US 20050271999 A1
A loop is formed by a bow having across one side a strip or blade. The bow has flexure and memory. The flexure and memory of the bow are imparted to the strip, enabling the strip to be either taut or loose, depending on the pressure exerted by the operator upon the bow. The bow is held and manipulated by the operator with the thumb and finger. The strip is positioned under tension. A holder for the device allows additional variability in the angle of attack of the strip, and facilitates quick and easy interchange of the strips. A holder avoids insertion of fingers far back in the mouth, where working space is limited.
1. A loop that is introduced into an interproximal space between teeth, said loop comprising
a semi-annular bow having a center member that connects a generally vertical leg on a proximal end of said bow with a generally vertical leg on a distal end of said bow, said bow having a wing extending outwardly from said generally vertical leg on said proximal end of said bow and said bow having a wing extending outwardly from said generally vertical leg on said distal end of said bow; and
a strip that is insertible into an interproximal space between adjacent teeth, wherein said strip is attached to at least one of said proximal end and said distal end of said semi-annular bow.
2. A loop that is introduced into an interproximal space between teeth as described in
3. A loop that is introduced into an interproximal space between as described in
4. A loop that is introduced into an interproximal space between teeth as described in
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9. A loop that is introduced into an interproximal space between teeth as described in
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16. A loop that is introduced into an interproximal space between teeth as described in
17. A loop that is introduced into an interproximal space between teeth as described in
18. A loop that is introduced into an interproximal space between teeth as described in
Applicant claims the priority of International Application No. PCT/US04/03785 filed Feb. 11, 2004, which claims priority from Provisional Application Ser. No. 60/447,382 filed Feb. 14, 2003.
Applicant claims the benefit of Provisional Application Ser. No. 60/613,449 filed Sep. 27, 2004.
The invention relates to dental devices and methods generally, and is more specifically directed to devices and methods for delivering polishing or cutting strips or points between the contact areas of teeth, resulting in a more convenient and effective methodology to cut, abrade, or polish interproximal surfaces or restorations thereon.
It is common knowledge that all surfaces of a dental restoration should be polished. Due to access, the polishing of the interproximal surface of a restoration presents a particular challenge. As used herein, dental “restorations” include, but are not limited to bridges, splints, fillings, caps, veneers, crowns, inlays, and onlays. “Polishing” includes cutting, sawing, and abrading, as well as polishing and flossing. The term “strip” includes a blade as well as a strip or floss. It is common knowledge that interproximal surfaces of teeth may require polishing, regardless of whether restorations are involved, so that the surfaces are cleaner and smoother. It is also common knowledge that a dental restoration should be smoothed (polished), particularly in the gingival area, as rough restorations are a cause of inflammation and other gingival problems. Particularly dangerous to periodontal health are rough ledges or “overhangs” in the gingival areas. Interproximal areas, whether they have restorations or not, should be polished to prevent the accumulation of dental plaque, which is a scummy, bacterial film that can lead to tooth decay, as well as periodontal problems.
There have been recent improvements in polishing modalities for other surfaces of the teeth. However, the standard (conventional) method of polishing the interproximal areas has not changed. With the advent of newer porcelain and composite restorations, the need to polish these interproximal surfaces is more significant.
A standard method of polishing the interproximal areas utilizes narrow (4 mm is typical, although the width may be more or less), five inch (13 cm) strips made of fine sandpaper, diamond-coated metal, linen or other material. As referred to, the “strip” may be made of any of these materials. Limitations in using this (long) strip in polishing methodology include:
Manipulation of the strip requires two (2) hands utilizing four (4) fingers in an area of the mouth having very limited working space. Since two (or both) hands are needed to manipulate the strip, there is no free hand to hold back (retract or protect) the tissues of the mouth, particularly the tongue and the lip(s). The strip as shown in can easily cut these tissues, especially where a heavy lip line is present, and there is no free hand available to hold the lip back. A cotton roll under the lip is sometimes utilized in these situations, but this technique is not always effective in holding the lip back, and commonly, the strip tangles in the cotton fibers. An equally significant factor in the need to hold the lip back is the field of vision—being able to see the objective. Frequently, a cotton roll under the lip further blocks vision.
Because so much of the strip is utilized by the gripping of the fingers, a large percentage of the strip is wasted. This waste is especially significant when employing the costly diamond coated strip, which is in common use.
Control is a problem with a five-inch strip. It is difficult to concentrate the polishing force in a particular area of the surface or the restoration.
While a strip can be pulled forward to polish, it is almost impossible to push to the rear (posterior) of the mouth when one of these surfaces needs to be polished.
While rotary polishing instruments are good for polishing all of the other surfaces of the teeth, the rotary bur, due to the direction it must take in the interproximal areas, can cause uncontrollable and harmful notching of the interproximal surfaces, as in the “flame-shaped diamond” bur.
There is a need for an interproximal polishing device that may be economically produced, may be used while exercising both control and force, may be operated by only two fingers of just one hand, and in which the polishing strip can be held taut for going through the contact area, and taut while being retrieved back through the contact area. There is further need for the same invention which can be angled, and tension selectively and progressively relaxed on the strip for interproximal polishing so as to follow the contour of the tooth with wrap-around capability that does not damage the interdental papilla.
The present invention is a flexible loop comprising a bow and a strip or blade along a side thereof. The loop is insertable in an interproximal space between adjacent teeth. The bow has flexure and memory in its body and legs. The flexure and memory of the bow are imparted to the strip or blade, enabling the strip or blade to be either taut or loose, depending on the pressure exerted by the operator upon the bow. The loop is held and manipulated by the operator with the thumb and forefinger of one hand. The strip is positioned relative to the bow under tension. A holder for the device allows additional variability in the angle of attack of the strip, and facilitates quick and easy interchange of the strips. The narrow legs of the holder eliminate the insertion of fingers far back in the mouth, where working space is limited. The device of the invention can be used by grasping the bow between a finger and a thumb or by positioning the bow in a holder for the device.
In another aspect, the present invention includes a strip, which may be a blade having a base end and an exposed end. The base end of the strip is pivotally connected to a proximal end of the handle and is adapted to secure the exposed end of the strip upon insertion of the exposed end between predetermined adjacent teeth.
In further aspect, the present invention includes creating or manipulating an interdental space between adjacent teeth by: providing a bow having at least one proximal end and distal end, at least one strip having a base end and an exposed end for insertion in an interproximal space between adjacent teeth, the base end pivotally connected to the proximal end, the distal end adapted to secure the exposed end upon insertion of the exposed end between desired adjacent teeth; inserting exposed end into the desired interproximal space; rotating the bow until the exposed end is secured by distal end; and manipulating the bow to effect the desired interdental spacing.
In one embodiment, the apparatus of the present invention comprises a manually flexible semi-annular and oblong bow 2.
In another embodiment, wings for holding and deforming the bow extend from the legs.
In the embodiment of
In another embodiment, wings extend from the legs in each direction.
The strip may be attached to the bow by a fastener 26, or the strip may be otherwise fixed to the bow. The strip may be inserted as a plastic bow is molded.
The memory inherent in the flexible bow, imparts to the strip a force necessary to keep the strip taut when the bow is released from manual pressure. The flexibility of the bow selectively and progressively loosens the strip as manual pressure is applied to the ends of the bow. In general, the strip is desired to be taut as it pushed down or pulled up between the contacts of the teeth. The strip in one embodiment can be further tightened for positioning the strip between the contacts of the teeth, by the operator pushing the thumb and forefinger towards each other on grips that are provided above the center member. However, most of the tautness of the strip may be built into the bow/strip, by placing the strip under tension between the legs of the bow at the time of manufacture. As shown in
As used herein, when it is stated that the bow is linear, it means that, when viewed from the top, the bow is formed substantially along a straight line. Similarly, the strip is linear when, when viewed from the top, it is formed substantially along a straight line. In the embodiments of
After the strip passes between the contact area of adjacent teeth, the strip can be loosened by positioning the thumb and forefinger towards the ends of the legs of the bow and pushing the opposing legs toward each other to manually deform the bow. The strip loses its linear shape upon manual deformation of the bow, and assumes a shape that is suitable for manipulating the strip against the tooth or other objective having a compound and generally non-linear shape. The operator guides the strip, whenever it is necessary to go under the gum, to the particular side of the interdental papilla in such a manner as to not damage the papilla or the rest of the gum surface. If the surface to be polished is to the front of the papilla, the strip is placed in front of the papilla; and vice-versa for the surface behind the papilla. The bow makes it easy to guide the strip in the placement. The bow may be made of plastic, autoclavable plastic, metal, or other materials having memory that meet the objects of the invention. This invention may embody several different shapes of bows and blades/strips. When used for polishing or cleaning teeth, the strip may be formed of thin, less abrasive material such as linen.
One alternate shape for the strip is shown in
A strip that has an abrasive or is non-abrasive may convey the delivery of anti-caries agents, such as fluorides, or for the delivery of medicaments, such as for the treatment of an interproximal periodontal pocket, or the prevention thereof.
The legs, with the strip attached, may be manually compressed medially as well as pushed towards the posterior (back of the mouth) or pulled towards the anterior (front of the mouth), depending on which surface requires polishing.
Additional manual pressure is applied to the ends of the bow, so that it is progressively deformed. If the mounting points of the strip are moved closer together, additional slack is present in the strip. This additional looseness of the strip, while the strip is pulled against the distal surface of the bicuspid, enables a greater surface area on the facial and lingual surfaces of the bicuspid to be polished.
The bow may be tilted slightly from a vertical position.
The device may be used in an opposite, so that the device is used to polish the front (mesial) surface of the molar. The bow may be flexed and tilted in an opposite direction.
The device may be used with teeth in the lower front region of the mouth. The operation is being performed with one hand, which allows the operator's opposite hand to, for example, hold the patient's lip away from the bow. With the bow held so that it is generally linear, and the attachment points of the strip relatively far apart, the strip is relatively linear and taut. The memory of the bow assumes the relatively linear shape when no pressure beyond that necessary to hold the bow is applied to the wings or tabs of the bow.
In the embodiments of
The strip may be placed slightly under the gum (gingival papilla) without damage to the gum. Pressure is applied to the bow until the desired level of looseness or slack is achieved in the strip, and the device is tilted as desired to achieve the desired angle of attack for the strip relative to the teeth and gums.
The legs may be formed to be narrow, and the strip is attached to lower wings or tabs. The use of lower wings or tabs facilitates the narrower legs, which facilitates use of the device in the back of the mouth, where working space is particularly critical.
Another embodiment incorporates a bow holder, which facilitates the use of, but is not limited to use with, the bow described above. This invention comprises a metal or plastic two-prong fork 70.
The ends of the fork can be inserted into the notches 3,5 of the bow of
As shown in the embodiment of
In still another embodiment of the holding device, the holder is attached through holes in the bow, with one on each side, and the bow is further stabilized by pushing the forked ends of the major fork through these holes. For the removal, the ends are pinched and removed back through the holes. The holder can be manually operated, or it may be an electro-mechanical device, such as a reciprocating dental drill or reciprocating powered toothbrush.
In another embodiment, the same principle of the bow is used to hold a metal or plastic matrix band used in the restoring of the interproximal side of a tooth. As with the polishing bow, the matrix band has memory imparted to it from the bow, and the matrix band is taut as it forced between the teeth, and as it is retrieved from between the tooth and a new restoration. Just as with the polishing bow, the bow is flexed at its crest, by the thumb and forefinger, to become more taut when going through the contact area, and is loosened to follow the contour of the tooth, achieve the necessary amount of wrap-around, and provide for a secure contact between the adjacent tooth surface and the new restoration (to prevent food impaction between the adjacent tooth surface and the new interproximal restoration).
The bows and the strips/bands for the matrix system assume several configurations. As the band is flexed, it will “bulge-out” against the adjacent tooth and provide good contact for the upcoming restoration. If desired, an optional cross-wire or a conventional matrix band clip may be placed to hold the legs of the bow in proper position while the restoration is being placed.
Advantages and uses of the bow matrix band technique:
The metal, plastic, or autoclavable bow may bend in the direction of the polishing side. This is accomplished by mounting the strip or blade on that side, but may be dictated by tapering the bow at the bottom of its major connector, as well as by hollowing out of this same area on the side toward which the bow is to be flexed. The amount of flexure and directional bending of the legs may be adjusted by similar methods. Tabs or wings 14, 16, at the ends of the legs 6, 8 of the bow 2 determine which way the bow bends, through lever action. The lever action, through these wings, enables the operator to bend the legs with greater facility, allowing the strip to more closely conform to the contour of the tooth, and allowing the operator to control the degree of flexure required.
The angle of the bow's major connector also determines the “rise” of the legs 6, 8 of the bow 2 as well as the way certain areas of the bow are “hollowed-out” to control its direction and amount of bending. A “thin-leg” bow allows more room for the strip. Note that the mouth has plenty of room for a bow in an anterior-posterior (front-to-back) dimension but not, in the posterior part of the mouth, in a lateral dimension.
In one embodiment, the strips are attached to the bow 2 by small protrusions or hooks that are a part of the material of the legs, but which protrude outwardly from the ends of the legs, to allow for the attachment of the strip thereto. This method of attachment allows for replacement of strips.
Other methods of attachment of the strips to the bow are:
Alternatively, the strip area is not attached to the bow, but is formed as an inherent part of the bow. The strip in this embodiment is a very thin, continuous part of the bow. The strip may become a polishing agent by treating it with an abrasive, or by abrading the thin surface.
Among the advantages of the present invention is that the dental bow may be cheaply produced, and may be heat sterilized (autoclaved), or it may be completely disposable. If the bow/strip is autoclaved and a metal strip is used, the bow-mounted strip will probably fare better in the autoclave because the regular un-mounted metal strip, not stretched under tension, tends to curl in the autoclave in such a manner as it makes its reuse difficult.
A further advantage of the present invention is that a strip too narrow to be manipulated by direct finger contact may be successfully utilized in the bow. Some tasks call for a narrow strip, and it is easier to pass a narrow strip through a heavy contact, resulting in less damage (loosening) to the contact area. Some strips may be “hybrids”, that is, the same strip can have a narrow portion for placement through tight contacts, and a wider portion for polishing. The narrow portion may be smooth or gritty. A smooth portion of the strip makes it easier for the strip to go through a tight contact. The narrow portion facilitates upward and downward movement on the tooth to detect overhangs or ledges on the side of the tooth. While it is difficult to position a strip between tight contacts, the bow of the present invention facilitates this task, since the bow can provide a better angle of attack, be controlled better, and assist in the application of additional force in penetrating a difficult contact. The bow is better suited for directing the strip to the areas that need polishing than is conventional strip technology.
While most strips have an abrasive side and a safe side, grit or abrasive on both sides of the strip is sometimes desirable, such as in the case of an orthodontic procedure, to make room for orthodontic bands, or to make space to move teeth into. This device of the present invention is useful with such strips. Since the strip is abrasive on each side thereof, the bow may have tabs facing forward and backward, so that the bow and strip may be flexed in either direction to further contour the adjacent teeth while the strip is still in place between them.
Still another advantage of the present invention is that the bows may be color-coded according to the grit level of the strip. Color coding is not desirable with current strip technology, because the color of the strip may be transferred to the new interproximal restoration or tooth surface. The bow of the present invention may by color-coded, without color-coding the strip. Color coding may also be used to indicate the dimensions or composition of the strip.
In one embodiment, an upper anterior bow, is wider and higher (the anterior teeth are longer than the back teeth) than a posterior bow. This embodiment accounts for fact that the upper front (anterior) part of the mouth provides more operating space, since there is no tongue in the way and a lip that can be held out of the way by that “free” hand.
A summary of advantages of preferred embodiments:
The polishing bow as described will smooth an interproximal rough area. However, a difficult and gross amount of cement, calculus, or rough excess filling material may be present that should be pushed or “chipped out” of the interproximal area. An adjustable “pin ring” positioned on the finger, with a rigid point protruding at a right angle from the surface of the ring, facilitates accomplishment of this task.
After cementing a dental restoration such as a bridge, splint, crown (cap), inlay/onlay or veneer, there often remains a hardened mass of cement that is very difficult to dislodge. Scalers are the accepted method for this removal, but they are time consuming to use, and not sufficiently effective or efficient. Due to the direction of approach to the interproximal space with hand instrument scalers, these scalers are constructed with angles making the scaler susceptible to breaking against hard cement. If an instrument had a direct approach, the chance of fracture of the instrument may be lessened. Traditional thought and design has not allowed this. Also, these traditional hand instruments (scalers) are designed to “pull up”, and may dislodge the recently cemented restoration. What is needed is an instrument that is not at a right angle to the mass (as are traditional hand instruments), but which pushes on the mass in a direct fashion. For tactile feel and tactile strength, the new instrument is at the end of the operator's fingertip, not at the far-away end of the handle of the conventional hand instrument. This proximity to the fingertip allows the operator to feel, dislodge, and push the offending mass out of the interproximal space. If the material is allowed to remain, whether it is cement, or a large amount of tenacious calculus, or rough or excess filling material, serious periodontal problems may arise.
An adjustable plastic ring that is positioned over a finger, preferably the first digit of the index finger (the forefinger), and particularly near the tip thereof, is used to remove this material. Protruding from the ring, preferably at a right angle to the ring, is a rigid metal point. If desired, the ring may have a color-coded bottom. While the ring fits comfortably, it is sufficiently firm-fitting to permit it to be angled upwardly or downwardly, front or back, by changing the angle or rotation of the finger. The point may be round, oblong, or triangular, or of other desired shape. This rigid metal point may used for pushing/pulling the device unilaterally through an interproximal space, or it may be opposed by a stipple-surfaced thimble on the opposing thumb of the same hand. The rigid point is pushed by the forefinger through the interproximal space where the point will catch on, or at least be stabilized, in the stippled part to the thumb thimble. Alternatively, a brush, which could be a spiral brush, could be used in place of the pin.
If the rigid point is serrated, abraded, or it is coated with an abrasive substance, a polishing back-and-forth action is accomplished by a sawing action between the thumb and forefinger. The ring of the index finger as well as the ring of the thumb, is easily interchanged to the opposite hand, giving the operator the option of approaching the task from either the lingual or facial side.
Another embodiment of this invention is a thimble for the forefinger that is designed with a hollow tunnel on top (most distal end of the thimble). Into this hollowed tunnel, a blade is inserted. The body of the blade preferred to be is encased in a plastic or rubber sheath that allows the blade to be inserted, with friction, securely into the tunnel. The blade does not rotate or intrude beyond its intended position. The stipple thumb thimble as discussed above may oppose the tip of the blade. The blade may be removed and replaced by another blade of a different shape or grit. Each of the removable blades can be sterilized. The thimble may be worn on either hand for the option of approaching the task from either the lingual or the facial side.
In another embodiment of the device, the strip 54 is attached at one end to a leg 58, or an attached wing, of the bow in a manner that allows the end to pivot.
Bow 52 may have a slot formed in proximal end adapted for securing a base end 72 of the strip therein. A fastener may be provided for the base end, or the base end may be secured within the bow at the time of manufacture. Preferably, a bow permitting ease of angular flexure of the strip is substantially contained within proximal end. The strip extends in a direction away from the base end terminating at tapered exposed end in the embodiment shown. Upon sufficient directed rotation of the strip, which is preferably coplanar with the longitudinal axis, exposed end 64 may be secured in a keeper 62. Once the exposed end is secured in keeper, the strip is structurally supported at its ends. In a preferred use, the exposed end of the strip is directed toward the interproximal space the desired adjacent teeth, which may be by use of a handle connected to the bow as previously discussed, preferably from the facial side toward the lingual side adjacent the sulcus as this typically provides the widest space and therefore the highest chance of insertion of strip there through. To ease insertion, the strip 54 has a flat, narrow profile, but may be triangular shaped to substantially match the shape of the space typically defined by adjacent teeth at the sulcus. After end 64 is sufficiently inserted through the interproximal space, it is desirable to secure the end in the keeper. To effect this securement, the strip is rotated or moved until the end engages the keeper.
Once the end is secured, the bow is manipulated in an effort to further widen/polish or otherwise perform procedures in the interproximal space. Another advantage is acceptance of dental floss there between. This interproximal space widening is accomplished by bringing any combination of upper, lower and lateral surfaces of the strip into abrasive contact with the surfaces between adjacent teeth. To create this abrasive contact, these surfaces may be provided with an abrasive coating, typically comprised of diamond, or by forming discontinuities on these surfaces by exposure to dies under pressure, chemical etching, exposure to high speed particles to cause pitting, or any other method of mechanically changing the surfaces of the strip so that the surfaces are suitable to remove dental material from between adjacent teeth.
In another embodiment, the blade or strip is a semicircle. Among the advantages of curved blade over a “straight” blade is that a curved blade provides additional usable blade length while utilizing the same attach points of the bow. A blade may be used to separate unwanted contacts, such as when composites bond in an undesired manner.
Once the strip is secured within the bow, the user may apply any combination of horizontal, vertical and torsional forces thereto to remove composite resin material from between adjacent teeth. In each instance, increased surface area contact regions between adjacent teeth result from the application of forces in directions that are substantially perpendicular to the direction of the strip when it is secured in the bow. Although increased surface area contact regions should result in response to any application of forces to bow more preferably, a twisting force most beneficially produces contact regions when applied about an axis that is about forty five degrees or less as measured along from axis which corresponds to the direction adjacent teeth extending from the gum line.
Although not shown, it is readily apparent that the apparatus in
An adjustment screw such as at fastener 26 (
The flexible strip shown in
The operating capabilities of the apparatus may be advantageously enhanced to include a reciprocal motion capability along the tool-holding axis of each apparatus. More preferably, the extent of reciprocal motion is adjustable, such as 15 degrees in each direction, incrementally increasable to up to about 360 degrees, further being capable of controllably adjustable rotational motion along the tool-holding axis, the apparatus even further having the capability to operate with any combination of vibration, rotating or reciprocating motion.
Referring to the drawings,
Referring back to
The oscillating device may be used to apply viscous or thixotropic materials to the surface of teeth. The oscillating device leads to unexpectedly superior results over manual application of these materials. The materials include but are not limited to composite resins and glass ionomer materials.
Prior to the present invention, the material is applied to the surface of the tooth, and manual spread over the surface of the tooth to the desired level. Manual spreading of the material is accomplished by repeatedly tapping the material with a small spatula type device. The material is designed to have substantial surface adhesion so that it will remain on the tooth. The material also has a high viscosity, and is not readily spreadable. In particular, the material tends to stick to the surface of the spatula type spreader, resulting in a certain “pull back” of the material as the spreader is pulled away from the material is successive and repeated taps of the spreader against the material that is present on the surface of the tooth.
The use of the oscillating device will much more quickly spread the material. Unexpectedly, there is no resulting pull back, meaning that spreading may be controlled in a superior manner to manual spreading. Further, a surface results that has superior gloss or shine is achieved. The device and method also achieve stronger interdental contacts.
The oscillating device shown in
PANASONIC, Model No. Toothbrush EW129 may also be used in the vertical mode and attached to the loop to produce a reciprocating motion for manipulation of the strip in the interproximal space between adjacent teeth.
The powered device may be used to remove an installed mechanical dental restoration. The vibrating or oscillating mechanism is configured to vibrate or oscillate at a predetermined frequency that below the ultrasonic range. A removal tool is connected to the oscillating or vibrating mechanism so that the tool oscillates or vibrates when the powered device or mechanism operates and at about the same frequency. The tool is placed in physical contact for a predetermined period of time with a mechanical dental restoration that may be secured at least partially inside a tooth by a dental adhesive. The device induces vibration or oscillation along the length of the dental restoration. The dental adhesive becomes loosened due to the movement imparted by the tool, so that the dental restoration may be more easily removed.
The powered device may be used for mixing dental materials when a tip of the appropriate configuration is attached. Tip 136 is an example of a tip that is appropriate for certain applications. The powered device may be used for the placement of posts and dowels.
The tip 136 may be in the form of a small roller. A wire having a plastic roller formed on the end of the wire is used in combination with the oscillating mechanism to apply the material. The roller that rotates about the wire as the oscillating mechanism imparts vibration or oscillation to the roller.