EP1962713A2 - Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire - Google Patents

Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire

Info

Publication number
EP1962713A2
EP1962713A2 EP06829216A EP06829216A EP1962713A2 EP 1962713 A2 EP1962713 A2 EP 1962713A2 EP 06829216 A EP06829216 A EP 06829216A EP 06829216 A EP06829216 A EP 06829216A EP 1962713 A2 EP1962713 A2 EP 1962713A2
Authority
EP
European Patent Office
Prior art keywords
adhesive
bone
apical
root
root canal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP06829216A
Other languages
German (de)
English (en)
Inventor
Erfindernennung liegt noch nicht vor Die
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from EP05090327A external-priority patent/EP1790308A1/fr
Application filed by Individual filed Critical Individual
Priority to EP06829216A priority Critical patent/EP1962713A2/fr
Publication of EP1962713A2 publication Critical patent/EP1962713A2/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00—Filling or capping teeth
    • A61C5/50—Implements for filling root canals; Methods or instruments for medication of tooth nerve channels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00—Filling or capping teeth
    • A61C5/40—Implements for surgical treatment of the roots or nerves of the teeth; Nerve needles; Methods or instruments for medication of the roots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K6/00—Preparations for dentistry
    • A61K6/80—Preparations for artificial teeth, for filling teeth or for capping teeth
    • A61K6/831—Preparations for artificial teeth, for filling teeth or for capping teeth comprising non-metallic elements or compounds thereof, e.g. carbon
    • A61K6/838—Phosphorus compounds, e.g. apatite
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K6/00—Preparations for dentistry
    • A61K6/80—Preparations for artificial teeth, for filling teeth or for capping teeth
    • A61K6/849—Preparations for artificial teeth, for filling teeth or for capping teeth comprising inorganic cements
    • A61K6/864—Phosphate cements

Definitions

  • the invention relates to a method and a kit for producing a closure means for apical sealing of a tooth root canal, for improving root canal fillings;
  • the invention also relates to the use of bone adhesive for closing root canals.
  • the known preparations of the root canal relate to the expansion, cleaning and shaping of the root canal, in particular by a biomechanical treatment, which includes in particular the filing and rinsing of the root canal to substantially absolute shape and cleanliness.
  • the root is filled, wherein the goal of the root filling is to close the entire channel system hermetically as long as possible in order to prevent the ingress of microorganisms or fluids after the treatment.
  • various techniques are available to the expert.
  • a well-known technique, for example, is the so-called lateral condensation, in which a gutta-percha pin coated with sealing cement (sealer) and longer - filling the tooth canal - is introduced into the previously prepared canal.
  • gutta-percha points By spreader and the insertion of further gutta-percha pins (gutta-percha points), the channel is almost completely filled.
  • the lateral condensation of the accessory pins makes it possible to increase the density of the gutta-percha filling, which is only possible with great expenditure of time.
  • Another problem arises when too much sealer is applied to the gutta-percha point syringe or when overly general sealer is used, since in these cases there is a risk of overstuffing.
  • the excessive sealer material then penetrates the end of the root and settles in the surrounding bone.
  • thermoplastic filling material (Thermafill, Dentsply Maillefer, Ballaigues, Switzerland).
  • the thermoplastic filler material requires that a conical canal be available in the tooth and that an intact apical end of the tooth be provided, for example by the introduction of sealer.
  • these prerequisites for the thermoplastic filling material describe the decisive disadvantage of this process, since it can easily lead to overpressing of sealer beyond the apex.
  • the cement material is pressed into the tissue surrounding the tooth and permanently stored.
  • the embedded cement material can lead to unwanted defense reactions in the tissue or to cyst formation.
  • Another known method is the thermoplastic condensation. Prerequisite for this is an intact and narrow foramen apicale.
  • the skilled artisan has the ability to treat the root canal by a thermoplastic injection in which heated gutta-percha outside the mouth is introduced into the canal by means of a hypodermic syringe. Since the gutta-percha is introduced in a liquid state, there is also the risk of overstuffing, whereby gutta-percha material is introduced beyond the tooth canal into the surrounding tissue. Another disadvantage of this method is that always an intact foramen apicale must be available as a prerequisite for successful root filling.
  • the object of the invention was therefore to provide means and methods which do not have the disadvantages of the prior art, and in particular allow a simple, safe and effective treatment of a tooth, in particular a safe and less time-consuming root filling, preferably a spike-free blocking ,
  • the invention solves this problem by the use of a bone adhesive for apical blocking of a root canal.
  • apical root filling material which preferably comprises or preferably consists of physiological adhesive, for example bone adhesive or tissue adhesive. If, for the purposes of the invention, a bone adhesive is mentioned, this always also applies to tissue adhesives and thus to all physiological adhesives.
  • a root canal can be apically blocked, even if the canal has an oval or non-round shape at its apex, preferably to ensure 100% tightness in the area of the apex or, preferably, the circumradical (around the apex of the root bone) shows a bone substance loss.
  • the bone adhesive used can comprise, for example, silicates and / or silanes.
  • Preferred physiological adhesives or bone adhesives are calcium phosphate cements or their granules (ex: by the company 'Baxter'), but also monomers and comonomers, hydroxyapatite, methyl acrylate-based polymers and also composite-based polymers; furthermore, "Cerasorb” can be used (an adhesive comprising calcium ions), further bone adhesives according to the invention are methacrylates, cement-based bone adhesives and "gelrin” (an adhesive consisting of fibrin and glycol). The person skilled in further bone adhesives are known, such as fibrin glue.
  • the bone adhesive combined with a probe, which consists for example of a gutta-percha cork.
  • the aim and subject matter of the teaching according to the invention is the termination of the apical region of the opened root canal, so that later introduced material which serves for tooth filling can no longer penetrate out of the root canal and into the surrounding tissue and even with non-round apices and / or or in damaged circumradicular bone.
  • the use according to the invention of the bone adhesive does not serve for completely filling up the root canal, but preferably for apical blocking.
  • the blocking here describes the positioning of the bone adhesive in the apical region, so that the subsequently introduced root filling material can not escape from the root canal in the apical direction.
  • the blocking preferably takes place hermetically and / or bacteria-tight or substantially hermetically and / or essentially bacteria-tight.
  • the method according to the invention is carried out both therapeutically and cosmetically.
  • the process according to the invention is preferably not used in EPC member states for the treatment of the human or animal body in the sense that it aims at maintaining or restoring health or at preventing pain or discomfort. Accordingly, the process according to the invention is intended in particular to solve cosmetic problems in EPC member states, or problems which have a disturbing (but not harmful to health) influence on the dental health. Unless in connection with the invention of therapeutic therefore, in relation to EPC member states, this is limited to the use of the agents according to the invention for the preparation of a treatment agent for the therapeutic treatment of pathological changes of the tooth root, in particular the blocking or securing of the circumradicular (around the Root tip) bone and securing the foramen apicale.
  • the method may also be directed to the preparation of a treatment agent which is used to restore a healthy condition of a tooth root or to secure the apical foramen or to secure the periapical bone, using a bone adhesive.
  • a treatment agent which is used to restore a healthy condition of a tooth root or to secure the apical foramen or to secure the periapical bone, using a bone adhesive.
  • the invention also relates to a dental root sealing kit comprising at least one bone adhesive, optionally with information for combining or using the contents of the kit.
  • the kit may also be possible for the kit to include probes adjacent to the bone cement that serve to seal the root canal.
  • the kit comprises a plurality of, for example, gutta-percha corks or different probes which have gutta-percha corks with different conicities.
  • the information for combining the contents or for using the contents of the kit may, for example, be a therapy plan. include a plan for the treatment or prevention of dental lesions, in particular for the treatment of root canals and their filling.
  • a method for root canal filling characterized in that it comprises a subsequent root filling with the Einstatttechnik, lateral condensation and / or with thermoplastic filling material.
  • An apical root filling material comprising bone adhesive and / or a gutta-percha cork is preferred.
  • a swimming spallmaterial characterized in that it does not extend into the non-apical region of the root canal and more preferably covers 1/3 to 1/2 of the root canal length. Most preferably, 1/5 to 1/10 of the root canal length is covered, in particular not more than 1/10 of the total root length.
  • a method for bacteria-tight closure of a root canal characterized in that a separate apical stopper is introduced into the root canal, wherein the stopper comprises a bone adhesive.
  • the bone adhesive or the tissue adhesive is introduced into the root canal in such a way that it overstocks.
  • the overstuffing is particularly advantageous if it takes place so that the adhesive is pressed out of the root canal and penetrates into the surrounding tissue. In particular with lesions in the bone, this can result in a faster healing and thus a more premature final restoration of the tooth.
  • the bone adhesive is preferably used for secure sealing in non-round foramina with lateral lateral channels; apical delta.
  • the adhesive preferably bone adhesive, can be used particularly preferably to apically complete milk teeth, the bone adhesive being advantageous over the previously related calcium hydroxide (especially in deciduous teeth).
  • the adhesive in a preferred embodiment, should be constructed to include components that enable both rapid fixation and slow fixation; the person skilled in such components are known.
  • the slow binding of the adhesive advantageously results in it penetrating beyond the apex into the tissue.
  • the adhesive may further comprise materials that result in X-ray opacity.
  • the adhesive can also be mixed with bioresorbable granules.
  • the cyanoacrylates were synthesized in 1959 by Coover et al. developed. From this, various derivatives have been produced. The simplest is methyl 2-cyanoacrylate. Other derivatives have more C atoms, such as ethyl, butyl and isobutyl-2-cyanoacrylate.
  • the liquid monomers polymerize on addition of water to a solid polymer. They have a strong adhesive power, especially in humid environments. Their adhesion decreases as the number of carbon atoms increases, with increasing elasticity and polymerization time. However, the often observed toxicity with a longer side chain decreases as well. It is believed that this toxicity is present all things from the breakdown products.
  • the Cyanoacry- latkleber has the great advantage of being able to be broken down.
  • the glue finds its application above all also in the Verkelbung of soft tissue.
  • Ostamer is the best known and best studied polyurethane; it polymerizes under cavitation, so that bones can grow into these cavities.
  • the polymerized polyurethane preferably serves as a framework for the ingrowing bone.
  • PMMA polymethyl methacrylate
  • PMMA can be used, which can be a bone adhesive within the meaning of the invention.
  • it can be used as a stabilizer and space filler of osteoporotic and tumorous bone in the tooth area.
  • PMMA shows no toxicity.
  • PMMA interlocks with the trabecular bone.
  • PMMA can be used as a medicament carrier, above all for antibiotics.
  • Epoxy resins are also advantageous as bone adhesives.
  • Most fibrin sealants are mixtures of fibrinogen, thrombin, calcium and Faxtor XIII. They represent the most physiological glue and therefore show no allergic or toxic reactions. This results in other benefits. They are degraded within a short time without tissue irritation, whereby this time can be too short for the bony structure. Furthermore, they do not show high polymerization temperatures. In addition, there are studies describing an acceleration of healing, hemostasis and improved revascularization.
  • the invention also relates to a device for the apical introduction of bone adhesive into a root canal, wherein the Device comprises the following components: an adhesive depot, a plunger, a plunger top, a standardized click approach a guide pin, a rubber stopper for length assurance, a Meßskal mich, a guide pin with application tubes, an integrated application tube, an ISO-normalized pen tip laterally with application Schlauchaus operations sansn, a Click system on the adhesive depot and / or an application hose attachment.
  • the constituents of this device are preferably to be implemented by injection molding and should preferably be embodied in polymers.
  • the device accordingly comprises a two-component adhesive or a one-component adhesive filled metering device, a connection piece with a mixing device and a filling tube with a scale. Furthermore, it is possible to use a cartridge with dosing in addition to the classic syringe version.
  • the adhesive is contained in a deformable cartridge, which can be clamped in a reusable dosing device.
  • the invention also relates to a method for producing the mixing device comprising a cannula, wherein it is advantageously designed as a disposable article as a sprayable polymer.
  • TRICOS resorbable bone substitute can be used as a bone adhesive.
  • This is a resorbable, bioactive bone substitute material, which can be replaced particularly preferably by newly forming bone tissue. It includes a two-phase ceramics made of calcium phosphate and beta-tricalcium phosphate. The teaching according to the invention therefore has the following advantages:
  • a two-depot system with a flexible, scaled cannula can be triggered by a simple pressure mechanism. It eliminates complicated introduction of other filler. The attached scale allows easy checking of the length at any time of treatment.
  • An apical stop is introduced, for example in the case of thermoplastic injection, which brings about improvements mentioned above and below.
  • the risk of overpressing is minimized, almost extinguished, and the resulting consequences such as inflammation, cyst formation, loss of bone substance and pain for the patient are also reduced to zero.
  • the apical leakage is almost extinguished and its consequences such as bacterial invasion of apical and resulting destruction of the hard tooth substance minimized.
  • the 'glue' is applicable to almost all common methods. Even with anatomical deviations of the 'adhesive' is applicable, which is a difference from the previously known methods. cheapening:
  • Costs for a revision are around 800.00 - 1.000,00 EUR; In America, the cost per channel is estimated at $ 1,000.00, so for a complete tooth, which can span four to five channels, it can be estimated at up to $ 5,000. Costs for tooth extraction and subsequent restoration by implants, for example, amount to approx. 2,000.00 EUR per implant, etc.
  • Combination invention Known WF materials such as bone adhesive are combined and combined with the newly developed measuring handle.
  • the invention is based on examples and
  • the plastic of the preferred agent according to the invention is chosen so that it is biocompatible, flexible and flexible, crush resistant, non-toxic and resilient. It is produced so that the agent (application cannula) as a disposable System is to use. Further, the scale of the agent is kept in 0.5 mm increments, with each full 1 mm increment represented by solid circles and each 0.5 mm increment by half circles. Every 5 mm a different color is selected for the scaling so that the dentist can carry out the length check at any time. In addition, the length is printed on each 5th graduation in the form of a number (eg: on the length of 20 mm there is a 20 next to the scale graduation).
  • FIG. 1 is a diagrammatic representation of FIG. 1:
  • 1 shows a preferred variant of the invention 0, which consists of the following components: adhesive depot (1), plunger (2), plunger upper part (3), standardized click approach of the guide pin (4), rubber stopper for securing length (movable) (5) , Measuring scaling (6), guide pin with application hoses (or only one hose) (7), integrated application hoses (or hose) (8), ISO standardized pen tip with laterally located application hose hoses (9), click system at the adhesive depot (10), Application hose extension (reinforced) (11).
  • the two major components (or only one component) of the adhesive are stored in (one) two separate depots in the handle portion of the syringe, whereby here too the injection cannulas are usable as a disposable system.
  • the same plastic is used as injection cannula guide pin, as is the case with the preferred variant of the probe according to the invention.
  • On the guide pin is located in each case (or only one center) left / right side of an injection tube, each of its adhesive component to apical (toward the root tip) promoted, (there to let the two components flow together.)
  • the scaling is designed in the same way as explained above for FIG. 1.

Landscapes

  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dentistry (AREA)
  • Chemical & Material Sciences (AREA)
  • Plastic & Reconstructive Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Neurosurgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • Inorganic Chemistry (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Medicinal Chemistry (AREA)
  • Polymers & Plastics (AREA)
  • Organic Chemistry (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Dental Preparations (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

L'invention concerne un procédé et un ensemble de fabrication d'un élément d'obturation destiné à l'étanchement apical d'un canal de racine dentaire afin d'améliorer l'obturation du canal de racine dentaire. L'invention concerne également l'utilisation de ciment à os pour l'obturation de canaux de racine dentaire.
EP06829216A 2005-11-25 2006-11-24 Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire Ceased EP1962713A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP06829216A EP1962713A2 (fr) 2005-11-25 2006-11-24 Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US73973805P 2005-11-25 2005-11-25
EP05090327A EP1790308A1 (fr) 2005-11-25 2005-11-25 Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire
DE102006012777 2006-03-17
PCT/EP2006/011519 WO2007060024A2 (fr) 2005-11-25 2006-11-24 Utilisation de ciment a os pour l'etanchement apical d'un canal de racine dentaire
EP06829216A EP1962713A2 (fr) 2005-11-25 2006-11-24 Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire

Publications (1)

Publication Number Publication Date
EP1962713A2 true EP1962713A2 (fr) 2008-09-03

Family

ID=37761941

Family Applications (1)

Application Number Title Priority Date Filing Date
EP06829216A Ceased EP1962713A2 (fr) 2005-11-25 2006-11-24 Sonde, procédé et kit et leur utilisation pour rendre étanche l'extrémité apicale d'un canal radiculaire dentaire

Country Status (3)

Country Link
US (2) US20090226858A1 (fr)
EP (1) EP1962713A2 (fr)
WO (2) WO2007060024A2 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015086660A1 (fr) 2013-12-11 2015-06-18 Transcodent GmbH & Co. KG Utilisation d'un dispositif de mesure de cavités dentaires
CN107149499A (zh) * 2017-05-05 2017-09-12 滨州医学院 一种牙髓腔糊剂填充器

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WO2000033793A1 (fr) * 1998-12-11 2000-06-15 Dentsply International Inc. Composition dentaire
WO2005016368A2 (fr) * 2003-08-19 2005-02-24 University Of Pittsburgh Of The Commonwealth System Of Higher Education Methode permettant d'induire la biomineralisation, methode permettant d'induire la regeneration osseuse et methodes associees

Also Published As

Publication number Publication date
WO2007060023A1 (fr) 2007-05-31
US20140030672A1 (en) 2014-01-30
WO2007060024A3 (fr) 2007-10-11
US20090226858A1 (en) 2009-09-10
US9724173B2 (en) 2017-08-08
WO2007060024A2 (fr) 2007-05-31

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