Abstract:
A method and apparatus to improve and accelerate orthodontic tooth movement and alveolar bone apposition and resorption, constituted of a device providing biocompatible contact anode in contact with gingival epithelia at the area of osteoclastic activity, and biocompatible contact cathode in contact with gingival epithelia at the area of osteoblastic activity, arranged to apply electric current across the anode and the cathode to stimulate alveolar bone remodeling. The method and apparatus provide for an electronic circuit that is pre-programmed via wireless communication to adjust the electric current magnitude and time duration so as to enhance tooth movement, oseteogenesis, and osteoclasia.

Description:
[0001]    This invention relates to orthodontic techniques in general, and the reduction in time required for specific tooth movements in particular. 
       BACKGROUND OF THE INVENTION 
       [0002]    For well over a century, orthodontists have been engaged in the process of repositioning teeth from a bad relationship, or “malocclusion,” into a healthier and more esthetic arrangement. In order to move teeth, three elements are generally required: 1) force, 2) time and 3) space. The mouth responds to a sustained force placed on a tooth by rearranging, or “remodeling,” the jawbone around the root of the tooth. This remodeling creates space around the tooth allowing the tooth to move in the direction of the force. Not only does the tooth need space within the jawbone, but it is also imperative to have or create spacing between the teeth in order for movement to occur. 
         [0003]    Over the years, orthodontists have invented devices, generally referred to as an “appliance,” that permit clinicians to deliver sustained forces to the teeth. Braces, or “orthodontic brackets and arch wires,” are the classic appliances that most, if not all, orthodontists use. Braces consist of small brackets that are glued, or “bonded,” to the crowns of teeth, and a wire is then inserted into slots in the brackets and held into place with a ligature or clip. The brackets do not generate forces themselves, but rather transfer forces to the teeth from the deflected wire, when it is inserted into the slot on the bracket and held in place by the ligature. The wire has a “memory,” i.e., a characteristic by which the wire tends to return to its original shape, and in doing so, exerts a force on the bracket that is in turn transmitted to the tooth. Through the application of various types, shapes and sizes of wires, the teeth eventually align themselves into a more ideal occlusion. The technical term used among orthodontists to describe braces is “comprehensive fixed appliance.” 
         [0004]    Because the orthodontic treatment takes a long time, and of the obvious drawbacks of having foreign objects glued to a patient&#39;s teeth, appliances have been heretofore developed that can be inserted and removed by the patient, and worn part-time. A myriad of removable appliances have been developed over the years, but the vast majority of them are not “comprehensive” in nature. In other words, the removable appliances address specific movements or malocclusions, and are only used for a certain limited period of time. Treatment with removable appliances is often used in conjunction with braces or other appliances. 
         [0005]    As mentioned above, Orthodontic tooth movement presently is accomplished by the application of mechanical forces to teeth. An apparatus is connected inside the mouth of a patient which applies, through the use of springs, rubber bands, composite material casting apparatus or other means, a mechanical force in the direction of desired tooth movement. These forces cause the bone to resorb (be removed) in the direction of force and cause the bone to grow on the other side of the tooth, to fill-up the space created by the movement of the dental root in the direction of the force. 
         [0006]    This process of orthodontic force application enables teeth to move in the mouth within the boundaries of the neighboring teeth and tissues. The tooth movement is clarified by Wolffs Law which states, in effect, that bone under mechanical stress is remodeled to accommodate and reduce the stress. The common practical aspect to known techniques of orthodontic movement is that the mechanical apparatus, commonly referred to as “braces,” must be worn by the patient for extended periods of time, often several years or more in order to achieve the desired results. The classic orthodontic tooth movement treatment that requires the continuous application of forces to create the necessary tooth movement is expensive as it requires frequent modifications of the magnitude and direction of forces applied to different teeth to achieve the necessary results, requiring frequent adjustments by the treating Orthodontist. Moreover, wearing the mechanical fixtures known as “braces” creates a considerable discomfort for the patient, and at the same time this condition will cause an aesthetic concern to the patient as the mechanical fixtures (Braces) are visible to other people. In addition, the braces enable the accumulation of bacteria and viruses, harmful to the teeth and their surrounding tissues. For these reasons, it is very desirable to shorten the duration of orthodontic treatment in each and every case. 
         [0007]    U.S. Pat. No. 3,842,841 teaches the application of a direct current to aid healing of bone fractures in the human body, but requires surgical implantation. A negative electrode (cathode) is surgically inserted into the site of a fracture, and a positive electrode (anode) is taped to the skin elsewhere. The precise biological process is complex; and the current flowing through the fractured bone increases the healing rate of the damaged bone tissue thus reducing the healing time of the injury, enabling the patient to return to normal life in many instances much faster relative to the classical treatment that is not using direct current as used in the prior art above. 
         [0008]    U.S. Pat. No. 4,153,060 teaches a method and apparatus for electrically stimulating bone growth and tooth movement in the mouths of humans. A positive electrode is placed on the gum surface adjacent the bone structure which is to be resorbed. A negative electrode is placed on the gum surface adjacent the bone tissue which is to be accreted or built up. A current source is connected, such that a small current flows between the electrodes, which have the effect of stimulating bone growth in a specific direction. In a particular arrangement, the electrodes are placed on the gum surface adjacent a tooth, the positive electrode on the side towards which the tooth should move, and the negative on the side from which the tooth will move. Application of a small current to the electrodes will enhance the repositioning of the tooth in conjunction with normal orthodontic practices. 
         [0009]    U.S. Pat. No. 4,854,865 teaches an improved method of orthodontic electro-osteogenesis using a biocompatible anode in contact with an electrolytic gel between the anode and epithelial gingiva at an area of osteoclastic or osteoblastic activity, and a biocompatible cathode in contact with a different type of electrolytic gel between the cathode and epithelial gingiva at an area of osteoclastic or osteoblastic activity. Electric current is then applied across the anode and cathode to stimulate osteogenesis. This method stimulates osteogenesis, which is a crucial element in tooth movement but is unable to demonstrate how to achieve desirable results, or to enable to complete orthodontic treatment in a shorter amount of time. 
         [0010]    To date, there have been no recognizable inventions that demonstrate improvements in enhancing tooth movement, non-invasively, with the ability to effect one tooth or many teeth, to reduce the total amount of time over which an orthodontic appliance must be used in order to accomplish a given amount of tooth movement or repositioning. 
         [0011]    It is therefore an object of this invention to provide a method to accelerate tooth movement which will shorten the overall time a patient has to wear an orthodontic appliance system which will overcome the drawbacks of the prior art. 
       SUMMARY OF THE INVENTION 
       [0012]    Therefore, in view of the foregoing, it is an object of the present invention to reposition teeth in a patient&#39;s mouth by applying an electrical potential to the patient&#39;s gums in the immediate vicinity. 
         [0013]    It is a further object of the present invention to increase the rate of movement of teeth undergoing mechanical stress in accordance with known orthodontic practices. 
         [0014]    Actors in this operation are cells capable of responding to a circuit mounted in an housing that will be placed in conjunction with any type of existing orthodontic appliance for providing the necessary electric current output to electrodes located adjacent to a tooth to be positioned, in such a manner that electric current polarity, electric current direction and electric field strength will all increase the rate of teeth movement undergoing mechanical stress in accordance with known orthodontic practices. 
         [0015]    It is an additional object of the present invention to provide a method and apparatus for stimulating and controlling bone growth in a patient&#39;s mouth in order to correct alveolar bone defects, close cleft palates, or maintain the alveolar ridge in edentulous patients (those who have lost their teeth). 
         [0016]    In accordance with the above, the other objects, a method and apparatus for the initiation and enhancement of tooth movement comprises the disposition of an anodic electrode of a particular size and shape in the direction of applied force and a cathodic electronic of a particular size and shape on the opposite side of the tooth to be moved. A current source is connected to the two electrodes which causes the tooth to be repositioned in combination with an existing orthodontic appliance. 
         [0017]    In accordance with the above, yet another objective of the present invention will be to benefit from the ability to administer simultaneously two or more methods to cells capable of responding to an exposure to each method alone from the biological, cellular and molecular stand point of tooth structure. The present invention will further show that the combined application of tooth pushing force and electric current together, which evokes additive or synergistic responses by the affected cells, allows the treating Orthodontist to reduce the dose of each of the stimulating factors in order to achieve an optimal response. This principle means that the addition of exogenous electric currents, which is the principle of the present invention, to the orthodontic mechanical force will enable the treating Orthodontist to reduce the amount of mechanical pressure necessary to achieve the desired results, and by following the teachings of the present invention will reduce the risk of root resorption associated with the application of orthodontic force alone. 
         [0018]    The novelty and usefulness of this invention is that the application of a specific electric current, through appropriate surface electrodes in the mouth, also can be utilized to stimulate bone accretion in the vicinity of a cathodic electrode and bone resorption in the vicinity of an anodic electrode, and that this biological stimulation accelerates the velocity of orthodontic tooth movement. 
         [0019]    In accordance with the above, yet another objective of the present invention will be the augmentation of orthodontic anchorage non-invasively applying an electrical potential to the patient&#39;s gums in the immediate vicinity. Modern orthodontics is a field of medicine based on an understanding of growth and development, and is implemented by biomechanics. The biological response to the mechanical force(s) applied to the teeth will determine changes in their position. Inherent in this mode of therapy is Newton&#39;s third law of physics which states that for every action there is an equal and opposite reaction. A common example in orthodontics illustrating this point is when protruding upper front teeth are retracted against the posterior teeth (referred to as the anchorage segment/unit) of either arch, which causes the latter to be protracted in reaction. This is not always a desirable side effect and attempts to negate it are numerous, and are based on altering the balance on the mechanics side of the equation. However, our ever increasing understanding of the biology of tooth movement has offered the clinician a non-invasive simplistic method of altering this imbalance on the biological side of the equation. To achieve this, the specific made and fit appliance to a patient&#39;s mouth comprising the application of a specific electric current, through appropriate surface electrodes in the mouth, can be directed (with specifically placed electrodes), to cause bone apposition in areas to where tooth movement needs to be minimized, while causing bone resorption where movement is desired simply by changing the direction (polarity) of the flow of current in each of these areas. This effect can be modified according to the stage of treatment for the individual patient by programming the above mentioned specific appliance to perform the above mentioned function. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0020]    The invention will now be described with reference to the accompanying drawing which is a plain illustrative view of the apparatus which operates in accordance with the method for the invention. 
           [0021]      FIG. 1  is a schematic illustration of a longitudinal section of a human mandibular canine. 
           [0022]      FIG. 2  is a schematic illustration of some physical changes that result from application of an orthodontic force to a tooth. 
           [0023]      FIG. 3  is a schematic presentation of the rationale for the location of the electrodes on the gingival tissues near teeth undergoing orthodontic treatment. 
           [0024]      FIG. 4  illustrates the electric field strength between Anode and Cathode made at the same size. 
           [0025]      FIG. 5  illustrates the electric field strength between Anode and Cathode made at different size. 
           [0026]      FIG. 6  illustrates a simplified orthodontics particular tooth movement required by the repositioning teeth into a healthier and more esthetic arrangement. 
           [0027]      FIG. 7  illustrates a simplified orthodontic particular tooth movement required by the repositioning teeth and the required placement of anode and cathode for accelerating tooth movement. 
           [0028]      FIG. 8  illustrates a simplified orthodontic particular tooth rotational movement required by the repositioning teeth and the required placement of anodes and cathodes for accelerating tooth movement. 
           [0029]      FIG. 9  illustrates orthodontic personalized brace that places the Anodes and Cathodes based on the particular tooth movement required by the repositioning of teeth into a healthier and more esthetic arrangement. 
           [0030]      FIG. 10  illustrates orthodontics personalized brace that places the Anodes and Cathodes based on the particular tooth movement mounted On the patient jaw. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0031]    Referring to FIG.  1 ., there is shown a schematic illustration of a longitudinal section of a human mandibular canine. The tooth is comprised of a crown  100  and a root  101 . Centrally located within the body of the tooth is its root canal  102 . The crown is visible in the mouth, while the root is not, because it is encased in soft connective tissue fibrous mesh known as the periodontal ligament (PDL)  103 , and the PDL is surrounded by alveolar bone  104 . The alveolar bone faces the PDL on one side, and is covered by the gingival and mucosal tissue (gum)  105  on the other. All these tissues, dental and paradental, contain living cells, which are responsible for the remodeling of all these tissues in response to orthodontic forces. This remodeling process is the mechanism that facilitates orthodontic tooth movement. 
         [0032]    Referring to  FIG. 2 , there is shown a schematic illustration of some physical changes that result from application of an orthodontic force to a tooth  100 . The mechanical forces and moments are applied to affect the desired type of tooth movement. Accordingly, a tooth may be extruded, intruded, rotated, tipped, or translated. This figure illustrates a translatory movement which results from a translational force  107  and a rotation  106  of the crown around a center of rotation, or fulcrum, located near the apex of the root. In order to insure a translatory movement a force couple is created opposite to the rotational force  106 . This force couple (generated by the interaction between the bracket and the arch wire for braces, and attachments and aligners for Invisalign) creates a moment that moves the root along with the crown extending the center of rotation from the apex to infinity. The translational force  107  literally pushes the root against the alveolar wall of bone  104 , opposite to the point of force application, compressing the PDL  109 . Likewise, on the side of the tooth where the force  107  is being applied, the PDL is being stretched  108 . In the latter case, the dental root  101  is displaced within the alveolar bone dental socket  104 , and the PDL  103  responds by widening  108  and compressing  109 . In the latter case, the dental root  101  is displaced within the alveolar bone dental socket  104 , and the PDL  103  is stretched on the aspect of the dental root being distanced from the alveolar bone  108 . In contrast, the opposing aspect  101 , pressure is created in the PDL  109  as a result of approximating the root  101  toward the alveolar bone  104 . 
         [0033]      FIG. 3 , there is a schematic presentation of the rationale for the location of the electrodes on the gingival tissues near teeth undergoing orthodontic treatment. When a tooth is undergoing translatory movement, as depicted in  FIG. 2 , the alveolar bone facing the compressed PDL  109  undergoes removal (resorption), while in zones where the PDL is stretched  108 , new layers of bone are deposited on the surface of the old alveolar bone. Over time, the alveolar bone socket  104  remodels, allowing the tooth to assume a new position in the place that the translational force  107  caused it to move. This remodeling is a direct result of, and consistent with, the compression/resorption and stretching/deposition activity in the PDL and juxtaposed alveolar bone. When alveolar bone is pressed upon, as occurs when a translational force  107  presses on a tooth and the PDL compresses, a short-lived electrical spike can be measured across the alveolar  104  bone&#39;s matrix. This is known as a piezoelectric effect, characterized by the negative side (cathode) of the potential being detected on the concave side of the flexed bone and that contain positive side (anode) of the potential being detected on the convex side. In addition, the mechanical stress causes movement of tissue fluids. These fluids contain electrical charges that change the cellular electric polarity, stimulating the cells to remodel their surrounding matrices. These stress-generated streaming potentials (SGP) last about 20-30 minutes. When the bone is held in a flexed state, the concave side experiences bone deposition and the convex side experiences bone resorption. As long as the bone remains flexed, this process continues over time until the previously flexed bone appears unflexed or straight. Our research has revealed that by applying minute electrical direct currents to oral tissues, the underlying bone exhibits similar patterns of deposition (cathode  110 ) and resporption (anode  111 ) observed following the application of orthodontic treatment. In this manner, simultaneous applications of mechanical forces and electric current will augment the apposition and resorption of bone, thereby reducing the resistance of the bone, enhancing translation and accelerating the velocity of tooth movement. 
         [0034]      FIG. 4 . shows a schematic presentation of an anode  120  placed in parallel to a cathode  121  at a particular distance, and when electric voltage is applied on the said anode  120  and cathode  121 , the electric current that flows through the media between the anode  120  and cathode  121  will form an electric field that the equi-potential lines  122  will be as shown in  FIG. 4  herein. The distance between anode  120  and cathode  121  and the media in between will influence the curvature of the electric field  122 . In this preferred embodiment the use of identical size anode and cathode will limit the volume of human tissue that is influenced by the electric field and electric current that is in between the anode and cathode. 
         [0035]      FIG. 5  shows a schematic presentation of a large diameter size anode  123  placed in parallel to a smaller diameter size cathode  124  at a particular distance, and when electric voltage is applied on the said larger anode  123  and smaller size cathode  124 , the electric current flow through the media in between the anode  123  and cathode  124  will form an electric field that the equi-potential lines  125  will be as shown in  FIG. 5  herein. The distance between the larger size anode  123  and smaller cathode  124  and the media in between will influence the curvature of the electric field  125 . In this yet another preferred embodiment, the use of a larger anode  124  with a smaller size cathode  125  will increase the volume of human tissue that is influenced by the electric field and electric current that is in between the anode and cathode. In yet another preferred embodiment the anode  123  will be of a smaller diameter size while the cathode  124  will be of a larger diameter size to change the electric field influence on the human tissue that is placed between the anode  123  and cathode  124 . 
         [0036]      FIG. 6  is a schematic presentation of a human lower jaw  130 , with the gum tissue  131 , where the canine tooth  132  needs to be moved in the direction  133  shown herein. The need to move the canine tooth  132  is determined by an Orthodontist that is treating a patient in the process of repositioning teeth from a bad relationship, or “malocclusion,” into a healthier and more esthetic arrangement. In this preferred embodiment the use of canine tooth is for illustration and for explanation of this invention. Referring to FIG.  6 .,  135  is the vertical axis that is parallel to the center line of jaw,  131 , while  134  is the orthogonal axis that will be referred to as the x axis. The desired canine tooth movement vector  133  can be defined by an angle  136  in relation to a jaw x axis  134 . In this preferred embodiment the Orthodontist will define the corrective need to move the canine tooth at a magnitude defined by vector  133 , measured in millimeters, and the movement direction in relations to x axis  136  with angle  133  measured in degrees. 
         [0037]      FIG. 7  is a schematic presentation of a human lower jaw  130 , with the gum tissue  131 , where the canine tooth  132  needs to be moved at the direction  133  shown in  FIG. 6  above. The need to move the canine tooth  132  is determined by an Orthodontist who is treating a patient in the process of repositioning teeth from a bad relationship, or “malocclusion,” into a healthier and more esthetic arrangement. In this preferred embodiment the use of the canine tooth is for illustration and for explanation of this invention. Referring to  FIG. 7 , the direction of moving canine tooth  132  shown by vector  133  of  FIG. 6  above will create the imaginary center line  137  shown in  FIG. 8  herein. In this preferred embodiment, the imaginary center line that is aligned and parallel to the canine tooth desired movement shown in  133  of  FIG. 6 , will be used to place cathode  139  at the labial (lip) side of the gum line  131 , whereas the anode  138  will be placed at the lingual (tongue) side of the gum tissue  131 . The centerline of the cathode  139  and anode  138  will be parallel and aligned with the desired canine tooth movement  133  of  FIG. 6  above. In this preferred embodiment the anode  138  and cathode  139  are of the same diameter and size to guide the electric current activity at the root of the canine tooth. In yet another preferred embodiment the cathode  139  will be of a larger diameter size whereas the anode  138  will be at a smaller diameter size to distribute the electric field over larger area in the canine tooth root. And yet in another preferred embodiment, the anode  138  will be of a larger diameter size, whereas the cathode  139  will be of a smaller diameter size to distribute the electric field over larger area in the canine tooth root. In this preferred embodiment the polarity of the electric filed which is set by the placement of the anode  138  and the cathode  139  will be perfectly aligned and parallel with the axis  137  that is parallel and aligned with the canine tooth desired movement vector  133  of  FIG. 6  above. In yet another preferred embodiment where the canine desired tooth movement vector  133  of  FIG. 6  above will be parallel to  133  of  FIG. 6  above but in an opposite direction, the placement of anode  138  and cathode  139  will be different, such that in this yet another preferred embodiment where the canine desired tooth movement vector  133  of  FIG. 6  is 180 degrees opposite in direction from what is shown in  FIG. 6  above, than in this yet another preferred embodiment the anode will be placed at  139  shown in  FIG. 7  and the cathode will be placed at  138  to support the opposite desired canine tooth movement. 
         [0038]    In this preferred embodiment the electric current characteristics will be of a Direct Current with the capabilities to regulate and deliver constant current of 20 micro-Amperes (20 millionth of a one Ampere current) for duration of 4 hours, while the treated patient will wear the appliance  140  of  FIG. 8  below. In yet another preferred embodiment, the Direct Current will be varied constantly in a range of 15-25 micro-Amperes for durations that will be 3 to 5 hours. In this preferred embodiment, the appliance  140  of  FIG. 8  below, will be recharged during the time that it will not be in use, preferably during day time, so the appliance  140  of  FIG. 8  would be used by the treated patient during the night hours while sleeping. In this preferred embodiment, the electronic circuit will be preprogrammed by the treating Orthodontist to operate for 4 hours and to regulate both the Direct Current voltage and the electric current to be 20 micro-Amperes. 
         [0039]      FIG. 8  is a schematic presentation of a human lower jaw  130 , with the gum tissue  131 , where the canine tooth  132  needs to be moved at the rotational direction  142  shown herein, the need to move the canine tooth  132  is determined by an Orthodontist who is treating a patient in the process of repositioning teeth from a bad relationship, or “malocclusion,” into a healthier and more esthetic arrangement. In this preferred embodiment the use of the canine tooth is for illustration and for explanation of this invention. Referring to  FIG. 8 , in this another preferred embodiment, the direction of rotational movement of canine tooth  132  shown by motion symbol  142 , will create the imaginary center line  147  shown in  FIG. 8  herein, representing canine tooth  132  movement of one side as part of the rotational canine tooth movement, and the other imaginary center line  148  shown in  FIG. 8  herein, representing the canine tooth  132  movement on the other side as part of the rotational movement of the canine tooth  132  shown herein. In this preferred embodiment, the 2 imaginary center lines that are aligned and parallel to the canine tooth  132  desired rotational movement, will be used to place cathodes  143  and anode  144  at the labial (lip) side of the gum line  131 , whereas the anodes  146  and cathode  145  will be placed at the lingual (tongue) side of the gum tissue  131 . The centerline of the cathode  143  and anode  146  will be parallel and aligned with the desired canine tooth rotational movement  142  of  FIG. 8  herein, and at the same time the center line of cathode  145  and anode  144  will be parallel and aligned with the desired canine tooth rotational movement  142  of  FIG. 8  herein. 
         [0040]    In this preferred embodiment the anodes  144  and  146  and cathode  143  and  145  are of the same diameter and size to guide the electric current activity at the root of the canine tooth. In yet another preferred embodiment the cathodes  144  and  146  will be of a larger diameter size whereas the anodes  143  and  145  will be at a smaller diameter size to distribute the electric field over larger area in the canine tooth root. And yet in another preferred embodiment, the anodes  143  and  145  will be of a larger diameter size, whereas the cathodes  144  and  146  will be of a smaller diameter size to distribute the electric field over larger area in the canine tooth root. In this preferred embodiment the polarity of the electric filed which is set by the placement of the anodes  143  and  145  and the cathodes  144  and  146  will be perfectly aligned and parallel with the axis of rotation defined by symbol  142  that are parallel and aligned with the canine tooth desired rotational movement direction  142  shown herein. In yet another preferred embodiment where the canine desired tooth rotational movement will be in an opposite direction to rotational direction  142  shown herein, the placement of anodes  143  and  145  and cathodes  144  and  146  will be different, such that the anodes will be placed at  144  and  146  shown in  FIG. 8  and the cathodes will be placed at  143  and  145  to support the opposite desired canine rotational tooth movement. 
         [0041]    In this preferred embodiment the electric current characteristics will be of a Direct Current with the capabilities to regulate and deliver constant current of 20 micro-Amperes (20 millionth of a one Ampere current) for duration of 4 hours, while the treated patient will wear the appliance  140  of  FIG. 9  below. In yet another preferred embodiment, the Direct Current will be varied constantly in a range of 15-25 micro-Amperes for durations that will be 3 to 5 hours. In this preferred embodiment, the appliance  140  of  FIG. 9  below will be recharged during the time that it will not be in use, preferably during day time, so the appliance  140  of  FIG. 9  would be used by the treated patient during the night hours while sleeping. In this preferred embodiment, the electronic circuit will be preprogrammed by the treating Orthodontist to operate for 4 hours and to regulate both the Direct Current voltage and the electric current to be 20 micro-Amperes. 
         [0042]      FIG. 9 . is a schematic presentation of a complete appliance  140 , prepared to fit a particular patient&#39;s lower jaw  130  herein. In this preferred embodiment in the appliance  140  provided a section  142  which holds the anode  138  of  FIG. 7  above, connected to an internal electronic circuit that provides the positive voltage connected to the anode  138  of  FIG. 6  above. Also, in this preferred embodiment in the appliance  140  provided a section  141  which holds the cathode  139  of  FIG. 7  above, connected to an internal electronic circuit that provides the positive voltage connected to the cathode  139  of  FIG. 6  above. In this preferred embodiment the appliance  140  will provide the location and the means to contact the anode  138  of  FIG. 7  above and the correct location, and the appliance  140  will provide the location and the means to contact the cathode  139  of  FIG. 7  above and the correct location so the centerline of the anode  138  and cathode  139   137  of  FIG. 7  will be perfectly aligned and parallel with the canine desired tooth movement vector  133  of  FIG. 6  above. 
         [0043]      FIG. 10  is a schematic presentation of a complete appliance  140  that is mounted on the patient&#39;s jaw  130 .