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    • 专利摘要:
    The invention relates to a method of manufacturing an orthodontic appliance intended to be secured to the teeth of a user in order to apply orthodontic treatment, the appliance comprising a monoblock member, said method comprising the following steps: information relating to said set of teeth; b) determining, according to said information, at least first and second stable forms of said organ to which the organ should tend to deform during first and second periods of treatment, respectively, the stable form towards which said organ tends to deform at a given moment being called "operational"; c) manufacturing and programming said organ so that the application of a stimulus during the first period of treatment makes operational said second stable form.
    公开号:FR3032609A1
    申请号:FR1551287
    申请日:2015-02-16
    公开日:2016-08-19
    发明作者:Dan Benarouch；Delphine Malbruch
    申请人:Dan Benarouch；
    IPC主号:
    专利说明:

    [0001] TECHNICAL FIELD The present invention relates to an orthodontic appliance, in particular a so-called "active" orthodontic appliance, that is to say capable of delivering a constraint for moving the teeth from an initial positioning corresponding to a "malposition" towards a final positioning, or a so-called "passive" orthodontic appliance, that is to say intended to hold the teeth in position to prevent these teeth from moving towards a malposition.In the category of "active" orthodontic appliances, one also includes devices that are selectively active, i.e., that can be maintained in the patient's mouth after orthodontic treatment, and activated in the event of recurrence. The invention also relates to a method of treatment by means of such a device State of the art An active orthodontic appliance conventionally comprises a plurality of fasteners, or "brackets", intended to be fixed on the teeth of a user, and an arc to be fixed temporarily on said fasteners. Conventionally, the arc must be changed regularly by another arc of larger section or another alloy.
    [0002] Alternatively, an active orthodontic appliance may consist of an active orthodontic splint, or "aligner". Invisalign® is an example of an active gutter made of a transparent plastic part having a tooth impression corresponding to a final positioning for a set of teeth of a user. The user carries the active gutter on his teeth and the elasticity of the material of the active gutter forces these teeth towards the final positioning. Conventionally, the final positioning corresponds to a displacement of about 0.25 mm of the teeth, which usually involves a change of gutter every two or three weeks. The transparency of the active gutter makes it substantially invisible. Whether the active orthodontic appliance is with brackets or is an active trough, the stress exerted on the teeth is maximum at the installation of the appliance, then decreases with time (see 3032609 2 figure 2a). After a few days (active gutters), weeks or months, the efficiency of the device becomes low and, if the desired positioning is not achieved, the active arc or gutter must be replaced. A high initial elasticity makes it possible to increase the life of an active bow or gutter, and thus to limit the number of visits to the orthodontist. However, high elasticity can reduce the efficiency of the device. In addition, an active arc or gutter loses its effectiveness at the end of its life, and must then be replaced quickly. Otherwise, the new arc or the new active gutter can also cause physiological phenomena of hyalinization.
    [0003] A removable expansion device, or "palatal expansion plate", is an active orthodontic appliance, the geometry of which can be modified by means of a screw allowing different parts of the appliance to be moved relative to one another . During the treatment, the geometry of the device must be conventionally modified several times, which requires as many interventions by the user or the orthodontist.
    [0004] In addition, the actuation of a screw can be difficult, which increases the risk of poor compliance with the recommendations of the orthodontist. Finally, the possible geometries for the device are not predetermined. The determination of a new geometry therefore requires the competence of an orthonessist. There is a need for an orthodontic appliance to simplify treatment, including limiting visits to the orthodontist. An object of the present invention is to satisfy, at least partially, this need. SUMMARY OF THE INVENTION To this end, the invention provides an orthodontic appliance intended to be secured to a user's teeth, for example by complementarity of form with said teeth, for example an active trough, or via a plurality of fasteners after said fasteners have been attached to said teeth. According to the invention, the apparatus comprises a monoblock member programmed to deform, by applying a predetermined stimulus, from a first stable form to a second stable form.
    [0005] The first and second stable shapes may correspond to predetermined positions of the teeth, for example to intermediate positioning and final positioning of the teeth.
    [0006] As will be seen in more detail in the following description, an apparatus of the invention allows to easily and accurately control, possibly without the aid of an orthodontist, the stress exerted by the device on the teeth to be treated. In addition, the variation of the stress over time can be reduced. The efficiency of the apparatus may for example be kept substantially constant and the duration of the treatment may be shorter. Preferably, the member comprises, or even consists of a retractable material or expansible under the effect of the stimulus, preferably a polymeric material. Preferably, the modification of the volume of the organ under the effect of the stimulus is greater than 1%, 2%, 5%, 8%, or 10%, 20% or even 50% of the initial volume, before application of the stimulus. The organ can be configured to deform gradually or instantly under the effect of the stimulus. More preferably, the stimulus applied to the organ is selected from the group consisting of radiation, especially bright, infrared, ultraviolet or sonic, a change in moisture and / or acidity and / or temperature and / or chemical composition of the organ environment, application of electric current and / or voltage and / or magnetic field, and combinations thereof. In one embodiment, the stimulus is applied for less than 1 hour, 30 minutes, 60 seconds, 30 seconds, 10 seconds, 5 seconds, 1 seconds.
    [0007] In one embodiment, the organ is configured so that its deformation to reach the second stable form continues after the application of said stimulus. For example, the orthodontist or the user applies for a few seconds the stimulus, which initiates the deformation. The deformation then continues to the second stable position.
    [0008] Preferably, after application of the stimulus and in the absence of stress, the organ has a shape that varies for a duration greater than 1 day, 30 days or even 60 days, before reaching the second stable form. Preferably, the member is arranged to be made operational by the stimulus while the device is in the service position, in the mouth of the user.
    [0009] The orthodontist or the user can thus modify the operation of the apparatus without having to extract it from the mouth.
    [0010] More preferably, the stimulus is applied without contact with the organ. The risk of injury is reduced. An apparatus according to the invention may further comprise one or more of the following optional features, according to all possible combinations: the organ is made of a biocompatible material; in the second stable form, the organ has at least one dimension greater than 1%, greater than 3%, greater than 5%, greater than 10% that it has in the first stable form; the organ is configured so that the transition from the first stable form to the second stable form is irreversible; the organ is programmed to be configurable according to more than 2, more than 5, more than 10 predetermined stable forms, the transition from one stable form to another resulting from the application of a said stimulus, identical or different from the one required to pass from the first to the second stable form; A stable form corresponds to a real or desired positioning of the teeth; the organ is in the form of an active gutter; the member is in the form of a block of expansible or retractable material, for example disposed in the chamber of a jack; the organ is in the form of an arc having a structure, for example a number of strands and / or a chemical composition and / or a variable profile depending on its length; the organ is in the form of an arc comprising a plurality of strands and / or a plurality of layers and / or a plurality of longitudinal portions, each of which can take several configurations under the effect of the application of a said stimulus; The organ has, according to its length, a variable composition and / or transverse profile and / or has, in a cross-section, a composition and / or a heterogeneous structure (s), and / or present, according to its length; , a number of variable strands and / or strands having, according to their length, a composition and / or a transverse profile variable (s) and / or having, in a cross section, a composition and / or a heterogeneous structure (s) ); the organ is made of a material that is not in shape memory; - the body is designed and manufactured in a computer-assisted manner; The organ, preferably the apparatus, is manufactured by 3D printing. The invention also relates to a method of manufacturing an apparatus according to the invention comprising a monobloc member and intended to be fixed on a set of teeth of a user, said method comprising the following steps: a) recording of information relating to said set of teeth, and in particular information relating to the positioning of said teeth; b) determining, based on said information, at least first and second stable forms of said organ to which the organ should tend to deform during first and second periods of treatment, respectively, the stable form towards which said organ tends to deform at a given moment being called "operational"; c) manufacturing and programming said organ so that the application of a stimulus during the first period of treatment makes operational said second stable form.
    [0011] Such a method advantageously allows a personalized treatment, preferably exerting a substantially continuous stress until the end of the treatment. The stable forms depend on the treatment to be applied. In the case of active orthodontic treatment, the organ may in particular be programmed so that, after fixation of the organ on said teeth, the shape of the organ 20 tends to come closer, at the moment when the set of teeth presents the initial positioning, of a target shape which corresponds to the first stable form and, at the moment when the set of teeth presents an intermediate positioning, after application of the stimulus, of a target shape which corresponds to the second stable form . The second stable form may for example correspond to the desired final position for the teeth. The stable shapes are determined so that the apparatus exerts a predetermined stress on the set of teeth. A method according to the invention may further comprise one or more of the following optional features, in any possible combination: in step c), a shrinkable or expandable material is incorporated in the organ under the effect of the stimulus; In step c), a deformable material is incorporated in the member under the effect of a stimulus chosen from the group consisting of a mechanical force applied by contact, a vibration, a radiation, in particular a luminous radiation, infrared, ultraviolet or sound, a change in the humidity and / or acidity and / or temperature and / or chemical composition of the environment of the organ, an application of an electric current and / or an electrical voltage and / or a magnetic field, and combinations thereof; in step c), a deformable material is incorporated in the organ under the effect of a stimulus whose effect on said organ is not modified when its intensity and / or duration exceeds a threshold; in step c), a deformable material is incorporated in the organ under the effect of a stimulus and the deformation of which continues, after cessation of said stimulus, for a duration greater than 1 day, 30 days, or even 60 days ; in step c), a deformable material is incorporated in the member under the effect of a non-contact stimulus; in step c), there is incorporated in the organ a deformable material according to more than 2, more than 5, more than 10 stable forms under the effect of said stimulus; the organ is in the form of an active gutter or an orthodontic arch or a ram containing expansible or retractable material; In step c), the organ or the apparatus is manufactured by 3D printing. The invention also relates to an apparatus manufactured according to a method according to the invention. The invention finally relates to a method of active or passive orthodontic treatment, in particular for therapeutic and / or non-therapeutic purposes, and in particular exclusively aesthetic, according to which an apparatus according to the invention is applied, in particular a fixed orthodontic appliance with fasteners according to the invention or an active trough according to the invention is placed on the teeth of a user. BRIEF DESCRIPTION OF THE FIGURES Other features and advantages of the invention will become apparent on reading the following detailed description and on examining the appended drawing, in which: FIG. 1 represents a schematic diagram illustrating a stable change of shape of a member that can be implemented in an apparatus according to the invention; Figures 2a to 2c show different profiles showing, as a function of time t, a stress g applied to teeth by means of different members; FIG. 3 represents, very schematically and seen from above, an organ, in the form of an arc, which can have two stable shapes; Figures 4 and 5 show, schematically, cylinders that can be implemented in an apparatus according to the invention, in median longitudinal section. In the various figures, identical references have been used to designate identical or similar members. Definitions By "stable form" is meant the form to which, at a given moment, the organ tends to deform. In a preferred embodiment, the member tends to be returned to a resiliently stable shape when spaced apart, in the manner of a spring. To observe a stable form, the organ must not be constrained (if not by the corresponding gravity and reaction forces). In active orthodontic treatment, the stable forms constitute "target forms" towards which the organ tends to be brought back, thereby causing the teeth to move. The "programming" of the organ means that the first and second stable shapes are predetermined according to the destination of the device. They are "inscribed" in the organ, so that it is sufficient for the user or the orthodontist to apply the stimulus so that the organ, initially in the first stable form, deforms towards the second stable position. . The stable form towards which the organ tends to be brought back is called "operational". By "monoblock member" is meant that the member consists of a single piece or a plurality of parts immobilized relative to each other. A member consisting of a dimensionally stable support and a screw screwed into a thread of the support and whose position can be modified is therefore not a "monoblock member"; By "stress applied to the teeth" means all the actions exerted by the device on the teeth.
    [0012] DETAILED DESCRIPTION An apparatus according to the invention may be an active or passive orthodontic appliance, particularly an orthodontic appliance with attachments or an active gutter. In particular, the apparatus may be selected from a fixed orthodontic appliance, said "fixed" because it can not be removed by the user and thus remains attached to the user's teeth between visits to the orthodontist , and an orthodontic appliance, called "removable" because it can be removed by the user, in particular a palatal plate or an active trough. The apparatus may be selected from the group consisting of removable expansion devices such as Schwarz, Split Plate, fan expansion apparatus, functional and mandibular advancement apparatus, such as Bionator, Twin Block invented by William Clark, nocturnal lingual envelopes (ELN), alignment aligners, contention devices like Hawley, regular type, "wrapped around" or "positionned", mandibular advancement orthoses, such as the Morpheus, Orthosomamo, and passive restraints, and orthodontic ancillary devices, such as orthodontic anchor minivis positioning guides or surgical guides for implant abutment. Two particular embodiments are described hereinafter, namely a fastener apparatus and an active gutter.
    [0013] Fastener Apparatus Conventionally, an active orthodontic appliance with fasteners has a plurality of fasteners and an arc. In one embodiment, the arc constitutes the programmed monoblock member. The bow is shaped to be attached to the fasteners after said fasteners have been attached to a user's teeth to constrain the teeth to a desired position.
    [0014] The fasteners may be commonly used orthodontic fasteners. Preferably, the fasteners are designed to allow replacement and / or adjustment of the member, without the fasteners being damaged. They may be of any material, in particular a metal alloy or a ceramic material. All fasteners can be made of the same material.
    [0015] Each fastener comprises a base having a lower surface intended to be fixed rigidly, and preferably during the entire duration of the treatment, or even during the compression phase, by means of a film of adhesive or resin on an internal or external surface of a user's tooth 3032609 9. The maximum thickness of the film is preferably less than 0.5 mm and greater than 0.2 mm. A fastener also comprises, conventionally, fastening means for temporarily securing the arc. These fixing means may be incorporated in the fastener (for example for the so-called "self-ligating" fasteners) or be constituted by a ligature which may be either of metal or of elastomer. This attachment can be obtained in particular by clamping, for example by deformation of the fastener. The fastening means conventionally project from the base. Preferably, the fasteners allow adjustment and / or replacement of the arc during processing. The arc may have a section having a diameter of between 0.12 and 0.20 inches (i.e., between 3.048 and 5.08 mm) for round sections and having a side length of between 0, 16 and 0.25 inches (i.e., between 4.064 and 6.35 mm) for square or rectangular sections. The arc is preferably of round, square, or rectangular section. It is preferably metal, usually nickel-titanium, steel or titanium alloy and molybdenum (TMA). The arc may be single-strand or comprise a plurality of strands, preferably twisted, preferably more than five and less than ten strands. A beam of six to nine strands is well suited.
    [0016] The arc typically has a length of less than 100 mm and greater than 20 mm. The bow is elastic and is shaped so as to constrain, after attachment to the fasteners, one or more teeth to a desired positioning, or "target positioning". Preferably, the arc is machine bent, preferably at a temperature above 400 ° C, which allows high accuracy and dimensional stability.
    [0017] Preferably, the shape of the arc is determined so as to minimize the number and complexity of creases. The folding machines usually used for producing mechanically active orthodontic arches in lingual orthodontics may be used. The implementation of a folding machine advantageously makes it possible to obtain a very high precision in the shaping of the arc. Methods for the design and digital manufacture of fasteners are described, for example, in FR 2 952 803. An elastic conventional arc has only a stable form, namely the rest form which it presents when it undergoes only the corresponding gravity and reaction forces. 11 shows for example the rest form when it is placed on the tray of the orthodontist, 3032609 10 before being secured to the teeth of the user. Such an arc tends to return quickly to its rest form, typically in less than one second, regardless of the elastic deformation applied. This tendency to return to the form at rest is all the stronger as the geometry of the arc is removed from the form at rest.
    [0018] According to the invention, the arc can take one or more stable forms different from the resting form. Several techniques are possible for this purpose. For example, the arc may comprise one or more strands and / or several portions, each of which may take more than one, for example two stable configurations, in the manner of a bistable blade (for the sake of clarity, the terms "configuration" "and" form "were reserved for the strands and the bow respectively, but they must be considered equivalent). If the arc has three such configurable strands in first and second stable configurations, the stress it will exert on the teeth will depend on the number of these strands that have the first stable configuration. The stiffnesses of each strand may be identical or different. With three strands each having two stable configurations, the arc can thus take eight stable forms. These stable shapes are programmed in the arc. In particular, the strands are adapted so that the stable shapes correspond to different periods of treatment and / or predetermined positioning of the teeth. In other words, at the time of placing in the service position of the arc, the possible stable shapes are known and in limited numbers. This programming of the arc thus facilitates the implementation of the treatment. At the desired moment, it is sufficient for the user or the orthodontist to apply the stimulus to adapt the treatment. The stable change of configuration of a strand may result from a mechanical action of the user or the orthodontist on the strand. The mechanical action can also result from a displacement of a tooth under the effect of the device or the deformation of another strand, which advantageously avoids intervention by the user or the user. orthodontist. Stable configuration change of a strand can also result from a change in temperature, provided that the change is irreversible and that the return to the initial temperature does not result in a return to the initial stable configuration.
    [0019] The bow may also comprise several strands or several portions of different materials. In particular, a strand may exert a stress on the teeth only from a specific form of the arc, which itself will be obtained progressively by the action of another strand. The actions of the strands can thus complement each other in order to obtain a temporal profile of constraint on the teeth adapted to the need. In one embodiment, the shape of the arc may be modified by applying a magnetic or electric field, provided that the stable shape change is irreversible without the application of a new stimulus. Preferably, the application of the stimulus makes it possible to cross a threshold beyond which the arc tends to deform to reach the next stable form. Of course, the arc may be of heterogeneous composition and / or structure, so that its different regions react differently to the same stimulus or react to different stimuli. In particular, depending on its length, the arc may have a composition and / or a transverse profile and / or a number of variable strands and / or strands of composition and / or variable transverse profile (s). The transverse profile may in particular have a contour and / or variable dimensions (s). The transverse profile may also retain its shape, but have a variable orientation depending on the length of the arc. The composition may also be variable depending on the width and / or thickness of the arc. Active gutter Controlled deformation materials, that is to say whose general shape and / or volume can be modified in a controlled manner, can be used to produce an active gutter according to the invention.
    [0020] The principle of controlled deformation may in particular be based on a composite structure, as illustrated in FIG. 1. The member, for example an active trough, may comprise two regions made of materials exhibiting different behaviors, for example a first hard material. and static, acting as a skeleton, and a second deformable material under the effect of a stimulus. The desired deformation can be achieved by conforming said regions appropriately. Barrier layers may also be provided to control the effect of the stimulus. FIG. 1 represents, for example, a first region 20 in the form of a T-section made of a first acrylic polymer material such as VeroBlack and two second regions 22 and 22 'in a second expandable polymer material, for example under the effect of FIG. a stimulus, for example by placing a reagent in the presence of a reagent. Collagen or agar are, for example, expandable in the presence of water and may constitute a second material. To control this expansion in a moist environment such as the mouth, it is possible to protect the expandable material with a barrier layer, for example a layer of polytetrafluoroethylene and / or polyurethane and / or dacron, as described, for example In WO 02/05731 A1. By determining the thickness and open porosity of this barrier layer, it is possible to control the expansion dynamics of the expandable material. A succession of layers in the second material and barrier layers is also possible. The two materials are arranged so that, following the application of the stimulus, the first material constrains the expansion of the second material in specific directions.
    [0021] The Cyborg software from Autodesk or the VoxCAD software can be used in particular to model and simulate the behavior of materials. On the basis of this principle, the organ can be programmed to take on a precise stable form. It thus becomes possible to program the shape of an organ according to applicable stimuli, in particular to follow the evolution of the stresses that the orthodontist wishes to apply to the teeth. When the organ is an active gutter, the action of the gutter can evolve under the action of the stimulus, for example by progressive humidification of the gutter.
    [0022] Method of manufacture Preferably, at least a part of the apparatus, in particular at least the body, is designed and manufactured by computer. An apparatus according to the invention can be manufactured according to steps a) and c) described above.
    [0023] In step a), measurements can be taken, in a known manner, on a plaster model of the dental arches of the user or directly in his mouth. Preferably, the measurements are performed electronically, for example with optical laser type measuring devices. A professional apparatus, for example a 3D scanner, preferably implemented by a healthcare professional, for example by an orthodontist or an orthodontic laboratory makes it possible to manufacture numerical models from these measurements. Such measuring devices make it possible to obtain numerical models, providing information on the positioning of the teeth with an error of less than 5/10 mm, preferably less than 3/10 mm, preferably less than 1/10 mm. . Preferably, the numerical models are three-dimensional models of the dentition, for example of the .stl or .Obj, .DXF 3D, IGES, STEP, VDA, or point cloud type.
    [0024] Advantageously, such models, called "3D" models, can be observed at any angle. Numerical models can be determined to model and simulate the positioning of teeth at different stages of treatment, particularly at the beginning and end of treatment, but also, for each organ, at the beginning and end of the use of 10 the organ. Such modeling is well known to those skilled in the art. Preferably, the computer still determines at least one intermediate positioning of the teeth, between the initial and final positions. For a fastener device, numerical models can also be used to calculate the position and shape of the arc fastener housings on the fasteners.
    [0025] In step b), the treatment to be applied is determined, and preferably, stable forms are determined which the organ should adopt in the absence of constraints (if not gravity and corresponding reaction), so that the treatment be effective. In step c), an organ is produced accordingly. In particular, the organ can be programmed to have a first stable form, which is the resting form, and towards which, in use, the organ will tend to deform, the first stable form serving as a target shape during a first period of treatment for the teeth to reach an intermediate position, and a second stable form different from the first stable form determined to serve as a target form during a second period of the treatment, for example from the moment the teeth are disposed in the intermediate position: When fixing on the teeth of the user, the member is deformed and exerts a stress on the teeth in response. If the member is attached while initially in the resting position, this constraint tends to bring it back into its rest form, like conventional arcs. During the first treatment period, the resting form then forms the target form, i.e., the first stable form towards which the organ tends to deform. According to the invention, the member is programmed to have a second stable shape different from the initial rest position. If, after being fixed on the teeth, the organ receives a stimulus capable of making the second stable form operational, it will tend to be brought back to this second stable form. The second stable form then forms the target form for a second period of treatment. The organ may be programmed so that this tendency to deform to the target shape is exploited to constrain the teeth to move to a desired position. The possibility of changing the target shape makes it possible to better control this displacement. The organ can adopt several stable forms and, during the treatment, the stable form serving as the target form is modified. The difference between the target shape and the instantaneous shape of the organ can thus be advantageously limited, which limits the stresses exerted on the teeth, and therefore the risks of hyalinization. In addition, the programming of the target form is possible according to the stress profile that the orthodontist wishes to apply during the treatment. 8f is the displacement still to be made by a point of a tooth from a "present" position, at any time during the treatment, until the final positioning, corresponding to the end of the treatment. Called "inactivation shift" 8, the displacement that should make said point from the current positioning to the target positioning at time t. Preferably, whatever the current positioning considered, the ratio R = 81.5f is less than 50%, 20%, 15%, 10%, 5%, 2%. Unlike conventional apparatuses, in which the target positioning is always the final positioning and where the ratio 818f is therefore always about 100%, the stress exerted on the point of the tooth may therefore not correspond, during at least one part of the treatment, only at a fraction of the stress necessary to move this point to its position in the final positioning. The risks of hyalinization are reduced.
    [0026] Preferably, these preferences on the ratio R are applicable regardless of the point of the tooth under consideration and, preferably, regardless of the tooth of the set of teeth of the user.
    [0027] Figures 2a to 2c schematically illustrate different stress profiles during treatment with a dental displacement member. With a dental displacement member of the state of the art, the stress decreases during the entire treatment period with the organ (curve 2a).
    [0028] Curve 2b illustrates a profile with a member of an apparatus according to the invention having a first stable form. At the beginning of the treatment, the target form is the first stable form. At the instant ts, a stimulus makes it possible to modify the target form, as explained above. The strain on the teeth increases again. Curve 2b illustrates a situation in which this new target shape is substantially the shape corresponding to the final positioning. It is found that the apparatus according to the invention confers a higher efficiency by maintaining at a more constant level the stress exerted on the teeth. The life of the organ is therefore increased. The member 30 shown in FIG. 3 could allow a stress curve according to curve 2b. The member 30 may take first and second stable forms, referenced fs1 and fs2, respectively, the second stable form being shown in broken lines. Until the instant ts, the target form is the first stable form. After the instant ts, the target form is the second stable form. Curve 2c illustrates a profile with a member having five stable shapes. At each moment a new target form is programmed. By limiting the amplitude of the stress exerted on the teeth, an apparatus according to the invention advantageously provides greater comfort to the user. 3D printing is a well-adapted technology for manufacturing a programmed monoblock device, or even an apparatus comprising such an organ. 3D printing can be used in particular to produce an active gutter with 25 deformation programmed according to the invention, but also for a fixed apparatus, and in particular for an arc, or even for fasteners. A mufti-materials printer such as the Connex 500 from Stratasys and / or a photopolymerizable resin, for example of the Orthocryl® type, can be used. The polyethylene glycol diacrylate hydrogels (PEG-DA) described by L A Hockaday et al. in the article "Rapid 3D printing of anatomically accurate and mechanically heterogeneous aortic valve hydrogel scaffolds" by L A Hockaday et al, 2012 Biofabrication 4 035005 are other examples of biocompatible and 3D printable materials. Expansible or retractable materials, and in particular the materials mentioned above, can also be used, for example, to form a jack, as shown in FIG. 4. As shown in this figure, such a jack conventionally comprises a cylinder 31 in which a piston 32 is slidably mounted. The chamber defined by the cylinder 31 and the piston 32 may contain an expandable or retractable material 34, activatable by a stimulus, preferably by irradiation, in particular by irradiation of visible or non-visible light, or by electromagnetic radiation. In the embodiment of FIG. 5, the chamber may contain a plurality of expansible or retractable materials 34i, whose expansion or retraction is preferably controlled by means of different stimuli, for example by means of irradiations at frequencies different. For example, from an initial position 15 retracted, the piston 32 can thus gradually exit the cylinder 31 by successive application of different stimuli. In a first step, a first irradiation may for example lead to the expansion of the material 341. In a second step, a second irradiation may lead to an expansion of the second material 342, etc. Such a jack can be particularly advantageously used for removable expansion devices.
    [0029] Advantageously, it makes it possible to reach several predetermined stable shapes, without having to use screwing. The different positions of the cylinder thus allow the device to adopt corresponding geometries and therefore, in use, allow an adaptation of the device according to the stress to exert on the teeth. At the end of step c), if necessary, the member is assembled to the other parts constituting the orthodontic appliance. In particular, if the organ is an arc, this arc is assembled to the fasteners. Treatment Process Orthodontic treatment using an apparatus according to the invention is similar to conventional treatment. With a fastener apparatus, the orthodontist fixes on a plurality of teeth of the user, in particular by gluing, orthodontic fasteners, and then fixes an arc programmed according to the invention on said fasteners so as to exert, during a duration of treatment with said arc, a stress, preferably permanent, on said teeth tending to position said teeth towards a target positioning. In one embodiment, the arc is programmed so that the target positioning is modified during said processing time with said arc, without modifying the attachment points of the arc on the fasteners, and in particular without readjustment of the arc voltage. During said duration of treatment with said organ, the stresses, in particular their amplitudes and / or directions, are thus modified, without any detachment, even partial, of the organ, thanks to the existence of several stable forms, which correspond to different 10 target positions. It is the same with an active trough according to the invention. Preferably, the member may be configurable in a multitude of stable shapes, which correspond to as many target positions. More preferably, the application of a suitable stimulus on the organ makes it possible to render a stable form non-operational in order to make the next one operational. The application of the stimulus after fixation on the fasteners or laying on the teeth thus makes it possible to change the target positioning. Preferably, the stimulus is "boolean", that is to say that its application is in all or nothing. In particular, there is no change in the intensity of the stimulus. Preferably, the nature of the stimulus is determined before the start of treatment. Advantageously, no particular skill is then required to apply the stimulus. The stimulus may be applied by the orthodontist or by the user, depending on his particular nature. For example, in one embodiment, after a certain period of use of the active gutter, the user may place it in a reagent bath, so as to obtain a new stable shape. Different baths can be provided to obtain several different stable shapes. In another embodiment, the orthodontist may have means for irradiating the organ by means of a particular radiation, leading to make operational a new stable form. Preferably, the stimulus is applied while the apparatus is in the service position.
    [0030] In one embodiment, the stimulus may be the application of a force or vibration to the organ. Preferably, however, the stimulus is applied without applying a force, preferably without contact with the organ. To apply the stimulus, it is then not necessary to interact directly with the organ, as is the case for example to change the position of a screw of a removable expansion device. The duration of treatment with the same organ is typically greater than one month, preferably greater than two months.
    [0031] 5 The higher the number of programmed stable positions, the greater the possibility of modifying the action of the device. The control of this action will be improved. In a preferred embodiment, the programming of the organ results from a simulation of the evolution of a treatment. Typically from a digital model of the teeth, the orthodontist anticipates the positioning of the teeth at different stages of treatment, then programs his device accordingly. At each of said steps, it is then sufficient to apply the stimulus necessary to make operational the stable form corresponding to the positioning of the teeth provided in the next step. Advantageously, the adaptation of the apparatus is thus simple, fast, and corresponds precisely to that which was originally planned. As is now clear, the invention provides an orthodontic appliance whose action can be precisely controlled, limiting the risk of error. This control, resulting from a "programming" of the organ, makes it possible to increase the life of the organ, and thus to limit the number of visits to the orthodontist. It also makes it possible to limit the amplitude of the stress exerted on the teeth, without reducing the efficiency of the organ. It thus considerably limits the risks of hyalinization. Finally, it allows a quick adaptation of the treatment. Of course, the invention is not limited to the embodiments described, provided by way of illustration and not limitation. All the possible combinations of these different embodiments are in particular envisaged. Moreover, the user is not limited to a human being. In particular, an apparatus according to the invention can be used for another animal. Stable forms may correspond to stages of a therapeutic treatment. In one embodiment, a stable form corresponds to inactivation of the orthodontic appliance. For example, the orthodontic appliance may be programmed to be inactivated, that is to say to have no effect on the teeth when, for example following a shock, the orthodontic appliance has deformed. in a particular way, for example partially detached teeth. This prevents the device being improperly fixed on the teeth, it acts inappropriately on the teeth.
    权利要求:
    Claims (10)
    [0001]
    REVENDICATIONS1. A method of manufacturing an orthodontic appliance intended to be secured to the teeth of a user in order to apply orthodontic treatment, the appliance comprising a monoblock member, said method comprising the following steps: a) recording of information relating to said set of teeth; b) determining, according to said information, at least first and second stable forms of said organ to which the organ should tend to deform during first and second periods of treatment, respectively, the stable form towards which said organ tends to deform at a given moment being called "operational"; c) manufacturing and programming said organ so that the application of a stimulus during the first period of treatment makes operational said second stable form.
    [0002]
    2. Method according to the preceding claim, wherein in step c) is incorporated in the body a shrinkable or expandable material under the effect of the stimulus.
    [0003]
    3. Method according to any one of the preceding claims, wherein in step c) is incorporated in the body a deformable material under the effect of a stimulus selected from the group consisting of vibration, radiation, particularly bright, infrared, ultraviolet or sonic, a change in the humidity and / or acidity and / or temperature and / or chemical composition of the organ environment, an application of a electric current and / or electrical voltage and / or magnetic field, and combinations thereof.
    [0004]
    4. Method according to any one of the preceding claims, wherein in step c) is incorporated in the body a deformable material under the effect of a stimulus whose effect on said body is not modified when its intensity and / or duration exceeds a threshold.
    [0005]
    5. Method according to any one of the preceding claims, wherein in step c), is incorporated in the body a deformable material under the effect of a stimulus and 3032609 21 whose deformation continues, after cessation of said stimulus for more than 1 day, 30 days or 60 days.
    [0006]
    6. A method according to any one of the preceding claims wherein in step c) a deformable material is incorporated into the member under the effect of a non-contact applicable stimulus.
    [0007]
    7. Method according to any one of the preceding claims, wherein in step c) is incorporated in the body a deformable material of more than 2, more than 5, more than 10 forms stable under the effect of said stimulus.
    [0008]
    8. A method according to any one of the preceding claims, wherein the member 10 is in the form of an active trough or an orthodontic arch or a cylinder containing expansible or retractable material.
    [0009]
    9. A method according to any one of the preceding claims, wherein in step c), the member is manufactured by 3D printing.
    [0010]
    An orthodontic appliance comprising an organ manufactured by a method as claimed in any one of the preceding claims, said apparatus being selected from the group consisting of a removable expansion apparatus, a fan expansion apparatus, a functional apparatus and mandibular advancement, a nocturnal lingual envelope, a mandibular advancement orthosis, an active or passive restraining apparatus and an active gutter. 20
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    同族专利:
    公开号 | 公开日
    US20180021107A1|2018-01-25|
    FR3032609B1|2020-04-10|
    US11129695B2|2021-09-28|
    EP3258878B1|2020-01-15|
    KR20180011055A|2018-01-31|
    CN107249504A|2017-10-13|
    EP3258878A1|2017-12-27|
    ES2784878T3|2020-10-01|
    WO2016131827A1|2016-08-25|
    HK1243618A1|2018-07-20|
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    法律状态:
    2016-02-29| PLFP| Fee payment|Year of fee payment: 2 |
    2016-08-19| PLSC| Publication of the preliminary search report|Effective date: 20160819 |
    2016-12-30| PLFP| Fee payment|Year of fee payment: 3 |
    2017-12-29| PLFP| Fee payment|Year of fee payment: 4 |
    2019-01-31| PLFP| Fee payment|Year of fee payment: 5 |
    2020-02-27| PLFP| Fee payment|Year of fee payment: 6 |
    2021-11-12| ST| Notification of lapse|Effective date: 20211005 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1551287A|FR3032609B1|2015-02-16|2015-02-16|ORTHODONTIC APPARATUS|
    FR1551287|2015-02-16|FR1551287A| FR3032609B1|2015-02-16|2015-02-16|ORTHODONTIC APPARATUS|
    ES16704653T| ES2784878T3|2015-02-16|2016-02-16|Orthodontic appliance|
    EP16704653.1A| EP3258878B1|2015-02-16|2016-02-16|Orthodontic appliance|
    KR1020177026015A| KR20180011055A|2015-02-16|2016-02-16|Orthodontic appliance|
    CN201680010252.XA| CN107249504A|2015-02-16|2016-02-16|Orthodontic appliance|
    PCT/EP2016/053269| WO2016131827A1|2015-02-16|2016-02-16|Orthodontic appliance|
    US15/551,137| US11129695B2|2015-02-16|2016-02-16|Orthodontic appliance|
    HK18103299.2A| HK1243618A1|2015-02-16|2018-03-08|Orthodontic appliance|
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