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A system and method for repositioning teeth in a patient jaw includes an attachment bonded to a tooth. The attachment has at least one force receiving component for receiving a force. A polymeric shell repositioning appliance is positioned over at least some of the teeth in the patient jaw. The poly

A system and method for repositioning teeth in a patient jaw includes an attachment bonded to a tooth. The attachment has at least one force receiving component for receiving a force. A polymeric shell repositioning appliance is positioned over at least some of the teeth in the patient jaw. The polymeric shell has at least one force transmitting component for engaging the force receiving component to form a locus of engagement. The locus of engagement transmits the force and moves but is maintained as the tooth is repositioned. In specific embodiments the locus of engagement is maintained over a substantial range of motion. The force transmitted at the locus of engagement increases in response to the tooth lagging an intended position. A space between the positioned appliance and the tooth permits the tooth to move into an intended position.

대표청구항 ▼

1. A method of repositioning teeth, the method comprising:bonding an attachment having at least one force receiving component to a preselected position on at least one of the teeth; andproviding a polymeric shell repositioning appliance, wherein the polymeric shell has at least one force transmittin

1. A method of repositioning teeth, the method comprising:bonding an attachment having at least one force receiving component to a preselected position on at least one of the teeth; andproviding a polymeric shell repositioning appliance, wherein the polymeric shell has at least one force transmitting component for transmitting a force;wherein the polymeric shell repositioning appliance is placeable over the teeth so that the force transmitting component and the force receiving component engage each other at a contact point within a locus of engagement, wherein a position of the contact point adjusts within the locus of engagement as the tooth is repositioned. 2. The method of claim 1 wherein the locus of engagement extends over a pre-selected distance. 3. The method of claim 2 wherein the force receiving component and the force transmitting component are positioned so that the force transmitted to at least one tooth which lags its intended position is increased. 4. The method of claim 2 wherein the polymeric shell appliance placed over the teeth includes a cavity shaped so that a space between the appliance and the tooth permits the tooth to move into an intended position. 5. The method of claim 4 wherein the polymeric shell and attachment are shaped to permit the attachment to move relative to the appliance along a channel as the contact point position adjusts within the locus of engagement. 6. The method of claim 1 wherein a first pair comprises the force transmitting component and a second pair comprises force receiving component, each member of each pair being positioned on opposing sides of the tooth. 7. The method of claim 2 wherein the distance is at least about 0.5 mm. 8. The method of claim 7 wherein the distance is at least about 1 mm. 9. The method of claim 1 wherein the force transmitting component and force receiving component are arranged to rotate at least one of the teeth with the force. 10. The method of claim 1 wherein the force transmitting component and force receiving component are arranged to extrude at least one of the teeth with the force. 11. The method of claim 1 wherein the force transmitting component and force receiving component are arranged to intrude at least one of the teeth with the force. 12. The method of claim 1 wherein the force transmitting component and the force receiving component comprise a cam and a follower. 13. The method of claim 3 wherein the position of the contact point adjusts within the locus of engagement as the force transmitted to the at least one tooth which lags its intended position is increased to establish an equilibrium. 14. The method of claim 3 wherein the force transmitting and force receiving components are arranged to counter a force from a first surface with a force from a second surface. 15. The method of claim 14 wherein the force from the first surface is an intrusive force and the force from the second surface is an extrusive force. 16. The method of claim 14 wherein the force from the first surface is an extrusive force and the force from the second surface is an intrusive force. 17. The method of claim 14 wherein a single attachment device comprises the first surface and the second surface. 18. The method of claim 14 wherein a first attachment device comprises the first surface and a second attachment device comprises the second surface. 19. The method of claim 5 wherein the force transmitting component and the force receiving component comprise a pawl and a ratchet. 20. The method of claim 19 wherein the force transmitting component comprises the ratchet and the force receiving component comprises the pawl. 21. The method of claim 19 wherein the force transmitting component comprises the pawl and the force receiving component comprises the ratchet. 22. The method of claim 5 wherein the force receiving component and the force transmitting component comprise meshing teeth. 23. A system for repositioning teeth in a patient jaw, the system comprising:an att achment for bonding to a tooth at a pre-selected position, said attachment having at least one force receiving component for receiving a force; anda polymeric shell repositioning appliance placeable over at least some of the teeth in the patient jaw, the polymeric shell having at least one force transmitting component positioned to engage the force receiving component of the attachment when the attachment at the pre-selected position and the force receiving component engage each other at contact point, wherein a position of the contact point adjusts within the locus of engagement as the tooth is repositioned. 24. The system of claim 23 wherein the locus of engagement extends over a preselected distance. 25. The system of claim 24 wherein the force receiving component and the force transmitting component are positioned so that the force transmitted to at least one tooth which lags its intended position is increased. 26. The system of claim 24 wherein the polymeric shell appliance placed over the teeth includes a cavity shaped so that a space between the appliance and the tooth permits the tooth to move into an intended position. 27. The system of claim 26 wherein the polymeric shell and attachment are shaped to permit the attachment to move relative to the appliance along a channel as the position of the contact point adjusts within the locus of engagement. 28. The system of claim 23 further comprising a pair comprising the force transmitting component and a pair comprising the force receiving component, each member of each pair being on opposing sides of the tooth. 29. The system of claim 24 wherein the range of motion is at least about 0.5 mm. 30. The system of claim 29 wherein the range of motion is at least about 1 mm. 31. The system of claim 23 wherein the force transmitting component and the force receiving component are arranged to rotate at least one of the teeth with the force. 32. The system of claim 23 wherein the force transmitting component and the force receiving component are arranged to intrude at least one of the teeth with the force. 33. The system of claim 23 wherein the force transmitting component and the force receiving component are arranged to extrude at least one of the teeth with the force. 34. The system of claim 25 wherein the position of the contact point adjusts within the locus of engagement to establish an equilibrium as the force transmitted to the at least one tooth which lags its intended position is increased. 35. The system of claim 25 wherein the force transmitting and force receiving components are arranged to counter a force from a first surface with a force from a second surface. 36. The system of claim 35 wherein the force from the first surface is an intrusive force and the force from the second surface is an extrusive force. 37. The system of claim 35 wherein the force from the first surface is an extrusive force and the force from the second surface is an intrusive force. 38. The system of claim 35 wherein a single attachment device comprises the first surface and the second surface. 39. The system of claim 35 wherein a first attachment device comprises the first surface and a second attachment device comprises the second surface. 40. The system of claim 27 wherein the force transmitting component and the force receiving component comprise a pawl and a ratchet. 41. The system of claim 40 wherein the force transmitting component comprises the ratchet and the force receiving component comprises the pawl. 42. The system of claim 40 wherein the force transmitting component comprises the pawl and the force receiving component comprises the ratchet. 43. The system of claim 27 wherein the force receiving component and the force transmitting component comprise meshing teeth. 44. A method for designing a polymeric shell tooth repositioning appliance, the method comprising:locating an attachment on at least one tooth among several teeth of a model to define at least one force receiving compone nt for receiving a transmitted force; andpositioning an attachment receptacle to define at least one force transmitting component in a polymeric shell placeable over the teeth;wherein the force transmitting and force receiving components are shaped to engage each other at a contact point within a locus of engagement, a position of the contact adjusting within the locus of engagement as the tooth is repositioned. 45. The method of claim 44 wherein the locus of engagement extends over a preselected distance. 46. The method of claim 44 wherein the force receiving component and the force transmitting component are positioned so that the force transmitted to at least one tooth which lags its intended position is increased. 47. The method of claim 45 wherein the polymeric shell appliance placed over the teeth includes a cavity shaped so that a space between the appliance and the tooth permits the tooth to move into an intended position. 48. The method of claim 47 wherein the polymeric shell and attachment are shaped to permit the attachment to move relative to the appliance along a channel as the position of the contact point adjusts within the locus of engagement. 49. The method of claim 44 further comprising placing a prominence at the locus of engagement for increasing the transmitted force. 50. The method of claim 44 wherein the model is a computer model and the attachment is a virtual attachment. 51. The method of claim 50 further comprising modifying the virtual attachment to form a modified virtual attachment, the modified virtual attachment for forming the attachment receptacle in the polymeric shell. 52. The method of claim 51 wherein the modifying of the virtual attachment includes modifying a position of the virtual attachment. 53. The method of claim 51 wherein the modified virtual attachment is similar to a shape of at least a portion of the virtual attachment. 54. The method of claim 53 further comprising truncating a portion of the virtual attachment. 55. The method of claim 51 wherein the modifying of the virtual attachment increases the force transmitted by the polymeric shell. 56. The method of claim 51 further comprising enhancing a surface detail during the modifying of the virtual attachment to form a modified virtual attachment with enhanced surface detail.