Note: Descriptions are shown in the official language in which they were submitted.
2032556
SPECIFICATION
TITLE OF THE INVENTION
ODONTOTHERAPEUTICAL MATERIALS
BACKGROUND OF THE INVENTION
Field of the Invention
The present invention relates to lenitives, primers
and fillers used for odontotherapies and, more particularly,
to lenitives for hypersensitivity, coating primers and root
canal filling materials.
Prior Art
Among stimuli to teeth are hypersensitivity and
pulpalgia that are clinically considered to offer grave
problems.
Hypersensitivity is induced, as when vital teeth are
put in a senso-sthenic condition by exposure of their
dentines and come into physical or chemical contact with
cold or sweet-sour foods and drinks, chill, galvanic
current, toothbrushes, toothpicks, etc., and causes induced
pain and acute pain, although they are transient or
fugitive.
The Brannstrom's hydrodynamic theory about the
mechanism of hypersensitivity teaches that an external
stimulus applied to the surface of dentine causes a tissue
(or pulpal) fluid to move through dentinal tubules in an
inward or outward direction and thereby stimulates dentinal
nerves in the pulp to cause pain.
~ 2032~56
As various other theories have also been suggested
about the mechanism of hypersensitivity, however, it has so
far been treated by such various therapies as set out below.
(1) Mechanical protection of the surfaces of exposed
dental tubules against stimuli of external origin. To this
end, a paraformaldehyde-containing "Hyperband" is coated on
those surfaces.
~ 2) Protection of dental tubules against stimuli of
external origin by promoting their intra-calcification for
their closure. To this end, a "Saforide" containing a
diammine silver fluoride solution or an "F vani3h"
containing a sodium fluoride is coated on the dental tubules
- therapy ~2-1~. Alternatively, the principle of
iontophoresis is applied to feed a drug ionized in a
solution deeply into the affected region with the aid of
current - Therapy ~2-2).
~ 3) A silver nitrate solution is coated on
odontoblasts to modify and coagulate them, thereby keeping
them from reacting with stimuli of external origin.
~ 4) Irradiation of laser beams.
These therapies (1)-(4) have been found to be
inefficacious for those who suffer from hypersensitivity,
.e. these ha~e the following defects.
For instance, the coating of the paraformaldehyde
containing "Hyperband" so as to protect the surfaces of
exposed dentinal tubules mechanically against stimuli of
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external origin - therapy (1) - involves much work, since
the powder and liquid components must be mixed and kneaded
together for use, and is thus restricted by time, because a
period as long as 5-6 hours is needed to set the
powder/liquid mixture completely. Moreover, the efficacy of
Therapy (1) is generally as low as 50 %.
A Therapy (2-1), in which the "Saforide" containing a
diammine silver fluoride or the F vanish containing a sodium
fluoride is applied on dentinal tubules to promote their
intra-calcification to close up them and thereby protect
them against stimuli of external origin, blackens the
affected region coated, and is thus not desirable from the
aesthetic point of view and unfit for adults. Moreover, the
efficacy of therapy (2-1) is generally as low as 47 %.
Problems with therapy (2-2) or iontophoresis therapy, in
which the principle of electrophoresis is applied to feed a
drug ionized in a solution deeply into the affected part
with the aid of a current, are that an expensive ion feeder
is needed, it involves much work; it causes the patient to
feel friyht; and the like. Moreover, therapy (2-2) does not
pay off for operation, as understood from its efficacy being
generally as low as 40 %.
Therapy (3), in which odontoblasts are modified and
coagulated by the coating of a silver nitrate solution to
keep them from reacting with stimuli of external origin,
makes the region coated blackish brown, and is thus
~ ~rc~ k - 3 -
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aesthetically not desirable and unfit for adults. Moreover,
it generally shows an efficacy of at most 50 %.
Therapy (4) by the irradiation of laser beams, in
which laser beams are applied to the dentinal surface of the
affected part for about 1 minute, is efficacious, but needs
a costly laser irradiator. Moreover, therapy (4) shows an
80 % efficacy in some cases, but it is not good in others.
The therapies so far used to treat hypersensitivity
do not only involve time-consuming and troublesome work but
also may need special equipment. Even without it, they
incurs considerable expense. From the patients' point of
view, on the other hand, one problem is that the region
coated becomes black and so aesthetically not desirable.
Another problem is that for lack of durable effect, the
affected region has to be coated periodically. Thus,
clinicians have yet to find crucially efficacious therapy in
spite of many people suffering from hypersensitivity.
Pulpalgia, on the other hand, i5 induced by physical
or chemical factors such as cavity preparation, tooth
preparation for fixeci prostho~ontics, resin filling,
traumatic occlusion, changes in atmospheric pressure,
fatigue and food debris, and causes every pain from acute,
pulsating and lancinating pains to slight pains. Pulpalgia
by and large is considered to be caused for similar reasons
to those mentioned about hypersensitivity, but is still far
from being pathogenically elucidated, as is the case with
20325~
._
hypersensitivity.
Accordingly, pulpalgia has so far been treated with
liners such as calcium hydroxide preparations, zinc oxide-
eugenol cements, glass ionomer cements and carboxylate
cements and others. These cements are designed to be
mechanically coated on the surfaces of dentinal tubules to
protect them against stimuli of external origin.
Problems with the calcium hydroxide preparations are
that they are never hardened; they are incapable of forming
roentgenograms; they are poor in strength and the like. The
zinc oxide-eugenol cements consist of powders and liquid
components which have to be mixed and kneaded together for
use. Since the liquid/powder ratio should be about 0.5 and
a large amount of the powder component should be
incorporated into the liquid component, mixing and kneading
above all involve much work. Moreover, this cement cannot
be used for cases in which a composite resin is to be filled
in place, because the liquid component or eugenol interferes
with the polymerization of that resin. The zinc oxide-
eugenol cements offer problems irl strength, etc. as well.
The glass ionomer and carboxylate cements each
consist of powders and liquid components which must be mixed
and kneaded together for use. Mixing is again troublesome.
Because of the liquid having pH of 1.2 to 1.7, the mixture
causes a lingering pain to the patient upon filled. Since
the cement film is likely to increase in thickness, there is
20325~
a corresponding decrease in the thickness of a composite
resin, offering an aesthetic problem, etc.
The handling problems with the therapies so far used
to treat pulpalgia are that mixing and kneading is
troublesome; the cement film is likely to increase in
thickness and the like. From the patients' point of view,
the problems are that they cause a lingering pain to the
patients upon filled in place; no aesthetic color matching
is achievable and the like.
Thus, clinicians have yet to find crucially
efficacious therapy or an efficacious lenitives (or primers)
for pulpalgia in spite of many people suffering from
pulpalgia.
Various root canal fillers have been used with a
view to blocking a passage from the oral cavity to around
the root apex by closing up the formed and cleaned root
canal and apical foramen, or promoting the growth and
calcification of the connective tissue around the root apex.
For instance, gutta-percha points, silver points, calcium
hydroxide preparations, iodoform preparations, formaldehyde
preparations and zinc oxide-eugenol type fillers have been
used.
(1) Gutta-Percha Point
This material has suitable plasticity, provides high
sealability and is stable, but has difficulty in finding its
way through the fine, meandering root canals.
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(2) Silver Point
This material is so fine and so rich in elasticity
that it is suitable for closing up the meandering root
canal, but is so difficult to pull out and so prone to
corrode that it can cause tissue disorders.
(3) Calcium Hydroxide Preparation
Problems with this preparation, which is a pasty
material designed mainly to promote the healing of
ossiferous scars and the formation of hard tissue, are that
it is never set; it is lacking in airtightness; it is
incapable of being radiographed; it is free from any
antiseptic action and the like.
(4) Iodoform Preparation
This material is less harmful to tissue, capable of
being radiographed and antiseptic, but has a defect that it
is never set upon filled in place.
(5) Formaldehyde Preparation
This material shows antiseptic and disinfecting
actions, but is most likely to put the parodontium of the
root apex in ill condition upon when the material is pushed
out of it.
(6) Filler Based on Zinc Oxide-Eugenol
This material shows lenitive and antiseptic actions
with an increased sealability, but is irritating to the
parodontinum of the root tip and prone to contracting.
The following refer to what the lenitives for
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hypersensitivity is required to possess:
(1) it should be unstimulating to the dental pulp
and gingival and mitigate or remove any induced pain;
(2) it should cause no damage to teeth;
(3) it should cause no discoloration of teeth;
(4) it should produce its effect through simple
work;
(5) it should have an immediate effect;
(6) it should maintain its effect;
(7) it should cause no pain to the patient during or
after treatment; and
(8) it should dispense with special hardware or
equipment.
The following refer to what the pulpalgia remedy
(coating primers) is required to have:
(1) it should be unstimulating to the dental pulp
and gingival and mitigate or remove any induced pain;
(2) it should cause no damage to dentin;
(3) it should cause no discoloration of dentin;
~ 4) it should produce its effect through simple
work;
(5) it should have an immediate effect;
(6) it should maintain its effect;
(~) it should cause no pain to the patient during or
after treatment;
(8) it should dispense with special hardware or
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equipment, and
(9) it should not inhibit the polymerization of
resin.
Table 1, given below, shows how efficacious the
conventional therapies are against hypersensitivity and
pulpalgia.
Table 1
\ (1) (2) (3) (4) (5) ~6) (7) (8) ~9) Effi-
A Trade Na ~ ciency
Hyperband O O aa X O O O 50 %
Saforide ~ aaxaaaa O 47 %
Silver Nitrate aaxaaaa O 50 %
Solution
Laser Beams O O O O O O O X 80 %
Calcium
Hydroxide O O aoaa O O O 50 %
Preparation
Zinc Oxide O O axaa O O X 50 %
Eugenol Cement
Carboxylate O O aa O O X O O 50 %
Cement
O: Satisfactory (1)~(9): See the above
a Less Satisfactory
X: Unsatisfactory
As can be understood from Table 1, the conventional
hypersensitivity therapies do not only offer problems that,
3~ r~/e~) k
203255~
by way of example alone, they are irritating to the dental
pulp and cause discoloration of gingival and dentin, but are
also disadvantageous in that, by way of example alone, they
make mixing and kneading work troublesome and their effect
is neither reliable nor durable. Also, the conventional
pulpalgia therapies do not only pose problems that, by way
of example only, they are irritating to the dental pulp and
give rise to discoloration of gingival and dentin, but also
are disadvantageous in that, by way of example only, they
may make resin filling a taboo.
It is therefore an object of this invention to
provide an odontotherapeutical material which can
successfully meet both what is required for treating
hypersensitivity and what is required for treating
pulpalgia.
The following refer to-~what the root canal filler is
required to possess:
(1) it should have a good biocompatibility with a
living body;
~ 2) it should be unstimulating and harmless to part
of the parodontinum around the apical foramen;
(3) it should be unporous;
~ 4) it should cause no discoloration of dentin;
(5) it should undergo no change in its quality;
(6) it should be removed, if necessary;
(7) it should be of radiopacity; and
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- 20325~6
(8) it should be easy to handle.
Among currently available root canal fillers, there
is a sealer capable of sealing up the apical foramen in the
root canal, which is essentially required to have a good bio-
compatibility. To this end a gutta-percha point is now
mainly used. Even with a commercially available root canal
length gauge, however, it is nearly impossible to accurately
measure the size of the root apex in the rool canal. A
problem with the gutta-percha point is that when actually
filled under pressure into the root canal, it thrusts
through the root apex, or it is not well sealed up.
According to what the Brannstrom's hydraulic
dynamics theory teaches about why hypersensitivity occurs,
an external irritation applied to the surface of dentin
causes a tissue (or pulpal) fluid to flow through dentinal
tubules and thereby give rise to a variation of their
internal pressure, irritating dentinal nerve fibers to cause
pain. Thus, a key to solving the problems associated with
the conventional hypersensitivity and pulpalgia therapies
and meeting what is required for treating them is to control
the fluid movement in the dentinal tubules. From the
results of various studies made to achieve that, it has now
been found that it is desired to seal up dentinal tubules
with a material which is difficult to dissolve in water and
unstimulating. It has also been noted that such a material
is required to seal up elongated dentinal tubules.
- ~032~i56
SUMMARY OF THE INVENTION
In view of the foregoing, the inventors have made
intensive and extensive studies in search of a material
which can seal up elongated dentinal tubules and be of
greater safety in use, succeeding in finding an
odontotherapeutical material according to this invention.
Thus, the present invention provides a two-pack
system consisting of liquids A and B designed to be
successively applied on the affected part on which they are
allowed to react with each other to form a substance
difficult to dissolve in water. This substance can then be
used to seal up elongated dentinal tubules or the root apex
in the root canal.
More specifically, liquid A is mainly an aqueous
solution containing 1-70 % of one or more of sodium,
potassium and lithium salts of an inorganic or organic
acids, while liquid B is chiefly an aqueous solution
containing 1-70 % of one or more of chlorides, nitrates,
sulfates and acetates of calcium, zinc, strontium,
magnesium, aluminium, barium, iron, copper, silver, lead and
tin. For use, liquids A and B are mixed together.
The substances used for liquid A in the form of a 1-
% aqueous solution may be one or more of sodium,
potassium and lithium salts of phosphoric acid,
pyrophosphoric acid, tripolyphosphoric acid, metaphosphoric
acid, polyphosphoric acid, phosphonic acid, phosphinic acid,
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203255~
sulfuric acid, sulfurous acid, carbonic acid, hydrogen
fluoride, hydrogen sulfide and silicic acid or members as
acidic groups carboxyl, phosphoric, thiophosphoric,
pyrophosphoric, phosphonic, phosphinic and sulphonic groups,
all being water-soluble. Part of water may be substituted
by alcohol, acetone, dimethyl sulfoxide or the like.
Specific mention is made of trisodium phosphate, disodium
phosphate, monosodium phosphate, sodium pyrophosphate,
dihydrogen sodium pyrophosphate, sodium tripolyphosphate,
sodium metaphosphate, sodium phosphate, sodium phosphite,
sodium sulfate, sodium sulfite, sodium carbonate, sodium
fluoride, sodium sulfide, sodium silicate, sodium benzoate,
sodium salicylate, sodium oxalate, sodium malate, sodium
malonate, sodium citrate, sodium succinate, sodium
gluconate, sodium acrylate, sodium methacrylate, sodium
vinyl benzoate, sodium styrene sulfonate, sodium phthalate
and sodium trimellitate as well as polymers or copolymers of
sodium acrylate, sodium methacrylate or sodium maleate. Use
may also be made of substances represented by the following
chemical for~ula I~III or their equivalents. Of course,
potassium and lithium salts of the aforesaid substances may
be used as well.
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20~2556
CH3
I. CH2 = C - C - 0 - ( CH2 )n - R
o
H
II. CH2 = C - C - 0 -( CH2 )n - R
o
III. CH2 = CH ~ C - O - ( CH2 )n - R
(R denotes 1~9 shown hereinbelow)
R = - O O C ~ C 0 O N a
C 0 O N a
- 0 - P - O N a
1 N a
O O
-- O -- " -- O -- P -- O --
O N a 1 N a
2~32556
- O - P - O N a
1 N a
S S
--O--P--O--P--O--
lNa lNa
o
- O - P - O
0 N a
- C H ( C O O N a )2
- 0 0 C C H = C H C 0 0 N a
- O 0 C C H 2 C H 2 C 0 O N a
. V 15
,. ~,
~032556
The subst~nc~c used for liquid B in the form of a 1-70%
aqueous solution may be one or more of chlorides, nitrates,
sulfates and acetates of calcium, zinc, strontium, magnesium,
aluminum, barium, iron, copper, silver, lead or tin, all
being soluble in water. Part of water may be substituted by
alcohol, acetone, dimethyl sulfoxide or the like. Specific
mention is made of calcium chloride, zinc chloride, ~ o..~ium
chloride, magnesium chloride, aluminium chloride, iron
chloride, copper chloride, barium chloride, tin chloride,
zinc sulfate, strontium sulfate, magnesium sulfate, aluminium
sulfate, copper sulfate, calcium nitrate, zinc nitrate,
~Lo~lLium nitrate, magnesium nitrate, aluminium nitrate, iron
nitrate, copper nitrate, silver nitrate, barium nitrate, lead
nitrate, barium acetate, calcium acetate, strontium acetate,
magnesium acetate, zinc acetate and lead acetate and others.
Although not generally determinable, the substances may
account for 1-70% of liquid A or B. However, the substances
should preferably account for 3-30% of liquid A or B for the
treatment of hypersensitivity and pulpalgia. At a
concentration lower than 1%, the reaction product is less
precipitated and applying should thus be repeated three or
four times to seal up the root canal. At a concentration
higher than 70%, on the other hand, it takes long to dissolve
the component in the water, rendering the work troublesome.
A concentration range, which produces an effect in one
operation, enables that effect to be maintained and makes
dissolution work easy, is thus considered at 3-30~.
,
-- 2032556
The subst~nc~c should preferably account for 10-60% of
treating material of sealing up the root apex in the root
canal. At a concentration lower than 10% the reaction
product is so less precipitated that the root apex cannot be
sealed up completely, while at a concentration higher than
60% it takes long to dissolve the component in water,
rendering the work troublesome. A concentration range, which
enables the root apex in the root canal to be sealed ~p in
one operation and makes dissolution work easy, is thus
considered to lie at 10-60%.
Liquids A and/or B may contain, in addition to water and
the essential component, a monomeric component having one or
more hydrophilic groups such as hydroxyl, carboxyl and
sulfone groups and, at the same time, a polymerizable double
bond. Illustrative mention, for instance, is made of 2-
hydroxyethyl (meth)acrylate, 2-hydroxypropyl (meth)acrylate,
3-hyrdroxypropyl (meth)acrylate, 2,3-dihyroxypropyl
(meth)acrylate, methacrylic acid, acrylic acid, 2-acrylamide-
2-methylpropanesulfone acid, N-vinylpyrrolidone, polyethylene
glycol di(meth)acrylate and their mixture. Concentrations of
these monomers in water are preferably in the range of 5-80%.
How to use the odontotherapeutical material
17
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~,.
- 20~2556
according to this invention will now be explained.
For hypersensitivity:
(1) the affected region is cleaned and dried up;
(2) liquid A is applied on the affected region from
a dental plate with a sponge,;
(3) liquid B is applied on the coat of liquid A from
another dental plate with a sponge; and
(4) excessive liquid deposited onto the affected and
other parts is removed by a cotton pellet.
The order of application of liquids A and B may be
reversed.
For treating pulpalgia (with a coating primer):
(1) A cavity cleaner commercialized by G-C Dental
A Industrial Corp. under the trade namc of "GC Dentine
Conditioner" is applied on the affected region to remove
smear layers which have formed by the mechanical cutting of
the dentin;
(2) the affected region is cleaned and dried up;
(3) liquid A is applied on the affected region with
a sponge,;
(4) liquid B is applied on the coat of liquid A with
a sponge;
(5) excessive liquid deposited onto the affected and
other parts is removed by a cotton pellet; and
(6) A dental bonding material is coated on the
resulting coats for setting.
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2 0~ 2 5~
The order of application of liquids A and B may be
reversed.
For sealing up the root apex in the root canal:
(1) The root canal is enlarged by a reamer, a file or
the like, and the root canal is well cleaned inside;
(2) the root canal is again cleaned inside with liquid
A, using a dental syringe; and
(3) liquid B is forced through the root apex into the
root canal, using a syringe again.
The order of application of liquids A and B may be
reversed.
Examples
The odontotherapeutical materials according to this
invention will now be explained more illustratively but not
exclusively with reference to their examples. The components
forming the odontotherapeutical materials are set out
according to Examples 1-34.
Example 1
A 5% aqueous solution of disodium phosphate was prepared
as liquid Al, which was then adjusted to pH 7.4 with a 5%
aqueous solution of monosodium phosphate.
Next, a 10~ aqueous solution of calcium chloride was
prepared as liquid Bl, which was then adjusted to pH 7.4 with
a 5~ hydrochloric acid solution.
The affected region of a patient suffering from
hypersensitivity was cleaned and dried, and liquid Al were
19
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- 20325~6
applied to it with the aid of a sponge. Subsequently,
liquid B1 were applied to the coat of liquid A1 with the aid
of a sponge. The pain was immediately removed from the
patient.
Examples 2-22
The procedures of Example 1 were followed with the
exception that liquids A2-22 and B2-22 were used. The
results were the same as described in Example 1.
Example 2
Liquid A2 - A mixed liquid of a 5 % aqueous solution of
disodium phosphate with a 2 % aqueous solution
of sodium fluoride, which was adjusted to pH
7.2 with a 5 % aqueous solution of monosodium
phosphate.
Liquid B2 - A 10 % aqueous solution of calcium chloride,
which was adjusted to pH 7.2 with a 5 %
aqueous solution of hydrochloric acid.
Example 3
Liquid A3 - A 10 % aqueous solution of trisodium phosphate,
which was adjusted to pH 7.0 with a 10 /0
aqueous solution of monosodium phosphate.
Liquid B3 - A 20 % aqueous solution of zinc chloride, which
was adjusted to pH 7.0 with a 5 % aqueous
solution of sodium hydroxide.
Example 4
Liquid A4 - A 10 ~ aqueous solution of trisodium phosphate,
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2032SSG
, ~?
which was adjusted to pH 7.0 with a 10 %
aqueous solution of monosodium phosphate.
Liquid B4 - A 20 % aqueous solution of strontium chloride,
which was adjusted to pH 7.0 with a 1 %
aqueous solution of sodium hydroxide.
Example 5
Liquid A5 - A 5 % aqueous solution of disodium phosphate,
which was adjusted to pH 7.0 with a 5 %
aqueous solution of monosodium phosphate.
Liquid B5 - A 20 % aqueous solution of zinc chloride, which
was adjusted to pH 7.0 with a 5 % aqueous
solution of sodium hydroxide.
Example 6
Liquid A6 - A 5 % aqueous solut ion of disodium phosphate,
which was adjusted to pH 7.0 with a 5 %
aqueous solut ion of monosodium phosphate.
Liquid B6 - A 20 % aqueous solution of strontium chloride,
which was adjusted to pH 7.0 with a 5 %
aqueous solution of sodium hydroxide.
Exampie ~
Liquid A7 - A S % aqueous solut ion of sodium pyrophosphate,
which was adjusted to pH 7.4 with a 5 %
aqueous solution of monosodium phosphate.
Liquid B7 - A 15 % aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5 %
a~ueous solution of hydrochloric acid.
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Example 8
Liquid A8 - A 5% aqueous solution of sodium pyrophosphate,
which was adjusted to pH 7.4 with a 5% aqueous
solution of monosodium phosphate.
Liquid B8 - A 10~ aqueous solution of zinc chloride, which
was adjusted to pH 7.4 with a 5% aqueous solution
of sodium hydroxide.
Example 9
0 Liquid A9 - A 5~ aqueous solution of sodium pyrophosphate,
which was adjusted to pH 7.4 with a 5% aqueous
solution of monosodium phosphate.
Liquid B9 - A 20% aqueous solution of strontium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of sodium hydroxide.
Example 10
Liquid A10 - A 10% aqueous solution of sodium malonate,
which was adjusted to pH 7.4 with a 5% aqueous
solution of monosodium phosphate.
Liquid Blo - A 10% aqueous solution of zinc chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of sodium hydroxide.
Example 11
Liquid All - A 5% aqueous solution of sodium salicylate,
which was adjusted to pH 7.4 with a 5% aqueous
22
X~ ~
2032556
solution of monosodium phosphate.
Liquid Bll - A 20% aqueous solution of zinc chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of sodium hydroxide.
Example 12
Liquid A12 - A mixed liquid of a 5% aqueous solution of
disodium phosphate with a 5% aqueous solution of
sodium pyrophosphate, which was adjusted to pH 7.0
with a 5% aqueous solution of monosodium phosphate.
Liquid B12 - A 20% aqueous solution of zinc chloride,
which was adjusted to pH 7.0 with a 5% aqueous
solution of sodium hydroxide.
Example 13
Liquid A13 - A mixed liquid of a 5% aqueous solution of
disodium phosphate with a 5% aqueous solution of
sodium polyacrylate, which was adjusted to pH 7.0
with a 5% aqueous solution of monosodium phosphate.
0 Liquid B13 - A 20% aqueous solution of calcium chloride,
which was adjusted to pH 7.0 with a 5% solution
of hydrochloric acid.
Example 14
Liquid A14 - A mixed liquid of a 5% aqueous solution of
disodium phosphate with a 5% aqueous solution of
sodium polyacrylate, which was adjusted to pH 7.0
~. .
~'.
'~ ~r
2032556
with a 5% aqueous solution of monosodium phosphate.
Liquid B14 - A 20% aqueous solution of zinc chloride,
which was adjusted to pH 7.0 with a 5% solution of
sodium hydroxide.
Example 15
Liquid A15 - A mixed liquid of a 5% aqueous solution of
disodium phosphate with a 1% aqueous solution of
monosodium phosphate, which was adjusted to pH 7.0
with a 5% aqueous solution of monosodium phosphate.
Liquid B15 - A 10% aqueous solution of calcium chloride,
which was adjusted to pH 7.0 with a 5% solution
of hydrochloric acid.
Example 16
Liquid A16 - A 2.5% aqueous solution of disodium phosphate,
which was adjusted to pH 7.4 with a 2.S% aqueous
solution of monosodium phosphate.
Liquid B16 - A 5% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
Example 17
Liquid A17 - A 10% aqueous solution of disodium phosphate,
which was adjusted to pH 7.4 with a 10% aqueous
solution of monosodium phosphate.
24
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' ~.
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`_ 2032556
Liquid B17 - A 15% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
Example 18
Liquid A18 - A 2.5% aqueous solution of disodium phosphate,
which was adjusted to pH 7.4 with a 5% aqueous
solution of monopotassium phosphate.
Liquid B18 - A 10% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
Example 19
Liquid A19 - A 2.5% aqueous solution of dipotassium
phosphate, which was adjusted to pH 7.4 with a 2.5%
aqueous solution of monosodium phosphate.
Liquid Bl9 - A 5% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
Example 20
Liquid A20 - A 5~ aqueous solution of dipotassium phosphate,
which was adjusted to pH 7.4 with a 5% aqueous
solution of monosodium phosphate.
Liquid B20 - A 5% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
''
,~
-
~OJ~6
Example 21
Liquid A21 - A 10% aqueous solution of dipotassium phosphate,
which was adjusted to pH 7.4 with a 10% aqueous
solution of monosodium phosphate.
Liquid B21 - A 5% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
Example 22
0 Liquid A22 - A 20% aqueous solution of dipotassium phosphate,
which was adjusted to pH 7.4 with a 20% aqueous
solution of monosodium phosphate.
Liquid B22 - A 10% aqueous solution of calcium chloride,
which was adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
Example 23
A 5% aqueous solution of disodium phosphate was prepared
as liquid A23, which was then adjusted to pH 7.4 with a 5%
aqueous solution of monosodium phosphate.
Next, a 10% aqueous solution of calcium chloride was
prepared as liquid B23.
The affected region of a patient suffering from
hypersensitivity was cleaned and dried, and liquid A23 were
applied to it with the aid of a sponge. Subsequently, liquid
''`'X,'
20325~6
B23 were applied to the coat of liquid A23 with the aid of a
~ol,~e. The pain was immediately removed from the patient.
Example 24
A 5% aqueous solution of disodium phosphate was prepared
as liquid A24.
Next, a 10% aqueous solution of calcium chloride was
prepared as liquid B24.
The affected region of a patient suffering from
hypersensitivity was cleaned and dried, and liquid A24 were
applied to it with the aid of a sponge. Subsequently, liquid
B24 were applied to the coat of liquid A24 from another
dental plate with the aid of a sponge. The pain was
immediately removed from the patient.
Example 25
A 5% aqueous solution of disodium phosphate was prepared
as liquid A25, which was then adjusted to pH 7.4 with a 5%
aqueous solution of monosodium phosphate.
Then, 5% of calcium chloride was dissolved in an aqueous
solution cont~i n; ng 25~ of 2-hydroxyethyl methacrylate to
form liquid B25, which was in turn adjusted to pH 7.4 with a
5% aqueous solution of hydrochloric acid.
For the filling of a dental resin, a Class I cavity was
formed in the lower first molar of a patient. To remove
smear layers, a cavity cleaner - commercialized by G-C Dental
Industrial Corp. under the trade mark of "GC Dentine
27
-~'
-
2~3255~
Conditionern - was applied on the cavity, followed by water
cleaning and drying. Afterwards, liquid A25 was applied on
the cavity with the aid of a sponge, and liquid B25 was then
applied on the coat of liquid A25 with the aid of a sponge.
The resulting coats were allowed to stand for about 30
s~cQn~c. Air was subsequently blown into the cavity with a
dental syringe for drying the coats, followed by the
application of a light cured composition consisting of 30% of
2-hydroxyethyl methacrylate, 68 ~ of triethylene glycol
dimethacrylate, 1% of dimethylaminoethyl methacrylate and 1%
of camphor-quinone. The resulting coats were exposed to
visible light with a dental visible light irradiator for one
minute for setting. Afterwards, a light cured type of a
resin - commercialized by G-C Dental ~ndustrial Corp. under
the trade mark of "GC Graft LC" - was filled in the cavity
and set by a 30-second irradiation of visible light with a
dental visible light irradiator. The patient was
substantially released from pain and kept in good condition
even after the lapse of one month.
Examples 26 & 27
The procedures of Examples 25 were followed with the
exception that liquids A26-27 and B26-27, mentioned just
below, were used. The results were the same as described in
Example 25.
X
Liquid A26 - A 5% aqueous solution of disodium phosphate,
which was adjusted to pH 7.4 with a 5% aqueous
solution of monosodium phosphate.
Liquid B26 - 10% of zinc oxide was dissolved in an aqueous
solution containing 30~ of 2-hydroxyethyl
methacrylate oxide, which was adjusted to pH 7.4
with a 5% aqueous solution of sodium hydroxide.
Liquid A27 - A mixed liquid of a 5% aqueous solution of
disodium phosphate with a 1% aqueous solution of
sodium vinyl benzoate, which was adjusted to pH 7.4
with a 5~ aqueous solution of monosodium phosphate.
Liquid B27 - 10% of calcium chloride was dissolved in an
aqueous solution cont~i ning 20% of 2-hydroxyethyl
methacrylate, which was adjusted to pH 7.4 with a
5% aqueous solution of hydrochloric acid.
Example 28
A 5~ aqueous solution of disodium phosphate was prepared
as liquid A28, which was then adjusted to pH 7.4 with a 5
aqueous solution of monosodium phosphate.
Then, a 10% aqueous solution of calcium chloride was
prepared as liquid B28, which was in turn adjusted to pH 7.4
with a 5% aqueous solution of hydrochloric acid.
For the filling of a dental resin, a Class I cavity was
formed in the upper first molar of a patient. To remove
smear layers, a cavity cleaner - commercialized by G-C Dental
Industrial Corp. under the trade mark of "GC Dentine
29
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20~2556
Conditioner" - was applied on the cavity, followed by water
washing and drying. Afterwards, liquid A28 was coated on the
cavity with the aid of a sponge, and liquid B28 was then
applied on the coat of liquid A28 with the aid of a sponge.
-- The resulting coats were allowed to stand for about one
minute. Air was subsequently blown onto the cavity with a
dental syringe for drying the coats, followed by the
application of a light cured composition - commercialized by
Kuraray Co., Ltd. under the trade mark of 0PhotoBond". The
resulting coats were exposed to visible light with a dental
visible light irradiator ~or one minute for setting.
Afterwards, a light cured type of resin - commercialized by
Kuraray Co., Ltd. under the trade mark of "PhotoClearfiln -
was filled in the cavity and set by a 60-second irradiation
of visible light with a dental visible light irradiator. The
patient was substantially released from pain and kept in good
condition even after the lapse of two months.
Example 29
A 5% aqueous solution of A;CoA;um phosphate was mixed
with 1% of sodium vinyl benzoate to prepare liquid A29, which
was then adjusted to pH 7.4 with a 5% aqueous solution of
monosodium phosphate.
Then, a 10~ aqueous solution of calcium chloride was
prepared as liquid B29, which was in turn adjusted to pH 7.4
with a 5~ aqueous solution of hydrochloric acid.
^ V
~,
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~032556
For the filling of a dental resin, a Class I cavity was
formed in the upper first molar of a patient. To remove
smear layers, a cavity cleaner - commercialized by G-C Dental
Industrial Corp. under the trade mark of "GC Dentine
Conditionern - was coated on the cavity, followed by water
cleaning and drying. Afterwards, liquid A29 was coated on
the cavity with the aid of a sponge, and liquid B29 was then
coated on the coat of liquid A29 with the aid of a sponge.
The resulting coats were allowed to stand for about 30
seconds. Air was subsequently blown onto the cavity with a
dental syringe for drying the coats, followed by the
application of a light cured composition - commercialized by
Kuraray Co., Ltd. under the trade mark of "PhotoBond". The
resulting coats were exposed to visible light with a dental
visible light irradiator for 30 seconds for setting.
Afterwards, a light cured type of resin - commercialized by
Kuraray Co., Ltd. under the trade mark of "PhotoClearfil" -
was filled in the cavity and set by a 60-second irradiation
of visible light with a dental visible light irradiator. The
patient was substantially released from pain and kept in good
condition even after the lapse of three months.
Example 30
The procedures of Example 29 were followed with the
exception that a 5% aqueous solution of disodium phosphate
adjusted to pH 7.4 with a 5% aqueous solution of monosodium
phosphate was used as liquid A30; a 30% aqueous solution of
31
. ...
~,
2 0 3 25 5 ~
2-hydroxyethyl methacrylate in which 5% of calcium chloride
was dissolved and which was adjusted to pH 7.4 with a 5%
aqueous solution of hydrochloric acid was employed as liquid
B30; and coats were exposed to visible light for one minute.
The results were the same as mentioned in Example 29.
Example 31
A 5% aqueous solution of disodium phosphate was prepared
as liquid A31, which was then adjusted to pH 7.4 with a 5%
aqueous solution of monosodium phosphate.
Then, a 10% aqueous solution of calcium chloride was
prepared as liquid B31, which was in turn adjusted to pH 7.4
with a 5% aqueous solution of hydrochloric acid.
For the filling of a dental resin, a Class I cavity was
formed in the lower secon~ premolar of a patient. To remove
smear layers, a cavity cleaner - commercialized by G-C Dental
Industrial Corp. under the trade mark of "GC Dentine
Conditioner" - was coated on the cavity, followed by water
cleaning and drying. Afterwards, liquid A31 was coated on
the cavity with the aid of a sponge, and liquid B31 was then
coated on the coat of liquid A31 with the aid of a sponge.
The resulting coats were allowed to stand for about 30
seconds. Air was subsequently blown onto the cavity with a
dental syringe for drying the coats, followed by the filling
and setting of a light cured type of resin - commercialized
by ICI Co., Ltd. under the trade mark of "Occlusin". The
~r
,~,,
2a32~5~
patient was substantially released from pain and kept in good
condition even after the lapse of one month.
Example 32
The procedures of Example 31 were followed with the
exception that a mixture of a 3% aqueous solution of disodium
phosphate with a 6% aqueous solution of sodium vinyl
benzoate, which was adjusted to pH 7.4 with a 5% aqueous
solution of monosodium phosphate, was used as liquid A32; and
a 10~ aqueous solution of calcium chloride adjusted to pH 7.4
with a 5~ agueous solution of hydrochloric acid was employed
as liquid B32. The results, even after the lapse of 2
months, were the same as mentioned in Example 31.
Example 33
A 5~ aqueous solution of disodium phosphate was prepared
as liquid A33, which was then adjusted to pH 7.4 with a 5%
aqueous solution of monosodium phosphate. Then, a 10%
aqueous solution of zinc chloride was prepared as liquid B33,
which was in turn regulated to pH 7.4 with a 5~ aqueous
solution of sodium hydroxide.
For the filling of a dental resin, a Class I cavity was
formed in the lower second premolar of a patient. To remove
smear layers, a cavity cleaner - commercialized by G-C Dental
Industrial Corp. under the trade mark of "GC Dentine
Conditioner" - was coated on the cavity, followed by water
cleaning and drying. Afterwards, liquid A33 was coated on
33
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2032556
the cavity with the aid of a sponge, and liquid B33 was then
coated on the coat of liquid A33 with the aid of a sponge.
The resulting coats were allowed to stand for about 30
seCon~C. Air was subsequently blown onto the cavity with a
dental syringe for drying the coats, followed by the
application of a light cured composition consisting of 30% of
2-hydroxyethyl methacrylate, 68% of triethylene glycol
dimethacrylate, 1% of dimethylaminoethyl methacrylate and 1%
of camphor-quinone. The resulting coats were exposed to
visible light with a dental visible light irradiator for one
minute for setting. Afterwards, a light cured type of a
resin - commercialized by G-C Dental Industrial Corp. under
the trade mark of "GC Graft LC" - was filled in the cavity
and set by a 30-second irradiation of visible light with a
dental visible light irradiator. The patient was
substantially released from pain and kept in good condition
even after the lapse of three months.
Example 34
A 5% aqueous solution of disodium phosphate was prepared
as liquid A34, which was then adjusted to pH 7.4 with a 5%
aqueous solution of monosodium phosphate. Then, a 10%
aqueous solution of calcium chloride was prepared as liquid
B34, which was in turn adjusted to pH 7.4 with a 5% aqueous
solution of hydrochloric acid.
After tooth preparation for fixed prosthodontics with a
diamond point, the affected region of a patient suffering
34
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-- 2(~32556
from pain was cleared and dried up. Liquid A34 was applied
on the affected region with the aid of a sponge, and liquid
B34 was coated on the coat of liquid A34 with the aid of a
sponge. The patient was immediately released from the pain.
Example 35
A 5% aqueous solution of disodium phosphate was mixed
with a 2% aqueous solution of sodium fluoride to prepare
liquid A35, which was in turn adjusted to pH 7.2 with a s%
aqueous solution of monosodium phosphate. Then, a 10%
aqueous solution of calcium chloride was prepared as liquid
B35, which was in turn adjusted to pH 7.2 with a 5% aqueous
solution of hydrochloric acid.
As the affected region of a patient suffering from
furcation involvement was subjected to root planning, the
patient complained of a pain. After cleaning and drying up
the affected region, liquid A35 was applied on that region
with the use of a sponge, and liquid B35 was coated on the
coat of liquid A35 with a sponge. The patient was
immediately relieved of the pain.
Example 36
A 10% aqueous solution of disodium phosphate was
prepared as liquid A36, which was in turn adjusted to pH 7.4
with a 5% aqueous solution of monosodium phosphate. Then, a
15% aqueous solution of calcium chloride was prepared as
,
X 35
~ 2032~;56
liquid B36, which was in turn adjusted to pH 7.4 with a 5%
aqueous solution of hydrochloric acid.
After the molar required to receive a root canal
treatment was reamed and filed to enlarge the root canal and
the root canal was fully cleaned inside, it was again cleaned
inside with liquid A36, using a dental syringe. Then, liquid
B36 was forced near the apical foramen into the root canal,
using again a dental syringe for obtAini ng precipitates.
Some paper points were then used to remove eYc~cive liquid,
followed by inspection with roentgen equipment. After it was
confirmed that the apical foramen was sealed up, some gutta-
percha points were filled in the root canal. After six
months, roentgenograpy confirmed that the periradicular and
periodontal tissues were kept in good condition.
Comparative Example 1
A diammine silver fluoride preparation cont~i ni ng a
diammine silver fluoride solution - commercialized by Bibrand
Medico Dental Co., Ltd. under the trade mark of "Saforide" -
was applied to a patient complaining of hypersensitivity, butthe patient was not relieved of the pain. The patient's
teeth became black.
Comparative Example 2
The patient was exposed for 30 seconds to soft laser
with ~Stomalaser*" made by Sedatelec Co., Ltd. However, the
* trademark
36
.
-
20325~
pain was removed from the upper jaw, but the lower jaw was
still in an ill condition.
Comparative Example 3
For the filling of a dental resin, a Class II cavity was
formed in the upper first molar of a patient. Applied on the
cavity, a light cured composition - commercialized by Kuraray
Co., Ltd. under the trade mark of "PhotoBondn - was set by a
one-minute exposure to visible light with a dental visible
light irradiator. Afterwards, a light cured type of a resin
- commercialized by Kuraray Co., Ltd. under the trade mark of
"PhotoClearfiln - was filled in the cavity, followed by a 30-
second exposure to visible light with a dental visible light
irradiator. Immediately after the filling, the patient
complained of a pain. The pain lingered for one week. On
the 10th day on which the pain became more serious,
pulpectomy was performed.
Comparative Example 4
The molar required to receive a root canal treatment was
reamed and filed to enlarge the root canal and the root canal
was well-cleaned inside. Afterwards, some paper points were
used to remove excessive water and some gutta-percha points
were then filled in the root canal.
After the filling, roentgenography indicated that the
point thrusted about 1 mm through the root apex. On the next
day, the inflammation became more serious and the pain
37
,
~-r
i ~,
~ 2~3255~
increased. Thus, the root canal treatment had to be
performed again.
According to this invention, liquids A and B con~;n;ng
substances capable of form difficult-to-dissolve precipitates
rapidly by mixing are successively applied on the affected
region, on which they are permitted to react with each other
to form the difficult-to-dissolve substance, thereby sealing
up an elongated dentinal tubule.
Liquid A is mainly an aqueous solution containing 1-70%
of one or more of sodium, potassium and lithium salts of
inorganic or organic acids, while liquid B is chiefly an
aqueous solution cont~in;ng 1-70% of one or more of
chlorides, nitrates, sulfates and acetates of calcium, zinc,
strontium, magnesium, aluminium, barium, iron, copper,
silver, lead or tin.
When the odontotherapeutical material according to this
invention is used as a lenitive for hypersensitivity, liquid
A is applied on the affected region, already cleaned and
dried up, with a sponge, and liquid B is then coated on the
coat of liquid A with a sponge. The order of application of
liquids A and B may be reversed.
When the odontotherapeutical material according to this
invention is used as a pulpalgia lenitive (or a coating
primer), a cavity cleaner commercialized by G-C Dental
Industrial Corp. under the trade mark of "GC Dentine
Conditioner" is applied to the dentinal part of the affected
region to remove smear layers, followed by the cleaning and
38
.. .
...
.~
203255~
drying of the affected region. Liquid A is applied on the
affected region with a sponge, and liquid B is coated on the
coat of liquid A with a sponge. Afterward, a dental bonding
material is applied on the resulting coats for setting. The
order of application of liquids A and B may be reversed.
When the odontotherapeutical material according to this
invention is used to seal up the root apex in the root canal,
the root canal is enlarged by a reamer, a file, etc. and is
then well cleaned inside. Afterwards, the root canal is
again cleaned inside with liquid A, using a dental syringe.
Subsequently, liquid B is forced through the root apex into
the root canal, using again a syringe. The order of
application of liquids A and B may be reversed.
As detailed above, when the odontotherapeutical material
according to this invention is used as the lenitive for
hypersensitivity, liquids A and B with or without adjusted pH
are successively applied on the affected region for the
reaction of them with each other, forming a difficult-to-
dissolve substance capable of sealing up elongated dentinal
tubules. This makes it possible to control such a fluid
movement in dentinal tubules as referred to in the
Brannstrom's hydrodynamic theory, cutting off stimuli to the
dental pulp.
The odontotherapeutical material according to this
invention can also meet all the eight items of requirements,
39
, .,i
2,r)3~556
enumerated below, which the conventional lenitive for
hypersensitivity is suppose to rOcs~s~s:
(1) it should be unstimulating to the dental pulp and
gingival and mitigate or remove an induced pain;
(2) it should cause no damage to teeth;
(3) it should cause no discoloration of teeth;
(4) it should produce its effect through simple work;
(5) it should achieve its effect immediately;
(6) it should sustain its effect;
(7) it should cause no pain to the patient during or
after treatment; and
(8) it should dispense with special hardware or
equipment.
When the odontotherapeutical material according to this
invention is used as the pulpalgia lenitive (a coating
primer), liquids A and B with or without adjusting pH are
successively applied on the affected region, on which they
are reacted with each other to form a difficult-to-dissolve
substance in the dentinal tubules and on the dentinal
surface, which may then be set with or without a light cured
composition. This renders it possible to control such a
fluid movement in tubules as referred to in the Brannstrom's
hydrodynamic theory, cutting of stimuli to the dental pulp.
The odontotherapeutical material according to this invention
also enables commercially available dental cements or liners
.. ..
., '~
2032556
used as bases to be filled in place and dental resins to be
placed thereon with greater safety. Taken altogether, the
odontotherapeutical material according to this invention can
meet all the nine items of requirements, enumerated below,
which the conventional pulpalgia lenitive is supposed to
possess:
(1) it should be unstimulating to the dental pulp and
gingival and mitigate or remove an induced pain;
40a
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2032556
(2) it should cause no damage to dentin;
(3) it should cause no discoloration of dentin;
(4) it should produce its effect through simple
work;
(5) it should achieve its effect immediately;
(6) it should sustain its effect;
(7) it should cause no pain to the patient during or
after treatment;
(8) it should dispense with special hardware or
equipment; and
(9) it should take no part in the polymerization of
resin.
Also, the odontotherapeutical material according to
this invention can be used after scaling or root planing.
Also, the odontotherapeutical material according to
this invention can be used to learn whether the pain is
induced by hypersensitivity or pulpitis.
Further, when the odontotherapeutical material
according to this invention is used to seal up the apex in
the root canal, liquids A and B with or without adjusted pH
are successively forced into the root canal, in which they
are reacted with each other to form a difficult-to-dissolve
substance and thereby seal up the root apex stationarily.
Thus, the thrusting of a gutta-percha point through the root
apex, which is one of the problems with the conventional
material, can be avoided.
