Endodontic therapy, otherwise known as root canal treatment, is the treatment of conditions pertaining to the pulp cavity of a tooth. Various kinds of tissues are located in proximity to and within a tooth. These include blood vessels and other matter that are referred to as pulp, and are found within the pulp cavity, which is also known as the root canal of a tooth. When an infection or other undesired condition occurs in a tooth, or in proximity to a tooth, which affects or potentially will affect the root canal, one course of endodontic therapy used by dental professionals involves removing substantially all the matter inside the root canal. Endodontic therapy is practiced by several different kinds of professionals, such as, for example, dentists and endodontists. Herein, the phrase dental professional is meant to include all such professionals who practice endodontic therapy.
In some cases, endodontic therapy includes drilling a hole into the subject tooth, in order to facilitate the removal of substantially all the pulp and other matter contained within the root canal. In many cases, in order to remove the material from the root canal, a dental professional employs an instrument known as an endodontic file. Endodontic files generally have a blade with at least one sharp surface that the dental professional uses to clear the root canal of matter. After the root canal is sufficiently cleared, the dental professional fills the canal with a sealant.
However, other anatomic structures and tissues besides pulp are in proximity to a root canal. During endodontic therapy, the sharp surface of an endodontic file sometimes causes unintended damage to these other anatomic structures and tissues. For example, a surface of the blade may perforate the soft tissues in proximity to the root canal, causing nerve damage or other tissue injury. As further illustration of possible complications from endodontic therapy, the inferior alveolar nerve is located in proximity to the root canals. In some cases, the mechanism of damage involves a sharp surface of an endodontic file perforating the soft tissues in proximity to a root canal, to the point where the surface of the endodontic file penetrates the inferior alveolar canal. In some cases, the contact between the surface of the endodontic file and the nerve or some related tissue is the damaging insult.
Nerve and tissue damage also occurs when a sharp surface of the endodontic file causes a perforation within surrounding tissues, which allows sealant to migrate into an unintended area in proximity to nerve fibers. As the sealant hardens, in some cases the migration causes a compression injury to nerve cells and other tissues. In other cases, the sealant or other chemicals used in the endodontic therapy produce a neurotoxic effect. Such unintended occurrences frequently produce pain or other undesired consequences, such as, for example, loss of nerve function, and may require surgery.
Consequently, dental professionals have sought ways to reduce the chances of unintentionally perforating or penetrating the tissues that are in proximity to a root canal. One such way has been to position a gasket-like ring around the blade, which provides some indication of the depth of the root canal. However, a gasket-like ring is not constrained except by the small frictional forces between the inner surface of the ring and the outer surface of the blade. Consequently, in practice, gasket-like rings move with great ease along the axis of the blade. Moreover, the force that dental professionals use in clearing a root canal of matter easily overcomes the frictional force between the inner surface of the ring and the outer surface of the blade. Consequently, a gasket-like ring will not provide a consistent and reliable indication of the depth of an endodontic file blade in a root canal. The lack of a consistent and reliable indication of the depth of an endodontic file blade in a root canal is a risk factor for purposes of the complications that arise in endodontic therapy.
Moreover, other solutions that have been attempted, such as, for example, those involving a depth measurement that involves the use of a ruler, require separate devices in order to make adjustments to the working length of the endodontic file. These result in a significant expenditure of time, and often result in similar problems regarding a consistent and reliable indication of working length.
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Appropriately adjusting the working length of the endodontic file 10 means that the distal-most surface edge of the marker 30 is positioned for making contact with the crown of the tooth, before the tip at the distal end 27 of the blade 23 will penetrate beyond the apex of the root canal. The user repositions the marker 30 in order to adjust the working length of the endodontic file 10 by moving the marker along the axial line 29 either toward the proximal end 25 of the blade 23 or toward the distal end 27. Accordingly, the marker 30 integrated with the blade 23 and handle 13 provides for adjustments to the working length of the endodontic file 10 without the use of a separate device.
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In some embodiments, the proximal end 25 of the blade 23 is housed within the handle 13. The handle 13 is contoured such that the outer circumference latitudinally at a central point of the handle is smaller than the diameter of the proximal end 15 and the distal end 17, respectively. Accordingly, the outer surface shape of the handle 13 facilitates manual interaction with the handle 13 of the endodontic file 10 during use by a dental professional. In some embodiments, the contour is formed as a streamlined curve, a parabolic curve, or a hyperbolic curve. Optionally, the outer surface of the proximal end 15 of the handle 13 is rounded.
In some embodiments, the distal end 27 of blade 23 comprises a sharp point. The blade 23 is made for the purpose of cutting into tissues and clearing matter from a root canal. In some embodiments the blade 23 has a tip size according to standard sizes routinely used by dental professionals, as well as a taper toward the distal direction. The taper of the blade 23 encompasses the distal end 27, and it generally terminates at the tip of the blade 23 at the far distal end 27.
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The marker 30 is slidably movable along the blade 23 parallel to the axial line 29. A working length adjustment occurs when a user pushes the marker 30 proximally along the blade 23 in the direction of the handle 13, which increases working length. A working length adjustment also occurs when a user pulls the marker 30 distally away from the handle 13 and toward the distal end 27 of the blade 23, which reduces the working length. This range of motion of the marker provides for a working length adjustment scale. In some embodiments, the working length adjustment scale is about 0.5 mm-12.0 mm, including all values and increments therebetween. This range of motion facilitates the adjustment of the working length for use in connection with a variety of root canal depths, thus reducing the need to maintain a large inventory of different endodontic file classifications and lengths. In some embodiments, the working length adjustment scale is about 3 mm-8 mm, including all values and increments therebetween.
In some instances, a dental professional uses the endodontic file 10 in order to gauge the depth of a root canal of interest prior to cutting and clearing matter from a root canal. The user gauges the depth of the root canal, and then adjusts the positioning of the marker 30 so that the working length of the endodontic file 10 is substantially equal to or, slightly less than, the depth of the subject root canal. After the marker 30 is positioned accordingly, the blade 23 is inserted distal end 27 first into the root canal. When the distal-most surface edge of the marker 30 contacts the crown of the tooth, it provides an indication that (1) the entire working length of the endodontic file 10 has been inserted into the root canal; and (2) the tip at the distal end 27 of the blade 23 is no deeper than the apex of the root canal. In this way, it is possible for the dental professional to relatively quickly and easily place the endodontic file 10 into the root canal consistent with a more safe and accurate working length of the endodontic file 10, while the endodontic file 10 is in contact with the crown of the tooth. While in this position, it is possible for the dental professional to then obtain an x-ray image to confirm the placement of the blade 23 such that the tip at the distal end 27 is no deeper than the apex of the root canal while the distal-most surface edge of the marker 30 is in contact with the crown of the tooth.
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In some embodiments, the tapered portion at the distal end 27 of the blade 23 is adapted for cutting and clearing of a root canal. Optionally, the tapered portion of the blade 23 comprises a geometric shape, corresponding to a form chosen from the group K-File, Hedstrom File, Helical file, and Reamer. All of these forms are known to those practicing in the pertinent field.
In some embodiments, the marker 30 has a section with a surface 16 for affixing a designation regarding the length of the blade 23, such as, for example, a numerical designation. Alternatively, the numerical designation indicates the tip size of the blade 23, or the taper of the blade 23. Optionally, surface 16 is a relatively flat, enlarged section to accommodate a numerical designation of sufficient size to be easily discernible to the eye, and the designation is glued to the surface 16 or affixed to the surface 16 through other means known to those practicing in the pertinent field. As shown in several drawing figures, including but not limited to
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In some embodiments, the interference ribs 31 are staggered such that every other one envelopes the outer surface of the marker 30 circumferentially, while the alternating ones do not envelope the entire circumference of the outer surface. This difference provides another tactile cue that differentiates, for example, a 1 mm adjustment in comparison to a 0.5 mm adjustment.
Optionally, a cutout is placed along a portion of the surface of the inner cavity 20 at the distal end 17 of the handle 13 for increased interference. Optionally, the cutout is along the entire latitudinal surface of inner cavity 20, at a depth substantially equal to the rise of the interference ribs 31.
In some embodiments, the interference ribs 31 are raised sufficient to make the effective outer circumference (if cylindrical) or the effective outer perimeter (if non-cylindrical) of a portion of the marker 30 housed within the handle 13 to be equal to, or greater than, the circumference along the surface of the inner cavity 20. In some embodiments, for example where the effective outer circumference or perimeter of the marker 30 exceeds the inner circumference or perimeter of the inner cavity 20, the marker 30 is made from a deformable material. For example, the marker 30 is formed from materials having a modulus of elasticity within a range of about 9.00 ksi (kilopounds per square inch)-9860 ksi, including all values and increments therebetween. Alternatively, the marker 30 is formed from materials having a modulus of elasticity within a range of about 34.8 ksi-798 ksi, including all values and increments therebetween.
Optionally, the material for the handle 13 is chosen from the group nylon 6, nylon 6,6, nylon 6,10, acrylonitrile butadiene styrene, polycarbonate, polyvinyl chloride, high density polyethylene, polyethylene terephthalate, polyether ether ketone, polypropylene, and polyoxymethylene. In some embodiments, the marker 30 is formed from a material of lesser flexural rigidity than the material used in forming the handle 13.
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Means for connecting the handle 13 to the engine device include at least one connection key cutout 50 located at or near a proximal end 49 of the handle 48. The connection key cutout 50 comprises a 3-dimensional shape, with a depth that is adapted to lockably fit with a mating element 51 (not shown) of an engine device 42, as illustrated in
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In some embodiments, the arms 59 are parallel to the axial line 29. Each arm 59 has a needle 68 located at the distal end 67. The marker 30 is positioned substantially around a portion of the outer circumference or periphery of the blade 23, and the marker 30 is partially housed within the handle 13. Optionally, the blade 23 has an end cap (not shown) overmolded onto the proximal end 25, such that the end cap is insert molded, snapped in place or press fit into the proximal end 15 of the handle 13.
In some embodiments, the marker 30 has a proximal end 55 and a distal end 57. The marker 30 moves parallel to the axial line 29 within the handle 13, and at least a portion of the marker 30 is housed within the handle 13. Additionally, at least one arm 59 is attached to the handle 13, wherein each of the at least one arm 59 has a proximal end 65 and a distal end 67. The arm 59 is movable relative to the handle 13. The arm 59 has a needle 68 located on an edge of the arm. Additionally, the handle 13 includes at least one aperture 70 that is sized to accommodate and positioned to receive the needle 68. From time to time herein, arm 59, needle 68, and aperture 70, are referred to in the singular, but the descriptions would also include the plural. Likewise, descriptions of embodiments that refer to the plural would also include the singular.
The endodontic file 10 further comprises needle position securing means, whereby contact between the needle on the and the marker in the engaged position results from the protrusion of the needle through the aperture 70 in order to maintain a friction force on the marker 30 sufficient to retain the marker 30 in a substantially static position relative to the blade as selectably desired by a user.
In some embodiments, the blade 23 is formed from titanium. The marker 30 is formed from a rubber material (e.g., neoprene). The arms 59 are formed from a ductile polymer (e.g., Nylon 6,6), and each needle 68 is formed from titanium or, optionally, steel. Optionally, the needle 68 located at the distal end 67 of each arm 59 is formed from a material having greater rigidity than the material used in forming the marker 30, thus increasing the frictional force upon the marker.
In some embodiments, the needle position securing means comprise two parallel arms attached to the handle 13 and located approximately 180 degrees apart. Optionally, the arms 59 are attached at the proximal end 15 of the exterior of the handle 13. In some embodiments, the arms 59 protrude perpendicularly from the handle 13 at the attachment point. In some embodiments, the arms 59 are permanently attached to the handle 13 chemically such as, for example, in the form of a polymer chain, in order to comprise an unitary body. Alternatively, the arms 59 are attached to the handle 13 using a hinge (not shown), which is optionally in the form of a barrel with cylindrical cutout on one body and mating protrusion in the form of a pin on the other body. Alternatively, the hinge comprises two mating barrels with cylindrical cutout on each body having an external pin completing the connection of the two barrels.
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In some embodiments, the arm 59 includes an alignment flange 72. The alignment flange 72 is in the form of a cylindrical protrusion positioned on the arm 59 to be received through the aperture 70 in the handle 13. In some embodiments, the alignment flange 72 is chamfered to help urge the needles as they enter the aperture 70. Optionally, the aperture 70 is approximately the same diameter as the needle 68. Alternatively, the aperture 70 is greater in diameter than the needle 68. In some embodiments, the aperture 70 is located at the distal end 17 of the handle 13.
In some embodiments, the inner cavity 20 of the handle 13, being cylindrically hollow, has at least three stepped incremental diametric cut outs that are mutually concentric along with the largest diameter at the surface of the handle 13 along a latitudinal section. The largest cut out diameter is positioned at the proximal end 15 of the handle 13 with the diameter made substantially equal to that of the end cap overmolded on the blade 23. The depth of the largest cut out is substantially equal to that of the end cap of the blade 23. An incrementally smaller diameter second cut out is located distal (along the axial line 29) to the largest cut out. The diameter of the second cut out is substantially equal to the largest outer surface diameter of the portion of the marker 30 that moves within the handle 13. This second cut out provides the moving freedom of the marker 30. An incrementally smaller (than the other two) third cut out is located distal (along the axial line 29) to the other two cut outs, at the distal end 17 of the handle 13. The diameter of the third cut out is substantially equal to the smaller outer diameter of the marker 30 such that the marker 30 passes through the cut out to be viewed during use. The smallest cut out is of a depth sufficient to allow the needle 68 to penetrate the inner cavity 20 of the handle 13. This movement causes the needle 68 to contact the marker 30, and creates a friction force whereby the position of the marker 30 is maintained within the handle 13 relative to the blade 23.
In some embodiments, the overmolded end cap at the proximal end 25 of the blade 23 has an outer circumference less than the space along the inner cavity 20 at the proximal end of the handle 13, which allows the end cap to fit into position and to create a mechanical lock within the handle 13. In some embodiments, the overmolded end cap is chamfered. In some embodiments the endodontic file 10 is an unitary instrument, such that the various structures are integrated and joined within a single instrument.
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In some embodiments, needle position securing means are in contact with, but not permanently attached to, the handle 13 of the endodontic file 10. More particularly, needles 68 are positioned at the opening at the distal end 17 of the handle 13. Optionally, the needles 68 are slidably attached to the exterior of the opening, wherein the sliding movement is in a direction substantially perpendicular to axial line 29. The user fits a sheath 78 around the outer circumference of the handle 13. Referring now to
In some embodiments, the needles 68 are positioned near apertures 70 located at the distal end 17 of the handle 13. A compression force as described above moves the needles 68 through the aperture and into contact with the marker 30. In some embodiments, alignment flanges 72 position each needle 68 in alignment with its corresponding aperture 70.
Alternatively, needle position securing means comprise an outer sleeve 77 (not shown) that is adapted to fit tightly around a portion of the handle 13. In some embodiments, this portion of the handle 13 is the distal end 17. In some embodiments, the outer sleeve 77 is formed from material chosen from the group nylon 6, nylon 6,6, nylon 6,10, acrylonitrile butadiene styrene, polycarbonate, polyvinyl chloride, aluminum, and steel. This fit creates a compression force sufficient to actuate the needles 68 into secure contact with the marker 30, in order to hold the marker 30 in a substantially static position relative to the blade, as selectably desired by a user.
In some embodiments, the sheath 78 is used for marker securing means, without the use of needles 68. The sheath 78 is formed from a material having a greater flexural rigidity than the material used in forming the handle. Optionally, the material for the sheath 78 is chosen from the group nylon 6, nylon 6,6, nylon 6,10, acrylonitrile butadiene styrene, polycarbonate, polyvinyl chloride, high density polyethylene, polyethylene terephthalate, polyether ether ketone, polypropylene, and polyoxymethylene. The sheath 78 is adapted to create a compression force at the distal end 17 of the handle 13, sufficient to cause the handle 13 to compress the marker 30 creating a friction stop force upon the marker 30.
Alternatively, the outer sleeve 77 is used for marker securing means, without the use of needles 68. The outer sleeve 77 is formed from a material having a greater flexural rigidity than the material used in forming the handle. Optionally, the material for the outer sleeve 77 is chosen from the group nylon 6, nylon 6,6, nylon 6,10, acrylonitrile butadiene styrene, polycarbonate, polyvinyl chloride, high density polyethylene, polyethylene terephthalate, polyether ether ketone, polypropylene, and polyoxymethylene. The outer sleeve 77 is adapted to create a compression force at the distal end 17 of the handle 13, sufficient to cause the handle 13 to compress the marker 30 creating a friction stop force upon the marker 30.
It will be understood that the embodiments described herein are not limited in their application to the details of the teachings and descriptions set forth, or as illustrated in the accompanying figures. Rather, it will be understood that an endodontic file with working length adjustment scale, as taught and described according to multiple embodiments disclosed herein, is capable of other embodiments and of being practiced or carried out in various ways.
Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use herein of “including,” “comprising,” “e.g.,” “containing,” or “having” and variations of those words is meant to encompass the items listed thereafter, and equivalents of those, as well as additional items.
Accordingly, the descriptions herein are not intended to be exhaustive, nor are they meant to limit the understanding of the embodiments to the precise forms disclosed. It will be understood by those having ordinary skill in the art that modifications and variations of these embodiments are reasonably possible in light of the above teachings and descriptions.
This application claims priority to U.S. Provisional Application No. 61/352,754 filed on Jun. 8, 2010.
Number | Date | Country | |
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61352754 | Jun 2010 | US |