JP7194710B2 - dental treatment device - Google Patents

Description

The present invention relates to a dental treatment instrument . More particularly, it relates to a dental treatment instrument using a guide sleeve used as a guide when inserting an electrode into a root canal of a human tooth.

The structure of a human tooth consists of a crown a and a root b, as shown in FIG. The crown a consists of enamel a1, dentin a2, pulp a3 and gingiva a4. There are 1 to 4 tooth roots b, which are covered with cementum b5. The tooth root b has a root canal b9, which is an elongated hole, through which a blood vessel b7 and a nerve b8 pass. The root b is surrounded by and supported by the alveolar bone b6. The gingiva a4 surrounds the crown a above the alveolar bone b6.
When a human tooth is affected by caries and the bacteria that have reached the nerve b8 of the tooth reach the area around the root through the root canal b9, they release pathogenic factors into the alveolar bone b6 to dissolve and absorb the bone. This is called an apical lesion. In FIG. 6, the thick dotted line indicates the apical lesion C. As shown in FIG.

As the alveolar bone b6 is absorbed by the periapical lesion, the tooth loses the supporting force of the alveolar bone b6 and begins to sway. When the alveolar bone b6 is absorbed up to ⅔ of the tooth root, or the bone is absorbed up to about 8 mm, the tooth is extracted in the current treatment method.
However, once the tooth is extracted, the tooth cannot be regenerated, so it is preferable if treatment can be performed without extracting the tooth.

As a conventional technique for treating periapical lesions as described above, there is the technique of Patent Document 1 proposed by the present inventor.
This conventional technique uses an active needle electrode having a metal electrode that generates heat when energized, and the electrode is inserted into the root canal of the tooth to reach the lesion and heat it. When the lesion is heated, it is thermocoagulated and can also kill the bacteria around the root of the tooth. Therefore, it is excellent in that it is not necessary to incise the diseased tissue.

However, when inserting the electrode into the root canal of the tooth as in the above-described prior art, the burden on both the doctor and the patient can be reduced if the insertion can be performed smoothly.

Japanese Patent No. 4469015

SUMMARY OF THE INVENTION It is an object of the present invention to provide a dental treatment instrument in view of the above circumstances.

The dental treatment device of the first invention comprises an active needle electrode, a guide sleeve through which the electrode of the active needle electrode is passed, a counter electrode for passing current between the electrode and the counter electrode, and a an energization controller for controlling energization, the tip of the electrode is curved in a normal state, and the guide sleeve is a cylindrical member used for inserting the electrode into the root canal of a human tooth. It has a length that reaches from the top surface of the crown to the vicinity of the tip of the root canal, an outer diameter that allows it to be inserted into the root canal, and is made of ceramics.
A dental treatment instrument according to a second invention is characterized in that, in the first invention, the guide sleeve has a tapered shape with a thick base and a thin tip .

According to the 1st invention, there exist the following effects.
a) When the electrode is inserted into the root canal of the tooth using the guide sleeve, and the counter electrode is attached to the human mouth and energized from the energization controller, current flows between the active needle electrode and the counter electrode. As a result, only the tip of the electrode without an insulating coating layer can be heated, and the root canal lesion and inflammatory granulation tissue are thermally coagulated and sterilized, and the root apex that cannot be treated by conventional chemical and mechanical treatments. Lesions can be improved.
b) Even if the electrode is curved from the tip, when it contacts the inner wall of the cylindrical guide sleeve, the tip becomes almost straight, so that the electrode can be easily inserted into the root canal, and the electrode can be easily inserted. can be easily rotated, reducing the burden of treatment on both doctors and patients. By being made of ceramics, the guide sleeve can be given heat resistance and insulation.
According to the second aspect of the invention, since the sleeve has a tapered shape, it can be easily inserted into the root canal of the tooth .

FIG. 4 is an explanatory diagram of a guide sleeve 5 according to one embodiment of the present invention; FIG. 2 is an explanatory diagram of an active needle electrode A; 1 is an explanatory diagram of a dental treatment device B used in the present invention; FIG. FIG. 3 is an explanatory view showing the active needle electrode A, the guide sleeve 5, and the electrode 1 during insertion. FIG. 2 is an explanatory view of active needle electrode A, guide sleeve 5 and electrode 1 in use. It is an explanatory diagram of a human tooth.

Next, embodiments of the present invention will be described with reference to the drawings.
A guide sleeve 5 constituting a dental treatment instrument according to one embodiment of the present invention will be described with reference to FIG.
The guide sleeve 5 according to the present invention is used for dental treatment, especially when the electrode 1 of the active needle electrode A (a needle-like metal having a length of 20 to 40 mm and a diameter of about 0.10 to 0.20 mm) is attached to a human body. It is a guide member used for inserting into the root canal of a tooth.

Therefore, first, the basic configuration of the active needle electrode A to which the guide sleeve 5 is used will be described with reference to FIG. In the figure, 1 is an electrode, 2 is a handle portion, and 3 is an insulating coating layer. These three members constitute an active needle electrode A. FIG.
The electrode 1 is a metal needle that generates heat when energized, and is made of a superelastic alloy with a curved tip 1a under no load.
A handle portion 2 is formed at the base of the electrode 1 to facilitate handling of the active needle electrode A by medical personnel.
The insulating coating layer 3 is a coating layer using an insulating agent and covers the outer surface of most of the electrode 1 (the portion excluding the tip portion 1a). The electrode 1 without the insulating coating layer 3 is also included in the object of use of the guide sleeve 5 of the present invention.

The guide sleeve 5, which guides the insertion of the electrode 1, is a cylindrical member having a length that reaches from the top surface of the tooth crown to the vicinity of the tip of the root canal and an outer diameter that allows it to be inserted into the root canal. is.
The length L5 of the sleeve 5 is preferably 12 to 27 mm, particularly preferably about 20 mm. If the length is shorter than 20 mm, there is a problem that all tooth types cannot be handled, and if it is longer than 27 mm, the operability is poor. Within the above range, the electrode 1 can be inserted into the root canal from the top surface of the crown to reach the vicinity of the tip of the root canal, which is efficient and versatile.

The guide sleeve 5 has a tapered shape with a thick base and a thin tip.
The outer diameter d1 of the proximal end portion of the sleeve 5 is preferably 0.6 to 1.0 mm, particularly preferably about 0.8 mm. The inner diameter d2 is preferably 0.5 to 0.9 mm, more preferably about 0.7 mm. The outer diameter d3 of the tip of the sleeve 5 is preferably 0.25 to 0.45 mm, more preferably about 0.35 mm. The inner diameter d4 is preferably 0.15 to 0.35 mm, more preferably about 0.25 mm. With such a dimension, it becomes easy to insert the electrode 1 (having a diameter of 0.10 to 0.20 mm), which will be described later.

In the above-described guide sleeve 5, since the inner wall d2 of the proximal end portion is large, the electrode 1 can be easily inserted even if the distal end portion 1a of the electrode 1 is normally curved.
The guide sleeve 5 shown in FIG. 1 has a tapered shape, but a straight shape having the same diameter at the proximal end and the distal end can also be used without particular limitation and is included in the present invention.

Various materials can be used for the guide sleeve 5 without any particular limitation.
Ceramics are preferable for imparting heat resistance, wear resistance and insulating properties to the sleeve 5 itself. As ceramics, oxides such as alumina, zirconia, and barium titanate are preferable. When the guide sleeve 5 itself is insulated in this way, the electrode 1 itself does not have to be insulated, so the electrode 1 without the insulating coating layer 3 can be used.

On the other hand, as will be described later, when the electrode 1 is provided with an insulating coating layer 3 to provide insulation, the sleeve itself does not need to have insulation, so a metal such as stainless steel can be used as the sleeve material. Since stainless steel has high corrosion resistance, it is preferable to use martensitic stainless steel, ferritic stainless steel, austenitic stainless steel, austenitic-ferritic stainless steel, precipitation hardened stainless steel, or the like. Metals, including stainless steel, are excellent in formability, so that they can be processed into small thicknesses and small diameters, and are easy to handle because they have high mechanical strength and are hard to break.

The details of the active needle electrode A used with the guide sleeve 5 will now be described.
The electrode 1 is made of a superelastic alloy. A superelastic alloy is a metal that deforms when an external force is applied, but returns to its original shape when the external force is removed. Titanium-nickel alloys are generally used as superelastic alloys, but not limited thereto, and various alloys can be used.
The tip portion 1a of the electrode 1 is curved as indicated by the dotted line in FIG. 1 when no external force is applied. However, when an external force is applied, it becomes straight. The straightening external force may be a small force, for example, the force received from the inner wall of the root canal when the tooth is passed through the root canal to bend the tooth straight. The term “straight” used herein does not mean geometrically straight, but includes a shape that is nearly straight enough to pass through the root canal even if it is somewhat curved.

The length L1 of the electrode 1 is preferably in the range of 20.0-40.0 mm, most preferably about 30.0 mm. With this length, the distal end portion 1a of the electrode 1 can reach deep around the tooth root through the root canal of the tooth. On the other hand, if it is shorter than 20.0 mm, it cannot reach the periphery of the tooth root, making it impossible to perform tooth regeneration treatment. Conversely, if it is longer than 40.0 mm, problems such as bending and breakage of the electrode 1 will occur, making it difficult to handle.

The length L1a of the tip portion 1a of the electrode 1 is preferably about 1 to 3 mm, but is not limited to this dimension.
If the heating area is limited to a narrow range in this way, the apical lesion can be heated with a small amount of electric power, and the virulence factors can be heat-coagulated and sterilized without heating above the tooth root unnecessarily.

The diameter of the electrode 1 is preferably 0.10-0.20 mm, most preferably about 0.15 mm. With this diameter, it can be passed through the guide sleeve 5 without difficulty. If the outer diameter is smaller than 0.10 mm, the rigidity will be low, and it will be easy to break and difficult to handle. Conversely, if it is larger than 0.20 mm, it is difficult to pass the root canal, and operability is poor.

The shape of the electrode 1 can be exemplified by a needle shape whose cross section remains circular from the base to the tip. Moreover, the shape of the needle can adopt either a tapered shape or a straight shape. Further, each needle may be spiral-shaped.

Since the tapered electrode 1 has a thick base and a thin tip, it can be easily inserted into the guide sleeve 5. Moreover, since the base is thick, it is less likely to break. A taper of 1/100 to 6/100 is preferable, and about 2/100 is particularly suitable.

The length of the insulating coating layer 3 is the length L1 of the electrode 1 excluding the tip portion L1a.
As the insulating agent constituting the insulating coating layer 3, a commercially available insulating coating agent can be used without particular limitation. Representative examples include resins such as polyethylene, polyethylene terephthalate, polytetrafluoroethylene, silicon, and parylene (registered trademark of Japan Parylene LLC).

The insulating coating layer 3 prevents the portion of the electrode 1 other than the tip portion 1a (the portion inserted into the tooth during treatment) from being energized and generating heat, and only the tip portion 1a that has entered the apical lesion C. used to generate heat.

Next, a dental treatment device B using the active needle electrode A described above will be described.
In FIG. 3, 10 is a counter electrode which is used to pass current between electrode 1 and electrode 1 . The shape of the counter electrode 10 is arbitrary, and a plate-like or rod-like shape is used without particular restrictions. A hook 11 is used to hook the counter electrode 10 to the corner of the mouth on the same side as the tooth to be treated, but the shape of the hook 11 is also arbitrary. Also, any device other than hooks may be used.
On the other hand, a clip 12 is attached to the base of the electrode 1 to fix the conducting wire. An energization controller 13 is connected between the counter electrode 10 and the clip 12 via an energization line.
Although the electrode 1 shown in FIG. 3 has an insulating coating layer 3, the reference numeral 3 is omitted in order to avoid complication of the drawing.

The energization controller 13 is a device that is connected to a DC or AC power source to energize the active needle electrode A, and is composed of a known electric circuit. When the active needle electrode A and the counter electrode 10 are energized using this energization controller 13, heat is generated in the electrode 1 having a small cross-sectional area, and the heat is transferred from the distal end portion 1a of the electrode 1 to the lesion.
At the time of treatment, the heat generation temperature of the distal end portion 1a of the electrode 1 is preferably 100° C. or higher.

As for the energization waveform, it is preferable to use a tone burst wave rather than a continuous wave. This is because the tissue is incised when a continuous wave current is applied, but the tissue is thermally coagulated when a tone burst wave, which is an intermittent waveform, is applied. The toneburst wave referred to in this specification is a half-wave square waveform, and each waveform is intermittent.

A dental treatment method using the guide sleeve 5 and the dental treatment instrument B of the present invention will be described with reference to FIGS. 4 and 5. FIG.
In FIG. 4, T is the tooth, b9 is the root canal, and C is the apical lesion. As shown, the guide sleeve 5 is first inserted into the root canal b9 of the tooth T, and then the electrode 1 is inserted into the guide sleeve 5. As shown in FIG. The electrode 1 has an insulating coating layer 3 formed thereon. Therefore, the guide sleeve 5 may be made of ceramics or metal. The crown a is provided with a hole for inserting the guide sleeve 5 with a dental treatment instrument, if necessary.

The distal end portion 1a of the electrode 1 is normally curved (see FIG. 2), but since the electrode 1 is thin and easily curved, the curved state is corrected by contact with the inner wall of the guide sleeve 5 during insertion into the guide sleeve 5. be. In addition, since the electrode 1 itself has a sufficient length, the distal end portion 1a of the electrode 1 can be deeply inserted into the guide sleeve 5 and can reach beyond the apical portion.

FIG. 5 shows a state in which the distal end portion 1a of the electrode 1 protrudes downward from the root apex. Since the electrode 1 of the present invention is elongated and soft, it can pass through the apical foramen from the root canal b9, protrude out of the apex, and reach the apical lesion C. In this state, since the external force is released, the distal end portion 1a of the electrode 1 bends back and contacts the outer surface of the root apex. In this state, when the handle portion 2 is rotated by hand, the electrode 1 rotates within the guide sleeve 5, and the distal end portion 1a of the electrode 1 also rotates, so that the bacteria bc clinging to the outer surface of the apical portion can be scraped off.

Next, when the current is supplied by the current supply controller 13 shown in FIG. 3, the current flows through the moisture in the mouth through the tip portion 1a of the electrode 1, the apical lesion C, the periodontal ligament cavity, the gingiva, the buccal mucosa, and the counter electrode 10. . At this time, the entire outer surface of the tooth root can be efficiently heated by rotating the tip portion 1a of the electrode 1, which is generating heat, along the outer periphery of the root apex. As a result, the apical lesion C pus and the inflammatory granulation tissue are heated, thermally coagulated and sterilized.
Since the electrode 1 can be easily rotated with the guide sleeve 5, the treatment time can be shortened, and the burden on the doctor and the patient can be reduced.

A active needle electrode 1 electrode 3 insulating coating layer 5 guide sleeve B dental treatment device

Claims (2)

An active needle electrode, a guide sleeve through which the electrode of the active needle electrode passes, a counter electrode for passing current between the electrode and an energization controller for controlling energization between the electrode and the counter electrode become,
The tip of the electrode is curved in a normal state,
The guide sleeve is a cylindrical member used for inserting the electrode into the root canal of a human tooth, and has a length that reaches from the top surface of the tooth crown to the vicinity of the tip of the root canal, and A dental treatment instrument characterized by having an insertable outer diameter and being made of ceramics. 2. The dental treatment instrument according to claim 1, wherein said guide sleeve has a tapered shape with a thick base and a thin tip .

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