JP5343199B2 - Orthodontic appliance - Google Patents

Description

The present invention relates to an orthodontic apparatus in indirect bonding in which a wire is held by a bracket attached to a tooth surface and a tooth is pulled and moved.

  Conventionally, indirect bonding is known as an orthodontic correction method (see, for example, Patent Document 1). In such indirect bonding, a working model (model tooth) accurately duplicated in advance so as to form a clean arched dentition with the patient's teeth as the final correction target is formed with gypsum. An archwire is formed along the arch, and a bracket is defined at a predetermined position held by the archwire and corresponding to each tooth. Specifically, since each tooth has a different thickness and shape for each individual patient, one end of the bracket is temporarily fixed to the archwire, and the resin is buried in the gap between the bracket and the model tooth at that time. Provide spacers.

Next, the model tooth is covered with a synthetic resin material such as a resin so as to embed the bracket, thereby forming a core (hereinafter referred to as a carrier) having a shape corresponding to each tooth. Thereby, the carrier for positioning a bracket corresponding to each tooth of the dentition to be corrected is formed. And the inner surface of the carrier removed from the teeth is in a state where the tooth-side fixing surface of the bracket is exposed. Then, when each bracket is moved to the patient's tooth surface, the tooth side fixing surface of the bracket is fixed to the tooth surface with an adhesive while covering the patient's teeth with a carrier prepared on the model tooth in advance. When the adhesive is sufficiently cured, the carrier is removed, and the bracket attached to the teeth holds the archwire fixed to the back teeth, for example, so that the teeth are tensioned to the wire side and the teeth are gradually It is corrected so that it becomes the target dentition by moving.
Special table 2007-5072878 gazette

However, conventional orthodontic orthodontic orthodontic treatment has the following problems.
That is, when creating a carrier having a shape in which a bracket is embedded, if a fluid-like synthetic resin is poured so as to cover each model tooth, the synthetic resin will also turn to the adjacent tooth side. For this reason, it is necessary to perform a shaving operation for removing unnecessary portions of the cured synthetic resin and adjusting the outer shape of the carrier, and it takes time and effort to reduce the work efficiency. .

The present invention has been made in view of the above-described problems, and provides an orthodontic apparatus capable of improving work efficiency and reducing work time by reducing labor for carrier creation. With the goal.

In order to achieve the above object, the orthodontic apparatus according to the present invention is capable of forming an image target dentition corresponding to a dentition to be corrected based on a three-dimensional image of a tooth before correction. It is equipped with a treatment device and is attached to each tooth, and is composed of a bracket that holds an arch-shaped wire along the orthodontic dentition, and a thin plate-like and bendable integrated plate body. An orthodontic apparatus for positioning the bracket at a predetermined position with respect to the teeth at one end in the axial direction of the plate body, and pulling and moving the teeth by holding the wire. The image processing apparatus includes a first display processing unit that positions and displays an image bracket corresponding to the bracket at a position that can be held on an image wire formed in an arch shape along the image target dentition, A second display processing unit for displaying a thin plate-like image positioning member at a predetermined position of the determined image bracket, and a display for bringing one end of the image positioning member into contact with or close to the tooth tip of each tooth of the image target dentition And a third display processing unit for performing display, and a fourth display processing unit for performing display for forming an image carrier having a shape covering one end of the image positioning member and the tooth tip of the image target dentition, and the shape of the image carrier Based on the above, the present invention is characterized by comprising a scraping device or a stereolithography device that scrapes a real carrier in a state of having a real bracket and a real positioning member corresponding to the image positioning member.

In the present invention, for example, an image processing device such as a personal computer having an image processing function is used, and the model tooth is created by capturing image data of the same shape of the existing bracket and positioning member in the image processing device in advance. Instead of this, the image bracket can be positioned at an optimal position with respect to the image target dentition created in advance as a three-dimensional image. Further, the image bracket is formed so as to cover the image target dentition and the image positioning member. Based on the shape of the image carrier, it is possible to manufacture the existing carrier using a shaving device or an optical modeling device in a state in which the actual carrier and the positioning member are provided (that is, an orthodontic jig). Then, the manufactured orthodontic jig is attached corresponding to each of the teeth before correction, and the target dentition is formed by the actual wire formed based on the image wire having an arch shape along the target dentition. Can be moved by pulling the teeth.

Further, in the present invention, since the size of the carrier can be made thinner and smaller than the carrier formed so as to embed the bracket as in the prior art, a work space can be secured around the bracket, and the bracket The carrier attached to the uncorrected tooth, which can easily remove the excess protruding from the spacer by the adhesive for bonding the spacer provided in the gap between the tooth surface and the tooth surface. There exists an effect which prevents the malfunction of mutual interference.
Furthermore, the shape of the target dentition, wire, bracket, positioning member, etc. can be handled accurately as three-dimensional image data, and the bracket can be positioned with high accuracy in the image processing apparatus, so that the actual orthodontic correction The jig can be manufactured with high quality, and the orthodontic correction can be reliably performed on the target dentition.

Moreover, in the orthodontic apparatus which concerns on this invention, it is preferable that the bending apparatus which forms the arch shape of the actual wire based on the shape of an image wire is provided .
In the present invention, similar to the formation of the actual carrier described above, based on the arch-shaped image wire formed by the image processing apparatus, the actual wire can be easily and accurately created by a bending apparatus, for example.

Further, in the orthodontic apparatus according to the present invention, in the image processing apparatus, display is performed to form an image spacer that fills a gap between the image bracket and the tooth surface of the target dentition , and in the shaving apparatus or the optical shaping apparatus Based on the shape of the image spacer, it is preferable to form a spacer that is fixed to an existing bracket.
In the present invention, the shape of the image spacer attached to the bracket by the image processing apparatus can be set in the same manner as the formation of the actual carrier described above. It can be created easily and accurately using a modeling apparatus.

According to the orthodontic apparatus of the present invention, an image carrier can be formed by positioning an image bracket at an optimal position with respect to an image target dental array based on a three-dimensional image by using an image processing apparatus. Since the actual carrier can be manufactured based on the carrier, it is not necessary to actually create a model of the target dentition, and it is possible to machine the carrier based on the image, Since manual cutting work can be reduced, the work effort can be greatly reduced, work efficiency can be improved, the time can be shortened, and mass production of orthodontic appliances can be realized. There is an effect.

Hereinafter, embodiments of the orthodontic apparatus of the present invention will be described with reference to FIGS. 1 to 9.
FIG. 1 is a diagram for explaining an outline of a method for manufacturing an orthodontic jig by an image processing apparatus according to an embodiment of the present invention, and FIG. 2 is a state in which an image bracket is attached to an image target tooth array in the image processing apparatus. FIG. 3 is a diagram showing a state in which the image bracket is positioned along the image target dentition, FIG. 4 is a diagram showing a state in which an image carrier is created, and FIG. 5 is a bracket and positioning of the orthodontic jig. FIG. 6 is a perspective view showing the structure of the plate, FIG. 6 is a view showing the structure of the bracket, (a) is a side view thereof, (b) is a view taken along the line A-A shown in (a), and FIG. It is a figure which shows the structure of a plate, Comprising: (a) is the side view, (b) is a BB arrow line view shown to (a), FIG. 8 is a side view which shows the state which attached the positioning plate to the bracket. 9 is a view taken along the line CC of FIG. .

  As shown in FIGS. 1 and 2, the orthodontic appliance according to the present embodiment is attached to each tooth before correction, and is formed into an arch shape along the orthodontic target dentition (hereinafter, referred to as an orthodontic target). A bracket 10 for holding the arch wire 2), and using the orthodontic jig 1 that pulls the tooth by holding the arch wire 2 in the bracket 10 and moves the tooth to a target position. It is used for orthodontic treatment by indirect bonding.

That is, as shown in FIGS. 1 to 4, the orthodontic apparatus captures a tooth image D0 before correction into the image processing apparatus 30 as a three-dimensional image (step S1). An image target dentition D1 arranged in a correction target dentition is formed based on the tooth image D0 captured above (step S2), and the image bracket 31 corresponding to the bracket 10 is displayed in the first display processing unit . Positioning and display is performed at a position that can be held by the image wire 32 formed in an arch shape along the image target tooth row D1 (step S3) , and the thin plate is placed at a predetermined position of the positioned image bracket 31 in the second display processing unit. 3 is displayed, and the tip of the image positioning plate 33 (FIG. 3) is displayed in the third display processing unit . , To display that Ru is in contact with or in proximity to the tooth tip Da of each tooth of the image target dentition D1 sign 21a) of FIG. 4 (step S4), and the distal end portion of the fourth display processing unit, the image positioning plate 33 ( 21a) and an image carrier 34 having a shape covering the tooth tip Da of the target dentition D1 is displayed (step S5). Based on the shape of the image carrier 34, the scraping device 6 is used to actually The carrier 4 is cut out and manufactured with the positioning plate 20 corresponding to the bracket 10 and the image positioning plate 33 to be manufactured (step S6).
The image processing apparatus 30 performs the image processing steps from the above-described step S1 for capturing the uncorrected tooth image D0 to step S5 until the image carrier 34 is created. In the following description, the direction toward the tooth tip in the vertical direction in the mouth is used as the “tip” side, and the opposite side is used as the “proximal end” side.

Here, the orthodontic jig 1 according to the present embodiment will be described with reference to the drawings.
As shown in FIG. 2, the arch wire 2 is formed in a range corresponding to the teeth to be corrected by the arch portion 2a. In the present embodiment, the range from the front teeth to the premolars (or molars) The teeth corresponding to the arch portion 2a are guided to move to a desired position.

  As shown in FIGS. 2 and 3, the orthodontic jig 1 specifically includes a spacer 3 made of a base resin at a predetermined position on the back surface Da of the target tooth row D (or target tooth row image D1). And a bracket 10 for holding the arch portion 2a of the archwire 2 formed along the target dentition shape, and the bracket 10 is determined at a predetermined position corresponding to each tooth. And a positioning plate 20 (positioning member). Here, as the spacer 3, a synthetic resin material such as plastic having fluidity and curability can be used.

As shown in FIGS. 5, 6 (a) and 6 (b), the bracket 10 is provided with a main body 11 and teeth provided on one end face of the main body 11 and fixed to the spacer 3 (two-dot chain line in the figure). A flat fixing plate 12 having a side fixing surface 12a, a concave groove 13 for holding the archwire 2 formed on the other end surface of the main body 11, and both sides sandwiching the concave groove 13 are shown in FIG. The 1st protrusion part 14 and the 2nd protrusion part 15 which were formed in substantially bowl shape by the side view shown are provided. Here, the bracket 10 is arranged in a state where the left side is directed to the tip side of the tooth in FIG. 6A toward the paper surface (see FIG. 3).
In the fixing plate 12, almost the entire tooth-side fixing surface 12 a is formed in a concavo-convex shape in order to improve the adhesiveness of an adhesive (described later).
The concave groove 13 is formed to extend in a direction along the axial direction of the archwire 2 with the bracket 10 attached to the tooth.

The first projecting portion 14 is formed in a state projecting from the main body 11 to the proximal end side, and is formed on the first engaging recess 14 a formed on the end surface opposite to the tooth side and on the tooth surface side of the first projecting portion 14. A first locking portion 14b for locking the connecting member 5 such as a rubber band so as to be hooked is formed.
The second projecting portion 15 is formed in a state of projecting from the main body 11 toward the distal end side, and is connected to the second engaging recess 15 a formed on the end surface opposite to the tooth side and the tooth surface side of the second projecting portion 15. A second locking portion 15b for locking the material 5 so as to be hooked is formed. And it is comprised so that the latching | locking part 22c (refer Fig.7 (a)) of the positioning plate 20 mentioned later may contact | abut to the front end side edge part 15c of the 2nd protrusion part 15. FIG.

  As shown in FIGS. 5, 7 (a) and 7 (b), FIG. 8, and FIG. 9, the positioning plate 20 is composed of a thin plate-shaped and bendable plate body 21, and the proximal end in the axial direction of the plate body 21. A bracket mounting portion 22 that can be attached to and detached from the bracket 10 shown in FIG. Then, the positioning plate 20 places the plate tip 21a of the plate body 21 of the positioning plate 20 attached to the bracket 10 in a state where the bracket 10 is disposed at a predetermined position with respect to the target tooth row D (see FIG. 2). The carrier 4 (see FIG. 4) is formed so that it can be bent so as to contact or approach the tooth tips Da of the row D, and is embedded so as to cover the curved plate tip 21a and the tooth tips Da. The configuration is possible.

  Here, the carrier 4 shown in FIG. 4 is made of a synthetic resin material such as a resin, determines the bracket 10 at an optimum position with respect to each tooth through the positioning plate 20, and fixes the bracket 10 to the tooth before correction. It is for attaching in the said optimal position.

The bracket attaching portion 22 is provided on the proximal end side in the axial direction of the plate body 21, and corresponds to the first engaging convex portion 22 a that can be engaged with the first engaging concave portion 14 a of the bracket 10. A second engagement convex portion 22b corresponding to be engageable with the two engagement concave portions 15a, a locking portion 22c projecting larger than the second engagement convex portion 22b on the distal end side of the second engagement convex portion 22b, The plate body 21 includes a protrusion 22d that protrudes from the surface opposite to the tooth side.
That is, while the first engagement convex portion 22a is engaged with the first engagement concave portion 14a of the bracket 10, the second engagement convex portion 22b is engaged with the second engagement concave portion 15a, and the locking portion 22c is 2 The positioning plate 20 is placed at a predetermined position with respect to the bracket 10 by abutting against the distal end portion 15c of the protruding portion 15.

  The positioning plate 20 is made of a metal material such as stainless steel, and the plate body 21 has a width dimension of approximately 2 mm (W shown in FIG. 7B), for example. The length of the plate body 21 is arbitrary, but in the state where the positioning plate 20 is attached to the bracket 10 attached at a predetermined position of the tooth, the length dimension at which the plate tip 21a is near the tip of the tooth. Preferably, the dimension is slightly longer than the tip of the tooth. In short, the plate body 21 only needs to have a length dimension such that when the plate tip 21a is bent, the plate tip 21a is in contact with or close to the tip of the tooth (FIGS. 3 and 3). 4). Alternatively, when the plate tip 21a is brought into a position in contact with or close to the tip of the tooth without being bent, the work of bending the tip 21a can be omitted.

Next, the orthodontic apparatus described above will be described more specifically.
In addition, about each site | part etc. in the image bracket 31 and the image positioning plate 33, it demonstrates below using the same code | symbol as the site | part of the existing bracket 10 and the positioning plate 20 mentioned above.
As shown in FIGS. 1 and 2, in step S <b> 1, an orthodontic person's tooth shape image D <b> 0 is scanned and captured as a three-dimensional image into the image processing apparatus 30. Here, the image processing apparatus 30 takes in image data of the same shape of the existing bracket 10 and positioning plate 20 in advance. Then, the image processing device 30 creates an image target dentition D1 in which individual image teeth are arranged in a dentition that is a correction target based on the acquired tooth image D0 (step S2).

  Next, as shown in FIG. 1, in step S3, the image wire 32 is formed so as to be an optimum arch along the arch of the image target tooth row D1, and the concave groove 13 of the image bracket 31 corresponding to each tooth is formed. (See FIG. 6A) is positioned at a position where the image wire 32 can be held. At this time, each image bracket 31 is in a non-fixed state having a gap with respect to the image target tooth row D1, that is, in an arrangement state having a predetermined interval from the tooth surface of the image target tooth row D1. Further, after the image bracket 31 is positioned at a predetermined position, the image wire 32 becomes unnecessary.

As shown in FIG. 4, in step S4, the image positioning plate 33 is attached to the predetermined position of the image bracket 31 positioned in step S3, and the image target plate 21a of the image positioning plate 33 is positioned in the direction indicated by the arrow E. The tooth tip Da of each image tooth of the tooth row D1 is bent and brought into contact with or in close proximity.
Here, the method of attaching the image positioning plate 33 (same as the actual positioning plate 20) to the image bracket 31 (same as the actual bracket 10) is the second protrusion of the image bracket 31 as shown in FIGS. The image positioning plate 33 is in contact with the engaging portion 22c of the image positioning plate 33 while the image positioning plate 33 is in contact with the first engaging recess 14a and the second engaging recess 15a. The first engaging convex portion 22a and the second engaging convex portion 22b of the plate 33 are engaged. In the case of the actual positioning plate 20, the bracket 10 is positioned with respect to the bracket 10 by hooking and locking the connecting member 5 such as a rubber band between the protrusion 22 d of the positioning plate 20 and the first locking portion 14 b of the bracket 10. The plate 20 is connected.

  In step S5, an image carrier 34 having a shape covering the plate tip 21a of the image positioning plate 33 and the tooth tip Da of the image target tooth row D1 is formed. As a result, the image positioning plate 33 is integrated with the image carrier 34, and the image bracket 31 can be positioned at an optimum position corresponding to each image tooth.

  Subsequently, based on the shape of the image carrier 34, the carrier 4 corresponding to the image carrier 34 is provided with the actual bracket 10 corresponding to the image bracket 31 and the actual positioning plate 20 corresponding to the image positioning plate 33. Is manufactured by the scraping device 6 (see FIG. 1), and the orthodontic jig 1 corresponding to each tooth is manufactured. When the plate tip 21a of the image positioning plate 33 is bent, the plate tip 21a of the positioning plate 20 that actually exists using the bending device 7 (see FIG. 1) according to the curved shape of the image. To bend.

  In the present embodiment, as shown in FIG. 1, not only in the manufacture of the orthodontic jig 1 including the bracket 10, the positioning plate 20 and the carrier 4, but also in the process of forming the image carrier 34 with the image processing device 30. Based on the image wire 32 formed with an arch along the image target dentition D1, the actual wire 2 is created by, for example, a bending apparatus. Further, in the image processing device 30, an image spacer 35 is formed in a gap between the image bracket 31 and the image target tooth row D <b> 1, and the scraping device 6 is used for the actual bracket 10 based on the image spacer 35. A spacer 3 having the same shape as the image spacer 35 is formed at a predetermined position.

  Next, when the orthodontic treatment is performed, the manufactured carrier 4 with the positioning plate 20 is attached to each tooth D. At this time, an adhesive (not shown) is applied to the tooth-side fixing surface of the spacer 3 while the carrier 4 is covered with the teeth D, and is fixed to the tooth surface. And the excess part of the adhesive protruded from the spacer 3 is removed.

  After that, when the adhesive is sufficiently cured, the carrier 4 and the positioning plate 20 are removed from the bracket 10, and the arch wire 2 is held in the concave groove 13 of the bracket 10 fixed to each tooth D. Form a state of tension. Note that a relatively soft archwire 2 is used in the initial stage of correction, and the archwire 2 is gradually changed as the teeth gradually move. Thereby, a patient's tooth can be corrected to the dentition shape used as a correction target.

Thus, in the present orthodontic apparatus , since the size of the carrier 4 can be made thinner and smaller than a carrier formed so as to embed a bracket as in the prior art, a work space is provided around the bracket 10. The adhesive for adhering the spacer 3 provided in the gap between the bracket 10 and the tooth surface to the teeth can easily remove the excess portion protruding from the spacer 3, and the position of the adhesive 3 There exists an effect which prevents the malfunction that the carriers 4 and 4 attached to the tooth before correction with a sticking interfere.

  Further, the shapes of the target dentition D, the wire 2, the bracket 10, the positioning plate 20, and the like can be handled accurately as three-dimensional image data, and the positioning of the bracket 10 can be accurately performed in the image processing apparatus 30. The actual orthodontic jig 1 can be manufactured with high quality, and the orthodontic correction can be reliably performed on the target denture D.

  Further, in the orthodontic jig 1, since the carrier 4 can be provided only at the tip of the tooth and can be made compact, the carrier is shaved after the conventional synthetic resin such as resin is cured. The work process at the time of carrier formation, such as a soup, is not necessary, and the work can be simplified.

In the orthodontic apparatus according to the present embodiment described above, the image carrier 31 is positioned at an optimal position with respect to the image target tooth array D1 based on the three-dimensional image using the image processing apparatus 30 to form the image carrier 34. Since the actual carrier 4 can be manufactured based on the image carrier 34, it is not necessary to actually create a model of the target dentition, and the cutting work of the carrier 4 is based on the image. Since it can be performed by a machine and the cutting work by hand can be reduced, the labor can be greatly reduced, the work efficiency can be improved, the time can be shortened, and the orthodontic jig 1 There is an effect that mass production of can be realized.

As mentioned above, although embodiment of the orthodontic apparatus by this invention was described, this invention is not limited to said embodiment, In the range which does not deviate from the meaning, it can change suitably.
For example, in the present embodiment, the positioning plate 20 having the thin plate-shaped plate body 21 is employed, but the shape and configuration are not limited to this, and the bracket 10 and the wire 2 are not limited. The shape and configuration of the carrier 4 are not limited to the present embodiment, and can be arbitrarily set according to conditions such as the state of the teeth to be corrected and the degree of correction.
In the present embodiment, an actual carrier or the like is manufactured by using the shaving device 6, but an optical modeling device may be used instead.

It is a figure for demonstrating the outline of the method of manufacturing the orthodontic jig by the image processing apparatus by embodiment of this invention. It is a figure which shows the state which attached the image bracket to the image target dentition in the image processing apparatus. It is a figure which shows the state which positioned the image bracket along the image target dentition. It is a figure which shows the state which produces an image carrier. It is a perspective view which shows the structure of the bracket and positioning plate of an orthodontic jig. It is a figure which shows the structure of a bracket, Comprising: (a) is the side view, (b) is an AA arrow directional view shown to (a). It is a figure which shows the structure of a positioning plate, Comprising: (a) is the side view, (b) is a BB line arrow view shown to (a). It is a side view which shows the state which attached the positioning plate to the bracket. It is CC line arrow directional view shown in FIG.

Explanation of symbols

1 Orthodontic jig 2 Arch wire (wire)
3 Spacer 4 Carrier 6 Cutting device 7 Bending device 10 Bracket 20 Positioning plate (positioning member)
DESCRIPTION OF SYMBOLS 21 Plate body 21a Plate front-end | tip part 30 Image processing apparatus 31 Image bracket 32 Image wire 33 Image positioning plate (image positioning member)
34 image carrier 35 image spacer D tooth Da tooth tip D1 image target dentition

Claims (3)

An image processing apparatus capable of forming an image target dentition corresponding to a dentition to be corrected based on a three-dimensional image of a tooth before correction,
A bracket which is attached to each tooth and holds an arch-shaped wire along the orthodontic dentition, and a thin plate-like and bendable integrated plate body. A positioning member for positioning the bracket at a predetermined position with respect to the tooth at one end in the axial direction, and an orthodontic apparatus for pulling and moving the tooth by holding the wire,
The image processing apparatus includes:
A first display processing unit for displaying and displaying an image bracket corresponding to the bracket at a position that can be held by an image wire formed in an arch shape along the image target dentition;
A second display processing unit for performing display for attaching a thin plate-like image positioning member to a predetermined position of the positioned image bracket;
A third display processing unit for performing display in which one end of the image positioning member is brought into contact with or close to a tooth tip of each tooth of the image target dentition;
A fourth display processing unit for performing display to form an image carrier having a shape covering one end of the image positioning member and the tooth tip of the image target dentition;
With
Based on the shape of the image carrier, there is provided a scraping device or an optical modeling device for scraping the actual carrier in a state of having the actual bracket and the actual positioning member corresponding to the image positioning member. Orthodontic appliances.   The orthodontic apparatus according to claim 1, further comprising a bending device that forms an arch shape of the existing wire based on the shape of the image wire. In the image processing apparatus, display to form an image spacer that fills a gap between the image bracket and the tooth surface of the target dentition,
The orthodontic apparatus according to claim 1 or 2, wherein in the shaving apparatus or the optical modeling apparatus, a spacer that is fixed to the bracket that is actually present is formed based on a shape of the image spacer.

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