U.S. patent number 3,916,526 [Application Number 05/358,972] was granted by the patent office on 1975-11-04 for method and apparatus for orthodontic treatment.
Invention is credited to Fred Frank Schudy.
United States Patent |
3,916,526 |
Schudy |
November 4, 1975 |
Method and apparatus for orthodontic treatment
Abstract
The apparatus for the orthodontic treatment of teeth which form
a dental arch includes a 0.016 inch by 0.022 inch rectangular arch
wire, labial brackets having a 0.016 inch slot, buccal brackets
having a 0.022 inch slot, and two-way buccal tubes. The two-way
buccal tubes have a two-way slot for anchoring the arch wire
regardless of whether the 0.016 or the 0.022 dimension is in the
vertical position. The arch wire, therefore, can initially be
secured to the dental arch with its 0.016 inch dimension being
vertical. Then the arch wire may be twisted 90.degree. at the
junctures of the anterior and posterior teeth and be secured to the
dental arch by inserting the vertical 0.016 dimension of the arch
wire into the 0.016 slot of the labial brackets and by inserting
the vertical 0.022 dimension of the arch wire into the 0.022 slot
of the buccal brackets. In both instances the two-way tube can
anchor the arch wire. The apparatus further includes a locking
mechanism to lockingly engage the headgear hook of a headgear to
the arch wire. Also an anti-friction spring is used to prevent
friction between a bracket and the arch wire through the
application of a counter moment to a tooth. This allows the tooth
to slide along the arch wire when an elastic force is applied to
the tooth.
Inventors: |
Schudy; Fred Frank (Houston,
TX) |
Family
ID: |
23411783 |
Appl.
No.: |
05/358,972 |
Filed: |
May 10, 1973 |
Current U.S.
Class: |
433/8; 433/17;
433/5; 433/20 |
Current CPC
Class: |
A61C
7/30 (20130101) |
Current International
Class: |
A61C
7/30 (20060101); A61C 7/00 (20060101); A61C
007/00 () |
Field of
Search: |
;32/14 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Peshock; Robert
Attorney, Agent or Firm: Robinson; Murray Conley; Ned L.
Rose; David Alan
Claims
I claim:
1. An orthodontic apparatus for the treatment of the anterior and
posterior teeth of a dental arch comprising:
an arch wire having a rectangular cross section with a large
dimensioned side and a small dimensioned side; said arch wire
having two approximately 90.degree. twists located at the
juxtapositions of the anterior and posterior teeth on each side of
the dental arch;
labial brackets secured to the anterior teeth and each having a
slot slightly larger than the dimension of the small dimensioned
side of the arch wire;
buccal brackets secured to the posterior teeth and each having a
slot slightly larger than the dimension of the large dimensioned
side of the arch wire; and
said small dimensioned side of said arch wire being slidingly
received within the slot of said labial brackets and said larger
dimensioned side of said arch wire being slidingly received within
the slot of said buccal brackets.
2. An orthodontic apparatus as defined in claim 1 further including
buccal tubes attached to two posterior teeth for anchoring said
arch wire, said buccal tubes having a bore with a square
cross-section of a dimension slightly larger than the large
dimensioned side of the arch wire and means disposed within said
bore to limit the rotation of said arch wire when said arch wire is
inserted within said bore with the large dimensioned side vertical
or horizontal.
3. An orthodontic appliance as defined in claim 1 wherein one of
the dimensions of said rectangular cross-section is .016
inches.
4. An orthodontic appliance as defined in claim 1 further including
calibrations on said arch wire for sizing said arch wire element
with the dental arch.
5. An orthodontic appliance as defined in claim 1 further including
locking means disposed on said arch wire adapted for locking
engagement with a headgear to hold said arch wire element in
position.
6. A buccal tube for securing an arch wire having a rectangular
cross-section with a large dimensioned side and a small dimensional
side to a tooth comprising:
a tube affixed to a tooth and having a longitudinal bore
therethrough, said bore having a square cross-section with a
dimension slightly greater than the length of the large dimensioned
side of the arch wire; and
means disposed longitudinally within said bore causing a vertical
portion and a horizontal portion of said bore to have a dimension
smaller than the large dimensioned side of the arch wire whereby
the arch wire may pass through said bore with its larger
dimensioned side vertical or horizontal within said bore and said
means preventing rotation of the arch wire within said bore.
7. A buccal tube as defined in claim 6 wherein said means includes
at least one square cross-sectioned stop member disposed in one or
more longitudinal corner of said bore; said stop member having a
dimension slightly smaller than the difference between the
dimension of the large dimensioned side and the small dimensioned
side of the arch wire.
8. An orthodontic apparatus as defined in claim 1 further including
means for shifting a tooth along said arch wire substantially
without friction between one of said brackets and said arch wire
comprising:
elastic means for applying a horizontal force on the tooth causing
a first moment due to the resistance of the mouth to the movement
of the tooth; and
spring means for placing a second moment on the tooth which
negatives said first moment.
9. An orthodontic apparatus as defined in claim 8 wherein
said one of said brackets has a first rotating lever and a second
rotating lever; and
said spring means includes a spring engaging said first rotating
lever, extending under said second rotating lever and engaging said
arch wire.
10. An orthodontic apparatus for the treatment of a dental arch
composed of anterior teeth and posterior teeth comprising:
an arch wire having an elongate cross-section, the longitudinal
axis of said cross-section being substantially perpendicular to the
plane of the dental arch at the juxtaposition of said arch wire and
the posterior teeth and being substantially parallel to the plane
of the dental arch at the juxtaposition of said arch wire and the
anterior teeth;
anterior and posterior brackets for securing said arch wire to the
teeth regardless of whether said longitudinal axis is perpendicular
or parallel to the plane of the dental arch;
spring means for preventing friction between said arch wire and
said brackets;
calibrated means for positioning said longitudinal axis with
respect to the anterior and posterior teeth; and
lock means for applying pressure to said arch wire whereby said
apparatus allows said anterior brackets to be filled by the smaller
dimension of said arch wire and said posterior brackets to be
filled by the larger dimension of said arch wire thus permitting
complete control over the movement of the teeth.
11. An orthodontic appliance for receiving and securing the
terminal ends of a rectangular cross-sectioned arch wire to a
tooth, comprising:
a tube banded to the tooth and having a longitudinal bore having a
horizontal and vertical dimension slightly larger than the larger
dimension of the arch wire whereby said tube will receive the arch
wire with either dimension in the vertical or horizontal position,
said bore having at least one corner invaginated therein whereby
after the arch wire is inserted into said tube, the smaller
dimension of the arch wire is confined by said corner thereby
preventing the arch wire from rotating regardless of which
dimension of the arch wire is horizontal or vertical.
12. An orthodontic appliance comprising:
a rectangular arch wire having two anterior loops disposed on an
anterior portion of said arch wire, and two posterior loops
disposed near the terminal ends of said arch wire;
buccal tubes on two posterior teeth for anchoring said arch wire
regardless of whether the larger dimensioned side of said arch wire
is vertical or horizontal, said posterior loops securing said arch
wire to said buccal tubes;
anterior brackets secured to the anterior teeth and having a slot
slightly larger than the smaller dimension of said arch wire;
posterior brackets secured to the posterior teeth and having a slot
slightly larger than the larger dimension of said arch wire;
whereby said arch wire will fill the slots of said anterior and
posterior brackets upon twisting said arch wire approximately
90.degree. at the juxtapositions of the anterior and posterior
teeth when precise control of all the teeth is desired and said
arch wire will fill only the slots of said anterior brackets when
said arch wire is not so twisted when such precise control is not
desired; and
a headgear wire having a hook on one end for insertion into one of
said anterior loops of said arch wire whereby as the other end of
said headgear wire is moved toward said arch wire, said headgear
wire becomes locked with said arch wire.
13. An orthodontic appliance as defined in claim 12 wherein said
anterior loops have an opening slightly larger than the diameter of
said hook and said hook includes a groove.
14. An orthodontic appliance as defined in claim 13 wherein said
anterior loops have an opening slightly larger than the diameter of
the said hook and said hook has an arcuate diameter slightly
smaller than the diameter of said anterior loops in said arch
wire.
15. An appliance for straightening teeth comprising:
labial brackets affixed to the central incisors, lateral incisors
and cuspids, said labial brackets having a slot with a vertical
dimension slightly larger than 0.016 inches;
buccal brackets affixed to the first bicuspids, second bicuspids
and first molars, said buccal brackets having a slot with a
vertical dimension slightly larger than 0.022 inches;
buccal tubes affixed to the second molars, said buccal tubes having
a generally square bore with a dimension slightly larger than 0.022
inches and at least one stop in one corner of said bore having the
dimensions 0.006 by 0.006 inches;
a rectangular archwire having a 0.016 inch dimensioned side and a
0.022 inch dimensioned side, and two approximate 90.degree. twists
located at the juxtaposition of the cuspids and first bicuspids
whereby the 0.016 inch side of the archwire is vertical and
inserted into the 0.016 inch slot of the labial brackets, and the
0.022 inch side of the archwire is vertical and inserted into the
0.022 inch slot of the buccal brackets and into the 0.022 inch bore
of the buccal tube.
16. A buccal tube for anchoring a rectangular archwire having the
dimensions 0.016 inches by 0.022 inches comprising:
a tube mounted on a band adapted for attachment to a molar;
said tube having a longitudinal bore with a generally square
cross-section with dimensions slightly larger than 0.022 inches by
0.022 inches;
said tube further having at least one longitudinal stop running the
length of the bore dimensioned 0.006 inches by 0.006 inches whereby
said archwire may be inserted two ways, one where the 0.016 inch
side of the archwire is vertical and a second where the 0.022 inch
side of the archwire is vertical, the stop preventing the archwire
from rotating within the bore of the buccal tube regardless of
which side of the archwire is vertical.
17. An orthodontic apparatus for the treatment of a dental arch
composed of anterior teeth and posterior teeth comprising:
a filamentary member having an elongate cross-section, the
longitudinal axis of said cross-section being substantially
perpendicular to the plane of the dental arch at the juxtaposition
of said member and the posterior teeth and being substantially
parallel to the plane of the dental arch at the juxtaposition of
said member and the anterior teeth;
securement means for securing said member to the teeth regardless
of whether said longitudinal axis is perpendicular or parallel to
the dental arch;
spring means for preventing friction between said filamentary
member and said securement means;
calibrated means for positioning said longitudinal axis with
respect to the anterior and posterior teeth; and
lock means for applying pressure to said member.
18. An orthodontic appliance comprising:
an arch wire having a loop disposed on said arch wire; and
a headgear wire having a hook on one end for insertion into said
loop whereby as the other end of said headgear wire is moved toward
said arch wire, said headgear wire becomes locked with said arch
wire.
19. An orthodontic appliance as defined in claim 18 wherein said
loop has a opening slightly larger than the diameter of the arch
wire and said hook includes an arcuate groove.
20. An orthodonic appliance as defined in claim 18 wherein said
loop has an opening slightly larger than the diameter of the arch
wire and said hook has an arcuate diameter equal to the diameter of
said arch wire.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention pertains to orthodontic treatment and more
particularly relates to a method and apparatus for the utilization
of an arch wire.
2. Description of the Prior Art
The art of orthodontics is the correction of irregularities of the
teeth. Typical orthodontic mechanotherapy during orthodontic
treatment are the rotating of the teeth into proper position, the
shifting of a tooth to close a void caused by the extraction of a
tooth, the uprighting of the teeth in the dental arch, the aligning
of the teeth in a proper arch form, and the coordinating of the
lower dental arch with the upper dental arch. To achieve this
mechotherapy certain orthodontic apparatus and appliances have been
constructed. Such appliances include arch wires, brackets, buccal
tubes, various springs, elastic bands, and headgear, to name a
few.
The arch wire is a wire or band which is positioned around the
outer periphery of the dental arch extending from the posterior
teeth on one side of the arch to the posterior teeth on the other
side of the arch. Similar arrangements are employed on both the
upper and lower dental arches. The arch wire is secured to the
teeth by brackets attached to each tooth by a metal band. The arch
wire is anchored to one of the posterior teeth, generally the
second molars, by means of a buccal tube which is likewise secured
to the anchor tooth by a metal band.
In certain cases the dental arch is too small to accommodate all of
the teeth whereby it is desirable to extract certain teeth to allow
space for the alignment of the others. Appliances are then used to
shift the teeth to close the void caused by the extraction of a
tooth. Generally, an elastic band or thread is attached to the
tooth to be shifted and to one or more anchor teeth. The elastic
band causes the tooth to move towards the anchor teeth. However,
under existing methods the bracket secured to the tooth to be
shifted must slide on the arch wire since the arch wire is disposed
in a horizontal slot in the bracket. Problems arise because the
crown of the tooth will tend to tip due to resistance of the bone
and gums around the root of the tooth. As the tooth tips the arch
wire engages the edges of the slot in the bracket and tends to bind
so as to cause friction between the arch wire and the bracket. Such
friction retards the movement of the tooth.
One solution to this problem is to lengthen or widen the
longitudinal length of the slot of the brackets to resist the
binding tendency of the bracket and arch wire. However, the wider
bracker reduces the distance between brackets leaving no space for
hooks, loops, joints, and the like. The orthodontist has no working
room which tends to increase work time not to mention the tension
and frustration created for the patient and orthodontist. Greater
force is required to seat the arch wire and more arch wires are
required since the size of the wires have to be increased slowly to
permit the threading of the wires through all the slots of the
brackets due to the sharp bends required. The flexibility from one
bracket to another is also decreased. Needless to say all
operations have to be more exact due to the reduction of space.
A variety of sizes and shapes of arch wires are used during
orthodontic treatment under present methods. Generally a series of
round arch wires, having much resiliency, are used initially and
their size is increased from 0.014 to 0.020 inches until the dental
arch is sufficiently formed to use a square or rectangular arch
wire having greater strength and rigidity to close voids and to
level the dental arch. Likewise several different square or
rectangular wires are used to increase the strength of the arch
wire to stabilize the teeth in their new positions and to
coordinate the upper dental arch with the lower dental arch.
Rectangular arch wires have a range of sizes. The rectangular wire
size most often used is that of 0.018 .times. 0.025 as described in
U.S. Pat. No. 3,076,265. Other rectangular arch wires are described
generally in U.S. Pat. Nos. 2,566,414; 3,043,007; 3,052,028;
3,076,265; 3,091,857; 3,464,112; and 3,578,744. It should be noted
that much resiliency in the arch wire is lost when the round arch
wire is replaced for the 0.018 .times. 0.025 rectangular arch
wire.
The rectangular arch wire is generally formed by hand and then
installed. Methods of forming arch wires are described in U.S. Pat.
Nos. 2,566,414 and 3,578,744. Often forming the arch wire by hand
is time consuming due to inadequate means of measurement. Much time
would be saved by accurate measuring means and preformed arch
wires.
As described previously and in U.S. Pat. No. 3,494,034, the arch
wire is anchored at each end to buccal tubes generally secured to
the second molars. Such buccal tubes, previously used, limit the
snug fit of the rectangular arch wire to one cross-sectional
direction. To use the other cross-sectional direction or wires of
another size, a loose fit could only be maintained within the tube.
Heretofore all tubes and brackets only provided a precision fit
where the longer cross-sectional dimension was in the horizontal
position.
Various brackets, some of which are described in U.S. Pat. Nos.
1,280,628; 1,584,501; 1,890,487; 2,971,258; 3,043,007; 3,052,028;
3,076,265; 3,091,857; 3,128,553; and 3,302,288, are used to secure
the different sized arch wires to the teeth. Generally such
brackets have a slot which retains the arch wire. The arch wire is
then secured to the bracket by a wire engaging device. Existing
arch wire engaging devices or brackets are of three types. The
first is a ligating bracket which requires the use of soft wire to
tie the arch wire to the bracket. The second is a non-ligating
bracket with a removable cover which may be secured to the bracket
for holding the arch wire. The third type is a non-ligating bracket
with an attached cover which secures the arch wire to the
bracket.
In using a rectangular arch wire to level the posterior teeth, it
is necessary to have a clearance between the rectangular arch wire
and the inner surface of the slots in the buccal brackets to permit
the teeth to slide on the arch wire as the posterior teeth shift
into position. The arch wire cannot be permitted to completely fill
the slots or to fit snugly therein since friction will occur
between the brackets and the arch wire limiting the movement of the
tooth. However, since the labial brackets on the anterior teeth
have the same sized slots as the buccal brackets, there will be a
gap between the wire and the labial brackets which is undesirable
because the orthodontist then loses control of the anterior teeth.
Therefore the anterior teeth begin to lose some of the proper
alignment previously achieved while the orthodontist is attempting
to level the posterior teeth.
To exert some pressure on the appliance to either move teeth
posteriorly and/or prevent their movement anteriorly, a headgear is
connected to the arch wire. The headgear generally includes an
orthodontic headgear hook attached to the arch wire and an elastic
band attached to the ends of the headgear hook for the application
of pressure to the arch wire. A face bow is shown in U.S. Pat. No.
3,492,044. The prior art headgear have a hook attached to the arch
wire and a loop on the headgear hook creating various
disadvantages. Often the headgear comes disconnected from the arch
wire during the night.
SUMMARY OF THE INVENTION
The apparatus for the orthodontic treatment of teeth includes an
anti-friction spring which hooks to the rotating levers of the
bracket secured to a tooth to be shifted into a void. The spring is
affixed to the arch wire at various distances from the bracket. The
spring provides a moment on the crown countering the moment on the
root due to the gums and bone.
The apparatus also includes a 0.016 by 0.022 inch rectangular arch
wire, labial brackets having a 0.016 vertical slot, buccal brackets
having a 0.022 vertical slot, and two-way buccal tubes. This
permits the orthodontist to level the posterior teeth while still
maintaining control of the anterior teeth since the 0.016 vertical
dimension of the arch wire fills the slots of the labial brackets
but still permits a 0.006 inch gap in the slots of the buccal
brackets to prevent any friction between the buccal brackets and
arch wire.
The arch wire may be twisted 90.degree. at the junctures of the
anterior and posterior teeth whereby the 0.016 arch wire dimension
fills the labial brackets and the 0.022 arch wire dimension fills
the buccal brackets. This permits the orthodontist to control the
anterior teeth and the posterior teeth at the same time; but yet
the twisted arch wire will have its 0.016 dimension vertical when
adjacent to the anterior teeth for added resiliency and will have
its 0.022 dimension vertical when adjacent to the posterior teeth
where more strength and rigidity are required.
The 90.degree. twist makes maximum use of the strength of the arch
wire and permits fewer removals and replacements of arch wires.
Further the treatment is much easier on the patient and requires
less time.
Another advantage is the use of one arch wire to take the place of
two arch wires of different sizes.
Further the reduction of the size of the slots of the labial
brackets from 0.018 to 0.016 increases the torquing capability and
produces a lighter force.
The arch wire in the present invention is coded whereby a unique
arch caliper is used to measure the length of the dental arch
comprising the anterior teeth, and the length of the arch wire
required. The caliper is applied to the dental arch to mark the
location of the 90.degree. twists and to indicate the length of the
arch wire required. A calibrated preformed arch wire is then
selected which has the proper dimensions. Such a device eliminates
haphazard measurement and permits the use of preformed arch
wires.
The present invention further includes two-way buccal tubes
permitting the rectangular arch wire to be secured with either
dimension in the vertical position.
The present invention further describes an orthodontic headgear
hook and connector which elimnates an accidental removal of the
headgear from the arch wire.
The method of orthodontic treatment comprises the steps of securing
the arch wire in the untwisted position with the 0.016 dimension in
the vertical direction to the labial brackets, buccal brackets, and
two-way tubes; removing the arch wire; locating the junctures of
the anterior and posterior teeth; twisting the arch wire 90.degree.
at these junctures; securing the twisted arch wire to the labial
brackets by inserting the 0.016 dimension of the twisted arch wire
being vertical into the 0.016 slot; securing the twisted arch wire
to the buccal brackets by inserting the 0.022 dimension of the
twisted arch wire being vertical into the 0.022 slot; and anchoring
the twisted arch wire in the two-way tubes with the 0.022 arch wire
dimension being vertical.
Another object of the present invention is to streamline
orthodontic appliances by eliminating various removable auxillary
attachments to rotate, torque, and upright teeth. The present
invention permits the use of the edgewise technique in its simplest
form.
Other objects and advantages of the invention will appear from the
following description.
BRIEF DESCRIPTION OF THE DRAWINGS
For a detailed description of a preferred embodiment of the
invention, reference will now be made to the accompanying drawings
wherein:
FIG. 1 is a side view of two arch wires secured and anchored to a
set of teeth;
FIG. 2 is a plan view of a dental arch having two voids;
FIG. 3 is a side view of the dental arch shown in FIG. 2;
FIG. 4 is a front view of an anti-friction spring mounted on a
tooth;
FIG. 5 is a view of the spring as indicated in plane 5--5 in FIG.
4;
FIG. 6 is a side view of one of the brackets shown in the
environmental view of FIG. 1;
FIG. 7 is a plan view of an arch caliper;
FIG. 8 is a plan view of an arch wire having two 90.degree.
twists;
FIG. 9 is an enlarged view of one of the 90.degree. twists in the
arch wire shown in FIG. 8;
FIG. 10 is a plan view of a buccal tube and a portion of a
band;
FIG. 11 is an end view of the buccal tube as indicated in FIG.
10;
FIG. 12 illustrates the end view of a variety of buccal tubes
lettered A through E;
FIG. 13 is a plan view of a calibrated arch wire;
FIG. 14 is an end view of the calibrated arch wire of FIG. 13
showing the connectors for a face bow;
FIG. 15 is a plan view of a headgear hook for engagement with the
connectors and arch wire of FIGS. 13 and 14;
FIG. 16 is a plan view showing a headgear hook attached to an arch
wire; and
FIG. 17 is an end view of the headgear hook and arch wire of FIG.
16.
DESCRIPTION OF THE PREFERRED EMBODIMENT
A variety of appliances are utilized in orthodontics. In FIG. 1
there is shown an environmental view of a set of appliances. Those
appliances include an arch wire 120, brackets 124, and a buccal
tube 190 installed on an upper dental arch 10 and a lower dental
arch 12. Referring now to the upper dental arch 10, arch 10
includes central incisors 14, lateral incisors 16, cuspids 18,
first bicuspids 20, second bicuspids 22, first molars 24, and
second molars 26. Of course a corresponding set of those teeth is
located on the other side of dental arch 10. The central incisors
14, lateral incisors 16, and the cuspids 18 can be generally
defined as the anterior teeth or front teeth, and the first
bicuspids 20, second bicuspids 22, first molars 24, and second
molars 26 can be generally defined as the posterior teeth or back
teeth. A similar arrangement is found in the lower dental arch. An
exception to the above will occur if one of those teeth has been
extracted.
The hereinafter described appliances are utilized for orthodontic
mechanotherapy to rotate and shift the teeth to achieve proper
alignment. As shown in FIG. 1 brackets 124 are secured to the teeth
and buccal tubes 190 are affixed to an anchor tooth such as the
second molars. Then an arch wire is attached to the brackets 124
and anchored to buccal tubes 190 to provide a source of pressure
and leverage for aligning the teeth.
Referring again to FIG. 1 a variety of arch wires have been used in
the past during treatment which are of all sizes and shapes.
Initially a series of preliminary arch wires are used which are
round and have much resiliency. The preliminary round arch wires
generally range from 0.014 to 0.020 inches in diameter. Later in
the treatment rectangular wires are used which have greater
strength and rigidity. In the present invention only two different
arch wires are required, barring exceptional circumstances, first a
preliminary round arch wire and then a rectangular arch wire.
In FIG. 1 it is seen that the arch wire 120 is inserted into a
rectangular slot 122 in brackets 124, best illustrated in FIG. 6,
which are secured to the teeth by metal bands 126 or may be by
adhesive. Brackets 124 could be any of three types for securing
arch wire 120. The first is a ligating bracket which requires the
use of soft wire to tie the arch wire to the bracket. The second is
a non-ligating bracket with a removable cover which may be secured
to the bracket for holding the arch wire. The third type is a
non-ligating bracket with an attached cover which secures the arch
wire to the bracket 124. Any of these types may be used. However,
FIG. 6 illustrates the first type which is preferred.
Buccal tubes 190 anchor the arch wire 120 and are generally secured
to the two molars 26 by means such as metal bands 132 or possibly
by adhesive.
The preliminary round arch wire (not shown) is formed and then
installed on dental arch 10 shown in FIG. 1. The round arch wire is
inserted into slots 122 of brackets 124 and a soft wire (not shown)
is wrapped around bracket wings 134, 136 and the round arch wire to
secure the round arch wire to brackets 124. The ends of the round
arch wire are anchored by insertion within buccal tubes 190.
The preliminary round wire is used principally to rotate the
irregular teeth into position and to place the teeth in general
alignment for the application of the arch wire 120 shown in FIG. 1.
After the removal of the preliminary round arch wire, arch wire 120
is installed to close any voids, to level the teeth and to produce
fair arch form.
Where a tooth has been extracted, as for making room for the other
teeth, a non-friction spring is illustrated in FIGS. 4 and 5.
Referring now to FIGS. 2 and 3 a space 62 is shown in dental arch
64. To shift tooth 66 into space 62 an elastic band 76 is engaged
to bracket 68 secured to tooth 66 by metal band 70 and is also
engaged to buccal tube 72 on molar 74. Elastic band 76 may be an
elastic thread or a rubber band. Elastic thread 76 is wrapped
around bracket 68 and tube 72 and is then tied. A rubber band may
merely be slipped over bracket 68 and tube 72.
Another method of closing a space is also shown in FIG. 2. To close
space 78 by moving tooth 80, a hook 82 has been soldered or
otherwise secured to the lingual side of metal band 84 on tooth 80.
Another hook 88 is secured to the lingual side of metal band on
molar 90. An elastic band 92 similar to band 76 is secured to hooks
82, 88.
During this treatment the molars 74 and 90 together with teeth 94,
96 respectively are an anchor by which a distal force is placed on
teeth 66, 80 to move them into spaces 62, 78.
Referring specifically to the movement of tooth 66 since a similar
movement is made of tooth 80, there is shown in FIG. 3 a tendency
for the crown 98 of tooth 62 to tip in a clockwise direction 100
due to the resistance of the distal movement of the root 102 of
tooth 62 by gum and bone at 104. This tipping causes arch wire 106
to bind within slot 108 of bracket 68. The binding increases the
friction between bracket 68 and arch wire 106 because the edges of
slot 108 bite into arch wire 106. The narrower the slot in bracket
68 the greater the increase in binding and friction.
Referring now to FIGS. 4 and 5 there is shown anti-friction spring
110. Spring 110 has a hook 112 on one end which engages the upper
portion of rotating lever 114 on bracket 68. Spring 110 then bends
around the lower side of bracket 68 and up under rotating lever 116
and arch wire 106. It then arches over arch wire 106 and is
attached to arch wire 106 by means of hook 118 on the other end of
spring 110 at a point on arch wire 106 some distance from tooth 68
in the distal direction. Spring 110 is thereby coiled around
bracket 68 and attached to arch wire 106 causing a counterclockwise
moment on tooth 66 to counteract the clockwise moment caused by
bone and gums at 104. Spring 110 maintains tooth 68 in a
substantially vertical plane as tooth 66 moves into space 62
thereby eliminating the binding and friction between bracket 68 and
arch wire 106.
Referring now to FIG. 8, arch wire 120 is a filamentary member
which may be a wire or a band which is formed around the outer
periphery of the patient's dental arch 10 extending from the
posterior teeth 20, 22, 24, 26 around anterior teeth 14, 16, 18 and
to the other side of arch 10. Arch wire 120 is a strong resilient
non-corrodible wire made of a metal such as stainless steel.
Although prior arch wire designs had a variety of cross sectional
configurations such as circular, square, and rectangular, arch wire
120 has an elongated cross-section, preferably rectangular but it
could be elliptical, polygonal, trapezoidal, rhomboidal or the
like, with the longest axis being defined as the longitudinal axis
of the cross-section. Further wire 120 is preferred to have the
cross-sectional dimensions of 0.016 inches by 0.022 inches as shown
in FIG. 9.
To secure arch wire 120 to arch 10, brackets 124 shown in FIG. 1
include labial brackets 140 having a vertical slot dimension of
0.016 inches and buccal brackets 142 having a vertical slot
dimension of 0.022 inches. Arch wire 120 is anchored by two-way
buccal tubes 190, hereinafter described in detail, having a
vertical and a horizontal slot dimension of 0.016 inches (see FIG.
11).
Arch wire 120 is installed on dental arch 10 with the 0.016 inch
dimension in the vertical position (occlusalgingival) and the 0.022
inch dimension in the horizontal position (labial-lingual) around
the anterior teeth and the posterior teeth. Since the 0.016
dimension is vertical, the 0.016 inch slot 122 of labial brackets
140 will be completely filled providing a precision fit between
labial brackets 140 and arch wire 120. There will be a 0.006 inch
gap or clearance in the 0.022 inch slot 122 of buccal brackets 142.
Arch wire 120 will also fit snugly within the 0.016 inch slot of
two-way tube 190.
The gap in buccal brackets 142 permits arch wire 120 to slide
freely within the bracket as the posterior teeth shift into
position during the leveling process. However, no control over the
anterior teeth is lost since there is a precision fit between arch
wire 120 and labial brackets 140. Further arch wire 120 is also
well anchored to tubes 190 since there are no gaps. The fits
between arch wire 120 and labial brackets 140 and tubes 190 prevent
a rotation relative thereto.
Traditionally brackets have had either the dimensions 0.018 inches
or 0.022 inches. By decreasing the width of the slot of the labial
brackets 140 to 0.016 inches, greater torque may be placed on an
individual tooth and a lighter force is required providing obvious
advantages. Therefor by decreasing the size of slot 122 of labial
brackets 140 the orthodontist can obtain a maximum torquing
capability not before attained. This means a minimum number of arch
wires used with a minimum number of removals.
To obtain parallel roots and to coordinate the lower dental arch
with the upper dental arch, arch wire 120 is removed and is either
reformed as hereinafter described or replaced by a preformed arch
wire as hereinafter described. It is preferred that a preformed
arch wire be used because of the convenience and because of the
time saved. There is shown in FIG. 7 a new and unique arch caliper
150 permitting the use of preformed arch wires. Caliper 150
includes an arcuate bow 152 and a pin 154. Bow 152 and pin 154 are
made of a slender non-corrodible metal or plastic wire-like member.
Bow 152 attaches to pin 154 at 156 near one end of pin 154 leaving
a projection 158 at that end. On the other end of pin 154 a handle
160 may be formed, such as a loop or the like, to operate caliper
150. A series of anatomical markings 162 and a series of size
markings 164 are provided on arcuate bow 152. Identical markings
180, 182 respectively are placed on the preformed arch wire 120
shown in FIG. 8 as hereinafter discussed. Anatomical markings 162
include colored rings on bow 152 to determine the length of the
arch from the juncture 166 of central incisors 14 to the juncture
168 of cuspid 18 and first bicuspid 20 shown in FIGS. 7 and 8. From
this measurement the length of the anterior arch of the anterior
teeth may be determined. Size markings 164 are provided to measure
the length of dental arch 10 by determining the distance from
juncture 166 between central incisors 14 to the second molar 26.
Markings 162, 164 are merely calibrations or indicia which may be
numerical or not. They may be scored onto caliper 150 and arch wire
120 or may be colored rings as shown in FIGS. 7 and 8. No actual
numerical measurements are required since by knowing the color
markings 162, 164, a proper preformed arch wire having the same
markings may be selected.
In operation caliper 150 is inserted into the patient's mouth so as
to partially circumscribe the dental arch to be fitted. Projection
158 is positioned at juncture 166 between central incisors 14 while
arcuate bow 152 extends around one side of the dental arch 10. The
position of the anatomical markings 162 and size markings 164 with
reference to juncture 168 and second molar 26 respectively are
thereby indicated. Obviously these measurements are quite easy to
make using caliper 150 and such a task can easily be delegated by
the orthodontist.
Having the sizes of the dental arch 10, a proper preformed arch
wire may be selected having the same markings thereby having the
proper lengths. Arch wire 120 may be either reformed by hand by the
orthodontist or the orthodontist can be provided with an array of
preformed arch wires from which to choose. In the present
invention, the orthodontist may have the convenience of selecting a
preformed arch wire.
In the reformed arch wire 120 twists 172 are made in wire 120 at
the junctures 168 between the cuspids 18 and first bicuspids 20.
Twist 172 is illustrated in the enlarged view of FIG. 9. As wire
120 is formed into an arch for positioning around dental arch 10,
an arcuate portion 174 and two linear portions 176, 178 are formed.
This formation and twists 172 form arch wire 120 so that the
longitudinal axis of the cross-section of wire 120 is substantially
perpendicular to the occlusal plane, i.e., the plane of dental arch
10 along the arcuate portion 174 and will be juxtaposed with the
anterior teeth when installed. Further the longitudinal axis will
be substantially parallel to the occlusal plane along linear
portions 176, 178 and will be juxtaposed with the posterior teeth
when installed.
In essence this method combines two arch wires into one because the
arcuate portion 54 will have the longitudinal axis of wire 120 in
the horizontal position thereby being very resilient for the
anterior teeth and the linear portions 176, 178 will have the
longitudinal axis of wire 120 in the vertical position thereby
emphasizing the strength and rigidity of wire 120 for the posterior
teeth.
Preferably the twist 172 in wire 120 will be a 90.degree. rotation
of wire 120 at the determined location. However, it must be
understood that the twist need not be exactly 90.degree. but may be
for example approximately an 83.degree. twist or approximately a
97.degree. twist depending upon the mechanotherapy required. Often
the labial and buccal sides of the anterior and posterior teeth are
not vertical within the month thereby requiring a twist 172 to be
slightly greater or smaller than 90.degree..
By utilizing caliper 150 arch wire 120 may be preformed. The
anterior arch measurement, by means of anatomical markings 162,
will determine the location of twists 172, and the dental arch
measurement, by means of size markings 164, will set the length of
wire 120. To further simplify the selection of the proper preformed
arch wire, calibrations have been disposed on wire 120 at 180 for
the anatomical reading and at 182 for the size reading thereby
corresponding to markings 162, 164.
FIGS. 10 and 11 illustrate the preferred buccal tube 190 for
anchoring reformed arch wire 120. Tube 190 is a two-way tube which
may be made of stainless steel, plastic, or an alloy of gold,
platinum and irridium. Tube 190 has a longitudinal bore 192
extending mesial-distally and also has a generally square
cross-section with dimensions of 0.022 inches. However, a stop 194
of a generally isosceles triangular cross-section having a side of
0.006 inches, the difference between the dimensions of arch wire
120, is milled, molded or in likewise fashion secured in the
occlusal-buccal corner 196 of tube 190. Stop 194 permits arch wire
120 to be secured from rotation within tube 190 regardless of
whether the 0.016 inch or the 0.022 dimension is edgewise or in the
ginguval-occlusal axis and to provide a precision fit of wire 120
within tube 190. The 0.006 inch dimension permits a 0.006 inch
clearance on the buccal side of the tube 190 if the 0.022 inch
dimension is vertical and also permits a 0.006 inch clearance on
the occlusal side of the tube 190 if the 0.016 inch dimension is
vertical. However, in both cases, stop 194 arch wire 120 in
position and prevents rotation. Buccal tube 190 may either be
secured, as by brazing, to a metal band 198 extending around the
anchor tooth or be secured by an adhesive.
Referring now to FIG. 12 there is shown five other embodiments of
tube 190. Embodiment A comprises four stops 200 which has the
advantage of holding arch wire 120 from rotation at four locations.
In essence embodiment A includes two rectangular bores through tube
202 each having the same dimensions as wire 120 and are
perpendicular to each other with a common mesialdistal axis.
Embodiment B also has four stops 204 of the form of stop 194 in
FIG. 16 except that a stop has been located in each longitudinal
corner of tube 206. Embodiments C and D provide square shouldered
stops 208 and 210 respectively. Embodiment E has two projections
212, each providing a positive stop to the rotation of wire 120
depending upon the dimension which is vertical.
As the preformed arch wire 120 is installed on arch 10, the .016
dimension of arch wire 120 will face the anterior teeth and will
completely fill the 0.016 slots of labial brackets 140 thus
providing a precision fit between wire 120 and brackets 140. The
0.022 dimension of arch wire 120 will face the posterior teeth due
to twists 172 and will also completely fill the 0.022 slots of
buccal brackets 142 thereby also providing a precision fit between
wire 120 and brackets 142. Two-way buccal tubes 190 will also hold
wire 120 securely and prevent rotation relative thereto. Thus the
orthodontist has resiliency for the anterior teeth and strength and
rigidity for the posterior teeth and yet has complete control of
all the teeth.
FIGS. 13-17 describe a new headgear hook 220 for use with a
headgear (not shown) to apply pressure to arch wire 120. FIGS.
13-14 illustrate the preferred embodiment. Eyes or loops 222 are
formed in the front portion of arch wire 120 and comprise circular
or omega-shaped loops made in wire 120.
FIG. 15 illustrates headgear hook 220. Hook 220 is generally in the
form of a large hook which extends from loops 222 on wire 120 out
of the mouth and around the cheek where the end 224 of hook 220 is
attached to an elastic band (not shown). End 224 may be in the form
of a circular loop for attachment to the elastic band. A notch or
groove 226 is ground into the other end of hook 220 for engagement
with loop 222 having approximately the same diameter as the
diameter of arch wire 120. Groove 226 acts as a lock preventing
disengagement once inserted into and engaged with loop 222. The
closer that end 224 is brought to the cheek the better the locking
engagement.
FIGS. 16 and 17 illustrate a second embodiment of the headgear hook
230. As shown in FIG. 17 eyes 232 are made into a small semi-circle
or into a complete loop as illustrated in FIG. 17 and soldered or
brazed to arch wire 120. Headgear hook 230 has a small hook 234
secured to one end 236 which engages eye 232 as illustrated in FIG.
16. Hook 234 has an arcuate diameter the same size as the diameter
of arch wire 120. Again as end 238 moves towards the patient's
cheek, the headgear hook 230 becomes locked into engagement with
eye 232. It must be understood that headgear hooks 220 and 230 may
be made of either metal or plastic.
In the method of orthodontic treatment labial brackets 140 having a
0.016 slot are secured to the anterior teeth and buccal brackets
142 having a 0.022 slot are secured to the posterior teeth. Two-way
buccal tubes 190 are anchored to the second molars 26. The
preliminary round arch wire is installed on dental arch 10 by means
of brackets 140, 142 and tubes 190 to rotate the irregular teeth
into position and to place the teeth in general alignment for the
application of rectangular arch wire 120. The round arch wire must
be removed prior to installation of the rectangular arch wire
120.
A 0.016 by 0.022 rectangular arch wire 120 is then installed to
close any voids, to level the teeth, and to produce good arch form.
The rectangular arch 120 has its 0.016 side vertical thereby
filling the slots of the labial brackets 140 and leaving a gap in
the slots of the buccal brackets 142. Wire 120 is anchored to
two-way buccal tubes 190 and prevented from rotation relative
thereto. In closing the voids the antifriction spring 110 is used
to maintain the tooth to be shifted substantially vertically during
its movement. The rectangular wire 120 is then removed.
Caliper 150 is used to measure the dental arch for a preformed arch
wire 120. By virtue of these measurements, two 90.degree. twists
172 have been placed in wire 120 at the juncture 168 of the
anterior and posterior teeth. The preformed arch wire 120 is then
installed with its 0.016 side facing the anterior teeth filling the
0.016 slots of labial brackets 140 and with its 0.022 side facing
the posterior teeth filling the slots of buccal brackets 142 due to
90.degree. twists 172. Two-way buccal tube 190 again secures
preformed arch wire 120 and prevents relative rotation
therewith.
Each time after the rectangular arch wire 120 and the preformed
rectangular arch wire 120 is installed, headgear hook 220 is
lockingly engaged to the wires to apply pressure to move teeth
posteriorly and/or prevent their movement anteriorly.
While a preferred embodiment of the invention has been shown and
described, modifications thereof can be made by one skilled in the
art without departing from the spirit of the invention.
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