WO2002038068A2 - Periodontal medicament delivery tray - Google Patents
Periodontal medicament delivery tray Download PDFInfo
- Publication number
- WO2002038068A2 WO2002038068A2 PCT/US2001/048363 US0148363W WO0238068A2 WO 2002038068 A2 WO2002038068 A2 WO 2002038068A2 US 0148363 W US0148363 W US 0148363W WO 0238068 A2 WO0238068 A2 WO 0238068A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- teeth
- patient
- tray
- recess
- medication
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C19/00—Dental auxiliary appliances
- A61C19/06—Implements for therapeutic treatment
- A61C19/063—Medicament applicators for teeth or gums, e.g. treatment with fluorides
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C19/00—Dental auxiliary appliances
- A61C19/06—Implements for therapeutic treatment
- A61C19/063—Medicament applicators for teeth or gums, e.g. treatment with fluorides
- A61C19/066—Bleaching devices; Whitening agent applicators for teeth, e.g. trays or strips
Definitions
- This invention relates to treatment of periodontal disease, and in particular to a dental tray and method for delivering medicament subgingivally to treat the infected area.
- Periodontal (gum) disease affects a majority of adults at some time in their lives. Warning signs often are unnoticed until advanced stages of the disease. Treatment methods depend upon the type of disease and how far the condition has progressed. When deep pockets (3 mm or greater) exist between teeth and gums, it is difficult for the dentist to thoroughly remove plaque and tartar. While surgery may be necessary to reduce the depth of the pockets or to restore or reshape bone that has been destroyed, typically it is preferable to attempt to avoid such invasive procedures by treating the affected areas with antibacterial or antimicrobal agents (i.e., chemical, antibiotic, or other pharmacological agents) to restore periodontal health. Such antibacterial or antimicrobal agents have been found to control the growth of bacteria that create toxins and cause periodontal disease and encourage normal healing, thereby reducing the necessity or the invasiveness of periodontal or oral surgery.
- antibacterial or antimicrobal agents i.e., chemical, antibiotic, or other pharmacological agents
- medicament can be delivered in close proximity to the bone and supporting structure of the teeth by flossing using tufted floss, brushing using an interdental brush, injection using a syringe, or by hydrostatic or mastication pressure using a dental tray.
- Dental trays often are constructed from a soft plastic elastomeric material that is molded in place to a patient's teeth so as to firmly and closely fit in place on the patient's teeth, and a seal is made to hold the tray solidly against the dental tissues.
- Medicament is placed in recesses formed in the tray that are adapted to accommodate the patient's teeth, and then guided or forced along the teeth and into the gingiva by the sealing means to the infected site as the patient closes his jaw on the tray.
- a propulsion agent such as hydrogen peroxide also can be placed in the recesses to guide or force the medicament into the infected site as the hydrogen peroxide breaks down and increases the pressure within the recesses.
- Other examples of dental trays are set forth in U.S. Patent Nos.
- U.S. Patent No. 3,874,084, issued April 1 , 1975 to Cole discloses a molded tooth cleansing and gingival therapeutic device that includes a plurality of bristles projecting inwardly from the inner walls of the upper and lower channels of a tray.
- the bristles are provided to clean food particles and bacteria from the surfaces of a user's teeth and the gingival crevices.
- the walls of the channels are of a sufficient thickness to form ridges or ledges extending away from the gingival lines. These ridges compress the gingiva to allow for cleansing of the gingival crevice between the teeth and gum and massaging of the free marginal gingival.
- the Cole device does not form a sufficient seal around the teeth and gums to allow for application of medicaments subgingivally.
- a dental tray and method for treatment of periodontal disease that provides a seal around teeth associated with the infected area to guide or force medication onto the surface of the teeth and subgingivally into the infected area.
- Such a seal also should assist in holding the medication in a desired location corresponding to the infected site.
- Such a tray and method of treatment also should be easily and conveniently administered by the patient, without special training or undue skill.
- one object of the present invention is to provide an improved periodontal medicament delivery tray and method for treating periodontal disease providing a seal around each tooth or edentulous region associated with the infected area to guide or force medication onto the surface of the teeth and subgingivally into the infected area.
- Another object of this invention is to provide such a periodontal medicament delivery tray and method of treatment that reduces the invasiveness of and the need for periodontal surgery.
- Another object of this invention is to provide such a periodontal medicament delivery tray that applies pressure from chewing or mastication to help to deliver or force the medicament to the source of the periodontal infection.
- Another object of this invention is to provide a dental tray that can be used as an anti-bruxing or anti-clenching appliance.
- Yet another object of this invention is to provide a dental tray that can be used as a mouthpiece to properly relate the lower jaw to the upper jaw, and relax muscles and decrease pressure on the jaw joints.
- a tray fitted to at least some teeth of a patient's upper or lower arch for the application of medications to the teeth and to adjacent gum tissue for treatment of periodontal disease.
- the tray is constructed from resilient material molded to conform to the teeth and gum tissue.
- the tray includes at least one recess formed to conform to the teeth.
- a seal surrounds the recess at a location corresponding to the patient's gum line for applying pressure at the patient's gum line when the patient's teeth are disposed in the recess.
- the recess contains a quantity of a medication.
- a propulsion agent can be disposed within the recess such that upon application of the tray onto the patient's teeth, the propulsion agent generates pressure within the recess so as to positively force the medication onto the patient's teeth and into any of the pockets in the patient's gums proximate the teeth.
- a dental tray for delivering medicament subgingivally including a molded body that conforms to at least a portion of a patient's dentition and adjacent gingival tissue.
- the body has at least one recess formed therein that is adapted to snugly accommodate the crown portion of at least certain of the patient's teeth.
- a seal projects outwardly from the body and surrounds the recess at locations corresponding to the patient's gum line.
- the recess contains a quantity of medicament, whereby medicament is forced subgingivally by the seal and onto the patient's teeth when the patient's teeth are positioned in the recess.
- a third aspect of the present invention is that of a method for applying medication to at least certain of a patient's teeth and to gums proximate said teeth.
- This method includes the steps of: making a female impression of the patient's teeth and adjacent gums supporting the teeth from a suitable hardenable material; making a male model of the patient's teeth and surrounding gums from the female impression, the male model being formed of a suitable hardenable material; at the intersection of the gums and at least certain of the teeth of the male model, removing a bead (i.e., a desired amount or quantity) of the hardenable material from the male model proximate the juncture of each of the teeth and the gum surrounding the teeth and/or between the teeth thereby to form at least one trough; forming a tray of moldable resilient material molded over the male model having at least one recess representative of the teeth with a quantity of said resilient material formed in the groove forming a seal; applying a mediation into the recess of the tray; and fitting
- FIG. 1 is a perspective new of the dental tray and mold of the present invention
- FIG. 2 is a bottom plan view of the dental tray
- FIG. 3 is a sectional view of a patient's tooth and adjacent soft tissue aid support structure
- FIG. 4 is a sectional side view of the dental tray showing the patient's tooth and gingiva disposed therein;
- FIG. 5 is a perspective view of an alternative embodiment of the dental tray and mold.; Corresponding reference characters indicate corresponding parts throughout the several views of the drawings. Best Mode for Carrying Out the Invention
- FIG. 1 a periodontal medicament delivery tray is shown, designated generally by reference numeral 10, for delivering medicament subgingivally to an infected area or areas.
- FIG. 3 shows a sectional view of a patient's tooth 18 and adjacent gingiva 20. Pockets or gingival crevices 19 exist between the patient's gingiva 21 and the teeth 18. Bacteria enter into the epithelial attachment, periodontal ligaments 23, and supporting jaw or cortical bone 25 through the gingival crevice 19. Pocket depths for gingival crevices 19 in a healthy mouth typically range from 0.05 to 3 mm.
- the tray 10 of the present invention is adapted for use on patient's having periodontal disease with pocket depths greater than 3 mm.
- a dentist takes an exact female impression (not shown) of the dentition, edentulous regions 26 (if any) and adjacent periodontal tissues 20 for a particular prospective user of the tray 10.
- the dentist can use any conventional impression-taking technique.
- the patient can bite into a container filled with a suitable hardenable material such as, for example, an alginate material.
- a suitable hardenable material such as, for example, plaster or dental stone is poured into the impression to create a male model or mold 16 that includes teeth 22 and gums 24 which are representative of the patient's teeth 18 and adjacent soft tissue 20.
- the mold 16 can be made for some or all of the upper and/or lower teeth, at locations corresponding to the infected sites into which the medicament will be delivered.
- the mold 16 also can be made for edentulous regions , if present, to allow for application of medicament to the bone (see FIG. 5).
- the dentist or technician uses a hand-held tool (e.g., a round dental bar of desired dimension in a dental handpiece or laboratory engine) to remove the desired amount of the stone or plaster material at locations corresponding to desired level at the patient's gingival or gum line.
- a hand-held tool e.g., a round dental bar of desired dimension in a dental handpiece or laboratory engine
- the dentist removes portions of the hardenable material from the model 30 at the intersections of at least certain of the teeth 22 and gum 24 on the mold 30. This creates one or more trough-like recesses or grooves 30 formed around the front and rear surfaces of affected teeth 22 at a gum line 28 of the mold 16 (FIG 5).
- a hand-held tool e.g., a round dental bar of desired dimension in a dental handpiece or laboratory engine
- the trough 30 is formed at the front and rear gum line for each tooth, and extends around the exposed surfaces of the upper second molars of the mold 16 and is make to extend between the teeth interproximally.
- One trough 30 is made around each tooth 22 or group of teeth 22 or edentulous region 26 (FIG.5) where a seal 44 (discussed below) will be needed in the dental tray to force medicament subgingivally into the infected site or the bone.
- the troughs 30 preferably are formed around exposed surfaces of teeth 22 at the gum line 28, and do not extend into interproximal spaces 34 between adjacent teeth.
- Multiple grooves 30 can be formed at gum lines 28 of only certain teeth 22 or edentulous regions 26 corresponding to those that are affected by periodontal disease. Furthermore, the grooves 30 can be formed along only the front gum line or the rear gum line, if desired.
- FIG. 5 shows an alternative embodiment of the present invention that includes model or mold 16' and tray 10'.
- Mold 16' is for a patient's upper arch having two edentulous regions 26a, 26b (referred to collectively as edentulous regions 26 at locations corresponding to the upper right second bicuspid and first molar and the upper left first and second molars, respectively.
- Troughs 30 are formed at the gum line 28 for the central, left lateral, left cuspid, and left first and second bicuspid teeth 18a, 18b, 18c, 18d, 18e and 18f, respectively.
- Trough 30 also is formed around edentulous region 26b.
- a partial upper dental tray 10' also is shown, with a seal 44 (discussed below) formed in the tray 10 for teeth 18a-18f and region 26b.
- the dental tray 10 is a precise form fitted flexible tray, preferably constructed from a moldable resilient material, such as a suitable soft plastic elastomeric material.
- a moldable resilient material such as a suitable soft plastic elastomeric material that works well for this purpose is a about 2 - 3 mm. thick layer of mouthguard material.
- the tray 10 is formed placing the heated tray material on the model 16, and then applying positive air pressure to the tray material on the mold, or using a suction or other suitable methods to cure the tray material.
- the resulting dental tray 10 is molded as a replica of the original impression of the patient's teeth and periodontal tissue.
- the tray 10 also includes one or more seals 44 formed at locations corresponding to the troughs 30 that are added to the mold 16 by the dentist. As shown in FIGS.
- the dental tray 10 includes a molded body 42 having a substantially U-shaped configuration that conforms to the shape of the patient's dentition and adjacent soft tissue structures.
- the body 42 has form fitted recesses 40 therein that is adapted to snugly accommodate the crown portion of the patient's teeth 18.
- the tray 10 further includes a positive pressure seal of tray material formed in the trough of the model, with each positive pressure seal 44 that preferably surrounding at least a desired portion of one or more of the recessed areas 40.
- the seal 40 is formed at locations corresponding to the 30 in the mold 16.
- the seal 44 projects outwardly from body 42 of the tray 10 at locations corresponding to the juncture of the patient's teeth and gums (gum line ).
- the seal 44 applies pressure at the patient's gum line when the patient's teeth 18 are disposed in the recess 40 to force medicament 45 disposed in, the tray subgingivally into any pockets in the patient's gums 20 proximate the teeth 18.
- the tray 10 is shown in FIGS. 1 and 2 to be a full upper arch tray 10, but those skilled in the art will appreciate that a lower arch tray 10, dual arch tray 10 or partial arch tray 10 can be used, if desired.
- the patient Prior to applying a desired antimicrobal agent or other medicament or dental substance to the tray 10, the patient preferably inserts a small amount of a propulsion agent such as a gel-based antiseptic cleanser including hydrogen peroxide or other medicament preferably into the recess 40 of the tray 10.
- an antimicrobal agent e.g., a tetracycline solution
- the antimicrobal agent can be included in a medicament that has a potential to provide pressure to force the medicament subgingival.
- propulsion agents could include, but not be limited to, any one of the following peroxide compounds: peroxyl, gly- oxide, carbamide peroxide, peroxide containing materials, or any other agent that will undergo status altering processes providing a change in ambient or localized pressure gradients.
- Such peroxide based propulsion agents are preferably, but not necessarily in a gel-like state to allow for ease of application to the tray and to the teeth and gum surfaces.
- antimicrobial agents include any one or more of the following anti-infective agents: penicillin, cephalosporings, carbapenem, monobactams, chloramphenicol, quinolones, floroquinolones, teteracyclines, macrolides, spectinomycin, vancomycin, lincosamides, aminoglycosides, colistimethates, ploymyxin, bactracin, vovobiocin, metronidazole, sulfnonnamides, nitrofurans, methenamines, and folate antagonists.
- antiobiotic combinations may be used as well as antiviral, antiretrovirai, immunologic agents, anti-infective agents, astringeents, topical ointments or liniments, or other antibiotics.
- the medicament and antimicrobal agent are collectively referred to medication 45, and schematically illustrated in FIG. 4.
- the patient then fits the tray 10 onto the patient's appropriate arch, depending upon whether the tray 10 is designed for the patient's upper or lower arch or both.
- the hydraulic action of inserting the teeth 18 snugly into the tray 10 within the recess 40 tends to move the medicament 45 toward the gingiva 20 of the patient's mouth.
- the seal 44 directs the medication 45 to the region of the infection and helps hold the medication in the desired location.
- mastication forces forcibly squeeze the medicament 45 along the teeth 18 and into the gingiva 20 into the infected site or to the bone.
- the seal 44 of the tray 10 applies pressure to the patient's gingiva 20 when the patient compresses his or her jaw on the tray 10, medicament 45 is forced onto the teeth 18 and gingiva 20 and into the gingival crevices.
- Gingival tissues 21 are compressed by the seal 44 as the patient closes his or her jaw against the tray 10 to expose at least a portion of the gingival crevices 19 and allow for application of the medicament 45 subgingivally into the pockets (see FIG. 4). At least a portion of the pockets is exposed when the gingiva 21 is compressed by the seal 44. Compression and release of the gingiva 21 by the seal 44 because of mastication pressure also stimulates and massages the patient's gingiva 20.
- the dental tray 10 allows for application of medicament 45 subgingivally by the patient several times each day.
- the patient can adjust the dosage or frequency of medicament delivery, as directed by the dentist or health care professional. While this method for treating periodontal disease is closely monitored by the dentist, use of the dental tray eliminates the need for the patient to make time consuming visits to the dentist for application of medicament to the infected site.
- Using the tray 10 to apply antibacterial or antimicrobal medicament to the site of infection subgingivally impedes deterioration of the bone and gum, and promotes healing and regeneration of the supporting bone structures around the patient's teeth.
- the dental tray also can be used as a nighttime anti-bruxing or anti-clenching appliance.
- the tray can be used to properly relate the lower jaw to the upper jaw. The tray relaxes muscles and decreases pressure on the jaw joints.
- the trays allow for control of jaw position, and can be used as an anti-snoring device.
- the trays also can be used as a protective mouthpiece for sporting activities.
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- Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Epidemiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
- Medicinal Preparation (AREA)
Abstract
Description
Claims
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2002232585A AU2002232585A1 (en) | 2000-11-13 | 2001-11-13 | Periodontal medicament delivery tray |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US71140200A | 2000-11-13 | 2000-11-13 | |
US09/711,402 | 2000-11-13 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2002038068A2 true WO2002038068A2 (en) | 2002-05-16 |
WO2002038068A3 WO2002038068A3 (en) | 2002-09-26 |
Family
ID=24857939
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2001/048363 WO2002038068A2 (en) | 2000-11-13 | 2001-11-13 | Periodontal medicament delivery tray |
Country Status (2)
Country | Link |
---|---|
AU (1) | AU2002232585A1 (en) |
WO (1) | WO2002038068A2 (en) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1633272A2 (en) * | 2003-06-18 | 2006-03-15 | Duane Keller | Periodontal medicament delivery tray |
RU211184U1 (en) * | 2021-09-14 | 2022-05-24 | Федеральное государственное бюджетное учреждение Национальный медицинский исследовательский центр "Центральный научно-исследовательский институт стоматологии и челюстно-лицевой хирургии" Министерства здравоохранения Российской Федерации | Complete removable lamellar denture for the upper jaw with reservoirs for artificial saliva |
CN114983608A (en) * | 2022-06-27 | 2022-09-02 | 温州医科大学 | Device is paintd with periodontal stopper to department of stomatology |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5085585A (en) * | 1991-02-05 | 1992-02-04 | Zimble Alan W | Dental medicament applicator and method of use |
US5211559A (en) * | 1991-07-18 | 1993-05-18 | Gillette Canada Inc. | Dental treatment tray for holding medicament gel |
-
2001
- 2001-11-13 WO PCT/US2001/048363 patent/WO2002038068A2/en not_active Application Discontinuation
- 2001-11-13 AU AU2002232585A patent/AU2002232585A1/en not_active Abandoned
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5085585A (en) * | 1991-02-05 | 1992-02-04 | Zimble Alan W | Dental medicament applicator and method of use |
US5211559A (en) * | 1991-07-18 | 1993-05-18 | Gillette Canada Inc. | Dental treatment tray for holding medicament gel |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1633272A2 (en) * | 2003-06-18 | 2006-03-15 | Duane Keller | Periodontal medicament delivery tray |
JP2007515987A (en) * | 2003-06-18 | 2007-06-21 | ペリオ プロテクト,エルエルシー | Root drug delivery tray |
EP1633272A4 (en) * | 2003-06-18 | 2009-03-11 | Duane Keller | Periodontal medicament delivery tray |
EP3092975A1 (en) * | 2003-06-18 | 2016-11-16 | Duane Keller | Periodontal medicament delivery tray |
RU211184U1 (en) * | 2021-09-14 | 2022-05-24 | Федеральное государственное бюджетное учреждение Национальный медицинский исследовательский центр "Центральный научно-исследовательский институт стоматологии и челюстно-лицевой хирургии" Министерства здравоохранения Российской Федерации | Complete removable lamellar denture for the upper jaw with reservoirs for artificial saliva |
CN114983608A (en) * | 2022-06-27 | 2022-09-02 | 温州医科大学 | Device is paintd with periodontal stopper to department of stomatology |
CN114983608B (en) * | 2022-06-27 | 2023-10-24 | 温州医科大学 | Device is paintd with tooth Zhou Saiji to department of stomatology |
Also Published As
Publication number | Publication date |
---|---|
WO2002038068A3 (en) | 2002-09-26 |
AU2002232585A1 (en) | 2002-05-21 |
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