar. When the force generating device is
assembled, the elastomeric member operationally connects the first
collar and the second collar and the piston is slidably engaged
within the orifice.
[0005] The force generating member is preferably an elastomeric
polymer tube having one end which frictionally engages the outer
surface of the first collar and having a second end which
frictionally engages the outer surface of the second collar.
Preferably, the first collar and the second collar have ribbed
outer surfaces in order to enhance the frictional engagement
between inner surfaces of the elastomeric polymer tube and the
outer ribbed surfaces of the collars. Preferably, the first collar
includes a first end stop and the second collar includes a second
end stop and the first end of the force generating member is
limited in axial movement by the first end stop and the second end
of the force generating member is limited in axial movement by the
second end stop.
[0006] In one embodiment, the force generating device can be
operationally interconnected with a tooth of an orthodontic
patient. The device for interconnecting preferably includes a
"trombone-slide" shaped connector which includes means for
attaching the connector to a tooth; a first segment extending at
least distally from the means for attaching; a second segment
interconnected with the first segment and extending at least
gingivally from the first segment; and a third segment
interconnected with the second segment and extending at least
mesially from the second segment. The means for attaching the
connector to a tooth can comprise a band attached to a tooth of an
orthodontic patient, the band having a first band tube attached
thereto, and a first post slidably interconnectable with the first
band tube.
[0007] The force generating device can be incorporated into a
variety of appliances, including appliances selected from the group
consisting of lingual arch developers, labial arch developers and
distallizing appliances. For example, in an arch developer the
second collar is operationally attached to an arch wire.
[0008] The force generating device of the present invention can be
employed as part of a connector. Preferably the connector includes
as least one post which is removably insertable into a tube on a
patient's tooth (e.g, via an orthodontic band attached to the
patient's tooth). The connector also includes at least one
generally horizontal or mesio-distally extending hollow tube which
provides for an interface with an orthodontic appliance (e.g., the
force generating device of the present invention, a lingual arch, a
palatal expander, a Nance button, a bite block). When the connector
interfaces with a force generating device, the hollow tube can be
employed as the first collar and/or orifice. Typically, the
connector will utilize two generally occlusal-gingivally extending
posts (i.e., which are mesio-distally displaced) which are
disposable in two generally occlusal-gingivally extending tubes
(i.e., which are mesio-distally displaced) associated with a
patient's tooth.
[0009] For certain orthodontic treatment applications (e.g.,
mesially-directed arch expansion from the lingual or hereafter
lingual arch development) it may be desirable to dispose the noted
horizontal tube gingivally. One embodiment which provides a
gingivally disposed horizontal tube includes a first segment which
is interconnected with the post(s) and extends at least generally
distally from the post (e.g., the first segment may also extend
occlusally and/or gingivally). A second segment of the connector is
interconnected with the first segment and extends at least
generally gingivally from the first segment (e.g., the second
segment may also extend mesially and/or distally, such as by being
generally semicircular, i.e., such that the second segment would
initially extend distally and gingivally along an arcuate path, and
then mesially and gingivally along an arcuate path). Finally, a
third segment of the connector is interconnected with the second
segment and extends at least generally mesially from the second
segment (e.g., the third segment may also extend occlusally and/or
gingivally). At least the mesial-most portion of this third segment
is the hollow tube. Preferably, the hollow tube is the orifice
which receives the piston of the force generating device. One
configuration which is encompassed by the above-described connector
is a generally trombone-shaped segment inter-connected with the
post(s) (either integrally or by some appropriate attachment).
[0010] The above-described embodiment may contain a variety of
additional features. For instance, a fourth segment may be
cantilevered from the first segment and extend mesially beyond the
first post a short distance, such as to provide a handle for
installing the connector (e.g., extending about 3 mm mesially
beyond the mesial-most post). This fourth segment may also be
curved to generally follow the surface of the adjacent tooth (e.g.,
the lingual). The connector may include another generally
horizontally disposed or mesio-distally extending tube. One tube
may be gingivally disposed as noted above, while this second
horizonal tube may be more occlusally disposed. This may be
affected by having this second generally horizontal tube extend
mesially from the first segment of the connector.
[0011] Another feature which may be incorporated into the
above-described embodiment is that the third segment may be more
lingually disposed than the first segment. This may be effected by
having the second segment "spiral" in both a gingival and lingual
direction. Moreover, this may be effected by having the second
segment be disposed at an angle relative to an occlusal-gingivally
extending reference plane (e.g., at an angle of about
45.degree.).
[0012] One use for the above-described force generating device
and/or connector is in lingual arch development. Lingual arch
development involves the application of a generally
mesially-directed force on the lingual arch of an orthodontic
patient. This may be affected by having a lingual arch slidably
interconnected with two anchor teeth, one on each side of a
patient's mouth. It may be desirable to limit or control in some
respect the mesial advancement of the lingual arch relative to
these anchor teeth. The structure of the above-described embodiment
may be adapted to provide this feature without adversely affecting
performance of the lingual arch developer by interconnecting the
force generating device of the present invention with the
above-noted connector.
[0013] The above-described connector may be adapted for use in
conjunction with other types of orthodontic treatments. In some
cases it may be desirable to incorporate a fourth segment which is
cantilevered from the first segment and extends mesially a distance
whereby if this fourth segment were adapted to the lingual of a
patient (e.g., bent to follow the lingual of the patient's
corresponding dentition), the free end of the fourth segment would
be at least at and preferably slightly beyond the midline of the
patient's dentition. One use of this type of fourth segment is to
adapt the fourth segment to the lingual of the desired dentition of
the orthodontic patient. Installing a connector on each side of the
patient's mouth then results in two of these fourth segments being
in an overlapping relation at generally the patient's midline. In
this configuration, one may attach the two free ends of the two
fourth segments together. Various types of bends may then be placed
in one or both of these fourth segments to apply desired
orthodontic treatment forces to the corresponding dentition.
Another option is to let the free ends of the two fourth segments
act independently of each other by not joining them together such
that both remain independently active. In this overlapping
arrangement, it should be appreciated that the fourth segment could
be bent so as to be more gingivally disposed as well if such would
be desirable or required for certain applications.
[0014] Another use of the above-noted type of fourth segment when a
connector is installed on each side of the patient's mouth is to
bend both fourth segments in a manner such that their respective
free ends are disposed generally proximate to the forward portion
of the orthodontic patient's mouth but at a location which is away
from the teeth. In this position the fourth segments may provide a
frame of sorts for a frontal anchorage which does not adversely
affect tooth position since the anchorage is not directly on the
patient's tooth or teeth (e.g., an acrylic may be molded over the
free end portions of the two fourth segments, which acrylic will
engage the patient's soft tissue but not the patient's teeth to
provide the desired anchorage for other orthodontic treatment
forces being applied to the patient). Mounting a connector on each
side of the patient's upper dentition will further allow the fourth
segments to be bent to extend up to the vault of the patient's
palate. This provides a desirable mounting for certain palatal
expanders.
[0015] Another aspect of the present invention relates to a lingual
orthodontic assembly. A generally mesio-distally extending tube is
lingually attached to a tooth on each side of the orthodontic
patient's mouth. This may be provided by installing one of the
above-described connectors on each side of the patient's mouth. As
such, it should be appreciated that various aspects of the present
invention may be used combinatively as well as singularly. The ends
of a lingual arch are typically compressed toward each other (e.g.,
for arch expansion) and inserted into the associated mesio-distally
extending tube such that the arch exerts an expansive (relative to
the patient's midline) force on the patient's corresponding
dentition. Two mountings (e.g., hooks) are provided on at least one
side of the orthodontic assembly. One of these mountings is
associated with the tooth on which one of the mesio-distally
extending tubes is installed. The other may be associated with
another tooth on the same side of the patient's mouth, but is more
preferably associated with the lingual arch. A torquing member is
attached to and extends between each of these mountings to apply a
torquing force to at least the tooth on which the mesio-distally
extending tube is installed. This may be affected by wrapping the
torquing member about the horizontal tube and/or the lingual arch.
Appropriate torquing members include elastics (e.g., energy chain
elastics). In the case where the above-described connector is used,
the torquing member would be wrapped around both the third segment
of the connector and then the sectional. It should be appreciated
that this aspect of the invention could be incorporated on only one
side of the patient's mouth, but would preferably be used on both
sides of the patient's mouth.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] FIG. 1 illustrates a force generating device incorporated
into a lingual arch developer and includes a magnified view of the
force generating device.
[0017] FIG. 2 illustrates a lingual arch developer with a force
generating device.
[0018] FIG. 3 illustrates a lingual arch developer with a force
generating device.
[0019] FIG. 4 illustrates the "trombone-shaped" connector with dual
posts with detents.
[0020] FIG. 5 illustrates a connector with an upper extension.
[0021] FIG. 6 illustrates another embodiment of a connector with an
upper extension.
[0022] FIG. 6A illustrates a ribbed collar.
[0023] FIG. 6B illustrates a ribbed collar.
[0024] FIG. 7A is a perspective view of one embodiment of a lingual
arch developer orthodontic assembly in relation to an orthodontic
patient.
[0025] FIG. 7B is a side view of the assembly of FIG. 7A in the
installed position.
[0026] FIG. 7C is a top view of the assembly of FIG. 7A in the
installed position.
[0027] FIG. 7D is a side view of the assembly of FIG. 7A which
illustrates the installation of the assembly on the patient.
[0028] FIG. 8A is a perspective view of another embodiment of a
lingual arch developer orthodontic assembly in relation to an
orthodontic patient.
[0029] FIG. 8B is a side view of the assembly of FIG. 8A which
illustrates the installation of the assembly on the patient.
[0030] FIG. 8C is a perspective view of the assembly of FIG. 8A
with an additional pair of helices.
[0031] FIG. 8D is a side view of the assembly of FIG. 8C.
[0032] FIG. 9 is a perspective view of another embodiment of a
lingual arch developer orthodontic assembly in relation to an
orthodontic patient.
[0033] FIG. 10A is a partial, exploded, perspective view of another
embodiment of a lingual arch developer orthodontic assembly.
[0034] FIG. 10B is a side view of the assembly of FIG. 10A which
illustrates the telescoping nature of the developer of FIG.
10A.
[0035] FIG. 10C is a perspective view of a connector used with the
lingual arch developer of FIG. 10A.
[0036] FIG. 11 is a side view (looking labially) of another
embodiment of an orthodontic connector, such as for a lingual arch
developer.
[0037] FIG. 12 is an end view (looking distally) of the connector
of FIG. 11.
[0038] FIG. 13 is a side view (looking labially) of another
embodiment of an orthodontic connector, such as for a lingual arch
developer.
[0039] FIG. 14 is an end view (looking distally) of the connector
of FIG. 13.
[0040] FIG. 15 is a cross-sectional view (looking labially) of
another embodiment of a connector for a lingual arch developer.
[0041] FIG. 15A is a partial cross-sectional view of the
"resistance" position of the ligature assembly from the connector
of FIG. 15.
[0042] FIG. 16 is a cross-sectional view (looking labially) of
another embodiment of an orthodontic connector, such as for a
lingual arch developer.
[0043] FIGS. 17A-C are views of another embodiment of an
orthodontic connector for providing an interface between a tooth
and an orthodontic appliance, such as a lingual arch developer.
[0044] FIG. 18A is a side view of an end section for use with any
of the above-described orthodontic connectors.
[0045] FIG. 18B is a side view of an assembly which ligates the
lingual arch and which also generates a torquing force.
[0046] FIG. 18C are views of various embodiments of elastics for
use in the ligature assembly of FIG. 18B.
[0047] FIGS. 19A-B are views of another embodiment of an
orthodontic connector for providing an interface between a tooth
and an orthodontic appliance, such as a lingual arch developer.
[0048] FIGS. 20A-B are views of one application for the connector
of FIGS. 19A-B.
[0049] FIG. 21 is a side view of another application of the
connector of FIGS. 19A-B.
[0050] FIGS. 22A-B are views of another embodiment of a connector
for providing an interface between a tooth and an orthodontic
appliance, such as a lingual arch developer.
[0051] FIG. 23 is a side view of another embodiment of a lingual
arch developer which utilizes magnets.
[0052] FIG. 24 is a perspective view of one embodiment of a magnet
which may be used with the lingual arch developer of FIG. 23.
DETAILED DESCRIPTION
[0053] As noted above, lingual arch development may be affected
utilizing a lingual arch which accommodates the exertion of a
generally mesially directed force lingually on a patient's arch and
which comprises another aspect of the present invention. That is,
this aspect of the present invention generally relates to lingual
arch development and more specifically relates to lingual arches
which accommodate the application of a generally mesially directed
force lingually to a patient's arch. A number of new orthodontic
assemblies, including new lingual arch designs, as well as
orthodontically-related procedures, have evolved which are useful
in utilizing this application of a mesially-directed treatment
force to the lingual arch of an orthodontic patient.
[0054] In one embodiment of this lingual arch development aspect of
the present invention, such relates to the application of a
generally mesially-directed force to a generally U-shaped lingual
arch, such as the lingual arch configurations discussed below. The
lingual arch is preferably slidably interconnected with each side
of a jaw of an orthodontic patient undergoing treatment. For
instance, at least one horizontal tube may be attached to teeth on
opposite sides of the jaw being treated. The mesially-directed
force may then be applied to the lingual arch to affect mesial
movement of the lingual arch and thus part of the patient's arch
relative to at least one reference point(s) (e.g., the teeth on
which the tubes are installed which provide an anchor for the
application of the mesially-directed treatment force). Appropriate
sources for the mesially-directed forces include compression
springs and compressible elastomers or tubing (e.g., cylindrical
elastomeric polymer tube sections which may be axially
compressed).
[0055] The force generating device preferably employs an
elastomeric tube. For example, the elastomeric tube can be made of
any polymer or composite which is compressible and which possesses
a memory. As used herein, the term "memory" refers to the property
of an elastomeric member which causes it to attempt to return to
its original shape after deformation. The material should be
biocompatiable, as it will be used in the mouth of a patient. A
preferred material is silicone and more preferably, platinum cured
silicone. However, any other suitable polymer or composite can be
used, including natural (e.g., rubber) and synthetic (e.g.,
silicone) polymers.
[0056] As illustrated in FIGS. 1-6, the force generating device of
the present invention includes a first end stop 12 and a second end
stop 14. Located adjacent first end stop 12 is first collar 16.
Located adjacent second end stop 14 is second collar 18.
Preferably, one or both of the collars 16 and 18 are ribbed as
shown in FIGS. 6a and 6b. Attached to second collar 18 is inner
wire 20. Inner wire 20 can be received in outer tube 22. Outer tube
22 is formed by providing a receiving orifice within first collar
16. The force generating tube 24 is positioned in a tight fitting
arrangement over first collar 16 and second collar 18 with inner
wire 20 received in outer tube 22. Alternatively, as illustrated in
FIG. 3, the force generating member 24 can be placed inside collars
16b and 18b. Collar 16b has a further inner orifice (not shown) for
receiving the inner wire or piston (not shown). When compressed,
the force generating tube 24 will, due to its memory, attempt to
return to its original uncompressed configuration, thereby
generating a force along the longitudinal axis of the force
generating member (see arrow 26).
[0057] In a preferred embodiment, the force generating device 10 is
employed in a lingual arch developer 30 as illustrated in FIGS. 1
and 2. Corresponding parts and different embodiments of similar
parts have the same number, followed by a lower case letter (e.g.
10, 10a etc.). Therefore, the force generating device 10 can
generate a force in the antero-posterior direction. In other words,
the force is generated along a mesio-distally extending axis. The
arch wire 32 employed in a lingual arch developer 30 can also apply
desired forces in order to expand the arch of the patient. The
lingual arch developer 30 illustrated in FIG. 1 is designed to be
inserted on the lingual side of the orthodontic patient's teeth.
Bands 34 can be wrapped around, and preferably cemented, to teeth
(e.g., molars) on each side of the patient's mouth. Preferably, the
bands include a tube or tubes 36. A trombone-shaped connector 38
including posts 40 can be inserted into the tubes 36. The lingual
arch developer 30 can be easily assembled and inserted into the
patient's mouth. The connectors 38d and 38e shown in FIGS. 5a and
5b, respectively, can further include upper extensions 42d and 42e,
respectively, as will be discussed in greater detail below. As
shown in FIGS. 4, 5a and 5b, detents 44c, 44d and 44e can be
employed on posts 40c, 40d and 40e, respectively, to secure the
posts in corresponding tubes, as is more fully disclosed in U.S.
Provisional Patent Application Serial No. 60/063,890, filed on Oct.
24, 1997 and entitled "FIXATION MECHANISM FOR POST AND TUBE DENTAL
APPLIANCE," which is incorporated herein by reference in its
entirety.
[0058] An advantage of the present device is that the force
generating tube 24 can also generate a torsional or torquing force.
For example, by providing a radial twist to the tube 24 prior to
installing the tube 24 over the last collar, the memory of the
force generating tube 24 will cause the tube 24 to try to return to
its original configuration. This can apply a torquing force to the
tooth (not shown) to which the force generating device 10 is
attached (e.g. a molar).
[0059] An advantage of providing a torquing force to the tooth to
which the device 10 is attached is that it helps counteract
"tipping" of the anchored tooth. Tipping occurs because the
connector band 34 of a device, such as a lingual arch developer 30,
is typically attached above the centroid of the attached tooth.
Therefore, as forces move the tooth in a buccal direction, the
tooth can have a tendency to "tip", i.e., the crown of the tooth
may be forced outward to a greater degree than the root. Therefore,
the use of a twisted force generating tube 24 can counteract this
tipping by providing a torque in the opposite direction.
[0060] Alternatively, tipping can be counteracted by using a
configuration for the inner wire and the outer receiving tube which
prevents relative rotation. For example, if the inner wire and
outer tube orifice are non-circular (e.g., square or rectangular)
(not shown), tipping can be reduced or eliminated because relative
rotation will be reduced or eliminated. In other words, the
connector 38 will be restrained from rotating or tipping relative
to the inner wire 20. As used herein, the terms "inner wire" and
"outer tube" are not limited to circular cross-sectional
configurations, but can include other cross-sections (e.g., oval,
polygonal, including square, rectangular, triangular, star-shaped,
etc.) which prevent relative rotation between the inner wire 20 and
outer tube 22.
[0061] The force generating device of the present invention can be
employed in any device in which an axial force is desired. Examples
of orthodontic devices include lingual arch developers, labial arch
developers and distillizing appliances. A labial arch developer can
be used on the labial side of the teeth to modify an orthodontic
patient's arch. A distillizing appliance can be employed to move
the molars back in a distal direction to provide greater arch
length, i.e. to open up the arch length.
[0062] When employed, for example in a lingual arch developer, the
entire device including the arch wire, the force generating member,
the post and tube connector and the connector band can all be
assembled prior to insertion into the patient's mouth. Typically,
the band will be cemented to the anchoring teeth, for example, the
molars of the patient. Thereafter, adjustments can easily be made
by removing the post from the tubes and replacing the force
generating tube and making any other necessary adjustments.
Typically the force generating tube will be increased in length as
treatment progresses in order to expand, or open up the arch.
[0063] The initial configuration of a lingual arch developer and
the desired length of the force generating tube can be determined
relatively easily. For example, a mold can be made of the teeth. A
transparent template can then be placed over the mold. The template
includes guidelines which assist the orthodontist in determining
the correct configuration of the lingual arch developer, as well as
the desired length of the force generating (e.g., silicone) tubes.
The device can then be fabricated and easily inserted into the
patient's mouth. The device is especially useful when combined with
the "trombone shaped" post and tube attachment system. This
trombone shape provides a greater length in which to accommodate
the force generating device. Advantages of the present device are
ease of use, ease of assembly and ease of adjustment. In addition,
the device reduces the number of parts which can become
disconnected and act as small foreign bodies in the mouth.
[0064] In another embodiment relating to the lingual arch
development aspect of the invention, such as generally directed
toward installing lingual arches, preferably such that the
above-noted generally mesially-directed forces may be exerted
thereon. In one variation, a lingual arch includes at least one
helical winding, and preferably at least one helical winding on
each of the two sides of the lingual arch relative to a central
axis extending therethrough. These helical winding(s) may be used
to generate/transmit orthodontic treatment forces, other than a
mesially directed force, lingually to the patient's teeth (e.g.,
expansion forces). The helical winding(s) also allow the mesial
section of the lingual arch to be pivoted occlusally relative to
the distal section of the lingual arch in a predetermined manner.
This facilitates installation of the two distal ends of the lingual
arch into horizontal, lingual tubes which are attached to the
patient's teeth, typically via an orthodontic band. As will be
discussed in more detail, the use of a slidable interconnection
between the lingual arch and the horizontal tubes allows the
lingual arch to be advanced mesially relative to the anchor teeth
on which the tubes are positioned when a mesially directed
orthodontic treatment force is utilized.
[0065] In another variation, an orthodontic assembly includes a
lingual arch in which at least the distal ends thereof are hollow.
The assembly further includes at least two gingivally-occlusally
extending tubes which are attached to teeth on opposite sides of
the mandibular jaw or maxillary jaw of an orthodontic patient
(e.g., at least one tube on one tooth on one side of the patient's
jaw, and at least one tube on one tooth on the other side of the
patient's jaw). The interconnection between this lingual arch and
the tubes is provided by an interconnecting member or sectional
which includes at least one gingivally-occlusally extending post
for insertion into the associated at least one
gingivally-occlusally extending tube on the patient's tooth. The
sectional further includes a mesially extending segment disposed
mesially of the post(s) and which is slidable within the associated
hollow distal end of the lingual arch. At least one force
generating member (e.g., an elastomeric member or compression
spring) may then be disposed between two fixed locations on each
side of the lingual arch such that a mesially directed force may be
applied to the lingual arch and such that the lingual arch may then
advance mesially relative to the sectional by a sliding-like or
telescoping action. For instance, one end of the force generating
member may engage effectively a fixed stop on one side of the
lingual arch, while its other end may engage the tube which is
fixed to the tooth. Alternatively, the mesial ends of the sectional
may be hollow to slidably receive the distal ends of the lingual
arch.
[0066] In yet another variation, a lingual arch (e.g., formed by a
radius of less than about 0.700 inches) includes an
arcuately-shaped mesial section and first and second distal
sections extending from opposite ends of the mesial section. The
mesial section has a diameter which is less than that of the first
and second distal sections and/or is formed from a material which
allows the mesial section to be deflected occlusally relative to
the first and second distal sections. This again facilitates
installation of the two distal ends of the lingual arch into
horizontal, lingual tubes which are attached to the patient's
teeth, typically via an orthodontic band.
[0067] An interconnection means of mounting assemblies can provide
selective antero-posterior positioning and preferably includes a
dual connection member having a first mating portion for slidable
mating engagement with one of the extending portions of the
connection means, and a second mating portion, oriented
transversely to said first mating portion, for mating engagement
with a complimentary member inter-connected to the tooth attachment
means. In this regard, it is preferred that such complimentary
member comprise a female means (e.g., one or more vertical tubes)
fixedly connected to the tooth attachment means (e.g., a band), and
that the second mating portion of the dual connection member
include a male means (e.g., one or more vertical posts) for easy
vertical insertion into the female means of the complimentary
member. The first mating portion of the dual connection member may
comprise a female means (e.g., a horizontal tube) for slidably
receiving one of the extending portions of the connection means.
Alternatively, the first mating portion may comprise a male means
(e.g., a horizontal wire end section) for slidable positioning
within a female tubular end of the connection means.
[0068] Preferably, the above-described connection member and
complementary member of the interconnection means are lingually
disposed for interconnection with a first extending portion of the
connection means. In this regard, the interconnection means of each
mounting assembly that provides selective antero-posterior
positioning may also comprise a buccally disposed member for
slidably engaging the second extending portion of the connection
means. Preferably, the second engaging portion also extends
longitudinally from the orthodontic component (e.g., rearwardly)
and the buccally disposed member horizontally and slidably engages
the second portion. As will be appreciated then, the
above-described mounting assembly most preferably provides both
lingual/buccal support and selective slidable, antero-posterior
positioning for an orthodontic component relative to a given tooth
or other reference position.
[0069] It has been recognized that a dual connection member and
tooth attachment means having a lingually disposed complementary
member (as described above) can be readily mounted on each side of
the mandible so as to slidably receive an active lingual arch
device there-between. In this regard, for example, it has been
discovered that each end of a lingual archwire can be slidably
received by a horizontal tube (e.g., each being interconnected to a
corresponding dual connection member as described above) with a
resilient sheath positioned on the archwire being compressed and
retained between the two dual connection members. In such an
arrangement, the mounting assembly facilitates mounting and allows
the lingual archwire to slidably pass through the dual connection
members as mandible growth is augmented in response to the
expansion force applied to the lingual aspect of the lower teeth by
the resilient sheath.
[0070] One embodiment of a ligature assembly includes a hollow stop
tube (e.g., a hollow, generally cylindrical structure) with a hook
attached thereto. An inner sleeve (e.g., a hollow, generally
cylindrical structure) is disposed within at least part of the stop
tube, extends out from at least the end of the stop tube which
projects toward the connector, and is attached to the stop tube. A
lingual arch is inserted through the stop tube and the inner sleeve
and extends out the distal end of the inner sleeve. Prior to
installing the end of the lingual arch in the above-described
connector, a portion of the lingual arch disposed distally of the
distal end of the inner sleeve may be crimped or otherwise deformed
such that it will not be able to slide back through the inner
sleeve. This deformation of the lingual arch limits the amount
which the lingual arch will be able to move mesially relative to
the inner sleeve. An alter-native to the foregoing is to replace
the inner sleeve with an outer sleeve which would be at least
partially disposed over the stop tube, which would extend from at
least one end of the stop tube and thereby be disposable over the
distal end of the third segment of the corresponding connector, and
which would include a hook.
[0071] One ligature assembly will typically be installed on each of
the two ends of the lingual arch. The two distal ends of the
lingual arch may then be inserted into the hollow tubes on the
mesial ends of the third segments of two of the above-described
connectors (one being installed on each side of the patient's arch
undergoing treatment). The inner sleeve will also be inserted into
the corresponding hollow tube of the third segment of the connector
and the distal end of the stop tube will typically abut the mesial
end of the hollow tube of the corresponding third segment of the
connector. A ligature may then be attached to the hook on the stop
tube and attached at a second distal location (e.g., on a hook
associated with the corresponding connector). Although the ligature
applies a ligating force to the stop tube and keeps it engaged with
the mesial end of the hollow tube of the associated third segment
of the connector, it provides no resistance to mesial movement of
the lingual arch relative to the hollow tube of the third segment
of the connector, the inner sleeve of the ligature assembly, or the
stop tube of the ligature assembly until the crimped wire section
of the lingual arch abuts the distal end of the inner sleeve. This
could be preselected to occur at an incremental point in the
lingual arch development or upon some dislodgement of the lingual
arch from the patient's dentition. In either case, the ligature
would then resist further mesial movement of the lingual arch.
[0072] Another type of ligature assembly which may be used with the
above-described connector during lingual arch development is a
hollow, typically cylindrical sectional which is slidably
insertable into the hollow tube of the third segment of the
connector. One of these sectionals would be installed on each end
of the lingual arch and would be fixedly attached to the lingual
arch (e.g., by placing bends in the two free end portions of the
lingual arch which would then be fixably retained within the
interior of the associated sectional by a binding-like engagement
with the sectional). A hook or other appropriate mounting is
attached to the sectional, and preferably another hook is attached
to the third segment of the connector. Installation of this type of
ligature assembly for the above-described type of lingual arch
development would then further entail disposing the
force-generating member, which is used to affect mesial advancement
of the lingual arch, over the sectional and distally of the hook
and inserting the sectional into the hollow tube portion of the
third segment of the associated connector such that the
force-generating member would be retained between the connector
(e.g., the hook on the third segment) and the hook on the
sectional. An appropriate ligature may then be tied or otherwise
attached to the hook on the third segment and also the hook on the
sectional.
[0073] If there is no slack in the ligature in this last-described
ligature assembly, it will immediately oppose mesial advancement of
the lingual arch. However, this may actually be advantageous in
some cases. For instance, the ligature may be used to reduce the
magnitude of the generally mesially-directed forces being applied
to the lingual arch by the force-generating member(s) (e.g., if the
force-generating member applies larger than desired
mesially-directed forces to the lingual arch when initially
"loaded", the ligature assembly may be used to reduce the magnitude
of the generally mesially-directed forces to a more desired level).
Other desirable effects may be achieved with this ligature
assembly. For instance, the ligature may be wrapped around the
third segment and/or the sectional which will apply a torquing
force to at least the tooth on which the connector is attached.
When the lingual arch is also used for arch expansion, wrapping the
ligature in this manner will allow the root of the tooth to also be
moved transversely away from the patient's midline as a result of
the torquing force generated by the wrapped ligature.
[0074] Other similar applications and extensions of the disclosed
mounting assembly are possible. In this regard, it should also be
noted that the assembly described hereinabove may be supplemented
by plural additional components such as force generating devices,
connectors, bands, archwires, tubes (e.g., horizontal, angulated or
vertical), posts, etc. interconnected in various configurations to
create and accommodate various orthodontic appliances and
components.
[0075] Referring to the drawings, one embodiment of a lingual arch
developer orthodontic assembly which accommodates the use of these
types of treatment forces is illustrated in FIGS. 7A-D. The lingual
arch developer 112 includes a generally U-shaped lingual arch 158
having a mesial section 114 and first and second distal sections
118, 122, respectively, which are fixedly interconnected with the
mesial section 114. The mesial section 114 is generally arcuately
shaped, the arcuate extent of which will typically be no greater
than that defined by a radius of about 0.700 inches (although the
mesial section 114 need not be defined by a single radius, the
maximum radius which may be positioned within the mesial section
114 is about 0.700 inches). The mesial section 114 has a diameter
of about 0.020 inches whereas each of the distal sections 118, 122
have a diameter of about 0.040 inches. That is, the first and
second distal sections 118, 122, respectively, are more robust than
the mesial section 114 which may be desirable for molar control
(e.g., to provide resistance for tipping and/or rotation of these
molars, while allowing for torquing of these molars via a labial
archwire). When installed, the mesial section 114, as well as the
first and second distal sections 118, 122, respectively, are
disposed substantially parallel to the occlusal plane but
gingivally disposed (e.g., at the gingival level of the teeth
102).
[0076] The lingual arch 158 is slidably interconnected with
typically two of the orthodontic patient's teeth 102 in order to
allow the lingual arch 158 to advance mesially during orthodontic
treatment, and thus to mesially advance part of the patient's arch
101. In this regard, the lingual arch developer 112 further
includes two horizontal tubes 132 each having a mesio-distally
aperture or hole extending therethrough. These tubes 132 may be
fixedly interconnected with a band 134 (e.g., soldered), which is
then typically attached to the patient's first molars 106 such that
the tubes 132 are lingually disposed on the patient's first molars
(e.g., FIG. 7C). The two distal ends 126 of the lingual arch 158
are inserted into these tubes 132 such that the first and second
distal sections 118, 122, respectively, are slidably received
within the tubes 132.
[0077] The lingual arch developer 112 provides for mesial movement
of the lingual arch 158 during treatment in order to achieve, for
instance, increased arch length for the orthodontic patient and/or
to provide for desired spacings between the teeth 102 or diastamas.
This movement is affected by positioning at least one force
generating member 138 between the lingual arch 158 and at least one
anchor location on the patient. More specifically and in the
illustrated embodiment, each force generating member 138 is
disposed between two "fixed points". One of these "fixed points" is
on the lingual arch 158 and the other fixed point is interconnected
with the anchor teeth. In the illustrated embodiment, a first force
generating member 138a is positioned on the left side 146 of the
lingual arch 158 between a left helical winding 154a and the left
tube 132a, and a second force generating member 138b is positioned
on the right side 152 of the lingual arch 158 between a right
helical winding 154b and the right tube 132b. Instead of engaging
the helical windings 154, a small cylindrical stop (not shown) may
be disposed over each of the first and second distal sections 118,
122, may engage the associated helical winding 154, and may be
engaged by the associated force generating member 138.
[0078] Appropriate force generating members 138 include devices
such as compression springs (shown and e.g., helical) and axially
compressible elastomers or tubing (e.g., generally tubular or
cylindrical tubing which may be axially compressed, see FIGS. 1-6).
In this case, when the lingual arch developer 112 is installed the
force generating members 138 are under compression to generate
activating forces which are generally mesially-directed on the
lingual arch 158. Specifically, the force generating members 138
exert a generally mesially-directed force on the two sides 146, 152
of the lingual arch 152, and when the lingual arch 158 begins to
mesially advance via the slidable interconnection with the tubes
132, part of the patient's arch 101, specifically the four anterior
teeth, also begins to mesially advance. The cuspids and bicuspids
will also move buccally (e.g., arch expansion) by this mesial
movement of the lingual arch 158.
[0079] In order to assist in the installation of the lingual arch
158 into the lingually disposed horizontal tubes 132, at least one,
and preferably at least two helical windings 154 are incorporated
into the lingual extent of the lingual arch 158. The helical
windings 154 are thus disposed in sections of the lingual arch 158
which are substantially parallel to the occlusal plane but
gingivally disposed (e.g., at the gingival level of the teeth 102).
In the illustrated embodiment, one helical winding 154a is provided
on the left side 146 of the lingual arch 158 and one helical
winding 154b is provided on the right side 152 of the lingual arch
158 at substantially the same location mesio-distally. The helical
windings 154 allow the mesial section 114 of the lingual arch 158
to pivot in an occlusal direction relative to the first and second
distal sections 118, 122, respectively, in a predetermined manner
and as illustrated in FIG. 7D. In the illustrated embodiment, the
helical windings 154 extend or spiral in a downwardly direction.
This offers a number of advantages. For instance, when the mesial
section 114 of the lingual arch 158 is pivoted in an occlusal
direction relative to the first and second distal sections, 118,
122, respectively, the inside diameter of the helical windings 154
increases. Less resistance may be encountered when pivoting the
lingual arch 158 in this manner than if the helical windings 154
were generally upwardly extending (not shown). Moreover, the
downwardly extending helical windings 154 also provide a way to
position the portion of the lingual arch 158 disposed mesially of
the helical windings 154 at a more gingival location that the
portion of the lingual arch 158 disposed distally of the helical
windings 154 as illustrated in FIG. 7B. Disposing the lingual arch
158 gingivally is desired for orthodontic treatment such that the
lingual arch is disposed closer to the tooth's centroid.
[0080] The size, location, and/or orientation of the helical
windings 154 may be selected to facilitate the generation of
orthodontic treatment forces in addition to those generated by the
force generating members 138. For instance, the helical windings
154 may be disposed to apply rotational forces to the molars 106.
Moreover, the helical windings 154 may be oriented to
generate/augment arch expansion forces. Nonetheless, the helical
windings 154 are disposed in sections of the lingual arch 158 which
are substantially parallel to the occlusal plane but gingivally
disposed (e.g., at the gingival level of the teeth 102).
[0081] The lingual arch 158 slidably advances relative to the tubes
132 in a mesial direction as orthodontic treatment progresses. In
order to reduce the potential for the lingual arch 158 advancing
too far such that it becomes disengaged from the tubes 132, at
least one ligature (e.g., metal or elastic and not shown), may be
disposed between at least one of the hooks 142 and the associated
tube 132 (e.g., on the same side) and/or a hook (not shown)
attached to the band 134. A stout elastic could be utilized which,
during the initial part of orthodontic treatment with the lingual
arch developer 112, would not be under tension. After treatment had
progressed a certain degree (e.g., after a certain degree of mesial
advancement of the lingual arch 158 has been achieved by the
lingual arch 158 advancing relative to the tubes 132), the elastic
would come under tension to retain the lingual arch 158 at least
partially within the tubes 132. This not only accomplishes a
desired safety objective of reducing the potential for the lingual
arch 158 becoming dislodged, but it also allows for treatment to
progress incrementally. A metal ligature could also be utilized
which would have some "slack" at the start of treatment, but would
become taut before the lingual arch 158 became dislodged from the
tubes 132, all to provide the same objectives as the elastic
ligature. In the case of a metal ligature, it could be disposed
within the associated force generating member 138 (e.g., disposed
inside of a spring).
[0082] Another embodiment of a lingual arch developer orthodontic
assembly which accommodates the use of the generally mesially
directed treatment forces is illustrated in FIGS. 8A-B. The lingual
arch developer 166 includes a generally U-shaped lingual arch 214
having a mesial section 170 and first and second distal sections
174, 178, respectively, integrally formed with the mesial section
170. The mesial section 170 is generally arcuately shaped, the
arcuate extent of which will typically be no greater than that
defined by a radius of about 0.700 inches (e.g., although the
mesial section 170 need not be defined by a single radius, the
maximum radius which may be positioned within the mesial section
170 is about 0.700 inches). In this embodiment, the lingual arch
214 is of constant diameter with regard to the wire which forms the
same (e.g., the diameter of the mesial section 170 in cross section
is equal to the diameters of each of the first and second distal
sections 174, 178 in cross section). When installed, the mesial
section 170, as well as the first and second distal sections 174,
178, respectively, are disposed substantially parallel to the
occlusal plane but gingivally disposed (e.g., at the gingival level
of the teeth 102).
[0083] The lingual arch 214 is slidably interconnected with
typically two of the orthodontic patient's teeth 102 in order to
allow the lingual arch 214 to advance mesially during orthodontic
treatment, and thus to mesially advance the patient's arch 101 in
the above-noted manner. In this regard, the lingual arch developer
166 further includes two horizontal tubes 186 each having a
mesio-distally aperture or hole extending therethrough. These tubes
186 may be fixedly interconnected with a band 190 (e.g., soldered),
which is then typically attached to the first molars 106 such that
the tubes 186 are lingually disposed on the patient's teeth 102.
The two distal ends 182 of the lingual arch 214 may therefore be
inserted into these tubes 186 such that the first and second distal
sections 174, 178, respectively, are slidably received within the
tubes 186.
[0084] The lingual arch developer 166 provides for mesial movement
of the lingual arch 214 during treatment in order to achieve, for
instance, increased arch length for the orthodontic patient and/or
to provide for desired spacings between the teeth 102. This
movement is affected by positioning at least one force generating
member 198 between the lingual arch 214 and at least one anchor
location on the patient. More specifically and in the illustrated
embodiment, each force generating member 198 is disposed between
two fixed points. One of these fixed points is on the lingual arch
214, such as against one of the helical windings 210 or a
cylindrical member disposed about the lingual arch 214 and which
abuts the associated helical winding 210 (not shown), and the other
fixed point is interconnected with the patient's teeth 102. In the
illustrated embodiment, a first force generating member 198a is
positioned on the left side 202 of the lingual arch 214 between the
left helical winding 210a and the left tube 186a, and a second
force generating member 198b is positioned on the right side 206 of
the lingual arch 214 between the right helical winding 210b and the
right tube 186b.
[0085] Appropriate force generating members 198 include devices
such as compression springs (shown and e.g., helical) and axially
compressible elastomers (e.g. generally tubular or cylindrical
tubing which may be axially compressed, see FIGS. 1-6). In this
case, when the lingual arch developer 166 is installed the force
generating members 198 are under compression to generate activating
forces which are generally mesially-directed. That is, the force
generating members 198 exert a generally mesially-directed force on
the two sides 202, 206 of the lingual arch 214, and when the
lingual arch 214 mesially advances via the slidable interconnection
with the tubes 186, the patient's arch 101 advances in the
above-noted manner.
[0086] In order to assist in the installation of the lingual arch
214 into the lingually disposed horizontal tubes 186, at least one
and preferably at least two helical windings 210 are incorporated
into the lingual extent of the lingual arch 214. The helical
windings 210 are thus disposed in sections of the lingual arch 214
which are substantially parallel to the occlusal plane but
gingivally disposed (e.g., at the gingival level of the teeth 102).
In the illustrated embodiment, one helical winding 210a is provided
on the left side 202 of the lingual arch 214 and one helical
winding 210b is provided on the right side 206 of the lingual arch
214 at substantially the same location mesio-distally. The helical
windings 210 allow the mesial section 170 of the lingual arch 214
to pivot in an occlusal direction relative to the first and second
distal sections 174, 178, respectively, in a predetermined manner
and as illustrated in FIG. 8B. In the illustrated embodiment, the
helical windings 210 extend in a downwardly direction to provide
the above-noted advantages.
[0087] The size, location, and/or orientation of the helical
windings 210 may also be selected to facilitate the generation of
orthodontic treatment forces in addition to those generated by the
force generating members. For instance, the helical windings 210
may be disposed to apply rotational forces to the first molars 106.
Moreover, the helical windings 210 may be oriented to
generate/augment arch expansion forces. Nonetheless, the helical
windings 210 are disposed in sections of the lingual arch 214 which
are substantially parallel to the occlusal plane but gingivally
disposed (e.g., at the gingival level of the teeth 102).
[0088] Four helical windings 210' may be incorporated into the
lingual arch 214' as well and as illustrated in FIGS. 8C-D. In this
case, two helical windings 210' could be disposed on the left side
202' of the lingual arch 214' and two helical windings 210' could
be disposed on the right side 206' of the lingual arch 214'. In
this case, two of the helical windings 210a' could be disposed at
one mesio-distal location on opposite sides of the lingual arch
214', and the other two of the helical windings 210b' could be more
distally disposed at the same mesio-distal position on opposite
sides of the lingual arch 214'. This could allow the mesially
located pair of helical windings 210a' to be oriented so as to
store arch expansion forces and the distally located pair of
helical windings 210b' to be oriented to store rotationally
directed forces (e.g., for rotating the first molars 106 when the
tubes 190' are installed thereon).
[0089] Another lingual arch developer which may be used for arch
development by the application of generally mesially-directed
forces to the lingual of a patient's teeth is illustrated in FIG.
9. The lingual arch developer 222 includes a generally U-shaped
lingual arch 266 having a mesial section 226 and first and second
distal sections 230, 234, respectively, which are fixedly
interconnected with the mesial section 226. The mesial section 226
is generally arcuately shaped, the arcuate extent of which will
typically be no greater than that defined by a radius of about
0.700 inches (although the mesial section 226 need not be defined
by a single radius, the maximum radius which may be positioned
within the mesial section is about 0.700 inches). The mesial
section 226 has a diameter of about 0.020 inches whereas each of
the distal sections 230, 234 have a diameter of about 0.040 inches.
That is, the first and second distal sections 230, 234,
respectively, are more robust than the mesial section 226 which may
be desirable for certain types of orthodontic treatment as noted
above. When installed, the mesial section 226, as well as the first
and second distal sections 230, 234, respectively, are disposed
substantially parallel to the occlusal plane but gingivally
disposed (e.g., at the gingival level of the teeth 102).
[0090] The lingual arch 266 is slidably interconnected with
typically two of the orthodontic patient's teeth 102 in order to
allow the lingual arch 266 to advance mesially during orthodontic
treatment, and thus to advance the patient's arch 101 in the
above-noted manner. In this regard, the lingual arch developer 222
further includes two horizontal tubes 242 each having a
mesio-distally aperture or hole extending therethrough. These tubes
242 may be fixedly interconnected with a band 246, which is then
typically attached to the patient's first molars 106 such that the
tubes 242 are lingually disposed on the patient's first molars 106.
The two distal ends 238 of the lingual arch 266 may therefore be
inserted into these tubes 242 such that the first and second distal
sections 230, 234, respectively, are slidably received within the
tubes 242.
[0091] The lingual arch developer 222 provides for mesial movement
of the lingual arch 266 during treatment in order to achieve, for
instance, increased arch length for the orthodontic patient and/or
to provide for desired spacings between the teeth 102. This
movement is affected by positioning at least one force generating
member 250 between the lingual arch 266 and at least one anchor
location. More specifically and in the illustrated embodiment, each
force generating member 250 is disposed between two fixed points.
One of these fixed points is on the lingual arch 266, such as a
hook 254 which also may be used as a safety feature as discussed
below, and the other fixed point is interconnected with the
patient's anchor teeth. In the illustrated embodiment, a first
force generating member 250a is positioned on the left side 258 of
the lingual arch 266 between the left hook 254a and the left tube
242a, and a second force generating member 250b is positioned on
the right side 262 of the lingual arch 266 between the right hook
254b and the right tube 242b.
[0092] Appropriate force generating members 250 include devices
such as compression springs (shown and e.g., helical) and axially
compressible elastomers (e.g., generally tubular or cylindrical
tubing which may be axially compressed). In this case, when the
lingual arch developer 222 is installed the force generating
members 250 are under compression to generate activating forces
which are generally mesially-directed. That is, the force
generating members 250 exert a generally mesially-directed force on
the two sides 258, 262 of the lingual arch 266, and when the
lingual arch 266 advances mesially via the slidable interconnection
with the tubes 242, the patient's arch 101 advances in the
above-noted manner.
[0093] In order to assist in the installation of the lingual arch
266 into the horizontal tubes 242, the mesial section 226 of the
lingual arch 266 may be deflected occlusally relative to the first
and second distal sections 230, 234, respectively, of the lingual
arch 266 since the diameter of the mesial section 226 is less than
that of each of the first and second distal sections 230, 234,
respectively. With the mesial section 226 deflected in this manner
and with the force generating members 250 being installed over the
first and second distal sections 230, 234, respectively, the distal
ends 238 of the lingual arch 266 may be advanced within the tubes
242 a sufficient distance such that the mesial section 226 of the
lingual arch 266 may be disposed inside of the patient's arch
101.
[0094] The lingual arch 266 slidably advances relative to the tubes
242 in a mesial direction as orthodontic treatment progresses. In
order to reduce the potential for the lingual arch 266 advancing
too far such that it becomes disengaged from the tubes 242, at
least one ligature (e.g., metal or elastic and not shown), may be
disposed between at least one of the hooks 254 and the associated
tube 242 (e.g., on the same side) or a hook (not shown) also
positioned on the tube 242 or the band 246. A stout elastic could
be utilized which, during the initial part of orthodontic treatment
with the lingual arch developer 222, would not be under tension.
After treatment had progressed a certain degree (e.g., after a
certain degree of mesial advancement of the lingual arch 266 has
been achieved by the arch 266 advancing relative to the tubes 242),
the elastic would come under tension to retain the lingual arch 266
in the tubes 242. This not only accomplishes a desired safety
objective of reducing the potential for the arch 266 becoming
dislodged, but it also allows for treatment to progress
incrementally. A metal ligature could also be utilized which would
have some "slack" at the start of treatment, but would become taut
before the arch 266 became dislodged from the tubes 242, all to
provide the same objectives as the elastic. In the case of a metal
ligature, it could be disposed within the associated force
generating member 250.
[0095] Another lingual arch developer which may be used for arch
development by the application of forces to the lingual of a
patient's teeth is illustrated in FIGS. 10A-C. The lingual arch
developer 274 is an orthodontic assembly which includes a generally
U-shaped lingual arch 278 having a mesial section 282, a first
distal section 286, and left distal section (not shown, but the
mirror image of the first distal section 286 in that it is on the
opposite side of the patient's jaw). The mesial section 282 is
fixedly interconnected with the first distal section 286 and the
second distal section. The mesial section 282 is also generally
arcuately shaped, the arcuate extent of which will typically be no
greater than that defined by a radius of about 0.700 inches
(although the mesial section 282 need not be defined by a single
radius, the maximum radius which may be positioned within the
mesial section is about 0.700 inches). The mesial section 282 has a
diameter of about 0.020 inches whereas each of the distal sections
have a diameter of about 0.040 inches. That is, the first distal
section 286 and the second distal section (not shown), are more
robust than the mesial section 282 which may be desirable for
certain types of orthodontic treatment. The first distal section
286 and the second distal section are shorter than the first and
second distal sections 118, 122, respectively, of the lingual arch
developer 112 of FIGS. 7A-D and shorter than the first and second
distal sections 230, 234, respectively, of the lingual arch
developer 222 of FIG. 9, and at least the distal-most portion 294
of the first distal section 286 and the distal-most portion of the
second distal section (not shown), are hollow for establishing a
slidable interconnection with the patient's teeth 102 in a manner
described in more detail below. When installed, the mesial section
282, as well as the first distal section 286 and the second distal
section, are disposed substantially parallel to the occlusal plane
but gingivally disposed (e.g., at the gingival level of the teeth
102).
[0096] The lingual arch 278 is slidably interconnected with
typically two of the orthodontic patient's teeth in order to allow
the lingual arch 278 to advance mesially during orthodontic
treatment, and thus to mesially advance the patient's arch. In this
regard, the lingual arch developer 274 further includes at least
one generally occlusal-gingivally extending tube 298, and
preferably two of such tubes 298, which may be fixedly
interconnected with a band 302, which is then typically attached to
one of the patient's first molars 106 such that the tubes 298 are
lingually disposed on the patient's first molars 106. One of these
bands 302 with the tube(s) 298 thereon would be positioned on the
first molar 106 on one side of the patient's jaw, while another
band 302 with the tube(s) 298 thereon would be positioned on the
first molar on the other side of the patient's jaw.
[0097] A sectional 306 is installed in each pair of tubes 298 on
the first molars 106. Each sectional 306 is preferably integrally
formed (i.e., of one-piece construction) and includes two generally
occlusal-gingivally extending posts 310. These posts 310 are
disposed in the pair of tubes 298. Each sectional 306 also includes
a mesially extending section 314 which is disposed mesially of each
of the posts 310. The mesially extending section 314 is also
gingivally offset as best illustrated in FIG. 10C. The mesially
extending sections 314 are each sized so as to be positionable and
slidable within the hollow distal-most portions 294 of the
associated first distal section 286 or the second distal section of
the lingual arch 278. Alternatively, the sections 314 could be
hollow to slidably receive the distal sections of the lingual arch
278.
[0098] The lingual arch developer 274 provides for mesial movement
of the lingual arch 278 during treatment in order to achieve, for
instance, increased arch length for the orthodontic patient and/or
to provide for desired spacings between the teeth. This movement is
affected by positioning at least one force generating member 318
between each the lingual arch 278 and at least one anchor location
on the patient. More specifically and in the illustrated
embodiment, each force generating member 318 is disposed between
two fixed points. One of these fixed points is on the lingual arch
278, such as a hook 322 which also may be used as a safety feature
as discussed below, and the other fixed point is interconnected
with the patient's anchor teeth. In the illustrated embodiment, the
force generating member 318 is positioned on the left side of the
lingual arch 278 between the left hook 322 and mesial left tube
298, and a second force generating member (not shown) is positioned
on the right side (not shown) of the lingual arch 278 between the
right hook (not shown) and the mesial right tube (not shown).
[0099] Appropriate force generating members 318 include devices
such as compression springs (shown and e.g., helical) and axially
compressible elastomers (e.g., generally tubular or cylindrical
tubing which may be axially compressed, see FIGS. 1-6). In this
case, when the lingual arch developer 274 is installed the force
generating members 318 are under compression to generate activating
forces which are generally mesially-directed. That is, the force
generating members 318 exert a generally mesially-directed force on
the two sides of the lingual arch 278, and when the lingual arch
278 mesially advances by the slidable interconnection with the
patient's teeth on which the tubes 298 are disposed (i.e., by the
telescoping of the lingual arch 278 relative to the two sectionals
306, specifically by the first and distal sections sliding mesially
relative to the associated mesially extending section 314 of the
associated sectional 306), the patient's arch advances in the
above-noted manner.
[0100] As will be appreciated, the lingual arch developer 274
alleviates the need for any pivotal-like action for installation of
the lingual arch 278 on the patient. Summarily, one force
generating member 318 is disposed over each of the first distal
section 286 and the sectional 306, specifically its mesially
extending section 314, which is inserted into the distal-most
portion 294 of the first distal section 286. The second distal
section is similarly interconnected with its corresponding
sectional. The force generating members 318 are then compressed a
sufficient degree such that the lingual arch developer 274 may be
dropped within the lingual arch of the orthodontic patient, with
the posts 310 of each sectional 306 being inserted into their
associated tubes 298.
[0101] The lingual arch 278 slidably advances relative to the tubes
298, via the telescoping of the first distal section 286 and the
second distal section on the associated mesially extending section
314 of the associated sectional 306, in a mesial direction as
orthodontic treatment progresses. In order to reduce the potential
for the lingual arch 278 advancing too far such that it becomes
disengaged from the sectional 306, at least one ligature (e.g.,
metal or elastic), may be disposed between at least one of the
hooks 322 and the associated tube 298 and/or hook attached to the
band 302 (e.g., on the same side). A stout elastic could be
utilized which, during the initial part of orthodontic treatment
with the lingual arch developer 274, would not be under tension.
After treatment had progressed a certain degree (e.g., after a
certain degree of mesial advancement of the lingual arch 278 has
been achieved by the lingual arch 278 advancing relative to the
tubes 298), the elastic would come under tension to retain the arch
278 on the mesially extending sections 314 of the sectionals 306.
This not only accomplishes a desired safety objective of reducing
the potential for the arch 278 becoming dislodged, but it also
allows for treatment to progress incrementally. A metal ligature
could also be utilized which would have some "slack" at the start
of treatment, but would become taut before the arch 278 became
dislodged from the sectionals 306, all to provide the same
objectives as the elastic. In the case of a metal ligature, it
could be disposed within the associated force generating
member.
[0102] Another embodiment of a device for interconnecting an
orthodontic appliance with a patient's tooth, including any of the
above-described lingual arch developers, is illustrated in FIGS.
11-12. The connector 326 provides an interface between a band (not
shown) attached to a patent's tooth (e.g., a first molar) and an
orthodontic appliance, such as a lingual arch of a lingual arch
developer. Hereafter, the connector will be described for lingual
applications, although it will be appreciated that the connector
may have some applications on the buccal.
[0103] The connector 326 includes two generally occlusal-gingivally
extending posts 330 with the mesial post 330a extending more
gingivally than the distal post 330b. Although shown as being in
the occlusal-gingival reference plane 346, the posts may be
lingually tipped to a small degree (e.g., about 10.degree.). These
posts 330 are slidably insertable into a pair of corresponding,
generally occlusal-gingivally extending tubes (not shown) attached
to the patient's teeth via a band (not shown) (e.g., see band 302
and tubes 298 in FIG. 10). Although these posts 330 could be
separately formed, in the illustrated embodiment they are
integrally formed.
[0104] A first segment 334 is generally mesio-distally extending
and is interconnected with one or more of the posts 330. Although
the first segment 334 and posts 330 could be integrally formed, in
the illustrated embodiment the posts 330 are integrally formed and
separately attached to the first segment 334 (e.g., laser welding,
brazing). The first segment 334 extends distally of at least the
mesial post 330a, and in the illustrated embodiment also extends
distally of the distal post 33b.
[0105] The connector 326 further includes a second segment 338
which is interconnected with the first segment 334. The second
segment 338 is generally semi-circular. Therefore, the second
segment 338 initially extends gingivally and distally from the
first segment 334 along an arcuate path. At the mid point of the
second segment 338, the second segment 338 then extends generally
gingivally and mesially along an arcuate path from this midpoint.
Although the second segment 338 could be separately attached to the
first segment 334, preferably the first segment 334 and second
segment 338 are integrally formed.
[0106] A third segment 342 is interconnected with the second
segment 338 and extends generally mesially from the second segment
338. The entire third segment 342 is a generally cylindrical,
hollow tube in the illustrated embodiment, although only the
mesial-most portion of an appropriate length need be of this type
of construction. In one embodiment, the tube portion of the third
segment 342 has an inner diameter ranging from about 0.025 inches
(0.635 mm) to about 0.060 inches (1.524 mm). The second segment 338
may actually extend within the distal end of the third segment 342
a short distance and be appropriately secured thereto (e.g., laser
welding, brazing). In one embodiment, the mesial end of the second
segment 338 extends about 3 mm into the distal end of the third
segment 342.
[0107] As is evident by review of FIG. 11, the third segment 342 is
gingivally disposed relative to the first segment 334. The third
segment 342 may slidably interface with an end of a force
generating device, a lingual arch and other orthodontic appliances.
For instance and in the illustrated embodiment, an end of a lingual
arch may be slidably received in the mesial end of the third
segment 342. The connector 326 is also advantageous in that the
third segment 342 may be of a length which provides for enhanced
stability of the lingual arch or other orthodontic appliance
therewithin and/or for extended mesial movement of the lingual arch
relative to the third segment 342 without the lingual arch becoming
disengaged from the third segment 342. In one embodiment, the
length of the tube portion of the third segment 342 available for
interfacing with the lingual arch or another orthodontic appliance
may range from about 7 mm to about 16 mm, and is preferably about
12 mm.
[0108] In the illustrated embodiment and as best illustrated in
FIG. 12, the third segment 342 is also actually lingually offset in
relation to the first segment 334 (i.e., the third segment 342 is
disposed closer to the patient's tongue than the first segment
334). Advantages associated with the lingual offset include
rotational considerations and it also facilitates the installation
of the connector 326. Lingual offsetting of the third segment 342
may be provided by having the second segment 338 generally
contained within a plane which is disposed at an angle relative to
an occlusal-gingivally extending reference plane 346. In one
embodiment, this first angle 344 ranges from about 20.degree. to
about 55.degree., and in the illustrated embodiment is actually
about 45.degree.. As such, the third segment 342 need not be moved
relative to the first segment 334 in order to install the posts 330
into the generally vertically extending tubes on the orthodontic
band.
[0109] The connector 326 may also include a hook 350. Generally,
the hook 350 is interconnected with the first segment 334 and
extends generally mesially from the first segment 334. Although the
hook 350 could be separately attached to the mesial end of the
first segment 334, preferably the hook 350 is integrally formed
with the first segment 334. In the illustrated embodiment, the hook
350 also extends gingivally and lingually from the first segment
334 as illustrated in FIG. 12. The opening to the hook 350 projects
generally distally such that a ligature (not shown) may interface
with the hook 350 and a location disposed mesially thereof.
[0110] A variation of the connector 326 is illustrated in FIGS.
13-14. Portions of the connector 326.sup.i of FIGS. 13-14 which at
least generally correspond to portions of the connector 326 of
FIGS. 11-12 are similarly numbered, followed by a super-scripted
"i" designation. The main difference between the connector
326.sup.i of FIGS. 13-14 and the connector 326 of FIGS. 11-12 is
that the hook 350 of connector 326 has been replaced with a
generally mesio-distally extending, generally horizontally disposed
tube 360. The tube 360 is occlusally disposed relative to the third
segment 342.sup.i of the connector 326.sup.i. The tube 360 is also
typically generally cylindrical and hollow, and will typically have
an inner diameter ranging from about 0.025 inches (0.635 mm) to
about 0.060 inches (1.524 mm) and a length for interfacing with an
orthodontic appliance ranging from about 7 mm to about 16 mm. In
the illustrated embodiment, the tube 360 extends mesially beyond
the mesial end of the third segment 342.sup.i. The horizontal tube
360, as well as the horizontal tube 342.sup.i, may be used to
provide an interface with a variety of types of orthodontic
appliances, such as a spring-driven palatal expander. Therefore,
the connector 326.sup.i need not be limited to use with lingual
arch development, but instead may be used for other applications as
well. Moreover, the horizontal tube 360 may interface with the
posts 330.sup.i without a need for the third segment 342.sup.i (not
shown). That is, the connector 326.sup.i could be modified to
include only the post(s) 330.sup.i and the horizontal tube 360 (not
shown).
[0111] Another embodiment of a connector which may be utilized with
each of the above-described lingual arch developers is illustrated
in FIG. 15. The connector 326.sup.ii of FIG. 15 is generally
similar to the connector 326 of FIGS. 11-12 discussed above.
Portions of the connector 326.sup.ii of FIG. 15 which at least
generally correspond to portions of the connector 326 of FIGS.
11-12 are similarly numbered, followed by a superscripted "ii"
designation. One difference between the connector 326.sup.ii of
FIG. 15 and the connector 326 of FIG. 11 is that the hook 364 in
FIG. 15 does not extend gingivally down like the hook 350 of the
connector 326, but is instead generally mesio-distally extending.
Another difference between the connector 326 and the connector
326.sup.ii is that the connector 326.sup.ii interfaces with a
ligature assembly 368 which in turn interfaces with the lingual
arch developer to reduce the potential for the lingual arch
developer becoming dislodged. However, the ligature assembly 368
could be used with all connectors described herein unless otherwise
noted.
[0112] The ligature assembly 368 allows for the above-described
types of lingual arch developers to be ligated to the connector
326.sup.ii without providing any significant resistance to the
mesial advancement of the lingual arch for a predetermined amount
of mesial advancement of the lingual arch. The ligature assembly
368 generally includes a stop tube 372 which in the illustrated
embodiment is generally cylindrical and hollow. An inner sleeve 376
is disposed partially within the distal end of the stop tube 372,
extends distally from the stop tube 372, and is appropriately
secured to the stop tube 372 (e.g., laser welding, brazing). The
outer diameter of the inner sleeve 376 is selected to be smaller
than the inner diameter of the third segment 342.sup.ii of the
connector 326.sup.ii such that it may be slidably received therein
without sacrificing stability. In one embodiment, there is about a
0.002 inch (0.0508 mm) to about 0.004 inch (0.01016 mm) annular gap
between the inner sleeve 376 and the inner diameter of the third
segment 342.sup.ii.
[0113] In order to install a lingual arch developer utilizing the
ligature assembly 368, first an appropriate force generating member
396 is installed on the lingual arch 384. The distal end of a
lingual arch 384 is disposed through the mesial end of the stop
tube 372 to extend through the inner sleeve 376 and distally from
the distal end of the inner sleeve 376 an appropriate distance. The
distal end of the force generating member 396 may abut the mesial
end of the stop tube 372. A crimp 388 or other deformation may be
formed on a distal portion of the lingual arch 384. The lingual
arch 384 may then slide into the hollow interior of the third
segment 342.sup.ii of the connector 326.sup.ii. The crimp 388 in
the lingual arch 384 is freely, slidably received within the hollow
interior of third segment 342.sup.ii. After installing the opposite
end of the lingual arch 384 on another connector 326.sup.ii
disposed on the opposite side of the patient's mouth in this same
general manner, the connectors 326.sup.ii may be installed in the
generally vertical tubes on the respective bands in the
above-described manner.
[0114] The ligature assembly 368 is disposed mesially of the
connector 326.sup.ii such that the inner sleeve 376 extends within
the hollow interior of the third segment 342 and the distal end of
the stop tube 372 engages the mesial end of the third segment
342.sup.ii. A ligature 392 (e.g., elastic, metal) may then engage
the hook 364 on the connector 326.sup.ii and extend down into
engagement with a tiehook 380 which is attached to the stop tube
372 of the ligature assembly 368. The ligature 392 may be exerting
at least a distally directed force on the stop tube 372 to maintain
engagement between the stop tube 372 and the third segment
342.sup.ii of the connector 326.sup.ii. However, since the lingual
arch 384 is slidable relative to the stop tube 372, as well as the
inner sleeve 376 and the third segment 342.sup.ii of the connector
326.sup.ii and since the crimp 388 is disposed distally of the
distal end of the stop tube 372, no resistance is provided to
mesial movement of the lingual arch 384 relative to the connector
326.sup.ii at this time. Once the lingual arch 384 has advanced
such that the crimp 388 engages the distal end of the inner sleeve
376, however, the ligature 392 will begin to oppose further mesial
movement of the lingual arch 384. Further mesial movement of the
lingual arch 384 will cause the distal end of the stop tube 372 to
become displaced from the mesial end of the third segment
342.sup.ii of the connector 326.sup.ii as illustrated in FIG.
15A.
[0115] Having the ligature assembly 368 generate opposing forces to
the mesial advancement of the lingual arch 384 after a certain
amount of mesial advancement may be used as an indicator of an
incremental advancement in the treatment of the orthodontic patient
and may trigger a visit to the orthodontist. Alternatively, this
resistance will assist in maintaining the interconnection between
the lingual arch 384 and the third segment 342.sup.ii of the
connector 326.sup.ii if the lingual arch 384 inadvertently becomes
disengaged with the patient's dentition (e.g., the ligature
assembly 368 provides safety enhancement features).
[0116] Another embodiment of a ligature assembly which may be used
with the connector 326.sup.ii, as well as all other connectors
described herein, is illustrated in FIG. 16. The ligature assembly
400 allows for the above-described types of lingual arch developers
to be ligated to the connector 326.sup.ii without providing any
resistance to the mesial advancement of the lingual arch for a
predetermined amount of mesial advancement of the lingual arch. The
ligature assembly 400 generally includes a stop tube 404 which in
the illustrated embodiment is generally cylindrical and hollow. An
outer sleeve 408 is disposed partially over the distal end of the
stop tube 404, extends distally from the stop tube 404, and is
appropriately secured to the stop tube 404 (e.g., laser welding,
brazing). The inner diameter of the outer sleeve 408 is selected to
be larger than the outer diameter of the third segment 342.sup.ii
of the connector 326.sup.ii such that it may be slidably associated
therewith but with sufficient stability.
[0117] The ligature assembly 400 is disposed mesially of the
connector 326.sup.ii such that the outer sleeve 408 extends over
the hollow third segment 342.sup.ii and the distal end of the stop
tube 404 engages the mesial end of the third segment 342.sup.ii. A
ligature 392 (e.g., elastic, metal) may then engage the hook 364 on
the connector 326.sup.ii and extend down into engagement with the
tiehook 412 attached to the outer sleeve 408 of the ligature
assembly 400. The ligature 392 may be exerting at least a distally
directed force on the stop tube 404 to maintain engagement between
the stop tube 404 and the third segment 342.sup.ii of the connector
326.sup.ii. However, since the lingual arch 384 is slidable
relative to the stop tube 404, as well as the outer sleeve 408 and
the third segment 342.sup.ii of the connector 326.sup.ii, no
resistance is provided to mesial movement of the lingual arch 384
relative to the connector 326.sup.ii until the lingual arch 384 has
advanced a certain predetermined amount relative to the connector
326.sup.ii. That is, once the lingual arch 384 has advanced such
that the crimp 388 engages the distal end of the stop tube 404, the
ligature 392 will begin to oppose further mesial movement of the
lingual arch 384 as in the above-described embodiment.
[0118] Another embodiment of a connector which may be utilized with
each of the above-described lingual arch developers and/or ligature
assemblies, as well as a variety of other orthodontic appliances,
is illustrated in FIGS. 17A-C. The connector 326.sup.iii is
generally similar to the connectors 326, 326.sup.i, and 326.sup.ii
discussed above. Corresponding structure is similarly numbered, and
a superscripted "iii" designation is used. The connector
326.sup.iii includes a pair of generally occlusal-gingivally
extending, mesio-distally spaced posts 330.sup.iii, a generally
distally extending first segment 334.sup.iii, a generally
semi-circular second segment 338.sup.iii, and a generally mesially
extending third segment 342.sup.iii which is again lingually offset
in a lingual application. The posts 330.sup.iii are actually
disposed generally within the occlusal-gingivally extending
reference plane 346.sup.iii, but may be disposed at a relatively
small angle 348 (e.g., 10.degree.) relative to this reference plane
346.sup.iii (e.g., the tips of the posts 330.sup.iii being disposed
more lingually). This is within the meaning of "generally
occlusal-gingivally extending" in relation to the orientation of
the posts of the connector and their corresponding lingual tubes on
the band.
[0119] The connector 326.sup.iii also includes a number of
additional advantageous features. The connector 326.sup.iii
includes a hook 352 which is disposed on the mesial end of the
third segment 342.sup.iii and opens or faces generally distally.
Having the hook 352 in this position versus as an extension off of
the first segment as in the case of the connectors 326 and
326.sup.ii reduces the potential for food becoming trapped in the
connector 326.sup.iii. As such, it should be appreciated that the
connectors 326 and 326.sup.ii could also utilize a similarly
configured and positioned hook 352 instead of the hooks described
with such embodiments.
[0120] The connector 326.sup.iii also includes an extension 354
which extends mesially from the first segment 334.sup.iii beyond
the mesial post 330a.sup.iii and is a cantilever in that it has a
free, unsupported mesial end. Preferably, the extension 354 is
integrally formed with the first segment 334.sup.iii. Having the
extension 354 extend a certain distance beyond the mesial post
330a.sup.iii assists in the installation and/or removal of the
connector 326.sup.iii from the associated band having the pair of
generally occlusal-gingivally extending lingual tubes. In one
embodiment, the extension 354 extends about 0.120 inches (about 3
mm) beyond the mesial post 330a.sup.iii. The extension 354 is also
curved to generally approximate the contour of the tooth on which
the connector 326.sup.iii is disposed (i.e., the free end of the
extension 354 curves inwardly toward the tooth). This further
facilitates the extension's 352 functioning as a handle (e.g., for
interfacing with a Howe pliers), as well as reducing the potential
for the trapping of food. In one embodiment this curvature is
defined by a radius of about 0.30 inches (7.62 mm).
[0121] Stability during relative movement between the lingual arch
and the horizontal tube of the above-described connectors is
desirable for treatment. This may be realized through use of the
end section 356 illustrated in FIG. 18A. The end section 356 is
effectively a hollow tube having a hook 358 on its mesial end. The
inner diameter of the end section 356 is sized such that it will
receive the distal end of a lingual arch. One way in which the
lingual arch may be substantially rigidly connected to the end
section 356 is to place bends in the distal end of the lingual arch
that "catch" on the interior of the end section 356 when sliding
therethrough. The outer diameter of the end section 356 is selected
to be slidably received in the horizontal tube of the noted
connectors, for instance the third segment 342.sup.iii of the
connector 326.sup.iii. Preferably, there will be an appropriate
annular gap between the outer surface of the end section 356 and
the inner surface of the third segment 342.sup.iii (e.g., 0.002
inch to 0.004 inch annular gap).
[0122] The end section 356 and its hook 358 also allows for the use
of a ligature assembly with a lingual arch of a lingual arch
developer. Referring to FIG. 18B, a ligature assembly 444 includes
the above-described end section 356 and an appropriate ligature 448
(e.g., metal ligature, elastic). The lingual arch 450 is
appropriately secured to the end section 356. An appropriate force
generating member 454 is disposed over or about the distal end of
the end section 356, and the distal end of the end section 356 is
disposed within the third segment 342.sup.iii. This disposes the
force generating member 454 between the hook 352 and the hook 358
such that the force generating member 454 can apply generally
mesially-directed forces to the end section 356 and the lingual
arch 450 fixedly interconnected therewith.
[0123] The ligature 448 extends between the hook 352 on the third
segment 342.sup.iii and the hook 358 on the end section 356. The
ligature 448 is illustrated as being in a relatively taut
condition. Forces which counteract those being applied to the
lingual arch 450 by the force generating member 454 are thereby
being generated/applied by the ligature 448 to the lingual arch
450. This may be desirable in some cases such as when the force
generating member 454 has the ability to apply more than the
desired force to the lingual arch 450. The ligature 448 also
functions to reduce the potential for the end section 356, and thus
the lingual arch 450, becoming disengaged with the connector
326.sup.iii, and thus provides a safety enhancement feature.
[0124] The ligature 448 may have a variety of characteristics which
provide for and/or contribute to the generation of counteracting
force and/or the provision of safety features. Initially, the
ligature 448 may be such that no counteracting forces are applied
to the mesial advancement of the lingual arch 450 until treatment
has progressed a predetermined amount. This may be affected by
using a metal ligature 448 of an appropriate length (e.g., such
that there is some slack in the ligature 448 in the beginning of
treatment, but which becomes taut after a predetermined amount of
mesial advancement of the lingual arch 450 to completely counteract
the abilities of the force generating member 454). The ligature 448
may also be such that the counteracting forces which it applies to
the lingual arch 450 increase in some fashion during mesial
advancement of the lingual arch 450 (e.g., such that it applies
increasing counteracting forces as treatment progresses).
[0125] The ligature 448 may provide a function in addition to those
presented above by the way in which the ligature 448 is installed.
Continuing to refer to FIG. 18B, the ligature 448 may engage the
hook 352 and then wrap around the mesial portion of the third
segment 342.sup.iii and then the end section 356 in generally
helical fashion for engagement with the hook 358. Torsional forces
are generated by this positioning of the ligature 348 and these
forces are applied to the tooth on which the connector 326.sup.iii
is disposed. This is advantageous when the lingual arch 450 is also
being used for transverse movement of the patient's arch (e.g.,
expansion). Expansion of the arch may result in a degree of
transverse movement of the crown(s) of the various teeth which is
different than that of the root(s) of the various teeth which
results in an undesired torquing of the tooth. An example would be
the crown of a given tooth "tipping" away from the patient's
midline during transverse arch expansion, with the root of this
tooth actually "tipping" toward the patient's midline. The
above-described wrapping of the ligature 448 actually generates
forces which are applied to the third segment 342.sup.iii to
counteract this type of movement of the associated tooth which
keeps the tooth more upright during outward movement (e.g., the
ligature 448 achieves a more bodily movement of the tooth
interconnected with the connector 326.sup.iii). Wrapping the
ligature 448 in one direction will apply these torsional forces in
one direction, while wrapping the ligature 448 in the opposite
direction will apply these torsional forces in the opposite
direction. Although various ligatures 448 may be used to provide
this torquing function, elastics are believed to be preferred.
Representative elastics for use as a ligature 448 are illustrated
in FIG. 18C and are commercially available from the assignee of
this patent application and referred to as "Energy-Chain.TM."
Elastics.
[0126] Alternatively, the force generating device illustrated in
FIGS. 1-6 can be employed to exert torsional forces in one or
another direction. This can be accomplished by twisting the
elastomeric member in a first direction. The memory of the
elastomeric member will cause the member to exert a force in the
direction opposite to which it is twisted in order to return to its
original undeformed configuration. The amount of force exerted can
be regulated by the amount the elastomeric member is twisted prior
to placing the free end over the second of the two collars. The
twisting is preferably accomplished before the two ends of the
elastomeric members are placed over the respective collars. For
example, one end of the elastomeric member can be placed over one
collar, the elastomeric member can be twisted and then the other
end can be placed over the other collar. Due to the memory of the
elastomeric material, the member will exert a force in the attempt
to return to its original undeformed configuration, thereby
exerting a torsional force which can be transferred to the tooth to
which the force generating member is anchored. In another
embodiment, tipping can be reduced or eliminated by reducing or
eliminating relative motion between the first collar and the second
collar. One way to accomplish this is to employ cross-sectional
configurations for the piston and the orifice which do not allow
relative rotational motion. For example, the piston and orifice can
be mating, non-circular cross-sectional configurations (e.g.
square, rectangle, triangle, star-shaped, oval, polygonal, etc.).
In this manner, the first collar would be prevented from rotating
relative to the second collar, thereby reducing or eliminating
tipping of the tooth to which the first collar is attached.
[0127] Another embodiment of a connector which may be utilized with
each of the above-described lingual arch developers and/or ligature
assemblies is illustrated in FIGS. 19A-B. The connector 326.sup.iv
is generally similar to the connectors 326, 326.sup.i, 326.sup.ii,
and 326.sup.iii discussed above and corresponding structure is
identified by a superscripted "iv" designation. The connector
326.sup.iv includes a pair of generally occlusal-gingivally
extending, mesio-distally spaced posts 330.sup.iv, a generally
distally extending first segment 334.sup.iv, a generally
semicircular second segment 338.sup.iv, and a generally mesially
extending and lingually offset third segment 342.sup.iv. The posts
330.sup.iv may also be disposed in the manner discussed above in
relation to the posts 330.sup.iii.
[0128] The connector 326.sup.iv also includes a number of
additional advantageous features. The connector 326.sup.iv includes
a hook 352.sup.iv which is disposed on the mesial end of the third
segment 342.sup.iv and opens generally distally as in the case of
the connector 326 The connector 326.sup.iv also includes an
extension 416 which extends mesially from the first segment
334.sup.iv and is a cantilever in that it has a free end 418. The
length of the extension 416 is selected such if it was adapted to
the lingual of a patient's dentition (i.e., the extension 416 may
be bent to generally conform to the lingual of a patient's
dentition), the end 418 of the extension 416 would be disposed
preferably slightly beyond the midline (FIG. 20B) of the patient's
arch (e.g., at the distal of the opposite lateral tooth). In one
embodiment, the extension 416 will typically extend between about
55 mm and about 65 mm beyond the mesial-most post 330a.sup.iv. The
orthodontic practitioner or lab may adapt the extension 416 to the
application with which it is being used. This may entail bending
the extension 416 and/or shortening the extension 416 by cutting
off a portion of its length from the mesial end thereof.
[0129] One use of the connector 326.sup.iv and its extension 416 is
as a mounting frame of sorts for bite blocks. This application is
illustrated in FIGS. 20A-B in which the connector 326.sup.iv is
mounted on a lower first molar and in which the bite block is
illustrated in dashed lines (FIG. 20A). A band (not shown) is
mounted on the first molar and has a pair of generally
occlusal-gingivally extending lingual tubes 468 and a generally
mesio-distally extending buccal tube 464. In order to adapt the
connector 326.sup.iv for this bite block mounting application, the
mesial extension 416 is bent into a generally U-shaped
configuration. The extension 416 is bent into a first section 420
which extends generally mesially of the mesial post 330a.sup.iv of
the connector 326.sup.iv, a second section 424 which extends up and
over the dentition (in the illustrated embodiment up and over the
second bicuspid), and a third section 428 which extends distally
from the second section 424 to interface with the buccal tube 440.
When installing the connector 326.sup.iv, the free end 418 of the
extension 416 slides through the buccal tube 440 and each of the
posts 330.sup.iv is disposed in the associated lingual tube 468.
The end 418 of the extension 416 may then be bent to further
rigidly interconnect the connector 326.sup.iv with the patient's
tooth (typically occlusally or gingivally).
[0130] When adapting the extension 416 to this bite block mounting
application, the extension 416 is bent into the above-described
configuration typically using a stone model of the orthodontic
patient. Thereafter, the bite block is mounted on the reconfigured
extension 416. In the case in which the connector 326.sup.iv is
used with a bite block, the second section 424 is disposed in the
preformed portion of the bite block. Typically, this is done by
molding (e.g., insert, injection) the preformed portion about the
second section 424. An enhanced interlocking relationship between
the connector 326.sup.iv and the bite block may be realized by
bending the second section 424 into the illustrated configuration
of FIG. 20A prior to "installing" the bite block thereon.
[0131] Other uses of the extension 416 of the connector 326.sup.iv
involve adapting the extension 416 to the lingual of the patient's
dentition. In one application in which this lingual adaptation is
provided, a portion of the extension 416 mesial of the posts
330.sup.iv is bent into an "omega" configuration 417 which is
illustrated in FIG. 21 and the function of which is discussed in
more detail in U.S. Pat. No. 4,354,834, entitled "Modular
Orthodontic Appliances, and issued Oct. 19, 1982. The entire
disclosure of U.S. Pat. No. 4,354,834 is incorporated by reference
in its entirety herein. Portions of the extension 416 disposed
mesially of the omega 417 are then bent to conform to the lingual
shape of the arch. By similarly configuring the extension 416 of
the connector 326.sup.iv disposed on the opposite side of the
patient's mouth, portions of the two extensions 416 will be in an
overlapping relation generally at/about the midline 460 (FIG. 20B)
of the corresponding dentition. The overlapping portions of the two
extensions 416 may then be joined together at the overlapping
interface (e.g., via brazing). With this configuration, the omega
417 of one or both of the extensions 416 may be activated in a
variety of ways as described in U.S. Pat. No. 4,354,834 to
provide/generate the desired type of orthodontic treatment force.
The third segment 342.sup.iv, of course, is available for use by
interfacing with other orthodontic appliances at the same type
which may beneficially interact with the forces being generated by
the joined extensions 416.
[0132] Another configuration of the connector 326.sup.iv when the
extension 416 is adapted to the patient's lingual is to conform the
extension 416 to the patient's lingual and leave the two ends 417
of the two extensions 416 unconnected. In this case the extensions
416 would remain independently active which may be desirable if
there is a need for a significant amount of advancement of anterior
teeth.
[0133] Another use for the connector 326.sup.iv is to utilize the
extensions 416 as a mounting for establishing anchorage on the
forward portion of the patient's mouth. For instance, with the
connectors 326.sup.iv being installed on the patient's upper arch
(in an inverted position to that illustrated in FIG. 19A), the
extensions 416 could be cocked upwardly at an angle of about
30.degree. such that the free ends of the two extensions 416 would
be disposed at the front part of the patient's palate. With free
end portions of the extensions 416 being in an overlapping relation
in this location, an acrylic button or the like (e.g., a Nance
button) may be molded around the free end portions of the
extensions 416. The acrylic is molded on a stone casting of the
patient and will be in general conforming engagement with the
patient when installed. With the connectors 326.sup.iv being
disposed on the patient's upper first molars, this will allow other
orthodontic appliances to interface with the upper first molars
without affecting movement of the upper first molars due to the
anchorage provided by the above-described extensions 416. For
instance, elastics may be mounted on the buccal of the upper first
molars and extend to teeth of the patient's lower dentition to
apply an orthodontic treatment force thereto without having any
significant effect on the position of the upper first molars since
they are maintained in a fixed position by the above-described
frontal anchorage provided by the extensions 416. The connectors
326.sup.iv of course may also be installed on the lower arch and
provide this type of forward anchorage by having the ends 418 of
the mesial extensions 416 be disposed below the patient's gum line
on the forward portion of the lower dentition.
[0134] Yet another use for the connector 326.sup.iv is to utilize
the extension 416 for interfacing with other orthodontic
appliances. When a connector 326.sup.iv is installed on the
patient's upper arch, (the position of the connector 326.sup.iv
then being inverted from that illustrated in FIG. 19A), the
extension 416 may be bent upwardly at an angle of about 90.degree.
such that the end 418 is at the vault of the patient's palate. The
free end 418 of the extension 416 may then interface with a palatal
expansion appliance (e.g., devices which achieve transverse arch
width).
[0135] Another embodiment of a connector which may be utilized with
each of the above-described lingual arch developers and/or ligature
assemblies is illustrated in FIGS. 22A-B. The connector 326.sup.v
is generally similar to the connectors 326, 326.sup.i, 326.sup.ii,
326.sup.iii, and 326.sup.iv discussed above and corresponding
structure is similarly numbered and identified by a superscripted
"v" designation. The connector 326.sup.v includes a pair of
generally occlusal-gingivally extending, mesio-distally spaced
posts 330.sup.v, a generally distally extending first segment
334.sup.v, a generally semi-circular second segment 338.sup.v, and
a generally distally extending and lingually offset (for a lingual
application) third segment 342.sup.v. The posts 330.sup.v may also
be disposed similar to the posts 330.sup.iii discussed above.
[0136] The connector 326.sup.v also includes a number of additional
advantageous features. The connector 326.sup.v includes a hook
352.sup.v which is disposed on the mesial end of the third segment
342.sup.v and opens generally distally as in the case of the
connector 326.sup.iv. The connector 326.sup.v also includes an
extension 416.sup.v which is interconnected with the first segment
334v and extends gingivally and then mesially beyond the mesial
post 330a.sup.v. The extension 416.sup.v is cantilevered in that it
includes a free end 418.sup.v. The length of the extension
416.sup.v is selected such if it was adapted to the lingual of a
patient's dentition (i.e., the extension 416.sup.v may be bent to
generally conform to the lingual of a patient's dentition), the end
418.sup.v of the extension 416.sup.v would be disposed preferably
slightly beyond the midline of the arch (e.g., at the distal of the
opposite lateral tooth). Therefore, the extension 416.sup.v is
sized similarly to the extension 416 discussed above. Although the
extension 416.sup.v may have a variety of uses, typically it will
be used in the case where the extension 416.sup.v is adapted to the
lingual of the patient's dentition and put into overlapping
relation with an extension 416.sup.v disposed on the opposite side
of the patient's arch, all as discussed above with regard to the
extension 416.sup.v.
[0137] Another embodiment of a lingual arch developer is
illustrated in FIG. 23. The lingual arch developer 472 is
illustrated as being interconnected with the orthodontic patient by
the connector 326.sup.iii and an end section 356. Another connector
326.sup.iii and end section 356 would of course be disposed on the
opposite side of the patient's jaw. It will be appreciated that the
lingual arch developer 472 may be used with other connectors
described herein which would allow the lingual arch developer 472
to advance the patient's arch in the above-described manner.
[0138] The lingual arch developer 472 includes a lingual arch 476
which engages the lingual surface of the patient's dentition
defining the patient's arch. The first distal section 478
interfaces with the connector 326.sup.iii via the end section 356
similar to that described above. That is, the first distal section
478 is fixedly attached to the end section 356 such that the
lingual arch 476 and the end section 356 move together
simultaneously (e.g., by bending a portion of the first distal
section 478 and disposing this bent portion within the interior of
the end section 456 to fix the end section 356 relative to the
lingual arch 476 as discussed above). The end section 356 then
slidably interfaces with the third segment 342.sup.iii of the
connector 326.sup.iii.
[0139] An aspect of the present invention relates to developing an
orthodontic patient's arch from the lingual. A lingual arch is
slidably interconnected with the lingual of the patient's arch. At
least two magnets are utilized to have some type of effect on the
movement of the lingual arch during development of the patient's
arch. Mesial advancement of the lingual arch and therefore the
patient's arch may be affected at least in part by these two
magnets, such as through using magnets whose respective magnetic
fields generate repulsive forces such that the magnets repel or
move away from each other. The magnets may be the sole source for
generating the generally mesially-directed forces applied to the
lingual arch, or may be used in conjunction with one or more other
force-generating members (e.g., springs, elastomers). Magnets whose
respective magnetic fields generate an attraction between the
magnets may also be used to retard the mesial advancement of the
lingual arch by biasing the magnets toward each other. This may be
utilized to reduce the magnitude of mesially-directed forces being
applied to the lingual arch by the force-generating member(s)
(e.g., to reduce the effect which a compressed spring has on the
lingual arch).
[0140] In one embodiment of this aspect, a first of the magnets is
maintained in a fixed position while a second of the magnets is
associated and moves with the lingual arch during development of
the patient's arch. Maintaining the first magnet in a fixed
position allows the first magnet to provides an anchoring-like
function for movement of the second magnet which has some type of
effect on the movement of the lingual arch. This may be affected by
attaching the first magnet to a connector associated with one of
the patient's teeth and which is used to provide an interface
between the lingual arch and the orthodontic patient (e.g., the
connector discussed above in the first aspect of the present
invention), or otherwise such that it remains substantially
stationery relative to the mesially-advancing lingual arch and/or
the orthodontic patient.
[0141] Association of the second magnet with the lingual arch may
be realized by attaching the second magnet to the lingual arch or
structure which also moves with the lingual arch (e.g., an end
section which is fixed to be lingual arch and which slidably
interfaces with the connector of the first aspect). Treatment
options which are available with this type of interconnection
include using magnets as the sole source for the mesially-directed
forces applied to the lingual arch and using magnets to retard or
resist the mesial advancement of the lingual arch provided by the
force-generating member(s) which mesially advance the lingual arch
and thereby the patient's arch. The second magnet may also be
movably interconnected with the lingual arch or structure which
also moves with the lingual arch (e.g., an end section which is
fixed to be lingual arch and which slidably interfaces with the
connector of the first aspect). This will typically be utilized
when additional force-generating members are being used. For
instance, a spring may be disposed between this second magnet and a
stop associated with the lingual arch (e.g. a hook attached to an
end section which is fixed to an end or end portion of the lingual
arch). As the second magnet moves mesially relative to the first
magnet, the magnitude of the repulsive forces therebetween is
reduced. However, this mesial movement of the second magnet will
maintain the spring in a certain state of compression such that the
magnitude of forces being applied to the lingual arch remain within
a certain desired range for a certain period of time.
[0142] The lingual arch developer 472 includes at least one
force-generating member for exerting a generally mesially-directed
force on the lingual arch 476, and thereby the lingual surface of
the patient's dentition which defines the arch undergoing
development. In the illustrated embodiment, the force-generating
member is actually a system including a first magnet 480, a second
magnet 484, and a spring 488. Typically, the same type of
configuration would be provided on the other side of the lingual
arch 476 as well such that symmetrical forces are applied to the
lingual arch 476.
[0143] The first magnet 480 is maintained in a fixed position
relative to the connector 326.sup.iii and the end section 356. This
may be affected by fixedly attaching the first magnet 480 to the
mesial end of the third segment 342.sup.iii of the connector
326.sup.iii (e.g., by a butt joint) or the mesial end portion of
the third segment 342.sup.iii (e.g., by disposing the first magnet
480 about the third segment 342.sup.iii). Various alternatives
exist for maintaining this fixed attachment, including being potted
in acrylic or in a metallic sheath. The second magnet 484
interfaces with the end section 356 in a manner discussed below and
is positioned between the first magnet 480 and the spring 488. One
end of the spring 488 engages the second magnet 484, while the
other end of the spring engages the hook 358 on the end section
356.
[0144] As noted, the magnets 480 and 484 are part of a system which
is at least one of the force-generating member(s) used by the
lingual arch developer 472. In the illustrated embodiment, the
magnets 480 and 484 are repulsive in that the interaction of the
magnetic fields of the magnets 480 and 484 move the second magnet
484 mesially away from the first magnet 480. Again, the first
magnet 480 remains in a fixed position to provide an anchoring
function for movement of the second magnet 484. The second magnet
484 is movably interconnected with the end section 356 in that it
is able to slide relative to the exterior surface of the end
section 356. This is provided in the illustrated embodiment by
utilizing a generally cylindrical or doughnut-shaped configuration
for the second magnet 484 as illustrated in FIG. 24. As the second
magnet 484 moves along the end section 356, the distance between
the magnets 480 and 484 increases. Increasing the distance between
the first magnet 480 and the second magnet 484 will of course
reduce the magnitude of the repulsive forces therebetween. However,
the movement of the second magnet 484 along the exterior of the end
section 356 also maintains the spring 488 in compression. As a
result, the combinative forces applied to the lingual arch 276
remain within a desired range for a desired period of time.
[0145] It may be possible to use the magnets 480 and 484 as the
sole source of the generally mesially-directed forces applied to
the lingual arch 476 in certain applications (not shown). The
second magnet 284 would be fixedly attached to the end section 356
and its magnetic field would interact with the magnetic field of
the first magnet 480. Due to the first magnet 480 being fixedly
attached to the connector 326.sup.iii, the second magnet 484
advances mesially away from the first magnet 480. This movement of
the second magnet 484 similarly mesially advances the lingual arch
476 to develop the patient's arch.
[0146] The magnets 480 and 484 may also be used to reduce the
amount of forces being applied to the lingual arch 472 by another
portion of the force-generating system. This would be desirable,
for instance, when undesirably strong mesially-directed forces are
being transmitted to the lingual arch 476 by this part of the
force-generating system. Attractive forces would be utilized
between the first magnet 480 and the second magnet 484 in this
instance. Specifically, the interaction of the magnetic fields of
the first magnet 480 and the second magnet 484 would bias the
second magnet 484 distally toward the first magnet 480 which is
again maintained in a fixed position relative to the lingual arch
476. In order to affect this type of "tethering-like" function, the
second magnet 484 would be fixedly attached to the end section 356
(not shown). This type of configuration would be desirable if, for
instance, the spring 488 exerted more forces than desired on the
lingual arch 476.
[0147] A variety of magnetic materials may be utilized for the
first magnet 480 and the second magnet 484. Preferred materials for
the magnets 480 and 484 include the rare earth metals since such
materials provide desired properties for this orthodontic treatment
application. Rare earth magnets generate strong magnetic fields and
retain their magnetic field for a desired period of time. These
strong magnetic fields may be obtained through use of relatively
small sized magnets. Various configurations may also the utilized
in the case of rare earth magnets. Rare earth magnets are also not
bipolar. Preferred rare earth materials for the magnets 480 and 484
include neodynium/boron and sararium/cobalt.
[0148] The foregoing description of the present invention has been
presented for purposes of illustration and description.
Furthermore, the description is not intended to limit the invention
to the form disclosed herein. Consequently, variations and
modifications commensurate with the above teachings, and skill and
knowledge of the relevant art, are within the scope of the present
invention. For example, the various elements of the assemblies
described herein can be used in different configurations.
Specifically, the force generating device employing an elastomeric
member can be substituted for force generating devices employing
springs or other members in the embodiments described herein. The
embodiments described hereinabove are further intended to explain
best modes known of practicing the invention and to enable others
skilled in the art to utilize the invention in such, or other
embodiments and with various modifications required by the
particular application(s) or use(s) of the present invention. It is
intended that the appended claims be construed to include
alternative embodiments to the extent permitted by the prior
art.
* * * * *