WO2020218933A1 - Spiral gutta-percha cone and endodontic canal root filling method by spiral gutta-percha cone - Google Patents

Abstract

The invention refers to a spiral gutta-percha cone and to a root canal endodontic filling method using the spiral gutta-percha cone. The spiral gutta-percha cone is composed of a truncated cone (1) provided on its external side with one or more spiral shape canals (2). Root canal endodontic filling method with spiral gutta-percha cone comprises the following stages: a humid paper cone is inserted to leave the canal damp; the cone in the canal is checked to correspond to the electronically identified working length by the apex locator and the limit where the cone exits the tooth is marked, by tuck pressing or by other means, with an easily reproducible benchmark; the spiral cone is loaded with MTA cement, by its rotation in the previously prepared cement and it is inserted in the root canal, rotating in the direction of pushing, simultaneously with a back and forth push from the coronary to the apical section, up to the apex; the cone is easily extracted, rotating in the direction of pushing; a paper cone is inserted to remove any excess moisture, followed by a second insertion of a paper cone to measure the size of the MTA cement apical plug; the reduced spiral cone is loaded with cement, then the same rotation movements are used for pushing and back and forth movements successively, until the spiral cone encounters resistance in the canal, checking if the working length, previously marked on the cone, is observed; it is further rotated and then left in the canal; it is reduced at the pulp space floor or lower by a plugger; the filling is radiologically tested.

Description

SPIRAL GUTTA-PERCHA CONE AND ENDODONTIC CANAL ROOT FILLING METHOD BY SPIRAL GUTTA-PERCHA CONE

The invention refers to a spiral gutta-percha cone and to an endodontic root canal filling method by means of the spiral gutta-percha cone.

The gutta-percha cone is used in dental medicine, in endodontics, for the teeth root canal filling.

A gutta-percha cone with check markings of the utility length for canal root filling and a method of its insertion in a root canal are known, according to the patent US6264471 B1. The gutta-percha cone intended for root canal filling comprises a cone, provided with a fastening hub and an insertion tip. The cone is also defined by some indicators arranged laterally, side by side, in pre-determined positions in relation to the cone tip, to allow a visual alignment in relation to a plane reference point. The gutta-percha cone includes a series of useful length control markings to facilitate the visibility of the reference plane insertion point in a prepared root canal. The markings are positioned in relation to the gutta-percha cone tip, and preferred positions conform to the average length of the prepared root canal. There are specifically four markings and the preferred marking positions are at 19 mm, 21 mm, 23 mm, and 25 mm respectively, all measured from the gutta-percha cone tip. These figures are based on the average value of the molar root canal, which is approximately 22 mm long.

The insertion method comprises the following steps:

The cone is brought next to the prepared root canal and it is pushed into the canal until it is fully inserted. The dentist can easily view the markings from the reference plane. If gutta-percha cone is too long, the dentist can easily remove it and cut off 1 mm, 2mm ... etc., after which the cone is reinserted into the canal. If the reference plane visibly falls between the existent printed markings, the readings will be as follows: 20 mm, 22 mm, 24 mm. Therefore, the total visible markings are in fact 19....25 mm. These visible markings facilitate a more precise fastening of the gutta-percha cone in the root canal. In fact, the steps are as follows: the determination of a reference plane in relation to a prepared root canal; the visual check of the position of said markers in relation to the reference plane to determine if the gutta-percha cone is too long; cone cutting with reference to said markings; cone reinsertion into the root canal to achieve a precise fitting.

The role of gutta-percha cone until present was to fill best (tightly) the endodontic space, next to the canal sealing material (as little as possible).

The present invention aims at transforming the passive role of the guttapercha cone, namely that of its positioning into the root canal, adapted as much and as well as possible, into an active role, of applying the MTA cement by rotation of the cone in the direction of pushing the cement to the apex.

To achieve this, the gutta-percha cone is provided with spiral grooves.

By cutting off the spiral cone to the size of the canal preparation, initially 0.3mm-0.5mm or the use of a cone with an apical diameter one size smaller and thereafter reduced by 1...3 mm or more, as the case may be, the cut-off part will be replaced with an apical MTA cement plug, as in the case of a resection, only that the filling is performed from the crown towards the apex.

The apical or ISO conicity size of the master needle preparation is of no relevance; being ISO standard, cones can be produced for each size, even in variable sizes, the important thing is that the conicity of the canal preparation coincide to the cone conicity in the first 5 mm.

The technical problem the present invention proposes to solve is to transform the passive role of the gutta-percha cone, namely that of its positioning into the root canal as adapted as possible, into that of applying the MTA cement by rotation of the cone, to seal, using an easy technique, the root canal with MTA-type cement. The spiral gutta-percha cone, according to the invention, solves the above mentioned technical problem, by the fact that it is provided on its external side with one or more canals having the form of a spiral; due to the rotation of the spirals in the direction of pushing, the cone can carry the MTA cement into the root canal, sealing it.

The root canal endodontic filling method with spiral gutta-percha cone, according to the invention, solves the above mentioned technical problem, by the fact that it comprises the following steps:

1. After the preparation and chemical cleaning of the root canal, the irrigation with normal saline solution is recommended, after which a paper cone is inserted to remove the excess of normal saline solution, and if the canal walls have dried up, a damp paper cone is inserted to leave the canal moist/damp;

2. Canal preparation conicity must coincide with that of the spiral cone in the first 5 mm or more by at least 1 mm, proportionally to how much it is wanted to cut off of the cone, in order to have the apical cap of the same size;

3. The cone in the canal is checked to correspond to the electronically identified working length by the apex finder and the limit where the cone exits the tooth by an easily reproducible benchmark is marked by forceps pressing or by other method;

4. The spiral cone is loaded, according to the invention, with MTA cement, by its spinning in the previously prepared cement; the cement consistency has to be cream like and it is inserted in the root canal, rotating in the direction of pushing, simultaneously with a back and forth push from the coronary to apical section, up to the apex;

5. The cone is easily extracted by rotating it in the direction of pushing;

6. A paper cone is inserted to remove excess liquid and at the same time, to compact the MTA cement. Another paper cone is inserted to check the resulting canal length after the applying of the cement; 7. In large canals, one can also use MTA cement by a Lentulo type needle or even with the last needle by means of which the reverse rotation preparation was carried out, but without entering the entire working length (minus 0.5 - 1 mm) and then the previous step is applied. The procedure must be repeated if insufficient MTA cement, related to the size of the endodontic space, was applied the first time on the cone;

8. A portion of the cone tip, of equal length to the size of the apical MTA plug (which has resulted from the measuring mentioned at 6.), is cut off (by a pair of scissors or a scalpel blade); depending on the required size of the MTA apical plug, this can be achieved in consecutive steps by applying MTA cement and by cone reduction, respectively, by means of the same method as above mentioned;

9. The reduced spiral cone is loaded with cement, then the same rotation movements are used for pushing, until the spiral cone encounters resistance in the canal, checking if the working length previously marked on the cone is observed;

10. It is further spun and it is left in the canal;

1 1. It is reduced at the level of the pulp space floor or lower, if the use of a glass fibre pivot is wanted, carefully compacting by use of a plugger;

12. The filling is radiologically checked.

The invention has the following advantages:

easy application technique for filling the root canals with MTA-type cement, known in the professional literature as a time tested material, successfully used, but which is difficult to work with given the known application techniques;

it can be used if a complete root canal drying cannot be achieved (blood, sinus fluid, secretions); one can fill the following types of canals: long, curved, with large apical diameters, with lateral perforations, with resorptions, with previous resections, with zipping;

In case of some canals with large preparations or fissures, using a guttapercha cone with ISO conicity of 4 %, a large endodontic space filled with MTA cement remains, thus reinforcing the root canal;

possibility of a re-treatment, at least up to the length of the gutta-percha cone length in case of a lateral canal;

one can perform the coronary reconstruction within the same session, the coronary sealing being made by gutta-percha;

one can re-intervene to mount a RCR/DCR-type root anchoring system, after cement hardening, avoiding perforations.

It is further given an example of invention achievement related to figures 1 and 2, representing:

> Fig.1 an overview of a spiral gutta-percha cone with more spirals.

> Fig.2 an overview of a spiral gutta-percha cone with one spiral.

The spiral gutta-percha cone, according to the invention, as it also results from figures 1 and 2, is composed of a truncated cone 1 provided on its surface with at least one canal 2 similar to a spiral or in the shape of an endodontic Kerr K or R-type needle. It is ideal that the spirals 2 be rarer than in the Kerr K (file)-type needle, but denser than in Kerr R-type needle (Reamers), namely one, two or more canals.

The spiral gutta-percha cone, according to the invention, can be produced in more constructive variants, namely it can be a simple cone, it can be provided with a handle in the upper section or fitted into a mandrel, it can be provided with a head, compatible with an endomotor or a vibrating machine e.g. sonic, it can be reinforced on the inside, or it can be treated on the exterior to create adhesion with MTA cement or to achieve a higher level of hardness.

At the same time, it can be marked on its surface by length markings/indicators, according to the quoted document of the technique stage. In any of these situations, the active part, namely the one being inserted in the canal, composed of the truncated cone 1 provided with spirals 2, represents the innovation part of the invention.

The root canal endodontic filling method with spiral gutta-percha cone, according to the invention, comprises the following phases:

1. After the preparation and chemical cleaning of the root canal, the irrigation with normal saline solution is recommended, after which a paper cone is inserted to remove the excess of normal saline solution, and if the canal walls have dried up, a damp paper cone is inserted to leave the canal moist/damp;

2. Canal preparation conicity must coincide with that of the spiral cone in the first 5 mm or more by at least 1 mm, proportionally to how much it is wanted to cut off of the cone, in order to have the apical cap of the same size;

3. The cone in the canal is checked to correspond to the electronically identified working length by the apex finder and the limit where the cone exits the tooth by an easily reproducible benchmark is marked by forceps pressing or by other method;

4. The spiral cone is loaded, according to the invention, with MTA cement, by its spinning in the previously prepared cement; the cement consistency has to be cream like and it is inserted in the root canal, rotating in the direction of pushing, simultaneously with a back and forth push from the coronary to apical section, up to the apex;

5. The cone is easily extracted by rotating it in the direction of pushing;

6. A paper cone is inserted to remove excess liquid and at the same time, to compact the MTA cement. Another paper cone is inserted to check the resulting canal length after the applying of the cement;

7. In large canals, one can also use MTA cement by a Lentulo type needle or even with the last needle by means of which the reverse rotation preparation was carried out, but without entering the entire working length (minus 0.5 - 1 mm) and then the previous step is applied. The procedure must be repeated if insufficient MTA cement, related to the size of the endodontic space, was applied the first time on the cone;

8. A portion of the cone tip, of equal length to the size of the apical MTA plug (which has resulted from the measuring mentioned at 6.), is cut off (by a pair of scissors or a scalpel blade); depending on the required size of the MTA apical plug, this can be achieved in consecutive steps by applying MTA cement and by cone reduction, respectively, by means of the same method as above mentioned;

9. The reduced spiral cone is loaded with cement, then the same rotation movements are used for pushing, until the spiral cone encounters resistance in the canal, checking if the working length previously marked on the cone is observed;

10. It is further spun and it is left in the canal;

11. It is reduced at the level of the pulp space floor or lower, if the use of a glass fibre pivot is wanted, carefully compacting by use of a plugger;

12. The filling is radiologically checked.

Claims

1. Spiral guta-percha cone, composed of a truncated cone (1), characterised by the fact that the truncated cone (1) is provided on its external side with a spiral shape canal (2) .

2. Spiral guta-percha cone, according to claim 1 , characterised by the fact that the truncated cone (1) can be provided on its surface with more spiral shape canals (2) .

3. Spiral guta-percha cone, according to claims 1 and 2, characterised by the fact that the material of the truncated cone (1) provided with one or more canals (2), can be any type of rubber, plastic, metal, silicone, or other flexible materials.

4. Root canal endodontic filling method with spiral guta-percha cone, characterised by the fact that it comprises the following stages:

1. After the preparation and chemical cleaning of the root canal, the irrigation with normal saline solution is recommended, after which a paper cone is inserted to remove the excess of normal saline solution, and if the canal walls have dried up, a damp paper cone is inserted to leave the canal moist/damp;

2. Canal preparation conicity must coincide with that of the spiral cone in the first 5 mm or more by at least 1 mm, proportionally to how much it is wanted to cut off of the cone, in order to have the apical cap of the same size;

3. The cone in the canal is checked to correspond to the electronically identified working length by the apex finder and the limit where the cone exits the tooth by an easily reproducible benchmark is marked by forceps pressing or by other method;

4. The spiral cone is loaded, according to the invention, with MTA cement, by its spinning in the previously prepared cement; the cement consistency has to be cream like and it is inserted in the root canal, rotating in the direction of pushing, simultaneously with a back and forth push from the coronary to apical section, up to the apex;

5. The cone is easily extracted by rotating it in the direction of pushing;

6. A paper cone is inserted to remove excess liquid and at the same time, to compact the MTA cement. Another paper cone is inserted to check the resulting canal length after the applying of the cement;

7. In large canals, one can also use MTA cement by a Lentulo type needle or even with the last needle by means of which the reverse rotation preparation was carried out, but without entering the entire working length (minus 0.5 - 1 mm) and then the previous step is applied. The procedure must be repeated if insufficient MTA cement, related to the size of the endodontic space, was applied the first time on the cone;

8. A portion of the cone tip, of equal length to the size of the apical MTA plug (which has resulted from the measuring mentioned at 6.), is cut off (by a pair of scissors or a scalpel blade); depending on the required size of the MTA apical plug, this can be achieved in consecutive steps by applying MTA cement and by cone reduction, respectively, by means of the same method as above mentioned;

9. The reduced spiral cone is loaded with cement, then the same rotation movements are used for pushing, until the spiral cone encounters resistance in the canal, checking if the working length previously marked on the cone is observed;

10. It is further spun and it is left in the canal;

1 1. It is reduced at the level of the pulp space floor or lower, if the use of a glass fibre pivot is wanted, carefully compacting by use of a plugger;

12. The filling is radiologically checked.