Embodiments of the invention relates generally to dental instruments. More particularly, the invention relates to dental surgical stents that fit a patient's tooth or teeth to help guide a dentist during a procedure such as a root canal, apicoectomy, or the like.
The following background information may present examples of specific aspects of the prior art (e.g., without limitation, approaches, facts, or common wisdom) that, while expected to be helpful to further educate the reader as to additional aspects of the prior art, is not to be construed as limiting the present invention, or any embodiments thereof, to anything stated or implied therein or inferred thereupon.
The primary aim of any endodontic treatment is to disinfect the root canal system in order to reduce the bacterial load as much as possible and to seal the system to prevent ingress or egress of bacteria or their byproducts. A root canal procedure often accesses the root from the top of the tooth to remove infection therein. In some applications, a dental professional, such as an endodontist, would need to access infection, cracks or other anomalies of the root sub gingivally. A flap may be made of the soft tissue to provide access to the bone and a tool may be used to remove the bone to gain access to the area of interest. The infection may be removed, and the flap replaced to heal. In some circumstances, the root tip may be removed, a root-end cavity prepared and a biocompatible root end filling placed.
Often, once a flap is cut, it is difficult to handle and maintain it in its proper position during the surgical procedure. The surgeon needs to keep the flap out of the way during the surgery and properly position the flap back in place thereafter. The soft tissue flap may be difficult to handle after it is cut. There is bleeding and fluid also in the surgical crypt making visualization difficult in some cases.
Moreover, to access the infection, the surgeon may need to remove a substantial amount of bone to not only gain access but also to visually ensure the position and depth of hard tissue is correct.
In view of the foregoing, there is a need for dental surgical stents, that may secure the flap during surgery as well as provide a hard tissue drilling location during dental surgery, and a surgical sleeve to ensure accurate access to any area of the root and crypt to allow manipulation whilst working in a dry field.
In some embodiments, the present invention provides a dental surgical system comprising a stent body configured to drape over at least one tooth; a surgical guide attached to one side of the stent body, the surgical guide positioned over at least a portion of a gum region of a tooth; an opening disposed through the surgical guide; a sleeve configured to fit into the opening of the surgical guide; and a bore through the sleeve, the bore communicating a proximal end of the sleeve with a side of the sleeve adjacent to a distal end thereof.
Embodiments of the present invention further provide method for accessing a root canal of a tooth comprising draping a stent body at least one tooth, the stent body having a surgical guide attached to one side thereof, the surgical guide positioned over at least a portion of a gum region of the tooth; creating an incision through tissue near a desired access site; flapping the tissue at the incision; positioning the surgical guide under the flap; positioning a trephine bur through an opening in the surgical guide; forming an access opening through tissue and bone with the trephine bur; terminating the access opening at any point in the crypt or root which may be the base of a root of the tooth; and inserting a sleeve into the access opening, the sleeve having a bore through the sleeve, the bore communicating a proximal end of the sleeve with a side of the sleeve adjacent a distal end thereof, the bore positioned adjacent the root canal of the tooth.
Embodiments of the present invention also provide a method for treating a tooth, comprising draping a stent body at least one tooth, the stent body having a surgical guide attached to one side thereof, the surgical guide positioned over at least a portion of a gum region of the tooth; creating a first incision and a second incision at each side of the surgical guide; removing the surgical guide to provide a further incision connecting the first incision with the second incision; flapping the tissue at the incision with a tissue separator, attached to the surgical guide opposite the stent body, as the surgical guide is positioned under the flap; positioning a trephine bur through an opening in the surgical guide; forming an access opening through tissue and bone with the trephine bur; terminating the access opening at any location on the root; inserting a sleeve into the access opening, the sleeve having a bore through the sleeve, the bore communicating a proximal end of the sleeve with a side of the sleeve adjacent a distal end thereof, the bore positioned adjacent to the root of the tooth; inserting a dental tool, such as a file, bur, sonic, ultrasonic, piezo, laser root preparation tips, or the like, through the bore to manipulate the root/root canal; and inserting a retro filling material through the bore to be applied into the root canal.
These and other features, aspects and advantages of the present invention will become better understood with reference to the following drawings, description and claims.
Some embodiments of the present invention are illustrated as an example and are not limited by the figures of the accompanying drawings, in which like references may indicate similar elements.
Unless otherwise indicated illustrations in the figures are not necessarily drawn to scale.
The invention and its various embodiments can now be better understood by turning to the following detailed description wherein illustrated embodiments are described. It is to be expressly understood that the illustrated embodiments are set forth as examples and not by way of limitations on the invention as ultimately defined in the claims.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well as the singular forms, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof.
Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one having ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and the present disclosure and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.
In describing the invention, it will be understood that a number of techniques and steps are disclosed. Each of these has individual benefit and each can also be used in conjunction with one or more, or in some cases all, of the other disclosed techniques. Accordingly, for the sake of clarity, this description will refrain from repeating every possible combination of the individual steps in an unnecessary fashion. Nevertheless, the specification and claims should be read with the understanding that such combinations are entirely within the scope of the invention and the claims.
In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the present invention. It will be evident, however, to one skilled in the art that the present invention may be practiced without these specific details.
The present disclosure is to be considered as an exemplification of the invention and is not intended to limit the invention to the specific embodiments illustrated by the figures or description below.
As is well known to those skilled in the art, many careful considerations and compromises typically must be made when designing for the optimal configuration of a commercial implementation of any device, and in particular, the embodiments of the present invention. A commercial implementation in accordance with the spirit and teachings of the present invention may be configured according to the needs of the particular application, whereby any aspect(s), feature(s), function(s), result(s), component(s), approach(es), or step(s) of the teachings related to any described embodiment of the present invention may be suitably omitted, included, adapted, mixed and matched, or improved and/or optimized by those skilled in the art, using their average skills and known techniques, to achieve the desired implementation that addresses the needs of the particular application.
Broadly, embodiments of the present invention provide a dental surgical stent that can be used to assist a dental surgeon. A hard tissue stent can include an access hole formed in one side and may be placed over one or more of the patient's teeth where the access hole is accurately aligned at a location for drilling to, for example, to repair a crack, perforation, resorptive defect, removing infected root end, foreign material or remove infection. A soft tissue stent may be placed over one or more of the patient's teeth, where the stent can include a mark positioned where the surgeon is to cut to create an access flap in the soft tissue. By keeping the flap attached to the semi-circular window of the soft tissue stent, the surgeon can more easily return the flap to the proper position and protect it from damage during the dental procedure.
Referring now to
The sleeve 10 can include inside threads 18 (also referred to as female threads 18) that begin at the front face 12 and extend downward toward a back face thereof. The sleeve 10 can include outside threads 20 (also referred to as male threads 20) extending from the back face of the sleeve 10 as shown in
A groove 22 may be disposed about an exterior circumference of the sleeve 10 at a longitudinally central portion thereof. The groove 22 may be helpful to minimize the concentration of compressive stress during use of the surgical guide as discussed in greater detail below.
A nut 30, as shown in
A screw 50, as shown in
Referring now to
Referring now to
Referring to
A stent may be applied to a patient's teeth and a surgical guide may be used to provide access to the soft tissue and bone below a tooth of interest. The below describes the use of such a system, including an alignment guide for ensuring consistent and accurate placement of retro filling material.
Referring now to
For most surgical procedures, anesthetic approaches are conventional. In most regions, a block is administered. Then local infiltration of an anesthetic with 1:50,000 epinephrine is given to enhance hemostasis. A long-acting anesthetic agent is recommended, such as bupivacaine or etidocaine. Bupivacaine 0.5% with epinephrine 1:200,000 has been shown to give long-lasting anesthesia and later provide lingering analgesia.
A properly designed and carefully reflected flap 110 can result in proper access and post-op healing. The basic principles of full thickness, semi-lunar flap design should be followed. The surgical guide 102 can be placed on the patient and arced incisions, for example, a 120° clockwise incision 112 and a 120° anti-clockwise incision 114, can be made with blade #15 to the alveolar mucosa around the surgical guide 102.
The surgical guide 102 can be removed and a firm incision should be made through periosteum to alveolar bone connecting the two previous incisions 112, 114. Typically, one wants to incise and reflect a full-thickness flap to minimize hemorrhage and to prevent tearing of the tissue.
The surgical guide 102 can be placed gently on the teeth 104 so that the tissue 116 is directed towards the back of the tissue separator 108. The tissue separator 108 may be a rigid or semi-rigid member disposed at a side of the surgical guide 102 opposite the stent 100. The tissue separator 108 may be configured to be inserted into the incision and separate the external tissue so that it may be reattached over a hole drilled thereunder. If hemorrhage from soft or hard tissue is excessive to the extent that visibility is compromised, homeostatic agents or other techniques are useful.
After putting the surgical guide 102 on the patient's teeth 104, the patient should bite the surgical guide 102 and keep it for stability. Optionally, the patient can bite on a bite block placed on the teeth 104.
At this point, everything is ready for the surgery. Before using the trephine 120 bur, as shown in
The trephine bur 120 with the stopper 122 attached to it, can be inserted into a central hole 126 of the surgical guide 102 (see
Bone and root tip, infected tissue or foreign material can be removed. Usually the hard tissue is stuck inside the trephine bur. If, in some cases, there are debris from root tip or bone left in the surgical site, it can be removed with a bone curette or bur. The surgical site can be flushed with copious amounts of sterile saline to remove soft and hard tissue debris, hemorrhage, blood clots, and excess root end filling material (if present from a prior endodontic procedure).
Before manipulation of the root, such as a perforation repair, crack repair or root end cavity preparation, and insertion of injecting the retro filling material in the canal, a radiograph is taken to verify that the surgical objectives are satisfactory. If corrections are needed, these are made. In cases of endodontic surgery, the cut root end surface may be prepared for a cavity into the root to include the canal or other configurations such as a dome preparation. (see
Referring now to
The length of the sleeve 140 may be configured so that the end of the bore 146 is positioned at any site within the trephinated cavity including on the root canal space immediately below the root of the tooth of interest, as shown in
In cases where a root end filling 171 may need to be placed, according to the CBCT image, the end 154 of the bore 140 of the sleeve 140 is designed to be exactly next to the canal location. Root end preparation can be done by rotary files/bur, sonic, piezo, laser or ultrasonic tip.
Once the canal 170 is prepared, the retro-filling materials (not shown) may be placed in the canal. Before inserting the filling materials in the canal, a radiograph can be made to verify that the canal is properly prepared. If corrections are needed, these are made before inserting root end filling material. A tip set to the measured length can be used to place the root end filling materials.
The sleeve 140 and the surgical guide 102 can be removed and the surgical site can be flushed with copious amounts of sterile saline to remove soft and hard tissue debris, hemorrhage, blood clots and excess root end filling material. Bone graft material can be mixed with sterile saline and applied to the surgical site until the hole is filled.
To conclude the procedure, the flap can be returned to its original position and held with moderate digital pressure and moistened gauze. This expresses hemorrhage from under the flap and initial adaptation and more accurate suturing. Sutures are generally used, such as absorbable 4-0 suture. After suturing, the flap should again be compressed digitally with moisten gauze for several minutes to express more hemorrhage. The suture knots should note be too tight or it may strangle the tissue and decrease blood supply and cause hypertrophic scars. This encourages less postoperative swelling and more rapid healing.
Referring to
All the features disclosed in this specification, including any accompanying abstract and drawings, may be replaced by alternative features serving the same, equivalent or similar purpose, unless expressly stated otherwise. Thus, unless expressly stated otherwise, each feature disclosed is one example only of a generic series of equivalent or similar features.
Claim elements and steps herein may have been numbered and/or lettered solely as an aid in readability and understanding. Any such numbering and lettering in itself is not intended to and should not be taken to indicate the ordering of elements and/or steps in the claims.
Many alterations and modifications may be made by those having ordinary skill in the art without departing from the spirit and scope of the invention. Therefore, it must be understood that the illustrated embodiments have been set forth only for the purposes of examples and that they should not be taken as limiting the invention as defined by the following claims. For example, notwithstanding the fact that the elements of a claim are set forth below in a certain combination, it must be expressly understood that the invention includes other combinations of fewer, more or different ones of the disclosed elements.
The words used in this specification to describe the invention and its various embodiments are to be understood not only in the sense of their commonly defined meanings, but to include by special definition in this specification the generic structure, material or acts of which they represent a single species.
The definitions of the words or elements of the following claims are, therefore, defined in this specification to not only include the combination of elements which are literally set forth. In this sense it is therefore contemplated that an equivalent substitution of two or more elements may be made for any one of the elements in the claims below or that a single element may be substituted for two or more elements in a claim. Although elements may be described above as acting in certain combinations and even initially claimed as such, it is to be expressly understood that one or more elements from a claimed combination can in some cases be excised from the combination and that the claimed combination may be directed to a subcombination or variation of a subcombination.
Insubstantial changes from the claimed subject matter as viewed by a person with ordinary skill in the art, now known or later devised, are expressly contemplated as being equivalently within the scope of the claims. Therefore, obvious substitutions now or later known to one with ordinary skill in the art are defined to be within the scope of the defined elements.
The claims are thus to be understood to include what is specifically illustrated and described above, what is conceptually equivalent, what can be obviously substituted and also what incorporates the essential idea of the invention.
This application is a continuation-in-part of U.S. patent application Ser. No. 16/365,468, filed Mar. 26, 2019, the contents of which are herein incorporated by reference.
Number | Date | Country | |
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Parent | 16365468 | Mar 2019 | US |
Child | 17037374 | US |