Abstract:
The present invention provides an orthodontic bracket placement device comprising a horizontal bracket engaging element for engaging an orthodontic bracket; and a vertical shaft extending from the horizontal bracket engaging element, the shaft including a plurality of indicia for aligning with the incisal edge of a tooth when the bracket placement device is used to place an orthodontic bracket engaged by the engaging element on the tooth. A method is also provided for placing an orthodontic bracket on a tooth comprising placing the orthodontic bracket on the tooth at a particular vertical position on the tooth using a bracket placement device by engaging a horizontal bracket engaging element of the device with a bracket and aligning one of a plurality of indicia on the bracket placement device with the incisal edge of the tooth; and adhering the orthodontic bracket to the tooth. Kits comprising bracket placement devices of the present invention are also provided.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates generally to dental and orthodontic equipment, and more particularly to an orthodontic bracket placement device and coordinated bracket placement method. 
     2. Description of the Prior Art 
     Orthodontic brackets are dental devices used to guide tooth movement during orthodontic treatment. These brackets are typically made of either stainless steel, gold or ceramic material. Brackets are manufactured with specific “prescriptions” which take into account the ideal mesiodistal tip of teeth, labiolingual torque of teeth, and the facial-lingual projection of the teeth (in-out). This prescription makes it imperative that specific brackets be used for specific teeth since the dimensions listed above are different to take into account the anatomical and functional differences observed in teeth. Brackets are typically manufactured in specific dimensions, with the most common sizes of brackets having working surfaces (slots) in 0.018 inch and 0.022 inch dimensions. Either of these measurements allows for an arch wire of similar dimension to be placed in the slot and used to assist in the movement of teeth. In addition, orientation dots may be placed by the bracket manufacturer at the distogingival wing of each bracket to reduce vertical orientation problems during the bonding process. 
     Orthodontic brackets are typically attached to teeth (bonded) with composite resin at the facial or lingual (palatal) side of the teeth to be moved, and the operator uses the orientation dot to assist in proper bracket orientation. The orthodontic arch wire passes through the arch wire slot and is positioned within the mid-portion of the bracket. This bracket/arch-wire interface allows for movement of teeth within the confines and shape of the wire and the overall prescription of each bracket. Proper orthodontic bracket placement is second only to appropriate orthodontic diagnosis in the overall scheme of standardized orthodontic treatment. There is significant scientific and clinical evidence to indicate that appropriate and well-planned orthodontic tooth movement is less likely to occur if bracket placement is not precise and carefully controlled. Furthermore, the primary problem in correctly bonding brackets directly to teeth is “ . . . that the dentist must be able to judge the proper position for the attachment and must carry it to place rapidly and accurately”.  Contemporary Orthodontics , Proffit, W. R. (editor), 2 nd  edition, (1993 ), the entire contents and disclosure of which is hereby incorporated by reference herein. For example, improper bracket placement may result in (1) improper tooth movement, (2) worsening of occlusal and periodontal conditions, and (3) potential problems in the development of dental caries at bracket sites. 
     Therefore, there is still a need for an orthodontic bracket placement device and method of bracket placement that may improve bracket placement and subsequently improve the overall accuracy of orthodontic tooth movement. 
     SUMMARY OF THE INVENTION 
     It is therefore an object of the present invention to provide a bracket placement device that allows for specific positioning of each bracket based upon measurements found to be beneficial for tooth movement and orthodontic positioning of the teeth. 
     It is a further object of the present invention to provide a coordinated bracket placement method to provide for proper bracket placement and positioning. 
     It is a further object of the present invention to provide saleable kits including a bracket placement device. 
     According to a first broad aspect of the present invention, there is provided an orthodontic bracket placement device comprising a horizontal bracket engaging means for engaging an orthodontic bracket; and a vertical shaft extending from the horizontal bracket engaging means, the shaft including a plurality of indicia for aligning with the incisal edge of a tooth when the bracket placement device is used to place an orthodontic bracket engaged by the engaging means on the tooth. 
     According to second broad aspect of the invention, there is provided a method for placing an orthodontic bracket on a tooth comprising placing the orthodontic bracket on the tooth at a particular vertical position on the tooth using a bracket placement device by engaging a horizontal bracket engaging means of the device with a bracket and aligning one of a plurality of indicia on the bracket placement device with the incisal edge of the tooth; and adhering the orthodontic bracket to the tooth. 
     According to a third broad aspect of the invention, there is provided a saleable kit comprising at least one orthodontic bracket placement device comprising a horizontal bracket engaging means for engaging an orthodontic bracket; and a vertical shaft extending from the horizontal bracket engaging means, the shaft including a plurality of indicia for aligning with the incisal edge of a tooth when the bracket placement device is used to place an orthodontic bracket engaged by the engaging means on the tooth. 
    
    
     Other objects and features of the present invention will be apparent from the following detailed description. 
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The invention will be described in conjunction with the accompanying drawings, in which: 
     FIG. 1 is a schematic illustration of a bracket placement device constructed in accordance with an embodiment of the present invention; 
     FIG. 2 illustrates a bracket placement device constructed in accordance with an embodiment of the present invention; 
     FIG. 3 is a schematic illustration of a bracket placement method of the present invention with a bracket placement device of the present invention engaged with a coordinated bracket; 
     FIG. 4 illustrates a bracket placement method of the present invention with a bracket placement device of the present invention in use; 
     FIG. 5 illustrates a bracket placement method of the present invention with a bracket placement device of the present invention engaged with a bracket; 
     FIG. 6 illustrates a bracket placement device of the present invention with a mirror on one end; 
     FIG. 7 illustrates a bracket placement device of the present invention with a dental scaler on one end; 
     FIG. 8 illustrates a dental stop according to an embodiment of the present invention; and 
     FIG. 9 illustrates a kit according to an embodiment of the present invention. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     It is advantageous to define several terms before describing the invention. It should be appreciated that the following definitions are used throughout this application. 
     Definitions 
     Where the definition of terms departs from the commonly used meaning of the term, applicant intends to utilize the definitions provided below, unless specifically indicated. 
     For the purposes of the present invention, the term “prescription” refers to the angulation and orientation of an orthodontic bracket. 
     For the purposes of the present invention, the term “distogingival” refers to the lower, left-most region or direction of a bracket. 
     For the purposes of the present invention, the term “incisal edge” refers to the cutting edge of a tooth. 
     For the purposes of the present invention, the term “bracket” refers to any standard or non-standard/custom orthodontic or dental bracket. 
     For the purposes of the present invention, when referring to a tooth, the term “long axis” refers to the axis of a tooth measured from the incisal edge to the root along the midline. 
     For the purposes of the present invention, the term “stop” refers to a device used to prevent an orthodontic or dental instrument from moving passed a certain point or used to indicate when such an instrument has reached a predetermined point. 
     For the purposes of the present invention, the term “tip” refers to a defined bracket angulation that is other than square. 
     For the purposes of the present invention, the term “orientation dot” refers to a mark that appears on a bracket to indicate a particular bracket prescription and used to assist in orienting the bracket properly on a tooth. 
     For the purposes of the present invention, the term “wing” refers to a raised region located in each corner of a bracket. 
     For the purposes of the present invention, when referring to a tooth, the terms “facial aspect” refers to the front-side of a tooth. 
     For the purposes of the present invention, the term “sidedness” refers to the appropriate bracket (left incisor, for example) being placed on the correct tooth due to the prescription requirements of that particular tooth and the corresponding bracket for that tooth. 
     Description 
     FIG. 1 illustrates an orthodontic bracket placement device  100  according to the present invention. Device  100  has a vertical shaft  102  and a horizontal bracket engaging means  104 . The identifiers “vertical” and “horizontal” are for illustrative purposes only and refer to the typical orientation of device  100  when in use. Vertical placement bands  106  represent vertical placement prescriptions for brackets. Each band  106  represents a different desired placement height of a bracket on a tooth. 
     Vertical placement bands of the present invention may be etched into the shaft of the bracket placement device and/or may include visible indicia, markers, numbers, colors, etc. In a preferred embodiment of the present invention, the bands are each of a different color and may correspond to colors on particular brackets. The bands may be made to glow in the dark or to react to UV or other light stimulation. Although four bands are illustrated in FIG. 1, it should be understood that any number of bands may be placed on a shaft of a device according to the present invention. The bands may correspond to standard bracket prescriptions or may correspond to non-standard/custom heights. 
     The angle formed between vertical shaft  102  and horizontal bracket engaging means  104  is represented in FIG. 1 as 90°. However, as is indicated by arrows  108 , horizontal bracket engaging means  104  may be formed on vertical shaft  102  such that the angle is from about 70° to about 110°, such as 70°, 75°, 80°, 85°, 95°, 100°, 105°, 110° or any other suitable angle, to allow for versatility and use with brackets having prescriptions requiring the angle to be other than 90°. This variation allows a device of the present invention to be constructed based on various manufacturers&#39; prescriptions and thus accounts for a desired bracket tip. 
     The placement end or proximal end of an orthodontic bracket placement device of the present invention is defined by the junction of a vertical shaft and a horizontal bracket engaging means. At the opposite end or distal end of an orthodontic bracket placement device of the present invention, any suitable orthodontic or dental tool may be included, such as a dental scaler, mirror, etc. 
     FIG. 2 illustrates an embodiment of an orthodontic bracket placement device  200  of the present invention. As may be seen in FIG. 2, vertical shaft portion  202  of device  200  is formed with bends  204  and  206  between horizontal bracket engaging means  208  and handle  210 . Bends  204  and  206  are formed to provide a level of comfort with respect to a user&#39;s angle of approach to a patient&#39;s mouth. It should be understood that bends  204  and  206  are illustrative and may be modified in number and degree to allow for various angles and orientations of device  200 . 
     Orthodontic bracket placement devices of the present invention may be constructed of any suitable material for dental and/or orthodontic devices, including, but not limited to metal, such as stainless steel, and polymeric materials, such as plastics. Metals, such as stainless steel, are beneficial in that devices constructed from such materials may be sterilized and reused. Polymeric materials, such as plastics, are beneficial in that devices constructed from such materials may be made transparent to allow for better visualization of the teeth on which the dentist/orthodontist is working. In addition, plastic devices may be single-use. In particular embodiments of the present invention, the device is preferably rigid in construction. 
     Devices of the present invention may be made from a single piece of material (i.e., unibody), or may be multiple pieces that are put together, either before or after manufacture, by welding, screws, etc. For example, a horizontal bracket engaging means may screw into one end of a vertical shaft. Thus, a single vertical shaft could be used for multiple horizontal bracket engaging means, for example, each having a different tip or prescription. 
     FIG. 3 illustrates an orthodontic bracket placement device  300  according to the present invention being used to place a coordinated bracket  302  on a tooth  304 . Device  300  has a vertical shaft  306  and a horizontal bracket engaging means  308 . The identifiers “vertical” and “horizontal” are for illustrative purposes only and refer to the typical orientation of device  300  when in use. Vertical placement bands  310  represent vertical placement prescriptions for brackets. Each band  310  represents a different placement height of a bracket on a tooth. 
     Bracket  302  has a horizontal arch wire slot  312 . Horizontal bracket engaging means  308  fits within arch wire slot  312  to allow the user to apply pressure to bracket  302  against tooth  304  and to move bracket  302  into the proper location. A horizontal bracket engaging means of the present invention may be made to fit into any standard arch wire slot, such as 0.022 inches or 0.018 inches, or to fit into any custom arch wire slot. A horizontal bracket engaging means of the present invention may be longer than, shorter than, or the same length as the width of the bracket. 
     Bracket  302  may also have vertical alignment markings  314  and/or horizontal alignment markings  316 . Markings  314  and  316  may be etched into bracket  302  or may be lines or colors to provide a reference line for proper alignment. 
     In use, horizontal bracket engaging means  308  is inserted into arch wire slot  312 . Bracket  302  is placed against tooth  304 , preferably on the facial aspect of tooth  304 , and moved into a proper position. A suitable dental or orthodontic adhesive is used to hold bracket  302  in place. To determine proper horizontal placement of bracket  302 , the user identifies the long axis of the tooth and aligns bracket  302  and vertical shaft  306  along the long axis of the tooth. Optional vertical alignment markings may assist in aligning vertical shaft  306  properly. For proper vertical placement, the user identifies the desired vertical placement for the particular tooth and bracket and aligns the band  310  that corresponds to the desired vertical placement with the incisal edge  318  of tooth  304 . To ensure the proper placement, bracket  302  may have an orientation dot  320  located on a wing  322  of bracket  302  that is colored, etched, or otherwise distinguishable from other such markings. In embodiments of the present invention, orientation dot  320  corresponds to indicia, markings, colors etc. on bands  310 . Thus, to achieve the desired vertical placement of bracket  302 , the user aligns band  310  having the same color or other marking as orientation dot  320  with incisal edge  318  of tooth  304 . 
     FIGS. 4 and 5 illustrate the use of an embodiment of an orthodontic bracket placement device of the present invention. As outlined above, a bracket placement device  402  of the present invention may be used to engage an orthodontic bracket  404  and allow a user to move bracket  404  into a proper location. A bracket placement device  402  of the present invention allows for proper vertical and horizontal placement, as well as proper orientation and angulation of a bracket  404  on a tooth  406 . Bracket placement device  402  may be used to align a bracket  404  to allow for proper insertion of arch wire  408  into a bracket  404 . 
     FIGS. 6 and 7 show alternate embodiments of a bracket placement device of the present invention. FIG. 6 shows a bracket placement device  602  having a mirror  604  on one end of bracket placement device  602 . FIG. 7 shows a bracket placement device  702  having a dental scaler  704  on one end of bracket placement device  702 . 
     According to an embodiment of the present invention as shown in FIG. 8, an orthodontic bracket placement device of the present invention may include a stop or stops  800  to assist the user in making accurate placement determinations. An example of a suitable stop  800  is a slidable device having an extension  802  that extends over the incisal edge of a tooth. Such a slidable device may be moved up and down a shaft  804  of a bracket placement device of the present invention and may engage with bands  806  on the placement device. When engaged with a band  806  corresponding to the desired height, the user would align extension  802  of stop  800  with the incisal edge of the tooth. Such a stop would assist the user in making the proper height determination. Any other suitable dental or orthodontic stop may be used with the present invention. 
     The present invention also provides for saleable kits. As shown in FIG. 9. a kit  900  of the present invention may include a bracket placement device of the present invention  902 , at least one bracket  904 , arch wire  906 , and/or adhesive  908 . In an embodiment of the present invention, the components of the kit may be individually sterilized and/or the entire kit may be sterilized. 
     EXAMPLES 
     Example I 
     A bracket placement device of the present invention was constructed with a 0.016 inch×0.022 inch stainless steel horizontal bracket engaging means. The stainless steel bracket engaging means was constructed to be approximately the width of a standard orthodontic bracket, and narrow enough gingivally and incisally so as to fit within the arch wire slot of a standard 0.022 inch and 0.018 inch orthodontic bracket. The shaft of the device is marked in colors (see below) at specific distances from the junction of the vertical shaft and the horizontal 0.016 inch×0.022 inch stainless steel bracket engaging means. The measurements on the shaft are 3.5 mm, 4.0 mm, 4.5 mm, and 5.0 mm. Standardized measurements for proper placement of brackets have been established at the following distances from the middle of an arch wire slot to the incisal edge of an associated tooth: 
     
       
         
               
               
               
               
               
               
               
               
               
               
               
               
               
             
           
               
                   
               
               
                 Tooth Number 
                 6 
                 5 
                 4 
                 3 
                 2 
                 1 
                 1 
                 2 
                 3 
                 4 
                 5 
                 6 
               
               
                   
               
             
             
               
                 Maxillary 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 Arch: 
               
               
                 Position 
                 4 
                 4 
                 4 
                 5 
                 4 
                 4.5 
                 4.5 
                 4 
                 5 
                 4 
                 4 
                 4 
               
               
                 (in mm from 
               
               
                 incisal edge) 
               
               
                 Mandibular 
               
               
                 Arch: 
               
               
                 Position 
                 4 
                 4 
                 4 
                 4.5 
                 4 
                 4 
                 4 
                 4 
                 4.5 
                 4 
                 4 
                 4 
               
               
                 (in mm from 
               
               
                 incisal edge) 
               
               
                   
               
             
          
         
       
     
     These specific measurements help insure the appropriate vertical, horizontal, and lingual orientation and final positioning of teeth following orthodontic treatment. If these dimensions are not used, the manufactured prescription for the brackets will not be “filled” or carried out, and a random alignment of the teeth can be anticipated as a direct result of inappropriate and substandard treatment. 
     As mentioned above, the colored markings on the shaft correspond with the same color orientation dot on the distogingival wing of each bracket. In other words, since each bracket has been assigned a specific position vertically from the incisal edge of the tooth to the mid portion of the bracket slot by the bracket manufacturer in order to best “fill” the individual bracket-tooth prescription, the selected color on the measuring shaft corresponds to that particular bracket and its vertical specifications for that tooth. For this example, randomly chosen colors have been assigned to specific measurements required for proper bracket placement: 
     3.5 mm=red 
     4.0 mm=blue 
     4.5 mm=black 
     5.0 mm=green 
     If a bracket has been manufactured for placement on a tooth having a 4.0 mm incisal-edge/bracket-slot dimension, that specific bracket will have a “blue” orientation dot. That is, each color on the shaft of the bracket placement device will correspond to the prescribed vertical prescription for each bracket having the same colored orientation dot as the appropriate increment on the bracket placement device. The vertical shaft of the bracket placement device is used to align the bracket along the long axis of each tooth and the horizontal bracket engaging means of the device fits within the arch wire slot of each bracket to allow for precise vertical height adjustment as well as orientation along the long axis of the tooth being bracketed. 
     Although the present invention has been fully described in conjunction with the preferred embodiment thereof with reference to the accompanying drawings, it is to be understood that various changes and modifications may be apparent to those skilled in the art. Such changes and modifications are to be understood as included within the scope of the present invention as defined by the appended claims, unless they depart therefrom.