# US 2014/0193766 A1 · Methods and systems for treating teeth > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0193766 A1 - Document ID: US20140193766A1 - Status: Published application - Kind: A1 - Application number: 14/155,236 - Filed: 2014-01-14 - Published: 2014-07-10 - Earliest claimed: 2000-12-29 - Assignees: Align Technology, Inc. - Applicants: Align Technology, Inc. - Inventors: Ross MILLER - Web page: https://patentgrep.com/patent/US20140193766A1 ## CPC - A61C 7/002: {Orthodontic computer assisted systems} - A61C 7/00: Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions - A61C 7/08: Mouthpiece-type retainers {or positioners, e.g. for both the lower and upper arch (arch-shaped medicament applicators for teeth or gums A61C19/063; mouthguards for protecting the teeth of sportsmen A63B71/085)} - A61C 7/12: Brackets; Arch wires; Combinations thereof; Accessories therefor - A61C 7/146: {Positioning or placement of brackets; Tools therefor} - A61C 7/20: Arch wires (A61C7/28 takes precedence) - G16H 10/60: for patient-specific data, e.g. for electronic patient records - B33Y 50/00: Data acquisition or data processing for additive manufacturing - B33Y 80/00: Products made by additive manufacturing - A61C: DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE (non-driven toothbrushes A46B; {tongue scrapers A61B17/24;} preparations for dentistry A61K6/00; preparations for cleaning the teeth or mouth A61K8/00, A61Q11/00) - G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA - B33Y: ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING ## Abstract A system for repositioning teeth comprises a plurality of individual appliances used with braces. The appliances are configured to be placed successively on the patient's teeth and to incrementally reposition the teeth from an initial tooth arrangement, through a plurality of intermediate tooth arrangements, and to a final tooth arrangement. The appliances may be substituted with braces as appropriate to optimize the treatment of the teeth. ## Claims ### Claim 1 A system for determining a treatment plan for repositioning teeth from a first arrangement to a target arrangement, the system comprising: a processor; a display device coupled to the processor; and a data storage device coupled to the processor, the data storage device storing instructions executable by the processor to cause the system to: receive a digital data set comprising a digital model of the patient's teeth in a first arrangement for determining a severity of a malocclusion of a patient; generate, based on the determined severity of the patient's malocclusion, a first treatment plan having data comprising a plurality of intermediate digital data sets each corresponding to a different successive tooth arrangement for repositioning the patient's teeth from the first arrangement toward a target arrangement, the treatment plan prescribing a first phase and a second phase in a pre-selected order, the first phase comprising successively placing polymeric shell appliances having tooth receiving cavities having different geometries selected to progressively reposition the teeth, the second phase comprising placing a wire and bracket system to progressively reposition the teeth; receive evaluation data indicating whether repositioning of the teeth is progressing in a satisfactory fashion after the patient has been administered at least some of the polymeric shell appliances; and generate a second treatment plan data in response to the evaluation data, the second treatment plan comprising a prescribed schedule for transitioning between administering to the patient polymeric shell appliances as in the first phase of the first treatment plan and placing a wire and bracket system to progressively reposition the teeth as in the second phase of the first treatment plan. ### Claim 2 (depends on 1) The system of claim 1, wherein the second treatment plan prescribes a third phase that comprises providing a plurality of successively worn polymeric shell repositioning appliances after placing of a wire and bracket system. ### Claim 3 (depends on 1) The system of claim 1, wherein the evaluation data comprises input from a treating professional. ### Claim 4 A system for formulating a treatment plan for treating a dental malocclusion so as to reposition a patient's teeth toward a desired arrangement, the system comprising: a processor; a display device coupled to the processor; and a data storage device coupled to the processor, the data storage device storing instructions executable by the processor to cause the system to: receive a 3-D digital model of a current arrangement of the patient's teeth; access digital data comprising criteria for determining the severity of a patient's malocclusion; identify a more severe malocclusion of the patient's teeth by comparing the current arrangement digital model and the criteria; and generate treatment plan data based on the received digital data and the identification of the more severe malocclusion of the patient's teeth, the treatment plan comprising prescription of a pre-selected order of in seriatim use of both a wire and bracket system and a plurality of successive polymeric shell appliances having tooth receiving cavities, at least two of the appliance having cavities with different geometries selected to progressively reposition teeth toward a desired or prescribed arrangement; wherein the treatment plan data is generated prior to use of the wire and bracket system or plurality of polymeric shell appliances by the patient. ### Claim 5 (depends on 4) The system of claim 4, wherein the criteria indicating a more severe malocclusion comprises at least one of: A-P correction of greater than 2 mm; autorotation of the mandible required for vertical/A-P correction; CR-CO discrepancy correction/treatment to other than centric occlusion; correction of moderate to severe rotations of premolars and/or canines that are greater than 20 degrees; severe deep bite opened to ideal or open bite to be closed to ideal; extrusion of teeth greater than 1 mm other than as part of torquing or in conjunction with intruding adjacent teeth; teeth tipped by more than 45 degrees; multiple missing teeth; crowns less than 70% of normal size; posterior open bite; and movement of entire arch required for A-P correction. ### Claim 6 (depends on 5) The system of claim 5, wherein the criteria indicating a more severe malocclusion comprises a plurality of: A-P correction of greater than 2 mm; autorotation of the mandible required for vertical/A-P correction; CR-CO discrepancy correction/treatment to other than centric occlusion; correction of moderate to severe rotations of premolars and/or canines that are greater than 20 degrees; severe deep bite opened to ideal or open bite to be closed to ideal; extrusion of teeth greater than 1 mm other than as part of torquing or in conjunction with intruding adjacent teeth; teeth tipped by more than 45 degrees; multiple missing teeth; crowns less than 70% of normal size; posterior open bite; and movement of entire arch required for A-P correction. ### Claim 7 (depends on 6) The system of claim 6, wherein the criteria indicating a more severe malocclusion comprises at least six of: A-P correction of greater than 2 mm; autorotation of the mandible required for vertical/A-P correction; CR-CO discrepancy correction/treatment to other than centric occlusion; correction of moderate to severe rotations of premolars and/or canines that are greater than 20 degrees; severe deep bite opened to ideal or open bite to be closed to ideal; extrusion of teeth greater than 1 mm other than as part of torquing or in conjunction with intruding adjacent teeth; teeth tipped by more than 45 degrees; multiple missing teeth; crowns less than 70% of normal size; posterior open bite; and movement of entire arch required for A-P correction. ### Claim 8 (depends on 4) The system of claim 4, wherein the treatment plan specifies the use of a wire and bracket system following use of a series of successive shell appliances. ### Claim 9 (depends on 4) The system of claim 4, wherein the data storage device stores instructions executable by the processor to cause the system to: receive a second indication of the severity of a patient's malocclusion after orthodontic treatment has begun; and generate a second treatment plan to use a plurality of successive polymeric shell appliances to resiliently reposition the teeth to a desired arrangement when the malocclusion is determined from the second indication to be less severe. ### Claim 10 (depends on 4) The system of claim 4, wherein the data storage device stores instructions executable by the processor to cause the system to generate a plurality of digital models representing different arrangements of the patient's teeth progressing from the current arrangement toward the desired arrangement. ### Claim 11 (depends on 4) The system of claim 4, the treatment plan further comprising a prescribed schedule for transitioning between administering to the patient polymeric shell appliances and administering a wire and bracket system. ### Claim 12 A system for formulating a treatment plan for treating a dental malocclusion so as to reposition a patient's teeth to a desired arrangement, the system comprising: a processor; a display device coupled to the processor; and a data storage device coupled to the processor, the data storage device storing instructions executable by the processor to cause the system to: receive a digital model of a patient's teeth; determine whether the patient's malocclusion is more severe or less severe by accessing digital data comprising pre-determined criteria indicating severity of a malocclusion and comparing the digital model of the patient's teeth and the criteria; and generate treatment plan data in response to a determination of a more severe malocclusion, the treatment plan comprising prescription of a pre-selected order of in seriatim use of both a wire and bracket system and a plurality of successive polymeric shell appliances having tooth receiving cavities, at least two of the appliance having cavities with different geometries selected to progressively reposition teeth; wherein the combined treatment is selected to reposition the teeth toward a desired or prescribed arrangement, and wherein the treatment plan is generated prior to the patient being treated with the wire and bracket system and plurality of successive polymeric shell appliances. ### Claim 13 (depends on 12) The system of claim 12, wherein the data storage device stores instructions executable by the processor to cause the system to formulate a treatment plan to use a plurality of successive polymeric shell appliances to resiliently reposition the teeth to a desired arrangement when the malocclusion is determined to be less severe, the appliances having geometries selected to progressively reposition the teeth. ### Claim 14 (depends on 12) The system of claim 12, wherein the determination of severity of the malocclusion is based at least in part on input from a treating professional. ### Claim 15 (depends on 12) The system of claim 12, wherein the criteria indicating severity of a malocclusion comprises at least one of: A-P correction of greater than 2 mm; autorotation of the mandible required for vertical/A-P correction; CR-CO discrepancy correction/treatment to other than centric occlusion; correction of moderate to severe rotations of premolars and/or canines that are greater than 20 degrees; severe deep bite opened to ideal or open bite to be closed to ideal; extrusion of teeth greater than 1 mm other than as part of torquing or in conjunction with intruding adjacent teeth; teeth tipped by more than 45 degrees; multiple missing teeth; crowns less than 70% of normal size; posterior open bite; and movement of entire arch required for A-P correction. ### Claim 16 (depends on 15) The system of claim 15, wherein the criteria indicating severity of a malocclusion comprises a plurality of: A-P correction of greater than 2 mm; autorotation of the mandible required for vertical/A-P correction; CR-CO discrepancy correction/treatment to other than centric occlusion; correction of moderate to severe rotations of premolars and/or canines that are greater than 20 degrees; severe deep bite opened to ideal or open bite to be closed to ideal; extrusion of teeth greater than 1 mm other than as part of torquing or in conjunction with intruding adjacent teeth; teeth tipped by more than 45 degrees; multiple missing teeth; crowns less than 70% of normal size; posterior open bite; and movement of entire arch required for A-P correction. ### Claim 17 (depends on 16) The system of claim 16, wherein the criteria indicating severity of a malocclusion comprises at least six of: A-P correction of greater than 2 mm; autorotation of the mandible required for vertical/A-P correction; CR-CO discrepancy correction/treatment to other than centric occlusion; correction of moderate to severe rotations of premolars and/or canines that are greater than 20 degrees; severe deep bite opened to ideal or open bite to be closed to ideal; extrusion of teeth greater than 1 mm other than as part of torquing or in conjunction with intruding adjacent teeth; teeth tipped by more than 45 degrees; multiple missing teeth; crowns less than 70% of normal size; posterior open bite; and movement of entire arch required for A-P correction.