WO2009029083A1 - Procédure interne de fermeture de perforations de membrane sinusale - Google Patents
Procédure interne de fermeture de perforations de membrane sinusale Download PDFInfo
- Publication number
- WO2009029083A1 WO2009029083A1 PCT/US2007/026406 US2007026406W WO2009029083A1 WO 2009029083 A1 WO2009029083 A1 WO 2009029083A1 US 2007026406 W US2007026406 W US 2007026406W WO 2009029083 A1 WO2009029083 A1 WO 2009029083A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- sinus
- perforation
- membrane
- sinus membrane
- patching material
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0003—Not used, see subgroups
- A61C8/0004—Consolidating natural teeth
- A61C8/0006—Periodontal tissue or bone regeneration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
- A61C8/0092—Implanting tools or instruments for sinus lifting
Definitions
- the present invention is directed to a sinus membrane patching procedure that may be employed if a sinus membrane perforation should occur in the formation of the upward channel or is discovered as having been previously formed during an independent dental procedure or as a result of a physical accident suffered by the patient.
- the procedure of the present invention comprises the steps of (i) creating an opening in the sinus floor of a patient to expose the portion of the sinus membrane including the perforation, (ii) inserting a quantity of a sinus membrane patching material through the opening to a location adjacent the sinus perforation and (iii) laterally expanding and forcing the patching material against the sinus membrane to seal the perforation .
- the creation of the opening may be accomplished by the use of standard drills and drilling techniques and the like controlled to create an upward channel in the bone of the patient leading to the sinus floor.
- the upper open end of the channel should extend to the base of the sinus floor and should be small enough to only expose the portion of the sinus membrane having the perforation.
- a sinus lifting tool that includes a disk-shaped tip and an angled neck.
- the disk-shaped tip is designed to release the sinus membrane from the bony wall of sinus floor.
- the angled neck is designed to aid in the proper positioning of the working tip.
- An inflection portion of the angled neck extending from the working tip allows the clinician to feel the tension of the sinus membrane and to determine the amount of initial lateral and vertical membrane reflection. The procedure for membrane release and elevation should be continued until a planned amount of sinus extension is achieved and a pocket of desired size is defined.
- a patching material carrying instrument or insertion tool including a central support and laterally moveable outer supports spaced laterally outward of the central support.
- a preferred form of such an instrument is described and illustrated in detail in United States patent application Serial Number 11/895,814 filed August 28, 2007 and entitled “Improved Sinus Membrane Patch Insertion Tool” (Docket 07JY-6) , incorporated herein by this reference.
- Fig. 1 is a fragmentary sectional side view illustrating the step of creating an opening in the sinus floor to expose the portion of a sinus membrane including the perforation as by employing a standard drill to form an upward channel through bone leading to the sinus floor.
- Fig. 2 is a fragmentary sectional side view showing the bone channel of Fig. 1 and illustrating the creation of a perforation in the sinus membrane by a fragment of bone during the drilling of the upward channel.
- Fig. 3 is a fragmentary sectional side view of the bone channel of Fig. 1 receiving a sinus-lifting tool that includes a disk-shaped tip and an angled neck simultaneously lifting and laterally separating the exposed portion of the sinus membrane from the sinus floor to form a relatively small pocket between the sinus membrane and the sinus floor with lateral movement and a turning of the sinus lifting tool about a vertically extending axis of rotation.
- a sinus-lifting tool that includes a disk-shaped tip and an angled neck simultaneously lifting and laterally separating the exposed portion of the sinus membrane from the sinus floor to form a relatively small pocket between the sinus membrane and the sinus floor with lateral movement and a turning of the sinus lifting tool about a vertically extending axis of rotation.
- Fig. 4A is a fragmentary sectional side view of the bone channel of Fig. 3 receiving a sinus membrane patch insertion tool including a central support and laterally outward and moveable outer supports, the outer laterally moveable supports being laterally compressed against the central support to carry a quantity of sinus patching material upward in the bone channel to a location adjacent the lower surface of the lifted sinus membrane including the perforation formed in Fig. 2.
- Fig. 4B is a fragmentary sectional side view of the bone channel and sinus patch insertion tool of Fig. 4A with the patching material engaging the sinus membrane over the perforation and the outer supports laterally separated from the central support, the patching material being extended laterally to form a patch sealing the perforation.
- Fig. 5 is a fragmentary sectional side view of the bone channel and sinus patch insertion tool of Fig. 4B, the tool being lowered away from the sinus membrane leaving the patch in place.
- an opening 10 is created in the sinus floor of a patient exposing the portion of the sinus membrane 12 including the perforation 14.
- This may be accomplished following a standard osteotomy drilling sequence using a surgical guide, a round marker and subsequent twist drills.
- a standard twist drill 16 is shown forming a channel 18 in bone 20 in the maxillary posterior area of a patient.
- Conventional twist drills or surgical round diamond burs can be used to drill up to the sinus floor 22, barely breaking through the existing bone and forming the desired opening 10 for exposing a preexisting sinus perforation or a perforation formed during a dental procedure such as shown in Fig. 2 where the drilling results in the sinus perforation 14 by the forcing of a bone fragment 24 into and through the sinus membrane 12.
- the sinus perforation 14 may be patched following the procedure of the present invention.
- the actual patching of the sinus perforation 14 may be preceded by a lifting and separation of the perforated sinus membrane 12 from the sinus floor 22 to form a pocket 25 between a lower surface of the sinus membrane 12 and the sinus floor.
- a sinus lifting tool 26 that includes a disk-shaped tip 28 and an angled neck 30 extending longitudinally from a handle portion 32.
- the disk-shaped tip 28 is designed to release the sinus membrane 12 from the bony wall of sinus floor 22.
- the angled neck 30 is designed to aid in the proper positioning of the working tip 28.
- An inflection portion 31 of the angle of the neck 30 extending from the working tip 28 allows the clinician to feel the tension of the sinus membrane 12 and to determine the amount of initial lateral and vertical membrane reflection.
- the tool 26 in the formation of the pocket 25 the tool 26 is simultaneously raised and turned back and forth on vertically extending axis 34 with the tip 28 simultaneously lifting and laterally separating the membrane 20 from the sinus floor 22 to form and enlarge the pocket 25.
- a preferred form of the tool 26 is described and illustrated more fully in United States patent application, Serial Number 11/895,811 filed August 28, 2007 and entitled ⁇ x Improved Sinus Membrane Lifting and Lateral Separation Instrument” (Docket 07JY-3) , incorporated herein by this reference.
- the patching of the perforation 14 in the sinus membrane 12 is then accomplished as shown in Figs. 4A and B and Fig. 5.
- an appropriate standard sinus membrane patching material 36 is introduced through the opening 10 into the pocket 25 using a patching material insertion tool 38 designed to carry the material upward in the channel 18 and into the pocket to a location adjacent and just below the portion of the sinus membrane 12 including the perforation 14.
- the insertion tool 38 comprises a central support 40 and outer supports 42 and 44 laterally spaced from and laterally moveable relative to the central support 40.
- the central support may comprise and is illustrated as comprising a ball 41 extending from a vertical support rod 43.
- a preferred form of the insertion tool 38 is described and illustrated more fully in the concurrently filed United States patent application, Serial Number 11/895,814 filed August 28, 2007 and entitled “Improved Sinus Membrane Perforation Patching Material Carrying Instrument” (Docket 07JY-6) , incorporated herein by this reference.
- the outer supports 42 and 44 are moved laterally against the central support 40 and the patching material is carried by the upper surface of the central support 40 and the upper surfaces of the outer supports.
- the patching material 36 is moved by the insertion tool 38 upward through the opening 10 and into the pocket 25 to a location adjacent to and immediately below the perforation 14 in the sinus membrane 12.
- the insertion tool 38 is then moved upwardly within the channel 18 until the patching material 36 is engages the sinus membrane 12 and extends slightly into the perforation 14.
- the outer supports 42 and 44 are released and moved laterally outward from the central support 40 to aid the central support 40 in laterally extending the patching material 36 to cover the lower surface of the sinus membrane adjacent the perforation and form a patch 46 as shown in Fig. 5.
- the standard patching material 36 is usually a semi-solid material as initially mounted on the insertion tool 38 as shown in Fig. 4A.
- the patching material 36 engages the moist surface of the sinus membrane 12 it softens and becomes laterally extendable upon the release of the outer supports 42 and 44 and shapeable by the central support 40 to form a sticky adhesive patch 46 covering the perforation 14 and the adjacent lower surfaces of the sinus membrane 12 in response to movement of the central support 40.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Epidemiology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dentistry (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Developmental Biology & Embryology (AREA)
- Cardiology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Otolaryngology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
L'invention porte sur une procédure interne sinusale d'application d'une pièce sur une perforation (14) de la membrane sinusale d'un patient (12), comprenant les étapes de : (i) création d'une ouverture (10) dans le plancher sinusal (22) d'un patient pour exposer la partie de la membrane sinusale comprenant la perforation (14) ; (ii) introduction d'une quantité d'un matériau d'application de pièce pour membrane sinusale (36) à travers l'ouverture jusqu'à une position adjacente à la perforation sinusale (14) ; et (iii) déploiement latéral et forçage du matériau d'application de pièce (36) contre la membrane sinusale (12) pour fermer hermétiquement la perforation.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/895,813 | 2007-08-28 | ||
US11/895,813 US7837707B2 (en) | 2006-12-31 | 2007-08-28 | Internal procedure for closing sinus membrane perforations |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2009029083A1 true WO2009029083A1 (fr) | 2009-03-05 |
Family
ID=40387590
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2007/026406 WO2009029083A1 (fr) | 2007-08-28 | 2007-12-28 | Procédure interne de fermeture de perforations de membrane sinusale |
Country Status (1)
Country | Link |
---|---|
WO (1) | WO2009029083A1 (fr) |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5380329A (en) * | 1992-07-28 | 1995-01-10 | Dental Marketing Specialists, Inc. | Bone augmentation method and apparatus |
US5501700A (en) * | 1993-01-08 | 1996-03-26 | Hirata; Keisuke | Eardrum perforation patch and eardrum undersurface scraper |
US20010025176A1 (en) * | 1995-06-07 | 2001-09-27 | Arthrocare Corporation | Systems and methods for electrosurgical treatment of submucosal tissue |
US20050054972A1 (en) * | 2003-09-09 | 2005-03-10 | Adams Kenneth M. | Surgical micro-burring instrument and method of performing sinus surgery |
-
2007
- 2007-12-28 WO PCT/US2007/026406 patent/WO2009029083A1/fr active Application Filing
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5380329A (en) * | 1992-07-28 | 1995-01-10 | Dental Marketing Specialists, Inc. | Bone augmentation method and apparatus |
US5501700A (en) * | 1993-01-08 | 1996-03-26 | Hirata; Keisuke | Eardrum perforation patch and eardrum undersurface scraper |
US20010025176A1 (en) * | 1995-06-07 | 2001-09-27 | Arthrocare Corporation | Systems and methods for electrosurgical treatment of submucosal tissue |
US20050054972A1 (en) * | 2003-09-09 | 2005-03-10 | Adams Kenneth M. | Surgical micro-burring instrument and method of performing sinus surgery |
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