Abstract:
A system and method are provided for organizing and loading orthodontic appliances, for example orthodontic brackets, onto set-up trays. The system includes an organizer tray which holds a set-up tray in a fixed orientation, and also holds a plurality of packages of orthodontic brackets in predetermined relationships to bracket staging areas on the set-up tray. Bracket packages and the organizer tray are configured so that the brackets are presented in the same orientation, when in their packages held by the organizer tray, as they will have when transferred to the set-up tray. As a result, the brackets can be loaded onto the set-up tray from the packages without re-orientation. The organizer tray has a storage base that holds supplies of packages of the different brackets of a given set so that the organizer tray can be reloaded with packages. Preferred organizer tray and package configurations are also provided.

Description:
This invention relates to the packaging of dental appliances, particularly orthodontic appliances, and to the organizing of the appliances for their loading onto set-up trays. The invention particularly relates to methods of packaging and organizing of the appliances and of loading set-up trays with the appliances, and to the packages, organizers and set-up trays and appliance packaging, loading and organizing systems. 
   BACKGROUND OF THE INVENTION 
   In the practice of dentistry, the efficient use of a dentist&#39;s time is enhanced by preparing the equipment and supplies needed by the dentist for a scheduled patient visit in advance of appointment, so that the dentist may proceed directly with an examination or treatment. The preparation is typically done by a technician or assistant on the dentist&#39;s staff. As a result, the dentist may see more patients in a specified period of time than would be possible if the dentist were to personally assemble the items. 
   Orthodontic practitioners, for example, have a number of examination or treatment activities, each of which may require different tools or supplies. A common task for an orthodontist is the installation of an orthodontic appliance on a patient. Currently, a most effective and widely used orthodontic appliance is an orthodontic brace that is formed of an archwire and a number of orthodontic brackets. Installation of such an appliance involves the bonding of the individual brackets of a set, each specific one to a given one of the patient&#39;s teeth. For such an installation, a set of brackets must be assembled for the orthodontist, along with adhesives, primers and other chemical substances, plus tweezers, curing light guns and other tools needed for the appliance installation. 
   The installation of a bracket-archwire appliance requires careful selection and placement of individual brackets from a supply thereof onto the crown of a patient&#39;s teeth in a one-by-one transfer of the brackets from the supply to the patient. The transfer involves the engagement of the correct bracket for a given tooth and the proper orientation of the bracket for placement on the appropriate tooth. Since the brackets are each tooth-specific, with each having a geometry specially configured to fit the surface of a tooth and to engage an archwire to exert specific forces on the tooth, an error in the selection of a bracket can be costly in terms of treatment time and loss of treatment quality. 
   Placement of a bracket on a patient&#39;s tooth requires the holding of the bracket by the orthodontist, usually with a pair of tweezers designed for that purpose, with the base of the bracket coated with adhesive and oriented for placement against the patient&#39;s tooth. Each bracket base may be considered as having four sides, one intended as the gingival side that must face the gum when mounted on the tooth with the opposite intended as the occlusal side which will face the occlusal plane. At right angles to these are the opposite sides intended as the mesial and distal sides, which must face the mesial and distal sides of the tooth, respectively. This requires proper orientation of the bracket in the hand of the orthodontist, with the gingival side facing downward for lower teeth and facing upward for the upper teeth. 
   Historically, an orthodontist stocks a plurality of brackets for each tooth, which have been often supplied loose in boxes. Each bracket was retrieved from a respective one of the boxes and oriented for application to the patient&#39;s tooth. When the orthodontist undertakes to retrieve the brackets from the boxes at chair-side, considerable professional time is consumed, while care must be taken to insure that the correct bracket is retrieved for a given tooth and is oriented correctly to have its pad coated with adhesive and applied to the tooth. The orthodontist will typically stock one type or model of appliance that is most commonly suitable for a patient, plus alternative types or sizes for use as the case may indicate. 
   The trend toward the use of a set-up tray has resulted in better use of the orthodontist&#39;s chair-side time in installing orthodontic appliances. This time has been replaced by technician or assistant time in loading the set-up trays employing many of the same motions and careful attention previously employed by the orthodontist. Set-up trays are usually hand-size trays or cards having compartments or sticky adhesive-coated pad areas to hold the individual appliances in a predetermined arrangement for pick-up by the orthodontist at tray side. Set-up trays of the type that not only hold the brackets for the orthodontist but present tooth-specific, single-doses of adhesive for use with each respective bracket are described in U.S. Pat. Nos. 6,213,767 and 6,482,003. Simpler set-up trays that hold only the brackets are also common. 
   Whether done by the practitioner or the practitioner&#39;s assistant, the efficiency of dental practice and the reduction of error occurrence can be improved by better ways for supplying and handling dental supplies. 
   SUMMARY OF THE INVENTION 
   A primary objective of the present invention is to improve the efficiency and accuracy of dental practice, and particularly orthodontic practice. 
   According to certain principles of the present invention, dental appliances are provided by a manufacturer or supplier thereof packaged in a manner that promotes their efficient handling by the practitioner. According to other principles of the invention, the appliances are organized and set-up trays are loaded in a manner than requires less time and results in fewer errors than with the prior art. 
   According to the illustrated embodiments of the invention, orthodontic appliances, particularly tooth-specific orthodontic brackets, are packaged in a predetermined orientation in a package containing a plurality of identical brackets of a given type and for a given tooth. The package is configured as an elongated package that serves as a carrier of the brackets to an organizing tray. 
   Further according to the illustrated embodiments of the invention, an organizer tray is provided with slotted recesses to receive each of a plurality of carriers, each containing a different bracket of a set. The recesses are arranged on the organizer tray so as to correspond to a logical arrangement that make it clear to an experienced practitioner which one contains brackets for which tooth. The organizer tray also contains a support for a set-up tray, such as a tray of the type described in U.S. Pat. Nos. 6,213,767 or 6,482,003. These set-up trays each contain bracket support areas, one for each tooth, arranged in a logical order that suggests the corresponding tooth of a patient for which the bracket supported thereat is for. The carrier supporting recesses are arranged on the organizer tray in a one-for-one correspondence to the areas of a set-up tray supported on the organizer tray. 
   According to still other principles of the invention, the organizer tray is in the form of a drawer cover, which covers a drawer having a plurality of compartments each arranged in the same order as and lying below the recesses of the organizer tray when the tray is applied to cover the drawer. In each of the compartments is stored a plurality of the carriers containing the brackets in the corresponding recesses of the organizer-tray drawer-cover. The drawer constitutes the orthodontist&#39;s supply of brackets for appliances of a particular type. The orthodontist may have a plurality of such drawers, one for each type of bracket or appliance used by the orthodontist. These drawers may be stored in a supply cabinet. 
   In practice, pluralities of each of the brackets used by an orthodontist are supplied to the orthodontist&#39;s office and each of the drawers are stocked. When a case is scheduled for installation of an appliance on a patient, an orthodontic assistant withdraws the organizer tray containing the brackets of the type selected by the orthodontist, and, if any of the recesses is empty of a carrier containing at least one bracket, loads a carrier into that recess. The assistant also places an empty set-up tray on the support on the organizer tray. Then, the assistant uses a tweezers to remove one bracket from each carrier and transfers the bracket to a corresponding area of the set-up. Each bracket is placed on the respective area in an orientation that will enable the orthodontist to remove it without reorienting it for placement onto the patient&#39;s tooth. This orientation is preferably the same orientation that the bracket has on the carrier that is inserted into the recess on the organizer tray. The brackets were loaded into the carrier, which served as its packaging for shipment, by the appliance manufacturer to the practitioner. 
   The set-up tray, so loaded, maximizes the use of the time not only of the orthodontist, but of the orthodontist&#39;s assistant. Additionally, bracket orientation and selection errors are minimized. 
   These and other objectives and advantages of the present invention will be more readily apparent from the following detailed description. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is a perspective view of one version of an orthodontic set-up tray of the prior art. 
       FIG. 2  is a perspective view of one embodiment of an orthodontic bracket package and carrier according to certain principles of the present invention. 
       FIG. 2A  is an enlarged view of a portion of the package and carrier of  FIG. 2 . 
       FIG. 3  is a perspective view of an orthodontic bracket organizer according to certain embodiments of the present invention, in a closed condition. 
       FIG. 3A  is a disassembled perspective view of the upper sliding portion of the organizer of  FIG. 3 . 
       FIG. 3B  is a disassembled perspective view of the lower base portion of the organizer of  FIG. 3 . 
       FIG. 4  is a cross-sectional elevational view of the organizer tray of  FIG. 3  taken along line  4 - 4  of  FIG. 3 . 
       FIG. 5  is a perspective view, similar to  FIG. 3 , of an organizer in an open condition. 
       FIG. 6  is a perspective view of the organizer of  FIG. 3 , showing the organizer in use. 
       FIG. 6A  is an enlarged perspective view of a portion of  FIG. 5 . 
   

   DETAILED DESCRIPTION 
   In most dental practices, a set-up tray of some sort is prepared by a dental assistant and placed at chair-side next to a patient before the dental practitioner enters the treatment area for a dental appointment. This is particularly true in orthodontic practices for appointments to install orthodontic appliances on patients. In such orthodontic practices, an orthodontic set-up tray is typically loaded with orthodontic appliances that have been pre-selected by the practitioner for treatment of a patient for whom an appointment has been scheduled to install the appliance. One of several such prior art set-up trays that are in use by orthodontists is illustrated in  FIG. 1 . 
   In  FIG. 1  is illustrated a set-up tray  10  of the type described in U.S. Pat. No. 6,482,003, hereby expressly incorporated by reference herein, and which is used in the description of the invention below. It is one prior art example of several types of set-up trays that can be used with the present invention. The particular set-up tray  10  that is illustrated and described is, in addition to being a set-up tray, a delivery system for delivering orthodontic adhesive in individual bracket doses for securing orthodontic brackets to teeth, although the adhesive delivery feature is not a necessary feature of any set-up tray for use with the present invention. The set-up tray  10  includes a resilient foam-board base  11  having a smooth plastic surface  12  that contains bracket mounting areas  13  and  14 , lying on opposite sides of a centerline  19 , that are coated with tacky pressure-sensitive adhesive. The area  13 , when held by an orthodontist, will lie along the side of the tray  10  that faces a patient and will hold brackets  30  for the patient&#39;s upper dental arch, while the area  14  will lie along the side toward the orthodontist and will hold brackets for the patient&#39;s lower arch. The brackets  30  will be arranged on the tray in the order of the teeth in the patient&#39;s mouth, with staging areas  15  on the left side of the tray containing, from left to right, brackets for the right second molar through the right central incisor, and staging areas  16  on the right side of the tray containing, from left to right, brackets for the left central incisor through the right second molar. In the center of the tray  10  are provided enclosures  17  containing single doses of adhesive corresponding to each of the brackets, and cups  18  for holding primers or cleaning liquid. 
     FIG. 2  illustrates a package  20  embodying certain features of the present invention. The package  20  includes an elongated carrier  21  having a plastic base  22  with an elongated recess  23  formed therein. The recess  23  contains a flexible foam insert  24  having a plurality of cavities  25  therein adapted to receive and to snugly but releasably hold an orthodontic appliance, for example an orthodontic bracket  30 , as illustrated in more detail in  FIG. 2A . The base  22  of the carrier  21  has a tab or handle  26  formed at one end thereof that is part of a flat flange  27  that extends in a plane around the recess  23 . The package  20  includes a clear plastic cover  28  that slides over the carrier  21 , having internal channels formed therein into which the flange  27  of the base  22  fit. The cover  28  covers the brackets  30  and keeps them in the cavities  25  for shipment from the bracket manufacturer. 
   The brackets  30  have pads or bases  31  to which is attached or integrally formed a bracket body  32  that is typically composed of a pair of tie wings  33  in which is formed a generally horizontal archwire slot  34 . As illustrated in  FIGS. 2 and 2A , the brackets  30  are packaged in the cavities  25  of the carrier  21  with base  32  facing down so that the tie wings can be gripped easily with tweezers to remove the bracket from the package  20 . Further, the brackets  30  may each be considered as having four sides  35 - 38  that include a gingival side  35  that will face the gum when the bracket  30  is mounted on a patient&#39;s tooth. The brackets  30  are inserted into the cavities of the package  20  oriented such that the gingival side  35  of the bracket  30  faces the handle or tab  26  of the carrier  21 . The other sides  36 - 38  include, proceeding clockwise around the bracket  30 , a first mesial/distal side  36 , an occlusal side  37  that is opposite the gingival side  35 , and a second mesial/distal side  38  that is opposite the first mesial/distal side  38 . For upper right and lower left brackets, side  36  is the mesial side of the bracket and side  38  is the distal side of the bracket; and for upper left and lower right brackets, side  36  is the distal side of the bracket and side  38  is the mesial side of the bracket. 
   The packages  20  have a plurality of the cavities  25  in a line. For brackets of more often used prescriptions, the number of cavities  25  in the plurality is typically seven to ten. The packages  20  may be made with other numbers of cavities  25 . Three to five brackets per package may be a practical number, particularly for brackets of less often used appliance prescriptions. 
   According to a method of the present invention, brackets  30  are loaded onto a set-up tray  10  from the carriers  21 , illustrated as carriers and  21   a  and  21   b , by personnel at a treating orthodontic practitioner&#39;s office with the use of an organizer  40 , illustrated in  FIG. 3 , also according to the present invention. The organizer  40  includes an organizer tray  41  and a storage base  42 . Both the organizer tray  41  and storage base  42  are each preferably made of a respective integral piece of molded plastic, although metal or other materials may be used. 
   The organizer tray  41  has a four-sided, set-up tray support or set-up-tray-receiving recess  43  formed at its center and a plurality of appliance holders  44 . The holders are in the form of three-sided, open-ended, carrier-receiving recesses or slots, half of which are formed along one side of the organizer tray  41  and half formed along the opposite side of the organizer tray  41 . The holders  44  are configured to hold the appliances, such as brackets  30 , preferably in packages of appliances, such as the carriers  21 . The number of the holders  44  is equal to the maximum number of brackets  30  that will form an orthodontic brace, typically twenty-eight. 
   As illustrated in  FIGS. 3 and 3A , the organizer tray  41  is prepared by placing in the recess  43  an empty set-up tray  10  that is to be loaded with brackets from carriers  21 . Carriers  21  containing brackets  30  are inserted into the holders  44  of the organizer tray  41 , with their covers  28  removed, by sliding the flanges  27  onto grooves  45  in the sides of the holders  44 , with the handles or tabs  26  of the carriers  21  at the open ends of the holders  44 . Each holder  44  receives a carrier  21  containing brackets for a different one of the teeth. The carriers  21  containing the different brackets  30  of a set are loaded into the holders  44  of the organizer tray  41  in the same relative order as the staging areas  15  and  16  are arranged on the set-up card, with the upper bracket carriers  21 , carriers  21   a , along the side  46  that is adjacent the upper bracket mounting area  13  of the set-up tray  10 , while the carriers  21  and with the lower bracket carriers  21 , carriers  21   b , along the side  47  that is adjacent the lower bracket mounting area  14  of the set-up tray  10 . That is, the fourteen holders  44  along the side  46  of the organizer tray  41  contain brackets  30  for the upper teeth, arranged, left to right with brackets for the upper right second molar to the upper left second molar, and the fourteen holders  44  along the side  47  of the organizer tray  41  contain brackets  30  for the lower teeth, arranged, left to right with brackets for the lower right second molar to the lower left second molar. 
   The base  42  contains hollow storage compartment  51 - 53 , as illustrated in  FIGS. 3B and 4 . The compartment  51  is directly beneath the recess  43  in the organizer tray  41  when the tray  41  is in a closed position over the base  42  ( FIG. 3 ). The compartment  51  contains a supply of empty set-up trays  10 . Similarly, the compartment  52  is directly beneath the holders  44  on side  46  of the organizer tray  41  when the tray  41  is in this closed position and holds a supply of carriers  21   a  that contain upper brackets  30 ; and the compartment  53  is directly beneath the holders  44  on side  47  of the organizer tray  41  when in the closed position and holds a supply of carriers  21   b  that contain lower brackets  30 . 
   The organizer tray  41  forms a cover to the compartments  51 - 53  in the base  42 , and slides over the base  42  with its outer edges along sides  46  and  47  fitting into grooves  54  along the sides of the base  42  adjacent compartments  52  and  53 , respectively. The organizer tray  41  is shown in its closed position over the base  42  in  FIG. 3  and in a partially open position in  FIG. 5 . 
   Further, a lid  50  may be provided to cover the organizer tray  41  so that the entire organizer  40  can be stored when partially empty carriers  21  are present in the holders  44  of the organizer tray  41 . This allows the organizer  40  to be stored in any condition at the office of the orthodontic practitioner. Typically, a slotted cabinet or rack (not shown) is provided at the practitioner&#39;s office for storage of organizer trays  40  containing different bracket prescriptions or types. 
   The use of the organizer  40  is illustrated in  FIGS. 6 and 6A . The contemplated typical use of the organizer  40  involves the use of the organizer tray  41  by an orthodontic assistant to load a set-up tray  10  with one set of orthodontic brackets  30  to provide to the treating practitioner in installing the brackets  30  on the teeth of a patient. The assistant may use the organizer tray  41  separate from the base  42 , or with the base  42  still attached. In loading a set-up tray  10 , supported in the recess  43  at the center of the organizer tray  41 , the assistant may use an instrument such as a pair of tweezers  60  to transfer each bracket  30  of a set from a hole  25  in a carrier  21  onto a staging area  15  for the particular bracket  30  on the set-up tray  10 . The brackets  30  are placed on the staging areas  15  of the set-up tray  10  with their occlusal sides  37  facing the centerline  19  of the set-up tray  10 . Because the brackets  30  are provided in the carriers  21  with their gingival edges facing the handles  26  of the carriers  21 , and the carriers  21  are loaded into the holders  44  on the organizer tray  41 , the brackets  30  are oriented on the organizer tray  41  so their occlusal edges face the centerline  19  of the set-up tray  10  that is supported in the recess  43 . Accordingly, a mere translation, with no rotation, is all that is required to load a bracket  30  from a carrier  21  to the set-up card  19 . 
   The organizer tray  41  is, in the prefeffed embodiment, loaded with supplies of brackets  30  from the compartments  52  and  53  beneath the corresponding holders  44  of the tray  41 . This loading is carried out by removing one of the packages or carriers  21  from the compartment  52  or  53  and sliding the flanges  27  of the carriers  21  into the slots  45  of the tray  41 , with the handles  26  of the carriers  21  facing away from the recess  43  that holds the set-up tray  10 . In an alternative embodiment, the carriers  21  and the holders  44  may be configured so that the brackets  30  or other appliances can be transferred from the alternatively configured versions of the packages  21  to alternatively configured versions of the holders  44 , with their orientations preferably preserved in the transfer. 
   When a set-up  10  tray is loaded as described above, an orthodontist may hold the set-up tray  10  with the centerline horizontal and the side holding the bracket mounting areas  13  facing the patient, and then similarly transfer the brackets  30  with tweezers onto the teeth of the patient. Such transfer requires only rotating the pad  31  of the bracket  30  from a horizontal to a vertical plane. Further reorientation of a bracket  30  is not necessary to place the bracket  30  in its correct orientation for mounting on the patients tooth. 
   The invention has been described in the context of exemplary embodiments. Those skilled in the art will appreciate that additions, deletions and modifications to the features described herein may be made without departing from the principles of the present invention. Accordingly, the following is claimed: