Patent Publication Number: US-2021186663-A1

Title: Orthodontic Appliance for Malocclusion Correction

Description:
TECHNICAL FIELD 
     The present disclosure relates to a device that is useful during the course of orthodontic treatment for correcting the position of one dental arch relative to the other. More specifically, the present disclosure concerns an orthodontic bite corrector for urging one of the dental arches either in a forward or rearward direction relative to the other dental arch. 
     BACKGROUND 
     Orthodontic treatment is a specialized form of treatment within the field of dentistry, and involves movement of malpositioned teeth to orthodontically correct locations. Orthodontic treatment often greatly improves the aesthetic appearance of the patient&#39;s teeth. Orthodontic treatment can also improve the patient&#39;s occlusion, so that when the jaws are closed the upper teeth are in proper positions relative to the lower teeth. 
     The orthodontic treatment of some patients includes correction of the alignment of the upper dental arch to the lower dental arch. Certain patients have a condition referred to as a Class II malocclusion where the lower dental arch is located an excessive distance rearward of the upper dental arch when the jaws are closed. Other patients may have an opposite condition referred to as a Class III malocclusion where the lower dental arch is located forward of the upper dental arch when the jaws are closed. 
     SUMMARY 
     In one aspect, provided is an orthodontic bite corrector for moving the relative positions of an upper dental arch and a lower dental arch, the orthodontic bite corrector comprising a post extending from a first support, the first support for connection to the first dental arch; a hub extending from a second support, the second support for connection to the second dental arch, and a ramp extending from the hub, the ramp including an occlusal end and a gingival end,
         where the hub is adjustable between a first fixed hub position and a second fixed hub position, and where the post is configured to slide along the ramp from the occlusal end to the gingival end when the upper dental arch and the lower dental arch are closed. In some embodiments, the post includes a rounded head. In some embodiments, the post has a substantially circular cross-sectional profile. In some embodiments, the post comprises a ceramic material. In some embodiments, the first support comprises a metal selected from the group consisting of a gold alloy and stainless steel. In some embodiments, the hub includes a core, a cover, a washer, and a connector. In some embodiments, the core includes a notch. In some  cover includes a stop. In some embodiments, the washer includes a peg. In some  connector is a screw. In some embodiments, the hub comprises a metal selected from the group consisting of a gold alloy and stainless steel. In some embodiments, the ramp includes a channel In some embodiments, the ramp has an occlusal end and gingival end and is wider at the occlusal end. In some embodiments, the second support comprises a metal selected from the group consisting of a gold alloy and stainless steel. In some embodiments, at least one of the first support and the second support is an orthodontic band.       

     In another aspect, provided is method of correcting a malocclusion, the method comprising attaching the orthodontic bite corrector as described in the present disclosure to a patient&#39;s jaws. In some embodiments, the malocclusion is a Class II or a Class III malocclusion. In some embodiments, the orthodontic bite corrector is set at the first fixed hub position for a first period of time and is set at the second fixed hub position for a second period of time, where the second period of time is after the first period of time. 
     Features and advantages of the present disclosure will be further understood upon consideration of the detailed description as well as the appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a perspective view of a first embodiment of an appliance of the present disclosure attached to a subject&#39;s closed jaws. 
         FIG. 2  is a perspective view of the first embodiment of an appliance of the present disclosure attached to a subject&#39;s open jaws. 
         FIG. 3  is an exploded view of the appliance of  FIGS. 1 and 2 . 
         FIG. 4  is an exploded view from a buccal perspective of the hub of the appliance of  FIGS. 1 and 2 . 
         FIG. 5  is an exploded view from a lingual perspective of a portion of the hub of the appliance of  FIGS. 1 and 2 . 
         FIG. 6  is an exploded view of the appliance of  FIGS. 1 and 2  showing the hub in a first position. 
         FIG. 7  is an exploded view of the appliance of  FIGS. 1 and 2  showing the hub in a second position. 
     
    
    
     Repeated use of reference characters in the specification and drawings is intended to represent the same or analogous features or elements of the disclosure. It should be understood that numerous other modifications and embodiments can be devised by those skilled in the art, which fall within the scope and spirit of the principles of the disclosure. The figures may not be drawn to scale. 
     DETAILED DESCRIPTION 
     As used herein:
         “Mesial” means in a direction toward the center of the patient&#39;s curved dental arch.  a direction away from the center of the patient&#39;s curved dental arch.  in a direction toward the outer tips of the patient&#39;s teeth.   “Gingival” means in a direction toward the patient&#39;s gums or gingiva.   “Facial” means in a direction toward the patient&#39;s lips or cheeks.   “Labial” means in a direction toward the patient&#39;s lips.   “Buccal” means in a direction toward the patient&#39;s cheeks.   “Lingual” means in a direction toward the patient&#39;s tongue.       

     Known devices for malocclusion correction that are used in conjunction with clear-tray aligners commonly depend on the use of elastic bands and/or patient compliance for success. Provided are orthodontic appliances for malocclusion correction that overcome at least these problems. The disclosed orthodontic appliances do not include elastic bands, desirably allow for complete separation of the maxilla and mandible, and maintenance of the class correction forces both with and without clear-tray aligners inserted and without dependence on patient compliance. The disclosed orthodontic appliances also beneficially allow the dental practitioner to adjust corrective forces of the malocclusion correction appliance during treatment without having to completely disengage the appliance from the patient&#39;s jaws. 
       FIGS. 1 and 2  show an embodiment of an orthodontic bite corrector  100  for moving the relative positions of an upper dental arch  50  and a lower dental arch  60 , the orthodontic bite corrector  100  including a post  110 , a hub  120 , and a ramp  140 .  FIGS. 1 and 2  show the orthodontic bite corrector  100  as it might be installed for repositioning the lower dental arch  60  relative to the upper dental arch  50 . In particular, the force provided by the orthodontic bite corrector  100  according to the example shown in  FIGS. 1 and 2  tends to move the lower dental arch  60  in a forward direction relative to the upper dental arch  50  when the patient&#39;s jaws are closed ( FIG. 1 ) in order to correct what is known in the dental art as a Class II malocclusion. The same device, simply attached differently to the patient&#39;s teeth, e.g., with the ramp  140  extending in a mesial direction instead of a distal direction as shown, can also be used to move the lower dental arch  60  in a rearward direction relative to the upper dental arch  50  when the patient&#39;s jaws are closed in order to correct what is known in the dental art as a Class III malocclusion.  FIG. 2  represents the orthodontic bite corrector  100  attached to a patient&#39;s open jaws and shows that the orthodontic bite corrector  100  of the present disclosure allows for complete separation of the maxilla and mandible. Complete separation of the maxilla allows, inter alia, for freedom of movement of the mandible in lateral directions and may therefore result in an improvement in patient experience during the term of treatment.  FIGS. 3  shows an exploded view of the orthodontic bite corrector  100  of  FIGS. 1 and 2 . 
     Referring to  FIG. 3 , the orthodontic bite corrector  100  includes a post  110  extending from a first support  65 , the first support  65  for connection to a first dental arch, for example, the lower dental arch  60  as shown in  FIG. 3 . It is also possible to connect the first support  65  to the upper dental arch  50  and may be the preferred connection in some circumstances, for example, when required to better accommodate    3   e  of a patient&#39;s upper and lower dental arches. The post  110  is connected to the first  se  111  and extends laterally from the base  111 , away from the outer surface of the first support  65  to a bend  112  and then extends in an occlusal direction, ending at a rounded head  113 , the head  113  configured to slidably engage with the ramp  140  as described below. A cross section of the post  110  may have a substantially circular cross-sectional profile, but other geometries, e.g., oval, rectangular, triangular, are possible. 
     The first support  65  may be an orthodontic band such as, for example, a saddle band. The orthodontic band may comprise a metal, such as, for example, gold, a gold alloy, steel (e.g., stainless steel) or combinations thereof. As shown in  FIGS. 1 and 2 , the first support  65  may be cemented to a patient&#39;s lower first molar. In some embodiments, the first support  65  may be attached to a different tooth, e.g., a patient&#39;s second molar, or may be attached to more than one tooth, e.g., a patient&#39;s first and second molars. 
     The post  110  may be made of a material or combination of materials suitable for use in an orthodontic appliance and capable of withstanding forces exerted upon it as the patient repeatedly opens and closes the jaws during normal daily activities. In some embodiments the post  110  may include a metal, such as, for example, gold, a gold alloy, a steel (e.g., stainless steel) or combinations thereof. In other embodiments, the post  110  may include a ceramic material, such as, for example, a dental-grade ceramic. In some embodiments, the post  110  may include a metal and a ceramic material. 
     In some embodiments, the first support  65  and the post  110  can be formed as a single unit by methods known in the art, such as, for example,  3 -dimensional (“ 3 D”) printing, milling, casting, molding (e.g., injection molding, compression molding), scintering, or machining In some embodiments, the first support  65  and the post  110  can be formed separately and coupled using a variety of coupling means including, but not limited to, one or more of adhesives, cohesives, magnets, welding (e.g., sonic [e.g., ultrasonic] welding), a thermal bonding or heat sealing technique (e.g., heat and/or pressure applied to one or both of the components to be coupled), other suitable coupling means, or combinations thereof. The post  110  may be made of the same material or combination of materials as the first support  65  or may be made of a different material or combination of materials than the first support  65 . 
     The orthodontic bite corrector  100  further includes the hub  120  extending from a second support  55 , the second support  55  for connection to a second dental arch, for example, the upper dental arch  50  as shown in  FIG. 3 . It is also possible to connect the second support  55  to the lower dental arch  60 , and is necessary to do so when the first support  65  has been or will be connected to the upper dental arch  50 . 
     The second support  55  may be a device similar to or the same as the first support  65  or it may be another device capable of anchoring the hub  120  to the second dental arch. As shown in  FIGS. 1 and 2 , the second support  55  may be cemented to a patient&#39;s upper first molar, though the second support  55  may be attached to a different tooth, e.g., a patient&#39;s second molar.    to  FIG. 3 , the hub  120  is connected to the second support  55  at a base  122  and extends base  122 , away from the outer surface of the second support  55 . The base  122  is connected to a core  121 , the core  121  having a substantially cylindrical shape and configured to fit inside an opening  126  of a cover  125 . The core  121  includes an aperture  124  configured to receive a connector  130 , such as, for example, a screw as shown, though other connecting means known in the art may be used. As shown in  FIG. 4 , the core  121  includes a notch  123  on its outer curved surface, the notch  123  configured to cooperate with a stop  127  when the core  121  is inserted into the opening  126 , the stop  127  positioned on the inside of the opening  126  and having a shape complementary to that of the notch  123 . In the embodiment shown, the notch  123  has a substantially trapezoidal shape complementary to the trapezoidal profile of the stop  127 , though different geometries for the notch  123  and stop  127  are contemplated, such as, for example, rectangular, circular, or oval. In the present disclosure the notch  123  is shown located on the gingival outer surface of the core  121 , though it could be located at other positions on the outer surface of the core  121 , e.g., the occlusal outer surface of the core  121 . The hub  120  further includes a washer  128  that is positioned on the buccal face of the cover  125  and is held in contact with the cover  125  by the connector  130 . The washer includes a peg  129  configured to cooperate with the stop  127  and hold the hub  120  and ramp  140  in one of two fixed positions, as shown in  FIGS. 6 and 7 . The peg  129  is shown as having a substantially cylindrical shape, but other geometries, e.g., rectangular, are contemplated. 
     Referring to  FIG. 6 , the core  121  may be positioned in the cover opening  126  such that the stop  127  abuts a mesial edge of the notch  123 , providing a first position aperture  131  into which the peg  129  may be inserted, thereby holding the orthodontic bite corrector  100  in a first therapeutic position when the connector  130  is secured in the aperture  124 . Referring to  FIG. 7 , the core  121  may be positioned in the cover opening  126  such that the stop  127  abuts a distal edge of the notch  123 , providing a second position aperture  132  into which the peg  129  may be inserted, thereby holding the orthodontic bite corrector  100  in a second therapeutic position when the connector  130  is secured in the aperture  124 . As can be seen in  FIGS. 6 and 7 , the ramp  140  is in a more distal orientation when the orthodontic bite corrector  100  in the first therapeutic position compared to when the ramp  140  is in the second therapeutic position. In some cases, for example, it may be appropriate for the practitioner to start treatment of a patient in need of Class II or Class III malocclusion correction with the orthodontic bite corrector  100  in the first therapeutic position and during treatment, as the patient&#39;s upper and lower jaws approach the desired relationship to each other, to adjust the orthodontic bite corrector  100  to the second therapeutic position to compensate for example, for movement of the jaws or remodeling of the temporomandibular joint. 
     The ramp  140  is connected to the hub  120  at a gingival end  142  of the ramp  140  and extends in a substantially occlusal-distal direction to an occlusal end  141 . The ramp  140  includes a channel  143 , the channel  143  configured to slidably engage with the head  113  of the post  110 , the post  110  sliding along the ramp from the occlusal end  141  to the gingival end  142  when the upper dental arch and the lower dental arch are closed. As shown, the channel  143  may form a rounded trough, particularly when the  ost  110  is rounded, as the complementary rounded configurations of the head  113  and  flow for smooth sliding as the head  113  moves along the channel  143  when the upper dental arch and the lower dental arch are opened and closed and prevent the head  113  from disengaging along the lingual or buccal sides of the channel  143  as the head  113  travels up and down the length of the ramp  140 . 
     In some embodiments, and as shown in  FIGS. 1-7 , the ramp  140  may be wider at the occlusal end  141  than at the gingival end  142 . The wider occlusal end  141  may enable the ramp  140  to reliably reengage upon closing of the patient&#39;s jaws ( FIG. 1 ) after the post  110  and the ramp  140  disengage upon opening of the patient&#39;s jaws ( FIG. 2 ). 
     The hub  120  and ramp  140  may be made of a material or combination of materials suitable for use in an orthodontic appliance and capable of withstanding forces exerted upon it and similar to or the same as those exerted on the post  110  as the patient repeatedly opens and closes the jaws during normal daily activities. In some embodiments the hub  120  and ramp  140  can be made of a metal, such as, for example, gold, a gold alloy, steel (e.g., stainless steel), or combinations thereof. In other embodiments, the hub  120  and ramp  140  may include a ceramic material, such as, for example, a dental-grade ceramic. In some embodiments, the post  110  may include a metal and a ceramic material. In some embodiments the hub  120  and the ramp  140  may be made of the same material or combination of materials. In some embodiments the hub  120  and the ramp  140  may be made of different materials or combination of materials. In some embodiments, it may be desirable for the post  110  to be made of a harder material or materials than the ramp  140 , for example, the post  110  could be made of a ceramic material and the ramp  140  could be made of stainless steel, as the ramp  140  could be replaced easily in case of wear resulting from repeated contact between the post  110  and the ramp  140  during normal daily activities. 
     In some embodiments, the second support  55 , the hub  120 , and the ramp  140  can be formed as a single unit by methods known in the art, such as, for example, 3-dimensional (“3D”) printing, milling, casting, molding (e.g., injection molding, compression molding), scintering, or machining. In some embodiments, the second support  55  and the hub  120  and/or the ramp  140  can be formed separately and coupled using a variety of coupling means including, but not limited to, one or more of adhesives, cohesives, magnets, welding (e.g., sonic [e.g., ultrasonic] welding), a thermal bonding or heat sealing technique (e.g., heat and/or pressure applied to one or both of the components to be coupled), other suitable coupling means, or combinations thereof The hub  120  and/or ramp  140  may be made of the same material or combination of materials as the second support  55  or may be made of a different material or combination of materials than the second support  55 . 
     An orthodontic bite corrector  100  of the present disclosure may be used in conjunction with clear-tray aligners or other orthodontic devices, and advantageously does not depend on the use of elastic bands and/or patient compliance for success in correcting the patient&#39;s Class II or Class III malocclusion.  of correcting a malocclusion according to the present disclosure can include attaching  to corrector  100  as described above to a patient&#39;s jaws. In some embodiments, the bite corrector  100  is set at the first fixed hub position for a first period of time, such as, for example, one week, one month, two months, three months, four months, five months, six months, seven months, eight months, nine months, or one year and is set at the second fixed hub position for a second period of time, such as, for example, one week, one month, two months, three months, four months, five months, six months, seven months, eight months, nine months, or one year, where the second period of time is after the first period of time. 
     SELECT EMBODIMENTS OF THE PRESENT DISCLOSURE 
     Embodiment 1 is an orthodontic bite corrector for moving the relative positions of an upper dental arch and a lower dental arch, the orthodontic bite corrector comprising:
         a post extending from a first support, the first support for connection to the first dental arch;   a hub extending from a second support, the second support for connection to the second dental arch, and   a ramp extending from the hub, the ramp including an occlusal end and a gingival end,   wherein the hub is adjustable between a first fixed hub position and a second fixed hub position, and wherein the post is configured to slide along the ramp from the occlusal end to the gingival end when the upper dental arch and the lower dental arch are closed.       

     Embodiment 2. The orthodontic bite corrector of embodiment 1, wherein the post includes a rounded head. 
     Embodiment 3 The orthodontic bite corrector of embodiment 1 or claim 2, wherein the post has a substantially circular cross-sectional profile. 
     Embodiment 4. The orthodontic bite corrector of any one of embodiments 1-3, wherein the post comprises a ceramic material. 
     Embodiment 5. The orthodontic bite corrector of any one of embodiments 1-4, wherein the first support comprises a metal selected from the group consisting of a gold alloy and stainless steel. 
     Embodiment 6. The orthodontic bite corrector of any one of embodiments 1-5, wherein the hub includes a core, a cover, a washer, and a connector. 
     Embodiment 7. The orthodontic bite corrector of embodiment 6, wherein the core includes a notch. 
     Embodiment 8. The orthodontic bite corrector of embodiment 6 or embodiment 7, wherein the cover includes a stop. 
     Embodiment 9. The orthodontic bite corrector of any one of embodiments 6-8, wherein the washer includes a peg. 
     Embodiment 10. The orthodontic bite corrector of any one of embodiments 6-9, wherein the connector is a screw.  The orthodontic bite corrector of any one of embodiments 1-10, wherein the hub  selected from the group consisting of a gold alloy and stainless steel. 
     Embodiment 12. The orthodontic bite corrector of any one of embodiments 1-11, wherein the ramp includes a channel 
     Embodiment 13. The orthodontic bite corrector of any one of embodiments 1-12, wherein the ramp has an occlusal end and gingival end and wherein the ramp is wider at the occlusal end. 
     Embodiment 14. The orthodontic bite corrector of any one of embodiments 1-13, wherein the second support comprises a metal selected from the group consisting of a gold alloy and stainless steel. 
     Embodiment 15. The orthodontic bite corrector of any one of embodiments 1-14, wherein at least one of the first support and the second support is an orthodontic band. 
     Embodiment 16 is a method of correcting a malocclusion, the method comprising: attaching the orthodontic bite corrector of any of embodiments 1-15 to a patient&#39;s jaws. 
     Embodiment 17. The method of claim 16, wherein the malocclusion is a Class II or a Class III malocclusion. 
     Embodiment 18. The method of embodiment 16 or embodiment 17, wherein the orthodontic bite corrector is set at the first fixed hub position for a first period of time and is set at the second fixed hub position for a second period of time, wherein the second period of time is after the first period of time. 
     All cited references, patents, and patent applications in the above application for letters patent are herein incorporated by reference in their entirety in a consistent manner. In the event of inconsistencies or contradictions between portions of the incorporated references and this application, the information in the preceding description shall control. The preceding description, given in order to enable one of ordinary skill in the art to practice the claimed disclosure, is not to be construed as limiting the scope of the disclosure, which is defined by the claims and all equivalents thereto.