US1938576A - Dental coupling - Google Patents

Description

J. B. BOUTET DENTAL COUPLI NG Dec. 12, 1933.

Filed April 25, 1932 Job 71133011162 IN VENTOR A TTORNE Y5 Patented Dec. 12, 1933 UNITED STATES PATENT OFFICE 4 Claims.

The present invention relates to a removable denture or removable bridge and has for an obiect the provision of a device of this kind which is adapted to be suspended between and an- 5 chored to the natural teeth on opposite sides of the void or space occasioned by the loss of one or more intervening teeth, in such a way as to be readily removed and replaced by the fingers of the wearer but without danger of becoming separated or disengaged during the act of mastication.

Another object is to provide a means and method of removably mounting an artificial bridge consisting of one or more teeth at practically any location in the mouth in such a way as to be absolutely secure for the intended pur pose and without having any of the mounting and supporting means visible from the outer or buccal side.

Another object is to provide a method of making and. mounting artificial dentures so that a minimum of work is performed in the mouth of the patient, whereby much time is saved for the patient, and a great deal of time is saved and tedious effort avoided on the part of the dental prosthetist, and to furthermore provide a coupling means which may be standard for all types of bridge work regardless of the particular tooth or teeth to which they are intended to be attached.

Another object is to provide an artificial bridge wherein the supporting means are seated in and are disposed centrally of the occlusal surfaces for taking the biting strain and wherein the attaching means or couplings for said bridge are disposed in the lingual inter-proximal spaces between the bridge or pontic and inlays which are mounted in the existing natural teeth adjacent thereto; the combination thus eifected giving all of the desired strength to resist biting stress and at the same time avoiding displacement but permitting a movement simulating the rocking of a natural tooth in its socket under the same conditions, and in this way providing an accommodation of the artificial bridge to the movement or" the existing natural teeth and avoiding the rapid breaking down of the natural teeth which has heretofore been an attendant circumstance with the use or" removable bridges.

Another object is to provide a coupling means for the removable attachment of dental bridges or pontics which is capable of being standard in construction and which is furthermore adapted for reversal of the coupling members at the time of constructing the particular bridge or pontic.

Another and further object of the invention is to provide coupling members of the class referred to with a means whereby the alignment of the couplings in all planes'is accomplished simply, accurately, and quickly.

These and other objects are attained by the means described herein and disclosed in the accompanying drawing, in which:

Fig. 1 is a fragmental elevational view of the natural teeth adjacent a space occasioned by the loss of a tooth and showing in position substantially all of the dental or inlay work which must be performed within the patients mouth.

Fig. 2 is a view taken on line 2--2 of Fig. 1 showing the inlays in the natural teeth and the sockets in the inlays for receiving the stress bearing portions of the removable replacement or pontic.

Fig. 3 is a view showing the natural teeth with the inlays in position and a mass ofimpression material in place.

Fig. 4 is a cross sectional view of a model made from the impression shown in Fig. 3 and having the inlays set therein.

Fig. 5 is a cross sectional view of an impres- 180 sion made from the model shown in Fig. 4.

Fig. 6 is an enlarged cross sectional view showing a fragment of the model made from the impression in Fig. 5 and having the wax form in position preparatory to casting the basket or supporting means for the artificial porcelain tooth.

Fig. 7 is a view taken on the lingual or tongue side of the natural mouth with the completed replacement in position and showing the couplings of the invention.

Fig. 8 is an enlarged top plan view showing the method of mounting the couplings and aligning them with the teeth prior to soldering the coupling members to the basket member and the inlays respectively.

Fig. 9 is a view taken on line 99 of Fig. '7.

Fig. 10 is a perspective view of a pair of coupling members in separated condition.

Fig. 11 is an enlarged fragmental cross sectional view showing the coupling members in engaged relation.

Fig. 12 is a view similar to Fig. 11 showing a modified form of the coupling.

Heretofore there were two disadvantages in the making and in the use of removable dental bridge work. In making them much tedious work in the patients mouth and in the laboratory was required to align the replacement tooth or denture; and the supporting teeth usually required excessive cutting away so that painful nerve irritation of the tooth was involved in order to seat the inlays in the supporting teeth. Other difficulties and disadvantages were that these heretofore used removable bridges were not well adapted functionally for use in the upper or lower dental arch.

The present device is usable in the front of either arch because it is free of encircling hooks or bands.

The method and means of the present invention provide for the replacement of missing teeth at any place in either dental arch with complete invisibility, with security against displacement during use and are nevertheless readily removable by means of the fingers of the wearer. Furthermore the replacements thus effected are comfortable to the wearer and have none of the derogatory effects on the supporting teeth which are common to other types of removable dental bridges.

The method and means of the present invention will be described concurrently with reference to the drawing as the description proceeds. As shown in Fig. l the pair of support teeth 12 and 13 be any two teeth in the upper or lower dental arch having a void 14 between them occasioned by the removal or loss of a tooth. The support teeth 12 and 13 are ground to form a shallow shoulder for a distance well over the occlusal surfaces and, to a greater depth along their adjacent faces and inlays 15 and 16 are made and temporarily inserted in the natural support teeth 12 and 13. It is to be noted that these inlays 15 and 16 are so made as to allow the lingual aspect of each inlay to cover about one-third of its proximo-distal-dimension and then continues about the proximal surfaces into the occlusal surfaces to insure proper dove-tail anchorage. The proximo-lingual surfaces 1'7 and 18 of the inlays 15 and 16 do not follow or fill out completely the belly or contour of the natural tooth surface but preferably slope away to provide a more acute angle at the proximc-lingual angle of the tooth. This can be best appreciated in Fig. 8 wherein the coupling means of the in vention are shown in position preparatory to permanently securing them to the inlays and the tooth. A generally rectangular concavity 19 and a similar concavity 20 are formed in the inlays 1'7 and 18 mid-way between the tongue side and cheek side of the teeth and are open on the occlusal surfaces and at the proximal sides.

These inlays l5 and 16 are temporarily inserted in their proper places in the support teeth 12 and 13; and while in this position, a bite of wax is taken in order to enable the dentist to later properly carve the occlusal surfaces of the finished replacement.

With the inlays temporarily in position, as aforesaid, an impression is taken of a quick-setting plastic substance which does not expand nor contract upon setting but which may disintegrate in boiling water. This step is shown in Fig. 3 with the quick-setting plastic impression material 21 in place. Into this impression 21 the inlays are placed in their proper positions after which a model of refractory material which is not subject to thermal changes is made from the impression 21. This model 22 with the inlays l5 and 16 therein is now an accurate replica of the corresponding part of the patients mouth and constitutes the model upon which all the work of making the bridge will be done. For convenience, this may be referred. to as model No. 1.

The model, it will be appreciated, is of refractory material. This model is now saturated with water and the external surface thereof is covered with a light oil to permit a second impression to be made of the model. This second impression is of a substance well known to the dental art and is of such nature that it is plastic and soft when hot but, when cooled, becomes relatively hard and elastic so that it will resume the shape to which it was molded while hot. This may be referred to as an elastic i1 .pression and is used to make a second model, No. 2, of the same material as the first model or model No. l. The second model is to be used for making the suspensory member or basket for the bridge. Ihis model is cut away slightly at the sides corresponding to the inlays so that a slightly oversize suspending member may be made with the result that the dentist may ultimately have material to grind away slightly to insure contact between the replacement and the supporting teeth which is identical with the contact which obtained when all of the natural teeth were present. The impression of the elastic material is shown at 23 (see Fig. 5). terial made therefrom is shown in enlarged cross section at 24 (see Fig. 6). Fig. 6 is a cross section of the model No. 2 into which the cast gold for the suspending member or basket is poured.

In making the removable tooth or bridge, inlay wax is placed in the space in model No. 2 of the refractory mater al 24 and the porcelain or other replacement tooth or teeth fitted into position and waxed in place. Two lugs of wax conforming to the concavities l9 and 2D in the inlays are made at the distal ends of this wax pattern. The wax pattern is then adapted to suit the artificial tooth. The disal ends of the wax pattern are shaped so as to allow a large V-shaped space to exist between the said ends and the proximal surfaces of the abutment teeth, diverging toward the lingual or tongue side of the pontic and abutment teeth with the vertex of the V extending toward the cheek side or buccal and thus providing a wide inter-proximal space on the lingualof the abutting teeth and the distal of the replacement or pontic.

The porcelain tooth or teeth are then removed from the wax pattern and the gold casting is The impression in refractory mamade by the usual method, namely the building up of thin wax rods or sprews 25 filling up the space between and above with refractory clay 26 and melting and carbonizing the wax by high heat whereby a space is caused wherein the encased wax pattern formerly existed in the mold. after which the gold is forced. into the hollow mold thus effected.

A central peg or rod is cast integrally with the resulting gold casting 28, said rod or pin 29 corresponding with the central wax portion 27 shown in Fig. 6. This cast gold member then receives the usual grinding and polishing and is fitted in its proper position between the abutment teeth 120 and of model No. l which correspond with the natural abutment teeth 12 and 13. The waxconstitute occlusal rests which permit the pontic or basket member to suspend itself from the abutment teeth and they are countersunk into the inlays to hold them against lateral mobility and play. This basket member is temporarily fastened to model No. 1 with wax.

The device, as shown in Fig. 8, should now be considered. To provide for the removable attachment of the basket with the inlay of the abutment teeth, a pin and socket coupling member is provided. One form of this member is shown with the elements separated in Fig. 10. It consists of a female member indicated generally as 32 and a male member indicated generally as 33. The female member has at its one end the longitudinally slitted tube 34, the opposite ends of which have a tapered counterbore 35. The main body 36 of female member 32 extends radially from the tube portion 34 for a distance and is then turned upon itself so that the aligning lug 37 extends at right angles to the main body. A corresponding main body on the male member likewise has an aligning lug 3'7 disposed in the same relation. At the coupling end of this body is a pin 38 having a knobular head 39. 'The split tube 34 of the female member is somewhat resilient so that when the end 39 of the male member is forced against the countersunk bore, it will spread the tube and pass into it whereupon the counterbored opposite ends 35 of the tube will seat on the correspondingly tapered top and bottom portions 40 of the male coupling and the two members will center themselves longitudinally due to the contractile tendency of the split tubular female coupling member. These members are amply secure in their normal couple connection but may be readily separated by digital force. It is to be understood that these coupling members may be varied to some extent in construction so long as one of the members has suitably resilient characteristics. Also, as shown in Fig. 12, the female body 36 may have a truncated conical slotted tube member 41 and the male body 36 a corresponding truncated conical pin 42, these members being internally and externally taper shouldered at their ends, as shown as a matter of preference. The body members are of course provided with the aligning lugs 37 similar to those shown in Fig. 19. This taper pin and socket form of coupling is preferable in that the socket and pin are not only longitudinally self-centering but a pair of said couplings mounted, for example, as shown in Fig. 8, will mutually cooperate even though a degree of error exists in the work of attaching the parts of the bridge and inlays. Furthermore, it will be possible for the skilled worker to align members of this type accurately by sighting along the alignment lugs, since, in coupling the slotted tube does not have to spread its entire length during the passage of the knobular male head. The coupling members are applied one pair in each of the interproximal spaces on the lingual side of the dental arch. As aforementioned, it is clearly shown in Fig. 8. In the embodiment shown the body 36 of the male coupling member would be secured to the inlays and relatively close to the bottom thereof. In this case the female coupling member would be secured to the basket or pontic member and relatively closer to the occlusal surface of the replacement tooth. These couplings, however, are capable of inversion relative to the method of attachment just named. In Figs. '7 and 8, both upstanding and depending male members are shown in order that the drawing may be fully illustrative. Common practice would normally indicate to have either both male members or both female members attached to the inlays and the remaining members to the pontic or vice versa. It is a highly desirable feature to have the coupling members capable of this inversion since the shape and size of various teeth and their locations may make such installations desirable. I

The mode of aligning and arranging the basket or pontic member 28 so that the replacement porcelain or other replacement 43 may be properly positioned without difficulty is as follows. Referring to Fig. 8, it will be seen that the gold inlays l5 and 16 are in position and that the basket or suspending member 28 is in position between them with the support lugs 30 and 31 seating in the inlays or cavities l9 and 20, respectively. The female member 32 would then have the body portion thereof placed against one of the arms 44 of the basket member and lightly held in place with a bit of wax. The male member 33 would likewise then be lightly held in place with a bit of wax on the face of inlay 15. In the same manner a second coupling member would be held in place on the basket and the inlay 16. In order that these couplings may be properly aligned, either the uppermost wings or ends 37 of the two couplings or, if desired, the lowermost of said wings are stuck tightly but temporarily with wax onto a straight edge such as a small steel rule 45 (with the couplings in assembled condition) thus automatically aligning the pair of couplings in all planes. When the parts are in the position shown in Fig. 8 (i. e. when the body members are in contact with the basket and respective inlays, and all lightly but temporarily held in place with wax), a suitable investment material is painted over the pin and tube connection to exclude the flux of solder thereinto; and the body portions 36 are then soldered to the respective parts with suitable gold solder. The inlays, basket member, and supporting lug, all having been held in exact aligned position by investment material and the straight edge removed, the soldering is quickly and positively done, after which the wings 37 are cut off and the basket member with its coupling members attached is removed and the inlays are also removed from the model. All parts are then ground and polished and the porcelain or other replacement tooth is cemented into the gold casting including the center rod 29, whereupon the parts are polished and ground to afford proper contact between the inlays and replacement. The inlays are then permanently mounted in the natural teeth whereupon the replacement or bridge is ready to be inserted for use by the wearer. In inserting the bridge or replacement, the wearer merely positions it in the space between the abutment teeth andpresses it into its functional position whereupon the resilient female or male member (as the case may be) yields sufficiently to allow the coupling members to engage. The replacement now has all the attributes of a natural tooth insofar as likelihood of accidental separation during mastication and as to comfort. The coupling portions, it will be noted, especially in Fig. 7, are set well into the interproxirnal spaces on the lingual side of the arch so that there is no strange or uncomfortable feeling to the tongue. After eating and such other times as it is found desirable to cleanse the replacement, the wearer of the teeth need merely take a firm grip on the replacement and pull it free of the coupling members which are r It should be teeth are exposed while all of the coupling members or portions are sealed on the inside of the arch so that only close inspection of the open mouth will reveal them.

As to the coupling means, it is especially to be noted that the aligning wings 37 extend initially well beyond the lingual alignment of the teeth for the purpose of facilitating the positioning of the parts for the purpose of waxing them into position preparatory to the soldering operation.

As alternative laboratory technique, model No. 1 may be a metal die and the wax pattern may be fashioned on this model, then removed and a gold or other casting made therefrom. Then the casting or suspending member may be mounted in position on the metal die and a model made therefrom. The inlays and suspending casting would then be mounted on the refractory model and the soldering operation completed as in the previously described method.

What is claimed is:

1. In a dental coupling the combination of a flat strip member, a headed pin extending lateral- 1y of one end of said strip member, a portion of the opposite end of said strip being twisted through ninety degrees on the longitudinal axis of said strip, a second strip member twisted at one end like the first member, and a hollow socket on the opposite end of the second member and seating between the first member and the head of the pin on said first member.

2. In a device for detachably coupling dental bridge Work to abutment teeth, the combination of a pair of flat body members for fixation to a bridge and a 'tooth respectively, a headed pin extending vertically of one of said members, and a slotted resilient socket on the other of said members for detachably receiving said pin, said pin and said socket being complementarily tapered at opposite ends whereby the pin and socket automatically center themselves longitudinally the one in the other.

3. As a new article of manufacture a separable anchoring coupling comprising a pair of body members for attachment to a removable bridge anda supporting tooth respectively, a tapered pin extending laterally of an end of one body member, a tapered socket member on the other body member adapted to slidably receive the pin to effect a hinged coupling of the body members, and extended transverse alignment lugs on both said body members for paralleling a plurality of said anchorage couplings.

e. In a dental coupling the combination of a pair of separable body members each provided at oneend with an extended transverse aligning lug, one body having a tapered pin at the free end perpendicular to its aligning lug, the other body having a longitudinally slotted truncated conical sleeve perpendicular to its aligning lug, the sleeve having a tapered counter bore at each end, and tapered base and head portions on the pin cooperating with the counter-bored portions of the sleeve serving to preclude accidental longitudinal relative shifting of the sleeve and pin.

JOHN B. BOUTET.

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