Note: Descriptions are shown in the official language in which they were submitted.
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
A PROCESS FOR MAKING A DENTAL RESTORATION AND RESULTANT APPARATUS
DESCRIPTION
BACKGROUND OF THE INVENTION
[Para 1 ] The present invention relates to a process for making a dental
restoration and the resultant apparatus. More particularly, the present
invention
relates to a process for attaching a decal to a resultant dental appliance for
creating a dental restoration having desired color and characteristics similar
in
appearance to natural teeth and/or oral tissue.
[Para 2] Dental restorations, in general, are fabricated to replicate the
natural
anatomical appearance in the oral cavity. This fabrication process is highly
dependent on the artistic abilities of dental technicians. This dependence
creates
a difficulty among dental laboratory owners and dentists to produce consistent
quality for patients. The reason for this difficulty lies in the fact that
there are
relatively few dental technicians that have the artistic ability or experience
to
artistically perform dental restorations to a level necessary to achieve high
aesthetic results. This creates a high demand for experienced dental
technicians
and correspondingly drives up costs as there are few dental technicians with
the
requisite experience. Such high costs make it difficult for laboratories to
stay
competitive in a global market.
Page 1 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
[Para 3] A current dental restoration trend is to use veneers, which are a
thinner, more conservative tooth restoration. These restorations are applied
with
the dentist removing little or no natural tooth structure. The sacrifice for
this type
of restoration is that, while the natural tooth stays relatively intact, the
thin
structure of the veneer provides little to no room for the laboratories to
create the
natural aesthetics that are achieved using three dimensional color and
structures.
Many patients do not understand the anatomy of a tooth and do not understand
the importance of these structures in making smiles appear natural. Most
dentists
understand the importance of preserving the natural tooth for the purpose of
maintaining sound structure. For this reason, some dentists may choose to make
any necessary changes using minimally invasive dentistry. But, dentists are
forced
to use these thin veneers because of mass marketing to the public. Some
dentists
provide these restorations only to meet patient demand. The present invention
endeavors to allow dentists to continue offering these conservative
restorations
without sacrificing the natural appearance of the restored tooth.
[Para 4] Thus, there is a need in the art for a process for making a dental
restoration, and resultant apparatus, having desired color and characteristics
similar to the natural oral cavity of which is applicable to crowns, bridges,
ceramic
restorations, resin, denture teeth, veneers, pre-fabricated matrixes, pre-
cured
resins and composites, and any other kind of restorative dental appliance. The
present invention fulfills these needs and provides further related
advantages.
Page 2of32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
SUMMARY OF THE INVENTION
[Para 5] The present invention is directed to a process for making a dental
restoration and the resultant apparatus. The process for making the dental
restoration includes the step of forming an image which represents a natural
oral
cavity characteristic. The natural oral cavity characteristic preferably
comprises
internal and external structures and coloration of teeth and oral cavity
tissue,
comprising teeth, enamel, dentin, crazing lines, stains, veins, blood vessels,
bony
coloration, hyper-calcification, mucosal tissue or gum tissue. Preferably, the
step
of forming the image includes the step of creating the image on a computer. In
this regard, the image may be created digitally by hand by an artist or by
capturing
a digital photograph of an oral cavity. In one embodiment, the captured
photograph is of the oral cavity of the patient receiving the dental
restoration. In
an alternative embodiment, the oral cavity photograph is of another person and
is
modified with a computer-aided software program to obtain the desired natural
oral cavity characteristic. Furthermore, the process may include the step of
colorizing the image to match the desired natural oral cavity characteristic
of the
patient receiving the dental restoration. Moreover, the forming step may also
include the step of fabricating a stock set of standard images representative
of
select natural oral cavity characteristics a patient may receive. In this
regard, a set
of distributable pictures of the image may be created and matched to a decal
printed from the image.
[Para 6] The printed decal is then attached to the dental restoration base.
Accordingly, the decal and the dental restoration base are conditioned to
create a
Page 3 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
finished dental restoration having the desired oral cavity color and
characteristics.
In one embodiment, the conditioning step may include the step of curing the
decal
and the dental restoration base with a high intensity light. In an alternative
embodiment, the conditioning step includes the step of firing the decal and
the
dental restoration base in an oven. Moreover, the process for making a dental
restoration base may further include the step of placing a sealant over the
decal
and at least a portion of the dental restoration base. Preferably, the sealant
comprises a composite resin, a semi-transparent acrylic resin, a protective
layer, a
ceramic or a glaze. Thereafter, an additional secondary decal may be attached
over the sealant. A glaze may then be applied over the secondary decal for
protection thereof. Preferably, the dental restoration base comprises a
composite
resin, a veneer, an acrylic resin, a ceramic or a semi-transparent acrylic
resin.
[Para 7] The resultant dental restoration apparatus includes a dental
restoration base preferably made from a composite resin, a veneer, a ceramic
or an
acrylic resin. A decal attached to the dental restoration base has a select
natural
oral cavity characteristic and is preferably printed from a computer-based
image.
The computer-based image may comprise a photograph, a computer-generated
model image or a drawing. The natural oral cavity characteristic may be
painted to
the computer-based image on a computer-aided software program. The natural
oral cavity characteristic preferably comprises teeth, enamel, dentin, crazing
lines,
stains, veins, blood vessels, bony coloration, hyper-calcification, mucosal
tissue or
gum tissue. These natural oral cavity characteristics may be included in a
stock of
standard computer-based images representative of the natural oral cavity
Page 4of32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
characteristics in the corresponding dental restoration. A distributable
picture of
the computer-based images matching the decal may also be provided so the
patient may select the desired oral cavity characteristic prior to receiving
the
dental restoration. Additionally, a sealant is disposed over the decal and at
least a
portion of the dental restoration base for protection thereof. The sealant
preferably comprises a composite resin, a semi-transparent acrylic resin, a
protective layer, a ceramic or a glaze. An additional secondary decal may also
be
affixed to the sealant. Another layer of glaze may then be disposed over the
secondary decal for protection thereof.
[Para 8] Other features and advantages of the present invention will become
apparent from the following more detailed description, when taken in
conjunction
with the accompanying drawings, which illustrate, by way of example, the
principles of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[Para 9] The accompanying drawings illustrate the invention. In such
drawings:
[Para 10] FIGURE 1 is a flowchart illustrating the process of producing and
selecting a decal for use in a dental appliance;
[Para 11 ] FIGURE 2 is a flowchart illustrating the process of incorporating a
decal in a composite resin-based dental restoration;
[Para 12] FIGURE 3 is a front view of a rebuilt chipped tooth having a decal
therein;
Page 5 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
[Para 13] FIGURE 4 is cross-sectional view of a restored chipped tooth,
including
an external decal having an enamel composite resin layer thereover;
[Para 14] FIGURE 5 is a flowchart illustrating the process of incorporating a
decal into a veneer-based dental restoration;
[Para 15] FIGURE 6 is a cross-sectional view of an internal decal incorporated
into the veneer-based dental restoration;
[Para 16] FIGURE 7 is an alternative cross-sectional view of the dental
restoration of FIG. 6, including an external decal for added color and
characteristics;
[Para 17] FIGURE 8 is a cross-sectional view of an external decal formed on a
veneer before application to the veneer-prepped tooth;
[Para 18] FIGURE 9 is a flowchart illustrating a process of incorporating a
decal
into a ceramic denture tooth;
[Para 19] FIGURE 10 is a cross-sectional view of a decal located between an
enamel ceramic and a dentin ceramic in the ceramic denture tooth;
[Para 20] FIGURE 1 1 is a front view of a ceramic denture tooth having a decal
located therein, illustrating detail lines and lobes;
[Para 211 FIGURE 12 is a front view of a ceramic denture tooth having a decal
located therein, illustrating crazing lines and other characterizations;
[Para 22] FIGURE 13 is a flowchart illustrating the process of incorporating a
decal into an acrylic resin representing tissue in dentures;
[Para 23] FIGURE 14 is a cross-sectional view of an internally placed decal
representing the tissue area of dentures; and
Page 6 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
[Para 24] FIGURE 15 is a cross-sectional view of an externally placed decal
representing the tissue area of dentures.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[Para 25] The present invention resides in a process for making a dental
restoration having a decal therein, and the resultant apparatus. The decals
are
designed to replicate the natural anatomical appearance of the oral cavity.
Specifically, the decals are designed to replicate tooth coloration, crazing
lines,
internal coloration, hyper-calcification, transparency, enamel variation,
veins,
white stains, lines in teeth, and other tissue and tooth colorations
artistically
difficult to replicate.
[Para 26] FIG. 1 illustrates a flowchart for a process of creating decals for
placement in dental appliances (100). First, an artist creates multiple sets
of
images to replicate natural tooth and tissue coloration and characteristics
(102).
The images may be created via any one of a number of techniques that include
manually drawing art work, photographs or computer generated images. In one
embodiment, the decals may be made from artwork drawn out manually in a large
format on an 8x1 0 sheet to provide accurate painted details of internal and
external structures, characteristics and coloration of teeth and oral cavity
tissue.
The artist may choose to draw the decals based on photos of the patient,
general
photos of models, or drawings of internal and/or external tooth and oral
cavity
tissue. Alternatively, the artist may photograph the teeth of the patient to
be later
printed and used as the aforementioned decal. In this embodiment, the
Page 7 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
photographic image of the external structures, characteristics and coloration
of
the teeth and oral cavity tissue of the patient is not altered by the artist.
In a
similar sense, and a particularly preferred embodiment, the artist creates a
set of
decals by manipulating images in a digital-based computer aided software
program to obtain the desired color and characteristics. The digital images
may
be those photographed of the patient or another person. The images may also be
computer generated images developed completely by the artist through the
related
software program. The artist may manipulate the images through the computer
aided software program to obtain the color and characteristics desired by the
patient. Computer generated photographs are particularly preferred because the
artist has the option of selecting one of many base or standard decals, making
minor modifications to any of the base or standard decals, or using
photographs
of the oral cavity of the patient, including any desired modifications, to
produce
the most realistic and accurate decal specific to each individual patient
receiving a
dental restoration. Accordingly, the decals will vary in style, color,
characteristics
and may vary in size depending on the patient. The decals may include
additional
anatomical details such as mucosal tissue replication, veins, blood vessels,
mimic
bony coloring, hyper-calcification, crazing lines or any other natural or
unnatural
effects that affect tooth and oral cavity tissue color and characteristics.
Appropriately, the decals will vary according to the application and desired
use.
[Para 27] Once the details of the artwork are complete, the artwork is reduced
in
size to the size of natural teeth for dental application. The smaller size
images are
then transferred to computer software (104) suitable for printing the images
to
Page 8 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
paper (106) having a water-based glue thereon. Next, the printed paper image
is
roll heated to a wax substrate (108). The decal remains on the wax substrate
when the paper and wax substrate are subsequently separated. The decal on the
wax substrate may comprise various color pigments to help correct tooth
discoloration. The color pigment may even be opaque to facilitate blocking
unwanted discoloration in cases where severe discoloration exists. The decals
block out the darker background portion of a tooth to achieve lighter and
brighter
results. Alternatively, the color pigments of the decal may introduce desired
color
and structures within this layer. Accordingly, the printed decals are capable
of
being fired at recommended temperatures, to securely attach to the desired
dental
prosthesis. The versatility of such decals is virtually unlimited and can be
used to
recreate any type of dental effect, both existing structures and non-existing
structures in the oral cavity.
[Para 28] Next, replica images are categorized in a chart and/or catalog as
samples for viewing by dentists and/or patients (1 10). The catalog will
include a
variety of styles, colors and stylizations for the dentist to share with the
patient in
preparation for creating a dental restoration. The catalog is representative
of the
types of decals that are available at the dental laboratory, or any other
facility
where dental restorations are fabricated. Accordingly, the dentist and patient
select a replica image or multiple replica images from the chart/catalog
having the
desired color and characteristics for the tooth or tissue restoration (112).
The
selected decal should have the appropriate color and transparency
characteristics
that match the natural oral cavity coloration and characteristics the patient
desires.
Page 9 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
The dentist then communicates the selected decals to the dental lab technician
at
a facility that manufacturers the tooth restoration. From this information,
the
dental lab technician selects a decal, or multiple decals, matching the
replica
image, or multiple replica images, selected by the dentist and patient (114).
The
lab technician chooses the corresponding decals from the artist decal sheet to
match the chosen images selected by the dentist and/or patient (112). The lab
technician or dentist then creates the dental appliance according to the needs
of
the patient (116), as more specifically described in the flowcharts in FIGS.
2, 5, 8
and 12. Of course, the selected decal may include a standard or stock decal, a
decal representative of a model tooth or a decal (modified or unmodified)
created
by photographing the oral cavity of the patient.
[Para 29] For standard or base decals, a reference catalog provided to
dentists
helps ensure the consistency and accuracy of selecting a particular style
decal
needed for the tooth restoration. Manufacturers and laboratories will have
corresponding transparent decals that match the replica images selected by the
dentist and/or patient. The decals are applied to the selected dental
appliance.
This method increases the aesthetic predictability of the appearance of the
tooth
restoration and virtually eliminates the difficult task of artistically
mimicking the
natural color and characterization of the oral cavity, one patient at a time.
The
present invention also reduces the need for training technicians to fabricate
artistically realistic tooth restorations and transforms the manufacturing
process
into a much simpler technique, especially for ceramic teeth manufactured for
use
with dentures. As a result, the present invention will allow manufacturers to
Page 10 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
reduce the cost of tooling as multiple layer manufacturing of the denture
teeth will
no longer be needed.
[Para 30] FIG. 2 illustrates a process for creating an oral cavity model or
restoring a natural tooth, due to breakage, chipping or grinding (200). The
first
step is to apply a dentin composite resin to rebuild the chipped and/or
damaged
tooth (202). The dentin composite resin also forms the base of the oral cavity
model. The dentin composite resin varies in coloration, but is commonly some
shade of yellow. For a damaged natural tooth, the dentin composite resin is
placed in an appropriate location to create a fairly flat platform to allow
the decals
to conform to the surface thereof. Hardening the dentin composite resin is
accomplished by any one of several polymerization processes. In one
embodiment, the dentin composite resin is cured using a halogen-based bulb
that
concentrates a specific wavelength of light on the composite resin. A chemical
catalyst in the composite resin is sensitive to the light. When exposed to the
light,
the composite resin hardens. A light-based hardening process may be
accomplished chair side. Alternatively, non-chair side processes may include
using pressure or heat to further harden the dentin composite resin. These
hardening procedures are typically used to create model teeth or for
replacement
teeth for use in dentures or partials. In one embodiment, pressure is used to
remove air gaps within the composite resin material to increase the density
thereof, thereby forming a harder structure than if only hardened by light.
Accordingly, light may be used to further harden the structure by reacting
with a
chemical catalyst in the composite. In another alternative embodiment, the
light
Page 1 1 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
and pressure is combined with heat. In this embodiment, the dentin composite
resin achieves a high degree of polymerization at high intensity temperatures
as
high as 1700 F. Chemical catalysts in the composite resin react and harden at
these high temperatures. Alternatively, the heating and pressurizing processes
may be used exclusively without light. Different chemical compounds may be
used in the composite resin depending on the desired polymerization process.
Accordingly, the dentist or dental technician would endeavor to select the
corresponding chemical catalyst that hardens in response to light, pressure or
heat.
[Para 31 ] Next, the selected decal is placed on the hardened dentin composite
resin of the model or prepped tooth (204). The decal is then cured to the
dentin
composite resin (206). To complete the initial contour and shape of the
restored
tooth, a layer of enamel composite resin is placed over the cured structure of
the
dentin composite resin and the decal (208). The dentist must then decide
whether
to add additional coloring (210). When adding additional coloring, an external
decal is placed over the layer of enamel colored composite resin (212) to add
the
necessary stylizations to replicate the natural tooth colorizations and
characteristics. Next, a thin layer of enamel composite resin is placed over
the
external decal (214). Thereafter, an optional layer of glaze is placed over
the
composite resin (216) to protect the dental restoration from possible long-
term
deterioration. The glaze is applied primarily to fill micro holes in the
enamel
composite resin and to enable the dentist to polish the outer surface of the
tooth
restoration. Decals can be used on external surfaces to achieve the desired
Page 12 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
colorization results. This application may also be used for pressable or
milled
ceramics for any ceramic restoration (tooth and oral tissue, such as mucosal
tissue) that requires coloration variations where additional stylizations will
enhance the overall aesthetic results of the tooth or tissue restoration, as
further
described herein. The completed structure should replicate the natural tooth
coloration and characteristics (218) such that the restoration of the natural
tooth
coloration and characteristics is complete (220).
[Para 32] FIGS. 3 and 4 illustrate a tooth restoration 10 of a chipped tooth
12
having a decal 14 therein. FIG. 3 is a front view of the tooth restoration 10
wherein a portion of the chipped tooth 12 is filled in with a filler 16. As
shown in
FIG. 4, the filler 16 comprises a dentin composite resin base 18 having the
decal
14 formed thereon. Accordingly, after the decal is cured as described in step
(206), an enamel composite resin 20 is disposed over the decal 14 and the
dentin
composite resin base 18. The filler 16 is designed to fix a cracked or broken
portion of the tooth 12, generally shown in FIG. 3. The decal 14 is visible
through
the enamel composite resin 20 such that the colorization and characteristics
of the
decal 14 are viewable as shown through the front side of the chipped tooth 12
in
FIG. 3. An additional external decal 22 may be disposed on top of the enamel
composite resin 20 for additional coloring or characteristics. The external
decal
22 may be protected by applying a thin layer of enamel composite resin 24
thereover. Optionally, a substantially transparent glaze 26 may be applied to
the
thin layer of enamel composite resin 24 for further protection thereof.
Page 13 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
[Para 33] In an alternative embodiment, the tooth restoration 10 of FIGS. 3
and
4 could be used to create an oral cavity model. The process for making the
model
is generally illustrated in the flowchart in FIG. 2. The model comprises
similar
compositions as the tooth restoration illustrated in FIG. 4. Of course, the
model
would not include a portion of the natural chipped tooth 12. Therefore, the
dentin
composite resin base 18, the enamel composite resin 20, the decal 14 and the
thin
enamel composite resin layer 24 would extend the entire length of the tooth
restoration 10 as shown in partial form in FIG. 4. Likewise, the external
decal 22
and optional glaze 26 should also extend the length of the model. The decal 14
or
the external decal 22 may be applied as a whole sheet or as a series of
partial
sheets in sections of the front, back and bottom portions of the tooth. This
process further ensures accurate replication of natural tooth colorization and
characteristics.
[Para 34] Alternatively, the present invention may also be applied to
composite
resin-based or porcelain-based veneers. FIG. 5 illustrates a process for
creating a
tooth restoration using a decal and a porcelain-based veneer (500). The first
step
is to apply dentin porcelain to an external surface of the veneer-prepped
tooth
(502) via CAD milling, hard build-up or pressing. Accordingly, step (502)
involves
shaving a portion of the existing tooth enamel down to make room for the
necessary depth of the veneer. Prepping a tooth for veneer placement is well-
known in the art. Alternatively, the dentin porcelain may be applied to an
unprepped tooth. In this embodiment, a portion of the existing tooth enamel
does
not need to be shaved prior to the subsequent steps described below.
Page 14 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
[Para 35] The next step is to determine whether the decal will be placed
internal
or external in the tooth restoration (504). For internal placement, it must be
decided whether to add an enamel porcelain layer to the tooth restoration
before
application of the decal (506). In one embodiment, the enamel porcelain layer
is
not needed and the selected decal is placed directly on the dentin porcelain
of the
prepared tooth (508). Internal placement of the decal on the tooth restoration
in
this embodiment is similar to the process disclosed in FIG. 2. The decal is
cured to
the dentin porcelain (510) by any of the previously described methods. Then, a
layer of enamel porcelain is placed over the dentin porcelain and decal (512).
Sometimes only a small layer of dentin porcelain is required because the tooth
may
not be chipped as previously described and shown in FIGS. 3 and 4. In an
alternative embodiment, determining to first add enamel porcelain over the
dentin
porcelain during step (506) necessarily requires that the selected decal be
placed
on the enamel porcelain (514) instead of being placed on the dentin porcelain
(508). In this embodiment, the decal is cured together with the enamel
porcelain
and the dentin porcelain (516). A second layer of enamel porcelain is placed
over
the cured structure of the first layer of enamel porcelain and the decal
(518).
[Para 36] In accordance with both of the above-described embodiments, the
dentist must next determine whether to add additional coloring (520) to the
tooth
restoration. In the case that additional coloring is desired, an external
decal is
placed on the enamel porcelain (522). Next, a thin layer of enamel porcelain
over
the external decal (524). Optionally, a layer of glaze may then be placed over
the
enamel porcelain (526) for further protection of the dental restoration. The
Page 15 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
external decal is placed over the enamel porcelain to further enhance the
natural
aesthetic look of the restored tooth. Thereafter, the prepped tooth is ready
to
have the veneer attached thereto (528). The restoration of the natural tooth
coloration and characteristics is then complete (530) for that tooth once the
veneer
is attached using methods known in the art. The steps for creating a tooth
restoration with a decal and a porcelain-based veneer (500) and specifically
steps
(502) - (526), may be repeated for multiple teeth. Often it is desirable to
restore
more than one tooth with veneers to ensure color consistency and
characteristics
among the restored teeth and non-restored teeth.
[Para 37] Alternatively, the process for creating a tooth restoration with a
decal
and a porcelain-based veneer (500) may include the step of placing the decal
external to the tooth restoration (532). As shown in FIG. 5, after deciding to
use
an external decal (504), the selected decal is externally placed on the veneer
(532)
before attachment to a natural tooth. Next, the veneer and decal are fired in
an
oven (534). Thereafter, a layer of glaze (536) is placed over the external
decal for
protection thereof. Accordingly, the veneer is then attached to the prepped
tooth
(528). The restoration of the natural tooth coloration and characteristics is
then
complete (530). Similarly, steps (502)-(536) may be repeated for each veneer
the
patient requires.
[Para 38] FIGS. 6-8 are cross-sectional side views of a tooth restoration 10
having a porcelain-based veneer 28. FIG. 6 illustrates the tooth restoration
10
having an internally placed decal 14. As shown, a veneer prepped tooth 30 has
a
dentin porcelain base 32 applied along the exterior thereof. The veneer-
prepped
Page 16 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
tooth 30 may be reduced slightly in size (e.g. 1.5 millimeters) to make room
for
the veneer 28 and the corresponding dentin porcelain base 32, an enamel
porcelain layer 34 and the decal 14. Accordingly, the decal 14 is applied to
the
external front layer of the dentin porcelain base 32. The enamel porcelain 34
is
thereafter applied to the external surface of the decal 14 and the dentin
porcelain
base 32. Lastly, the veneer 28 is attached to the external portion of the
enamel
porcelain 34 of the tooth restoration 10 illustrated in FIG. 6. The decal 14
is
visible through the enamel porcelain 34 and the veneer 28.
[Para 39] FIG. 7 illustrates an alternative embodiment of the tooth
restoration
illustrated in FIG. 6. The tooth restoration 10 in FIG. 7 similarly includes
the
veneer-prepped tooth 30 and the dentin porcelain 32. In this embodiment,
however, the enamel porcelain 34 is applied directly to the dentin porcelain
32
before application of the decal 14. The decal 14 is then applied directly to
the
enamel porcelain 34. Thereafter, a second layer of enamel porcelain 36 is
applied
over the decal 14 and any exposed portion of the enamel porcelain 34. The
second layer of enamel porcelain 36 provides the necessary long term
protection
for the decal 14. An optional glaze 26 may be applied to the second layer of
enamel porcelain 36 for further protection thereof. The glaze 26 primarily
fills
micro holes in the enamel porcelain and enables the dentist to polish the
outer
surface of the tooth restoration. The veneer 28 is then applied to the second
layer
of enamel porcelain 36 in a similar manner as shown and described with respect
to
FIG. 6. Additionally, the external decal 22 may be applied to the second layer
of
enamel porcelain 36 before application of the veneer 28. In this embodiment,
an
Page 17 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
external enamel porcelain 38 is applied to the external decal 22, according to
the
steps described above. Again, the optional glaze 26 may be applied to the
external enamel porcelain 38 for further protection thereof. Once the dentist
determines that the appropriate colorization and characterization of the tooth
are
adequate, the veneer 28 is attached thereto according to the processes
described
above.
[Para 40] FIG. 8 illustrates attachment of the porcelain-based veneer 28 to
the
veneer-prepped tooth 30 utilizing only the external decal 22. As shown in FIG.
8,
the veneer-prepped tooth 30 has the dentin porcelain base 32 applied thereto.
The veneer 28, which is eventually applied directly to the dentin porcelain
32,
receives the external decal 22 thereon before application to the tooth
restoration
10. In this regard, the external decal 22 is applied to the exterior of the
veneer 28
pre-application to the veneer-prepped tooth 30. In this embodiment, the
external
decal 22 and the veneer 28 are fired together in an oven. A glaze 26 is then
applied to the exterior of the veneer 18 to protect the external decal 22
fired
thereto. The veneer 28 having the external decal 22 and the glaze 26 thereon
is
thereafter attached to the dentin porcelain 32 by any method known in the art.
The attached veneer 28 then displays the desired coloration and
characteristics of
the natural tooth via the external decal 22.
[Para 41 ] The decal 14 may also be used with ceramic teeth for placement in
dentures, as generally shown in the flowchart in FIG. 9. In most instances,
the
steps in FIG. 9 may be accomplished by a ceramic tooth manufacturer, rather
than
a dentist or lab technician. Multiple decals may be needed to replicate the
Page 18 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
coloration and characteristics of multiple teeth that the dentures will
replace. The
use of decals in the fabrication phase of ceramic teeth for use in dentures
simplifies the production process and provides more realistic dentures. The
fabricated ceramic teeth contain better aesthetic coloration and
characteristics.
[Para 42] The process for forming a ceramic denture tooth for placement in
dentures (900) starts by forming a dentin ceramic tooth via CAD/CAM milling,
liquid-powder build-up, or pressing (i.e. a pressable) (902). The next step is
to
determine whether the decal will be placed internal or external in the dentin
ceramic denture tooth (904). Internal placement of the decal on the dentin
ceramic denture tooth is similar to the process disclosed in FIG. 5. First,
the
selected decal is placed on the dentin ceramic denture tooth (906). Next, a
layer
of enamel ceramic is placed over the decal and the dentin ceramic denture
tooth
(908). The structure that includes the dentin ceramic denture tooth, the decal
and
the enamel ceramic is then fired in an oven for hardening (910). Thereafter,
the
ceramic tooth manufacturer or subsequent dental lab technician may determine
whether or not to add external coloring (912). In the event that the external
coloring is desired, an external decal is placed on the enamel colored ceramic
(914). A thin layer of enamel ceramic is then placed over the external decal
(916).
Optionally, a layer of glaze is then placed over the enamel ceramic (918) for
further protection thereof. The finished ceramic tooth should accurately
replicate
natural tooth coloration and characteristics (920). The necessary quantity of
ceramic teeth is then attached to the denture base (922). Thereafter, the
patient is
fitted with the dentures (924) having a natural look. Alternatively, it may be
Page 19 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
decided that external coloring is not needed (912), wherein the dentures are
finished (920) without any additional steps. Accordingly, the ceramic teeth
are
attached to the denture base (922) and then fitted to the patient (924).
[Para 43] Alternatively, it may be determined during step (904) that the decal
is
to be placed external in the tooth restoration. In this embodiment, the
selected
decal is placed externally on the dentin ceramic tooth (926). Next, the decal
and
the dentin ceramic tooth are fired in an oven (928). This hardens the
resultant
structure. A layer of glaze is then placed over the external decal (930). The
finished ceramic tooth replicates the natural tooth coloration and
characteristics of
the oral cavity (920). The requisite quantity of ceramic teeth are then
attached to
the denture base (922) before the patient is fitted with the dentures (924).
[Para 44] The process illustrated in FIG. 9 is tremendously advantageous over
current practices in that the ceramic teeth of the dentures include actual
color and
characteristics of natural teeth without spending hours in an artistic studio
drawing the details. Ceramic teeth otherwise not having these details appear
unnaturally consistently white (or a shade thereof). This is an undesirably
unnatural look. The present invention eliminates the time and cost associated
with
an artist adding the necessary details to make the teeth look natural.
[Para 45] FIGS. 10-12 illustrate a sample ceramic tooth 40 for placement in
dentures. FIG. 10 illustrates a cross-sectional view of the ceramic tooth 40
comprising a dentin ceramic base 42 having the decal 14 placed thereover and
protected by an enamel ceramic 44. The stylizations of the internal decal 14
placed between the dentin ceramic base 42 and the enamel ceramic 44 are
visible
Page 20 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
through the enamel ceramic 44. FIG. 1 1 illustrates a front view of the
ceramic
tooth 40 having a plurality of details therein. For example, the ceramic tooth
40
includes a set of detail lines 46 and lobes 48. As more specifically shown in
FIG.
12, the detail lines 46 may include a set of crazing lines 50 or white stains
52. In
each of the embodiments illustrated in FIGS. 10-12, the ceramic tooth 40 has
the
decal 14 placed internally. The details illustrated in FIGS. 1 1 and 12 may
come in
many different types of stylizations, as previously described and listed.
Moreover,
the decal 14 may be placed externally, as described above. The decal may also
be
used in dentures with composite resin-based teeth in addition to the ceramic-
based teeth.
[Para 46] FIG. 13 illustrates the general process for incorporating a decal in
a
dental appliance for replicating the natural color and characteristics of oral
tissue
(1300). First, a lab technician must determine whether the decal is to be
located
internally or externally on a tissue colored acrylic resin base (1302). An
internally
located decal is placed directly on the tissue colored acrylic resin (1304) in
the
dental appliance. These decals may, alternatively, be used to represent soft
tissue
coloration and characteristics and can be used in conjunction with veneers,
crowns, bridges and other implants. The decals mimic the tissue stylizations
applied to dental restorations when soft tissue prosthesis is necessary. A
layer of
semi-transparent acrylic resin or composite resin is then placed over the
decal
(1306). The tissue colored acrylic resin base and the decals are then fired in
an
oven (1308). External placement of the decal requires that the selected decal
be
placed on the tissue colored acrylic resin base (1310). This structure is then
also
Page 21 of32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
hardened by firing in an oven (1 312). Next, a thin layer of protective glaze
is
placed over the external decal (1314). The protective glaze provides
insulation of
the decal from the environment and protects against wear. The result of steps
(1308) and (1314) is that the finished dental appliance replicates the natural
tissue
coloration and characteristics of the oral cavity (1316). The finished
structure is
then delivered to the dentist or a dental technician, for attachment of
ceramic
teeth (1318) before being fitted to the patient (1320). In this embodiment,
the
internal or external decals mimic the oral tissue coloring, which may comprise
blood vessels, tissue covering, musculature areas, tendons, tissue colors or
bony
anatomy changes. The steps disclosed in FIG. 13 may also be combined with
those steps disclosed in FIG. 9 to provide dentures having both natural
looking
teeth (FIGS. 10-12) and oral tissue (FIGS. 14-15).
[Para 47] FIGS. 14 and 15 illustrate the internal and external placement,
respectively, of the decal 14 in the oral tissue area of dentures. FIGS. 14
and 15
are a cross-sectional view of a denture 54, generally. Accordingly, the
dentures
54 include a tissue colored acrylic resin 56 adjacent to the previously
described
ceramic tooth 40. In FIG. 14, the decal 14 is placed internal in the denture
54 as
sandwiched between the tissue colored acrylic resin 56 and a semi-transparent
tissue colored acrylic resin 58. The semi-transparent tissue colored acrylic
resin
58 allows the details of the decal 14 to be seen externally. Thus, the natural
tissue
coloration the decal 14 aims to display is visible. Alternatively, in FIG. 15
the decal
14 is external to the tissue colored acrylic resin 56 and is protected by a
protective
layer 60. Preferably the protective layer 60 is the previously described
glaze.
Page 22 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
[Para 48] In general, the decals of the present invention are fabricated from
a
photo, captured image or drawing to aesthetically mimic the internal and/or
external coloration and characteristics of natural teeth and the internal
and/or
external coloration and characteristics of natural tissue surrounding tooth
areas,
such as papillae and mucosal tissue. The fabrication of the composite resin
restorations, either directly or indirectly, includes placing a decal or part
of a decal
in a composite resin or ceramic fabrication to mimic the internal and external
anatomical coloration of the oral cavity. Mimicking the natural color
stylizations
allows dentists to offer patients dental restorations having tooth and tissue
coloration and characteristics, within a thin dimension, that best matches the
oral
cavity aesthetics of the patient.
[Para 49] The decals can create a three-dimensional natural looking tooth
restoration by placing the decals in multiple layers of composite resin or
ceramic
material. Alternatively, the multiple decals may be stacked on one another or
placed intermittently in the front, bottom or rear portions of the tooth
restoration.
The key aspect of the present invention is that the decal replaces any need
for
drawing tooth or tissue coloration and characteristics to the dental
restoration.
The composite resin, ceramic, porcelain or glaze protect the decal to increase
durability. The decals described herein can be placed in areas where composite
resin layering, ceramic layering and acrylic resin layering are being used.
Such
layering may be used in the fabrication of denture teeth, tooth restorations
or
mucosal tissue replication. The present invention may also be used with
partial
Page 23 of 32
CA 02713047 2010-07-22
WO 2009/097288 PCT/US2009/032150
veneers, crown and bridge applications and chipped or broken teeth as well as
non-prepared teeth for veneering purposes.
[Para 50] Although several embodiments have been described in some detail for
purposes of illustration, various modifications may be made to each without
departing from the scope and spirit of the invention. Accordingly, the
invention is
not to be limited, except as by the appended claims.
Page 24 of 32
