WO2022188190A1 - 一种机械振动加旋转双驱动模式的根管治疗装置 - Google Patents

一种机械振动加旋转双驱动模式的根管治疗装置 Download PDF

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Publication number
WO2022188190A1
WO2022188190A1 PCT/CN2021/080776 CN2021080776W WO2022188190A1 WO 2022188190 A1 WO2022188190 A1 WO 2022188190A1 CN 2021080776 W CN2021080776 W CN 2021080776W WO 2022188190 A1 WO2022188190 A1 WO 2022188190A1
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WIPO (PCT)
Prior art keywords
shaft
root canal
shaped
vibration
wheel
Prior art date
Application number
PCT/CN2021/080776
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English (en)
French (fr)
Inventor
王中
周劲松
Original Assignee
深圳市速航科技发展有限公司
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Priority to US17/769,339 priority Critical patent/US20230157787A1/en
Publication of WO2022188190A1 publication Critical patent/WO2022188190A1/zh

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00—Filling or capping teeth
    • A61C5/40—Implements for surgical treatment of the roots or nerves of the teeth; Nerve needles; Methods or instruments for medication of the roots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/0007—Control devices or systems
    • A61C1/0015—Electrical systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/0007—Control devices or systems
    • A61C1/0015—Electrical systems
    • A61C1/003—Control of rotation of instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/02—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design characterised by the drive of the dental tools
    • A61C1/06—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design characterised by the drive of the dental tools with electric drive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/02—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design characterised by the drive of the dental tools
    • A61C1/07—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design characterised by the drive of the dental tools with vibratory drive, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/12—Angle hand-pieces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/18—Flexible shafts; Clutches or the like; Bearings or lubricating arrangements; Drives or transmissions
    • A61C1/185—Drives or transmissions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00—Filling or capping teeth
    • A61C5/40—Implements for surgical treatment of the roots or nerves of the teeth; Nerve needles; Methods or instruments for medication of the roots
    • A61C5/42—Files for root canals; Handgrips or guiding means therefor

Definitions

  • the invention relates to a root canal treatment device, in particular to a root canal treatment device in a mechanical vibration and rotation dual drive mode.
  • Root canal therapy is an ideal and mature treatment method for various diseases such as pulpitis and pulp necrosis. And shape a complete and smooth root canal cavity, and then fill the prepared root canal with other materials, such as gutta percha, to achieve the purpose of root canal repair and treatment.
  • the commonly used root canal preparation method is to use the root canal therapy instrument in conjunction with the mechanical root canal instrument.
  • the root canal treatment instrument drives the root canal instruments to move in the root canal, shaping and cleaning the inner wall of the root canal.
  • the advantages of using a root canal therapy instrument are that the root canal forming efficiency is high, the forming effect is good, and the work intensity of the operator is reduced.
  • the traditional root canal treatment apparatus system generally includes a rotary root canal treatment machine and an ultrasonic root canal treatment apparatus.
  • the treatment machine drives the machine to rotate with the root canal instrument, and cuts the inner wall of the root canal through the blade of the instrument to achieve the purpose of root canal shaping.
  • the power is generally provided by an electromagnetic motor.
  • the advantages of the rotary root canal treatment machine are that the output speed of the motor is stable, the torque is controllable, it can reciprocate alternately in both positive and negative directions, and the head part can be sterilized by high temperature and high pressure.
  • the use of mechanical rotary instruments in the process of root canal preparation is likely to form a smear layer on the root canal wall, which is determined by the structure and movement of the root canal file instrument.
  • the working part of the root canal file instrument has a certain taper and has threads distributed on it. In order to form a cutting edge, the working part needs to have a certain cross-sectional shape, as shown in Figure 1.
  • the root canal file instrument is used as a cutting tool for dental surgery. Due to the limitation of radial size and processing means, the cutting angle ⁇ 0 is generally large, so the root canal file basically cuts the root canal wall in a "scratch" way. , which will inevitably lead to the extrusion of the instrument against the root canal wall and the generation of frictional heat.
  • the heat generated by the friction of the instrument denatures the organic matter of the root canal wall, and the dentin debris, dentinal tubule overflow, saliva and bacteria are under the action of the drilling and grinding pressure of the instrument. It adheres to the inner wall of the root canal to form a smear layer with a thickness of about 1-2 microns.
  • the contamination layer will block the lateral root canal, hinder the penetration of the drug into the lateral wall of the root canal and the dentinal tubules, resulting in the failure of filling the lateral root canal. If the contamination layer cannot be completely removed, it will lead to an increase in the failure rate of treatment and an increase in complications, which will directly affect the treatment effect. The resulting smear layer needs further cleaning.
  • the principle of the ultrasonic root canal therapy instrument is to use the ultrasonic transducer to drive the root canal file device, so that the ultrasonic root canal file device generates ultrasonic vibration to shape and clean the inside of the root canal.
  • the working principle is shown in Figure 2.
  • transducer 2-1 made of piezoelectric or magnetostrictive material rod, can generate longitudinal vibration under the excitation of alternating electric field or magnetic field;
  • working head 2-2 ultrasonic root canal file instrument 2-3;
  • the ultrasonic vibration generated by the energy generator 2-1 is transmitted to the root canal file 2-3 through the working head 2-2, but due to the change of the vibration propagation direction, ultrasonic vibration with the vibration wave as a transverse wave is generated at the tip of the root canal file 2-3.
  • the tip of the ultrasonically vibrated root canal file will shear the surrounding liquid medium and produce a cavitation effect to form cavitation. Shape and clean root canals.
  • the ultrasonic root canal therapy instrument has unique advantages in root canal cleaning, but it is not good in root canal shaping. This is because the ultrasonic root canal file does not rotate when working, only the tip has the function of removing dentin. , it is difficult to avoid serious deviation between the axis of the root canal after shaping and the axis of the original root canal during root canal shaping, especially when dealing with curved root canals, it is easy to cause local damage and lateral penetration of the root canal.
  • the root canal treatment devices that have been disclosed so far, the design of the rotary and ultrasonic vibration root canal treatment instruments are independent, so the common method of clinical root canal preparation is to first use the rotary root canal treatment machine to shape the root canal , After the shaping is completed, the ultrasonic vibration root canal therapy instrument is used to remove the smear layer and clean the root canal. If the root canal file can be rotated and cut in the root canal, there will be additional slight vibration, which will increase the chip removal capacity of the root canal file, significantly reduce the cutting resistance and cutting temperature, effectively avoid the generation of smear layers, and improve the The quality of root canal preparation reduces the labor intensity of the operator.
  • the ultrasonic vibrators are all arranged on the rotary shaft of the rotary motion.
  • Such a design can well realize the combination of rotary motion and vibration motion, but such a structure is too bulky and is not suitable for dental applications.
  • Root canal therapy device because the handpiece of the dental root canal therapy device needs to be inserted into the patient's mouth when in use, and the volume cannot be too large.
  • the present invention provides a root canal treatment device in a mechanical vibration and rotation dual-drive mode, which can simultaneously provide a mechanical vibration and rotation dual-drive mode.
  • the invention provides a root canal treatment device in a mechanical vibration and rotation dual drive mode, comprising a handpiece, a handle, a first flexible transmission shaft and a second flexible transmission shaft, the handpiece comprising an outer body for installing a root canal A mandrel portion of a file instrument, a first drive input shaft portion and a second drive input shaft portion, the mandrel portion being mounted within the outer body, the handle having a first drive motor and a second drive motor , the first drive motor is connected with the first drive input shaft part through a first flexible transmission shaft, the first drive input shaft part is connected with the mandrel part, and drives the mandrel part to rotate, so
  • the second drive motor is connected with the second drive input shaft portion through a second flexible transmission shaft, the second drive input shaft portion is connected with the mandrel portion, and drives the mandrel portion to mechanically vibrate.
  • the second drive input shaft part includes a vibration input shaft, a wheel, an eccentric shaft, a connecting plate and a vibration output shaft, and one end of the vibration input shaft is connected with the second flexible transmission shaft, so The other end of the vibration input shaft is connected to the wheel, the eccentric shaft is installed on the wheel, the connecting plate is installed on the eccentric shaft, and the vibration output shaft is installed on the connecting plate, so The vibration output shaft is connected with the mandrel part, and drives the mandrel part to mechanically vibrate.
  • the mandrel part includes a T-shaped end face gear shaft, an upper bushing, an I-shaped wheel and a lower bushing installed in the outer body, the upper bushing, the I-shaped wheel and the lower bushing
  • the shaft sleeve is installed on the T-shaped end face gear shaft from top to bottom, a lever ring is sleeved on the outer side of the I-shaped wheel, and one end of the lever ring is rotatably connected with the outer main body, and the lever The other end of the ring is connected with the vibration output shaft, and the T-shaped face gear shaft is connected with the first drive input shaft part.
  • an upper ball groove is provided between the upper end of the I-shaped wheel and the upper bushing, and a lower ball groove is provided between the lower end of the I-shaped wheel and the lower bushing
  • the upper ball groove and the lower ball groove are both provided with balls, and the I-shaped wheel and the T-shaped end face gear shaft are in clearance fit.
  • the waist of the I-shaped wheel is provided with radially arranged holes
  • the lever ring is an annular ring with ears with left and right ears, and is sleeved on the center of the I-shaped wheel
  • the lever ring is provided with a radially inward protruding shaft, and the protruding shaft is in clearance fit with the hole on the I-shaped wheel.
  • the left ear of the lever ring is provided with a left trunnion hole
  • the outer body is provided with a left trunnion
  • the left trunnion hole and the left trunnion are in clearance fit
  • the right ear of the lever ring is provided with a side plate
  • the waist of the side plate is provided with a right trunnion hole
  • the right trunnion hole is matched with the vibration output shaft in a clearance fit.
  • the first drive input shaft portion includes a gear shaft, the gear shaft is mounted on the top of the side plate, and the gear shaft is connected with the T-shaped end face gear shaft through gear meshing.
  • the outer body includes a sleeve, the T-shaped end face gear shaft, the upper shaft sleeve, the I-wheel and the lower shaft sleeve are all installed in the sleeve, and the upper end of the sleeve is installed in the sleeve.
  • There is an upper annular gland the lower end of the sleeve is provided with a lower annular gland, the I-shaped wheel is arranged between the upper annular gland and the lower annular gland, and the I-shaped wheel is connected to the upper annular gland.
  • An upper elastic ring is arranged between the annular glands, and a lower elastic ring is arranged between the I-shaped wheel and the lower annular gland.
  • the upper elastic ring and the lower elastic ring are made of polymer material or metal material, and the upper elastic ring and the lower elastic ring are both annular or spring-shaped or diaphragm-shaped.
  • a locking nut is connected to the lower end of the T-shaped end face gear shaft, the locking nut is tightly attached to the lower end of the lower shaft sleeve, and the locking nut connects the upper shaft sleeve, The I-shaped wheel and the lower bushing are locked on the T-shaped end face gear shaft.
  • the handpiece, the flexible transmission shaft and the handle can be separated from each other, and the handpiece and the flexible transmission shaft can be sterilized by high temperature and high pressure.
  • the first flexible transmission shaft and the second flexible transmission shaft may be stainless steel wire stranded wire flexible shafts, flexible shafts made of polymer materials, or rigid transmission shafts with universal joints.
  • first flexible transmission shaft and the second flexible transmission shaft can be quickly connected and disassembled, and the connection manner is not limited.
  • connection between the handpiece and the handle is a tight-fit quick connection, so as to facilitate disassembly and assembly, and the connection mode is not limited.
  • the root canal file instrument can be moved in two ways: rotation and vibration during root canal preparation, which not only realizes the efficient cutting of the root canal wall by the instrument, but also effectively reduces the vibration of the additional instrument.
  • the cutting resistance and cutting temperature avoid the generation of smear layer and significantly improve the quality and efficiency of root canal preparation.
  • FIG. 1 is a schematic diagram of a mechanical root canal file instrument in the prior art.
  • FIG. 2 is a schematic diagram of the principle of an ultrasonic root canal treatment machine in the prior art.
  • FIG. 3 is a schematic diagram of a root canal treatment device in a mechanical vibration and rotation dual drive mode of the present invention.
  • FIG. 4 is a schematic diagram of a handpiece of a root canal treatment device in a mechanical vibration and rotation dual drive mode of the present invention.
  • FIG. 5 is a detailed structural diagram of the handpiece of a root canal treatment device in a mechanical vibration and rotation dual-drive mode of the present invention, (a) is a structural diagram of an outer body, (b) is a schematic diagram of a mandrel, and (c) is a cross-sectional view , (d) is the cross-sectional view.
  • FIG. 6 is a schematic view of the handle of a root canal treatment device in a mechanical vibration and rotation dual drive mode of the present invention.
  • FIG. 7 is a schematic diagram of a flexible transmission shaft of a root canal treatment device in a mechanical vibration and rotation dual drive mode of the present invention.
  • the purpose of the present invention is to provide a root canal treatment device that can be used for dental root canal treatment and has a mechanical vibration and rotation dual drive mode.
  • the device of the invention can effectively realize the combination of rotary motion and vibration motion, can improve the chip removal ability of root canal file instruments, significantly reduce cutting resistance and cutting temperature, avoid the generation of smear layer, and effectively improve root canal preparation. quality, reducing the operator's labor intensity.
  • the present invention relates to a root canal treatment device in a mechanical vibration and rotation dual drive mode, which is mainly composed of a handpiece 1, a handle 2 and flexible transmission shafts 3 and 4, as shown in FIG. 3 .
  • the outer body of the handpiece 1 is composed of a sleeve A1 and a shell A2, the sleeve A1 and the shell A2 are rigidly and fixedly connected, and the end of the shell A2 can be tightly connected with the handle 2, as shown in Figure 3, Figure 4 and (a) in Fig. 5.
  • a window hole A1-1 and a window hole A1-2 are opened on the wall of the sleeve A1.
  • a shaft A1-3 is installed in the window hole A1-1; a window hole A2-1 is opened on the shell A2.
  • An annular gland A1-4 and an annular gland A1-5 are respectively provided at the upper and lower ends of the sleeve A1, and an elastic ring A1-6 and an elastic ring A1-7 are respectively arranged inside the annular gland.
  • An input shaft A2-2 is installed in the housing A2, and the cross section of the rear axle head of the input shaft A2-2 is square.
  • a wheel A2-3 is fixedly installed on the front end of the input shaft A2-2, and an eccentric shaft A2-4 is fixedly installed on the wheel A2-3.
  • the connecting plate A2-5 is movably installed on the eccentric shaft A2-4, and the vibration output shaft A2-6 is fixedly installed on the connecting plate A2-5.
  • the elastic ring A1-6 and the elastic ring A1-7 can be made of polymer material or metal, and the structure can be annular, spring-shaped, or diaphragm-shaped, and the installation method is not limited.
  • the mandrel part of the machine head 1 is composed of a T-shaped end face gear shaft B1, an upper shaft sleeve B2, an I-shaped wheel B3, a lower shaft sleeve B4, and a locking nut B5, as shown in Figures 4 and 5 (b) to (d).
  • a through hole B1-1 is provided in the center of the T-shaped gear shaft B1, in which the root canal file instrument can be fastened.
  • a ball B6 is arranged between the I-shaped wheel B3, the upper sleeve B2 and the lower sleeve B4, and a groove is provided on the contact surface of the I-shaped wheel, the shaft sleeve and the ball, and the ball B6 can roll in the groove without As for falling off.
  • a thread is arranged on the lower end of the T-shaped end face gear shaft B1 to cooperate with the lock nut B5, and the upper shaft sleeve B2, the I-shaped wheel B3 and the lower shaft sleeve B4 are locked on the T-shaped gear shaft B1 through the lock nut B5.
  • a hole B3-1 and a hole B3-2 are provided at the waist of the I-shaped wheel B3, as shown in (d) in FIG. 5 .
  • the structure of the T-shaped end face gear shaft B1 is not limited, and the end face gear can also be in the middle of the gear shaft.
  • the handpiece 1 further includes a lever ring C1, as shown in Fig. 4 and (c) in Fig. 5 .
  • the lever ring C1 is an annular ring with ears, and is sleeved in the center of the I-shaped wheel B3.
  • a shaft hole C1-1 is provided on the left ear of the lever ring C1 for clearance fit with the axis A1-3, and the lever ring C1 can swing around the axis A1-3.
  • the shaft C1-2 and the shaft C1-3 are respectively connected with the hole B3-1 and the hole B3-2 of the I-shaped wheel B3 Clearance fit, in this way, when the lever ring C1 swings, it can drive the I-shaped wheel B3 to move together. Since the I-shaped wheel B3 is locked on the T-shaped end face gear shaft, the vibration of the I-shaped wheel B3 will drive the T-shaped end face gear shaft to vibrate together.
  • a side plate C1-4 is arranged on the right ear of the lever ring C1, and a shaft hole C1-5 is arranged at the waist of the side plate, and the hole C1-5 is in clearance fit with the vibration output shaft A2-6.
  • a gear shaft C1-6 is mounted on the top of the side plate C1-4, and the shaft head section of the gear shaft C1-6 is square.
  • the assembly schematic diagram of the machine head 1 is shown in Figure 4.
  • the I-shaped wheel B3 is elastically constrained in the middle of the sleeve A1 through the elastic ring A1-6 and the elastic ring A1-7, and the lever ring C1 is installed on the I-shaped wheel B3, forming the present invention.
  • the gear shaft C1-6 on the lever ring C1 meshes with the gear on the T-shaped end face gear shaft B1
  • the shaft hole C1-5 on the side plate of the lever ring C1 is clearance fit with the vibration output shaft A2-6.
  • a power supply 2-1, a drive control system 2-2, a rotary motor 2-3 and 2-4, a rotary motor 2-3 and an output shaft 2-3-1 of the rotary motor 2-4 are provided.
  • the output shaft 2-4-1 extends out of the handle shell 2-5.
  • a working button 2-6 is arranged on the handle shell 2-5.
  • a sub-port 2-7 connected to the outer casing A2 is provided at the front end of the handle casing 2-5.
  • the output shafts 2-3-1 and 2-4-1 of the rotary motors 2-3 and 2-4 are square in section, as shown in FIG. 6 .
  • FIG. 7 The structure of the flexible transmission shaft 3 and the flexible transmission shaft 4 is shown in FIG. 7 .
  • a coupling 3-2 and a coupling 3-3 are fastened at both ends of the flexible shaft 3-1, and a hole 3-4 with a square section is opened in the center of the coupling 3-2 and the coupling 3-3.
  • hole 3-5, hole 3-4 is clearance fit with the square section shaft head of gear shaft C1-6
  • hole 3-5 is clearance fit with output shaft 2-3-1 of rotary motor 2-3 and rotary motor 2-3.
  • the rotation of the rotary motor 2-3 can be transmitted to the gear shaft C1-6 through the flexible shaft 3 to drive the gear shaft C1-6 to rotate. In this way, the rotation of the rotary motor 2-4 is transmitted to the input shaft A2-2 through the flexible shaft 4.
  • the flexible shafts of the flexible transmission shaft 3 and the flexible transmission shaft 4 may be stainless steel wire stranded wire flexible shafts, flexible shafts made of polymer materials, or rigid transmission shafts with universal joints.
  • the root canal treatment device in the mechanical vibration and rotation dual drive mode of the present invention is used, when the head 1 is tightly connected with the connecting sub-ports 2-7 on the handle 2 through the outer casing A2; the gear shaft C1 of the handpiece -6 is connected to the rotary motor 2-3 of the handle through the flexible transmission shaft 3, and the input shaft A2-2 of the handpiece is connected to the rotary motor 2-4 of the handle through the flexible transmission shaft 4 to form the combination shown in Figure 3 .
  • the root canal file instrument is fastened and installed in the through hole B1-1 of the end face gear shaft B1 in the handpiece.
  • the rotary motor 2-3 inputs torque to the gear shaft C1-6 and rotates, through the meshing with the T-shaped end gear shaft B1, it will drive the T-shaped end gear shaft B1 and the root canal file instrument installed in it to rotate, and the I-shaped end face gear shaft B1 is driven to rotate.
  • Wheel B3 does not rotate with it.
  • the rotary motor 2-4 inputs torque to the shaft A2-2 and rotates the driving wheel A2-3 to rotate, it will drive the eccentric shaft A2-4 to vibrate.
  • the vibration of the eccentric shaft A2-4 is transmitted to the lever ring C1 through the connecting plate A2-5 and the vibration output shaft A2-6, which drives the lever ring C1 to vibrate. Since the convex shaft C1-2 and the convex shaft C1-3 in the middle of the lever ring C1 are in clearance fit with the holes B3-1 and B3-2 of the I-shaped wheel B3, the vibration of the lever ring C1 will drive the I-shaped wheel C3 to vibrate together. And because the I-shaped wheel B3, the upper sleeve B2 and the lower sleeve B4 are locked on the T-shaped gear shaft B1 through the locking nut B5, the vibration of the I-shaped wheel B3 will drive the T-shaped gear shaft B1 and the root canal installed in it. The file instrument vibrates together. When the rotary motor 2-3 and the rotary motor 2-4 work at the same time, the mechanical vibration and rotation of the root canal file instrument can be moved in a dual driving mode.
  • the handpiece 1, the flexible transmission shafts 3 and 4 and the handle 2 can be separated from each other, and the handpiece 1 and the flexible transmission shafts 3 and 4 can be sterilized by high temperature and high pressure.
  • the invention provides a root canal treatment device with mechanical vibration and rotation in a dual drive mode.
  • the root canal file device can move in rotation and vibration modes at the same time, and the rotary motion of the device during root canal preparation can meet the needs of The cutting of the wall and the maintenance of the original root canal axis, and the vibration of the instrument can significantly reduce the cutting resistance and cutting temperature, and the agitation of the liquid in the root canal with the vibration can increase the chip removal capacity of the root canal file, effectively avoiding the need for The generation of the smear layer significantly improves the quality of root canal preparation and reduces the labor intensity of the operator.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Dentistry (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Neurosurgery (AREA)
  • Water Supply & Treatment (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

一种机械振动加旋转双驱动模式的根管治疗装置，包括机头（1）、手柄（2）、第一柔性传动轴和第二柔性传动轴，所述机头（1）包括外主体、用于安装根管锉器械的芯轴部分、第一驱动输入轴部分和第二驱动输入轴部分，所述芯轴部分安装在所述外主体之内，所述手柄（2）上设有第一驱动马达和第二驱动马达。有益效果是：实现了根管锉器械在根管预备时可以旋转和振动两种方式运动，既实现了器械对根管壁的高效切削，附加的器械振动又有效降低切削阻力和切削温度，避免了玷污层的产生，显著提高了根管预备的质量和效率。

Description

一种机械振动加旋转双驱动模式的根管治疗装置 技术领域
本发明涉及根管治疗装置，尤其涉及一种机械振动加旋转双驱动模式的根管治疗装置。
 背景技术
根管治疗是目前治疗各种牙髓炎、牙髓坏死等疾病比较理想和成熟的治疗方法，其主要过程是使用根管器械对病变根管内部和根管壁进行彻底清理，去处病变组织，并塑造出完整、光滑的根管内腔，然后在已预备好的根管内填充其他材料，如牙胶尖等，以达到根管修复和治疗的目的。
目前常用的根管预备手段是采用根管治疗仪与机用根管器械配合使用。工作时，根管治疗仪带动根管器械在根管内运动，对根管内壁进行塑形和清洁。使用根管治疗仪的优点是根管成型效率高，成型效果好，减轻操作者的工作强度等。
传统的根管治疗仪系统一般有旋转式根管治疗机和超声波式根管治疗仪。
旋转式根管治疗机工作时，治疗机带动机用根管器械旋转，通过器械的刃部对根管内壁进行切削，以达到根管塑形的目的，其动力一般由电磁马达提供。旋转式根管治疗机的优点是电机输出速度稳定，扭矩可控，可以正反两方向交替往复运动，机头部分可以高温高压灭菌等。但机用旋转器械在根管预备过程中的使用，容易在根管壁上形成玷污层，这是于根管锉器械的结构和运动方式决定的。
根管锉器械的工作部有一定的锥度，且有螺纹分布其上，为了形成切削刃，工作部需要有一定的截面形状，如图1。根管锉器械作为牙科手术切削工具，由于径向尺寸的限制和加工手段的制约，切削角γ 0一般较大，所以根管锉对根管壁的切削基本是以“剐蹭”的方式进行的，这势必导致器械对根管壁的挤压和摩擦热的产生。
以旋转式根管治疗机进行根管预备时，器械摩擦所产的热使根管壁的有机质变性，牙本质碎屑、牙本质小管溢出液、唾液和细菌等在器械钻磨压力的作用下附着于根管内壁，形成一层厚度约1-2微米的玷污层。沾污层会堵塞侧支根管，阻碍药物向根管侧壁和牙本质小管内的渗透，导致侧支根管无法填充。如果沾污层不能完全去除，将导致治疗的失败率提高和并发症的增加，直接影响治疗效果。产生的玷污层，需要进一步进行清理。
超声波根管治疗仪的原理是，利用超声波换能器驱动根管锉器械，使超声根管锉器械发生超声振动，对根管内部进行塑形和清理，工作原理如图2。包括换能器2-1，由压电或磁致伸缩材料棒制成，在交变电场或磁场激励作用下可产生纵向振动；工作头2-2，超声根管锉器械2-3；换能器2-1产生的超声振动通过工作头2-2传递给根管锉2-3，但由于振动传播方向的改变，在根管锉2-3的尖部产生振动波为横波的超声振动。超声振动的根管锉尖端会对周围的液体介质进行剪切并产生空化效应形成空泡，在空泡溃灭时会，空泡中心会辐射出冲击波作用于根管壁上，从而实现了对根管塑形与清洁。
超声波根管治疗仪在根管的清洁方面有着独到的优势，但在根管塑形方面能力欠佳，这是因为超声根管锉器械工作时并不旋转，只有尖端具有对牙本质去除的功能，在根管塑形时很难避免塑形后根管轴线与原始根管轴线不发生严重偏移，尤其是在处理弯曲根管时，极易造成根管的局部损伤和侧穿等。
目前已经公开的根管治疗装置，旋转式和超声振动式根管治疗仪的设计都是独立的，所以临床根管预备的常用方法是，先采用旋转式根管治疗机对根管进行塑形，完成塑形后再采用超声振动式根管治疗仪对玷污层进行祛除和根管清洁。如果能实现根管锉器械在根管内旋转切削的同时，附加有微小的振动，这将增加根管锉器械的排屑能力，显著降低切削阻力和切削温度，有效避免玷污层的产生，提高根管预备的质量，减少操作者的劳动强度。
公开的关于超振动加旋转运动的加工装置的技术信息已有很多，在公布号CN 107104514 A《适用于超声加工中心自动换刀的环绕式无线电能传输系统》的文件中，压电陶瓷振子布置于电机回转轴上与回转轴一起转动，通过线圈耦合的无接触方式给换能器供电，实现了刀具的旋转加振动；在公布号CN 108213508 A《一种轴承供电的超声手钻》的文件中，采用了通过滚针轴承对超声振子进行供电的方式；在公布号CN 108988679 A《一种纵一纵扭复合夹心式换能器》的文件中，公开了以纵扭藕合振子和压电陶瓷叠堆的方式，实现了超声波钻探器钻具的冲击和回转运动。
在上述公开的技术资料中，超声振子均设置在旋转运动的回转轴上，如此的设计可以很好的实现旋转运动和振动运动的复合，但这样的结构体积过大，不适用于齿科用根管治疗仪，因为齿科根管治疗仪的机头在使用时需要伸入到患者口腔中，体积不可能过大。
在公开的申请号为202011190107.9《一种复合运动模式的根管治疗装置》的文件中，采用了通过变幅杆将超声振动从手柄传递给机头、带动机头整体振动结构，实现了根管锉器械可以同时以转动和振动的复合运动模式工作。该结构对变幅杆的材质、结构参数设计，以及加工制造，均有较高的要求，在实际应用中有一定难度。
 技术问题
为了解决现有技术中的问题，本发明提供了一种机械振动加旋转双驱动模式的根管治疗装置，可以同时提供机械振动加旋转双驱动模式。
 技术解决方案
本发明提供了一种机械振动加旋转双驱动模式的根管治疗装置，包括机头、手柄、第一柔性传动轴和第二柔性传动轴，所述机头包括外主体、用于安装根管锉器械的芯轴部分、第一驱动输入轴部分和第二驱动输入轴部分，所述芯轴部分安装在所述外主体之内，所述手柄上设有第一驱动马达和第二驱动马达，所述第一驱动马达通过第一柔性传动轴与所述第一驱动输入轴部分连接，所述第一驱动输入轴部分与所述芯轴部分连接，驱动所述芯轴部分进行旋转，所述第二驱动马达通过第二柔性传动轴与所述第二驱动输入轴部分连接，所述第二驱动输入轴部分与所述芯轴部分连接，驱动所述芯轴部分进行机械振动。
作为本发明的进一步改进，所述第二驱动输入轴部分包括振动输入轴、轮、偏心轴、连接板和振动输出轴，所述振动输入轴的一端与所述第二柔性传动轴连接，所述振动输入轴的另一端与所述轮连接，所述偏心轴安装在所述轮上，所述连接板安装在所述偏心轴上，所述振动输出轴安装在所述连接板上，所述振动输出轴与所述芯轴部分连接，驱动所述芯轴部分进行机械振动。
作为本发明的进一步改进，所述芯轴部分包括安装在所述外主体内的T型端面齿轮轴、上轴套、工字轮和下轴套，所述上轴套、工字轮和下轴套自上而下安装在所述T型端面齿轮轴上，所述工字轮的外侧套设有拨杆环，所述拨杆环的一端与所述外主体旋转连接，所述拨杆环的另一端与所述振动输出轴连接，所述T型端面齿轮轴与所述第一驱动输入轴部分连接。
作为本发明的进一步改进，所述工字轮的上端与所述上轴套之间设有上滚珠凹槽，所述工字轮的下端与所述下轴套之间设有下滚珠凹槽，所述上滚珠凹槽与所述下滚珠凹槽内均设有滚珠，所述工字轮与所述T型端面齿轮轴为间隙配合。
作为本发明的进一步改进，所述工字轮的腰部设有径向设置的孔，所述拨杆环为具有左耳和右耳的带耳圆环状，套于所述工字轮的中央，所述拨杆环上设有径向向内的凸轴，所述凸轴与所述工字轮上的孔间隙配合。
作为本发明的进一步改进，所述拨杆环的左耳设有左耳轴孔，所述外主体上设有左耳轴，所述左耳轴孔与所述左耳轴为间隙配合，所述拨杆环的右耳设有侧板，所述侧板的腰部设有右耳轴孔，所述右耳轴孔与所述振动输出轴间隙配合。
作为本发明的进一步改进，所述第一驱动输入轴部分包括齿轮轴，所述齿轮轴安装在所述侧板的顶部，所述齿轮轴与所述T型端面齿轮轴通过齿轮啮合连接。
作为本发明的进一步改进，所述外主体包括套筒，所述T型端面齿轮轴、上轴套、工字轮和下轴套均安装在所述套筒之内，所述套筒的上端设有上环形压盖，所述套筒的下端设有下环形压盖，所述工字轮设置在所述上环形压盖、下环形压盖之间，所述工字轮与所述上环形压盖之间设有上弹性圈，所述工字轮与所述下环形压盖之间设有下弹性圈。
作为本发明的进一步改进，所述上弹性圈、下弹性圈均采用高分子材料或者金属材料制备而成，所述上弹性圈、下弹性圈均为环状或弹簧状或膜片状。
作为本发明的进一步改进，所述T型端面齿轮轴的下端连接有锁紧螺母，所述锁紧螺母紧贴在所述下轴套的下端，所述锁紧螺母将所述上轴套、工字轮和下轴套锁紧在所述T型端面齿轮轴上。
作为本发明的进一步改进，在使用后，机头、柔性传动轴和手柄可以彼此分离，机头和柔性传动轴可以进行高温高压灭菌处理。
作为本发明的进一步改进，第一柔性传动轴和第二柔性传动轴可以是不锈钢丝绞线软轴、高分子材料的软轴，也可以是带万向节的刚性传动轴。
作为本发明的进一步改进，第一柔性传动轴和第二柔性传动轴可以快速连接和拆卸，连接方式不限。
作为本发明的进一步改进，所述的机头与手柄连接为紧配合的快速连接，以便拆装方便，连接方式不限。
 有益效果
本发明的有益效果是：通过上述方案，实现了根管锉器械在根管预备时可以旋转和振动两种方式运动，既实现了器械对根管壁的高效切削，附加的器械振动又有效降低切削阻力和切削温度，避免了玷污层的产生，显著提高了根管预备的质量和效率。
 附图说明
图1是现有技术中机用根管锉器械的示意图。
图2是现有技术中超声根管治疗机的原理示意图。
图3是本发明一种机械振动加旋转双驱动模式的根管治疗装置的示意图。
图4是本发明一种机械振动加旋转双驱动模式的根管治疗装置的机头的示意图。
图5是本发明一种机械振动加旋转双驱动模式的根管治疗装置的机头的细节结构图，（a）为外主体结构图，（b）为芯轴示意图，（c）为剖面图，（d）为剖面图。
图6是本发明一种机械振动加旋转双驱动模式的根管治疗装置的手柄示意图。
图7是本发明一种机械振动加旋转双驱动模式的根管治疗装置的柔性传动轴的示意图。
 本发明的实施方式
下面结合附图说明及具体实施方式对本发明作进一步说明。
本发明的目的是提供一种可用于齿科根管治疗的、机械振动加旋转双驱动模式的根管治疗装置，与传统的旋转式根管治疗机和超声振动式根管治疗仪相比，本发明所述的装置可有效地实现了旋转运动和振动运动的复合，能提高根管锉器械的排屑能力，显著降低切削阻力和切削温度，避免了玷污层的产生，有效提高根管预备的质量，减少操作者的劳动强度。
本发明涉及到一种机械振动加旋转双驱动模式的根管治疗装置，主要由机头1、手柄2和柔性传动轴3、4构成，如图3所示。
所述机头1的外主体由套筒A1和壳体A2构成，套筒A1和壳体A2刚性固定连接，壳体A2的末端与手柄2可紧固配合连接，见图3、图4和图5中的（a）。在套筒A1壁上，开设有窗孔A1-1和窗孔A1-2，在窗孔A1-1中，安装有轴A1-3；在壳体A2上开设有窗孔A2-1。在套筒A1的上下两端分别设置有环形压盖A1-4和环形压盖A1-5，在环形压盖内侧，分别设置有弹性圈A1-6和弹性圈A1-7。在壳体A2内安装有输入轴A2-2，输入轴A2-2的后轴头截面为方形的。在输入轴A2-2前端固定安装有轮A2-3,在轮A2-3上固定安装有偏心轴A2-4。连接板A2-5活动安装于偏心轴A2-4上，在连接板A2-5上固定安装有振动输出轴A2-6。
所述的弹性圈A1-6和弹性圈A1-7，可以是高分子材料的，也可以是金属的，结构可以是环状、弹簧状，或膜片状，安装方式不限。
所述机头1的芯轴部分由T形端面齿轮轴B1、上轴套B2、工字轮B3、下轴套B4、锁紧螺母B5组成，见图4、图5中的（b）至（d）。在T形齿轮轴B1中心设有通孔B1-1，根管锉器械可以紧固安装其中。在工字轮B3与上轴套B2和下轴套B4之间设置有滚珠B6，在工字轮、轴套与滚珠的接触面上设置有凹槽，滚珠B6可以在凹槽内滚动而不至于脱落。在T形端面齿轮轴B1下端设置有螺纹与锁紧螺母B5配合，通过锁紧螺母B5将上轴套B2、工字轮B3和下轴套B4锁紧在T形齿轮轴B1上，其中工字轮B3的中心孔与T形齿轮轴B1之间设置有间隙，工字轮B3通过滚珠B6的滚动，可以相对T形齿轮轴B1自由转动。在工字轮B3腰部设置有孔B3-1和孔B3-2，见图5中的（d）。
所述的T形端面齿轮轴B1，其结构不限，端面齿轮也可以在齿轮轴的中部。
所述的机头1，还包括有拨杆环C1，见图4和图5中的（c）。拨杆环C1为带耳圆环状，套于工字轮B3中央。在拨杆环C1左耳上开设有轴孔C1-1与轴A1-3间隙配合，拨杆环C1可绕轴A1-3摆动。在拨杆环C1的中部固定安装有向内的凸轴C1-2和凸轴C1-3，轴C1-2和轴C1-3分别与工字轮B3的孔B3-1和孔B3-2间隙配合，如此，拨杆环C1摆动时可带动工字轮B3一起运动。由于工字轮B3被锁紧张T形端面齿轮轴上，工字轮B3的振动将带动T形端面齿轮轴一起振动。在拨杆环C1的右耳上设有侧板C1-4,在侧板的腰部设有轴孔C1-5，孔C1-5与振动输出轴A2-6间隙配合。在侧板C1-4的顶部安装有齿轮轴C1-6，齿轮轴C1-6的轴头截面为方形的。
机头1的装配示意图如图4，工字轮B3通过弹性圈A1-6和弹性圈A1-7被弹性约束在套筒A1中间，拨杆环C1安装于工字轮B3上，形成了本发明所述的机头1。其中，拨杆环C1上的齿轮轴C1-6与T形端面齿轮轴B1上的齿轮啮合，拨杆环C1的侧板上的轴孔C1-5与振动输出轴A2-6间隙配合。
所述的手柄2内，设置有电源2-1、驱动控制系统2-2、旋转马达2-3和2-4，旋转马达2-3和旋转马达2-4的输出轴2-3-1和输出轴2-4-1伸出手柄外壳2-5外。在手柄外壳2-5上设置有工作按键2-6。在手柄外壳2-5的前端设置有与外壳体A2连接的子口2-7。旋转马达2-3和2-4的输出轴2-3-1和输出轴2-4-1截面为方形的，如图6。
所述的柔性传动轴3和柔性传动轴4，其结构如图7。在柔性轴3-1两端紧固连接有联轴器3-2和联轴器3-3，在联轴器3-2和联轴器3-3中心开设有方形截面的孔3-4和孔3-5，孔3-4与齿轮轴C1-6的方形截面轴头间隙配合，孔3-5与旋转马达2-3旋转马达2-3的输出轴2-3-1间隙配合。旋转马达2-3的转动可以通过柔性轴3传递给齿轮轴C1-6，带动齿轮轴C1-6旋转。如此，旋转马达2-4的转动通过柔性轴4传递给输入轴A2-2。
所述的柔性传动轴3和柔性传动轴4的柔性轴可以是不锈钢丝绞线软轴、高分子材料的软轴，也可以是带万向节的刚性传动轴。
本发明所述的一种机械振动加旋转双驱动模式的根管治疗装置，使用时机头1通过外壳体A2与手柄2上的连接的子口2-7紧配合连接；机头的齿轮轴C1-6通过柔性传动轴3和手柄的旋转马达2-3相连接，机头的输入轴A2-2通过柔性传动轴4和手柄的旋转马达2-4相连接，形成图3所示的组合体。
工作时，根管锉器械紧固安装于机头内的端面齿轮轴B1的通孔B1-1内。当旋转马达2-3给齿轮轴C1-6输入扭矩转动时，通过与T形端面齿轮轴B1的啮合，将带动T形端面齿轮轴B1和安装于其中的根管锉器械转动，而工字轮B3不随着旋转。当旋转马达2-4给轴A2-2输入扭矩转动带动轮A2-3转动时，将带动偏心轴A2-4振动。偏心轴A2-4的振动通过连接板A2-5和振动输出轴A2-6传递给拨杆环C1，带动拨杆环C1振动。由于拨杆环C1中部的凸轴C1-2和凸轴C1-3与工字轮B3的孔B3-1和孔B3-2间隙配合，拨杆环C1振动将带动工字轮C3一起振动。又由于工字轮B3与上轴套B2和下轴套B4通过锁紧螺母B5锁紧在T形齿轮轴B1上，工字轮B3的振动将带动T形齿轮轴B1和安装其中的根管锉器械一起振动。当旋转马达2-3和旋转马达2-4同时工作时，可实现根管锉器械的机械振动加旋转双驱动模式运动。
在使用后，机头1、柔性传动轴3、4和手柄2可以彼此分离，机头1和柔性传动轴3、4可以进行高温高压灭菌处理。
本发明提供的一种机械振动加旋转双驱动模式运动的根管治疗装置，工作时根管锉器械可同时以旋转和振动方式进行运动，在根管预备时器械的旋转运动可以满足对根管壁的切削和原始根管轴线的保持，而器械的振动则能显著降低切削阻力和切削温度，伴随振动对根管内液体的搅拌，可增加根管锉器械的排屑能力，有效地避免了玷污层的产生，显著提高了根管预备的质量，减少操作者的劳动强度。
以上内容是结合具体的优选实施方式对本发明所作的进一步详细说明，不能认定本发明的具体实施只局限于这些说明。对于本发明所属技术领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干简单推演或替换，都应当视为属于本发明的保护范围。

Claims (10)

  1. 一种机械振动加旋转双驱动模式的根管治疗装置，其特征在于：包括机头、手柄、第一柔性传动轴和第二柔性传动轴，所述机头包括外主体、用于安装根管锉器械的芯轴部分、第一驱动输入轴部分和第二驱动输入轴部分，所述芯轴部分安装在所述外主体之内，所述手柄上设有第一驱动马达和第二驱动马达，所述第一驱动马达通过第一柔性传动轴与所述第一驱动输入轴部分连接，所述第一驱动输入轴部分与所述芯轴部分连接，驱动所述芯轴部分进行旋转，所述第二驱动马达通过第二柔性传动轴与所述第二驱动输入轴部分连接，所述第二驱动输入轴部分与所述芯轴部分连接，驱动所述芯轴部分进行机械振动。
  2. 根据权利要求1所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述第二驱动输入轴部分包括振动输入轴、轮、偏心轴、连接板和振动输出轴，所述振动输入轴的一端与所述第二柔性传动轴连接，所述振动输入轴的另一端与所述轮连接，所述偏心轴安装在所述轮上，所述连接板安装在所述偏心轴上，所述振动输出轴安装在所述连接板上，所述振动输出轴与所述芯轴部分连接，驱动所述芯轴部分进行机械振动。
  3. 根据权利要求2所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述芯轴部分包括安装在所述外主体内的T型端面齿轮轴、上轴套、工字轮和下轴套，所述上轴套、工字轮和下轴套自上而下安装在所述T型端面齿轮轴上，所述工字轮的外侧套设有拨杆环，所述拨杆环的一端与所述外主体旋转连接，所述拨杆环的另一端与所述振动输出轴连接，所述T型端面齿轮轴与所述第一驱动输入轴部分连接。
  4. 根据权利要求3所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述工字轮的上端与所述上轴套之间设有上滚珠凹槽，所述工字轮的下端与所述下轴套之间设有下滚珠凹槽，所述上滚珠凹槽与所述下滚珠凹槽内均设有滚珠，所述工字轮与所述T型端面齿轮轴为间隙配合。
  5. 根据权利要求3所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述工字轮的腰部设有径向设置的孔，所述拨杆环为具有左耳和右耳的带耳圆环状，套于所述工字轮的中央，所述拨杆环上设有径向向内的凸轴，所述凸轴与所述工字轮上的孔间隙配合。
  6. 根据权利要求5所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述拨杆环的左耳设有左耳轴孔，所述外主体上设有左耳轴，所述左耳轴孔与所述左耳轴为间隙配合，所述拨杆环的右耳设有侧板，所述侧板的腰部设有右耳轴孔，所述右耳轴孔与所述振动输出轴间隙配合。
  7. 根据权利要求6所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述第一驱动输入轴部分包括齿轮轴，所述齿轮轴安装在所述侧板的顶部，所述齿轮轴与所述T型端面齿轮轴通过齿轮啮合连接。
  8. 根据权利要求3所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述外主体包括套筒，所述T型端面齿轮轴、上轴套、工字轮和下轴套均安装在所述套筒之内，所述套筒的上端设有上环形压盖，所述套筒的下端设有下环形压盖，所述工字轮设置在所述上环形压盖、下环形压盖之间，所述工字轮与所述上环形压盖之间设有上弹性圈，所述工字轮与所述下环形压盖之间设有下弹性圈。
  9. 根据权利要求8所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述上弹性圈、下弹性圈均采用高分子材料或者金属材料制备而成，所述上弹性圈、下弹性圈均为环状或弹簧状或膜片状。
  10. 根据权利要求3所述的机械振动加旋转双驱动模式的根管治疗装置，其特征在于：所述T型端面齿轮轴的下端连接有锁紧螺母，所述锁紧螺母紧贴在所述下轴套的下端，所述锁紧螺母将所述上轴套、工字轮和下轴套锁紧在所述T型端面齿轮轴上。
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