ORTHODONTIC APPLIANCE

Abstract: An orthodontic appliance including: bracket (101) having a substantially flat base (102) for engaging a tooth, and a securing member (103); and facia (110) able to engage with the securing member (103) to form part of the bracket (101); wherein the combination of the facia (110) and the securing member (103) forms a slot within the bracket (101), able to receive a pin (114) and secure the pin in position.

Description: ORTHODONTIC APPLIANCE This invention relates generally to the field of orthodontics and in particular to a novel orthodontic appliance, including a bracket and a facia, the combination of which is able to accommodate a series of pins. The invention also relates to a technique of utilising such an appliance. The field of orthodontics generally applicable to the present invention, involves appliances and techniques relating to the application of appliances to teeth in order to straighten or in some manner move the teeth within the mouth. Treatment with such appliances are generally for cosmetic or other functional purposes. The most commonly used techniques involve the use of brackets which are affixed to the tooth surface, and archwires which are held in position by the brackets. Correct manipulation of the archwire and the bracket, allows the operator to apply forces upon a tooth in an attempt to cause movement. Various techniques have developed utilising differing brackets and archwires in order to provide orthodontic treatment. One such technique is the Begg technique which involves the gentle free tipping movement of the teeth. The teeth may be moved into existing spaces or spaces created by extracting strategic teeth. Other techniques utilise Edgewise brackets and variations of the Edgewise bracket in order to induce movement of teeth. A bracket is a device that is generally attached either directly to the tooth or by means of a band surrounding the tooth and may include a horizontal projection to support an archwire. Generally, the appliances used in current techniques utilise brackets and an archwire. The archwire is generally secured to the bracket by means of ligatures, or by the use of pins. The archwire may be secured within the bracket or received between the bracket surface and the inside of the bracket and held firmly against the inside of the bracket. Appliances that are used in orthodontic treatments are classified generally according to their surface application. Such appliances include labial and buccal, utilising appliances that are applied to the outer surface of the tooth; lingual, utilising appliances affixed to the interior surface of the tooth, or labialingual applied to both surfaces. Generally, the Edgewise technique is a labial and buccal arch technique that allows for suitable control in the labiolingual, mesiodistal and gingival directions. In the Edgewise appliance, a ribbon, round or rectangular archwire is layed flat against the labial/buccal surface of the tooth. The archwire is shaped and ligatured into a support in the brackets. The Edgewise bracket has a rectangular cross sectioned support into which the archwire fits, and spurs for tying the archwire with some form of ligature. The support may be single, double or treble, and may be straight or angulated in order to provide torque to the tooth. With such brackets, the width of the attachment is important, since this is what allows control of the movement of tooth in the mesiodistal direction. Other types of brackets such as the begg bracket utilise a pin to secure the archwire rather than ligatures. Auxiliaries such as uprighting springs, rotational springs and torquing arches are used to empirically drive the teeth into their desired position. Ceramic and plastic brackets have also been used in the Begg and various alternatives of the Edgewise technique. With the Begg bracket technique, the ceramic brackets are tending to fracture due to the fine nature of the bracket design or dilaminate from the bases to which they adhere to. Stainless steel and titanium wires also have a detrimental effect upon ceramic brackets causing fracture of brackets and wear. Plastic brackets have generally been discarded, as they readily distort. In the Edgewise techniques the width and depth of the support are critical and thus any excessive wear is detrimental to good treatment. Once the brackets are placed on a tooth they can not be easily interchanged and as such, once the bracket is worn, or damaged, the treatment is effected. This applies to both the Begg and Edgewise techniques. The ceramic Edgewise bracket is also prone to fracture and is generally bulky. The present invention aims to overcome or at least alleviate one or more of the difficulties associated with the prior art. The present invention relates to an orthodontic appliance that includes; a bracket, having a substantially flat base for engaging a tooth, and a securing member; and a facia, able to engage with the securing member to form part of the bracket; wherein the combination of the facia and the securing member form a slot within the bracket, able to receive a pin and secure the pin in position. Generally, the pin may be considered to form part of the orthodontic appliance of the invention. The pin should have a foot which includes a recess having an active edge. The pin is adapted to be secured within the slot formed between the bracket and the facia of the orthodontic appliance, in such a manner so as to prevent rotation. The orthodontic appliance, in use, will include a number of pins, each having a varying active edge. The pin may be removed and replaced, during treatment depending upon the specific treatment required. A different type of pin may be used on different teeth at any one time. A specific pin may be manufactured and utilised in the appliance depending upon the treatment. During the treatment of a patient, a plurality of different pins may be used within a particular appliance. Most preferably, the facia is a separate unit, that is compatible with the securing member of the bracket however, it is possible that the facia is formed integrally with the securing member and so formed to allow for a slot that is able to house the pin. The securing member of the bracket may form a tongue arrangement that is compatible with a groove formed within the facia, forming a sleeve to secure over the tongue. The facia is generally secured to the bracket by the configuration of the sleeve and the securing member. Preferably, the facia also includes a centrally located channel, however, a channel may be formed in only one of the securing member or the facia. It is not critical whether the channel is formed in either the securing member, facia or both, however when the facia is secured over the securing member, a slot should be formed between these components when they are placed together. The slot should be of such dimension so as to readily receive, and lock the pin into position, so that it cannot rotate. The slot is the passive factor in the mechanisms and the pins are the active aspect of the appliance. Rotation is generally prevented if the pin has the same cross section as the slot. The pin and the slot may have for example a square cross section. The appliance may also be ligated, or a C clamp used to assist in maintaining the pin in the bracket slot. The C clamp may be used with all techniques and at any time after the arch wires are seated firmly in the bracket, they may be used during a tip control procedure and whilst uprighting, with no uprighting springs or auxiliaries required, including latex elastic modules. It is a further preferred feature that the securing member includes a V shaped terminal aspect, having a sharp edge, such that the contact between the archwire and the securing member is a sharp edged contact. This sharp edge contact allows for active movement of the bracket. A pin that may be used during early treatment may include an active edge also having a sharp edge, such that the shaφ edge is located to hold the archwire. This provides a shaφ edge contact on either side of the archwire. In a further aspect of the invention, there is provided a pin for use in an orthodontic appliance according to the invention, said pin including: a foot including a recess having an active edge, wherein the pin is adapted to be secured within the slot formed between the bracket and the facia of the orthodontic appliance. The active edge of the pin may be varied in shape depending upon the movement required for each individual tooth. For example, the active edge may be flat or sharp edged depending upon the prescribed treatment or arch wire to be used. The pin and bracket arrangement effectively allows positive and negative root torque and other movements to take place on alternate teeth in a specifically designated way and at any time during treatment. The pins may be individualised in a patient to provide a prescribed treatment for each tooth. When a specific designated force requirement is placed upon a tooth, it is preferred to use either a steel or ceramic facia as some plastic facias may be subject to distortion. The recess within the pin, in conjunction with the V-shaped aspect of the securing member, forms an opening for the archwire to pass through, to secure the archwire. The foot of the pin holds the archwire away from the facia, so that the archwire does not contact the facia in use. The pin may be varied during treatment, to alter the dynamics of the pin. The opening provided between the recess in the pin and the bracket allows for rectangular, round and ribbon archwires to be used which allows for individual torque, uprighting and rotation movements of every tooth. The degree of movement can be determined for each tooth separately and accurately according to a prescription, and can be either negative or positive depending upon the requirements of each individual tooth. The pins may be made from any suitable material, but are preferably made from brass or stainless steel depending upon the type of movement which is required. The bracket may be formed of any suitable material, such as metal or ceramics. Most preferably the bracket is stainless steel. The facia may also be formed of any suitable material such as plastic, ceramic or metal, and be the same or different from the rest of the bracket. As the facia does not contact the archwire, it may readily be made of ceramic or plastic as it will not be subject to the wear caused by the archwire. In a preferred form, the facia simply slides over the rest of the bracket and it is able to be readily removed and replaced during treatment as necessary. The facia may be made in such a way that fracture of the facia is unlikely to occur with all aspects of the facia preferably being curved to facilitate soft tissue acceptance. The facia may be made with sufficient depth, without effecting treatment considerations. The archwire is held in the same position to the enamel tooth surface regardless of the depth of the facia, as it is the combination of the bracket and the pin which positions the archwire. O rings may be used in order to secure the facia if it is necessary to assist in placement of the archwire by drawing the prescribed pin into the bracket slot. The slot in the bracket acts as a stabiliser for the utilisation of the pin. In order to prevent adhesive from entering the slot, it is preferred to place a plastic prepositioner in the channel of the securing member, which will assist the operator in placing the bracket in exactly the position required and at the same time safeguard against any adhesive material entering the channel and thus preventing the pin from being housed. The bracket may have a guide to assist in placement of the pin. Once the bracket and pin are in position, the facia may be placed over the bracket and complete the slot. The pins may be formed to provide initial pins and also finishing, rotational, uprighting and torquing pins. The pins should be made such that each pin is able to locate securely within the slot formed between the bracket and facia. Because the pins are able to fit into the slot and are locked into the bracket, the pin cannot rotate and therefore any modification of the foot of the pin can be utilised to achieve various desirable tooth movements. The slot may be used occlusaly or gingivally, depending upon the specific requirements of the bracket. By utilising specific pins, it is also possible to obviate the need to use multiple tubes on molars. An appliance may be placed on a molar such that the V-shaped aspect of the bracket faces gingivally or occlusally as desired. A specifically adapted pin where the foot includes a tube to locate an archwire may then be positioned. The tube may be either round, rectangular or specifically shaped, depending on the archwire used. According to a further embodiment of the invention, there is provided an orthodontic appliance for a molar tooth including: a bracket, having a substantially flat base for engaging a tooth, and a securing member; a facia able to engage with the securing member to form part of the bracket; and a specially adapted pin including a tube at the foot of the pin; wherein the combination of the facia and the securing member form a slot in the bracket, able to receive the pin and secure it in position; said tube so formed that it is able to locate and secure an archwire in position. In yet a further aspect, the present invention also resides in a pin, for use in the orthodontic appliance according to the invention including a foot adapted to form a tube to secure an archwire. ln yet a further aspect, the invention provides a method of orthodontic treatment using the orthodontic appliance of the invention including the steps of: bonding the bracket to the enamel of an individual tooth, said bracket having a securing member. fixing a pin within a slot formed between the securing member and the facia when the facia is placed over the securing member; the pin having a foot with a recess having an active edge; and placing an archwire so that it is secured between the bracket and the active edge of the pin. During treatment, an appliance according to the invention is affixed to a number of teeth of a particular patient. Each appliance may have the same or a different pin depending on the treatment required. The following is a description of preferable features of the method, which may be varied depending upon the specific treatment requirements. In the first stage of treatment, free tipping and rotation of a tooth is enhanced by a point to point contact between the V shaped terminal aspect of the securing member of the bracket and active edge of the pin. In this initial stage, the active edge of the pin is preferably shaφ. The pin is firmly locked into position as it is located between the bracket and the facia and no rotation of the pin may occur. This allows for free rotation and tipping of the tooth. It is envisaged that during the first stage of treatment, a round wire may be used, and a finishing wire may be used at the end of the treatment. Uprighting and rotation of teeth can be achieved by auxiliary wires which are utilised in such a way that a first order leverage is used in both instances. The uprighting pins and the brackets allow a transition of leverage to occur from second, third and then to first order leverage. Such movement will be achieved by the utilisation of the first order of leverage whereby the fulcrum is the center of the bracket and the applied rotational or uprighting force applied to the main archwire on both the mesial and distal of the bracket. The result is that less auxiliary components are required with a 50% force requirement on each side of the bracket. The result is a much less complex but more dynamic movement. The tooth can move in all three dimensions at the one time. Currently used auxiliaries may however be utilised with the appliance of the invention and may be modified in order to be used in the new appliance system. The bracket may also incorporate small holes in the mid section of the securing member to allow ligation of severely displaced teeth. Once such displaced teeth are drawn to the main archwire, the formation of the slot may be achieved by the placement of the facia over the securing member. Torquing can be achieved using ordinary torquing auxiliaries as used in the existing techniques and therefore the finishing procedure may be achieved using current principles. It is preferred that treatment procedures be commenced in light round wires and finishing can be achieved in either round, rectangular or even ribbon archwires. The archwire height does not need to be changed during treatment as may be the case in existing combination brackets. The appliance of the invention is able to individually root torque all teeth including premolars in the finishing stage. Furthermore, the torque is controlled to the exact degree by the specific pins that are utilised with the appliance. The appliance of the invention may be used both in an inverted or upright position during any stage of the aforementioned technique, so that the pin foot may face in the gingival or occlusal direction. The appliance may be applied to teeth in any prescribed manner, including labialy, bucaly, lingually and palately. The method also involves the use of brackets that include a pin where the foot forms a tube adapted to secure the archwire in position. The pin is designed for use on the molars of a patient. A plurality of different tube pins may be used during the treatment of a patient to accommodate variations in the archwire used. For example, the tube pin may be replaced when the archwire is changed from a round wire to a rectangular or ribbon wire. It is envisaged that this method of providing molar tubes may be used in other techniques and conventional brackets. The tubes are easily interchanged during treatment to the desired configuration, simply by slipping a new tube pin into the molar bracket. An advantage is that in most instances, only one or at most two molar tubes need to be used on each molar tooth. The occlusal plane does not vary as the archwire remains in the same position throughout the treatment. This differs from present utilisation of combination brackets where there is a need to change the position of the archwire during finishing in order to engage the horizontal bracket slot and combination tubes on molar teeth An advantage achieved by the bracket of the invention in general use, is that the archwire is held close to the enamel surface of the tooth. This is achieved by the formation of the opening between the recess in the pin and the bracket to hold the archwire, as the opening is formed near the base of the bracket. The archwire is held in the same position in relation to the tooth. A further advantage is that the contact between the archwire and the bracket is a metal to metal contact at all stages, and the archwire does not need to contact the facia. The facia, whilst forming part of the bracket, in that it creates the slot with the securing member, is not basically in contact with the archwire. A further advantage is that the facia may be readily changed without the necessity to remove the bracket from the tooth, which provides aesthetic benefits. The facia can be changed from ceramic to plastic and to metal during treatment and even differing colours may be utilised by simply removing the facia from the rest of the bracket and replacing it with a different facia. There is no need to debond the bracket in order to change the facia. A further advantage of the bracket, is the unique shaφ terminal aspect formed in the securing member of the bracket. This forms a knife edge connection with the archwire which allows the operator to control the torque of the tooth for precision of movement. The bracket of the invention has the ability to torque accurately individual teeth, both premolars and anterior teeth, the teeth can be torqued individually and separately and at the same time. The teeth can also be uprighted and rotated in a precise and individual manner and at the same time. A further advantage is that the teeth may be precisely moved in a prescribed manner individually and collectively. An operator may simply prescribe a particular pin in order to effect the correct treatment. A further advantage is the smoothness of the bracket which adds to the comfort of the patient. As the archwire is held at a constant distance to the enamel surface on all the teeth, treatment procedures are enhanced and simplified. The present invention will now be described with reference to the accompanying drawings. It should be understood that these drawings are merely illustrative of preferred embodiments of the invention, and the scope should not be considered to be limited thereto. Figure 1 illustrates a perspective view of a bracket (without the facia) in accordance with the invention. Figure 2 is a top view of the same embodiment, while Figures 3 and 4 are side and end views respectively. Figure 5 is a perspective view of a facia in accordance with the present invention. Figure 6 is a top view of the same embodiment while Figures 7 and 8 are side and end views respectively. Figure 9 is a perspective view of a pin in accordance with the present invention, whilst Figure 10 is a side view of the same embodiment. Figure 11 is a perspective view of a further pin in accordance with the present invention, while Figure 12 is a side view of the same embodiment. Figure 13 is a perspective view of a further pin in accordance with the invention. Figure 14 is a top view of the same embodiment, while Figures 15 and 16 are a end and side view respectively. Figure 17 is a perspective view of a further pin in accordance with the invention. Figure 18 is a top view of the same embodiment, while Figures 19 and 20 are a side and end view respectively. Figure 21 is a perspective view of a further pin in accordance with the invention. Figure 22 is a top view of the same embodiment, while Figures 23 and 24 are a side view and end view respectively. Figure 25 is a perspective view of a pin in accordance with the invention which may be used for a molar tube. Figure 26 is a top view of the same embodiment, while Figures 27 and 28 are a end view and side view respectively. Figure 29 is a perspective view of a further pin in accordance with the invention which may also be used as a molar tube. Figure 30 is a top view of the same embodiment, while Figures 31 and 32 are an end and side view respectively. Figure 33 is an exploded view of a bracket, facia and pin in combination. Figures 1 to 4 illustrate a bracket (101) (without a facia) having a base (102) and a securing member (103). The base has a flat surface (104), the securing member being positioned opposite the flat surface. The securing member has a central channel (105) culminating in a V-shaped terminal aspect (106). The V-shaped terminal aspect produces a sharp edge (107). The base of the bracket may include a terminal recess (108) for engaging the foot of a pin in order to assist in securing a pin to the bracket. A ligature hole (109) is positioned in the securing member and may be used if the treatment so requires. Figures 5 to 8 illustrate a facia (110) which includes a securing sleeve (111) which is able to surround the securing member (103) of the bracket. The securing sleeve is adapted to slide over the securing member. A central channel (112) is located in the facia, which in combination with the channel (105) of the bracket forms a slot when the facia is secured over the bracket, which is shaped to secure the pin. The facia also includes a terminal recess (113) into which the heel of a pin may locate assisting in securing both the pin and the facia. The facia has a smooth outer surface (125) which aids the comfort of the patient. Figures 9 and 10 illustrate a torqueing pin (114) in accordance with the invention having a leg (115) which is able to locate within the slot formed between the facia and the bracket. The leg (115) is shaped specifically to locate firmly within the slot. The foot of the pin has a recess (116) with a shaφ edge (122) . The recess (116) in conjunction with the V-shaped aspect (106) of the securing member forms an opening through which an archwire may be passed. The foot includes a heel (117) which is able to position in the terminal recess (113) of the facia while toe (118) is able to secure into the terminal recess (108) of the bracket. The pin itself is held securely between the securing member of the bracket and the facia and is unable to rotate as it has the same cross sectional dimension to the slot. Figures 11 and 12 illustrate an alternative pin (214) wherein the active edge of the recess (216) is rectangular shaped and angled so as to provide torque for a particular tooth movement. Figures 13 through to Figure 24 illustrate various other embodiments of pins (314, 414 and 514 respectively) wherein the foot, and in particular the active edge of the recess located in each pin various depending upon the treatment required for a particular tooth. The angle of the active edge (316, 416 and 516 respectively) varies the uprighting force applied to each tooth. Each pin is able to locate and be secured within the slot between the securing member and the facia. Figures 25 and 32 illustrate embodiments of a pin (614 and 714 respectively) that may be used as a molar tube. The pins may be used occlusally where the bracket is placed such that the V-shaped edge of the bracket faces gingivally, or the pins may be used gingivally depending on positioning of brackets. When the pin of figure 25 or 29 is located within a bracket in such a position, the need for multiple tubes to be used, as in current techniques is eliminated. The archwire remains at the same level during treatment and both round archwires (Figure 25) and rectangular archwires (Figure 29) are able to be slotted into tubes (120) or (121) respectively. The use of the bracket and the particular pin eliminates the need as in current techniques to use expensive or multiple tubes on molars. Figure 33 illustrates an exploded view with bracket (101), facia (110) and pin (114) all in appropriate relation to each other. The facia is able to slide over the securing member (103) of the bracket to form a slot within the bracket. The pin is able to be secured within the slot formed by the facia and the securing member in such a manner that it is unable to rotate. An archwire (not illustrated) is able to be located within an opening formed between the recess (116) of the pin and the sharp edge (107) of the bracket. It should be understood that the above description is merely illustrative of the present invention, and any modification without departing from the spirit or ambit of the invention is also to be included herein.

Claims: CLAIMS: 1. An orthodontic appliance including: a bracket, having a substantially flat base for engaging a tooth, and a securing member; and a facia, able to engage with the securing member to form part of the bracket; wherein the combination of the facia and the securing member form a slot within the bracket, able to receive a pin and secure the pin in position. 2. An orthodontic appliance according to claim 1 further including a pin; said pin having a foot including a recess having an active edge, wherein the pin is adapted to be secured within the slot formed between the bracket and the facia, in such a manner so as to prevent rotation of the pin. 3. An orthodontic appliance according to any one of the preceding claims, wherein the securing member includes a terminal aspect having a sharp active edge. 4. An orthodontic appliance according to claim 3 wherein, in use, an archwire is secured between the active edge of the securing member and the active edge of the pin recess. 5. An orthodontic appliance according to claim 4 wherein the active edge of the pin recess is shaped to provide a prescribed movement of the tooth of a patient in use. 6. An orthodontic appliance according to any one of the preceding claims, wherein the securing member forms a tongue arrangement that is compatible with a groove within the facia, and so formed that when the facia is placed over the securing member, the slot is formed between the facia and the securing member. 7. An orthodontic appliance according to any one of the preceding claims, wherein, in use, the facia will not contact the archwire. 8. An orthodontic appliance according to any one of the preceding claims, wherein the bracket is formed of metal or ceramics, and the facia is formed of metal, ceramics or plastic. 9. An orthodontic appliance according to any one of the preceding claims, wherein the bracket includes a guide to assist in the placement of the pin. 10. An orthodontic appliance according to any one of claims 2 to 9, wherein the pin is made of brass or stainless steel. 11 . An orthodontic appliance according to any one of claims 2 to 10, wherein the appliance includes a plurality of pins, to provide a selection of pins having differing active edges, where, in use, a pin may be removed and replaced with an alternative pin depending on the type of treatment required to the patient. 12. An orthodontic appliance according to claim 11 wherein the facia may be readily removed to allow for replacement of the pin and/or replacement of the facia. 13. A pin, adapted for use in an orthodontic appliance, said appliance including: a bracket, having a substantially flat base for engaging a tooth, and a securing member; and a facia, able to engage with the securing member to form part of the bracket wherein the pin is adapted to secure within a slot formed by the combination of the bracket and the facia; and wherein said pin includes a foot having a recess having an active edge. 14. A pin according to claim 13 wherein the active edge is shaped to provide a prescribed movement of the tooth of a patient in use. 15. A pin, adapted for use in an orthodontic appliance, said appliance including: a bracket, having a substantially flat base for engaging a tooth, and a securing member; and a facia, able to engage with the securing member to form part of the bracket wherein the pin is adapted to secure within a slot formed by the combination of the bracket and the facia; and wherein said pin includes a foot adapted to form a tube able to secure an archwire in use. 16. A method of orthodontic treatment using an orthodontic appliance according to any one of claims 1 to 12 including the steps of: bonding the bracket to the enamel of an individual tooth, said bracket having a securing member; fixing a pin within the slot formed between the securing member and the facia when the facia is placed over the securing member; said pin having a foot with a recess having an active edge; and placing an archwire so that it is secured between the bracket and the active edge of the pin. 17. A method according to claim 16 wherein the appliance is placed in either an inverted or an upright position so that the foot of the pin faces in either the gingival or occlusal direction. 18. A method according to claim 16 or 17 wherein the appliance is applied to the teeth in a labialy, buccaly, lingualy or palately manner. 19. A method according to any one of claims 16 to 18 wherein a specifically adapted pin is used on an appliance affixed to a molar tooth, said specifically adapted pin includes a tube able to locate an archwire in said tube when in position. 20. A method according to any one of claims 16 to 19, wherein, during treatment the pin and/or the facia and/or the archwire may be replaced and varied depending upon the treatment required for the tooth. 21. An orthodontic appliance for a molar tooth including: a bracket, having a substantially flat base for engaging a tooth, and a securing member; a facia able to engage with the securing member to form part of the bracket; and a specially adapted pin including a tube at the foot of the pin; wherein the combination of the facia and the securing member form a slot in the bracket, able to receive the pin and secure it in position; said tube so formed that it is able to locate and secure an archwire in position. 22. An orthodontic appliance according to claim 1 substantially as hereinbefore described with reference to any one of the drawings. 23. A pin according to claim 13, substantially as hereinbefore described with reference to any one of Figures 9 to 24 or Figure 33. 24. A pin, according to claim 15, substantially as hereinbefore described with reference to any one of Figures 25 to 32. 25. A method according to claim 16 substantially as hereinbefore described with reference to any one of the drawings. 26. A method according to claim 19 substantially as hereinbefore described with reference to Figures 25 to 32.

Inventors: GOLDSCHMIED FELIX, GOLDSCHMIED, FELIX
Applicants: GOLDSCHMIED FELIX, GOLDSCHMIED PTY LTD, GOLDSCHMIED PTY. LTD., GOLDSCHMIED, FELIX
Application year: 1996
Main classification: A61C7
IPC codes: A61C7