CN110177521A - 用于托槽放置的间接正畸粘结***和方法 - Google Patents

用于托槽放置的间接正畸粘结***和方法 Download PDF

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CN110177521A
CN110177521A CN201780083536.6A CN201780083536A CN110177521A CN 110177521 A CN110177521 A CN 110177521A CN 201780083536 A CN201780083536 A CN 201780083536A CN 110177521 A CN110177521 A CN 110177521A
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bracket
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pallet
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H·佟
R·李
V·达卡
A·黄
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Swift Health Systems Inc
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    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
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    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y50/00—Data acquisition or data processing for additive manufacturing
    • B33Y50/02—Data acquisition or data processing for additive manufacturing for controlling or regulating additive manufacturing processes
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    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
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Abstract

公开了用于制造间接粘结托盘的***和方法。可以使用非功能性占位器托槽形成患者牙齿的物理模型，其印模可以转移到间接粘结托盘。这可以形成功能性托槽可以放入其中的孔，减少将功能性托槽从物理模型转移到间接粘结托盘上所产生的误差。

Description

用于托槽放置的间接正畸粘结***和方法
相关申请的参考
本申请根据35U.S.C.§119(e)要求作为2016年12月2日提交的第62/429,664号美国临时申请的非临时申请的权益，其全部内容通过引用并入本文。在本申请提交的申请数据表中确定了外国或国内优先权要求的任何和所有申请根据37CFR1.57通过引用结合在此。
背景
发明领域
在一些方面，本发明涉及用于正畸托槽放置的改进的间接粘结***和方法。
概述
在一些实施方案中，本文公开了用于制造用于放置正畸托槽的间接粘结托盘的方法。所述方法可以包括，例如，提供患者牙齿的物理模型。所述模型可包括附接到物理模型的牙齿的至少一个非功能性占位器正畸托槽。可模塑材料可施加在物理模型的牙齿和至少一个占位器托槽上，从而形成间接粘结托盘。所述间接粘结托盘可包括与至少一个非功能性占位器托槽对应的至少一个孔。功能性正畸托槽可以固定在间接粘结托盘的每个孔内。所述功能性正畸托槽可包括与非功能性占位器正畸托槽相同的外部几何形状。可模塑材料可以被固化，并且包含例如聚乙烯基硅氧烷。在一些情况下，所述模型可以是咬合不正模型。所述间接粘结托盘可包括对应于多个非功能性占位器托槽的多个孔。所述非功能性占位器托槽可以包含与物理模型的材料相同的材料。所述非功能性占位器托槽可以作为物理模型的组成部分来制造。所述物理模型可以快速原型化，例如在一些情况下通过三维(3D)打印。可以根据来自数字模型的信息来制造物理模型。在一些情况下，可以在远程位置处执行数字建模和模型制造。在一些情况下，模型制造和间接粘结(IDB)托盘制造可以在彼此的远程位置处执行。
在一些实施方案中，本文还公开了一种用于将正畸托槽放置在牙齿上的方法。所述方法可包括提供间接粘结托盘，所述间接粘结托盘包括包含一个或多个功能性正畸托槽的孔。来自功能性正畸托槽的孔可以由非功能性占位器正畸托槽的印模产生，其包括与功能性占位器正畸托槽相同的外部几何形状。间接粘结托盘可以定位成与患者的牙齿接触。然后可以将功能性正畸托槽从间接粘结托盘转移到患者的牙齿上。
本文还公开了一种用于制造用于放置正畸托槽的间接粘结托盘的***。所述***可以包括患者牙齿的物理模型。所述模型可包括附接到物理模型的牙齿的多个非功能性占位器正畸托槽。所述非功能性占位器正畸托槽可以永久地附接到物理模型的相应牙齿，并且因此不能被转移以用于患者口中。所述非功能性占位器正畸托槽可以被特定地配置(例如，从相应功能性托槽的实际结构修改)以优化间接粘结托盘的制造(例如，模制)，从而具有允许功能性托槽的最佳安置或放置和/或便于托槽转移到患者牙齿的孔。例如，可以通过消除(例如，占位器托槽可以不包括)复杂的内部几何形状(例如，底切)来优化占位器托槽，这些几何形状对于形成保持并适当定位功能性正畸托槽的负面印模是不必要的。换句话说，在一些实施方案中，占位器托槽可以仅包括相对平滑、连续的外表面而没有任何底切。
在一些实施方案中，公开了一种用于制造用于放置正畸托槽的间接粘结托盘的方法。所述方法包括提供患者牙齿的物理模型。所述模型具有至少一个、两个或更多个附接到物理模型的牙齿上的非功能性占位器正畸托槽。所述方法还包括在物理模型的牙齿和至少一个占位器托槽上施加可模塑材料，从而形成间接粘结托盘。所述间接粘结托盘具有至少一个与至少一个非功能性占位器托槽对应的孔。所述方法还包括将功能性正畸托槽固定在间接粘结托盘的每个孔内。所述功能性正畸托槽具有与非功能性占位器正畸托槽相同的外部几何形状。
所述方法可包括固化可模塑材料。可模塑材料可以是或可包含聚乙烯基硅氧烷。所述模型可以是咬合不正模型。间接粘结托盘可包括对应于多个非功能性占位器托槽的多个孔。非功能性占位器托槽可以是与物理模型的材料相同的材料。
物理模型可以由患者牙齿的数字模型制造。所述方法可以包括将数字托槽定位在患者牙齿的数字模型上并修改数字托槽的几何形状，同时保持数字托槽的外表面的整体轮廓。修改数字托槽的几何形状可以包括减少或移除内部底切。修改数字托槽的几何形状包括移除托槽的内部细节。所述方法可以包括将牙齿从咬合不正的位置数字化地移动到理想咬合的位置。所述方法还可以包括在咬合不正的位置中时将数字托槽定位在牙齿表面上，以及在保持将数字托槽定位在牙齿的表面上的同时将牙齿恢复到咬合不正的位置。
所述方法可以包括在可模塑材料周围施加柔性膜并将可模塑材料成型为牙弓形状。物理模型可以包括指示间接粘结托盘在患者牙齿上的适当定位和/或患者身份的指导信息，并且所述方法可以包括将指导信息从物理模型转移到间接粘结托盘。所述方法可以包括在可模塑材料可模塑时，将指示间接粘结托盘在患者牙齿上的适当定位和/或患者身份的指导信息从定位在可模塑材料周围的外部托盘传递到间接粘结托盘。提供物理模型可以包括根据数字模型3D打印物理模型。物理模型可以包括支撑结构，并且所述方法可以包括在施加可模塑材料之前从物理模型移除支撑结构。物理模型可以包括两个牙齿之间的至少一个穿孔，并且所述方法可以包括沿着穿孔切割物理模型。提供物理模型可以包括制造物理模型，使得仅制造对应于患者牙弓的一部分的患者牙齿的子集。间接粘结托盘在尺寸上可以对应于患者牙弓的所述部分。
在一些实施方案中，公开了一种用于将正畸托槽放置在牙齿上的方法。所述方法包括提供具有孔的间接粘结托盘。孔包含多个功能性正畸托槽。这些孔是由非功能性占位器正畸托槽的印模产生的，其包括与功能性正畸托槽相同的外部几何形状。所述方法还包括将间接粘结托盘定位成与患者的牙齿接触，并将功能性正畸托槽从间接粘结托盘转移到患者的牙齿。
在一些实施方案中，公开了一种用于制造用于放置正畸托槽的间接粘结托盘的***。所述***包括患者牙齿的物理模型。所述模型包括附接到物理模型的多个牙齿上的多个非功能性占位器正畸托槽。非功能性占位器正畸托槽永久地附接到物理模型的相应牙齿上。
所述***可包括形成为物理模型的负面印模的间接粘结托盘。所述***可包括多个功能性正畸托槽，每个功能性正畸托槽在外部几何形状上对应于多个非功能性占位器正畸托槽中的一个。
下面参考附图详细描述本公开内容所考虑的各种实施方案的其它特征和优点。
附图简述
这些附图是说明性实施方案，并未呈现本发明的所有可能的实施方案。
图1A-1D示意性地示出了根据本发明的一个实施方案的可以对数字托槽的外部尺寸或几何形状进行的各种非限制性修改。图1A和1B描绘了功能性正畸托槽的实施例的侧视图。图1C和1D分别示出了与图1A和1B相同的托槽视图，包括对托槽外表面轮廓或几何形状的各种可能修改的示意图。
图2示出了根据本发明的一些实施方案的包括非功能性占位器托槽的制造的粘结模型的数字3D打印。
图3A-3C示出了根据本发明的一些实施方案的间接粘结托盘的渐进式制造，其使用聚乙烯基硅氧烷并将其施加在粘结模型上并确保所有占位器托槽被捕获在印模中。
图4A-4C示出了根据本发明的一些实施方案在间接粘结托盘的渐进式制造中使用聚合物包裹物，产生膜使得聚乙烯基硅氧烷可以进一步模塑成期望的拱形。
图5示出了通过使托盘在环境室温下保持期望的固化时间，例如约1-10分钟，或在一些实施方案中约3分钟间接粘结托盘的固化。
图6A-6C示出了根据本发明的一些实施方案，在发生固化之后间接粘结托盘与粘结模型的分离。
图7示意性地描绘了根据本发明的一些实施方案的间接粘结托盘的咬合视图。
详述
间接粘结(IDB)托盘已经用于正畸，以将托槽的计划位置从数字或物理研究模型转移到患者的牙齿。在物理模型中，这传统上通过将功能性托槽放置在物理模型(例如，患者体外)上然后通过间接粘结转移托盘技术将托槽转移到患者来完成。
最近，通过在计算机上数字化地规划托槽的位置，已经改进了该过程。然后通过几种方法将托槽的这种数字位置传递给患者。一种方法是直接从数字世界打印夹具或间接粘结托盘，该数字世界保持相对于每个牙齿的托槽位置的信息。然后，夹具或间接粘结托盘将能够在数字计划位置向患者递送物理托槽。然而，用于形成间接粘结托盘的理想材料可能不适合直接从数字模型精确制造复杂几何形状。例如，理想的间接粘结托盘可以具有一定程度的弹性，其可能比理想的刚性更小，以用于方便和快速制造，例如通过3D打印。另一种方法是从数字计划的托槽位置打印出物理研究模型。从数字计划托槽位置打印的物理模型将通常在牙齿表面具有“孔”或“凹槽”，允许放置物理的、功能性托槽，所述托槽能够粘结到牙齿上并固定弓丝。然后可以通过间接粘结转移托盘拾取这些物理的、功能性托槽，然后通过常规方法将其递送给患者。在一些情况下，这种方法的缺点在于，在如何将托槽放置在物理模型上方面经常出现人为错误，这会传导到间接粘结托盘上然后传导到患者身上。例如，孔的深度可以改变功能性托槽在间接粘结托盘中的适当定位和/或如果不够深可以允许间接粘结托盘的移动。可能存在上述两种方法的轻微置换的其他方法。需要改进的***和方法。
在一些实施方案中，本文公开了形成间接粘结托盘的改进的***和方法。在一些情况下，此方法可以使用数字规划将托槽放在其正确的位置。一些实施方案不是在物理模型上打印出孔或凹槽以放置实际托槽，而是形成占位器托槽，其不是待转移到患者牙齿的实际物理托槽，而是物理托槽的真实轮廓或针对间接转移方法优化的真实轮廓的修改版本。占位器托槽在一些实施方案中是非功能性的(例如，不能固定弓丝)，并且在一些情况下可以与物理模型整体形成并且相对于物理模型不可移除，例如通过使用3D打印或其它技术。在一些实施方案中，占位器托槽缺乏额外的底切和内部细节，但具有与它们各自的功能性正畸托槽相同或基本相同的外部几何形状。在一些实施方案中，占位器托槽可以由与物理模型相同的材料制成，并且在一些情况下不由任何金属制成。然后可以从该物理模型形成托盘，例如间接粘结托盘，其具有来自物理托槽的真实实际轮廓的占位器托槽。在一些情况下，这种方法可能是有利的，因为托槽现在可以直接安装在间接粘结托盘上，而不需要通过传统的“拾取方法”拾取，在传统的“拾取方法”中功能性托槽在被转移到间接粘结托盘之前被粘附到物理模型上。换句话说，功能性托槽可以直接放置在间接粘结托盘上，而不需要它们预先从物理模型转移。一个潜在的好处是，因为直到形成间接粘结托盘，才第一次放置物理托槽，所以潜在地存在较小的误差可能性，例如在各个步骤期间，例如形成间接粘结托盘期间托槽的不准确放置或移动。然后可以使用各种粘结技术将IDB托盘中的托槽转移到牙齿上。
在一些实施方案中，这样的方法可以允许容易地传输模型，该模型现在可以数字化地传输给正畸医生或其它医疗保健提供者，使得能够例如在远程位置(例如制造设施)或在办公室里有3D打印机的医生的诊疗椅旁制造IDB托盘。在一些实施方案中，不需要为所有牙齿打印整个IDB托盘。可以形成IDB托盘的部分/子集，用于在需要时有针对性地放置一组托槽或适当的替换托槽，例如，在托槽已经脱离牙齿/从牙齿脱落的情况下，或者在咬合不正状态下存在托槽的物理干扰的情况下，一旦导致干扰的初始拥挤被解决，就阻止在第二步骤中放置一个或多个托槽。
现在将公开用于制造办公室内IDB托盘的方法的一些实施方案。该方法可以包括例如以下任意数量的元素：
医生可以采取牙齿的一种或多种咬合不正数字表示。例如，可以从牙齿的直接口内3D数字扫描、牙齿印模的3D扫描或患者牙齿的3D模型的qv3D扫描获得数字表示。也可以使用用于获得精确3D表示的任何其它方法；
咬合不正数字模型可以通过互联网发送到实验室，例如通过电子方式(例如，通过互联网)；
实验室可以将患者的咬合不正数字模型的牙齿分离成单独的牙齿或牙齿组。实验室可以将牙齿数字化地移动到理想的咬合位置；
实验室可以将正畸托槽的数字表示定位到数字理想咬合模型上；
数字托槽可以是功能性正畸托槽的修改表示。例如，数字托槽可以表示功能性托槽的3D外部几何形状的轮廓。例如，可以修改数字托槽以阻挡功能性托槽的过多底切和内部细节，留下将被称为占位器托槽的3D结构轮廓。
图1A-1D示意性地示出了可以对功能性托槽的外部尺寸或几何形状进行的各种非限制性修改的示例。图1A和1B描绘了功能性正畸托槽100的实例。图1A示出了托槽100的侧视图(例如，远端或中间视图)，而图1B示出了托槽100的正交侧视图(例如，牙龈或咬合视图)。图1C和1D分别示出了与图1A和1B相同的托槽100的视图，包括对托槽100的外表面的轮廓或几何形状的各种可能的修改102(以虚线描绘)的示意图。可以基于功能性托槽100将一个或多个修改102结合到占位器托槽的数字表示中。修改102可以简化托槽100的外部几何形状的复杂程度。例如，弓丝槽可以被消除或减少尺寸。修改102可以被设计成优化和/或简化从具有占位器托槽的牙齿的物理模型的占位器托槽的负面印模(例如，IDB托盘)的制造。例如，这些修改可以消除(例如，填充)托槽100的空隙体积，所述空隙体积对于IDB托盘中的功能性托槽100的正确放置和/或保持是不必要的、不会显著地促进和/或卷绕(convolute)IDB托盘中的功能性托槽100的正确放置和/或保持。例如，导致从IDB托盘中的孔的内表面突出的非常薄和/或脆弱突起的几何形状可以为功能性托槽100提供很少或没有结构支撑和/或很少或没有定位引导，特别是取决于制造IDB托盘的材料的物理性质。在一些实施方式中，可以修改几何形状以便于将功能性托槽100转移到患者的牙齿。例如，可以修改几何形状，使得IDB托盘可以更容易地从患者的牙齿缩回或取出，而不会过度地粘附到(clingto)粘结的功能性托槽100。IDB托盘可以具有一定程度的可变形性，使得托盘在粘结到患者牙齿上之后能够从托槽100上移除。可以修改占位器托槽的几何形状以优化功能性托槽100在IDB托盘中的保持(例如，在诸如转移到患者口的移动期间)以及在粘结之后从功能性托槽100释放IDB托盘。修改102可以包括重新缠绕(reangling)外部几何形状的部分、消除或减小底切的尺寸等。在一些实施方案中，占位器托槽的外部几何形状可以另外地或供选择地扩展超出功能性托槽100的真实尺寸；
实验室可以用数字占位器托槽替换数字托槽。数字占位器托槽可以放置在与数字托槽相同的精确位置或基本相似的位置。托槽与单个牙齿的界面的真实轮廓可以被保留，以确保在转移期间功能性托槽100与患者牙齿的适当的对准；
可以将理想咬合模型的数字牙齿和占位器托槽移回到咬合不正数字模型上。当牙齿从理想的咬合状态重新定位回到咬合不正的初始状态时，可以保持相对于牙齿的数字占位器托槽位置。
数字占位器托槽和咬合不正数字模型可以对于每个牙弓组合成单个文件；
可以在模型中添加支撑结构，以帮助快速原型制作。支撑结构可以促进物理模型的制造和/或物理模型的处理。例如，支撑结构可在制造期间为物理模型提供结构支撑；
可以在一个或多个牙齿之间添加数字穿孔。这些穿孔将允许临床医生将单个牙齿或一组牙齿折断以形成部分(sectional)间接粘结(IDB)托盘；
实验室可以快速地将该最终的数字模型原型化，该最终的数字模型包括具有占位器托槽的咬合不正数字模型，并支持转化为物理模型。供选择地，实验室可以将最终的数字模型发送给医生(例如，通过互联网以电子方式发送)以允许医生直接制造。图2描绘了包括占位器托槽202的患者牙齿的物理模型200的图像。在模型200的制造期间，占位器托槽202可以形成为模型200的整体部分。在一些实施方案中，占位器托槽可以是简化为功能性正畸托槽的一般立方体表示。物理模型的制造可以通过快速原型制作手段，例如3D打印，或本领域已知的任何其他合适的手段来进行。在一些实施方案中，物理模型可以包括整个集合，或者仅包括患者牙齿的子集。牙齿的子集可以对应于牙弓的一部分。物理模型可以在尺寸(例如，托盘沿着牙弓延伸的长度)上对应于牙弓的部分，或者可以对应于整个牙弓，但是可以不包括未被选择作为子集的一部分的牙齿；
如有必要，可以从快速原型制作模型中移除任何添加的支撑结构。可以制造支撑结构(例如，具有减小的横截面)，使得它们允许在施加足够量的手动力的情况下，支撑结构从模型的剩余部分容易且精确地断裂。支撑结构也可以保持用作把手以保持物理模型200以用于后续过程；
如果实验室产生物理模型，则实验室可以继续制作IDB托盘，或者实验室可以将快速原型制作模型邮寄给医生以允许医生制作IDB托盘；
IDB托盘可以通过在覆盖占位器托槽和牙齿的所有或选定表面的快速原型制作模型上施加聚乙烯基硅氧烷(PVS)或其它印模成型的可模塑材料来形成。图3A-3C示出了可模塑材料204(例如，PVS)渐进式施加到物理模型200的图像。如图3A-3C所示，可使用具有施加尖端252的输送装置250将可模塑材料注射到物理模型200上。也可以使用任何其它合适的施加手段。来自快速原型制作模型的占位器托槽202可以形成可以将正畸托槽100放置在IDB托盘上的孔。在物理模型仅包括患者牙弓的一部分的实施方案中，可模塑材料204可以仅施加在该部分上(其可以包括整个物理模型)，使得形成在尺寸上仅对应于该部分的IDB托盘。供选择地，可模塑材料204可仅施加到选定的牙齿子集上，以形成一个或多个在尺寸上对应于牙弓的一个或多个部分的IDB托盘。如本文其它地方所述，部分IDB托盘可用于执行托槽替换和/或随后放置最初不可放置的托槽(例如，由于诸如过度拥挤的物理干扰)；
虽然可模塑材料204仍然是可模塑的，但可模塑材料204可模制成期望的拱形。在一些实施方案中，柔性膜210可用于促进可模塑材料204模制到IDB托盘中。在一些实施方案中，膜可包含聚乙烯(例如，聚合物包裹物)。膜210可以有助于将稍微流动的可模塑材料204保持在物理模型200周围的期望几何形状中，同时允许临床医生将可模塑材料204弯曲和成型为期望的形式。图4A-4C示出了使用膜将所施加的可模塑材料204围绕物理模型200逐渐成型为期望的拱形的图像。膜210可特别用于成型IDB托盘的外表面；
可模塑材料204可在成型后固化。可模塑材料204可在施加时随时间自动固化。图5示出了可模塑材料204的固化以在物理模型200周围形成固体IDB托盘。例如，PVS可以通过将PVS材料在环境室温下放置几分钟(例如，1-10分钟，或更多或更少)固化。在一些实施方案中，PVS可在约3、4、5、6、7、8、9或10分钟后或包括任何两个上述值的范围后充分固化。在一些实施方案中，可以施加热和/或光来固化或促进印模材料的固化；
在完成固化之后，可以从快速原型制作模型中移除可模塑材料204，从而产生IDB托盘300，其可以用于间接粘结正畸托槽。图6A示出了在已经发生可模塑材料的固化之后分离的IDB托盘300和物理模型200的图像。图6B和6C分别描绘了分离的物理模型200和IDB托盘300。图7示意性地描绘了IDB托盘300的咬合视图。IDB托盘300可以形成为物理模型200的负面印模，其包括占位器托槽202。IDB托盘300可以包括用于配合(fit to)患者牙齿的孔302，以及用于接收一个或多个待转移到患者牙齿上的功能性正畸托槽100的孔304。牙齿的孔302可以彼此合并。每个牙弓可基本上形成一个大孔或多个比单个牙齿更大的孔。孔304也可以合并到牙齿的孔302中。可以基于数字修改的占位器托槽202形成孔304以匹配功能托槽100的外部轮廓或几何形状。托槽孔304可以使牙齿孔302更深地延伸到IDB托盘300的印模材料中，例如在咬合方向和/或舌方向。虽然这里描述的托槽100被描绘为舌正畸托槽，但是本文描述的方法和***可以同样地应用于正畸装置的其它装置，包括口腔正畸托槽；
实验室或医生可以将功能性托槽100牢固地放置在IDB托盘300中的托槽孔304内，其中托槽的粘结侧面向外远离IDB托盘的印模材料并朝向适合接收患者的牙齿的开口孔302；
可以在IDB托盘300的粘结侧添加粘合剂。在一些情况下，在将所有托槽适当地放置在IDB托盘300中之后，可以将粘合剂添加到托槽100中。在转移托盘之前和/或在将IDB托盘300施加到患者牙齿期间，粘合剂可以被固化或部分固化。在允许足够的时间使功能性托槽100牢固地结合到患者的牙齿之后，可以将IDB托盘300从患者的口中移除，将功能性托槽100留在患者的牙齿上适当位置；和
如果实验室制作IDB托盘300，则实验室可以将预先装有托槽100的IDB托盘300和任选的快速原型制作模型200邮寄或以其它方式发送给医生；
供选择地，可以将IDB托盘300发送到正畸办公室，允许办公室将托槽100装载到IDB托盘200中。
多种印模材料可用于获取牙齿印模，例如以形成IDB托盘200。弹性体印模材料的主要化学类别包括不可逆的水性胶体、可逆的水性胶体、聚硫化物、聚醚、缩合反应硅氧烷和加成反应硅氧烷。藻酸盐是通过组合藻酸的钠盐、硫酸钙和水形成的不可逆水性胶体的实例。可商购的藻酸盐印模材料包括(Dentsply/Caulk)、Coe(Coe)和(Lascod S.p.A.)。聚醚是由碱和催化剂糊剂组成的两部分体系。所述碱含有具有亚胺端基的聚醚，并且所述催化剂含有芳香族磺酸。这些组分可以手工混合或从双腔药筒中分配，该药筒自动混合正确比例的碱和催化剂材料。可商购的聚醚材料包括Impregum(ESPE)、(ESPE)和(Dentsply/Caulk)。与聚醚类似，加成反应硅氧烷是由碱和催化剂糊剂组成的两部分体系。这些材料也称为聚乙烯基硅氧烷或乙烯基硅氧烷，因为乙烯基基团在一种糊剂中作为末端基团存在。另一种糊剂含有末端氢。当它们混合在一起时，它们形成高度交联的弹性体材料，该材料可以很好地从变形恢复。可商购的PVS印模材料包括(Discus Dental)、(Dentsply/Caulk)和(ESPE)。取决于托盘和印模材料在一些应用中的不透射线性，将不透射线材料直接配混(compound)到印模材料中以实现期望的衰减可能是有用的。不透射线材料可以配制成前面描述的印模材料。
在一些实施方案中，IDB托盘300可以包括标记，所述标记包括在托盘300上打印或以其它方式标记的指导信息。该信息可以包括例如识别标记，该识别标记包括例如与将适当托盘放置在正确患者牙齿的适当位置相关的信息(例如，牙齿编号位置、上部或下部弓形指示器、患者编号等)。在一些情况下，信息可以从物理模型200传输到间接粘结托盘200的内表面。例如，物理模型300可以用文本的凸纹、浮雕、***、凹槽等或其它指示信息的标记来修改。例如，可以将信息定位在牙齿孔中，使得即使在放置功能性正畸托槽100之后也可以看到该信息。可以确定信息的尺寸(例如，在面积和/或深度上)，使得其不显著改变负面印模，并且因此不会干扰IDB托盘300与患者牙齿的适当的配合。在一些情况下，间接粘结托盘的相应孔可以着色(例如，用试剂、油墨或涂料)以使信息更容易可见。例如，着色剂、油墨或涂料可以在干燥之前填充IDB托盘300中的凹槽，使得它使信息突出。可以从IDB托盘300的表面清洁残留试剂、油墨或染料。另外地或供选择地，信息可以通过将IDB托盘300与形成IDB托盘300的外表面的另外的外部托盘模制而传递到间接粘结托盘的外表面。在一些实施方案中，信息可以直接传输到IDB托盘300上。例如，信息可以写在托盘上，或者包括信息的标记可以附在托盘IDB托盘上。在一些实施方案中，信息可以是非文本形式。例如，信息可以是颜色或基准标记。在一些实施方案中，信息可以包含在条形码、无源或有源RFID标签或可以定位在与上述标记类似的各种位置的其它元件内。
根据上述教导，各种其它修改、改编和替代设计当然是可能的。例如，在Khoshnevis等人的第2014/0120491A1号美国公开中公开的包括托槽的特征，其全部内容通过引用并入本文，可以使用或修改或与本文公开的实施方案一起使用。因此，此时应该理解，在所附权利要求的范围内，本发明可以不同于本文具体描述的方式实施。预期可以进行上面公开的实施方案的特定特征和方面的各种组合或子组合，并且仍然落入本发明中的一个或多个中。此外，本文中与实施方案相关的任何特定特征、方面、方法、性质、特性、质量、属性、元件等的公开内容可以用于本文阐述的所有其它实施方案中。因此，应该理解的是，所公开的实施方案的各种特征和方面可以彼此组合或替换，以便形成所公开的发明的各种模式。因此，意图是本文公开的本发明的范围不应受上述具体公开的实施方案的限制。此外，尽管本发明易于进行各种修改和替换形式，但是其具体示例已在附图中示出并在本文中详细描述。然而，应该理解，本发明不限于所公开的特定形式或方法，相反，本发明将覆盖落入所描述的各种实施方案和所附权利要求的精神和范围内的所有修改、等同物和替代物。本文公开的任何方法不需要按照所述顺序进行。本文公开的方法包括从业者采取的某些动作；但是，它们也可以明确地或暗示地包括这些行为的任何第三方指示。例如，诸如“转移正畸托槽”的动作包括“指示正畸托槽的转移”。本文公开的范围还包括任何和所有重叠、子范围及其组合。诸如“至多”、“至少”、“大于”、“小于”、“之间”等语言包括所述的数字。在此之前使用诸如“近似”、“大约”和“基本上”之类的术语的数字包括所引用的数字(例如，大约10％＝10％)，并且还表示接近所述量的量，该量仍然执行期望的功能或实现期望的结果。例如，术语“近似”、“大约”和“基本上”可以指小于10％、小于5％、小于1％、小于0.1％和小于0.01％所述量的量。

Claims (21)

1.一种用于制造用于放置正畸托槽的间接粘结托盘的方法，其包括：
提供患者牙齿的物理模型，所述模型包括附接到物理模型的牙齿的至少一个非功能性占位器正畸托槽；
在所述物理模型的所述牙齿和所述至少一个占位器托槽上施加可模塑材料，从而形成间接粘结托盘，所述间接粘结托盘包括至少一个与所述至少一个非功能性占位器托槽对应的孔；和
将功能性正畸托槽固定在间接粘结托盘的每个孔内，所述功能性正畸托槽包括与非功能性占位器正畸托槽相同的外部几何形状。
2.前述权利要求中任一项所述的方法，其还包括固化可模塑材料。
3.前述权利要求中任一项所述的方法，其中，所述可模塑材料包含聚乙烯基硅氧烷。
4.前述权利要求中任一项所述的方法，其中，所述模型是咬合不正模型。
5.前述权利要求中任一项所述的方法，其中，所述间接粘结托盘包括与多个非功能性占位器托槽对应的多个孔。
6.前述权利要求中任一项所述的方法，其中，所述非功能性占位器托槽包含与所述物理模型的材料相同的材料。
7.前述权利要求中任一项所述的方法，其中，所述物理模型由患者牙齿的数字模型制造，所述方法还包括：
将数字托槽定位在患者牙齿的数字模型上；和
修改数字托槽的几何形状，同时保留数字托槽外表面的整体轮廓。
8.权利要求7所述的方法，其中，修改所述数字托槽的几何形状包括减少或移除内部底切。
9.权利要求7或8所述的方法，其中，修改所述数字托槽的几何形状包括移除所述托槽的内部细节。
10.前述权利要求中任一项所述的方法，其中，所述物理模型由患者牙齿的数字模型制造，所述方法还包括：
将牙齿从咬合不正的位置数字化地移动到理想咬合的位置；
在咬合不正的位置时将数字托槽定位在牙齿表面上；和
在保持数字托槽在牙齿表面上的定位的同时将牙齿恢复到咬合不正的位置。
11.前述权利要求中任一项所述的方法，其还包括在所述可模塑材料周围施加柔性膜并将所述可模塑材料成形为牙弓的形状。
12.前述权利要求中任一项所述的方法，其中，所述物理模型包括指示所述间接粘结托盘在所述患者牙齿上的适当定位和/或患者身份的指导信息，所述方法还包括将所述指导信息从物理模型转移到间接粘结托盘。
13.前述权利要求中任一项所述的方法，其还包括在可模塑材料可模塑时，将指示所述间接粘结托盘在所述患者牙齿上的适当定位和/或患者身份的指导信息从定位在所述可模塑材料周围的外部托盘传送到所述间接粘结托盘。
14.前述权利要求中任一项所述的方法，其中，提供所述物理模型包括根据数字模型3D打印所述物理模型。
15.前述权利要求中任一项所述的方法，其中，所述物理模型包括支撑结构，所述方法还包括在施加所述可模塑材料之前从所述物理模型移除所述支撑结构。
16.前述权利要求中任一项所述的方法，其中，所述物理模型包括在两个牙齿之间的至少一个穿孔，所述方法还包括沿着所述穿孔切割所述物理模型。
17.前述权利要求中任一项所述的方法，其中，提供物理模型包括制造物理模型，使得仅制造对应于所述患者牙弓的一部分的所述患者牙齿的子集，并且其中所述间接粘结托盘在尺寸上对应于患者牙弓的所述部分。
18.一种用于将正畸托槽放置在牙齿上的方法，其包括：
提供一种间接粘结托盘，其包括包含多个功能性正畸托槽的孔，其中所述孔由非功能性占位器正畸托槽的印模形成，所述托槽包括与所述功能性正畸托槽相同的外部几何形状；
将间接粘结托盘定位成与患者的牙齿接触；和
将功能性正畸托槽从间接粘结托盘转移到患者的牙齿。
19.一种用于制造用于放置正畸托槽的间接粘结托盘的***，其包括：
患者牙齿的物理模型，所述模型包括附接到物理模型的多个牙齿的多个非功能性占位器正畸托槽，所述非功能性占位器正畸托槽永久地附接到物理模型的各个牙齿。
20.权利要求19所述的***，其还包括形成为物理模型的负面印模的间接粘结托盘。
21.权利要求19或20所述的***，其还包括多个功能性正畸托槽，每个功能性正畸托槽在外部几何形状上对应于所述多个非功能性占位器正畸托槽中的一个。
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