US 3439421 A
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April 22, 1969 T. E. PERKOWSKI 2 METHOD OF MAKING ORTHODONTIC APPLIANCES Filed Jan. 9, 1967 Sheet of s (a mmmmumi W llllfllll THOMAS E. PYERKOWSKI BY FIG. 2 M M ATTORNEYS April 1969 T. E. PERKOWSKI 3,439,421
METHOD OF MAKING ORTHODONTIC APPLIANCES Filed Jan. 9, 1967 Sheet .2 of 3 l2 INVENTOR.
THOMAS E. PERKOWSK/ F163 BY MP,
A T TOR NE Y5 April 1969 T. E. PERKOWSKI I 3,439,421
METHOD OF MAKING ORTHODONTIC APPLIANCES Filed Jan. 9, 1967 Sheet 5 of 5 INVENTOR. THOMAS E. PERKOWSKI ATTORNEYS United States Patent Office Patented Apr. 22, 1969 3,439,421 METHOD OF MAKING ORTHODONTIC APPLIANCES Thomas E. Perkowski, 1310 N. Wooster Ave., Dover, Ohio 44622 Filed Jan. 9, 1967, Ser. No. 614,381 Int. Cl. A61c 7/00 US. CI. 32-14 2 Claims ABSTRACT OF THE DISCLOSURE An indirect method of fabricating bands and appliances for corrective orthodontic situations. An impression casting of the patients mouth is separated and rearranged on the articulator beneath a preselected arch form diagram that has resulted from earlier diagnoses. Bands are formed on the separated individual dies and the brackets are then applied to the casting by a bracket positioning gauge that moves across the surface table supporting the articulator so as to be parallel to the occlusal plane. Treatment wires are then preformed for engagement with the band brackets. These wires are then used to complete the orthodontic treatment.
Field of the invention This invention relates to the field of orthodontic appliances and further relates to a specific form of articulator and bracket positioning device that permits a new and improved method of indirect fabrication of orthodontic appliances to be achieved.
Description of the prior art No prior patent art is known to the applicant relating to this subject.
The practical state of the prior art known to the applicant relates principally to a method of fabricating and applying orthodontic appliances by what is known as the direct method.
Under the direct method of fabricating orthodontic appliances an impression is first taken of the patients existing teeth structure. Based on this impression as well as X-rays, the orthodontist is normally enabled to determine the course of corrective action that must be taken. Normally bands are then positioned around the individual teeth with brackets then being positioned on the bands so as to permit the bands to be interconnected together by a spring wire with the result that repositioning force is constantly exerted on the teeth in an effort to realign them into a proper condition of registry with each other.
Also existent in the prior art is a method of fabrication known as the indirect method wherein the bands are first applied to a rigid replica of the patients teeth and then fitted individually after being fabricated on the die replica.
In both the direct and indirect methods of application above described bracket positioning is done on a cut and try basis with the result that the brackets are rarely if ever positioned in the proper condition of alignment that would result in maximum utilization of the spring forces. Further, there is no set goal that has been established by these methods with progress being determined by constant examination and the exercise of orthodontic skill directed towards achieving the 'optimum condition of correction.
Summary of the invention Applicant has discovered an improved orthodontic result can be achieved by using an articulator that permits reassembly of the patients teeth into a desired form of realignment under an arch plate that is utilized with the articulator to effectuate such realignment.
Applicant has further discovered that if a bracket positioning guage is employed in connection with such articulator that all brackets will be positioned in a parallel with the occlusal plane with the result that perfect alignment is achieved in every instance of fabricating an orthodontic appliance. Applicant thus deviates from standard practice by fabricating the orthodontic appliance on the basis of the ideal condition to be achieved rather than on the condition of initial treatment as has been the case in prior art.
Brief description of the drawings FIGURE 1 is a schematic view showing the improved articulator, bracket, retaining catch and surface table that are'employed in the practice of the invention.
FIGURE 2 is a side elevational view showing a complete set of teeth ready for application of the orthodontic bands.
FIGURE 3 is a similar side elevational view of the improved articulator with the glass: plate positioned therein.
FIGURE 4 is a top plan view of the improved articulator.
FIGURE 5 is an end elevation of the improved articulator.
FIGURE 6 is a side elevation of the bracket applying gauge.
FIGURE 7 is a vertical section taken on the lines 77 of FIGURE 6.
FIGURE 8 is a top plan view of the improved bracket applying gauge.
FIGURE 9 is a schematic view illustrating the manner of applying the brackets to the orthodontic bands.
Description of the preferred embodiment Referring now to the drawings and in particular to FIGURE 1, the improved apparatus for fabricating orthodontic appliances includes an articulator 10, a bracket applying gauge 11 and a surface table 12 with the arrangement being such that the articulator 10' is used for the purpose of creating a replica of the patients teeth as they will exist at the conclusion of orthodontic treatment. The surface table 12 serves: to provide a common plane over which the bracket applying gauge may be freely moved for the purpose of locating the wire engaging brackets (not shown) on the teeth T that are positioned on the articulator 10.
Before proceeding with a detailed description of the articulator 10 per se it is believed in order to first describe the manner in which the teeth T are positioned in the form shown in FIGURES 1 and 2.
To this end the articulator 10 includes a transparent plate 20 preferably of glass that has penciled thereon the arch forn line 21 that has resulted from the orthodontists diagnosis of the patients particular case. In reality the line 21, which is arch shaped as shown, is plotted from the X-rays and study models that have been taken at the commencement of patient treatment and as a result it shows the ideal arch line within which the teeth should be aligned following orthodontic treatment.
In practicing the invention an impression is first taken of the malposed teeth and this impression is then poured up in epoxy resin in the usual fashion to create a molded replica of the teeth as they actually exist at the commencement of treatment.
With the biting surface of the teeth facing down and the impression surface being up from the standpoint of access, dowels are then positioned in the individual teeth which are then separated as by sawing.
The bands are then formed on each individaul die or tooth replica. A wax horseshoe 23 (FIGURE 1) is then placed on the lower hinged member 24 to accept and temporarily position the dowels of the individual dies. The horseshoe 23 is held in place by the posterior pins 25, '25 and the retractable anterior pin 26 as clearly shown in FIGURE 1.
Using the arch line 21 as a guide the orthodontist or technician then positions the teeth directly below the arch line by forcing the dowel into the wax horseshoe which temporarily aligns the teeth in the correct position.
When the complete arrangement of lower teeth has been accomplished as shown in FIGURE 1 a wax darn can be formed in encircling relation with the set up teeth to thus allow pouring of a plaster index so as to stabilize the teeth in the position of parallelism with the occlusal plane X-X as clearly shown in FIGURE 2 of the drawings, with the occlusal plane X-X being coplanar with the bottom of the glass plate as clearly shown in FIGURE 3 of the drawings.
When the lower teeth have been realigned as just described into aligned relationship with the arch line 21 the upper teeth can be made similarly by opening up the articulator to the position shown in FIGURE 1 and repeating the process just described with it being noted that in this instance the glass plate member 20 will be removed by withdrawing hinge pin 27 so as to permit the upper teeth to be positioned with relationship to the lower teeth as clearly shown in FIGURE 2.
In this regard it will be noted that the fact that the lower teeth have been set to the proper arch form automatically serves as an aligning template for the upper arch form.
When the upper and lower teeth have been realigned as just described the orthodontist or technician will then commence to apply the brackets to the individual bands. In this regard bracket positioning is achieved by using wax to initially locate the bracket on the band with the band then being removed so that the bracket may be permanently spot welded to the same by conventional practice.
Because of the fact that the bracket applying gauge has a bottom surface that is copolanar with the surface plate table 12 it is manifest that all brackets will be applied in a condition in which their longitudinal length is parallel to the occlusal plane X-X as well as the surface table 12. Following this it is a relatively simple matter to preform the connecting wires that interconnect the respective brackets and when this has been done the brackets are ready for positioning on the patients teeth with it being apparent that when such positioning has been achieved that application of the corrective wires will tend to urge the patients teeth towards the position that exists on the orthodontic model that has been created as a replica of the ideal final form of tooth positioning.
Referring now to FIGURE 3 for a more detailed description of the articulator 10 it will first be noted that the same includes a lower hinge member 24 and an upper member 30 with the 45 degree arm extensions 24a and 30a thereof being respectively journalled about a pair of hinge bushings 31, 31 as to permit movement between the full and chain dotted line positions that are shown in FIGURE 3.
As earlier indicated, each of the hinge plates includes a setup supporting surface 24b and 30b with the upper and lower plaster indices being held in place with respect to these surfaces by the posterior pins 25, and the retractable anterior pin 26.
Locating apertures 24c and 300 are provided in the actual face of the plate members 24 and respectively for the purpose of coacting with locating pins 33, 33 that extend upwardly from the surface table 12 as clearly shown in FIGURE 3 of the drawings. The purpose of this pin in hold position is merely to obviate movement of the articulator during the time that the brackets are being positioned as has wrlier been described.
As has been indicated before, a glass plate 20 is removably associated with the articulator 10 for the purpose of associating the particular arch form line of a patient with the articulator for the purpose of rearrangement of tooth locations as has been previously described. To this end plate member 35 has rearwardly extending boss members 36, 36 that are journalled about hinge pin 27, with the hinge pin 27 being inserted through appropriate openings that are provided in the hinge bushings 31, 3-1.
In this fashion the hinge plate 36 as well as the components associated therewith can be quickly removed by merely withdrawing the hinge pin 27.
In order that the plate 20 may be quickly changed, the right hand end 36 of the plate 35 is notched as at 38 (FIGURE 3) with a spring clip 39 tensionally overlying the notch so as to releasably hold the plate 20 in place as is clearly apparent from FIGURE 3 of the drawings.
Finally locating stop pins 40, 40 are provided in projecting relationship to the side edges of the plate member 36 so as to limit the pivotal movement of the plate 36 to the 180 degree arcuate pivot that is shown existing between the full and chain dotted line positions of FIGURE 3 with the pins bearing against the arm members 24a, 24a, and 30a, 30a as is clearly apparent.
Turning now to FIGURES 1 and 6 through 8 for a detailed description of the bracket applying gauge 11 it will first be noted that the same includes a base portion that has a perfectly fiat lower surface 51 that is designed to be in coplanar relationship with the work surface of the surface table 12. A central threaded aperture 52 is further provided in the base 50 for reception of a post 53 with the lower end of the post 53 being threaded for engagement with an interiorally threaded ring 54. By this arrangement the post 53 may be raised or lowered with respect to the base by merely rotating the ring 54 with this arrangement permitting fine adjustment of the height plane of the gauge 11.
As shown in FIGURE 7 the upper end of post 53 is bifurcated to define opposed legs 56 and 57, with the leg 56 having a tapped aperture 56a while the leg 57 is bored so as to permit passage of the shank portion of a tightening screw 59.
A rigid bar 60 is carried by gauge 11 and has a flattened center section 61 which is adapted to be received between the faces of the leg members 56 and 57 as clearly shown in FIGURES 6 and 7 of the drawings, with the flattened portion 61 being appropriately bored so as to permit passage of the shank portion of locking screw 59.
A bracket holding pin 65 is received in a socket 66 that is provided at one end of the bar 60, with the pin 65 being held in place by screw 67 as clearly shown in FIGURE 6 of the drawings.
The pin 65 preferably has therein a right angle portion 65a that is designed to engage with portions of the bracket so as to permit mounting of the same as clearly shown in FIGURE 9 of the drawings.
An additional slot 68 may be provided in the opposite end of bar 60, as shown in FIGURE 6, so as to permit insertion of another type of pointer so as to make the gauge double-ended in operation with a similar screw 69 being used to retain the pointer 70 or other element in place within the socket.
By the arrangement just described it will be noted that the bar 60 may pivot around the axis of the shank portion of the screw 59 until such time as the screw 59 is tightened in place. At this time any movement of the gauge 11 with regard to the surface table 12 will not change the height of the pin 65, with the result that all brackets will be applied at an identical spacing from the occlusal plane so as to be coplanar and longitudinally aligned with each other in end-to-end relationship.
FIGURE 9 illustrates schematically a typical bracket member 90 that is to be mounted on band B which encircles tooth T. The bracket member 90, that is illustrated has a thin flat welding flange 91 as well as a pair of wire receiving members 92, 92. Each member 92 includes a central slot 93 within which the treatment wires may be inserted. By this arrangement ligature wires can be used in known fashion on hooked portions 94, 94 to retain the treatment wires in place with respect to the bracket slot 93. It is also to be understood that the invention is not restricted to any particular form of bracket. In other words, all forms of brackets are equally capable of being used with the bracket applying gauge 11.
As has been indicated earlier, the bracket positioning gauge 11 serves to perform the very important function of arranging the brackets in coplanar relationship on the respective bands and this arrangement clearly facilitates the effective use of the treatment wires. Specifically, the treatment wire may be formed to fit the contour of the assembled set up of teeth, bands and brackets. By this arrangement a progressive series of treatment Wires of increasing rigidity can be precisely preformed to conform to the arch form that has been established as Well as the individual tooth to tooth relationship that has been recreated in the final desired form on the set up.
By this arrangement, when the bands are positioned on the patients teeth and the treatment wires positioned therein, these treatment wires are always seeking to move the teeth towards the desired end result in view of the memory and resiliency property of such wire.
It will be seen from the foregoing that there has been provided a new and improved type of orthodontic articulator and bracket applying gauge that permits improvement and a degree of accuracy in orthodontic treatment.
It has been shown how this orthodontic articulator ditfers from the prior art in that it provides a replica of the patients mouth in the corrected form rather than a replica of the patients mouth at commencement of treatment.
It has further been shown how the bracket applying gauge insures maximum accuracy in that all brackets are arranged in end-to-end relationship in a plane that is parallel to the occlusal plane.
Finally, it has been shown that the improved orthodontic articulator permits attainment of an orthodontic procedure wherein the orthodontist is Working towards a given end.
What is claimed is:
1. A method of making orthodontic appliances comprising the steps of:
(A) cutting an impression molding of a patients malformed teeth into individual tooth dies;
(B) resetting said tooth dies in registry with a prescribed arch form diagram;
(C) banding said reset dies While the same are in said reset position; and
(D) attaching brackets to said bands in substantially coplanar relationship with each other.
2. The method of claim 1 further characterized by the step of preforming and attaching the arch wires to said brackets while said teeth are in said reset position.
References Cited UNITED STATES PATENTS 2,467,432 4/1949 Kesling 32-14 2,775,036 12/1956 Kesling 3214 3,316,640 5/1967 Kesling '3214 LOUIS G. MANCENE, Primary Examiner.
C. R. WENTZEL, Assistant Examiner.