Abstract:
An orthodontic appliance, includes a crimpable tubular shaped portion having at least three walls selected from the group consisting of a lingual wall, a buccal or labial wall, an occlusal wall and a gingival wall, the at least three walls defining and opening configured to receive an archwire therethrough in a mesial-distal direction. The appliance includes at least one wing joined to the tubular shaped portion, the at least one wing extending longitudinally in the mesial-distal direction. A slot is provided in the at least one wing open to an end of the wing in the mesial or distal direction and having a depth in the mesial distal direction and a height in a gingival-occlusal direction configured to receive a ligature wire or elastic.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application is a nonprovisional application claiming benefit of the filing date of provisional application 62/197,223, filed Jul. 27, 2015, the contents of which is incorporated herein in its entirety. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    The objective of orthodontic treatment is to reconfigure teeth in a patient&#39;s mouth to achieve a comfortable, functional bite and a more attractive smile. Orthodontists use various hardware configurations commonly known as braces to achieve this. Braces primarily consist of brackets, archwires, and auxiliaries, e.g., elastics, springs, stops and tiebacks. Together, brackets, archwires, and auxiliaries enable the orthodontist to tailor movement and repositioning of individual or segments of teeth by transferring forces to the dental facial structures. 
         [0003]    Orthodontists have used stops on archwires since the beginning of orthodontics as a specialty in the early twentieth century. A traditional use of a stop is to prevent the archwire from sliding through a bracket beyond the desired position. This situation would cause discomfort to the patient because the end of the wire would poke out beyond the bracket into the cheek. Stops had the appearance of a V-Shaped dimple and were bent in the archwire by the orthodontist. The placement of two such stops on either side of an orthodontic bracket would prevent the archwire from sliding through the brackets and thus prevent irritation of the oral soft tissues. Two stops could also be placed on the distal side of the terminal bracket on each side of a segment of teeth to prevent space from opening in that segment, for example distal to the right and left maxillary lateral incisor brackets. 
         [0004]    Tie backs were also bent in the archwire and were a modification of a stop. A conventional tie back loop is shown in  FIG. 1 . A conventional tie back loop  1  bent in archwire  2  has, as shown in  FIG. 1 , the appearance of a tear drop and is usually placed mesial to the first molar brackets. The tie back loop  1  can be tied to the bracket  3  (to a hook  3 ′ of the bracket) with a ligature  4  for the purpose of preventing space from opening throughout the dental arch. Tie back loops could also be placed several millimeters mesial to the first molar brackets in an archwire which also had closing loops bent in it. The tie backs could then be tied to the first molar bracket with a ligature and thereby activate the closing loops. 
         [0005]    It is also possible to provide a tie back hook on an archwire, e.g., by soldering. A conventional tie back hook  5  is shown in  FIG. 2  fixed to the archwire  2 . The tie back hook  5  can be tied to the bracket  3  (to a hook  3 ′ of the bracket) with a ligature  4  for the purpose of preventing space from opening throughout the dental arch. 
         [0006]    The bending of stops and tie backs in an archwire is a time consuming process. The development of crimpable stops facilitated the placement of stops. An archwire could be marked with a wax marker and a small stainless steel tube could be slid on the wire to the mark and simply crimped with an orthodontic plier to secure it in place. The placement of crimpable stops serves the same functions of preventing archwires from sliding through the brackets and preventing space from opening in a segment as the stops bent in the archwire did. Conventional crimpable stops cannot be used as tie backs, however, since there is no way to tie a ligature to them. 
         [0007]    A crimpable stop having a hook is also known. See U.S. Pat. No. 5,306,142 to Richards, the contents of which are incorporated herein by reference. The Richards patent discloses an orthodontic device defining an anchor for an elastic, ligature or spring. It combines a ball hook attached to a crimpable stop, the stop having a tubular body with inner wire-engaging surfaces coated with an abrasive material to produce an anti-sliding and anti-rotating engagement with the wire when crimped down upon the wire. This patent discloses that the crimpable ball hooks can be mounted on archwires and when used with intermaxillary elastics can provide intermaxillary fixation, can be mounted on a lip bumper received in buccal tubes or can be mounted on the inner bow of a face bow received in buccal tubes. The hooks tend to be large, e.g., have a height of about 4 mm in the gingival-occlusal direction and can cause irritation of the gingiva. 
       SUMMARY OF THE INVENTION 
       [0008]    The present invention relates to an orthodontic appliance, including a crimpable tubular shaped portion having at least three walls selected from the group consisting of a lingual wall, a buccal or labial wall, an occlusal wall and a gingival wall, the at least three walls defining an opening configured to receive an archwire therethrough in a mesial-distal direction. The appliance includes at least one wing joined to the tubular shaped portion, the at least one wing extending longitudinally in the mesial-distal direction. A slot is provided in the at least one wing open to an end of the wing in the mesial or distal direction and having a depth in the mesial distal direction and a height in a gingival-occlusal direction configured to receive a ligature wire or elastic. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0009]      FIG. 1  is a schematic view of a conventional tie back loop. 
           [0010]      FIG. 2  is a schematic view of a conventional tie back hook. 
           [0011]      FIG. 3A  is a schematic perspective view of one embodiment of an orthodontic appliance according to the present invention. 
           [0012]      FIG. 3B  is a schematic front view of the orthodontic appliance of  FIG. 3A . 
           [0013]      FIG. 3C  is a schematic left end view of the orthodontic appliance of  FIG. 3A . 
           [0014]      FIG. 3D  is a schematic top view of the orthodontic appliance of  FIG. 3A . 
           [0015]      FIG. 3E  is a schematic perspective view of another embodiment of an orthodontic appliance according to the present invention. 
           [0016]      FIG. 3F  is a schematic left end view of the orthodontic appliance of  FIG. 3E . 
           [0017]      FIG. 4A  is a schematic view of an embodiment of the orthodontic appliance of the present invention in use in an orthodontic treatment using a rectangular archwire. 
           [0018]      FIG. 4B  is a schematic view of an embodiment of the orthodontic appliance of the present invention in use in an orthodontic treatment using a round archwire. 
           [0019]      FIG. 4C  is a schematic view of another embodiment of the orthodontic appliance of the present invention in use in an orthodontic treatment using a round archwire. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0020]    Applicant has developed an orthodontic appliance that is a modification of the crimpable stop to allow it to also be used as a tie back. The modified crimpable stop of the present invention includes a slot incorporated in a portion of the stop, the slot being configured to allow the placement of a ligature, e.g., made of stainless steel, which then allows the modified crimpable stop to function in the same way as the tie back bent in the archwire would, i.e., preventing space from opening throughout the dental arch. In a preferred embodiment, the slot has the dimensions 0.018×0.015 inch to allow the placement of the ligature. The same benefit of ease of placement as the conventional crimpable stop applies as well as the benefit of the modified crimpable stop being much smaller than a tie back bent in the archwire and having a shorter height in the gingival-occlusal direction, and therefore much less likely to cause irritation of the oral soft tissues as well as being more hygienic. 
         [0021]      FIGS. 3A-3D  are schematic views showing one embodiment of an orthodontic appliance, in the form of a modified crimpable stop, according to the present invention.  FIG. 3A  is a schematic perspective view of one embodiment of an orthodontic appliance according to the present invention.  FIG. 3B  is a schematic front view of the orthodontic appliance of  FIG. 3A .  FIG. 3C  is a schematic left end view of the orthodontic appliance of  FIG. 3A .  FIG. 3D  is a schematic top view of the orthodontic appliance of  FIG. 3A . The internal lines in the drawings are intended to show changes in direction/elevation and not intended to depict that the stop is made of separate pieces. In fact, it is preferred that the stop is made as a single unitary piece of orthodontic-grade corrosion-resistant material, such as stainless steel, by, e.g., stamping, molding or forming. 
         [0022]      FIGS. 3A-3D  show the orthodontic appliance, in the form of a modified crimpable stop, generally designated by the reference numeral  30 , according to one embodiment of the present invention. The crimpable stop  30  has a tubular shaped portion  31  having, in this embodiment, a generally rectangular inner cross-section or profile defining a tubular opening configured to receive an archwire therethrough. The tubular shaped portion  31  has a lingual wall  32  opposed to a buccal (or labial) wall  33  joined by an occlusal wall  34 . The tubular shaped portion  31  is joined to a pair of extensions or wings  35  and  36 . The lower portions of the extensions or wings  35  and  36 , where they join, respectively, the lingual wall  32  and buccal (or labial) wall  33 , forms a partial gingival wall having an opening  37 . This opening  37  allows the crimpable stop  30  to be placed on the archwire, even if the archwire is already attached to the brackets in a patient&#39;s mouth. The tubular shaped portion  31  has a length in the mesial-distal direction long enough for the wings to provide sufficient strength for the ligature in the slots and short enough so as not to completely occupy the interbracket distance, e.g., a length of about 1.5 mm to 2.5 mm, preferably 2.16 mm in the mesial-distal direction. Preferably, the extensions or wings  35  and  36  preferably have a length in the mesial-distal direction the same as the length of the tubular shaped portion  31  in the mesial-distal direction or slightly shorter as long as the wings are long enough for the wings to provide sufficient strength for the ligature in the slots. The extensions or wings  35  and  36  have a height h (see  FIG. 3B ) in the gingival-occlusal direction as short as possible but still have sufficient strength for the ligature in the slots, e.g., about 0.7 to 2.5 mm, preferably, 0.9 to 1.1 mm, e.g., about 1 mm. 
         [0023]    The extensions or wings  35  and  36  have slots  38  and  39 , respectively, provided therein. The slots  38 ,  39  are configured to allow the placement of a ligature, e.g., made of stainless steel, which then allows the modified crimpable stop  30  to function in the same way as the tie back bent in the archwire would, i.e., preventing space from opening throughout the dental arch. In a preferred embodiment, each of the slots  38 ,  39  has the dimensions 0.01 inch to 0.05 inch, e.g., 0.024 inch (depth in the mesial-distal direction) x 0.01 to 0.02, e.g., 0.018 inch (height in the gingival-occlusal direction) to allow the placement of the ligature. Each slot  38 ,  39  opens at one end in the mesial-distal direction, is closed at the other end in the mesial-distal direction and is closed in the gingival and occlusal directions. In the embodiment shown in the drawings, the slot  38 ,  39  has a C or inverted C shape. Of course, other shapes for the slot (e.g., a V-shape rotated by, e.g., 90°) can be used as long as the slots are configured to allow the placement of a ligature as will be described in more detail hereinafter. If it is desired to use an elastic rather than a stainless steel ligature in the slot, the slot can be sized accordingly (e.g., having a depth in the mesial-distal direction and a height in the gingival-occlusal direction) to match the diameter of the elastic (e.g., 0.028 inch). However, since the elastic is soft and will narrow when stretched, the size of the slot can be smaller than the diameter of the elastic and the elastic can still fit within the slot. 
         [0024]      FIG. 3E  is a schematic perspective view of another embodiment of an orthodontic appliance according to the present invention and  FIG. 3F  is a schematic left end view of the orthodontic appliance of  FIG. 3E . The embodiment of  FIGS. 3E and 3F  is similar to that of  FIGS. 3A-3D  but is specifically made for use with a round archwire as will be explained below. In this embodiment, the tubular shaped portion  31 ′ has a semicircular cross-sectional profile with a lingual wall  32 ′ opposed to a buccal (or labial) wall  33 ′ joined by an occlusal wall  34 ′. 
         [0025]      FIG. 4A  is a schematic view of an embodiment of the orthodontic appliance  30  of the present invention in use in an orthodontic treatment using a rectangular archwire  22 . In  FIG. 4A , the crimpable stop  30  has been placed on the archwire and crimped, the crimping taking place in a manner known in the art to fix the stop  30  on the archwire  22 . For example, orthodontic ligature cutters can be used to crimp the stop  30  onto the archwire  22  so that the stop  30  is fixed in place on the archwire  22  by friction and/or forming indentations in the stop  30  and archwire  22 . In  FIG. 4A , the marks or indentations made by the ligature cutter are shown with reference numeral  40 . It is also possible to crimp the wings  35 ,  36 . A friction increasing coating or surface, such as diamond grit, can be provided on the inner walls of the tubular shaped portion  31  to provide an anti-sliding effect. The opening  37  allows the crimpable stop  30  to be placed on the archwire  22 , even if the archwire is already attached to the brackets  23  in a patient&#39;s mouth. It is also possible to slip the archwire  22  through the tubular shaped portion  31  before the archwire  22  is attached to the brackets  23  in a patient&#39;s mouth. In this latter case, it is possible to make the tubular shaped portion  31  such that there is a complete gingival wall, i.e., one not having an opening  37 . 
         [0026]    Once the stop  30  is crimped onto the archwire  22 , the orthodontist or technician can tie it off with ligature wire  24 , e.g., in a figure-eight configuration, to secure the stop  30  to an anchor point such as a hook  23 ′ on bracket  23 , or to activate a closing loop. Alternatively, an elastic ligature can be used. 
         [0027]      FIG. 4B  is a schematic view of an embodiment of the orthodontic appliance  30  of the present invention in use in an orthodontic treatment using a round archwire  32 . In this case, a tubular shaped portion  31  having a generally rectangular inner cross-section or profile may be used if there is sufficient friction. Preferably, however, as shown in  FIGS. 3E, 3F and 4C , the tubular shaped portion  31 ′ will have a generally semicircular or circular inner cross-section or profile, the diameter of which would preferably be 0.165 inch-0.19 inch, e.g., 0.17 for 0.16 archwires and 0.19 for 0.18 archwires.  FIG. 4C  is a schematic view of this embodiment of the orthodontic appliance  30 ′ of the present invention in use in an orthodontic treatment using a round archwire  32 . 
         [0028]    While the orthodontic appliance of the present invention can be used anywhere in the patient&#39;s mouth as desired by the orthodontist, it is especially advantageous for use between the second pre-molars and the first molars or between the first molars and the second molars. The present invention provides advantages over the prior art, including being more hygienic, having a small height in the gingival-occlusal direction providing less irritation and more comfort, and having a small length in mesial-distal greater providing a great range of activation. 
         [0029]    While one orientation of the stop  30  has been shown in the  FIGS. 3A-3D, 4A and 4B , it is possible, of course, to use the stop  30  rotated 180° in the horizontal plane (about a vertical axis), in which case, the wall  32  would be a buccal (or labial) wall and the wall  33  a lingual wall. Alternatively or additionally, the stop  30  rotated 180° in the vertical plane (about a horizontal axis), in which case wall  34  would be a gingival wall and the portions of the extensions or wings  35  and  36  that join the lingual wall and buccal (or labial) wall would form a partial occlusal wall.