U.S. patent number 3,919,774 [Application Number 05/392,382] was granted by the patent office on 1975-11-18 for combination endodontic apical sealer and crown post.
Invention is credited to Mark J. Fishman.
United States Patent |
3,919,774 |
Fishman |
November 18, 1975 |
Combination endodontic apical sealer and crown post
Abstract
A method and apparatus for sealing the apex of endodontically
treated teeth and simultaneously providing a post-core crown build
up for teeth that need both endodontics and a core for retention of
a crown, the apparatus involving an endodontic sealer screw or plug
having a shaft configured to bond with a root canal filler and a
crown core form.
Inventors: |
Fishman; Mark J. (Brooklyn,
NY) |
Family
ID: |
23550360 |
Appl.
No.: |
05/392,382 |
Filed: |
August 28, 1973 |
Current U.S.
Class: |
433/224 |
Current CPC
Class: |
A61C
13/30 (20130101); A61C 5/50 (20170201) |
Current International
Class: |
A61C
13/30 (20060101); A61C 5/04 (20060101); A61C
13/225 (20060101); A61K 005/02 () |
Field of
Search: |
;32/4R,57,13,15 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Peshock; Robert
Attorney, Agent or Firm: Rusz; Joseph E. Goldman; Sherman
H.
Government Interests
STATEMENT OF GOVERNMENT INTEREST
The invention described herein may be manufactured and used by or
for the Government for governmental purposes without the payment of
any royalty thereon.
Claims
What is claimed is:
1. A method for endodontically treating a tooth in combination with
a post-core crown build up procedure comprising the steps of
debridement of the nerve canal of said tooth, said nerve canal
having an apex, coronal and cervical regions,
cleaning and shaping the nerve canal with instruments of gradually
increasing size,
placing a sealing element having a sealing portion of substantially
the same size and shape as the apex of said canal at the apex of
said canal, said sealing element having a post portion which
extends from the apex through said canal beyond the cervical region
thereof,
syringe filling a liquid root canal filler into the apical region
of said canal,
packing the coronal region of said canal around said post portion
with a filling material,
applying a hardenable material around the exposed portion of said
post which extends beyond the cervical region of said canal, and
trimming and shaping said material and post for receipt of a
crown.
2. A method as defined in claim 1 wherein said cleaning and shaping
step includes enlarging the coronal region of said canal.
3. A method as defined in claim 2 wherein said cleaning and shaping
step includes placing an undercut in the cervical region of said
canal.
4. A method as defined in claim 1 wherein said step of placing a
sealing element involved a threaded engagement of said element with
the wall of said canal.
5. An apical sealing element for sealing the apex of a tooth root
canal which has been instrumented to a predetermined size at said
apex while providing a post for a post-core crown build up
comprising
a frusto-conical solid of revolution of a size corresponding to the
dimensions of the apical end of said root canal,
means on the outer periphery of said frusto-conical solid of
revolution and projecting therefrom for sealing said solid of
revolution to the apical end of a root canal, and
means at the larger end of and integral with said solid of
revolution forming a post for a post-core crown build up the end of
said post at said solid of revolution having a cross sectional area
less-than the largest cross sectional area of said solid of
revolution.
6. A device as defined in claim 5 wherein said means for sealing
comprises a thread around the tapered wall of said solid of
revolution for engagement with the wall of said root canal.
7. A device as defined in claim 5 wherein said means for sealing
comprises a gutta percha O-ring in a groove around the tapered wall
of said solid of revolution.
8. A device as defined in claim 5 including a domed portion at the
smaller end of said frusto-conical solid of revolution.
9. A device as defined in claim 8 wherein said element has a
material inert with respect to apical fluids and tissue at said
domed portion.
Description
BACKGROUND OF THE INVENTION
This invention relates generally to a technique and apparatus for
endodontically treating teeth and providing a support for a crown
and more particularly to a tapered self-sealing screw or plug
having an extension which forms a support for a crown while the
plug portion seals the apical end of a root canal.
Previously, endodontic procedures and preparation of a core for a
crown to be applied to an endodontically treated tooth involved two
or three procedures or visits and required canal impressions
followed by castings or gold posts which were not as stable as
might be desired. The endodontic procedure and apparatus has been
described in my copending application Ser. No. 374,824, filed June
29, 1973 and titled "Endodontic Apical Sealer Method and Apparatus"
and allows for the syringing of filler into lateral canals, when
present, and the main canal, without overfilling, i.e., the
presenting of the sealing material beyond the apex of the canal in
contact with periapical tissue.
When a tooth also required a post-core crown build up, a separate
procedure was instigated to ream the root canal remote from the
apex to receive a post. An impression of the canal and a casting of
a post to support a crown were formed as a part of the core build
up. This usually required separate visits.
SUMMARY OF THE INVENTION
This invention comprises an endodontic self-sealing apical element
or screw having an extension which is utilized in a post-core crown
build up to enable a technique capable of performing both functions
in a single procedure. The element is placed in position and sealed
to the root canal at its apex after filing or reaming. Root canal
filler is syringed and the coronal portion is packed. The core form
extension then has material brushed or packed around it and the
excess extension is removed and the material shaped.
Accordingly, it is an object of this invention to provide a
technique and apparatus which enables both endodontic and post-core
crown build up in one procedure.
It is another object of this invention to provide a structure which
enables the double sealing of root canals.
It is still another object of this invention to provide a technique
and apparatus which enables the provision of a secure seal at a
tooth root apex.
It is a further object of this invention to provide a combination
endodontic and post-core crown build up procedure which utilizes
canal syringing by controlling flow in the apical region.
It is a still further object of this invention to provide a
combination endodontic and post-core crown build up procedure which
avoids overfilling.
It is another object of this invention to provide a combination
endodontic post-core crown build up procedure which avoids the
removal of part of a root canal filler to make room for a post.
Still another object of this invention involves the utilization of
a post in a post-core crown build up procedure that can be as long
as the root canal thereby aiding in post retention.
A further object of this invention involves a combination
endodontic and post-core crown build up procedure which avoids the
usual step of taking impressions of a root canal.
A still further object of this invention involves a combination
endodontic and post-core crown build up procedure which avoids
fitting of a post to a root canal.
An additional object of this invention involves a post-core crown
build up procedure whereby the possibility of perforating the canal
when preparing it for a post is eliminated while allowing for the
use of undercuts.
A still additional object of this invention involves the provision
of a post for a post-core crown build up procedure which is longer
than that heretofore used to increase the stability thereof by
taking advantage of the root filling in order to enhance post
retention.
Another object of this invention involves a technique and apparatus
for a combination endodontic and post-core crown build up procedure
which greatly reduces procedure or chair time.
Still another object of this invention involves the provision of a
combination apical sealer element and post for core build up which
may be easily and economically manufactured of conventional
currently available materials that lend themselves to standard mass
production manufacturing techniques.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a partially schematic view in cross section of a portion
of a tooth which has been prepared in accordance with the method of
this invention;
FIG. 2 is a partially schematic view in cross section of a portion
of a tooth illustrating the apical sealing procedure and the
post-core crown build up procedure; and
FIG. 3 is a frontal view of an alternative form of the sealer
portion of the apical sealer element.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The invention involves both an endodontic procedure and a post-core
crown build up. The endodontic procedure follows generally the
description of my aforementioned copending patent application with
important differences as will become apparent subsequently.
The endodontic treatment of a tooth in accordance with my invention
follows the usual routine at the outset and involves debridement,
i.e., drilling to the nerve and removing it. At this point
measurement control may be effected by x-raying the tooth with a
file in place. Instrumentation for shaping and cleaning the canal
comprises the next step of the endodontic procedure and is usually
performed with tapered files or reamers of gradually increasing
size until the walls of the canal are properly cleaned and
prepared. FIG. 1 illustrates schematically a canal wherein the
apical wall portion 10 has been instrumented. The canal at this
point would be ready for sterilization and sealing of the apical
portion under normal circumstances; however, in the practice of
this invention a coronal portion 12 of the root canal is next
enlarged as illustrated in FIG. 1 by means of a bur or diamond
stone. The cervical region 14 of the canal is undercut next as
schematically illustrated in FIGS. 1 and 2 by means of an
appropriate bur in order to complete the mechanical preparation of
the canal for the combination endodontic and post-core crown build
up procedure. The canal may now be irrigated, i.e., flushed and
sterilized and, if desired, a culture procedure may be instigated
to determine the effectiveness of the sterilization.
The next step requires the sealing of the apex of the root canal
and represents a departure from standard procedures other than that
described in the aforementioned patent application. Since tapered
files or reamers used in the instrumentation step are usually
graduated and numbered to correspond to their size, and since they
are utilized by gradually increasing the size to enlarge the
passageway until the canal is properly cleaned and shaped, the
shape and size of the apical portion 10 of the root canal is
related to the last numbered file or reamer used in the
instrumentation procedure. The sizes of the sealer elements or
screws, therefore, are directly related to the file or reamer size,
and the one chosen for a particular endodontic procedure is in
accordance with the size of the last used file or reamer. The
sealer element or screw 16 is to be placed in contact with the
prepared canal wall at 10. If the accuracy of the placement of the
element is desired to be checked, the element is first dipped in
chlora percha or root canal cement and positioned within the canal
close to the apex thereof as illustrated in FIG. 2. After x-raying,
the element is finally positioned and the tooth is ready for the
filling of the canal. X-raying for determining the position is not
necessary in that the sealer element 16 of this invention has a
portion thereof 18 which may be graduated to provide a gaging of
the depth as a part of the structure as will be later
described.
FIG. 2 illustrates one embodiment of the sealing element 16 which
utilizes a sharp screw thread 20 on the frusto-conical solid of
revolution forming the tapered skirt portion 22 of the element. The
top 24 of the sealing screw is domed as shown in FIG. 2 in order to
minimize any possible irritation of periapical tissue which may
come in contact with it. Since the body fluids would be in contact
with the sealing element 16, it may be made of or plated with
ticonium or other non-reactive material at portion 24 or also along
the tapered skirt portion 22. It should be noted that the
dimensions of the screw are directly related to the last used
instrumenting file. The sharp thread 20 along the tapered portion
22 is utilized to engage the dentinal wall structure of the root
canal.
If a threaded engagement with the wall of the canal is not deemed
desirable, the embodiment of the sealing element or plug 16a, shown
in FIG. 3, may be utilized. The thread 20 of the embodiment of FIG.
2 is eliminated and has a gutta percha O-ring 20a in a groove 26 in
the tapered body or skirt portion 22. Chemical softening, for
example, with chloroform or heating to soften the gutta percha
enables a sealing action between the canal wall 10 and the skirt
portion 22.
When the embodiment of FIG. 2 is utilized, a one-quarter turn
clockwise is required to have the sharp thread 20 of the sealer
element or screw 16 in engagement with the dentinal canal wall 10
for sealing the apex of the root canal after the screw is
positioned.
The sealer elements 16 and 16a have attached to the bases 28
thereof a tapered post portion 18. The element and post structures
may be made separately and later joined or they may be manufactured
as a unitary, integral structure. The post is tapered and has on
its outer periphery either indentation or projections as
illustrated at 30, 32 and 34 which enable the intimate bonding of
any material in contact with the post 18 such that it forms a
matrix for the crown form. Although particular configurations for
30, 32 and 34 are shown in the post, any means for roughing the
area to enable engagement by the root canal filler would be
adequate. Additionally, the indentations or projections could be
located to form a graduation of the post for its utilization as a
depth gage. Also, numerical values could be applied for calibration
in accordance with depth for facilitating proper placement of the
sealer element.
After placement of the combined sealer element 16 or 16a and post
18, the root canal is syringed with liquid root canal filler 36
into the apical region of the canal. The coronal portion 12 with
the undercut at 14 is next packed with an acrylic or epoxy resin or
amalgam as illustrated by the numeral 38 in FIG. 2. The basic core
form 40 for the crown is either brushed on with liquid acrylic or
other resin or adaptic such as an epoxy resin is packed around the
exposed portion of the stump of the shaft 18.
It is optional as to whether the incisal excess of shaft 18 is
snipped to length prior to the core form build up or whether it is
done as part of the final step which is performed after the core
form material has hardened. The bulk of the resin crown form is
shaped for crown preparation as illustrated by the dashed lines in
FIG. 2 by means of an appropriate bur or diamond stone.
Conventional crown placement procedure is then followed.
Although the invention has been described with reference to
particular embodiments, it will be understood to those skilled in
the art that the invention is capable of a variety of alternative
embodiments within the spirit and scope of the appended claims.
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