US 3121953 A
Description (OCR text may contain errors)
Feb. 25, 1964 Filed Aug. 30, 1962 S. ASHER ORTHODONTIC APPLIANCE AND METHOD 2 Sheets-Sheet 1 INVENTOR. .Szdney Asher BY 3; MY M4 4 4) aziys Feb. 25, 1964 s. ASHER ORTHODONTIC APPLIANCE AND METHOD 2 Sheets-Sheet 2 Filed Aug. so. 1962 INVENTOR. Sidney Asher BY .9 W
CZii'l/s United States Patent 3,121,953 ORTHODONTIC APPLIANCE AND METHOD Sidney Asher, Chicago, Ill., assignor to Pages, Inc., Chicago, 111., a corporation of Illinois Filed Aug. 30, 1962, Ser. No. 220,519 Claims. (Cl. 3214) This invention relates to novel and improved methods and means for correcting certain classes of malocclusion and for realigning one or more teeth at the beginning, during, or at the conclusion of orthodontic treatment.
Orthodontic arches, colloquially known as braces, have been applied to patients teeth for many years for correcting a variety of conditions. By making adjustments in selected parts of those arches and by using various types of supplemental tools and appliances in conjunction with those arches, dentists and orthodontists have been able to elfect changes in patients mouths when changes are necessary from a functional viewpoint or desirable from a cosmetic point of view.
The face-bow is one of the types of supplemental tools which is used. A face-bow can be described generally as an orthodontic appliance which may be adjusted periodically by an orthodontist and which is readily and easily attachable to an orthodontic arch by the patient himself. It extends outwardly of the patients mouth and is activated by external means such as head harnesses or neck straps.
This invention contemplates the use of a face-bow of novel construction for correcting certain classes of malocclusion by methods and means which are more effective and more rapid than procedures and appliances which are now available. Particularly does it enable orthodontic practitioiners to avoid the use of palates or plates and to use instead far simpler improve face-bows.
The novel face-bow of this invention may be used to correct malocclusion in both extraction and non-extraction cases, and in a variety of classes of such cases.
One of the techniques with which this invention is concerned is that of sectional arch treatment. It is possibie, with the face-bow to be described, to move a canine and an entire buccal segment as a unit distally in the alveolar trough when such treatment is desirable, without the necessity of using separate finishing appliances and without the necessity of extracting teeth as is ofttimes done to provide space into which the canines may be posteriorly relocated.
Movement distally of one or both entire buccal segments very often may be necessary before locked in and severely malposed (crushed) upper incisors can be aligned correctly and permanently. Unless sufficient room is obtained for these crushed incisors they will tend to relapse. Where necessary, movement distally of one or both buccal segments including the canines to make full room for the incisors assures a permanent alignment of the upper incisors. In such cases which have required correction of locked in and crushed incisors with forwardly disposed canines and buccal segments, extraction of the first bicuspids to facilitate realignment of the incisors and canines is frequently undertaken. Since the buccal segment and canine can be easily and rapidly moved posteriorly as a unit in accordance wtih this invention, that enables the orthodontist to align or distally drive the incisors much more quickly. That results in faster, less expensive correction and circumvents the necessity, in many cases, of extracting bicuspids.
Thus the technique of moving an entire buccal segment and canine as a unit may be used where that is the only correction necessary and also where it is desirable to align the incisors.
When face-bows without the improvements of this in- 3,121,953 Patented Feb.25, 1964 "ice vention are used, because strong, vigorous forces are exerted against the first molars through the face-bows, spaces sometimes open up at the contact points of the first molar and second bicuspid, the second bicuspid and the first bicuspid, and the first bicuspid and the canine. That can and does occasionally occur, particularly when distal driving of the upper buccal segments is the principal function being performed by the face-bows, and the buccal segments are in forward position with crushed incisors and high canines, that is canines disposed in part diagonally across the front of the adjacent lateral incisors. With the face-bow to be described, since the entire buccal segment can be relocated as a unit, such spaces can be prevented from opening up. And, where spaces have already opened up at those contact points, the face-bow of this invention may be used to close those spaces rapidly and easily.
It is also possible, with the face-bow of this invention, to distally drive the upper anterior teeth to correct cases of overjet or buck teeth and even move the entire buccal segment and close spaces in that segment while the upper anterior teeth are being distally driven.
It is therefore the principal object of this invention to provide novel and improved means for correcting certain classes of malocclusion.
It is a further object of this invention to provide a novel face-bow embodying improved means for correcting certain classes of malocclusion.
Yet another object of this invention is the provision of a face-bow which is capable of performing several corrective techniques simultaneously whereby a more rapid ultimate occlusion may be achieved.
Yet another object of this invention is the provision of a corrective appliance that obviates the necessity of extracting teeth in many cases where extraction has been otherwise necessary to achieve desired orthodontic results.
Further within the purview of this invention is the provision of novel methods for moving canines and entire adjacent buccal segments as units.
Further objects and advantages will become apparent to those skilled in the orthodontic arts from the following description and drawings of which:
FIG. 1 is a plan view of a preferred embodiment of the face-bow of this invention;
FIG. 2 is an enlarged partial side elevation taken substantially along line 22 of FIG. 1;
FIG. 3 is an enlarged partial perspective view of a portion of the face-bow of FIG. 1 looking downwardly on and from the right of FIG. 1;
FIG. 4 illustrates a case of malocclusion wherein the face-bow of FIG. 1 has been fitted to move the canine and an entire buccal segment posteriorly as a unit; and
FIG. 5 is an enlarged perspective view (taken from upper right of the mouth) showing the face-bow of FIG. 1 in the vicinity of the retracting wire.
The face-bow 1 illustrated in FIGS. 1 to 3 includes a frame 10. Frame 10 comprises diverging rearwardly extending arms, a long arm 12 and a short arm 14, each terminating at one end in a hook 16. The other ends of the arms 12 and 14 meet generally U-shaped segments 18 which in turn are joined by an elongated central portion 20.
An arch engaging member 22 is welded adjacent its central segment 24 to central portion 20. To assist in connecting central segment 24 and central portion 20 to each other, and to reinforce the central area, silver solder 26 is provided. Lever arms 28 diverge and extend rearwardly from central segment 24. They may be joined by central segment 24, as described, or may be individual arms connected adjacent central portion 20.
For a purpose to be described, each lever arm 28 is provided with a double bend section 30 and terminates in slightly offset ends 32.
Hooks 34 are brazed to lever arms 28 at positions which, when the face-bow is inserted in a patients mouth, will lie in the vicinity of the point of contact of the canine and second bicuspids. Hooks 34 open rearwardly.
Spaced rearwardly of right-hand hook 34 is retracting Wire 36. Retracting wire 36 is brazed to lever arm 28 with silver solder. Wire 36 includes an inverted hairpin or U-shaped section 38, the rounded end of which section is disposed so that it will lie within the vestibule of the mouth. Hairpin section 38 terminates in a forwardly extending retracting wire arm 40 which lies inside of hook 34. At the forward end of retracting wire arm 40, an activating section 42 is disposed.
In the embodiment illustrated the activating section 42 is generally semi-circular in shape and is adapted to surround partially the tooth to be directly acted upon or against by the retracting wire 36. To facilitate engagement with the teeth, as will be described, the end of the activating section is somewhat thinned down. However, the precise configuration and disposition of activating section 42 will depend in large measure upon'the initial position of the tooth it acts upon, the direction in which, and the extent to which, the tooth is to be moved, the particular corrective technique which is indicated, and other factors which will be apparent from this description to those skilled in the orthodontic arts.
For example, if it is desirable merely to move the canines rearwardly to assist in closing spaces between the posterior teeth, then the activating section 42 may be disposed adjacent the gum line. If, however, it is necessary or desirable to rotate a canine which has erupted diagonally across a lateral incisor, then the activating section may encompass a lower aspect of the mesial surface of the canine to give greater leverage.
It is, however, the retracting that contributes to the novelty and improved results obtained with the face-bow of this invention.
As will become apparent, hooks 34 are provided to anchor rubber bands for exerting distal driving forces against the incisors. However, they are adapted and are disposed to perform an additional function as well.
Since retracting Wire arm 40 is relatively long, the activating section 42, as well as wire arm 40, may tend to ride up vertically on the tooth it contacts. Hooks 34 are used to assist in limiting and fixing the vertical disposition of activating section 42. Hook 34, as illustrated, substantially prevents upward vertical movement of retracting wire 36, at the same time permitting horizontal movement of retracting wire 36 as the spring action thereof drives the canines rearwardly.
Although the specific dimensions are not critical, it bears mentioning that a face-bow of this invention can be constructed of 304 stainless steel wire, having a frame of 0.066" in diameter, lever arms 28 of 0.050" in diameter, turned down to 0.045 in diameter rearwardly of the point at which retracting wire 36 is connected, :1 retracting Wire 0.032 in diameter and a flattened end portion, the end of section 42, 0.020" in width.
T o understand fully the manner in which the embodiment of the face-bow of this invention which has been described is to be utilized, its operative relationship to an orthodontic arch will be described with reference to FIGS. 4 and 5.
FIG. 4 incorporates an orthodontic arch 50. Orthodontic arch 50 consists generally of a plurality of caps 52 suitably secured to a plurality of teeth in any conven tional manner, and an orthodontic arch wire 54 connected to caps 52 by brackets 56. Brackets 56 have upper and lower sections between which the arch wire is adapted to lie. To retain arch wire 54 in its nestled position between the upper and lower segments of the brackets, tie wires 58 are provided. Nothing unusual in the orthodontic arch is necessary to the practice of this invention except that it must be an orthodontic arch capable of cooperating with the face-bow of this invention.
Two molar caps bear molar tubes 60. Each molar tube 69 is provided with two longitudinal tunnels, a lower tunnel 62 and an upper tunnel 64. It is through lower tunnel 62 that each end of arch wire 54 extends, each end terminating in rearwardly disposed angled segments 66. Forwardly of tunnels 62, loops 68 are provided in arch wire 54. Loops 68 function to stop arch wire 54- from moving rearwardly more than a predetermined amount, and angled segments 66 resist withdrawal of the arch wire from lower tunnels 62.
Upper tunnels 64 are adapted to receive the offset lever arm ends 32. lever arm ends 32 extend into tunnels 64 as far as the double bend sections 30. Double bend sections 3% limit, where desirable or necessary, the extent to which ends 32 may move inwardly of upper tunnels 64 and are provided for that limiting function.
To maintain the face-bow in operative engagement with the orthodontic arch, an elastic neck strap 70 having hooks 72 adapted to engage frame arm hooks 16 is provided. The degree of tension it is desired to exert against the molar tubes 60 of orthodontic arch 5t) dictates the strength of neck strap 70. To vary the tension, neck straps of different lengths may be used. Adjustments in tension may be made from time to time. Alternatively an adjustable neck strap may be provided. The relative lengths of long arm 12 and short arm 14 also assist in controlling relative magnitude of the forces exerted against the molar tubes by the double bend sections 30. The double bend section adjacent long arm 12 exerts greater force against its molar tube 60 than does the double bend section adjacent short arm 14.
So that the elastic strap 70 is free-flowing, that is enabled to seek its position of equilibrium freely, and thereby exerts the proper predetermined forces against the rearwardly extending arms of the face-bow, a satin sleeve 74 may be provided. The inner surface of this sleeve rests against the patients neck thereby enabling elastic strap 70 to move more freely with respect to the back of the neck than would otherwise be possible.
To complete the full assembly illustrated in FIG. 4, reference should be made to rubber band 76. Rubber band 76, generally twisted several times, extends between hooks 34, beneath the brackets 56 on the lateral and central incisor caps. The rubber band induces distal driving of the incisors in a known manner.
FIG. 4 illustrates a condition wherein it is desirable to move the entire buccal segment and the canine, the whole posterior section, rearwardly as a unit. The face-bow illustrated in FIGS. 1 to 3 has been shown in FIG. 4 in operative relationship to the orthodontic arch to accomplish that purpose.
It is apparent from FIG. 4 that before the incisors can be satisfactorily relocated, it is necessary to drive the canine rearwardly. Unless the buccal segment is also driven rearwardly in the alveolar trough to provide space for the canine, the first or second bicuspid would have to be removed, as is the case in present orthodontic practice.
A face-bow of this invention is disposed to exert driving forces against the first molar and the canine to drive the whole section rearwardly as a unit. Once the canine and the buccal segment are relocated, the incisors may be brought into proper occlusion and aligned correctly and permanently. One of the great reasons for failure of orthodontic results is that the incisors are aligned without regard to obtaining permanent arch length.
It is possible, if some distal driving of the incisors is necessary, to begin that operation after the buccal segment and canine treatment has begun. It is not necessary to complete relocation of the posterior teeth before distal driving of the upper anterior teeth ensues, as is presently the case where palates are used to relocate canines as a separate initial technique. Neither is it necessary to extract teeth to provide room for a canine as is the present practice.
Face-bow 1 is shown in FIG. 4 as being connected to the orthodontic arch 50. In fitting the face-bow to the orthodontic arch a number of adjustments must be made, including placing double bend sections 30 in lever arms 28 to determine and fix the orientation of the other parts of the face-bow with respect to the teeth.
Additionally frame arms 12 and 14 should be molded to the particular patients face and U-shaped segments 18 and the frame as a whole molded to accommodate the specific shape and size of the patients mouth, teeth and lips, all in a manner known to the art.
Then retracting wire 36 must be adjusted to the size and disposition of the particular teeth to be acted upon. To shorten or lengthen the effective length of forwardly extending 'wire arm 40, the width of hairpin section 38 may be adjusted such as by squeezing it with a pliers. Hairpin section 38 also acts as a spring to help activate retracting Wire 36. Then activating section 42 is finally conformed to the particular patient, such as by molding the semi-circular section 42 seen in FIGS. 1 to 3 to engage the mesial portion of the canine near the gum line.
Hooks 34 also serve to mount rubber band 76 which distally drives the incisors. So, as the canines are drawn rearwardly by the retracting wire 36, the incisors may be driven distally. However distal driving need not accompany treatment with the retracting wire.
Whether or not hooks 34 are used to accomplish distal driving, they may be utilized to orient retracting Wire 36 and to prevent it from rid-ing up on the canine. In the absence of hook 34, other equivalent means may be provided to assist in orienting retracting wire 36.
In installing the face-bow described, it having been satisfactorily adjusted, it is necessary to be certain that both offset lever arm end 32 and activating section 42 assume their proper positions. Depending upon the final ad justed configuration, it may be easier to insert arm ends 32 in the tunnels 64 first, and then spring activating section 42 into place. Alternatively, it may be easier to insert both at the same time. The order is not critical, as long as the desired action is obtained from retracting wire 36.
It is apparent that spring action is transmitted to the canine through the retracting wire 36. Some of that is derived through a properly adjusted hairpin section 38 and part of it comes from the disposition and orientation of arm 4% and activating section 42. Part of the driving force for the canine is furnished by lever arm 28 as it moves rearwardly during treatment.
In the sectional arch treatment described, forces up to several ounces may be exerted against the canines through the retracting wire 36. Forces in terms of pounds may be transmitted to the first molar through the molar tubes from the neck strap if necessary. The magnitudes of those forces will depend largely upon the individual patient and must be arrived at empirically.
As was mentioned earlier, other corrective techniques may be employed with the face-bow of this invention. For example, in a non-extraction case where spaces have developed at the contact points between the canines and first bicuspids, the first bicuspids and the second bicuspids, etc., the retracting wire may be used to drive the canines rearwardly along the alveolar trough to close up those spaces. In such a case the activating section of the arch Wire may be located just above the contact point between the canine and lateral incisor gingivally, and the activating section may be generally straight and at right angles to, and in a generally horizontal plane with respect to, the forwardly extending wire arm 40. Hooks 34, or the like, may be used to assist in maintaining the desired disposition of auxiliary spring wire 36, for example to prevent the activating section from cutting the gum if that be necessary.
A unilateral right-handed face-bow embodying the invention herein has been illustrated. It is apparent that a left-handed face-bow may be constructed in a manner identical to that described for treating the left side of the upper jaw. In such a case the left arm of the frame would be the longer, and the right arm, the shorter, of the two arms.
It is also possible to construct a face-bow in accordance with this invention which provides a retracting wire on each side, for example where rearward driving of both upper canines and upper buccal segments is desired.
The face-bow described herein and the methods and techniques described herein will make apparent to those ordinarily skilled in the art other advantages of this invention, and other techniques which may be employed with this invention. The foregoing description, likewise, will make obvious to others skilled in the orthodontic arts the fact that various changes may be made in the embodiments illustrated and discussed without departing from the spirit and scope of the invention as claimed.
1. A face-bow including a frame having two diverging arms extending distally when the face-bow is worn, each of said arms terminating at its distal end in a hook, two diverging distally extending levers disposed between said arms and adapted to engage an orthodontic arch, means for limiting distal movement of said levers with respect to portions of an orthodontic arch which said levers are adapted to engage, and a retracting wire connected to at least one of said levers and adapted to engage a tooth when said levers are in engagement with an orthodontic arch.
2. The face-bow of claim 1 wherein said retracting wire has an elongated section lying generally parallel to the lever to which it is connected, and means connected to the same lever adjacent said elongated section and overlying said elongated section for restricting freedom of upward movement of said elongated section.
3. The face-bow of claim 1 wherein said arm closer to the lever bearing the retracting wire is longer than said other arm.
4. A face-bow having a frame including two diverging arms extending distally when said face-bow is worn, hooks integral with the distal ends of said arms, a rigid central portion, and two diverging distally extending levers connected adjacent said central portion and lying between said arms and adapted to engage and cooperate with an orthodontic arch, said face-bow further including means integral with said levers for limiting their distal movement when in engagement with said orthodontic arch,
and a retracting wire connected to one of said levers for engaging a tooth.
5. The face-bow of claim 4 wherein said retracting wire includes a mesially extending elongated portion lying closely adjacent the lever to which it is connected, an inverted U-shaped segment at the distal end of said mesially extending elongated portion and a laterally extending activating section connected to the mesial end of said elongated portion, and restricting means connected to the lever bearing the retracting wire, said restricting means comprising a distally extending hook overlying said elongated portion for restricting freedom of upward movement of said elongated portion, and a complementary second distally extending hook connected to the other of said levers, said hooks being adapted to support a rubber band for distally driving a patients incisors.
6. A face-bow comprising a frame having two diverging arms extending distally when the face-bow is worn and terminating at their distal ends in hooks, and a reinforced central portion, two diverging distally extending levers adapted to engage an orthodontic arch connected adjacent said central portion and lying between said arms, means integral with said levers for limiting their distal movement when in engagement with an orthodontic arch, a mesially extending retracting wire connected to the first of said levers, said retracting wire including an inverted U-shaped section, an elongated section and an activating section at the mesial end of said elongated section extending laterally and inwardly of said elongated section, a first hook connected to said first lever overlying said elongated section for restricting upward movement of said elongated section, and a second hook on the second lever complementary to the first hook.
7. An orthodontic appliance for distally moving a canine and adjacent buccal segment as a unit comprising an orthodontic arch having molar tubes, a face-bow having strap engaging hooks and having portions seated in the molar tubes and means limiting the extent to which said portions may move distally, a neck strap connected to said face-bow strap engaging hooks, a mesially extending activatable retracting wire connected to said face-bow and adapted to engage said canine, whereby when said face-bow is activated by said neck strap and said retracting wire is in activated engagement with said canine, the entire canine and buccal segment section is moved distally as a unit.
8. A method of relocating a buccal segment and adjacent canine as a unit in a patient wearing an orthodontic arch having molar tubes comprising, inserting the ends of lever arms of a face-bow into the molar tubes, engaging the canine with an activated retracting wire connected to the face-bow, activating the face-bow with a neck strap to exert forces against the molars in a distal direction whereby over an extended period of time the entire canine and buccal segment section is driven distally.
9. A method of correcting malocclusion wherein relocation of a buccal segment and adjacent canine section is necessary and wherein distal driving of the incisors is necessary and cannot be accomplished until the section is relocated, comprising fitting a patient with an orthodontic arch having molar tubes and incisor caps, inserting the terminal portions of levers of a face-bow into the molar tubes, engaging the canine with an activatable retracting wire connected to the face-bow, activating the face-bow with a neck strap to exert forces against the molars and against the canine, continuing exertion of forces against the molars and canine until partial relocation of the buccal segment and canine section is accomplished, then, while continuing that, distally driving the incisors by connecting a rubber band spanning the incisors to the face-bow, and continuing those treatments until malocclusion is corrected.
10. A method of correcting malocclusion in a patient wearing an orthodontic arch comprising, engaging the orthodontic arch with a face-bow, engaging at least one tooth with a retracting wire connected to the face-bow, and activating the retracting Wire whereby over an extended period of time the retracting wire moves the tooth into more proper occlusion.
OTHER REFERENCES Orthodontia, by Victor H. Jackson, published in 1904 (pages 399-403 relied on).