Patent Description:
For a range of reasons, teeth can acquire a non-ideal configuration in a person's mouth. This can be problematic for medical and/or dental health, and there may therefore be a need for medical treatment e.g. to preserve longevity or prevent loss of teeth in a patient, e.g. into old age. In addition, teeth have long been recognised as being linked to the external appearance and recognition or perception of a human face, particularly when smiling. Misaligned teeth relative to a reference external appearance condition (e.g. a social "ideal") can therefore also be experienced to be problematic for a person, e.g. for the psychological or general wellbeing of that person. There can therefore be a need for correction of teeth misalignment in patients for many purposes ranging from medical to cosmetic.

Various devices have been developed for reducing or aligning misaligned sets of teeth. In orthodontic dentistry, known arrangements for orthodontic tooth positioning can be generally divided into removable orthodontic apparatus and permanent orthodontic apparatus.

Removable orthodontic variants may include plates which are most often plastics based and which are often combined with steel bows and steel brackets which either function as fastening arrangements or as components for active positioning of teeth. For purposes of active positioning, the steel element is typically configured such that through the resilience of the metal, one may apply a force to a tooth or group of teeth which will result in a certain displacement of the tooth or teeth away from an original position. Alternatively, such plates may consist of plastics only where the resilient nature of the plastics can be utilised to apply a force to a tooth or group of teeth which results in a smaller displacement of the tooth away from the original position. A series of plastics rails can be manufactured, and these can function to move the teeth gradually little by little from the original position to a desired end position for the treatment.

In all types of plates and rails, the amount of displacement that can be generated is typically limited. The amount of control over the displacement obtained is also limited. This can lead to a need for frequent reactivation of the apparatus through adjustment of steel components or through manufacturing several new plastics rails. In addition, the possibilities for controlling the produced displacement of the tooth or teeth can be limited.

An advantage of removable orthodontic apparatus is that the patient has the option of taking the apparatus out in situations where it may be desirable to not have the apparatus in place. This may for instance be in social or job-related settings or when cleaning teeth and support tissue such as gums.

A permanent orthodontic apparatus differs from removable apparatus in that it is fastened to a patient's teeth in such a way that the patient cannot readily take the apparatus off by him or herself, and needs professional assistance to do so. Permanent apparatus may also be referred to as "fixed apparatus" in the art, but herein, the term "permanent apparatus" is applied to distinguish from removable apparatus where the removable apparatus is fixed to the teeth in operational use to apply the treatment but can be readily taken off and put back in place by hand by the patient him/herself when desired, without requiring specialist input or equipment.

An advantage of a permanently mounted orthodontic apparatus in comparison to removable apparatus can be a greater degree of control of the force vectors which act upon the teeth and support tissue. This can provide better control of the produced displacement of the teeth in all planes. By using the permanent apparatus, a tooth with root and support tissue can be subject to positioning in all relevant planes of movement, which in contrast is of limited possibility in removable apparatus.

The drawbacks of a permanent apparatus are that it can make access more difficult for cleaning teeth and supporting tissue, and also the fact that the apparatus protrudes from the tooth surface which can be experienced as intrusive toward cheeks, lips, and tongue of the patient, dependent upon whether the apparatus is fastened to the front or rear of the teeth. In the case of apparatus mounted on the rear of the teeth it may also affect a person's pronunciation of certain sounds. As is common to most permanent apparatus, there can often be a need to replace constituent parts of the apparatus and also there can be a need for adjustment and activation of the apparatus. In most cases, this must be performed by a skilled dentist to obtain the desired type and degree of movement of the teeth.

Typical intervals between check-up, reactivation, and adjustment of the apparatus at a dentist is normally in the region of <NUM> to <NUM> weeks. In this period, there can be generally an exponential decrease in the effects of the applied force from the apparatus against the tooth and of the degree of movement that has taken place.

There are many variants of permanent apparatus. Common to many of these, simple block elements are glued to the patient's teeth. The block elements have a groove of fixed dimension with space for fitting different types of metal bows which bind the elements together. By varying the dimension of the bow and its cross section (e.g. circular, quadratic, or rectangular), it may be possible to adapt and control the movement to which the teeth will experience. Other components for fixation of the bows to the block elements may include permanently mounted clips and "doors" which can retain the bows in the groove or small steel threads or elastic bands which can keep the bow in the groove on the block elements.

Document <CIT> discloses a pair of orthodontic brackets, wherein a male bracket has a bar which cannot be transformed by the forces of occlusion and retraction, and a female bracket has a tube which holds and supports the bar.

Treatment using a permanent orthodontic apparatus of this kind requires typically close follow up from a dentist and the achievement of the result will typically be dependent upon the experience and technical knowledge and experience of the dentist concerned. Such treatment does not form part of the claimed invention.

According to a first aspect of the invention defined in claim <NUM>, there is provided a plurality of elements configured to be arranged along a set of teeth and for use in apparatus for aligning or positioning teeth, the apparatus configured to be worn in a mouth of a wearer and further configured to be supported on the teeth of the wearer, the apparatus including at least one flexible elongate member which comprises at least one flexible thread, the or some of the elements being individually attachable to different teeth of a wearer, the plurality of elements comprising: at least one pair of elements comprising a first element and a second element, wherein at least one part of the first element is configured to bear against at least one part of the second element when engaged by the at least one flexible thread during operational use of the apparatus to facilitate aligning or positioning the teeth of the wearer, the elements to be engaged having at least one passageway for receiving at least one throughgoing flexible thread slidably therein and allowing the flexible thread to be relaxed to conform to variations in projection of the teeth in malocclusion or tensioned to engage the elements for imparting at least one force for aligning the teeth when applied thereto.

According to a second aspect of the invention defined in claim <NUM>, there is provided apparatus for aligning or positioning teeth, the apparatus configured to be worn in a mouth of a wearer and further configured to be supported on the teeth of the wearer, the apparatus comprising: the plurality of elements in accordance with the first aspect of the invention; at least one flexible elongate member for engaging the elements for moving one or more of the teeth; the flexible elongate member being configured to be tensioned to apply a component of force to the elements to engage the elements for moving the one or more of the teeth; the at least one pair of the elements of the plurality being arranged to be engaged by the flexible elongate member such that the at least one part of the first element of the pair is arranged to bear against the at least one part of the second element of the pair; the flexible elongate member comprising at least one flexible thread which is configured to be received slidably in the at least one passageway of the elements and which is further configured to be relaxed to conform to variations in projection of the teeth in malocclusion and tensioned to engage the elements for imparting at least one force for aligning or positioning the teeth.

The pair of elements may in this way cooperate to facilitate the alignment of the teeth during their movement upon engaging the elements.

The elements in the pair may be in contact or may be brought into contact with one another through the movement of the teeth upon engaging the elements. Thus, a surface of the first element may be arranged to contact a surface of the second element. The part, e.g. surface, of the first element may be arranged to slidably contact the part, e.g. surface, of the second element. The surface of the first element in the pair may be arranged to complement the surface of the second element in the pair.

The part of the first element in the pair may comprise a socket or hollow portion for receiving the part of the second element of the pair in the socket or hollow portion, e.g. in a male-female relationship. The part of the second element may comprise a fitting for fitting into the socket or hollow portion. The socket or hollow portion may have at least one surface for guiding the part of the second element into the socket or hollow portion.

The parts of the elements in the pair may be movable toward or away from one another. The parts of the elements in the pair may be movable in contact with one another, one relative to the other. The parts may be movable toward or away from one another with a component of movement along a length of the plurality of elements. The parts may be movable into a configuration in which further movement between the parts of the elements along a length of the plurality of elements may be prevented. The elements of the pair may lock together, e.g. by "clicking" or snapping into place. The locking together may facilitate obtaining a sufficiently stiff structure of the apparatus for transmitting mechanical forces to the teeth, and may e.g. reduce freedom of movement between elements for facilitating the alignment of teeth.

The parts may be movable relative to one another with a component of movement along a length of the plurality of elements for urging the first element outwardly or inwardly relative to the second element in response to the movement of the parts.

Either or both of said parts of the first and second elements in the pair may comprise at least one surface that is at least partially curved. The curved surface may have an arc, and the surface of the first element may be in contact with the surface of the second element in the pair and may be movable one relative to the other along the arc.

Typically, some of the plurality of elements may be fixed elements configured to be fixed to different teeth. At least one other of the plurality of elements may be a floating element that can move with respect to one or more of said fixed elements. The first element of the pair may be one of the fixed elements or may be a floating element that can move with respect to one or more of said fixed elements. The second element of the pair may be another one of the fixed elements or may be another floating element that can move with respect to one or more of said fixed elements.

In certain embodiments, the plurality of elements may comprise two fixed elements configured to be fixed individually to different teeth, and one or more intermediate elements positioned between the two fixed elements.

The floating element(s) may be an intermediate element(s) positioned between two fixed elements. The two fixed elements may be configured to be fixed respectively to adjacent teeth in the set of teeth. The first element of the pair may be one of the two fixed elements and the second element of the pair may be the intermediate element.

The pair of elements may be a first pair, and the apparatus may further comprise a second pair of elements wherein a part of one element of the second pair may be arranged to bear against a part of another element of the second pair, wherein the first element of the first pair may be one of the fixed elements and the second element of the first pair may be a floating element, and the one element of the second pair may be the floating element and the other element of the second pair may be another one of the fixed elements.

The flexible elongate member may comprise any one or more of: metal, synthetic material, and plastics material. The flexible elongate member may comprise cord, lacing, ribbon or the like. The flexible elongate member may be non-resiliently flexible.

The apparatus may be further configured to be attached to the teeth so as to be releasably attachable and detachable by the wearer.

The apparatus may further comprise fastening means for attaching the apparatus to the set of teeth. The fastening means may comprise fasteners. The fastener may be configured to grip onto one or more individual teeth when pushed onto the teeth by a user, e.g. the wearer. The fastener may comprise a "grip" device. The fastener may be adapted to individual characteristics of a tooth of the wearer. The fastener may be applied by the wearer for fixed attachment to a tooth of the wearer.

Any one or more of the elements may comprise a block or blocks respectively.

The apparatus may be an orthodontic treatment apparatus. The treatment may be for cosmetic or dental health purposes.

The plurality of elements may comprise a series of elements wherein the parts of the pair or pairs of elements may be mutually adapted to one another, and may make up a continuous row of mutually adapted elements. The row may extend along the set of teeth.

The surfaces between which contact may be obtained may be three-dimensionally complementary and may cooperate when they are in active contact with each other.

The flexible elongate member(s), e.g. thread(s), may define a degree of cooperation of the elements through defining a degree of contact between the parts, e.g. surfaces, of the pair of elements, e.g. a relative position or amount overlap of one surface relative to the other. The flexible elongate member may be resilient, elastic, rigid (non-elastic), or any combination thereof.

The elements may be cooperable by contact between the parts of the elements in the pair. The degree of cooperation may be determined at least partly by the flexible elongate member. The elements may be moved or driven toward or away from one another, and may be held together by one of more throughgoing flexible elongate members, which may preferably be integrated into the apparatus as a unitary structure. The apparatus may comprise a unitary structure which can be inserted and mounted in the mouth of the wearer as a single entity, e.g. applied by hand of the wearer.

The flexible elongate member may be configured to define a degree of contact between the parts in the pair of elements. The parts may comprise complementary three-dimensional contact surfaces. The elements and/or the parts in the pair of elements can be reversibly moved away and moved together again to an original or previous relationship between the elements and/or parts. The flexible elongate member may cooperate with the elements or parts, e.g. three-dimensional complementary surfaces, of the pair or pairs of elements and thereby may mutually support and optionally lock the elements to each other. The locking may thus prevent further relative movement between elements longitudinally along the set of teeth, rotationally about the longitudinal axis of the apparatus along the set of teeth, and/or laterally with respect to the longitudinal axis.

The apparatus may be shaped and/or adapted to a desired tooth configuration after completion of the tooth alignment process. The apparatus may be further shaped and/or adapted to a planned tooth configuration or position of individual teeth during a process of alignment between an initial tooth configuration and a desired tooth configuration.

"Releasable/removable" apparatus as used herein indicates that the patient/wearer can put the apparatus on and take it off themselves. "Permanent" apparatus as used herein indicates that the patient/wearer cannot put the apparatus on or take it off without professional help. The apparatus may be configured to be a removable apparatus. Alternatively, the apparatus may be configured to be a permanent apparatus.

The parts of the pair or pairs of elements, e.g. the three-dimensional complementary contact surfaces, may together with the throughgoing or longitudinally extending flexible elongate member, allow the teeth and/or supporting tissue obtain exact positions and relations. The parts, e.g. contact surfaces, may cooperate in dependence upon the operation of the flexible elongate member which may be tightened and slackened as required. The apparatus may include an activator for activating the flexible elongate member to be tightened or slackened as required. By tightening, elements in the plurality may be moved toward one another so that the parts of the at least one pair of elements, e.g. the complementary contact surfaces thereof, may advance into contact or into greater degree of contact with one another. Upon further activation, full contact between the surfaces may be obtained. In full contact, the elements may be supported and/or locked to one another. A precise force may in this way be transferred to the teeth and supporting tissue, the teeth may obtain new positions and relations through remodelling or adaptation of the root membrane, attachment apparatus, and/or surrounding bone structure. A change in position of the teeth may in this way be defined by the way in which the parts of the elements may bear against each other, e.g. the three-dimensional contact surfaces, and may be shaped.

A transfer of force to the teeth and support tissue may be obtained through activation of a longitudinally extending and/or throughgoing elastic, rigid, and/or resilient flexible elongate member. By activating the flexible elongate member, the apparatus may operate to obtain a planned desired configuration of elements with full degree of contact between the parts of the elements in the pair or pairs of elements. A force that may be transferred from the flexible elongate member to the elements and their parts, e.g. contacting surfaces, may be transmitted to the teeth and support tissue. Contact between the parts of the elements in the pair, may therefore define the final positions of the teeth after the movement/adjustment of teeth has ended. The fixed, elastic, and/or resilient flexible elongate member may be arranged to allow contact to be re-established, or is sought to be achieved between the parts of the one or more pairs of elements in the apparatus, at all times after slackening and subsequent activation of the flexible elongate member. Thus, the wearer in practice may deactivate the elements to remove the apparatus if desired. Later on, the wearer may reattach the apparatus to the teeth, and may reactivate the elements. By reactivation of the elements, the parts of the pair or pairs of elements may cooperate to reobtain a previous relationship between parts and progress toward an end desired configuration to align the teeth.

Any of the aspects may have further features as defined in relation to any other aspect, wherever described herein.

Embodiments of the invention can be advantageous in various ways, as will be apparent from reading of the specification throughout. In general, the apparatus may be operable to move individual teeth or groups of teeth from a given position to another. This apparatus may change an appearance of the teeth of the wearer and may produce an alignment of teeth in an arrangement where the teeth may be arranged for better dental health.

There will now be described, by way of example only, embodiments of the invention with reference to the accompanying drawings, in which:.

With reference first to <FIG>, an apparatus <NUM> for aligning and/or positioning teeth is generally depicted. The apparatus <NUM> has a plurality of elements in the form of a plurality of discrete blocks 5a-5c arranged in series. The set of blocks 5a-5c is configured to be mounted as a unit to part of an upper or lower arch of a set of teeth. When the blocks 5a-5c are fitted to the target teeth of the arch, the blocks 5a-5c are arranged distributed along the set of teeth.

The apparatus <NUM> includes engager members in the form of flexible engaging threads 6a, 6b ("flexible elongate members"). The blocks 5a-5c (i.e. "elements") are connected to one another by the throughgoing engaging threads 6a, 6b. The engaging threads 6a, 6b pass from one block to the next through internal channels 7a, 7b in the blocks. The blocks 5a-5c are movable relative to one another, toward or away from one another, along the engaging threads 6a, 6b.

Consider the pair of blocks 5a and 5b of the plurality. A part of the block 5a is arranged to bear against a part of the adjacent block 5b when the blocks in the pair are engaged and are moved upon activation of the apparatus in use. In <FIG>, the blocks 5a-5c are arranged apart from one another, such as typically is an initial configuration of the apparatus before it is activated.

More specifically, the block 5b has a hollow receiving part <NUM> into which a penetrating part <NUM> of the block 5a is arranged to fit in a male-female relationship when the blocks 5a, 5b are brought together. The block 5a has a contact surface <NUM> and the block 5b has a contact surface <NUM>. The surfaces <NUM>, <NUM> are shaped to complement one another. The contact surfaces <NUM>, <NUM> are in contact during the movement together of the blocks 5a, 5b toward a configuration in which they are engaged in the male-female relationship. The activation and use of such apparatus <NUM> will be described further below.

The surfaces <NUM>, <NUM> in <FIG> are curved in three dimensions. Typically, the surface <NUM> of the penetrating part <NUM> has generally a bulbous shape such as that of a dome while the surface <NUM> of the receiving part <NUM> has generally a concave shape such as that of a bowl. The surfaces <NUM>, <NUM> are co-operable to obtain a position of the block 5a relative to the block 5b based on the angle between the surfaces <NUM>, <NUM> and degree to which they are engaged, e.g. how far the penetrating part <NUM> overlaps or has entered the receiving part <NUM>. The receiving part <NUM> defines in effect a path where the surface <NUM> helps to guide the penetrating end <NUM> toward an end position in full engagement between the elements 5a, 5b.

The blocks 5a and 5c are configured to be fixedly attached to the respective adjacent teeth. However, the block 5b is an intermediate "floating" block which is movable relative to the fixed blocks 5a, 5c and movable relative to the teeth upon use. Upon being engaged, the blocks 5a and 5c are subjected to a force via the engaging threads 6a, 6b. The force is transmitted to the teeth to which the blocks 5a, 5c are fixed and the teeth are thereby caused to move toward alignment. After sufficient movement of one relative to the other, the block 5a engages the block 5b via the contact surfaces <NUM>, <NUM> as described above. The surfaces <NUM>, <NUM> contact one another and are shaped to constrain or guide the relative movement between blocks 5a-5c so as to correct the position of the teeth appropriately.

It can be appreciated that the blocks 5a, 5c that are to be fixedly attached to the teeth may be fixed in various ways, for example to provide a permanent apparatus or a removable apparatus. The blocks may be applied by suitable fastening means. For example, it is possible to "glue" the blocks 5a, 5c to a front or rear surface of the teeth by means of an adhesive or cement for a permanent attachment, or the blocks 5a, 5c could be applied fixedly in place on the teeth by fasteners such as attachment caps which are fitted to and removed from the teeth simply by hand force for providing a removable attachment of the apparatus.

<FIG> depict generally apparatus <NUM> for aligning teeth where a plurality of blocks 105a-105c are arranged in series and are connected together via engaging threads 106a, 106b. The apparatus <NUM> operates similarly to that of apparatus <NUM>. In <FIG> however, the apparatus <NUM> and blocks 105a-105c are shaped differently to those of Figures 1A and 1B. In particular, the block 105b has penetrating parts <NUM> each having an angled surface <NUM> to bear against a complementary angled surface <NUM> on the receiving parts <NUM> of adjacent blocks 105a, 105b. All or some of the blocks 105a-105c may be fixedly attached to respective teeth of a patient in use. In <FIG>, the configuration of the apparatus <NUM> in full engagement is indicated. <FIG> is an initial configuration before the blocks 105a-c have moved relative to one another along the engaging threads 106a, 106b.

<FIG> provides an example of apparatus <NUM> for aligning teeth having two floating blocks 205a, 205b intended to form part of the series of blocks. The floating blocks 205a, 205b are to be arranged in a series of blocks along the arch, in an intermediate position between other blocks (not shown) that are fixedly attached to the teeth by appropriate fastening means. These intermediate floating blocks 205a, 205b include surfaces <NUM> where one bears against the other during relative movement therebetween during activation of the apparatus <NUM> and engagement of the blocks. <FIG> indicates the configuration after full engagement of the block 205a, with respect to the block 205a. Flexible engaging threads 206a, 206b are also indicated in <FIG>.

The manner in which the apparatus of the above examples is used will now be described in further detail.

We turn first to consider <FIG> and <FIG>. The process for preparing an apparatus <NUM> for use by a patient begins first by using a model of the teeth <NUM>, in a so-called "set-up" configuration. The set-up model may for example be a physical model or a digital model on a computer. In <FIG>, the set-up model <NUM> of a patient's teeth is shown, showing the teeth aligned in the future ideal, corrected position. The upper arch <NUM> of teeth of the model <NUM> is seen in <FIG>.

The apparatus <NUM> is applied to the model arch of teeth <NUM> as indicated in <FIG>. On this basis, the apparatus <NUM> is adapted to the final configuration for the end of the treatment intended to be achieved for the set of teeth <NUM>. This is typically therefore a fully tightened configuration of the apparatus <NUM>, adapted to the teeth <NUM> in their desired end position. The series of elements <NUM> in the apparatus <NUM> include tooth supported fixed blocks <NUM> and intermediate floating blocks <NUM>. The elements <NUM> are arranged to follow the final tooth arch shape and are individually adapted to obtain the desired final positions of the teeth after completed active treatment. The end position of the teeth <NUM> is defined through this set up of the teeth in the ideal position (setup) either digitally produced or manually produced. This model <NUM> defines the tooth arch and the position of the individual teeth in all planes. The apparatus <NUM> can be produced and adapted to the physical setup model or it may be produced based on data regarding the teeth from the digital setup model.

After the setup and obtaining the appropriately configured apparatus <NUM>, the series of blocks <NUM>, <NUM> are adapted and distributed in the apparatus according to the desired placement and in desired relation to the surface of the target teeth to be moved.

In order to attach the apparatus <NUM> to the patient's teeth in the proper position, e.g. based on the model data, the blocks <NUM> need to be attached in fixed position to the teeth. A suitable fastening means is used for correct attachment and positioning of the blocks <NUM> on the teeth. In this example, fastening means in the form of fasteners <NUM> are used which may be defined and/or adapted to the teeth in the setup model.

The fasteners <NUM> can be digitally or manually produced for the relevant teeth and the corresponding fixed blocks <NUM>, and are appropriately integrated with the blocks <NUM> in unitary fashion such that the blocks <NUM> are adapted to the teeth and fit onto respective teeth in suitable position and/or orientation. The fasteners <NUM> can be provided as "grip" devices that grip onto individual teeth surfaces when pushed onto the tooth by a user. Alternatively, the fasteners <NUM> can be permanently attached, e.g. by adhesive. One or more intermediate blocks <NUM> providing contact surfaces which are complementary in shape are disposed in the spaces between the fixed blocks <NUM>.

The number, size, and shape of the fixed blocks <NUM> may in general vary according to the anatomy and tooth arch shape, together with the position of the teeth and the bite discrepancy which is sought to be corrected.

Engaging threads <NUM> are fed through channels or tracks in the blocks <NUM>, so as to pass through all of the blocks <NUM> in the orthodontic apparatus <NUM>.

Referring now further to <FIG>, the apparatus <NUM> which has been prepared in accordance with the setup model or models is then mounted to the teeth of the patient. The blocks <NUM> which are to be fixedly attached to the teeth are attached to the relevant teeth of the patient in the appropriate positions by application of the fasteners <NUM>.

It can be appreciated that the individual teeth of the set up model are anatomically the same as those of the patient, except that in the set up model they are positioned and aligned in the final planned configuration for the treatment. A print or scan of the patient's teeth may be taken in order to reproduce the surface anatomy for the model. The fasteners <NUM> and blocks <NUM> can therefore be designed to fit the individual teeth of the patient in the model and are attached in the same positional relationship on an individual tooth when applied to the patient. The engaging threads <NUM> which connect between the blocks flex to allow for the difference in position and alignment of the patient's teeth in malocclusion compared with the model positions.

The apparatus <NUM> is then activated. The engaging thread or threads <NUM> are tensioned between fixed blocks <NUM>. This generates a force which engages the fixed block <NUM>, and the teeth to which they are fixed, to move relative to one another. The intermediate blocks <NUM> engage such that the surface of an intermediate block <NUM> bears against a complementary surface of an adjacent intermediate block <NUM> or fixed block <NUM>, and the further movement of the teeth toward alignment takes place in dependence upon the contact established between the complementary surfaces. While throughout herein complementary surfaces in contact with one another are mentioned as an example, it can be readily appreciated that other arrangements can achieve a guiding effect upon the movement of the teeth by one element bearing against another during the movement of the elements relative to one another and/or progression toward the end of treatment conditions, once the apparatus is activated.

Activating the apparatus <NUM> to engage the elements is achieved through tensioning the engaging threads <NUM> ("engager members"). Various arrangements can be provided for doing so. For example, an arrangement for tightening and slackening the engaging thread or threads <NUM> can be established in or on one or more of the blocks <NUM>, <NUM> in the apparatus. A mechanism, e.g. a rotatable spool or the like mounted to one of the elements, may be used for tightening or slackening the engaging threads or threads <NUM>. By tightening the thread tension may be applied and a force may be transmitted to the elements to engage them.

The length of the engaging thread or threads <NUM> is determined by the linear distance through the channels on the blocks <NUM>, <NUM> from end to end of the orthodontic apparatus when the blocks <NUM>, <NUM> are transferred from the setup to the malocclusion model or patient. This distance is larger than the end-to-end linear distance through the channels of the blocks when applied to the setup model. By activation and/or tightening of the engaging threads <NUM>, the blocks <NUM>, <NUM> in the orthodontic apparatus are driven toward one another. Through the fastener arrangement, the teeth will follow from the relevant position in malocclusion to final ideal position dictated by and defined by the orthodontic apparatus according to the setup of the ideal position of the teeth.

In <FIG>, the apparatus <NUM> at the end of treatment has aligned the patient's teeth <NUM> in the desired configuration as planned. The apparatus <NUM> is removed and, in <FIG>, the teeth <NUM> can be seen without the apparatus in their final positions.

Turning to <FIG>, another example apparatus <NUM> is depicted for aligning teeth. A setup model of the lower set of teeth <NUM> in the ideal planned positions after treatment is provided, as seen in <FIG>. In <FIG>, the apparatus <NUM> is adapted to the setup model teeth <NUM> and data obtained for properly positioning the teeth when transferred to the patient's teeth <NUM> in malocclusion. The apparatus is relaxed so that it can be fitted to the patient's teeth <NUM> in malocclusion. In <FIG>, the apparatus <NUM> is fitted to the patient's teeth <NUM>. The apparatus <NUM> is then tensioned. The blocks <NUM>, <NUM> are engaged so as to progress the teeth toward the final treatment positions. Pairs of adjacent blocks bear against each other, where part of one block contacts part of an adjacent block to control the movement of the blocks and teeth relative to one another during the treatment period. Eventually, the apparatus <NUM> and teeth <NUM> is brought into substantially the same position as planned on the setup model teeth <NUM> in <FIG>. The teeth <NUM> are then aligned, and the planned treatment using the apparatus <NUM> is complete.

While the above examples illustrate blocks <NUM>, <NUM>, <NUM>, <NUM> applied along an outside of the teeth <NUM>, <NUM>, it will be appreciated that in other examples the apparatus <NUM>, <NUM> could be applied in the corresponding manner to place blocks on the along an inside of the arch of the teeth <NUM>, <NUM>.

In the above, the apparatus can be provided as a unit. It can be provided throughout the process without need for adjusting or replacing the whole or part of the apparatus during the treatment process, since the apparatus can change dynamically during treatment. In this regard, the apparatus can be adapted to a predefined initial situation (set up) which represents the ideal position of the teeth that would be desirable to obtain through the treatment. The apparatus can flex and flexibly adapted to different orientations and degrees of inward or outward protrusion between teeth. Through stretching or slackening of the engaging threads the apparatus is adapted to the variations of a patient's teeth positions in the relevant malocclusion. When relaxed, the threads can readily flex and fully bend back on itself so that the apparatus can be fitted along a tortuous path if required in order to accommodate variations in teeth position or orientation. During the treatment process, the predefined initial configuration of the apparatus can be recreated by drawing the engaging threads together or tightening them. Through this activation of the engaging threads in the apparatus, the blocks can be driven toward and into contact with one another, whereby eventually the predefined initial configuration for the apparatus can be recreated. The apparatus by virtue of it being fastened to the patient's teeth will, as a result, guide the teeth from their original positions in malocclusion to the desired ideal positions defined for the treatment.

A further advantage of the orthodontic treatment apparatus can be that the apparatus is removable such that the patient themselves can put the apparatus on and take it off without assistance from a dentist. The patient can therefore be without the apparatus during certain periods of the day. The patient can also both tighten and slacken the apparatus through activation or slackening of the engaging thread or threads. The activation mechanism for engaging the apparatus can therefore be hand operated by the wearer.

The predefined treatment result to which the apparatus is adapted can reduce the need for follow up by a dentist for adjustment or activation. The movement produced during engagement of blocks can depend upon the nature of contact between the various pairs of blocks. The surfaces bearing against each other may thus facilitate to guide the blocks directly toward the desired location with full control of force vectors and the degree of force impressed upon individual teeth and supporting tissue.

The apparatus may also have an ability to capture any unforeseen wander of teeth that may undesirable either during and/or after the orthodontic treatment has ended. Teeth that have been moved in general have a tendency to wander back or wander in the direction back toward their original position both during and after orthodontic treatment. This can be a complicating factor for treatment of bite discrepancies.

In the prior art (removable and permanent), one will usually need to replace parts of the apparatus or produce a new apparatus to correct unintended tooth displacements or wander during the treatment. After treatment has ended, undesired changes in teeth position or wander can lead to a need to start a new process of treatment and produce new apparatus, either permanent or removable.

Using the present apparatus, such discrepancies in teeth position can be corrected without needing to produce a new apparatus or replace parts of the apparatus.

The treatment apparatus may be fastened to the target teeth by utilizing known techniques such as glue and/or a fastener such as a close-fitting sleeve, grip device, or cap or the like. The apparatus can in general be releasably removable or permanently fastened (not removably) to the target teeth.

It should also be noted although two engaging threads <NUM> are illustrated above, it can be appreciated that only one such thread could be applied in other embodiments. The threads <NUM> connect the blocks <NUM> together to provide a series of blocks <NUM> along the threads <NUM>.

The threads <NUM> can be wound or folded about a tight angle or arc. For example, they can bend by <NUM> degrees, <NUM> degrees or more, e.g. without exhibiting permanent plastic deformation. The threads <NUM> may typically not exhibit resilience in response the conditions that they are subject to in application to the model or actual teeth in the apparatus described above. Thus, the threads <NUM> can readily flex and slacken to required configurations and conform to the surface profiles of the teeth in the applicable malocclusion. However, elastic threads may be employed in certain variants. A flexible elongate members may similarly be embodied in the form of string, ribbon, lacing, or cord, e.g. of natural or synthetic fibres.

Claim 1:
A plurality of elements (5a-5c, 105a-105c) configured to be arranged along a set of teeth and for use in apparatus for aligning or positioning teeth, the apparatus configured to be worn in a mouth of a wearer and further configured to be supported on the teeth of the wearer, the apparatus including at least one flexible elongate member which comprises at least one flexible thread, the or some of the elements (5a-5c,105a-105c) being individually attachable to different teeth of a wearer, the plurality of elements (5a-5c,105a-105c) comprising:
at least one pair of elements (5a-5c, 105a-<NUM>05c) comprising a first element (5a-5c,105a-105c) and a second element (5a-5c,105a-105c), wherein at least one part of the first element (5a-5c,105a-105c) is configured to bear against at least one part of the second element (5a-5c,105a-105c) when engaged by the at least one flexible thread (6a, 6b) during operational use of the apparatus (<NUM>) to facilitate aligning or positioning the teeth of the wearer, characterized in that
the elements to be engaged have at least one passageway for receiving at least one throughgoing flexible thread (206a, 206b) slidably therein and allowing the flexible thread to be relaxed to conform to variations in projection of the teeth in malocclusion or tensioned to engage the elements for imparting at least one force for aligning the teeth when applied thereto.