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    • 专利摘要:
    "RETAINER AND METHOD OF MANUFACTURING THE SAME" The present invention relates to a retainer (1, 1 ') that cooperates with a plurality of teeth and suitable for stabilizing the teeth, said retainer (1, 1') comprising, at least at least, an elongated arch (3), in which the arch (3) globally comprises a curved shape following the natural curvature of a lower or upper jaw and is individually adapted to a contour of the surface of a respective adjacent tooth, in which the retainer (1, 1 ') is made of metal and is made from a plate-shaped part, in particular a metal blade that has two surfaces (19) parallel to each other. In order to produce a retainer that avoids the disadvantages of known retainers (insufficient durability, accidental activation, tooth locking), it is proposed according to the invention that the metal be formed from a nickel-titanium alloy, more preferably of Nitinol, and a working surface (13) of the retainer (1, 1 '), in its installed state, faces a tooth surface (17) on which the retainer (1, 1') rests and a upper side (2) or lower side (11) of the retainer (1, 1 ') corresponds to a plane of the original metal blade. The present invention also relates to a method for producing such a retainer.
    公开号:BR112015022477B1
    申请号:R112015022477-6
    申请日:2014-03-11
    公开日:2021-02-23
    发明作者:Hildegard Brigitte Schumacher
    申请人:Retaintechnology Ug (Haftungsbeschrankt)；
    IPC主号:
    专利说明:

    DESCRIPTION INTRODUCTION
    [001] The invention relates to a retainer that cooperates with a plurality of teeth and is suitable for stabilizing the teeth, comprising at least one elongated arch, the arch comprising locally a curved shape following the natural curvature of a lower jaw or upper jaw and is adapted locally and individually to a contour of the surface of a respective adjacent tooth, the retainer being made of a metal and is made from a plate-shaped part, in particular a metal plate, which comprises two surfaces parallel to each other.
    [002] In addition, the invention relates to a method of manufacturing a aforementioned retainer, which comprises the following steps of the method:
    [003] a) a contour of teeth is detected individually to be stabilized.
    [004] b) the retainer is made from a metal plate.
    [005] Here, the term "contour" of teeth almost means itstopography. This means that detecting the contour of the teeth includes detecting the surface of the tooth which is to cooperate with the retainer in such a way that the attending physician is provided with information indicating what shape the retainer should have both globally and locally, in order to lean against your teeth as closely as possible. PREVIOUS TECHNIQUE
    [006] Retainers of the type mentioned above have been known for some time. They basically serve to correct the position of a patient's teeth. That is, by means of a retainer, a status quo is fixed in relation to the position of the teeth, in order to avoid possible variations in the position of the tooth over time.
    [007] Particularly typical is the use of retainers in the course of a post-treatment of an orthodontic treatment. The latter involved an active influence on the position of a patient's teeth, and by means of appropriate devices, forces are exerted on the teeth in such a way that they change their position or orientation over time. After a treatment, such orthodontic treatment is completed and the use of the respective device is completed, the teeth tend to return to their previous position. If no post-treatment is performed, the result obtained through active treatment will regress, at least partially and consequently, cancel the active treatment.
    [008] Therefore, subsequent to the active treatment, usually the use of a retainer is recommended which fixes the position of the newly obtained teeth. In order to achieve this, such retainers are connected to a plurality of teeth, in which the retainer is adapted to receive forces produced due to a desired intrinsic mobility of a tooth and to distribute the forces to the remaining teeth. In this way, movement of the tooth is prevented. Such retainers are known, for example, from the documents DE 004 20 419 U1, 2012 and DE 102 45 008 A1, in the last document a so-called "2-retainer point" is described, which is firmly connected with only two teeth.
    [009] In known retainers it has been proven to be particularly disadvantageous that an exact adaptation of the respective retainer to the individual contours of the teeth to be fixed on one side is very expensive and on the other hand, it is generally characterized only by low precision, even in the case of a careful treatment by an experienced dental technician. This is mainly due to the production of the retainers known today, which are adapted to the shape of the respective dental impression in a manual process, bending the raw material - usually a metal wire. The accuracy of such processing is naturally limited, as the finished retainer can have a distance of a few millimeters from a tooth to be clamped. So, in order to close this "gap" between the retainer and the tooth, it is necessary to provide a correspondingly larger adhesive bond that reliably covers the retainers, despite their great distance from the teeth and consequently connects the retainer to the teeth in a way by force. This is disadvantageous for both the wearing comfort of the retainer and its durability, because shear forces that occur during chewing and acting on the retainer or its adhesive union are greater the more "attack surface" they provide in the oral cavity . This often results in a retainer being separated locally and then has to be re-attached manually. Likewise, a fracture of the retainer occurs regularly.
    [0010] In addition, known retainers have the disadvantage that their purely passive effect can be "activated" in advance by small accidental displacements of the retainer. Thus, it happens regularly that a retainer in an interdental area, where it freely, that is, detached, extends from one tooth to the corresponding adjacent tooth is accidentally bent, for example, as a result of an interacting chewing force.
    [0011] By doubling the projected length of the retainer, it is locally reduced, which results in the retainer pulling from there the teeth adjacent to each other. That is, the retainer is changed through the unwanted deformation of a passive to an active element, which now no longer acts as a purely fixed element, but actively influences the position of the teeth. Such influence, however, must be avoided in any case, since active dental treatment is usually completed already when using the retainer and additional tooth movements are not desirable. If deformation of a retainer occurs, it may even be necessary to replace it completely.
    [0012] Another disadvantage of today's retainers is their defixation effect, which can be called "entanglement". This entanglement means that a retainer known in the prior art actually achieves the desired stabilizing effect, however, it couples the teeth so tightly together that any load that acts locally on a tooth is substantially and evenly distributed to all teeth. An independent movement in a sagittal direction is largely suppressed due to the retainer. The same applies to vertical movements and rotations of the teeth around its vertical axis. As a consequence, the impact of the force due to external forces is permanently diminished for each individual tooth which has the consequence that the alveolar bone, in which the teeth are anchored by their roots, is much less irritated than is the case in the absence of the retainer. , that is, under "natural" conditions. This irritation, however, is particularly important because it leads to stimulation of bone tissue, so that it will be preserved. If bone tissue irritation is reduced, it degrades. The impact of the decreasing force on each individual tooth has, correspondingly, the consequence that the alveolar bone degenerates in the region of the "interlaced" teeth because the impact of external forces on the bone tissue decreases locally.
    [0013] From the foregoing, it is clear that two types of tooth movement have to be distinguished: on the one hand, tooth migrations occur, which represents a continuous movement of the tooth back to a bad position, in which the referred migrations of the teeth teeth must be suppressed by the retainer. On the other hand, the teeth also have a certain intrinsic mobility due to which the teeth can move in all directions within a certain margin (approximately 0.2 mm), especially when chewing loads occur, in which the teeth return to its initial position after the load is relieved. However, these intrinsic movements are extremely important because of the associated stimulation of bone tissue and should be restricted as little as possible by a retainer.
    [0014] From EP 1782748 A1 a retainer is known to consist of a zirconium oxide, that is, a ceramic material. Due to the fact that zirconium oxide is not deformable, the retainer is milled or ground from a block. Zirconium oxide is characterized by a high resistance to bending and is therefore very rigid and inflexible. However, because of the risk of fracture inherent in the brittle ceramic material, the known retainer has very thick and bulky walls. However, these characteristics of the known retainers result in the disadvantage of "entanglement" described above, which limits the movement of the teeth in the socket (socket) and become non-physiological, which eventually leads to bone tissue degeneration. OBJECT OF THE INVENTION
    [0015] It is an object of the present invention to overcome the drawbacks of known retainers. SOLUTION
    [0016] With regard to the retainer described above, the aforementioned object is achieved according to the invention in which the metal is formed from a nickel titanium alloy, more preferably from a nitinol and a surface of formation of the the retainer in its installed state faces a tooth surface on which the retainer rests, and an upper or lower surface of the retainer corresponds to an original sheet metal plane. Nickel titanium and nitinol alloys are memory-shaped materials that are particularly well suited for the retainer according to the invention, since they have a material behavior called "pseudo-elastic" (also called "super-elasticity" ). This behavior of the material with respect to the present invention means that the retainer can even experience relatively large deflections without therefore being plastically deformed - that is, permanently. The elastic region of the shape memory material is exceptionally large due to a phase transformation inside the material under the influence of stress and can be greater than twenty times the elastic region of a "normal" steel, as is commonly used for today's retainers. This leads to the particular advantage that such a retainer according to the invention can practically not be plastically deformed, which means that a "bend" or other accidental permanent deformation of the retainer is not possible. Thus, it is not possible for the retainer according to the invention to be accidentally "activated" due to a local deflection of a single tooth as a result of its intrinsic mobility (for example, under the impact of high local chewing forces caused, for example, by bite a grain). As a result, tooth movement caused by the retainer comparable to orthodontic treatment is excluded with the use of the retainer according to the invention.
    [0017] In addition, the material with shape memory is advantageous in terms of the problems described above in relation to the lack of stimulation of the alveolar bone. This is because changes in the short-term position of the teeth, which are based on local forces acting on individual teeth - that is, as part of their intrinsic mobility - are made possible by the material's pseudo-elasticity, that is, extremely low elastic recovery forces. By means of a reversible elastic deformation of the retainer, the applied force is produced and the tooth can be deflected in a natural amount inside the alveolus, which is in the alveolus of the tooth, where the tooth is suspended by the collagen fibers. Once the force of the impact is no longer present, both the retainer and the affected tooth return to their original shape or position.
    [0018] The pseudo-elasticity of the material with shape memory, in addition, promotes the durability of the retainer according to the invention. Thus, it is not subject to the risk of a fracture or a fracture induced by deformation or a "fatigue" of the restoration properties.
    [0019] In addition, the shape memory material is relatively smooth due to the low modulus of elasticity, in such a way that it can be elastically deformed more easily. Thus, a break in a joint with a tooth is less likely to occur than with retainers in the prior art. In addition, the low stiffness is positive in view of the possibility of sagittal and vertical deformation of the individual teeth, since the retainer couples or interlaces the connected teeth less rigidly.
    [0020] Therefore, a retainer formed from a material with shape memory is also preferable with respect to a lower interlacing effect.
    [0021] Through the use of titanium and nickel alloys, in particular, nitinol, a conflict of interest previously existing in the use and formation of retainers is resolved: on the one hand, someone strives to connect the teeth to each other in a form of force transmission in order to neutralize unwanted tooth movements and tooth migrations. On the other hand, the intrinsic physiological mobility of individual teeth, should be restricted as little as possible. Both are possible with the method or the retainer according to the invention, however, not with the previously known retainers.
    [0022] This is the case, due to the titanium and nickel alloys, in particular, nitinol, they are characterized by the fact that with loads that occur quickly a deformation (elastic) can occur and with loads that occur slowly, no deformation of the retainer is caused . This is particularly advantageous because, in chewing movements, the desired tooth movements that occur briefly in the structure of their intrinsic mobility are allowed while continuous tooth movements or tooth migration towards malposition are being suppressed. Even if deflections are allowed, there is always a small recovery force towards the initial position of the retainer. Steel, for example, has a certain recovery force, but this is significantly less and there is a high probability that the steel will be bent permanently and thus will not exert any recovery force at all, however, on the contrary, exerts a force on the teeth, which directs them to a bad position.
    [0023] Regarding the characteristic of the retainer according to the invention that a retainer forming surface in its installed state faces a tooth surface on which the retainer touches and an upper or lower surface of the retainer corresponds to the original plane of the sheet metal, this is advantageous because in this way a flex-free separation of the retainer is possible or occurs. This means that the retainer is produced in the form in which it eventually touches a patient's teeth. Bending the sheet metal to produce the retainer is in no way possible for a material with superelastic properties, because no permanent deformation can be made. The retainer according to the invention is therefore a finished product that can be used without further processing. An advantageous finishing process in the form of electropolishing is not considered at this point.
    [0024] In a retainer according to the invention, which is connected in joining parts by means of an adhesive material to the respective adjacent teeth in a way for transmitting force, and is preferably embedded in an adhesive material adhering to the respective tooth, it is also particularly advantageous when in each of the joining parts a maximum distance between a surface of the respective tooth and a position of the retainer, which measured perpendicularly to the surface of the respective tooth has the shortest distance to this surface of the tooth, is at most 0 , 1 mm, preferably not more than 0.01 mm, more preferably not more than 0.005 mm. Such a retainer is adapted particularly and precisely to the natural contour of the respective teeth. This is advantageous in that the insertion of such a retainer is particularly easy for the specialist who performs the treatment, since the retainer touches the teeth exactly in just one position. Therefore, an accidental "oblique" installation is almost impossible. In addition, the exact fit, according to the explanation above, promotes the use of thin joining parts, which in turn has a positive effect on the durability and susceptibility to failure of the retainer. In addition, a thin layer of adhesive material is considered less disturbing by the patient.
    [0025] Advantageously, the retainer is formed locally, so that it protrudes, at least partially in at least one inter-dental space between two adjacent teeth so that a relative movement between the retainer and the teeth in the longitudinal direction of the retainer is blocked even if the retainer touches the teeth in a disconnected state.
    [0026] Here, the term "disconnected state" means that the retainer is not yet connected to the teeth in a way for the transmission of force and, consequently, for example, it can be manually removed from the oral cavity again. On the contrary, in a "connected state" the retainer is fixedly connected with the teeth, in particular glued. The modeling of the described retainer is possible exclusively by means of the method according to the invention. The formation of regions that protrude into the inter-dental spaces is inconceivable through the usual deformation methods of the prior art.
    [0027] Modeling the retainer as described provides a number of advantages. For this purpose, reference is made to the problem of "entanglement" described above. This results from the fact that today the usual retainers couple the teeth tightly with each other, so that an intrinsic independent movement of the teeth is very strongly restricted. The problem associated with alveolar bone degeneration has already been described above. Through the orientation of the retainer upwards within the inter-dental spaces, the effect is now achieved, that the so-called "free length", which is the length along which the retainer rests freely, that is, "not adhered" to the teeth. between two adjacent teeth, it is considerably larger in the retainer according to the invention than in known retainers. In the latter case, the retainer extends essentially directly between two adjacent joints, that is, along the shortest possible path. In the retainer according to the invention, however, the retainer extends in a kind of "deviation", as the retainer is guided upwards within the inter-dental spaces. This has the consequence that a "built-in length" of the retainer according to the invention, that is, an unrolled length of the same, is significantly longer than the unrolled length of a conventional retainer. Here again the pseudo-elastic behavior of the nickel-titanium alloy or nitinol has an effect, because only if a pseudo-elastic material is used can a significant increase in deflection capacity be achieved due to an increase in the short distance per se between two teeth. By increasing the length between two adhesive connections, the flexibility of the retainer is additionally increased. If, however, a rigid material, such as ceramic, is used for a retainer, it can, in fact, also be designed in such a way that it protrudes within the inter-dental spaces of the adjacent teeth, however, the flexibility or The elasticity of the retainer is not increased, but in a way, due to the stiffness of the ceramic material, still not enough intrinsic movement of the teeth is possible.
    [0028] The increased free length between two joints eventually has the advantageous effect of reducing the described entanglement of the teeth, in comparison with the prior art. This is due to the fact that the coupling of a respective tooth to the respective adjacent tooth is smaller the larger the connecting part, which couples both teeth together. This greater freedom of movement is manifested, in practice, in that the individual teeth can move significantly more freely both in the sagittal plane and in the transverse and vertical directions when using the retainer according to the invention more clearly than in the use of a conventional retainer. In addition, the tooth is able to rotate and change its axial inclination. Thus, the disadvantageous previous lack of stimulation of the alveolar bone is substantially eliminated. However, the coupling effect of the teeth in the transverse direction, that is, the coupling, which, in principle, is to be achieved by means of the retainer, is not adversely affected by the longer free length of the retainer according to the invention.
    [0029] The longer free length of the retainer according to the invention is also advantageous for its durability. Thus, in the retainer according to the invention, fractures of the arch or its connection rarely occur. This is because the arch can be more easily and freely deformed than in the retainers according to the prior art. In the last deformations it has to be reduced over short distances, with deflections sometimes resulting in a fracture of the retainer or a fracture of the adjacent joint.
    [0030] In addition, the high precision of adjustment that is demonstrated here by the adaptation of the retainer upwards within the inter-dental spaces, is basically advantageous for the comfort of use of the retainer. Here, reference is made to the above statements.
    [0031] In an advantageous embodiment of the retainer the arc has a radius of curvature of 1.0 mm or less, preferably 0.5 mm or less, more preferably 0.2 mm or less. Such a small radius of curvature is provided, for example, in the region of an inter-dental space. At such a point, the arch of the retainer extends locally almost in the direction of a "point". In addition, such "sharp" curvatures in the arch can be adapted to replicate topographies present on tooth surfaces locally. The formation of such radii of curvature is inconceivable with conventional retainers.
    [0032] The retainer according to the invention is particularly advantageous when the arch comprises a parallelogram shape, preferably a square cross section, characterized by the fact that the lengths of the sides of the cross section are, at most, 0.7 mm, preferably at most 0.5 mm, more preferably at most 0.3 mm. A square cross section is particularly suitable. An "edge-shaped" configuration of the retainer mainly offers the advantage of a so-called "torque control", that is, to stabilize the axial inclination or inclination of the teeth. This is due to the fact that the edge-shaped retainer can be properly interwoven with the adhesive material of the joint and thus prevents it from rotating. Usual retainers, on the other hand, have an oval or round cross section, whereby such stabilization is not achieved due to the lack of interlacing of the retainer cross section with the respective adhesive connection.
    [0033] The small cross-sectional size of the retainer according to the invention, furthermore, results in that the joints with the tooth surface can be made relatively shallow. This, on the one hand, favors the durability of the retainer because an attack surface for shear forces can be minimized and, on the other hand, the comfort of use since the patient feels only a small irregularity on the surface of the teeth.
    [0034] Preferably, the retainer according to the invention is used as a so-called "6-point retainer" and, as such, is connected to more than two teeth or more than three teeth in a force transmission mode. However, use as a so-called "2-point retainer" is conceivable in principle.
    [0035] Regarding the connection of the retainer to the teeth, it is particularly advantageous if the retainer is completely encapsulated by the adhesive material in the bonding parts. This means that the retainer is surrounded by the adhesive material on the gluing parts on the four sides. Thus, the retainer is at least in parts completely embedded within the plastic mass, so that in the corresponding part, no part of the retainer is exposed or visible. In this way, a particularly permanent connection between the retainer and the tooth is provided.
    [0036] In a particularly advantageous embodiment, the retainer is made of one piece. This is the normal case, when using the method according to the invention, because, in the course of preparing the retainer from the sheet metal, a single continuous piece is obtained, which forms the complete retainer. However, it is conceivable to mount the retainer according to the invention from a plurality of individual parts.
    [0037] If one considers the retainer according to the invention as enclosed by an imaginary parabola of the innermost envelope seen in the plan, the innermost innermost parabola abutting in the innermost points of the retainer and the outer outermost part of the parabola abutting at the points further away from the retainer, then such retainer is preferable, where locally in the region of an interdental space, a maximum distance between the parabola of the inner shell and the parabola of the outer shell measured perpendicularly to the parabola of the innermost shell is at least 1.0 mm, preferably 1.5 mm, more preferably 2.0 mm. This distance between the casing parabolas is conceivable as a measure of the "penetration depth" of the retainer into the inter-dental spaces. The longer the retainer follows these inter-dental spaces, the more precisely it rests on the teeth and the longer the free length between adjacent joints. In this regard, a retainer comprising the distances described is particularly advantageous.
    [0038] Furthermore, it can be advantageous when the retainer has at least partly a rough surface, where preferably all surfaces (bottom surface, top surface, front surface, rear surface) of the retainer are rough. Such roughness allows a better connection between the retainer and the material through which the retainer is connected to the teeth.
    [0039] In an advantageous embodiment, the retainer is treated by electropolishing or plasma polishing. The advantages of such retainers have already been explained above.
    [0040] Finally, it is particularly advantageous if the nickel-titanium alloy has an AF temperature between 25 ° C and 35 ° C, preferably between 27 ° C and 33 ° C, more preferably between 29 ° C and 31 ° C. It was found that the closer to the AF temperature the temperature at which the workpiece is used, which, in the case of the seals, corresponds to the body temperature of approximately 37 ° C, the more reliable the desired region of the induced tension martensite plateau. that is achieved by stretching the material.
    [0041] According to the invention the underlying objective is achieved using a method of the type described above, through the following steps of the method:
    [0042] c) the detected contour of the teeth is converted into a model of digital preference and the retainer is projected on the base of the model.
    [0043] d) the designed retainer is made from dmetal plate, which consists of a titanium nickel alloy, preferably nitinol, at the base of the model by means of a computer-controlled process, with a forming surface of the the retainer in its installed state faces a tooth surface on which the retainer rests, and an upper or lower surface of the retainer corresponds to an original plane of the sheet metal.
    [0044] The invention is based on the idea that an improvement in the precision in adapting the retainer to the respective contours of the patient's teeth results in a considerable improvement in both the effect of the retainer and the comfort in use. In addition, accidental treatment errors that are based on accidental activation of a retainer can be avoided.
    [0045] The method according to the invention allows a significant increase in the accuracy of the finished retainer over currently known retainers in a way that locally a distance from the retainer from the respective tooth surface, which is to be touched, is very low. From the detected contour, a particularly accurate model for a retainer can be obtained by using a computer with corresponding CAD (Computer Assisted Design) software. Based on this model by means of a computer controlled machining process (Computer Aided Production - CAM), finally, the retainer can be made automatically from the sheet metal in the exact form specified by the CAD model.
    [0046] This procedure is therefore also referred to as the "CAD-CAM method". Since the retainer according to the invention is made from sheet metal, this method is a method called subtractive.
    [0047] As a result, the method according to the invention produces a retainer that rests exactly on the contour of the detected teeth and has a secure fit. In particular, a subsequent deformation or processing of the retainer - whether by machine or by hand - is not necessary and, when using a titanium nickel alloy, in particular nitinol, with its pseudo-elastic properties, even impossible, because the material after an imposed deformation returns to its initial position. The retainer according to the invention, therefore, once it has been made from sheet metal, it directly obtains its eventual shape (both globally and locally), and additional adaptations are not necessary or possible. This results in several advantages:
    [0048] The joints in which the retainer is to be connected to the denter-perspective, can be implemented much more shallow than is the case according to the prior art. That is, the thickness of the required layer of the plastic material that forms the joint is less. This is due to the fact that the retainer rests closely or directly on the surface of the corresponding tooth. The plastic layer, through which such retainers are normally connected to the teeth, is required to have a comparatively small extent in a direction perpendicular to the tooth surface in order to completely surround or incorporate or encapsulate the retainer. A gap bridging connection between the retainer and the tooth, as is regularly required in the prior art, is not required. A "shallow" joint, on the one hand, considerably improves the wearing comfort of such a retainer. This is mainly related to a more pleasant wearing comfort, since the spatial extent of the foreign body, which the retainer with the adhesive material represents, ultimately, in the patient's mouth, is very small. In addition, it facilitates the patient's oral hygiene. On the other hand, a thin joint due to its small dimensions within the oral cavity has a significantly smaller surface area than is the case with joints according to the prior art, and is therefore subject to significantly lower shear forces or chewing forces. The latter is particularly advantageous for the durability of a retainer produced by the method according to the invention, since the probability of detaching the retainer from one or more teeth, due to these force impacts is significantly reduced. In view of the durability of the retainer, it is also advantageous that, by means of the pseudo-elasticity of the titanium and nickel alloy or nitinol to a force of impact by chewing and a tooth deflection resulting from less tension, that is, the tension, it is produced in the tooth retainer compound, which in the worst case, can lead to stress fracture.
    [0049] The lack of plastic deformability of a retainer formed from a material with memory is also the reason why such retainers are not yet available on the market. Thus, the currently known production processes, which - as described - require an individual mold of the retainer in relation to the respective line of teeth to be corrected by bending, are not adapted or cannot be used to form such a retainer from a titanium and nickel alloy, because they cannot be permanently or plastically deformed. Only by means of the method according to the invention - that is to say, that the retainer is made from a sheet of metal according to the specified orientation - the use of a material with shape memory is absolutely conceivable.
    [0050] Another important advantage of a precisely shaped retainer is its simplicity in terms of its application or introduction in a patient. In retainers according to the prior art, the physician responsible for the treatment is quickly attempted to apply the points of the retainer, in which a distance between the retainer and the tooth to be fixed is relatively large, manually and subsequently gluing. During this application the retainer is elastically deformed and consequently develops a restoring force, which tends to move back to its previous position. When fixing the retainer to the tooth, this restoring force is preserved and acts from now on the respective tooth. This means that the retainer no longer acts as a purely passive element that simply fixes the teeth in their current position, but is activated and causes the respective tooth to move due to the force. Through the production process of the present invention, however, the retainer is precisely adapted to the teeth in such a way that accidental activation of the retainer is almost impossible and, in particular, is not necessary. Therefore, by the method, the success of the subsequent treatment can be significantly improved and the use of a retainer is significantly safer than in the prior art.
    [0051] The retainer is made from sheet metal in such a way that a surface forming the retainer in an installed state of it faces a tooth surface on which the retainer rests and which is adapted to the respective contours of the retainer. surface of the respective teeth and an upper or lower surface of the retainer corresponds to a plane of the original sheet metal. A "top surface" and a "bottom surface" of the retainer means those surfaces of the retainer, which are aligned parallel to each other. In the example of Figure 1 of the exemplary embodiments, the upper surface of the retainer is the surface that is visible to the viewer of the Figure. The "forming surface" means the surface of the retainer, which is obtained by making the retainer from the sheet metal. Thus, the forming surface is the flat one, which is arranged perpendicular to the plane of Figure 1 of the exemplary embodiments. The forming surface normally touches the surface of the respective teeth to be corrected. This forming surface at least partially touches the tooth surface. The opposite plane facing away from the tooth surface can also be interpreted as a forming surface.
    [0052] This orientation during the preparation of the retainer from the metal plate allows to produce it directly in the format in which it will later be applied to the teeth of the respective patient. In particular, the curved path that is seen globally is approximately parabolic, can be "walked" directly automated by means of a suitable tool, so that the retainer can be separated without flexing or deformation of the material. From the document DE 102 45 008 A1, mentioned above basically, a method can also be extracted for the elaboration of a retainer of a metal plate, in which reference is made to the exemplary embodiment according to Figure 4 of the referred document. However, in the retainer described therein the forming surface also called as the processing plane coincides with the upper surface and the lower surface of the retainer respectively. The retainer designed then as a result is "flat" (which is necessary due to the significantly enlarged parts of the adhesive ends) and has to be adapted to the tooth in an additional step, in which it is normally bent. Such an additional step, which is normally performed manually, in turn, carries the risk of inaccuracy in relation to the adjustment of the retainer and is not necessary, by means of the method according to the invention and due to the characteristics of the titanium and nickel alloy it is not even possible.
    [0053] The method according to the invention is particularly advantageous if the retainer is cut from the metal sheet by means of laser cutting or by wire erosion, in which using this method the cut is performed by the impact of heat and not by a shear process of two cutting edges moving over each other. Such cutting methods are particularly accurate. In addition, associated devices that are adapted to cut metal sheets in an automated manner are readily available. Alternatively, however, other methods are possible, for example, water jet cutting.
    [0054] The method is also particularly advantageous if the contour of the teeth to be stabilized is detected intraorally. This is activated through so-called "intraoral scanners". However, in conventional molding processes, in which a (negative) impression of the teeth to be stabilized is made by means of a printing material and a positive one is obtained by casting the impression with a mortar material, they are of an especially high quality. Despite this, the accuracy of intraoral examinations is better related to the process, since even when using good impression materials there is always a drying-induced contraction and during the transfer of contour information from the natural tooth to the impression model and in turn from the mold to the finished form a loss inevitably occurs. In addition, bubbles trapped by trapped air regularly occur during the printing process which has a negative effect on the accuracy of the positive. In today's standard retainers, this is irrelevant since its accuracy cannot detect these small discrepancies between the model and the actual tooth. In retainers that are produced using the method according to the invention, intraoral verification, however, can provide an advantage in the final result of the retainer.
    [0055] In a particularly advantageous embodiment of the method according to the invention, the metal plate from which the retainer is made, consists of a pre-curved metal plate, in which an axis of curvature over which the plate sheet metal is at least curved in an unfolded state the sheet metal extends into a sheet metal plane. A pre-curved sheet metal during the production process offers the opportunity to produce the curved retainers in the same way.
    [0056] Through the use of a flat metal plate the retainer produced according to the invention has an arc shape, in which the retainer, however, has two planes that extend parallel to each other. Consequently, the retainer made from a flat metal plate could be placed horizontally on a flat surface, such as a table top, where a lower surface of the retainer would form a contact across the entire surface with the table surface. Through the use of pre-curved metal sheets from which the retainer is made, the retainer obtains an additional dimension (vertical), because, as a consequence, it also has a curved geometry. Using the table top example, this would mean that the retainer would only rest on the table top plane, with its bottom surface in parts and would otherwise be lifted from the table top. Such an option to form the retainer with an additional dimension possibly allows a better adaptation of the retainer to the overall shape of the dental arch.
    [0057] In a particularly advantageous method the retainer is electropolished or polished by plasma after being cut from the sheet, whereby the edges are rounded. Such treatment of the retainer reduces micro-roughness and nano-roughness of its surface and, thus, prevents the adherence of potentially harmful germs. In addition, the corrosion resistance of the retainer is increased. The upper surface and the lower surface newly formed after polishing according to the present invention are likewise to be understood as a "plane of the original sheet metal" according to the invention, since the removal of the material by polishing is only small, particularly since the removal of the material occurs on the micrometer scale. EXEMPLIFICATIVE ACHIEVEMENTS
    [0058] In the following, the invention described above is explained in details with reference to an exemplary embodiment illustrated in the figures.
    [0059] In the drawing:
    [0060] Figure 1 is a plan view of a retainer according to the invention for use in the upper jaw;
    [0061] Figure 2 is similar to Figure 1, but it is used in an upper jaw model;
    [0062] Figure 3 is an outline of a retainer used in a model of a lower jaw;
    [0063] Figure 4 is similar to Figure 1, but is shown as a model of the three-dimensional structure;
    [0064] Figure 5 is a cross section through one of the teeth provided with a retainer according to the invention;
    [0065] Figure 6 is an enlarged view of the retainer of Figure 5;
    [0066] Figure 6a is an enlarged view of an alternatively formed retainer; and
    [0067] Figure 7 is a plan view of a sheet of nitinol with an elaborate retainer.
    [0068] A first exemplary embodiment, shown in Figure 1, comprises a retainer 1, which is adapted for use on an upper jaw. Retainer 1 is configured as a 6-point retainer and is connected to six teeth in a form of force transmission after being inserted into the corresponding patient. Retainer 1 is shown in Figure 1 in a plan view, so that an upper surface 2 of retainer 1 is visible.
    [0069] Retainer 1 consists of an arc 3, the global shape of which is parabolic. This overall shape of the arch 3 is determined by the shape of the respective upper jaw, into which the retainer 1 is to be inserted. Arch 3 comprises locally individual formations 4, which can be divided into two categories. The first category refers to 4 formations in the form of "surface waves" 5 that are configured to adapt the retainer 1 to an individual topography of the adjacent teeth. These surface waves 5 are therefore correspondingly adapted to a patient's individual tooth shape. The second category describes "vertices" 6 that form the points of the arch 3, which will enter the inter-dental spaces between adjacent teeth. At the vertices 6 the arc 3 has small radii of curvature, which are in the range of 0.5 mm to 1.0 mm. These vertices 6 are different from waves 5 by means of their amplitudes relative to the overall shape of the arc 3.
    [0070] This can be shown based on two wrapping parables 7, 8 surrounding the arch 3 and shown in dashed lines in Figure 1. These wrapping parables 7, 8 describe an inner boundary line and an outer boundary line of the retainer 1, where the inner shell parabola 7 includes those points that are located more internally with respect to the shape of the retainer 1 and the outer shell parabola includes those points that are further out in relation to the shape of the retainer 1. Thus the outer shell parabola (8) extends substantially across the maximum points of the vertices 6. In the example shown, a distance as measured perpendicularly to the inner shell parabola 7 between it and the outer shell parabola 8 is continuously about 2 mm. This value describes, at the same time, the amplitude of the vertices 6 mentioned above. A parabola that would be placed substantially across the maximum points of the shallow waves 5 would have a much shorter distance from the inner shell parabola 7. That is, the amplitude of the waves 5 compared to the vertices 6 is small. This is clearly visible in the form of the retainer 1 shown.
    [0071] Retainer 1 is formed from the nitinol material and was cut from a corresponding nitinol sheet by a laser cutting process. Before this stage, it is always necessary to detect the respective contour to be reproduced from the teeth to be stabilized. This is usually implemented by scanning an impression that reproduces a dental impression of the upper or lower jaw, or by means of a so-called "intra-oral check", which is done using an intraoral scanner. In the latter method, the shape of the teeth is detected directly in the patient's mouth. Here, it is advantageous that this method is possible comparatively fast and allows for greater precision than a printing process.
    [0072] The result of the respective scanning of the teeth is then processed using CAD software and a three-dimensional model of the retainer 1 is created, which is very well adapted for scanning and, consequently, the actual topography of the respective teeth. Based on the model, the laser is subsequently programmed, whereby retainer 1 is cut out. This step in the process is also known as computer-aided production (CAM).
    [0073] Retainer 1 is shown in Figure 2 in an inserted state where retainer 1 is initially applied freely to the teeth. Retainer 1 is formed in such a way that a distance between a tooth surface on which retainer 1 rests and a point on retainer 1, the distance from which, measured perpendicular to the tooth surface is the smallest, is a maximum of 10 μm, that is, 0.01 mm. Such precision cannot be achieved with retainers according to the prior art. The resulting advantages are explained in detail above.
    [0074] Figure 3 shows another example of a retainer 1 'according to the invention, in which retainer 1' is adapted for use in a lower jaw. Retainer 1 'like retainer 1 is connected to six teeth in a way for transmitting force. However, the retainer is shown in Figure 3 in its inserted state, that is, without the necessary connections for a connection. Here, vertices 6 'of retainer 1' protrude into inter-dental spaces between the teeth in such a way that the displacement of the retainer 1 'in relation to the teeth is blocked at least in a transverse direction.
    [0075] From the figure it is evident that the amplitude of the vertices 6 'is significantly greater in retainer 1' than is the case in retainer 1. This results from the natural shape of the teeth.
    [0076] Retainer 1 is finally shown in Figure 4, in a three-dimensional structure model. From the illustration, it is evident that the retainer 1 has a square cross section, with a side length of the cross section being 0.3 mm. Likewise, in Figure 4, both a front surface 9 and a rear surface 10 of retainer 1 are shown. These are arranged parallel to each other, where the front surface 9 faces a tooth surface of the respective abutment tooth in a state installed of the retainer 1. Perpendicular to the front surface 9 and to the rear surface 10 the upper surface 2 and the lower surface 11 of the retainer 1 are oriented.
    [0077] The upper surface 2 and the lower surface 11 of the retainer1, each extend in a plane. These plans define a metal plate (not shown) from which retainer 1 was originally made, in which the metal plate has a thickness of 0.3 mm. This means that a machining tool (laser, water jet, erosion wires, etc.) has been moved parallel to the upper surface 2 of retainer 1 on the metal plate corresponding to the contour of the retainer 1, in order to develop the retainer 1 from the metal plate. Through this process step the front surface 9 and the rear surface 10 of the retainer 1 were obtained. These are, therefore, to be understood as processing plans 12 or machining surfaces 13 because they represent the plans that have been processed or where retainer 1 has been made. After preparation, retainer 1 is supplied directly in the illustrated form and can be applied to the patient's teeth without further adaptation.
    [0078] Figure 5 shows a cross section through an incisor 14 that is fitted with retainer 1 according to the invention of Figure 1, in which only the area of the incisor 14 is shown, which is located above the gums 15. For the sake of clarity, Figure 6 shows an enlarged view of retainer 1 in Figure 5. In a connecting part - in which retainer 1 is glued with incisor 14 - retainer 1 is embedded within an adhesive material 16, which has previously been applied to an internal surface of tooth 17 and leans almost directly on the surface of tooth 17. The surface with which retainer 1 leans against the surface of tooth 17 corresponds to the forming surface 13 of retainer 1, or that is, a cutting edge 18 that was formed during the production of the retainer 1. The upper surface 2 of the retainer 1 corresponds to an upper surface of the sheet metal 19 and the lower surface 11 of the retainer 1 corresponds to a lower surface of the sheet metal. goal 1, wherein said upper and lower surface of the plate 19 are parallel to each other. The top and bottom surface of the plate corresponds to a plane of the original metal plate. The upper surface 2 and the lower surface 11 of the retainer 1 extend perpendicularly to the inner surface 17 of the tooth.
    [0079] Figure 6a shows an alternative formed 1 "retainer that has a square cross section and is mounted on its gluing part by means of the adhesive material 16 on the incisor 14 in such a way that it is completely surrounded by the adhesive material 16.
    [0080] Finally, Figure 7 shows a plan view of a sheet of nitinol 20, in which the process of making retainer 1 according to the invention in Figure 1 has just been completed and, finally, cutout retainer 1 is still arranged inside the nitinol sheet 20. The surface of the nitinol sheet 20 and the retainer 1, which extends in the drawing plane corresponds to the upper surface 19 of the nitinol sheet or the upper side 2 of the retainer 1. The cutting edge 18 of retainer 1, of which only one line 21 is visible in the figure, extends perpendicular to the drawing plane. It corresponds to the forming surface 13 of the retainer 1, which comes to rest against the inner surface 17 of the tooth. A cutting edge 22 that extends parallel to the cutting edge 18, which in turn is only visible as a line 24 in Figure 7, is also to be considered as a forming surface 23, which faces outwards from the internal surface of tooth 17, in the inserted state. LIST OF REFERENCE SYMBOLS 1, 1 ', 1 "retainer 2 top surface 3 arc 4 formation 5 wave 6, 6' vertex 7 wrapper parabola 8 wrapper parabola 9 front surface 10 back surface 11 bottom surface 12 processing plane 13 surface forming edge 14 incisor 15 gums 16 adhesive material 17 inner tooth surface 18 cutting edge 19 top surface of sheet metal 20 nitinol sheet 21 line 22 cutting edge 23 forming surface 24 line
    权利要求:
    Claims (15)
    [0001]
    1. Retainer (1, 1 ') which is intended to cooperate with a plurality of teeth, suitable for stabilizing the teeth, comprising at least one elongated arch (3), with the arch (3) overall having a curved shape following a natural curvature of a lower or upper jaw and is adapted locally and individually to a contour of the surface of a respective adjacent tooth in the installed state of the retainer (1, 1 '), the retainer (1, 1') being formed from a plate-shaped piece, which has two surfaces (19) arranged parallel to each other, in such a way that the retainer (1, 1 '), after being cut, presents its final shape directly, characterized by the fact that that the retainer (1, 1 ') is composed of a nickel-titanium alloy and a forming surface (13) of the retainer (1, 1') in its installed state faces a tooth surface (17), on which abut the retainer (1, 1 '), and an upper side (2) or a lower side (11) of the retainer (1, 1 ') corresponds to one of the original surfaces (19) of the plate-shaped part.
    [0002]
    2. Retainer (1, 1 ') according to claim 1, characterized by the fact that the retainer (1, 1') can be connected to the respective adjacent teeth in such a way as to transmit force in connecting parts by means of a adhesive material in some sections, preferably being able to be embedded in an adhesive material that adheres to the respective tooth, and in a state connected in each of the joining parts, a maximum distance between a respective surface of the tooth and a position of the retainer ( 1, 1 ') which, measured perpendicular to the respective tooth surface, has the shortest distance from this tooth surface, is a maximum of 0.1 mm.
    [0003]
    3. Retainer (1, 1 ') according to claim 1 or 2, characterized by the fact that the retainer (1, 1') is formed locally, in such a way that, in the installed state, it protrudes at least partially, in at least one inter-dental space that is between two adjacent teeth, so that a relative movement between the retainer (1, 1 ') and the teeth oriented in the longitudinal direction of the retainer (1, 1') is blocked even if the retainer (1, 1 ') touches the teeth in a disconnected state.
    [0004]
    Retainer (1, 1 ') according to any one of claims 1 to 3, characterized in that the arc (3) has a radius of curvature of 1.0 mm or less, preferably 0.5 mm, locally or less, more preferably 0.2 mm or less.
    [0005]
    Retainer (1, 1 ') according to any one of claims 1 to 4, characterized by the fact that the arch (3) has a parallelogram-shaped cross section, preferably a rectangular cross section, with lateral lengths of the cross-sections are at most 0.7 mm, preferably at most 0.5 mm, more preferably at most 0.3 mm.
    [0006]
    Retainer (1, 1 ') according to any one of claims 1 to 5, characterized in that the retainer (1, 1') is configured in one piece.
    [0007]
    7. Retainer (1, 1 ') according to any one of claims 1 to 6, characterized in that, in top view, the retainer (1, 1') can be encapsulated by an inner shell parabola (7) and an outer casing parabola (8), and locally, in the region of an inter-dental space, a distance, measured perpendicularly to the inner casing parabola (7) between the inner casing parabola (7) and the outer casing parabola (8), is at least 1.0 mm, preferably 1.5 mm, more preferably 2.0 mm.
    [0008]
    Retainer (1, 1 ') according to any one of claims 1 to 7, characterized by a surface at least partially made rough, with preferably all surfaces extending in the longitudinal direction of the retainer (1, 1 ') are made rough.
    [0009]
    Retainer (1, 1 ') according to any one of claims 1 to 8, characterized in that a surface of the retainer (1, 1') is at least partially treated by means of electropolishing or polishing. plasma.
    [0010]
    10. Retainer (1, 1 ') according to any one of claims 1 to 9, characterized in that the nickel-titanium alloy has an AF temperature between 25 ° C and 35 ° C, preferably between 27 ° C and 33 ° C, more preferably between 29 ° C and 31 ° C.
    [0011]
    11. Method for producing a retainer (1, 1 '), as defined in claim 1, with the following steps a) a contour of teeth to be stabilized individually is detected; b) the retainer (1, 1 ') is cut from a plate that is formed of metal; characterized by the following process steps c) the detected contour of the teeth is converted into a model and the retainer (1, 1') is designed on the basis of the model; d) the designed retainer (1, 1 ') is made from the plate, which consists of a nickel-titanium alloy, at the base of the model by means of a computer-controlled process, so that the retainer (1, 1 '), after being cut from the plate, directly to its final shape, with a finished retainer (1, 1') forming surface, in its installed state, facing a tooth surface on which the tooth rests. retainer (1, 1 '), and an upper or lower side of the retainer (1, 1') corresponds to one of the original surfaces (19) of the plate.
    [0012]
    Method according to claim 11, characterized in that the retainer (1, 1 ') is cut from the sheet by means of a laser cut or by means of a wire erosion.
    [0013]
    13. Method according to claim 11 or 12, characterized in that the contour of the teeth to be stabilized is detected intra-orally.
    [0014]
    Method according to any one of claims 11 to 13, characterized in that the plate, from which the retainer (1, 1 ') is cut, is curved around at least one axis of curvature, being that the axis of curvature, in a non-curved state of the plate, extends in a plane parallel to the plate.
    [0015]
    Method according to any one of claims 11 to 14, characterized in that the retainer (1, 1 '), after being cut from the plate, is electro-polished or polished by plasma, by means of which edges are rounded.
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    同族专利:
    公开号 | 公开日
    JP6436918B2|2018-12-12|
    WO2014140013A1|2014-09-18|
    BR112015022477A2|2017-07-18|
    US20160058527A1|2016-03-03|
    AU2014230906A1|2015-10-29|
    BR112015022477A8|2019-11-26|
    AU2014230906B2|2018-03-08|
    HUE054605T2|2021-09-28|
    JP2016509907A|2016-04-04|
    PL2967756T3|2020-03-31|
    EP3563793A1|2019-11-06|
    HUE046096T2|2020-01-28|
    EP2967756A1|2016-01-20|
    US20190069974A1|2019-03-07|
    DE102013204359A1|2014-09-18|
    PT3563793T|2021-05-28|
    ES2874778T3|2021-11-05|
    KR102062942B1|2020-01-06|
    EP2967756B1|2019-06-12|
    DK3563793T3|2021-05-31|
    ES2744992T3|2020-02-27|
    DK2967756T3|2019-09-16|
    US10278791B2|2019-05-07|
    EP3563793B1|2021-03-10|
    PL3563793T3|2021-10-25|
    HRP20191576T1|2019-12-27|
    KR20150128917A|2015-11-18|
    US10772706B2|2020-09-15|
    PT2967756T|2019-10-02|
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    KR102350802B1|2020-06-09|2022-01-14|주식회사 스마일캐드|Method for making removable retainer|
    法律状态:
    2018-11-13| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2020-04-22| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-12-08| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-02-23| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 11/03/2014, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    DE102013204359.7|2013-03-13|
    DE102013204359.7A|DE102013204359A1|2013-03-13|2013-03-13|Retainer and method for its production|
    PCT/EP2014/054703|WO2014140013A1|2013-03-13|2014-03-11|Retainer and method for production thereof|
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