WO2018191337A1

WO2018191337A1 - Endodontic obturator

Info

Publication number: WO2018191337A1
Application number: PCT/US2018/027029
Authority: WO
Inventors: Jiayin LIU; Emanuele Maretto; Carlos Munoz
Original assignee: Kerr Corporation
Priority date: 2017-04-13
Filing date: 2018-04-11
Publication date: 2018-10-18

Abstract

A dental obturator includes a storage body defining an internal cavity to store endodontic filling material, at least a portion of the storage body being adjustable to control a volume of endodontic filling material in the storage body. The obturator further includes an elongated, hollow tube extending from the storage body and in fluid communication with the internal cavity.

Description

ENDODONTIC OBTURATOR

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Provisional Application No. 62/485,328, filed April 13, 2017, the entire contents of which are incorporated herein by reference.

FIELD OF THE INVENTION

[0002] Embodiments relate to apparatuses and methods for obturating a root canal. BACKGROUND OF THE INVENTION

[0003] Dental root canal treatment generally involves three stages: shaping, cleaning, and obturation (generally involving filling and sealing). Ultimately, the goal of a root canal treatment is to eliminate the infection inside the dental root system and to tightly seal or obturate the small opening at the end of the root canal (i.e., the apex). Failure to completely seal the apex or the root canal leads to micro-leakage. Micro-leakage may lead to bacteria colonization inside the root canal system, re-infection, and possible loss of the tooth. Micro-leakage is the most common cause of tooth failure.

[0004] Conventional methods of obturating an extirpated or stripped root canal commonly involve first locating the apex (e.g., by using x-rays and radiovisiographs), and then packing the root canal, including the apex, with an endodontic filling material such as radiopaque gutta percha (e.g., trans 1-4 polyisoprene or polysulfone), so that the root canal space is filled with the filling material.

SUMMARY

[0005] With some conventional methods, the filling material is first generally shaped into a slender cone having a small taper angle prior to insertion and packing into the root canal. The root canal is then filled and packed with the cone, forming a seal that prevents leakage between the root canal and the surrounding tissue. However, such methods are generally only suitable for simple anatomy, and not for more complex and tortuous canals. [0006] In other conventional methods, the filling material is first applied over a carrier (e.g., rod or other structure), often made of plastic, prior to insertion into the root canal in order to facilitate insertion into the root canal. The filling material is then heated (e.g., in an oven) prior to insertion, such that the filling material forms a soft jacket over the carrier. The carrier and jacket of filling material are then inserted into the root canal, where the jacket of filling material forms a seal at the apex. The carrier is often designed to remain permanently inside the root canal as part of the final seal (e.g. by breaking the carrier after the filling material has cooled and sealed the root canal). However, carriers pre-coated with gutta percha are often expensive to produce and purchase. Additionally, when further root canal treatment is needed, the presence of the carrier provides an obstacle to regaining access to the apex of the root canal, thus potentially lengthening the procedure. Also, such carrier systems are only generally suitable for simple anatomy, and not for more complex and tortuous canals.

[0007] In other conventional methods, electromechanical systems are used to inject heated filling material (e.g., gutta percha) into the root canal to form a seal. However, these

electromechanical systems are often difficult and complicated to operate, and require operation by a specialist.

[0008] One embodiment provides an endodontic obturator including a storage body defining an internal cavity to store endodontic filling material, at least a portion of the storage body being adjustable to control a volume of endodontic filling material in the storage body. The obturator further includes an elongated, hollow tube extending from the storage body and in fluid communication with the internal cavity.

[0009] Other embodiments and aspects will become apparent by consideration of the detailed description and accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0010] FIG. 1 is a schematic representation of an endodontic obturator according to one embodiment, having a silicone rubber ball storage body. [0011] FIG. 1 A is a schematic representation of the obturator of FIG. 1, illustrating a curved elongated tube.

[0012] FIG. IB is a schematic representation of the obturator of FIG. 1, illustrating a tapered elongated tube.

[0013] FIG. 1C is a schematic representation of the obturator of FIG. 1, illustrating a stepped elongated tube.

[0014] FIG. 2 is a schematic representation of an endodontic obturator according to another embodiment, having a removable tip.

[0015] FIG. 3 is a schematic representation of an endodontic obturator according to another embodiment, having a syringe storage body.

[0016] FIG. 4 is a schematic representation of an endodontic obturator according to another embodiment, having a curved elongate hollow tube.

[0017] FIG. 5 is a schematic representation of an endodontic obturator according to another embodiment, having a balloon storage body.

DETAILED DESCRIPTION

[0018] Before any embodiments are explained in detail, it is to be understood that those embodiments are not limited in theirs application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. Other embodiments are possible and embodiments capable of being practiced or of being carried out in various ways. In addition, a device or structure disclosed as being configured in a certain way can be configured in at least that way, but can also be configured in ways that are not listed. In addition, in the following description, it can be seen that various features are grouped together in various embodiments for the purpose of streamlining the disclosure. This does not mean that the claimed embodiments require more features than are expressly recited in each claim. It only means that inventive subject matter may be encompassed in fewer than all features of a single disclosed embodiment or combinations (whether full or partial) of disclosed embodiments as set forth in the written description.

[0019] FIG. 1 illustrates an endodontic obturator 10 for use in obturating a root canal. The obturator 10 includes a storage body 14 (e.g., reservoir, container, or other structure) defining an internal cavity 16 therein to store endodontic filling material. The endodontic filling material may include, for example, a thermoplastic material (e.g., 2-hydroxyethyl methacrylate (HEMA), polyurethane, polypropylene, polyethylene), a chemo-plastic material (i.e., a material that may be softened by chemicals), or similar polymeric material such as gutta percha. In some embodiments, the filling material includes one or more additives such as plasticizing, antibiotic, cariostatic, antibacterial, or other anti-inflammatory, biologically active or therapeutic additives. In some embodiments, the filling material is radiopaque, bacteriostatic, and/or is a silver/iron oxide composite. The filling material may be used at room temperature. In other embodiments the filling material may be heated to different temperatures. In some embodiments, the filling material may be self-cured, light cured, and/or thermoplastic.

[0020] With continued reference to FIG. 1, the obturator 10 includes an elongated, hollow tube 18 extending from the storage body 14 and in fluid communication with the internal cavity. The tube 18 is formed for example of stainless steel, nitinol, polyimide, or polysulfone, although other embodiments include different materials. The tube 18 includes a first end 22 coupled to (e.g., integrally formed as a single piece with, adhered to, etc.) the storage body 14. The tube 18 further includes a second, distal end 26 disposed opposite the first end 22. An internal passageway 28 extends from the first end 22 to the second end 26, to provide a pathway for the filling material to move from internal cavity in the storage body 14 out of the obturator 10. In the illustrated embodiment the tube 18 is straight. In other embodiments, such as in FIGS. 1 A, IB, and 1C, the tube 18 is curved, tapered, or stepped, respectively, and/or has other shapes and sizes than that illustrated. The tube 18 may have a circular cross-section, oval cross-section, or other shaped cross-section.

[0021] With continued reference to FIG. 1, at least a portion of the storage body 14 is adjustable to control a volume of filling material in the storage body 14. In the illustrated embodiment, the storage body 14 is a silicone rubber ball. Thus, the storage body 14 may easily be deformed by external pressure (e.g., squeezed / compressed) by an endodontist, dentist, dental technician, or any other user of the obturator 10, so as to control the volume of the filling material in the internal cavity in the storage body 14, and to control the amount of filling material that is dispersed out of the obturator 10 and into a root canal. Other embodiments of the storage body 14 include material other than silicone.

[0022] In some embodiments, the obturator 10 is warmed up (e.g., in an oven) prior to use. For example, the obturator 10 may be heated to approximately 70°C - 250°C, although other embodiments include different values and ranges. The heating of the obturator 10 warms and softens the filling material (e.g., gutta percha) inside the obturator 10.

[0023] In use, at least a portion of the tube 18 is inserted into an extirpated or stripped root canal, such that the distal, second end 26 of the tube 18 is placed adjacent an apex of the root canal (e.g., within 4mm, 3mm, 2mm, 1mm, or other distances or ranges of distances from the apex). In some embodiments, the tube 18 is flexible, to permit the tube 18 to be inserted into tortuous canals and better reach the apex. Once the second end 26 is placed adjacent the apex of the root canal, the storage body 14 is squeezed to change the volume of the filling material in the internal cavity and to force at least a portion of the filling material to pass through the internal passageway 28 of the tube 18, out of the obturator 10, and into the root canal, thus sealing the root canal at the apex and areas of the canal adjacent the apex.

[0024] If the filling material inside the obturator 10 has been heated prior to use, the filling material may more easily flow out of the obturator 10 and fill in the tortuous canal prior to hardening, thus forming a more uniform and complete seal. In some embodiments, the filling material is liquid material inside the storage body 14 that solidifies when exposed to air.

[0025] Once the apex has been initially sealed, the obturator 10 may be slowly retracted out of the root canal, and additional back-filling and sealing of the root canal may be completed by further squeezing additional filling material out of the storage body 14. In some embodiments, a conventional condenser or plugger may later be used after the obturator 10 has been removed, to compress the filling material while the filling material is still in a softened state, thereby pressing the filing material further into the root canal and forming a tighter, more compressed seal. [0026] FIG. 2 illustrates an endodontic obturator 110 for use in obturating a root canal. The obturator 110 includes a storage body 114 (e.g., reservoir, container, or other structure) defining an internal cavity 116 therein to store endodontic filling material. The filling material includes, for example, a thermoplastic material (e.g., 2-hydroxy ethyl methacrylate (HEMA), polyurethane, polypropylene, polyethylene), a chemo-plastic material (i.e., a material that may be softened by chemicals), a chemo-plastic material (i.e., a material that may be softened by chemicals), or similar polymeric material such as gutta percha. In some embodiments, the filling material includes one or more additives such as plasticizing, antibiotic, cariostatic, antibacterial, or other anti-inflammatory, biologically active or therapeutic additives. In some embodiments, the filling material is radiopaque, bacteriostatic, and/or is a silver/iron oxide composite.

[0027] With continued reference to FIG. 2, the obturator 110 includes an elongated, hollow tube 118 extending from the storage body 114 and in fluid communication with the internal cavity. The tube 118 is formed for example of stainless steel, nitinol, or polyimide, although other embodiments include different materials. The tube 118 includes a first end 122 coupled to (e.g., integrally formed as a single piece with, adhered to, etc.) the storage body 114. The tube 118 further includes a second, distal end 126 disposed opposite the first end 122. An internal passageway 128 extends from the first end 122 to the second end 126, to provide a pathway for the filling material to move from the internal cavity in the storage body 114 out of the obturator 110. In the illustrated embodiment the tube 118 is straight. In other embodiments (similar to FIGS. 1 A, IB, and 1C) the tube 118 is curved, tapered, or stepped, and/or has other shapes and sizes than that illustrated. The tube 118 may have a circular cross-section, oval cross-section, or other shaped cross-section. In some embodiments, the tube 118 is flexible, to permit the tube 118 to be inserted into tortuous canals and better reach the apex.

[0028] With continued reference to FIG. 2, at least a portion of the storage body 114 is adjustable to control a volume of filling material in the storage body 114. In the illustrated embodiment, the storage body 114 is a silicone rubber ball, similar to the embodiment of FIG. 1. Thus, the storage body 114 may easily be deformed by external pressure (e.g., squeezed / compressed) by an endodontist, dentist, dental technician, or any other user of the obturator 110, so as to control the volume of the filling material in the internal cavity in the storage body 114 and to control the amount of filling material that is dispersed out of the obturator 110 and into a root canal.

[0029] As illustrated in FIG. 2, the obturator 110 further includes a removable tip 130 coupled to the second end 126 of the tube 118. The tip 130 is formed of silicone rubber or gutta percha (e.g., gutta percha with high melting temperature), although other embodiments include different materials. In some embodiments, the tip 130 blocks at least a portion of the internal passageway 128 at the second end 126. The tip 130 may be threaded into the internal passageway at the second end 126 (e.g., via external threads on the removable tip and internal threads within the internal passageway 128), or may be mechanically coupled to the tube 118, or may be integrally formed as a single piece with the tube 118, or may otherwise coupled to the second end 126. In some embodiments, the tip 130 is soft and smooth initially, and is threaded by internal threads within the internal passageway 128 during assembly. In other embodiments, the tip 130 is smooth and is pressed at least partially up into the internal passageway 128, and fits into the second end 126 via a frictional fit. Other embodiments include different structures or methods by which to attach the tip 130 to the tube 118.

[0030] During use, the tip 130 is placed adjacent the apex in the root canal. The tip 130 may then be released by breaking off the tip 130 (e.g., twisting the obturator to unthread the tip 130) or by dispersing the filling material. For example, when the filling material travels from the storage body 114 and through the internal passageway 128 of the tube 118, pressure may build within the tube 118. This pressure may release the tip 130 from the second end 126 (e.g., by breaking a connection between the tip 130 and the tube 118). When the tip 130 has been released, the tip 130 may fill in the apex and facilitate a seal at the apex. Thus, the tip 130 may be sized and shaped to generally fit into an apex within the root canal. The filling material that flows out the obturator 110 may then surround and otherwise fill in space around the tip 130, further facilitating the seal at the apex and in other adjacent areas in the root canal. In some embodiments, the tip 130 is soft and is deformed to a shape of the root canal apex.

[0031] FIG. 3 illustrates an endodontic obturator 210 for use in obturating a root canal. In this example, the obturator 210 includes a storage body 214 (e.g., reservoir, container, or other structure) defining an internal cavity 242 therein to store endodontic filling material 246. The filling material 246 includes, for example, a thermoplastic material (e.g., 2-hydroxyethyl methacrylate (HEMA), polyurethane, polypropylene, polyethylene), a chemo-plastic material (i.e., a material that may be softened by chemicals), a chemo-plastic material (i.e., a material that may be softened by chemicals), or similar polymeric material such as gutta percha. In some embodiments, the filling material 246 includes one or more additives such as plasticizing, antibiotic, cariostatic, antibacterial, or other anti-inflammatory, biologically active or therapeutic additives. In some embodiments, the filling material 246 is radiopaque, bacteriostatic, and/or is a silver/iron oxide composite.

[0032] With continued reference to FIG. 3, the obturator 210 includes an elongated, hollow tube 218 extending from the storage body 214 and in fluid communication with the internal cavity 242. The tube 218 is formed for example of stainless steel, nitinol, or polyimide, although other embodiments include different materials. The tube 218 includes a first end 222 coupled to (e.g., integrally formed as a single piece with, adhered to, etc.) the storage body 214. The tube 218 further includes a second, distal end 226 disposed opposite the first end 222. An internal passageway 228 extends from the first end 222 to the second end 226, to provide a pathway for the filling material 246 to move from internal cavity 242 in the storage body 214 out of the obturator 210. In the illustrated embodiment the tube 218 is straight. The hollow tube 218 may have a circular cross-section, oval cross-section, or other shaped cross-section.

[0033] With continued reference to FIG. 3, at least a portion of the storage body 214 is adjustable to control a volume of filling material 246 in the storage body 214. In the illustrated embodiment, the storage body 214 is a syringe having a main syringe body 234 and a plunger 238 that moves relative to the main syringe body 234 to control an amount of filling material 246 within the internal cavity 242 in the storage body 214. Thus, at least a portion (i.e., the plunger 238) of the storage body 214 may easily be moved by external pressure (e.g., compressed down by hand) by an endodontist, dentist, dental technician, or any other user of the obturator 210, so as to control the volume of the filling material 246 in the internal cavity 242 and to control the amount of filling material 246 that is dispersed out of the obturator 210 and into a root canal.

[0034] FIG. 4 illustrates an endodontic obturator 310 for use in obturating a root canal, having a storage body 314 (e.g., reservoir, container, or other structure), an elongated, hollow tube 318 with a first end 322 and a second, distal end 326. In this example, the storage body 314 is a syringe having a main syringe body 334 and a plunger 338, and includes an internal cavity 342 that stores endodontic filling material 346. The obturator 310 is identical to the obturator 210, with the exception that the tube 318 is curved.

[0035] The tubes 218, 318 described above, may have other shapes or sizes than that illustrated (e.g., tapered, stepped, etc.), and in some embodiments are flexible to permit the tubes 218, 318 to be inserted into tortuous canals and better reach the apex.

[0036] FIG. 5 illustrates an endodontic obturator 410 for use in obturating a root canal. The obturator 410 includes a storage body 414 (e.g., reservoir, container, or other structure) defining an internal cavity 416 therein to store endodontic filling material. The filling material includes, for example, a thermoplastic material (e.g., 2-hydroxy ethyl methacrylate (HEMA), polyurethane, polypropylene, polyethylene), a chemo-plastic material (i.e., a material that may be softened by chemicals), a chemo-plastic material (i.e., a material that may be softened by chemicals), or similar polymeric material such as gutta percha. In some embodiments, the filling material includes one or more additives such as plasticizing, antibiotic, cariostatic, antibacterial, or other anti-inflammatory, biologically active or therapeutic additives. In some embodiments, the filling material is radiopaque, bacteriostatic, and/or is a silver/iron oxide composite.

[0037] With continued reference to FIG. 5, the obturator 410 includes an elongated, hollow tube 418 extending from the storage body 414 and in fluid communication with the internal cavity. The tube 418 is formed for example of stainless steel, nitinol, or polyimide, although other embodiments include different materials. The tube 418 includes a first end 422 coupled to (e.g., integrally formed as a single piece with, adhered to, etc.) the storage body 414. The tube 418 further includes a second, distal end 426 disposed opposite the first end 422. An internal passageway 428 extends from the first end 422 to the second end 426, to provide a pathway for the filling material to move from internal cavity in the storage body 414 out of the endodontic obturator 410. In the illustrated embodiment the tube 418 is straight. In other embodiments (similar to FIGS. 1 A, IB, and 1C) the tube 418 is curved, tapered, or stepped, and/or has other shapes and sizes than that illustrated. The tube 418 may have a circular cross-section, oval cross- section, or other shaped cross-section. In some embodiments, the tube 418 is flexible, to permit the tube 418 to be inserted into tortuous canals and better reach the apex.

[0038] With continued reference to FIG. 5, at least a portion of the storage body 414 is adjustable to control a volume of endodontic filling material in the storage body 414. In the illustrated embodiment, the storage body 414 is an elongate polyethylene terephthalate balloon. Thus, the storage body 414 may easily be deformed by external pressure (e.g., squeezed / compressed) by an endodontist, dentist, dental technician, or any other user of the obturator 10, so as to control the volume of the filling material in the internal cavity in the storage body 414, and to control the amount of filling material that is dispersed out of the obturator 410 and into a root canal. Other embodiments of the storage body 414 include material other than polyethylene terephthalate (e.g., nylon).

[0039] In some embodiments, one or more of the obturators 10, 110, 210, 310, 410 described herein includes a marking or markings (e.g., numbers or lines along its associated storage body) to identify an amount of filling material that has been delivered out of the obturator, or at least out of the storage body. For example, one or more of the storage bodies described herein may be transparent or partially transparent, so that an endodontist, dentist, dental technician, or other user of the obturator may have a visual indication (e.g., based on a marking or markings) of how much filling material has been delivered into the root canal. In some embodiments, one or more of the obturators 10, 110, 210, 310, 410 may include a length marker 500 (illustrated

schematically for example in FIG. 5) that is printed, molded, or marked by a rubber stop or other marking or physical structure along the tube 18, 118, 218, 318, 418 that provides an indication of how far the tube 18, 118, 218, 318, 418 has been inserted. The length marker may be used, for example, to locate the apex of the root canal. In some embodiments the diameter of the root canal is not consistent, and excess gutta percha or other filling material be easily be removed.

[0040] While the obturators 10, 110, 210, 310, 410 described above include a storage body in the form of a ball, balloon, or syringe, other embodiments include different structures or combinations of structures to store the filling material. Additionally, while the obturators 10, 110, 210, 310, 410 described above each include a single elongate, hollow tube, other embodiments include other numbers and arrangements of tubes or other (e.g., flexible) structures that are sized and shaped to fit within a root canal and to deliver filling material from the storage body toward the apex in the root canal (e.g., including through tortuous root canal cavities). Additionally, while only the embodiment illustrated in FIG. 2 includes a removable tip, any of the other embodiments described herein may also include a removable tip similar to the tip 130.

[0041] As described above, the obturators 10, 110, 210, 310, 410, are suitable for torturous anatomy. The obturators 10, 110, 210, 310, 410 are also easy to use, require no

electrical/mechanical systems, and at least in some instances may be operated by an endodontist, general dentist, or dental technician, or others. Additionally, the obturators 10, 110, 210, 310, 410 do not include carriers such as those conventionally used in current obturator systems. Thus, the obturators 10, 110, 210, 310, 410 are relatively low-cost, are easy to insert and remove from the root canal, and do not leave behind structures that slow subsequent access to the root canal.

[0042] Variations and modifications exist within the scope and spirit of one or more independent aspects of the embodiments described.

[0043] Various embodiments, features, and advantages are set forth in the following claims.

Claims

CLAIMS What is claimed is:

1. An endodontic obturator comprising:

a storage body defining an internal cavity to store endodontic filling material, at least a portion of the storage body being adjustable to control a volume of endodontic filling material in the storage body; and

an elongated, hollow tube extending from the storage body and in fluid communication with the internal cavity.

2. The endodontic obturator of claim 1, further comprising endodontic filling material disposed within the internal cavity.

3. The endodontic obturator of claim 2, wherein the endodontic filling material includes gutta percha.

4. The endodontic obturator of claim 2, wherein the endodontic filling material is a liquid material that solidifies when exposed to air.

5. The endodontic obturator of claim 2, wherein the endodontic filling material is at least one of radiopaque, bacteriostatic, or a silver/iron oxide composite.

6. The endodontic obturator of claim 1, wherein the elongated, hollow tube is formed from at least one of stainless steel, nitinol, or polyimide.

7. The endodontic obturator of claim 1, wherein the elongated, hollow tube is straight.

8. The endodontic obturator of claim 1, wherein the elongated, hollow tube is curved.

9. The endodontic obturator of claim 1, wherein the elongated, hollow tube is tapered.

10. The endodontic obturator of claim 1, wherein the elongated, hollow tube is stepped.

11. The endodontic obturator of claim 1, wherein the elongated, hollow tube is flexible.

12. The endodontic obturator of claim 1, wherein the elongated, hollow tube includes at least one of a circular or oval cross-section.

13. The endodontic obturator of claim 1, wherein the storage body includes at least one of a silicone rubber ball, polyethylene terephthalate balloon, or nylon balloon that is deformable via external pressure to control the volume of endodontic filling material in the storage body.

14. The endodontic obturator of claim 1, wherein the storage body includes a syringe having a main syringe body and a plunger that moves relative to the main syringe body to control the volume of endodontic filling material in the storage body.

15. The endodontic obturator of claim 1, wherein the elongated, hollow tube includes a first end coupled to the storage body and a second, opposite end, wherein an internal passageway extends from the first end to the second end, and wherein the endodontic obturator further includes a removable tip coupled to the second end.

16. The endodontic obturator of claim 15, wherein the removable tip is formed of silicone rubber or gutta percha.

17. The endodontic obturator of claim 16, wherein the removable tip is formed of heated gutta percha.

18. The endodontic obturator of claim 15, wherein the removable tip blocks at least a portion of the internal passageway at the second end.

19. The endodontic obturator of claim 15, wherein the removable tip is threaded into the internal passageway at the second end.

20. A method of sealing a root canal comprising:

providing the endodontic obturator of claim 2;

inserting at least a portion of the elongated, hollow tube into a root canal, such that a distal end of the elongated, hollow tube is adjacent an apex of the root canal; and

adjusting the portion of the storage body to change the volume of the endodontic filling material in the internal cavity and to force at least a portion of the endodontic filling material to pass through the elongated, hollow tube, out of the endodontic obturator, and into the root canal, thus sealing the root canal at the apex.