WO1996029952A1

WO1996029952A1 - Intraoral vacuum retractor foldable in half comprising two u-shaped members

Info

Publication number: WO1996029952A1
Application number: PCT/BE1996/000032
Authority: WO
Inventors: Joseph Makanga; Jadviga Goxhi
Original assignee: Joseph Makanga; Jadviga Goxhi
Priority date: 1995-03-24
Filing date: 1996-03-20
Publication date: 1996-10-03

Abstract

An oral vacuum retractor designed to be positioned entirely within the oral cavity and including a frame shaped to fit the mouth. The frame includes an outer portion in the form of two U-shaped members joined together at the ends of their arms and having a sufficient degree of elasticity at the point of connection to enable the retractor to be manually inserted into and withdrawn from the mouth. An inner portion in the form of an additional frame essentially parallel to at least one segment of the outer portion is also provided at a sufficient spacing to let through one dental arch. A dental dam in the form of an optionally stretched rubber sheet may be attached to the frame. As the instrument is tubular, fluids (Fig. 9) may be sucked out of the oral cavity more easily through the connector leading to the suction apparatus. The frame with the extraoral dam includes a sufficiently flexible external frame to which the rubber sheet for use as a dam during dental and intraoral treatment (Fig. 12) is adhered or otherwise attached. The frame may have a variety of shapes and the instrument is designed to be used only once (Fig. 12) (1, 2, 3, 4, 5). The double frame enables the dam to be attached without using an adhesive and may be sterilised. (Fig. 12.2).

Description

Half-arch intraoral vacuum foldable in half

The invention relates to a medical instrument for endo-oral use, the role of which is to maintain a constant opening while allowing continuous aspiration and possible protection of the cavity in the event of use of the dam, during various endo manipulations. -oral.

The present invention provides:

- the opening of the oral cavity by spreading the two maxillae

- the suction of saliva and the used liduices

- protection of the respiratory and cigestive tracts thanks to the dike and continuous aspiration

- the replacement of the assistant whose role becomes almost useless.

The field of use is wide:

operative dentistry, endo-oral surgery (tumor, calculosis, toothless segment, intervention on the tongue, etc ...) periodontology (scaling, etc ...), prosthesis, intervention under narcosis, ENT

(tonsilectomy, etc.), implantology, orthodontics, etc.

According to one embodiment of the invention, the instrument is in the form of a flexion frame to be placed inside the.

Doucne. This frame is made up of two parts: an exterior and an interior. They also come in different forms.

The external part is oval or formed by two opposite semi-ellipses. U-shaped, which create at their level of union an element forming a spring and hinge, and giving the instrument, laid flat, an elliptical shape. The purpose of this part is to settle at the bottom of the vestibules, along and outside the dental arches, to separate the jaws and to serve as a support for the possible fixing of a protective dam. An internal part is provided inside the external part

above, approximately parallel to it and at a distance of about 1.5 cm. This internal part, integral with the external part, is intended to be placed along and inside at least one segment of the dental arches, leaving free an intermediate space between the two parts for the passage of the teeth, and / or toothless segments. The internal part is therefore included inside the external part and can have the same shape, it is elliptical, or in the shape of a semi-ellipse or horseshoe.

The role of this internal part is therefore to be fixed inside the dental arches and, in collaboration with the external part, to keep the rubber sheet taut, possibly fixed by gluing, which will in a known manner be pre-perforated and which will also cover the teeth, any edentulous segment, the tongue and the gingival mucosa. This sheet is used to protect the oral cavity during various manipulations.

According to one embodiment, the two parts are also made integral by two, three or possibly more, small arches or U-shaped bridges preferably placed near the segment acting as a spring, the branches being directed towards the inside of the cap. They serve to solidify the instrument and fix it at the bottom of the vestibulojugale and labial grooves, as well as inside the dental arches and edentulous segments (near the mylonyoid - mandibular line and about 1 cm below the palatal collar ). The deck material is generally the same as that of the reinforcement. It protects the soft tissues of the vestibular groove against trauma thanks to their support on the dental arches.

The aforementioned frame may be made of plastic and, when it is not inserted into the mouth, be in the form of a flexible flat part. This is provided, original or not, with a dam which is fixed in a known manner to the outer periphery of the flat part.

In this case, the part will act essentially as a support for a protective dike. Its function of maintaining the spacing of the jaws will depend on the flexibility of the plastic used, which can moreover be made of composite plastic comprising a metallic wire incorporated.

According to one embodiment, the instrument is presented in material of hollow tubular shape either plastic or metallic which will allow the aspiration during various manipulations and the fixing of the dam when it will be necessary, fig. 9

According to another embodiment, the reinforcement is rigid or semi-rigid but can also serve as a support for a dam. The part is then an effective retractor in itself, which may or may not include a dike attached thereto. It will be referred to as being an autostatic retractor whose shape, even when not in use, is not flat. Fig. 2 and 1 2

All the forms mentioned can also be made of tubular material reinforced with a metal wire or another means to provide it with the necessary flexibility which will allow the use of the instrument without gene for the patient. Fig. 9 and 1 1

The invention will be better understood on examining the appended drawings provided by way of example only.

Fig. 1 shows a dike-spacer support, flexible in its relaxed and flattened form, fitted with a rubber sheet (8, dike) fixed to the beam of the external ellipse, or possibly less adequately, to the periphery two internal and external concentric pseudo-ellipses 1,2 defining a space 3 for the teeth.

In addition, the support has lateral fins 5 which play the role of court spacers, upper and lower lip lowerers 4,4.1 respectively in the form of a crescent and a skirt widening towards the outside. Note also the presence of U-shaped bridges 6 and zone 7, more or less flexible, intended to form a hinge. The dotted line in 5. 1 illustrates a variant in which the fins extend beyond the hinge zone and thus make it possible to more completely cover the cheeks. These supports, depending on their degree of rigidity, can have a more or less pronounced secondary jaw separation function.

Fig. 2 shows various embodiments of other flexible shapes with or without a fin. Fig. 2.1 corresponds to fig. I without lip depressor or fin. Fig.2.2 shows a semiellipse interior arc, fig. 2.3 is a variant with a free segment

lateral. There are the U-shaped bridges in fig. 1 used to secure the internal structure to the external ellipse fig.2.4.16

Fig. 2.5 represents a flexible retractor with bilateral judaie fins 15, FIG. 2.6 with unilateral fin and lip lip I2.I These structures may or may not be provided with a dike 18. FIG. 2.7 shows a retractor with lateral anette and free segment without rubber sheet 18.

For all the illustrious cases, the external ellipses can be produced in two complementary ellipses, of flattened outline, which ie overlap and cooperate to fix the rubber sheet between them by pressure (buttoning). The sheet is then interchangeable. All the mentioned forms can be made of tubular material. fig. 9

The internal arched seedlings in cnevai can be replaced by a piastidue or metallic membrane or pladuette which will serve as a tongue depressor fig.9.2

The connection between the two ends of tuastic terms in piastic can be carried out either with these connectors in the form of olives in T-or with tuoes in T, or directly by manufacturing. fig. 9.I.5 and

The connection between the two arcs does not necessarily have to be entirely in a hollow tube except at the level of the suction, thus facilitating the realization of the instrument by invagination, thus avoiding the loss of the force of the suction fig. 9.3

Fig.3 shows SELF-STRETCHING SELF-SPREADERS also part of the invention. These spacers are semi-rigid and do not allow access to the anterior teeth. Unlike flexible support spacers, they cannot have a piate shape. Fig. 3.1 Fig. 3.2 represents a frame provided with a rubber sheet 32 without rear bar.

Other variants are shown in plan 3.3, 3.4, 3.5 on the understanding that the perspective shape is similar to that of FIGS. 3.3 and 3.5 the ellipses form a vestibular framework and support elements which pass above the teeth and fall back on the lingual or palatal side.

Fig. 4-1 shows a perspective view of an autostatic buccal retractor 40 which may for example be made of semi-rigid plastic or of metallic wire. The lower or upper dental arch can occupy the space 43 delimited by the frame, the device being able to be used in the inverted position. A lip depressor is also illustrated in the form of a removable part 43 which can be fixed on the part of the front frame 44 by clipping effect on the corresponding branch 44, possibly also wedging a rubber sheet 45 arranged around of the said branch. A section is also illustrated according to fig. 4.3.

Fig. 4.2. shows the same retractor provided with fins 41 (cheek spreader) and a lip depressor 42. A second upper lip depressor 42.1 can also be provided. These fins or lip depressors may have a continuous surface of material identical to that of the frame.

The lip depressor 42 can be in two complementary parts (42, 42.2) having male and female fixing elements

(ribs 48, orifices 49) which, reversibly, adapt and lock by pressure by wedging the rubber sheet possibly used.

On all flexible forms with dam, fixed without wing, one can add a flexible frame which will be installed outside the oral cavity and which will have the function of keeping fixed, in known manner, the rubber sheet.

This frame can be fixed either at the front of the arches of the instrument to extend laterally, or on the lip depressors if necessary

present at the front of the instrument. It will also be covered by the rubber sheet which will be fixed Fig. II.2 on the edges of the frame in a known manner. Also for the tubular form.

The form of the invention incorporating fixed rubber (dike 6, 18) is practical for short-term procedures, under locoregional anesthesia. Fig. II and I2

The flexible forms of figs, 1 to 2 can be more particularly made of single-use plastic, or sterelizable for the tubular form.

According to a particular embodiment of the invention, a spacer is therefore proposed with a U-shaped or cnevai iron-shaped internal arc imitating the

mandibular groove.

The external part of the instrument is elliptical while the inside has the shape of a horseshoe and is placed inside the half

external of the instrument by at least two small arches or bridges of

fixing 6 U-shaped fixing (fig. 2.1)

According to a particularly advantageous variant, on the outer half of the ellipse, one or two skirts or fins are provided for or placed on one side or the other, or on both sides of the instrument, preferably in the area where it is located. the internal U-shaped arc. They must form an angle

sufficiently open with the external arch to allow the use of endo-oral and dental instruments, so as not to create

unnecessary difficulties during the introduction of the retractor.

The fins or lip depressors can be in the form of a complementary frame segment, to which the

rubber sheet, or in the form of a solid piece of plastic, material similar or not to that of the frame.

It should be noted that the forms mentioned can be used as universal retractors and protectors, for upper and lower maxillary aes by reversing them. According to another variant of the invention, which is particularly important, provision is made for an "anterior spacer" shape illustrated in FIGS. 3.1 and 3.3 and 44. 4.

For the anterior teeth it can be made in the form of,

essentially, two slightly curved internal bars, a vestibular bar 30 and a lingual bar 30,1 or palatine. These bars are interconnected by two U-shaped arches which pass through the

above the teeth and which fix the bars at the bottom of the vestibular groove and inside the dental arches. According to a variant, the internal bar can be omitted (fig. 3.2 with dam).

Inside the lower and upper U-shaped arches are interconnected to form a single piece used for the two arches. With this shape, you can also use the rubber sheet, glued to the plastic instrument. The sheet can also be fixed with silk thread or with "wedjets", for example in rubber. According to this embodiment, no clamps are used.

The aforementioned shapes can be made either of plastic or of metal,

The metal shape can be used as an autostatic buccal retractor with or without use of the rubber sheet. If the rubber sheet is used, the instrument can serve as a frame or skeleton for it.

Each sheet is then attached

- either by the edges of the instrument au- includes attachment teeth (taking advantage of the elasticity of the sheet and leaving it protruding in the conventional manner),

- either by a curved sheath also serving as a lip thimber given its thickness

- either through a frame outside the oral cavity but integrated or incorporated into the instrument

- either by gluing, prefabricated fixing or not through a sheath. This is an additional aspect of the invention which is particularly advantageous.

The plastic form, with its elasticity, is preferred in many

name Two cases. It provides a more pronounced flexiDilite to the instrument when it is put in and out. In this form the rubber sheet can be glued to the frame of the instrument. If the plastic is more rigid (semi-rigid), this form can also be used as an "autostatic retractor" as with the metal form.

Both forms can be used without the rubber sheet

(fig. O, this dui constitutes a particular advantage that a mode of realization according to the invention. This is made possible thanks to the elements forming a spring dui used to spread the jaws and to keep them sufficient: open during the various endo- mouth, thus playing the role of a self-retracting retractor, even under general anesthesia.

The tubular shape with reinforced walls is advantageous.

To increase the possibilities of using the instrument, we can eliminate, for example, part of the external or internal arch (lingual and palatal) (with or without fins) thus creating a free segment on the vestibular side which will facilitate the 'intervention in the areas concerned (see variants of ia fig. 2 for the flexible rorme)

We can reduce the length of the internal arch to make it localize umduement on an internal arch segment of anterior teeth (see fig.3.4 for the ton autostatic retractor), or we can replace it by one or two small tubes fixed on the instrument, cinges towards the interior, whose channel communicates with the frame in order to aspirate. a plastic head ends the small ann tubes to avoid aspiration of the

muddy, while making the saliva suction fig. fig 9.1.2, and 3.3.4

For its use and placement in the mouth, in the case of

presence of a dike,

- we first cover the instrument all around with the rubber sheet on the outside, if it is not originally fixed, or in ia doub the armature for the use of the interchangeable - press on the upper and lower arches so that they can enter the mouth with a slight rotation to the left or to the right. The external arches thus arise at the bottom of the vestibules;

the internal arch on the lingual or palatal side of the dental arch is in contact with the alveolo-dental wall. The arcs wedge the rubber sheet, leaving only the entrance to the mouth free. There are therefore the teeth and or the edentulous segments between the arcs of the instrument, covered by the rubber sheet, and also, the immobilization and separation of the tongue and of the two maxillae. The dike is punctured with a conventional perforator before placing in the mouth.

- using "wedjets" or a silk thread, we cross the dental contact points and fix the rubber sheet at the level of the collar using wooden and plastic corners either with ligatures "wedjets".

- clamps can be useful in this case.

For the forms with glued rubber (flexible, fig. 1 and 2) either pass the clamp in a conventional manner over the perforation of the dam and afterwards over the tooth; either slide the perforated dam over the clamps fixed before; either fix with "wedjet" wires after passing the inter-dental contact point.

The instrument can advantageously be used directly in the oral cavity without a dike during various manipulations, for example stomatological or surgical. The tubular shape is more advantageous thanks to the continuous aspiration as necessary.

The instrument can thus be used in wider areas than in the case of conventional dikes.

Indeed, the constant opening of the mouth allows the operator to ensure maximum comfort during the execution of the work. The protective dam is an effective means of asepsis, dryness and isolation of the operating field (D, O. Fixed prosthesis). It provides protection against swallowing and inhalation of materials or instruments during the various endodontic and oral procedures, such as: - preparation of cavities, canals, dental reconstruction,

composite treatment (in the case of the use of the dam)

- oral surgery on toothed and toothless segments, calculosis of the salivary canals, tumors, alveolectomy, gingivectomy in the case of use without a dam

- on the tongue: an opening is made in the sheet of

rubber and the tongue is passed through this opening while installing the instrument in the mouth

- in anesthesia and resuscitation; for local anesthesia the form is preferably used with the single-use glued rubber

- for general anesthesia and intubation: the autostatic form of metal or hard plastic is advantageous for patients under narcosis, The mouth remains open, the practitioner or operator can work freely, The saliva-liquid fluid aspiration will be easier .

The introduction of the instrument before intubation facilitates the task of the anesthetist.

It will be noted that the instrument can be produced in different dimensions, for example for children, adults, or even small, medium and large dimensions.

The frame of the instrument according to the invention can be produced:

- either in plastic tubes or bars, for example of round or flattened section, for example 0.5 cm high and 0.2 cm thick with well rounded edges .figs.2, 9, II and I2

- either in relatively rigid metallic film but preferably

substantially deformable from 1 to 2 mm in diameter, possibly plasticized - either in hollow plastic tube (diameter 0.3 - 0.5 cm) reinforced or not with metal wire (depending on the manufacturing method) allowing

suction (advantageous form) fig. 9.I and 9.3.

- either in stainless steel tube.

According to another aspect of the invention, illustrated in FIG. 5, on the peripheral frame 50 or on the lip depressor 52, it is advantageous to install (by clipping) or provide an original (.molding, welding) structure

51 rigid forming a frame intended to extend outside of the mouth, for fixing the rubber sheet thus carrying out the incorporation of the outer frame retractor and thus replacing the frame and the conventional lip depressor, The outer frame according to the invention is therefore interrupted at the levels of its incorporation into the spacer itself. It measures 8 to 10 cm in height and more or less the same width fig. I2.It can adopt a contour adapted to the face, in particular adapted to the lower contour of the nose. On the outer frame there are provided notches or points facing the outside of the instrument for fixing the rubber sheet. Figs. 5.1 and 5.2 illustrate

realizations without lip depressors and figs. 5.3 and 5.4 illustrate achievements where the frame is fixed to the anterior ends of the eyebrows

Fig.6 illustrates an embodiment in which the outer frame comprises two lateral bars: rigid and parallel 63 and 64, the

long desduelies can slide a lip commissor retractor 61 whose position can be adjusted by screwing (locking screw 62).

A second retractor can also be provided or be adapted on the other side. The retractor is of planned shape in order to be able to hang and spread the commissure of the lips. According to an alternative embodiment, the side bars can be telescoped in order to be able to adjust, with a movable oiocage, for example with screws, their length and therefore also the degree 65 of opening of the device. Advantageously, the elements 64 connecting these bars to the elliptical frame 66 (or to the lip lifts) can be slightly curved and / or flexible to conform to the shape of the face.

At fig.7.1.71 it forms a cnarmère. The arcs bend over each other, fig.I2.3

Other variants with external frame applied to the self-retracting spacer are illustrated in perspective in FIGS. 7, 2 and 7.3 This last figure shows the hooking points located along the outer casing and allowing the rubber sheet to be fixed. (99) Fig. 7.2 illustrates a variant in which the outer frame is incomplete and simply consists of two support arms 83

attached in this example to a lip depressor 82, comprising the

hanging points 84

Fig. 8 illustrates various configurations of means for fixing two complementary halves of armature segment 100.1 and 100.2.

In fig, 100 .1 the holes 101 adapt to the studs 102.

Alternatively (fig. 100.2) a longitudinal rib 103 provided along one half of the frame adapts and locks in a complementary groove 104 of the other half of the frame by wedging the

rubber sheet 105 possibly placed between these two

elements forming a tubular finite reinforcement.

Remarks concerning the forms of the invention:

1- Note that in the embodiments not provided with integrated lip depressors, it is possible to adapt a removable lip depressor, for example at the level of the anterior bar of the autostatic retractor (fig. 4.3) and the anterior part of the spacers mentioned figs. 2. We can add a plate or wing of 2.5 to 3 cm in semi-lunar shape which will serve to lower or raise the lip thus eliminating the possible external frame serving as a dyke holder. The lip depressors can be presented as gutters fixed on the external part of the instrument. The adaptation can be carried out by providing male or female adaptation means or by clipping, taking care however that the connection is sufficiently stiff to allow the forced folding of the lips, fig. 4.42.2.

2- The fins can be fixed either on two anterior and posterior points, or by gluing it along the relevant part of the instrument,

3- Notes on the adaptation of the spacer in the mouth: to adapt the instrument to the various spacings, modular elements can be provided in the form of peripheral arcs of shapes

on the one hand and the internal spring extension

(autostatic form retractor anterior) on the other hand, with the

branches of the arcs which slide on the branches of the internal element, for example telescopically, and which are fixed by means of a stopper, a screw or a cap, thus offering the instrument the

possibility of deviating and adapting to different oral cavities. The adaptation can be carried out in the mouth or outside.-Figs.6,7

4- We can also increase the spring effect of an autostatic retractor by incorporating a hinge effect into the semi-rigid frame, at the level of the sections to be presented.

5- General remarks concerning the fixing of the rubber sheet: to better reinforce the fixing of the rubber sheet to the instrument, as already fully exposed, one can always provide an internal ellipse or an internal bar.

The shape with the fixed sheet can be achieved by joining the sheet between two complementary reinforcing halves, the fixing

being obtained

either by pressing the sheet between the two halves, the contact surfaces of which are glued fig.12

either by providing on the halves, a rib and a gutter

complementary joined together by pressure and which wedge the

rubber sheet fig. 2 bis, 3,2,5,8, 11.2. and I2

either by making a kind of buttoning all along the external part of the instrument between which the sheet will be fixed by pressure of the two frame halves. fia.8 and 12.2

In the latter two cases, the external part is advantageously in the form of two complementary flat parts. The thickness will preferably vary from 2 to 5 mm and the width from 4 to 7 mm. - either by adapting the flat or semi-curved part with a tubular part between which the rubber sheet will be fixed,

either according to fig. I2.

The protruding part of the rubber sheet can be either cut out or attached to a frame on the outside. For fixing the edges of the rubber sheet outside the mouth, the frame incorporated in the instrument can be used. You can also use a plastic or metal sheath adaptable to the frame which will also serve as a lip depressor or the spacer

classic (lateral) of the lips of the mouth.

6- In the case of a glued rubber sheet, on the external frame, the rubber sheet is not glued on the small U (bridges) but only on the external or internal parts of the instrument fig.2 , II.2 and I2

The U will preferably have a height of 2 to 3 cm to better adapt the instrument to the bottom of the hallway especially for the flexible shape

(plastic). They also serve as a means of suction in forms with or without internal ellipses,

7- The lower lip is located in the extension of the part

peripheral of the instrument thus possibly creating a third arc thereon. In the case of a more rigid structure (autostatic retractor) it can be detachable and in the form of a sheath fixed to the frame and which will also serve as fixator of the rubber sheet, It can be slightly curved downwards, for the

maxilla, so as not to interfere with breathing through the nose.

8- in the case of the embodiment of the flexible spacer support with dike and flat plastic edges, at the level of the curvature between the two arcs, the flat edges of the instrument can advantageously change orientation over a distance of 1 or 2 cm, having, in position in the mouth at the level of the hinge segment, the wide face (for example 5 mm) laterally instead of essentially horizontally. This gives the instrument a stronger spring area and makes it easier to place the arches of the instrument at the bottom of the vestibule (thickness 2 mm). This double bilateral twist of 90 ° can be carried out hot during manufacture, either by fixing the two tubular parts with a plate whose elasticity will also allow the flexibility of the instrument (metallic tubular form).

9- According to a variant of the invention, it can advantageously be provided that the frame has flattened parts intended to come into contact with the oral cavity, thus reducing discomfort and the risk of injury caused by wire frames or rigid plastic.

It is also possible to provide removable or non-supporting support pieces to be inserted in certain places or all along the frame. The fully tubular instrument (plastic forms) reinforced at the periphery or inside by metal wire or with double tube which would facilitate aspiration on a larger surface fig .9. I .2 and 9.3.4

10- According to another variant of the invention, a flexible plastic armature configuration is proposed in which the latter is kept under tension and is curved by an additional lateral armature of the fin type. The lateral branches of the main arcs are connected by a complementary link maintaining the curved pseudo-ellipse shape, similar to the rigid autostatic shape in Figure 4.

If a dam covers or is fixed on the entire frame, a flexible pocket is obtained, thus also protecting the cheeks and which can be easily inserted and removed from the oral cavity fig. II

11- Unlike previous methods, the rubber sheet or dam should not be stretched over the frame but may be loose enough to allow the installation of clamps, silk threads or other means of attachment to the tooth to be operated. figs. 2, 3.2, II.2, I2 ...

We no longer have to pull on the plastic sheet to fix it on the outer frame. This also allows X-ray photos to be taken inside the mouth without having to move part of the dam or without having to force on it to place and maintain the sensitive film, fig.12

12- In addition, two hinges may be provided, preferably vertically, at the level of the external frame, which allow the opening of half of the frame and the taking of X-ray pictures during the endo-oral treatment. fig. 12.2

13- The thickness of the filiform elements forming the skeleton or the armature of the instrument may vary. For comfort, especially in the case of a metal structure, local thickenings can be provided, preferably made of plastic. It is also possible to provide a sheath in the form of a gutter or an elastic split tube capable of adapting to said filiform elements, advantageously also serving as a wedging means for the embankment that may be used. This sheath can serve as a shock absorber for the tibulo-labio-jugal tissues. (cf. page 15 - item 9) Fig. 4.3.43

Figure 9.I: as a basic model for tubular shapes. item 1. the tube

item 2. intraoral suction cannula with cap item 3. place of connection with the suction device

item 4. holes to be made by the operator according to the place of intervention

item 5. cannula

Figure 10: cross section for the shape of the dike

item 1. the tube

item 2. the dike

item 3. semi-open sheath Finally, it will be noted that in the present description, for the flexible plastic embodiments (FIGS. 1 and 2), the term "retractor" has been used whereas the forced spacing function obtained by the instrument may be minimal by relative to the protective function provided by the dam which is prefixed or not to the instrument.

The invention is not limited to the above-mentioned embodiments which may vary in their structures and details.

Claims

claims

1. Eco-aspirator with and / or without a dam for endo-buccal use to be placed entirely inside the buccal cavity and comprising a frame adapting thereto, said frame comprising at least

- an external part in the approximate form of two U-shaped half-ellipses, joined by the end of their branches, and having an elasticity at their union levels allowing the manual insertion and removal of the spacer by relation to the mouth fig. 9, II and 2.

- an internal part in the form of a complementary reinforcement

approximately parallel to at least one segment of the external part at a distance leaving free space for the passage of the teeth, the internal part and the external part being secured by the frame itself. fig. 2, 5 and 4

2. Oral vacuum cleaner according to claim 1 characterized in that it consists of metal wire.

3. Oral vacuum cleaner according to claim 1 wherein the internal part and the external part are made integral by at least two inverted U bridges.

4. Oral vacuum cleaner according to claims 1 to 3 characterized in that the internal part extends parallel to only the front part of the external part, on one or the other of the half-arcs, the part internal being connected to the external part by at least two inverted U-shaped bridges, preferably provided at the ends of the internal part.

5. Oral vacuum cleaner according to any one of the preceding claims, characterized in that it is provided with one or more

reinforcement segments complementary to the external part, extending

outwardly thereof, anteriorly or laterally at one or two semi-arcs thus forming a complementary reinforcement fig. 9 along the inner face of the cheeks and / or forming elements which separate the lips and accessories for carrying out saliva aspiration.

6. Oral vacuum aspirator according to any one of the preceding claims, characterized in that the external part is provided laterally on one side or sides, fins or plates integral therewith, capable of laterally protecting the internal faces of the cheeks when the instrument is used, as well as small suction holes depending on the level

of the intervention. figo9.I.4 and 9.3

7. Oral vacuum aspirator according to any one of the preceding claims, characterized in that the external part is provided anteriorly, on the upper arc and / or the lower arc with fins or plates y

united, capable of spreading the lips respectively towards the

up and / or down Fig. 3.I, 2.4. 2 bis 6

8. Buccal resuscitator according to any one of the preceding claims, characterized in that it is provided with frame segments

complementary elastically connecting the lower arch and the upper arch for example by fixing at the bottom of the jaws of the instrument at least one wire or rod forming a spring by compression and connecting the two

jaws.

9. Oral vacuum cleaner according to any one of the preceding claims 1 to 7, characterized in that the elasticity is in particular

obtained by the presence of two lateral loops formed by the branches of the arcs at the level of the hinge section of the instrument.

10. Oral vacuum cleaner according to the preceding claims 1 to 8 characterized in that the frame is at least partially made of plastic and the elasticity is obtained by thinning of the material at the junction of the two U's of the external ellipse, hinge forming, fig. 9.3

1 1. Oral vacuum cleaner according to claim 10 characterized in that the frame is entirely made of plastic. fig. 9, II and I2.

12. Oral vacuum cleaner according to any one of the preceding claims, characterized in that it is provided with a dam in the form of a plastic sheet stretched over at least part of the frame fig. 2a, II and I2.

13. Oral vacuum cleaner according to] has claim 12, characterized in that it is provided with a dam in the form of an elastic sheet of rubber or plastic stretched and fixed on at least part of the frame. fig. II and 12.

14. Oral vacuum cleaner according to claim 13, characterized in that the plastic sheet is removable and fixed to the frame using a pinching means forming a spring fig, I2.2

15. Oral vacuum cleaner according to ia claim read, characterized in that the pinching means forming a spring is constituted by one or more hollow tubular segments split iongitudinally and able to adapt elastically but firmly around a segment of

the reinforcement by wedging the periphery of the sheet forming a dam which is interposed therein fig. I0, II.2 and I2

16. Oral vacuum cleaner according to claims I2 to I5, characterized in that the internal part and the external part are maintained

integral by means of the dike, the latter being fixed by gluing, tying, stapling, wedging or any eduivalent means, to said external and internal parts, fig. 2, II.2, 3.2 and I2.

17. Oral vacuum cleaner according to claims 12 to 16, characterized in that the dam extends over the entire frame, the external and internal part thus forming two ellipses, one being included inside of the ocher. fig. 2 and I2.4

18. Oral vacuum cleaner according to any one of the preceding claims, characterized in that the frame is plastic having a certain flexibility, the spacer at rest being planar, ellipsoid or forming a circle. The frame can be doubled in all plastic forms to allow the attachment of the dam and enhance the spring effect of the instrument. Fig. II and I2

19. Oral space vacuum cleaner with dike for endo-oral use characterized by an elastic plastic sheet and a more rigid peripheral edge in plastic, ellipsoidal in shape, of elasticity allowing its introduction into the mouth, the dike being provided with a second support in the form of a plastic frame, parallel and internal with respect to said edge, at a distance varying from 0.5 to 2 cm, preferably from 1 to 1.5 cm.

20. Oral vacuum cleaner according to any one of the preceding claims, characterized in that it is for single use (plastic) and sterilizable (double fixing frame, rigid form) fig. 12 (2,3,4,5)

21. Buccal vacuum cleaner according to any one of the preceding claims, characterized in that the instrument is in tubuiairefio.il (hollow) form thus allowing the suction and the spacing of the arches. fig. 9

22. Oral vacuum aspirator whose flexibility will be ensured either by the material itself, or by a reinforcing wire incorporated in the wall or inside the tube, fig. II and 99

23. Oral vacuum cleaner according to the preceding claim which may or may not be provided with the interior ellipse.

24. Oral vacuum cleaner according to any one of the preceding claims, characterized in that the internal part of the oral vacuum cleaner is a tongue depressor, fig.9-2.I.

25. Oral vacuum cleaner, the suction of which will be ensured by a removable cannula to orient it according to the need for the intervention, which can also serve as a tongue spreader, fig.9.I and 9.3

26. Oral vacuum cleaner (plastic form) whose holes will be made by the operator himself according to the level of the intervention (with scissors or scalpel); the holes must be made near the dental arch to avoid aspiration of the mucosa. fig. 9.1.4

27. Oral vacuum cleaner in any metallic shape, the flexibility of which will be ensured by a hinge or by a flexible plate at the junction of the two arches. figs. 4, 7, 6