U.S. patent application number 15/567297 was filed with the patent office on 2018-03-29 for bone graft injection osteotome.
This patent application is currently assigned to MAXILLENT LTD.. The applicant listed for this patent is MAXILLENT LTD.. Invention is credited to Adi ALPHANDARY, Gideon FOSTICK, Yossi GROSS, Zev SOHN, Ilan UCHITEL.
Application Number | 20180085200 15/567297 |
Document ID | / |
Family ID | 56024346 |
Filed Date | 2018-03-29 |
United States Patent
Application |
20180085200 |
Kind Code |
A1 |
UCHITEL; Ilan ; et
al. |
March 29, 2018 |
BONE GRAFT INJECTION OSTEOTOME
Abstract
A composition delivery source (300) includes a chamber (302), a
solid-liquid composition delivery tube (314), a mixing tube (316),
and a liquid-supply tube (318). A filter (304) divides the chamber
(302) into a liquid compartment (306) and a solid-liquid
composition compartment (308). The solid-liquid composition
delivery tube (314) is in fluid communication with the solid-liquid
composition compartment (308). The mixing tube (316) is in fluid
communication with the liquid compartment (306) and the
solid-liquid composition compartment (308). The liquid-supply tube
(318) is in fluid communication with the liquid compartment (306)
and a liquid solution container (366). A pump unit (301) is
provided that includes a mixing pump (322), which is arranged to
cause flow in the mixing tube (316); and a liquid-supply pump
(324), which is arranged to cause flow in the liquid-supply tube
(318). Other embodiments are also described.
Inventors: |
UCHITEL; Ilan; (Kefar Saba,
IL) ; ALPHANDARY; Adi; (Hod Hasharon, IL) ;
FOSTICK; Gideon; (Givat Shmuel, IL) ; GROSS;
Yossi; (Moshav Mazor, IL) ; SOHN; Zev; (Ginot
Shomron, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
MAXILLENT LTD. |
Herzliya |
|
IL |
|
|
Assignee: |
MAXILLENT LTD.
Herzliya
IL
|
Family ID: |
56024346 |
Appl. No.: |
15/567297 |
Filed: |
April 20, 2016 |
PCT Filed: |
April 20, 2016 |
PCT NO: |
PCT/IL2016/050423 |
371 Date: |
October 17, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
14707688 |
May 8, 2015 |
9730773 |
|
|
15567297 |
|
|
|
|
62150969 |
Apr 22, 2015 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/8808 20130101;
A61B 17/8811 20130101; A61C 1/0092 20130101; A61C 8/0092 20130101;
A61B 17/8827 20130101; A61B 2017/00734 20130101; A61C 3/02
20130101; A61C 17/14 20130101; A61C 1/0084 20130101; A61C 8/0006
20130101; A61B 2017/00539 20130101; A61B 17/8822 20130101; A61B
2090/036 20160201; A61C 17/0202 20130101; A61B 2017/8813 20130101;
A61B 2017/8838 20130101; A61C 1/06 20130101; A61B 17/8816 20130101;
A61C 1/087 20130101 |
International
Class: |
A61C 8/00 20060101
A61C008/00; A61C 1/08 20060101 A61C001/08; A61C 1/06 20060101
A61C001/06 |
Claims
1. Apparatus for use with solid particles and a liquid container
containing a physiological liquid solution, the apparatus
comprising: (1) a composition delivery source, which comprises: (a)
a chamber, which: (i) comprises a filter, which is disposed within
the chamber so as to divide the chamber into a liquid compartment
and a solid-liquid composition compartment, and (ii) is shaped so
as to define (A) one or more liquid ports in fluid communication
with the liquid compartment, and (B) one or more solid-liquid
composition ports in fluid communication with the solid-liquid
composition compartment; (b) a solid-liquid composition delivery
tube, which is in fluid communication with at least one of the one
or more solid-liquid composition ports; (c) a mixing tube, which is
in fluid communication with at least one of the one or more liquid
ports and at least one of the one or more solid-liquid composition
ports; and (d) a liquid-supply tube, which is in fluid
communication with at least one of the one or more liquid ports,
and is coupled in fluid communication with an interior of the
liquid solution container; and (2) a pump unit, which comprises:
(a) a mixing pump, which is arranged to cause flow in the mixing
tube; and (b) a liquid-supply pump, which is arranged to cause flow
in the liquid-supply tube.
2. The apparatus according to claim 1, wherein the solid particles
are solid bone graft particles, and wherein the apparatus is for
use with the solid bone graft particles.
3. The apparatus according to claim 1, further comprising the solid
particles, wherein the filter is configured to inhibit passage of
the solid particles and allow passage of the physiological liquid
solution.
4. The apparatus according to claim 1, wherein the mixing pump is
arranged to cause, in the mixing tube, flow that raises the solid
particles in a puff into the physiological liquid solution in the
solid-liquid composition compartment.
5. The apparatus according to claim 1, wherein a closest distance
between the one or more solid-liquid composition ports and the
filter equals at least 75% of a distance between the filter and a
point on an interior of a wall of the solid-liquid composition
compartment farthest from the filter.
6. The apparatus according to claim 1, wherein the mixing tube (a)
merges with the liquid-supply tube at an exit junction, and (b) is
in fluid communication with the at least one of the one or more
liquid ports via a portion of the liquid-supply tube.
7. The apparatus according to claim 1, wherein the liquid-supply
tube (a) merges with the mixing tube at an exit junction, and (b)
is in fluid communication with the at least one of the one or more
liquid ports via a portion of the mixing tube.
8. The apparatus according to claim 1, wherein the chamber is
shaped so as to define exactly one liquid port in fluid
communication with the liquid compartment, and wherein the chamber
is shaped so as to define exactly one solid-liquid composition port
in fluid communication with the solid-liquid composition
compartment.
9. The apparatus according to any one of claims 1-8, wherein the
pump unit further comprises control circuitry, which is configured
to repeatedly: (a) assume a mixing activation state, in which the
control circuitry activates the mixing pump to mix the solid
particles and the physiological liquid solution in the solid-liquid
composition compartment to form a solid-liquid composition, by
pumping the physiological liquid solution through the mixing tube
and into the solid-liquid composition compartment, and (b) assume a
particle-delivery activation state, wherein the control circuitry,
during at least a portion of the particle-delivery activation
state, activates the liquid-supply pump to apply positive pressure
to pump the solid-liquid composition from the solid-liquid
composition compartment into the solid-liquid composition delivery
tube.
10. The apparatus according to claim 9, wherein the control
circuitry is configured to assume the mixing activation state and
the particle-delivery activation state at the same time.
11. The apparatus according to claim 9, wherein the control
circuitry is configured in assume the mixing activation state and
the particle-delivery activation state at partially-overlapping
times.
12. The apparatus according to claim 9, wherein the control
circuitry is configured to assume the mixing activation state and
the particle-delivery activation state at non-overlapping
times.
13. The apparatus according to claim 9, wherein the control
circuitry is configured to, when in the particle-delivery
activation state, activate the liquid-supply pump to apply the
positive pressure to pump the physiological liquid solution (a)
from the liquid solution container, (b) through the liquid-supply
tube, (c) into the liquid compartment, (d) through the filter, (e)
into the solid-liquid composition compartment, (f) from the
solid-liquid composition compartment, and (g) to the solid-liquid
composition delivery tube.
14. The apparatus according to claim 9, wherein the control
circuitry is configured, during each of one or more
negative-positive particle delivery cycles of the particle-delivery
activation state, to assume: a negative particle-delivery
activation sub-state, in which the control circuitry activates the
liquid-supply pump to apply negative pressure to pump liquid from
the solid-liquid composition delivery tube toward the liquid
compartment via the solid-liquid composition compartment, and a
positive particle-delivery activation sub-state, in which the
control circuitry activates the liquid-supply pump to apply the
positive pressure to pump the solid-liquid composition from the
solid-liquid composition compartment into the solid-liquid
composition delivery tube, wherein a direction of pumping of the
liquid-supply pump in the positive particle-delivery activation
sub-state is opposite a direction of pumping of the liquid-supply
pump in the negative particle-delivery activation sub-state.
15. The apparatus according to claim 14, wherein the control
circuitry is configured to assume the mixing activation state and
the particle-delivery activation state at non-overlapping
times.
16. The apparatus according to claim 14, wherein the control
circuitry is configured to assume the mixing activation state and
the negative particle-delivery activation sub-state at
partially-overlapping times.
17. The apparatus according to claim 14, wherein the control
circuitry is configured to assume the particle-delivery activation
state in a plurality of particle-delivery-state cycles, and to
begin the particle-delivery activation state in each of the
particle-delivery-state cycles with the negative particle-delivery
activation sub-state.
18. The apparatus according to claim 14, wherein the control
circuitry is configured to provide a plurality of the
negative-positive particle delivery cycles during the
particle-delivery activation state.
19. The apparatus according to claim 14, wherein the control
circuitry is configured to, when in the negative particle-delivery
activation sub-state, activate the liquid-supply pump to pump the
liquid from the solid-liquid composition delivery tube, into the
solid-liquid composition compartment, and into the liquid
compartment.
20. The apparatus according to claim 14, wherein the liquid-supply
pump is a liquid-supply peristaltic pump, which comprises a rotor,
wherein the liquid-supply peristaltic pump is capable of (a)
pumping fluid at an average rate throughout a full 360-degree
revolution of the rotor at a certain speed, and (b) pumping fluid
at a maximum rate during portions of the full 360-degree revolution
at the certain speed, the maximum rate greater than the average
rate, and wherein the control circuitry is configured, when in both
the positive and the negative particle-delivery activation
sub-states, to activate the liquid-supply peristaltic pump to (a)
rotate the rotor, at the certain speed, a partial revolution equal
to a fraction of the full 360-degree revolution of the rotor, the
fraction less than 1, and (b) pump, throughout the partial
revolution, the fluid at the maximum rate.
21. The apparatus according to claim 14, wherein the liquid-supply
pump is a liquid-supply peristaltic pump, which comprises a rotor,
and wherein the control circuitry is configured: when in the
positive particle-delivery activation sub-state, to activate the
liquid-supply peristaltic pump to rotate the rotor, in a first
rotational direction, a first partial revolution equal to a
fraction of a full 360-degree revolution of the rotor, the fraction
less than 1, and when in the negative particle-delivery activation
sub-state, to activate the liquid-supply peristaltic pump to rotate
the rotor, in a second rotational direction opposite the first
rotational direction, a second partial revolution equal to the
fraction of the full 360-degree revolution of the rotor.
22. The apparatus according to claim 14, wherein the liquid-supply
pump is a liquid-supply peristaltic pump, which comprises a rotor,
and wherein the control circuitry is configured, when in the
positive particle-delivery activation sub-state, to activate the
liquid-supply peristaltic pump to: rotate the rotor a partial
revolution equal to a fraction of a full 360-degree revolution of
the rotor, the fraction less than 1, and pump, throughout the
partial revolution, a volume of fluid that is greater than the
product of the fraction and a volume of fluid pumpable throughout
the full 360-degree revolution of the rotor.
23. The apparatus according to claim 9, wherein the liquid-supply
pump is a liquid-supply peristaltic pump, which comprises a
rotor.
24. The apparatus according to claim 23, wherein the control
circuitry is configured to assume the particle-delivery activation
state a plurality of times in alternation with mixing activation
states, and to begin each of the particle-delivery activation
states with the rotor at a same rotational position.
25. The apparatus according to claim 9, wherein the mixing pump is
a mixing peristaltic pump, which comprises a rotor.
26. The apparatus according to claim 25, wherein the mixing
peristaltic pump comprises a total number of rollers equal to at
least two, and wherein the control circuitry is configured to
assume the mixing activation state a plurality of times in
alternation with particle-delivery activation states, and to begin
the mixing activation states with the rotor at respective starting
rotational positions, which are identical to one another or
rotationally offset from one another by the product of (a) 360
degrees divided by the total number of rollers and (b) a positive
integer.
27. The apparatus according to claim 25, wherein the mixing
peristaltic pump comprises (a) a pump casing that is shaped so as
to define a partial-circle mixing tube channel in which the mixing
tube is disposed, and (b) an odd total number of rollers, the odd
total number equal to at least one, and wherein the control
circuitry is configured to assume the mixing activation state a
plurality of times in alternation with particle-delivery activation
states, and to begin each of the mixing activation states with an
aligned total number of the rollers rotationally aligned with the
mixing tube channel, the aligned total number equal to more than
half of the odd total number.
28. The apparatus according to claim 27, wherein the odd total
number equals at least three.
29. The apparatus according to any one of claims 1-8, wherein the
chamber comprises a receptacle component and a cover component,
wherein the cover component (a) comprises the filter, and (b) is
shaped so as to define (i) a cap and (ii) a bone-graft container
having an opening that (x) faces away from the cap and (y) is
farther from the cap than the filter is from the cap, and wherein
the receptacle component and the cover component are shaped so as
to be reversibly coupleable with each another to form a watertight
seal, with the bone-graft container disposed within the receptacle
component.
30. The apparatus according to any one of claims 1-8, wherein the
mixing pump and the liquid-supply pump are respective peristaltic
pumps.
31. The apparatus according to any one of claims 1-8, wherein the
mixing tube (a) merges with the solid-liquid composition delivery
tube at a return junction, and (b) is in fluid communication with
the at least one of the one or more solid-liquid composition ports
via a portion of the solid-liquid composition delivery tube.
32. The apparatus according to any one of claims 1-8, wherein the
mixing tube (a) merges with the solid-liquid composition delivery
tube at a return junction, and (b) is in fluid communication with
the at least one of the one or more solid-liquid composition ports
via a portion of the solid-liquid composition delivery tube.
33. The apparatus according to claim 32, wherein the chamber
comprises a receptacle component and a cover component, which is
shaped so as to define a cap, wherein the return junction is
disposed along a longitudinal portion of the solid-liquid
composition delivery tube and around a circumferential portion of
the solid-liquid composition delivery tube, wherein the
longitudinal portion includes a point that is closest to the cap
when the cap is coupled to the receptacle component, and wherein
the circumferential portion includes the point.
34. The apparatus according to any one of claims 1-8, wherein the
apparatus further comprises a shaft unit, which comprises a shaft
delivery tube in fluid communication with a distal end of the
solid-liquid composition delivery tube.
35. The apparatus according to claim 34, wherein the shaft unit
further comprises a removable depth limiting element, which is
configured to limit a depth of insertion of the shaft delivery tube
into a bore through a bone when the shaft delivery tube is inserted
into the bore.
36. The apparatus according to claim 35, wherein the shaft unit
comprises a shaft delivery tube, wherein the shaft unit further
comprises a sealing element disposed around an external surface of
the shaft delivery tube, and wherein the depth limiting element is
removable from the shaft unit without removal of the sealing
element.
37. Apparatus for use with solid particles and a liquid container
containing a physiological liquid solution, the apparatus
comprising a composition delivery source, which comprises: (a) a
chamber, which: (i) comprises a filter, which is disposed within
the chamber so as to divide the chamber into a liquid compartment
and a solid-liquid composition compartment, and (ii) is shaped so
as to define (A) one or more liquid ports in fluid communication
with the liquid compartment, and (B) one or more solid-liquid
composition ports in fluid communication with the solid-liquid
composition compartment; (b) a solid-liquid composition delivery
tube, which is in fluid communication with at least one of the one
or more solid-liquid composition ports; (c) a nixing tube, which is
in fluid communication with at least one of the one or more liquid
ports and at least one of the one or more solid-liquid composition
ports; and (d) a liquid-supply tube, which is in fluid
communication with at least one of the one or more liquid ports,
and is coupled in fluid communication with an interior of the
liquid solution container.
38. Apparatus for use with solid particles and a liquid container
containing a physiological liquid solution, the apparatus
comprising a pump unit, which comprises: (a) a mixing pump; (b) a
liquid-supply pump; and (c) control circuitry, which is configured
to repeatedly: (i) assume a mixing activation state, in which the
control circuitry activates the mixing pump, and (ii) assume a
particle-delivery activation state, wherein the control circuitry
is configured, during each of one or more negative-positive
particle delivery cycles of the particle-delivery activation state,
to assume: a negative particle-delivery activation sub-state, in
which the control circuitry activates the liquid-supply pump apply
negative pressure to pump in a first direction, and thereafter, a
positive particle-delivery activation sub-state, in which the
control circuitry activates the liquid-supply pump to apply
positive pressure to pump in a second direction opposite the first
direction.
39. Apparatus for use with solid particles and a physiological
liquid solution, the apparatus comprising: a composition delivery
source, which comprises: (a) a chamber, which is shaped so as to
define one or more liquid ports and one or more solid-liquid
composition ports; (b) a solid-liquid composition delivery tube,
which is in fluid communication with at least one of the one or
more solid-liquid composition ports; and (c) a mixing tube, which
is in fluid communication with at least one of the one or more
liquid ports and at least one of the one or more solid-liquid
composition ports; and a pump unit, which comprises a mixing pump,
which is arranged to cause, in the mixing tube, flow that raises
the solid particles in a puff into the physiological liquid
solution in the chamber.
40. Apparatus comprising a surgical tool for use with solid
particles and a physiological liquid solution, the surgical tool
comprising: a shaft unit, which is shaped so as to define a
delivery lumen, and a distal opening, which is disposed within 10
mm of a distal end of the shaft unit, in fluid communication with
the delivery lumen; a composition source, which is coupled in fluid
communication with the delivery lumen, and which is configured to
provide a solid-liquid composition of the solid particles and the
physiological liquid solution; and a pump, which is configured to
pump the solid-liquid composition through the distal opening via
the delivery lumen.
41. The apparatus according to claim 40, wherein the surgical tool
is configured as an oral surgical tool.
42. The apparatus according to claim 40, wherein the pump is
configured to pump the solid-liquid composition at a pulsating
hydraulic pressure that periodically varies between positive arid
negative.
43. The apparatus according to claim 42, wherein the pump is
configured to pump the solid-liquid composition through the distal
opening via the delivery lumen during a plurality of
positive-pressure periods that alternate with a plurality of
negative-pressure periods, and to set an average duration of the
positive-pressure periods to be less than or equal to an average
duration of the negative-pressure periods.
44. The apparatus according to claim 43, wherein the pump is
configured to set the average duration of the positive-pressure
periods to be equal to the average duration of the
negative-pressure periods.
45. The apparatus according to claim 40, wherein the pump is
configured to pump the solid-liquid composition at a pulsating
positive hydraulic pressure.
46. The apparatus according to any one of claims 40-45, wherein the
composition source comprises a combining unit, which is configured
to provide the solid-liquid composition by combining the solid
particles with the physiological liquid solution.
47. The apparatus according to claim 46, wherein the combining unit
comprises a mixing unit, which is configured to provide the
solid-liquid composition by mixing the solid particles with the
physiological liquid solution.
48. The apparatus according to any one of claims 40-45, wherein the
solid particles arc solid bone graft particles, and wherein the
surgical tool is for use with the solid bone graft particles.
49. Apparatus comprising a surgical tool for use with solid
particles and a physiological liquid solution, the surgical tool
comprising: exactly one shaft unit, which is shaped so as to define
a delivery lumen and a drainage lumen; a distal opening, which is
disposed within 10 mm of a distal end of the shaft unit, in fluid
communication with the delivery lumen; a composition source, which
is coupled in fluid communication with the delivery lumen, and
which is configured to provide a solid-liquid composition of the
solid particles and the physiological liquid solution; and a
filter, which is disposed in fluid communication with the drainage
lumen, and which is configured to inhibit passage of the solid
particles of the solid-liquid composition and allow passage of the
physiological liquid solution of the solid-liquid composition.
50. The apparatus according to claim 49, wherein the filter is
disposed within 10 mm of the distal end of the shaft unit.
51. The apparatus according to claim 49, wherein the filter is
disposed around an axis of the distal opening.
52. The apparatus according to claim 49, wherein the drainage lumen
is disposed alongside the delivery lumen in the shaft unit.
53. The apparatus according to claim 49, wherein the filter
disposed around the delivery lumen in the shaft unit.
54. The apparatus according to claim 49, further comprising a pump,
which is configured to clear the solid particles that accumulate on
the filter during drainage of the physiological liquid solution
through the filter, by periodically applying a positive pressure to
the drainage lumen.
55. The apparatus according to claim 49, wherein the filter is
shaped so as to define a plurality of slits having a width narrower
than the solid particles.
56. The apparatus according to claim 49, wherein the surgical tool
is configured to move the distal opening and the shaft unit with
respect to each other.
57. The apparatus according to claim 56, wherein the surgical tool
further comprises a filter clearing element, which is fixed to the
distal opening, and is configured to clear the solid particles that
accumulate on the filter during drainage of the physiological
liquid solution through the filter.
58. The apparatus according to claim 56, wherein the surgical tool
is configured to rotate the distal opening and the shaft unit with
respect to each other.
59. The apparatus according to claim 49, wherein the surgical tool
further comprises a filter clearing element, which is configured to
clear the solid particles that accumulate on the filter during
drainage of the physiological liquid solution through the
filter.
60. Apparatus comprising a surgical tool for use with solid
particles and a physiological liquid solution, the surgical tool
comprising: exactly one shaft unit, which is shaped so as to define
a delivery lumen and a drainage lumen; a distal opening, which is
disposed within 10 mm of a distal end of the shaft unit, in fluid
communication with the delivery lumen; a composition source, which
is coupled in fluid communication with the delivery lumen, and
which is configured to provide a solid-liquid composition of the
solid particles and the physiological liquid solution; and a
plurality of elements disposed around and outside the delivery
lumen for facilitating (a) inhibiting passage of the solid
particles of the solid-liquid composition to the drainage lumen,
and (b) allowing passage of the physiological liquid solution of
the solid-liquid composition to the drainage lumen.
61. Apparatus comprising a surgical tool for use with solid
particles and a physiological liquid solution, the surgical tool
comprising: exactly one shaft unit, which (a) is shaped so as to
define a drainage lumen, and (b) comprises a delivery shaft, which
is shaped so as to define (i) a delivery lumen, and (ii) a
plurality of rib elements that extend radially outward from an
external surface of the delivery shaft; a distal opening, which is
disposed within 10 mm of a distal end of the shaft unit, in fluid
communication with the delivery lumen; and a composition source,
which is coupled in fluid communication with the delivery lumen,
and which is configured to provide a solid-liquid composition of
the solid particles and the physiological liquid solution.
62. The apparatus according to claim 61, wherein the rib elements
extend an average distance of between 0.1 and 2 mm radially outward
from the external surface of the delivery shaft.
63. The apparatus according to claim 61, wherein the rib elements
extend longitudinally along the external surface of the delivery
shaft for an average distance of at least 1 mm.
64. The apparatus according to claim 61, wherein the surgical tool
further comprises a depth limiting element, which is configured to
limit a depth of insertion of the shaft unit into a bore through a
bone when the shaft unit is inserted into the bore.
65. The apparatus according to claim 64, wherein the depth limiting
element is removably attached to the shaft unit.
66. The apparatus according to claim 64, wherein the depth limiting
element is shaped so as to define a portion of the drainage lumen
between at least a portion of an internal surface of the depth
limiting element and a portion of the external surface of the
delivery shaft.
67. The apparatus according to any one of claims 49, 60, and 61,
wherein the surgical tool is configured as an oral surgical
tool.
68. The apparatus according to any one of claims 49, 60, and 61,
wherein the solid particles are solid bone graft particles, and
wherein the surgical tool is for use with the solid bone graft
particles.
69. The apparatus according to any one of claims 49, 60, and 61,
wherein the drainage lumen is disposed around the delivery lumen in
the shaft unit.
70. The apparatus according to any one of claims 49, 60, and 61,
wherein the surgical tool further comprises a suction source, which
is coupled in fluid communication with the drainage lumen.
71. The apparatus according to any one of claims 49, 60, and 61,
for use with a suction source, wherein the drainage lumen is
coupleable in fluid communication with the suction source.
72. The apparatus according to any one of claims 49, 60, and 61,
wherein the surgical tool further comprises a depth limiting
element, which is configured to limit a depth of insertion of the
shaft unit into a bore through a bone when the shaft unit is
inserted into the bore.
73. The apparatus according to any one of claims 49, 60, and 61,
wherein the composition source comprises a combining feeder unit,
which is configured to provide the solid-liquid composition by
combining the solid particles with the physiological liquid
solution.
74. The apparatus according to claim 73, wherein the combining
feeder unit comprises a mixing feeder unit, which is configured to
provide the solid-liquid composition by mixing the solid particles
with the physiological liquid solution.
75. The apparatus according to any one of claims 49, 60, and 61,
wherein the surgical tool is configured to automatically apply
motion to the shaft unit selected from the group consisting of:
vibrational motion, rotational motion, oscillatory motion, axial
back-and-forth motion, and lateral side-to-side motion.
76. The apparatus according to any one of claims 49, 60, and 61,
further comprising a pump, which is configured to pump the
solid-liquid composition through the distal opening via the
delivery lumen.
77. The apparatus according to claim 76, wherein the pump is
configured to pump the solid-liquid composition at a pulsating
positive hydraulic pressure.
78. The apparatus according to claim 76, wherein the pump is
configured to pump the solid-liquid composition at a pulsating
hydraulic pressure that periodically varies between positive and
negative.
79. The apparatus according to any one of claims 49, 60, and 61,
wherein the surgical tool further comprises a solid-particle
container, which contains the solid particles for combining with
the physiological liquid solution.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application (a) claims priority from U.S.
Provisional Application 62/150,969, filed Apr. 22, 2015, and (b)
claims priority from and is a continuation-in-part of U.S.
application Ser. No. 14/707,688, filed May 8, 2015, both of which
are assigned to the assignee of the present application and are
incorporated herein by reference.
FIELD OF THE APPLICATION
[0002] The present invention relates generally to surgical tools
and implantation methods, and specifically to minimally-invasive
surgical tools and implantation methods.
BACKGROUND OF THE APPLICATION
[0003] Osseointegrated dental implants are typically metallic or
ceramic screws that are placed in the jawbone for supporting
artificial teeth after the loss of natural teeth. Replacement of
the maxillary teeth is often a challenging surgical procedure when
the remaining maxillary bone has insufficient height to support the
implant. One surgical technique for augmenting the maxillary bone
includes injecting a regenerative material, such as autogenic,
allogeneic, xenogeneic, or synthetic bone graft, into the vicinity
of the maxillary bone. The regenerative material forms additional
bone mass that integrates with the existing maxillary bone,
providing the necessary alveolar height to support the implant.
[0004] Bone augmentation procedures are often surgically difficult
to perform, and are associated with complications, including
infection of the maxillary sinus. The top of the maxillary alveolar
ridge forms the floor of the maxillary sinus, and is covered by a
thin membrane known as the Schneiderian or subantral membrane. In
one surgical procedure, known as a closed or internal sinus lift or
elevation procedure, the surgeon drills a bore through the
maxillary alveolar ridge from the oral cavity at the desired
location of the implant. The bore penetrates the ridge to below the
Schneiderian membrane. The surgeon injects the regenerative
material through the bore to below the membrane, forming a cavity
defined by the top of the ridge and the bottom of the membrane,
which cavity occupies a portion of the space initially occupied by
the maxillary sinus.
[0005] To prevent potentially serious complications, the surgeon
must be careful not to perforate the Schneiderian membrane. This is
often difficult, because of the delicacy of the membrane, and the
restricted access afforded by the closed approach.
[0006] Hydraulic sinus lifting is performed by applying hydraulic
pressure between the sinus floor and the Schneiderian membrane. The
hydraulic elevation can be performed via a crestal or lateral
approach. Once the membrane is elevated, using a hydraulic, closed,
or lateral window technique, a bone graft material is applied,
typically using one of two conventional techniques. The first
conventional technique is the mechanical insertion of bone graft,
which is formulated in small particles. This technique is manually
demanding, and it may cause application of unequal stresses to the
membrane, which may result in perforation of the membrane. The
second conventional technique is the injection of bone graft in a
gel formulation by applying the same principles of hydraulic
elevation used during raising of the membrane.
SUMMARY
[0007] Some embodiments of the present invention provide surgical
tools and methods for use in conjunction with minimally-invasive
sinus lift techniques for performing a bone augmentation procedure
on the maxillary alveolar ridge while reducing the risk of
perforating the Schneiderian membrane and of infection.
[0008] For some applications, the surgical tool is configured to
inject, through a bore (osteotomy) and into a sinus cavity, a
solid-liquid composition of bone graft particles and a
physiological liquid solution, and to drain the physiological
liquid solution through the same bore, leaving the bone graft
particles in the cavity. Typically, a filter of the surgical tool
is used to inhibit passage of bone graft particles from the cavity.
Typically, hydraulic pressure is equally applied on the
Schneiderian membrane by the solid-liquid composition throughout
the injection of the solid-liquid composition. Such uniform
hydraulic pressure prevents bone graft particles from applying
local or uneven pressure on the Schneiderian membrane, and thus
reduces the risk of perforation. The surgeon further screws an
implant into the bone graft material in the cavity, either during
the same procedure or after bone grows into the bone graft
material. After bone grows into the bone graft material, a dental
appliance, such as a crown, is coupled to the implant.
[0009] For some applications, the surgical tool comprises a
composition delivery source, which comprises a chamber, a
solid-liquid composition delivery tube, a mixing tube, and a
liquid-supply tube. The chamber comprises a filter, which is
disposed within the chamber so as to divide the chamber into a
liquid compartment and a solid-liquid composition compartment. The
chamber is shaped so as to define (a) one or more liquid ports in
fluid communication with the liquid compartment, and (b) one or
more solid-liquid composition ports in fluid communication with the
solid-liquid composition compartment. The solid-liquid composition
delivery tube is in fluid communication with at least one of the
one or more solid-liquid composition ports. The mixing tube is in
fluid communication with at least one of the one or more liquid
ports and at least one of the one or more solid-liquid composition
ports. The liquid-supply tube is in fluid communication with at
least one of the one or more liquid ports, and is coupled in fluid
communication with an interior of the liquid solution
container.
[0010] For some applications, the surgical tool further comprises a
pump unit, which comprises (a) a mixing pump, which is arranged to
cause flow in the mixing tube, and (b) a liquid-supply pump, which
is arranged to cause flow in the liquid-supply tube. Typically, the
mixing pump is arranged to cause, in the mixing tube, flow that
raises the solid bone graft particles in a puff into the
physiological liquid solution in the chamber. For some
applications, the mixing pump and the liquid-supply pump are
respective peristaltic pumps.
[0011] For some applications, the pump unit further comprises
control circuitry, which is configured to repeatedly: [0012] assume
a mixing activation state, in which the control circuitry activates
the mixing pump to mix the solid bone graft particles and the
physiological liquid solution in the solid-liquid composition
compartment to form a solid-liquid composition, by pumping the
physiological liquid solution through the mixing tube and into the
solid-liquid composition compartment, and [0013] assume a
particle-delivery activation state, wherein the control circuitry,
during at least a portion of the particle-delivery activation
state, activates the liquid-supply pump to apply positive pressure
to pump the solid-liquid composition from the solid-liquid
composition compartment into the solid-liquid composition delivery
tube.
[0014] For some applications, the control circuitry is configured,
during each of one or more negative-positive particle delivery
cycles of the particle-delivery activation state, to assume: [0015]
a negative particle-delivery activation sub-state, in which the
control circuitry activates the liquid-supply pump to apply
negative pressure to pump liquid from the solid-liquid composition
delivery tube toward the liquid compartment via the solid-liquid
composition compartment, and [0016] a positive particle-delivery
activation sub-state, in which the control circuitry activates the
liquid-supply pump to apply the positive pressure to pump the
solid-liquid composition from the solid-liquid composition
compartment into the solid-liquid composition delivery tube,
wherein a direction of pumping of the liquid-supply pump in the
positive particle-delivery activation sub-state is opposite a
direction of pumping of the liquid-supply pump in the negative
particle-delivery activation sub-state.
[0017] For some applications, the surgical tool comprises an
automated device that both prepares (e.g., mixes) and delivers the
solid-liquid composition during the procedure.
[0018] There is therefore provided, in accordance with an inventive
concept 1 of the present invention, apparatus for use with solid
particles and a liquid container containing a physiological liquid
solution, the apparatus comprising: [0019] (1) a composition
delivery source, which comprises: [0020] (a) a chamber, which:
[0021] (i) comprises a filter, which is disposed within the chamber
so as to divide the chamber into a liquid compartment and a
solid-liquid composition compartment, and [0022] (ii) is shaped so
as to define (A) one or more liquid ports in fluid communication
with the liquid compartment, and (B) one or more solid-liquid
composition ports in fluid communication with the solid-liquid
composition compartment; [0023] (b) a solid-liquid composition
delivery tube, which is in fluid communication with at least one of
the one or more solid-liquid composition ports; [0024] (c) a mixing
tube, which is in fluid communication with at least one of the one
or more liquid ports and at least one of the one or more
solid-liquid composition ports; and [0025] (d) a liquid-supply
tube, which is in fluid communication with at least one of the one
or more liquid ports, and is coupled in fluid communication with an
interior of the liquid solution container; and [0026] (2) a pump
unit, which comprises: [0027] (a) a mixing pump, which is arranged
to cause flow in the mixing tube; and [0028] (b) a liquid-supply
pump, which is arranged to cause flow in the liquid-supply tube.
[0029] Inventive concept 2. The apparatus according to inventive
concept 1, wherein the solid particles are solid bone graft
particles, and wherein the apparatus is for use with the solid bone
graft particles. [0030] Inventive concept 3. The apparatus
according to inventive concept 1, further comprising the solid
particles, wherein the filter is configured to inhibit passage of
the solid particles and allow passage of the physiological liquid
solution. [0031] Inventive concept 4. The apparatus according to
inventive concept 1, wherein the mixing pump is arranged to cause,
in the mixing tube, flow that raises the solid particles in a puff
into the physiological liquid solution in the solid-liquid
composition compartment. [0032] Inventive concept 5. The apparatus
according to inventive concept 1, wherein a closest distance
between the one or more solid-liquid composition ports and the
filter equals at least 5 mm. [0033] Inventive concept 6. The
apparatus according to inventive concept 5, wherein the closest
distance equals at least 10 mm. [0034] Inventive concept 7. The
apparatus according to inventive concept 1, wherein a closest
distance between the one or more solid-liquid composition ports and
the filter equals at least 75% of a distance between the filter and
a point on an interior of a wall of the solid-liquid composition
compartment farthest from the filter. [0035] Inventive concept 8.
The apparatus according to inventive concept 1, wherein the mixing
tube (a) merges with the liquid-supply tube at an exit junction,
and (b) is in fluid communication with the at least one of the one
or more liquid ports via a portion of the liquid-supply tube.
[0036] Inventive concept 9. The apparatus according to inventive
concept 1, wherein the liquid-supply tube (a) merges with the
mixing tube at an exit junction, and (b) is in fluid communication
with the at least one of the one or more liquid ports via a portion
of the mixing tube. [0037] Inventive concept 10. The apparatus
according to inventive concept 1, wherein the chamber is shaped so
as to define exactly one liquid port in fluid communication with
the liquid compartment. [0038] Inventive concept 11. The apparatus
according to inventive concept 1, wherein the chamber is shaped so
as to define exactly one solid-liquid composition port in fluid
communication with the solid-liquid composition compartment. [0039]
Inventive concept 12. The apparatus according to inventive concept
1,
[0040] wherein the chamber is shaped so as to define exactly one
liquid port in fluid communication with the liquid compartment,
and
[0041] wherein the chamber is shaped so as to define exactly one
solid-liquid composition port in fluid communication with the
solid-liquid composition compartment. [0042] Inventive concept 13.
The apparatus according to any one of inventive concepts 1-12,
wherein the pump unit further comprises control circuitry, which is
configured to repeatedly:
[0043] (a) assume a mixing activation state, in which the control
circuitry activates the mixing pump to mix the solid particles and
the physiological liquid solution in the solid-liquid composition
compartment to form a solid-liquid composition, by pumping the
physiological liquid solution through the mixing tube and into the
solid-liquid composition compartment, and
[0044] (b) assume a particle-delivery activation state, wherein the
control circuitry, during at least a portion of the
particle-delivery activation state, activates the liquid-supply
pump to apply positive pressure to pump the solid-liquid
composition from the solid-liquid composition compartment into the
solid-liquid composition delivery tube. [0045] Inventive concept
14. The apparatus according to inventive concept 13, wherein the
control circuitry is configured to assume the mixing activation
state and the particle-delivery activation state at the same time.
[0046] Inventive concept 15. The apparatus according to inventive
concept 13, wherein the control circuitry is configured to assume
the mixing activation stale and the particle-delivery activation
state at partially-overlapping times. [0047] Inventive concept 16.
The apparatus according to inventive concept 13, wherein the
control circuitry is configured to assume the mixing activation
state and the particle-delivery activation state at non-overlapping
times. [0048] Inventive concept 17. The apparatus according to
inventive concept 16, wherein the control circuitry is configured
to assume the particle-delivery activation state within 500 ms
after completing the mixing activation state. [0049] Inventive
concept 18. The apparatus according to inventive concept 17,
wherein the control circuitry is configured to assume the
particle-delivery activation state within 100 ms after completing
the mixing activation state. [0050] Inventive concept 19. The
apparatus according to inventive concept 16, wherein the control
circuitry is configured to repeatedly, in alternation, (a) assume
the mixing activation state for between 100 and 1200 ms, and (b)
assume the particle-delivery activation state. [0051] Inventive
concept 20. The apparatus according to inventive concept 19,
wherein the control circuitry is configured to repeatedly, in
alternation, (a) assume the mixing activation state for between 100
and 1200 ms, and (b) assume the particle-delivery activation state
for between 150 and 3000 ms. [0052] Inventive concept 21. The
apparatus according to inventive concept 13, wherein the control
circuitry is configured to, when in the particle-delivery
activation state, activate the liquid-supply pump to apply the
positive pressure to pump the physiological liquid solution (a)
from the liquid solution container, (b) through the liquid-supply
tube, (c) into the liquid compartment, (d) through the filter, (e)
into the solid-liquid composition compartment, (f) from the
solid-liquid composition compartment, and (g) to the solid-liquid
composition delivery tube. [0053] Inventive concept 22. The
apparatus according to inventive concept 13, wherein the control
circuitry is configured to repeatedly assume the mixing activation
state and the particle-delivery activation state over a time period
having a duration of between 30 and 600 seconds. [0054] Inventive
concept 23. The apparatus according to inventive concept 13,
wherein the control circuitry is configured, during each of one or
more negative-positive particle delivery cycles of the
particle-delivery activation state, to assume:
[0055] a negative particle-delivery activation sub-state, in which
the control circuitry activates the liquid-supply pump to apply
negative pressure to pump liquid from the solid-liquid composition
delivery tube toward the liquid compartment via the solid-liquid
composition compartment, and
[0056] a positive particle-delivery activation sub-state, in which
the control circuitry activates the liquid-supply pump to apply the
positive pressure to pump the solid-liquid composition from the
solid-liquid composition compartment into the solid-liquid
composition delivery tube, wherein a direction of pumping of the
liquid-supply pump in the positive particle-delivery activation
sub-state is opposite a direction of pumping of the liquid-supply
pump in the negative particle-delivery activation sub-state. [0057]
Inventive concept 24. The apparatus according to inventive concept
23, wherein the control circuitry is configured to assume the
mixing activation state and the particle-delivery activation state
at non-overlapping times. [0058] Inventive concept 25. The
apparatus according to inventive concept 23, wherein the control
circuitry is configured to assume the mixing activation state and
the negative particle-delivery activation sub-state at
partially-overlapping times. [0059] Inventive concept 26. The
apparatus according to inventive concept 23, wherein the control
circuitry is configured to assume the particle-delivery activation
state in a plurality of particle-delivery-state cycles, and to
begin the particle-delivery activation state in each of the
particle-delivery-state cycles with the negative particle-delivery
activation sub-state. [0060] Inventive concept 27. The apparatus
according to inventive concept 23, wherein the control circuitry is
configured to repeatedly, in alternation, (a) assume the mixing
activation state for between 100 and 1200 ms, and (b) assume the
particle-delivery activation state. [0061] Inventive concept 28.
The apparatus according to inventive concept 23, wherein the
control circuitry is configured to provide a plurality of the
negative-positive particle delivery cycles during the
particle-delivery activation state. [0062] Inventive concept 29.
The apparatus according to inventive concept 28, wherein the
control circuitry is configured to provide up to 10 of the
negative-positive particle delivery cycles during the
particle-delivery activation state. [0063] Inventive concept 30.
The apparatus according to inventive concept 23, wherein the
control circuitry is configured to assume the negative
particle-delivery activation sub-state for between 25 and 300 ms
during each of the one or more negative-positive particle delivery
cycles. [0064] Inventive concept 31. The apparatus according to
inventive concept 30, wherein the control circuitry is configured
to assume the negative particle-delivery activation sub-state for
between 25 and 100 ms during each of the one or more
negative-positive particle delivery cycles. [0065] Inventive
concept 32. The apparatus according to inventive concept 23,
wherein the control circuitry is configured to assume the positive
particle-delivery activation sub-state for between 25 and 300 ms
during each of the one or more negative-positive particle delivery
cycles. [0066] Inventive concept 33. The apparatus according to
inventive concept 32, wherein the control circuitry is configured
to assume the positive particle-delivery activation sub-state for
between 25 and 100 ms during each of the one or more
negative-positive particle delivery cycles. [0067] Inventive
concept 34. The apparatus according to inventive concept 23,
wherein the control circuitry is configured to assume the negative
particle-delivery activation sub-state for between 25 and 300 ms
during each of the one or more negative-positive particle delivery
cycles, and to assume the positive particle-delivery activation
sub-state for between 25 and 300 ms during each of the one or more
negative-positive particle delivery cycles. [0068] Inventive
concept 35. The apparatus according to inventive concept 23,
wherein the control circuitry is configured to assume the negative
particle-delivery activation sub-state for a first duration during
each of the one or more negative-positive particle delivery cycles,
and to assume the positive particle-delivery activation sub-state
for a second duration during each of the one or more
negative-positive particle delivery cycles, the second duration
equal to between 80% and 120% of the first duration. [0069]
Inventive concept 36. The apparatus according to inventive concept
23, wherein the control circuitry is configured to, when in the
negative particle-delivery activation sub-state, activate the
liquid-supply pump to pump the liquid from the solid-liquid
composition delivery tube, into the solid-liquid composition
compartment, and into the liquid compartment. [0070] Inventive
concept 37. The apparatus according to inventive concept 23,
[0071] wherein the liquid-supply pump is a liquid-supply
peristaltic pump, which comprises a rotor,
[0072] wherein the liquid-supply peristaltic pump is capable of (a)
pumping fluid at an average rate throughout a full 360-degree
revolution of the rotor at a certain speed, and (b) pumping fluid
at a maximum rate during portions of the full 360-degree revolution
at the certain speed, the maximum rate greater than the average
rate, and
[0073] wherein the control circuitry is configured, when in both
the positive and the negative particle-delivery activation
sub-states, to activate the liquid-supply peristaltic pump to (a)
rotate the rotor, at the certain speed, a partial revolution equal
to a fraction of the full 360-degree revolution of the rotor, the
fraction less than 1, and (b) pump, throughout the partial
revolution, the fluid at the maximum rate. [0074] Inventive concept
38. The apparatus according to inventive concept 23,
[0075] wherein the liquid-supply pump is a liquid-supply
peristaltic pump, which comprises a rotor, and
[0076] wherein the control circuitry is configured: [0077] when in
the positive particle-delivery activation sub-state, to activate
the liquid-supply peristaltic pump to rotate the rotor, in a first
rotational direction, a first partial revolution equal to a
fraction of a full 360-degree revolution of the rotor, the fraction
less than 1, and [0078] when in the negative particle-delivery
activation sub-state, to activate the liquid-supply peristaltic
pump to rotate the rotor, in a second rotational direction opposite
the first rotational direction, a second partial revolution equal
to the fraction of the full 360-degree revolution of the rotor.
[0079] Inventive concept 39. The apparatus according to inventive
concept 23, wherein the control circuitry is configured:
[0080] when in the positive particle-delivery activation sub-state,
to activate the liquid-supply pump to pump a volume of between 0.1
and 2 cc of fluid, and
[0081] when in the negative particle-delivery activation sub-state,
to activate the liquid-supply pump to pump the volume of fluid.
[0082] Inventive concept 40. The apparatus according to inventive
concept 23,
[0083] wherein the liquid-supply pump is a liquid-supply
peristaltic pump, which comprises a rotor, and
[0084] wherein the control circuitry is configured, when in the
positive particle-delivery activation sub-state, to activate the
liquid-supply peristaltic pump to: [0085] rotate the rotor a
partial revolution equal to a fraction of a full 360-degree
revolution of the rotor, the fraction less than 1, and [0086] pump,
throughout the partial revolution, a volume of fluid that is
greater than the product of the fraction and a volume of fluid
pumpable throughout the full 360-degree revolution of the rotor.
[0087] Inventive concept 41. The apparatus according to inventive
concept 40, wherein the liquid-supply peristaltic pump further
comprises a total number of rollers equal to at least two, and
wherein the fraction is less than the quotient of 1 divided by the
total number of rollers. [0088] Inventive concept 42. The apparatus
according to inventive concept 41, wherein the fraction is less
than or equal to the quotient of 0.5 divided by the total number of
rollers. [0089] Inventive concept 43. The apparatus according to
inventive concept 23, wherein the control circuitry and the
liquid-supply pump are configured such that during at least a
portion of the positive particle-delivery activation sub-state, the
liquid-supply pump pumps the physiological liquid solution at a
rate of at least 3 cc/sec. [0090] Inventive concept 44. The
apparatus according to inventive concept 43, wherein the rate is at
least 7 cc/sec. [0091] Inventive concept 45. The apparatus
according to inventive concept 23, wherein the control circuitry
and the liquid-supply pump are configured such that during at least
a portion of the negative particle-delivery activation sub-state,
the liquid-supply pump pumps the physiological liquid solution at a
rate of at least 3 cc/sec. [0092] Inventive concept 46. The
apparatus according to inventive concept 45, wherein the rate is at
least 7 cc/sec. [0093] Inventive concept 47. The apparatus
according to inventive concept 13, wherein the control circuitry
and the mixing pump are configured such that during at least a
portion of the mixing activation state the mixing pump pumps the
physiological liquid solution at a rate of at least 3 cc/sec.
[0094] Inventive concept 48. The apparatus according to inventive
concept 47, wherein the rate is at least 7 cc/sec. [0095] Inventive
concept 49. The apparatus according to inventive concept 13,
wherein the control circuitry and the mixing pump are configured
such that throughout the mixing activation state the mixing pump
pumps between 0.5 and 9 cc of the physiological liquid solution.
[0096] Inventive concept 50. The apparatus according to inventive
concept 49, wherein the control circuitry and the mixing pump are
configured such that throughout the mixing activation state the
mixing pump pumps between 1.8 and 3.9 cc of the physiological
liquid solution. [0097] Inventive concept 51. The apparatus
according to inventive concept 13, wherein the liquid-supply pump
is a liquid-supply peristaltic pump, which comprises a rotor.
[0098] Inventive concept 52. The apparatus according to inventive
concept 51, wherein the liquid-supply peristaltic pump comprises an
index sensor, which identifies a rotational position of the rotor.
[0099] Inventive concept 53. The apparatus according to inventive
concept 51, wherein the control circuitry is configured to assume
the particle-delivery activation state a plurality of times in
alternation with mixing activation states, and to begin each of the
particle-delivery activation states with the rotor at a same
rotational position. [0100] Inventive concept 54. The apparatus
according to inventive concept 13, wherein the mixing pump is a
mixing peristaltic pump, which comprises a rotor. [0101] Inventive
concept 55. The apparatus according to inventive concept 54,
wherein the mixing peristaltic pump comprises an index sensor,
which identifies a rotational position of the rotor. [0102]
Inventive concept 56. The apparatus according to inventive concept
54,
[0103] wherein the mixing peristaltic pump comprises a total number
of rollers equal to at least two, and
[0104] wherein the control circuitry is configured to assume the
mixing activation state a plurality of times in alternation with
particle-delivery activation states, and to begin the mixing
activation states with the rotor at respective starting rotational
positions, which are identical to one another or rotationally
offset from one another by the product of (a) 360 degrees divided
by the total number of rollers and (b) a positive integer. [0105]
Inventive concept 57. The apparatus according to inventive concept
54,
[0106] wherein the mixing peristaltic pump comprises (a) a pump
casing that is shaped so as to define a partial-circle mixing tube
channel in which the mixing tube is disposed, and (b) an odd total
number of rollers, the odd total number equal to at least one,
and
[0107] wherein the control circuitry is configured to assume the
mixing activation state a plurality of times in alternation with
particle-delivery activation states, and to begin each of the
mixing activation states with an aligned total number of the
rollers rotationally aligned with the mixing tube channel, the
aligned total number equal to more than half of the odd total
number. [0108] Inventive concept 58. The apparatus according to
inventive concept 57, wherein the odd total number equals at least
three. [0109] Inventive concept 59. The apparatus according to
inventive concept 13, wherein the control circuitry is configured
to, before repeatedly assuming the mixing and the particle-delivery
activation states, assume a filling state, in which the control
circuitry activates the liquid-supply pump to apply positive
pressure to pump a volume of the physiological liquid solution from
the solid-liquid composition compartment into the solid-liquid
composition delivery tube, the volume equal to between 0.5 and 3
cc. [0110] Inventive concept 60. The apparatus according to any one
of inventive concepts 1-12,
[0111] wherein the chamber comprises a receptacle component and a
cover component,
[0112] wherein the cover component (a) comprises the filter, and
(b) is shaped so as to define (i) a cap and (ii) a bone-graft
container having an opening that (x) faces away from the cap and
(y) is farther from the cap than the filter is from the cap,
and
[0113] wherein the receptacle component and the cover component are
shaped so as to be reversibly coupleable with each another to form
a watertight seal, with the bone-graft container disposed within
the receptacle component. [0114] Inventive concept 61. The
apparatus according to inventive concept 60, wherein the bone-graft
container has a volume of between 0.2 and 6 ml. [0115] Inventive
concept 62. The apparatus according to inventive concept 60,
wherein the chamber has a volume of between 0.2 and 20 ml. [0116]
Inventive concept 63. The apparatus according to inventive concept
60, wherein a volume of the bone-graft container equals less than
50% of a volume of the chamber. [0117] Inventive concept 64. The
apparatus according to inventive concept 63, wherein the volume of
the bone-graft container equals less than 33% of the volume of the
chamber. [0118] Inventive concept 65. The apparatus according to
inventive concept 64, wherein the volume of the bone-graft
container equals less than 20% of the volume of the chamber. [0119]
Inventive concept 66. The apparatus according to any one of
inventive concepts 1-12, wherein the mixing pump and the
liquid-supply pump are respective peristaltic pumps. [0120]
Inventive concept 67. The apparatus according to inventive concept
66, wherein the peristaltic pumps comprise respective rotors and
index sensors, which identify respective rotational positions of
the rotors. [0121] Inventive concept 68. The apparatus according to
inventive concept 66, wherein the pump unit further comprises
control circuitry, which is configured to assume a mixing
activation state, in which the mixing peristaltic pump rotates
between 1/3 and 3 revolutions. [0122] Inventive concept 69. The
apparatus according to inventive concept 68, wherein the mixing
peristaltic pump rotates one revolution throughout the mixing
activation state. [0123] Inventive concept 70. The apparatus
according to any one of inventive concepts 1-12, wherein the mixing
tube (a) merges with the solid-liquid composition delivery tube at
a return junction, and (b) is in fluid communication with the at
least one of the one or more solid-liquid composition ports via a
portion of the solid-liquid composition delivery tube. [0124]
Inventive concept 71. The apparatus according to inventive concept
70, wherein a proximal end of the solid-liquid composition delivery
tube is in fluid communication with the at least one of the one or
more solid-liquid composition ports, and wherein a distance between
the return junction and the proximal end of the solid-liquid
composition delivery tube is less than 60 mm. [0125] Inventive
concept 72. The apparatus according to inventive concept 71,
wherein the distance is less than 20 mm. [0126] Inventive concept
73. The apparatus according to inventive concept 70, wherein an
internal cross-sectional area of the solid-liquid composition
delivery tube perpendicular to an axis of the solid-liquid
composition delivery tube is non-decreasing from the return
junction to a distal end of the solid-liquid composition delivery
tube. [0127] Inventive concept 74. The apparatus according to any
one of inventive concepts 1-12, wherein the mixing tube (a) merges
with the solid-liquid composition delivery tube at a return
junction, and (b) is in fluid communication with the at least one
of the one or more solid-liquid composition ports via a portion of
the solid-liquid composition delivery tube. [0128] Inventive
concept 75. The apparatus according to inventive concept 74,
[0129] wherein the chamber comprises a receptacle component and a
cover component, which is shaped so as to define a cap,
[0130] wherein the return junction is disposed along a longitudinal
portion of the solid-liquid composition delivery tube and around a
circumferential portion of the solid-liquid composition delivery
tube,
[0131] wherein the longitudinal portion includes a point that is
closest to the cap when the cap is coupled to the receptacle
component, and
[0132] wherein the circumferential portion includes the point.
[0133] Inventive concept 76. The apparatus according to any one of
inventive concepts 1-12, wherein the apparatus further comprises a
shaft unit, which comprises a shaft delivery tube in fluid
communication with a distal end of the solid-liquid composition
delivery tube. [0134] Inventive concept 77. The apparatus according
to inventive concept 76, wherein the shaft delivery tube is more
rigid than at least a portion of the solid-liquid composition
delivery tube. [0135] Inventive concept 78. The apparatus according
to inventive concept 76, wherein the shaft unit further comprises a
removable depth limiting element, which is configured to limit a
depth of insertion of the shaft delivery tube into a bore through a
bone when the shaft delivery tube is inserted into the bore. [0136]
Inventive concept 79. The apparatus according to inventive concept
78,
[0137] wherein the shaft unit comprises a shaft delivery tube,
[0138] wherein the shaft unit further comprises a sealing element
disposed around an external surface of the shaft delivery tube,
and
[0139] wherein the depth limiting element is removable from the
shall unit without removal of the sealing element. [0140] Inventive
concept 80. The apparatus according to inventive concept 79,
wherein a distal end of the shaft delivery tube is disposed more
distally than the sealing element by a distance of between 0 and 20
mm. [0141] Inventive concept 81. The apparatus according to
inventive concept 80, wherein the distance is between 3 and 15 mm.
[0142] Inventive concept 82. The apparatus according to inventive
concept 76, wherein the shaft delivery tube is straight. [0143]
Inventive concept 83. The apparatus according to inventive concept
82, wherein, when the chamber, the solid-liquid composition
delivery tube, and the shaft unit are unconstrained, respective
central longitudinal axes of the shaft delivery tube and a proximal
longitudinal portion of the solid-liquid composition delivery tube
form an angle of between 70 and 110 degrees. [0144] Inventive
concept 84. The apparatus according to inventive concept 83,
wherein the angle is between 85 and 95 degrees. [0145] Inventive
concept 85. The apparatus according to inventive concept 82,
wherein, when the chamber, the solid-liquid composition delivery
tube, and the shaft unit are unconstrained, a central longitudinal
axis of the shaft delivery tube and a plane defined by the filter
form an angle of between 70 and 110 degrees. [0146] Inventive
concept 86. The apparatus according to inventive concept 82,
wherein, when the chamber and the solid-liquid composition delivery
tube are unconstrained, (a) a central longitudinal axis of a
proximal longitudinal portion of the solid-liquid composition
delivery tube and (b) a plane defined by the filter are parallel or
form an angle of less than 20 degrees.
[0147] There is further provided, in accordance with an inventive
concept 87 of the present invention, apparatus for use with solid
particles and a liquid container containing a physiological liquid
solution, the apparatus comprising a composition delivery source,
which comprises:
[0148] (a) a chamber, which: [0149] (i) comprises a filter, which
is disposed within the chamber so as to divide the chamber into a
liquid compartment and a solid-liquid composition compartment, and
[0150] (ii) is shaped so as to define (A) one or more liquid ports
in fluid communication with the liquid compartment, and (B) one or
more solid-liquid composition ports in fluid communication with the
solid-liquid composition compartment;
[0151] (b) a solid-liquid composition delivery tube, which is in
fluid communication with at least one of the one or more
solid-liquid composition ports;
[0152] (c) a mixing tube, which is in fluid communication with at
least one of the one or more liquid ports and at least one of the
one or more solid-liquid composition ports; and
[0153] (d) a liquid-supply tube, which is in fluid communication
with at least one of the one or more liquid ports, and is coupled
in fluid communication with an interior of the liquid solution
container. [0154] Inventive concept 88. The apparatus according to
inventive concept 87, wherein the solid particles are solid bone
graft particles, and wherein the apparatus is for use with the
solid bone graft particles. [0155] Inventive concept 89. The
apparatus according to inventive concept 87, further comprising the
solid particles, wherein the filter is configured to inhibit
passage of the solid particles and allow passage of the
physiological liquid solution. [0156] Inventive concept 90. The
apparatus according to inventive concept 87, wherein a closest
distance between the one or more solid-liquid composition ports and
the filter equals at least 5 mm. [0157] Inventive concept 91. The
apparatus according to inventive concept 90, wherein the closest
distance equals at least 10 mm. [0158] Inventive concept 92. The
apparatus according to inventive concept 87, wherein a closest
distance between the one or more solid-liquid composition ports and
the filter equals at least 75% of a distance between the filter and
a point on an interior of a wall of the solid-liquid composition
compartment farthest from the filter. [0159] Inventive concept 93.
The apparatus according to inventive concept 87, wherein the mixing
tube (a) merges with the liquid-supply tube at an exit junction,
and (b) is in fluid communication with the at least one of the one
or more liquid ports via a portion of the liquid-supply tube.
[0160] Inventive concept 94. The apparatus according to inventive
concept 87, wherein the liquid-supply tube (a) merges with the
mixing tube at an exit junction, and (b) is in fluid communication
with the at least one of the one or more liquid ports via a portion
of the mixing tube. [0161] Inventive concept 95. The apparatus
according to inventive concept 87, wherein the chamber is shaped so
as to define exactly one liquid port in fluid communication with
the liquid compartment. [0162] Inventive concept 96. The apparatus
according to inventive concept 87, wherein the chamber is shaped so
as to define exactly one solid-liquid composition port in fluid
communication with the solid-liquid composition compartment. [0163]
Inventive concept 97. The apparatus according to inventive concept
87,
[0164] wherein the chamber is shaped so as to define exactly one
liquid port in fluid communication with the liquid compartment,
and
[0165] wherein the chamber is shaped so as to define exactly one
solid-liquid composition port in fluid communication with the
solid-liquid composition compartment. [0166] Inventive concept 98.
The apparatus according to any one of inventive concepts 87-97,
[0167] wherein the chamber comprises a receptacle component and a
cover component,
[0168] wherein the cover component (a) comprises the filter, and
(b) is shaped so as to define (i) a cap and (ii) a bone-graft
container having an opening that (x) faces away from the cap and
(y) is farther from the cap than the filter is from the cap,
and
[0169] wherein the receptacle component and the cover component are
shaped so as to be reversibly coupleable with each another to form
a watertight seal, with the bone-graft container disposed within
the receptacle component. [0170] Inventive concept 99. The
apparatus according to inventive concept 98, wherein the bone-graft
container has a volume of between 0.2 and 6 ml. [0171] Inventive
concept 100. The apparatus according to inventive concept 98,
wherein the chamber has a volume of between 0.2 and 20 ml. [0172]
Inventive concept 101. The apparatus according to inventive concept
98, wherein a volume of the bone-graft container equals less than
50% of a volume of the chamber. [0173] Inventive concept 102. The
apparatus according to inventive concept 101, wherein the volume of
the bone-graft container equals less than 33% of the volume of the
chamber. [0174] Inventive concept 103. The apparatus according to
inventive concept 102, wherein the volume of the bone-graft
container equals less than 20% of the volume of the chamber. [0175]
Inventive concept 104. The apparatus according to any one of
inventive concepts 87-97, wherein the mixing tube (a) merges with
the solid-liquid composition delivery tube at a return junction,
and (b) is in fluid communication with the at least one of the one
or more solid-liquid composition ports via a portion of the
solid-liquid composition delivery tube. [0176] Inventive concept
105. The apparatus according to inventive concept 104, wherein a
proximal end of the solid-liquid composition delivery tube is in
fluid communication with the at least one of the one or more
solid-liquid composition ports, and wherein a distance between the
return junction and the proximal end of the solid-liquid
composition delivery tube is less than 60 mm. [0177] Inventive
concept 106. The apparatus according to inventive concept 105,
wherein the distance is less than 20 mm. [0178] Inventive concept
107. The apparatus according to inventive concept 104, wherein an
internal cross-sectional area of the solid-liquid composition
delivery tube perpendicular to an axis of the solid-liquid
composition delivery tube is non-decreasing from the return
junction to a distal end of the solid-liquid composition delivery
tube. [0179] Inventive concept 108. The apparatus according to any
one of inventive concepts 87-97, wherein the mixing tube (a) merges
with the solid-liquid composition delivery tube at a return
junction, and (b) is in fluid communication with the at least one
of the one or more solid-liquid composition ports via a portion of
the solid-liquid composition delivery tube. [0180] Inventive
concept 109. The apparatus according to inventive concept 108,
[0181] wherein the chamber comprises a receptacle component and a
cover component which is shaped so as to define a cap,
[0182] wherein the return junction is disposed along a longitudinal
portion of the solid-liquid composition delivery tube and around a
circumferential portion of the solid-liquid composition delivery
tube,
[0183] wherein the longitudinal portion includes a point that is
closest to the cap when the cap is coupled to the receptacle
component, and
[0184] wherein the circumferential portion includes the point.
[0185] Inventive concept 110. The apparatus according to any one of
inventive concepts 87-97, wherein the apparatus further comprises a
shaft unit, which comprises a shaft delivery tube in fluid
communication with a distal end of the solid-liquid composition
delivery tube. [0186] Inventive concept 111. The apparatus
according to inventive concept 110, wherein the shaft delivery tube
is more rigid than at least a portion of the solid-liquid
composition delivery tube. [0187] Inventive concept 112. The
apparatus according to inventive concept 110, wherein the shaft
unit further comprises a removable depth limiting element, which is
configured to limit a depth of insertion of the shaft delivery tube
into a bore through a bone when the shaft delivery tube is inserted
into the bore. [0188] Inventive concept 113. The apparatus
according to inventive concept 112,
[0189] wherein the shaft unit comprises a shaft delivery tube,
[0190] wherein the shaft unit further comprises a sealing element
disposed around an external surface of the shaft delivery tube,
and
[0191] wherein the depth limiting element is removable from the
shaft unit without removal of the sealing element. [0192] Inventive
concept 114. The apparatus according to inventive concept 113,
wherein a distal end of the shaft delivery tube is disposed more
distally than the sealing element by a distance of between 0 and 20
mm. [0193] Inventive concept 115. The apparatus according to
inventive concept 114, wherein the distance is between 3 and 15 mm.
[0194] Inventive concept 116. The apparatus according to inventive
concept 110, wherein the shaft delivery tube is straight. [0195]
Inventive concept 117. The apparatus according to inventive concept
116, wherein, when the chamber, the solid-liquid composition
delivery tube, and the shaft unit are unconstrained, respective
central longitudinal axes of the shaft delivery tube and a proximal
longitudinal portion of the solid-liquid composition delivery tube
form an angle of between 70 and 110 degrees. [0196] Inventive
concept 118. The apparatus according to inventive concept 117,
wherein the angle is between 85 and 95 degrees. [0197] Inventive
concept 119. The apparatus according to inventive concept 116,
wherein, when the chamber, the solid-liquid composition delivery
tube, and the shaft unit are unconstrained, a central longitudinal
axis of the shaft delivery tube and a plane defined by the filter
form an angle of between 70 and 110 degrees. [0198] Inventive
concept 120. The apparatus according to inventive concept 116,
wherein, when the chamber and the solid-liquid composition delivery
tube are unconstrained, (a) a central longitudinal axis of a
proximal longitudinal portion of the solid-liquid composition
delivery tube and (b) a plane defined by the filter are parallel or
form an angle of less than 20 degrees.
[0199] There is still further provided, in accordance with an
inventive concept 121 of the present invention, apparatus for use
with solid particles and a liquid container containing a
physiological liquid solution, the apparatus comprising a pump
unit, which comprises:
[0200] (a) a mixing pump;
[0201] (b) a liquid-supply pump; and
[0202] (c) control circuitry, which is configured to repeatedly:
[0203] (i) assume a mixing activation state, in which the control
circuitry activates the mixing pump, and [0204] (ii) assume a
particle-delivery activation state,
[0205] wherein the control circuitry is configured, during each of
one or more negative-positive particle delivery cycles of the
particle-delivery activation state, to assume: [0206] a negative
particle-delivery activation sub-state, in which the control
circuitry activates the liquid-supply pump apply negative pressure
to pump in a first direction, and [0207] thereafter, a positive
particle-delivery activation sub-state, in which the control
circuitry activates the liquid-supply pump to apply positive
pressure to pump in a second direction opposite the first
direction. [0208] Inventive concept 122. The apparatus according to
inventive concept 121, wherein the solid particles are solid bone
graft particles, and wherein the apparatus is for use with the
solid bone graft particles. [0209] Inventive concept 123. The
apparatus according to inventive concept 121, wherein the control
circuitry is configured to assume the mixing activation state and
the particle-delivery activation state at the same time. [0210]
Inventive concept 124. The apparatus according to inventive concept
121, wherein the control circuitry is configured to assume the
mixing activation state and the particle-delivery activation state
at partially-overlapping times. [0211] Inventive concept 125. The
apparatus according to inventive concept 121, wherein the control
circuitry is configured to assume the mixing activation state and
the particle-delivery activation state at non-overlapping times.
[0212] Inventive concept 126. The apparatus according to inventive
concept 125, wherein the control circuitry is configured to assume
the particle-delivery activation state within 500 ms after
completing the mixing activation state. [0213] Inventive concept
127. The apparatus according to inventive concept 126, wherein the
control circuitry is configured to assume the particle-delivery
activation state within 100 ms after completing the mixing
activation state. [0214] Inventive concept 128. The apparatus
according to inventive concept 125, wherein the control circuitry
is configured to repeatedly, in alternation, (a) assume the mixing
activation state for between 100 and 1200 ms, and (b) assume the
particle-delivery activation state. [0215] Inventive concept 129.
The apparatus according to inventive concept 128, wherein the
control circuitry is configured to repeatedly, in alternation, (a)
assume the mixing activation state for between 100 and 1200 ms, and
(b) assume the particle-delivery activation state for between 150
and 3000 ms. [0216] Inventive concept 130. The apparatus according
to inventive concept 121, wherein the control circuitry is
configured to repeatedly assume the mixing activation state and the
particle-delivery activation state over a time period having a
duration of between 30 and 600 seconds. [0217] Inventive concept
131. The apparatus according to inventive concept 121, wherein the
control circuitry is configured to assume the particle-delivery
activation state in a plurality of particle-delivery-state cycles,
and to begin the particle-delivery activation state in each of the
particle-delivery-state cycles with the negative particle-delivery
activation sub-state. [0218] Inventive concept 132. The apparatus
according to inventive concept 121, wherein the control circuitry
is configured to repeatedly, in alternation, (a) assume the mixing
activation state for between 100 and 1200 ms, and (b) assume the
particle-delivery activation state. [0219] Inventive concept 133.
The apparatus according to inventive concept 121, wherein the
control circuitry is configured to provide a plurality of the
negative-positive particle delivery cycles during the
particle-delivery activation state. [0220] Inventive concept 134.
The apparatus according to inventive concept 133, wherein the
control circuitry is configured to provide up to 10 of the
negative-positive particle delivery cycles during the
particle-delivery activation state. [0221] Inventive concept 135.
The apparatus according to inventive concept 121, wherein the
control circuitry is configured to assume the negative
particle-delivery activation sub-state for between 25 and 300 ms
during each of the one or more negative-positive particle delivery
cycles. [0222] Inventive concept 136. The apparatus according to
inventive concept 135, wherein the control circuitry is configured
to assume the negative particle-delivery activation sub-state for
between 25 and 100 ms during each of the one or more
negative-positive particle delivery cycles [0223] 137. The
apparatus according to inventive concept 121, wherein the control
circuitry is configured to assume the positive particle-delivery
activation sub-state for between 25 and 300 ms during each of the
one or more negative-positive particle delivery cycles. [0224]
Inventive concept 138. The apparatus according to inventive concept
137, wherein the control circuitry is configured to assume the
positive particle-delivery activation sub-state for between 25 and
100 ms during each of the one or more negative-positive particle
delivery cycles. [0225] Inventive concept 139. The apparatus
according to inventive concept 121, wherein the control circuitry
is configured to assume the negative particle-delivery activation
sub-state for between 25 and 300 ms during each of the one or more
negative-positive particle delivery cycles, and to assume the
positive particle-delivery activation sub-state for between 25 and
300 ms during each of the one or more negative-positive particle
delivery cycles. [0226] Inventive concept 140. The apparatus
according to inventive concept 121, wherein the control circuitry
is configured to assume the negative particle-delivery activation
sub-state for a first duration during each of the one or more
negative-positive particle delivery cycles, and to assume the
positive particle-delivery activation sub-state for a second
duration during each of the one or more negative-positive particle
delivery cycles, the second duration equal to between 80% and 120%
of the first duration. [0227] Inventive concept 141. The apparatus
according to inventive concept 121,
[0228] wherein the liquid-supply pump is a liquid-supply
peristaltic pump, which comprises a rotor,
[0229] wherein the liquid-supply peristaltic pump is capable of (a)
pumping fluid at an average rate throughout a full 360-degree
revolution of the rotor at a certain speed, and (b) pumping fluid
at a maximum rate during portions of the full 360-degree revolution
at the certain speed, the maximum rate greater than the average
rate, and
[0230] wherein the control circuitry is configured, when in both
the positive and the negative particle-delivery activation
sub-states, to activate the liquid-supply peristaltic pump to (a)
rotate the rotor, at the certain speed, a partial revolution equal
to a fraction of the full 360-degree revolution of the rotor, the
fraction less than 1, and (b) pump, throughout the partial
revolution, the fluid at the maximum rate. [0231] Inventive concept
142. The apparatus according to inventive concept 121,
[0232] wherein the liquid-supply pump is a liquid-supply
peristaltic pump, which comprises a rotor, and
[0233] wherein the control circuitry is configured: [0234] when in
the positive particle-delivery activation sub-state, to activate
the liquid-supply peristaltic pump to rotate the rotor, in a first
rotational direction, a first partial revolution equal to a
fraction of a full 360-degree revolution of the rotor, the fraction
less than 1, and [0235] when in the negative particle-delivery
activation sub-state, to activate the liquid-supply peristaltic
pump to rotate the rotor, in a second rotational direction opposite
the first rotational direction, a second partial revolution equal
to the fraction of the full 360-degree revolution of the rotor.
[0236] Inventive concept 143. The apparatus according to inventive
concept 121, wherein the control circuitry is configured:
[0237] when in the positive particle-delivery activation sub-state,
to activate the liquid-supply pump to pump a volume of between 0.1
and 2 cc of fluid, and
[0238] when in the negative particle-delivery activation sub-state,
to activate the liquid-supply pump to pump the volume of fluid.
[0239] Inventive concept 144. The apparatus according to inventive
concept 121, wherein the control circuitry and the liquid-supply
pump are configured such that during at least a portion of the
positive particle-delivery activation sub-state, the liquid-supply
pump pumps the physiological liquid solution at a rate of at least
3 cc/sec. [0240] Inventive concept 145. The apparatus according to
inventive concept 144, wherein the rate is at least 7 cc/sec.
[0241] Inventive concept 146. The apparatus according to inventive
concept 121, wherein the control circuitry and the liquid-supply
pump are configured such that during at least a portion of the
negative particle-delivery activation sub-state, the liquid-supply
pump pumps the physiological liquid solution at a rate of at least
3 cc/sec. [0242] Inventive concept 147. The apparatus according to
inventive concept 146, wherein the rate is at least 7 cc/sec.
[0243] Inventive concept 148. The apparatus according to inventive
concept 121, wherein the control circuitry and the mixing pump are
configured such that during at least a portion of the mixing
activation state the mixing pump pumps the physiological liquid
solution at a rate or at least 3 cc/sec. [0244] Inventive concept
149. The apparatus according to inventive concept 148, wherein the
rate is at least 7 cc/sec. [0245] Inventive concept 150. The
apparatus according to inventive concept 121, wherein the control
circuitry and the mixing pump are configured such that throughout
the mixing activation state the mixing pump pumps between 0.5 and 9
cc of the physiological liquid solution. [0246] Inventive concept
151. The apparatus according to inventive concept 150, wherein the
control circuitry and the mixing pump are configured such that
throughout the mixing activation state the mixing pump pumps
between 1.8 and 3.9 cc of the physiological liquid solution. [0247]
Inventive concept 152. The apparatus according to any one of
inventive concepts 121-151,
[0248] wherein the liquid-supply pump is a liquid-supply
peristaltic pump, which comprises a rotor, and
[0249] wherein the control circuitry is configured, when in the
positive particle-delivery activation sub-state, to activate the
liquid-supply peristaltic pump to: [0250] rotate the rotor a
partial revolution equal to a fraction of a full 360-degree
revolution of the rotor, the fraction less than 1, and [0251] pump,
throughout the partial revolution, a volume of fluid that is
greater than the product of the fraction and a volume of fluid
pumpable throughout the full 360-degree revolution of the rotor.
[0252] Inventive concept 153. The apparatus according to inventive
concept 152, wherein the liquid-supply peristaltic pump further
comprises a total number of rollers equal to at least two, and
wherein the fraction is less than the quotient of 1 divided by the
total number of rollers. [0253] Inventive concept 154. The
apparatus according to inventive concept 153, wherein the fraction
is less than or equal to the quotient of 0.5 divided by the total
number of rollers. [0254] Inventive concept 155. The apparatus
according, to any one of inventive concepts 121-151, wherein the
liquid-supply pump is a liquid-supply peristaltic pump, which
comprises a rotor. [0255] Inventive concept 156. The apparatus
according to inventive concept 155, wherein the liquid-supply
peristaltic pump comprises an index sensor, which identifies a
rotational position of the rotor. [0256] Inventive concept 157. The
apparatus according to inventive concept 155, wherein the control
circuitry is configured to assume the particle-delivery activation
state a plurality of times in alternation with mixing activation
states, and to begin each of the particle-delivery activation
states with the rotor at a same rotational position. [0257]
Inventive concept 158. The apparatus according to any one of
inventive concepts 121-151, wherein the mixing pump is a mixing
peristaltic pump, which comprises a rotor. [0258] Inventive concept
159. The apparatus according to inventive concept 158, wherein the
mixing peristaltic pump comprises an index sensor, which identifies
a rotational position of the rotor. [0259] Inventive concept 160.
The apparatus according to inventive concept 158,
[0260] wherein the mixing peristaltic pump comprises a total number
of rollers equal to at least two, and
[0261] wherein the control circuitry is configured to assume the
mixing activation state a plurality of times in alternation with
particle-delivery activation states, and to begin the mixing
activation states with the rotor at respective starting rotational
positions, which are identical to one another or rotationally
offset from one another by the product of (a) 360 degrees divided
by the total number of rollers and (b) a positive integer. [0262]
Inventive concept 161. The apparatus according to inventive concept
158,
[0263] wherein the mixing peristaltic pump comprises (a) a pump
casing that is shaped so as to define a partial-circle mixing tube
channel in which the mixing tube is disposed, and (b) an odd total
number of rollers, the odd total number equal to at least one,
and
[0264] wherein the control circuitry is configured to assume the
mixing activation state a plurality of times in alternation with
particle-delivery activation states, and to begin each of the
mixing activation states with an aligned total number of the
rollers rotationally aligned with the mixing tube channel, the
aligned total number equal to more than half of the odd total
number. [0265] Inventive concept 162. The apparatus according to
inventive concept 161, wherein the odd total number equals at least
three. [0266] Inventive concept 163. The apparatus according to any
one of inventive concepts 121-151, wherein the mixing pump and the
liquid-supply pump are respective peristaltic pumps. [0267]
Inventive concept 164. The apparatus according to inventive concept
163, wherein the peristaltic pumps comprise respective rotors and
index sensors, which identify respective rotational positions of
the rotors. [0268] Inventive concept 165. The apparatus according
to inventive concept 163, wherein the control circuitry is
configured to rotate the mixing peristaltic pump rotates between
1/3 and 3 revolutions in the mixing activation state. [0269]
Inventive concept 166. The apparatus according to inventive concept
165, wherein the mixing peristaltic pump rotates one revolution
throughout the mixing activation state.
[0270] There is additionally provided, in accordance with an
inventive concept 167 of the present invention, apparatus for use
with solid particles and a physiological liquid solution, the
apparatus comprising:
[0271] a composition delivery source, which comprises: [0272] (a) a
chamber, which is shaped so as to define one or more liquid ports
and one or more solid-liquid composition ports; [0273] (b) a
solid-liquid composition delivery tube, which is fluid
communication with at least one of the one or more solid-liquid
composition ports; and [0274] (c) a mixing tube, which is in fluid
communication with at least one of the one or more liquid ports and
at least one of the one or more solid-liquid composition ports;
and
[0275] a pump unit, which comprises a mixing pump, which is
arranged to cause, in the mixing tube, flow that raises the solid
particles in a puff into the physiological liquid solution in the
chamber. [0276] Inventive concept 168. The apparatus according to
inventive concept 167, wherein the solid particles are solid bone
graft particles, and wherein the apparatus is for use with the
solid bone graft particles. [0277] Inventive concept 169. The
apparatus according to inventive concept 167,
[0278] wherein the chamber comprises a filter, which is disposed
within the chamber so as to divide the chamber into a liquid
compartment and a solid-liquid composition compartment,
[0279] wherein the one or more liquid ports are in fluid
communication with the liquid compartment, and
[0280] wherein the one or more solid-liquid composition ports are
in fluid communication with the solid-liquid composition
compartment. [0281] Inventive concept 170. The apparatus according
to inventive concept 169, further comprising the solid particles,
wherein the filter is configured to inhibit passage of the solid
particles and allow passage of the physiological liquid solution.
[0282] Inventive concept 171. The apparatus according to inventive
concept 169, for use with a liquid container,
[0283] wherein the composition delivery source further comprises a
liquid-supply tube, which is in fluid communication with at least
one of the one or more liquid ports, and is coupled in fluid
communication with an interior of the liquid solution container,
and
[0284] wherein the pump unit further comprises a liquid-supply
pump, which is arranged to cause flow in the liquid-supply
tube.
[0285] There is yet additionally provided, in accordance with an
inventive concept 172 of the present invention, a method for use
with solid particles and a liquid container containing a
physiological liquid solution, the method comprising:
[0286] providing a composition delivery source, which comprises (a)
a chamber, which (i) comprises a filter, which is disposed within
the chamber so as to divide the chamber into a liquid compartment
and a solid-liquid composition compartment, and (ii) is shaped so
as to define (A) one or more liquid ports in fluid communication
with the liquid compartment, and (B) one or more solid-liquid
composition ports in fluid communication with the solid-liquid
composition compartment; (b) a solid-liquid composition delivery
tube, which is in fluid communication with at least one of the one
or more solid-liquid composition ports; (c) a mixing tube, which is
in fluid communication with at least one of the one or more liquid
ports and at least one of the one or more solid-liquid composition
ports; and (d) a liquid-supply tube, which is in fluid
communication with at least one of the one or more liquid ports,
and is coupled in fluid communication with an interior of the
liquid solution container;
[0287] providing a pump unit, which comprises (a) a mixing pump,
which is arranged to cause flow in the mixing tube; and (b) a
liquid-supply pump, which is arranged to cause flow in the
liquid-supply tube;
[0288] inserting, from a first side of a maxillary bone of a jaw, a
shaft delivery tube of a shaft unit into a bore that passes through
the maxillary bone from the first side to a second side of the
maxillary bone, such that a distal opening of the shaft delivery
tube is disposed in the bore or in a cavity that is (a) adjacent to
the second side of the maxillary bone and (b) between the second
side of the maxillary bone and a Schneiderian membrane, wherein the
distal opening is in fluid communication with the delivery tube,
and the shaft delivery tube is in fluid communication with a distal
end of the solid-liquid composition delivery tube; and
[0289] activating the pump unit to: [0290] provide a solid-liquid
composition of (a) the solid particles and (b) the physiological
liquid solution, and [0291] injecting the solid-liquid composition
through the distal opening via the shaft delivery tube and the
solid-liquid composition delivery tube. [0292] Inventive concept
173. The method according to inventive concept 172, wherein the
solid particles are solid bone graft particles, and wherein
activating the pump unit to provide the solid-liquid composition
comprises activating the pump unit to provide the solid-liquid
composition of (a) the solid bone graft particles and (b) the
physiological liquid solution. [0293] Inventive concept 174. The
method according to inventive concept 172, further comprising
raising the Schneiderian membrane to form the cavity. [0294]
Inventive concept 175. The method according to inventive concept
174,
[0295] wherein inserting the shaft delivery tube comprises
positioning the distal opening at a
solid-liquid-composition-delivery location,
[0296] wherein raising the Schneiderian membrane comprises: [0297]
positioning the distal opening at a liquid-delivery location that
is within the bore or within 1 mm above the bore; and [0298] while
the distal opening is positioned at the liquid-delivery location,
injecting the physiological liquid solution to raise the
Schneiderian membrane, and
[0299] wherein positioning the distal opening at the
solid-liquid-composition-delivery location comprises positioning
the distal opening at the solid-liquid-composition-delivery
location after finishing injecting the physiological liquid
solution to raise the Schneiderian membrane. [0300] Inventive
concept 176. The method according to inventive concept 175,
[0301] wherein positioning the distal opening at the
liquid-delivery location comprises positioning the distal opening
at the liquid-delivery location while a removable depth limiting
element is attached to the shaft delivery tube, wherein the
removable depth limiting element limits advancement of the shaft
delivery tube through the bore, and
[0302] wherein positioning the distal opening at the
solid-liquid-composition-delivery location comprises removing the
depth limiting element from the shaft delivery tube, and
subsequently advancing the shaft delivery tube through the bore
until the distal opening reaches the
solid-liquid-composition-delivery location. [0303] Inventive
concept 177. The method according to inventive concept 172, wherein
activating the pump unit comprises activating control circuitry of
the pump unit to repeatedly:
[0304] (a) assume a mixing activation state, in which the control
circuitry activates the mixing pump to mix the solid particles and
the physiological liquid solution in the solid-liquid composition
compartment to form a solid-liquid composition, by pumping the
physiological liquid solution through the mixing tube and into the
solid-liquid composition compartment, and
[0305] (b) assume a particle-delivery activation state, wherein the
control circuitry, during at least a portion of the
particle-delivery activation state, activates the liquid-supply
pump to apply positive pressure to pump the solid-liquid
composition from the solid-liquid composition compartment into the
solid-liquid composition delivery tube. [0306] Inventive concept
178. The method according to inventive concept 177, wherein
activating the control circuitry comprises activating the control
circuitry, during each of one or more negative-positive particle
delivery cycles of the particle-delivery activation state, to
assume:
[0307] a negative particle-delivery activation sub-state, in which
the control circuitry activates the liquid-supply pump to apply
negative pressure to pump liquid from the solid-liquid composition
delivery tube toward the liquid compartment via the solid-liquid
composition compartment, and
[0308] a positive particle-delivery activation sub-state, in which
the control circuitry activates the liquid-supply pump to apply the
positive pressure to pump the solid-liquid composition from the
solid-liquid composition compartment into the solid-liquid
composition delivery tube, wherein a direction of pumping of the
liquid-supply pump in the positive particle-delivery activation
sub-state is opposite a direction of pumping of the liquid-supply
pump in the negative particle-delivery activation sub-state. [0309]
Inventive concept 179. The method according to inventive concept
172,
[0310] wherein the chamber comprises a receptacle component and a
cover component,
[0311] wherein the cover component (a) comprises the filter, and
(b) is shaped so as to define (i) a cap and (ii) a bone-graft
container having an opening that (x) faces away from the cap and
(y) is farther from the cap than the filter is from the cap,
and
[0312] wherein providing the composition delivery source comprises,
while the bone-graft container contains the solid particles,
reversibly coupling the receptacle component and the cover
component with each another to form a watertight seal, with the
bone-graft container disposed within the receptacle component.
[0313] Inventive concept 180. The method according to inventive
concept 172, wherein the mixing pump and the liquid-supply pump are
respective peristaltic pumps.
[0314] There is also provided, in accordance with an inventive
concept 181 of the present invention, a method for use with solid
particles and a liquid container containing a physiological liquid
solution, the method comprising:
[0315] providing a composition delivery source, which comprises (a)
a chamber, which (i) comprises a filter, which is disposed within
the chamber so as to divide the chamber into a liquid compartment
and a solid-liquid composition compartment, and (ii) is shaped so
as to define (A) one or more liquid ports in fluid communication
with the liquid compartment, and (B) one or more solid-liquid
composition ports in fluid communication with the solid-liquid
composition compartment; (b) a solid-liquid composition delivery
tube, which is in fluid communication with at least one of the one
or more solid-liquid composition ports; (c) a mixing tube, which is
in fluid communication with at least one of the one or more liquid
ports and at least one of the one or more solid-liquid composition
ports; and (d) a liquid-supply tube, which is in fluid
communication with at least one of the one or more liquid ports,
and is coupled in fluid communication with an interior of the
liquid solution container;
[0316] inserting, from a first side of a maxillary bone of a jaw, a
shaft delivery tube of a shaft unit into a bore that passes through
the maxillary bone from the first side to a second side of the
maxillary bone, such that a distal opening of the shaft delivery
tube is disposed in the bore or in a cavity that is (a) adjacent to
the second side of the maxillary bone and (b) between the second
side of the maxillary bone and a Schneiderian membrane, wherein the
distal opening is in fluid communication with the delivery tube,
and the shaft delivery tube is in fluid communication with a distal
end of the solid-liquid composition delivery tube;
[0317] providing a solid-liquid composition of (a) the solid
particles and (b) the physiological liquid solution from
composition delivery source; and
[0318] injecting the solid-liquid composition through the distal
opening via the shaft delivery tube and the solid-liquid
composition delivery tube. [0319] Inventive concept 182. The method
according to inventive concept 181, wherein the solid particles are
solid bone graft particles, and wherein providing the solid-liquid
composition comprises providing the solid-liquid composition of (a)
the solid bone graft particles and (b) the physiological liquid
solution. [0320] Inventive concept 183. The method according to
inventive concept 181, wherein providing the composition delivery
source comprises orienting the chamber such that the liquid
compartment is above the solid-liquid composition compartment.
[0321] Inventive concept 184. The method according to inventive
concept 183, wherein when the chamber is oriented such that the
liquid compartment is above the solid-liquid composition
compartment, the one or more solid-liquid composition ports are
disposed no more than a distance from a bottom of the solid-liquid
composition compartment, the distance equal to 25% of a vertical
height of the solid-liquid composition compartment. [0322]
Inventive concept 185. The method according to inventive concept
183, wherein when the chamber is oriented such that the liquid
compartment is above the solid-liquid composition compartment, the
one or more solid-liquid composition ports are located through a
side wall of the solid-liquid composition compartment. [0323]
Inventive concept 186. The method according to inventive concept
181, wherein injecting the solid-liquid composition comprises
orienting the solid-liquid composition delivery tube within 45
degrees of horizontal. [0324] Inventive concept 187. The method
according to inventive concept 186, wherein orienting comprises
orienting the solid-liquid composition delivery tube within 15
degrees of horizontal. [0325] Inventive concept 188. The method
according to inventive concept 181,
[0326] wherein the chamber comprises a receptacle component and a
cover component,
[0327] wherein the cover component (a) comprises the filter, and
(b) is shaped so as to define (i) a cap and (ii) a bone-graft
container having an opening that (x) faces away from the cap and
(y) is farther from the cap than the filter is from the cap,
and
[0328] wherein providing the composition delivery source comprises,
while the bone-graft container contains the solid particles,
reversibly coupling the receptacle component and the cover
component with each another to form a watertight seal, with the
bone-graft container disposed within the receptacle component.
[0329] Inventive concept 189. The method according to inventive
concept 181, wherein the shaft unit further comprises a removable
depth limiting element, which is configured to limit a depth of
insertion of the shaft delivery tube into the bore when the shaft
delivery tube is inserted into the bore. [0330] Inventive concept
190. The method according to inventive concept 189,
[0331] wherein the shaft unit comprises a shaft delivery tube,
[0332] wherein the shaft unit further comprises a sealing element
disposed around an external surface of the shaft delivery tube,
and
[0333] wherein the depth limiting element is removable from the
shaft unit without removal of the sealing element.
[0334] There is further provided, in accordance with an inventive
concept 191 of the present invention, a method for use with solid
particles and a physiological liquid solution, the method
comprising:
[0335] providing a composition delivery source, which comprises:
[0336] (a) a chamber, which is shaped so as to define one or more
liquid ports and one or more solid-liquid composition ports; [0337]
(b) a solid-liquid composition delivery tube, which is in fluid
communication with at least one of the one or more solid-liquid
composition ports; and [0338] (c) a mixing tube, which is in fluid
communication with at least one of the one or more liquid ports and
at least one of the one or more solid-liquid composition ports;
and
[0339] activating a pump unit, which comprises a mixing pump, to
cause, in the mixing tube, flow that raises the solid particles in
a puff into the physiological liquid solution in the chamber,
thereby forming a solid-liquid composition. [0340] Inventive
concept 192. The method according to inventive concept 191, wherein
the solid particles are solid bone graft particles, and wherein
activating the pump unit comprises activating the pump unit to
cause, in the mixing tube, the flow that raises the solid bone
graft particles in the puff. [0341] Inventive concept 193. The
method according to inventive concept 191,
[0342] wherein the chamber comprises a filter, which is disposed
within the chamber so as to divide the chamber into a liquid
compartment and a solid-liquid composition compartment,
[0343] wherein the one or more liquid ports are in fluid
communication with the liquid compartment, and
[0344] wherein the one or more solid-liquid composition ports are
in fluid communication with the solid-liquid composition
compartment. [0345] Inventive concept 194. The method according to
inventive concept 193, wherein the filter is configured to inhibit
passage of the solid particles and allow passage of the
physiological liquid solution. [0346] Inventive concept 195. The
method according to inventive concept 193, for use with a liquid
container,
[0347] wherein the composition delivery source further comprises a
liquid-supply tube, which is in fluid communication with at least
one of the one or more liquid ports, and is coupled in fluid
communication with an interior of the liquid solution container,
and
[0348] wherein the pump unit further comprises a liquid-supply
pump, which is arranged to cause flow in the liquid-supply tube.
[0349] Inventive concept 196. The method according to inventive
concept 193, wherein providing the composition delivery source
comprises orienting the chamber such that the liquid compartment is
above the solid-liquid composition compartment. [0350] Inventive
concept 197. The method according to inventive concept 196, wherein
when the chamber is oriented such that the liquid compartment is
above the solid-liquid composition compartment, the one or more
solid-liquid composition ports are disposed no more than a distance
from a bottom of the solid-liquid composition compartment, the
distance equal to of a vertical height of the solid-liquid
composition compartment. [0351] Inventive concept 198. The method
according to inventive concept 196, wherein when the chamber is
oriented such that the liquid compartment is above the solid-liquid
composition compartment, the one or more solid-liquid composition
ports are located through a side wall of the solid-liquid
composition compartment. [0352] Inventive concept 199. The method
according to inventive concept 191, further comprising activating
the pump unit to pump the solid-liquid composition through the
solid-liquid composition delivery tube. [0353] Inventive concept
200. The method according to inventive concept 199, wherein
activating the pump unit to pump the solid-liquid composition
through the solid-liquid composition delivery tube comprises
orienting the solid-liquid composition delivery tube within 45
degrees of horizontal. [0354] Inventive concept 201. The method
according to inventive concept 200, wherein orienting comprises
orienting the solid-liquid composition delivery tube within 15
degrees of horizontal.
[0355] There is still further provided, in accordance with an
inventive concept 202 of the present invention, a method
comprising:
[0356] inserting, from a first side of a maxillary bone of a jaw, a
shaft delivery tube of a shaft unit of a injection system into a
bore that passes through the maxillary bone from the first side to
a second side of the maxillary bone, such that a distal opening of
the shaft delivery tube is disposed in a cavity that is (a)
adjacent to the second side of the maxillary bone and (b) between
the second side of the maxillary bone and a Schneiderian membrane,
wherein the distal opening is in fluid communication with the shaft
delivery tube;
[0357] positioning the distal opening at a location at a distance
from the second side of the maxillary bone, the distance equal to
at least 50% of a height of the cavity directly above the bore;
[0358] providing a solid-liquid composition of (a) solid particles
and (b) a physiological liquid solution from a solid-liquid
composition source that is coupled in fluid communication with the
shaft delivery tube; and
[0359] while the distal opening is positioned at the location,
injecting the solid-liquid composition through the distal opening
via the shaft delivery tube. [0360] Inventive concept 203. The
method according to inventive concept 202, wherein the solid
particles are solid bone graft particles, and wherein providing the
solid-liquid composition comprises providing the solid-liquid
composition of (a) the solid bone graft particles and (b) the
physiological liquid solution. [0361] Inventive concept 204. The
method according to inventive concept 202, wherein the distance is
equal to at least 75% of the height of the cavity directly above
the bore. [0362] Inventive concept 205. The method according to
inventive concept 202, wherein the distal opening of the shaft
delivery tube is disposed within 10 mm of a distal end of the shaft
delivery tube. [0363] Inventive concept 206. The method according
to inventive concept 202, further comprising raising the
Schneiderian membrane to form the cavity. [0364] Inventive concept
207. The method according to inventive concept 206,
[0365] wherein positioning the distal opening at the location
comprises positioning the distal opening at a
solid-liquid-composition-delivery location,
[0366] wherein raising the Schneiderian membrane comprises: [0367]
positioning the distal opening at a liquid-delivery location that
is within the bore or within 1 mm above the bore; and [0368] while
the distal opening is positioned at the liquid-delivery location,
injecting the physiological liquid solution to raise the
Schneiderian membrane, and
[0369] wherein positioning the distal opening at the
solid-liquid-composition-delivery location comprises positioning
the distal opening at the solid-liquid-composition-delivery
location after finishing injecting the physiological liquid
solution to raise the Schneiderian membrane. [0370] Inventive
concept 208. The method according to inventive concept 207,
[0371] wherein positioning the distal opening at the
liquid-delivery location comprises positioning the distal opening
at the liquid-delivery location while a removable depth limiting
element is attached to the shaft delivery tube, wherein the
removable depth limiting element limits advancement of the shaft
delivery tube through the bore, and
[0372] wherein positioning the distal opening at the
solid-liquid-composition-delivery location comprises removing the
depth limiting element from the shaft delivery tube, and
subsequently advancing the shaft delivery tube through the bore
until the distal opening reaches the
solid-liquid-composition-delivery location. [0373] Inventive
concept 209. The method according to inventive concept 208,
[0374] wherein the shaft unit further comprises a sealing element
disposed around an external surface of the shaft delivery tube,
and
[0375] wherein removing the depth limiting element from the shaft
delivery tube comprises removing the depth limiting element from
the shaft delivery tube without removing the sealing element.
[0376] Inventive concept 210. The method according to inventive
concept 202, wherein positioning the distal opening comprises
positioning the distal opening at between 2 and 12 mm from the
Schneiderian membrane at a roof of the cavity directly above the
bore. [0377] Inventive concept 211. The method according to
inventive concept 210, wherein positioning the distal opening
comprises positioning the distal opening at between 4 and 6 mm from
the Schneiderian membrane at the roof of the cavity directly above
the bore. [0378] Inventive concept 212. The method according to
inventive concept 202, wherein the distal opening is disposed at
the distal end of the shaft delivery tube, and wherein positioning
the distal opening comprises positioning the distal end of the
shaft delivery tube at the location. [0379] Inventive concept 213.
The method according to inventive concept 202, wherein raising the
Schneiderian membrane comprises injecting physiological solution
through the shaft delivery tube after inserting the shaft delivery
tube into the bore. [0380] Inventive concept 214. The method
according to inventive concept 202, wherein injecting the
solid-liquid composition comprises pumping the solid-liquid
composition through the distal opening via the shaft delivery tube
at a pulsating hydraulic pressure that periodically varies between
positive and negative.
[0381] There is additionally provided, in accordance with an
inventive concept 215 of the present invention, a surgical tool for
use with solid particles and a physiological liquid solution, the
surgical tool comprising:
[0382] a shaft unit, which is shaped so as to define a delivery
lumen, and a distal opening, which is disposed within 10 mm of a
distal end of the shaft unit, in fluid communication with the
delivery lumen;
[0383] a composition source, which is coupled in fluid
communication with the delivery lumen, and which is configured to
provide a solid-liquid composition of the solid particles and the
physiological liquid solution; and
[0384] a pump, which is configured to pump the solid-liquid
composition through the distal opening via the delivery lumen.
[0385] Inventive concept 216. The apparatus according to inventive
concept 215, wherein the surgical tool is configured as an oral
surgical tool. [0386] Inventive concept 217. The apparatus
according to inventive concept 215, further comprising the
physiological liquid solution. [0387] Inventive concept 218. The
apparatus according to inventive concept 215, wherein the pump is
configured to pump the solid-liquid composition at a pulsating
hydraulic pressure that periodically varies between positive and
negative. [0388] Inventive concept 219. The apparatus according to
inventive concept 218, wherein the pump is configured to pump the
solid-liquid composition through the distal opening via the
delivery lumen during a plurality of positive-pressure periods that
alternate with a plurality of negative-pressure periods, and to set
an average duration of the positive-pressure periods to be less
than or equal to an average duration of the negative-pressure
periods. [0389] Inventive concept 220. The apparatus according to
inventive concept 219, wherein the pump is configured to set the
average duration of the positive-pressure periods to be equal to
the average duration of the negative-pressure periods. [0390]
Inventive concept 221. The apparatus according to inventive concept
215, wherein the pump is configured to pump the solid-liquid
composition at a pulsating positive hydraulic pressure. [0391]
Inventive concept 222. The apparatus according to inventive concept
215, wherein the distal opening is disposed within 5 mm of the
distal end of the shaft unit. [0392] Inventive concept 223. The
apparatus according to inventive concept 222, wherein the distal
opening is disposed at the distal end of the shaft unit. [0393]
Inventive concept 224. The apparatus according to inventive concept
215, wherein the shaft unit comprises a nozzle disposed at the
distal opening. [0394] Inventive concept 225. The apparatus
according to inventive concept 215, wherein the surgical tool
further comprises a sealing element disposed around an external
surface of the shaft unit, and configured to form a liquid-tight
seal with tissue around and outside a bore through a bone when the
shaft unit is inserted into the bore. [0395] Inventive concept 226.
The apparatus according to inventive concept 225, wherein the
distal end of the shaft unit is disposed no more distal than a
distal-most surface of the sealing element. [0396] Inventive
concept 227. The apparatus according to inventive concept 215,
wherein the surgical tool further comprises a depth limiting
element, which is configured to limit a depth of insertion of the
shaft unit into a bore through a bone when the shaft unit is
inserted into the bore. [0397] Inventive concept 228. The apparatus
according to any one of inventive concepts 215-227, wherein the
composition source comprises a combining unit, which is configured
to provide the solid-liquid composition by combining the solid
particles with the physiological liquid solution. [0398] Inventive
concept 229. The apparatus according to inventive concept 228,
wherein the combining unit comprises a mixing unit, which is
configured to provide the solid-liquid composition by mixing the
solid particles with the physiological liquid solution. [0399]
Inventive concept 230. The apparatus according to any one of
inventive concepts 215-227, wherein the surgical tool further
comprises a solid-particle container, which contains the solid
particles for combining with the physiological liquid solution.
[0400] Inventive concept 231. The apparatus according to inventive
concept 230, wherein the solid-particle container has a volume of
between 0.2 and 20 ml. [0401] Inventive concept 232. The apparatus
according to inventive concept 230, wherein the surgical tool
further comprises the physiological liquid solution. [0402]
Inventive concept 233. The apparatus according to any one of
inventive concepts 215-227, wherein the solid particles are solid
bone graft particles, and wherein the surgical tool is for use with
the solid bone graft particles.
[0403] There is yet additionally provided, in accordance with an
inventive concept 234 of the present invention, a method
comprising:
[0404] inserting, from a first side of a bone, a shaft unit of a
surgical tool into a bore that passes through the bone from the
first side to a second side of the bone, such that a distal opening
disposed within 10 mm of a distal end of the shaft unit is disposed
in the bore or in a cavity adjacent to the second side of the bone,
wherein the distal opening is in fluid communication with a
delivery lumen defined by the shaft unit;
[0405] providing a solid-liquid composition of (a) solid particles
and (b) a physiological liquid solution from a solid-liquid
composition source that is coupled in fluid communication with the
delivery lumen; and
[0406] pumping the solid-liquid composition through the distal
opening via the delivery lumen. [0407] Inventive concept 235. The
method according to inventive concept 234, wherein the solid
particles are solid bone graft particles, and wherein providing the
solid-liquid composition comprises providing the solid-liquid
composition of (a) the solid bone graft particles and (b) the
physiological liquid solution. [0408] Inventive concept 236. The
method according to inventive concept 234, wherein pumping
comprises pumping at a pulsating hydraulic pressure that
periodically varies between positive and negative. [0409] Inventive
concept 237. The method according to inventive concept 236, wherein
pumping comprises pumping the solid-liquid composition through the
distal opening via the delivery lumen during a plurality of
positive-pressure periods that alternate with a plurality of
negative-pressure periods, and setting an average duration of the
positive-pressure periods to be less than an average duration of
the negative-pressure periods. [0410] Inventive concept 238. The
method according to inventive concept 236, wherein pumping
comprises pumping the solid-liquid composition at a pulsating
positive hydraulic pressure. [0411] Inventive concept 239. The
method according to inventive concept 234, wherein the surgical
tool is configured as an oral surgical tool, wherein the bone is a
bone of a jaw, and wherein inserting comprises inserting the shaft
unit of the oral surgical tool into the bore that passes through
the bone of the jaw. [0412] Inventive concept 240. The method
according to inventive concept 234, wherein the cavity is between
the second side of the bone and a membrane. [0413] Inventive
concept 241. The method according to inventive concept 240, further
comprising, before pumping the solid-liquid composition, raising
the membrane to form the cavity between the second side of the bone
and the membrane. [0414] Inventive concept 242. The method
according to inventive concept 241,
[0415] wherein the membrane is a Schneiderian membrane, and the
bone is a maxillary bone,
[0416] wherein inserting the shaft unit comprises positioning the
distal opening at a location at a distance front the second side of
the maxillary bone, the distance equal to at least 50% of a height
of the cavity directly above the bore, and
[0417] wherein pumping comprises pumping while the distal opening
is positioned at the location. [0418] Inventive concept 243. The
method according to inventive concept 242, wherein the distance is
equal to at least 75% of the height of the cavity directly above
the bore. [0419] Inventive concept 244. The method according to
inventive concept 242, wherein positioning the distal opening
comprises positioning the distal opening at between 2 and 12 mm
from the Schneiderian membrane at a roof of the cavity directly
above the bore. [0420] Inventive concept 245. The method according
to inventive concept 244, wherein positioning the distal opening
comprises positioning the distal opening at between 4 and 6 mm from
the Schneiderian membrane at the roof of the cavity directly above
the bore. [0421] Inventive concept 246. The method according to
inventive concept 242, wherein the distal opening is disposed at
the distal end of the shaft unit, and wherein positioning the
distal opening comprises positioning the distal end of the shaft
unit at the location. [0422] Inventive concept 247. The method
according to inventive concept 242, wherein raising the
Schneiderian membrane comprises injecting physiological solution
through the delivery lumen after inserting the shaft unit into the
bore. [0423] Inventive concept 248. The method according to
inventive concept 241,
[0424] wherein the membrane is a Schneiderian membrane, and the
bone is a maxillary bone, and
[0425] wherein inserting the shall unit comprises positioning the
distal opening at a location at a distance of between 2 and 12 mm
from the Schneiderian membrane at a roof of the cavity directly
above the bore. [0426] Inventive concept 249. The method according
to inventive concept 248, wherein positioning the distal opening
comprises positioning the distal opening at between 4 and 6 mm from
the Schneiderian membrane at the roof of the cavity directly above
the bore. [0427] Inventive concept 250. The method according to
inventive concept 248, wherein the distal opening is disposed at
the distal end of the shaft unit, and wherein positioning the
distal opening comprises positioning the distal end of the shaft
unit at the location. [0428] Inventive concept 251. The method
according to inventive concept 248, wherein raising the
Schneiderian membrane comprises injecting physiological solution
through the delivery lumen after inserting the shaft unit into the
bore. [0429] Inventive concept 252. The method according to
inventive concept 240, wherein the membrane is a Schneiderian
membrane. [0430] Inventive concept 253. The method according to
inventive concept 234, wherein the bore is exactly one bore through
the bone. [0431] Inventive concept 254. The method according to
inventive concept 234, further comprising, after pumping the
solid-liquid composition, implanting an implant at least partially
within the cavity. [0432] Inventive concept 255. The method
according to inventive concept 234, wherein the distal opening is
disposed within 5 mm of the distal end of the shaft unit. [0433]
Inventive concept 256. The method according to inventive concept
255, wherein the distal opening is disposed at the distal end of
the shaft unit. [0434] Inventive concept 257. The method according
to inventive concept 234, wherein providing the solid-liquid
composition and pumping the solid-liquid composition comprises
providing the solid-liquid composition and injecting the
solid-liquid composition such that between 0.2 and 20 ml of solid
particles accumulate in the cavity. [0435] Inventive concept 258.
The method according to inventive concept 234, wherein the
solid-liquid composition source comprises a combining unit, and
wherein providing the solid-liquid composition comprises activating
the combining unit to provide the solid-liquid composition by
combining the solid particles with the physiological liquid
solution. [0436] Inventive concept 259. The method according to
inventive concept 258, wherein the combining unit comprises a
mixing unit, and wherein providing the solid-liquid composition
comprises activating the mixing unit to provide the solid-liquid
composition by mixing the solid particles with the physiological
liquid solution.
[0437] There is also provided, in accordance with an inventive
concept 260 of the present invention, apparatus comprising a
surgical tool for use with solid particles and a physiological
liquid solution, the surgical tool comprising:
[0438] exactly one shaft unit, which is shaped so as to define a
delivery lumen and a drainage lumen;
[0439] a distal opening, which is disposed within 10 mm of a distal
end of the shaft unit, in fluid communication with the delivery
lumen;
[0440] a composition source, which is coupled in fluid
communication with the delivery lumen, and which is configured to
provide a solid-liquid composition of the solid particles and the
physiological liquid solution; and
[0441] a filter, which is disposed in fluid communication with the
drainage lumen, and which is configured to inhibit passage of the
solid particles of the solid-liquid composition and allow passage
of the physiological liquid solution of the solid-liquid
composition. [0442] Inventive concept 261. The apparatus according
to inventive concept 260, wherein the filler is disposed within 10
mm of the distal end of the shaft unit. [0443] Inventive concept
262. The apparatus according to inventive concept 260, wherein the
filter is disposed around an axis of the distal opening. [0444]
Inventive concept 263. The apparatus according to inventive concept
260, wherein the drainage lumen is disposed alongside the delivery
lumen in the shaft unit. [0445] Inventive concept 264. The
apparatus according to inventive concept 260, wherein the filter is
disposed around the delivery lumen in the shaft unit. [0446]
Inventive concept 265. The apparatus according to inventive concept
260, further comprising a pump, which is configured to clear the
solid particles that accumulate on the filter during drainage of
the physiological liquid solution through the filter, by
periodically applying a positive pressure to the drainage lumen.
[0447] Inventive concept 266. The apparatus according to inventive
concept 260, wherein the filter comprises a mesh having openings
smaller than the solid particles. [0448] Inventive concept 267. The
apparatus according to inventive concept 260, wherein the filter is
shaped so as to define a plurality of slits having a width narrower
than the solid particles. [0449] Inventive concept 268. The
apparatus according to inventive concept 260, wherein the surgical
tool is configured to move the distal opening and the shaft unit
with respect to each other. [0450] Inventive concept 269. The
apparatus according to inventive concept 268, wherein the distal
opening comprises a nozzle. [0451] Inventive concept 270. The
apparatus according to inventive concept 268, wherein the surgical
tool further comprises a filter clearing element, which is fixed to
the distal opening, and is configured to clear the solid particles
that accumulate on the filter during drainage of the physiological
liquid solution through the filter. [0452] Inventive concept 271.
The apparatus according to inventive concept 270, wherein the
distal opening comprises a nozzle, and wherein the filter clearing
element is fixed to the nozzle. [0453] Inventive concept 272. The
apparatus according to inventive concept 268, wherein the surgical
tool is configured to rotate the distal opening and the shaft unit
with respect to each other. [0454] Inventive concept 273. The
apparatus according to inventive concept 272, wherein the surgical
tool is configured to rotate the distal opening while holding the
shaft unit rotationally immobile. [0455] Inventive concept 274. The
apparatus according to inventive concept 272, wherein the surgical
tool is configured to rotate the shaft unit while holding the
distal opening rotationally immobile. [0456] Inventive concept 275.
The apparatus according to inventive concept 272, wherein the
surgical tool further comprises a filter clearing element, which is
fixed to the distal opening, and is configured to clear the solid
particles that accumulate on the filter during drainage of the
physiological liquid solution through the filter. [0457] Inventive
concept 276. The apparatus according to inventive concept 268,
wherein the surgical tool is configured to move the distal opening
and the shaft unit side-to-side with respect to each other. [0458]
Inventive concept 277. The apparatus according to inventive concept
268, wherein the surgical tool is configured to move the distal
opening and the shaft unit axially back-and-forth with respect to
each other. [0459] Inventive concept 278. The apparatus according
to inventive concept 268, wherein the surgical tool is configured
to vibrate the distal opening and the shaft unit side-to-side with
respect to each other. [0460] Inventive concept 279. The apparatus
according to inventive concept 268, wherein the surgical tool is
configured such that flow of the solid-liquid composition causes
the distal opening and the shaft unit to move with respect to each
other. [0461] Inventive concept 280. The apparatus according to
inventive concept 268, wherein the surgical tool is configured such
that flow of the filtered physiological liquid solution causes the
distal opening and the shah unit to move with respect to each
other. [0462] Inventive concept 281. The apparatus according to
inventive concept 260, wherein the surgical tool further comprises
a filter clearing element, which is configured to clear the solid
particles that accumulate on the filter during drainage of the
physiological liquid solution through the filter. [0463] Inventive
concept 282. The apparatus according to inventive concept 281,
wherein the surgical tool is configured to move the filter clearing
element with respect to the filter. [0464] Inventive concept 283.
The apparatus according to inventive concept 282, wherein the
surgical tool is configured to rotate the filter clearing element.
[0465] Inventive concept 284. The apparatus according to inventive
concept 282, wherein the surgical tool is configured to axially
move the filler clearing element. [0466] Inventive concept 285. The
apparatus according to inventive concept 281, wherein the filter
clearing element is fixed to the distal opening. [0467] Inventive
concept 286. The apparatus according to inventive concept 285,
wherein the distal opening comprises a nozzle, and wherein the
filter clearing element is fixed to the nozzle.
[0468] There is further provided, in accordance with an inventive
concept 287 of the present invention, apparatus comprising a
surgical tool for use with solid particles and a physiological
liquid solution, the surgical tool comprising:
[0469] exactly one shaft unit, which is shaped so as to define a
delivery lumen and a drainage lumen;
[0470] a distal opening, which is disposed within 10 mm of a distal
end of the shaft unit, in fluid communication with the delivery
lumen;
[0471] a composition source, which is coupled in fluid
communication with the delivery lumen, and which is configured to
provide a solid-liquid composition of the solid particles and the
physiological liquid solution; and
[0472] a plurality of elements disposed around and outside the
delivery lumen for facilitating (a) inhibiting passage of the solid
particles of the solid-liquid composition to the drainage lumen,
and (b) allowing passage of the physiological liquid solution of
the solid-liquid composition to the drainage lumen.
[0473] There is still further provided, in accordance with an
inventive concept 288 of the present invention, apparatus
comprising a surgical tool for use with solid particles and a
physiological liquid solution, the surgical tool comprising:
[0474] exactly one shaft unit, which (a) is shaped so as to define
a drainage lumen, and (b) comprises a delivery shaft, which is
shaped so as to define (i) a delivery lumen, and (ii) a plurality
of rib elements that extend radially outward from an external
surface of the delivery shaft;
[0475] a distal opening, which is disposed within 10 mm of a distal
end of the shaft unit, in fluid communication with the delivery
lumen; and
[0476] a composition source, which is coupled in fluid
communication with the delivery lumen, and which is configured to
provide a solid-liquid composition of the solid particles and the
physiological liquid solution. [0477] Inventive concept 289. The
apparatus according to inventive concept 288, wherein the rib
elements extend an average distance of between 0.1 and 2 mm
radially outward from the external surface of the delivery shaft.
[0478] Inventive concept 290. The apparatus according to inventive
concept 288, wherein the rib elements extend longitudinally along
the external surface of the delivery shaft for an average distance
of at least 1 mm. [0479] Inventive concept 291. The apparatus
according to inventive concept 288, wherein the surgical tool
further comprises a depth limiting element, which is configured to
limit a depth of insertion of the shaft unit into a bore through a
bone when the shaft unit is inserted into the bore. [0480]
Inventive concept 292. The apparatus according to inventive concept
291, wherein the depth limiting element is removably attached to
the shaft unit. [0481] Inventive concept 293. The apparatus
according to inventive concept 291, wherein the depth limiting
element is shaped so as to define a portion of the drainage lumen
between at least a portion of an internal surface of the depth
limiting element and a portion of the external surface of the
delivery shaft. [0482] Inventive concept 294. The apparatus
according to any one of inventive concepts 260, 287, and 288,
wherein the surgical tool is configured as an oral surgical tool.
[0483] Inventive concept 295. The apparatus according to any one of
inventive concepts 260, 287, and 288, wherein the solid particles
are solid bone graft particles, and wherein the surgical tool is
for use with the solid bone graft particles. [0484] Inventive
concept 296. The apparatus according to any one of inventive
concepts 260, 287, and 288, wherein the distal opening is disposed
within 5 mm of the distal end of the shaft unit. [0485] Inventive
concept 297. The apparatus according to inventive concept 296,
wherein the distal opening is disposed at the distal end of the
shaft unit. [0486] Inventive concept 298. The apparatus according
to any one of inventive concepts 260, 287, and 288, wherein the
distal opening comprises a nozzle. [0487] Inventive concept 299.
The apparatus according to any one of inventive concepts 260, 287,
and 288, wherein the surgical tool is configured to vibrate the
solid-liquid composition in the delivery lumen. [0488] Inventive
concept 300. The apparatus according to any one of inventive
concepts 260, 287, and 288, wherein the drainage lumen is disposed
around the delivery lumen in the shaft unit. [0489] Inventive
concept 301. The apparatus according to any one of inventive
concepts 260, 287, and 288, wherein the surgical tool further
comprises a suction source, which is coupled in fluid communication
with the drainage lumen. [0490] Inventive concept 302. The
apparatus according to any one of inventive concepts 260, 287, and
288, for use with a suction source, wherein the drainage lumen is
coupleable in fluid communication with the suction source. [0491]
Inventive concept 303. The apparatus according to any one of
inventive concepts 260, 287, and 288, wherein the surgical tool
further comprises a sealing element disposed around an external
surface of the shaft unit, and configured to form a liquid-tight
seal with tissue around and outside a bore through a bone when the
shaft unit is inserted into the bore. [0492] Inventive concept 304.
The apparatus according to inventive concept 303, wherein the
distal end of the shaft unit is disposed no more distal than a
distal-most surface of the sealing element. [0493] Inventive
concept 305. The apparatus according to any one of inventive
concepts 260, 287, and 288, wherein the surgical tool further
comprises a depth limiting element, which is configured to limit a
depth of insertion of the shaft unit into a bore through a bone
when the shaft unit is inserted into the bore. [0494] Inventive
concept 306. The apparatus according to any one of inventive
concepts 260, 287, and 288, wherein the composition source
comprises a combining feeder unit, which is configured to provide
the solid-liquid composition by combining the solid particles with
the physiological liquid solution. [0495] Inventive concept 307.
The apparatus according to inventive concept 306, wherein the
combining feeder unit comprises a mixing feeder unit, which is
configured to provide the solid-liquid composition by mixing the
solid particles with the physiological liquid solution. [0496]
Inventive concept 308. The apparatus according to any one of
inventive concepts 260, 287, and 288, wherein the surgical tool is
configured to automatically apply motion to the shaft unit selected
from the group consisting of: vibrational motion, rotational
motion, oscillatory motion, axial back-and-forth motion, and
lateral side-to-side motion. [0497] Inventive concept 309. The
apparatus according to any one of inventive concepts 260, 287, and
288, further comprising a pump, which is configured to pump the
solid-liquid composition through the distal opening via the
delivery lumen. [0498] Inventive concept 310. The apparatus
according to inventive concept 309, wherein the pump is configured
to pump the solid-liquid composition at a pulsating positive
hydraulic pressure. [0499] Inventive concept 311. The apparatus
according to inventive concept 309, wherein the pump is configured
to pump the solid-liquid composition at a pulsating hydraulic
pressure that periodically varies between positive and negative.
[0500] Inventive concept 312. The apparatus according to any one of
inventive concepts 260, 287, and 288, wherein the surgical tool
further comprises a solid-particle container, which contains the
solid particles for combining with the physiological liquid
solution. [0501] Inventive concept 313. The apparatus according to
inventive concept 312, wherein the solid-particle container has a
volume of between 0.2 and 20 ml. [0502] Inventive concept 314. The
apparatus according to inventive concept 312, wherein the surgical
tool further comprises the physiological liquid solution.
[0503] There is additionally provided, in accordance with an
inventive concept 315 of the present invention, apparatus
comprising a surgical tool for use with solid particles and a
physiological liquid solution, the surgical tool comprising:
[0504] exactly one shaft unit, which is shaped so as to define a
lumen;
[0505] a distal opening, which is disposed within 10 mm of a distal
end of the shaft unit, in fluid communication with the lumen;
[0506] a composition source, which is coupled in selective fluid
communication with the lumen, and which is configured to provide a
solid-liquid composition of the solid particles and the
physiological liquid solution; and
[0507] a one-way filter, which is disposed in fluid communication
with the lumen, and which is configured to: [0508] allow passage,
in a proximal-to-distal direction, of the solid particles and the
physiological liquid solution of the solid-liquid composition,
[0509] inhibit passage, in a distal-to-proximal direction, of the
solid particles of the solid-liquid composition, and [0510] allow
passage, in the distal-to-proximal direction, of the physiological
liquid solution of the solid-liquid composition. [0511] Inventive
concept 316. The apparatus according to inventive concept 315,
wherein the surgical tool is configured as an oral surgical tool.
[0512] Inventive concept 317. The apparatus according to inventive
concept 315, wherein the solid particles are solid bone graft
particles, and wherein the surgical tool is for use with the solid
bone graft particles. [0513] Inventive concept 318. The apparatus
according to inventive concept 315, wherein the distal opening is
disposed within 5 mm of the distal end of the shaft unit. [0514]
Inventive concept 319. The apparatus according to inventive concept
318, wherein the distal opening is disposed at the distal end of
the shaft unit. [0515] Inventive concept 320. The apparatus
according to inventive concept 315, wherein the shaft unit is
shaped so as to define exactly one lumen. [0516] Inventive concept
321. The apparatus according to inventive concept 315, wherein the
one-way filter is disposed within 10 mm of the distal end of the
shaft unit. [0517] Inventive concept 322. The apparatus according
to inventive concept 315, wherein the composition source comprises
a combining feeder unit, which is configured to produce the
solid-liquid composition by combining the solid particles with the
physiological liquid solution. [0518] Inventive concept 323. The
apparatus according to inventive concept 315, wherein the distal
opening comprises a nozzle. [0519] Inventive concept 324. The
apparatus according to inventive concept 315, wherein the surgical
tool is configured to automatically apply motion to the shaft unit
selected from the group consisting of: vibrational motion,
rotational motion, oscillatory motion, axial back-and-forth motion,
and lateral side-to-side motion. [0520] Inventive concept 325. The
apparatus according to inventive concept 315, wherein the surgical
tool is configured to vibrate the solid-liquid composition in the
lumen. [0521] Inventive concept 326. The apparatus according to
inventive concept 315, wherein the surgical tool further comprises
a sealing clement disposed around an external surface of the shaft
unit, and configured to form a liquid-tight seal with tissue around
and outside a bore through a bone when the shaft unit is inserted
into the bore. [0522] Inventive concept 327. The apparatus
according to inventive concept 326, wherein the distal end of the
shaft unit is disposed no more distal than a distal-most surface of
the sealing element. [0523] Inventive concept 328. The apparatus
according to inventive concept 315, wherein the surgical tool
further comprises a depth limiting element, which is configured to
limit a depth of insertion of the shaft unit into a bore through a
bone when the shaft unit is inserted into the bore. [0524]
Inventive concept 329. The apparatus according to any one of
inventive concepts 315-328, further comprising a one-way filter
valve that comprises the one-way filter, the one-way filter valve
in fluid communication with the lumen. [0525] Inventive concept
330. The apparatus according to inventive concept 329, wherein the
one-way filter valve comprises a leaf valve, which comprises one or
more leafs that comprise mesh having openings smaller than the
solid particles. [0526] Inventive concept 331. The apparatus
according to inventive concept 329, wherein the one-way filter
valve comprises a leaf valve, which comprises one or more leafs
that are shaped so as to define a plurality of slits having a width
narrower than the solid particles. [0527] Inventive concept 332.
The apparatus according to any one of inventive concepts 315-328,
for use with a suction source, wherein the surgical tool is shaped
so as to define a suction port, and wherein the one-way filter is
in selective fluid communication with the suction source via the
suction port. [0528] Inventive concept 333. The apparatus according
to inventive concept 332, wherein the suction port is disposed at a
site along a fluid path between the one-way filter and the
composition source, and wherein the surgical tool further comprises
a source one-way valve, which is disposed along the fluid path
proximal to the site at which the suction port is disposed. [0529]
Inventive concept 334. The apparatus according to any one of
inventive concepts 315-328, wherein the surgical tool is shaped so
as to define a suction port, and wherein the apparatus further
comprises a suction source, which is in selective fluid
communication with the one-way filter via the suction port. [0530]
Inventive concept 335. The apparatus according to inventive concept
334, wherein the suction port is disposed at a site along a fluid
path between the one-way filter and the composition source, and
wherein the surgical tool further comprises a source one-way valve,
which is disposed along the fluid path proximal to the site at
which the suction port is disposed. [0531] Inventive concept 336.
The apparatus according to any one of inventive concepts 315-328,
wherein the surgical tool further comprises a filter clearing
element, which is configured to clear the solid particles that
accumulate on the one-way filter during drainage of the
physiological liquid solution through the one-way filter. [0532]
Inventive concept 337. The apparatus according to inventive concept
336, wherein the surgical tool is configured to move the filter
clearing element with respect to the one-way filter. [0533]
Inventive concept 338. The apparatus according to any one of
inventive concepts 315-328, further comprising a pump, which is
configured to pump the solid-liquid composition through the distal
opening via the lumen. [0534] Inventive concept 339. The apparatus
according to inventive concept 338, wherein the pump is configured
to pump the solid-liquid composition with an on-off duty cycle.
[0535] Inventive concept 340. The apparatus according to inventive
concept 339, for use with a suction source, wherein the surgical
tool is shaped so as to define a suction port, wherein the one-way
filter is in selective fluid communication with the suction source
via the suction port, and wherein suction port is configured to
assume an open state when the pump is off, and a closed state when
the pump is on. [0536] Inventive concept 341. The apparatus
according to inventive concept 339, wherein the surgical tool is
shaped so as to define a suction port, and wherein the apparatus
further comprises a suction source, which is in selective fluid
communication with the one-way filter via the suction port, and
which is configured to apply suction when the pump is off, and not
apply the suction when the pump is on. [0537] Inventive concept
342. The apparatus according to inventive concept 338, wherein the
pump is configured to pump the solid-liquid composition at a
pulsating positive hydraulic pressure. [0538] Inventive concept
343. The apparatus according to inventive concept 338, wherein the
pump is configured to pump the solid-liquid composition at a
pulsating hydraulic pressure that periodically varies between
positive and negative. [0539] Inventive concept 344. The apparatus
according to any one of inventive concepts 315-328, wherein the
surgical tool further comprises a solid-particle container, which
contains the solid particles for mixing with the physiological
liquid solution. [0540] Inventive concept 345. The apparatus
according to inventive concept 344, wherein the solid-particle
container has a volume of between 0.2 and 20 ml. [0541] Inventive
concept 346. The apparatus according to inventive concept 344,
wherein the surgical tool further comprises the physiological
liquid solution.
[0542] There is yet additionally provided, in accordance with an
inventive concept 347 of the present invention, apparatus
comprising an osteotome, which is shaped so as to define:
[0543] a lumen through the osteotome, a distal end of the lumen
opening through a distal opening disposed within 10 mm of a distal
end of the osteotome, and a proximal end of the lumen opening
through a proximal opening disposed at least 5 mm proximal to the
distal opening,
[0544] a lateral external surface, at least a portion of which is
shaped so as to define, a screw thread that (a) has a distal thread
end that is disposed within 10 mm of the distal end of the
osteotome, and (b) comprises one or more raised helical ribs going
around the osteotome, and
[0545] one or more longitudinal drainage slots, which extend along
at least respective longitudinal portions of the osteotome having
respective longitudinal lengths of at least 5 mm, measured parallel
to a central longitudinal axis of the osteotome. [0546] Inventive
concept 348. The apparatus according to inventive concept 347,
wherein the osteotome is configured as a dental osteotome. [0547]
Inventive concept 349. The apparatus according to inventive concept
347, wherein the longitudinal lengths of the respective
longitudinal portions are at least 8 mm. [0548] Inventive concept
350. The apparatus according to inventive concept 349, wherein the
longitudinal lengths of the respective longitudinal portions are at
least 10 mm. [0549] Inventive concept 351. The apparatus according
to inventive concept 350, wherein the longitudinal lengths of the
respective longitudinal portions are at least 12 mm. [0550]
Inventive concept 352. The apparatus according to inventive concept
347, wherein the proximal opening is disposed within 10 mm of a
proximal end of the osteotome. [0551] Inventive concept 353. The
apparatus according to inventive concept 347, wherein at least one
of the one or more longitudinal drainage slots reaches a proximal
end of the osteotome. [0552] Inventive concept 354. The apparatus
according to inventive concept 347, wherein respective distal ends
of the one or more longitudinal drainage slots are disposed at
least one pitch of the screw thread from the distal thread end.
[0553] Inventive concept 355. The apparatus according to inventive
concept 354, wherein respective distal ends of the one or more
longitudinal drainage slots are disposed at least two pitches of
the screw thread from the distal thread end. [0554] Inventive
concept 356. The apparatus according to inventive concept 347,
wherein the screw thread is multi-start. [0555] Inventive concept
357. The apparatus according to inventive concept 347, wherein the
osteotome further comprises a sealing element disposed around an
external surface of the osteotome, and configured to form a
liquid-tight seal with tissue around and outside a bore through a
bone when the osteotome is inserted into the bore. [0556] Inventive
concept 358. The apparatus according to inventive concept 347,
wherein respective distal ends of the one or more longitudinal
drainage slots are disposed at least 1.5 mm from the distal end of
the osteotome. [0557] Inventive concept 359. The apparatus
according to inventive concept 358, wherein respective distal ends
of the one or more longitudinal drainage slots are disposed at
least 4 mm from the distal end of the osteotome. [0558] Inventive
concept 360. The apparatus according to inventive concept 358,
wherein the osteotome further comprises a sealing element disposed
around an external surface of the osteotome, and configured to form
a liquid-tight seal with tissue around and outside a bore through a
bone when the osteotome is inserted into the bore. [0559] Inventive
concept 361. The apparatus according to inventive concept 347,
wherein respective average widths of the one or more longitudinal
drainage slots are no more than 2 mm. [0560] Inventive concept 362.
The apparatus according to inventive concept 347, wherein
respective average depths of the one or more longitudinal drainage
slots, measured with respect to an outermost portion of the screw
thread, are at least 10% greater than an average depth of the screw
thread. [0561] Inventive concept 363. The apparatus according to
any one of inventive concepts 347-362, wherein the one or more
longitudinal drainage slots cross the one or more ribs respective
pluralities of times. [0562] Inventive concept 364. The apparatus
according to inventive concept 363, wherein the one or more
longitudinal drainage slots comprise two or more longitudinal
drainage slots. [0563] Inventive concept 365. The apparatus
according to inventive concept 363, wherein the one or more
longitudinal drainage slots are parallel to the longitudinal axis.
[0564] Inventive concept 366. The apparatus according to inventive
concept 363, wherein the one or more longitudinal drainage slots
helically go around the osteotome in a direction opposite to a
direction of the screw thread. [0565] Inventive concept 367. The
apparatus according to inventive concept 363, wherein the one or
more longitudinal drainage slots helically go around the osteotome
with a slot pitch greater than a thread pitch of the screw thread.
[0566] Inventive concept 368. The apparatus according to inventive
concept 367, wherein the slot pitch equals at least 1.5 times the
thread pitch. [0567] Inventive concept 369. The apparatus according
to inventive concept 367, wherein the screw thread has one or more
starts, and wherein the slot pitch equals at least the quotient of
(a) 2 mm divided by (b) the number of starts of the screw thread.
[0568] Inventive concept 370. The apparatus according to any one of
inventive concepts 347-362, wherein the screw thread has one or
more starts and a corresponding number of roots, and wherein the
osteotome is shaped so as to define a number of longitudinal
drainage slots that corresponds to a number of the starts of the
screw thread, and which are disposed within the one or more roots
of the screw thread, respectively. [0569] Inventive concept 371.
The apparatus according to inventive concept 370, wherein a distal
end of the one or more longitudinal drainage slots is disposed at
least one pitch of the screw thread from the distal thread end.
[0570] Inventive concept 372. The apparatus according to inventive
concept 371, wherein the distal end of the longitudinal drainage
slot is disposed at least two pitches of the screw thread from the
distal thread end. [0571] Inventive concept 373. The apparatus
according to inventive concept 371, wherein the osteotome further
comprises a sealing element disposed around an external surface of
the osteotome, and configured to form a liquid-tight seal with
tissue around and outside a bore through a bone when the osteotome
is inserted into the bore. [0572] Inventive concept 374. The
apparatus according to any one of inventive concepts 347-362, for
use with solid particles and a physiological liquid solution, the
apparatus further comprising a composition source, which is coupled
in fluid communication with the lumen, and which is configured to
provide a solid-liquid composition of the solid particles and the
physiological liquid solution. [0573] Inventive concept 375. The
apparatus according to inventive concept 374, wherein the solid
particles are solid bone graft particles, and wherein the osteotome
is for use with the solid bone graft particles. [0574] Inventive
concept 376. The apparatus according to inventive concept 374,
wherein the composition source comprises a combining feeder unit,
which is configured to provide the solid-liquid composition by
combining the solid particles with the physiological liquid
solution. [0575] Inventive concept 377. The apparatus according to
inventive concept 376, wherein the combining feeder unit comprises
a mixing feeder unit, which is configured to provide the
solid-liquid composition by mixing the solid particles with the
physiological liquid solution.
[0576] There is also provided, in accordance with an inventive
concept 378 of the present invention, a method comprising:
[0577] inserting, from a first side of a bone, exactly one shaft
unit of a surgical tool into a bore that passes through the bone
from the first side to a second side of the bone, such that a
distal opening disposed within 10 mm of a distal end of the shaft
unit is disposed in the bore or in a cavity adjacent to the second
side of the bone, wherein the distal opening is in fluid
communication with a delivery lumen defined by the shaft unit;
[0578] providing a solid-liquid composition of solid particles and
a physiological liquid solution from a composition source that is
coupled in fluid communication with the delivery lumen; and
[0579] injecting the solid-liquid composition through the delivery
lumen and the distal opening into the cavity, such that (a) a
portion of the physiological liquid solution drains into a drainage
lumen defined by the shaft unit, and (b) passage of solid particles
of the solid-liquid composition into the drainage lumen is
inhibited, such that the solid particles accumulate in the cavity.
[0580] Inventive concept 379. The method according to inventive
concept 378, wherein injecting comprises injecting the solid-liquid
composition through the delivery lumen and the distal opening into
the cavity, such that (a) the portion of the physiological liquid
solution drains through a filter of the surgical tool and into the
drainage lumen, and (b) the filter inhibits the passage of the
solid particles into the drainage lumen. [0581] Inventive concept
380. The method according to inventive concept 379, wherein
injecting the solid-liquid composition comprises injecting the
solid-liquid composition such that at least 50% of the
physiological liquid solution drains through the filter in a
distal-to-proximal direction. [0582] Inventive concept 381. The
method according to inventive concept 379, wherein injecting
comprises injecting the solid-liquid composition through the
delivery lumen and the distal opening into the cavity, such that at
least 50% of the physiological liquid solution drains through the
filter while the solid-liquid composition is being injected. [0583]
Inventive concept 382. The method according to inventive concept
379, wherein the filter is disposed within 10 mm of the distal end
of the shaft unit. [0584] Inventive concept 383. The method
according to inventive concept 378,
[0585] wherein the exactly one shaft unit includes a delivery
shaft, which is shaped so as to define (i) the delivery lumen, and
(ii) a plurality of rib elements that extend radially outward from
an external surface of the delivery shaft,
[0586] wherein inserting the exactly one shaft unit into the bore
comprises inserting the exactly one shaft unit into the bore such
that the rib elements space the external surface of the delivery
shaft away from an inner wail of the bore, thereby defining a fluid
flow path between the external surface of the delivery shaft and
the inner wall of the bore, and
[0587] wherein injecting comprises injecting the solid-liquid
composition through the delivery lumen and the distal opening into
the cavity, such that (a) the portion of the physiological liquid
solution drains through the fluid flow path and into the drainage
lumen, and (b) passage of solid particles of the solid-liquid
composition into the fluid flow path is inhibited, such that the
solid particles accumulate in the cavity. [0588] Inventive concept
384. The method according to inventive concept 383, wherein the rib
elements extend an average distance of between 0.1 and 2 mm
radially outward from the external surface of the delivery shaft.
[0589] Inventive concept 385. The method according to inventive
concept 383, wherein the rib elements extend longitudinally along
the external surface of the delivery shaft for an average distance
of at least 1 mm. [0590] Inventive concept 386. The method
according to inventive concept 383, wherein the surgical tool
further includes a depth limiting element, which is configured to
limit a depth of insertion of the shaft unit into a bore through a
bone when the shaft unit is inserted into the bore. [0591]
Inventive concept 387. The method according to inventive concept
386, wherein the depth limiting element is removably attached to
the shaft unit. [0592] Inventive concept 388. The method according
to inventive concept 386, wherein the depth limiting element is
shaped so as to define a portion of the drainage lumen between at
least a portion of an internal surface of the depth limiting
element and a portion of the external surface of the delivery
shaft. [0593] Inventive concept 389. The method according to
inventive concept 378, wherein the solid particles are solid bone
graft particles, and wherein providing the solid-liquid composition
comprises providing the solid-liquid composition of the solid bone
graft particles and the physiological liquid solution. [0594]
Inventive concept 390. The method according to inventive concept
378, wherein the surgical tool is configured as an oral surgical
tool, wherein the bone is a bone of a jaw, and wherein inserting
comprises inserting the exactly one shaft unit of the oral surgical
tool into the bore that passes through the bone of the jaw. [0595]
Inventive concept 391. The method according to inventive concept
378, wherein the cavity is between the second side of the bone and
a membrane. [0596] Inventive concept 392. The method according to
inventive concept 391, further comprising, before injecting the
solid-liquid composition, raising the membrane to form the cavity
between the second side of the bone and the membrane. [0597]
Inventive concept 393. The method according to inventive concept
391, wherein the membrane is a Schneiderian membrane. [0598]
Inventive concept 394. The method according to inventive concept
378, wherein the bore is exactly one bore through the bone. [0599]
Inventive concept 395. The method according to inventive concept
378, further comprising, after injecting the solid-liquid
composition, implanting an implant at least partially within the
cavity. [0600] Inventive concept 396. The method according to
inventive concept 378, wherein the distal opening is disposed
within 5 mm of the distal end of the shaft unit. [0601] Inventive
concept 397. The method according to inventive concept 396, wherein
the distal opening is disposed at the distal end of the shaft unit.
[0602] Inventive concept 398. The method according to inventive
concept 378, wherein injecting the solid-liquid composition
comprises injecting 2-300 ml of the solid-liquid composition.
[0603] Inventive concept 399. The method according to inventive
concept 378, wherein providing the solid-liquid composition and
injecting the solid-liquid composition comprises providing the
solid-liquid composition and injecting the solid-liquid composition
such that between 0.2 and 20 ml of solid particles accumulate in
the cavity. [0604] Inventive concept 400. The method according to
inventive concept 378, wherein the composition source comprises a
combining feeder unit, and wherein providing the solid-liquid
composition comprises activating the combining feeder unit to
provide the solid-liquid composition by combining the solid
particles with the physiological liquid solution. [0605] Inventive
concept 401. The method according to inventive concept 400, wherein
the combining feeder unit comprises a mixing feeder unit, and
wherein providing the solid-liquid composition comprises activating
the mixing feeder unit to provide the solid-liquid composition by
mixing the solid particles with the physiological liquid
solution.
[0606] There is further provided, in accordance with an inventive
concept 402 of the present invention, a method comprising:
[0607] placing a sealing element of a surgical tool against tissue
around and outside a bore that passes through a bone from a first
side to a second side of the bone, such that: [0608] the sealing
element forms a liquid-tight seal with the tissue on the first side
of the bone, and [0609] a distal opening of the surgical tool is
disposed in fluid communication with the bore, wherein the distal
opening is in fluid communication with a delivery lumen defined by
the surgical tool;
[0610] providing a solid-liquid composition of solid particles and
a physiological liquid solution from a composition source that is
coupled in fluid communication with the delivery lumen; and
[0611] injecting the solid-liquid composition through the delivery
lumen, the distal opening, and the bore, into a cavity adjacent to
the second side of the bone, such that (a) a portion of the
physiological liquid solution drains through a filter of the
surgical tool, and (b) the filter inhibits passage of solid
particles of the solid-liquid composition such that the solid
particles accumulate in the cavity, wherein the filter is disposed
in fluid communication with a drainage lumen defined by the
surgical tool. [0612] Inventive concept 403. The method according
to inventive concept 402, wherein the solid particles are solid
bone graft particles, and wherein providing the solid-liquid
composition comprises providing the solid-liquid composition of the
solid bone graft particles and the physiological liquid solution.
[0613] Inventive concept 404. The method according to inventive
concept 402,
[0614] wherein the scaling clement disposed around an external
surface of exactly one shaft unit of the surgical tool,
[0615] wherein the distal opening disposed within 10 mm of a distal
end of the shaft unit,
[0616] wherein the delivery lumen is defined at least in part by
the shaft unit, and
[0617] wherein the drainage lumen is defined at least in part by
the shaft unit. [0618] Inventive concept 405. The method according
to inventive concept 404, wherein the distal opening is disposed
within 5 mm of the distal end of the shaft unit. [0619] Inventive
concept 406. The method according to inventive concept 405, wherein
the distal opening is disposed at the distal end of the shaft unit.
[0620] Inventive concept 407. The method according to inventive
concept 404, wherein the filter is disposed within 10 mm of the
distal end of the shaft unit. [0621] Inventive concept 408. The
method according to inventive concept 402, wherein the surgical
tool is configured as an oral surgical tool, wherein the bone is a
bone of a jaw, and wherein placing comprises placing the sealing
element against the tissue around and outside the bore the passes
through the bone of the jaw. [0622] Inventive concept 409. The
method according to inventive concept 402, wherein the cavity is
between the second side of the bone and a membrane. [0623]
Inventive concept 410. The method according to inventive concept
409, further comprising, before injecting the solid-liquid
composition, raising the membrane to form the cavity between the
second side of the bone and the membrane. [0624] Inventive concept
411. The method according to inventive concept 409, wherein the
membrane is a Schneiderian membrane. [0625] Inventive concept 412.
The method according to inventive concept 402, wherein the bore is
exactly one bore through the bone. [0626] Inventive concept 413.
The method according to inventive concept 402, further comprising,
after injecting the solid-liquid composition, implanting an implant
at least partially within the cavity. [0627] Inventive concept 414.
The method according to inventive concept 402, wherein injecting
the solid-liquid composition comprises injecting the solid-liquid
composition such that at least 50% of the physiological liquid
solution drains through the filter in a distal-to-proximal
direction. [0628] Inventive concept 415. The method according to
inventive concept 402, wherein injecting the solid-liquid
composition comprises injecting 2-300 ml of the solid-liquid
composition. [0629] Inventive concept 416. The method according to
inventive concept 402, wherein providing the solid-liquid
composition and injecting the solid-liquid composition comprises
providing the solid-liquid composition and injecting the
solid-liquid composition such that between 0.2 and 20 ml of solid
particles accumulate in the cavity. [0630] Inventive concept 417.
The method according to inventive concept 402, wherein injecting
comprises injecting the solid-liquid composition through the
delivery lumen and the distal opening into the cavity, such that at
least 50% of the physiological liquid solution drains through the
filter while the solid-liquid composition is being injected. [0631]
Inventive concept 418. The method according to inventive concept
402, wherein the composition source comprises a combining feeder
unit, and wherein providing the solid-liquid composition comprises
activating the combining feeder unit to provide the solid-liquid
composition by combining the solid particles with the physiological
liquid solution. [0632] Inventive concept 419. The method according
to inventive concept 418, wherein the combining feeder unit
comprises a mixing feeder unit, and wherein providing the
solid-liquid composition comprises activating the mixing feeder
unit to provide the solid-liquid composition by mixing the solid
particles with the physiological liquid solution.
[0633] There is still further provided, in accordance with an
inventive concept 420 of the present invention, a method
comprising:
[0634] inserting, from a first side of a bone, exactly one shaft
unit of a surgical tool into a bore that passes through the bone
from the first side to a second side of the bone, such that a
distal opening disposed within 10 mm of a distal end of the shaft
unit is disposed in the bore or in a cavity adjacent to the second
side of the bone, wherein the distal opening is in fluid
communication with a lumen defined by the shaft unit;
[0635] providing a solid-liquid composition of solid particles and
a physiological liquid solution from a composition source that is
coupled in fluid communication with the lumen; and
[0636] injecting the solid-liquid composition through the lumen, a
one-way filter of the surgical tool, and the distal opening into
the cavity, the one-way filter disposed in fluid communication with
the lumen, and configured to: [0637] allow passage, in a
proximal-to-distal direction, of the solid particles and the
physiological liquid solution of the solid-liquid composition,
[0638] inhibit passage, in a distal-to-proximal direction, of the
solid particles of the solid-liquid composition, such that the
solid particles accumulate in the cavity, and [0639] allow passage,
in the distal-to-proximal direction, of the physiological liquid
solution of the solid-liquid composition. [0640] Inventive concept
421. The method according to inventive concept 420, wherein the
solid particles are solid bone graft particles, and wherein
providing the solid-liquid composition comprises providing the
solid-liquid composition of the solid bone graft particles and the
physiological liquid solution. [0641] Inventive concept 422. The
method according to inventive concept 420, wherein the surgical
tool is configured as an oral surgical tool, wherein the bone is a
bone of a jaw, and wherein inserting comprises inserting the
exactly one shaft unit of the oral surgical tool into the bore that
passes through the bone of the jaw. [0642] Inventive concept 423.
The method according to inventive concept 420, wherein the cavity
is between the second side of the bone and a membrane. [0643]
Inventive concept 424. The method according to inventive concept
423, further comprising, before injecting the solid-liquid
composition, raising the membrane to form the cavity between the
second side of the bone and the membrane. [0644] Inventive concept
425. The method according to inventive concept 423, wherein the
membrane is a Schneiderian membrane. [0645] Inventive concept 426.
The method according to inventive concept 420, wherein the bore is
exactly one bore through the bone. [0646] Inventive concept 427.
The method according to inventive concept 420, further comprising,
after injecting the solid-liquid composition, implanting an implant
at least partially within the cavity. [0647] Inventive concept 428.
The method according to inventive concept 420, wherein the distal
opening is disposed within 5 mm of the distal end of the shaft
unit. [0648] Inventive concept 429. The method according to
inventive concept 428, wherein the distal opening is disposed at
the distal end of the shaft unit. [0649] Inventive concept 430. The
method according to inventive concept 420, further comprising
draining the physiological liquid solution of the solid-liquid
composition through the one-way filter. [0650] Inventive concept
431. The method according to inventive concept 430, wherein
injecting and draining comprise alternatingly injecting and
draining. [0651] Inventive concept 432. The method according to
inventive concept 430,
[0652] wherein injecting the solid-liquid composition comprises
pumping the solid-liquid composition at a positive hydraulic
pressure, and
[0653] wherein draining the physiological liquid solution comprises
suctioning the physiological liquid solution at a negative
hydraulic pressure. [0654] Inventive concept 433. The method
according to inventive concept 432, wherein pumping and suctioning
comprise alternatingly pumping and suctioning. [0655] Inventive
concept 434. The method according to inventive concept 420, wherein
injecting the solid-liquid composition comprises injecting the
solid-liquid composition such that at least 50% of the
physiological liquid solution drains through the one-way filter in
the distal-to-proximal direction. [0656] Inventive concept 435. The
method according to inventive concept 420, wherein injecting the
solid-liquid composition comprises injecting 2-300 ml of the
solid-liquid composition. [0657] Inventive concept 436. The method
according to inventive concept 420, wherein providing the
solid-liquid composition and injecting the solid-liquid composition
comprises providing the solid-liquid composition and injecting the
solid-liquid composition such that between 0.2 and 20 ml of solid
particles accumulate in the cavity. [0658] Inventive concept 437.
The method according to inventive concept 420, wherein the
composition source comprises a combining feeder unit, and wherein
providing the solid-liquid composition comprises activating the
combining feeder unit to provide the solid-liquid composition by
combining the solid particles with the physiological liquid
solution. [0659] Inventive concept 438. The method according to
inventive concept 437, wherein the combining feeder unit comprises
a mixing feeder unit, and wherein providing the solid-liquid
composition comprises activating the mixing feeder unit to provide
the solid-liquid composition by mixing the solid particles with the
physiological liquid solution. [0660] Inventive concept 439. The
method according to inventive concept 420, wherein the one-way
filter is disposed within 10 mm of the distal end of the shaft
unit.
[0661] There is additionally provided, in accordance with an
inventive concept 440 of the present invention, a method
comprising:
[0662] placing a sealing element of a surgical tool against tissue
around and outside a bore that passes through a bone from a first
side to a second side of the bone, such that: [0663] the sealing
element forms a liquid-tight seal with the tissue on the first side
of the bone, and [0664] a distal opening of the surgical tool is
disposed in fluid communication with the bore, wherein the distal
opening is in fluid communication with a lumen defined by the
surgical tool;
[0665] providing a solid-liquid composition of solid particles and
a physiological liquid solution from a composition source that is
coupled in fluid communication with the lumen; and
[0666] injecting the solid-liquid composition through the lumen, a
one-way filter of the surgical tool, the distal opening, and the
bore, into a cavity adjacent to the second side of the bone,
wherein the one-way filter is disposed in fluid communication with
the lumen, and configured to: [0667] allow passage, in a
proximal-to-distal direction, of the solid particles and the
physiological liquid solution of the solid-liquid composition,
[0668] inhibit passage, in a distal-to-proximal direction, of the
solid particles of the solid-liquid composition, such that the
solid particles accumulate in the cavity, and [0669] allow passage,
in the distal-to-proximal direction, of the physiological liquid
solution of the solid-liquid composition. [0670] Inventive concept
441. The method according to inventive concept 440, wherein the
solid particles are solid bone graft particles, and wherein
providing the solid-liquid composition comprises providing the
solid-liquid composition of the solid bone graft particles and the
physiological liquid solution. [0671] Inventive concept 442. The
method according to inventive concept 440,
[0672] wherein the sealing element disposed around an external
surface of exactly one shaft unit of the surgical tool,
[0673] wherein the distal opening disposed within 10 mm of a distal
end of the shaft unit, and
[0674] wherein the lumen is defined at least in part by the shaft
unit. [0675] Inventive concept 443. The method according to
inventive concept 442, wherein the distal opening is disposed
within 5 mm of the distal end of the shaft unit. [0676] Inventive
concept 444. The method according to inventive concept 443, wherein
the distal opening is disposed at the distal end of the shaft unit.
[0677] Inventive concept 445. The method according to inventive
concept 442, wherein the one-way filter is disposed within 10 mm of
the distal end of the shaft unit. [0678] Inventive concept 446. The
method according to inventive concept 440, wherein the surgical
tool is configured as an oral surgical tool, wherein the bone is a
bone of a jaw, and wherein placing comprises placing the sealing
element against the tissue around and outside the bore that passes
through the bone of the jaw. [0679] Inventive concept 447. The
method according to inventive concept 440, wherein the cavity is
between the second side of the bone and a membrane. [0680]
Inventive concept 448. The method according to inventive concept
447, further comprising, before injecting the solid-liquid
composition, raising the membrane to form the cavity between the
second side of the bone and the membrane. [0681] Inventive concept
449. The method according to inventive concept 447, wherein the
membrane is a Schneiderian membrane. [0682] Inventive concept 450.
The method according to inventive concept 440, wherein the bore is
exactly one bore through the bone. [0683] Inventive concept 451.
The method according to inventive concept 440, further comprising,
after injecting the solid-liquid composition, implanting an implant
at least partially within the cavity. [0684] Inventive concept 452.
The method according to inventive concept 440, further comprising
draining the physiological liquid solution of the solid-liquid
composition through the one-way filter. [0685] Inventive concept
453. The method according to inventive concept 452, wherein
injecting and draining comprise alternatingly injecting and
draining. [0686] Inventive concept 454. The method according to
inventive concept 452,
[0687] wherein injecting the solid-liquid composition comprises
pumping the solid-liquid composition at a positive hydraulic
pressure, and
[0688] wherein draining the physiological liquid solution comprises
suctioning the physiological liquid solution at a negative
hydraulic pressure. [0689] Inventive concept 455. The method
according to inventive concept 454, wherein pumping and suctioning
comprise alternatingly pumping and suctioning. [0690] Inventive
concept 456. The method according to inventive concept 440, wherein
injecting the solid-liquid composition comprises injecting the
solid-liquid composition such that at least 50% of the
physiological liquid solution drains through the one-way filter in
the distal-to-proximal direction. [0691] Inventive concept 457. The
method according to inventive concept 440, wherein injecting the
solid-liquid composition comprises injecting 2-300 ml of the
solid-liquid composition. [0692] Inventive concept 458. The method
according to inventive concept 440, wherein providing the
solid-liquid composition and injecting the solid-liquid composition
comprises providing the solid-liquid composition and injecting the
solid-liquid composition such that between 0.2 and 20 ml of solid
particles accumulate in the cavity. [0693] Inventive concept 459.
The method according to inventive concept 440, wherein the
composition source comprises a combining feeder unit, and wherein
providing the solid-liquid composition comprises activating the
combining feeder unit to provide the solid-liquid composition by
combining the solid particles with the physiological liquid
solution. [0694] Inventive concept 460. The method according to
inventive concept 459, wherein the combining feeder unit comprises
a mixing feeder unit, and wherein providing the solid-liquid
composition comprises activating the mixing feeder unit to provide
the solid-liquid composition by mixing the solid particles with the
physiological liquid solution.
[0695] There is yet additionally provided, in accordance with an
inventive concept 461 of the present invention, a method
comprising:
[0696] injecting, from a first side of a bone, through (a) a bore
that passes through the bone from the first side to a second side
of the bone, and (b) into a cavity adjacent to the second side of
the bone, a solid-liquid composition of solid particles and a
physiological liquid solution; and
[0697] draining, from the cavity and through the bore, the
physiological liquid solution of the solid-liquid composition,
while inhibiting passage of the solid particles of the solid-liquid
composition, such that the solid particles accumulate in the
cavity. [0698] Inventive concept 462. The method according to
inventive concept 461, wherein inhibiting the passage of the solid
particles comprises using a filter to inhibit the passage of the
solid particles. [0699] Inventive concept 463. The method according
to inventive concept 462, wherein injecting the solid-liquid
composition comprises injecting the solid-liquid composition such
that at least 50% of the physiological liquid solution drains
through the filter in a distal-to-proximal direction. [0700]
Inventive concept 464. The method according to inventive concept
461, wherein injecting the solid-liquid composition comprises
injecting 2-300 ml of the solid-liquid composition. [0701]
Inventive concept 465. The method according to inventive concept
461, wherein the cavity is between the second side of the bone and
a membrane. [0702] Inventive concept 466. The method according to
inventive concept 465, further comprising, before injecting the
solid-liquid composition, raising the membrane to form the cavity
between the second side of the bone and the membrane. [0703]
Inventive concept 467. The method according to inventive concept
465, wherein the membrane is a Schneiderian membrane. [0704]
Inventive concept 468. The method according to inventive concept
461, wherein the bore is exactly one bore through the bone. [0705]
Inventive concept 469. The method according to inventive concept
461, further comprising, after injecting the solid-liquid
composition, implanting an implant at least partially within the
cavity.
[0706] There is also provided, in accordance with an inventive
concept 470 of the present invention, a method comprising:
[0707] providing an osteotome, which is shaped so as to define (i)
a lumen through the osteotome, a distal end of the lumen opening
through a distal opening disposed within 10 mm of a distal end of
the osteotome, and a proximal end of the lumen opening through a
proximal opening disposed at least 5 mm proximal to the distal
opening, (ii) a lateral external surface, at least a portion of
which is shaped so as to define a screw thread that (a) has a
distal thread end that is disposed within 10 mm of the distal end
of the osteotome, and (b) comprises one or more raised helical ribs
going around the osteotome, and (iii) one or more longitudinal
drainage slots, which extend along at least respective longitudinal
portions of the osteotome having respective longitudinal lengths of
at least 5 mm, measured parallel to a central longitudinal axis of
the osteotome;
[0708] inserting, from a first side of a bone, the osteotome into a
bore that passes through the bone from the first side to a second
side of the bone, such that the distal opening is disposed in the
bore or in a cavity adjacent to the second side of the bone;
[0709] providing a solid-liquid composition of solid particles and
a physiological liquid solution from a composition source that is
coupled in fluid communication with the lumen; and
[0710] injecting the solid-liquid composition through the lumen and
the distal opening into the cavity, such that (a) a portion of the
physiological liquid solution drains through the one or more
longitudinal drainage slots, and (b) the one or more longitudinal
drainage slots inhibit passage of solid particles of the
solid-liquid composition such that the solid particles accumulate
in the cavity. [0711] Inventive concept 471. The method according
to inventive concept 470, wherein the solid particles are solid
bone graft particles, and wherein providing the solid-liquid
composition comprises providing the solid-liquid composition of the
solid bone graft particles and the physiological liquid solution.
[0712] Inventive concept 472. The method according to inventive
concept 470, wherein the osteotome is configured as a dental
osteotome, wherein the bone is a bone of a jaw, and wherein
inserting comprises inserting the dental osteotome into the bore
that passes through the bone of the jaw. [0713] Inventive concept
473. The method according to inventive concept 470, wherein the
cavity is between the second side of the bone and a membrane.
[0714] Inventive concept 474. The method according to inventive
concept 473, further comprising, before injecting the solid-liquid
composition, raising the membrane to form the cavity between the
second side of the bone and the membrane. [0715] Inventive concept
475. The method according to inventive concept 474,
[0716] wherein respective distal ends of the one or more
longitudinal drainage slots are disposed at least one pitch of the
screw thread from the distal thread end,
[0717] wherein raising the membrane comprises: [0718] advancing the
osteotome into the bore such that a portion of the screw thread
distal to the respective distal ends of the one or more
longitudinal drainage slots sealingly engages a wall of the bore;
and [0719] thereafter, injecting a fluid through the bore under
sufficient pressure to raise the membrane, and
[0720] wherein the method further comprises, before injecting the
solid-liquid composition, further advancing the osteotome into the
bore until the one or more drainage slots come into fluid
communication with the cavity. [0721] Inventive concept 476. The
method according to inventive concept 473, wherein the membrane is
a Schneiderian membrane. [0722] Inventive concept 477. The method
according to inventive concept 470, wherein the bore is exactly one
bore through the bone. [0723] Inventive concept 478. The method
according to inventive concept 470, further comprising, after
injecting the solid-liquid composition, implanting an implant at
least partially within the cavity. [0724] Inventive concept 479.
The method according to inventive concept 470, wherein the
longitudinal lengths of the respective longitudinal portions are at
least 8 mm. [0725] Inventive concept 480. The method according to
inventive concept 479, wherein the longitudinal lengths of the
respective longitudinal portions are at least 10 mm. [0726]
Inventive concept 481. The method according to inventive concept
480, wherein the longitudinal lengths of the respective
longitudinal portions are at least 12 mm. [0727] Inventive concept
482. The method according to inventive concept 470, wherein the
longitudinal lengths of the respective longitudinal portions are at
least 2 mm greater than a thickness of the bone adjacently
surrounding the bore. [0728] Inventive concept 483. The method
according to inventive concept 470, wherein the proximal opening is
disposed within 10 mm of a proximal end of the osteotome. [0729]
Inventive concept 484. The method according to inventive concept
470, wherein at least one of the one or more longitudinal drainage
slots reaches a proximal end of the osteotome. [0730] Inventive
concept 485. The method according to inventive concept 470, wherein
respective distal ends of the one or more longitudinal drainage
slots are disposed at least one pitch of the screw thread from the
distal thread end. [0731] Inventive concept 486. The method
according to inventive concept 485, wherein respective distal ends
of the one or more longitudinal drainage slots are disposed at
least two pitches of the screw thread from the distal thread end.
[0732] Inventive concept 487. The method according to inventive
concept 470, wherein the screw thread is multi-start. [0733]
Inventive concept 488. The method according to inventive concept
470, wherein the osteotome further comprises a sealing element
disposed around an external surface of the osteotome, and wherein
inserting comprises inserting the osteotome into the bore such that
the sealing element forms a liquid-tight seal with tissue around
and outside the bore. [0734] Inventive concept 489. The method
according to inventive concept 470, wherein respective distal ends
of the one or more longitudinal drainage slots are disposed at
least 1.5 mm from the distal end of the osteotome. [0735] Inventive
concept 490. The method according to inventive concept 489, wherein
respective distal ends of the one or more longitudinal drainage
slots are disposed at least 4 mm from the distal end of the
osteotome. [0736] Inventive concept 491. The method according to
inventive concept 489, wherein the osteotome further comprises a
sealing element disposed around an external surface of the
osteotome, and wherein inserting comprises inserting the osteotome
into the bore such that the sealing element forms a liquid-tight
seal with tissue around and outside the bore. [0737] Inventive
concept 492. The method according to inventive concept 470, wherein
respective average widths of the one or more longitudinal drainage
slots are no more than 2 mm. [0738] Inventive concept 493. The
method according to inventive concept 470, wherein respective
average depths of the one or more longitudinal drainage slots,
measured with respect to an outermost portion of the screw thread,
are at least 10% greater than an average depth of the screw thread.
[0739] Inventive concept 494. The method according to inventive
concept 470, wherein the one or more longitudinal drainage slots
cross the one or more ribs respective pluralities of times. [0740]
Inventive concept 495. The method according to inventive concept
494, wherein the one or more longitudinal drainage slots comprise
two or more longitudinal drainage slots. [0741] Inventive concept
496. The method according to inventive concept 494, wherein the one
or more longitudinal drainage slots are parallel to the
longitudinal axis. [0742] Inventive concept 497. The method
according to inventive concept 494, wherein the one or more
longitudinal drainage slots helically go around the osteotome in a
direction opposite to a direction of the screw thread. [0743]
Inventive concept 498. The method according to inventive concept
494, wherein the one or more longitudinal drainage slots helically
go around the osteotome with a slot pitch greater than a thread
pitch of the screw thread. [0744] Inventive concept 499. The method
according to inventive concept 498, wherein the slot pitch equals
at least 1.5 times the thread pitch. [0745] Inventive concept 500.
The method according to inventive concept 498, wherein the screw
thread has one or more starts, and wherein the slot pitch equals at
least the quotient of (a) 2 mm divided by (b) the number of starts
of the screw thread. [0746] Inventive concept 501. The method
according to inventive concept 470, wherein the screw thread has
one or more starts and a corresponding number of roots, and wherein
the osteotome is shaped so as to define a number of longitudinal
drainage slots that corresponds to a number of the starts of the
screw thread, and which are disposed within the one or more roots
of the screw thread, respectively. [0747] Inventive concept 502.
The method according to inventive concept 501, wherein a distal end
of the one or more longitudinal drainage slots is disposed at least
one pitch of the screw thread from the distal thread end. [0748]
Inventive concept 503. The method according to inventive concept
502, wherein the distal end of the longitudinal drainage slot is
disposed at least two pitches of the screw thread from the distal
thread end. [0749] Inventive concept 504. The method according to
inventive concept 502, wherein the osteotome further comprises a
sealing element disposed around an external surface of the
osteotome, and wherein inserting comprises inserting the osteotome
into the bore such that the sealing element forms a liquid-tight
seal with tissue around and outside the bore. [0750] Inventive
concept 505. The method according to inventive concept 470, for use
with solid particles and a physiological liquid solution, the
method further comprising providing a solid-liquid composition of
the solid particles and the physiological liquid solution. [0751]
Inventive concept 506. The method according to inventive concept
470, wherein the composition source comprises a combining feeder
unit, and wherein providing the solid-liquid composition comprises
activating the combining feeder unit to provide the solid-liquid
composition by combining the solid particles with the physiological
liquid solution. [0752] Inventive concept 507. The method according
to inventive concept 506, wherein the combining feeder unit
comprises a mixing feeder unit, and wherein providing the
solid-liquid composition comprises activating the mixing feeder
unit to provide the solid-liquid composition by mixing the solid
particles with the physiological liquid solution.
[0753] The present invention will be more fully understood from the
following detailed description of embodiments thereof, taken
together with the drawings, in which:
BRIEF DESCRIPTION OF THE DRAWINGS
[0754] FIG. 1 is a schematic illustration of a surgical tool for
the insertion of bone graft particles into a cavity, in accordance
with an application of the present invention;
[0755] FIGS. 2A-C are schematic illustrations of respective
configurations of an injector unit of the surgical tool of FIG. 1,
in accordance with respective applications of the present
invention;
[0756] FIGS. 3A-B are schematic illustrations of respective
configurations of the injector unit of FIG. 1, in accordance with
respective applications of the present invention;
[0757] FIGS. 4A-B and 5A are schematic illustrations of uses of the
surgical tool of FIGS. 1, 2A-B, and 3A-B, in accordance with
respective applications of the present invention;
[0758] FIG. 5B a schematic illustration of an alternative
configuration of a shaft unit of the surgical tool of FIGS. 1,
2A-B, and 3A-B and one use thereof, in accordance with an
application of the present invention;
[0759] FIGS. 6A-B and 7 are schematic illustrations of another
surgical tool comprising an injector unit, in accordance with an
application of the present invention;
[0760] FIGS. 8A-K are highly schematic illustrations of several
configurations of a mixing feeder unit, in accordance with
respective applications of the present invention;
[0761] FIGS. 9A-D are schematic illustrations of several
configurations of an osteotome, in accordance with respective
applications of the present invention;
[0762] FIGS. 10A-D are schematic illustrations of a portion of a
sinus lift and bone graft injection procedure performed using the
configuration of the osteotome of FIG. 9B, in accordance with an
application of the present invention;
[0763] FIG. 11 is a schematic illustration of one use of the
surgical tool of FIGS. 1-5B for ridge augmentation, in accordance
with an application of the present invention;
[0764] FIGS. 12A-B are schematic illustrations of one use of the
surgical tool of FIGS. 1-5B for performing a minimally-invasive
spinal interbody fusion, in accordance with an application of the
present invention;
[0765] FIG. 13 is a schematic illustration of one use of the
surgical tool of FIGS. 1-5B for filling a bone defect, in
accordance with an application of the present invention;
[0766] FIG. 14 is a schematic illustration of a bone graft
injection system for the insertion of solid bone graft particles
into a cavity, in accordance with an application of the present
invention;
[0767] FIG. 15 is a diagram illustrating the schematic arrangement
of certain elements of the bone graft injection system of FIG. 14,
in accordance with an application of the present invention;
[0768] FIG. 16A is a schematic illustration of a portion of a
composition delivery source of the bone graft injection system of
FIG. 14, in accordance with an application of the present
invention;
[0769] FIG. 16B is a schematic illustration of another
configuration of a portion of a composition delivery source of the
bone graft injection system of FIG. 14, in accordance with an
application of the present invention;
[0770] FIG. 17 is a timeline schematically showing activation
states of control circuitry of the bone graft injection system of
FIG. 14, in accordance with an application of the present
invention;
[0771] FIGS. 18A-D are schematic illustrations of the activation
states of control circuitry of FIG. 17, in accordance with an
application of the present invention;
[0772] FIG. 19 is a schematic illustration of configurations of a
mixing pump and a liquid-supply pump of the bone graft injection
system of FIG. 14, in accordance with an application of the present
invention;
[0773] FIGS. 20A-B are schematic illustrations of a chamber of a
composition delivery source of the bone graft injection system of
FIG. 14, in accordance with an application of the present
invention; and
[0774] FIG. 21 is a schematic illustration of a portion of a method
of using the bone graft injection system of FIG. 14, in accordance
with an application of the present invention.
DETAILED DESCRIPTION OF APPLICATIONS
[0775] FIG. 1 is a schematic illustration of a surgical tool 20 for
the insertion of bone graft particles into a cavity, in accordance
with an application of the present invention. For some
applications, surgical tool 20 is configured as an oral surgical
tool. Surgical tool 20 may comprise one or more of the following
components: [0776] a handheld motor 24, as is known in the art,
which is typically connected to external control unit 22 by a cord
26; [0777] an external control unit 22, which optionally comprises
a conventional surgical implant external control unit; typically,
external control unit 22 comprises a power supply, electronics, and
a user interface for controlling handheld motor 24, as is known in
the art; for some application, external control unit 22 comprises a
pump 27, such as a peristaltic pump, as is known in the art; [0778]
one or more conventional drilling handpieces 28; and/or [0779] a
foot control 30 for controlling external control unit 22, as is
known in the art.
[0780] Surgical tool 20 further comprises a handheld bone graft
injector unit 32. For some applications, injector unit 32 is
implemented as an attachment to a separate handheld motor 24, such
as shown in FIGS. 1, 2A, and 2C. Handheld motor 24 may be a
surgeon's conventional motor, which may allow a surgeon to leverage
conventional equipment already available. Alternatively, handheld
motor 24 may be another external motor. For other applications,
injector unit 32 is implemented as a standalone unit comprising its
own motor, such as described hereinbelow with reference to FIG.
2B.
[0781] Surgical tool 20 is configured to be used with bone graft
particles 34 and a physiological liquid solution 36, such as saline
solution or blood. For some applications, the bone graft particles
comprise natural bone mineral particles (either xenograft or
allograft), synthetic particles, demineralized bone matrix, an
autograft, or bioactive composites. To this end, surgical tool 20
comprises a composition source 38, which is configured to provide a
solid-liquid composition 39 (labeled in FIGS. 2A-C) of bone graft
particles 34 and physiological liquid solution 36. For some
applications, physiological liquid solution 36 is substantially
non-viscous, e.g., has a viscosity of water. Alternatively,
physiological liquid solution 36 is somewhat viscous, e.g., may
comprise glycerol or hyaluronic acid, which is sufficiently
non-viscous to be injected and to drain under clinically-safe
pressures. For some applications, solid-liquid composition 39
further comprises a radiopaque agent, to enable X-ray visualization
of the procedure. For some applications, bone graft particles 34
have an average particle size (measured as the greatest dimension
of each particle) of at least 0.01 mm, no more than 3 mm, and/or
between 0.01 mm and 3 mm. For some applications, bone graft
particles 34 comprise bone graft blocks, in which case the greatest
dimension is selected for ready passage through delivery lumen 42,
described hereinbelow. For some applications, composition source 38
comprises a combining feeder unit 60, such as described hereinbelow
with reference to FIGS. 2A-C. For other applications, composition
source 38 comprises a container of pre-combined bone graft
particles 34 and physiological liquid solution 36; for example, the
container may comprise a syringe. For some applications, injector
unit 32 comprises composition source 38, while for other
applications, composition source 38 is provided as a separate unit,
e.g., a tabletop unit, or as a component of external control unit
22.
[0782] For some applications, surgical tool 20 (e.g., injector unit
32 thereof) further comprises a solid-particle container 37, which
contains bone graft particles 34 for combining with physiological
liquid solution 36. For example, solid-particle container 37 may
have a volume of at least 0.2 ml, no more than 20 ml, and/or
between 0.2 and 20 ml. Optionally, solid-particle container 37, in
addition to bone graft particles 34, contains some physiological
liquid solution 36, which may enable combining of bone graft
particles 34 and physiological liquid solution 36 in solid-particle
container 37, such as described hereinbelow with reference to FIGS.
8A-K.
[0783] For some applications, external control unit 22 is
configured to display one or more of the following: (a) bone graft
volume injected, (b) bone graft volume remaining, (c) pressure of
solid-liquid composition 39, and/or (d) total volume injected (bone
graft plus physiological liquid solution).
[0784] Reference is now made to FIGS. 2A-C, which are schematic
illustrations of respective configurations of injector unit 32, in
accordance with respective applications of the present
invention.
[0785] In the configurations shown in FIGS. 2A and 2C, injector
unit 32 is implemented as an attachment to separate handheld motor
24.
[0786] In the configuration shown in FIG. 2B, injector unit 32 is
implemented as a standalone unit, which typically comprises one or
more of the following elements: (a) its own motor 41, (b) a pump
43, such as described hereinbelow, (c) a rechargeable or disposable
battery 45, (d) liquid solution container 66, and/or (e) a drainage
container 47. For some applications, injector unit 32 comprises a
combined liquid-solution-drainage container instead of a separate
liquid solution container 66 and a separate drainage container 47.
This configuration provides close loop circulation of physiological
liquid solution 36, and thus may, for example, allow the use of
less physiological liquid solution 36 because the solution is
reused during operation.
[0787] Injector unit 32 comprises a shaft unit 40, such as exactly
one shaft unit 40, which is shaped so as to define a delivery lumen
42 and a drainage lumen 44. Shaft unit 40 comprises one or more
shafts (including, for example, a delivery shaft 56, which defines
delivery lumen 42), which may be arranged concentrically and/or
alongside one another. Composition source 38 is coupled in fluid
communication with delivery lumen 42, such as via a feeder tube 35,
which optionally is flexible and/or transmits torque. Delivery
lumen 42 and drainage lumen 44 are typically not in fluid
communication with each other within shaft unit 40. Typically, a
largest circle circumscribed by a cross-section of delivery lumen
42 has a diameter of at least 1 mm, such as at least 1.5 mm, and/or
no more than 7 mm, such as no more than 4 mm (the cross-section is
perpendicular to a longitudinal axis of the delivery lumen).
[0788] Injector unit 32 further comprises a distal opening 46,
which is typically disposed within 10 mm of a distal end 48 of
shaft unit 40 (e.g., within 5 mm of the distal end, such as at the
distal end), in fluid communication with delivery lumen 42. For
some applications, distal opening 46 comprises a nozzle, for
controlling the direction and/or flow rate of the distribution of
solid-liquid composition 39. The nozzle may be shaped so as to
define one or more lateral or distal openings. As used in the
present application, including in the claims, distal end 48 of
shaft unit 40 means the distal-most point(s) of the shaft unit.
[0789] For some applications, such as shown in FIGS. 2A-C, surgical
tool 20 comprises a plurality of elements disposed around and
outside delivery lumen 42 for facilitating (a) inhibiting passage
of bone graft particles 34 of solid-liquid composition 39 to
drainage lumen 44, and (b) allowing passage of physiological liquid
solution 36 of solid-liquid composition 39 to drainage lumen
44.
[0790] To this end, for some applications, such as shown in FIGS.
2A-B, injector unit 32 further comprises a filter 50 (which may
comprise the plurality of elements mentioned immediately above),
which is disposed in fluid communication with drainage lumen 44,
and which is configured to (a) inhibit passage of bone graft
particles 34 of solid-liquid composition 39 and (b) allow passage
of physiological liquid solution 36 of solid-liquid composition 39.
For some applications, filter 50 is disposed within 10 mm of distal
end 48 of shaft unit 40, e.g., at distal end 48. For other
applications filter 50 is disposed elsewhere along shaft unit 40,
or outside of shaft unit 40 in fluid communication with drainage
lumen 44. For some applications, such as shown in FIGS. 2A, 3A, and
3B, filter 50 is shaped so as to define a plurality of slits 52
having a width narrower than bone graft particles 34. Alternatively
or additionally, for some applications, filter 50 comprises a mesh
having openings smaller than bone graft particles 34.
[0791] For some applications, filter 50, distal opening 46, and/or
solid-particle container 37 are detachable from surgical tool 20
and/or disposable.
[0792] For other applications, such as shown in FIG. 2C, delivery
shaft 56 of exactly one shaft unit 40 is shaped so as to define a
plurality of rib elements 76 that extend radially outward from an
external surface 78 of delivery shaft 56 (the rib elements may be
the plurality of elements mentioned above). For some applications,
rib elements 76 extend an average distance of at least 0.1 mm, no
more than 2 mm, and/or between 0.1 and 2 mm radially outward from
external surface 78 of delivery shaft 56. Alternatively or
additionally, for some applications, rib elements 76 extend
longitudinally along external surface 78 of delivery shaft 56 for
an average distance of at least 1 mm, such as at least 1 cm.
[0793] As mentioned above, for some applications, composition
source 38 comprises combining feeder unit 60, which is configured
to provide solid-liquid composition 39 by combining bone graft
particles 34 with physiological liquid solution 36. For some
applications, combining feeder unit 60 comprises a mixing feeder
unit 62, which is configured to provide solid-liquid composition 39
by mixing bone graft particles 34 with physiological liquid
solution 36. Several possible configurations of mixing feeder unit
62 are described hereinbelow with reference to FIGS. 8A-K. For some
applications, such as shown in FIGS. 2A-B, mixing feeder unit
comprises an Archimedes screw 180. For other applications, such as
shown in FIG. 2C, mixing feeder unit 62 comprises a shaft 72 and a
plurality of mixing blades 74 attached to shaft 72, optionally
extending radially outward from shaft 72.
[0794] As described hereinbelow with reference to FIGS. 4A-B and
5A-B, injector unit 32 is configured to inject solid-liquid
composition 39 through delivery lumen 42 and distal opening 46 into
a cavity, such that (a) a portion of physiological liquid solution
36 drains through filter 50, and (b) filter 50 inhibits passage of
bone graft particles 34 of solid-liquid composition 39, such that
bone graft particles 34 accumulate in the cavity.
[0795] To enable such injection, for some applications surgical
tool 20 further comprises a pump, which is configured to pump
solid-liquid composition 39 through distal opening 46 via delivery
lumen 42. For some applications, such as those in which injector
unit 32 is implemented as an attachment to separate handheld motor
24 (such as shown in FIGS. 2A and 2C), the pump comprises pump 27
of external control unit 22. In these applications, a supply tube
64 typically is coupled in fluid communication with (a) a liquid
solution container 66 (such as a bag) that contains physiological
liquid solution 36, and (b) combining feeder unit 60; supply tube
64 passes through pump 27. For other applications, such as those in
which injector unit 32 is implemented as a standalone unit (such as
shown in FIG. 2B), the pump comprises pump 43 of injector unit
32.
[0796] For some applications, the pump is configured to pump
solid-liquid composition 39 at a pulsating positive hydraulic
pressure. Such pulsation may help distribute solid-liquid
composition 39 in the cavity, and/or inhibit clogging of filter 50,
such as described hereinbelow. For some applications, the pump is
configured to pump solid-liquid composition 39 at a pulsating
hydraulic pressure that periodically varies between positive and
negative (optionally, the negative pressure is applied a smaller
portion of the time than is the positive pressure). Such pulsation
may help inhibit clogging of filter 50, such as described
hereinbelow. For some applications, the pump is configured to pump
solid-liquid composition 39 through distal opening 46 via delivery
lumen 42 during a plurality of positive-pressure periods that
alternate with a plurality of negative-pressure periods, and to set
an average duration of the positive-pressure periods to be less
than or equal to an average duration of the negative-pressure
periods. For some applications, the pump is configured to set the
average duration of the positive-pressure periods to be equal to
the average duration of the negative-pressure periods. This
technique typically allows time for at least a portion (e.g., most
or nearly all) of bone graft particles 34 to settle in cavity 90
before liquid of solid-liquid composition 39 is withdrawn, thereby
allowing for accumulation of bone graft particles 34 in cavity
90.
[0797] For some applications, surgical tool 20 further comprises a
suction source 49 (labeled in FIG. 1), which is coupled in fluid
communication with drainage lumen 44, such as by a suction tube 51.
The suction provided by suction source 49 facilitates drainage of
the filtered physiological liquid solution 36. Alternatively,
suction is not used, and passive drainage is sufficient, such as
because of pressure build-up in the cavity generated by the
injection of solid-liquid composition 39. For some applications,
the pump is configured to clear bone graft particles 34 that
accumulate on filter 50 during drainage of physiological liquid
solution 36 through filter 50, by periodically applying a positive
pressure to drainage lumen 44.
[0798] For some applications, surgical tool 20 (e.g., injector unit
32 thereof, such as shaft unit 40) is configured to inhibit
clogging of filter 50 by bone graft particles 34 as physiological
liquid solution 36 drains through filter 50. For some applications,
surgical tool 20 (e.g., injector unit 32 thereof, such as shaft
unit 40) is configured to move distal opening 46 and shaft unit 40
with respect to each other (for applications in which distal
opening 46 comprises the nozzle, the nozzle and shaft unit 40 with
respect to each other), for example during delivery of solid-liquid
composition 39. For example, surgical tool 20 (e.g., injector unit
32 thereof, such as shaft unit 40) may be configured to: [0799]
rotate distal opening 46 and shaft unit 40 with respect to each
other; the rotation may be either full or partial, and/or
unidirectional and/or bidirectional; for some applications,
surgical tool 20 (e.g., injector unit 32 thereof) is configured to
rotate distal opening 46 while holding shaft unit 40 rotationally
immobile, while for other applications, surgical tool 20 (e.g.,
injector unit 32 thereof) is configured to rotate shaft unit 40
while holding distal opening 46 rotationally immobile; [0800] move
distal opening 46 and shaft unit 40 side-to-side with respect to
each other; [0801] move distal opening 46 and shaft unit 40 axially
back-and-forth with respect to each other; and/or [0802] vibrate
distal opening 46 and shaft unit 40 side-to-side with respect to
each other; and/or
[0803] Alternatively or additionally, for some applications,
surgical tool 20 (e.g., injector unit 32 thereof) is configured to
automatically apply motion to shaft unit 40 selected from the group
consisting of: vibrational motion, rotational motion, oscillatory
motion, axial back-and-forth motion, and lateral side-to-side
motion. Further alternatively or additionally, for some
applications, surgical tool 20 (e.g., injector unit 32 thereof) is
configured to vibrate solid-liquid composition 39 in delivery lumen
42.
[0804] For some applications, in order to provide any of the
above-mentioned motions, surgical tool 20 uses electromagnetic
power or pneumatic power.
[0805] For some applications, surgical tool 20 (e.g., injector unit
32 thereof, such as shaft unit 40) is configured such that flow of
solid-liquid composition 39 causes distal opening 46 and shaft unit
40 to move with respect to each other. Alternatively or
additionally, for some applications, surgical tool 20 (e.g.,
injector unit 32 thereof, such as shaft unit 40) is configured such
that flow of filtered physiological liquid solution 36 causes
distal opening 46 and shaft unit 40 to move with respect to each
other.
[0806] For some applications, such as shown in FIGS. 2A-C, surgical
tool 20 (e.g., injector unit 32 thereof) further comprises an
element 54 disposed around an external surface of shaft unit 40.
For some applications, element 54 comprises a scaling element,
which is configured to form a liquid-tight seal with tissue
(gingiva or bone) around and outside a bore through the bone when
shaft unit 40 is inserted into the bore. Sealing element 54 may
inhibit flow of the filtered physiological liquid solution 36 into
the patient's mouth.
[0807] For some applications, such as shown in FIG. 2A-C, element
54 comprises a depth limiting element, which is configured to limit
a depth of insertion of shaft unit 40 into a bore through a bone
when shaft unit 40 is inserted into the bore; optionally, the depth
limiting element is removably attached to shaft unit 40. For some
applications, element 54 alternatively or additionally serves as
the depth limiting element; optionally, element 54 is removably
attached to shaft unit 40. For some applications, a plurality of
depth limiting elements are provided having different respective
lengths. For some applications, such as shown in FIG. 2C, depth
limiting element 54 is shaped so as to define a portion of drainage
lumen 44 between at least a portion of an internal surface of depth
limiting element 54 and a portion of external surface 78 of
delivery shaft 56.
[0808] Reference is now made to FIGS. 3A-B, which are schematic
illustrations of respective configurations of injector unit 32, in
accordance with respective applications of the present invention.
In these configurations, surgical tool 20 (e.g., injector unit 32
thereof, such as shaft unit 40) further comprises a filter clearing
element 70, which is configured to clear bone graft particles 34
that accumulate on filter 50 during drainage of physiological
liquid solution 36 through filter 50. Filter clearing element 70
may also serve to distribute solid-liquid composition, in order to
provide better distribution of bone graft particles 34 in cavity 90
and to prevent the bone graft particles from clogging distal
opening 46.
[0809] For some applications, surgical tool 20 (e.g., injector unit
32 thereof) is configured to move filter clearing element 70 with
respect to filter 50. For example, surgical tool 20 (e.g., injector
unit 32 thereof) may be configured to (a) rotate filter clearing
element 70 (the rotation may be either full or partial, and/or
unidirectional and/or bidirectional); and/or (b) axially move
filter clearing element 70.
[0810] For some applications, such as shown in FIGS. 3A-B, filter
clearing element 70 is fixed to distal opening 46 (i.e., to the
structure that defines distal opening 46). For some applications in
which distal opening 46 comprises the nozzle, filter clearing
element 70 is fixed to the nozzle. In some of these applications,
the various motions of distal opening 46 and shaft unit 40 with
respect to each other, described hereinabove with reference to
FIGS. 2A-B, facilitate the movement of filter clearing element 70
with respect to filter 50.
[0811] For some applications, such as shown in FIGS. 2A-C and 3A,
filter 50 is disposed around an axis 80 of distal opening 46. For
some applications, such as shown in FIGS. 2A-C and 3A, filter 50 is
disposed around delivery lumen 42 in shaft unit 40.
[0812] For some applications, such as shown in FIGS. 2A-C and 3A,
drainage lumen 44 is disposed around delivery lumen 42 in shaft
unit 40. For other applications, such as shown in FIG. 3B, drainage
lumen 44 is disposed alongside delivery lumen 42 in shaft unit
40.
[0813] Reference is now made to FIGS. 4A-B and 5A, which are
schematic illustrations of uses of surgical tool 20, in accordance
with respective applications of the present invention. The
illustrated use is typically performed in conjunction with a
minimally-invasive closed sinus lift surgical procedure for
implanting a dental implant. The procedure is typically employed
when a patient's alveolar maxillary bone 82 lacks sufficient bone
mass to support a conventional dental implant. The procedure may be
performed using any of the techniques described in the patents and
patent application publications incorporated hereinbelow by
reference, or using other sinus lift techniques known in the art.
For some applications, the surgeon reflects gingiva 84, exposing an
occlusal surface of maxillary alveolar bone 82 as shown in FIGS.
4A-B and 5A. Alternatively, a flapless procedure is performed, in
which the gingiva is not reflected (approach not shown). Although a
crestal approach is shown, a lateral approach may alternatively be
used.
[0814] A bore 86 (e.g., exactly one bore) is formed through bone 82
from a first side of the bone to a second side of the bone. A
Schneiderian membrane 88 is raised to form a cavity 90 between the
second side of the bone and Schneiderian membrane 88, such as using
hydraulic pressure or mechanical elevation.
[0815] Reference is still made to FIGS. 4A-B. Exactly one shaft
unit 40 is inserted, from the first side of a bone, into bore 86,
such that distal opening 46 is disposed in bore 86 or in cavity 90
(in other words, distal opening 46 may or may not penetrate the
sinus floor). Solid-liquid composition 39 is injected through
delivery lumen 42 and distal opening 46 into cavity 90, such that
(a) a portion of physiological liquid solution 36 drains into
drainage lumen 44, and (b) passage of bone graft particles 34 of
solid-liquid composition 39 into drainage lumen 44 is inhibited,
such that bone graft particles 34 accumulate in cavity 90, and
function as regenerative material. Typically, at least 50% of
physiological liquid solution 36 drains through filter 50 in a
distal-to-proximal direction, optionally while solid-liquid
composition 39 is being injected. Typically, 2-300 ml of
solid-liquid composition 39 is injected. Typically, between 0.2 and
20 ml of bone graft particles accumulate in the cavity. Typically,
but not necessarily, physiological liquid solution 36 drains into
drainage lumen 44 (e.g., through filter 50) at the same time that
solid-liquid composition 39 is injected.
[0816] For some applications, such as shown in FIG. 4A, in which
shaft unit 40 has the configuration described hereinabove with
reference to FIGS. 2A-B, (a) the portion of physiological liquid
solution 36 drains through filter 50 and into drainage lumen 44,
and (b) filter 50 inhibits passage of bone graft particles 34 of
solid-liquid composition 39, such that bone graft particles 34
accumulate in cavity 90, and function as regenerative material.
[0817] For other applications, such as shown in FIG. 4B, in which
shaft unit 40 has the configuration described hereinabove with
reference to FIG. 2C, exactly one shaft unit 40 is inserted into
bore 86 such that rib elements 76 space external surface 78 of
delivery shaft 56 away from an inner wall of bore 86, thereby
defining a fluid flow path 79 between external surface 78 of
delivery shaft 56 and the inner watt of bore 86. As a result, (a)
the portion of physiological liquid solution 36 drains through
fluid flow path 79 and into drainage lumen 44, and (b) passage of
bone graft particles 34 of solid-liquid composition 39 into fluid
flow path 79 is inhibited, such that the solid particles accumulate
in the cavity.
[0818] For some applications, inserting shaft unit 40 comprises
positioning distal opening 46 at a location at a distance from the
second side of the bone, the distance equal to at least 50% (e.g.,
at least 75%) of a height of cavity 90 directly above bore 86, and
solid-liquid composition is injected (e.g., pumped) while distal
opening 46 is positioned at the location. For some applications,
distal opening 46 is positioned at between 2 and 12 mm (e.g., 4 and
6 mm) from Schneiderian membrane 88 at a roof of cavity 90 directly
above bore 86. For some applications, distal opening 46 is disposed
at distal end 48 of shaft unit 40, and positioning distal opening
46 comprises positioning distal end 48 of shaft unit 40 at the
location. For some applications, raising Schneiderian membrane 88
comprises injecting physiological solution through delivery lumen
42 after inserting shaft unit 40 into bore 86.
[0819] Alternatively, the surgeon injects solid-liquid composition
39 to lift membrane 88, thereby combining the lift and bone graft
injection steps into a single step. Further alternatively, the
surgeon uses surgical tool 20 to inject physiological solution,
e.g., saline solution, to raise the membrane.
[0820] After solid-liquid composition 39 is injected, an implant is
implanted at least partially within cavity 90, either during the
same procedure or after bone grows into bone graft particles 34 in
cavity 90. After bone grows into bone graft particles 34, a dental
appliance, such as a crown, is coupled to the implant.
[0821] Reference is now made to FIG. 5B, which a schematic
illustration of an alternative configuration of shaft unit 40 and
one use thereof, in accordance with an application of the present
invention. In this configuration, distal end 48 of shaft unit 40 is
disposed no more distal than a distal-most surface of sealing
element 54. Distal end 48 of shaft unit 40 may be either flush with
the distal-most surface of sealing element 54, or recessed within
sealing element 54 (i.e., proximal to the distal-most surface of
sealing element 54). Because sealing element 54 forms a fluid-tight
seal with the tissue (gingiva or bone) surrounding bore 86, distal
opening 46 is disposed in fluid communication with bore 86 (and
cavity 90), and solid-liquid composition 39, when injected through
distal opening 46, flows into bore 86 and then into cavity 90.
Similarly, filtered physiological liquid solution 36 passes from
cavity 90, through bore 86, and into drainage lumen 44. For some
applications, shaft unit 40 is not provided. Distal opening 46 may
instead be provided by another portion of injector unit 32 (such as
an external surface thereof), and configured to provide fluid
communication with an opening through sealing element 54.
[0822] Reference is now made to FIGS. 6A-B and 7, which are
schematic illustrations of a surgical tool 120 comprising an
injector unit 132, in accordance with an application of the present
invention. Except as described hereinbelow, surgical tool 120 and
injector unit 132 are generally similar to surgical tool 20 and
injector unit 32, described hereinabove with reference to FIGS.
1-3B, and may implement any of the features thereof. Surgical tool
120 (e.g., injector unit 132 thereof) comprises exactly one shaft
unit 140, which is shaped so as to define a lumen 142, and a distal
opening 146, which is typically disposed within 10 mm of a distal
end 148 of shaft unit 140 (e.g., within 5 mm of the distal end,
such as at the distal end), in fluid communication with lumen 142.
Composition source 38, described hereinbelow with reference to
FIGS. 2A-C, is coupled in selective fluid communication with lumen
142. As used in the present application, including in the claims,
distal end 148 of shaft unit 140 means the distal-most point(s) of
the shaft unit.
[0823] For some applications, shaft unit 140 is shaped so as to
define exactly one lumen 142. For other applications, shaft unit
140 is shaped so as to define a plurality of lumens that are in
fluid communication with one another in shaft unit 140. Typically,
a largest circle circumscribed by a cross-section of lumen 142 has
a diameter of at least 1 mm, such as at least 1.5 mm, and/or no
more than 7 mm, such as no more than 4 mm (the cross-section is
perpendicular to a longitudinal axis of the lumen).
[0824] Injector unit 132 further comprises a one-way filter 150,
which is disposed in fluid communication with lumen 142, and which
is configured to: [0825] allow passage, in a proximal-to-distal
direction ((schematically indicated by an arrow 151 in FIG. 6A), of
bone graft particles 34 and physiological liquid solution 36 of
solid-liquid composition 39, [0826] inhibit passage, in a
distal-to-proximal direction (schematically indicated by an arrow
153 in FIG. 6B), of bone graft particles 34 of solid-liquid
composition 39, and [0827] allow passage, in the distal-to-proximal
direction, of physiological liquid solution 36 of solid-liquid
composition 39.
[0828] For some applications, surgical tool 120 (e.g., injector
unit 132 thereof) comprises a one-way filter valve 152 that
comprises one-way filter 150. One-way filter valve 152 is in fluid
communication with lumen 142. For example, one-way filter valve 152
may comprise a leaf valve 154, which comprises one or more leafs
156. For example, leafs 156 may comprise mesh 158 having openings
smaller than bone graft particles 34, or may be shaped so as to
define a plurality of slits having a width narrower than bone graft
particles 34. For some applications, one-way filter 150 is disposed
within 10 mm of distal end 148 of shaft unit 140.
[0829] Composition source 38 is coupled in fluid communication with
lumen 142, such as via a feeder tube 135. For some applications,
surgical tool 20 is shaped so as to define a suction port 160, and
one-way filter 150 is in selective fluid communication with suction
source 49 via suction port 160. For some applications, suction port
160 is disposed at a site 162 along a fluid path between one-way
filter 150 and composition source 38, and surgical tool 20 (e.g.,
injector unit 32 thereof) further comprises a source one-way valve
166, which is disposed along the fluid path proximal to site 162 at
which suction port 160 is disposed.
[0830] For some applications, the pump (e.g., pump 27 of external
control unit 22, or pump 43 of injector unit 132) is configured to
pump solid-liquid composition 39 through distal opening 146 via
lumen 142. For some applications, the pump is configured to pump
solid-liquid composition 39 with an on-off duty cycle. For some
applications, suction port 160 is configured to assume an open
state when the pump is off, and a closed state when the pump is on.
For some applications, suction source 49 is configured to apply
suction when the pump is off, and not apply the suction when the
pump is on.
[0831] To inhibit suctioning of bone graft particles 34 through
suction port 160, for some applications, source one-way valve 166
is configured to open at a higher pressure gradient than the
pressure gradient at which one-way filter valve 152 opens (the
injection pressure is typically substantially higher than the
suction vacuum). Alternatively or additionally, application of the
suction is synchronized with application of the pressure, so that
the suction is off when the solid-liquid composition 39 is injected
and vice versa.
[0832] For some applications, surgical tool 120 is used in
conjunction with a minimally-invasive sinus lift surgical procedure
for implanting a dental implant. Other than as described below, the
procedure is similar to the procedure described hereinabove with
reference to FIGS. 4A-B and 5A. After the bore has been formed and
Schneiderian membrane 88 has been raised to form cavity 90, the
exactly one shaft unit 140 is inserted, from a first side of bone
82, such that distal opening 146 is disposed in the bore or in
cavity 90. Solid-liquid composition 39 is injected through lumen
142, one-way filter 150, and distal opening 146 into cavity 90, as
shown in FIGS. 6A and 7. Physiological liquid solution 36 of
solid-liquid composition 39 drains through one-way filter 150, as
shown in FIG. 6B. Typically, at least 50% of physiological liquid
solution 36 drains through filter 50 in the distal-to-proximal
direction.
[0833] For some applications, injecting and draining comprise
alternatingly injecting (as shown in FIGS. 6A and 7) and draining
(as shown in FIG. 6B). For some applications, injecting
solid-liquid composition 39 comprises pumping solid-liquid
composition 39 at a positive hydraulic pressure, and draining
physiological liquid solution 36 comprises suctioning physiological
liquid solution 36 at a negative hydraulic pressure. For some
applications, pumping and suctioning comprise alternatingly pumping
and suctioning.
[0834] An implant is implanted, as described hereinabove with
reference to FIGS. 4A-B and 5A.
[0835] For some applications, distal end 148 of shaft unit 140 is
disposed no more distal than a distal-most surface of sealing
element 54, such as described hereinabove with reference to FIG.
5B, mutatis mutandis. Distal end 148 of shaft unit 140 may be
either flush with the distal-most surface of sealing element 54, or
recessed within sealing element 54 (i.e., proximal to the
distal-most surface of sealing element 54). Because sealing element
54 forms a fluid-tight seal with the tissue (gingiva or bone)
surrounding bore 86, distal opening 146 is disposed in fluid
communication with bore 86 (and cavity 90), and solid-liquid
composition 39, when injected through distal opening 146, flows
into bore 86 and then into cavity 90. Similarly, physiological
liquid solution 36 passes from cavity 90, through bore 86 and
one-way filter 150, and into lumen 142. For some applications,
shaft unit 140 is not provided. Distal opening 146 may instead be
provided by another portion of injector unit 132 (such as an
external surface thereof), and configured to provide fluid
communication with an opening through sealing element 54.
[0836] Reference is again made to FIGS. 2A-C, and is additionally
made to FIGS. 8A-K, which are highly schematic illustrations of
several configurations of mixing feeder unit 62, in accordance with
respective applications of the present invention. Mixing feeder
unit 62 may retrieve bone graft particles 34 from solid-particle
container 37 passively (such as by gravity and/or flow of
physiological liquid solution 36 through solid-particle container
37). Alternatively or additionally, mixing feeder unit 62 may
retrieve bone graft particles 34 from solid-particle container 37
actively, such as using one or more of the following: vibration (in
order to overcome the pressure filtration effect), ultrasonic
energy, positive pressure (automatic or manual) in the container
applied by physiological liquid solution 36, suction, and/or
dosage-controlled portioning of bone graft particles 34 using
Archimedes screw 180 (shown in FIGS. 2A-B), shaft 72 with mixing
blades 74 (shown in FIG. 2C), or by periodically opening an exit
orifice, which releases bone graft particles into the flow of
physiological liquid solution 36.
[0837] FIGS. 8A-K schematically illustrate several configurations
for mixing bone graft particles 34 with physiological liquid
solution 36 to generate solid-liquid composition 39. By way of
example and not limitation, in these figures physiological liquid
solution 36 is referred to as "saline," and solid-liquid
composition 39 is referred to as "mixed solution."
[0838] FIG. 8A illustrates passive mixing without application of
pressure to physiological liquid solution 36.
[0839] FIG. 8B illustrates active mixing (using a mixing unit 182)
without application of pressure to physiological liquid solution
36.
[0840] FIG. 8C illustrates active mixing (using mixing unit 182)
without application of pressure to physiological liquid solution
36, with the addition of active retrieval of bone graft particles
34 from solid-particle container 37.
[0841] FIG. 8D illustrates passive mixing with the application of
pressure to physiological liquid solution 36, and the flow of
physiological liquid solution 36 through solid-particle container
37.
[0842] FIG. 8E illustrates active mixing (using mixing unit 182)
with the application of pressure to physiological liquid solution
36, and the flow of physiological liquid solution 36 through
solid-particle container 37.
[0843] FIG. 8F illustrates active mixing (using mixing unit 182)
with the application of pressure to physiological liquid solution
36, with the addition of active retrieval of bone graft particles
34 from solid-particle container 37, and the flow of physiological
liquid solution 36 through solid-particle container 37.
[0844] FIG. 8G illustrates passive mixing with or without
application of pressure to physiological liquid solution 36, and
the flow of all of physiological liquid solution 36 through
solid-particle container 37.
[0845] FIG. 8H illustrates active mixing (using mixing unit 182)
with or without application of pressure to physiological liquid
solution 36, and the flow of all of physiological liquid solution
36 through solid-particle container 37.
[0846] FIG. 8I illustrates active mixing (using mixing unit 182)
without the application of pressure to physiological liquid
solution 36, with the addition of active retrieval of bone graft
particles 34 from solid-particle container 37, and the flow of all
of physiological liquid solution 36 through solid-particle
container 37.
[0847] FIG. 8J illustrates the reverse flow of all of physiological
liquid solution 36 through solid-particle container 37; the flow
against gravity minimizes the pressure filtration effect.
[0848] FIG. 8K illustrates the reverse flow of physiological liquid
solution 36 through solid-particle container 37, with the addition
of application of suction for active retrieval of bone graft
particles 34 and physiological liquid solution 36 from
solid-particle container 37, and active mixing (using mixing unit
182).
[0849] Reference is now made to FIGS. 9A-D, which are schematic
illustrations of several configurations of an osteotome 200, in
accordance with respective applications of the present invention.
Osteotome 200 is configured to be used with bone graft particles 34
and a physiological liquid solution 36, such as saline solution or
blood, in a manner similar to surgical tool 20, described
hereinabove with reference to FIGS. 1-5B and 8A-K. For some
applications, osteotome 200 is configured as a dental
osteotome.
[0850] Osteotome 200 is shaped so as to define: [0851] a lumen 210
through osteotome 200. A distal end 212 of lumen 210 opens through
a distal opening 214 disposed within 10 mm of a distal end 216 of
osteotome 200, such as within 5 nun of distal end 216, e.g., at
distal end 216. A proximal end 218 of lumen 210 opens through a
proximal opening 220 disposed at least 5 mm proximal to distal
opening 214. For some applications, proximal opening 220 is
disposed within 10 mm of a proximal end 222 of osteotome 200, such
as within 5 mm of proximal end 222, e.g., at proximal end 222,
[0852] a lateral external surface 230, at least a portion of which
is shaped so as to define a screw thread 232 that (a) has a distal
thread end 234 that is disposed within 10 mm of distal end 216 of
osteotome 200, such as within 5 mm of distal end 216, e.g., within
1 mm of distal end 216, and (b) comprises one or more raised
helical ribs 236 going around osteotome 200, and [0853] one or more
longitudinal drainage slots 250, which extend along at least
respective longitudinal portions 252 of osteotome 200 having
respective longitudinal lengths L of at least 5 mm, such as at
least 8 mm, e.g., at least 10 mm, such as at least 12 mm, measured
parallel to a central longitudinal axis 253 of osteotome 200
(typically, the longitudinal lengths L are no more than 20 mm).
[0854] As used in the present application, including in the claims,
distal end 216 of osteotome 200 means the distal-most point(s) of
the osteotome. Similarly, proximal end 222 of osteotome 200 means
the proximal-most point(s) of the osteotome.
[0855] Typically, a largest circle circumscribed by a cross-section
of lumen 210 has a diameter of at least 1 mm, such as at least 1.5
mm, and or no more than 7 mm, such as no more than 4 mm (the
cross-section is perpendicular to central longitudinal axis
253).
[0856] For some applications, the longitudinal lengths L of the
respective longitudinal portions 252 are at least 2 mm greater than
a thickness of bone 82 adjacently surrounding bore 86. This
provides for 1 mm of longitudinal draining slots on the top and the
bottom of the bone.
[0857] FIGS. 9A-D show four different configurations 200A, 200B,
200C, and 200D of osteotome 200. For some applications, such as in
all of the configurations shown, at least one of the one or more
longitudinal drainage slots 250 reaches proximal end 222 of
osteotome 200. Alternatively, at least one of the one or more
longitudinal drainage slots 250 does not reach proximal end 222 of
osteotome 200 (configuration not shown).
[0858] For some applications, such as in configurations 200B and
200D shown in FIGS. 9B and 9D, respectively, respective distal ends
260 of the one or more longitudinal drainage slots 250 are disposed
at least one pitch P of the screw thread from distal thread end
234, such as at least two pitches P of the screw thread from distal
thread end 234, or at least three pitches P of the screw thread
from distal thread end 234. For some applications, such as in
configurations 200B and 200D shown in FIGS. 9B and 9D,
respectively, respective distal ends 260 of the one or more
longitudinal drainage slots 250 are disposed at least 1.5 mm from
distal end 216 of osteotome 200, such as at least 4 mm from distal
end 216 of osteotome 200. For some applications, osteotome 200
further comprises a sealing element 254 disposed around an external
surface of osteotome 200, and configured to form a liquid-tight
seal with tissue (gingiva 84 or bone 82) around and outside bore 86
when osteotome 200 is inserted into bore 86. Sealing element 254
may be particularly useful in configurations 200A and 200C, but may
also be provided in the other configurations.
[0859] For some applications, screw thread 232 is multi-start,
i.e., is shaped to define more than one start, as is known in the
screw art. For example, screw thread 232 may be double-start (as
shown in FIGS. 9A-D), triple-start, or quadruple-start. It is noted
that the pitch P of a multi-start screw is measured between
axially-adjacent rib portions, even thought the rib portions are
from different ribs, as is known in the screw art.
[0860] For some applications, respective average widths of the one
or more longitudinal drainage slots 250 are no more than 3 mm, such
as no more than 2 mm, e.g., no more than 1.5 mm or 1 mm. Typically,
the widths of the one or more longitudinal drainage slots 250 are
selected to be smaller than the bone graft particles 34, in order
to filter the bone graft particles 34 (i.e., inhibit their passage
through the drainage slots).
[0861] For some applications, respective average depths or the one
or more longitudinal drainage slots 250, measured with respect to
an outermost portion of screw thread 232 (i.e., locally with
respect to the outermost portion of the screw thread; the width of
the screw thread may vary therealong), are at least 10% greater
than an average depth of screw thread 232, and/or at least 0.1 mm
(such as at least 0.3 mm, e.g., at least 0.5 mm) greater than the
average depth of screw thread 232, and/or at least 0.4 mm from the
outermost portion of screw thread 232. (Typically, the average
thread depth of screw thread 232 is at least 0.1 mm, such as at
least 0.3 mm.)
[0862] For some applications, such as in configurations 200A and
200B shown in FIGS. 9A and 9B, respectively, the one or more
longitudinal drainage slots 250 cross the one or more ribs 236
respective pluralities of times. For some of these applications,
the one or more longitudinal drainage slots 250 comprise two or
more longitudinal drainage slots 250, such as two, three, four,
five, six, or more than six slots 250. For some of these
applications, the one or more longitudinal drainage slots 250 are
parallel to central longitudinal axis 253. For some of these
applications, the one or more longitudinal drainage slots 250
helically go around the dental osteotome (a) either in the same or
opposite direction as screw thread 232, with a slot pitch greater
than a thread pitch of screw thread 232, such as at least 1.5 times
the thread pitch, or (b) in the opposite direction as screw thread
232 (in which case the slot pitch is not necessarily greater than
the thread pitch of screw thread 232). For some applications, the
slot pitch equals at least the quotient of (a) 2 mm divided by (b)
the number of starts of screw thread 232. (Typically, the thread
pitch is at least the quotient of (a) 1 mm (e.g., 1.2 mm, such as 2
mm) divided by (b) the number of starts of screw thread 232.)
[0863] For other applications, such as in configurations 200C and
200D shown in FIGS. 9C and 9D, respectively, screw thread 232 has
one or more starts and a corresponding number of roots, and
osteotome 200 is shaped so as to define a number of longitudinal
drainage slots 250 that corresponds to a number of the starts of
screw thread 232, and which are disposed within the one or more
roots of screw thread 232, respectively, typically at the deepest
part of the roots (and thus follow the helical path of screw thread
232 around the osteotome). For some of these applications, as in
configuration 200D shown in FIG. 9D, distal end 260 of longitudinal
drainage slot 250 is disposed at least one pitch P of screw thread
232 from distal thread end 234, such as at least two pitches P of
screw thread 232 from distal thread end 234, e.g., at least three
pitches P of screw thread 232 from distal thread end 234.
[0864] Typically, osteotome 200 is configured to be used with bone
graft particles 34 and physiological liquid solution 36, as
described hereinabove. During use, osteotome 200 is inserted, from
a first side of bone 82, into bore 86, such that distal opening 214
is disposed in the bore or in a cavity adjacent to the second side
of the bone. A solid-liquid composition 39 of bone graft particles
34 and physiological liquid solution 36 is provided from
composition source 38 that is coupled in fluid communication with
lumen 210. Solid-liquid composition 39 is injected through lumen
210 and distal opening 214 into cavity 90, such that (a) a portion
of physiological liquid solution 36 drains through the one or more
longitudinal drainage slots 250, and (b) the one or more
longitudinal drainage slots 250 inhibit passage of bone graft
particles 34 of solid-liquid composition 39 such that the bone
graft particles 34 accumulate in cavity 90.
[0865] For some applications, osteotome 200 is configured as a
dental osteotome, and bone 82 is a bone of a jaw. For some
applications, cavity 90 is between the second side of bone 82 and a
membrane, such as Schneiderian membrane 88. Typically, before
inserting osteotome 200, the membrane is raised to form cavity 90
between the second side of bone 82 and membrane 88.
[0866] Typically, proximal end 222 of osteotome 200 is shaped so as
to define a coupling interface, such as a male or female coupling
interface, which, for example, may be shaped so as to define a male
or female polygon having four or more sides, such as five or more
sides, or six or more sides, e.g., exactly four, five, or six
sides. The surgeon may use a conventional dental wrench or dental
drill to engage the coupling interface and rotate the
osteotome.
[0867] Reference is now made to FIGS. 10A-D, which are schematic
illustrations of a portion of a sinus lift and bone graft injection
procedure performed using configuration 200B of osteotome 200, in
accordance with an application of the present invention. The same
method may be used with configuration 200D, mutatis mutandis. As
mentioned above, in configurations 200B and 200D, shown in FIGS. 9B
and 9D, respectively, respective distal ends 260 of the one or more
longitudinal drainage slots 250 are disposed at least one pitch P
of screw thread 232 from distal thread end 234.
[0868] The procedure begins as described hereinabove with reference
to FIGS. 4A-B and 5A, including forming bore 86 (e.g., exactly one
bore) through bone 82 from a first side of bone 82 to a second side
of bone 82 (steps not shown). Thereafter, membrane 88 is raised by
(a) advancing osteotome 200 into bore 86 such that a portion of
screw thread 232 distal to respective distal ends 260 of the one or
more longitudinal drainage slots 250 sealingly engages a wall of
bore 86, such as shown in FIG. 10A, and (b) thereafter, injecting a
physiological fluid (e.g., saline solution) through the bore under
sufficient pressure to raise membrane 88, such as shown in FIG.
10B. Such raising may be performed using any of the techniques
described in the patents and patent application publications
incorporated hereinbelow by reference, or using other hydraulic
pressure sinus lift techniques known in the art.
[0869] As shown in FIG. 10C, osteotome 200 is further advanced into
bore 86 until the one or more drainage slots 250 come into fluid
communication with cavity 90. As shown in FIG. 10D, solid-liquid
composition 39 is injected into cavity 90, such as described above.
For some applications, the drained physiological liquid solution
may be suctioned using a conventional dental suction tool, or
sealing element 254 may provided with a collecting chamber that is
coupled to suction. Typically, after injecting the solid-liquid
composition, an implant is implanted at least partially within
cavity (step not shown).
[0870] Although the surgical tools and methods described herein
have been generally described for sinus lift dental applications,
these tools and methods may additionally be used for other dental
applications, such as ridge augmentation (in both the maxilla and
mandible) (such as by injecting the solid-liquid composition
between the gingiva and the bone crest), or sinus floor elevation.
In addition, these tools and methods may additionally be used for
non-dental applications, such as orthopedic applications. For
orthopedic applications, bone graft particles 34 may have a larger
average particle size, e.g., up to 7 mm.
[0871] Reference is now made to FIG. 11, which is a schematic
illustration of one use of surgical tool 20 for ridge augmentation,
in accordance with an application of the present invention. In this
application, surgical tool 20, described hereinabove with reference
to FIGS. 1-5B and 8A-K, is used to perform ridge augmentation of a
jaw bone 290 (either a mandible or a maxilla). For some
applications, gingiva 292 is dissected from jaw bone 290, such as
by tunneling, as is known in the art. Optionally, a structural
support 294 is placed under gingiva 292; for example, structural
support 294 may comprise a mesh, reinforced membrane, and/or stent.
Bone graft injector unit 32 of surgical tool 20 is used to inject
solid-liquid composition 39 between jaw bone 290 and gingiva 292,
or between jaw bone 290 and structural support 294. Alternatively,
surgical tool 120, described hereinabove with reference to FIGS.
6A-B, 7, and 8A-K, is used to perform this procedure.
[0872] Reference is now made to FIGS. 12A-B, which are schematic
illustrations of one use of surgical tool 20 for performing a
minimally-invasive spinal interbody fusion, in accordance with an
application of the present invention. The approach to the spine
(anterior, posterior, or lateral) depends on the site (e.g.,
lumbar, cervical, or thoracic spine). Typically, an inner vertebral
disc is removed or partially removed and replaced with a structural
support 296, such as a rigid cage. Bone graft injector unit 32 of
surgical tool 20, described hereinabove with reference to FIGS.
1-5B and 8A-K, is used to inject solid-liquid composition 39 into
structural support 296. Optionally, external fixation is also
performed to fixate the adjacent vertebrae, as is known in the art,
such as shown in FIG. 12B. For this application, shaft unit 40 is
generally coaxial with the body of bone graft injector unit 32,
i.e., faces forward rather than sideways; shaft unit 40 may also be
somewhat longer than in the configurations shown in FIGS. 1-5B.
Alternatively, surgical tool 120, described hereinabove with
reference to FIGS. 6A-B, 7, and 8A-K, is used to perform this
procedure, mutatis mutandis.
[0873] Reference is now made to FIG. 13, which is a schematic
illustration of one use of surgical tool 20 for filling a bone
defect, in accordance with an application of the present invention.
In this application, surgical tool 20, described hereinabove with
reference to FIGS. 1-5B and 8A-K, is used to fill a defect 500 in a
bone 510. This technique may be used for orthopedic procedures, as
well as for dental procedures. For some applications, a structural
element 520, such as a crib, is placed over defect 500 in order to
define a volume to be filled. Bone graft injector unit 32 of
surgical tool 20 is used to inject solid-liquid composition 39 into
the volume defined by structural element 520. As described
hereinabove with reference to FIGS. 12A-B, for this application,
shaft unit 40 is generally coaxially with the body of bone graft
injector unit 32, and be longer than in the configurations shown in
FIGS. 1-5B. Alternatively, surgical tool 120, described hereinabove
with reference to FIGS. 6A-B, 7, and 8A-K, is used to perform this
procedure, mutatis mutandis.
[0874] Reference is made to FIG. 14, which is a schematic
illustration of a bone graft injection system 320 for the insertion
of solid particles, typically solid bone graft particles 334, into
a cavity, in accordance with an application of the present
invention. For example, the cavity may be cavity 90, shown in FIGS.
18A-D and 21. Reference is also made to FIG. 15, which is a diagram
illustrating the schematic arrangement of certain elements of bone
graft injection system 320, in accordance with an application of
the present invention. Bone graft injection system 320 is for use
with a liquid solution container 366 containing a physiological
liquid solution 336, such as saline solution. Bone graft injection
system 320 comprises a composition delivery source 300 and a pump
unit 301. Typically, composition delivery source 300 is single-use
and disposable, while pump unit 301 is reused many times. For some
applications, the components of composition delivery source 300 are
provided as a preassembled unit, while for other applications, one
or more of the components are provided disconnected from one
another and are assembled by a healthcare worker, for example,
based on shape- or color-coding of the components.
[0875] Reference is still made to FIGS. 14 and 15, and is
additionally made to FIG. 16A, which is a schematic illustration of
a portion of composition delivery source 300, in accordance with an
application of the present invention. Composition delivery source
300 comprises a chamber 302, which comprises a filter 304. Filter
304 is disposed within chamber 302 so as to divide chamber 302 into
a liquid compartment 306 and a solid-liquid composition compartment
308. Chamber 302 is shaped so as to define (a) one or more (e.g.,
exactly one) liquid ports 310 in fluid communication with liquid
compartment 306, and (B) one or more (e.g., exactly one)
solid-liquid composition ports 312 in fluid communication with
solid-liquid composition compartment 308.
[0876] Composition delivery source 300 further comprises: [0877] a
solid-liquid composition delivery tube 314, which is in fluid
communication with at least one of the one or more solid-liquid
composition ports 312; [0878] a mixing tube 316, which is in fluid
communication with at least one of the one or more liquid ports 310
and at least one of the one or more solid-liquid composition ports
312; and [0879] a liquid-supply tube 318, which is in fluid
communication with at least one of the one or more liquid ports
310, and is coupled in fluid communication with an interior of
liquid solution container 366.
[0880] Pump unit 301 comprises: [0881] a mixing pump 322, which is
arranged to cause flow in mixing tube 316, typically
unidirectionally; and [0882] a liquid-supply pump 324, which is
arranged to cause flow in liquid-supply tube 318, typically
oscillating (bidirectional) flow.
[0883] It is noted that mixing tube 316 is considered to be in
fluid communication with the at least one of the one or more liquid
ports 310 and the at least one of the one or more solid-liquid
composition polls 312 even though mixing tube 316 is intermittently
not in such fluid communication because of the operation of
liquid-supply pump 324, as described hereinbelow. Similarly, it is
noted that liquid-supply tube 318 is considered to be in fluid
communication with the at least one of the one or more liquid ports
310 and to be coupled in fluid communication with the interior of
liquid solution container 366 even though liquid-supply tube 318 is
intermittently not in such fluid communication because of the
operation of mixing pump 322, as described hereinbelow.
[0884] For some applications, each of the tubes comprises one or
more tube segments that are coupled together to form the complete
tube, such as for applications in which the pumps do not comprise
peristaltic pumps and respective tube segments are coupled to an
inlet and an outlet of a pump.
[0885] For some applications, as shown in FIGS. 14 and 15, mixing
tube 316 (a) merges with liquid-supply tube 318 at an exit junction
326, and (b) is in fluid communication with the at least one of the
one or more liquid ports 310 via a portion of liquid-supply tube
318. For other applications, liquid-supply tube 318 (a) merges with
mixing tube 316 at an exit junction, and (b) is in fluid
communication with the at least one of the one or more liquid ports
310 via a portion of mixing tube 316 (not shown, but functionally
equivalent to the above-mentioned shown configuration).
[0886] For some applications, as shown in FIGS. 15 and 16A, mixing
tube 316 (a) merges with solid-liquid composition delivery tube 314
at a return junction 328, and (b) is in fluid communication with
the at least one of the one or more solid-liquid composition ports
312 via a portion of solid-liquid composition delivery tube 314.
This merging may help free any solid bone graft particles 334 that
may become lodged in the one or more solid-liquid composition ports
312, because the flow into the one or more solid-liquid composition
ports 312 is via the portion of solid-liquid composition delivery
tube 314 in the opposite direction of flow during delivery of
solid-liquid composition 339 in particle-delivery activation state
344 as described hereinbelow with reference to FIGS. 17 and
18A-D.
[0887] For some applications, a proximal end 330 of solid-liquid
composition delivery tube 314 is in fluid communication with the at
least one of the one or more solid-liquid composition ports 312,
and a distance D1 (labeled in FIG. 16A) between return junction 328
and proximal end 330 of solid-liquid composition delivery tube 314
is less than 60 mm, such as less than 20 mm. Disposing return
junction 328 so close to proximal end 330 of solid-liquid
composition delivery tube 314 reduces the amount of solid bone
graft particles 334 pumped back from solid-liquid composition
delivery tube 314 to solid-liquid composition compartment 308. For
other applications, mixing tube 316 is in fluid communication with
the at least one of the one or more solid-liquid composition ports
312 not via a portion of solid-liquid composition delivery tube
314. For some applications, an inner diameter of solid-liquid
composition delivery tube 314 is at least 1.4 mm, no more than 1.8
mm, and/or between 1.4 and 1.8 mm. For some applications,
solid-liquid composition delivery tube 314 is in fluid
communication with exactly one of the one or more solid-liquid
composition ports 312, and the exactly one port has a diameter of
between 0.1 and 0.3 mm less than the inner diameter of solid-liquid
composition delivery tube 314.
[0888] For some applications, an internal cross-sectional area of
solid-liquid composition delivery tube 314 perpendicular to an axis
of solid-liquid composition delivery tube 314 is non-decreasing
from return junction 328 to a distal end of solid-liquid
composition delivery tube 314. Typically, solid-liquid composition
339 (described hereinbelow with reference to FIG. 17) does not flow
along a converging flow path as it approaches the one or more
solid-liquid composition ports 312 from solid-liquid composition
compartment 308.
[0889] Reference is still made to FIG. 16A. For some applications,
when chamber 302 is oriented upright in the operational position
shown in FIG. 16A, return junction 328 is disposed on an upper side
of the solid-liquid composition delivery tube 314. In other words,
for some applications, return junction 328 is disposed along a
longitudinal portion 327 of solid-liquid composition delivery tube
314 and around a circumferential portion 329 of solid-liquid
composition delivery tube 314, and longitudinal portion 327
includes a point 331 that is closest to cap 374 when cap 374 is
coupled to receptacle component 370 (as described hereinbelow with
reference to FIGS. 20A-B). Circumferential portion 329 includes
point 331. This arrangement may reduce bone graft clogging, because
solid bone graft particles 334, because of gravity, are less likely
to flow upward back into mixing tube 316 toward mixing pump
322.
[0890] Reference is still made to FIG. 16A, and is additionally
made to FIG. 16B, which is a schematic illustration of another
configuration of a portion of composition delivery source 300, in
accordance with an application of the present invention. For some
applications, bone graft injection system 320 further comprises a
shaft unit 340, which comprises a shaft delivery tube 380 in fluid
communication with a distal end 382 of solid-liquid composition
delivery tube 314. For some applications, shaft unit 340 is more
rigid than at least a portion of solid-liquid composition delivery
tube 314 (all or a portion of solid-liquid composition delivery
tube 314 may be flexible). Shaft delivery tube 380 is further
shaped so as to define a distal opening 383, which is typically
disposed within 10 mm of a distal end 388 of shaft delivery tube
380, such as within 5 mm of distal end 388, in fluid communication
with shaft delivery tube 380. For example, distal opening 383 may
be disposed at distal end 388, as shown in FIG. 16A. Alternatively,
for some applications, such as shown in FIG. 16B, shaft delivery
tube 380 further comprises a cap 389 disposed distal to distal
opening 383; for these applications, distal opening 383 is
typically disposed within 10 mm, e.g., within 5 mm, of distal end
388 of shaft delivery tube 380 (distal end 388 of shaft delivery
tube 380 is defined by a distal-most point of cap 389).
[0891] For some applications, shaft unit 340 further comprises a
removable depth limiting element 384, which is configured to limit
a depth of insertion of shaft delivery tube 380 into a bore through
a bone when shaft delivery tube 380 is inserted into the bore, such
as described hereinbelow with reference to FIG. 21. For some
applications, depth limiting element 384 has a length, measured
alongside shaft delivery tube 380, of at least 6 mm, no more than
16 mm, and/or between 6 and 16 mm, such as at least 8 mm, no more
than 12 mm, and/or between 8 and 12 mm. For some applications, bone
graft injection system 320 further comprises a soft bite surface
381, which is configured to provide a soft surface for the teeth to
bite onto during a bone graft injection procedure. Typically, soft
bite surface 381 faces in generally the same direction that shaft
delivery tube 380 points.
[0892] For some applications, shaft delivery tube 380 further
comprises a sealing element 386 disposed around an external surface
of shaft delivery tube 380, and configured to form a liquid-tight
seal with (a) a channel of a screw, such as such as described
hereinbelow with reference to FIG. 21, or (b) tissue around and
outside the bore through the bone when shaft delivery tube 380 is
inserted into the bore. Typically, depth limiting element 384 is
removable from shaft unit 340 without removal of shaft unit 340
from sealing element 386. For some applications, distal end 388 of
shaft delivery tube 380 is disposed more distally than sealing
element 386 by a distance D2 of between 0 and 20 mm, e.g., between
3 and 15 mm.
[0893] Reference is still made to FIG. 16A. For some applications,
shaft delivery tube 380 is straight (as shown in the figures). For
some applications, when chamber 302, solid-liquid composition
delivery tube 314, and shaft unit 340 are unconstrained, (a) a
central longitudinal axis 390 of shaft delivery tube 380 and (b) a
central longitudinal axis 392 of a proximal longitudinal portion
394 of solid-liquid composition delivery tube 314 form an angle
.alpha. (alpha) of between 70 and 110 degrees, such as between 85
and 95 degrees, e.g., 90 degrees. Typically, proximal longitudinal
portion 394 of solid-liquid composition delivery tube 314 includes
proximal end 330 of solid-liquid composition delivery tube 314.
Alternatively or additionally, for some applications, when chamber
302, solid-liquid composition delivery tube 314, and shaft unit 340
are unconstrained, central longitudinal axis 390 of shaft delivery
tube 380 and a plane 396 defined by filter 304 form an angle .beta.
(beta) of between 70 and 110 degrees, such as between 85 and 95
degrees, e.g., 90 degrees. Further alternatively or additionally,
for some applications, when chamber 302 and solid-liquid
composition delivery tube 314 are unconstrained, (a) central
longitudinal axes 392 of proximal longitudinal portion 394 of
solid-liquid composition delivery tube 314 and (b) plane 396
defined by filter 304 are parallel or form an angle of less than 20
degrees, e.g., less than 5 degrees. Typically, proximal
longitudinal portion 394 of solid-liquid composition delivery tube
314 includes proximal end 330 of solid-liquid composition delivery
tube 314.
[0894] Reference is still made to FIG. 16A. For some applications,
a closest distance D3 between the one or more solid-liquid
composition ports 312 and filter 304 equals at least 5 mm, such as
at least 10 mm, and/or is less than 50 mm. Alternatively or
additionally, for some applications, the closest distance D3
between the one or more solid-liquid composition ports 312 and
filter 304 equals at least 75% of a distance D4 between filter 304
and a point 398 on an interior of a wall of solid-liquid
composition compartment 308 farthest from filter 304. These closest
distances provide space for raising solid bone graft particles 334
in a puff 399 into physiological liquid solution 336, as described
hereinbelow with reference to FIGS. 17 and 18B. Typically, the one
or more solid-liquid composition ports 312 are located through a
side wall of solid-liquid composition compartment 308 (rather than
a bottom wall of the solid-liquid composition compartment), to
prevent clogging of the one or more solid-liquid composition ports
312 as the solid bone graft particles 334 settle after being
raised.
[0895] For some applications, pump unit 301 further comprises
control circuitry 332. Typically, pump unit 301 further comprises a
power supply, electronics, a user interface 335 for controlling
bone graft injection system 320, and/or a foot control 333 for
controlling pump unit 301. For other applications, pump unit 301
does not necessarily comprise any circuitry, and the rotation and
relative timing of rotation of the pumps are achieved mechanically
(i.e., non-electronically), e.g., by connecting both pumps to a
common axle.
[0896] Reference is now made to FIG. 17, which is a timeline
schematically showing activation states of control circuitry 332,
in accordance with an application of the present invention.
Reference is also made to FIGS. 18A-D, which are schematic
illustrations of the activation states of control circuitry 332, in
accordance with an application of the present invention.
[0897] In some applications of the present application, bone graft
injection system 320 is configured to repeatedly (a) mix solid bone
graft particles 334 and physiological liquid solution 336 in
solid-liquid composition compartment 308 to form a solid-liquid
composition 339 and (b) pump solid-liquid composition 339 into
cavity 90 under a membrane, such as a Schneiderian membrane 88. For
some applications, in order to perform the mixing, bone graft
injection system 320 pumps filtered liquid from liquid compartment
306 into the bottom of solid-liquid composition compartment 308,
which raises solid bone graft particles 334 in a puff 399 into
physiological liquid solution 336 higher in solid-liquid
composition compartment 308. Because volume in chamber 302 is
conserved as fluid is pumped out of liquid compartment 306, the
pumped fluid reenters chamber 302 (rather than entering the portion
of solid-liquid composition delivery tube 314 beyond return
junction 328 in the opposite direction of chamber 302 (to the right
in FIGS. 15 and 16A)).
[0898] Typically, this mixing is repeated periodically, because
solid bone graft particles 334 very quickly settle and separate
from physiological liquid solution 336 (generally nearly all of the
particles settle within 500 ms). Typically, the immediately
following particle-delivery activation state 344 occurs (a) before
most of solid bone graft particles 334 settle and separate from
physiological liquid solution 336 and/or (b) even after solid bone
graft particles 334 have settled (in which case typically the solid
bone graft particles 334 that settled near the one or more
solid-liquid composition ports 312, and/or bone graft particles
puffed by the pulsating transfer itself).
[0899] FIG. 18A shows solid bone graft particles 334 settled at the
bottom of solid-liquid composition compartment 308 before being
mixed. This state occurs at the beginning of a bone graft injection
performed with bone graft injection system 320, and occurs, at
least approximately, near (e.g., slightly before, at, or slightly
after) the end of each particle-delivery activation state 344,
which is described below.
[0900] For some applications, in order to perform the mixing and
pumping described immediately above, control circuitry 332 is
configured to repeatedly (typically, in a plurality of cycles):
[0901] assume a mixing activation state 342, as shown in FIG. 18B,
in which control circuitry 332 activates mixing pump 322 to mix
solid bone graft particles 334 and physiological liquid solution
336 in solid-liquid composition compartment 308 to form
solid-liquid composition 339, by pumping physiological liquid
solution 336 through mixing tube 316 and into solid-liquid
composition compartment 308 (typically, the pumped physiological
liquid solution was already disposed in mixing tube 316, and
originated from liquid compartment 306 via the one or more liquid
ports 310), and [0902] assume a particle-delivery activation state
344, as shown in FIGS. 18C and 18D; control circuitry 332, during
at least a portion of particle-delivery activation state 344 (e.g.,
during positive particle-delivery activation sub-state 350, shown
in FIG. 18D, and described hereinbelow), activates liquid-supply
pump 324 to apply positive pressure to pump solid-liquid
composition 339 from solid-liquid composition compartment 308 into
solid-liquid composition delivery tube 314.
[0903] Typically, in order to perform the mixing during mixing
activation state 342, the physiological liquid solution pumped into
solid-liquid composition compartment 308 raises solid bone graft
particles 334 in a puff 399 into physiological liquid solution 336
in the compartment.
[0904] As mentioned above, control circuitry 332 is typically
configured to repeatedly, in a plurality of cycles, assume mixing
activation state 342 and particle-delivery activation state 344.
For some applications, control circuitry 332 is configured to
repeatedly assume mixing activation state 342 and particle-delivery
activation state 344 over a period time period having a duration of
at least 30 second, no more than 600 seconds, and/or between 30 and
600 seconds.
[0905] For some applications, control circuitry 332 is configured
to assume mixing activation state 342 and particle-delivery
activation state 344 at non-overlapping times, such as illustrated
in FIG. 17. For some applications, control circuitry 332 is
configured to assume particle-delivery activation state 344 within
500 ms after completing mixing activation state 342, such as within
100 ms after completing mixing activation state 342, e.g.,
immediately after completing mixing activation state 342, as shown
in FIG. 17.
[0906] For some applications, control circuitry 332 is configured
to repeatedly, in alternation, (a) assume mixing activation state
342 for between 100 and 1200 ms, such as between 200 and 800 ms,
e.g., 400 ms, and (b) assume particle-delivery activation state
344. For some applications, control circuitry 332 is configured to
repeatedly, in alternation, (a) assume mixing activation state 342
for between 100 and 1200 ms, and (b) assume particle-delivery
activation state 344 for between 150 and 3000 ms, such as between
1000 and 2000 ms, e.g., 1400 ms.
[0907] Typically, control circuitry 332 is configured to, when in
particle-delivery activation state 344, activate liquid-supply pump
324 to apply the positive pressure to pump physiological liquid
solution 336 (a) from liquid solution container 366, (b) through
liquid-supply tube 318, (c) into liquid compartment 306, (d)
through filter 304, (e) into solid-liquid composition compartment
308, (f) from solid-liquid composition compartment 308, and (g) to
solid-liquid composition delivery tube 314.
[0908] In some applications of the present invention, control
circuitry 332 is configured, during each of one or more
negative-positive particle delivery cycles 346 of particle-delivery
activation state 344, to assume: [0909] a negative
particle-delivery activation sub-state 348, as shown in FIG. 18C,
in which control circuitry 332 activates liquid-supply pump 324 to
apply negative pressure to pump liquid from solid-liquid
composition delivery tube 314 toward liquid compartment 306 via
solid-liquid composition compartment 308, and [0910] a positive
particle-delivery activation sub-state 350, as shown in FIG. 18D,
in which control circuitry 332 activates liquid-supply pump 324 to
apply the positive pressure to pump solid-liquid composition 339
from solid-liquid composition compartment 308 into solid-liquid
composition delivery tube 314; a direction of pumping of
liquid-supply pump 324 in positive particle-delivery activation
sub-state 350 is opposite a direction of pumping of liquid-supply
pump 324 in negative particle-delivery activation sub-state
348.
[0911] In other words, control circuitry 332 is configured to cause
liquid-supply pump 324 to oscillate during each of one or more
negative-positive particle delivery cycles 346.
[0912] During positive particle-delivery activation sub-state 350,
solid-liquid composition 339 is injected into cavity 90. Solid bone
graft particles 334 of solid-liquid composition 339 typically
quickly settle toward the bottom of cavity 90 (generally within 100
ms). As a result, physiological liquid solution 336, substantially
without solid bone graft particles 334, remains near distal opening
383 of shaft delivery tube 380. During the immediately following
negative particle-delivery activation sub-state 348, mostly this
physiological liquid solution 336 remaining near distal opening
383, rather than the settled solid bone graft particles 334, is
pumped back into solid-liquid composition delivery tube 314. This
non-return of solid bone graft particles 334 may be aided by
positioning distal opening 383 near the roof of cavity 90, as
described hereinbelow with reference to blow-up C of FIG. 21. Thus
each positive-negative cycle results in a net delivery of solid
bone graft particles 334 to cavity 90.
[0913] For some applications, at least a portion of solid-liquid
composition 339 that is pumped out of chamber 302 in a given
positive particle-delivery activation sub-state 350 exits distal
opening 383 into cavity 90 before the completion of the given
positive particle-delivery activation sub-state 350, such as at
least 50%, e.g., at least 80%, such as 100%. For some applications,
control circuitry 332 is configured to pump, throughout positive
particle-delivery activation sub-state 350, a volume of
solid-liquid composition 339 that is greater than a combined volume
of solid-liquid composition delivery tube 314 and shaft delivery
tube 380, such as equal to at least 100% of the combined volume,
and/or less than 700% of the combined volume.
[0914] For some applications, control circuitry 332 is configured
to assume particle-delivery activation state 344 in a plurality of
particle-delivery-state cycles, and to begin particle-delivery
activation state 344 in each of the particle-delivery-state cycles
with negative particle-delivery activation sub-state 348. Beginning
with the negative particle-delivery activation sub-state 348
reduces the risk of accidentally overfilling cavity 90 with
solid-liquid composition 339, which might burst Schneiderian
membrane 88.
[0915] For some applications, as mentioned above, control circuitry
332 is configured to assume mixing activation state 342 and
particle-delivery activation state 344 at non-overlapping
times.
[0916] For some applications, control circuitry 332 is configured
to provide a plurality of the negative-positive particle delivery
cycles 346 during particle-delivery activation state 344. For some
applications, control circuitry 332 is configured to provide up to
10 of the negative-positive particle delivery cycles 346 during
particle-delivery activation state 344, such as between 3 and 6
cycles 346, e.g., 4 cycles 346.
[0917] For some applications, control circuitry 332 is configured
to assume negative particle-delivery activation sub-state 348 for
between 25 and 300 ms, such as between 100 and 200 ms, e.g., 175
ms, during each of the one or more negative-positive particle
delivery cycles 346. For some applications, control circuitry 332
is configured to assume negative particle-delivery activation
sub-state 348 for between 25 and 100 ms during each of the one or
more negative-positive particle delivery cycles 346
[0918] For some applications, control circuitry 332 is configured
to assume positive particle-delivery activation sub-state 350 for
between 25 and 300 ms, such as between 100 and 200 ms, e.g., 175
ms, during each of the one or more negative-positive particle
delivery cycles 346. For some applications, control circuitry 332
is configured to assume positive particle-delivery activation
sub-state 350 for between 25 and 100 ms during each of the one or
more negative-positive particle delivery cycles 346.
[0919] For some applications, control circuitry 332 is configured
to assume negative particle-delivery activation sub-state 348 for
between 25 and 300 ms during each of the one or more
negative-positive particle delivery cycles 346, and to assume
positive particle-delivery activation sub-state 350 for between 25
and 300 ms during each of the one or more negative-positive
particle delivery cycles 346.
[0920] For some applications, control circuitry 332 is configured
to assume negative particle-delivery activation sub-state 348 for a
first duration during each of the one or more negative-positive
particle delivery cycles 346, and to assume positive
particle-delivery activation sub-state 350 for a second duration
during each of the one or more negative-positive particle delivery
cycles 346, the second duration equal to between 80% and 120% of
the first duration, such as between 90% and 110% of the first
duration.
[0921] For some applications, control circuitry 332 is configured
to, when in negative particle-delivery activation sub-state 348,
activate liquid-supply pump 324 to pump the liquid from
solid-liquid composition delivery tube 314, into solid-liquid
composition compartment 308, and into liquid compartment 306.
[0922] Reference is made to FIG. 19, which is a schematic
illustration of configurations of mixing pump 322 and liquid-supply
pump 324, in accordance with an application of the present
invention. In these configurations, mixing pump 322 is a mixing
peristaltic pump 352A, and liquid-supply pump 324 is a
liquid-supply peristaltic pump 352B. Peristaltic pumps 352A and
352B comprise (a) respective rotors 354A and 354B, (b) respective
motors, and, for some applications, (c) respective index sensors
356A and 356B, which identify respective rotational positions of
rotors 354A and 354B. Mixing peristaltic pump 352A comprises one or
more rollers 358A (typically, three or more rollers 358A, such as
exactly three rollers 358A), and liquid-supply peristaltic pump
352B comprises one or more rollers 358B (typically, two or more
rollers 358, such as three or more rollers 358B, such as exactly
three rollers 358B). For some applications, the index sensors
comprise optical sensors; for example, the rollers may comprise
visible flags that serve as indices, and the optical sensors may
image the flags to ascertain the rotational positions of the
rollers and thus the rotors. Alternatively, for some applications,
the index sensors comprise position (rotation) sensors. FIG. 19
shows mixing and liquid-supply peristaltic pumps 352A and 352B in
exemplary respective starting rotational positions within
respective rotational cycles.
[0923] Mixing peristaltic pump 352A comprises a pump casing 360A
that is shaped so as to define a partial-circle mixing tube channel
362A in which a portion of mixing tube 316 is disposed. Similarly,
liquid-supply peristaltic pump 352B comprises a pump casing 360B
that is shaped so as to define a partial-circle liquid-supply tube
channel 362B in which a portion of liquid-supply tube 318 is
disposed. For some applications, the portions of the tubes disposed
in the partial-circle liquid-supply tube channels comprise
silicone, which may be more flexible than the material that other
portions of the tubes comprise. Alternatively or additionally, for
some applications, the portions of the tubes disposed in the
partial-circle liquid-supply tube channels may have larger
diameters than the diameters of the other portions of the tubes.
These larger diameters may increase the pumping rate. The smaller
diameters of the other portions of the tubes may reduce the total
volume of fluid in the system, which may reduce the volume of fluid
needed to operate the system. Typically, mixing peristaltic pump
352A rotates unidirectionally, e.g., clockwise in FIG. 19.
[0924] For some applications, mixing peristaltic pump 352A and the
portion of mixing tube 316 disposed within mixing tube channel 362A
are configured such that mixing peristaltic pump 352A pumps at
least 2 cc, no more than 4 cc, and/or between 2 and 4 cc of fluid
per full revolution, such as 2.7 cc. For some of these
applications, the portion of mixing tube 316 disposed within mixing
tube channel 362A has an inner diameter of at least 3.2 mm, no more
than 9.6 mm, and/or between 3.2 and 9.6 mm, e.g., 6.4 mm.
[0925] For some applications, liquid-supply peristaltic pump 352B
and the portion of liquid-supply tube 318 disposed within
liquid-supply tube channel 362B are configured such that
liquid-supply peristaltic pump 352B pumps at least 2 cc, no more
than 4 cc, and/or between 2 and 4 cc of fluid per full revolution,
such as 2.7 cc. For some of these applications, the portion of
liquid-supply tube 318 disposed within liquid-supply tube channel
362B has an inner diameter of at least 3.2 mm, no more than 9.6 mm,
and/or between 3.2 and 9.6 mm, e.g., 6.4 mm.
[0926] When a roller 358 is fully engaged and closes off a tube,
the roller pushes a certain amount of liquid as it rotates. As the
leading roller begins to disengage from the tube, the next roller
behind the leading roller continues the pushing. However, since the
leading roller is disengaging from the tube, the leading roller
allows the tube to open up and hold a larger volume of liquid. This
absorption of liquid not pushed out of the pump reduces flow. There
are no voids anywhere in the tube. A reverse effect occurs as the
next roller begins engaging the tube. Maximum flow is achieved
during the period in which the leading roller is fully engaged with
tube. This is the range in which the oscillating liquid-supply
peristaltic pump 352B works. In a closed system, such as described
herein, the amount of liquid in the pillows in liquid-supply
peristaltic pump 352B is minimal when the most rollers are engaged
with the tube. If exactly three rollers are provided, this minimum
occurs, for example, when two of the rollers are symmetrically
located at 10 o'clock and 2 o'clock. For some applications, this is
the starting rotational position of mixing pump peristaltic pump
352A, since maximum liquid is in cavity 90 under Schneiderian
membrane 88.
[0927] Liquid-supply peristaltic pump 352B is capable of (a)
pumping fluid at an average rate throughout a full 360-degree
revolution of rotor 354B at a certain speed, and (b) pumping fluid
at a maximum rate during portions of the full 360-degree revolution
at the certain speed. The maximum rate is greater than the average
rate. For some applications, control circuitry 332 is configured,
when in both positive and negative particle-delivery activation
sub-states 350 and 348, to activate liquid-supply peristaltic pump
352B to (a) rotate rotor 354B, at the certain speed, a partial
revolution equal to a fraction of the full 360-degree revolution of
rotor 354B, the fraction less than 1, and (b) pump, throughout the
partial revolution, the fluid at the maximum rate.
[0928] For some applications, control circuitry 332 is configured:
[0929] when in positive particle-delivery activation sub-state 350,
to activate liquid-supply peristaltic pump 352B to rotate the rotor
354B, in a first rotational direction RD.sub.1 (e.g., clockwise in
FIG. 19), a first partial revolution equal to a fraction of a full
360-degree revolution of the rotor 354B, the fraction less than 1,
and [0930] when in negative particle-delivery activation sub-state
348, to activate liquid-supply peristaltic pump 352B to rotate
rotor 354B, in a second rotational direction RD.sub.2 (e.g.,
counterclockwise in FIG. 19) opposite the first rotational
direction RD.sub.1, a second partial revolution equal to the
fraction of the full 360-degree revolution of the rotor.
[0931] This technique for rotating rotor 354B results in
liquid-supply peristaltic pump 352B producing a net output of zero,
while maximizing both the positive and negative flow, because one
of rollers 358B is always squeezing, and thus occluding,
liquid-supply tube 318 (and thus pumping).
[0932] For some applications, control circuitry 332 is configured,
throughout positive particle-delivery activation sub-state 350, to
activate liquid-supply peristaltic pump 352B to: [0933] rotate
rotor 354B a partial revolution equal to a fraction of a full
360-degree revolution of rotor 354B, the fraction less than the
quotient of 1 divided by the total number of rollers 358B, or, for
example, less than or equal to the quotient of 0.5 divided by the
total number of rollers 358B (for example, in FIG. 19, the fraction
is indicated by arrow RD.sub.1 and equals 1/6, which is the
quotient of 0.5 divided by 3), and [0934] pump, throughout the
partial revolution, a volume of fluid that is greater than the
product of the fraction and a volume of fluid pumpable throughout
the full 360-degree revolution of the rotor. For some applications,
in order to achieve this volume of fluid pumping, control circuitry
332 is configured to rotationally position rotor 354B such that a
lead one of rollers 358B is rotationally aligned with (fully
squeezing) mixing tube channel 362A (and is thus operative)
throughout positive particle-delivery activation sub-state 350 (the
lead roller is the forward-most roller rotationally aligned with
partial-circle mixing tube channel 362A; one or more additional
rollers may also be rotationally aligned with the tube channel,
trailing the lead roller). For example, if the upstream entrance to
mixing tube channel 362A is disposed at 9 o'clock and the
downstream exit of mixing tube channel 362A is disposed at 3
o'clock (as shown in FIG. 19), the exactly one of rollers 358B may
operate between 11 o'clock and 1 o'clock throughout positive
particle-delivery activation sub-state 350.
[0935] As used in the present application, including in the claims,
"throughout" a time period (e.g., a particular state or sub-state)
means from the beginning to the end of the time period (e.g., an
occurrence of the state or sub-state). As mentioned above, each of
the states and sub-states typically occur a plurality of
non-contiguous times during operation of bone graft injection
system 320.
[0936] For some applications, mixing peristaltic pump 352A
comprises a total number of rollers 358A equal to at least two, and
control circuitry 332 is configured to assume mixing activation
state 342 a plurality of times in alternation with
particle-delivery activation states 344, and to begin mixing
activation states 342 with rotor 354A at respective starting
rotational positions, which are identical to one another or
rotationally offset from one another by the product of (a) 360
degrees divided by the total number of rollers 358A and (b) a
positive integer (i.e., 1 or greater). For example, for
configurations in which mixing peristaltic pump 352A comprises
exactly three rollers 358A, such as shown in FIG. 19, there are
three starting rotational positions which result in the same flow
rate over the same partial rotational cycle.
[0937] For some applications, mixing peristaltic pump 352A
comprises an odd total number of rollers 358A, the odd total number
equal to at least one (e.g., at least three), and control circuitry
332 is configured to assume mixing activation state 342 a plurality
of times in alternation with particle-delivery activation states
344, and to begin each of mixing activation states 342 with an
aligned total number of rollers 358A rotationally aligned with
mixing tube channel 362A, the aligned total number equal to more
than half of the odd total number. (Thus, in the case in which
mixing peristaltic pump 352A comprises exactly three rollers 358A,
as shown in FIG. 19, control circuitry 332 is configured to begin
each of mixing activation states 342 with two of rollers 358A
rotationally aligned with mixing tube channel 362A, i.e., the
aligned total number equals 2, which is more than half of the odd
total number (1.5).) As a result of this configuration, each of
mixing activation states 342 begins with a minimum volume of liquid
held within the portion of mixing tube 316 in mixing tube channel
362A. As a result, any rotation of rotor 354A will draw liquid from
the system and therefore will, if anything, reduce the volume of
liquid in cavity 90 under Schneiderian membrane 88, thereby
avoiding accidental overfilling of cavity 90 and bursting of
Schneiderian membrane 88. In addition, cavity 90 returns to its
full and maximum-filled state at end of each of the mixing
activation states 342. As a result, mixing peristaltic pump 352A
has full control of the maximum volume and variation in volume in
cavity 90. Typically, the mixing activation state always begins
when the volume cavity 90 is at a maximum, in order to avoid
overfilling the cavity and bursting Schneiderian membrane 88.
[0938] For some applications, control circuitry 332 is configured,
when in mixing activation state 342, to rotate mixing peristaltic
pump 352A between 1/3 and 3 revolutions, such as one revolution,
such as for applications in which mixing peristaltic pump 352A
comprises exactly three rollers 358A. More generally, for some
applications, control circuitry 332 is configured, when in mixing
activation state 342, to rotate mixing peristaltic pump 352A
between (a) a number of revolutions and (b) 3 revolutions, the
number of revolutions equal to the quotient of 1 divided by the
number of rollers 358A. For some applications, control circuitry
332 is configured, when in mixing activation state 342, to rotate
mixing peristaltic pump 352A at a rate of at least 50 rpm
(revolutions per minute), no more than 600 rpm, and/or between 50
and 600 rpm, e.g., 150 rpm. This rapid rotation helps generate the
puff 399 described hereinabove with reference to FIG. 17.
[0939] For some applications, control circuitry 332 is configured:
[0940] when in positive particle-delivery activation sub-state 350,
to activate liquid-supply pump 324 to pump a volume of between 0.1
and 2 cc of fluid (e.g., between 0.2 and 0.9 cc, such as between
0.3 and 0.6 cc), and [0941] when in negative particle-delivery
activation sub-state 348, to activate liquid-supply pump 324 to
pump the volume of fluid.
[0942] Alternatively or additionally, for some applications,
control circuitry 332 and mixing pump 322 are configured such that
throughout mixing activation state 342 (i.e., during each
occurrence of mixing activation state 342 in configurations in
which mixing activation state 342 occurs more than once in
alternation with particle-delivery activation state 344), pump 322
pumps between 0.5 and 9 cc of physiological liquid solution 336,
such as between 1.8 and 3.9 cc of physiological liquid solution
336.
[0943] For some applications, control circuitry 332 is configured
to assume particle-delivery activation state 344 a plurality of
times in alternation with mixing activation states 342, and to
begin each of particle-delivery activation states 344 with rotor
354B at a same rotational position.
[0944] For some applications, control circuitry 332 and
liquid-supply pump 324 are configured such that during at least a
portion of positive particle-delivery activation sub-state 350,
liquid-supply pump 324 pumps physiological liquid solution 336 at a
rate of at least 3 cc/sec, such as at least 7 cc/sec. Alternatively
or additionally, for some applications, control circuitry 332 and
liquid-supply pump 324 are configured such that during at least a
portion of the negative particle-delivery activation sub-state 348,
liquid-supply pump 324 pumps physiological liquid solution 336 at a
rate of at least 3 cc/sec, such as at least 7 cc/sec. Further
alternatively or additionally, for some applications, control
circuitry 332 and mixing pump 322 are configured such that during
at least a portion of mixing activation state 342 mixing pump 322
pumps physiological liquid solution 336 at a rate of at least 3
cc/sec, such as at least 7 cc/sec.
[0945] For some applications, control circuitry 332 is configured
to, before repeatedly assuming mixing and particle-delivery
activation states 342 and 344, assume a filling state, in which
control circuitry 332 activates liquid-supply pump 324 to apply
positive pressure to pump a volume of physiological liquid solution
336 from solid-liquid composition compartment 308 into solid-liquid
composition delivery tube 314, the volume equal to between 0.5 and
3 cc.
[0946] For some applications, control circuitry 332 is configured
to assume mixing activation slate 342 and particle-delivery
activation state 344 at partially-overlapping times. For some of
these applications, control circuitry 332 is configured to assume
negative particle-delivery activation sub-state 348 and
particle-delivery activation state 344 at partially-overlapping
times. For example, control circuitry 332 may be configured to:
[0947] begin negative particle-delivery activation sub-state 348
toward the end of mixing activation state 342 (e.g., within the
last 30% of mixing activation state 342), [0948] complete negative
particle-delivery activation sub-state 348 either simultaneously
with the completion of mixing activation state 342, or after the
completion of mixing activation state 342, and [0949] begin
positive particle-delivery activation sub-state 350 upon the
completion of negative particle-delivery activation sub-state 348,
typically immediately upon the completion of negative
particle-delivery activation sub-state 348.
[0950] For some applications, control circuitry 332 is configured
to assume mixing activation state 342 and particle-delivery
activation state 344 at the same time.
[0951] Reference is now made to FIGS. 20A-B, which are schematic
illustrations of chamber 302, in accordance with an application of
the present invention. In this configuration, chamber 302 comprises
a receptacle component 370 and a cover component 372. Cover
component 372 (a) comprises filter 304, and (b) is shaped so as to
define a cap 374 and (ii) a bone-graft container 376 having an
opening 378 that (x) faces away from cap 374 and (y) is farther
from cap 374 than filler 304 is from cap 374. Receptacle component
370 and cover component 372 are shaped so as to be reversibly
coupleable with each another to form a watertight seal, with
bone-graft container 376 disposed within receptacle component
370.
[0952] Before receptacle component 370 and cover component 372 are
coupled to each another, bone-graft container 376 contains solid
bone graft particles 334. For some applications, such as when
bone-graft container 376 is provided pre-loaded with solid bone
graft particles 334, bone-graft container 376 further comprises a
temporary cap (not shown). For some applications, bone-graft
container 376 is placed upside-down on a surface, such that opening
378 is facing up. The temporary cap, if provided, is removed.
Receptacle component 370 of chamber 302 is coupled to bone-graft
container 376 while bone-graft container 376 remains upside-down.
Typically, chamber 302 is turned over to its upright operational
position only after bone graft injection system 320 has filled the
chamber with physiological liquid solution 336 in the filling state
described above.
[0953] For some applications, bone-graft container 376 has a volume
of between 0.2 and 6 ml. Alternatively or additionally, for some
applications, chamber 302 has a volume of between 0.2 and 20 ml.
Further alternatively or additionally, for some applications, a
volume of bone-graft container 376 equals at least 10% of and/or
less than 50% of a volume of chamber 302, such as less than 33%,
e.g., less than 20% of the volume of chamber 302.
[0954] Reference is now made to FIG. 21, which is a schematic
illustration of a portion of a method of using bone graft injection
system 320, in accordance with an application of the present
invention. This portion of the method is typically performed after
Schneiderian membrane 88 has been raised to form cavity 90 between
the second (upper) side of maxillary bone 82 and Schneiderian
membrane 88, such as using hydraulic pressure or mechanical
elevation, either using shaft unit 340 of bone grail injection
system 320 (typically by injecting physiological solution through
shaft delivery tube 380 after inserting shaft delivery tube 380
into bore 86), or using another dental tool or a dental implant. In
blow-up A of FIG. 21, Schneiderian membrane 88 has settled toward
the bottom of cavity 90, such as after injected saline solution has
been allowed to drain front cavity 90 through the tool and/or the
bore through the bone.
[0955] For some applications, user interface 335 of bone graft
injection system 320 includes one or more of the following user
controls (which may comprise, for example, buttons), for performing
the following functions during use of bone graft injection system
320 in a bone augmentation procedure: [0956] a "load" user control,
which instructs control circuitry 332 to fill all of the tubes of
bone graft injection system 320 with physiological liquid solution
336, during the filling state described above with reference to
FIG. 19; [0957] a "volume" user control, which specifies the
maximum volume of physiological liquid solution 336 to be injected
into cavity 90 by control circuitry 332; [0958] a "raise" user
control, which instructs control circuitry 332 to raise
Schneiderian membrane 88 by injecting the volume of physiological
liquid solution 336 specified by the "volume" user control (the
user activates the "raise" user control when removable depth
limiting element 384 is attached to shaft delivery tube 380 and
shaft delivery tube 380 is disposed as described hereinbelow with
reference to blow-up B of FIG. 21); [0959] a "start" user control,
which instructs control circuitry 332 to deliver solid bone graft
particles 334 into cavity 90, as described herein (the user
activates the "start" user control after removing removable depth
limiting element 384 from shaft delivery tube 380 and advancing
shaft delivery tube 380 into cavity 90, as described hereinbelow
with reference to blow-up C of FIG. 21); [0960] a "stop" user
control, which instructs control circuitry 332 to cease delivering
solid bone graft particles 334; and [0961] an "empty" user control,
which instructs control circuitry 332 to pump all of physiological
liquid solution 336 from the system.
[0962] For some applications, a method of using bone graft
injection system 320 comprises inserting, from a first (lower) side
of maxillary bone 82 of a jaw, shaft delivery tube 380 of shaft
unit 340 of bone graft injection system 320 into bore 86 that
passes through maxillary bone 82 from the first (lower) side to the
second (upper) side of maxillary bone 82, such that distal opening
383 of shaft delivery tube 380 is disposed in bore 86 or in cavity
90 that is (a) adjacent to the second side of maxillary bone 82 and
(b) between the second side of maxillary bone 82 and Schneiderian
membrane 88. (As mentioned hereinbelow, distal opening 383 is in
fluid communication with shaft delivery tube 380.) For some
applications, distal opening 383 is disposed at tho distal end of
shaft delivery tube 380, and positioning distal opening 383
comprises positioning the distal end of shaft delivery tube 380 at
the location.
[0963] For some applications, a screw 400 that defines a channel is
screwed into bore 86 before insertion of shaft delivery tube 380,
and shaft delivery tube 380 is inserted into bore 86 by being
inserted into the channel of screw 400. Optionally, saline solution
was previously injected through the channel of the screw in order
to raise Schneiderian membrane 88. For some applications, a seal
(e.g., comprising an o-ring) is provided between the wall of the
channel and an external surface of shaft delivery tube 380.
Alternatively or additionally, a seal is provided against the first
(lower) side of first maxillary bone 82.
[0964] The method typically further comprises positioning distal
opening 383 near a roof 406 of cavity 90. For example, distal
opening 383 may be positioned at a
solid-liquid-composition-delivery location 402 at a distance D5
from the second side of maxillary bone 82, the distance D5 equal to
at least 50% (e.g., at least 75%) of a height H of cavity 90
directly above bore 86. Alternatively or additionally, for some
applications, distal opening 383 is positioned at a distance D6
between 2 and 12 mm, such as between 4 and 6 mm from Schneiderian
membrane 88 at roof 406 of cavity 90 directly above bore 86.
Providing such spacing between distal opening 383 and Schneiderian
membrane 88 may prevent solid-liquid composition 339 from
rebounding off the membrane directly back into distal opening 383
before solid bone graft particles 334 can settle in the cavity.
[0965] The method further comprises providing solid-liquid
composition 339 from a solid-liquid composition source, such as
chamber 302 and other elements of bone graft injection system 320
that are coupled in fluid communication with shaft delivery tube
380, typically by activating pump unit 301, such as by activating
control circuitry 332. While distal opening 383 is positioned at
solid-liquid-composition-delivery location 402, solid-liquid
composition 339 is injected through distal opening 383 via shaft
delivery tube 380. Typically, while solid-liquid composition 339 is
injected, chamber 302 is oriented such that liquid compartment 306
is above solid-liquid composition compartment 308. Typically, when
chamber 302 is oriented such that liquid compartment 306 is above
solid-liquid composition compartment 308: (a) the one or more
solid-liquid composition ports 312 are disposed no more than a
distance from a bottom of solid-liquid composition compartment 308,
the distance equal to 25% of a vertical height of solid-liquid
composition compartment 308, and/or (b) the one or more
solid-liquid composition ports 312 are located through a side wall
of solid-liquid composition compartment 308. Typically, while
solid-liquid composition 339 is injected, solid-liquid composition
delivery tube 314 is oriented within 45 degrees of horizontal, such
as within 15 degrees of horizontal, e.g., horizontally. (As used in
the present application, including in the claims, "horizontal"
means horizontal with respect to the Earth, i.e., perpendicular to
a vertical line directed to the center of gravity of the Earth,
e.g., as ascertained using a plumb-line.)
[0966] For some applications, the method further comprises raising
Schneiderian membrane 88 by injecting physiological liquid solution
336 through shaft delivery tube 380, such as shown in blow-up B of
FIG. 21. For some applications, raising Schneiderian membrane 88
comprises positioning distal opening 383 at a liquid-delivery
location 404 that is within bore 86 or within 1 mm above bore 86;
and, while distal opening 383 is positioned at liquid-delivery
location 404, injecting physiological liquid solution 336 to raise
Schneiderian membrane 88. Distal opening 383 is positioned at
solid-liquid-composition-delivery location 402 after finishing
injecting physiological liquid solution 336 to raise Schneiderian
membrane 88.
[0967] For some applications, distal opening 383 is positioned at
liquid-delivery location 404 while removable depth limiting element
384 is attached to shaft delivery tube 380. Removable depth
limiting element 384 limits advancement of shaft delivery lube 380
through bore 86. Positioning distal opening 383 at
solid-liquid-composition-delivery location 402 comprises removing
depth limiting element 384 from shaft delivery tube 380, and
subsequently advancing shaft delivery tube 380 through bore 86
until distal opening 383 reaches solid-liquid-composition-delivery
location 402, such as shown in blow-up C of FIG. 21.
[0968] For some applications, injecting solid-liquid composition
339 comprises pumping solid-liquid composition 339 through distal
opening 383 via shaft delivery tube 380 at a pulsating hydraulic
pressure that periodically varies between positive and
negative.
[0969] For some applications, bone graft injection system 320 is
used to perform the techniques described hereinabove with reference
to FIGS. 12A-B or FIG. 13, mutatis mutandis.
[0970] Although the techniques described herein have been generally
described for use with bone graft particles, these techniques may
also be used with other solid particles, such as, as for example,
drug-releasing solid particles or solid drug particles.
[0971] The scope of the present invention includes embodiments
described in the following patents and patent application
publications, which are assigned to the assignee of the present
application and are incorporated herein by reference. In an
embodiment, techniques and apparatus described in one or more of
the following patents or patent application publications are
combined with techniques and apparatus described herein: [0972]
U.S. Pat. No. 7,934,929 to Better et al. [0973] U.S. Pat. No.
8,029,284 to Better et al. [0974] U.S. Pat. No. 8,662,891 to
Uchitel et al. [0975] U.S. Pat. No. 8,388,343 to Better et al.
[0976] U.S. Pat. No. 8,702,423 to Better et al. [0977] PCT
Publication WO 2010/035270 to Better et al. [0978] PCT Publication
WO 2010/146573 to Better et al. [0979] PCT Publication WO
2014/199332 to Fostick et al.
[0980] It will be appreciated by persons skilled in the art that
the present invention is not limited to what has been particularly
shown and described hereinabove. Rather, the scope of the present
invention includes both combinations and subcombinations of the
various features described hereinabove, as well as variations and
modifications thereof that are not in the prior art, which would
occur to persons skilled in the art upon reading the foregoing
description.
* * * * *