WO2007078298A2 - Fil de rétraction gingivale comprenant un agent mouillant - Google Patents
Fil de rétraction gingivale comprenant un agent mouillant Download PDFInfo
- Publication number
- WO2007078298A2 WO2007078298A2 PCT/US2006/003351 US2006003351W WO2007078298A2 WO 2007078298 A2 WO2007078298 A2 WO 2007078298A2 US 2006003351 W US2006003351 W US 2006003351W WO 2007078298 A2 WO2007078298 A2 WO 2007078298A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cord
- retraction
- retracting
- agent
- silwet
- Prior art date
Links
- 239000000080 wetting agent Substances 0.000 title claims abstract description 23
- 239000003795 chemical substances by application Substances 0.000 claims abstract description 26
- 239000004094 surface-active agent Substances 0.000 claims abstract description 24
- VSCWAEJMTAWNJL-UHFFFAOYSA-K aluminium trichloride Chemical compound Cl[Al](Cl)Cl VSCWAEJMTAWNJL-UHFFFAOYSA-K 0.000 claims abstract description 14
- 239000013043 chemical agent Substances 0.000 claims abstract description 12
- 229940030225 antihemorrhagics Drugs 0.000 claims abstract description 11
- 239000002874 hemostatic agent Substances 0.000 claims abstract description 11
- 229910017053 inorganic salt Inorganic materials 0.000 claims abstract description 11
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 8
- UCTWMZQNUQWSLP-VIFPVBQESA-N (R)-adrenaline Chemical compound CNC[C@H](O)C1=CC=C(O)C(O)=C1 UCTWMZQNUQWSLP-VIFPVBQESA-N 0.000 claims abstract description 7
- 229930182837 (R)-adrenaline Natural products 0.000 claims abstract description 7
- DIZPMCHEQGEION-UHFFFAOYSA-H aluminium sulfate (anhydrous) Chemical compound [Al+3].[Al+3].[O-]S([O-])(=O)=O.[O-]S([O-])(=O)=O.[O-]S([O-])(=O)=O DIZPMCHEQGEION-UHFFFAOYSA-H 0.000 claims abstract description 7
- 229940103272 aluminum potassium sulfate Drugs 0.000 claims abstract description 7
- KWGRBVOPPLSCSI-UHFFFAOYSA-N d-ephedrine Natural products CNC(C)C(O)C1=CC=CC=C1 KWGRBVOPPLSCSI-UHFFFAOYSA-N 0.000 claims abstract description 7
- 229960005139 epinephrine Drugs 0.000 claims abstract description 7
- GRLPQNLYRHEGIJ-UHFFFAOYSA-J potassium aluminium sulfate Chemical compound [Al+3].[K+].[O-]S([O-])(=O)=O.[O-]S([O-])(=O)=O GRLPQNLYRHEGIJ-UHFFFAOYSA-J 0.000 claims abstract description 7
- KWGRBVOPPLSCSI-WCBMZHEXSA-N pseudoephedrine Chemical compound CN[C@@H](C)[C@@H](O)C1=CC=CC=C1 KWGRBVOPPLSCSI-WCBMZHEXSA-N 0.000 claims abstract description 7
- 229960003908 pseudoephedrine Drugs 0.000 claims abstract description 7
- BJORNXNYWNIWEY-UHFFFAOYSA-N tetrahydrozoline hydrochloride Chemical compound Cl.N1CCN=C1C1C2=CC=CC=C2CCC1 BJORNXNYWNIWEY-UHFFFAOYSA-N 0.000 claims abstract description 7
- 229940028445 visine Drugs 0.000 claims abstract description 7
- LYCAIKOWRPUZTN-UHFFFAOYSA-N Ethylene glycol Chemical compound OCCO LYCAIKOWRPUZTN-UHFFFAOYSA-N 0.000 claims description 15
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 claims description 9
- 229910052710 silicon Inorganic materials 0.000 claims description 9
- 239000010703 silicon Substances 0.000 claims description 9
- 229910052751 metal Inorganic materials 0.000 claims description 7
- 239000002184 metal Substances 0.000 claims description 7
- 239000002585 base Substances 0.000 claims description 6
- RUTXIHLAWFEWGM-UHFFFAOYSA-H iron(3+) sulfate Chemical compound [Fe+3].[Fe+3].[O-]S([O-])(=O)=O.[O-]S([O-])(=O)=O.[O-]S([O-])(=O)=O RUTXIHLAWFEWGM-UHFFFAOYSA-H 0.000 claims description 6
- 229910000360 iron(III) sulfate Inorganic materials 0.000 claims description 6
- LXOFYPKXCSULTL-UHFFFAOYSA-N 2,4,7,9-tetramethyldec-5-yne-4,7-diol Chemical compound CC(C)CC(C)(O)C#CC(C)(O)CC(C)C LXOFYPKXCSULTL-UHFFFAOYSA-N 0.000 claims description 5
- NECRQCBKTGZNMH-UHFFFAOYSA-N 3,5-dimethylhex-1-yn-3-ol Chemical compound CC(C)CC(C)(O)C#C NECRQCBKTGZNMH-UHFFFAOYSA-N 0.000 claims description 5
- 229920001214 Polysorbate 60 Polymers 0.000 claims description 5
- GOOHAUXETOMSMM-UHFFFAOYSA-N Propylene oxide Chemical compound CC1CO1 GOOHAUXETOMSMM-UHFFFAOYSA-N 0.000 claims description 5
- 235000014113 dietary fatty acids Nutrition 0.000 claims description 5
- 229920005676 ethylene-propylene block copolymer Polymers 0.000 claims description 5
- 229930195729 fatty acid Natural products 0.000 claims description 5
- 239000000194 fatty acid Substances 0.000 claims description 5
- -1 fatty acid ester Chemical class 0.000 claims description 5
- 229920002113 octoxynol Polymers 0.000 claims description 5
- UYDLBVPAAFVANX-UHFFFAOYSA-N octylphenoxy polyethoxyethanol Chemical compound CC(C)(C)CC(C)(C)C1=CC=C(OCCOCCOCCOCCO)C=C1 UYDLBVPAAFVANX-UHFFFAOYSA-N 0.000 claims description 5
- 229920001983 poloxamer Polymers 0.000 claims description 5
- 229920000136 polysorbate Polymers 0.000 claims description 5
- NBVXSUQYWXRMNV-UHFFFAOYSA-N fluoromethane Chemical compound FC NBVXSUQYWXRMNV-UHFFFAOYSA-N 0.000 claims description 4
- 229940063656 aluminum chloride Drugs 0.000 claims 4
- 229940010048 aluminum sulfate Drugs 0.000 claims 4
- 229940032950 ferric sulfate Drugs 0.000 claims 4
- 150000003839 salts Chemical class 0.000 abstract description 5
- 230000000740 bleeding effect Effects 0.000 abstract description 4
- 239000000126 substance Substances 0.000 description 10
- 238000005452 bending Methods 0.000 description 6
- 239000000835 fiber Substances 0.000 description 5
- 239000000463 material Substances 0.000 description 5
- 238000000034 method Methods 0.000 description 5
- 238000013459 approach Methods 0.000 description 4
- 238000006073 displacement reaction Methods 0.000 description 4
- 102000008186 Collagen Human genes 0.000 description 3
- 108010035532 Collagen Proteins 0.000 description 3
- 125000000129 anionic group Chemical group 0.000 description 3
- 125000002091 cationic group Chemical group 0.000 description 3
- 229920001436 collagen Polymers 0.000 description 3
- 230000014759 maintenance of location Effects 0.000 description 3
- 238000012856 packing Methods 0.000 description 3
- 238000007493 shaping process Methods 0.000 description 3
- 230000000451 tissue damage Effects 0.000 description 3
- 231100000827 tissue damage Toxicity 0.000 description 3
- 229920000742 Cotton Polymers 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 230000017531 blood circulation Effects 0.000 description 2
- 210000004204 blood vessel Anatomy 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 239000002736 nonionic surfactant Substances 0.000 description 2
- 230000002028 premature Effects 0.000 description 2
- 210000003296 saliva Anatomy 0.000 description 2
- 238000002791 soaking Methods 0.000 description 2
- 238000006243 chemical reaction Methods 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 238000001035 drying Methods 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 230000008030 elimination Effects 0.000 description 1
- 238000003379 elimination reaction Methods 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 230000002439 hemostatic effect Effects 0.000 description 1
- 150000008040 ionic compounds Chemical class 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 229910052573 porcelain Inorganic materials 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 238000012552 review Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C9/00—Impression cups, i.e. impression trays; Impression methods
- A61C9/0033—Gingival retraction appliances
Definitions
- the present invention generally relates to methods and apparatus used in gingival tissue management for the preparation of an impression, such as those used in artificial crowns and bridges and the like. More particularly, the present invention is directed to a gingival retraction cord for retracting gingival tissue preparatory to making such impressions of a tooth, the cord having a wetting agent so as to facilitate the taking of the impression and improve the results thereof.
- the gingival cuff must be horizontally retracted or distended from around the marginal area of the tooth sufficient to permit an adequate bulk of impression material to be placed around the margin of the tooth;
- the gingival tissue must be displaced vertically in order to expose a portion of the tooth below the margin so that the impression will clearly indicate the location of the margin and will give good marginal detail; all hemorrhaging must be arrested prior to taking the impression; and
- the gum or gingival cuff is typically retracted through the use of one or more retraction cords that are inserted into the gingival sulcus.
- current retraction cords do not adequately address the issues set forth above.
- the present invention resides in a retraction cord for retracting gingival tissue wherein the cord is pre-impregnated with a chemical agent and, in addition, has a wetting agent applied to the cord.
- the chemical agent can be either a retracting agent, a hemostatic agent, or both.
- the retraction cord may be a twisted cord, a braided cord, a knitted cord, or a cord including a ductile metal strand.
- the retracting agent may be an astringent water soluble inorganic salt or an inorganic salt of organic vascoconstrictors.
- Astringent water soluble inorganic salts include aluminum potassium sulfate, aluminum sulfate, aluminum chloride, or ferric sulfate.
- Inorganic salts of organic vascoconstrictors are epinephrine, pseudoephedrine, or "Visine" TM.
- the wetting agent may be an anionic, cationic, or non-ionic surface active surfactant.
- the wetting agent is preferably a non-ionic surface active surfactant such as a ZONYL fluorocarbon, a PLURONIC block copolymer of ethylene and propylene oxide to an ethylene glycol base, a TWEEN polyoxyethylene sorbitan fatty acid ester, a TRITON X series octylphenoxy polyethoxy ethanol, a SURFYNOL tetramethyl decynediol, a SILWET L-7614 silicon surfactant, or a SILWET L7607 silicon surfactant.
- the wetting agent is SILWET L-7607 at a concentration of 0.05% by volume.
- FIGURE 1 is a vertical section of a typical tooth and surrounding gingival tissue
- FIGURE 2 is a view similar to FIG. 1 but showing the tooth after it has been suitably shaped by a high speed drill preparatory for a dental impression;
- FIGURE 3 is a view similar to FIG. 2 but showing the tendency of the gingival cuff to contract after completion of the shaping and prior to packing of the retraction cord;
- FIGURE 4 illustrates the portion of FIG. 3 indicated by the line 4-4, drawn to a larger scale and showing the step of packing a length of prior art type retraction cord into the gingival sulcus;
- FIGURE 5 is a view similar to FIG. 3 but further illustrating the use of prior art types of retraction cord to retract the gingival tissue from around the margin of the shaped tooth;
- FIGURE 6 is an enlarged view of the portion of FIG. 5 taken along the line 6-6;
- FIGURE 7 is an enlarged view of the portion of FIG. 5 taken along the line 7-7; and [18] FIGURE 8 is a view similar to FIG. 4 but showing the appearance of the retracted gingival tissue upon removal of the retraction cord.
- the present invention is directed to a retraction cord for retracting gingival tissue pre-impregnated with a retracting agent and/or hemostatic agent, and a wetting agent.
- a retracting agent and/or hemostatic agent and/or a wetting agent.
- FIG. 1 illustrates a normal tooth 20 requiring restoration by use of an artificial crown. Tooth 20 is surrounded by gingival tissue 22 and 24 (gingival tissue is commonly referred to as the "gums").
- the dental practitioner first prepares the tooth to receive an artificial crown by removing portions of the tooth (shown by the broken line outline at 21) with a highspeed drill 26, as indicated in FIG. 2.
- the junction at which the uncut lower portion and the cut upper portion of the tooth meet is referred to as the "margin" 28.
- Gingival supporting tissue 22, 24 is comprised largely of collagen fibers. Because these collagen fibers are highly elastic, the gingival cuff will begin to constrict around the margin 28 of the cut tooth almost immediately after the tooth has been shaped to receive a crown (see FIG. 3). This prevents adequate amounts of impression material from being placed around the margin 28 of the tooth 20.
- damage to the gingival tissue 22, 24 during cutting of the tooth 20 results in bleeding around the periphery of the tooth into the space formed between the gingival tissue 22, 24 and the tooth 20, this space generally being referred to in the art as the "gingival sulcus" 23, which is shown in FIGS. 2 and 3. This bleeding further interferes with the taking of a good impression because extravasated blood tends to prevent adequate cleaning and drying of the marginal area of the tooth prior to taking an impression and tends to displace the impression material before it can set.
- retraction cord 30 The most common method for providing horizontal and vertical retraction is by use of retraction cord.
- a length of retraction cord 30 is packed between gingival tissue 22 and the margin 28 of tooth 20 by use of an appropriate dental instrument 32.
- Gingival retraction cords are small, multi-element cords constructed of individual threads. Typical final fo ⁇ ns are braided, knitted, or twisted. The cords typically range in diameter from 0.015 to 0.050 inches and can be made of any fiber imagined. The most widely used fibers are cotton, polyester, or cotton-poly blends. There are other fo ⁇ ns which include such oddities as multi-thread twisted cotton cords having a single strand formed from a ductile metal. Monofilament cords have been envisioned but there are none presently in commercial distribution. In use, all retraction cords 30 are cut into short lengths and then packed circumferentially around the base of the tooth 20 in the gingival sulcus 33.
- FIG. 5 illustrates two possible approaches for utilizing multiple lengths of retraction cord.
- cord 34 causes vertical displacement of the gingival tissue in a direction toward the root of the tooth ("apical" displacement). This permits an accurate determination of the location of the margin 28.
- Cords 36 and 38 are then packed side- by-side over cord 34 and margin 28 so as to cause horizontal displacement of the gingival tissue.
- FIG. 8 The result of the use of retraction cord is illustrated in FIG. 8; the margin 28 of the tooth is exposed sufficiently so that it is possible to make an impression having excellent marginal detail.
- FIG. 5 a second approach for retracting gingival tissue is illustrated on the right side of tooth 20.
- FIG. 5 it may be seen that it is possible to use only two retraction cords 40 and 42 to retract gingival tissue 24 in place of the three cords 34, 36 and 38 used in retraction of gingival tissue 22.
- FIG. 7 which is drawn to a larger scale, it may be seen that a small cord 40 corresponding to cord 34 of FIG. 6 can be used to accomplish vertical retraction, but a single cord 42 having a diameter approximately twice that of cord 40 may be used for obtaining the necessary horizontal retraction.
- gingival supporting tissue is comprised largely of flexible collagen fibers.
- a chemical retracting agent that reduces the tendency of the gingival tissue to contract over the margin after the retraction cord is removed. This is conveniently accomplished by soaking the retraction cord in a solution containing the chemical agent prior to packing the cord into the sulcus, or by pre-impregnating the cord with a suitable chemical agent.
- a suitable retracting agent and retraction cord are used, it is possible to maintain the gingival displacement illustrated in FIG. 8 for a period of time sufficient to permit the dental practitioner to make an accurate impression.
- the present invention resides in retraction cords which are pre-impregnated with the chemical retracting agents and/or chemical hemostatic agents and further include a wetting agent or surfactant. It has been found that the use of the appropriate wetting agent greatly increases the wetability of the cord.
- wetting agents such as surface active surfactants are classified under three very broad categories: 1) anionic; 2) cationic; and 3) non-ionic.
- the cationic and anionic forms dissociate in solution forming individual, charged surface active entities which can react with other ionic species in use.
- Non-ionic surfactants do not dissociate in solution, consequently they do not react with ionic compounds in solution.
- Typical gingival retraction agents fall into two main classes. The first being astringent water soluble inorganic salts such as Aluminum Potassium Sulfate, Aluminum Sulfate, Aluminum Chloride, or Ferric Sulfate. Inorganic salts of organic vascoconstrictors such as epinephrine, pseudoephedrine, or "Visine" TM present the second class of gingival retraction solutions. In both cases, the use of a non-ionic surfactant is indicated to ensure product efficacy and shelf stability as any potential reaction between the surfactant and the retraction agent is prevented.
- non-ionic sufactants include but not limited to:
- ZONYL fluorocarbons e.g., ZONYL FSO, available from E.I. du Pont de Nemours and Co. Of Wilmington, Del
- PLURONIC block copolymers of ethylene and propylene oxide to an ethylene glycol base available from BASF Corp. Chemicals Division of Mount Oliv, N. J.
- TWEEN polyoxyethylene sorbitan fatty acid esters available from ICI Americas, Inc. Of Wilmington, Del.
- TRITON X series octylphenoxy polyethoxy ethanol available from Rohm and Haas Co. Of Philadelphia, Pa
- SURFYNOL tetramethyl decynediol available from Air Products and Checmicals, Inc. Of Allentown, Pa.
- SILWET L-7614 and L-7607 silicon surfactants available from Union Carbide corp. of Danbury, Conn.
- a particularly preferred surfactant is the SILWET L-7607, at a concentration of 0.05% by volume. This surfactant when applied to the retraction cord, such as being impregnated therein or more typically coated thereon, increases the wetability of the retraction cord such that the dry cord wets rapidly by absorbing fluids and thus resistance to bending disappears.
Landscapes
- 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 Preparations (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
L’invention concerne un fil de rétraction servant à la rétraction du tissu gingival, lequel est préalablement imprégné d'un agent chimique servant à la rétraction chimique du tissu gingival et/ou d'un agent hémostatique servant à arrêter le saignement. Un agent mouillant est en plus appliqué sur le fil pour garantir l'efficacité et la stabilité au stockage du produit. L'agent de rétraction peut être un sel organique soluble dans l'eau astringent, tel que le sulfate d'aluminium et de potassium, le sulfate d'aluminium, le chlorure d'aluminium ou le sulfate ferrique, ou un sel inorganique de vasoconstricteurs organiques tels que l'épinéphrine, la pseudoéphédrine ou la VISINE. L'agent mouillant est de préférence un tensioactif non ionique tel que le SILWET L-7607 à une concentration de 0,05 % en volume.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US11/306,474 US20080003538A1 (en) | 2004-12-30 | 2005-12-29 | Gingival retraction cord with wetting agent |
| US11/306,474 | 2005-12-29 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| WO2007078298A2 true WO2007078298A2 (fr) | 2007-07-12 |
| WO2007078298A3 WO2007078298A3 (fr) | 2007-11-15 |
Family
ID=38228654
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/US2006/003351 WO2007078298A2 (fr) | 2005-12-29 | 2006-01-30 | Fil de rétraction gingivale comprenant un agent mouillant |
Country Status (1)
| Country | Link |
|---|---|
| WO (1) | WO2007078298A2 (fr) |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5554028A (en) * | 1994-03-24 | 1996-09-10 | Dentsply Research & Development Corp. | Dental impression taking |
| US20050175959A1 (en) * | 2000-03-14 | 2005-08-11 | Coll Partners Ltd. | System for the controlled delivery of an active material to a dental site |
| US20050277088A1 (en) * | 2004-06-09 | 2005-12-15 | Fischer Dan E | Reinforced gingival retraction cord |
-
2006
- 2006-01-30 WO PCT/US2006/003351 patent/WO2007078298A2/fr active Application Filing
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5554028A (en) * | 1994-03-24 | 1996-09-10 | Dentsply Research & Development Corp. | Dental impression taking |
| US20050175959A1 (en) * | 2000-03-14 | 2005-08-11 | Coll Partners Ltd. | System for the controlled delivery of an active material to a dental site |
| US20050277088A1 (en) * | 2004-06-09 | 2005-12-15 | Fischer Dan E | Reinforced gingival retraction cord |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2007078298A3 (fr) | 2007-11-15 |
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