Orthodontic devices for movement of impacted or malpositioned teeth

A method of using an orthodontic device to effect movement of an impacted or malpositioned tooth includes providing an orthodontic device, the orthodontic device including a bracket, a coiled spring, and an anchoring assembly, bonding the bracket to an impacted or malpositioned tooth, connecting a first end of the spring to a first spring attachment portion supported by the bracket, connecting a second end of the spring to a second spring attachment portion supported by the anchoring assembly, and coupling the anchoring assembly to a second orthodontic device that is installed in the patient's mouth.

COPYRIGHT STATEMENT

BACKGROUND OF THE PRESENT INVENTION

Field of the Present Invention

The present invention relates generally to orthodontic devices, and, in particular, to orthodontic devices for movement of impacted or malpositioned teeth.

Background

Orthodontics is the science of moving teeth within the mouth by the application of force to the teeth over time. Generally, the goal of orthodontic treatment is to ideally align the upper and lower teeth within their respective arches and jaws so that the teeth are both esthetically pleasing in appearance, and so that they also fit in the anatomically prescribed ideal positions. Frequently during orthodontic treatment, one or more teeth may fail to erupt or may erupt into a significantly non-ideal position. In such cases, the application of orthodontic force to such a tooth is required to move it closer to its ideal position within its respective dental arch.

Previous methods of moving such malpositioned or impacted teeth involved a surgical procedure to expose at least part of the involved tooth, followed by the bonding of some sort of chain-like attachment to the tooth as an attachment for an orthodontic force. Frequently, the orthodontic force would be applied via some sort of elastomeric thread or similar device tied to the chain, which would provide a very high level of force immediately upon insertion and activation. Unfortunately, this high level of force decreases rapidly, over only a few days, as the involved tooth began to move, requiring frequent reactivation by the orthodontist in order to keep pressure on the tooth for it to continue its movement.

This presents a problem in that the patient must return to the orthodontist very frequently for additional adjustments. Furthermore, multiple orthodontic studies have confirmed that teeth move best when the applied orthodontic force is both light and constant, or at least relatively constant. The aforementioned method of orthodontically moving an impacted tooth provided heavy, inconsistent (or “intermittent”) force to teeth, which has been shown to increase patient discomfort, result in slower tooth movement, and increase the risk of damage to the involved tooth. Thus, in order to provide a more efficient, less-painful, and safer method of moving an impacted or partially-impacted tooth, a need exists for a device designed to allow application of a lighter, continuous force to the tooth over time with less need for activation by the orthodontist.

Previous devices have been described in which the active portion of the device that is applying the orthodontic force consists of a “substantially planar device” made of some sort of superelastic metal. “Substantially planar” suggests that this portion of the appliance essentially lies within one plane of space or is “flat” in the essence of its form. This presents several problems, however, when it comes to applying ideal orthodontic forces within the oral cavity. Because of the requirement that the load-applying portion of the previously-described devices be “substantially planar,” the amount of superelastic wire that can be incorporated into the appliance is limited. This, in turn, results in several shortcomings when it comes to orthodontic tooth movement of an impacted or partially-impacted tooth.

First, a substantially planar design impacts the load-deflection rate (LDR) of the spring. The LDR pertains to the force, or load, that an orthodontic appliance, usually a wire, exerts when it is deformed from its original position. In most cases, the load increases the more that an appliance is activated (the load does taper and “plateau” for super elastic wires at some point). One way to reduce the LDR and keep it within a desired range is to incorporate a very large amount of wire into a small space, i.e. through loops or coils. A coil spring by nature is a design that incorporates an enormous amount of wire into a relatively short linear distance. Coil springs, therefore, can be stretched or activated over a large distance while still maintaining a relatively low LDR, keeping the force in a biologically-friendly range. Unfortunately, “substantially planar devices” potentially have a higher LDR over a shorter range of activation than a coil spring.

A substantially planar design also may suffer from permanent deformation, which is what can occur if a wire is stretched beyond its Elastic Limit, the point at which it can no longer return to its original shape without distortion. One way to avoid permanent deformation of a wire is to incorporate as much wire as possible into a given length, i.e. by coiling or looping the wire. Coil springs, therefore, are commonly used to provide orthodontic force because they can be activated over a large distance without undergoing permanent deformation, thus keeping the spring fully active. Permanent deformation of a wire or spring can reduce the load applied by the device or even render it inactive in an extreme case. So, using a coil spring that incorporates a large length of wire into a relatively short distance reduces the risk that the appliance will undergo permanent deformation when activated over a given distance. Unfortunately, a substantially planar device potentially has a greater chance of permanent deformation than does a coil spring because it incorporates less length of wire over the same linear distance.

Still further, it may be necessary for a substantially planar design to have a larger size in order to maintain functionality. In particular, in order to incorporate a large amount of wire into a “substantially planar” device, the active wire portion of the device must be made wider within that plane of space. Unfortunately, because the device is to be used intraorally, and in some cases will be actually covered with gingival tissue following the surgical exposure of the tooth and attachment of the device to the impacted or partially impacted tooth, its size is extremely important, and making the device substantially wider in order to incorporate more wire into its design could cause it to be more bulky and therefore potentially damaging to the oral tissues which cover it. Furthermore, excessive width of the active portion of the device could also make it more difficult for the orthodontist or surgeon to place it in the mouth without interference from adjacent teeth or tissues. This is potentially inferior to a coil spring, which by design incorporates a large amount of wire into a relatively small space from both a width and length standpoint.

A need exists for a device that is much smaller than previously described “substantially planar” devices, making it much less bulky, more tissue friendly, and easier to place, and which, when “activated” or stretched, has a design and size that causes less damage to overlying tissue than might a wider “substantially planar” device.

SUMMARY OF THE PRESENT INVENTION

Broadly defined, the present invention according to one aspect is an orthodontic device for movement of an impacted or malpositioned tooth, as shown and described.

Broadly defined, the present invention according to another aspect is a method of using an orthodontic device for movement of an impacted or malpositioned tooth, as shown and described.

Broadly defined, the present invention according to another aspect is an orthodontic device for movement of an impacted or malpositioned tooth, including: a bondable bracket; a spring connected at one end to the bracket; and an anchoring assembly connected to an opposite end of the spring.

In a feature of this aspect, the bondable bracket includes a bondable metal pad or button and a spring attachment portion to which the spring is connected. In a further feature, the spring attachment portion includes at least one slot through which the spring is routed.

In another feature of this aspect, the spring is a coil spring.

In another feature of this aspect, the anchoring assembly includes an anchoring feature and a spring attachment portion. In further features, the spring attachment portion includes at least one slot through which the spring is routed; and/or the anchoring feature includes a hook. In a still further feature, the hook is adapted to be coupled to an archwire installed in a patient's mouth.

Broadly defined, the present invention according to another aspect is a method of using an orthodontic device for movement of an impacted or malpositioned tooth, including: providing a first orthodontic device, the first orthodontic device including a bracket, a spring, and an anchoring assembly; bonding the bracket to an impacted or malpositioned tooth; connecting one end of the spring to the bracket; connecting the anchoring assembly to an opposite end of the spring; and coupling the anchoring assembly to a second orthodontic device that is installed in the patient's mouth.

In a feature of this aspect, the method further includes a step, prior to the bonding step, of surgically opening gum tissue of a patient to reveal the impacted or malpositioned tooth.

In another feature of this aspect, the bondable bracket includes a bondable metal pad or button and a spring attachment portion to which the spring is connected. In a further feature, the spring attachment portion includes at least one slot through which the spring is routed.

In another feature of this aspect, the spring is a coil spring.

In another feature of this aspect, the anchoring assembly includes an anchoring feature and a spring attachment portion. In further features, the spring attachment portion includes at least one slot through which the spring is routed; and/or the anchoring feature includes a hook. In a still further feature, the step of coupling the anchoring assembly to an orthodontic device includes coupling the hook to an archwire.

Broadly defined, the present invention according to another aspect is an orthodontic device for effecting movement of an impacted or malpositioned tooth, including: a bracket including a button or pad that is bondable to an impacted or malpositioned tooth; an anchoring assembly including an anchoring feature or archwire bracket that may be coupled to an archwire and a spring attachment portion; and a spring secured at a first end to the bracket and secured at a second end to the spring attachment portion of the anchoring assembly.

In a feature of this aspect, the bracket further includes a spring attachment portion to which the coiled spring is secured at its first end. In further features, the spring attachment portion includes a rigid loop extending from the button or pad; the first end of the spring extends through the loop; the first end of the spring is welded to a main portion of the button or pad; the first end of the spring is welded to a main portion of the button or pad on both sides of the loop; a ball or other body is formed at the first end of the spring so as to prevent the spring from being withdrawn from the loop; the rigid loop is a first rigid loop, and wherein the spring attachment portion includes a second rigid loop through which the first end of the spring also extends; the spring attachment portion is connected to the button or pad via a standoff portion; the spring attachment portion is parallel to a main portion of the button or pad; the standoff portion extends perpendicularly from a main portion of the button or pad; the standoff portion extends perpendicularly from the spring attachment portion; the standoff portion includes a relief opening along at least one edge thereof to facilitate manufacture; the spring attachment portion is co-planar with, and extends away from, a main portion of the button or pad; the spring attachment portion includes at least one slot through which the spring is routed; the at least one slot includes a pair of separate slot openings; the at least one slot includes a pair of conjoined slot openings; the conjoined slot openings are partially separated by a peg; and/or the spring is threaded through the at least one slot.

In another feature of this aspect, the spring is a coil spring. In further features, the first end of the coil spring is threaded through at least one slot in a spring attachment portion of the bondable bracket; the first end of the coil spring is threaded through a pair of slots in the spring attachment portion of the bondable bracket; the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with the spring attachment portion of the bondable bracket; the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with a main portion of the button or pad; the second end of the coil spring is threaded through at least one slot in the spring attachment portion of the anchoring assembly; the first end of the coil spring is threaded through a pair of slots in the spring attachment portion of the anchoring assembly; the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with the spring attachment portion of the anchoring assembly; and/or the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with a main portion of the anchoring feature or archwire bracket.

In another feature of this aspect, the spring attachment portion is connected to the anchoring feature or archwire bracket via a standoff portion; the spring attachment portion is parallel to a main portion of the anchoring feature or archwire bracket; the standoff portion extends perpendicularly from a main portion of the anchoring feature or archwire bracket; the standoff portion extends perpendicularly from the spring attachment portion; the standoff portion includes a relief opening along at least one edge thereof to facilitate manufacture; and/or the spring attachment portion is co-planar with, and extends away from, a main portion of the anchoring feature or archwire bracket.

In another feature of this aspect, the spring attachment portion includes at least one slot through which the spring is routed; the at least one slot includes a pair of separate slot openings; the at least one slot includes a pair of conjoined slot openings; the conjoined slot openings are partially separated by a peg; and/or the spring is threaded through the at least one slot.

In another feature of this aspect, the anchoring feature or archwire bracket includes a hook; the hook is a round hook; the hook is a rectangular hook; the rectangular hook includes an angled tip; and/or the angled tip may be crimped around the archwire.

Broadly defined, the present invention according to another aspect is an orthodontic device for effecting movement of an impacted or malpositioned tooth, including: a bracket including a button or pad that is bondable to an impacted or malpositioned tooth; an anchoring assembly that may be coupled to an archwire; and a coiled spring secured at a first end to the bracket and secured at a second end to the anchoring assembly.

In a feature of this aspect, the bracket further includes a spring attachment portion to which the coiled spring is secured at its first end. In further features, the spring attachment portion includes a rigid loop extending from the button or pad; the first end of the spring extends through the loop; the first end of the spring is welded to a main portion of the button or pad; the first end of the spring is welded to a main portion of the button or pad on both sides of the loop; a ball or other body is formed at the first end of the spring so as to prevent the spring from being withdrawn from the loop; the rigid loop is a first rigid loop, and wherein the spring attachment portion includes a second rigid loop through which the first end of the spring also extends; the spring attachment portion is connected to the button or pad via a standoff portion; the spring attachment portion is parallel to a main portion of the button or pad; the standoff portion extends perpendicularly from a main portion of the button or pad; the standoff portion extends perpendicularly from the spring attachment portion; the standoff portion includes a relief opening along at least one edge thereof to facilitate manufacture; the spring attachment portion is co-planar with, and extends away from, a main portion of the button or pad; the spring attachment portion includes at least one slot through which the spring is routed; the at least one slot includes a pair of separate slot openings; the at least one slot includes a pair of conjoined slot openings; the conjoined slot openings are partially separated by a peg; the spring is threaded through the at least one slot; the coil spring is threaded through at least one slot in the spring attachment portion; the coil spring is threaded through a pair of slots in the spring attachment portion; and/or the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with the spring attachment portion.

In another feature of this aspect, the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with a main portion of the button or pad; the anchoring assembly includes an anchoring feature and a spring attachment portion; the spring attachment portion is connected to the anchoring feature via a standoff portion; the spring attachment portion includes at least one slot through which the spring is routed; the anchoring feature includes a hook; the hook is a round hook; the hook is a rectangular hook; the rectangular hook includes an angled tip; and/or the angled tip may be crimped around the archwire.

Broadly defined, the present invention according to another aspect is an orthodontic device for effecting movement of an impacted or malpositioned tooth, including: a bracket including a button or pad that is bondable to an impacted or malpositioned tooth and a distinct spring attachment portion to which the spring is secured; an anchoring assembly that may be coupled to an archwire; and a spring secured at a first end to the spring attachment portion of the bracket and secured at a second end to the anchoring assembly.

In a feature of this aspect, the spring attachment portion includes a rigid loop extending from the button or pad. In further features, the first end of the spring extends through the loop; the first end of the spring is welded to a main portion of the button or pad; the first end of the spring is welded to a main portion of the button or pad on both sides of the loop; a ball or other body is formed at the first end of the spring so as to prevent the spring from being withdrawn from the loop; and/or the rigid loop is a first rigid loop, and wherein the spring attachment portion includes a second rigid loop through which the first end of the spring also extends.

In another feature of this aspect, the spring attachment portion is connected to the button or pad via a standoff portion. In further features, the spring attachment portion is parallel to a main portion of the button or pad; the standoff portion extends perpendicularly from a main portion of the button or pad; the standoff portion extends perpendicularly from the spring attachment portion; the standoff portion includes a relief opening along at least one edge thereof to facilitate manufacture; and/or the spring attachment portion is co-planar with, and extends away from, a main portion of the button or pad.

In another feature of this aspect, the spring attachment portion includes at least one slot through which the spring is routed. In further features, the at least one slot includes a pair of separate slot openings; the at least one slot includes a pair of conjoined slot openings; the conjoined slot openings are partially separated by a peg; and/or the spring is threaded through the at least one slot.

In another feature of this aspect, the spring is a coil spring. In further features, the coil spring is threaded through at least one slot in the spring attachment portion; the coil spring is threaded through a pair of slots in the spring attachment portion; the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with the spring attachment portion; and/or the coil spring defines a longitudinal axis, and wherein the longitudinal axis of the coil spring is co-planar with a main portion of the button or pad.

In another feature of this aspect, the anchoring assembly includes an anchoring feature and a spring attachment portion. In further features, the spring attachment portion of the anchoring assembly is connected to the anchoring feature via a standoff portion; the spring attachment portion of the anchoring assembly includes at least one slot through which the spring is routed; the anchoring feature includes a hook; the hook is a round hook; the hook is a rectangular hook; the rectangular hook includes an angled tip; and/or the angled tip may be crimped around the archwire.

Broadly defined, the present invention according to another aspect is a method of using an orthodontic device to effect movement of an impacted or malpositioned tooth, including: providing an orthodontic device, the orthodontic device including a bracket, a coiled spring, and an anchoring assembly; bonding the bracket to an impacted or malpositioned tooth; connecting a first end of the spring to a first spring attachment portion supported by the bracket; connecting a second end of the spring to a second spring attachment portion supported by the anchoring assembly; and coupling the anchoring assembly to a second orthodontic device that is installed in the patient's mouth.

In a feature of this aspect, the method further includes a step, prior to the bonding step, of surgically opening gum tissue of a patient to reveal the impacted or malpositioned tooth.

In another feature of this aspect, the bracket includes a bondable metal pad or button and the bonding step includes bonding the bondable metal pad or button to the impacted or malpositioned tooth. In further features, the first spring attachment portion includes at least one slot through which the spring is routed; and/or the second spring attachment portion includes at least one slot through which the spring is routed.

In another feature of this aspect, the anchoring feature includes a hook. In further features, the step of coupling the anchoring assembly to an orthodontic device includes coupling the hook to an archwire; and/or the method further includes a step of crimping the hook around the archwire

DETAILED DESCRIPTION

As a preliminary matter, it will readily be understood by one having ordinary skill in the relevant art (“Ordinary Artisan”) that the present invention has broad utility and application. Furthermore, any embodiment discussed and identified as being “preferred” is considered to be part of a best mode contemplated for carrying out the present invention. Other embodiments also may be discussed for additional illustrative purposes in providing a full and enabling disclosure of the present invention. As should be understood, any embodiment may incorporate only one or a plurality of the above-disclosed aspects of the invention and may further incorporate only one or a plurality of the above-disclosed features. Moreover, many embodiments, such as adaptations, variations, modifications, and equivalent arrangements, will be implicitly disclosed by the embodiments described herein and fall within the scope of the present invention.

Referring now to the drawings, in which like numerals represent like components throughout the several views, one or more preferred embodiments of the present invention are next described. The following description of one or more preferred embodiment(s) is merely exemplary in nature and is in no way intended to limit the invention, its application, or uses.

FIGS. 1 and 2are a front view and a side view, respectively, of an orthodontic device10for exposure of impacted teeth in accordance with one or more preferred embodiments of the present invention. As shown therein, the orthodontic device10includes a bondable bracket20, a spring30(shown in its inactive state) connected at one end to the bracket20, and an anchoring assembly40connected to the other end of the spring30. Each of these is described in greater detail herein.

FIGS. 3A and 3Bare front views, with and without contemplated dimensions, of the bondable bracket20ofFIGS. 1 and 2; andFIGS. 4, 5, and 6are a rear view, a top view, and a side view, respectively, of the bondable bracket20ofFIGS. 3A and 3B. The bracket20includes a bondable metal pad or button22and a spring attachment portion24. The pad or button22may be bonded to an impacted tooth or other tooth of interest using a conventional dental or orthodontic bonding adhesive. The rear of the pad or button22may include a metal retentive mesh26where the bonding adhesive (not shown) may be placed. In at least some embodiments, the pad or button22is curved so as to better fit the contours of the tooth to which it is to be bonded. Such curvature may be side to side, top to bottom, or both, and different amounts of curvature may be supplied on different bondable brackets20so as to facilitate selection of the proper degree of curvature. The spring attachment portion24may include one or more features for attaching or connecting an end of a spring thereto. For example, in the illustrated embodiment, the spring attachment portion24includes a pair of slot openings28for receiving one or more loops or coils of a coiled spring. In at least some embodiments, the bracket20, including the mesh26, are produced from stainless steel.

Dimensions of one particular contemplated embodiment are shown inFIG. 3B. The bondable bracket20may be 4.5 mm tall. The pad or button22may be 3.0 mm tall, 3.8 mm wide, and 0.3 mm thick. The spring attachment portion24may be 1.5 mm tall, 2.3 mm wide and 0.3-0.4 mm thick. The slot openings28may be 1.2 mm long and 0.4 mm wide, and may be spaced from each other and from the sides of the spring attachment portion24by 0.5 mm.

FIG. 7is a side view of the spring30ofFIGS. 1 and 2, shown in an inactive state. The spring30includes a first end32, a second end34, and a middle section36. The first end32connects to the bondable bracket20and the second end34connects to the anchoring assembly40. In the illustrated embodiment, multiple coils of the first spring end32are wound through the slot openings28in the bondable bracket20and multiple coils of the second spring end34are wound through the slot openings38in the anchoring assembly40. The middle spring section36is preferably between 3 and 13 mm in length, and is more preferably between 5 and 11 mm in length. In one contemplated embodiment, the middle spring section36is 5 mm in length. In another contemplated embodiment, the middle spring section36is 8 mm in length. In another contemplated embodiment, the middle spring section36is 11 mm in length. Also, in one contemplated embodiment, the first end32and the second end34are each approximately 0.5 mm in length. The diameter of the spring is preferably between 1.0 mm and 1.5 mm, and in a particular contemplated embodiment is 1.3 mm in diameter.

In at least some embodiments, the spring30is preferably produced from some sort of superelastic metal, such as nickel-titanium (“NiTi” or “nitinol”), copper nitinol, alloys thereof, or the like. Furthermore, in at least some embodiments, the middle section36of the spring30is shaped in the form of a non-planar, helical coil spring that can be stretched or “activated” to a greater length. In at least some of these embodiments, the spring exerts approximately 150-250 g of pull force as it collapses from its stretched or “active” state back to its inactive state.

FIGS. 8A and 8Bare front views, with and without contemplated dimensions, of the anchoring assembly40ofFIGS. 1 and 2, andFIGS. 9A and 9Bare side views, with and without contemplated dimensions, of the anchoring assembly40ofFIGS. 8A and 8B. The anchoring assembly40includes an anchoring feature42and a spring attachment portion44. In the illustrated embodiment, the anchoring feature42is a hook, but in some embodiments, the anchoring feature42may include a clamp or other fastening device. The hook or other anchoring feature42may be anchored to an orthodontic archwire98or the like as described elsewhere herein. The spring attachment portion44may include one or more features for attaching or connecting an end of a spring thereto. For example, in the illustrated embodiment, the spring attachment portion44includes a pair of slot openings48for receiving one or more loops or coils of a coiled spring. The attachment features may be similar to those on the bondable bracket20, or they may be different. In at least some embodiments, the anchoring assembly40is produced from stainless steel.

Dimensions of one particular contemplated embodiment are shown inFIGS. 8B and 9B. The anchoring assembly40may be 4.5 mm tall. The spring attachment portion44may be 1.5 mm tall, 2.3 wide, and 0.3-0.4 mm thick. The anchoring feature42may be 3.0 mm tall, 0.5 mm in diameter, and may create a hook having an internal diameter of 2.0 mm and an opening at the end of 2.0 mm. The slot openings48may be 1.2 mm long and 0.4 mm wide, and may be spaced from each other and from the sides of the spring attachment portion24by 0.5 mm.

The orthodontic device10may be used to quickly adjust the position, location, and/or orientation of an impacted tooth. In this regard,FIGS. 10A-10Eare a series of schematic illustrations of the device10ofFIGS. 1 and 2in use in a patient's mouth90. InFIG. 10A, an impacted tooth92is shown as being above the adjacent teeth94, where it has failed to erupt from the gum tissue96. It is anticipated that the device10may typically be installed during surgery, in which the gum tissue96is opened to facilitate access to the impacted tooth92, but it will be appreciated that in some situations surgery may not be necessary. InFIG. 10B, the bondable bracket20is shown installed on the impacted tooth92, and inFIG. 10C, the spring30and anchoring assembly40are shown connected to the bondable bracket20. (It will be appreciated that in some embodiments, the device10may be installed as a single unit, while in some embodiments, the bondable bracket20may be bonded to the tooth92first, and then the spring30and anchoring assembly40connected afterward.)

With the bondable bracket20bonded to the involved tooth92, the spring30is “activated” or stretched, and the anchoring assembly40is attached to the orthodontic archwire98, as shown inFIG. 10D. With the spring activated, the spring30applies a relatively constant and orthodontically-friendly force to the involved tooth92over a longer period of time when compared to traditional methods. It is thus potentially possible to carry out surgery on a particular patient a fewer number of times, to make adjustments less frequently, and to reduce the overall amount of time that is required to force eruption of the impacted tooth92through the gum tissue96and to bring it into a proper position between the adjacent teeth94as shown inFIG. 10E.

By selecting the shortest possible length of spring30that will stretch from the involved tooth92to the orthodontic archwire98without undergoing permanent deformation, the device10will remain active over the longest period of time without the need for adjustment or reactivation by the orthodontist. Ideally, the device10would be produced in different “sizes” that differ only in the length of the middle section36of the coil spring30, so that the practitioner could select the appropriate length of device10for the particular clinical situation in which it is being used. One contemplated set of sizes includes one size in which the middle spring section36is 5 mm in length when in its inactive state, one size in which the middle spring section36is 8 mm in length when in its inactive state, and one size in which the middle spring section36is 11 mm in length when in its inactive state. If the first and second spring end sections32,34are 0.5 mm in length, then the overall length of these three spring sizes would be 6 mm, 9 mm, and 12 mm, respectively.

FIG. 11is a front left view of an orthodontic device110, shown in its inactive state, for exposure of impacted teeth in accordance with one or more preferred further embodiments of the present invention, whileFIGS. 12A and 12Bare a front left view and a right side view, respectively, of the orthodontic device110ofFIG. 11, shown in its stretched or “activated” state. As shown therein, the orthodontic device110includes a bondable bracket120, a spring130(shown in its inactive state) connected at one end to the bracket120, and an anchoring assembly140connected to the other end of the spring130. Each of these is described in greater detail herein.

FIG. 13is a bottom rear orthogonal view of the bondable bracket120ofFIG. 12B; andFIGS. 14, 15, and 16are a front view, a top view, and a right side view, respectively, of the bondable bracket120ofFIG. 13. The bracket120includes a bondable metal pad or button122and a spring attachment portion124. The pad or button122may be bonded to an impacted tooth or other tooth of interest using a conventional dental or orthodontic bonding adhesive. The rear of the pad or button122may include a metal retentive mesh126(representatively illustrated inFIG. 13) where the bonding adhesive (not shown) may be placed. In at least some embodiments, the pad or button122is curved so as to better fit the contours of the tooth92to which it is to be bonded. Such curvature may be side to side, top to bottom, or both, and different amounts of curvature may be supplied on different bondable brackets120so as to facilitate selection of the proper degree of curvature. The spring attachment portion124may include one or more features for attaching or connecting an end of a spring thereto. For example, in the illustrated embodiment, the spring attachment portion124includes a pair of conjoined slot openings128, separated by a peg127, for receiving one or more loops or coils of a coiled spring. The bracket120also includes a standoff portion123extending perpendicularly between the pad or button122and the spring attachment portion124to position the spring attachment features in front of the pad or button122. As shown inFIGS. 15 and 16, relief openings121may optionally be provided in the standoff portion123near the attachment portion124to facilitate manufacturing.

Dimensions of one particular contemplated embodiment of the bondable bracket120are as follows. The bondable bracket120may be 4.5 mm tall. The pad or button122may be 3.0 mm tall, 3.8 mm wide, and 0.3 mm thick. The spring attachment portion124may be 1.5 mm tall, 2.3 mm wide and 0.3-0.4 mm thick. The conjoined slot openings128may be 1.2 mm long and 0.4 mm wide, and their main portions may be spaced from each other and from the sides of the spring attachment portion124by 0.5 mm.

FIG. 17is a side view of the spring130ofFIGS. 12A and 12B, shown in its active state. The spring130includes a first end132, a second end134, and a middle section136. The first end132connects to the bondable bracket120and the second end134connects to the anchoring assembly140. In the illustrated embodiment, multiple coils of the first spring end132are wound through the conjoined slot openings128in the bondable bracket120and multiple coils of the second spring end134are wound through conjoined slot openings148in the anchoring assembly140.

In at least some embodiments, the spring130is preferably produced from some sort of superelastic metal, such as nickel-titanium (“NiTi” or “nitinol”), copper nitinol, alloys thereof, or the like. Furthermore, in at least some embodiments, the middle section136of the spring130is shaped in the form of a non-planar, helical coil spring that can be stretched or “activated” to a greater length. In at least some of these embodiments, the spring exerts approximately 150-200 g of pull force as it collapses from its stretched or “active” state back to its inactive state. In at least some other embodiments, a constant force spring or constant tension spring, made from a flat ribbon or band of steel or the like, that exerts a constant or nearly constant force over its range of motion. In various alternative embodiments, other types of springs may utilized instead, including conical springs (particularly those providing constant or nearly constant forces), clock springs, simple wire springs, and/or the like.

FIG. 18is a bottom rear orthogonal view of the anchoring assembly140ofFIG. 12B, andFIG. 19is a right side view of the anchoring assembly140ofFIG. 18. The anchoring assembly140includes an anchoring feature142and a spring attachment portion144. In the illustrated embodiment, the anchoring feature142is a rectangular hook, but in some embodiments, the anchoring feature142may include a clamp or other fastening device. The hook or other anchoring feature142may be anchored to an orthodontic archwire98or the like as described elsewhere herein. The spring attachment portion144may include one or more features for attaching or connecting an end of a spring thereto. For example, in the illustrated embodiment, the spring attachment portion144includes a pair of conjoined slot openings148, separated by a peg147, for receiving one or more loops or coils of a coiled spring. The attachment features may be similar to those on the bondable bracket120, or they may be different. The anchoring assembly140also includes a standoff portion143extending perpendicularly between the anchoring feature142and the spring attachment portion144to position the spring attachment features in front of the anchoring feature142. As shown inFIGS. 18 and 19, relief openings141may optionally be provided in the standoff portion143near the attachment portion144to facilitate manufacturing.

Dimensions of one particular contemplated embodiment of the anchoring assembly bracket140are as follows. The anchoring assembly40may be 4.5 mm tall. The spring attachment portion144may be 1.5 mm tall, 2.3 wide, and 0.3-0.4 mm thick. The anchoring feature142may be 3.0 mm tall, 0.5 mm in diameter, and may create a hook having an internal cross-section of 2.0 mm and an opening at the end of 2.0 mm. The slot openings148may be 1.2 mm long and 0.4 mm wide, and may be spaced from each other and from the sides of the spring attachment portion124by 0.5 mm.

The orthodontic device110may be used to quickly adjust the position, location, and/or orientation of an impacted tooth. In this regard,FIGS. 20A-20Eare a series of schematic illustrations of the device110ofFIG. 11in use in a patient's mouth90. InFIG. 20A, an impacted tooth92is shown as being above the adjacent teeth94, where it has failed to erupt from the gum tissue96. It is anticipated that the device110may typically be installed during surgery, in which the gum tissue96is opened to facilitate access to the impacted tooth92, but it will be appreciated that in some situations surgery may not be necessary. InFIG. 20B, the bondable bracket120is shown installed on the impacted tooth92, and inFIG. 20C, the spring130and anchoring assembly140are shown connected to the bondable bracket120. (It will be appreciated that in some embodiments, the device110may be installed as a single unit, while in some embodiments, the bondable bracket120may be bonded to the tooth92first, and then the spring130and anchoring assembly140connected afterward.)

With the bondable bracket120bonded to the involved tooth92, the spring130is “activated” or stretched, and the anchoring assembly140is attached to the orthodontic archwire98, as shown inFIG. 20D. With the spring activated, the spring130applies a relatively constant and orthodontically-friendly force to the involved tooth92over a longer period of time when compared to traditional methods. It is thus potentially possible to carry out surgery on a particular patient a fewer number of times, to make adjustments less frequently, and to reduce the overall amount of time that is required to force eruption of the impacted tooth92through the gum tissue96, as shown inFIG. 10E. Ultimately, the same process may be used to bring the impacted tooth92into a proper position between the adjacent teeth94.

By selecting the shortest possible length of spring130that will stretch from the involved tooth92to the orthodontic archwire98without undergoing permanent deformation, the device110will remain active over the longest period of time without the need for adjustment or reactivation by the orthodontist. Ideally, the device110would be produced in different “sizes” that differ only in the length of the middle section136of the coil spring130, so that the practitioner could select the appropriate length of device110for the particular clinical situation in which it is being used. One contemplated set of sizes includes one size in which the middle spring section136is 5 mm in length when in its inactive state, one size in which the middle spring section136is 8 mm in length when in its inactive state, and one size in which the middle spring section136is 11 mm in length when in its inactive state. If the first and second spring end sections132,134are 0.5 mm in length, then the overall length of these three spring sizes would be 6 mm, 9 mm, and 12 mm, respectively.

In various alternative embodiments, a coiled spring may be connected to a bondable bracket in other ways. For example,FIG. 21is a front orthogonal view of an orthodontic device210, shown in its activated state, for exposure of impacted teeth in accordance with one or more further preferred embodiments of the present invention. As shown therein, the orthodontic device210includes a bondable bracket220, a spring230(shown in its active state) connected at one end to the bracket220, and an anchoring assembly140connected to the other end of the spring230.

The bracket220includes a bondable metal pad or button222and a spring attachment portion224. Like the pads or buttons22,122of previously-described embodiments, the pad or button222may be bonded to an impacted tooth or other tooth of interest using a conventional dental or orthodontic bonding adhesive. The rear of the pad or button222may include a metal retentive mesh226where the bonding adhesive (not shown) may be placed. In at least some embodiments, the pad or button222is curved so as to better fit the contours of the tooth92to which it is to be bonded. Such curvature may be side to side, top to bottom, or both, and different amounts of curvature may be supplied on different bondable brackets220so as to facilitate selection of the proper degree of curvature. In this embodiment, the spring attachment portion224includes a loop into which a first end232of the spring230may be inserted.

FIG. 22is a side view of the coiled spring230ofFIG. 21. The spring230includes a first end232, a second end234, and a middle section236. The first end232connects to the bondable bracket220and the second end234connects to the anchoring assembly140. In the illustrated embodiment, the first spring end232is a straight segment that is inserted through the loop224of the bondable bracket220and multiple coils of the second spring end234are wound through conjoined slot openings148in the anchoring assembly140. Other than the straight end232, the spring230may otherwise have characteristics similar to those of the springs30,130described previously.

In the illustrated embodiment, the anchoring assembly140may be identical to that ofFIG. 11, described previously.

Referring again toFIG. 21, the straight spring end232is connected to the bondable bracket220by first inserting the end232through the loop224and then welding the end232to the front of the bracket220using at least one weld228and, in some cases, a second weld229.FIG. 21illustrates the use of two welds228,229, whileFIG. 23is a front orthogonal view of the orthodontic device210ofFIG. 21but shown with only a single weld228. The welds228,229may, in at least some embodiments, be applied via laser welding and/or may, in at least some embodiments, be applied via spot welding. A groove225may be provided in the pad or button222to increase the surface area, thereby improving the strength and durability of the weld228. In at least some embodiments, the spring230may be heat treated, and in at least some of these embodiments such heat treatment would occur post-welding, thereby providing additional strength and reliability in the welds228,229.

The orthodontic device210may be used to quickly adjust the position, location, and/or orientation of an impacted tooth using methods similar to those described previously, except that in at least some embodiments the first spring end232must be permanently attached to the bondable bracket220before use. In particularly, after insertion through the loop224of the bondable bracket220, the first spring end232is welded to the pad or button222such that it cannot thereafter be removed from the loop224without destroying at least one of the spring230, the welds228,229, or the bracket220itself. With the spring230connected to the bracket220, further use of the device210may be similar to the usage illustrated, for example, inFIGS. 20C-20E.

FIG. 24is a front orthogonal view of an orthodontic device310, shown in its activated state, for exposure of impacted teeth in accordance with one or more further preferred embodiments of the present invention. As shown therein, the orthodontic device310includes a bondable bracket320, a spring230(shown in its active state) connected at one end to the bracket320, and an anchoring assembly140connected to the other end of the spring230. The bracket320includes a bondable metal pad or button322and a spring attachment portion224. The bracket320is somewhat similar to the bracket ofFIG. 23but includes a deeper groove325formed between two ridges327rising from the face of the pad or button322. This deeper groove325provides further improvement to the strength and durability of the weld228.

FIG. 25is a front orthogonal view of an orthodontic device410, shown in its activated state, for exposure of impacted teeth in accordance with one or more further preferred embodiments of the present invention. As shown therein, the orthodontic device410includes a bondable bracket420, a spring430(shown in its active state) connected at one end to the bracket420, and an anchoring assembly140connected to the other end of the spring430.

The bracket420includes a bondable metal pad or button422and a spring attachment portion424. Like the pads or buttons22,122,222,322of previously-described embodiments, the pad or button422may be bonded to an impacted tooth or other tooth of interest using a conventional dental or orthodontic bonding adhesive. The rear of the pad or button422may include a metal retentive mesh226where the bonding adhesive (not shown) may be placed. In at least some embodiments, the pad or button422is curved so as to better fit the contours of the tooth92to which it is to be bonded. Such curvature may be side to side, top to bottom, or both, and different amounts of curvature may be supplied on different bondable brackets420so as to facilitate selection of the proper degree of curvature. In this embodiment, the spring attachment portion424includes a loop into which a first end432of the spring430may be inserted.

FIG. 26is a side view of the coiled spring430ofFIG. 25. The spring430includes a first end432, a second end434, and a middle section436. The first end432connects to the bondable bracket420and the second end434connects to the anchoring assembly140. In at least some embodiments, the spring430is initially provided in a state similar to that of the spring230inFIG. 22. More particularly, in an initial state, the first spring end432is a straight segment that may be inserted through the loop424of the bondable bracket420. After insertion, the first spring end432is deformed, such as by melting, to form a “mushroom-” or other shaped head428. Once the head428is formed, the first spring end432may no longer be withdrawn from the loop424. Advantageously, the spring430itself may remain free to rotate, at least somewhat, within the loop424, thereby providing an element of rotational flexibility. Furthermore, because the spring430is retained via the head428, rather than by a weld such as the welds228,229of the spring230ofFIGS. 21-23, there is no risk of a weld breaking. This may be particularly important where such a weld is between two different alloys or other metals, such as between stainless steel and nitinol.

As inFIGS. 21 and 23, multiple coils of the second spring end434are wound through conjoined slot openings148in the anchoring assembly140. Other than the straight end432, the spring430may otherwise have characteristics similar to those of the springs30,130,230described previously. Also, as in the device210ofFIGS. 21 and 23, the anchoring assembly140may be identical to that ofFIG. 11, described previously.

The orthodontic device410may be used to quickly adjust the position, location, and/or orientation of an impacted tooth using methods similar to those described previously, except that in at least some embodiments the first spring end432must be permanently attached to the bondable bracket420before use. In particularly, after insertion through the loop424of the bondable bracket420, the first spring end432is deformed, such as by melting the end432to form a mushroom head428, such that it cannot thereafter be removed from the loop424without destroying at least one of the spring430, the mushroom head428, or the bracket420itself. With the spring430connected to the bracket420, further use of the device410may be similar to the usage illustrated, for example, inFIGS. 20C-20E.

FIGS. 27A and 27Bare a front view and a right side view, respectively, of an alternative anchoring assembly540. Like the anchoring assembly140ofFIGS. 18 and 19, the anchoring assembly540includes an anchoring feature542and a spring attachment portion544. Unlike the anchoring assembly140ofFIG. 19, the anchoring feature542of the alternative anchoring assembly540includes an angled tip546to facilitate maneuvering the anchoring feature542, which may be a sort of hook, over an orthodontic archwire98or the like. More particularly, the angled tip546creates a wider opening in the anchoring feature542. The hook or other anchoring feature542may be anchored to an orthodontic archwire98or the like as described elsewhere herein. In at least some embodiments, the angled tip546may be crimped into place, after being installed on the archwire98, to provide an improved, connection. The spring attachment portion544may include one or more features for attaching or connecting an end of a spring thereto. For example, in the illustrated embodiment, the spring attachment portion544includes a pair of separate slot openings548for receiving one or more loops or coils of a coiled spring, but in other embodiments, a pair of conjoined slot openings similar to the conjoined slot openings148ofFIG. 18may be provided.

FIG. 28is a front orthogonal view of an alternative bondable bracket620for use in an orthodontic device for exposure of impacted teeth in accordance with one or more further preferred embodiments of the present invention. As shown therein, the bondable bracket620includes a bondable metal pad or button and a spring attachment portion. Like the pads or buttons22,122,222,322,422of previously-described embodiments, the pad or button may be bonded to an impacted tooth or other tooth of interest using a conventional dental or orthodontic bonding adhesive. The rear of the pad or button may include a metal retentive mesh where the bonding adhesive (not shown) may be placed. In at least some embodiments, the pad or button is curved so as to better fit the contours of the tooth92to which it is to be bonded. Such curvature may be side to side, top to bottom, or both, and different amounts of curvature may be supplied on different bondable brackets620so as to facilitate selection of the proper degree of curvature. In this embodiment, the spring attachment portion includes a first loop into which a first end of a spring may be inserted as well as a second loop or bracket. A groove may extend between the two loops so as to accommodate the spring end.

In at least some contemplated embodiments, an orthodontic device includes a bondable bracket220and a spring230like those shown inFIG. 23and an anchoring assembly or archwire bracket540like that shown inFIGS. 27A and 27B. In various such embodiments, the bondable metal pad or button222is approximately 3.00-4.00 mm wide, 2.00-4.00 mm tall, and 0.20-0.40 mm thick; the loop224is approximately 0.50-1.00 mm wide (top to bottom) and 0.20-0.40 mm thick, has an internal radius of approximately 0.10-0.20 mm, and is disposed approximately 0.50-1.00 mm from the top of the pad222; and the weld228is in the form of a welded ball that is approximately 0.40-0.75 mm in diameter. Also in such embodiments, the wire comprising the spring230has a diameter of 0.15-0.35 mm, and the coil of the spring230has an exterior diameter of approximately 1.50-2.50 mm. Also in such embodiments, the spring attachment portion544is approximately 1.50-2.50 mm tall, 2.50-3.50 mm wide, and 0.20-0.40 mm thick; the anchoring feature542includes a first portion, which may be a standoff portion, extending perpendicularly from the spring attachment portion, that is approximately 0.75-1.25 mm wide, 2.00-2.50 mm long and 0.20-0.40 mm thick; the anchoring feature542includes a second portion, extending perpendicularly from the first portion (and parallel to the spring attachment portion542), that is 0.75-1.25 mm wide, 1.25-3.00 mm long and 0.20-0.40 mm thick; the angled tip546is angled approximately 15-45 degrees from the plane of the second portion of the anchoring feature542and is approximately 0.75-1.25 mm wide, 1.50-2.00 mm long and 0.20-0.40 mm thick; the slots548are approximately 1.00 mm long and 0.70 mm wide, and separated from one another by 0.20 mm. In one particular embodiment, the bondable metal pad or button222is approximately 3.25 mm wide, 2.50 mm tall, and 0.25 mm thick; the loop224is approximately 0.65 mm wide (top to bottom) and 0.25 mm thick, has an internal radius of approximately 0.15 mm, and is disposed approximately 0.60 mm from the top of the pad222; and the weld228is in the form of a welded ball that is approximately 0.50-0.60 mm in diameter. Also in at least such particular embodiment, the wire comprising the spring230has a diameter of approximately 0.25 mm, and spring coil of the spring230has an exterior diameter of approximately 1.60 mm. Also at least in such particular embodiment, the spring attachment portion544is approximately 2.0 mm tall, 2.60 mm wide, and 0.25 mm thick; the anchoring feature542includes a first portion, which may be a standoff portion, extending perpendicularly from the spring attachment portion, that is approximately 1.00 mm wide, 2.25 mm long and 0.25 mm thick; the anchoring feature542includes a second portion, extending perpendicularly from the first portion (and parallel to the spring attachment portion542), that is 1.00 mm wide, 1.50 mm long and 0.25 mm thick; the angled tip546is angled approximately 17.5 degrees from the plane of the second portion of the anchoring feature542and is approximately 1.00 mm wide, 1.75 mm long and 0.25 mm thick; the slots548are approximately 1.00 mm long and 0.70 mm wide, and separated from one another by 0.20 mm.

In at least some embodiments, the anchoring feature42,142,542is large enough that the interior width or diameter is sufficient to surround not only an archwire98but a spacer material, such as a stainless steel sleeve or spring, that surrounds the archwire98. Also in at least some embodiments, the internal radius (diameter) of the loop224is selected to match the diameter or width of the wire of the spring230.

Based on the foregoing information, it will be readily understood by those persons skilled in the art that the present invention is susceptible of broad utility and application. Many embodiments and adaptations of the present invention other than those specifically described herein, as well as many variations, modifications, and equivalent arrangements, will be apparent from or reasonably suggested by the present invention and the foregoing descriptions thereof, without departing from the substance or scope of the present invention.