Title: Intermaxillary force system
Abstract: A permanently mounted orthodontic intermaxillary constant force system wherein the force producing portions are attached to the orthodontic appliance in one jaw and small flexible cables transmit the forces to the patient's opposite jaw.
Patent Number: 6,887,076 Issued on 05/03/2005 to Graham
| Inventors:
|
Graham; Neil John (6017 Lido La., Long Beach, CA 90803)
|
| Appl. No.:
|
277692 |
| Filed:
|
October 23, 2002 |
| Current U.S. Class: |
433/19 |
| Intern'l Class: |
A61C 007//36 |
| Field of Search: |
433/18,19,21,22
|
References Cited [Referenced By]
U.S. Patent Documents
Other References
Orthoorganizers catalog this year p. 75 www.orthoorganizers.com.
Sullivan-Schein Dental Catalog 2002 p. 451 www.sullivanschein.com.
GAC International, Inc. current cataloge page with Sentalloy Springs http://gacintl.com.
|
Primary Examiner: Lewis; Ralph A.
Attorney, Agent or Firm: Graham; Neil John
Claims
1. An intermaxillary force system for applying permanent intermaxillary forces
during orthodontic treatment comprising:
a hollow longitudinal tube having a first and second end, a wall with an outer
and inner circumference wherein the tube is attached to an orthodontic appliance
to be positioned within a single jaw;
a force producing means within the tube for producing tooth movement;
a flexible cable connected to the internal force producing means wherein the
cable exits the tube at the first end and is attached to the orthodontic appliance
to be positioned in the opposite jaw for producing tooth movement pressure between
the jaws;
an attaching means for securing the horizontal tube to the orthodontic appliance.
2. The intermaxillary force system according to claim 1 wherein the force producing
means is a longitudinal open coiled spring with a first and second end, an interior
and an outer diameter, the outer diameter being slightly smaller than the inner
circumference of the longitudinal tube wherein the spring is placed in the tube
and the cable is attached to the spring which is compressed producing a pulling
force upon the cable.
3. The intermaxillary force system according to claim 2 wherein a sphere with
the same diameter as the outer diameter of the coiled spring containing an axially
mounted grooved pulley is mounted on the second end of the spring whereby the cable
is mounted to the first end of the spring, corresponding to the first end of the
tube, and the cable travels through the spring interior to the second end of the
spring, around the grooved pulley and returns to the first end of the tube where
it exits the tube to the opposite arch.
4. The intermaxillary force system according to claim 1 wherein the outer circumference
of the longitudinal tube is threaded at the first and second ends.
5. The intermaxillary force system according to claim 4 wherein internally threaded
caps are threaded over the externally threaded first and second tube ends, each
cap has an externally centrally mounted eyelet 2 millimeter in diameter, the cap
at the first tube end has a central shaft extending 2-4 millimeters into the longitudinal tube.
6. The intermaxillary force system according to claim 3 wherein there is a lateral
opening in the wall of the first end of the tube.
7. The intermaxillary force system according to claim 6 wherein a grooved pulley,
the same size and shape as the second end pulley, mounted on a pedestal base slightly
offset to the axial center of the base and adjacent to the lateral opening, the
pedestal base is pivotally mounted to the central shaft of the first end cap with
ball bearings between the pedestal and the cap, whereby the cable returns from
the first end, travels around the first end pulley and exits through the lateral
opening, the pivoting of the enabling various directional attachments of the cable
to the opposite jaw and allowing for movements of the lower jaw.
8. The intermaxillary force system according to claim 2 wherein the open coiled
spring is sufficiently open to allow compression to at least one-third of the coiled
spring's length.
9. An intermaxillary force system for applying permanent intermaxillary force
during orthodontic treatment comprising:
a longitudinal thin walled tube with first and second ends, a length sufficient
to extend from a patient's molars to the incisors, an opening in the wall of the
tube near the first end;
a coiled longitudinal spring within the tube;
a grooved pulley at the first end of the tube adjacent to the lateral opening;
and
a cable attached to the spring wherein the cable enters the pulley groove and
exits the tube through the adjacent lateral opening and is attached at a point
on the orthodontic appliance of the opposite dental arch.
10. The intermaxillary force system according to claim 9 wherein the cable is
a 0.020 inch gauge woven with the test strength of 60 pounds.
11. The intermaxillary force system as in claim 9 wherein the longitudinal tube
is comprised of metal.
12. The intermaxillary force system as in claim 9 wherein the horizontal tube
is comprised of stainless steel.
13. The intermaxillary force system of claim 9 wherein the attachment of the
cable in the opposite arch is an attachable hook comprising:
a 0.016 inch diameter stainless steel wire configured to attach to the orthodontic
bracket combination of the orthodontic appliance;
a hook attached to the stainless steel wire for the attachment of the cable from
the opposite arch; and
a locking configuration of the configured arch is achieved by the wire following
the following configuration:
a hook shape to grip the buccal surface of the arch wire where the end of the
hook points at the teeth;
the wire extends gingivally towards the base of the adjacent orthodontic bracket;
the wire turns parallel to the arch wire and engages the underside of the tie
wing of the bracket;
the wire turns towards the archwire at the opposite end of the bracket and passes
over the buccal surface of the archwire;
the wire passes towards the tooth and turns parallel to the arch wire and engages
the underside of the wing of the bracket; and
the wire returns to its original origin where it has a hook which engages over
the buccal of the archwire and the end of the hook points back towards the teeth,
wherein when the hook is engaged the wire configuration is held in a firm position
in relation to orthodontic appliance.
14. The intermaxillary force system as in claim 9 wherein the longitudinal coiled
spring is closed and the spring is attached to the second end of the tube, the
spring length is shorter than the tube and the cable is attached to the spring
end opposite the attached end wherein stretching of the spring produces force to
the cable.
15. The intermaxillary force system as in claim 9 wherein the longitudinal thin
walled tube is to be secured in the mouth with a circular mounted bracket which
engages the tube and is then attached to an attachable stainless-steel configured
wire which is in turn attached to the orthodontic appliance, the horizontal tube
is to be mounted horizontally in a single jaw centered to the gingival bracket
wing of the orthodontic bracket.
16. An intermaxillary force system comprising:
a hollow longitudinal tube containing a system capable of producing a pulling
force;
a cable system attached to the pulling force system for translating the force
to a point in the opposite jaw; and
a mounted C shaped clasp system attached to the hollow longitudinal tube wherein
the C shaped clasp is attached to an orthodontic appliance thereby attaching the
hollow longitudinal tube to an orthodontic appliance.
17. The intermaxillary force system as in claim 16 wherein the mounted clasp
for engaging the tube may be opened allowing insertion of the horizontal tube.
18. The intermaxillary force system as in claim 16 wherein the mounted C shaped
clasp comprises:
a solid C portion with first and second ends configured to fit circumferentially
around the longitudinal tube less than half the diameter of the tube, allowing
insertion of the tube;
a configured first end of the C portion which is configured outwards from the
circumference and turns back towards C portion to form a lip;
a first smaller curved section with two ends is curved to fit the longitudinal
tube is hinged to;
a second smaller curved section with two ends is hinged to the free end of the
first section, the second curved section is in turn hinged at its free end; and
a third smaller curved section with a center and two ends wherein the center
is hinged to the free end hinge of the second smaller section, wherein the third
section free end is curved towards the tube, the hooked end engages the curved
hook of the first C portion, the third section is held at an angle to the tube,
the third portion is then pressed towards the tube in the direction of the second
C portion thus firmly engaging the tube and locking the tube into position.
19. The intermaxillary force system as in claim 16 wherein the mounted C shaped
clasps are attached to a wire shaped the same as the orthodontic arch wire, but
heavier gauge, 0.025 inch to 0.055 inch diameter, wherein the wire is connected
to the orthodontic appliance by tying to the arch wire or attaching it to the bracket
using the same ties that ligate the archwire to the brackets.
Description
FIELD OF THE INVENTION
The present invention is directed to a device for applying intermaxillary force
from one jaw to another during orthodontic procedures where the intermaxillary
connection is performed using fine cables.
BACKGROUND OF THE INVENTION
Orthodontic procedures for straightening teeth involve fixed orthodontic
appliances wherein forces are often applied between the upper and lower jaws in
order to correct the patient's bite. The predominant method used requires the patient's
cooperation, wherein the patient repeatedly places latex rubber bands in selected
positions. The latex rubber bands quickly lose their elasticity, thereby requiring
the patient to repeatedly replace the latex bands. The patient's use of the bands
affects treatment progress, length, and the results obtained. The uncooperative
patient becomes a problem for the orthodontist.
The orthodontic profession has sought methods of applying the intermaxillary
forces by seeking devices that could be permanently attached; thereby, eliminating
patient cooperation. A primary requirement of a permanent force is that it maintain
its elasticity. Latex loses 25% of its elasticity in the first 24 hours. The best
non-latex material loses 40% of its elasticity in 24 hours. Coiled springs retain
their elasticity and have been permanently placed. These springs have been open
and closed coil in configuration. A close coiled spring is elongated to produce
force wherein an open coiled spring is compressed to produce force. In order to
produce force from one jaw to another the springs have been attached from one jaw
to another, thus crossing the chewing plane of the teeth. The disadvantages of
the coiled springs worn intermaxillary are that they are bulky, uncomfortable,
and prone to damage during mastication. The bulkiness of the springs makes their
use in the front of the mouth impossible.
SUMMARY OF THE INVENTION
In order to better understand the invention some dental terminology should be
explained. An orthodontic appliance consists of a series of orthodontic brackets
attached to a patient's teeth. The following dental terminology is used: buccal
is towards the patient's teeth; lingual is towards the tongue; gingival is towards
the gums; anterior is towards the front of the mouth; posterior is towards the
back of the mouth; incisors are the front teeth; molars are the back teeth; maxilla
is the upper jaw; mandible is the lower jaw; and intermaxillary is between the
jaws. A bracket has a central slot which receives an archwire. The archwire is
the force which actually aligns the teeth. The bracket has gingival and occlusal
wings which are used to ligate the archwire to the bracket.
The present invention is directed to a permanently attached device wherein the
force generating portion is attached to the orthodontic appliance within a single
jaw, either the maxillary or the mandibular jaw. The intermaxillary force device
comprises a longitudinal hollow tube with an inner and outer diameter and opposing
ends, a first end and a second end. In the preferred embodiment, the longitudinal
tube contains within its interior a longitudinal open coiled spring within its
first and second ends extending almost the length of the longitudinal tube. The
tube contains two v-grooved roller bearings, one at each end of the spring. A v-grooved
pulley is mounted to the first end of the tube on a shaft mounted to the tube at
a right angle to the tube's axis. Adjacent to the first end bearing the tube is
constricted to form a seat for the first end of the internal coiled spring
At the second end of the spring a second v-grooved pulley is housed and mounted
to a shaft within a ball which is seated within the second end of the internal spring.
A flexible cable is attached to the first of the spring and extends internally
within the spring to the second end of the spring and encircles the v-groove of
the second end pulley and returns internally within the spring to the v-groove
at the first end of the spring. This is an important path for the string as the
string travels twice the distance of compression of the spring. This allows for
the opening and closing of the jaw. The jaw in the anterior opens as wide as 35
mm and moves sagitally 12 mm. The average open-coiled spring is 27 mm and will
compress ⅔ of its length to 9 mm. The 18 mm of movement is not enough to
allow for the 35 mm of jaw movement. The use of the second end pulley allows the
cable to move twice the distance or 36 mm which is adequate for the jaw to open wide
The first end of the tube has an opening in the wall allowing the cable to circle
the v-grooved pulley and exit the tube to the opposing arch of teeth. In a preferred
embodiment, the first end v-grooved pulley is pivotally mounted allowing the pulley
to swivel to accommodate the different cable directions due to different points
of cable attachment in the opposite jaw end movement of the lower jaw.
The longitudinal tube is attached to the orthodontic appliance using, in a preferred
embodiment, a locking clasp which allows easy placement and removal of the longitudinal
tube. The locking clasp is attached to the orthodontic appliance using a configured
wire. The clasps may also be attached to a separate heavier arch wire which is
in turn ligated to the orthodontic appliance.
The flexible cable may be attached to the opposing arch by tying to to a bracket,
button, arch wire, or an attachable hook.
The attachable hook, in its preferred embodiment, is 3-4 mm in length and is
attached to a configured 0.016 inch stainless steel wire adapted to an orthodontic
bracket archwire combination.
In an alternative embodiment of the present invention, the cable returns to the
arch it originated from, producing a maxillary mandibular vertical pull, as in
a force in the front of the patient's mouth to close an anterior open bite.
In an alternative embodiment of the present invention, the cable is attached
directly
to the second end of the spring, eliminating the bearing at the second end of the spring.
In a further alternative embodiment of the invention, the spring is a close coiled
spring attached to the second end of the tube.
In a further alternative embodiment of the invention, the force system, such
as
the coil springs, can be used without the horizontal tube.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a prospective view of the intermaxillary force system;
FIG. 2 is an internal view of the intermaxillary force system of FIG. 1;
FIG. 3 is a view of the intermaxillary force system mounted to an orthodontic appliance;
FIG. 4 is an end view of the of the mounted first end v-shaped pulley;
FIG. 5 is a side view of the v-shaped pulley;
FIG. 6 is an internal view of the pivotally mounted first end v-shaped pulley;
FIG. 7 is a view of the spherically mounted second end v-shaped pulley resting
on the second end of the coiled spring;
FIG. 8 is another view of the pulley of FIG. 7;
FIG. 9 is an interior view of the mounted first end v-shaped pulley;
FIG. 10 is the circular clasp mounted to a wire configuration;
FIG. 11 the configured wire of FIG. 10 mounted on an orthodontic bracket archwire combination;
FIG. 12 is a cross-sectional view FIG. 11;
FIG. 13 is a view of the clasp wire configuration mounted in the mouth;
FIG. 14 is a view of the clasps mounted to a heavy archwire;
FIG. 15 is a view of the apparatus of FIG. 14 mounted in the mouth;
FIG. 16 is a view of the configured wire with a hook as it is placed in the mouth;
FIG. 17 is a view of the horizontal tube mounted with the first end in the front
of the mouth;
FIG. 18 is a view of the locking clamp in an open position; and
FIG. 19 is a view of the locking clamp of FIG. 18 in a closed position.
DETAILED DESCRIPTION OF THE INVENTION
Referring to FIGS. 1-3 the intermaxillary force appliance has a longitudinal
hollow tubular body
5 having sufficient length to extend from the patient's
posterior molar area
25 to the anterior cuspid area
26. The tube
is preferably metal. The diameter of the horizontal tube
5 may be 2-6 mm,
preferably 4 mm to be comfortably worn by the patient. The horizontal tube
5
has a first
8 and second
9 end. An open coiled longitudinal spring
10 is enclosed in the horizontal tube
5 extending from the first
tube end
8 to the second tube end
9. The spring
10 has a first
18 and second
19 end to correspond to the first
8 and second
end
10 of the tube
5. The external diameter of the spring is less
than the internal diameter of the tube
5, allowing the spring
10
to be compressed. A sphere
14 the same diameter as the spring
10
rests at the second spring end
19. The horizontal tube
5 is externally
threaded at the first
16 and second
15 ends. An internally threaded
cap, the first end cap
12, is threaded onto the first horizontal tube end
external thread
16. A second end cap
4 is threaded over the second
horizontal tube threaded end
15. The first and second end caps have eyelets
6-
7 for ligation. Referring to FIG. 6, in a preferred embodiment,
the first end cap
3 has an interior wherein a 4 mm shaft
38, 1-2
mm in diameter, is mounted centrally in the long axis of the horizontal tube
5.
Pivotally mounted upon the shaft is a v-shaped roller bearing
36 mounted
to mounting brackets
35 attached to a pedestal base
49. The pedestal
base
49 has a central hole
40 which receives the shaft
38.
The shaft
38 has an end
39 which extends into the horizontal tube
5 wherein the end
39 is enlarged locking the pedestal base
49
to the first end cap
3. Spherical bearings
37 may be placed between
the pedestal base
49 and the first end cap
3, enhancing the rotation
of the v-shaped roller bearing
36. Adjacent to the pivotally mounted first
end roller bearing
11 is an opening
2 in the wall of the horizontal
tube
5. The first end spherical bearing
36 is mounted offset
35
towards this opening
2. In FIG. 9, adjacent to the tube opening
12,
the horizontal tube
5 is circumferentially narrowed
77 to form a
seat for the first end
18 of the spring
10.
Referring to FIG. 4, another embodiment of the first end pulley
30
is mounted to a central shaft
32 mounted to the walls of the horizontal
tube
5. The v-shaped pulley is shown in FIGS. 30-31
4,
5, and
8. A central shaft housing
34 is surrounded by roller bearings
33.
The pulley is v-shaped to receive a cable.
Referring to FIGS. 1-3 a flexible cable
1 0.015-0.030 inch in diameter
is attached at the first tube end
8 and extends through the center of the
spring to the second end of the spring
19, wraps around the v-grooved pulley
14 at the second end and returns to through the center of the spring to
the first horizontal tube end
8, wraps around to his first end v-shaped
pulley
11, and exits the horizontal tube through the opening
2 in
the wall of the horizontal tube
5.
A preferred embodiment of the cable is a 0.016 inch diameter 60 pound test microfilament
line called POWER PRO® sold by Innovative Textiles, inc. The cable is made
from SPECTRA® FIBER from Honeywell International.
The horizontal tube
5 assembly is mounted, as shown in FIGS. 3 and 12,
positioned between the orthodontic brackets and the patient's cheek. The horizontal
tube
5 is positioned slightly gingival FIG. 12 to the central position of
the bracket
56 to keep the tube out of occlusal contact with the patient's
opposing teeth. Referring to FIG. 3, the cable I is shown exiting the first end
of the tube
8 and attaching to the patient's upper arch in the cuspid area
24. The length of the cable is adjusted to compress the spring sufficiently
to apply pressure from the patient's lower dental arch to the anterior of the patient's
upper arch. This force would move patient's upper teeth inward, correcting the bite.
Referring to FIGS. 2 and 7, in a preferred embodiment, there is a v-shaped
roller bearing
41 embedded within a sphere
14 mounted on the second
end
19 of the coiled spring
10. The sphere
14 and v-shaped
pulley
41 are mounted on an axial mounting shaft
43. The cable
1
originates at first end of the horizontal tube
8 and travels through the
interior of the coiled spring, engages the second end pulley
14 and returns
to the first end pulley
11. This pulley arrangement allows the cable to
have twice the movement of the compression distance of the spring, allowing for
full motion of the lower jaw.
The advantage of this appliance is that it is permanently attached eliminating
the variable of patient cooperation. The continuous force reduces the time the
patient will spend in orthodontic appliances, reduces the orthodontist's chair
time, and increases the success rate of the orthodontic treatment.
Referring to FIGS. 10-13 a configured wire
50-
54 attaches
the horizontal tube
5 to the orthodontic bracket
56 archwire
52
combination. An orthodontic bracket has a central horizontal slot for the archwire
and occlusal
59 and gingival
58 wings for ligating the archwire
52.
The configured wire has a clasp portion
50 and a portion
51 which
engages the archwire and bracket.
The horizontal tube assembly
5 is mounted to the orthodontic appliance,
in a preferred embodiment, using clasps
50 and
53 which grip the
horizontal tube
5 combination. The clamps are secured to the bracket archwire
combination. The mounting of the clasp
50 and
53 to the bracket is
done by using a 0.016 inch wire which is attached to the clasp and is configured
to engage the occlusal tie wings
59 of the orthodontic bracket, pass over
the buccal surface of the archwire, and return under the gingival tie wings
58
of the orthodontic bracket
56 to be attached to the clasp
50 and
53. The wire has a break in it where it passes over the archwire, resulting
in two ends. Each wire is configured as a small C-hook
53 which rests over
and engages the buccal of the archwire.
Referring to FIGS. 14-15 another embodiment in mounting the horizontal
tube assembly
5 to the orthodontic appliance is to mount the horizontal
tube
5 by soldering or attaching the tube to an overlay archwire
60.
The overlay archwire
60 is bent to the same arch form as the archwire
52
using the same tie-wires used for the existing archwire
52
A preferred embodiment of the horizontal tube clasp is in FIGS. 18-19 wherein
the
clasp is a locking clasp comprising a c-clasp
70 with a lip at one end
71.
The other end of the c-clasp
70 is hinged
80 to a first smaller curved
section
72 which is in turn hinged at its free end
81 to a smaller
second curved section
73 to which is hinged at its free end
82 to
the center of a third c-section
74 which has a lip at its free end
75
adjacent the c-hook lip
71. FIG. 18 shows the clasp open allowing easy insertion
or removal of the horizontal tube. FIG. 19 shows the clasp closed to a locked position.
Referring to another configuration of the intermaxillary force appliance
in FIG. 17 the horizontal tube
5 ends are reversed wherein the cable
1
exits the horizontal tube
5 at the front of mouth. The cable would be used
in this configuration for class III, or underbite correction. This embodiment can
also be used by attaching the cable straight upwards to the anterior of the patient's
mouth FIG. 17, for use in closing an anterior open bite.
*
