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WO1993015684A1 - Arc orthodontique d'expansion palatale en ni-ti - Google Patents

Arc orthodontique d'expansion palatale en ni-ti Download PDF

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Publication number
WO1993015684A1
WO1993015684A1 PCT/US1992/010288 US9210288W WO9315684A1 WO 1993015684 A1 WO1993015684 A1 WO 1993015684A1 US 9210288 W US9210288 W US 9210288W WO 9315684 A1 WO9315684 A1 WO 9315684A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheath
appliance
archwire
arch
teeth
Prior art date
Application number
PCT/US1992/010288
Other languages
English (en)
Inventor
Wendell V. Arndt
Original Assignee
Arndt Wendell V
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Arndt Wendell V filed Critical Arndt Wendell V
Priority to CA002129833A priority Critical patent/CA2129833C/fr
Priority to EP93900719A priority patent/EP0625888A4/fr
Publication of WO1993015684A1 publication Critical patent/WO1993015684A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/12—Brackets; Arch wires; Combinations thereof; Accessories therefor
    • A61C7/28—Securing arch wire to bracket
    • A61C7/282—Buccal tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/10—Devices having means to apply outwardly directed force, e.g. expanders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C2201/00—Material properties
    • A61C2201/007—Material properties using shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0019—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Definitions

  • the invention relates generally to the field of orthodontic appliances. More particularly, to an orthodontic appliance for spreading the palatal arch and an adapter for securing orthodontic appliances within the mouth and, with further particularity, appliances employing nickel-titanium alloys for moving and positioning teeth.
  • the dental specialty orthodontics is concerned with the correction of alignment and positional abnormalities of the teeth. It is not uncommon for patients receiving such treatment to require a regimen which continues over many months and involves the use of various appliances affixed within the mouth to achieve repositioning of displaced teeth.
  • the repositioning is accomplished, generally, by attachment of an orthodontic appliance to one or several of the teeth in order to provide forces on the affected teeth which accomplish the desired repositioning.
  • the tooth repositioning process with stainless steel involves the incorporation of U-shaped bends into the arch which are slowly expanded over weeks to maintain force on the teeth and to increase the distance of separation between the molars.
  • Such treatment requires multiple appointments with the orthodontic clinician and removal of the arch wire from the patient followed by reshaping of the device and reinstallation. This procedure can be time consuming and require substantial patient chair time.
  • the expansion screw is affixed to the molars and over a period of several weeks the teeth are expanded by having the patient lengthen the screw by quarter turn increments on a daily basis.
  • This type of device requires patient involvement in the treatment. Patient involvement may be improperly attended to or not conducted at all. In addition, patient manipulation of the device can result in damage to the appliance or injury to the patient. The vagaries of patent involvement are best avoided for most efficient results.
  • jack-screw type devices operate by the initial application of forces in the range of hundreds of grams. Forces on the order of 500 to 1300 grams are initially applied to the teeth when the jack screw is manipulated in the clinician's office. This initial high force application to the teeth is then followed by rapid movement of the teeth and a nearly immediate decay of the force to a pressure of zero. Such intermittent high force is considered, by orthodontic researchers, to be almost detrimental to the overall result and is suspected of resulting in retrograde bone destruction.
  • Ni-Ti nickel-titanium
  • Ti-Ti alloy nickel-titanium alloy combinations
  • Titinol nickel-titanium alloy combinations
  • the alloy may also include cobalt substituted for nickel on an atom-for-atom basis so that the composition is Ni-Ti; Co: .935, .065.
  • Nickel-titanium alloy metals offe unique physical characteristics. Of particular interest in the field of orthodontics is the property of conformation or shape memory of the metal. That is, the alloy presents temperature dependent flexibility properties and strength properties which can be utilized to particular advantage in orthodontic appliances.
  • Such nickel-titanium alloys present two types of physical states, the transition between which is temperature activated. The particular temperature at which the metal shifts from one state to another is dependent upon the contents of the alloy. At temperatures below the transition temperature the metal is in its "martensitic" state. In this state the metal is co paratively soft and may be deformed and twisted with relative ease.
  • This property of the alloy is of particular utility in orthodontics for the metal, when in its martensitic state, may be twisted and greatly distorted without surpassing the metals yield point which would result in permanent conformation changes. Thus, this property permits the orthodontic clinician to bend and twist the orthodontic appliance during the application session without damaging the appliance.
  • these metal alloys provide corrective force by taking advantage of the body temperature of the patient to provide the transition temperature of the particular metal alloy composition.
  • the metal When the metal is at a temperature above the transition temperature it is said to be in its "austenitic" state within which the metal seeks to return to a predetermined shape. It is this property of reverting to an original conformation at temperatures above the transition temperature which provides the forces useful in orthodontic appliances.
  • the properties of Nitinol permit the application of low forces to orthodontic applications and forces which are substantially consistent over the range of motion as the appliance moves back into its original or "memory" shape.
  • Nitinol orthodontic device it is necessary to use a crimp tube adapter to join a second workable metal to the Nitinol.
  • a crimp tube adapter to join a second workable metal to the Nitinol.
  • FIGs. 10 and 11 An example of such a prior art method of securing a Nitinol arch is illustrated in Figs. 10 and 11.
  • Such tube crimp connectors inhibit the joining of more than one Ni-Ti wire to another Ni-Ti wire or to a sheath insert or end piece. If the clinician desires to use multiple Ni-Ti wires in a treatment, several such crimp tubes must be soldered together, either one atop the other or some other arrangement, to permit the use of multiple Ni-Ti segments in the appliance.
  • Obiects of the Invention therefore it is an object of the present invention to provide an adapter for joining non-weldable orthodontic appliance materials directly to a sheath insert. Yet another object of the invention is to provide a device for releasably securing a lingual arch or other orthodontic appliance within a lingual sheath.
  • Another object of the present invention is to provide a device for joining multiple nickel-titanium lingual arch wires together and for joining multiple arch wires within a sheath insert.
  • Another object of the present invention is to provide a sheath insert which is removable.
  • Still another object of the present invention is to provide a sheath and sheath insert which are not easily separable by the patient.
  • Yet another object of the present invention is to provide a sheath and sheath insert which permit the use of small diameter nickel-titanium wires for use in orthodontic appliances for younger children.
  • Another object of the present invention is to provide a sheath and sheath insert which also act as a joining device for multiple arch wires.
  • Yet another object of the present invention is to provide a sheath insert which may be selectably modified by the orthodontic clinician to provide increased variation of directional forces utilized in the repositioning of teeth and in palatal arch expansion.
  • Another object of the present invention is to provide a sheath and sheath insert having redundant safety features to prevent patient dislodgement.
  • Yet another object of the present invention is to provide a sheath and sheath insert whic ⁇ have registrable indents to assist in removably locking the sheath insert within the sheath.
  • Still another object of the present invention is to provide a vertical sheath and vertical sheath insert which avoids the tendency of prior art devices to be removed by the patient.
  • Yet another object of the present invention is to provide a palatal expansion arch with memory-retaining characteristics capable of expanding the palate bilaterally and thus providing more space for the anterior teeth to assume their proper position in the maxillary arch.
  • Another object of the present invention is to provide a palatal expansion arch which is capable of providing palate expanding forces to expand the bicuspids and rotate, expand, intrude, and/or torque the molars.
  • Still another object of the invention is to provide a palatal expansion arch that provides low constant mechanical forces at ambient and below mouth temperatures and applies a greater sustained constant force when at mouth temperature through treatment until the desired change in palatal width and molar rotation is achieved.
  • Still another object of the invention is to provide a palatal expansion orthodontic appliance capable of delivering a constant, soft, uniform pressure or movement of teeth and to provide proper bone plating at the palatal suture.
  • FIG. 1 is a perspective view of the horizontal lingual sheath and showing the sheath indent
  • Fig. 2 is a perspective view of the horizontal lingual sheath insert showing the inserted arch wires of an orthodontic appliance
  • Fig. 3 is a side elevational view of the lingual sheath and lingual sheath insert and showing in phantom lines the appliance insert cavities and the extending stop;
  • Fig. 4 is a cross-sectional view of the sheath taken along line 4-4 of Fig. 1 and showing in side elevational view the sheath insert positioned within the sheath;
  • Fig. 5 is a side elevational view of an alternative embodiment of the invention showing a vertical sheath with a vertical sheath insert oriented for positioning within the vertical sheath;
  • Fig. 6 is a side elevational view of the embodiment of Fig. 5 showing the vertical sheath insert within the vertical sheath;
  • Fig. 7 is a side perspective view of the vertical sheath attached to a band on a molar;
  • Fig. 8 is a plan view of the vertical sheath of Fig. 7 and showing the band encompassing the molar;
  • Fig. 9 is a plan view of an arch wire connected to a prior art horizontal sheath insert by crimp tubes;
  • Fig. 10 is a side view of the arch wire and sheath insert of Fig. 9 showing the doubled over "U-shaped" end portion for insertion into a sheath;
  • Fig. 11 is a perspective view of the Ni-Ti tandem wire palatal expansion device
  • Fig. 12 is a cross-sectional view of the tandem wire device taken along line 12-12 of Fig. 11 and showing the oriente-tion of the arch wires within the sheath insert;
  • Fig. 13 is a plan view of the upper jaw illustrating the horizontal sheath insert embodiment joining the tandem wire device together and connecting the tandem wire device to a horizontal sheath;
  • Fig. 14 is a side elevational view of two opposing upper molars which are inwardly biased and showing horizontal sheaths attached thereto with the Ni-Ti tandem wire device connected thereto by the horizontal sheath insert;
  • Fig. 15 is a plan or occlusal view of the lower jaw illustrating a prior art stainless steel orthodontic device connected on one side to a sheath attached to a molar;
  • Fig. 16 is a plan or occlusal view of the lower jaw illustrating a prior art stainless steel arch expansion device connected on one side to a sheath attached to a molar;
  • Fig. 17 is a plan or occlusal view of the upper jaw illustrating a twin memory metal arch expansion device with stainless steel extenders in a partially compressed state for insertion into an unexpanded upper jaw;
  • Fig. 18 is a plan or occlusal view of the upper jaw of
  • Fig. 19 is a rear elevational view of the device of Fig. 17 and 18 showing the attachment of the memory metal arch wires within the sheath insert and showing the receptacle for the extenders;
  • Fig. 20 is a plan or occlusal view of the upper jaw before expansion by the memory metal single loop rotator and distalizer apparatus shown with a stainless steel stabilizer extending from the sheath insert;
  • Fig. 21 is a plan or occlusal view of the upper jaw of Fig. 20 after expansion by the memory metal rotator and distalizer device which is shown in its position after expansion of the arch has occurred;
  • Fig. 22 is a plan view of the lower jaw prior to expansion showing a single loop transverse expander device with adjacent stainless steel spring in compressed position;
  • Fig. 23 is a plan or occlusal view of the lower jaw of Fig. 22 after expansion by the device of Fig. 22 and showing the device in its relaxed expanded position;
  • Fig. 24 is a cross-sectional view of the device of Figs. 22 and 23 taken along line 24-24 of Fig. 22 showing the confirmation of the device to the concavity of the mouth;
  • Fig. 25 is a plan or occlusal view of the lower jaw illustrating misaligned anterior teeth and compressed posterior teeth with a tandem loop anterior-posterior expander with adjacent spring extenders positioned prior to expansion;
  • Fig. 26 is a plan or occlusal view of the lower jaw of Fig. 25 after expansion has taken place to expand and reposition the anterior teeth and expand the arch;
  • Fig. 27 is a cross-sectional view taken along line 27- 27 of Fig. 25 showing the position of the device of Figs. 25 and 26 with respect to the concavity of the lower jaw;
  • Fig. 28 is a plan or occlusal view of the upper jaw illustrating the application of the shape memory metal maxillary molar distalizer with palatal anchorage in place in a misaligned and compressed jaw;
  • Fig. 29 is a plan or occlusal view of the upper jaw of Fig. 28 after action of the distalizer device of Fig. 28 in moving the molars to provide expansion of the arch;
  • Fig. 30 illustrates one configuration of the inventive devices in their martensitic state allowing the device to be twisted and compressed and manipulated for insertion into the mouth of a subject
  • Fig. 31 illustrates the device of Fig. 30 after it has been warmed to its austenitic state causing it to revert to its original configuration
  • Fig. 32A illustrates in fragmentary plan view one possible configuration of a spring extender, in this case being cantilevered outwardly from the point of connection with the sheath insert, the spring extender has also been bent outwardly from the forward loop to provide additional pressure proximate to the teeth near the sheath insert;
  • Fig. 32B shows a spring extender similar to that of Fig. 32A, with the extender been bent outwardly from the forward loop in order to provide additional outward movement of the teeth proximate to the sheath insert;
  • Fig. 32C illustrates a spring extender being bent outwardly only slightly from the point of insertion into the sheath insert to provide additional pressure on anterior teeth;
  • Fig. 32D illustrates a spring extender being in a generally inactivated position and serving as a stabilizer for the orthodontic device to which it is attached.
  • Fig. 1 In Fig. 1 is illustrated horizontal sheath 20 of the present invention and in Fig. 2 is illustrated horizontal sheath insert 30 for capture by sheath 20.
  • Sheath 20 is provided with back portion 22 having flanges 24 to permit attachment of sheath 20 to a stainless steel band placed about a tooth or molar.
  • a band 90 is shown in Figs. 6 and 7, but illustrating the connection of an alternative sheath embodiment.
  • Sheath 20 of Fig. 1 is a horizontal-insert type of sheath and is positioned within the mouth such that anterior end 26 of sheath 20 is oriented towards the front of the mouth while posterior end 28 is oriented towards the back or posterior of the mouth. This orientation is such that indent 29 on lingual wall 27 is positioned at the posterior of the sheath. While sheath 20 and sheath insert 30 are usually composed of cast stainless steel, other alloys commonly employed in such orthodontic appliances are equally acceptable. Lingual wall 27 is attached to back wall 22 by sides 23, 25. The dimensions of sheath 20 are such that a frictional fit is provided with sheath insert 30.
  • Horizontal sheath insert 30 is illustrated in Fig. 2 and is shown with partially illustrated arch wires 31 of an orthodontic appliance inserted into cavities 50A, 50B (Fig. 3) .
  • Sheath insert 30 is composed of cast stainless steel or other suitable material for use in the mouth. Insert 30 may be subdivided, for purposes of discussion, into two general portions; sheath insert or post portion 32 and appliance reception or securing member portion 33. Appliance reception portion 33 may be altered according to the requirements and shape of the particular appliance. Sheath insert portion 32, however, is maintained in standard dimensions and conformation. In this manner sheath 20, once installed in a patient's mouth, may be utilized with a variety of orthodontic appliances where clinically efficacious. Extension 35 projects from edge 36 of insert post portion 32.
  • Extension 35 provides two functions, it serves as a positive stop when insert 30 is placed into sheath 20, and can act as an securing post for an elastomer or soldered wire lock. Extension 35 operates as a positive stop by contacting anterior end 26 of side 23 as sheath insert portion 32 is captured by sheath 20. This provides a positive stop on the rearward movement of sheath insert 30 during insertion into sheath 20. In addition, extension 35 offers added stability to sheath insert 30 and sheath 20 when in contact with one another.
  • extension 35 projects slightly above the anterior edge of side 23.
  • extension 35 may be useful in locking the sheath insert 30 into sheath 20 by application of an elastomer between extension 35 and arm 37.
  • a wire may be soldered to extension 35 and to arm 37 to prevent release of the orthodontic appliance.
  • Extending from posterior end 38 of sheath insert portion 32 is arm 37.
  • Arm 37 also extends rearwardly from posterior end 28 of sheath 20 when sheath insert 30 is seated within sheath 20. This relationship may be observed in Fig. 4.
  • arm 37 provides a second point of attachment for an orthodontic elastomer or for soldered a wire lock.
  • the elastomer may be attached to the orthodontic appliance held within appliance reception portion 33 and then extended rearwardly and attached to arm 37.
  • Appliance reception portion 33 of sheath insert 30 may be cast simultaneously with sheath insert portion 32 to present the final conformation of appliance reception portion 33.
  • appliance reception portion 33 may be cast as blocks of material, variously sized, for later shaping and drilling to accommodate the particular orthodontic appliance of choice for attachment to the sheath insert by the clinician.
  • sheath and the sheath insert of the present invention may be utilized with a wide range of orthodontic appliances made from a full range of materials
  • inventive sheath and sheath insert are of particular utility for use in conjunction with metal alloys which, due to their particular properties, may not be welded. Rather the formation of the appliance requires use of various "crimp tube" connectors to form the appliance and/or to join a sheath insert thereto to permit affixation within the mouth.
  • Fig. 9 nickel-titanium alloy arch 120 is joined to crimp tube 122. Attached to the other end of crimp tube 122 is adapter 124. Adapter 124 also contains adjustment loop 126 which may be utilized to lengthen or shorten the adapter 124 to correct for patient variations. Referring now to Fig. 10 a side elevational view of Fig. 9 is illustrated. A double-backed portion or U-shaped portion 128 of adapter 124 is shown and is the commonly utilized insert adapter of the prior art.
  • FIG. 3 the pre-insertion alignment of sheath insert 30 and sheath 20 is illustrated in side elevational view.
  • Fig. 4 the sheath insert 30 has been placed into sheath 20 and the abutting of extension 35 against side 23 to provide a positive stop to insertion can be observed.
  • indent 29 on sheath 20 and indent 39 on insert 30 may be discussed.
  • indent 39 on insert portion 32 is thrust towards the posterior end 28 of sheath 20 and will come into registration with indent 29 on sheath 20 as an extension 35 contacts side 23 of sheath 20.
  • Indent 29 of sheath 20 causes a portion of wall 27 to protrude inwardly and toward back wall 22 of sheath 20. This protrusion into the interior of sheath 20 and the close registration between sheath insert 30 and sheath 20 causes protruding indent 29 to be inserted into indent 39 when sheath insert portion 32 is seated within sheath 20.
  • This close registration provides a positive, but releasable lock of sheath insert 30 within sheath 20. This positive lock assists in preventing inadvertent patient removal of the appliance as the tongue contacts the appliance and pushes it forward.
  • arm 37 extends from the posterior 28 of sheath 20. This extension of arm 37 beyond sheath 20 provides a point of attachment for an orthodontic elastomer having its other end attached to the orthodontic appliance 31. Alternatively, if it is desired to more permanently attach the appliance, a piece of wire rather than an elastomer may be soldered between arm 37 and extension 35. Thus permanent capture of the sheath insert 30 within sheath 20 is accomplished.
  • Fig. 5 an alternative embodiment of the sheath and sheath insert is illustrated. The embodiment of Fig. 5 is in the vertical sheath and vertical insert configuration. This name is indicative of the nearly vertical direction of insertion of insert 70 into sheath 80.
  • Sheath insert 70 may again, for purposes of discussion, be divided into two portions; an appliance reception portion 72 and a sheath insert portion 74.
  • appliance reception portion 72 of vertical insert 70 is preferably cast in a unitary manner with sheath insert portion 74.
  • appliance reception portion 72 may be precisely shaped for the intended orthodontic appliance, or alternatively, appliance reception portion 72 may be cast as a generally defined block of material for later drilling and shaping.
  • the clinician may use the sheath insert and sheath with the available manufactured orthodontic appliances or the clinician may choose to modify appliance reception portion 72 for use with a custom orthodontic appliance.
  • the appliance reception portion 72 has been pre-drilled to include appliance cavities 50A, SOB.
  • Sheath insert portion 74 is provided with insertion posts 76 which are sized for complemental reception in sleeves 84 of sheath 80.
  • the vertical sheath and sheath insert embodiment is provided with indent 78 on sheath insert posts 76 and indent 88 on sleeves 84 of sheath 80.
  • Arm 75 extends rearwardly from the posterior edge of sheath insert portion 74. Arm 75 may be utilized as an attachment point for a soldered lock-wire between arm 75 and sheath 80.
  • FIG. 6 the vertical sheath 80 and sheath insert portion 74 of Fig. 5 are shown in their coupled position.
  • Each of insert posts 76 have been placed into sleeves 84 and sheath insert portion 74 pressed vertically to permit indents 78 on each of posts 76 to engage with indents 88 of sleeves 84.
  • Fig. 7 and Fig. 8 the attachment and orientation of sheath 80 (Fig. 5) is shown.
  • sheath 80 is shown attached to band 90 which encircles tooth 92.
  • Band 90 is a standard stainless steel band which has been long used in the art.
  • Sheath 80 is attached to band 90 by spot welds on flanges 82.
  • the orientation of indent 88 may be observed and it should be noted that the apex of the triangle is oriented upwardly.
  • Fig. 8 provides a plan view of Fig. 7.
  • the encirclement of tooth 92 by band 90 is shown as well as the orientation of sheath 80 thereon.
  • the interior of sleeve 84 of sheath 80 and the inward projection of indents 88 for registration with indents 78 on posts 76 of vertical sheath insert 70 may be observed.
  • a typical crimp tube connector which is used to hold a Ni-Ti arch in contact with a sheath insert.
  • an arch wire 120 spans the distance between crimp tube connectors 122.
  • Arch wire 120 is inserted into crimp tubes 122 and an insert wire 128 is inserted into the opposite opening of crimp connector 122.
  • crimp connector 122 is squeezed to maintain arch wire 120 and insert wire 128 in place within crimp connector 122.
  • This arch appliance 119 is then inserted into a sheath attached to a patient's teeth. This is accomplished by using insert wire 128 to act as a sheath insert. To this end, insert wire 128 is bent back upon itself to provide sufficient size for a friction fit within the sheath.
  • Fig. 10 the double back insert portion 124 which is constructed from insert wire 128 is shown.
  • insert wire 128 is adjusting loop 126 which permits the clinician to lengthen or shorten the distance between arch wire 120 and the sheath in contact with double back insert portion 124.
  • the arch appliance 119 is modified to the individual patient as well as modified during treatment.
  • the crimp tube arrangement shown in Figs. 9 and 10 does not permit multiple arch wires 120 to be incorporated into an orthodontic appliance without joining together multiple crimp tubes.
  • This connecting of crimp tubes by either soldering or welding incorporates one or more points for potential weakness in the device.
  • the double back insert portion 124 of the crimp connector type of insert does not provide any sure lock mechanism with the sheath and is easily worked loose from the sheath by manipulations of the patient's tongue.
  • adjusting loop 126 if improperly positioned may result in misdirection of the forces which are to be applied to the teeth. This can result in ineffective treatment of the patient's orthodontic problem.
  • the sheath and sheath insert of the present invention overcomes these limitations of crimp connector type methods of joining Ni-Ti arch wires to a sheath.
  • the arch wires are securely crimped within the sheath insert 30 (Fig. 2) 72 (Fig. 5) in an orientation which may be definitively determined by the clinician prior to insertion of the device within the patient's mouth.
  • the elimination of adjusting loop 126 eliminates the potential for misalignment of the arch wire with respect to the sheath and sheath insert.
  • the methods for locking the sheath insert within the sheath avoid the unintentional dislocation of the orthodontic appliance by patient manipulation of the device with the tongue or objects inserted into the mouth.
  • an inventive Ni-Ti tandem wire palatal expansion arch 140 is shown in perspective view.
  • Arch 140 is comprised of lower arch wire 142 and upper arch wire 144.
  • Arch wires 142, 144 are inserted into sheath insert 148, 149 and secured in place by the bilateral crimping of appliance reception portion 33.
  • Arch wires 142, 144 of expansion arch 140 are composed of a near-stoichiometric alloy of nickel and titanium having memory-retaining characteristics. Arch wires
  • sheath insert 148, 149 extend bilaterally along the palatal concavity to unite sheath inserts 148 and 149. It will be appreciated from the foregoing description that the particular characteristics of sheath insert 148, 149 permit this inventive tandem coupling of arch wires made from nickel-titanium to thereby allow construction of the tandem wire device.
  • Nickel-titanium tandem arch 140 due both to its tandem wire construction and utilization of a memory-retaining alloy such as nickel-titanium, provides a number of benefits for both the patient and the clinician involved in palatal expansion treatment beyond conventional stainless steel devices.
  • the tandem Ni-Ti wire arch provides simultaneous bilateral expansion of the mandibular cuspids, first bicuspids and second bicuspids. It has also been observed that a concomitant, spontaneous realignment of the mandibular teeth occurs in response to the increase in width of the maxillary arch by the nickel-titanium tandem arch device. It is believed that this effect is heretofore unobserved in the use of such palatal expansion devices. As shown in Fig.
  • Upper arch wire 144 is mounted above lower arch wire 142 within cavity 50A (Fig. 3) . This positioning of upper arch wire 144 is such that contact with bicuspids and 180 and cuspids 182 is avoided and the expansive force provided by upper arch wire 145 is specifically directed into sheath insert 148, 149 which is in contact with first permanent molar 184. This division of the forces which are applied to the various teeth in attempting to expand the palatal arch permits allocation of different magnitudes of force to the various teeth to be operated upon.
  • lower arch wire 142 contacts cuspids 182 and bicuspids 180 directly as well as first permanent molar 184 through its attachment to sheath insert 148, 149.
  • This arrangement of lower arch wire 142 permits force to be applied to each of these teeth.
  • the arrangement of upper arch wire 144 within tandem wire arch appliance 140 permits the application of additional pressure directly to the first permanent molar. Therefore, this unique arrangement of Ni-Ti tandem wires within palatal arch expansion appliance 140 permits the use of smaller wire dimensions for each of lower arch wire 142 and upper arch wire 144 thereby generating lower force values at any particular point. This provides greater patient comfort while at the same time permitting more specific control over the application of expansive forces to the palate.
  • the use of multiple wires for the application of force to the teeth and palate allows the clinician to select wires of different dimensions, and therefore, different degrees of force generation, in the various positions of the tandem wire expansion arch.
  • first permanent molars 184 are substantially rotated or deflected inwardly and being aware of the greater mass of first permanent molar 184, may choose a wire of greater diameter to impart additional correctional forces to first permanent molar 184.
  • a sheath 190 attached to band 192 on molar 184 will necessarily be in a skewed position due to the irregular position of molar 184.
  • molars 184 are shown inwardly displaced or canted from vertical by angle theta. The degree of displacement illustrated by angle theta will also be present in the horizontal orientation of sheath 190.
  • this inward deviation of molars 184 presents sheath 190, 191 in closer proximity to one another than are sheath inserts 148, 149.
  • molars 148, 149, having bands 192, 193 attached and sheath 190, 191 attached thereto respectively may present a rotational deviation of the molar as indicated by rotational movement arrows 194, 196. Movement of molar 184 in either direction indicated by rotational arrows 194, 196 will present a third degree of misalignment of sheath 190, 191 with respect to the orthodontic appliance for insertion into sheath 190, 191. The end result of this misdirection of sheath 190, 191 is that insertion of the orthodontic appliance 140 into the sheath is inhibited and requires some amount of compression or misshaping of the orthodontic appliance.
  • the nickel-titanium tandem wire palatal expansion arch appliance avoids these difficulties of the prior art devices by being substantially compressive and elastic thereby permitting the clinician far greater latitude in the degree to which the device may be misshapen for placement within the mouth.
  • the compressing or twisting of the nickel-titanium tandem wire device, wire permitting insertion of the device into sheath 190, 191 does not result in deformation of the appliance as lower arch wire 142 and upper arch wire 144 do not structurally yield by the manipulations of the clinician in inserting the device. Rather, as the device is in its "martensitic" state the nickel-titanium alloy is comparatively soft and may be deformed and twisted with relative ease and without causing permanent conformation changes in the appliance.
  • the nickel-titanium alloy begins to change its physical state.
  • the Ni-Ti begins the transition from its "martensitic” state where it is flexible into its “austenitic” state within which the metal seeks to return to a predetermined shape.
  • This predetermined shape has been provided to the device in its original manufacture by heating the nickel-titanium alloy arch wire 142, 144 segments of the apparatus at 1200° F while under a six percent strain.
  • This high temperature treatment of the Ni-Ti alloy provides it with its "memory" shape to which it seeks to return when it is in its austenitic state.
  • the inventive orthodontic appliance may be substantially misshaping during insertion, it will also be appreciated that the "misshaping" of the device to allow insertion into the sheaths results in forces being applied to the teeth which are a direct result of the misshaping of the tandem arch device as it is inserted into the sheaths. That is, as the inventive device 140 warms within the mouth and attempts to return to its "memory shape" it 11 begin to apply forces to the teeth which are in direct response to the direction and amount of misshaping the expansion arch appliance 140 has incurred during the insertion process.
  • the device applies a "dynamic” type of force to the teeth providing varying degrees of outward force as well as rotational and torque forces to the teeth and that these forces will vary throughout the movement of the device back to its “memory shape".
  • the "memory shape” represents the proper position of the teeth, once the teeth have been realigned into the correct position the nickel-titanium tande arch device will have achieved its memory position and will cease the application of force to the teeth.
  • Figs. 15 and 16 the standard stainless steel type devices of the prior art are illustrated partially inserted into a lingual sheath attached to a molar.
  • a stainless steel archwire device 200 is shown partially inserted into a sheath 202 which is attached molar 204.
  • Molar 204 is slightly rotated inwardly as is its counterpart molar 206.
  • This incremental shaping of device 200 results in high corrective forces being imparted to molars 204, 206 immediately after each new modification to device 200 by the orthodontic clinician.
  • These corrective forces while initially very high, are of short duration.
  • the tooth within one or two days moves that amount of distance provided by the incremental modification of the stainless steel device.
  • the corrective force is then dissipated and further correction of the tooth must await the next incremental modification of the stainless steel device.
  • This limitation of intermittent application of corrective forces is necessitated by the rigidity of the prior art stainless steel devices.
  • Stainless steel devices are capable only of generating a force over the short distance and in the specific direction provided by the bending of the device.
  • the orthodontic clinician by repetitive bending generates successive incremental corrective forces to adjust the teeth and to re-form shape of the stainless steel device.
  • the application of high force is followed by cessation of movement as soon as the tooth has moved beyond the influence of the force provided by the incremental bend.
  • This type of application of force to the tooth results in repeated painful episodes for the patient as the modification to the device causes rapid movement of the tooth resulting in shearing of the supporting tissues.
  • Fig. 16 a second prior art stainless steel device is presented which is used for rotating the teeth to which it is applied. Again, it may be observed that sheath 220, 222 are inwardly rotated in the direction of arrows "R".
  • inventive method and devices for practice of the inventive method contemplated herein avoid the stop-start force applications of stainless steel devices by relying on the application of very low, but constant, expansive and rotational forces. These forces are generated constructing the orthodontic device of a shape memory-retaining alloy, such as a nickel- titanium alloy or beta-titanium alloy or super-elastic nickel titanium alloy or nickel-titanium-copper alloy, which attempts to modify its shape configuration when the alloy is warmed to its austenitic state while within a patient's mouth.
  • a shape memory-retaining alloy such as a nickel- titanium alloy or beta-titanium alloy or super-elastic nickel titanium alloy or nickel-titanium-copper alloy
  • rapid palatal expansion devices are applied to the maxillary or mandibular arches which produce initial pressures of 6 to 10 lbs. with the Multiple daily manipulations of the device can result in cumulative loads of 20 lbs. or more. These high pressures disruptively overwhelm the tissues of the maxilla suture as well as providing outward movement of the teeth themselves. These high forces are achieved by implantation of jack-screw across the molars which generates initial high pressures each time the screw is rotated.
  • the alternative to "rapid palatal expansion” has been the “slow palatal expansion” procedure. This involves use of stainless steel lingual wire appliances equipped with springs to apply forces of approximately 2 lbs. The slow expansion procedures increase the amount of orthodontic movements (tooth movement within the palatal arch) and tend to minimize the orthopedic separation of the maxillary suture which results from the higher pressures of the rapid palatal expansion technique.
  • the present inventive method and apparatus relies on the constant low forces which may be generated through use of nickel-titanium alloys and other temperature-affected metals having a shape memory-retention.
  • This new method provides for expanding the pallet and rotating misaligned teeth through the use of a memory metal alloy in its austenitic phase to apply a constant low force to-the affected teeth to achieve their slow and gentle repositioning.
  • This method slowly expands the maxillary suture at a rate which promotes the reorganization of tissue about the suture as it expands.
  • the method provides greater stability for regeneration of the palatal suture while avoiding the significant deformation of maxillary bones which follows with rapid palatal expansion.
  • some researchers believe that with rapid palatal expansion the degree of tissue stress caused actually increases the required retention periods to allow reorganization and stabilization of the maxillary suture and avoid skeletal relapse. This too is avoided.
  • the inventive continuous low force method of treatment provides far greater patient comfort.
  • the pressures applied to the teeth are from 4 to 20 times less than the conventional recommended forces. Therefore the substantial discomfort that can arise from the high forces associated with rapid palatal expansion and even the lower forces of the slow expansion technique is not present.
  • the method also provides the patient the ability to control metallurgical state of the device while it is in place in the mouth.
  • the patient can shift the device from its more rigid austenitic state or phase into its more relaxed martensitic state by cooling the device to a temperature below its transition temperature with a drink of cold water. This allows greater comfort for the patient and provides increased adherence to treatment plans.
  • a particular problem which arises with the prior art methods of expanding the palate is that frequent visits to the orthodontic clinician are required to adjust the device.
  • patient participation is required to advance the jack screw on a daily basis. This can result in daily discomfort to the patient and patient involvement in the treatment which can be extremely variable and dependent upon the patient's willingness to comply with therapy.
  • Figs. 17 and 18 one embodiment of a device employed in application of the inventive method is illustrated.
  • Fig. 17 an occlusal view of the upper or maxillary arch is shown with premolars 240, 242 compressed inwardly and molars 244, 246 slightly rotated.
  • the nickel- titanium alloy device 248 is shown attached to sheath insert 250 with stainless steel extenders 252 in contact with premolars 240, 242.
  • the M-shaped wires 254 of device 248 are composed of a shape memory-retaining type metal alloy such as nickel- titanium.
  • the device is applied with the alloy in its martensitic state which permits manipulation and compression of the device to allow it to be fitted into sheath 256.
  • the nickel-titanium alloy has its transition temperature (approximately 94* in the particular alloy of this embodiment) below mouth temperature it is in its martensitic state and may be manipulated to the specific configuration of the patient's misaligned palatal arch and the sheath positions resulting therefrom to permit installation of the device without bending it as with stainless steel devices.
  • the device Once the device is inserted in the mouth, it warms to its austenitic state whereupon it becomes more rigid and attempts to restore itself to the specific configuration instilled in it during its formation by heating at 1,200'F while under a 6 percent strain. The device will therefore exert a constant, but very low force against the misaligned teeth as it attempts to regain its austenitic state conformation.
  • the device continues to operate on the misaligned teeth during each moment of its installation until it eventually arrives at its original conformation as represented in Fig. 18.
  • the device can be seen to have expanded the palatal arch to a desirable dimension and has succeeded in rotating molars 244, 246 into proper orientation.
  • the device has achieved its austenitic state conformation and can remain in place for a period of weeks to provide retention of the teeth in a proper alignment while the bony material of the jaw surrounding the teeth forms to securely hold the teeth in their newly oriented position.
  • Fig. 19 the device of Figs. 17 and 18 is shown from the rear and in elevational view. Archwires 254 may be seen as they are mounted in sheath insert 250. Stainless steel extenders 252 are hidden from view.
  • the inventive sheath insert 250 is shown which is specifically developed for the capture and holding of shape memory-retaining type metals which cannot be soldered into conventional devices.
  • Figs. 20 and 21 a maxillary Ni-Ti single loop rotator and distillizer with steibilizers is shown in position.
  • Fig. 20 a maxillary dental arch before rotation of the molars and distilization is shown.
  • molars 260 are rotated in the direction of arrows "R" and premolars 262, 264 are collapsed inwardly.
  • premolars 262, 264 are collapsed inwardly.
  • directional lines 266 show the orientation of the buccal portion of molars 260.
  • Fig. 21 the maxillary arch of Fig. 20 is shown after expansion and rotation of the teeth.
  • Molars 260 have been rotated so as to align the buccal surface in proper conformation as shown by directional lines 266a.
  • Stabilizers 263 have progressed outwardly with the rotation and expansion caused by device 261 as nickel-titanium archwire 265 moved into its austenitic state conformation. This rotation and outward movement served to press premolars 262, 264 into an outwardly expanded position.
  • the operation of the device of Figs. 20 and 21 indicates more than a single direction of movement can be accomplished through the use of the method of expansion and rotation of the inventive memory metal devices. In the treatment situation examined in Figs.
  • the device accomplished the lateral expansion of the maxillary arch, the rotational movement of the molars and the rearward or distal movement of the molars without any manipulation of the device after its installation.
  • the orthodontic clinician would be required to provide multiple directional bends to create moments of force in the desired direction of action.
  • a device utilized in the inventive method may have a shape similar to prior art stainless steel devices and yet be capable of accomplishing far more than the equivalent stainless steel device.
  • the archwire with stabilizers is first cooled to fully develop its martensitic state so the device may be compressed and manipulated to fit sheath insert 267 within the sheath 261 attached to bands 268 on molars 260. Once in place, the device warms to its austenitic state and attempts to revert to its austenitic state conformation. This results in the device both pulling and pushing on the misaligned teeth —a feature not heretofore available in stainless steel orthodontic archwires. It will be appreciated by those skilled in the art that the forces provided by the devices utilized in the inventive method apply forces in response to the degree and direction which the device is misshapen from its austenitic conformation.
  • the direction and continuation of force to which the misaligned teeth are subjected is directly a function of their deviation from the austenitic conformation of the device. If the archwire is originally formed to the proper final dimensions for the teeth or dental arch, the misaligned teeth will, by virtue of their degree of distortion from the final austenitic configuration of the device determine the direction and amount of force which is applied to them. In this manner the method and device can operate largely independent of additional manipulations by an orthodontic clinician.
  • Figs. 22 and 23 the operation of a mandibular single loop nickel-titanium transverse arch expander having adjacent stainless steel springs will be described.
  • the device of Fig. 22 is designed to operate under the inventive method to expand the anterior portion of the mandibular arch and to allow application of clinician-selectable outward forces by the manipulation of stainless steel springs 272.
  • the mandibular expander device 270 is composed of a shape-memory alloy metal archwire 271 which is mounted in sheath inserts 274 connected to sheath 276 attached to bands on molars 278.
  • the anterior portion of device 270 has a loop area 279 which may be compressed while in its martensitic state to conform to the collapsed position of incisors 280.
  • the device Upon device 270 being warmed within the mouth to its austenitic state, the device begins to change into its austenitic conformation from the shape into which it was manipulated while in its martensitic state. This causes application of a very low, but continuous outward pressure to incisors 280. While this mechanical counter-force is being applied to the teeth the clinician can utilize stainless steel springs 272 to accomplish outward movement of the premolars 282 and bicuspids 284. The specific manner of manipulation of stainless steel springs 272 will be discussed infra.
  • FIG. 23 the expanded position of the mandibular arch of Fig. 22 is shown.
  • Incisors 280 have been expanded by loop 279 which has now moved into its austenitic state conformation.
  • Stainless steel springs 272 have acted against premolars 282 and bicuspids 284 to push these teeth outwardly to overall expand the mandibular arch.
  • Fig. 24 the device of Figs. 22 and 23 is shown in cross- sectional view indicating the position of the device in relation to the soft tissue of the jaw to avoid interference with the tongue just above.
  • Figs. 32A-32D the action forces applied to the teeth by stainless steel springs 272 of Figs. 22, 23, 25, 26 will be described.
  • a spring 290 is shown positioned in sheath insert 291 and adjacent to archwire 292. This orientation of the spring provides the orthodontic clinician with a number of options which may be utilized to apply pressure of various amounts and directions to the premolars and bicuspids.
  • the spring has been bent outwardly at area 293 which is adjacent to its anchorage in sheath insert 291. This bend may be used to provide force against the bicuspid which would be adjacent to curve 294 of the spring device.
  • Free arm 295 of spring 290 also may be adjusted to provide various degrees of pressure on the adjacent premolars.
  • Figs. 32B-D variations on these manipulations of the spring are shown.
  • free arm 295 has been moved outwardly to provide additional pressure on the premolars.
  • Fig. 32C the curve portion 294 has been moved to specifically impact the bicuspid.
  • Fig. 32D the spring has been only slightly adjusted outwardly to provide a mild force against both the premolars and the bicuspid.
  • Figs. 30 and 31 the manipulation of the shape memory-retaining metal archwires in the various states may be seen.
  • a nickel-titanium or memory metal archwire has been cooled to its martensitic state. This allows the device to be compressed and manipulated for insertion into the sheaths attached to bands around misaligned teeth.
  • the device Once the device has been inserted into the mouth it then begins to warm to its austenitic state or phase. In the austenitic state the metal seeks to reorient itself into the conformation originally provided to it as it was formed.
  • Fig. 31 is shown the device of Fig. 30 once it has been warmed into its austenitic state and spontaneously configures itself into the austenitic state conformation. It will be appreciated that once the archwire has achieved its austenitic configuration it is no longer actively providing forces against the teeth to which it is attached or abuts. Rather, it is at that point serving only to retain the teeth in the confirmation presented. This will allow teeth that have achieved their proper configuration as a result of the device to be retained in that position until the adjacent bone structure is sufficiently developed to hold the teeth in their new position.
  • Figs. 25 and 26 the operation of a nickel-titanium mandibular tandem loop anterior-posterior expander with adjacent spring extenders will be examined.
  • Fig. 25 an occlusal view of a mandibular arch is presented showing misaligned teeth with several incisors 300 intruding into the center of the mandibular dental arch.
  • the position of premolars 302 and bicuspids 304 is substantially correct.
  • the tandem loop device 305 is connected to sheath inserts 306 which are attached to sheaths 307 about molars 308.
  • the nickel- titanium or other shape memory-retaining metal archwire extends, anteriorly to approach incisors 300.
  • archwire 310 is limited by the encroaching incisors 300 and therefore is slightly compressed.
  • stainless steel springs 312 may be utilized to either stabilize or press outwardly on premolars 302 until their desired expansion is achieved.
  • FIG. 27 the device of Figs. 25 and 26 is shown in cross-sectional view taken along line 27-27 of Fig. 25.
  • Fig. 27 the downward angle of the archwire 310 toward the jaw may be observed. This configuration allows the device to avoid abrading the base of the tongue.
  • Figs. 28 and 29 the operation of a tandem loop nickel-titanium maxillary molar distillizer with palatal anchorage is illustrated.
  • This device is utilized to apply the inventive method to shift molars 320 rearward or distally from their position illustrated in Fig. 28 and in this matter provide additional space to the maxillary arch allowing the other teeth to shift into expanded positions.
  • This is accomplished by anchoring nickel-titanium loops 322, 324 into vinyl cushion 325.
  • the other ends of archwires 322, 324 are fixed in sheath inserts 326 attached to sheaths 327.
  • vinyl cushion 325 presses against the inclined walls of the palatal vault and lingual alveolar plate 330.
  • distilized molars 320 are shown which have allowed premolars 332 and bicuspids 333 to also move into a correct orientation.
  • the nickel-titanium tandem arch device provides the type of pressure to the palatal arch which is believed ideal, but has heretofore been lacking in prior art devices.
  • This pressure is a constant pressure which is of a soft and uniform nature which results in expansion of the teeth and palatal arch generally while allowing incremental separation of the palatal suture thereby permitting proper bone plating.
  • the inventive tandem arch device provides pressures in the range of 150 to 200 grams initially. This application of low force is accompanied by a uniform linear force decay over time as the palatal arch is expanded. Such uniform decay of low pressure forces is considered more desirable for physiologic bone response.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

Arc d'expansion orthodontique (140) et dispositif insérable dans un fourreau (148) (149) destinés à l'expansion des arcades dentaires maxillaire et mandibulaire. Ledit despositif insérable dans un fourreau (148) permet l'utilisation d'appareils constitués de fils multiples (142), (144) composés d'alliages métalliques non soudables. L'utilisation desdits fils multiples est plus pratique et permet d'obtenir une plus grande diversité d'appareils.
PCT/US1992/010288 1992-02-10 1992-11-30 Arc orthodontique d'expansion palatale en ni-ti WO1993015684A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CA002129833A CA2129833C (fr) 1992-02-10 1992-11-30 Voute orthodontique au nickel-titanium pour l'expansion du palais
EP93900719A EP0625888A4 (fr) 1992-02-10 1992-11-30 Arc orthodontique d'expansion palatale en ni-ti.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US83353692A 1992-02-10 1992-02-10
US833,536 1992-02-10

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AU (1) AU3229093A (fr)
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WO1997015241A1 (fr) * 1995-10-26 1997-05-01 Ortho Organizers Ensemble extenseur de l'arcade palatale et procede de reglage
WO2013040144A1 (fr) * 2011-09-15 2013-03-21 Lee Sue S Appareil orthodontique et son procédé d'utilisation

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US1429749A (en) * 1921-10-08 1922-09-19 Baker & Co Inc Lock for orthodontic appliances
US1594143A (en) * 1922-03-11 1926-07-27 Edward H Angle Orthodontic implement
US4412819A (en) * 1982-09-15 1983-11-01 Cannon James L Orthodontic arch wire
US4815968A (en) * 1987-11-09 1989-03-28 Keller Duane C Orthodontic appliance
US4854864A (en) * 1987-11-09 1989-08-08 Unitek Corporation Orthodontic bracket and palatal bar system
US4897035A (en) * 1988-08-29 1990-01-30 Green William A Connector appliance for orthodontic appliance systems
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EP0465836B1 (fr) * 1990-06-07 1996-01-31 Tokin Corporation Ustensile orthodontique à force de correction contrÔlable
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US1429749A (en) * 1921-10-08 1922-09-19 Baker & Co Inc Lock for orthodontic appliances
US1594143A (en) * 1922-03-11 1926-07-27 Edward H Angle Orthodontic implement
US4412819A (en) * 1982-09-15 1983-11-01 Cannon James L Orthodontic arch wire
US4815968A (en) * 1987-11-09 1989-03-28 Keller Duane C Orthodontic appliance
US4854864A (en) * 1987-11-09 1989-08-08 Unitek Corporation Orthodontic bracket and palatal bar system
US4897035A (en) * 1988-08-29 1990-01-30 Green William A Connector appliance for orthodontic appliance systems
US5007828A (en) * 1990-02-08 1991-04-16 Farel Rosenberg Molar controlling and positioning orthodontic appliance with simplified orientation, pressure and adjustment mechanisms

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Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997015241A1 (fr) * 1995-10-26 1997-05-01 Ortho Organizers Ensemble extenseur de l'arcade palatale et procede de reglage
US5816800A (en) * 1995-10-26 1998-10-06 Ortho Organizers, Inc. Palatal arch expander assembly and method of adjusting
WO2013040144A1 (fr) * 2011-09-15 2013-03-21 Lee Sue S Appareil orthodontique et son procédé d'utilisation
US20130071802A1 (en) * 2011-09-15 2013-03-21 Sue S. Lee Applying corrective forces within the palate
JP2014526340A (ja) * 2011-09-15 2014-10-06 リー，スー，エス． 歯列矯正装置および同装置を使用する方法
EP2755592A4 (fr) * 2011-09-15 2015-03-25 Sue S Lee Appareil orthodontique et son procédé d'utilisation
US9089385B2 (en) 2011-09-15 2015-07-28 Sue S. Lee Apparatus for applying corrective forces to shape palate
US9615896B2 (en) 2011-09-15 2017-04-11 Sue S. Lee Apparatus for applying corrective forces to shape palate

Also Published As

Publication number Publication date
AU3229093A (en) 1993-09-03
CA2129833A1 (fr) 1993-08-11
EP0625888A1 (fr) 1994-11-30
EP0625888A4 (fr) 1995-01-25
CA2129833C (fr) 1999-08-17

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