US 20050136375 A1
An apparatus agitates fluid in a root canal of a living patient during cleaning of the root canal. The apparatus includes a tapered tip member having a proximate end and a distal end for insertion into said root canal. The tip member is vibrated or rotated by a driving device for the tapered tip member, which is connected at a proximate end for connection to the driving device. The tip member is made of an elastomeric, non-cutting material having a smooth surface or a textured surface of non-cutting elastomeric material. Optionally, the tip member may include abrasive particles impregnated therein, or coated thereon.
1. Apparatus for agitating liquid in a root canal of a living patient during cleaning of said root canal comprising:
a tapered tip member having a proximate end and a distal end for insertion into said root canal;
a driving device for said tapered tip member;
means on said proximate end for connection to said driving device; and
said tip member being of at least one non-cutting elastomeric material.
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41. A method for agitating debris in a root canal of a living patient during cleaning of said root canal comprising the steps of:
connecting a proximate end of a tapered tip member to a driving device, said tapered tip member having a distal end, and said tip member having a surface of non-cutting elastomeric material;
inserting said distal end of said tapered tip member into said root canal; and
energizing said driving device to loosen macro debris within said root canal.
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The present invention relates to endodontic intracanal irrigation.
After the canal of a tooth is filed and shaped during the usual and customary debridement procedure, organic and inorganic materials are left on the walls of the canal and in recesses therein that are difficult to clean. Traditional methods, such as irrigation of the canal, have been shown to be effective at removing larger loose debris. However, smaller sized particles can be lodged on ledges or around curves in the canal, or burnished against the wall surfaces; these are not easily removed by traditional cleaning and irrigation methods.
Significant amounts of micro and macro debris inside the canal have been demonstrated in scanning electron microscope (SEM) studies after traditional methods of cleaning. Many times the debris is tenaciously attached to the canal walls and behind fins and ledges. Irrigation procedures which simply douche the canal have not produced acceptable results.
Accordingly, these irrigation methods have not been able to effectively remove the “smear layer” which is an organic and inorganic film-like structure that occludes the dentin tubules. It has been demonstrated that removing this smear layer allows better sealing and a higher degree of sterility.
Sonic and ultrasonic rotary and hand metal files and reamers abrade and cut the dentin and are used to shape the canal. Shavings and particles are not completely removed and cause blockages in the root canal and accessory canals. Therefore these instruments are dangerous and ineffective in passively removing debris and smear layer as they continue to cut and adversely reshape the canal.
A kinder and gentler device and method is needed to clean the root canal as a final step before the root canal is sealed with gutta percha or other root canal sealer.
It is therefore an object of the present invention to provide a gentle but effective instrument which agitates liquid in a root canal during the cleaning phase thereof, without changing the shape of the walls, and is capable of scrubbing the canal walls.
In keeping with these objects and others which may become apparent, the present invention includes a plastic tipped sonic or ultrasonic device that vibrates, oscillates or rotates, or in a motion combining some or all of these actions, fits into the root canal and is sized to reach the apex.
The tip member can be parallel sided, tapered, side vented, bristled, or contain any surface irregularity which would help dislodge debris. The tip member may be split in an axial direction or may be multi-stranded with free ends or be joined at the distal tip thereof. The crossection of the tip shape, as well as its surface texturing, is designed to be compatible with the motion regime of the driving device to which it is attached.
The tip member is made of one or more non-cutting plastics, such as aromatic polyamide (KEVLAR®) or nylon, but it can also be made of other semi-rigid elastomers, including flexible metals, such as nitinol.
The tip member gyrates, stirs, and otherwise evacuates the canal due to its fluid dynamic motion and its displacement or fluid dynamic action. The liquid already inside the canal helps to dissolve the smear layer and loosen debris. There is a displacement effect as the tip member is inserted into the liquid of the canal. The liquid may be saline, water, sodium hypochloride, or any of the traditional irrigants used in endodontic procedures, such as ethylidiamine-tetra acetic acid (EDTA).
The tip members are made in sizes and tapers commonly used in endodontics as cutting and shaping tools. A typical working length is 16 mm although commonly used sizes will vary from 15 mm to 35 mm.
Besides the various surface textures and characteristics mentioned above, tip members can also have varying degrees of flexibility. The tip members are constructed with appropriate straight or curved shafts and shaped ends, to fit on a variety of drive devices, such as contra angle and CAVITRON® devices commonly used in dentistry, consumer flossing drivers, or purpose-built drive devices.
Additionally, the working end of the tip members can be treated with medicaments that are eluted into the canal area when inserted and wetted. Liquid in the canal will dissolve and activate the medicaments that are impregnated on the tip members.
Accordingly, a polishing component can be applied to, or impregnated into, the tip member, which assists in removing the smear layer, without adversely changing the canal shape.
In a second embodiment of this invention, the working end of the plastic tip member is not a solid one-piece structure. In a first variation thereof, the working end is bifurcated longitudinally, forming an end with two parts. In the second variation thereof, three or more longitudinal slits are used to partition the end into three or more separate parts (trifurcated) emanating from a common shaft. A third variation thereof substitutes longitudinally extending multiple fiber strands with loose ends for the single working end. In a fourth variation thereof, fibers emanating from a common shaft (as in the latter design) are attached at the distal end such that loose fiber strands exist in between.
In a third embodiment of this invention, abrasive coatings are used to aid in removing the smear layer. Abrasive particles, such as zirconium or aluminum oxide, are factory impregnated into the surface or used as a filler of the plastic material itself. Alternatively, smooth plastic tip members or plastic tip members coated in silicone are dipped into an abrasive slurry just prior to use. The particles will imbed into the surface of the tip members.
The present invention can best be understood in conjunction with the accompanying drawings, in which:
A typical prior art battery-driven flossing device offered by Water Pik® Technologies of Fort Collins, Colo. includes a driver which vibrates a short elastomeric flossing tip in two simultaneous orthogonal modes at about 167 Hz.
While tip members 1 shown in
For interfacing with other devices, such as a contra angle, a different coupling end or just a plain shaft end may be required. The four tip members 1 illustrate four of many possibilities of surface treatment or molded texturing. For example, in
However, its working end 26 has a textured plastic surface. If desired, this tip member 21, like all other tip members 1 of this invention, can optionally be impregnated with medicaments.
Tip member 21 has an attachment end 22 which matches the requirements of the driving tool 20. A metal shank 23 bent with the proper shape is used for stiffness and to reduce the attenuation of the ultrasonic vibration. End 25 of the metallic shank is embedded in the shaft 24 of plastic tip member 21. This construction reduces the attenuation of the vibration by reducing the length of the totally plastic structure.
It is possible to extend the metallic core 25 further along the inside of working end 26 if it is somewhat flexible.
A soft elastomeric tip member is not compatible with the use of an ultrasonic driver unless supported with a stiffer core, such as a metallic core, to the distal end, since the ultrasonic vibrations will be absorbed in the material and heated by the vibration.
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In a third embodiment of this invention, abrasive coatings are used to aid in removing the smear layer within a root canal. Abrasive particle 82, such as zirconium or aluminum oxide, are factory impregnated into the outer surface 82 of a tip shaft 80, as in
It is further noted that other modifications may be made to the invention, without departing from the scope of the appended Claims.