Methods and systems for concurrent tooth repositioning and substance delivery

Abstract

The present invention provides devices, systems and methods for orthodontic treatment using elastic repositioning appliances while concurrently providing dental and periodontal therapies. Such therapies are traditionally provided with the use of a variety of accessories and devices which are applied when the repositioning appliance is removed from the patient's mouth. The present invention eliminates the need for such removal and additional devices by incorporating these therapies into the repositioning appliance.

What is claimed is:  
     
         1 . An oral appliance comprising: 
 a polymeric shell having cavities shaped to fit a mold of digitally arranged teeth; and    means for releasing an agent to the oral environment when the appliance is in place over the patient's teeth, said releasing means comprising a reservoir formed in the shell in addition to the cavity which receives the teeth.    
     
     
         2 . An appliance as in  claim 1 , wherein the agent comprises a material selected from the group consisting of fluoride, an antibiotic, a bleaching material, a flavor and a scent.  
     
     
         3 . An appliance as in  claim 2 , wherein the agent comprises at least two materials selected from the group.  
     
     
         4 . An appliance as in  claim 1 , wherein said releasing means further comprises a rate controlling membrane which controls the rate at which the agent is released from the reservoir.  
     
     
         5 . An appliance as in  claim 4 , wherein the reservoir is sealed by the rate controlling membrane.  
     
     
         6 . An appliance as in  claim 4 , wherein the reservoir is accessible for replenishing with agent.  
     
     
         7 . An oral appliance comprising: 
 a polymeric shell having cavities shaped to be removably placeable over teeth; and    a material on or within the shell that changes a visual characteristic of the shell in response to a change in temperature.    
     
     
         8 . An oral appliance as in  claim 7 , wherein the visual characteristic is a color.  
     
     
         9 . An oral appliance as in  claim 7 , wherein the material is a dye which changes color in response to the change in temperature.  
     
     
         10 . An agent delivery device for use in combination with a dental appliance which fits over the teeth, said device comprising: 
 a sheet of material including the agent adapted for fitting against a surface of the dental appliance, wherein the material comprises a non-porous rate controlling polymer matrix which controls the rate at which the agent diffuses through the polymer matrix and is released.    
     
     
         11 . An agent delivery device as in  claim 10 , wherein the agent comprises a material selected from the group consisting of fluoride, an antibiotic, a bleaching material, a flavor and a scent.  
     
     
         12 . An agent delivery device as in  claim 10 , further comprising an adhesive layer, wherein the adhesive layer bonds the sheet to the appliance.  
     
     
         13 . An agent delivery device for use in combination with a dental appliance which fits over the teeth, said device comprising: 
 a sheet of material including the agent adapted for fitting against a surface of the dental appliance, wherein the material comprises a rate controlling polymer matrix which degrades to release the agent.    
     
     
         14 . An agent delivery device as in  claim 13 , wherein the agent comprises a material selected from the group consisting of fluoride, an antibiotic, a bleaching material, a flavor and a scent.  
     
     
         15 . An agent delivery device as in  claim 13 , further comprising an adhesive layer, wherein the adhesive layer bonds the sheet to the appliance.  
     
     
         16 . A system for repositioning teeth and releasing an agent to an oral environment, said system comprising: 
 at least three tooth positioning appliances, wherein said appliances comprise polymeric shells having cavities, which are removably placeable over the teeth and wherein the cavities of successive shells are shaped to reposition teeth from one arrangement to a successive arrangement;    means coupled to at least some of the appliances for releasing the agent to the oral environment when the appliance is in place over the teeth, wherein said releasing means comprises a reservoir formed in the shell in addition to the cavity which receives the teeth and a rate controlling membrane disposed over the reservoir wherein the rate controlling membrane controls the rate at which the agent is released from the reservoir.    
     
     
         17 . A system as in  claim 16 , wherein the reservoir is pre-filled with the agent to be released.  
     
     
         18 . A system as in  claim 16 , wherein the reservoir is replenishable with the agent to be released.  
     
     
         19 . A system as in  claim 16 , wherein the agent comprises the agent microencapsulated in a polymer material.  
     
     
         20 . A system as in  claim 16 , wherein the agent is released by diffusion through the membrane.  
     
     
         21 . A system as in  claim 16 , wherein the agent is released by degradation of the membrane.  
     
     
         22 . A system as in  claim 16 , wherein the rate controlling membrane is porous and the agent is released by elution through the pores.  
     
     
         23 . A system as in  claim 16 , wherein the agent comprises a material selected from the group consisting of fluoride, an antibiotic, a bleaching material, a flavor and a scent.  
     
     
         24 . A system as in  claim 23 , wherein the agent comprises at least two materials selected from the group.  
     
     
         25 . A system as in  claim 23 , wherein the material is a fluoride selected from the group consisting of acidulated phosphate fluoride gel, neutral sodium fluoride, hydrogen fluoride and stannous fluoride.  
     
     
         26 . A system as in  claim 23 , wherein the material is an antibiotic selected from the group consisting of tetracycline and chlorhexidine.  
     
     
         27 . A system as in  claim 23 , wherein the material is carbamide peroxide.  
     
     
         28 . A system as in  claim 23 , wherein the material is a flavor or scent selected from the group consisting of essential oils, natural flavorings and artificial flavorings.