Abstract:
Methods and kits of materials and supplies for forming a dental prosthesis by an injection molding process in situ in a patient&#39;s mouth so as to correct the imperfect teeth of the patient&#39;s dentition. The imperfect teeth are corrected by injection molding the dental prosthesis in situ in the patient&#39;s mouth using a mold of a corrected model of the patient&#39;s dentition placed over the imperfect teeth. Adjacent teeth are covered with a polymer release material prior to injection molding of teeth to be corrected, such that the teeth to be corrected have at least one tooth between them draped with the polymer release material to provide a space adjacent to each of the corrected teeth. The corrected teeth are then covered with the polymer release material in a second round of treatment to complete the procedure on the remaining teeth.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]     Not Applicable  
       STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT  
       [0002]     Not Applicable  
       BACKGROUND OF THE INVENTION  
       [0003]     (1) Field of the Invention  
         [0004]     The present invention relates generally to dental prosthesis, and more particularly to methods of forming dental prosthesis. Specifically, the present invention relates to methods of forming dental prosthesis in situ in a patient&#39;s mouth by injection molding using a mold of a corrected model of the patient&#39;s dentition.  
         [0005]     (2) Description of the Related Art  
         [0006]     U.S. Pat. No. 3,808,687 to Millet teaches pontics with a rigid core formed of a plastic material such as acrylic, lucite, plexiglass or other hard material, and detachable cap formed of a flexible plastic such as polyethylene which have the external contours of a natural tooth. The external configuration of the cap is substantially the same as the porcelainized portion of the restoration to be formed. The pontics are used for creating an investment mold for casting a metal frame of gold or other suitable materials to which porcelain is applied. The dental restoration is then fit into the patient&#39;s mouth.  
         [0007]     U.S. Pat. No. 3,987,545 to Kennedy teaches methods for forming a temporary dental prosthesis as a bridge in situ in a patient&#39;s mouth for restoration of missing or broken teeth. The method utilizes a positive model of the patient&#39;s mouth which is corrected to the desired size and shape of the teeth to be restored. An elastomeric mold is formed using the model as a pattern which is fitted over the patient&#39;s jaw. A self-curing liquid resin is drawn into the cavity by vacuum across the bridge to form the dental prosthesis which is removed and then cemented in place. This requires that a good seal be provided between the jaw and the mold.  
         [0008]     U.S. Pat. No. 4,080,736 also to Kennedy teaches a method and apparatus for forming a dental prosthesis for restoration of a patient&#39;s teeth. An elastomeric mold and a hard model are secured together to form an assembly with a mold cavity within. The assembly is placed in a vacuum chamber to produce a vacuum inside the chamber and the mold. When a connection between a source and the assembly is opened a liquid material is pushed into the mold cavity to form the prosthesis, which is then installed in the patient.  
         [0009]     U.S. Pat. No. 4,129,946 to Kennedy teaches hollow dental crown forms, preferably co-polyester plastics, having the shape of a natural tooth for holding and shaping composite resin material applied to a tooth which requires restoration. A tab which provides a gripping handle is formed at the base of the crown form, and a flange is formed around the base of the crown form. The crown is then installed in the patient.  
         [0010]     U.S. Pat. Nos. 5,192,207 and 5,332,390 to Rosellini teach crowns or replacement teeth and methods of production thereof. The crown or replacement teeth are formed by filling a transparent shell tooth with a light setting resin and disposing the filled transparent shell tooth onto a prepared tooth of a patient. The filled shell tooth is illuminated to set the resin and bond it to the shell tooth form. Polishing and shaping are then done in situ to form the crown.  
         [0011]     U.S. Pat. No. 5,775,913 to Updyke et al. teach a method of making caps of eight different sizes for each of a persons teeth. The caps are preferably prepared from quartz or silicon dioxide filled acrylic materials. The caps can be placed over a prepared tooth and exposed to ultraviolet light to form the solid capped tooth.  
         [0012]     U.S. Pat. No. 5,984,682 to Carlson teaches permanent composite dental bridges constructed either in situ or ex situ. The material is applied in the in situ process between abutment teeth and wings formed from the composite material are attached to surfaces of the abutment teeth before curing. These steps are successively repeated until a dental bridge is form within the patient&#39;s mouth. A gingival stent is used as a platform upon which the composite laminations are formed, and is removed after the formation of the bridge prior to contouring and finishing of the bridge.  
         [0013]     U.S. Pat. No. 6,769,913 to Hurson discloses an impression cap and methods of taking dental impressions in a patient&#39;s mouth by injecting an impression material into an inner cavity of the impression cap. The impression cap is then removed from the patient&#39;s mouth for the fabrication of a dental restoration.  
         [0014]     While the related art teach various methods of forming dental prosthesis in situ, there still exists a need for an improved method of forming injection molded dental prosthesis in situ in a patient&#39;s mouth.  
       OBJECTS  
       [0015]     Therefore, it is an object of the present invention to provide an improved method of forming dental prosthesis in situ in a patient&#39;s mouth by injection molding.  
         [0016]     It is further an object of the present invention to provide a kit of materials, supplies and instructions for correcting the teeth of a patient by the provided methods.  
         [0017]     These and other objects will become increasingly apparent by reference to the following description.  
       SUMMARY OF THE INVENTION  
       [0018]     The present invention provides a method for restoring teeth in need of restoration in a patient by providing a fluid dental restoration polymer composition which is curable on prepared teeth to be restored and curing the composition to provide the composition bonded to the prepared teeth in providing restored teeth, the improvement which comprises: (a) preparing selected teeth to be restored for bonding with the fluid polymer composition; (b) covering teeth which are not to be restored with a polymer release material; (c) fitting a clear polymer composition mold over the teeth to be restored and the teeth not to be restored, which mold provides a closed space to be filled between the teeth to be restored and the mold which defines a shape of the restored teeth, wherein the mold has an inlet port for injection of the fluid polymer composition and an outlet port for removing any excess air and/or excess fluid polymer resulting from the injection; (d) injection molding the fluid polymer composition into the mold to fill the space in the mold with the covered teeth and the teeth to be restored; (e) curing the fluid polymer composition onto the teeth to be restored in the clear polymer composition mold; (f) removing the mold from the teeth and the tape from the covered teeth to provide the restored teeth in the patient; and (g) optionally finishing exposed surfaces of the restored teeth, if necessary.  
         [0019]     In further embodiments of the method, the polymer release material is polytetrafluoroethylene. In still further embodiments the polymer release material is in tape which is preferably about 1.5 cm wide and about 0.2 mm thick. In still further embodiments the clear polymer composition mold comprises a clear plastic tray filled with a cured clear plastic polymer composition and which is derived from a prepared model with the teeth as they will be restored in the patient, and wherein the inlet and outlet ports are drilled into the mold. In further embodiments a dental cast is prepared from an impression of the teeth to be restored, then a dental stone model is prepared, and then the stone model is modified to simulate the restored teeth as they will be restored. In further embodiments the fluid polymer composition is cured with light. In still further embodiments the fluid polymer composition is cured with ultraviolet light of about 465 nm to about 480 nm. The activating ultraviolet light of 465 nm to 480 nm is directed throught the clear, light-transmitting mold for the purpose of hardening or curing the light-sensitive fluid polymer composition for the dental restoration. In further embodiments of the method, the dental restoration fluid polymer composition is a particle filled and pigmented poly(acrylicacid)polymer containing a curing agent activated by light. In still further embodiments the dental stone model is modified with a wax shaped to simulate the restored teeth. In further embodiments of the method, in step (a) prepared teeth are etched with an acid and then coated with a primer and bonding agent for bonding the dental restoration fluid polymer composition to the prepared teeth. In preferred embodiments the bonding agent comprises methacrylate ester monomers and the primer comprises alkyl dimethacrylate resins. In further embodiments of the method alternate of the teeth to be restored are restored in two or more repetitions of the steps (a) to (e).  
         [0020]     The present invention provides a kit for restoring teeth by injection molding and curing a dental restoration fluid polymer composition onto teeth in need of restoration in a patient which comprises: (a) mold forming means for providing a clear polymer mold which mold provides a closed space to be filled with the fluid polymer composition between the teeth to be restored and the mold and which defines a shape of the restored teeth, wherein the mold has an inlet port for injection of the fluid composition polymer and an outlet port for any excess air and/or excess fluid polymer; (b) a polymer release material for covering teeth which are not to be restored in the clear polymer mold; and (c) a fluid dental restoration polymer composition curable by light for bonding to the teeth to be restored.  
         [0021]     In further embodiments of the kit the fluid polymer composition comprises particles and pigment in a poly(acrylicacid) polymer composition containing a curing agent activated by light. In still further embodiments, the kit contains in addition an acid etchant for the teeth to be restored, a primer for these teeth and a bonding agent for bonding the fluid polymer composition to these teeth. In preferred embodiments the bonding agent comprises methacrylate ester monomers and the primer comprises alkyl dimethacrylate resins. In still further embodiments, the kit in addition can optionally contain a ceramic powder for forming a dental stone impression model of the prepared teeth of the patient and a modeling material such as a dental wax for modifying the dental stone model to simulate the restored teeth in the patient. In still further embodiments the polymer release material is a polytetrafluoroethylene tape. In preferred embodiments, the polymer release material is a polytetrafluoroethylene tape which is about 1.5 cm wide and about 0.2 mm thick. In further embodiments of the kit containing the clear plastic tray, a curable clear polymer composition to provide an impression of a dental cast or model of the teeth to be restored to provide the mold. In further embodiments of the kit, comprising in addition instructions for performing the method steps of Claim  1 . In still further embodiments of the kit, comprising in addition instructions for performing the method steps of Claim  1  and wherein the instructions call for restoration of alternate teeth to be restored in two or more of steps (a) to (e). 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0022]      FIG. 1  shows a patient&#39;s teeth  10  to be restored.  
         [0023]      FIG. 2  shows an impression  14  being taken of the current condition of the patient&#39;s teeth  10  to be restored.  
         [0024]      FIG. 3  shows a cross-section of a tooth  12  taken along line  3 - 3  of  FIG. 2 .  
         [0025]      FIG. 4  shows a plaster model  16  cast from the impression  14  taken of the current condition of the patient&#39;s teeth.  
         [0026]      FIG. 5  shows a waxed-up model  20  which is constructed from the plaster model  16  having desired changes made with the addition of dental wax  18 .  
         [0027]      FIG. 6  shows clear impression material  22  which remains over the waxed-up model  20  after removal of the impression tray.  
         [0028]      FIG. 7  is a cross-section of the waxed-up model  20  taken along line  7 - 7  of  FIG. 6  showing the mold  24  having desired changes over the plaster model  16  with the dental wax  18  corrections.  
         [0029]      FIG. 8  is a cross-section of the mold  24  taken along line  7 - 7  of  FIG. 6  after removal of the clear impression material  22  from the waxed-up plaster model.  
         [0030]      FIG. 9  is the mold  24  having desired changes after removal from the waxed-up model and cutting of the ingress holes  40  and vent holes  42  adjacent to each of the teeth.  
         [0031]      FIG. 10  shows preparation of the patient&#39;s teeth  10  by roughening the teeth with a fine diamond bur  44  and covering the teeth with a polymer release material  48 .  
         [0032]      FIG. 11  shows application of a bonding resin primer after teeth have been etched.  
         [0033]      FIG. 12  shows light curing of a bonding agent applied after the bonding resin primer.  
         [0034]      FIG. 13  shows injection of the flowable composite resin  54  with a syringe  56  having a narrow tip.  
         [0035]      FIG. 14  shows curing of the flowable composite resin using a curing light  52 .  
         [0036]      FIG. 15  shows removal of the tray and mold  24 , polymer release material  48 , and excess resin  60  prior to smoothing and polishing the restored teeth  10 .  
         [0037]      FIG. 16  shows the restored teeth  10  wrapped polymer release material  48  in preparation for a second round of restoration. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0038]     All patents, patent applications, government publications, government regulations, and literature references cited in this specification are hereby incorporated herein by reference in their entirety. In case of conflict, the present description, including definitions, will control.  
         [0039]     The term “polymer release material” as used herein refers to a material such as a tape for wrapping or draping untreated teeth. The material acts as a parting agent, preventing the molded composite from sticking to a surface covered with the material. The term refers to a material including, but not limited to tape such as a pipe thread tape including polytetrafluoroethylene (PTFE) pipe thread tapes. One example of the polymer release material is TEFLON® pipe thread tape (DuPont, Wilmington, Del.).  
         [0040]     The term “model” refers to a dental cast commonly referred to as a plaster model or a dental stone model which reflects the current condition of the patient&#39;s teeth. Preferably, the model comprises a gypsum die stone. More preferably, the gypsum die stone further comprises a resin including but not limited to acrylic, polyester, urethane or epoxy resins. Most preferably, the gypsum die stone material for the dental model is AMERICAN DIEROCK® resin die stone marketed by American Diversified Dental Systems of Anaheim, Calif.  
         [0041]     The term “modeling material” as used herein refers to any material used for the modification of dental models such as dental waxes.  
         [0042]     The term “fluid polymer composition” as used herein refers to a flowable material which can be cured to harden the material, including dental composite resins. The fluid polymer composition is preferably curable by exposure to light, however chemical curing is within the scope of the invention. Most preferably, the composition is cured with ultraviolet light of about 465 nanometers (nm) to about 480 nm. One example of a composite resin is HELIOMOLAR® Flow composite (Ivoclar Vivadent, Amherst, N.Y.) which is a monomer matrix of 2,2-bis-4-(3-methacryloxy-2-hydroxypropoxy)-phenylpropane (Bis-GMA), urethane dimethacrylate and decandiol dimethacrylate (40.5 wt %) with highly dispersed silicon dioxide, ytterbiumtrifluoride and copolymer (59 wt %) fillers and additionally catalysts, stabilizers and pigments (0.5 wt %).  
         [0043]     The methods of the present invention use common dental materials and supplies in a completely unique and helpful way. This invention will have a profound impact on the way dental restoratives are delivered to patients. Utilizing the methods of the present invention, common dental problems, from simple to complex, can be diagnosed and treated rapidly, and accurately, often at fees lower than comparative options.  
         [0044]     The present invention further provides a kit which provides all necessary materials and supplies in a plastic carrying case. The case can be moved from operatory to operatory as needed. The kit also contains all necessary educational materials, including written, video, and CD form for delivery of instruction. The kit provides all necessary contact information for reorder of needed products, and also contacts for technical support.  
         [0045]     The present invention enables a dentist to reproduce a diagnostic wax-up, in an exacting manner, directly in a patient&#39;s mouth. This enables the performance of complex, comprehensive and sometimes extensive treatment, with superb accuracy and in an exacting manner, at one sitting.  
         [0046]     Diagnostic wax-ups have been used for decades, to study ways of restoring damaged or mal-aligned dentitions. Once solutions are arrived at using the wax-up, a treatment plan is formed. The work in the mouth is made to approximate the wax-up, using various conventional methods. These methods include bonding (applying the restoratives directly in the mouth using a sculpting technique, or “free-hand” technique), crown and bridge preps and placement, or applying orthodontic appliances. These various methods can only approximate the diagnostic wax-up, because the work subsequently provided is subject to the dentist&#39;s, and/or dental lab technician&#39;s interpretations or hands-on manipulations. Prior to the present invention, no way existed to quickly and accurately transfer the exact contours of the wax-up directly to the patient&#39;s mouth.  
         [0047]     The object of this invention is improving a patient&#39;s current dental condition or acquired bite. The current condition, or wants or needs, described by the patient are referred to as the chief complaint. Current condition, or acquired bite may present as one or more of the following: worn tooth surfaces (when areas which are ideally or normally sharp and pointed are flattened or worn down); fractured teeth; severely decayed teeth; discolored or stained teeth; teeth which are too small for the arches and therefore have excess space between them; and mal-positioned or mal-aligned teeth.  
         [0048]     Therefore, the desired changes, or restoration of the teeth can be as follows: re-addition of worn surface (which may involve many teeth, and allows the option of “opening the bite”); repair and restoration of fractured teeth; repair and restoration of decayed teeth; covering up of unsightly stains or discolorations; widening of small teeth to close spaces or gaps; and additive or subtractive coronoplasty to improve symmetry and alignment (masking of malposed teeth-giving impression of “instant orthodontics”).  
         [0049]     The following discussion details the procedural steps of the methods of the present invention: A plaster model  16 , commonly referred to as a dental stone model, of the patient&#39;s teeth  10 , exhibiting the current condition is acquired as shown in the sequence of  FIGS. 1-4 . Preferably, the plaster model comprises a gypsum die stone. More preferably, the gypsum die stone further comprises a resin such as a urethane or an epoxy resin. Most preferably the gypsum die stone material for the plaster model is AMERICAN DIEROCK® resin die stone marketed by American Diversified Dental Systems of Anaheim, Calif. The model is an accurate reproduction of the patient&#39;s acquired bite, and demonstrates the chief complaint, which can then be studied carefully. Desired changes are made to the plaster model  16  by addition of dental wax  18  as shown in  FIG. 5 . The dental wax  18  is heated till flowable, and then “daubed” onto the plaster model  16 , with a metal waxing instrument. When the dental wax  18  has cooled, it can be shaped with carving instruments, and polished. A variety of conditions can be improved using the present invention. Examples include fractures, gaps, wear, and rotations and/or malpositions. Care must be taken to ensure that the desired changes are performed on the tooth models in an exacting manner. The transfer technique is highly accurate, and any changes represented by the wax  18  contours, on the plaster model  16 , will be reproduced on the teeth in the patient&#39;s mouth.  
         [0050]     Next, clear plastic impression trays are measured and selected to fit the modified dental plaster model  16 . The surface of the trays must be smooth, with no retention holes. Clear polyvinyl siloxane impression material  22  is then injected into the clear trays. A product such as RSVP® polyvinyl siloxane (Cosmodent, Chicago, Ill.) is a good choice of clear impression material.  
         [0051]     The tray full of impression material  22  is inverted over the waxed-up dental stone model  20 , and pressed down to entirely cover the tooth and tissue surfaces as shown in  FIGS. 6 and 7 , thus recording an impression which defines a space  58  reflecting the desired dentition. Prior to the setting, or hardening of the impression material  22 , while it remains viscous or plastic, the tray is maneuvered so that a thickness a of approximately two millimeters (mm) of material remains over the buccal surfaces  30  of the teeth, and a thickness P of approximately two millimeters (mm) of clear impression material  22  remains over the incisal surfaces  28  of the teeth. It is fine to have excess material to the lingual or palatal side  34  of the teeth  10 . The excess impression material  22  is desired for stiffness and rigidity of the set material  22 . The set material  22  will henceforth be referred to as a mold  24 .  FIG. 6  shows the clear impression material which remains over the waxed-up plaster model after removal of the impression tray which is the mold having the desired changes to the patient&#39;s teeth  
         [0052]     After three minutes, the impression material  22  will be set, or hardened to form the mold  24 . The hard, clear impression tray is carefully flexed, and removed from the mold  24 . The mold  24  will remain firmly attached to the waxed-up stone model  20 . Using a sharp lab knife, for example an exacto-knife, the excess clear impression material  22  is cut away from the waxed-up model  20  at the height of contour (gingival crest) or the buccal mucosa, and lingual and palatal tissues. Allowing the molded edges to extend beyond the teeth and rest on the gingival tissues is desirable and necessary, both for stability of the mold  24  during placement, and the accuracy of the restorative changes near the gum-line.  
         [0053]     Using fingers and thumbs, the edges of the clear mold  24  are carefully peeled from the waxed-up stone model  20 . If caution is exercised, the clear mold  24  can be lifted from the waxed-up stone model  20  with no damage to either the wax  18  or mold  24 . The dentist now possesses a clear, see-through mold  24 , which is a negative, or impression mold, of the idealized waxed-up model  20 . When this mold is placed over the patient&#39;s teeth  10 , it will snap into place with precision, and fit securely. The patient&#39;s teeth  10  will fill the space  58  in the mold  24  exactly, except where wax  18  was placed on the stone model  16 . Where wax  18  was placed, a space  58  will exist, either between, over, or around a tooth  12 , defined by the inner contours of the mold  24 . It is into this space  58  the restorative material, specifically the composite resin  54 , will be injected to make the desired changes to the teeth  10 .  FIG. 8  shows the mold which has been cut to ensure proper thickness on the buccal and incisal aspects of the teeth showing the ingress holes and vent holes which have been cut with a diamond bur.  
         [0054]     An ingress hole  40  must be placed in the mold  24  to allow access for the composite  54  to be injected. A vent  42  must also be placed in the mold  24 , to allow air to escape as the restorative is forced into the space  58  through the access of the ingress hole  40 . With the tray off the model, the ingress holes  40  for injection and the vents  42  are placed using an air rotor drill motor handpiece and a bur preferably a BRASSELER® #849L 009 diamond bur (Savannah, Ga). One injection ingress hole  40  and vent  42  are required for each tooth  12  to be restored. Any dust or debris from the venting procedure is removed with water rinse and compressed air. The mold  24 , as shown in  FIGS. 8 and 9 , is now ready for use.  
         [0055]     Patient Treatment Procedures: The patient is prepared according to normal custom. Anti-anxiety agents, and anesthetics are used as needed. The enamel and dentin tooth surfaces must be prepared for composite bonding according to standard procedures.  
         [0056]     A typical procedure is as follows: The teeth  10  are lightly scuffed  46 , or roughened with a fine diamond bur as shown in  FIG. 10 . These surfaces of the teeth  10  are etched, with a twenty second application of 35% phosphoric acid gel, then rinsed with water. The teeth will appear a frosty white color when etched. Thin, non-viscous bonding resin primer is then brushed onto the tooth using brush  50  as shown in  FIG. 11 . Next, a bonding agent (which is a slightly more viscous resin) is applied and is light  52  cured as shown in  FIG. 12 . In preferred embodiments the bonding agent comprises methacrylate ester monomers and the primer comprises alkyl dimethacrylate resins. Preferably, the primer and bonding agent are OPTIBOND FL® primer and adhesive marketed by Kerr Corporation, Orange, Calif.  
         [0057]     The best way to restore multiple teeth  10  in a row, is to do every other tooth  12  in two separate applications. That way, the teeth  10  are not fused together by the bonding resins. Teeth not to be bonded in the first application are “draped”, or isolated by. covering with a polymer release material  48  such as a pipe thread tape. Preferably, the polymer release material  48  is a polytetrafluoroethylene tape. As such, every other tooth will be covered with a wrap of polymer release material  48 . The first teeth to be restored will be not covered. Place the mold  24  over the arch, and snap firmly into place. Prior to injection, verify that the tray is seated firmly. Flowable composite resin  54  is now injected, with moderate pressure from the thumb on the composite syringe  56  plunger.  FIG. 13  shows injection of the flowable composite resin  54  with the syringe  56  having a narrow tip into the ingress hole  40  over a tooth to be treated after the mold  24  has been seated firmly over the arch in the patient&#39;s mouth.  
         [0058]     It is preferable to use a flowable composite resin  54  to restore with this technique. Many such materials are available for use. Some examples of composite resins are described in U.S. Pat. No. 6,479,592 to Rheinberger et al., U.S. Patent Application Publication No. 2004/0167246 to Subelka et al., and U.S. Patent Application Publication No. 2003/0069326 to Stangel et al. hereby incorporated herein by reference in their entirety. One preferred material is HELIOMOLAR® Flow composite (Ivoclar Vivadent, Amherst, N.Y.). The diameter of the tubing closely approximates the diameter of the BRASSELER® #849L 009 diamond bur used to make the injection ingress holes  40  in the clear mold  34 . The syringe  56  tip is placed in a ingress hole  40  directly over a tooth  12  not covered by with polymer release material  48 . The composite resin  54  is flowed, or injected by pushing on the plunger with the thumb. The dentist can monitor the progress of the composite resin  54  flow, and stop applying pressure when the composite resin  54  begins to escape from the vent  42 . After injection, cure, or harden the resin with electromagnetic energy such as light emitted from a curing light  52  (465-480 nm) for thirty seconds as shown in  FIG. 14 .  
         [0059]     Finally, repeat the injection steps of  FIGS. 10-15  for each tooth not covered by with the polymer release material  48  in the first application. First, remove the mold. Next, remove the polymer release material  48  and then remove any excess resin, such as flash  60 , as shown in  FIG. 15 . Next, smooth and polish restored teeth. Now, place polymer release material  48  over the restored teeth.  FIG. 16  shows the restored teeth wrapped polymer release material  48  in preparation for a second round of restoration similar to the first round shown in  FIG. 10  through  FIG. 15 . The unrestored teeth covered with the polymer release material  48  in  FIG. 10  are treated in the second round. Every other remaining tooth will be uncovered, and non-restored. Etch, prime and bond non-restored teeth. Next, place the mold  24  back over dental arch and snap into place. Inject composite resin  54  into remaining non-restored tooth spaces and light cure. Then remove the mold  24  and the polymer release material  48 . Afterwards, finish and polish the remaining restorations. Finally, check the occlusion (i.e. the bite) and adjust if needed.  
         [0060]     While the present invention is described herein with reference to illustrated embodiments, it should be understood that the invention is not limited hereto. Those having ordinary skill in the art and access to the teachings herein will recognize additional modifications and embodiments within the scope thereof. Therefore, the present invention is limited only by the Claims attached herein.