U.S. patent application number 17/662819 was filed with the patent office on 2022-08-25 for combined orthodontic movement of teeth with airway development therapy.
This patent application is currently assigned to uLab Systems, Inc.. The applicant listed for this patent is uLab Systems, Inc.. Invention is credited to Michael I. FALKEL.
Application Number | 20220265395 17/662819 |
Document ID | / |
Family ID | 1000006322289 |
Filed Date | 2022-08-25 |
United States Patent
Application |
20220265395 |
Kind Code |
A1 |
FALKEL; Michael I. |
August 25, 2022 |
COMBINED ORTHODONTIC MOVEMENT OF TEETH WITH AIRWAY DEVELOPMENT
THERAPY
Abstract
Systems, devices and methods are disclosed for reshaping airways
concurrently with dental and/or orthodontic treatment. The systems
can have a series of two or more oral appliances configured to
progressively reposition the maxillary and mandibular teeth in two
or more successive steps. Each oral appliance in the series can
have one or more maxillary blocks, one or more mandibular blocks, a
maxillary oral tray, and a mandibular oral tray. One or more
maxillary blocks can be attached to or integrated with the
maxillary oral tray. One or more mandibular blocks can be attached
to or integrated with the mandibular oral tray. The maxillary and
mandibular oral trays can be configured to move one or more teeth
from a tooth first position to a tooth second position. The
maxillary and mandibular blocks can be configured to interact with
one another to treat sleep breathing disorders.
Inventors: |
FALKEL; Michael I.; (Carmel,
CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
uLab Systems, Inc. |
Memphis |
TN |
US |
|
|
Assignee: |
uLab Systems, Inc.
Memphis
TN
|
Family ID: |
1000006322289 |
Appl. No.: |
17/662819 |
Filed: |
May 10, 2022 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
15710604 |
Sep 20, 2017 |
11364098 |
|
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17662819 |
|
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62397749 |
Sep 21, 2016 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61C 7/002 20130101;
A61F 5/05891 20130101; A61F 5/566 20130101; A61C 7/36 20130101;
A61C 7/10 20130101; A61C 7/08 20130101; A61F 2005/563 20130101 |
International
Class: |
A61C 7/36 20060101
A61C007/36; A61C 7/00 20060101 A61C007/00; A61C 7/08 20060101
A61C007/08; A61C 7/10 20060101 A61C007/10; A61F 5/058 20060101
A61F005/058; A61F 5/56 20060101 A61F005/56 |
Claims
1. A system for treating a sleep breathing disorder, the system
comprising: a nighttime oral appliance and a daytime oral
appliance, wherein the nighttime oral appliance is configured to
increase an interocclusal separation between maxillary teeth and
mandibular teeth more than the daytime oral appliance, and/or
wherein the nighttime oral appliance is configured to advance a
mandible more than the daytime oral appliance or by the same amount
as the daytime oral appliance.
2. The system of claim 1, wherein the nighttime oral appliance and
the daytime oral appliance are configured to orthodontically move
teeth.
3. The system of claim 1, wherein the daytime oral appliance is
configured to orthodontically move teeth with less force than the
nighttime oral appliance.
4. The system of claim 1, wherein the daytime oral appliance has a
component for treating the sleep breathing disorder that is smaller
than a component of the nighttime oral appliance.
5. The system of claim 4, wherein the component of the daytime oral
appliance comprises a maxillary block or a mandibular block, and
wherein the component of the nighttime oral appliance comprises a
maxillary block or a mandibular block.
6. The system of claim 5, wherein the maxillary block or the
mandibular block of the daytime oral appliance is removably
attachable to the daytime oral appliance, and wherein the maxillary
block or the mandibular block of the nighttime oral appliance is
removably attachable to the nighttime oral appliance.
7. The system of claim 1, further comprising a first stage of
treatment and a second stage of treatment, wherein the first stage
of treatment comprises the nighttime oral appliance, and wherein
the second stage of treatment comprises the daytime oral
appliance.
8. The system of claim 1, wherein the nighttime oral appliance and
the daytime oral appliance are a first nighttime oral appliance and
a first daytime oral appliance, respectively, and wherein the
system further comprises a second nighttime oral appliance and a
second daytime oral appliance.
9. The system of claim 8, wherein the second nighttime oral
appliance is configured to increase the interocclusal separation
between the maxillary teeth and the mandibular teeth more than the
second daytime oral appliance, and/or wherein the second nighttime
oral appliance is configured to advance the mandible more than the
second daytime oral appliance or by the same amount as the second
daytime oral appliance.
10. The system of claim 8, further comprising a first stage of
treatment and a second stage of treatment, wherein the first stage
of treatment comprises the first nighttime oral appliance and the
first daytime oral appliance, and wherein the second stage of
treatment comprises the second nighttime oral appliance and the
second daytime oral appliance.
11. A method of treating a sleep breathing disorder, the method
comprising: increasing an interocclusal separation between
maxillary teeth and mandibular teeth more with a nighttime oral
appliance than with a daytime oral appliance.
12. The method of claim 11, further comprising advancing a mandible
more with the nighttime oral appliance than with the daytime oral
appliance.
13. The method of claim 11, further comprising advancing a mandible
with the nighttime oral appliance and with the daytime oral
appliance.
14. The method of claim 11, further comprising orthodontically
moving teeth with the nighttime oral appliance and with the daytime
oral appliance.
15. The method of claim 14, wherein orthodontically moving teeth
with the nighttime oral appliance and with the daytime oral
appliance comprises orthodontically moving the teeth with less
force with the daytime oral appliance than with the nighttime oral
appliance.
16. The method of claim 11, wherein the nighttime oral appliance
and the daytime oral appliance are a first nighttime oral appliance
and a first daytime oral appliance, respectively, and wherein the
method further comprises increasing the interocclusal separation
between the maxillary teeth and the mandibular teeth more with a
second nighttime oral appliance than with a second daytime oral
appliance.
17. The method of claim 16, further comprising advancing a mandible
more with the first nighttime oral appliance than with the first
daytime oral appliance; and advancing the mandible more with the
second nighttime oral appliance than with the second daytime oral
appliance.
18. The method of claim 16, further comprising orthodontically
moving teeth with the first nighttime oral appliance and with the
first daytime oral appliance; and orthodontically moving the teeth
with the second nighttime oral appliance and with the second
daytime oral appliance.
19. The method of claim 16, further comprising a first stage of
treatment and a second stage of treatment, wherein the first stage
of treatment comprises the first nighttime oral appliance and the
first daytime oral appliance, and wherein the second stage of
treatment comprises the second nighttime oral appliance and the
second daytime oral appliance.
20. A method of treating a sleep breathing disorder, the method
comprising: increasing an interocclusal separation between
maxillary teeth and mandibular teeth more with an oral appliance
during nighttime than during daytime, wherein during nighttime a
maxillary block and a mandibular block are attached to the oral
appliance, and wherein during daytime the maxillary block and the
mandibular block are detached from the oral appliance.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a divisional of U.S. patent application
Ser. No. 15/710,604 filed Sep. 20, 2017, which claims the benefit
of priority to U.S. Provisional Application No. 62/397,749 filed
Sep. 21, 2016, the contents of each of which are incorporated
herein by reference in their entirety for all purposes.
BACKGROUND
1. Technical Field
[0002] Systems, devices and methods for reshaping airways are
disclosed. More specifically, systems, devices and methods are
disclosed for reshaping airways concurrently with dental and/or
orthodontic treatment.
2. Background of the Art
[0003] Airway disorders affect a large portion of the population
and are regarded as multifactorial conditions with a multitude of
etiologies and treatment modalities. Orthodontic treatment can aid
in the development of the airway a treatment modality for airway
disorders, the current invention allows for the combined use of
orthodontic and airway treatment modalities.
[0004] Airway disorders affect a significant population with
estimates of the 3% of pediatric population and 10% of the adult
population. Morbidity from airway disorders ranges from mental and
physical deterioration to disabling illnesses or even death. In
children, physical and cognitive development can be delayed or
stunted. Adult manifestations can include tiredness, somnolence,
memory loss and sleep disorders. The airway is shaped by various
craniofacial structures. Evaluation of craniofacial structures is
therefore of paramount importance in treating airway disorders.
Orthodontic treatment can manipulate craniofacial structures to
reshape and open the airway of both pediatric and adult patients.
Combining oral airway devices with orthodontic treatment can help
not only orthodontic issues but the overall health of the patient.
Results of this combined therapy by manipulating not only the
dental arches but also the drape of the soft tissue that
establishes airway size, shape and volume.
[0005] Obstructive sleep apnea (OSA) is a major health risk that
various oral and dental appliances have been addressing for years.
However, these appliances merely address the symptoms associated
with OSA--they are not therapeutic in nature. The present
disclosure addresses these deficiencies by combining orthodontic
and OSA treatments. Treating OSA concurrently with orthodontic
treatment can advantageously ease symptoms associated with OSA
while attaining a therapeutic result of the airway condition by
enlarging or otherwise reshaping the airway.
[0006] Comprehensive dental treatments should include consideration
of the structures involved, including the airway. The present
invention allows the dental provider to combine airway development
therapy, obstructive sleep apnea and orthodontic treatment to end
with a result that considers a beautiful smile with a patent airway
day and night. The invention allows for numerous different
treatment philosophies for OSA and airway development to be treated
with orthodontic aligners simultaneously. This includes but is not
limited to mandibular advancement style appliances, palatal and
mandibular expanders using the orthodontic aligners. By
manipulating the 3D models the aligners can act both as orthodontic
movers of teeth along with ideal positioning of the jaws to open
the airway.
[0007] A need exists to combine orthodontic and/or dental treatment
with OSA appliances. The advantages of combining these modalities
include: (1) opening the airway due to orthodontic advancing and/or
widening of the arches to potentially cure the disease or at least
lessen the symptoms, (2) OSA appliances worn exclusively at night
can cause temporomandibular joint dysfunction or myofascial pain
dysfunction, which can be advantageously addressed by the daytime
and nighttime appliances disclosed herein, (3) existing OSA devices
can cause morning malalignment of the teeth and/or with prolong use
cause orthodontic problems which by design can be prevented or
otherwise mitigated with the oral appliances disclosed herein, (4)
the oral appliances disclosed herein can be titrated over a series
of two or more steps for ideal mandibular advancement and/or
opening with the software and/or different ramp designs which can
encourage true hinge rotation as well as translation of the
temporomandibular joint, and/or (5) the oral appliances disclosed
herein can allow free mandibular motion while having the ability to
hold the joint in a fixed position if necessary for the desired
treatment or comfort of the patient.
BRIEF SUMMARY OF THE INVENTION
[0008] This disclosure relates generally to the combined
orthodontic movement and/or dental treatment of teeth, airway
development and treatment of sleep breathing disorders.
[0009] More specifically, orthodontic and/or dental airway
development systems, apparatuses and methods of using the same are
disclosed. The airway development systems and apparatuses disclosed
can concurrently move teeth and reshape the airway. The airway
development systems and apparatuses disclosed can concurrently
advance the mandible and reshape the airway. The airway development
systems apparatuses disclosed can concurrently expand the hard
and/or soft palate and reshape the airway. The airway development
systems and apparatuses disclosed can concurrently whiten teeth and
reshape the airway. The airway development systems and apparatuses
disclosed can concurrently clean teeth and reshape the airway. The
airway development systems and apparatuses disclosed can
concurrently move teeth, advance the mandible, expand the hard
and/or soft palate, whiten teeth, apply hygienic treatment, reshape
the airway, or any combination thereof.
[0010] The airway development systems and apparatuses can have
dental trays and/or orthodontic aligner trays. The airway
development systems and apparatuses can have airway development
blocks. The airway development blocks can be attached to or
integrated with one or more trays.
[0011] Oral appliances for the treatment of sleep breathing
disorders are disclosed. For example, an oral appliance is
disclosed that can have one or more maxillary blocks. The oral
appliance can have one or more mandibular blocks. The oral
appliance can have a maxillary oral tray. One or more maxillary
blocks can be attached to or integrated with the maxillary oral
tray. The oral appliance can have a mandibular oral tray. One or
more mandibular blocks can be attached to or integrated with the
mandibular oral tray. The maxillary and mandibular oral trays
configured to move one or more teeth from a tooth first position to
a tooth second position. Each maxillary block can have a maxillary
block guide surface. Each mandibular block can have a mandibular
block guide surface. Each maxillary block guide surface can be
opposed to and configured to interact with at least one mandibular
block guide surface to at least one of move one or more teeth,
advance a mandible, increase an interocclusal separation between a
maxillary dentition and a mandibular dentition, and expand a
palate.
[0012] Systems for the treatment of sleep breathing disorders are
disclosed. For example a system is disclosed that can have a series
of two or more oral appliances configured to progressively
reposition the maxillary and mandibular teeth in two or more
successive steps. Each oral appliance in the series can have one or
more maxillary blocks. Each oral appliance in the series can have
one or more mandibular blocks. Each oral appliance in the series
can have a maxillary oral tray. One or more maxillary blocks can be
attached to or integrated with the maxillary oral tray. Each oral
appliance in the series can have a mandibular oral tray. One or
more mandibular blocks can be attached to or integrated with the
mandibular oral tray. The maxillary and mandibular oral trays can
be configured to move one or more teeth from a tooth first position
to a tooth second position. Each maxillary block can have a
maxillary block guide surface. Each mandibular block can have a
mandibular block guide surface. Each maxillary block guide surface
can be opposed to and configured to interact with at least one
mandibular block guide surface to at least one of move one or more
teeth, advance a mandible, increase an interocclusal separation
between a maxillary dentition and a mandibular dentition, and
expand a palate.
[0013] Methods of treating sleep breathing disorders are disclosed.
For example, a method is disclosed that can include providing a
series of two or more oral appliances configured to progressively
reposition the maxillary and mandibular teeth in two or more
successive steps. Each oral appliance in the series can have one or
more maxillary blocks. Each oral appliance in the series can have
one or more mandibular blocks. Each oral appliance in the series
can have a maxillary oral tray. One or more maxillary blocks can be
attached to or integrated with the maxillary oral tray. Each oral
appliance in the series can have a mandibular oral tray. One or
more mandibular blocks can be attached to or integrated with the
mandibular oral tray. The maxillary and mandibular oral trays can
be configured to move one or more teeth from a tooth first position
to a tooth second position. Each maxillary block can have a
maxillary block guide surface. Each mandibular block can have a
mandibular block guide surface. Each maxillary block guide surface
can opposed to and configured to interact with at least one
mandibular block guide surface to at least one of move one or more
teeth, advance a mandible, increase an interocclusal separation
between a maxillary dentition and a mandibular dentition, and
expand a palate.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] The drawings shown and described are exemplary embodiments
and non-limiting. Like reference numerals indicate identical or
functionally equivalent features throughout.
[0015] FIG. 1 illustrates isometric views of a variation of airway
development blocks of an oral appliance.
[0016] FIG. 2 illustrates a top elevational view of the oral
appliance of FIG. 1.
[0017] FIG. 3 illustrates a side isometric view of the oral
appliance of FIG. 1 in an assembled configuration under
compression.
[0018] FIG. 4 illustrates a schematic of a variation of an aligner
on teeth.
[0019] FIG. 5 illustrates a schematic of a variation of a maxillary
aligner on teeth that has a variation of an airway development
block.
[0020] FIG. 6 illustrates a schematic of a variation of maxillary
and mandibular aligners on teeth with each having a variation of an
airway development block.
[0021] FIG. 7 illustrates a schematic of a variation of a series of
oral appliances.
[0022] FIG. 8 illustrates a variation of a process for making a
variation of an oral appliance.
DETAILED DESCRIPTION
[0023] Systems, devices and methods are disclosed that can
concurrently reshape and/or maintain the airway, apply orthodontic
treatment, apply dental treatment, or any combination thereof. The
systems, devices and methods disclosed can apply orthodontic
treatment to any craniofacial structure, including the dentition,
the palate, the maxilla, the mandible, or any combination thereof.
The systems, devices and methods disclosed can apply any dental
treatment to the teeth, including whitening treatments, cleaning
treatments, gingival recession treatments, or any combination
thereof. For example, systems, devices and methods are disclosed
that can concurrently move one or more teeth, advance the mandible,
retrude the mandible, expand the hard and/or soft palate, whiten
teeth, clean teeth, treat gum line recession, reshape the airway,
maintain the airway, or any combination thereof.
[0024] The disclosed systems, devices and methods can
orthodontically reshape the airway by manipulating one or more
craniofacial structures. The airway can be reshaped into a more
open configuration by widening the dental arches, by increasing the
interocclusal distance between the upper and lower teeth and/or by
advancing the lower jaw. The airway can be reshaped concurrently
with the orthodontic treatment of, for example, misaligned teeth,
malocclusions, and/or narrow arches. Additionally or alternatively,
the airway can be reshaped concurrently with a teeth whitening,
cleaning and/or gingival recession treatment.
[0025] More particularly, oral appliances are disclosed that can
reshape and/or maintain the airway to treat sleep breathing
disorders (SBD) such as obstructive sleep apnea (OSA) and snoring.
The oral appliances disclosed can reshape the airway by
simultaneously manipulating one or more craniofacial structures and
moving teeth, cleaning teeth, whitening teeth, or any combination
thereof. The oral appliances disclosed can treat SBD and snoring
with various orthodontic treatment modalities, for example,
mandibular advancement, palatal expansion and/or mandibular
expansion. The oral appliances disclosed can simultaneously provide
both orthodontic and SBD treatment and result in more properly
aligned teeth and a more open airway. The oral appliances disclosed
can simultaneously provide dental whitening, dental cleaning and/or
gingival recession treatments in combination with SBD treatment and
result in whiter teeth, cleaner teeth, healthier gums, fresher
breath, and a more open airway.
System and Apparatus
[0026] SBD appliance therapy can be combined with the orthodontic
movement of teeth, for example, with orthodontic aligner treatment.
The SBD appliances disclosed can simultaneously reposition the jaw
and orthodontically move teeth, for example, by virtue of their
combination with aligner treatment. The systems disclosed however,
not only simply allow for their combination, the systems also
advantageously allow for their treatments to be coordinated with
one another.
[0027] FIG. 1 illustrates a variation of a customizable oral
appliance 10 for reshaping and/or maintaining the airway. The
appliance 10 can have one or more maxillary blocks 12 and one or
more mandibular blocks 14. For example, the appliance 10 can have 1
to 6 maxillary blocks 12 and 1 to 6 mandibular blocks 14. The
number of maxillary blocks 12 can be less than, equal to, or
greater than the number of mandibular blocks 14. For example, FIG.
1 illustrates that the appliance 10 can have two maxillary blocks
12 and two mandibular blocks 14. As another example, the appliance
10 can have one maxillary block 12 and two mandibular blocks 14 or
vice versa. The appliance 10 can have one, two, three, four, or
five more maxillary blocks 12 than mandibular blocks 14 or vice
versa. The appliance 10 can have one or more maxillary blocks 12
and no mandibular blocks 14 or one or more mandibular blocks 14 and
no maxillary blocks 12. The blocks 12, 14 can be placed in a
person's oral cavity.
[0028] FIG. 1 illustrates that the appliance 10 can have a first
maxillary block 12a and a second maxillary block 12b. Anatomically,
the maxillary first block 12a can be a left block and the maxillary
second block 12b can be a right block, or vice versa. The maxillary
first and second blocks 12a, 12b can be configured to be placed on
a lateral left and right side, respectively, of a maxillary dental
arch. The appliance 10 can have a first mandibular block 14a and a
second mandibular block 14b. Anatomically, the mandibular first
block 14a can be a left block and the mandibular second block 14b
can be a right block, or vice versa. The mandibular first and
second blocks 14a, 14b can be configured to be placed on a lateral
left and right side, respectively, of a mandibular dental arch.
[0029] FIG. 1 illustrates that the blocks 12, 14 can each have a
buccal side 16, a lingual side 18, an anterior portion 20, a
posterior portion 22 and teeth surfaces 24. Each maxillary block 12
can have a maxillary tooth surface 24a and/or a mandibular tooth
surface 24b. Each mandibular block 14 can have a maxillary tooth
surface 24a and/or a mandibular tooth surface 24b. The surfaces 24
can conform to surfaces of the teeth and/or can have a geometry to
orthodontically move one or more teeth from one position to
another. One or more of the surfaces 24 of maxillary and mandibular
blocks can be configured to have a friction fit over a portion of
one or more teeth.
[0030] The maxillary tooth surfaces 24a of the maxillary blocks 12
can have a surface geometry configured to move one or more
maxillary teeth from a first position to a second position. The
mandibular tooth surfaces 24b of the maxillary blocks 12 can be
flat (e.g., as shown in FIG. 1) or can have a surface geometry
configured to move one or more mandibular teeth from a first
position to a second position. The mandibular tooth surfaces 24b of
the mandibular blocks 14 can have a surface geometry configured to
move one or more mandibular teeth from a first position to a second
position. The maxillary tooth surfaces 24a of the mandibular blocks
14 can be flat (e.g., as shown in FIG. 1) or can have a surface
geometry configured to move one or more maxillary teeth from a
first position to a second position.
[0031] A series of blocks 12, 14 can be designed to progressively
reposition the maxillary and/or mandibular teeth in two or more
successive steps, for example, as disclosed in PCT Publication WO
2016/004415 and U.S. application Ser. No. 15/386,280 (published as
US 2017/0100214) in relation to orthodontic trays, both of which
are herein incorporated by reference in their entireties for all
purposes. Each block 12, 14 in a series can have a surface 24 that
has a geometry that corresponds to an intermediate or end tooth
arrangement intended for the block 12, 14 in the series. The blocks
12, 14 can be sufficiently resilient to accommodate or conform to
misaligned teeth, but apply sufficient force against the misaligned
teeth to reposition the teeth to the intermediate or end
arrangement as desired for the particular treatment step. A series
of blocks 12, 14 can have geometries selected to progressively
reposition teeth from a first arrangement through one or more
successive intermediate arrangements to a final arrangement. Each
block in the series can have the same or different dimensions than
one or more other blocks in the series, as described below. A
series of blocks 12, 14 can have 1 to 100 maxillary blocks 12 and 1
to 100 mandibular blocks 14, for example, 1 to 55 maxillary blocks
12 and 1 to 55 mandibular blocks 14, 1 to 50 maxillary blocks 12
and 1 to 50 mandibular blocks 14, 1 to 45 maxillary blocks 12 and 1
to 45 mandibular blocks 14, 1 to 40 maxillary blocks 12 and 1 to 40
mandibular blocks 14, less than 40 maxillary blocks 12 and less
than 40 mandibular blocks, or any combination thereof. For example,
a series of blocks can have 40, 41, 42, 43, 44, 45, 46, 47, 48, 49,
or 50 maxillary blocks 12 and 40, 41, 42, 43, 44, 45, 46, 47, 48,
49, or 50 mandibular blocks 14. The number of maxillary blocks 12
can be the same or different as the number mandibular blocks 14 in
a series.
[0032] FIG. 1 illustrates that the maxillary blocks 12 can each
have one or more maxillary block guide surfaces 26 (e.g., 1 to 6 or
more maxillary guide surfaces 26) and that the mandibular blocks 14
can each have one or more mandibular block guide surfaces 28 (e.g.,
1 to 6 or more mandibular guide surfaces 28). The guide surfaces
26, 28 are variously referred to throughout as ramps, stops,
disclusion surfaces, expansion surfaces, resting surfaces and/or
other similar terms. The guide surfaces 26 can be on any part or
define any surface of the blocks 12, 14, for example, the anterior
and/or posterior portions 20, 22 of the maxillary and mandibular
blocks 12, 14.
[0033] FIG. 1 illustrates that the anterior portion 20 of the
maxillary blocks 12 can have one maxillary guide surface 26 and
that the posterior portion 22 of the mandibular blocks 14 can have
one mandibular guide surface 28. For example, FIG. 1 illustrates
that the maxillary first and second blocks 12a, 12b can have
maxillary first and second guide surfaces 26a, 26b, respectively,
and that the mandibular first and second blocks 14a, 14b can have
mandibular first and second guide surfaces 28a, 28b, respectively.
The exact number and orientation of the guide surfaces 26, 28 can
be customizable and depend on a person's tolerance for the blocks
12, 14, craniofacial structure, teeth alignment, orthodontic
treatments being applied, dental treatment being applied or any
combination thereof, each factor being critical to the design of
the blocks 12, 14. Each block in a series can have the same or
different number and/or orientation of guide surfaces 28a, 28b as
one or more other blocks in the series.
[0034] While FIG. 1 illustrates that the anterior portions 20 of
the maxillary blocks 12 and the posterior portions 22 of the
mandibular blocks 14 have the guide surfaces 26, 28 (e.g., guide
surfaces 26a, 26b, 28a, 28b), the anterior and/or posterior portion
20, 22 of each of the maxillary and mandibular blocks can have one
or more guide surfaces in addition to or in lieu of the guide
surfaces 26, 28 shown in FIG. 1. For example, the posterior
portions 22 of the maxillary blocks 12 can have guide surfaces
and/or the anterior portions 20 of the mandibular blocks 14 can
have guide surfaces. However, the anterior and/or posterior
portions 20, 22 of the maxillary and/or mandibular blocks 12 need
not have a guide surface. For example, FIG. 1 illustrates that the
posterior portions 22 of the maxillary blocks 12 and the anterior
portions 20 of the mandibular blocks 14 can have ends that do not
have a guide surface. FIG. 1 illustrates that the ends of the
posterior portions 22 of the maxillary blocks 12 and the anterior
portions 20 of the mandibular blocks 14 can have a flat or curved
surface with a portion that is perpendicular or nearly
perpendicular to an occlusal plane.
[0035] Each guide surface (e.g., guide surfaces 26, 28) can be
paired with an opposing (also referred to as cooperating,
interacting, engaging, contacting, or interfering) guide surface.
For example, the blocks 12, 14 can be paired such that their
corresponding guide surfaces 26, 28 form one or more corresponding
guide surfaces pairs 26-28. Each guide surface in a guide surface
pair can be configured to interact with its opposing guide surface.
For example, the opposing guide surfaces of a guide surface pair
26-28 can be configured to slidably engage or otherwise move
relative to one another and/or be configured to rest against each
other or otherwise inhibit or prevent movement relative to one
another. At least a portion of each guide surface, including the
entire guide surface, can be configured to contact at least a
portion of its opposing guide surface, including the entire
opposing guide surface, such that any portion 100% or less is
appreciated. FIG. 1 illustrates that the two left blocks 12a, 14a
can form a left guide surface pair 26a-28a and that the two right
blocks 12b, 14b can form a right guide surface pair 26b-28b. The
maxillary and mandibular guide surfaces 26a, 28a of the left pair
26a-28a can be designed to interact with each other and the
maxillary and mandibular guide surfaces 26b, 28b of the right pair
26b-28b can be designed to interact with each other. Each guide
surface 26, 28 can interact with its opposing guide surface in a
self-guided manner. The guide surfaces 26, 28 can position the
mandible in the anatomically correct joint position while the teeth
are moving orthodontically.
[0036] Each guide surface 26, 28 can be or have one or more planar
surfaces (e.g., 1 to 50 planar surfaces). For example, FIG. 1
illustrates that each guide surface 26, 28 can have one planar
surface. However, the guide surfaces 26, 28 can have any surface
geometry, including planar, curved (e.g., one or more concave
and/or convex portions), polygonal (e.g., any combination of two or
more planes), irregular, or any combination thereof. Thus, although
the guide surfaces 26, 28 can function as guide planes and may be
planar in general characteristics, strict conformity with flatness
associated with a plane is not required.
[0037] The guide surfaces 26, 28 can be angled such that they
define one or more inclined, horizontal, and/or declined planar
surfaces. The guide surfaces 26, 28 can be at one or more angles
relative to, for example, a reference plane, reference surface, or
reference axis. FIG. 1 illustrates that the maxillary guide
surfaces 26 (e.g., the maxillary first and second guide surfaces
26a, 26b) can each be at maxillary guide surface angle 30. The
maxillary guide surface angle 30 can be the angle formed between
the maxillary guide surfaces 26 and a reference plane, reference
surface, or reference axis such as the maxillary tooth surface 24a
(or an occlusal plane), maxillary orthodontic aligner (not shown),
or any combination thereof. The maxillary guide surface angle 30
can be from about 0 degrees to about 90 degrees or more broadly
from about 0 degrees to about 150 degrees. For angles greater than
90 degrees, the maxillary guide surface 26 can face toward as
opposed to away from the maxillary dentition. For example, the
maxillary guide surface angle 30 can be from about 15 degrees to
about 75 degrees, from about 40 degrees to about 50 degrees, from
about 30 degrees to about 60 degrees, from about 20 degrees to
about 70 degrees, or from about 10 degrees to about 80 degrees,
including every 1 degree increment within these ranges; for
example, the maxillary guide surface angle 30 can be about 0
degrees, about 5 degrees, about 10 degrees, about 15 degrees, about
20 degrees, about 25 degrees, about 30 degrees, about 35 degrees,
about 40 degrees, about 45 degrees, about 50 degrees, about 55
degrees, about 60 degrees, about 65 degrees, about 70 degrees,
about 75 degrees, about 80 degrees, about 85 degrees, about 90
degrees, about 130 degrees, about 135 degrees, about 140 degrees,
about 145 degrees, or about 150 degrees. Angles within these ranges
and/or having these values can advantageously allow the maxillary
and mandibular blocks 12, 14 to slidably engage or otherwise move
relative to one another and/or rest against each other or otherwise
inhibit or prevent movement relative to one another. Angles within
these ranges and/or having these values can advantageously allow
the maxillary and mandibular blocks 12, 14 to contact (e.g.,
slidably contact) each other to move and/or maintain the mandible
into a forward position and/or to increase and/or maintain the
interocclusal separation between the maxillary and mandibular
dental arches. Angles within these ranges and/or having these
values can therefore advantageously facilitate the reshaping of the
airway into a more open configuration (e.g., from a less open first
configuration to a more open second configuration). Each maxillary
block 12 in a series can have the same or different maxillary guide
surface angle 30 as one or more other maxillary blocks 12 in the
series.
[0038] FIG. 1 illustrates that the mandibular guide surfaces 28
(e.g., the mandibular first and second guide surfaces 28a, 28b) can
each be at a mandibular guide surface angle 32. The mandibular
guide surface angle 32 can be the angle formed between the
mandibular guide surfaces 28 and a reference plane, reference
surface, or reference axis such as the mandibular tooth surface 24b
(or an occlusal plane), mandibular orthodontic aligner (not shown),
or any combination thereof. The mandibular guide surface angle 32
can be from about 0 degrees to about 90 degrees or more broadly
from about 0 degrees to about 150 degrees. For angles greater than
90 degrees, the mandibular guide surface 28 can face toward as
opposed to away from the mandibular dentition. For example, the
mandibular guide surface angle 32 can be from about 15 degrees to
about 75 degrees, from about 40 degrees to about 50 degrees, from
about 30 degrees to about 60 degrees, from about 20 degrees to
about 70 degrees, or from about 10 degrees to about 80 degrees,
including every 1 degree increment within these ranges; for
example, the mandibular guide surface angle 32 can be about 0
degrees, about 5 degrees, about 10 degrees, about 15 degrees, about
20 degrees, about 25 degrees, about 30 degrees, about 35 degrees,
about 40 degrees, about 45 degrees, about 50 degrees, about 55
degrees, about 60 degrees, about 65 degrees, about 70 degrees,
about 75 degrees, about 80 degrees, about 85 degrees, about 90
degrees, about 130 degrees, about 135 degrees, about 140 degrees,
about 145 degrees, or about 150 degrees. Angles within these ranges
and/or having these values can advantageously allow the maxillary
and mandibular blocks 12, 14 to slidably engage or otherwise move
relative to one another and/or rest against each other or otherwise
inhibit or prevent movement relative to one another. Angles within
these ranges and/or having these values can advantageously allow
the maxillary and mandibular blocks 12, 14 to contact (e.g.,
slidably contact) each other to move and/or maintain the mandible
into a forward position and/or to increase and/or maintain the
interocclusal separation between the maxillary and mandibular
dental arches. Angles within these ranges and/or having these
values can therefore advantageously facilitate the reshaping of the
airway into a more open configuration (e.g., from a less open first
configuration to a more open second configuration). Each mandibular
block 14 in a series can have the same or different maxillary guide
surface angle 32 as one or more other mandibular blocks in the
series.
[0039] FIG. 1 illustrates that the maxillary and mandibular guide
surface angles 30, 32 of a maxillary and mandibular block pair
(e.g., pair 12a-14a, pair 12b-14b) can be any two complementary or
nearly complementary angles. For example, the first and second
block pairs 12a-14a and 12b-14b can have angle pairs (listed as
angle-angle, in degrees) of about 45-45, 40-50, 35-55, 30-60,
25-65, 20-70, 15-75, 10-80, 5-85, or vice versa--about 45-45,
50-40, 55-35, 60-30, 65-25, 70-20, 75-15, 80-10, 85-5. The
maxillary blocks 12 can have the first listed complementary angle
and the mandibular blocks 14 can have the second listed
complementary angle in each of the angle-angle pairs. The
mandibular blocks 14 can have the first listed complementary angle
and the maxillary blocks 12 can have the second listed
complementary angle in each of the angle-angle pairs. In this way,
the maxillary and mandibular blocks 12, 14 can form cooperating
pairs of blocks 12-14 and guide surfaces 26-28 as described above.
However, the maxillary and mandibular guide surface angles 30, 32
can be non-complementary and still enable one or more portions of
each of the guide surfaces 26, 28 to cooperate with one another.
Moreover, the guide surfaces 26, 28 need not form surface angles
30, 32--which can occur where, for example, the guide surfaces are
irregular, curved, polygonal, or any combination thereof, yet still
advantageously be configured to interact and function as guide
surfaces.
[0040] FIG. 1 illustrates that the maxillary first and second
blocks 12a, 12b can have maxillary first and second guide surface
angles 30a, 30b, respectively. The maxillary first and second guide
surface angles 30a, 30b can be the same or different from one
another. For example, the maxillary first guide surface angle 30a
can be less than, equal to, or greater than the maxillary second
guide surface angle 30b. The maxillary first guide surface angle
30a can be from about 1 degree to about 90 degrees greater or less
than the maxillary second guide surface angle 30b, more narrowly
from about 1 degree to about 45 degrees greater or less than the
maxillary second guide surface angle 30b, more narrowly yet from
about 1 degree to about 30 degrees greater or less than the
maxillary second guide surface angle 30b, still more narrowly from
about 1 degree to about 15 degrees greater or less than the
maxillary second guide surface angle 30b, yet still more narrowly
from about 1 degree to about 5 degrees greater or less than the
maxillary second guide surface angle 30b, or vice versa.
[0041] FIG. 1 illustrates that the mandibular first and second
blocks 14a, 14b can have mandibular first and second guide surface
angles 32a, 32b, respectively. The mandibular first and second
guide surface angles 32a, 32b can be the same or different from one
another. For example, the mandibular first guide surface angle 32a
can be less than, equal to, or greater than the mandibular second
guide surface angle 32b. The mandibular first guide surface angle
32a can be from about 1 degree to about 90 degrees greater or less
than the mandibular second guide surface angle 32b, more narrowly
from about 1 degree to about 45 degrees greater or less than the
mandibular second guide surface angle 32b, more narrowly yet from
about 1 degree to about 30 degrees greater or less than the
mandibular second guide surface angle 30b, still more narrowly from
about 1 degree to about 15 degrees greater or less than the
mandibular second guide surface angle 32b, yet still more narrowly
from about 1 degree to about 5 degrees greater or less than the
mandibular second guide surface angle 32b, or vice versa.
[0042] FIG. 1 illustrates that the maxillary guide surfaces 26 can
extend away from an occlusal surface of the maxillary dentition
and/or from a maxillary oral tray (not shown, e.g., a maxillary
orthodontic tray), for example, toward the mandible. The mandibular
guide surfaces 28 can extend away from an occlusal surface of the
mandibular dentition and/or a mandibular oral tray (not shown,
e.g., a mandibular orthodontic tray), for example, toward the
maxilla. Each guide surface (e.g., guide surfaces 26, 28) can have
a first end and a second end. The first and second ends can be the
base of the guide surface and the second end can be the top of the
guide surface. The base of the maxillary guide surface 26 can be
closer to a surface of a maxillary tooth and/or maxillary oral tray
than the top of the maxillary guide surface 26 and the base of the
mandibular guide surface 28 can be closer to a surface of a
mandibular tooth and/or mandibular oral tray than the top of the
mandibular guide surface 28. For example, FIG. 1 illustrates that
the bases of the maxillary and mandibular guide surfaces 26, 28 can
be proximate to and extend from maxillary and mandibular occlusal
surfaces, respectively, toward the opposing dentition; however, one
or more of the bases can be offset from the occlusal surface or
oral tray such that the offset base(s) are separated from the
dentition or a surface of a maxillary or mandibular oral tray by
about 0.5 mm to about 50 mm. The tops can be proximate to or
separated from (e.g., by about 0.5 mm to about 50 mm) the opposing
dentition. FIG. 1 illustrates that the tops of the mandibular guide
surfaces 28 can be configured to be proximate the maxillary
detention and/or oral tray and that the tops of the maxillary guide
surfaces 26 can be configured to be separated from the mandibular
dentition and/or oral tray.
[0043] The guide surfaces 26, 28 can extend along any portion of a
length of a block, for example, 100% or less, 75% or less, 50% or
less, 25% or less. For example, FIG. 1 illustrates that each guide
surface 26, 28 can extend about 33% along a length of its
respective block, thereby advantageously providing a large guide
surface. Guide surfaces 26, 28 that extend along greater than about
10% of a length of a block can advantageously enable each block 12,
14 in a treatment series to be used for greater treatment period
before a user graduates to the next block. Guide surfaces greater
than this 10% threshold can reduce the number of blocks 12, 14
required in a treatment series. Guide surfaces greater than this
10% threshold can increase user comfort and tolerance for user
error. Although not illustrated, each maxillary ramp 26 can extend
about 100% along the length of a maxillary block 12, for example,
from a maxillary block first end to a maxillary block second end
such that the maxillary blocks 12 have a shape of a triangular
wedge when viewed from the side. Similarly, each mandibular ramp 28
can extend about 100% along the length of a mandibular block 14,
for example, from a mandibular block first end to a mandibular
block second end such that the mandibular blocks 14 have a shape of
a triangular wedge when viewed from the side.
[0044] FIG. 1 illustrates that the maxillary and mandibular guide
surfaces 26, 28 can be sloped longitudinally such that the angles
30, 32 are the angles that are formed as the guide surfaces 26, 28
extend longitudinally across the blocks 12, 14, for example, from
the anterior portion 20 to the posterior portion 22 of the blocks
12, 14. As a result, the guide surfaces 26, 28 can form one or more
longitudinal slopes. Additionally or alternatively, the maxillary
and mandibular guide surfaces 26, 28 can be sloped transversely
such that the angles 30, 32 can be the angles that are formed as
the maxillary guide surfaces 26 extend laterally across the block,
for example, from a first lateral side to a second lateral side
(e.g., left to right and/or right to left) of the blocks 12, 14, or
from a longitudinal center to a first and/or second lateral side of
the blocks 12, 14. As a result, the guide surfaces 26, 28 can form
one or more transverse slopes. Each guide surface 26, 28 can have a
longitudinal and/or transverse slope. The longitudinal and
transverse guide surfaces can have the same or different slope from
one another. For example, one or more guide surfaces can have a
longitudinal slope of about 35 degrees and a transverse slope of
about 20 degrees. The one or more longitudinal slopes can reshape
the airway by advancing the mandible. The one or more transverse
slopes can reshape the airway by causing palatal expansion, for
example, by exerting an outward force on the dentition. Each block
in a series can have the same or different longitudinal and/or
transverse slope(s) as one or more other blocks in the series.
[0045] FIG. 1 illustrates the relative positions of the maxillary
and mandibular blocks 12, 14 relative to the maxillary and
mandibular dental arches, respectively. The maxillary blocks 12
(e.g., maxillary first and second blocks 12a, 12b) can be
configured to overlay one or more posterior teeth and/or one or
more anterior teeth. The maxillary blocks 12 can be configured to
overlay a central incisor, a lateral incisor, a canine, one or more
premolars, one or more molars, or any combination thereof. FIG. 1
illustrates that the maxillary first and second blocks 12a, 12b can
overlay a portion of the posterior ends of the maxillary dental
arch, for example, the second and third molars. The mandibular
blocks 14 (e.g., mandibular first and second blocks 14a, 14b) can
be configured to overlay one or more posterior teeth and/or one or
more anterior teeth. The mandibular blocks 14 (e.g., mandibular
first and second blocks 14a, 14b) can be configured to overlay a
central incisor, a lateral incisor, a canine, one or more
premolars, one or more molars, or any combination thereof. FIG. 1
illustrates that the mandibular first and second blocks 14a, 14b
can overlay the posterior ends and an anterior portion of the
mandibular dental arch, for example, the second premolar and the
first, second and third molars. Each block in a series can have the
same or different relative position as one or more other blocks in
the series.
[0046] The location of the maxillary and/or mandibular blocks 12,
14 relative to a dentition and/or to each other can be determined
by a dentist, orthodontist, one or more computer algorithms, or a
combination thereof. For example, a computer program can be used to
retrieve data from oral data acquisition devices (e.g., scanners,
x-ray devices, cameras) to record and measure orthodontic
malocclusions and teeth misalignments. A computer program can be
used to retrieve data from oral data acquisition devices to record
and measure the orthodontic correction of malocclusions and
misalignments during treatment.
[0047] FIGS. 2 and 3 illustrate that the maxillary blocks 12 (e.g.,
maxillary first and second blocks 12a, 12b) can each have a length
12.sub.L, a width 12.sub.W and a height 12.sub.H. The length
12.sub.L can be from about 1 mm to about 50 mm, including every 0.5
mm increment between about 1 mm and about 50 mm, for example, about
15.0 mm. The width 12.sub.W can be from about 1 mm to about 30 mm,
including every 0.5 mm increment between about 1 mm and about 30
mm, for example, 8.0 mm. The height 12.sub.H can be from about 1 mm
to about 50 mm, including every 0.5 mm increment between about 1 mm
and about 50 mm, for example, 18 mm. Each maxillary block 12 in a
series can have the same or different length 12.sub.L, width
12.sub.W, and/or height 12.sub.H as one or more other maxillary
blocks 12 in the series. The lengths 12.sub.L of multiple or
successive maxillary blocks 12 can each have the same length or one
or more different lengths 12.sub.L. For example, the lengths
12.sub.L of multiple or successive maxillary blocks 12 can become
progressively longer, progressively shorter, follow another
progressive pattern (e.g., increase and/or decrease), or remain
constant. For example, the lengths 12.sub.L of the maxillary blocks
12 in a series can increase from about 15.0 mm to about 20.0 mm,
vice versa (e.g., decrease from about 15.0 mm to about 10.0 mm),
increase from about 15.0 to about 18.0 mm and then decrease to
about 16.5 mm, or remain constant at about 15.0 mm. pnThe widths
12.sub.W of multiple or successive maxillary blocks 12 can each
have the same width or one or more different widths 12.sub.W. For
example, the widths 12.sub.W of multiple or successive maxillary
blocks 12 can become progressively longer, progressively shorter,
follow another progressive pattern (e.g., increase and/or
decrease), or remain constant. For example, the widths 12.sub.W of
the maxillary blocks 12 in a series can increase from about 8.0 mm
to about 13.0 mm, vice versa (e.g., decrease from about 8.0 mm to
about 3.0 mm), increase from about 8.0 to about 11.0 mm and then
decrease to about 10.0 mm, or remain constant at about 8.0 mm. The
heights 12.sub.H of multiple or successive maxillary blocks 12 can
each have the same height or one or more different heights
12.sub.H. The height 12.sub.H can be a maximum height. For example,
the heights 12.sub.H of multiple or successive maxillary blocks 12
can become progressively longer, progressively shorter, follow
another progressive pattern (e.g., increase and/or decrease), or
remain constant. For example, the heights 12.sub.H of the maxillary
blocks 12 in a series can increase from about 10.0 mm to about 15.0
mm, vice versa (e.g., decrease from about 15.0 mm to about 10.0
mm), increase from about 8.0 to about 11.0 mm and then decrease to
about 10.0 mm, or remain constant at about 10.0 mm.
[0048] FIGS. 2 and 3 illustrate that the mandibular blocks 14
(e.g., mandibular first and second blocks 14a, 14b) can each have a
length 14.sub.L, a width 14.sub.W and a height 14.sub.H. The length
14.sub.L can be from about 1 mm to about 50 mm, including every 0.5
mm increment between about 1 mm and about 50 mm, for example, about
35.0 mm. The width 14.sub.W can be from about 1 mm to about 30 mm,
including every 0.5 mm increment between about 1 mm and about 30
mm, for example, 8.0 mm. The height 12.sub.H can be from about 1 mm
to about 50 mm, including every 0.5 mm increment between about 1 mm
and about 50 mm, for example, 9 mm. Each mandibular block 14 in a
series can have the same or different length 14.sub.L, width
14.sub.W, and/or height 14.sub.H as one or more other mandibular
blocks 14 in the series. The lengths 14.sub.L of multiple or
successive mandibular blocks 14 can each have the same length or
one or more different lengths 14.sub.L. For example, the lengths
14.sub.L of multiple or successive mandibular blocks 14 can become
progressively longer, progressively shorter, follow another
progressive pattern (e.g., increase and/or decrease), or remain
constant. For example, the lengths 14.sub.L of the mandibular
blocks 14 in a series can increase from about 35.0 mm to about 40.0
mm, vice versa (e.g., decrease from about 35.0 mm to about 30.0
mm), increase from about 35.0 to about 38.0 mm and then decrease to
about 36.5 mm, or remain constant at about 35.0 mm. The widths
14.sub.W of multiple or successive mandibular blocks 14 can each
have the same width or one or more different widths 14.sub.W. For
example, the widths 14.sub.W of multiple or successive mandibular
blocks 14 can become progressively longer, progressively shorter,
follow another progressive pattern (e.g., increase and/or
decrease), or remain constant. For example, the widths 14.sub.W of
the mandibular blocks 14 in a series can increase from about 8.0 mm
to about 13.0 mm, vice versa (e.g., decrease from about 8.0 mm to
about 3.0 mm), increase from about 8.0 mm to about 11.0 mm and then
decrease to about 10.0 mm, or remain constant at about 8.0 mm. The
heights 14.sub.H of multiple or successive mandibular blocks 14 can
each have the same height or one or more different heights
14.sub.H. The height 14.sub.H can be a maximum height. For example,
the heights 14.sub.H of multiple or successive mandibular blocks 14
can become progressively longer, progressively shorter, follow
another progressive pattern (e.g., increase and/or decrease), or
remain constant. For example, the heights 14.sub.H of the
mandibular blocks 14 in a series can increase from about 3.0 mm to
about 8.0 mm, vice versa (e.g., decrease from about 3.0 mm to about
0.5 mm), increase from about 3.0 mm to about 6.0 mm and then
decrease to about 4.5.0 mm, or remain constant at about 3.0 mm.
[0049] The length 12.sub.L can be greater than, equal to, or less
than the length 14.sub.L. For example, FIG. 2 illustrates that the
length 12.sub.L can be less than the length 14.sub.L. The width
12.sub.W can be greater than, equal to, or less than the width
14.sub.W. For example, FIG. 2 illustrates that the width 12.sub.W
can be about equal to the width 14.sub.W. The height 12.sub.H can
be greater than, equal to, or less than the height 14.sub.H. For
example, FIG. 2 illustrates that the height 12.sub.H can be less
than the height 14.sub.H. Each block 12, 14 can have one or more
lengths, widths, heights, or any combination thereof.
[0050] FIG. 3 illustrates that the guide surfaces 26 (e.g., guide
surface 26b) can have a guide surface length 26.sub.L and that the
guide surfaces 28 (e.g., guide surface 28b) can have a guide
surface length 28.sub.L. The surface length 26.sub.L can be from
about 1 mm to about 50 mm, including every 0.5 mm increment between
about 1 mm and about 50 mm, for example, about 5 mm, about 6 mm,
about 7 mm, about 8 mm, about 9 mm, about 10 mm, about 11 mm, about
12 mm, about 13 mm, about 14 mm, about 15 mm, about 16 mm, about 17
mm, about 18 mm, about 19 mm, about 20 mm. The surface length
28.sub.L can be from about 1 mm to about 50 mm, including every 0.5
mm increment between about 1 mm and about 50 mm, for example, about
5 mm, about 6 mm, about 7 mm, about 8 mm, about 9 mm, about 10 mm,
about 11 mm, about 12 mm, about 13 mm, about 14 mm, about 15 mm,
about 16 mm, about 17 mm, about 18 mm, about 19 mm, about 20 mm.
Each block in a series can have the same or different guide surface
length 26.sub.L as one or more other blocks in the series. The
guide surface lengths 26.sub.L of multiple or successive maxillary
blocks 12 can each have the same length or one or more different
lengths 26.sub.L. For example, the guide surface lengths 26.sub.L
of multiple or successive maxillary blocks 12 can become
progressively longer, progressively shorter, follow another
progressive pattern (e.g., increase and/or decrease), or remain
constant. For example, the guide surface lengths 26.sub.L of the
maxillary blocks 12 in a series can increase from about 10.0 mm to
about 20.0 mm, vice versa (e.g., decrease from about 10.0 mm to
about 5.0 mm), increase from about 10.0 to about 13.0 mm and then
decrease to about 5.0 mm, or remain constant at about 10.0 mm. The
guide surface lengths 28.sub.L of multiple or successive mandibular
blocks 14 can each have the same length or one or more different
lengths 28.sub.L. For example, the guide surface lengths 28.sub.L
of multiple or successive mandibular blocks 12 can become
progressively longer, progressively shorter, follow another
progressive pattern (e.g., increase and/or decrease), or remain
constant. For example, the guide surface lengths 26.sub.L of the
mandibular blocks 12 in a series can increase from about 10.0 mm to
about 20.0 mm, vice versa (e.g., decrease from about 10.0 mm to
about 5.0 mm), increase from about 10.0 to about 13.0 mm and then
decrease to about 5.0 mm, or remain constant at about 10.0 mm.
[0051] FIG. 3 illustrates that one or more of the maxillary and
mandibular blocks 12, 14 can have a free surface 25 (also referred
to as a hanging surface) positioned opposite a tooth surface 24
(e.g., tooth surface 24a and/or 24b) that is configured to not
contact an opposing block (e.g., any surface of the opposing
block), an opposing dental or orthodontic tray, an opposing
dentition, or any combination thereof. For example, FIG. 1
illustrates that one or more maxillary blocks 12 can have a free
surface 25. The maxillary first block 12a can have a maxillary
first block hanging surface 25a and/or the maxillary second block
12b can have a maxillary second block hanging surface 25b. A
hanging surface 25 can advantageously provide more space for the
tongue in the oral cavity, increase the size of the airway and help
keep open the airway. Additionally or alternatively, a hanging
surface can advantageously inhibit or prevent the blocks 12, 14
from triggering a person's gag reflex, for example, by reducing the
size of the oral appliance 10 positioned in the back of the oral
cavity.
[0052] FIG. 3 illustrates that a gap can form between a free
hanging surface 25 (e.g., the maxillary second block hanging
surface 25b) and an opposing dentition (e.g., the mandibular
dentition). The gap can be from about 0 mm to about 50 mm, more
narrowly from about 1 mm to about 20 mm, yet more narrowly from
about 1 mm to about 15 mm, yet still more narrowly from about 1 mm
to about 10 mm, including every 0.5 mm increment within these
ranges, for example, about 5 mm, about 6 mm, about 7 mm, about 8
mm, about 9 mm, about 10 mm. The gap can be the shortest distance
between the free surface 25 and the opposing dental tray,
orthodontic tray, or teeth. The gap can be the greatest distance
between the free surface 25 and the opposing dental tray,
orthodontic tray, or teeth. The gap can be measured between any
point on an opposing dental tray, orthodontic tray, or teeth to any
point on the hanging surface 25. The point on the hanging surface
may or may not correspond with a point that is closest to or
farthest from the opposing dental tray, orthodontic tray, or
teeth.
[0053] FIG. 3 illustrates a variation of the relative positions of
the maxillary and mandibular blocks 12, 14 to one another when the
jaw is in a closed position. FIG. 3 illustrates that when the jaw
is fully closed at least a portion of a posterior portion 22 of the
maxillary blocks 12 (e.g., the maxillary first and second blocks
12a, 12b) can be posterior to at least a portion of a posterior
portion 22 of the mandibular blocks 14 (e.g., the mandibular first
and second blocks 14a, 14b), or vice versa (if, for example, the
positions of the blocks 12, 14 are reversed such that the maxillary
blocks 12 are placed in their same relative positions on the
mandibular dental arch and the mandibular blocks 14 are place in
their same relative positions on the maxillary dental arch). For
example, FIG. 3 illustrates that the maxillary blocks 12 do not
extend anterior to the top of the ramp of the mandibular blocks 14,
and are accordingly posterior to the remaining portion of the
mandibular blocks 14.
[0054] The dimensions and relative positions of the blocks 12, 14
disclosed herein will depend on, and can be customized to
accommodate, for example, a person's airway, dental and/or
orthodontic needs, their anatomy, the number of blocks in a series,
the number oral trays in a series, or any combination thereof;
thus, although various positions, ranges and values are disclosed,
each permutation of the disclosed positions, ranges and values and
equivalents thereof is considered critical to the overall design of
the oral appliance 10, as each combination of dimensions and
positions, when used together to reposition the jaw, adjust the
bite, and/or reshape and/or maintain a person's airway, is critical
to providing the treatment desired. Additionally, each block in a
series can have any combination of the dimensions and positions
disclosed, as the design of each block in a series will depend on a
person's unique dentition and other craniofacial structures as well
as the implemented orthodontic and/or SBD treatment plan. If the
foregoing disclosure yet lacks clarity, every permutation of block
dimensions and positions within the ranges and values disclosed is
hereby explicitly disclosed, for example, in 0.1 mm increments,
such that any combination of block dimensions and/or relative
positions is claimable.
[0055] The first and second maxillary blocks 12a, 12b can be
connected via one or more maxillary connectors. The maxillary
connector(s) can be a wire, resilient wire, polymer strand,
resilient polymer strand, dental tray, orthodontic tray, or any
combination thereof that conform to, extend along, or wrap around a
buccal side, a lingual side, and/or an occlusal surface of at least
a portion of the maxillary dental arch. A first end of the
maxillary connector(s) can be attached to or integrated with any
portion of the maxillary first or second block 12a, 12b and a
second end of the maxillary connector(s) can be attached to or
integrated with any portion of the other of the maxillary first or
second block 12a, 12b. The maxillary connector(s) can be used to
stabilize the first and second maxillary blocks 12a, 12b. The
maxillary connector(s) can be designed and/or manipulated (e.g.,
progressively manipulated over a series of treatments) to
orthodontically move maxillary teeth. The first and second
mandibular blocks 14a, 14b can be connected via one or more
mandibular connectors. The mandibular connector(s) can be a wire,
resilient wire, polymer strand, resilient polymer strand, dental
tray, orthodontic tray, or any combination thereof that conform to,
extend along, or wrap around a buccal side, a lingual side and/or
an occlusal surface of at least a portion of the mandibular dental
arch. A first end of the mandibular connector(s) can be attached to
or integrated with any portion of the mandibular first or second
block 14a, 14b and a second end of the mandibular connector(s) can
be attached to or integrated with any portion of the other of the
mandibular first or second block 14a, 14b. The mandibular
connector(s) can be used to stabilize the first and second
mandibular blocks 14a, 14b. The mandibular connector(s) can be
designed and/or manipulated (e.g., progressively manipulated over a
series of treatments) to orthodontically move mandibular teeth.
Orthodontic and dental trays are individually and collectively
referred to throughout as oral trays such that an oral tray can be
an orthodontic and/or a dental tray, for example, an aligner (also
referred to as an orthodontic tray), a whitening tray, or an
orthodontic teeth whitening aligner that is configured to move and
whiten at least one tooth. Oral trays are also referred to as
aligners and aligner components throughout.
[0056] The blocks 12, 14 can be attached to or integrated with a
maxillary and/or mandibular oral tray. For example, the maxillary
blocks 12 can be integrated with a maxillary and/or mandibular oral
tray and/or the mandibular blocks 14 can be integrated with a
maxillary and/or mandibular oral tray. A series of oral trays can
be designed to progressively reposition the maxillary and/or
mandibular teeth in two or more successive steps, for example, as
disclosed in PCT Publication WO 2016/004415 and U.S. application
Ser. No. 15/386,280 (published as US 2017/0100214), both of which
have been incorporated herein by reference in their entireties for
all purposes. Each oral tray in a series can have a tooth surface
that has a geometry that corresponds to an intermediate or end
tooth arrangement intended for the oral tray in the series. The
oral trays can be sufficiently resilient to accommodate or conform
to misaligned teeth, but apply sufficient force against the
misaligned teeth to reposition the teeth to the intermediate or end
arrangement as desired for the particular treatment step. A series
of oral trays can have geometries selected to progressively
reposition teeth from a first arrangement through one or more
successive intermediate arrangements to a final arrangement. A
series of trays can have 1 to 100 maxillary trays and 1 to 100
mandibular trays, for example, 1 to 55 maxillary trays and 1 to 55
mandibular trays, 1 to 50 maxillary trays and 1 to 50 mandibular
trays, 1 to 45 maxillary trays and 1 to 45 mandibular trays, 1 to
40 maxillary trays and 1 to 40 mandibular trays, less than 40
maxillary trays 12 and less than 40 mandibular trays, including
every 1 tray increment within these ranges, or any combination
thereof. For example, a series of trays can have 40, 41, 42, 43,
44, 45, 46, 47, 48, 49, or 50 maxillary trays and 40, 41, 42, 43,
44, 45, 46, 47, 48, 49, or 50 mandibular trays. The number of
maxillary trays can be the same or different as the number
mandibular trays in a series.
[0057] The trays can orthodontically move the teeth into one or
more correct physiological positions. For example, the trays can
orthodontically move the teeth into one or more positions that
physiologically allows for a more open airway.
[0058] Each tray in a series can be configured to move one or more
teeth, or one or more trays in a series can be configured to not
move any teeth. For example, where the mandibular teeth are in a
desired alignment but the position of the maxillary teeth are still
in need of an adjustment, the mandibular tray can be configured to
maintain the position of the mandibular teeth and the maxillary
tray can be configured to move one or more maxillary teeth. The
blocks 12, 14 can be modular such that they can be removably
attached to a maxillary and/or mandibular oral tray, for example,
to an orthodontic tray and/or to a dental tray (i.e., any tray
without an orthodontic function). The blocks 12, 14 can be attached
to one or multiple oral trays with one or multiple attachment
mechanisms (also referred to as anchors), such as clasps, clips,
hooks, elastic hooks, barbs, spurs, fasteners, or any combination
thereof. Additionally or alternatively, the blocks 12, 14 can fit
over a portion of an oral tray with a friction fit and/or a snap
fit. For example, the oral tray can have a ridge over which the
blocks 12, 14 can be snapped. The ridge can extend at least
partially along a surface of the oral tray. A first end (e.g., a
base) of each maxillary block 12 can be anchored to a maxillary
oral tray. A second end (e.g., a top portion) of each maxillary
block 12 can be anchored to a mandibular oral tray. A first end
(e.g., a base) of each mandibular block 14 can be anchored to a
mandibular oral tray. A second end (e.g., a top portion) of each
mandibular block 14 can be anchored to a maxillary oral tray. A
modular block design can be especially advantageous where a series
of orthodontic trays are designed as disclosed in WO 2016/004415,
as the modular design can allow the reuse and/or repositioning of
the blocks 12, 14 along the arch of the maxillary and/or mandibular
dentition on a single aligner or on multiple successive aligners.
The modular design can advantageously allow the repositioning of
one or more blocks 12, 14 from a first position on an oral tray to
one or more other positions on the oral tray different from the
first position. For example, the modular design can allow the
repositioning each block (e.g., blocks 12 and/or 14) in a series 1
to 100 times on one or multiple oral trays, including every
increment of 1 between 1 and 100. A modular design can also
advantageously allow a series of blocks to be mixed and matched
with each oral tray in an oral tray series.
[0059] One or both guide surfaces of a guide surfaces pair 26-28
(e.g., pair 26a-28a and/or pair 26b-28b) can have a coating or
otherwise comprise a material which permits relative motion between
two opposed guide surfaces in a first direction and resists
relative motion between two opposed guide surfaces in a second
direction opposite the first direction. For example, the mandibular
blocks 14 can be configured to engage the maxillary blocks 12 and
slide forward along the guide surfaces 26 of the maxillary blocks
12 upon the application of a compressive force between two opposing
maxillary and mandibular blocks 12, 14 (e.g., upon closing the jaw
from an open position or by otherwise "biting down" on the blocks
12, 14). As another example, the mandibular blocks 14 can be
configured to engage the maxillary blocks 12 and slide forward
along the guide surfaces 26 of the maxillary blocks 12 in a first
direction when the jaw relaxes or is voluntarily opened and then
relaxed and be prevented or inhibited from sliding along the guide
surfaces 26 in a second direction opposite the first direction. The
guide surfaces (e.g., guide surfaces 26 and/or 28) can have a first
coefficient of friction associated with movement of the mandibular
blocks 12 in a first direction and a second coefficient of friction
associated with movement of the mandibular blocks 12 in a second
direction opposite the first direction. The second coefficient of
friction can be greater than the first coefficient of friction. The
first and second coefficients of friction can be static
coefficients of friction .mu..sub.s. The first and second
coefficients of friction can be kinetic coefficients of friction
.mu..sub.k.
[0060] One or both guide surfaces of a guide surface pair 26-28
(e.g., pair 26a-28a and/or pair 26b-28b) can have a coating or
otherwise comprise a material (e.g., an adhesive or a ferromagnetic
material) which inhibits relative motion between two opposed guide
surfaces when they interact. Additionally or alternatively, one or
more magnets can be placed in the blocks 12, 13 such that the
maxillary blocks 12 magnetically attract the mandibular blocks 14
and vice versa.
[0061] The maxillary and mandibular blocks 12, 14 can comprise a
thermoplastic material. The maxillary and mandibular blocks 12, 14
can be thermoformed with the aid of a computer algorithm. The
maxillary and mandibular aligners can comprise a thermoplastic
material. The maxillary and mandibular aligners can be thermoformed
with the aid of a computer program. The maxillary blocks 12 and the
maxillary aligners can be attached to, integrated with, or
monolithically formed with one another. The mandibular blocks 14
and the mandibular aligners can be attached to, integrated with, or
monolithically formed with one another.
[0062] The maxillary and mandibular blocks 12, 14 can be rigid such
that they resist deformation under pressure or semi-rigid such that
they permit deformation and/or are compliant under pressure.
Semi-rigid and/or compliant materials can advantageously increase
user comfort and prevent, inhibit, or limit sleep bruxism.
[0063] The blocks 12, 14 can be solid or hollow. For example, the
blocks 12, 14 can have one or more airway channels (e.g., 1 to 10
or more airway channels). The airway channels can extend at least
partially laterally and/or at least partially longitudinally
through the blocks 12, 14. The airway channels can extend through
the blocks 12, 14 from the buccal side 16 to the lingual side 18.
The airway channels can extend through the blocks 12, 14 from an
anterior side to a posterior side. One or more of the airway
channels of a maxillary block 12 can be at least partially aligned
(e.g., partially or completely collinear) with one or more channels
of a mandibular block 14. Each channel can have an anterior end and
a posterior end. A posterior end of the channel of an anterior
block (e.g., the mandibular blocks 14 in FIG. 1) can overlap
completely or partially with an anterior end of the channel of a
posterior block (e.g., the maxillary blocks 12 in FIG. 1). The
posterior ends of the airway channels of the posterior blocks
(e.g., the maxillary blocks 12 in FIG. 1) can be directed toward
the pharynx to facilitate inhalation and exhalation. A posterior
portion of the airway channels in the posterior blocks (e.g., the
maxillary blocks 12 in FIG. 1) can be curved such that the
posterior ends of the posterior blocks are directed toward the
pharynx or the base of the tongue. The airway channels can be
straight, curved, tapered, or any combination thereof.
[0064] A cooperating pair of blocks 12-14 can have 1 to 10 or more
airway channels. For example, the cooperating pair of blocks
12a-14a and 12b-14b can each have one maxillary airway channel and
two mandibular airway channels extending at least partially
longitudinally and/or laterally through the blocks 12a, 12b, 14a,
14b. One of the mandibular airway channels can be at least
partially aligned with the maxillary airway channel. The three
airway channels (the one maxillary and two mandibular channels) can
thereby advantageously form two airway channels from an anterior
portion of the oral appliance 10 to a posterior portion of the oral
appliance 10. The one or more airway channels in the oral appliance
10 can decrease the amount of dead space in the oral cavity by
increasing the size of the oral cavity available for airflow
through the oral cavity by allowing air to flow through the blocks
12, 14. By increasing the volume in the oral cavity available for
airflow, the one or more airway channels can advantageously reduce
the amount of respiratory effort required for inhalation and
exhalation and/or decrease the velocity of the air passing through
oral cavity, and can therefore, in turn, prevent, inhibit, and/or
reduce the likelihood of an SBD event and/or the occurrence of
snoring. The one or more airway channels can and/or can help
prevent, inhibit, and/or reduce SBD and/or snoring.
[0065] The airway channels can be substantially the same size as
the block or any lesser size, collectively or individually. For
example, a transverse and/or longitudinal cross-sectional area of
the airway channels can be about 1% to about 100% of a transverse
and/or longitudinal cross-sectional area of the blocks 12, 14, more
narrowly from about 1% to about 95%, more narrowly still from about
1% to about 90%, including every 1% increment within these ranges,
for example, about 25%, 50%, 75%, 90%, or 95%. A length of the
airway channels can be about 1% to about 100% of a length of the
blocks 12, 14, more narrowly from about 1% to about 90%, more
narrowly still from about 1% to about 80%, including every 1%
increment within these ranges, for example, about 25%, 50%, 75%, or
95%. The airway channels can extend laterally across the blocks 12,
14 such that the airway channels extend across about 1% to about
100% the width of a block, more narrowly from about 1% to about
90%, more narrowly still from about 1% to about 80%, including
every 1% increment within these ranges, for example, about 25%,
50%, 75%, or 95%.
[0066] One or more sensors can be positioned in one or multiple
airway channels, integrated into a wall of one or multiple airway
channels, integrated or positioned on an outer surface of one or
multiple blocks 12, 14, integrated in one or multiple blocks 12,
14, integrated or positioned on one or more oral trays, or any
combination thereof. The one or more sensors can be flow sensors,
pressure sensors, temperature sensors, or any combination thereof.
The sensor(s) can be in communication with a controller configured
to activate an alarm when an obstruction is detected, for example,
when a flow sensor detects a stoppage or reduction in flow that
exceeds a time interval threshold, when a pressure sensor detects a
drop in pressure that exceeds a pressure drop threshold, when a
temperature sensor detects a temperature increase of exhaled or
oral cavity air that exceeds a temperature threshold, or any
combination thereof. The alarm can be auditory and/or tactile
(e.g., vibration), and can be emitted from an alarm mechanism,
including, for example, the controller. The controller can be
integrated with the oral device 10 or be in wireless communication
therewith. The controller can be configured to communicate an alarm
signal to a smartphone or other computing device which can process
the signal and emit an auditory and/or tactile alarm. The alarm can
be configured to wake a person up from a potentially dangerous SBD
event. One or more sensors (e.g., one or more pressure sensors) can
be in communication with the controller to detect whether the oral
appliance 10 is properly or improperly positioned. The controller
can be configured to activate an alarm if the oral appliance 10 is
improperly positioned, for example, if it becomes dislodged when a
person is sleeping (e.g., if one or more pressure sensors detect a
pressure drop that exceeds a pressure drop threshold).
Method of Use
[0067] The oral appliance 10, or a series of oral appliances 10,
can be placed in an oral cavity as shown in FIG. 3.
[0068] The blocks 12, 14 can facilitate or otherwise encourage a
person to open their mouth and/or move their mandible forward, for
example, due to the size and/or shape of the blocks 12, 14 and/or
due the interaction between the blocks 12, 14 when a person opens
their mouth and/or bites down on the blocks after the oral
appliance is placed in the oral cavity. The size of the blocks 12,
14 can cause a person to open their mouth at least as wide as the
smallest thickness of the blocks 12, 14 (e.g., the length, width,
and/or height of the blocks) to accommodate placement of the blocks
12, 14 in the oral cavity.
[0069] The size and/or shape of the blocks 12, 14 can be configured
to encourage a person to move their mandible forward with or
without biting down on the blocks 12, 14. For example, the blocks
12, 14 can interact to move the mandible forward when a person
bites down on the blocks 12, 14. However, a person can use the
blocks 12, 14 with or without moving their mandible forward. The
size and/or shape of the blocks 12, 14 can be configured to advance
a person's mandible. The size and/or shape of the blocks 12, 14 can
be configured to not advance a person's mandible.
[0070] The size and/or shape of the blocks 12, 14 can cause a
mandible to advance from a retruded position, neutral position, or
advanced position. The size and/or shape of the blocks 12, 14 can
prevent, inhibit, or limit mandibular retrusion relative to a
retruded position, neutral position, or advanced position of the
mandible, whether such a position is a natural position of a
person, or whether it is caused by the blocks 12, 14. In this way,
the blocks 12, 14 can be configured to interact with one another to
reshape and/or maintain the airway and prevent, inhibit, or limit
the airway from partially and/or entirely closing to treat SBD, for
example, from a partially or entirely open configuration. Such an
arrangement can advantageously provide SBD treatment by
repositioning the jaw and/or by opening up the airway.
[0071] As described above, one or more maxillary blocks 12 can
cooperate with one or more mandibular blocks 14 to reposition the
jaw, adjust the bite, and/or reshape and/or maintain the airway.
FIG. 3 illustrates that the blocks 12, 14 can cooperate with one
another to move the mandible forward. FIG. 3 also illustrates that
the blocks 12, 14 can cooperate with one another to reshape the
airway into one or more open configurations, for example, by
increasing the interocclusal separation between maxillary and
mandibular dentitions. The blocks 12, 14 can be designed to
maintain the mandible in one or more forward positions when the
blocks 12, 14 are engaged with one another. The blocks 12, 14 can
also be designed to maintain the airway in one or more open
configurations, including one or more reshaped configurations
caused at least partially by the interaction of the blocks 12, 14.
The blocks 12, 14 can interact with one another to reshape the
airway by repositioning (also referred to as displacing) the
mandible relative to the maxilla. For example, the blocks 12, 14
can be configured to move the mandible forward and/or increase the
interocclusal separation between the maxillary and mandibular
dental arches when the blocks 12, 14 interact with one another.
Such displacement can advantageously reposition the jaw, adjust the
bite, and/or reshape the airway and cause the airway to become more
open--thus providing SBD treatment.
[0072] The blocks 12, 14 can interact with one another to adjust
the bite by maintaining a neutral position (e.g., non-advanced
position) or a displaced position (e.g., advanced position) of the
mandible relative to the maxilla. The blocks 12, 14 can also
interact with one another to maintain an open airway by maintaining
a neutral position (e.g., non-advanced) or a displaced position
(e.g., advanced position) of the mandible relative to the maxilla.
For example, the blocks 12, 14 can prevent, inhibit, or limit
posterior movement of the mandible and/or a reduction of the
interocclusal distance when the mandible is in a neutral and/or
displaced position. Such mandibular support can advantageously
treat SBD by training the jaw to return to a new, or modified,
neutral position. Such mandibular support can also advantageously
prevent, inhibit, or limit the tongue from falling back and
collapsing the airway. A neutral position is considered any natural
occlusal position. A displaced position is considered any
non-displaced position, for example, any advanced and/or retruded
position, natural or imposed. The blocks 12, 14 can cause a
displaced mandibular position to become a new natural occlusal
position, for example, by orthodontically manipulating (e.g.,
progressively manipulating with a series of trays and/or blocks)
craniofacial structures over time such that the mandible and
associated structures acquire a new equilibrium (e.g., neutral)
position.
[0073] The blocks 12, 14 can interact with one another to widen the
maxillary (also referred to as superior or upper) dental arch
and/or the mandibular (also referred to as inferior or lower)
dental arch. For example, the blocks 12, 14 can have one or more
transverse slopes that can interact with one another to widen the
hard and/or soft palates. Such widening can advantageously reshape
the airway and cause it to become more open. Widening the
mandibular dental arch can increase the size of the sublingual
space and decrease the amount of obstruction the tongue causes in
the oral cavity. Widening the maxillary dental arch can cause
palatal expansion and thereby increase the size of the oral
cavity.
[0074] The blocks 12, 14 can interact to move the mandible forward,
temporarily or permanently. The blocks 12, 14 can also interact to
cause the airway to develop a more open configuration, temporarily
or permanently. The blocks 12, 14 can be configured to temporarily
or permanently manipulate craniofacial structures.
[0075] The one or more guide surface pairs 26-28 of the oral
appliance 10 (e.g., pair 26a-28a and/or pair 26b-28b) can interact
in such a manner to prevent, inhibit, or limit posterior movement
of the mandible and associated structures (e.g., the tongue), for
example, to SBD. The maxillary and mandibular guide surfaces 26, 28
can be configured to interact with one another or to otherwise
contact each other throughout treatment or only during a portion
thereof. As described above, the blocks 12, 14 can be configured to
interact in a self-guided manner.
[0076] FIG. 3 illustrates that a cooperating pair of guide surfaces
26b, 28b can interact to advance the mandible into a forward
position (also referred to as advanced). FIG. 3 also illustrates
that such advancement can increase the interocclusal distance
between the dental arches, but the SBD appliance 10 can advance the
mandible without increasing the interocclusal distance as well.
Where there is an increase in the interocclusal distance, the
resultant interocclusal distance can be greater than the natural
interocclusal distance that would otherwise result between the
arches if the jaw were simply advanced without the use of guide
surfaces 26, 28. For example, the resultant interocclusal distance
can be greater than the natural interocclusal separation that the
alignment of the anterior teeth causes when the mandible is
advanced when clenched. Where the anterior teeth do not produce
natural disclusion upon the advancement of the mandible, the
resultant interocclusal distance that results can be due solely to
one or more cooperating pairs of guide surfaces 26, 28 when the
mandible is advanced.
[0077] FIG. 3 illustrates that the closing of the jaws with a
cooperating pair of guide surfaces 26, 28 can advance the mandible
forward an advancement distance 34. The advancement distance 34 can
be from about 0 mm to about 30 mm, more narrowly from about 0 mm to
about 20 mm, yet more narrowly from about 0 mm to about 10 mm, yet
still more narrowly from about 5 mm to about 10 mm, including every
0.25 mm increment within these ranges, for example, about 5 mm,
about 6 mm, about 7 mm, about 8 mm, about 9 mm, about 10 mm, about
11 mm, about 12 mm, about 13 mm, about 14 mm, about 15 mm, about 16
mm, about 17 mm, about 18 mm, about 19 mm, about 20 mm. FIG. 3
illustrates that the cooperating pair of guide surfaces 26, 28 can
advance the mandible forward a sufficient advancement distance 34
to artificially create an underbite (also referred to as a Class
III malocclusion). For example, the cooperating pair of guide
surfaces 26, 28 can advance the mandible forward such that the
maxillary incisors are within the anterior perimeter (as opposed to
posterior where the molars are) of the mandibular incisors by, for
example, from about 0.5 mm to about 5.0 mm, including every 0.25 mm
increment within this range.
[0078] The closing of the jaws with a cooperating pair of guide
surfaces 26, 28 can increase the interocclusal distance 36 between
the dental arches from about 0 mm to about 60 mm, more narrowly
from about 0 mm to about 50 mm, more narrowly from about 0 mm to
about 40 mm, yet more narrowly from about 0 mm to about 30 mm, yet
still more narrowly from about 0 mm to about 20 mm, yet more
narrowly still from about 0 mm to about 10 mm, including every 0.25
mm increment within these ranges, for example, about 30 mm, about
31 mm, about 32 mm, about 33 mm, about 34 mm, about 35 mm, about 36
mm, about 37 mm, about 38 mm, about 39 mm, about 40 mm. The range
of natural disclusion can range from 0 mm to about 10 mm, including
every 0.25 mm increment within this range. The interocclusal
distance 36 can be the height 12.sub.H of a maxillary block 12, the
height 14.sub.H of a mandibular block 14, or a combination
thereof.
[0079] At least a portion of each pair of cooperating guide
surfaces 26, 28 (e.g., guide surfaces 26b, 28b) can contact each
other when the jaw is being closed, for example from an open
configuration to a closed (or less open) configuration. At least a
portion of each pair of opposing guide surfaces 26, 28 can slidably
contact each other such that at least a portion of the guide
surfaces 26, 28 slide past one another to advance the mandible and
increase the interocclusal distance when the jaw is closed, for
example, from an open configuration to a less open configuration.
The cooperating guide surfaces can have a contact length that
ranges from 0 mm when not in contact to about 1 mm to about 30 mm
when in contact, including every 0.5 mm increment within this
range. The contact length can increase from 0 mm to a maximum
contact length as the mandible is closed against the maxilla, or
equivalently, as the mandibular dentition is closed against the
maxillary dentition. FIG. 3 illustrates that the cooperating guide
surfaces 26, 28 can have a maximum contact length of about 3 mm to
about 15 mm, including every 0.5 mm increment within this range,
for example, 12 mm. The maximum contact length can be the entire
length or only part of the length of one or both of the cooperating
guide surfaces 26, 28. FIG. 3 illustrates that the maximum contact
length can be the length of the maxillary guide surfaces 26.
Alternatively or additionally, at least a portion of each pair of
opposing guide surface 26, 28 can be configured to not slidably
contact each other, but rather merely rest against each another
when the jaw is open to prevent, inhibit, or limit retrusion of the
mandible.
[0080] For example, when the jaws are partially or fully closed, at
least a portion of each pair of cooperating guide surfaces 26, 28
(e.g., guide surfaces 26b, 28b) can contact its opposing guide
surface such that at least one of the guide surfaces 26, 28
prevents, inhibits, or limits posterior movement of the mandible.
For example, FIG. 3 illustrates that the maxillary second guide
surface 26b can interfere with (e.g., prevent, inhibit, or limit)
any posterior movement of the mandibular second guide surface 28b,
thereby interfering with any posterior movement of the mandibular
second block 14b and the mandible.
[0081] The maxillary and mandibular blocks 12, 14 can cooperate to
allow the mandible to move in multiple directions when the jaws are
in a fully closed position, for example, side-to-side,
front-to-back, and/or up-and-down (or in any three mutually
orthogonal reference planes). For example, the blocks 12, 14 can
have a movement tolerance of about 1 mm to about 5 mm (e.g.,
including every 0.25 mm increment within this range) along three or
fewer reference planes/axes to advantageously maximize comfort,
reduce the likelihood of the SBD device 10 from causing new SBD
issues, minimize sleep bruxism, and/or inhibit the blocks 12, 14
from becoming dislodged while concurrently treating SBD and/or
snoring. The posterior guide surface of a posterior-anterior guide
surface pair can, for example, resist but allow posterior movement
of the anterior guide surface. The posterior and anterior guide
surfaces can be any two opposing surfaces, for example, the
maxillary second guide surface 26b and the mandibular second guide
surface 28b pair, with the maxillary second guide surface 26b being
posterior to the mandibular second guide surface 28b. Alternatively
or additionally, the posterior guide surface can freely allow
posterior movement of the anterior guide surface over the tolerance
range and then begin to resist further posterior movement.
[0082] For example, the posterior and anterior guide surfaces
(e.g., posterior guide surfaces 26 and anterior guide surfaces 28)
can be partially or entirely coated with the coating described
above. The maxillary and mandibular guide surface angles 30, 32 can
have angles that self-guide the mandible to return to a more
forward position when the mandible moves posteriorly. The maxillary
and mandibular blocks 12, 14 can cooperate to allow the mandible to
have six degrees of freedom when the jaw is being opened and
closed. The maxillary and mandibular blocks 12, 14 can be locked
together when the mandible is in an advanced position, and allow
movement within the tolerance range within one, two, three, four,
five, and/or six degrees of freedom.
[0083] Alternatively or additionally, the oral appliances 10
disclosed herein can allow free mandibular motion except for the
retrusion prevented, inhibited, or limited by two opposed guide
surface pairs 26, 28 when they are in a position to interact with
one another.
[0084] As described above, a series of blocks 12, 14 can be
designed and applied or used over time to move one or more teeth,
advance and/or maintain a position of the mandible, increase the
interocclusal distance 36 and/or widen the hard and/or soft palates
in two or more successive steps in a series. Exemplary dimensional
variations are disclosed below, but these are in no way limiting,
as every permutation of the dimensions and relative positions
herein disclosed is appreciated, for example, including every 0.25
mm increment or 0.5% increment within the dimensional ranges
disclosed herein. Successive dimensional changes can advantageously
achieve the desired treatment in each step in a series. Each block
12, 14 in a series can have guide surface angles 30, 32 that
correspond to an intermediate or end mandible advancement position
or interocclusal distance intended for the block 12, 14 in the
series. Each block 12, 14 in a series can have block lengths,
widths and heights 12.sub.L, 14.sub.L, 12.sub.W, 14.sub.W,
12.sub.H, 14.sub.H that correspond to an intermediate or end
mandible advancement position or interocclusal distance intended
for the block 12, 14 in the series. Each block 12, 14 in a series
can have guide surface lengths 26.sub.L, 28.sub.L that correspond
to an intermediate or end mandible advancement position or
interocclusal distance intended for the block 12, 14 in the series.
Each block 12, 14 in a series can be configured to contact a
different portion or a length of a guide surface of an opposing
block. Each block 12, 14 in a series can have a longitudinal and/or
transverse slope that corresponds to an intermediate or end
mandible advancement position or interocclusal distance intended
for the block 12, 14 in the series. One or more of the dimensions
disclosed can be increased, decreased, or remain unchanged from one
treatment step to the next treatment step (i.e., one or more
dimensions can remain unchanged between two treatment steps). For
example, one or more dimensions can be increased and/or decreased
from a first dimension to a second dimension between two treatment
steps (e.g., between a first treatment step and a second treatment
step with no treatment step between the first and second treatment
steps, or between any two treatment steps) such that the second
dimension is about 0.5 mm to about 40 mm greater than or less than
the value of the first dimension in the first treatment step than
in the second (e.g., subsequent) treatment step, for example, every
0.25 mm increment between 0.5 mm and 40 mm (e.g., 0.5 mm, 1.0 mm,
1.5 mm, 2.0 mm, 2.5 mm, 3.0 mm, 3.5 mm, 4.0 mm, 4.5 mm, 5.0 mm and
so on). For example, one or more dimensions can be increased and/or
decreased from a first dimension to a second dimension between two
treatment steps (e.g., between a first treatment step and a second
treatment step with no treatment step between the first and second
treatment steps, or between any two treatment steps) such that the
second dimension is about 1% to about 500% greater than or less
than the value of the first dimension in the first treatment step
than in the second (e.g., subsequent) treatment step, for example,
every 1% increment between 1% and 500% (e.g., 1%, 5%, 10%, 15%,
20%, 25%, 30%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%,
90%, 95%, 100%, 125%, 150%, 175% and so on).
[0085] In a treatment series, the blocks 12, 14 can move one or
more teeth, reposition the mandible, adjust the bite, adjust the
interocclusal distance, and/or widen the hard and/or soft palates
to an intermediate or end arrangement as desired in one or more
treatment steps in a series. The blocks 12, 14 can progressively
move teeth, increase and/or decrease the advancement distance 34,
increase and/or decrease the interocclusal distance 36, widen the
hard and/or soft palates, adjust the bite, or any combination
thereof. For example, the blocks 12, 14 in a series can
progressively increase the advancement distance 34 from a first
distance to a second distance greater than the second distance. The
blocks 12, 14 in a series can progressively decrease the
advancement distance 34 from the second distance to a third
distance less than the second distance and greater than the first
distance. As another example, the blocks 12, 14 in a series can
progressively increase the interocclusal distance 36 from a first
distance to a second distance greater than the first distance. The
blocks 12, 14 in a series can progressively decrease the
interocclusal distance 36 from the second distance to a third
distance less than the second distance and greater than the first
distance. As another example, the blocks 12, 14 in a series can
progressively increase the width of a palate from a first width to
a second width greater than the first width. The design of a series
of blocks can advantageously reduce the initial shock of treatment
to the affected craniofacial (e.g., mandible, dental arches,
airway, palate) structures potentially caused by the blocks 12, 14
and therefore make the treatment more comfortable. Exemplary
dimensional variations are disclosed below, but these are in no way
limiting, as every permutation of the dimensions and relative
positions herein disclosed is appreciated, for example, including
every 0.25 mm increment or 0.5% increment within the dimensional
ranges disclosed herein. One or more of the dimensions disclosed
can be increased, decreased, or remain unchanged from one treatment
step to the next treatment step (i.e., one or more dimensions can
remain unchanged between two treatment steps). Such craniofacial
dimensions (e.g., dimensions 34 and 36) can be increased and/or
decreased from a first dimension to a second dimension between two
treatment steps (e.g., between a first treatment step and a second
treatment step with no treatment step between the first and second
treatment steps, or between any two treatment steps) such that the
second dimension is about 0.5 mm to about 40 mm greater than or
less than the value of the first dimension in the first treatment
step than in the second (e.g., subsequent) treatment step, for
example, every 0.5 mm increment between 0.5 mm and 40 mm (e.g., 0.5
mm, 1.0 mm, 1.5 mm, 2.0 mm, 2.5 mm, 3.0 mm, 3.5 mm, 4.0 mm, 4.5 mm,
5.0 mm and so on). Such craniofacial dimensions (e.g., dimensions
34 and 36) can be increased and/or decreased from a first dimension
to a second dimension between two treatment steps (e.g., between a
first treatment step and a second treatment step with no treatment
step between the first and second treatment steps, or between any
two treatment steps) such that the second dimension is about 1% to
about 500% greater than or less than the value of the first
dimension in the first treatment step than in the second (e.g.,
subsequent) treatment step, for example, every 1% increment between
1% and 500% (e.g., 1%, 5%, 10%, 15%, 20%, 25%, 30%, 40%, 45%, 50%,
55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 100%, 125%, 150%, 175%
and so on).
[0086] FIG. 4 illustrates a variation of an aligner 38 on teeth.
The aligner 38 can have the properties of the oral trays described
herein. For example, the aligner 38 can be a maxillary dentition
aligner 38a or a mandibular dentition aligner 38b. The aligner 38
can have an inner surface and an outer surface. The inner surface
can define a tooth-receiving cavity. The inner surface can be
configured to contact one or more teeth. The inner surface can have
a geometry configured to move one or more maxillary or mandibular
teeth from a first position to a second position, for example, by
exerting a force on one or more teeth (e.g., from an interference
fit configured to move one or more teeth). The aligner 38 can fit
over all or a subset of teeth in the maxillary and/or mandibular
dentition.
[0087] A series of aligners 38 (e.g., maxillary and/or mandibular
aligners 38a, 38b) can be designed and applied or used over time in
order to reposition one or more maxillary and/or mandibular teeth
in two or more successive steps, for example, as disclosed in PCT
Publication WO 2016/004415 and U.S. application Ser. No. 15/386,280
(published as US 2017/0100214), both of which have been
incorporated herein by reference in their entireties for all
purposes. As described above, each aligner 38 in a series can have
an inner surface that has a geometry that corresponds to an
intermediate or end tooth arrangement intended for each aligner 38
in the series. The aligners 38 can be sufficiently resilient to
accommodate or conform to misaligned teeth, but apply sufficient
force against the misaligned teeth to reposition the teeth to the
intermediate or end arrangement as desired for the particular
treatment step. A series of aligners 38 can have geometries
selected to progressively reposition teeth from a first arrangement
through one or more successive intermediate arrangements to a final
arrangement.
[0088] SBD appliance therapy can be combined with orthodontic
aligner treatment as described above, for example, with an aligner
38 (e.g., a maxillary and/or mandibular aligner 38a, 38b). As
further described above, one or more airway development blocks 12
and/or 14 (also referred to as guides) can be directly or
indirectly attached to or integrated with an aligner 38 (e.g., a
maxillary and/or mandibular aligner 38a, 38b). The one or more
maxillary blocks 12 can be monolithically formed with a maxillary
aligner 38a. The one or more mandibular blocks 14 can be
monolithically formed with a mandibular aligner 38a.
[0089] FIG. 5 illustrates that a maxillary aligner 38a can have a
maxillary guide 12 that has a guide surface 26. The guide 12 can be
on an anterior or posterior portion of the maxillary aligner 38a.
For example, FIG. 5 illustrates that the guide 12 can be on an
anterior portion of the aligner 38a. The guide 12 can be one of the
block 12, 14 described above with reference to FIGS. 1-3, and can
be integrated with the aligner 38a as shown in FIG. 5.
[0090] FIG. 6 illustrates that the guide 12 can be on a posterior
portion of the aligner 38a. The aligner 38a can advantageously
orthodontically move teeth concurrently with treating SBD, for
example, by interacting with a mandibular aligner 38b. For example,
FIG. 6 illustrates a jaw in a closed position having a maxillary
aligner 38a and a mandibular aligner 38b with posterior guides 12,
14, where the posterior guides 12, 14 are interacting to keep the
jaw in a closed position with more space between the upper and
lower dentition than would otherwise occur without the posterior
guides 12, 14. The guides 12, 14 can be the blocks 12, 14 described
above with reference to FIGS. 1-3, and can be integrated with the
aligners 38a, 38b, respectively, as shown in FIG. 6.
[0091] FIGS. 1-3, 5 and 6 each illustrate device components
comprising angled surfaces and disclusion ramps such as airway
development blocks 12, 14 that can be combined with the aligner 38
in FIG. 4 to concurrently provide SBD treatment along with the
orthodontic movement of teeth. However, all types of SBD appliance
therapy can be combined with orthodontic aligner treatment shown in
FIG. 4, including other mandibular advancement appliances (e.g.,
Herbst appliances, elastic mandibular advancement (EMA)
appliances), as well as, for example, stabilization splints (e.g.,
nightguards, day guards), deprogrammers (e.g., anterior
deprogrammers), flat planes, and full contact splints with anterior
guidance. For example, the aligner 38 can be combined with,
attached to, removably attached to, or integrated with these other
types of devices. The aligner 38 can replace the teeth (e.g.,
occlusal) engagement portions of these other types of SBD
devices/components so that each appliance 10 can provide
orthodontic treatment (e.g., orthodontically move teeth) in
addition to providing SBD treatment. Such orthodontic/SBD
appliances can advantageously orthodontically move the teeth into a
position that is physiologically correct for the craniofacial
musculature during SBD treatment with an SBD appliance. The
maxillary and mandibular aligner components and/or the SBD
components of these oral appliances 10 can comprise a thermoplastic
material that can, for example, be thermoformed with the aid of a
computer program.
[0092] A maxillary component (e.g., maxillary block 12a and/or
maxillary aligner 38a) can be attached to a mandibular component
(e.g., mandibular block 12b and/or mandibular aligner 38b), for
example, via an attachment mechanism. The attachment mechanism can
be an interference fit (also referred to as a friction fit), snap
fit, tether, band, elastic band, hook, elastic hook, or any
combination thereof. For example, the maxillary blocks 12 and/or
the maxillary aligners 38a can have a male component (e.g., a
protrusion) and the mandibular blocks 14 and/or the mandibular
aligners 38b can have a female component (e.g., a recess or a hole)
configured to receive the protrusion via an interference fit or a
snap fit, or vice versa. The male component can have a form factor
that is slightly larger than the female component to generate an
interference fit. For example, the protrusion can have a form
factor that is slightly larger than the recess or hole such that an
interference fit is produced when the protrusion is inserted into
the recess or hole. The male component can have a form factor that
is slightly smaller than the female component to generate an
interference fit. For example, the protrusion can have a form
factor that is slightly smaller than the recess or hole such that
an interference fit is produced when the protrusion is inserted
into the recess or hole. A maxillary block 12a can be attached to a
mandibular block 12b and/or to a mandibular aligner 38b via the
attachment mechanism. A maxillary aligner 38a can be attached to a
mandibular block 12b and/or to a mandibular aligner 38b via the
attachment mechanism.
[0093] The device 10 can have one or more attachment mechanisms,
for example a first attachment mechanism for the left maxillary and
mandibular components and/or a second attachment mechanism for the
right maxillary and mandibular components. The attachment mechanism
can have one, two, three, four, five, and/or six degrees of
freedom. The attachment mechanism can partially or completely
restrict movement of the jaw in one or more degrees of freedom. The
attachment mechanism can help keep the jaw in a desired
arrangement, for example, a desired open and/or closed position to
treat SBD. The freedom of movement allowed by the attachment
mechanism desirably enables the device 10 to treat SBD and
simultaneously prevent or inhibit the onset of temporomandibular
joint dysfunction (TMD). TMD can be caused by locking the jaw into
a position or otherwise restricting movement of the jaw. The jaw
movement permitted by the attachment between the maxillary
component (e.g., maxillary block 12 and/or maxillary aligner 38a)
and the mandibular component (e.g., mandibular block 14 and/or
mandibular aligner 38b) via the attachment mechanism when the
device 10 is in use can help prevent or otherwise inhibit the user
from developing problems with their temporomandibular joint.
Alternatively or additionally, the attachment mechanism can have
zero degrees of freedom and completely restrict motion of the lower
jaw.
[0094] Different blocks 12 and/or aligners 38 in a series can have
different degrees of freedom when in an attached configuration.
Changing the motion permitted by the jaw during treatment with
different appliances 10 in the series can desirably prevent or
inhibit the user from developing TMD. The appliances 10 in the
series can restrict movement of the lower jaw differently than one
or more preceding appliances 10 and/or differently than one or more
subsequent appliances 10. The amount of movement or the degrees of
freedom can be changed for every appliance 10 in the series, or
every 2-50 appliances 10 in the series, including every 1 appliance
increment within this range, for example, every 5 appliances
10.
[0095] When the maxillary and mandibular components are in an
attached configuration, the attachment mechanism can prevent the
jaw from moving (e.g., opening or closing vertically or moving from
side to side) and/or can limit the amount by which the lower jaw is
able to move, for example, by preventing or limiting the amount of
relative movement between the aligners 38 and/or between one or
more aspects of the SBD devices or components of the appliance 10.
When the maxillary and mandibular components are attached to one
another, the attachment mechanism can prevent all movement of the
lower jaw (e.g., by preventing all relative movement between the
aligners 38). When the maxillary and mandibular components are
attached to one another, the attachment mechanism can allow the
lower jaw to have one, two, three, four, five, or six degrees of
freedom such that the lower jaw is translatable along and/or
rotatable about one, two, and/or three axes (e.g., along and/or
about one, two, and/or three mutually perpendicular axes such as x,
y, and/or z Cartesian axes). To permit the lower jaw to move, the
attachment mechanism can permit relative movement between the
aligners 38 and/or between one or more aspects of the SBD devices
or components of the appliance 10. For example, when the maxillary
and mandibular components are in an attached configuration, the
attachment mechanism can permit the lower jaw to translate from
about 0.5 mm to about 5 mm, including every 0.5 mm increment within
this range, for example, about 2.0 mm, along one, two, or three
axes. For example, when the maxillary and mandibular components are
in an attached configuration, the attachment mechanism can permit
the lower jaw to rotate from about 1 degree to about 30 degrees,
including every 1 degree increment within this range, for example,
about 10 degrees, about one, two, or three axes.
[0096] The attachment mechanism can impart a restorative force to
the lower jaw to return to a neutral position (e.g., the desired
position) once displaced (e.g., translated and/or rotated) away
from the neutral position. Additionally or alternatively, the
attachment mechanism can include one or more elastic bands and/or
guide surfaces apart from the attachment mechanism to impart a
restorative force or otherwise encourage a return to the neutral
position.
[0097] The aligners described herein can form a friction fit with
the dentition. The friction fit can be non-uniformly spread across
the aligners to apply different forces to different teeth, thereby
enabling different teeth to be orthodontically moved by different
amounts, with the amounts being proportionate to the various (e.g.,
different) forces applied across the dentition.
[0098] Two sets of oral appliances 10 can be made for every stage
of treatment: one for daytime use and one for nighttime use. The
daytime oral appliances 10 can orthodontically move teeth with or
without SBD treatment. For example, the daytime oral appliances 10
can have an SBD component that is smaller than the nighttime oral
appliances 10, or the daytime oral appliances 10 can omit the SBD
component altogether. The nighttime oral appliances 10 can
concurrently treat SBD and orthodontically move teeth. The
nighttime oral appliances can have an SBD component. Each daytime
oral appliance 10 in a series can be designed to open and/or
advance the lower jaw less than the corresponding nighttime oral
appliance 10 in the series, or not at all. The daytime and
nighttime appliances can have the same corresponding stage of
orthodontic treatment. The daytime stage of orthodontic treatment
can be less aggressive (e.g., apply less force to the teeth) than
the nighttime stage of orthodontic treatment. Alternatively or
additionally, only one series of oral appliances 10 can be made for
every step of treatment (as opposed to two parallel series of
appliances--one for day use and one for night use). For example,
one or more of the locked configurations of the appliance 10 in
each step of a series can be for daytime use and one or more of the
locked configurations of the appliance 10 in each step of a series
can be for nighttime use.
[0099] FIG. 7 illustrates a schematic of a variation of a series
200 of oral appliances 10. The oral appliance series 200 can have
ND daywear oral appliances 10 in a daytime series 200.sub.D and/or
can have N.sub.N nightwear oral appliances 10 in a nighttime series
200.sub.N, where N.sub.D and N.sub.N can each be between 1 and 100,
including every increment of 1 within this range. N.sub.D can be
the same or different from N.sub.N. The dimensions of the daytime
and nighttime oral appliances 10 in each step of the series 200 can
be the same or different than one another. The daytime and
nighttime oral appliances 10 in each step of the series 200 can
advance the jaw as described above, for example, by the same
amount. For example, FIG. 7 illustrates that steps 1-4 of the
series 200 can each progressively move the jaw forward by about 1.0
mm, by about 0.5 mm, by about 0.5 mm, and by about 1.0 mm,
respectively, which is represented in FIG. 7 by arrows 201, 202,
203, and 204, respectively. FIG. 7 illustrates the relative
positions of the maxillary aligner and SBD components (e.g.,
aligner 38a and SBD components 12) relative to the mandibular
aligner and SBD components (e.g., aligner 38b and SBD components
14).
Method of Making
[0100] FIG. 8 illustrates a variation of a process 100 of making
the oral appliance 10. A computer program can be used to retrieve
data from data acquisition devices (e.g., oral scanners, x-ray
devices, cameras) to record and measure orthodontic malocclusions
and teeth misalignments. Step 102 illustrates that after a digital
model of the dentition is obtained, the digital models for the
lower and upper arches can be loaded, e.g., into a computer. Step
104 illustrates that the bite registration can be set and a model
of the appliance 10 can be created. The desired treatment can be
simulated in step 106, including, for example, mandibular
advancement, palatal expansion, teeth movement, or any combination
thereof. The TMJ temporal bone, disc and mandibular head
relationship can be checked in step 108, for example, when
mandibular advancement is simulated in step 106. If the check is
satisfactory, the process can move on to step 110, otherwise the
process can return to step 106 and run one or more additional
simulations. Based at least partly on the simulation(s) and
check(s) in steps 106 and 108, an algorithm can be configured to
design one or more aspects of the SBD components (e.g., guide
surfaces 26, 28) in step 110 to effect the desired mandibular
advancement. Step 112 illustrates that the blocks 12, 14 and/or
oral trays can be designed that have the guide surfaces 26, 28
designed in step 110. Step 112 also illustrates that an optional
elastic hook can be designed to prevent the jaw from opening and
moving away from the maxillary blocks 12 when a person is sleeping.
Step 114 illustrates that the blocks 12, 14 and/or oral trays
designed in step 112 can move one or more teeth to a new arch
occlusion based on a new arch relationship at least partly
determined by the algorithm. The process 100 can be used to create
one oral appliance 10 or a series of oral appliances 10.
[0101] Software can be used to manipulate digital impressions
(scans) of the dental arches to incrementally move the teeth as
well as designing the functional applications for daytime and/or
nighttime use on a 3D printed model for appliance fabrication
utilizing traditional vacu-form technique or direct to print
appliances.
[0102] Using the process 100 in FIG. 8, an oral appliance 10 and/or
a series of oral appliances 10 can be designed by the computer
algorithm based on data the algorithm receives and processes from
one or multiple data acquisition devices (e.g., scanners, x-ray
devices, cameras) that can individually or collectively form a
digital impression of an oral cavity and the dentition therein. For
example, the dimensions of the oral appliance 10 in each step,
including the SBD components (e.g., maxillary and mandibular blocks
12, 14, or one or more aspects thereof, including the oral trays)
and/or the aligner components (e.g., maxillary and mandibular
aligners 38a, 38b) can be determined from data received from the
data acquisition devices. The algorithm in process 100 can combine
orthodontic aligners with multiple different discipline SBD
treatments, for example, to adjust the bite, restore some or all of
the teeth, and move the teeth into a more desirable position.
[0103] For example, the data retrieved from the data acquisition
devices can be used to measure orthodontic malocclusions, determine
orthodontic corrections for the malocclusions while simultaneously
treating SBD, for example, by designing a series of oral appliances
10 that can progressively treat SBD (or SBD symptoms) concurrently
with a progressive orthodontic movement of teeth. Computer software
can be used to determine the orthodontic movements of the teeth in
one or more steps of a series. Computer software can be used to
design the appliances 10. Computer software can be used to
manufacture 3D models or directly print appliances 10. Models of
the appliances 10 can be created by using computer software to
incrementally move the teeth digitally and then print a 3D model
from which an orthodontic aligner can be fabricated. Alternatively
or additionally, the aligners can be fabricated directly with a 3D
printer using computer software. The orthodontic aligner can be
altered or otherwise modified on the occlusal surface to create the
desired SBD treatment appliance 10 while the orthodontic movement
is concurrently occurring. Giving the dentist or orthodontist the
ability to treat SBD simultaneously with the orthodontic movement
of teeth via a computer program that converts data received from
one or more data acquisition devices into a series of successive
orthodontic/SBD appliances 10 can advantageously open up many new
treatment protocols for dentists and orthodontists to use to serve
their patients.
[0104] The claims are not limited to the exemplary embodiments
shown in the drawings, but instead may claim any feature disclosed
or contemplated in the disclosure as a whole. Any elements
described herein as singular can be pluralized (i.e., anything
described as "one" can be more than one). Any species element of a
genus element can have the characteristics or elements of any other
species element of that genus. Some elements may be absent from
individual figures for reasons of illustrative clarity. The
above-described configurations, elements or complete assemblies and
methods and their elements for carrying out the disclosure, and
variations of aspects of the disclosure can be combined and
modified with each other in any combination. All devices,
apparatuses, systems, and methods described herein can be used for
medical (e.g., diagnostic, therapeutic or rehabilitative) or
non-medical purposes.
* * * * *