Patent ID: 12186144

DETAILED DESCRIPTION

Restorative dentistry may be used to add tooth structure to a patient's dentition, e.g., to an existing tooth, in order to improve at least one of function, integrity, aesthetics, or morphology of missing or irregular tooth structure. For example, restorative dentistry can be an aesthetic treatment to improve appearance of teeth by, for example, altering their shape and/or optical properties (e.g., shade, translucency), which can be achieved using any suitable technique, such as by applying a veneer, managing position or contour of adjacent soft tissues, lessening or removing a gap (diastema) and/or resolving the appearance of malposition. As another example, restorative dentistry may be used to adjust the biting or chewing function of teeth to affect tooth function and/or other aspects of overall oral health such as temporomandibular joint (TMJ) disorders, excessive wear, periodontal involvement, gingival recession or as part of a larger plan to construct a healthy and stable oral environment.

In some cases, a dental restoration process includes drilling decay from an infected tooth or reshaping teeth by removing undesired tooth structure (e.g., which may be referred to as “preparing” the tooth) and then using tools and craftsmanship to manually isolate, retract, fill and contour the finished restoration.

Different techniques may be used to isolate the dental restoration site. Quality isolation of the dental restoration site via a rubber dam can be cumbersome and may be skipped for less effective isolation via cotton rolls, which may increase the risk of contamination, reduce longevity of the restoration, or both. Retraction of soft and hard tissue may include manipulation of cords, wedges and matrix bands. Imperfect retraction techniques may result in contamination, difficulty in achieving proper tooth contours and symmetry, finishing and/or polishing in interproximal areas, poorly adapted contacts, or any combination thereof.

While “bulk fill” restorative materials and high intensity curing lights may facilitate relatively fast filling of deep cavities (e.g., 4-5 mm), many restorations may be completed in a single shade as practitioners may be uncertain of the correct layering protocol for multiple shades or types of restorative material. Additionally, with little geometrical guidance available on a prepared tooth, creation of the final filling level and occlusal surface geometry may include overfilling with restorative dental material, followed by an iterative process of grinding and checking tooth contact and biting function on an anesthetized patient. This process may be the most time consuming for dental restorations and errors here may result in tooth sensitivity and return visits for adjustment.

The tools described herein may include features designed to provide interferences between the two primary mold portions of the tool and certain engagement portions which interlock, which overall helps with preventing relative movement between the mold portions in multiple directions, helps with better clamping of the tool to the patient's teeth and for sealing the two mold portions together. Such interferences are digitally designed into the custom mold is when it is designed and produced. Traditional molds do not have digitally designed interferences. In order to interlock together or separate the two mold portions from each other, they may need to deform or bend. In addition, the tools described herein may eliminate the need for external tools, like ring clamps, and are instead self-contained and thus, quicker and simpler to install on a patient's teeth. In addition, captive doors provide a reduction of individual parts that need to be assembled, and decreasing the likelihood of losing individual parts. Lastly, the tools described herein may reduce flash and/or to allow increased control of the placement of restorative material compared to practitioners using more traditional skills, tools and techniques.

In some examples, a tool described herein may be digitally designed. For example, a tool may be designed using a three-dimensional (3D) model of the patient's tooth structure (e.g., obtained from an intraoral scan of all or part of the patient's dentition or scanning of a conventional impression or model). The tool can be, for example, manufactured from the digital data using an additive technique, such as 3D printing, or a subtractive technique, such as CAD/CAM milling.

In some examples, the tool for a dental restoration may include a mold designed based on the 3D model of the patient's tooth structure, and may include additional features to provide advantages over molds that are formed based simply on the 3D scan, a wax up model, or other molds based simply on the shape of the anatomy and/or desired tooth structure of the patient. The disclosed techniques may facilitate high quality dental restorations with improved quality, reduced flash, reduced time and/or skill requirements compared to conventional dental restoration techniques.

Example tools for a dental restoration are described in commonly-assigned patent applications United States Patent Publ. No. 2018/0021113, titled “Dental Restoration Molding Techniques,” filed Dec. 7, 2015, U.S. patent application Ser. No. 16/061,362, titled “One-Piece Dental Restoration Molds,” filed Dec. 15, 2016, U.S. patent application Ser. No. 16/061,350, titled “Dental Restoration Molds,” filed Dec. 15, 2016, WO 2018/022616 Publ. No., titled “Dental Restoration Molds,” filed Jul. 25, 2017, and U.S. Patent Provisional Application Ser. No. 62/560,457, titled “Dental Restoration Molds,” filed Sep. 19, 2017, the entire contents of which are incorporated by reference.

FIGS.1,2, and3illustrate an embodiment of a facial portion of the custom tool10of the present invention.FIGS.4,5, and6illustrate an embodiment of a lingual portion of the custom tool10of the present invention. “Facial” as used herein, including the claims, refers to the direction directed toward the cheeks or lips (i.e., the buccal and labial) of the patient, and opposite the lingual direction. “Lingual” as used herein, including the claims, refers to the direction directed toward the tongue of the patient, and opposite the facial direction.FIGS.7,8A,8B, and9illustrate how the facial and lingual portions fit together to form a complete a custom tool10for forming a patient-specific dental restoration.

FIGS.1-3are views of the facial mold body12custom tool10for forming a patient-specific dental restoration. The tool10includes a facial mold body12, which may be configured to provide a customized fit with at least one tooth of a patient. For example, facial mold body12may be specifically designed to fit next to, mate with, and provide restorative structure to the at least one tooth. In the example shown inFIG.1, the facial mold body12includes a restorative portion16and an engagement portion. A practitioner uses the restorative portion16of the custom tool to restore at least one tooth in the mouth of the patient. In the illustrated embodiment, there are two engagement portions18a,18b(collectively, engagement portion18) positioned at opposite ends of the restorative portion16, which is located between the engagement portions18a,18b. This is ideal, but not necessary. For example, the facial mold body12could include just one engagement portion positioned adjacent the restorative portion16. In tools having two engagement portions18a,18b, this provides two points of interlock between the lingual and facial mold bodies12,14. For descriptive ease and not otherwise depicted in the Figures, both the single and dual engagement portion embodiments may be referred to hereafter as engagement portion18.

The first engagement portion18aand second engagement portion18B both extend away from the restorative portion. In the illustrated embodiment, the engagement portions18extend at a generally right angle relative to the restorative portion16. When compared to the patient's mouth, which includes an occlusal plane shown generally by line A-A (inFIG.2) the engagement portions18extend generally perpendicular to such occlusal plane.

The length of the engagement portions18extend some distance from the restorative portion16of the facial mold body12. The length of the engagement portions may be customized and optimized for the individual patient. If the engagement portions are too long, they will stretch the patient's jaw, making it uncomfortable or painful for the patient. If the engagement portions are too short, the facial mold body12will disengage from the patient's teeth. In one embodiment, the length of the engagement portions may be 1 mm to 5 cm in length. However, it may depend on where exactly the engagement portions are located in the patient's mouth. They may be longer, if they are attach to the patient's teeth near the front of the mouth, such as the incisors. They may be shorter, if they are attached to the back of the mouth, like the molars. Also, the patient's overall opening distance between the upper and lower arches of teeth is a consideration.

As illustrated inFIG.3, engagement portions18of the facial mold body12may include a variety of engagement surfaces configured to mate appropriately with the engagement surfaces on a lingual mold body14. Engagement portions18A,18B of the facial mold body12may include a protrusion20A,20B respectively or some other mechanism known in the art for interlocking with the lingual mold body14. In the illustrated embodiment, protrusion20includes a first engagement surface24, a second engagement surface26, and a third engagement surface28. Protrusions20A,20B are sized and shaped to interlock or snap fit with the indentations30A,30B in the lingual mold body14. Alternatively, the facial mold body12may include the indentations30and the lingual mold body14may include the protrusions20. Alternatively, engagement portions18of the facial mold body12could include a protrusion on one end and an indentation on the opposite end, and the lingual mold body14could include an indentation on one end and a protrusion on the opposite end, to allow the two bodies12,14to interlock together. Various structures known in the art may be substituted for the protrusion20and indentations30, so long as they assist in securely interlocking the facial mold body12to the lingual mold body14. For example, dovetail vertical slides or button and snaps may also be used as interlocking features of the engagement portions.

The engagement portions18A,18B of the facial mold body12are structured to engage with or interlock with the engagement portions31,32, and33on the lingual mold body14, as explained in more detail below in reference toFIGS.7,8, and9.

In the illustrated embodiment, the restorative mold body16is sized and shaped to mate with the anterior teeth of a patient. The engagement portions18are sized and shaped be adjacent to the posterior teeth. However, in other embodiments (not illustrated), an engagement portion18could be adjacent the anterior teeth and the restorative portions16could be adjacent the posterior teeth.

In the example shown inFIG.1, the facial body12includes one or more apertures34, which may each be configured to align with a portion of a facial surface of a respective tooth of the patient to be restored. In some examples, the portion is a majority of the facial surface of the tooth to be restored. For example, aperture34may be configured to align with a portion comprising a majority of a facial surface of one tooth and aperture34may be configured to align with a portion comprising a majority of a facial surface of another tooth. The surface of the tooth to be restored and aligned with the respective apertures34may, for example, be defined by existing tooth structure or by the dental restoration formed using the facial mold body12and lingual mold body14.

Each of the apertures34has a suitable configuration (e.g., shape and/or size) for introducing restorative material into a mold cavity defined by an interior surface42of door40and the interior mold surface64(shown inFIG.4) to cover the portion of the surface of the tooth to be restored, where both interior surfaces42,64are surfaces facing the tooth or teeth to be restored. When door40is mated with a respective aperture34, the surface42of the door40and the tooth structure of a patient may help shape the restorative material that is placed in the mold cavity, e.g., in order to define the surface of the tooth to be restored.

In some embodiments, the shape of one or more of apertures34may be designed to substantially match the shape of the tooth and/or the portion of the tooth to be restored. For example, apertures34may be substantially noncircular. In other examples, however, the shape of one or more apertures34may be circular.

Apertures34may be sized to be larger than a tip of a dental capsule or a syringe tip that is used to introduce restorative dental material into the mold cavity defined by mold bodies12,14. Apertures34may be sufficiently large to allow placement and flow of restorative material to cover the portion of the surface of the tooth being restored. Additionally, or alternatively, apertures34may be sufficiently large to allow movement of the tip of the capsule or syringe tip within aperture34. As another alternative, the custom tool10could include injection ports, as discussed in more detail below relative toFIG.13.

The facial mold body12may have individual doors40sized to closely fit with corresponding apertures34. Some of the doors40may be attached to the facial mold body12as illustrated with a hinge48and hinge pin46at one end, and an attachment mechanism44at the other end. The attachment mechanism44in this case is a clip44which is designed to clip over or snap onto an engagement surface43on the facial mold body12. As such, the hinge48and hinge pin46are adjacent the occlusal surfaces of the patient's teeth or located proximate an incisal edge of a tooth or teeth to be restored and the clip44and engagement surface43are adjacent the gingiva of the patient's teeth. This arrangement is convenient for the clip to snap under the occlusal surfaces or incisal edge of the patient's teeth, spaced away from their tongue. However, in other embodiments not illustrated, their relative positions may be reversed, with the clip44and engagement surface43adjacent the incisal or occlusal surfaces of the patient's teeth and hinge48and hinge pin46adjacent the gingiva.

Additionally, some of the doors40may be attached to the facial mold body12as illustrated using a two-part hinge, having a first portion56and a second portion58, and hinge pin46at one end, and an attachment mechanism44at the opposite end. The attachment mechanism44in this case is a clip44which is designed to clip over or snap onto an engagement surface43on the facial mold body12. The first portion of the hinge56has a smaller diameter than the second portion of the hinge58. The two-part hinge is convenient for lifting away and pulling the door40away from the aperture34, when the second portion58is used. The two-part hinge is convenient for tightly inserting the door40into the aperture34. The hinge pin46may move between the smaller diameter first portion and the larger diameter second portion of the hinge58, as illustrated inFIGS.11aand11b. Additionally, the two-part hinge allows for it to be 3D printed already as a completed assembly. Also, the larger diameter in the second portion58of the hinge allows for easier cleanup of excess resin during use and helps prevent the bonding of the pin46to the hinge.

In the illustrated embodiment, the door body40and facial mold body12are mechanically connected to each other by using a hinge48and hinge pin46. This configuration helps maintain proper alignment between the door body40and corresponding aperture34during use of custom tool10. However, door body40and facial mold body12may be connected via a snap hinge, a living hinge, a barrel hinge, a pin joint hinge, or any other suitable type of hinge. Door hinge48and hinge pin46may be formed separate from the door body40and/or facial mold body12or door hinge48and hinge pin46may be formed as an integral part of door body40and/or facial mold body12.

The facial mold body12may include a first alignment member52, which assists in properly aligning the facial and lingual mold bodies12,14before interlocking them together. In the illustrated embodiment, the first alignment member52is a post that is sized to fit with the second alignment member54in the lingual mold body14, shown as a slot inFIGS.4-7.

The facial mold body12and lingual mold body14may be configured to combine with at least one tooth of the patient to define a mold cavity encompassing at least a portion of desired tooth structure of the tooth or teeth to be restored. For example, in the illustrated example, the facial mold body12and lingual mold body14may combine with teeth of the patient to define a mold cavity encompassing at least a portion of desired tooth structure for each of the teeth with facial portions aligning with apertures34A and34B. In some examples, the dental restoration may include a dental veneer restoration on the tooth or teeth to be restored, and the apertures34A and34B may allow a practitioner to have better control over the placement of restorative material in the mold cavity than a traditional mold. For example, the apertures34, which align with a majority of a surface of a lingual or facial surface of a tooth may allow a practitioner to have better control over the final appearance of that surface, including the final surface texture, shading, and layering of the restorative materials.

Tdoor body40may include a vent The vent may be configured to allow excess restorative material to flow out of a mold cavity, which may be removed prior to curing (e.g., with a scalar instrument), providing for easier removal of flash. Alternatively, or in addition, vent may be configured to allow air to flow out of the mold cavity.

The facial mold body12may include a custom gingival surface36that is generally contoured to match the gingiva, but not engaging the gingiva. This allows excess restoration material to be cleanly removed. The facial mold body12may also include a facial rib38to provide overall strength to the facial mold body.

Custom tool10may include a lingual mold body14, which may also be configured to provide a customized fit with the at least one tooth of the patient.FIGS.4,5, and6illustrate views of one embodiment of the lingual mold body14. Facial mold body12and lingual mold body14may be configured to combine with the at least one tooth of the patient to form the mold cavity. For example, facial mold body12and lingual mold body14may be configured to mate with one another and/or to be attached to the at least one tooth to form the mold cavity. In some examples, lingual mold body14is separable from and engageable with the facial mold body12, while maintaining the integrity of the respective mold bodies, through use of their engagement portions18,19.

In the example shown inFIGS.4-6, the lingual mold body14includes a restorative portion17and an engagement portion19. A practitioner uses the restorative portion17of the custom tool to restore at least one tooth in the mouth of the patient. In the illustrated embodiment, there are two engagement portions19A,19B positioned at opposite ends of the restorative portion17, which is located between the engagement portions19A,19B. This is ideal, but not necessary. For example, the lingual mold body14could include just one engagement portion19positioned adjacent the restorative portion17. In tools having two engagement portions19A,19B, this provides two points of interlock between the lingual and facial and lingual mold bodies12,14respectively.

Lingual mold body14includes first engagement portion19A and second engagement portions19B. The engagement portions19A,19B of the lingual mold body14are structured to engage with or interlock with the engagement portions18A,18B on the facial mold body12, as explained in more detail below in reference toFIGS.7,8, and9.

The first engagement portion19A and second engagement portion19B both extend away from the restorative portion. In the illustrated embodiment, the engagement portions19extend at a generally right angle relative to the restorative portion17. When compared to the patient's mouth, which includes an occlusal plane illustrated as reference line A-A (shown inFIG.6), the engagement portions19extend generally perpendicular to the occlusal plane.

As illustrated inFIG.6, engagement portions19of the lingual mold body14may include a variety of engagement surfaces configured to mate appropriately with the engagement surfaces24,26,28on the facial mold body12. Engagement portions19A,19B of the lingual mold body14may include an indentation30A,30B respectively or some other mechanism known in the art for interlocking with the facial mold body12. In the illustrated embodiment, indentation30includes a first engagement surface31, a second engagement surface32, and a third engagement surface33. Indentations30A,30B are sized and shaped to interlock or snap fit with the protrusions20A,20B in the facial mold body12. Various structures known in the art may be substituted for the indentations30and protrusion20, so long as they assist in securely interlocking the lingual mold body14to the facial mold body12.

In the illustrated embodiment, the restorative portion17is sized and shaped to mate with the anterior teeth of a patient. The engagement portions19are sized and shaped to be adjacent the posterior teeth. However, in other embodiments (not illustrated), an engagement portion19could be adjacent the anterior teeth and the restorative portion17mate with the posterior teeth.

The facial mold body12includes a plurality of an engagement surfaces43adjacent the occlusal surfaces of the patient's teeth or located proximate to an incisal edge of a tooth or teeth to be restored. This arrangement is convenient for the clip44(shown inFIGS.1-3) to snap under the occlusal surfaces or incisal edge of the patient's teeth, spaced away from their tongue. However, in other embodiments not illustrated, the engagement surface43may instead be adjacent the gingiva of the patient's teeth, with the clip44likewise being in a similar position.

The lingual body14includes mold surfaces64sized to create appropriate mold cavity or cavities with the inner surface42of the door40(shown inFIGS.1-3) and/or in combination with the tooth structure of a patient to help shape the restorative material that is placed in the mold cavity or cavities in order to define the surface of the tooth or teeth to be restored.

The lingual mold body14may include a custom lingual rib39to provide additional clamping or mating to the individual patient's mouth, which helps provide additional stiffness and/or rigidity for the lingual mold body14.

The lingual mold body14may include a second alignment member54sized and shaped to fit with the first alignment member52. In the illustrated embodiment, the second alignment member54may be mesial alignment receptor. Specifically, the second alignment member may be a slot sized to receive the post52on the facial mold body12.

FIGS.8A,8B,9and10are useful for illustrating how the facial mold body12and lingual mold body14are assembled together and around the teeth of a patient to form a custom tool10. One of the major benefits of this design is that once assembled, movement between the facial mold body and the lingual mold body is restricted in multiple directions and multiple rotations. As a result, practitioners are able to create more accurate restorations for their patients.

WithFIGS.8A and8Bas a point of reference, a practitioner may first place the lingual mold body14behind the patient's teeth, with the second alignment member54centered adjacent the occlusal surfaces of the patient's teeth. Then, the practitioner may place the facial mold body12over the front of the teeth and align the first alignment member52, the post, to fit into the second alignment member54, the hole. However, in other embodiments, mold bodies12,14could include indicia or alignment features (e.g., visual indicators, other forms of mechanical mating features, keyholes, notches, inking, and the like) to help a practitioner properly align and easily engage facial mold body12and lingual mold body14with one another.

The facial and lingual mold bodies12,14are preferably made of flexible materials to bend them at certain radiuses to successfully interlock them together, as illustrated inFIGS.8A and8B. A practitioner will interlock the mold bodies12,14together by placing the protrusions20A,20B into the corresponding indentations30A,30B. The release tabs22A,22B may optionally be used to help fit protrusions20A,20B into the indentations30A,30B. Custom tools can be made from the full range of 3D printed materials, molded polymeric material or CAD/CAM shaped polymeric materials having certain desired strength, flexibility, translucency, or color. For example, the mold material can be polymeric material that may be transparent, translucent, or opaque. In some embodiments, clear or substantially transparent polymeric material that may include, for example, one or more of amorphous thermoplastic polymers, semi-crystalline thermoplastic polymers, transparent thermoplastic polymers, and thermoset polymers. Thermoplastics can be chosen from polycarbonate, thermoplastic polyurethane, acrylic, polysulfone, polyprolylene, polypropylene/ethylene copolymer, cyclic olefin polymer/copolymer, poly-4-methyl-1-pentene or polyester/polycarbonate copolymer, styrenic polymeric materials, polyamide, polymethylpentene, polyetheretherketone and combinations thereof. In another embodiment, the mold may be chosen from clear or substantially transparent semi-crystalline thermoplastic, crystalline thermoplastics and composites, such as polyamide, polyethylene terephthalate. polybutylene terephthalate, polyester/polycarbonate copolymer, polyolefin, cyclic olefin styrenic polymer, copolymer, polyetherimide, polyetheretherketone, polyethersulfone, polytrimethylene terephthalate, and mixtures and combinations thereof. In some embodiments, the mold is a polymeric material chosen from polyethylene terephthalate, polyethylene terephthalate glycol, poly cyclohexylenedimethylene terephthalate glycol, and mixtures and combinations thereof. In additional embodiments thermoset polymers include acrylics, urethanes, esters, silicones, thiolenes, epoxies, olefin metathesis and combinations thereof.

The custom tool10is designed to ensure a relatively tight fit between the mold bodies12,14to assure an accurate and precisely shaped restoration while helping reduce or eliminate the flash that occurs along the edge where the two mate together. Any flash that does occur may be very thin along the incisal edge and may be relatively easily removed with a dental instrument. By providing a relatively tight fit along the incisal edge or another edge of mold bodies12,14, this may help excess restorative material preferentially flow toward the vent where flash may be relatively easily seen and removed during finishing of the restoration.

FIG.8Bis convenient for describing the clamping force that can be generated between the facial mold body12and the lingual mold body14. The facial mold body12has a certain arch length (C), and the lingual mold body14has a certain arch length (D). When the custom tool10is made, the geometry of the facial and/or lingual mold bodies12,14is altered. For instance, the arch length C of the facial mold body12may be shortened, while the arch length D of the lingual mold body is maintained, and this configuration creates a clamping force between the two mold bodes12,14when they are assembled. In addition, the mold bodies12,14are sufficiently strong so as not to break or buckle, and the protrusion20and the indentation30can be interlocked without creating undue pressure in the mouth of the patient. Clamping forces can also be generated by slightly reducing the radius of curvature of the facial mold body12, while maintaining the radius of curvature of the lingual mold body14. Angle θ illustrates the latching surface relative to the arch tangent.

The degree of clamping force between the facial mold body12and the lingual mold body14should be tailored to balance the security of the installed tool10around the patient's teeth and sealing it against the gingival tissues with ease of installation into and removal from the patient's mouth. The degree of clamping force can be increased by increasing the stiffness of the mold bodies12,14via materials, geometry the amount of shortening of the facial mold body12, and/or reduction of the radius of curvature of the facial mold body12. Modifications to the mold bodies12,14can be applied across the mold bodies, for instance by applying an appropriate shrinkage factor, or they can be applied locally to various regions of the mold bodies and/or latching mechanism between the two. Latch securement and ease of engagement and removal can be tailored by adjusting the latching angle, length of the latching surfaces (engagement surface)3132,33and topography of the surfaces24,26,28to obtain the best balance of performance. Tools such as finite element modeling can be used to predict the appropriate parameters for a given custom tool based on test results of previously tested cases. Machine learning can be applied to improve prediction capability over time, including feedback on clinical performance from practitioners. Digital design and manufacturing, such as 3D printing or CNC machining, is particularly helpful in creating custom tool molds with active clamping forces.

FIG.10illustrates the custom dental restorative tool10clamped appropriately around the patient's teeth72in the mouth70of the patient. The first engagement portions18A,19A of the facial and lingual mold bodies12,14are interlocked together within the mouth, offset from the occlusal surfaces of the premolars and extending the direction of the patient's tongue (not shown). Similarly, the second engagement portions18b,19bof the facial and lingual mold bodies12,14are interlocked. In the illustrated embodiment, the patient is having five teeth restored.

FIGS.11A-11Dare convenient for illustrating the method steps for using the custom tool10of the present invention after the custom tool is properly applied in the patient's mouth70.FIG.11Aillustrates some of the doors40opened to allow access to the teeth to be restored.FIG.11Billustrates restorative material80applied to the teeth to be restored.FIG.11Cillustrates curing of the restorative material80within the custom tool10.FIG.11Dillustrates the teeth72of the patient's mouth70restored.

In some examples, apertures34of tool10may allow the practitioner to apply the restorative material80directly to the tooth to be restored. However, in other examples, the practitioner may apply the restorative material80to the tooth to be restored or to mold body12,14before applying mold bodies12,14over the teeth72of the patient.

The practitioner may fill the mold cavity defined by mold bodies12,14and the teeth around which the mold bodies12,14are positioned with restorative material80by introducing the restorative material80through one or more of apertures34and into the mold cavity (FIG.11B). In some examples, the practitioner may use various tools to place the restorative material into the mold cavity. In some examples, restorative material80may be placed in the mold cavity through multiple apertures34. One preferable dental restorative material is Filtek IM Supreme Universal™, commercially available from 3M Company based in St. Paul, Minnesota. After at least some restorative material80is introduced into the mold cavity, the practitioner may then close the door bodies40within the corresponding apertures34(FIG.11C). The inner surfaces42of door bodies40and the mold surfaces64may be used to shape one or more layers of restorative material80on the facial or lingual surface of the tooth72, to compress restorative material80within the mold cavity, or any combination thereof.

In some examples, the practitioner may cure the restorative material80, while the door bodies40are closed into the apertures34of the facial mold body12. For example, if the restorative material is light curable, the practitioner may expose the restorative material to the curing light (e.g., a blue light) through one or both of the mold bodies12,14, which may be formed of a material transparent to the curing light. The practitioner may remove the facial mold body12and the lingual mold body14from the teeth72, which now have restored structure76defined by the restorative material (FIG.11D). Removing the mold bodies12,14from the mouth70may include separating the facial mold body12from the lingual mold body14, which may include, for example, disengaging one or more of the first engagement portions18A,19A of the mold bodies12,14from the second engagement portions19A,19B of the mold bodies12,14. In some example, the one or more of the door bodies40may leave “witness marks” on the lingual or facial surface of the tooth, but such marks may be relatively easily removable because they are relatively thin. In some examples, the practitioner may finish the teeth, which now include restored dental structure defined by the restorative material, such as by polishing, to remove flash or other undesired surface imperfections.

In some examples, the practitioner may place a release film on at least a portion of a surface42of the door40before placing the door40within its respective aperture34. The release film may reduce the likelihood of trapping air within the mold cavity during stamping of the restorative material80with the door and/or may facilitate release of restorative material80from the surface42of the door40.

In addition to, or instead of, the release film, in some examples, the device manufacturer practitioner may apply a coating on at least a portion of a surface42of the door40and/or the door body before placing the door40within the respective aperture34. The coating may reduce the likelihood of trapping air within the mold cavity during stamping of the restorative material with the door and/or may facilitate release of restorative material from the surface of the door. Release coatings may also be applied to any of the mold components during the manufacturing process.

The introduction of the restorative material80into mold cavity may have enough force to separate parts of mold bodies12,14from each other, thereby providing less of an engagement between facial mold body12and lingual mold body14and/or less of a customized fit with one or more teeth. However, the engagement portions18,19help mold bodies12,14self-align with each other and stay firmly fixed relatively to each other.

FIGS.12A-18Cillustrate additional embodiments of the custom tool of the present disclosure.

FIGS.12A-12Cillustrate additional embodiments of custom tools400,402,404of the present invention, where the hinges144pivot adjacent the patient's incisal surfaces of their teeth. The embodiments shown inFIGS.12A-12Care very similar to the embodiments shown in the other Figures, except they are engaged with different portions of the patient's mouth.

FIG.12Aillustrates an embodiment of a custom tool400, where the custom tool400engages with a portion of the arch of the patient's mouth70, specifically the portion of the patient's arch extending between a molar tooth and an incisor tooth. The engagement portions219of the lingual mold body214are in combination with the engagement portions218of the facial mold body112to form a complete the custom tool400for forming a patient-specific dental restoration. Engagement portion219acombines with protrusion220aof engagement portion218ato interlock adjacent one of the patient's incisor teeth. Engagement portion219bcombines with protrusion220bof engagement portion118bto interlock adjacent one of the patient's molar teeth. The release tabs222a,222bmay optionally be used to help fit protrusions220a,220binto the indentations230a,230b. The lingual mold body214may include a custom lingual rib239to provide additional clamping or mating to the individual patient's mouth.

FIG.12Billustrates an embodiment of a custom tool402, where the custom tool402engages with the full arch of the patient's mouth70, specifically the portion of the patient's arch extending between one molar tooth and another molar tooth. The engagement portions219of the lingual mold body214are in combination with the engagement portions218of the facial mold body212to form a complete the custom tool402for forming a patient-specific dental restoration. Engagement portion219acombines with protrusion220aof engagement portion218ato interlock adjacent one of the patient's incisor teeth. Engagement portion219bcombines with protrusion220bof engagement portion218bto interlock adjacent one of the patient's molar teeth. The release tabs222a,222bmay optionally be used to help fit protrusions220a,220binto the indentations230a,230b. The lingual mold body214may include a custom lingual rib239to provide additional clamping or mating to the individual patient's mouth.

FIG.12Cillustrates an embodiment of a custom tool404, where the custom tool404engages with a portion of the arch of the patient's mouth70, specifically the portion of the patient's arch extending between a molar tooth and a premolar tooth. The engagement portions219of the lingual mold body214are in combination with the engagement portions218of the facial mold body212to form a complete the custom tool404for forming a patient-specific dental restoration. Engagement portion219acombines with protrusion220aof engagement portion218ato interlock adjacent one of the patient's incisor teeth. Engagement portion219bcombines with protrusion220bof engagement portion218bto interlock adjacent one of the patient's molar teeth. The release tabs222a,222bmay optionally be used to help fit protrusions220a,220binto the indentations230a,230b. The lingual mold body214may include a custom lingual rib239to provide additional clamping or mating to the individual patient's mouth.

FIG.13illustrates an embodiment of a custom tool500for forming a dental restoration, where the custom tool500includes injection ports520and two different embodiments of engagement portions519a, and519b. The custom tool520includes injection ports520for delivery of restorative dental material into the mold cavities formed between the facial mold body512and the lingual mold body514. In this embodiment, the ports520are formed when the facial mold body512and lingual mold body514fit together to form a complete the custom tool500for forming a patient-specific dental restoration. Optionally, the custom tool500may include plugs (not shown) for positioning in the ports520following the injection of the restorative dental material into the mold cavities.

The facial mold body512may include first alignment members552a,552band the lingual mold body514may include second alignment members554a,554b, all of which assist in properly aligning the facial and lingual mold bodies512,514before interlocking them together. The first alignment member552ainterlocks with second alignment member554a. The first alignment member552binterlocks with second alignment member554b. In this embodiment, the injection ports520are positioned between the alignment members552a,554a,552b,554brespectively, however this is not necessary.

The lingual mold body514may include engagement portion519aor519b, as illustrated. However, other engagement portions may be used as discussed above.

The custom molds of the present invention are advantageous of those of the prior art. As one example U.S. Pat. No. 8,366,445 (Vuillemot) shows in FIGS. 4-5 alignment features to register the buccal and lingual mold portions. The alignment features are placed on the interfacial surface between the buccal and lingual molds. They may be toleranced to provide some frictional resistance to secure the assembled molds. This has the several disadvantages over the spaced part engaging portions that interlocks. For example, the retentive features as shown in Vuillemot complicate the seating and curing of the mold. To create space for the retentive features, the mold interface area must be expanding, resulting in a more bulky design. If frictional forces are used to secure the mold, then these same frictional forces must be overcome to seat the mold and it is difficult to know when the mold halves are completely seated. Molds that are not completely seated will lead to flash as the composite flows into the gap during use. The retentive features on the mating surface result in bonding of the composite to the mold during the curing process and make removal of the molds extremely difficult.

In contrast, the interlocking engaging portions of the present invention, are not placed along the interface, rather they are separately located away from the interfacial surface. This provides several advantages. The interface between the lingual and facial molds is not expanded or complicated by fine alignment features, rather it is smooth, easy to seat closed, and easy to verify that it is seated. There is a smooth interfacial surface to minimize retention forces of any flash cured at the interface. The present latching mechanism (interlocking engaging portion) is physically separated from the areas where flash may be expressed during filling. The present latching mechanism interlocking engaging portion) is separately activated from the seating and releasing of the facial and lingual molds by easy-to-grasp tabs. Lastly, the present latching mechanism (interlocking engaging portion) can be configured to provide a designed interference between facial and lingual molds such that a residual seating pressure exists when the engagement portions are interlocked, even when the facial and lingual molds are closed. This seating pressure helps to keep the custom tool remain securely shut even under the pressure of composite filling.

Custom tools as described herein may be formed based on a digital model of the teeth and mouth of an individual patient, which can be produced an intra-oral 3D scan, such as an intraoral scanner. In one particular example, the custom tools may be digitally designed using CAD software, such as solid modeling software based on the digital model of the planned restored dentition. Custom tool was designed to fit over the tooth or teeth to be restored teeth (the restorative portion) and a portion of the neighboring teeth (the engagement portions). Subsequently, the tooth structure model of the restored teeth may be digitally subtracted from a mold block to create a tool. Alternatively, an inverse of the tooth structure may be inverted within software to define the mold block. Engagement portions may be located in regions which correspond to regions of the teeth where they will extend from.

Within the digital model, the mold block design may be segmented into two sections (facial mold body and lingual mold body) to facilitate eventual assembly of the tool components on the teeth, with specific geometric interferences selected related to the arch lengths to provide desired the clamping forces, as discussed above. Within the digital model, engagement portions with certain interlocking geometries are designed, selecting overall heights of the engagement portions based where the engagement portions are placed within the patient's mouth, as discussed in more detail above.

The following embodiments are intended to be illustrative of the present disclosure and not limiting.

EXEMPLARY EMBODIMENTS

Embodiment 1 is a custom tool for forming a dental restoration in a mouth of a patient, the custom tool comprising: a facial mold body for a patient-specific, customized fit with the facial side of at least one tooth of the patient, wherein the facial mold body includes a restorative portion, at least one aperture aligned with a portion of a surface of a tooth to be restored and at least one door having an inner surface forming a portion of the mold cavity encompassing missing tooth structure of the tooth to be restored, wherein the door mates with the aperture; a lingual mold body for a patient-specific, customized fit with the lingual side of the tooth of the patient, wherein the lingual mold body includes a restorative portion; wherein the facial mold body and lingual mold body are configured to interlock together; and wherein the facial mold body and lingual mold body are configured to combine with the tooth of the patient to form a mold cavity encompassing missing tooth structure of at least one tooth to be restored.

Embodiment 2 is the custom tool of Embodiment 1, wherein the at least one door includes a hinge for attachment to the lingual mold body or the facial mold body.

Embodiment 3 is the custom tool of Embodiments 1-2, wherein the hinge includes a first portion with a first diameter and a second portion with a second diameter.

Embodiment 4 is the custom tool of Embodiment 3, wherein the at least one door includes an attachment mechanism for attachment to the facial mold body or the lingual mold body.

Embodiment 5 is the custom tool of Embodiment 4, wherein the attachment mechanism is a clip.

Embodiment 6 is the custom tool of Embodiments 1-5, further including a first mesial alignment member on the facial mold body and a second mesial alignment member on the lingual mold body.

Embodiment 7 is the custom tool of Embodiments 1-6, wherein the restorative portions of the facial mold body and lingual mold body mate with anterior teeth of the patient, and wherein the engagement portions are proximate to posterior teeth of the patient.

Embodiment 8 is the custom tool of Embodiments 1-7, wherein the restorative portions of the facial mold body and lingual mold body mate with posterior teeth of the patient, and wherein the engagement portions are proximate to anterior teeth of the patient.

Embodiment 9 is the custom tool of Embodiments 1-2, wherein the hinge for the door is adjacent a gingival portion of the facial mold body.

Embodiment 10 is the custom tool of Embodiments 1-2, wherein the hinge for the door is adjacent an occlusal portion of the facial mold body.

Embodiment 11 is the custom tool of Embodiments 1-2, wherein the hinge for the door is attached to the facial mold body is adjacent a mesial or distal side of the tooth to be restored.

Embodiment 12 is the custom tool of any of the proceeding Embodiments, wherein the facial mold body has a customized fit with the facial side of multiple teeth of the patient and the lingual mold body has a customized fit with the lingual side of multiple teeth of the patient.

Embodiment 13 is the custom tool of any of the proceeding Embodiments, wherein the facial mold body further includes a first engagement portion extending away from the restorative portion, wherein the lingual mold body further includes a first engagement portion extending away from the restorative portion, and wherein the first engagement portion of the facial mold body interlocks with the first engagement portion of the lingual mold body.

Embodiment 14 is the custom tool of Embodiment 13, wherein the mouth of the patient includes an occlusal plane, and wherein the first engagement portion of the facial mold body and the first engagement portion of the lingual mold body extend generally perpendicular to the occlusal plane.

Embodiment 15 is the custom tool of Embodiment 13, wherein the facial mold body includes a second engagement portion extending away from the restorative portion, and wherein the lingual mold body includes a second engagement portion extending away from the restorative portion; and wherein the second portion of the facial mold body interlocks with the second portion of the lingual mold body.

Embodiment 16 is the custom tool of Embodiment 15, wherein the first engagement portions are proximate the anterior teeth of the patient and the second engagement portions are proximate the posterior teeth of the patient, and the restoration portions of the facial mold body and lingual mold body mate with either the anterior or posterior teeth.

Embodiment 17 is custom tool of Embodiment 1, wherein the custom tool is configured to combine with a portion of the patient's dental arch extending between a molar tooth and an incisor tooth.

Embodiment 18 is custom tool of Embodiment 1, wherein the custom tool is configured to combine with a portion of the patient's dental arch extending between one molar tooth and another molar tooth.

Embodiment 19 is custom tool of Embodiment 1, wherein the custom tool is configured to combine with a portion of the patient's dental arch extending between a molar tooth and a premolar tooth.

Embodiment 20 is custom tool of Embodiment 1, further including a port, wherein a dental restoration material may be injected into the mold cavity through the port.