JP3594867B2

JP3594867B2 - Dental instrument for removing broken pieces

Info

Publication number: JP3594867B2
Application number: JP2000066321A
Authority: JP
Inventors: 吉継寺内
Original assignee: Individual
Current assignee: Individual
Priority date: 2000-01-21
Filing date: 2000-03-10
Publication date: 2004-12-02
Anticipated expiration: 2020-03-10
Also published as: JP2001269356A

Description

【０００１】
【発明の属する技術分野】
本発明は、リーマーやファイル等の歯科用根管治療器具の一部が根管内に破折片として残留した場合にこれを除去する破折片除去用歯科器具に関する。
【０００２】
【従来の技術】
口腔内の食物残留物に細菌類が作用し生成される乳酸により、歯の組織が浸食されるのが齲歯、一般に言われるところの虫歯である。この齲歯が歯髄にまで及ぶと、係る歯髄を除去後に、歯髄が連通していた根管を適宜切削拡大し、消毒措置してガッタパーチャー充填等を行う根管治療を施すこととなる。
【０００３】
この根管治療における根管拡大作業に用いられるファイル等の治療器具は、象牙質、歯質、歯髄組織等を切削する作業に由来して切削余剰物や細菌付着等の各種汚染が容易に予測される。従って、該治療を受ける各患者毎に器具の廃棄刷新が行われることが理想ではあるが、実際には係る器具の洗浄殺菌を使用毎に繰り返し行い、機能的に使用に耐えられなくなるまで継続使用するのが一般的であった。
【０００４】
しかしながら、上記の継続使用の後半期には治療措置中に器具の先端が破断してしまうことも少なくない。従来はこの破断により生じた破折片が根管内に残留する状況となっても、破折片回収除去といった対応措置を歯科的に完全に施すことは困難であり、放置されることが散見された。
【０００５】
【発明が解決しようとする課題】
従来は上記のように、ファイル等が根管内で破断した破折片を回収除去する器具はおろか、技術そのものも確立されておらず早期の技術開発が待望されていた。そこで、本発明はこのような従来の課題に着目してなされたもので、根管内に残留した破折片を簡便確実に回収除去し、術後の経過も良好となる破折片除去用歯科器具を提供するものである。
【０００６】
【課題を解決するための手段】
この発明は上記目的を達成するためになされたもので、根管内に生じた根管治療用器具の破折片を除去回収する破折片除去用歯科器具であって、器具操作を行う者が把持する把持部と、該把持部の端部から突出した柄部と、該柄部を内包し柄部に沿って滑動可能な筒部と、柄部先端に設けられて、除去対象物の一部あるいは全部を挿通可能な連通孔と、該除去対象物を挟持するホールド孔とからなる環状の係止部とを備え、前記筒部は、前記係止部に前記除去対象物を挿通させた後、当該係止部に向けて滑動させることにより、前記除去対象物を前記係止部に挟持するものであることを特徴とする。
【０００８】
【発明の実施の形態】
以下、本発明の好ましい実施の形態につき、添付図面を参照して詳細に説明する。図１（ａ）は本発明の破折片除去用歯科器具の第一実施例を示す説明図であり、同（ｂ）は該器具の係止部の拡大図である。
【０００９】
本発明の破折片除去用歯科器具１０の構造は、例えば合成樹脂等からなる棒状の把持部１１と、該把持部１１の一端から突設されニッケルチタン或いはステンレス等からなる柄部１２と、該柄部１２先端に設けられた（或いは柄部そのものを加工した）係止部１３とからなる。本実施例における把持部１１には、操作を行う者がこの器具を把持する際に係止感を高めて操作を容易にし、疲労感を低減するグリップ部１１ａと、このグリップ部１１ａと連接し操作時の手指を載置する凹部１１ｂとが備わっている。これにより良好な操作感を得ることが出来る。
【００１０】
柄部１２は、治療用薬物や唾液等が付着しても汚染・浸食されにくい素材（例えばニッケルチタンやステンレス鋼など）で形成され、また、治療時に視界の妨げとならぬよう十分な細身でかつ、歯列を跨越すことが出来るよう屈曲部１２ａを備える。この柄部１２の先端を長楕円状に加工し、捻り撚ったのが頸部１２ｂであり、さらに、この加工後に頸部１２ｂ先端に残されたのが係止部１３である。
【００１１】
係る係止部１３が環状であれば、例えば（ｂ）図に示すように涙滴形状をなし、破折片を挿通させる連通孔１３ａと、破折片を実際に挟持するホールド孔１３ｂとからなる。
【００１２】
図２（ａ）〜（ｄ）は、上記破折片除去用歯科器具１０を用いて実際に破折片除去を行う手順を示す説明図である。また、図３はその際に破折片除去用歯科器具１０先端の係止部１３に破折片がホールドされている様子を示す拡大図である。
【００１３】
口腔内の歯列２０において、齲歯が根管２２の歯髄にまで及んだ歯２１について根管治療を施した後、破折片Ｐ除去のためにガッタパーチャーを適宜取り除いた状況を示すのが（ａ）図である。本実施例では、根管治療に際しファイル等の根管治療器具の先端が破断して破折片Ｐとなり、根管２２内に残留した場合を想定する。治療対象となる歯２１の上方からの拡大図が（ｂ）である。実際の治療現場ではこの拡大視は顕微鏡等の装置を用いて行うこととなり、上記ガッタパーチャー除去作業はこの顕微鏡による破折片Ｐの直視を行うために行われるのである。更に、破折片Ｐが根管２２奥部に残留した場合にはこのガッタパーチャー除去に続き、顕微鏡下において破折片Ｐ周囲の歯質２２ｂを超音波切削器具等にて切削し根管２２を拡径しておく。
【００１４】
同（ｂ）図においては、歯２１の歯髄根管口２２が３箇所存在し、そのうち右下の根管口２２ａに破折片Ｐが残留している。この破折片Ｐを除去するため、本発明の破折片除去用歯科器具１０を用いる。除去作業にあたっては、（ｃ）図に示すように係止部１３に破折片Ｐを挿通させる。この時、係止部１３の連通孔１３ａに破折片Ｐをまず通した後、引き寄せ動作により破折片Ｐを狭隘なホールド孔１３ｂに導き確実に挟持する（図３参照）。
【００１５】
挟持された破折片Ｐはそのまま破折片除去用歯科器具１０とともに根管２２より引き上げられ、この後、根管２２内に適宜充填措置を施して破折片Ｐの除去作業は完了する。
【００１６】
図４（ａ）は本発明の破折片除去用歯科器具の第２実施例を示す説明図であり、同（ｂ）は係止部１３において筒部Ｔにより破折片Ｐがホールドされている様子を示す拡大図である。なお、上記第１実施例と対応する部位には同符号を付してある。
【００１７】
破折片除去用歯科器具１０の第２実施例における構造は、合成樹脂等からなる棒状の把持部１１と、該把持部１１の一端から突設されニッケルチタン或いはステンレス等からなる柄部１２と、該柄部１２を内包し柄部１２に沿って滑動可能な筒部Ｔと、前記柄部１２先端に設けられた（或いは柄部そのものを加工した）係止部１３とからなる。本実施例においても第１実施例と同様、把持部１１にはグリップ部１１ａと、このグリップ部１１ａと連接し操作時の手指を載置する凹部１１ｂとが備わっている。これにより良好な操作感を得ることが出来る。
【００１８】
柄部１２は、治療用薬物や唾液等が付着しても汚染・浸食されにくい素材（例えばニッケルチタンやステンレス鋼など）で形成され、また、治療時に視界の妨げとならぬよう十分な細身でかつ、歯列を跨越すことが出来るよう屈曲部１２ａを備える。そして本実施例においては、前記筒部Ｔが必要以上に滑動しないように柄部１２表面の適宜領域に、ネジ溝１２ｃが設けられている。この柄部１２の先端を長楕円状に加工し、捻り撚ったのが頸部１２ｂであり、さらに、この加工後に頸部１２ｂ先端に残されたのが係止部１３である。係る係止部１３が環状であれば、例えば第１実施例と同様に涙滴形状をなし、破折片を挿通させる連通孔と、破折片を実際に挟持するホールド孔とからなると好適である。
【００１９】
このような破折片除去用歯科器具１０を使用した、根管内に残留している破折片Ｐの除去作業にあたっては、第１実施例と同様に、根管に覆い被さっているガッタパーチャーを適宜除去し、顕微鏡下において破折片Ｐ周囲の歯質を超音波切削器具等にて切削し根管を拡径しておく。次に（ｂ）図に示すように歯科器具１０を治療対象となる歯に導入し、係止部１３に破折片Ｐを挿通させる。この時、係止部１３に破折片Ｐを通した後、筒部Ｔを係止部１３に向け沿って滑動させ破折片Ｐを狭隘化された係止部１３内に確実に挟持する。挟持された破折片Ｐはそのまま破折片除去用歯科器具１０とともに根管より引き上げられ、この後、根管内に適宜充填措置を施して破折片Ｐの除去作業は完了する。
【００２０】
この第２実施例の破折片除去用歯科器具１０によれば、破折片除去の作業において係止部１３に破折片Ｐを挿通させれば特に細やかな施術テクニックを要する状況も少なく、単純に筒部Ｔをスライドさせて破折片Ｐを挟み込めば破折片Ｐの把持は確実に行えることになる。これにより除去作業をより一層確実ならしめ、簡便化と効率化との両面の向上を図ることにもつながる。
【００２１】
これ以外の実施例として、破折片Ｐ表面の螺線条等に引っかかり或いは打ち込み可能な突起部を前記係止部１３に設けた破折片除去用歯科器具もある（特に図示しない）。この器具によると、係止部に破折片Ｐを挿通した後に、前記突起部に破折片Ｐを引っかけてバインドさせ、そのまま根管内から引き上げて破折片除去を行うこととなる。係る突起部は、係止部上において外方に凸の方向に設けられ、単なる直針形状の他に鈎状、多枝状、波状等種々の形状が採用できる。その設置数も破折片Ｐをバインド出来れば単数でも複数でも問題ない。
【００２２】
なお本発明の破折片除去用歯科器具１０は、本実施例に示した把持部１１及び柄部１２の形状のみに限定されず、使用状況や用途に応じて様々な形態をとることができる。
【００２３】
また、係止部１３の形状は破折片Ｐをホールドできるものであればいずれの形状でもよく、或いは、単なる環状などではなく投げ縄状に締付け機能（例えば操作者が手元で締付け動作を行うものなど）を有する構造となっていてもよい。更には、係止部１３自体（全部又は一部）が磁性を帯びて破折片Ｐを磁着させ、破折片Ｐが係止部１３から落下することを防ぐ機能を備えたり、或いはその様な磁性体を係止部１３に取り付けた構造であってもよい。
【００２４】
【発明の効果】
本発明によれば、従来除去回収が非常に困難で放置されることがままあった破折片を、簡便かつ確実に除去することが可能となる。これにより歯科的治療に限らずある種の外科的手術の必要性すら予見される再治療などは特に必要なくなる。したがって、歯科的治療の範囲内において完全な措置を施すことが出来、破折片残留による種々の症状発生を抑制し、患者に予後の不快感或いは不安を与えることも少ない。
【図面の簡単な説明】
【図１】（ａ）は本発明の破折片除去用歯科器具の第１実施例を示す説明図であり、同（ｂ）は該器具の係止部の拡大図である。
【図２】（ａ）〜（ｄ）は、破折片除去用歯科器具１０を用いて実際に破折片除去を行う手順を示す説明図である。
【図３】破折片除去用歯科器具１０先端の係止部１３に破折片がホールドされている様子を示す拡大図である。
【図４】（ａ）は本発明の破折片除去用歯科器具の第２実施例を示す説明図であり、同（ｂ）は係止部１３において筒部Ｔにより破折片Ｐがホールドされている様子を示す拡大図である。
【符号の説明】
１０破折片除去用歯科器具
１１把持部
１２柄部
１３係止部[0001]
TECHNICAL FIELD OF THE INVENTION
TECHNICAL FIELD The present invention relates to a broken piece removing dental instrument for removing a part of a dental root canal treatment instrument such as a reamer or a file that remains in a root canal as a broken piece.
[0002]
[Prior art]
Lactic acid generated by the action of bacteria on food residues in the oral cavity causes dental tissue to erode in caries, commonly referred to as caries. When the dental caries reach the dental pulp, after removing the dental pulp, the root canal to which the dental pulp has been communicated is appropriately cut and enlarged, and a root canal treatment for disinfecting and filling the gutta percha is performed.
[0003]
The treatment tools such as files used for root canal enlargement work in this root canal treatment easily predict various contaminations such as surplus cuttings and bacterial adhesion due to the work of cutting dentin, dentin, pulp tissue, etc. Is done. Therefore, it is ideal that the equipment be renewed and discarded for each patient who receives the treatment. However, in practice, the equipment is repeatedly washed and sterilized after each use, and is continuously used until the function becomes unusable. It was common to do.
[0004]
However, in the latter half of the above-mentioned continuous use, the tip of the instrument often breaks during the treatment procedure. Conventionally, it is difficult to completely take the necessary measures such as collecting and removing the broken pieces even if the broken pieces caused by this break remain in the root canal. Was done.
[0005]
[Problems to be solved by the invention]
Conventionally, as described above, let alone a device for collecting and removing a broken piece in which a file or the like is broken in a root canal, the technology itself has not been established, and early technological development has been anticipated. Accordingly, the present invention has been made in view of such a conventional problem, and is intended to simply and reliably collect and remove broken fragments remaining in the root canal, and to improve the broken pieces after the operation. A dental appliance is provided.
[0006]
[Means for Solving the Problems]
The present invention has been made in order to achieve the above object, and is a broken piece removing dental instrument for removing and collecting broken pieces of a root canal treatment instrument generated in a root canal, wherein the person who performs the instrument operation is provided. A grip portion to be gripped, a handle protruding from an end of the grip portion, a tubular portion including the handle and slidable along the handle, and provided at the tip of the handle to remove the object to be removed. A communication hole through which a part or the whole can be inserted , and an annular locking portion including a hold hole for holding the object to be removed , wherein the cylindrical portion allows the object to be removed to be inserted through the locking portion. Then, the object to be removed is sandwiched between the locking portions by sliding toward the locking portion .
[0008]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. FIG. 1 (a) is an explanatory view showing a first embodiment of a broken piece removing dental instrument of the present invention, and FIG. 1 (b) is an enlarged view of a locking portion of the instrument.
[0009]
The structure of the broken piece removing dental instrument 10 of the present invention includes, for example, a rod-shaped grip portion 11 made of synthetic resin or the like, a handle portion 12 protruding from one end of the grip portion 11 and made of nickel titanium or stainless steel, A locking portion 13 provided at the tip of the handle portion 12 (or by processing the handle portion itself). The grip portion 11 in the present embodiment includes a grip portion 11a that enhances a sense of engagement when the operator grips the device to facilitate the operation and reduces fatigue, and is connected to the grip portion 11a. A concave portion 11b on which a finger is placed for operation. Thereby, a good operation feeling can be obtained.
[0010]
The handle 12 is made of a material (for example, nickel titanium or stainless steel) that is hardly contaminated and eroded even when a therapeutic drug or saliva adheres thereto, and is thin enough so as not to obstruct the view during treatment. In addition, a bent portion 12a is provided so that the tooth row can be straddled. The neck portion 12b is formed by processing the tip of the handle portion 12 into an oblong shape and twisting and twisting, and the locking portion 13 is left at the tip of the neck portion 12b after this processing.
[0011]
If the locking portion 13 is annular, for example, as shown in FIG. 5B, the locking portion 13 has a teardrop shape, and includes a communication hole 13a through which a broken piece is inserted and a hold hole 13b that actually holds the broken piece. Become.
[0012]
FIGS. 2A to 2D are explanatory views showing a procedure for actually removing broken pieces using the broken piece removing dental instrument 10. FIG. 3 is an enlarged view showing a state where the broken piece is held by the locking portion 13 at the tip of the broken piece removing dental instrument 10 at that time.
[0013]
In the dentition 20 in the oral cavity, after performing root canal treatment on the tooth 21 in which the dental caries extended to the pulp of the root canal 22, the situation in which the gutta-percher was appropriately removed to remove the fragment P is shown. FIG. In the present embodiment, it is assumed that the distal end of a root canal treatment instrument such as a file is broken at the time of root canal treatment to become a broken piece P and remains in the root canal 22. An enlarged view from above of the tooth 21 to be treated is (b). At an actual treatment site, this magnified view is performed using a device such as a microscope, and the above-mentioned gutta-percher removal operation is performed in order to directly view the broken piece P using the microscope. Further, when the broken piece P remains in the inner part of the root canal 22, following the removal of the gutta-percher, the tooth material 22b around the broken piece P is cut with an ultrasonic cutting instrument or the like under a microscope to remove the root canal 22. Is expanded.
[0014]
In the same figure (b), there are three pulp root canals 22 of the teeth 21, of which the broken pieces P remain in the lower right root canal mouth 22 a. In order to remove the broken pieces P, the dental piece 10 for removing broken pieces of the present invention is used. In the removal operation, the broken piece P is inserted through the locking portion 13 as shown in FIG. At this time, the broken piece P is first passed through the communication hole 13a of the locking portion 13, and then the broken piece P is guided to the narrow hold hole 13b by a pulling operation and securely clamped (see FIG. 3).
[0015]
The sandwiched fragment P is pulled up from the root canal 22 together with the fracture-removing dental instrument 10 as it is, and then the root canal 22 is appropriately filled to complete the work of removing the fragment P.
[0016]
FIG. 4 (a) is an explanatory view showing a second embodiment of the broken piece removing dental instrument of the present invention, and FIG. 4 (b) shows the broken piece P held by the cylindrical portion T in the locking portion 13. FIG. Parts corresponding to those in the first embodiment are denoted by the same reference numerals.
[0017]
The structure of the second embodiment of the broken piece removing dental instrument 10 includes a rod-shaped grip 11 made of synthetic resin or the like, and a handle 12 projected from one end of the grip 11 and made of nickel titanium or stainless steel. It comprises a tubular portion T which includes the handle portion 12 and is slidable along the handle portion 12, and a locking portion 13 provided at the tip of the handle portion 12 (or by processing the handle portion itself). In this embodiment, similarly to the first embodiment, the grip portion 11 is provided with a grip portion 11a and a concave portion 11b which is connected to the grip portion 11a and on which a finger for operation is placed. Thereby, a good operation feeling can be obtained.
[0018]
The handle 12 is made of a material (for example, nickel titanium or stainless steel) that is hardly contaminated and eroded even when a therapeutic drug or saliva adheres thereto, and is thin enough so as not to obstruct the view during treatment. In addition, a bent portion 12a is provided so that the tooth row can be straddled. In the present embodiment, a thread groove 12c is provided in an appropriate region on the surface of the handle portion 12 so that the cylindrical portion T does not slide more than necessary. The neck portion 12b is formed by processing the tip of the handle portion 12 into an oblong shape and twisting and twisting, and the locking portion 13 is left at the tip of the neck portion 12b after this processing. If the locking portion 13 is annular, for example, it is preferable that the locking portion 13 has a teardrop shape as in the first embodiment and includes a communication hole through which the broken piece is inserted and a hold hole that actually holds the broken piece. is there.
[0019]
In the operation of removing the broken pieces P remaining in the root canal using such a broken piece removing dental instrument 10, as in the first embodiment, the gutta-perture covering the root canal is removed. Is appropriately removed, and the dentine around the fractured piece P is cut with an ultrasonic cutting instrument or the like under a microscope to enlarge the root canal. Next, the dental instrument 10 is introduced into a tooth to be treated as shown in FIG. At this time, after passing the broken piece P through the locking portion 13, the cylindrical portion T is slid along the locking portion 13, and the broken piece P is securely clamped in the narrowed locking portion 13. . The sandwiched fragment P is pulled up from the root canal together with the dental appliance 10 for removing the fragment, and thereafter, the filling operation is appropriately performed in the root canal to complete the work of removing the fragment P.
[0020]
According to the broken piece removing dental instrument 10 of the second embodiment, if the broken piece P is passed through the locking portion 13 in the work of removing the broken piece, there are few situations that require particularly fine surgical techniques. If the broken piece P is sandwiched simply by sliding the tubular portion T, the broken piece P can be reliably held. As a result, the removal operation can be further assured, which leads to improvements in both simplicity and efficiency.
[0021]
As another embodiment, there is a broken piece removing dental instrument in which a projection that can be hooked or driven into a thread or the like on the surface of the broken piece P is provided on the locking portion 13 (not particularly shown). According to this device, after the broken piece P is inserted through the locking portion, the broken piece P is hooked on the projection and bound, and the broken piece P is removed from the root canal to remove the broken piece. Such a protrusion is provided on the locking portion in a direction protruding outward, and various shapes such as a hook shape, a multi-branch shape, and a wavy shape can be adopted in addition to a simple straight needle shape. As long as the broken pieces P can be bound, the singular or plural pieces can be installed.
[0022]
The broken piece removing dental instrument 10 of the present invention is not limited to the shapes of the grip portion 11 and the handle portion 12 shown in the present embodiment, and can take various forms depending on the use conditions and applications. .
[0023]
Further, the shape of the locking portion 13 may be any shape as long as it can hold the broken piece P, or a lasso-shaped tightening function (for example, an operator performs a tightening operation at hand) instead of a simple ring or the like. Or the like. Further, the locking portion 13 itself (all or a part) has a function of magnetically attaching the broken piece P to prevent the broken piece P from dropping from the locking portion 13 or has a function. A structure in which such a magnetic material is attached to the locking portion 13 may be used.
[0024]
【The invention's effect】
ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to remove easily and reliably the broken piece which removal and collection | recovery was very difficult conventionally and was left as it was. This eliminates the need for re-treatment, which is not limited to dental treatment, and even predicts the necessity of a certain kind of surgical operation. Therefore, complete measures can be taken within the scope of dental treatment, the occurrence of various symptoms due to residual fragments is suppressed, and the patient is less likely to have discomfort or anxiety about the prognosis.
[Brief description of the drawings]
FIG. 1 (a) is an explanatory view showing a first embodiment of a broken piece removing dental instrument of the present invention, and FIG. 1 (b) is an enlarged view of a locking portion of the instrument.
FIGS. 2A to 2D are explanatory views showing a procedure for actually removing broken pieces using the broken piece removing dental instrument 10. FIGS.
FIG. 3 is an enlarged view showing a state in which a broken piece is held by a locking portion 13 at the distal end of the broken piece removing dental instrument 10.
FIG. 4 (a) is an explanatory view showing a second embodiment of a broken piece removing dental instrument of the present invention, and FIG. It is an enlarged view which shows a mode that it is performed.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Fragment removal dental instrument 11 Grip part 12 Handle part 13 Lock part

Claims

A broken piece removing dental instrument for removing and collecting broken pieces of a root canal treatment instrument generated in a root canal,
A gripper gripped by a person performing the instrument operation, a handle protruding from an end of the gripper, a tubular portion including the handle and slidable along the handle, and provided at the tip of the handle. A communication hole through which a part or the whole of the object to be removed can be inserted , and an annular locking portion composed of a hold hole for holding the object to be removed ,
The tubular portion is characterized in that the object to be removed is sandwiched between the locking portions by inserting the object to be removed through the locking portion and then sliding toward the locking portion. A dental instrument for removing broken pieces.