Note: Descriptions are shown in the official language in which they were submitted.
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APPARATUS AND METHOD FOR ENDODONTIC TREATMENT
RELATED APPLICATIONS
This application claims the benefit of priority under 35 USC 119(e) of U.S.
Provisional Patent Application Nos. 61/895,316 filed on October 24, 2013 and
61/894,762 filed on October 23, 2013.
The contents of the above applications are all incorporated by reference as if
fully set forth herein in their entirety.
FIELD AND BACKGROUND OF THE INVENTION
The present invention, in some embodiments thereof, relates to an apparatus
and
method for endodontic treatment and, more particularly, but not exclusively,
to an
apparatus and method for treating a root canal using one or more angled fluid
jets.
In cases where a tooth is decayed, infected, or abscessed, a root canal
procedure
may be performed to eliminate infection and decontaminate the tooth. During
the root
canal procedure, substances such as nerve and pulp tissue are removed in order
to
prevent future infection.
Current methods for treating a root canal may involve the use of files, such
as
metal files, for removing tissue such as nerve tissue, magma, pulp tissue or
blood
vessels from the root canal. In some cases, a rotary file drill is used for
shaping a root
canal and optionally widening a portion of it to enable access. One of the
risks of the
use of files for endodontic treatment is the spreading of a smear layer, which
may
include organic and/or inorganic debris, on the root canal wall after
instrumentation.
Another potential risk of the use of files may include wounding of the root
canal wall or
apex.
Endodontic treatment devices have been disclosed by several publications.
U.S. Patent No. 6,224,378 to Valdes et al. discloses "A method and apparatus
for dental procedures using a dental hydroj et tool having a cannula extending
therefrom.
The cannula is connected to a source of high pressure liquid, and delivers a
high
velocity, high pressure jet. For root canal procedures, the cannula is
directed through an
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opening formed in the crown of the tooth, and the hydroj et is directed at the
pulp, nerve
and vascular tissue within the interior chamber."
U.S. Patent No. 4,021,921 to Detaille discloses "a device for treating the
pulp
canals and -chamber of a tooth, the crown of which presents a previously
opened pulp-
chamber in which said canals open, comprising an apparatus tightly adaptable
to the
crown of the tooth and providing in the pulp-chamber and the pulp-canals of
said tooth
for the circulation of a treating solution acting substantially upon the
vasculo-nervous
bundle or the necroticmagma of the tooth; the pressure of the treating
solution being
subjected within the pulp-chamber and the pulp-canals to periodical impulses
combined
to oscillations of substantially higher frequency."
SUMMARY OF THE INVENTION
The present invention, in some embodiments thereof, relates to an apparatus
and
method for endodontic treatment and, more particularly, but not exclusively,
to an
apparatus and method for treating a root canal using one or more angled fluid
jets.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment, comprising: a nozzle connected
to a
fluid source comprising: a tip small enough to be inserted into a pulp chamber
of a
tooth; an inner geometry which forms a flow parameters including non-axial
flow
direction of nozzle fluid flowing through said inner geometry such that
discharge fluid
discharged from said inner geometry increase rotation of root canal fluid
within a root
canal sufficiently to remove tissue from said root canal.
According to some embodiments of the invention, said flow parameters are
sufficient to remove tissue from said root canal including an apex of said
root canal.
According to some embodiments of the invention, said flow parameters prevent
tissue
removal in an apical direction of a root canal apex. According to some
embodiments of
the invention, said at least one discharge fluid jet is at an angle to a
vertical axis of said
nozzle. According to some embodiments of the invention, said at least one
discharge
fluid jet enhances a helical flow pattern of said rotation of root canal fluid
in said root
canal. According to some embodiments of the invention, said inner geometry
comprises
a lumen and said nozzle fluid circulates along lumen walls, and an exit point
of said
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nozzle fluid is located at a lumen wall at an exit aperture of said nozzle.
According to
some embodiments of the invention, said nozzle comprises an internal cone and
an
external cone defining a lumen between them for said nozzle fluid to flow
through.
According to some embodiments of the invention, said inner geometry comprises
a
lumen; wherein said nozzle comprises one or more part adapted to move to
adjust a
geometry of said lumen. According to some embodiments of the invention, an
angle of
said discharge fluid jet does not intersect a vertical axis of said nozzle.
According to
some embodiments of the invention, said nozzle fluid comprises liquid and at
least one
of gas and abrasive powder. According to some embodiments of the invention, a
density
of a particle of said abrasive powder is larger than a density of other
particles
comprising said nozzle fluid. According to some embodiments of the invention,
said
abrasive powder is salt that dissolves following abrasion of said root canal
wall.
According to some embodiments of the invention, said apparatus comprises one
or more
inlet connected to a suction source, through which inlet root canal fluid and
debris is
collected from said root canal. According to some embodiments of the
invention, a
diameter of said angled discharge fluid jet is approximately 10% of a diameter
of an
entrance of said root canal or smaller.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment comprising: a nozzle connected
to an
input pipeline; wherein said nozzle comprises: a tip small enough to be
inserted into a
pulp chamber of a tooth; and a rotating element disposed inside a nozzle
lumen;
wherein said rotating element is operable to impart motion to nozzle fluid
passing
through said lumen such that, after said nozzle fluid is discharged from said
lumen, the
root canal fluid flows helically within a root canal.
According to some embodiments of the invention, said rotating element
comprises an inlet connected to said input pipeline, through which inlet flows
at least a
portion of nozzle fluid supplied to said nozzle. According to some embodiments
of the
invention, said rotating element comprises a plurality of blades.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment comprising: a nozzle connected
to an
input pipeline; wherein said nozzle comprises: a tip small enough to be
inserted into a
pulp chamber of a tooth; and a inner cone disposed inside a nozzle lumen;
wherein said
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inner cone is adapted to move with respect to said nozzle lumen thereby
changing
parameters of a nozzle flow through said nozzle lumen.
According to some embodiments of the invention, said nozzle comprises an
outer cone and nozzle fluid flow is through a lumen defined between said outer
cone
and said inner cone.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment comprising: a nozzle connected
to an
input pipeline comprising: a tip small enough to be inserted into a pulp
chamber of a
tooth; a lumen; wherein said input pipeline extends into said lumen such that
flow of
pipeline fluid from said pipeline impinges on walls of said lumen such that
said nozzle
fluid within said lumen has a helical pattern along walls of said lumen.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment comprising: one or
more
chamber containing material comprising: one of more of: pressurized gas, fluid
and
abrasive material; a nozzle comprising a tip small enough to be inserted into
a pulp
chamber of a tooth; said nozzle shaped to create a beam comprising at least
one
discharge fluid jet in an angle to a vertical axis of said nozzle, so that
said jet flows
along a wall of a root canal to remove tissue; and a pipeline connecting said
chamber
lumen and a nozzle lumen.
According to some embodiments of the invention, the apparatus comprises more
than one chamber, wherein each said chamber is connected to said nozzle lumen
by a
pipe, wherein said beam is at least partially created by said material;
wherein material
flowing from each chamber mixes within said nozzle lumen. According to some
embodiments of the invention, the apparatus comprises a powder cartridge
connected
between said chamber and said nozzle lumen; wherein said powder cartridge
comprises
internal cylinders formed with holes of various sizes for filtration of
components within
said cartridge.
According to an aspect of some embodiments of the present invention there is
provided a system comprising: a nozzle comprising a tip small enough to be
inserted
into a pulp chamber of a tooth; said nozzle shaped to create a beam comprising
at least
one discharge fluid jet in an angle to a vertical axis of said nozzle, so that
said jet flows
along a wall of a root canal to remove tissue; and a powder cartridge
connected to a
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nozzle lumen; a pipeline connecting one of a fluid tank and a compressor to
said
powder cartridge.
According to some embodiments of the invention, said powder cartridge
comprises internal cylinders formed with holes of various sizes for filtration
of
5 components within said cartridge.
According to an aspect of some embodiments of the present invention there is
provided a method for endodontic treatment comprising: discharging at least
one fluid
jet in a manner which increases speed of rotation of root canal fluid in a
root canal, said
rotating root canal fluid within said canal removing material from said root
canal.
According to some embodiments of the invention, said discharging comprises
discharging at least one angled discharge fluid jet, from a nozzle, at an
angle where said
angle of said discharge fluid jet does not intersect a vertical axis of said
nozzle.
According to some embodiments of the invention, said angled discharge fluid
jet is
created by circulating said fluid helically within a nozzle of an apparatus.
According to
some embodiments of the invention, said removing comprises separating soft
tissue
from said wall of a root canal. According to some embodiments of the
invention, said
soft tissue comprises at least one of nerve tissue, pulp tissue, and or blood
vessels.
According to some embodiments of the invention, said rotating root canal fluid
within
said canal flows helically along a wall of said root canal. According to some
embodiments of the invention, said root canal comprises at least one narrowing
portion,
and said rotating root canal fluid within said canal flows through said
narrowing portion
along a wall of said root canal. According to some embodiments of the
invention, said
root canal comprises at least one wide portion, and said rotating root canal
fluid within
said canal flows through said wide portion along a wall of said root canal.
According to
some embodiments of the invention, said root canal comprises at least one of a
curvature and branching, and said rotating root canal fluid within said canal
flows
through said at least one curvature and branching. According to some
embodiments of
the invention, the method comprises aligning said nozzle with respect to an
entrance of
said root canal so that a vertical axis of said nozzle unites with a vertical
axis of said
root canal; wherein said rotating root canal fluid within said canal does not
directly hit a
root canal apex. According to some embodiments of the invention, said root
canal fluid
in said canal has a level reaching to a tip of said nozzle. According to some
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embodiments of the invention, the method comprises eroding a layer of dentin
tissue
from at least a portion of a root canal wall. According to some embodiments of
the
invention, eroding is obtained by abrasive particles of said root canal fluid
applying
radially outward force onto said root canal wall. According to some
embodiments of the
invention, said abrasive particles rotate about an axis of said angled jet.
According to
some embodiments of the invention, the method does not leave a smear layer on
said
root canal wall. According to some embodiments of the invention, the method
comprises suctioning root canal fluid and debris from said root canal.
According to
some embodiments of the invention, suctioning comprises suctioning said root
canal
fluid and debris in pulses. According to some embodiments of the invention,
discharging comprises discharging said at least one discharge fluid jet in
pulses.
According to some embodiments of the invention, the method comprises
suctioning root
canal fluid and debris from said root canal in pulses. According to some
embodiments
of the invention, pulses are controlled through a control panel electrically
connected to
said apparatus. According to some embodiments of the invention, discharging
includes
clearing a root canal to prepare for sealing. According to some embodiments of
the
invention, said rotating root canal fluid within said canal removes material
from tubules
extending from said root canal. According to some embodiments of the
invention, said
root canal fluid in said root canal fills at least 20% of a volume of said
root canal.
According to some embodiments of the invention, said root canal fluid in said
root canal
comprises at least 10% liquid.
According to an aspect of some embodiments of the present invention there is
provided a method for endodontic treatment comprising: placing a nozzle at an
entrance
to a root canal; discharging at least one fluid jet, from said nozzle, at an
angle which
causes said fluid jet to flow along a wall of a root canal; and suctioning
root canal fluid
and debris from said root canal; wherein said discharging and said suctioning
are
controlled to maintain one or more of root canal fluid flow along said wall,
root canal
fluid flow at a root canal apex.
According to some embodiments of the invention, discharging and said
suctioning are alternating.
According to an aspect of some embodiments of the present invention there is
provided a method for endodontic treatment comprising: placing a nozzle at an
entrance
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to a root canal; inserting fluid into a lumen defined between nozzle inner
walls and an
element adapted to move within said nozzle walls; discharging at least one
discharge
fluid jet from said lumen at an angle which causes said discharge fluid jet to
flow along
a wall of said root canal; and changing a geometry of said lumen, by moving
said
element, to change a velocity of said fluid jet.
According to some embodiments of the invention, said element is an internal
cone and said lumen is defined between said internal cone and said nozzle
inner walls
and changing comprises moving said internal cone with respect to said nozzle
inner
walls.
According to some embodiments of the invention, moving comprises retracing
and advancing said internal cone in the proximal and distal directions within
said nozzle
inner walls. According to some embodiments of the invention, comprises moving
said
internal cone in a lateral direction within said nozzle inner walls. According
to some
embodiments of the invention, moving comprises changing an angle of a vertical
axis of
said inner cone with respect to a vertical axis of said nozzle inner walls.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment comprising: a nozzle connected
to an
input pipeline; wherein said nozzle comprises: a tip small enough to be
inserted into a
pulp chamber of a tooth; a lumen through which fluid flows through the nozzle;
and a
element located inside said lumen which, when moved, changes a geometry of
said
lumen thereby changing flow parameters through said nozzle.
According to some embodiments of the invention, said element is a rotating
element; wherein said rotating element is operable to impart motion to fluid
passing
through said lumen. According to some embodiments of the invention, said
rotating
element comprises an inlet connected to said input pipeline, through which
inlet flows
at least a portion of fluid supplied to said nozzle. According to some
embodiments of
the invention, said element is an inner cone; wherein a position of said
internal cone is
adjustable within said lumen in proximal and distal directions.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for mixing particles with fluid comprising: an outer
element
connected to an fluid source, said outer element comprising a plurality of
inlets through
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which fluid from said fluid source pass; an inner element disposed inside a
lumen of
said outer cylinder comprising a plurality of inlets through which fluid from
said outer
element pass into a lumen of said inner element; an outlet connected to said
lumen of
said inner element; wherein flow of fluid through the apparatus from said
fluid source to
said outlet collects particles within one or more of said inner element and
said outer
element.
According to some embodiments of the invention, said outer element inlets and
said inner element inlets are different sizes for filtration of one or more of
fluid and
particles. According to some embodiments of the invention, said powder
cartridge
comprises internal cylinders formed with holes of various sizes for filtration
of
components within said cartridge. According to some embodiments of the
invention, the
method comprises circulating fluid along nozzle lumen walls; wherein
discharging
comprises discharging said jet from said nozzle from an edge of an exit
aperture of said
nozzle. According to some embodiments of the invention, discharging and
suctioning
are balanced to maintain fluid within said root canal. According to some
embodiments
of the invention, discharging and suctioning are balanced to maintain flow of
fluid
along root canal walls. According to some embodiments of the invention, pulses
are
controlled through a control panel electrically connected to said nozzle.
According to
some embodiments of the invention, discharging and said suctioning includes
clearing a
root canal to prepare for sealing. According to some embodiments of the
invention,
removing comprises removing material from tubules extending into said tooth
from said
root canal.
According to an aspect of some embodiments of the present invention there is
provided a method for endodontic treatment comprising: placing a nozzle at an
entrance
to a root canal; inserting fluid into a lumen of said nozzle; discharging at
least one fluid
jet from said lumen at an angle which causes said fluid jet to flow along a
wall of said
root canal; and changing one or more of a shape or size of said lumen to
change a
velocity of said fluid jet.
According to some embodiments of the invention, changing comprises moving
an internal cone inside said lumen. According to some embodiments of the
invention,
said moving comprises retracing and advancing said internal cone in the
proximal and
distal directions within said lumen. According to some embodiments of the
invention,
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changing comprises rotating a rotating element inside said lumen. According to
some
embodiments of the invention, inserting comprises inserting fluid into said
lumen
through said rotating element.
According to an aspect of some embodiments of the present invention there is
provided an apparatus and method for endodontic treatment.
According to an aspect of some embodiments of the present invention there is
provided an apparatus for endodontic treatment comprising a nozzle, the nozzle
comprising a tip small enough to be inserted through a pulp chamber of a
tooth, the
nozzle is shaped to create a beam comprising at least one fluid jet in an
angle to a
vertical axis of the nozzle, so that it flows along a wall of a root canal to
remove soft
tissue in a helical flow pattern, and the nozzle is connected to an input
pipeline. In some
embodiments, the nozzle is positionable above an entrance of the root canal
such that
the vertical axis of the nozzle unites with a vertical axis the root canal.
According to
some embodiments, the nozzle comprises an internal cone and an external cone
defining
a lumen between them for the fluid to flow through. According to some
embodiments,
the nozzle comprises a tube extending between a lumen of the internal cone and
the
lumen between the internal cone and the external cone. According to some
embodiments, the fluid circulates in a helical flow through the lumen for
exiting the
nozzle in an angle, wherein an exit point of the fluid is located along walls
of the nozzle
at a location of an exit aperture. In some embodiments, the lumen between the
cones is
modified by movement of the internal cone with respect to the external cone.
In some
embodiments, movement comprises retraction and advancement of the internal
cone in
the proximal and distal directions within the external cone. In some
embodiments,
movement comprises positioning the internal cone at a different angle with
respect the
external cone. In some embodiments, a velocity of the flow ranges between 200-
300
m/sec. In some embodiments, the nozzle is adapted for discharging at least
1000 angled
fluid jets simultaneously. According to some embodiments, the angled fluid jet
does not
intersect a vertical axis of the nozzle. According to some embodiments, the
nozzle
comprises channels for creating at least one angled jet. According to some
embodiments, there is provided a system comprising: the apparatus, a liquid
tank, and
an air compressor, wherein the input pipeline of the apparatus passes through
a handle
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to connect the liquid tank and/or air compressor to the nozzle. According to
some
embodiments, the system is electrically controlled using a control panel
configured for
operating an electric circuit. In some embodiments, the handle comprises a
fusion tank
for mixing between liquid, gas, and/or abrasive powder. In some embodiments,
the
5 handle
comprises a disposable powder cartridge. In some embodiments, the powder
cartridge comprises internal cylinders formed with holes of various sizes for
filtration of
components. According to some embodiments, the fluid comprises gas and/or
liquid
and/or abrasive powder. According to some embodiments, the gas is air, and the
fluid
comprises between 50-95% air, and between 5-50% liquid. In some embodiments, a
10 density
of a particle of the abrasive powder is larger than a density of other
particles
comprising the fluid. In some embodiments, the abrasive powder is salt that
dissolves
following abrasion of the root canal. According to some embodiments, the
nozzle is
shaped so that the fluid exits the nozzle as an aerosol. According to some
embodiments,
the apparatus is connected to an air compressor with a pressure ranging
between 5-200
PSI. According to some embodiments, the apparatus is connected to a fluid tank
which
provides fluid at a volumetric flow rate ranging between 0.1-50 ml/sec.
According to
some embodiments, the angled jet has tangential and vertical velocity
components in
respect to the root canal wall. According to some embodiments, the apparatus
comprises
a suction cone for collecting returning fluid and debris, and the suction cone
has a tip
sized to fit within a pulp chamber of a tooth. In some embodiments, the
apparatus is
connected to a device suitable for removing the fluid and debris externally to
the tooth.
In some embodiments, the apparatus is suitable for treating a root canal of a
tooth in a
human mouth. In some embodiments, a diameter of the angled jet is 10% of a
diameter
of an entrance of the root canal, or smaller.
According to some embodiments there is provided a method for endodontic
treatment comprising discharging at least one fluid jet in a manner which
enhances
rotation of fluid in a root canal, the rotation sufficient to remove material
from a wall of
the canal. According to an aspect of some embodiments of the present invention
there is
provided a method for endodontic treatment comprising discharging at least one
fluid
jet at an angle which causes it to flow along a wall of a root canal so that
the flow
removes material from the root canal wall. According to some embodiments,
removing
comprises separating soft tissue from the root canal wall. According to some
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embodiments, the flow comprises a helical flow along the root canal wall.
According to
some embodiments, the root canal comprises at least one narrowing portion, and
the
flow comprises flowing through the narrowing portion along the wall of the
root canal.
In some embodiments, the root canal comprises at least one wide portion, and
the flow
passes through the wide portion along the wall of the root canal. According to
some
embodiments, the root canal comprises a curvature and/or a branching, and the
flow
comprises flowing through the curvature and/or the branching. According to
some
embodiments, the method comprises positioning a nozzle above an entrance to
the root
canal so that at least one angle fluid jet hits a wall of the root canal. In
some
embodiments, positioning comprises aligning the nozzle with respect to an
entrance of
the root canal so that a vertical axis of the nozzle unites with a vertical
axis of the root
canal.
In some embodiments, the method comprises discharging at least 20000 jets. In
some embodiments, the fluid jet merges with fluid contained within the root
canal for
intensifying a circulating motion of the fluid. In some embodiments, the fluid
in the
canal has a level reaching to a tip of the nozzle. According to some
embodiments, fluid
flows along the wall of at least a portion of the root canal so that the fluid
returns
upwards along at least a portion of a central lumen of the root canal.
According to some
embodiments, the method comprises eroding a layer of dentin tissue from at
least a
portion of the root canal wall. In some embodiments, eroding is obtained by
abrasive
particles of the fluid applying radially outward force onto the root canal.
According to
some embodiments, the layer has thickness ranging between 100-200 p.m.
According to
some embodiments, the angled jet is created by circulating the fluid in a
helical flow
within a nozzle of an apparatus. According to some embodiments, the soft
tissue
comprises nerve tissue, and/or pulp tissue and/or blood vessels. According to
some
embodiments, the method does not leave a smear layer on the root canal wall.
According to some embodiments, directing comprises directing the fluid jets in
pulses.
In some embodiments, a duration of a pulse ranges between 1-25 seconds, and
debris
and excess fluid are removed in intervals between pulses. In some embodiments,
the
pulses are controlled through a control panel electrically connected to the
apparatus.
According to some embodiments, directing includes clearing a root canal to
prepare for
sealing. In some embodiments, the components of the fluid rotate about an axis
of the
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angled jet. In some embodiments, the flow removes material from tubules
extending
from the root canal. In some embodiments, within a root canal dentine wall, a
layer of
tubules is removed, exposing further tubules which are clean and non-
contaminated.
Unless otherwise defined, all technical and/or scientific terms used herein
have
the same meaning as commonly understood by one of ordinary skill in the art to
which
the invention pertains. Although methods and materials similar or equivalent
to those
described herein can be used in the practice or testing of embodiments of the
invention,
exemplary methods and/or materials are described below. In case of conflict,
the patent
specification, including definitions, will control. In addition, the
materials, methods, and
examples are illustrative only and are not intended to be necessarily
limiting.
BRIEF DESCRIPTION OF THE DRAWINGS
Some embodiments of the invention are herein described, by way of example
only, with reference to the accompanying drawings. With specific reference now
to the
drawings in detail, it is stressed that the particulars shown are by way of
example and
for purposes of illustrative discussion of embodiments of the invention. In
this regard,
the description taken with the drawings makes apparent to those skilled in the
art how
embodiments of the invention may be practiced.
In the drawings:
FIG. 1 is a flowchart of an exemplary endodontic treatment procedure,
according to some embodiments of the invention;
FIG. 2 is a flowchart of an exemplary method for cleaning and/or abrading a
root canal using one or more angled fluid jets, according to some embodiments
of the
invention;
FIG. 3 is an illustration of angled fluid jets entering a root canal and
advancing
along the root canal wall in a helical flow, according to some embodiments of
the
invention;
FIGs. 4A-4C are illustrations of a conical nozzle positioned at an entrance to
a
root canal, according to some embodiments of the invention;
FIG. 5 is a side view of various outlines of a beam of angled fluid jets
exiting a
nozzle, according to some embodiments of the invention;
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FIGs. 6A-6B are a cross section and an outline view of an apparatus comprising
a handle and a conical nozzle, according to some embodiments of the invention;
FIGs. 7A-7B are a cross section of a conical nozzle and a side view of an
internal cone configured within the conical nozzle, according to some
embodiments of
the invention;
FIGs. 8A-8B are schematic diagrams of exemplary systems for treating a root
canal, according to some embodiments of the invention;
FIGs. 9A-9D are illustrations of a conical nozzle comprising a pipe extending
between a handle and an exit aperture of the nozzle, according some
embodiments of
the invention;
FIGs. 10A-10B are illustrations of a nozzle comprising a suction cone, and a
horizontal cross section of the nozzle respectively.
FIGs.11A-11B are illustrations of a nozzle including one or more directing
channels for creating the one or more angled fluid jets, according to some
embodiments
of the invention;
FIGs. 12A-12C are illustrations of a nozzle comprising a valve for controlling
the flow through the nozzle, according to some embodiments of the invention;
FIGs. 13A-13D are illustrations of a nozzle comprising a cone and a pin shaped
element occupying at least a portion of the internal lumen of the cone,
according to
some embodiments of the invention;
FIG. 14 shows an exemplary assembly of a nozzle, according to some
embodiments of the invention.
FIG. 15 is an illustration of a nozzle including exit flow shaping elements
for
creating the one or more angled fluid jets, according to some embodiments of
the
invention; and
FIGs. 16A-16B is a table of experimental results of an experiment for testing
the
feasibility of an apparatus for endodontic treatment, according to some
embodiments of
the invention.
FIG. 17 is an image of a dentin layer and dentinal tubules taken by an electro
scan microscope after treating a root canal using the apparatus.
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FIGs. 18A-18B show a conical nozzle in which a lumen between the internal
cone and external cone can be modified, according to some embodiments of the
invention;
FIGs. 19A-19B illustrate an additional configuration of a nozzle comprising an
internal cone movable with respect to an external cone, according to some
embodiments
of the invention;
FIGs. 20A-20B illustrate a nozzle comprising a suction cone and an internal
cone that are movable with respect to an external cone, according to some
embodiments
of the invention;
FIGs. 21A-21C illustrate an internal cone comprising an expandable portion,
according to some embodiments of the invention;
FIGs. 22A-22B illustrate an internal cone comprising an expandable portion
configured to occupy a relatively large volume of the lumen between the cones,
according to some embodiments of the invention;
FIG. 23A illustrates a conical nozzle comprising one or more internal
channels,
according to some embodiments of the invention;
FIG. 23B illustrates a conical nozzle comprising a movable pipe, an internal
channel, and a movable internal cone, according to some embodiments of the
invention;
FIGs. 24A-24B are exemplary configurations of a handle comprising a fusion
tube and a powder cartridge, according to some embodiment of the invention;
FIGs. 25A-25C illustrate various configurations of a powder cartridge supply
system, according to some embodiments of the invention;
FIG. 25D is an exemplary configuration of a handle in which powder and gas
are delivered separately from fluid, according to some embodiments of the
invention;
FIG. 26 is a schematic diagram of exemplary system for treating a root canal,
according to some embodiments of the invention;
FIG. 27 is a schematic diagram of exemplary system for treating a root canal,
according to some embodiments of the invention;
FIG. 28 illustrates a nozzle comprising a turbine for imparting spin to a
working
fluid, according to some exemplary embodiments of the invention;
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FIG. 29 illustrates a nozzle comprising an air turbine coupled to a pipe of
the
nozzle for spinning the fluid, according to some exemplary embodiments of the
invention;
FIG. 30 illustrates a conical nozzle comprising an air turbine configured for
5 rotating an internal cone, according to some exemplary embodiments of the
invention;
and
FIGs. 31A-31B show a conical nozzle in which only a narrowing portion of the
internal cone is movable with respect to the external cone, according to some
exemplary
embodiments of the invention.
10 FIGs.
32, 33 and 34 show the operation of a system in which a plurality of jets
are discharged by the nozzle, according to some embodiments of the invention;
FIGs. 35, 36 and 37 show the operation of a system in which fluid is delivered
through a needle-like cylinder, according to some embodiments of the
invention;
FIG. 38 shows various configurations of needle-like tubes which can be
15 assembled onto a nozzle, according to some embodiments of the invention;
FIG. 39A is a simplified schematic cross sectional view of a nozzle lacking an
internal cone, according to some embodiments of the invention;
FIG. 39B is a simplified schematic cross sectional view of a nozzle lacking an
internal cone, according to some embodiments of the invention;
FIG. 40A is a simplified schematic cross sectional view of a nozzle including
a
rotating inlet element, according to some embodiments of the invention;
FIGs. 40B-40C are simplified schematic cross sectional views of a nozzle
including a rotating inlet element, according to some embodiments of the
invention;
FIG. 41 is a simplified schematic cross section of a nozzle including a
rotating
element, according to some embodiments of the invention;
FIG. 42A is a simplified schematic cross sectional view of a nozzle treating a
root canal, controlling apical parameters, according to some embodiments of
the
invention.;
FIG. 42B is a simplified schematic cross sectional view of a nozzle treating a
root canal, controlling apical parameters, according to some embodiments of
the
invention;
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16
FIG. 42C is a simplified schematic cross sectional view of a nozzle surrounded
by a sealing element, according to some embodiments of the invention
FIG. 43A is a simplified schematic side view of a nozzle including an external
cone with a hollow portion and an internal cone with a hollow portion,
according to
some embodiments of the invention;
FIG. 43B is a simplified schematic cross sectional view of a nozzle including
external cone with a hollow portion and an internal cone with a hollow
portion,
according to some embodiments of the invention
FIG. 44 is a simplified schematic cross sectional view of a system including a
supply apparatus connected to a nozzle, according some embodiments of the
invention;
and
FIG. 45 is a simplified schematic cross sectional view of a supply apparatus
supplying two separate flows to a nozzle, according to some embodiments of the
invention.
DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION
The present invention, in some embodiments thereof, relates to an apparatus
and
method for endodontic treatment and, more particularly, but not exclusively,
to an
apparatus and method for treating a root canal using one or more angled fluid
jets.
In some embodiments, the apparatus is used for cleaning, abrading, and/or
decontaminating a root canal of a tooth before sealing the tooth.
Overview
A general aspect of some embodiments of the invention relates to cleaning
and/or abrading a root canal (e.g. in a human tooth within a human mouth)
where a flow
of fluid, for example a fluid jet (e.g. an angled fluid jet) or a plurality of
jets (e.g. a
plurality of angled fluid jets) and/or a flow beam and/or a flow cone is
discharged
hitting fluid within a root canal. In some embodiments, the flow is discharged
from a
nozzle inserted into the tooth (e.g. into a pulp chamber and/or into a root
canal). In some
embodiments, the flow from the nozzle (e.g. one or more jet, beam) comprises
significant non-axial (e.g. at an angle to a vertical axis of the nozzle)
velocity
components, for example, more than 10%, more than 30%, more than 50%, more
than
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90% non-axial components, or lower or higher or intermediate percentages. In
some
embodiments, the flow from the nozzle includes a small proportion of axial
velocity
components. In some embodiments, the flow includes less than 60%, or less than
40%,
or less than 20%, or less than 10%, or lower or higher or intermediate
percentages axial
velocity components.
In some embodiments, for example, when the root canal is at least partially
filled
with fluid, the flow, (e.g. jet/s and/or a beam) hits fluid within the root
canal causing
and/or intensifying spinning motion of the fluid within the canal. In some
embodiments,
the jet/s and/or beam increase a speed of rotation of the fluid within the
canal and/or a
proportion of fluid which is rotating within the canal.
In some embodiments, the flow from the nozzle intensifies spinning of fluid
adjacent to the root canal walls (e.g. fluid within lmm or 0.5mm or 0.25mm or
0.1mm
or 0.01mm from the root canal walls), for at least a coronal portion of the
root canal
(e.g. the upper 10%, or 30%, or 50%, or 70%, or 90%, or the entire root canal,
or
intermediate, higher or lower percentages of the root canal).
In some embodiments, the flow from the nozzle (e.g. one or more jet, beam)
does not travel through air after discharge from the nozzle, but may directly
hit fluid
within the root canal or is contiguous with such fluid (e.g. a nozzle exit
aperture is level
with or under the surface of fluid within the root canal). In some
embodiments, when
discharge from the nozzle is contiguous with fluid within a root canal,
movement (e.g.
rotation) of fluid within the nozzle (e.g. due to viscosity and/or surface
tension) causes
fluid within the root canal to move, for example, in the same direction and/or
with
approximately (e.g. within 20% of) the same velocity.
Alternatively, in some embodiments, the flow discharged from the nozzle hits
fluid within the root canal indirectly, for example, hitting a portion of the
tooth (e.g.
root canal wall) before hitting and/or merging with the fluid in the root
canal. For
example, in some embodiments, the flow discharged from the nozzle passes
through an
air gap before hitting the fluid in the root canal. In some embodiments, an
air gap
between a nozzle aperture and fluid in the root canal is measured by a
straight line
between an exit point of fluid from the exit aperture (or a central point of
the aperture)
and a point on the fluid level in the canal where discharge hits the fluid in
the canal (or a
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central point on the fluid level in the canal. In some embodiments, the air
gap is 0.1mm,
or 0.5mm, orlmm, or 3mm, or 5mm or lower, or higher, or intermediate
distances.
A general aspect of some embodiments of the invention relates to a nozzle for
insertion into a tooth (e.g. a tooth pulp chamber and/or a tooth root canal)
where the
behavior of material discharged from the nozzle is controlled and/or adjusted
by
movement of one or more part of the nozzle.
In some embodiments, movement is movement which changes the size and/or
shape of a nozzle lumen. In some embodiments, an inner cone moves within a
nozzle
lumen e.g. with respect to an external cone. In some embodiments, an inner
cone moves
distally-proximally within the lumen. In some embodiments, an inner cone moves
changing an angle of vertical axis of the inner cone with respect to a
vertical axis of the
nozzle lumen and/or external cone. In some embodiments, reduction of a lumen
size
increases flow rate and/or pressure of fluid passing through the nozzle.
In some embodiments, one or more part of the nozzle rotates. In some
embodiments, the nozzle includes an internal rotating element located within a
lumen of
the nozzle which stirs and/or moves and/or agitates fluid (e.g. liquid and/or
gas and/or
abrasive powder and/or nonabrasive powder) passing through the lumen.
In some embodiments of the invention, momentum, potentially including
angular momentum, is transferred from the motion of the rotating element to
the fluid
passing through the nozzle lumen and/or fluid passing through the rotating
element
before the fluid is ejected from the nozzle: In some embodiments, movement of
the
rotating element causes fluid with the nozzle lumen to rotate and/or have
helical
movement. In some embodiments, movement of the rotating element causes fluid
in the
lumen to flow along the lumen walls, for example, due to centrifugal force
applied to
the fluid by the rotating element. Potentially, fluid exiting the nozzle does
so at an angle
which is broadened by the tangential component of its momentum at the exit
aperture of
the nozzle.
In some embodiments, for example, due to fluid surface tension and/or cohesion
between fluid parts, fluid with helical and/or rotational movement within the
lumen
continues to move with helical and/or rotational movement once discharged from
the
nozzle (e.g., in an airspace and/or inside the root canal).
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In some embodiments, movement of the material is such that, after the fluid is
discharged from the lumen, the fluid flows helically within the root canal
e.g. due to the
angle the discharged jet/beam to the root canal wall, e.g. due to maintaining
of helical
flow initiated in the nozzle lumen.
In some embodiments, a rotating element stirs fluid in a wide diameter/cross
sectional area portion of a nozzle lumen (e.g. the widest 10%, or 30%, or 50%,
or 70%,
of the nozzle lumen length, or lower, higher or intermediate percentages) and,
as the
fluid flows distally through the lumen to a nozzle exit aperture, the lumen
diameter/cross sectional area reduces (e.g. the lumen is a cone shaped lumen),
the fluid
continues to rotate.
In some embodiments, the rotating element includes one or more inlet through
which fluid (a portion of or all of the fluid passing through the nozzle)
flows into the
nozzle lumen.
In some embodiments, the rotating element includes blades which are shaped
and/or angled such that rotation of the blades pushes fluid towards the nozzle
exit
aperture.
In some embodiments, a shape of discharged rotating fluid changes upon entry
into a root canal, in some embodiments following the shape of the root canal.
For
example, in some embodiments, discharged rotating fluid flows along the root
canal
walls (e.g. due to centripetal force of the rotating fluid and/or due to
surface tension
and/or boundary effects). In some embodiments, rotating of fluid along the
root canal
walls widens the walls of the root canal optionally increasing a size of the
root canal in
all three dimensions.
An aspect of some embodiments relates to cleaning and/or abrading a root canal
using concurrent control of discharge of fluid into a root canal and removal
(e.g. suction
by suction) of material from the root canal. In some embodiments flow of fluid
and/or
pressure is controlled within the root canal. In some embodiments, the root
canal is
sealed such that material can only enter or exit the root canal through a
nozzle (e.g. the
root canal is sealed at a coronal opening of the root canal). A potential
benefit of sealing
is prevention of introduction into the root canal of atmospheric contaminants
such as
dirt, bacteria. In some embodiments, control of discharge and suction controls
a depth
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(apically) of penetration of fluid and/or a depth (apically) of abrasion
and/or pressure
within the canal and/or at the canal apex and/or a canal region proximal to
the apex
and/or a quantity of fluid within the root canal. A potential benefit being
reduction of
risk of rupture and/or break-through of the root canal at the apex.
5 In some
embodiments, discharge of fluid into the root canal and/or suction of
material from the root canal are in pulses. A discharge pulse is a discrete
action where
discharge is for a time period where before and after the pulse there is no
discharge.
Similarly, a suction pulse is a discrete action where suction is for a time
period where
before and after the pulse there is no suction.
10 In some
embodiments, discharge and suction are controlled such that the root
canal remains at least partially filled with fluid.
In some embodiments, discharge and suction are in alternating pulses, where a
discharge pulse is followed by a suction pulse. In some embodiments, suction
and
discharge pulses overlap, were there is a time period where both suction and
discharge
15 occur.
In some embodiments, between discharge and suction pulses there is a pause
where there is neither suction nor discharge. In some embodiments, discharge
and
suction are in simultaneous pulses.
In some embodiments, parameters of discharged fluid from the nozzle (e.g.
speed, volume, angular velocity, location of discharge) and/or parameters of
suction
20 (e.g.
pressure or suction, quantity of material removed, position within the root
canal
where suction is supplied) are controlled to achieve desired flow
characteristics and/or
parameters within the root canal, for example, quantity of material within the
canal,
speed of rotation of fluid within the root canal.
An aspect of some embodiments relates to mixing fluid (e.g. air and/or liquid)
with abrasive powder before discharging the fluid including powder from a
nozzle. In
some embodiments, fluid is passed through (e.g. under pressure) a powder
cartridge
including powder (e.g. abrasive powder). In an exemplary embodiment, the
powder
cartridge includes internal cylinders each cylinder including holes for
passage of the
fluid (e.g. air) through the power cartridge, for example, to mix powder
within
cylinder/s with the fluid and/or for ejection of components (e.g. abrasive
powder) from
one cylinder to another cylinder and/or out the powder cartridge. Optionally,
in some
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embodiments, powder cartridge components are non-cylindrical. In some
embodiments,
the powder cartridge includes internal cylinders each cylinder including holes
for
filtration of components (e.g. abrasive powder).
An aspect of some embodiments relates to cleaning and/or abrading a root canal
using a system including a nozzle where fluid is supplied to the nozzle (e.g.
through a
pipe) by one or more chamber, for example, within an (optionally disposable)
pressurized gas container (e.g. a canister) containing pressurized gas and one
or more of
fluid and abrasive material. In some embodiments, the nozzle is connected to
more than
one chamber containing material (e.g. gas and/or liquid and/or abrasive
powder). In an
exemplary embodiment, the system includes a first chamber containing
pressurized gas
and fluid and a second chamber containing abrasive powder.
In an additional exemplary embodiment, a system supplies, e.g. using chamber/s
containing pressurized gas, more than one flow of material to the nozzle,
where the
flows meet and/or mix within the nozzle. For example, in some embodiments a
first
flow includes abrasive powder and gas and a second flow includes liquid. In
some
embodiments, abrasive powder is mixed with gas and liquid in the container
and/or at a
container exit.
In some embodiments, a supply apparatus is integrally packaged.
In some embodiments, a geometry of the nozzle and/or other parameters such as
the fluid composition, the fluid pressure, or others may be selected to
achieve the
desired conditions (e.g. pressure of fluid flow, speed of fluid rotation and
speed/pressure
of flow of fluid from the nozzle tip).
In some embodiments fluid flow within the nozzle (and optionally a rotating
element) is not exposed to the atmosphere, for example, preventing
introduction of
contaminants into the tooth and/or preventing degradation of the fluid and/or
component/s of the fluid. Degradation being e.g. by atmospheric contaminants
such as
dirt, bacteria, e.g. by exposure of reactive fluid component/s to atmospheric
oxygen.
Optionally, in some embodiments, flow input parameters (e.g. flow rate, flow
composition) are varied with rotation to provide desired jet/beam
characteristic and/or
parameter.
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Optionally, a nozzle includes a narrow, needle like tip, for example,
providing a
narrow beam of jets for cleaning of a narrow root canal and/or providing a
focused, high
pressure beam and/or facilitating insertion of the tip into a narrow root
canal.
Optionally, a nozzle tip (e.g. a needle like tip) includes an angled outlet
aperture,
or a rounded edged outlet aperture, or any other shape outlet aperture. In
some
embodiments, a shape of a nozzle outlet aperture changes beam flow
characteristics
and/or parameters, for example, flow direction, and/or improving acceleration
of fluid
circulation and/or spinning rate in the root canal. In some embodiments, a
shape of
nozzle tip is selected to affect flow direction of fluid discharged through
the tip, for
example, by flow sticking to a surface of the nozzle tip edge, for example a
notch, a
projection, an angled section.
Optionally, at least a portion of an inner surface of lumen walls is textured
(e.g.
grooved), potentially assisting and/or enabling helical flow of the fluid e.g.
as flow is
preferentially in the direction of helical grooves which spiral downward
towards a
nozzle outlet.
In some embodiments, a nozzle structures (e.g. lumens, suction cones, nozzle
tip) are cone-shaped. Alternatively, in some embodiments, one or more nozzle
structure
has a portion with parallel walls, and/or rounded walls (e.g. a straight
walled portion
terminating in a semi-hemispherical portion). In some embodiments, one or more
nozzle
structure has a different shape, for example, a nozzle with an outer cone
shape and a
cylindrical lumen. In some embodiments, an angle of the cone-shaped walls of a
nozzle
structure to a nozzle structure long axis is 5-75 degrees, or 20-60 degrees,
or lower or
higher or intermediate angles. In some embodiments, a nozzle has a flattened
shape at a
nozzle tip. In some embodiments, a cross sectional area of a nozzle tip
enlarges distally
(e.g. as illustrated in Figures 42A-B).
An aspect of some embodiments of the invention relates to cleaning and/or
abrading a root canal using one or more angled fluid jets. In some
embodiments, once
the angled jet hits the root canal wall, the force exerted by the wall
channels the jet to
travel down the root along the wall. In some embodiments, the angle includes a
component outside the plane of the axis of root canal, so that the flow spins
in a helical
flow along some or all the root canal. In some embodiments, the fluid advances
along
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the root canal wall to remove organic substance and/or abrade the canal wall.
In some
embodiments, the angled fluid jet does not cross a vertical axis of the root
canal and/or a
vertical axis of the nozzle. In some embodiments, as described below, an
angled jet or a
plurality of angled jets are not used, but instead a flow beam than comprises
significant
non-axial velocity components is used. In some embodiments, the beam does not
travel
through air when exiting the nozzle, but may directly hit fluid within a root
canal or be
contiguous with such fluid.
In some embodiments, the jet does not flow straight downwards towards the
apex of the root canal. In some embodiments, one or more jet meets the root
canal wall
at an angle to a plane of the root canal wall where the jet meets the root
canal, of 20-45
degrees, or 30-45 degrees, or lower, or higher, or intermediate ranges and/or
angles to
the root canal wall.
In some embodiments, the passing of the flow through the canal is facilitated
by
the fluid advancing along the wall. In some embodiments, the flow of fluid
passes
through a narrowing portion of the root canal to clean and/or abrade the
narrowing
and/or distal section of the root canal. In some embodiments, the flow of
fluid continues
to the apex of the root canal. In some embodiments, at least some of the fluid
flows
back up through the root canal (herein termed returning fluid), washing away
soft tissue
such as nerve tissue, blood vessels, magma and/or debris. In some embodiments,
since
the flow of fluid advances along the canal wall, the returning fluid passes
upwards
through the center of the canal.
Optionally, the resulting flow path allows continual irrigation for cleaning
and/or abrading the root canal. In some embodiments, maximum abrasion of the
fluid
flow is where the fluid flow changes direction, for example, where the flow
returns
upwards (e.g. in a coronal direction) through the root canal, e.g. at the
apex.
Alternatively, in some embodiments, for example, due to friction and/or
turbulence, as
the fluid flows apically abrasion reduces.
Optionally, fluid including liquid and/or gas (including different ratios of
liquid
to gas) is self-abrasive, for example, where bubbles within fluid abrade the
root canal.
Optionally, fluid where bubbles abrade the root canal includes nonabrasive
powder. In
some embodiments, bubbles include powder and/or act as powder and/or are
abrasive.
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Optionally, irrigation is performed periodically to allow fluid to exit the
canal.
In some embodiments, a volumetric flow rate of fluid that passes through the
root canal
ranges between 0.5-50 ml/second, for example between 1-9 ml/second, 30-40
ml/second.
In an exemplary embodiment of the invention, the flow travels along the wall
of
the root canal for at least 20%, 50%, 70%, 90% or intermediate or greater
percentages
of the length of the root canal. In some embodiments, flow travels along at
least 20%, or
at least 50%, or at least 70%, or at least 90%, or substantially all of the
surface area of
the root canal. In some cases, part of the flow, for example, at the distal
end of the
canal, includes a significant turbulent flow (e.g., away and towards the
wall). In some
embodiments, the flow travels a length of 0.1 mm, 0.5 mm, 1 mm, 2 mm, 3 mm
along
the wall of the canal. Optionally, the flow travels beyond the fluid level
within the
canal, for example 0.2 mm, 0.6 mm, 1 mm, beyond. In some embodiments, the
fluid
level is defined as a level which contains 30%, 50%, 70% of fluid vs. an
air/void
component.
In some embodiments, the direction and/or magnitude of the momentum of the
fluid exiting a nozzle of the apparatus is determined by the structure of the
nozzle. In an
exemplary embodiment, the fluid is circulated in a lumen formed between two
cones
within the nozzle so that it exits the nozzle in an angle to a vertical axis
of the nozzle. In
another embodiment, passing the fluid within a structural element of the
nozzle, such as
an inclined tube configured on a plane that crosses the vertical plane of the
tooth may
create the angled direction of the jets.
In some embodiments, a flow (e.g. a fast flow) of fluid passes through the
root
canal and optionally enters at least a portion (e.g. 1%, 4%, 5%, 10%, 20%,
50%, 100%)
of the dentinal tubules. In some embodiments, a ratio between gas (such as
air) and
liquid (such as water, disinfectant, antiseptic medication, and/or any other
solution) is
used. In one example, a fluid may comprise 90% air and 10% liquid. Other
examples
include 80% air and 20% liquid, 98% air and 2% liquid, 30% air and 70% liquid.
In
some embodiments, the selected ratio may affect parameters such as the
elasticity of the
fluid, the velocity of the fluid, and/or the flow rate. Optionally, components
of the fluid
such as air bubbles (e.g. pressurized gas bubbles) may facilitate the removal
of organic
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substance from the canal wall and/or erode root canal hard tissue (e.g.
dentine). In some
embodiments, fluid including bubbles includes nonabrasive powder.
In some embodiments, a relatively low source pressure of the jet or a beam of
jets exiting a nozzle is used, for example ranging between 10-200 PSI, 50-100
PSI, 20-
5 30 PSI,
200-300 PSI. In some embodiments, the pressure of the angled jet when hitting
a wall of the root canal is lower, for example ranging between 5-150 PSI, 10-
30 PSI,
70-120 PSI.
In some embodiments, the fast flow of fluid erodes a layer of tissue, for
example
dentin tissue. Optionally, eroding is accomplished by adding abrasive
particles to the
10 fluid,
which are then pushed against the walls of the canal, sweeping away a layer of
dentinal tissue, magma, debris and/or bacteria. In some embodiments, eroding
of at least
or 50-80%, or 20-30%, or 80-90%, or 40-70%, or substantially all of a surface
of the
root canal wall is performed.
In some embodiments, the flow of fluid smoothes the root canal wall, for
15 example
removing grooves. A potential advantage of smooth or groove-free canal walls
and/or a lack of a smear layer is that there is no need or there is a reduced
need for
chemical and/or disinfecting flushes of the root canal.
In some embodiments, a layer of eroded dentine tissue is thin in comparison to
traditional root cleaning treatments, a potential benefit being a less
invasive treatment
20 and/or
a stronger tooth after treatment, and/or less risk of rupturing the root
canal. In
some embodiments, the layer has thickness ranging between 100-200 [tm, or
between
40-400 [tm, or less than 400 [tm.
In some embodiments, the root canal wall is subjected to shear forces exerted
by
the flow of fluid. Optionally, a thin layer of tissue is removed due to the
applied force.
25 In some
embodiments, turbulent flow may be observed in at least a portion of
the root canal, for example in proximity to the apex. Optionally, a turbulent
flow may
increase the shear forces exerted by the flow of fluid. In some embodiments
(for
example, when fluid is discharged into a root canal containing fluid) a root
canal is
cleaned and/or abraded by turbulent fluid flow in the canal. In some
embodiments,
debris and/or eroded material is not pushed into root canal walls, but is
pulled away
(e.g. into a central portion of the root canal) and/or pushed along root canal
walls. A
potential benefit being that debris and/or contamination is not pushed into
tubules.
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In some embodiments, various parameters of the apparatus and/or system such
as the angle of the fluid jet, the ratio between gas and liquid, the type of
abrasive
powder and/or any other parameters or combinations of them may be selected to
optimize the effectiveness of the apparatus and/or system. In some
embodiments,
structural components of the nozzle such as an internal cone within the nozzle
are
movable with respect to each other. Optionally, the movement modifies a volume
of the
lumen. In some embodiments, a structure of an internal cone can be modified to
change
a shape of the lumen, for example by comprising a radially expanding portion
which
occupies a volume of the lumen. Optionally, the modification of the lumen
affects the
flow parameters of fluid passing within the nozzle and/or exiting the nozzle.
In an exemplary embodiment of the invention, a plurality of jets are used.
Optionally, the use of a plurality of jets allows more freedom (e.g. less
manual precision
and/or allowing matching to various geometries) in the orientation of the
nozzle, as it is
more likely that at least one jet will have an angle needed for proper
treating of the root
canal. Optionally or alternatively, the use of multiple jets may assist in
ensuring that all
portions of the root canal wall are hit by fluid flow at sufficient velocity
and/or other
parameters.
In some embodiments, the jets will be contiguous with each other, for example,
in the form of a cone and/or a segment thereof. Alternatively, a cone shaped
flow is
formed without distinct angled jets. Additionally or alternatively, the cone
shaped flow
or other form of flow comprises a vertical velocity component as well as a
circumferential velocity component. Additionally or alternatively, the
velocity
comprises a radial component. Exemplary ratios of a relative weight of each of
the
components out of the total velocity may include 70% vertical component, 20%
circumferential component, 10% radial component, or 40% vertical, 30% radial,
and
30% circumferential, or other ratios thereof In some embodiments, for example
when
the root canal is at least partially filled with fluid, the angled jet hits
the fluid within the
canal. Optionally, the jet merges with the fluid, and may intensify the
spinning motion
of the flow within the canal. An aspect of some embodiments relates to
cleaning and/or
abrading a root canal using turbulent flow in the canal. In some embodiments,
the
turbulent flow is created by providing one or more fluid jets at an angle. In
some
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embodiments, the turbulent flow is created by providing a spinning beam of
fluid which
merges with fluid within the canal.
In an exemplary embodiment of the invention a turbine such as an air turbine
is
coupled to an internal pipe within the nozzle, the turbine configured for
rotating the pipe
so that fluid circulates within the pipe. In some embodiments, the turbine
spins a cone
of the nozzle which contains the fluid. In some embodiments, the circulating
flow of
fluid exits the nozzle and enters the root canal, where the spinning momentum
may
cause the flow the flow along the canal walls, thereby removing tissue.
Various embodiments are described in this application, some of which describe
a relation between the nozzle structure and the flow regime within the nozzle,
the nozzle
structure and the flow within the canal, the shape of the beam and the flow
within the
canal, desired flow parameters of flow effects in the canal, or others. In an
exemplary
embodiment of the invention, a geometry of the nozzle and/or other parameters
such as
the fluid composition, the fluid pressure, or others may be selected to
achieve the
desired conditions. In some embodiments, a calibration is performed to match
up such
parameters and achieve a desired effect, optionally using different parameter
value sets
for different dental conditions. An exemplary device may include a knob which
selects
different parameter sets determined by such a calibration, and/or according to
the
selected nozzle geometry.
Before explaining at least one embodiment of the invention in detail, it is to
be
understood that the invention is not necessarily limited in its application to
the details of
construction and the arrangement of the components and/or methods set forth in
the
following description and/or illustrated in the drawings and/or the Examples.
The
invention is capable of other embodiments or of being practiced or carried out
in
various ways.
In some embodiments, a nozzle tip is sufficiently small such that at least a
portion of the tip can be inserted into a pulp chamber of a tooth. In some
embodiments,
a maximum extent of a nozzle tip perpendicular to a vertical axis of the
nozzle is less
than 0.05mm, or 0.1mm, or 0.2mm or 0.5mm, orlmm, or 2mm, or 5mm, or lOmm, or
smaller, or larger, or intermediate measurements.
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In some embodiments, tissue is removed from a root canal, for example by
rotating fluid within the root canal, at a rate of at least lug/s, or 0.1mg/s,
or lmg/s, or
20mg/s, or lower, or higher or intermediate rates.
In some embodiments, discharge of fluid from a nozzle into fluid within a root
canal causes the flow within the root canal to start rotating helically and/or
for a speed
(e.g. revolutions per second) of already rotating fluid within the canal to
increase and/or
for a number of revolutions of the fluid along the wall of the root canal to
increase.
In some embodiments, fluid in said root canal fills at least 5%, or at least
10%,
or at least 20%, or at least 30%, or at least 50%, or at least 90% or lower,
or higher or
intermediate percentages of a volume of said root canal.
In some embodiments, fluid in said root canal comprises at least 10% liquid,
or
at least 20%, or at least 30%, or at least 50%, or at least 90% or lower, or
higher or
intermediate percentages.
A description of an endodontic procedure, according to some embodiments of the
invention
Referring now to the drawings, Figure 1 is a flowchart of an endodontic
treatment procedure, in accordance with an exemplary embodiment of the
invention.
In some cases, for example if a tooth is decayed, infected, and/or cracked, a
dentist may decide to perform procedure for treating the root canal of a human
tooth,
e.g. as described at 101.
Commonly, the number of root canals in a tooth depends on the number of the
tooth roots, for example ranging between 1-5. In some cases, such as in root
canal
anastomosis, a single canal may split into branching canals.
In some embodiments, a root canal procedure includes removing pulp tissue
(pulpectomy), magma, nerve tissue, and/or blood vessels from the pulp chamber
and
root canal to prevent future infection and/or an abscessed tooth. In some
embodiments,
the root canal procedure includes shaping the root canal. In some embodiments,
the root
canal procedure includes decontaminating the tooth. A feature of some
embodiments
includes not performing one or more of the above, for example not performing
shaping
of the root canal.
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In an exemplary embodiment of the invention, for example, as will be described
below, the root canal is cleaned without leaving a smear layer which, for
example,
would otherwise block tubules and/or serve as a substrate for infection.
Prior to and/or during the procedure, imaging of the tooth may be performed,
as
described at 103. For example, X-ray imaging may be performed to determine the
shape
(or number) of the root canals and/or detect signs of infection.
At 105, an access cavity to the pulp chamber and root canal is created through
the crown of the tooth, for example using a dental drill. Once the access
cavity is
created, the entrance to the root canal is exposed, as described at 107,
optionally using a
root canal file inserted through the access cavity into the pulp chamber. In
some
embodiments, access is provided via a side of the tooth. This may be possible
if no files
are used on the root canal, for example, as described below.
At this stage, in order to clean, shape and/or decontaminate the root canal
through the exposed entrance, a distal tip of the apparatus, optionally
including a nozzle
as will be further described, is inserted through the pulp chamber, as
described at 109,
and an exit aperture of the nozzle is positioned above the exposed entrance to
the root
canal, as described at 111. Optionally, the exit aperture of the nozzle is
positioned
within the root canal, as will be further described. Optionally, the exit
aperture of the
nozzle is positioned in an angle to the root canal entrance. At 113, one or
more angled
fluid jets discharged from the exit aperture of the nozzle passes through the
root canal,
as will be explained by the following figure. In some embodiments, as the flow
of fluid
advances along the root canal wall, it removes tissue. In some embodiments,
the flow of
fluid removes organic substance such as pulp tissue, nerve tissue, blood
vessels, magma
and/or debris from the root canal. In some embodiments, the flow of fluid
erodes a thin
layer of dentin tissue from the wall of a root canal. In some embodiments, the
flow of
fluid smoothes the root canal wall. In some embodiments, the flow of fluid
disinfects
the root canal.
In some cases, manual cleaning (e.g. using a file or other methods known in
the
art) is used to remove some or all bulk debris from a canal before using fluid
jets as
described herein. Optionally, fluid jets are used to remove a smear layer
created by
manual cleaning.
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At 115, the dentist may optionally evaluate the effectiveness of the cleaning
and/or abrading procedure, for example by inserting a file to reach the apex
of the root
canal and test for remains of infected tissue. Optionally, a dentist may re-
wash and/or
dry and/or disinfect the root canal (116).
5 At this
stage, sealing of the root canal (and/or the pulp chamber) is optionally
performed (117). Optionally, sealing includes filling a hollow interior of the
root canal.
In some embodiments, a rubber compound such as Gutta Percha material may be
used
for sealing the root canal. Optionally, the Gutta Percha material is softened
and injected
into the root canal, in which it then hardens. Alternatively, a more solid
form of Gutta
10 Percha,
for example shaped as a cone, is inserted into the root canal to fill it. In
some
embodiments, the sealing process begins by inserting the filling material to
the apex of
the root canal, and then advancing upwards. In some embodiments, a temporary
filling
is used, which is later replaced by a permanent filling.
In various acts described above, techniques that are known in the art may be
15 used.
The acts described at 109-113 desirably use an embodiment of an inventive
apparatus and method for cleaning and/or abrading a root canal, for example,
as
described below.
Optionally, the procedure described at 101-117 is repeated for one or more
additional root canals, for example an additional root canal of the same tooth
and/or a
20 root
canal of a different tooth. Optionally, sealing is performed for the one or
more root
canals that were treated.
Various types of root canals may be treated using the described methods and/or
apparatuses, such as a curved shaped canal, L shaped canal, C shaped canal, S-
shaped
canal, V-shaped canal, U-shaped canal, istmus canal, root canal anastomosis,
webs
25 canal, fins canal, lateral canal, accessories canal, MB2 canal, root
canal type 1-8.
Figure 2 is a flowchart of an exemplary method for cleaning and/or abrading a
root canal using one or more angled fluid jets, according to some embodiments
of the
invention.
30 At 201,
one or more angled fluid jets are directed into a root canal to clean
and/or abrade it.
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In some embodiments, a jet is a directed flow of fluid, optionally exiting
from an
exit aperture of a nozzle. Different embodiments may have jets with different
shapes
and/or forms. For example, the jet may have a narrow ray form. In some
embodiments,
a beam of a plurality of jets is used. In some cases, the jet is thin and flat
and may
spread out angularly. In other embodiments, a jet is substantially pencil
like, but spreads
when contacting the root canal wall. In an exemplary embodiment of the
invention, the
jet shape is determined by the shape of the nozzle used. For example, in some
embodiments, the jet/beam shape is determined by the shape of the tip of the
nozzle
used. For example, in some embodiments, a shape of a jet/beam discharged is
the same
shape as a shape of the nozzle outlet. For example, in some embodiments, a
nozzle with
a narrow tip portion (e.g. see Figure 9B) discharges a narrow jet/beam. In
some
embodiments, the shape of the jet may depend on the fluid parameters, such as
air/liquid
ration and/or pressure and/or pulsatility. In other embodiments, the nozzle
may be able
to selectively provide one of several jet forms. Optionally, at least a
portion of the
nozzle is shaped as a needle-like tube, forming a relatively narrow passage
for the fluid
to flow through.
In some embodiments, each of a plurality of angled jet has hits the root canal
wall at a different angle so that the plurality of jets are channeled to flow
together along
the root canal wall in a helical pattern, as will be further described. In
some
embodiments, a helical pattern within a nozzle and/or within a root canal is
where the
path of fluid flow changes angle while flowing apically. In some embodiments,
the fluid
flow follows a number of revolutions where a direction of the fluid flow
repeats, at least
in an axis perpendicular to a vertical axis of the root canal.
In some embodiments, the one or more jets are directed into the root canal. In
some embodiments, at least a portion of a single jet or a plurality of jets
hits the wall of
the root canal. In some embodiments, force exerted by the wall channels the
jets to
advance along the root canal wall. In some embodiments, the fluid flows in a
helical
flow pattern along the walls of the root canal, for example, as will be
further described
in the following figure.
In some embodiments, as will be further explained, the one or more jets are
discharged from a nozzle such that they are angled to a vertical axis of the
nozzle. In
some embodiments, the one or more jets enter the root canal such that they are
angled to
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a vertical axis of the root canal. Optionally, the vertical axis of the nozzle
unites with
the vertical axis of the root canal.
In some embodiments, the shunting of the one or more jets in a specific angle
and/or direction is created by a designated inner structure of the nozzle, for
example, as
will be further explained below.
In some embodiments, a plurality of angled jets such as 2, 4, 8, 12, 50, 1000,
2000, 3000, or any intermediate or higher numbers are used. In some
embodiments, the
nozzle is adapted for discharging at least 2, or at least 4, or at least 8, or
at least 12, or at
least 50, or at least 1000, or at least 2000, or at least 3000 angled fluid
jets
simultaneously. A potential advantage of using a plurality of jets may include
a more
effective cleaning and/or eroding of the canal wall. For example, in some
embodiments,
a large number of jets (e.g. more than 5, 10, 50, 100, 300, 1000) means that
the entire
root canal wall is contacted by the jet. In some embodiments, a larger number
of jets
and constant liquid flow rate (e.g. jets have a higher proportion of air)
results in faster
circulation of fluid within the root canal.
In some embodiments, a plurality of jets includes disinfecting material and/or
abrasive material.
Optionally, a thickness of the layer of tissue eroded by the flow is
substantially
equal at various portions of the root canal.
In some embodiments, rotational flow of fluid along the canal walls means that
the root canal wall continues to be abraded when the shape of the wall changes
due to
the abrasion process (e.g. the fluid continues to flow along the canal walls
despite
changes in shape and/or angle of the walls). In some embodiments, rotation
flow of the
fluid along the canal walls causes enlargement of the canal in all three
dimensions. In
some embodiments, abrasion is complex shaped, for example, in a shape other
than
cylindrical.
In some embodiments, characteristics and/or parameters of the flow and/or
fluid
(e.g. speed, number of jets, angle of jets, composition of fluid) are changed
to be
suitable for abrading the root canal during treatment, for example, to
maintain erosion
as the canal widens. In some embodiments, a proportion of abrasive powder in
the fluid
and/or a speed of fluid flow is increased during a treatment, for example, so
that the root
canal wall continues to be abraded as the root canal increases in size (due to
abrasion).
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In some embodiments, abrasion is reduced (e.g. by reducing a proportion of
abrasive
powder in the fluid and/or a speed of fluid flow) during treatment, for
example, to
smooth the root canal wall after the majority of the abrasion/erosion has
occurred.
In some embodiments, one or more portion of a root canal is smoothed, for
example due to fluid flow and/or abrasion.
Another potential advantage of using a plurality of jets includes the ability
to
select a hitting angle, for example an angle of 30 , 45 , 70 between the
angled jet and
the root canal wall, and additionally and/or alternatively to assure that at
least some of
the jets of the beam will hit the root canal wall.
In some embodiments, a single angled jet may be used, for example being
narrow enough to effectively advance along the canal wall, creating a thin
coating-like
layer of fluid. Optionally, in the above described phenomena, the angled jets
advance
along the canal wall, optionally allowing some or all of the returning fluid
to flow back
up through a central lumen along the vertical axis of the canal, as will be
shown by the
following figure. For example, 60-80 %, 40-50%, 80-95% of the fluid may flow
back
through the central lumen, and 10-30%, 5-8%, 30-40%, may flow back up along
the
canal wall.
In some embodiments, as described at 203, the flow of fluid passing through
the
root canal removes soft tissue such as pulp tissue, magma, nerve tissue,
and/or blood
vessels. In some cases, the tissue removed is infected tissue. In some
embodiments, the
flow of fluid flushes away organic substance and/or debris. In some
embodiments, flow
of fluid cuts soft tissue (e.g. nerves and blood vessels) without pulling the
soft tissue
from the tooth e.g. a blood vessel is cut in half, with half of the vessel
remaining in the
tooth. In some embodiments, abrasion removes a layer of dentine, cutting
tubules and/or
blood vessels within the dentine, optionally including an apical area and/or
apex (e.g.
cutting blood vessels) of the root canal.
Optionally, a thickness of the layer of tissue eroded (e.g. soft tissue and/or
dentine) by the flow (e.g. rotation of fluid within the root canal) is
substantially equal at
various portions of the root canal. In some embodiments, a thickness of the
layer of
tissue eroded is between 50-90[tm thick, or between 10-150[tm thick, or
between 100-
200[tm thick, or lower, or higher, or intermediate thicknesses.
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In some embodiments, the flow of fluid erodes a layer of tissue, for example a
thin layer, such as a thin layer of dentin tissue. Optionally, the flow of
fluid causes
widening of the canal. In some embodiment, the flow of fluid smoothes the
surface of
the root canal wall. For example, the thickness of the eroded layer may range
between
100-200 p.m, 10-70 p.m, 200-300 p.m. Optionally, the thickness of the eroded
layer
and/or the amount of debris removed by the flow depends on various parameters,
such
as the application time.
In some embodiments, the fluid comprises liquid, such as water and/or
antibacterial liquid. Additionally and/or alternatively, the fluid comprises
gas, such as
air. Optionally, the mixture of air and liquid dispersed from the nozzle is an
aerosol.
Optionally, the pressure of the aerosol exiting a nozzle ranges between 10-200
PSI.
In some embodiments, a ratio between air and liquid is selected according to
the
need, for example a ratio between air and liquid may affect the viscosity of
the fluid
which in turn may affect the velocity of the fluid flowing through the canal.
In some embodiments, the gas is air, and the fluid comprises between 50-95%
air, and between 5-50% liquid, or the fluid comprises between 20-95% air and
between
5-80% liquid or lower, or higher, or intermediate ratios of liquid to air.
In an exemplary embodiment, the fluid comprises between 60-90% air, and
between 10-40% liquid, such as 70% air and 30% liquid, 85% air and 15% liquid,
98%
air and 2% liquid, or another higher or lower ratio, or an intermediate ratio.
In some embodiments, composition (e.g. percentage of components within the
fluid) of the fluid comprising liquid and one or more of air, abrasive
material and
disinfecting material is chosen to be suitable for the type of treatment
and/or the type of
root canal. For example, in some embodiments, a proportion of abrasive powder
is
increased to increase a rate of erosion of the root canal walls. For example,
in some
embodiments, disinfecting material is increased and/or added to the fluid at
the end of
the treatment, e.g. to leave a sterile and/or clean root canal. In some
embodiments, for
example, if there is a buildup of debris in the root canal, a proportion of
gas (e.g. air) in
the flow is increased to increase a speed of the flow, for example to flush
the root canal
from debris. In some embodiments, a proportion of gas in the fluid is reduced
for
flushing the canal, e.g. as a final stage of treatment.
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In another example, the ration between air and liquid is 90% liquid, and 10 %
air. In another example, the fluid comprises 100% liquid. Optionally, by
having fluid
with relatively high air content, faster spinning motion may be obtained.
Optionally, by
obtaining a relatively high angular velocity of the spinning fluid, the
radially outward
5 force
(i.e. centrifugal force) applied by the flow and/or by particles of the flow
such as
abrasive powder particles onto the root canal wall is increased. A potential
advantage
includes eroding a thicker layer of tissue, thereby optionally increasing the
treatment
effectiveness. Optionally, a friction produced between the gas (e.g. air)
components of
the fluid when contacting the root canal wall is relatively low with respect
to the friction
10
produced by the abrasive particles of the fluid during contact with the root
canal wall. In
some embodiments, a density of an abrasive particle is higher than a density
of a liquid
and/or gas particle comprising the fluid. In some embodiments, the percentage
of
abrasive powder in the fluid ranges between 0.05-15%., such as 0.1%, 2%, 10%,
or
higher, for example, 20%, 50 %.
15 In some
embodiments, eroding of the tissue is achieved by adding abrasive
particles such as an abrasive powder to the fluid. Optionally, the abrasive
powder
comprises between 0.01-3%, 2-2.5%, 0.8-1.2%, 3-8%, 5-7% of the fluid.
In some embodiments, the abrasive powder includes natural/organic material
and/or mixed material (e.g. containing more than one component), and/or
synthetic
20 material.
In some embodiments, the fluid does not include abrasive powder and abrades
the canal itself e.g. in some embodiments, bubbles within the fluid abrade the
canal. In
some embodiments, abrasive properties of fluid are affected by fluid density
and/or
viscosity, and/or particle size.
25 In some
embodiments, abrasive particles can change form and/or volume (e.g.
dissolve, e.g. absorb fluid to enlarge).
In some embodiments, size and/or proportion and/or composition of abrasive
particles affect flow within the nozzle and/or nozzle tip and/or angle jets
and/or from
the nozzle outlet and/or within the root canal. In some embodiments, abrasive
particles
30 size
and/or type are selected to be suitable for the type of treatment and/or type
of root
canal. For example, in some embodiments, large abrasive particles are selected
for a
canal which requires heavy abrasion. In some embodiments, a temperature of
fluid
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and/or other components (e.g. abrasive powder and/or gas) is selected for the
type of
treatment and type of canal. For example, in some embodiments, a higher fluid
temperature is used for cauterization. For example, in some embodiments, a
higher
temperature fluid has lower viscosity optionally associated with higher
velocity flow,
for example facilitating a heavy abrasive particle load with high velocity
rotation of
fluid. Some examples of abrasive powder that may be added to the mixture of
air and
liquid include crystallite, silicon powder, garnet powder, aluminum powder,
magnesium
powder, ceramic powder, plastic powder, synthetic, emery powders, sea shell
powder,
cement powder, salt, ground seeds, diamond powder, carbide powder, glass
powder,
iron/iron oxide powder, steel powder, aluminum oxide powder, baking soda,
acrylic
powder, granite powder, fruit powder, tree shell powder, plant seed powder,
sea sand
powder, synthetic diamond powder, stone powder, marble powder, copper powder,
silica and/or combinations of the above. In some embodiments, the powder
grains may
have a diameter ranging between 2-500 p.m, 10-50 p.m, 3-6 p.m, 0.1-1 p.m, 0.5-
2 p.m. In
some embodiments, the powder grains may be selected according to the type of
tissue
that is to be removed. In some embodiments, air bubbles can act as an abrasive
substance, for example to erode tissue, for example hard tissue (e.g.
dentine). In some
embodiments, reducing a size of the nozzle lumen increases a number of bubbles
within
the fluid, generating more abrasion. In some embodiments, pressure of air
within the
flow is increased, increasing a pressure of the bubbles, increasing abrasion.
In some
embodiments, the powder may comprise a disinfection component. In some
embodiments, the powder particle may generate a disinfection process during
the
cleaning and/or eroding process in the canal.
In some embodiments, the flow of fluid disinfects the root canal, as described
at
205, for example by adding disinfectant to the fluid. Optionally, an
antibacterial
substance and/or medicine is added. In one example, Sodium Hypochlorite is
added to
the fluid to be passed through the root canal, optionally followed by saline
and
hydrogen peroxide, to disinfect the root canal. In some embodiments, there are
three
fluid sources that can be used such as water, disinfectant, and medicine.
Optionally, the
fluid comprises one or more of these liquids.
In some embodiments, the duration of the process of removing organic
substance, eroding the tissue and/or disinfecting the interior of the root
canal ranges
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between 15-45 seconds, for example 20 seconds, 27 seconds, 43 seconds. In some
embodiments, for example if the root canal has an extremely narrow portion,
the
duration of the above process may range between 45-60 seconds, for example 50
seconds, 55 seconds. Optionally, shorter, intermediate and/or longer time
periods are
required to complete the process. In some embodiments, the treatment is
provided in
periodic pulses, for example a 10 second duration followed by a 10 second
interval, or a
2 second duration followed by a 5 second interval, or another combination of
larger,
smaller and/or intermediate intervals. In some embodiments, during the
interval access
fluid is collected from the root canal, for example by suctioning.
In some embodiments, a duration of a pulse ranges between 0.2-0.3, or 0.5-1,
or
1-25 seconds, or intermediate values, and, optionally, debris and excess fluid
are
removed in intervals between pulses. In some embodiments, the pulses are
controlled
through a control panel electrically connected to the apparatus. In some
embodiments,
pulses have different durations, and/or flow rates and/or volumes of
discharged fluid. In
some embodiments 0.1-300cc/s, or 0.5-155cc/s, or 0.5-70cc/s, or any
intermediate,
larger or smaller ranges and/or values of fluid flow in a pulse.
In some embodiments, suction and/or removal of material from the root canal
enables flow of fluid along the root canal wall. For example, because suction
empties
and/or partially empties the root canal revealing portions and/or the entire
root canal
wall. For example, because suction creates negative pressure within the root
canal,
encouraging flow of fluid along the root canal wall.
In some embodiments, suction increases the speed of circulation of the fluid
inside the root canal (e.g. due to lack of or reduction in resistance from
fluid in the root
canal and/or due to reduction of pressure in the root canal). In some
embodiments,
suction increases the speed of circulation of fluid at the root canal apex and
a lower
portion of the root canal proximal to the apex.
In some embodiments, suction reduces pressure at the root canal apex and/or an
apical portion of the root canal proximal to the apex, potentially reducing
the risk of
rupture of the apex and/or break-through at the apex.
In some embodiments, the treatment time period and/or the length of the
periodic pulses of the treatment are determined according to a ratio between
air and
liquid in the fluid and/or a ratio between air and powder and/or a ration
between liquid
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and powder. Optionally, operation parameters of the apparatus are determined
according to calibrated values.
Application of fluid by the apparatus into the root canal, according to some
embodiments of the inventions
Figure 3 shows angled fluid jets entering a root canal and advancing along the
root canal wall in a helical flow, according to some embodiments of the
invention.
In some embodiments, angled fluid jet 301 hits wall 303 of the root canal 305.
In some embodiments, the plane in which the angled fluid jet passes before
and/or
during entrance to the root crosses a vertical plane of the tooth, for example
a plane in
which vertical axis y passes, as will be explained.
In some embodiments, an angle y is formed between jet 301 and an axis
extending longitudinally along the canal wall 303, such as axis AA. In some
embodiments, for example if a portion of the root canal is shaped as a
cylinder, axis AA
may be parallel to vertical axis y. In some embodiments, angle y is an acute
angle, for
example ranging between 10-85 degrees, for example 20 degrees, 45 degrees, 73
degrees. In some embodiments, angle y is zero.
In some embodiments, one angled jet 301 or a plurality of angled jets hit the
root
canal wall. In some embodiments, the jets advance along the root canal wall.
In some
embodiments, once the jets hit the root canal wall, the force exerted by the
wall
channels the jets to spin in a helical flow 313 through the root canal.
Optionally, other
forms of flow such as longitudinal stream lines along the root canal wall are
formed.
Additionally or alternatively, when root canal 305 is at least partially
filled with
fluid, for example during steady state operation of the apparatus, angled jet
301 hits the
fluid 325 within the canal. Optionally, jet 301 merges with the fluid, and may
intensify
the spinning motion of flow 313 within the canal.
In some embodiments, a centrifugal force may be applied to canal wall 303 by
spinning flow 313. Optionally, a spiral path of the flow is maintained due to
rotational
momentum acquired when the fluid is advanced within and/or discharged by the
nozzle
of the apparatus. Optionally, the spinning pattern of flow 313 is achieved
when a
sufficient amount of angled jets enters the canal, such as, 3, 10, 100, 1000,
20000 jets or
intermediate, larger or smaller amount, such that the jets merge together to
form the
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helically spinning flow. Optionally, the plurality of applied jets comprise
different
angles, for example so that they cover the root canal opening
circumferentially.
Optionally, by hitting the opening circumferentially, a homogenous
distribution of the
flow is achieved with respect to a periphery of the root canal.
In some embodiments, flow 313 advances along a portion 315 of the root canal.
In some embodiments, portion 315 is cylindrical. In some embodiments, flow 313
passes through a narrowing portion 317 of the root canal. In some embodiments,
flow
313 passes through a narrowing portion and then through a widening portion. In
some
embodiments, flow 313 passes through a curve 323.
In some embodiments, narrowing portion 317 includes a portion having a
diameter less than 0.1 mm, less than 0.05 mm, and/or intermediate or smaller
values. In
some embodiments, curve 323 has a radius of curvature less than 0.05 mm, less
than
0.08 mm, and/or intermediate or smaller numbers. In some embodiments, a length
of a
root canal past curvature and/or past a narrowing which the fluid flows
through ranges,
for example, between 0.1-4 mm, for example 1 mm, 0.5 mm, 2 mm.
In some embodiments, flow 313 reaches apex 319 of the root canal. In some
embodiments, flow 313 passes through branches of the root canal, for example
reaching
at least a portion of branching dentinal tubules, (not shown in this figure).
In some
embodiments, for example if the anatomy of root canal 305 is unusual, such as
an L-
shaped or C-shaped root canal, and/or if root canal 305 has an extremely
narrowing
portion, flow 313 may pass through and clean at least most of the canal. A
potential
advantage of cleaning and/or eroding the root canal using the flow of fluid
includes the
ability to reach locations such as curves, narrowings and/or branches of the
root canal
which otherwise would have been impossible or hard to reach, for example when
using
a file. Optionally, a centrifugal force that is applied to canal wall 303 by
flow 313 (for
example by abrasive powder particles within the fluid) increases a thickness
of the
eroded layer, thereby optionally increasing treatment effectiveness.
In some embodiments, root canal wall 303 is subjected to shear forces, which
may be applied by flow 313. Optionally, due to the shear forces, a thin layer
of tissue
such as dentin tissue is removed by the flow. In some embodiments, the removal
of
tissue is homogenous. In some cases, for example in a narrowing and/or curvy
portion
of the root canal, the removal is non-homogenous. In some embodiments,
homogenous
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removal depends on the diameter of root canal 305. For example, in a narrowing
having
a smaller diameter than 0.1 mm, removal may be non-homogenous. Optionally, in
that
case, a file may be used for widening the narrowing. In some embodiments, the
thickness of the dentin layer removed by the flow of fluid ranges between 10-
300 [tm,
5 or between 100-200 [tm, for example 50 [tm, 80 [tm, 12 [tm. Optionally,
intermediate
and/or lower thickness layers are removed. In some embodiments, the shear
viscosity of
the fluid affects the thickness of the removed layer.
In some embodiments, for example, as the root canal is abraded gradually and
as, in some embodiments, debris is removed from the canal by the abrading
flow,
10 treatment does not result in a smear layer on the root canal walls.
In some embodiments, for example, if a drill has been used to remove material
(e.g. generating a smear layer on the root canal walls) removal of material
(e.g. a layer
of dentine) removes a contaminated layer of material from the root canal.
In some embodiments, removal of a layer of dentine, for example a layer 100-
15 200 [tm thick of dentine from the root canal reveals tubules.
In some embodiments, a rate of removal is controlled, for example, by applying
shorter pulses, for example to prevent perforation. In some embodiments,
imaging may
be performed, for example during treatment, to decide if additional cleaning
and/or
abrading is needed.
20 In some
embodiments, flow 313 reaches apex 319 of the root canal. In some
embodiments, flow 313 may become turbulent along some portions of the root
canal,
for example in proximity to apex 319.
In some embodiments, flow 313 erodes apex 319, optionally resulting in a
duller
root canal. In some embodiments, the flow 313 is applied so that it does not
widen a
25 natural opening of the apex, for example ranging between 0.3-0.5 mm, 0.1-
0.2 mm, 0.4-
0.5 mm. Optionally, treatment duration is selected so that penetration of at
least some of
the flow through the apex is avoided.
In some embodiments, at least some portion of flow 313, optionally including
the removed organic substance and/or debris, returns back up through the
canal.
30 Optionally, when a lumen of the canal is filled with fluid up to its
maximal capacity, at
least some of the fluid is caused to exit the canal. Optionally, the amount of
fluid that
accumulates within the canal before at least some of the fluid is caused to
exit the canal
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is determined by the components of the fluid and their respective amounts, for
example
determined by the gas-liquid ratio of the fluid. Optionally, fluid
accumulating within the
canal applies pressure on the apex and/or on the canal wall, and/or on
tubulates, and/or
branches, and/or on istmus canals and/or on accessory canals.
Optionally, the flow passes along path 321, for example in a central lumen
along vertical axis y. A potential advantage of the advancing and returning
flow path
may include the ability to use a large volume of fluid to clean the root
canal. For
example, a volumetric flow rate may range between 0.5-50 ml/sec, 10-30 ml/sec,
1-5
ml/sec.
In some embodiments, the velocity of flow 313 passing through root canal 305
may be affected by various parameters, such as the ratio between air and
liquid of the
fluid, the diameter of the root canal (which may vary along portions of the
root canal),
the viscosity of the fluid, the initial velocity of the fluid in the jet, the
angular velocity
of the fluid, the vertical velocity of the fluid, the ratio between components
such as gas,
liquid and powder in fluid, the centrifugal acceleration of the fluid, and/or
other
parameters or combinations of them. Optionally, the velocity of flow 313
increases
along some portions of the root canal, for example in a narrowing portion.
Optionally,
the typically conical shape of the root canal, in which a diameter of the root
canal
decreases, causes the velocity of the fluid to increase as it advances towards
the apex. In
one example, the velocity of flow 313 advancing along the root canal wall
ranges
between 0.5-50 m/sec, 30-80 m/sec, 50-300 m/sec, 10-100 m/sec, 0.6-2 mm/sec,
180-
350 m/sec, or any intermediate, larger or smaller ranges. In some embodiments,
the
flow velocity upon exiting to the atmosphere is, for example, 120 m/sec.
Optionally, the
velocity of flow 313 changes according to a current location within the root
canal. For
example, rotational flow velocity potentially increases with increasing root
canal depth,
while axial velocity decreases. In some embodiments, an estimated level of
dynamic
stress applied during operation of the nozzle within the root canal is about 6
PSI,
corresponding to a root canal wall velocity range of about 30-80 m/sec. In
some
embodiments, the velocity of the flow enables a relatively high volumetric
flow rate, for
example 50 ml/sec.
Figure 4A illustrates a conical nozzle 401 positioned above the entrance to
root
canal 403, according to some embodiments of the invention. Figure 4B
illustrates an
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apparatus comprising conical nozzle 401 and a handle 421, positioned within
access
cavity 423 of a tooth above the entrance to root canal 403. Figure 4C is a
geometric
representation of an angled fluid jet 405.
As seen in figure 4A, at least one angled fluid jet 405 is discharged from
nozzle
401 and directed into entrance 407 of root canal 403.
In some embodiments, for example, as will be further described in figure 7,
nozzle 401 includes one or more conical structures. Optionally, nozzle 401
includes an
internal cone 411 positioned within an external cone 413. In some embodiments,
circulating the fluid in a lumen between cones 411 and 413 creates the angled
direction
of fluid jet 405 or a plurality of fluid jets.
In some embodiments, the angled direction of fluid jet 405 or a plurality of
fluid
jets is obtained by the conical structure of nozzle 401. In an exemplary
embodiment,
fluid 415 flows into internal cone 411, passes (for example through a slanted
tube as
will be shown further on) into external cone 413, and circulates within a
narrowing
lumen 417 between external cone 413 and internal cone 411, until reaching exit
aperture
419 of nozzle 401. In some embodiments, the velocity of the fluid is increased
and/or
decreased when circulating through the lumen, for example by changing the
radius of
the circulating path.
In some embodiments, the diameter of a portion of nozzle 401, for example a
diameter of exit aperture 419 is smaller than a diameter of the root canal
opening. In
some embodiments, a diameter of the angled jet measured at the exit aperture
of the
nozzle is 2%, or 5%, or 10%, or 30%, or 50%, or lower, or higher, or
intermediate
percentages of a diameter of an entrance of the root canal, or smaller.
Additionally or
alternatively, a diameter of aperture 419 is smaller than a diameter of the
pulp chamber
of a tooth. Alternatively, the diameter of aperture 419 is similar to the
diameter of the
root canal opening and/or the diameter of the pulp chamber.
In some embodiments, nozzle 401 and/or exit aperture 419 of nozzle 401 are
positioned above entrance 407 to root canal 403, for example 1 mm, 7 mm, 1 cm
and/or
intermediate or higher distances above. In some embodiments, as shown for
example in
figure 4A, exit aperture 419 is positioned vertically above entrance 407 such
that a
longitudinal axis 433 of nozzle 401 and a longitudinal axis 435 of root canal
403 unite.
Optionally, when both axes unite, the exit aperture of the nozzle and the root
canal
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opening act as a unified structure, imposing a similar flow regime of the
fluid that
advances from the nozzle and into the root canal. Optionally, the velocity of
the fluid is
maintained when passing between the nozzle and the root canal. In some
embodiments,
the velocity of the fluid increases, for example if pressure in the root canal
is lower than
the pressure within the nozzle.
A potential advantage may include irrigating root canal 403 with one or more
angled fluid jets 405 while nozzle 401 is positioned directly above entrance
407 of root
canal 403. Another potential advantage of discharging angled jets may include
preventing the need for a diverting element for causing fluid discharged by
the nozzle to
contact the root canal wall.
Alternatively, in some embodiments, nozzle 401 is positioned such that axis
433
of the nozzle and axis 433 of the root canal do not unite. Optionally, axis
433 is parallel
to axis 435. Alternatively, nozzle 401 is positioned such that axis 433 is at
an angle to
axis 435 of the root canal.
In some embodiments, a diameter of angled jet 405 is smaller than a diameter
423 of exit aperture 419. For example, if a diameter of exit aperture 419 is
0.8 mm, a
diameter of fluid jet 405 for example when passing through exit aperture 419
may be 10
[tm, 90 [tm 0.5 mm, 0.1 mm, 0.3 mm, and/or intermediate or lower diameters. In
some
embodiments, the diameter of angled jet 405 changes as it flows between exit
aperture
419 and entrance 407 to the root canal. In some embodiments, a maximal
diameter of
angled jet 405 is 30%, 20%, 10%, 4%, 2%, 0.15%, 1%, 0.2%, or intermediate or
smaller
percentages of a maximal diameter 437 of root canal entrance 407.
In some embodiments, when a plurality of angled jets 405 are used, a distance
between any pair of angled jets exiting through exit aperture 419 ranges
between 0.01-3
mm, such as 0.05 mm, 0.8 mm, 2 mm. Optionally, this distance affects the
formation of
a coating-like layer of the flow of fluid advancing along root canal wall 421,
for
example, as described above.
In an exemplary embodiment, a relatively high number of angled jets is
discharged by the nozzle, for example ranging between 2000-60,000 jets, such
as 3000,
15,000, 45,000, jets. Optionally, a diameter of a single jet out of the
plurality of jets in
such a case ranges between, 1 p.m-2 mm, such as 50 [tm, 1 mm, 1.5 mm. In some
embodiments, as fluid 415 circulates within lumen 417, a direction and/or
magnitude of
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its momentum are determined by the structure of nozzle 401. In some
embodiments, one
or more parameters are selected (by a dentist and/or manufacturer) to create
the
designated flow of fluid along the root canal wall for the removal of soft
tissue. In some
embodiments, these parameters include: the number of angled fluid jets, the
pressure of
the angled fluid jets, the velocity of the jets, the diameter of the jets, the
viscosity of the
fluid, the ratio between gas and liquid, the amount of abrasive powder added
to the
fluid, the duration of the treatment, the positioning of the nozzle, and/or
any other
parameters or combinations of them. In one example, the velocity and pressure
of the
fluid jet may be selected so that once the jet hits a wall at the root canal
entrance, fluid
does not spray beyond the entrance to the root canal, for example in the
direction of the
crown of the tooth. In some embodiments, parameters may depend on each other,
for
example the ratio between gas, liquid and/or may affect the viscosity of the
fluid.
Table 1, now made reference to, presents a table of parameters describing
relative amounts and amounts of flow useable with some exemplary embodiments
of
the invention, for example, embodiments where fluid discharged from a nozzle
intensifies rotation of fluid within a root canal. The mass and volumetric
flow rates and
air/fluid mix percentages are exemplary. It should be understood that values
in ranges
between the given values, or higher or lower are also used and/or producible
in some
embodiments of the invention.
Table 1
Flow Rate Air Fluid
(cc/min)
% Air Mass Rate (kg/min) % Fluid Mass Rate (kg/min)
1 815 84% 0.00425 16% 0.1293
2 682 80% 0.00338 20% 0.1364
3 570 75% 0.00266 25% 0.1421
4 456 65% 0.00184 35% 0.1594
In some embodiments, (e.g. embodiments where fluid discharged from a nozzle
intensifies rotation of fluid within a root canal) a pressure of air at an
exit from a nozzle
aperture is, for example, about 75 PSI. In some embodiments of the invention,
a
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pressure of fluid at an exit from a nozzle aperture is, for example, about 75
PSI. In some
embodiments of the invention, the pressures are, for example, about 50-60 PSI,
about
60-65 PSI, about 65-70 PSI, about 70-75 PSI, about 60-80 PSI, about 75-100
PSI, about
90-130 PSI, or another higher or lower range of pressures suitable for
producing
5 cleansing of the pulp chamber.
Associated, for example, with line 1 of Table 1 are other parameters
describing
flow through the nozzle in some embodiments of the invention (e.g. embodiments
where fluid discharged from a nozzle intensifies rotation of fluid within a
root canal).
These include a velocity at the slanted tube of about 27 m/sec (for a 0.8 mm
tube exit
10 aperture), corresponding to a tangential velocity of about 24.5 m/sec,
and an axial
velocity of about 11.5 m/sec (for a 25 slanted tube angle). In some
embodiments, the
flow velocity is 5-10 m/sec, 10-20 m/sec, 20-22 m/sec, 22-25 m/sec, 24-30
m/sec, 20-30
m/sec, 25-40 m/sec, 35-50 m/sec, or another larger or smaller velocity. In
some
embodiments, velocity components (e.g. of flow discharged from the nozzle) are
15 divided between axial and tangential velocities according, for example,
to the angle set
by the slanted tube and/or an angle set by a lumen of the nozzle (e.g. conical
lumen of
the nozzle). In some embodiments of the invention, the tangential velocity is,
for
example, 5-10 m/sec, 8-15 m/sec, 10-20 m/sec, 15-30 m/sec, 25-35 m/sec, 20-40
m/sec,
40-60 m/sec, or another larger or smaller velocity. In some embodiments of the
20 invention, the axial velocity is, for example, 5-10 m/sec, 7-15 m/sec, 8-
20 m/sec, 15-22
m/sec, 20-25 m/sec, 22-30 m/sec, or another larger or smaller velocity.
Rotational velocity parameters describing flow through the nozzle comprise
(e.g.
in embodiments where fluid discharged from a nozzle intensifies rotation of
fluid within
a root canal), for example, a rotational velocity at the top of the cone of
about (2k-15k)
25 8,000-12,000 RPM (optionally in the range of 2,000-4,000 RPM, 3,000-
5,000 RPM,
4,000-8,000 RPM, 7,000-13,000 RPM, or 10,000-15,000 RPM, or a larger or
smaller
RPM)and a rotational velocity at the bottom of the cone of about 95,000 to
135,000
RPM (optionally in the range of 30,000-40,000 RPM, 30,000-50,000 RPM, 40,000-
80,000 RPM, 70,000-130,000 RPM, or 100,000-160,000 RPM, or a larger or smaller
30 RPM). These correspond also, for example, to a centrifugal acceleration
near the top of
the cone of about 150-220 m/s2. In some embodiments, the centrifugal
acceleration near
the top of the cone is about 100-120 m/s2, about 115-140 m/s2, about 130-150
m/s2,
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about 140-180 m/s2, about 170-200 m/s2, about 190-220 m/s2, about 210-250
m/s2, or
another larger or smaller range of angular velocities. In some embodiments,
the
rotational speeds are higher or lower by, for example, 10-15%, 12-20%, 17-25%,
20-
50%, or another higher or lower range of relative rotational speeds.
In some embodiments of the invention, (e.g. embodiments where fluid
discharged from a nozzle intensifies rotation of fluid within a root canal)
the mixing of
gas and fluid (for example, air and water), contributes to the determination
of a
Reynolds number at the exit aperture of the slanted tube and/or at other
places in the
nozzle apparatus and/or external to the nozzle apparatus. In some embodiments
for
example, the Reynolds number at the exit aperture of the slanted tube is in
the range of
22,500 to 49,000 (for a 0.8 mm exit aperture). In some embodiments, the range
of
Reynolds numbers at the exit aperture of the slanted tube is, for example,
about 5,000-
12,000, about 10,000-15,000, about 12,000-22,000, about 20,000-30,000, about
28,000-
40,000, about 35,000-60,000, about 50,000-85,000, about 80,000-120,000, about
100,000-180,000 or another higher or lower range of Reynolds numbers.
In some embodiments, a desired effect is achieved by selecting various
parameters. In some embodiments, a table is used for selection of parameters,
where
device parameters and/or treatment parameters (e.g. fluid parameters such as
fluid
speed, fluid pressure, fluid composition, treatment length) are listed based
on inputs
such as characteristics and/or parameters of a root canal (e.g. diameter,
shape, type of
tissue to be removed, extent of tissue to be removed).
In some embodiments, a desired effect is achieved by inserting inputs into a
function or neural network.
In some embodiments, a desired effect is achieved by changing a portion of the
apparatus. For example, in some embodiments, an apparatus includes
interchangeable
nozzles, where different nozzles are adapted for different treatments and/or
desired
effect. For example, a different nozzle for a curved root canal, a different
nozzle for a
straight canal, a different nozzle for abrading a root canal and a different
nozzle for
flushing a root canal. For example, different a supply apparatus for each of
abrading a
root canal and smoothing a root canal and flushing a root canal.
In some embodiments, a desired effect is achieved by changing device
parameters and/or treatment parameters according to feedback. In some
embodiments,
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feedback is manual, where a user witnesses the treatment and changes
parameters based
on the visual and/or manually measured parameters. In some embodiments,
feedback is
automatic, for example, the apparatus includes one or more sensor e.g.
thermometer e.g.
scale for weighing extracted material from the tooth and, for example, a
processing
application changes device and/or treatment parameters based on measured
parameters.
In some embodiments, (e.g. embodiments where fluid discharged from a nozzle
intensifies rotation of fluid within a root canal) one or more jet flows along
a wall of the
nozzle. In some embodiments, a jet follows a path where the jet exits the
nozzle (e.g.
through exit aperture 419) while in contact with a nozzle wall, for example
exiting a
nozzle exit aperture at a periphery of the exit aperture. In some embodiments,
jet 405
passes through exit aperture 419 adjacent to the wall of nozzle 401, for
example an exit
point of jet 405 from nozzle 401 is positioned along a periphery of aperture
419, defined
by the walls of the nozzle. Optionally, jet 405 does not exit aperture 419
from a central
point of the aperture.
In some embodiments, as seen on Figure 4B, an access cavity 423 is created, as
previously mentioned, through crown 425 of the tooth. Optionally, access
cavity 423
passes through layers of dentin and enamel tissue. In some embodiments, access
cavity
423 exposes pulp chamber 427. In some embodiments, pulp chamber 427 is cleaned
using the described system and/or method. Optionally, the pulp chamber is
cleaned
using other means. In some embodiments, the system and/or method as described
are
used for cleaning and/or abrading any other part of the tooth, but may have
special
advantages when used for treating a root canal.
In some embodiments, at least a portion of nozzle 401 passes through access
cavity 423. In some embodiments, at least a portion of nozzle 401 is inserted
through
pulp chamber 427. In some embodiments, at least a portion of nozzle 401, for
example
the tip including exit aperture 419, is narrow enough to enter into at least a
portion of
the internal lumen of root canal 403.
In some embodiments, nozzle 401 is connected to a handle 421. In some
embodiments, an input pipeline passes through handle 421 and connects to
nozzle 401,
as will be further explained. In some embodiments, handle 421 is used for
maneuvering
nozzle 401 (e.g. a user grasps handle 421).
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Figure 4C is a geometrical representation of angled jet 405. In the described
figure, angled jet 405 exits a nozzle at point A, and hits root canal wall at
point B. In
some embodiments, point B is located on a circumference of the root canal
entrance.
Alternatively, point B is located below the circumference of the root canal
entrance, for
example 0.1 mm, 1 mm, 3 mm and/or intermediate distances below.
As shown in this figure, axis x extends along a diameter of the root canal,
perpendicular to the root canal wall. As mentioned herein, axis y is vertical
axis running
longitudinally, for example in parallel to the root canal wall. Axis z is
perpendicular to
both axis x and y. Line A'B is a projection of angled jet 405 on the xz plane.
In some
embodiments, an angle a between angled jet 405 (line AB) and the xz plane, is
a sharp
angle, for example an angle between 10-85 , such as 20, 35, 75 . In some
embodiments,
an angle I between the projection A'B of angled jet AB and tangential axis z
is a sharp
angle, for example an angle smaller than 90 , such as 20 , 50 , 70 . In some
embodiments, the size of angle I affects the path of the flow. A potential
advantage of a
sharp angle (3, for example ranging between 5-10 , 15-20 , includes creating a
more
effective flow path, in which the flow passes closely along the canal wall.
Optionally,
the size of angle I may affect the radii of the helical flow through the root
canal. In
some embodiments, angle I may be selected to encourage adhesion of flow to
wall
and/or reduce bouncing. Optionally, for example if the longitudinal axis of
the nozzle
unite with the longitudinal axis of the root canal, as previously mentioned, a
similar
angle I is formed with respect to exit aperture 419 of the nozzle (i.e.
tangential to the
walls of the nozzle at exit aperture 419).
In some embodiments, a velocity vector V of angled jet 405 (line AB) can be
described by its three velocity components along the axis, showed in this
figure as Vx
(along axis x), Vy (along axis y) and Vz (along axis z). In one example,
velocity
component Vy may be 2-50 m/sec, and the velocity component Vz may be 0.5-25
m/sec.
In some embodiments, additionally and/or alternatively to the angled jets, an
axial jet (for example extending in parallel to vertical axis y) may be used.
In some embodiments, the fluid forming jet 405 and/or components of the fluid
rotate around the jet's axis.
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In some embodiments, any of the described above ideas and/or methods or
combinations them may be implemented in the embodiments described below and/or
any other embodiment of the invention.
Figure 5 shows a side view of various outlines of a beam 501 of angled fluid
jets (not shown in this figure), according to some embodiments of the
invention. The
outlines of the beams shown in this figure describe beams that exit a nozzle
503, which
have not yet entered a root canal.
In some embodiments, as previously described, a beam of a plurality of angled
fluid jets is discharged from nozzle 503. In some embodiments, the structure
of the
nozzle affects the shape of the beam. In some embodiments, the size and/or
shape of the
tip of the nozzle affects the shape of beam. For example, an elongated tip, as
will be
further shown, may be used to create a narrower, focused beam of angled jets.
Alternatively, a shorter tip may be used to create a more scattered beam of
angled jets.
In some embodiments, a diameter 505 of a beam extends beyond a diameter 507
of the exit aperture of the nozzle. In some embodiments, as shown in this
figure, a
diameter of the beam changes, for example increases as the flow advances
towards the
root canal entrance. Optionally, this outline is created due to opposite
angled jets (for
example jets exiting from opposite ends of a diameter of the nozzle). In some
embodiments, for example as shown in this figure, various beams may have
different
diameters at a certain axial distance from the exit aperture of the nozzle.
For example,
diameter 505 is shorter than diameter 509.
In some embodiments, the outline of the beam is the circumscribing shape of
the
beam. Optionally, the outline of the beam is fully filled with flowing fluid.
Alternatively, the outline of the beam is formed with constant spaces, for
example
between angled jets comprising the beam. Alternatively, the beam is formed
with
transient spaces.
In some embodiments, a large number of angle jets make up the circumscribed
beam. In some embodiments, the circumscribed beam is a symmetric shape, for
example, with circular cross-section. In some embodiments, the circumscribed
beam,
once discharged into a root canal, matches the shape of the root canal.
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In some embodiments, for example when an exit aperture of the nozzle is
positioned within a lumen of the root canal, the jets of the beam may
immediately hit
the root canal wall, which may channel the fluid to a helical flow along the
wall.
In some embodiments, the designated flow along the root canal wall is a result
5 of the original direction in which the angled jets exit the nozzle,
and/or a result of the
angle created when the jets hit the root canal.
In some embodiments, at least some of the angled jets flow in the same
direction.
In some embodiments, a ratio between air and liquid affects the shape of the
10 beam. Optionally, the fluid density affects the shape of the beam.
In some embodiments, the beam shape is affected by one or more of the
following: a vertical velocity component of fluid within the nozzle, an
angular velocity
component of the fluid within the nozzle, a centrifugal effect formed within
the nozzle,
a pattern of flow (e.g. circular) within the nozzle, a pressure difference
between the
15 nozzle and the atmospheric pressure and/or pressure formed within the
canal.
In some embodiments, structural elements such as internal guide tubes within
the nozzle may affect the shape of the beam. In some embodiments, the outline
of the
beam may have other shapes such as, for example, a bottle-neck shape, a
cylindrical
shape, a bell shape, and/or any other shapes.
20 In some
embodiments, the exit aperture comprises a circular rim. Alternatively,
the exit aperture comprises a rim having a different shape, for example
elliptical. In
some embodiments, at least a portion of the fluid flows adjacent and/or on the
walls of
the nozzle, for example forming a central portion of the exit aperture in
which air exists.
In some embodiments, structural components of the nozzle are movable for
25 example to manipulate a geometry of the beam, for example change a beam
diameter.
In some embodiments, the angle jet and/or beam of angled jets exit through a
center of the exit aperture. Additionally or alternatively, the jet or beam
exit the nozzle
while flowing along the walls of the nozzle at the exit aperture.
In some embodiments, the beam is shaped a cylinder, for example having a
30 diameter ranging between 0.2-4 mm, such as 0.3 mm, 1 mm, 2.3 mm. The
beam may
rotate around its axis. The rotating beam may widen to a conical
configuration,
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comprising one more angled jets which are formed at the external periphery of
the
beam.
In some embodiments, fluid exiting the nozzle may partially stick to the
nozzle
walls at the exit aperture. In some embodiments, the beam will be diverted as
a result of
adhering to the wall.
In some embodiments, the flow forming the beam comprises a turbulent flow
regime, which may affect the shape of the beam and/or may divert the beam.
In some embodiments, the beam is shaped as a cone and the flow within the
cone flows at an angle. Optionally, the cone is a continuous cone. In some
embodiments, the flow does not flow only along a longitudinal axis of the
cone, but
further comprises a circumferential component, so that it effectively
comprises a
plurality of angled jets. In some embodiments, the velocity of the fluid
determines the
angular spread of the cone. For example, the vertical and/or angular velocity
component
of the fluid may affect the angular spread of the cone. In some embodiments, a
pressure
difference between the nozzle and externally to the nozzle, for example in the
root
canal, affects the angular spread of the cone. In some embodiments, the
centrifugal
acceleration of the fluid within the nozzle affects the angular spread of the
cone.
In some embodiments, the cone shaped beam is formed of a single angled jet.
Alternatively, the cone shaped beam is formed of a plurality of jets flowing
on a plane
defined by the cone and/or at an angle to a plane defined by the cone.
In some embodiments, an angular velocity of the flow ranges between 1-
300 /sec, such as 1 /sec, 10 /sec, 100 /sec.
In some embodiments, a thickness of the walls of the cone (i.e. flow walls)
ranges between 0.01-5 mm, such as 0.03 mm, 0.1mm, 2mm, 4.5 mm.
Exemplary apparatus structure, according to some embodiments of the invention
Figure 6A is a cross section view of an embodiment of an apparatus comprising
a handle 601 and a nozzle 603, for cleaning and/or abrading a root canal with
one or
more angled fluid jets. Figure 6B is an outline of the apparatus comprising
the handle
and nozzle.
In some embodiments, handle 601 comprises one or more pipes 605, optionally
passing longitudinally along an internal lumen of the handle.
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In some embodiments, pipe 605 ends at its distal end in an entrance aperture
to
nozzle 603, for example an entrance aperture leading to an internal cone of
the nozzle,
as will be further described.
In some embodiments, a proximal end 607 of handle 601 is configured for
manual gripping by a user.
In some embodiments, a distal end 609 of handle 601 connected to nozzle 603 is
configured for insertion into a tooth, for example through a pulp chamber, to
allow the
positioning of an exit aperture of nozzle 603 above a root canal entrance as
previously
described. Optionally, handle 601 comprises a narrowing portion in proximity
to nozzle
603 (not shown in this figure), which may facilitate inserting distal end 609
through, for
example, an access cavity created in a tooth. In some embodiments, a height of
the
nozzle is small enough to enable its insertion into the mouth, for example
ranging
between 5-15 mm.
In some embodiments, inner pipe 605 extends beyond the proximal end 607 of
handle 601. Optionally, liquid passes through inner pipe 605, for example by
being
connected at the proximal end to a liquid tank. Optionally, air passes through
inner pipe
605, for example by being connected at the proximal end to an air compressor.
In some
embodiments, the fluid comprising both air and liquid passes through pipe 605.
In some
embodiments, two pipes are used, one for passing liquid and the other for
passing air. In
some embodiments, air and abrasive powder (for example transferred from an
abrasive
powder tank) pass together through at least one of the pipes. In some
embodiments, a
pipe may be surrounded by another pipe (co-centered pipes), such that the
inner pipe is
used, for example, for transferring liquid, and the outer pipe is used, for
example, for
transferring air. In some embodiments, air, liquid, abrasive powder and/or
combinations
of them pass through at least one of the pipes through the handle.
In some embodiments, the pipes may connect, for example at the proximal end
607 of handle 601, to create the fluid of air and liquid which then circulates
within
nozzle 603 until discharged in the form of angled jets.
In some embodiments, nozzle 603 has conical structure, for example, as will be
explained in the following figure. In some embodiments, nozzle 603 comprises
an
internal cone 613 positioned within an external cone 615. In some embodiments,
a
slanted tube 617 is used for passing fluid from internal cone 613 to a lumen
between the
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two cones, for example, as will be explained by the next figure. In some
embodiments,
the slanted tube 617 may deflect in any direction within the internal cone.
Optionally,
one or more additional tube (e.g. additional slanted tubes next to slanted
tube 617) is
used for passing fluid from internal cone 613 to a lumen between the two cones
and/or
is located in the region of space above internal cone 613.
In some embodiments, nozzle 603 comprises an additional cone 611, for
example used for suctioning the fluid returning upwards through the root
canal, for
example, as will be further explained in figure 10. In some embodiments, the
sucked
fluid may pass through the handle, for example passing in an opposite
direction to the
air and/or liquid passed into nozzle 603. Optionally, the sucked fluid passes
through one
or more pipes in the handle. Optionally, proximal end 607 of handle 601 is
connected to
a pipe and/or tank and/or any other element used for disposing the sucked
fluid.
In some embodiments, the nozzle and/or any components of it and/or the handle
may be made of various materials, such as, for example, one or more of
stainless steel,
titanium, aluminum, anodized coated aluminum, PPM, plastic, or other
biocompatible
and/or sterilizable materials and/or combination of materials. In some
embodiments, at
least a part of the nozzle and/or handle is disposable. In an exemplary
embodiment of
the invention, the nozzle is formed of rigid materials and/or geometries,
however, a tip
thereof may be made flexible.
In some embodiments, the nozzle may be manufactured and/or used separately
from the handle and/or the rest of the system, described below.
In some embodiments, the handle may comprise controls such as on/off button
to control the duration of the treatment, a dial to control the ration between
air and
liquid, etc. In some embodiments, the device comprises a calibration table and
settings
are selected according to the table.
Figure 7A is cross section view of a conical nozzle 701, and figure 7B a side
view of an internal cone 703 configured within conical nozzle 701, according
to some
embodiments of the invention.
In some embodiments, nozzle 701 comprises an internal cone 703 positioned
within an external cone 705. In some embodiments, internal cone 703 and
external cone
705 are connected by a tube, for example a slanted tube or channel 707
extending
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between an inner lumen of internal cone 703 and a lumen 709 between an
external face
of internal cone 703 and an internal face of external cone 705.
In some embodiments, external cone 705 has a cylindrical upper portion 711. In
some embodiments, external cone 705 has a recess 713 for example configured
along a
face the cylindrical upper portion 711, optionally in continuance to a pipe of
a handle as
described above, for allowing fluid to enter into internal cone 703. In some
embodiments, the recess may be circular, triangular, rectangular or any shape
allowing
the flow of fluid through into internal cone 703. Optionally, the size and/or
shape of the
recess is determined according to the size and/or shape of an entrance
aperture 719 to
internal cone 703.
In some embodiments, external cone 705 has an exit aperture 715, which may be
positioned above the entrance to a root canal. In some embodiments, the exit
aperture
may is circular, for example having a diameter 717 ranging between 0.3-2 mm.
Optionally, the diameter of the exit aperture is determined according to a
need, for
example according to a diameter of the root canal entrance.
In some embodiments, external cone 705 comprises a narrow needle-like tip
portion 737. In some embodiments, the length of narrow needle-like tip portion
737
ranges between 0.2-7 mm. In some embodiments, narrow tip 737 (comprising exit
aperture 715) is inserted into a lumen of the root canal. Optionally, narrow
tip portion is
inserted to a distance of 0.2 mm, 0.5 mm, 1 mm, 2.5 mm and/or any intermediate
or
higher distances measured longitudinally from the root canal entrance. In some
embodiments, an external diameter of tip portion 737 ranges between 0.5-2.5
mm, and
an internal diameter (optionally being the diameter of the exit aperture, as
previously
mentioned) ranges between 0.3-2 mm. in some embodiments, the diameter of tip
portion
737 is small enough to allow insertion of tip portion 737 into at least a
portion of the
root canal. Optionally, tip portion 737 is flexible, for example made of
flexible material.
In some embodiments, needle like tip portion 737, for example shaped as a
narrow tube,
is made of a disposable material. Optionally, needle like tip portion 737 can
be
assembled on the nozzle, for example by a user.
In some embodiments, cylindrical upper portion 711 is covered by a covering
lid
721, for example for preventing fluid from exiting through the top of nozzle
701.
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In some embodiments, covering lid 721 may be screwed on top of the
cylindrical upper portion 711.
In some embodiments, internal cone 703 comprises a cylindrical upper portion
723, which may be sized and/or shaped according to cylindrical upper portion
711 of
5 external cone 705.
In some embodiments, internal cone 703 comprises an entrance aperture 719, for
example configured along a face of the cylindrical upper portion 723. In some
embodiments, entrance aperture 719 is configured in continuance to recess 713
of
external cone 705. In some embodiments, the entrance aperture may be circular,
10 triangular, rectangular or any shape allowing the flow of fluid through.
In some embodiments, cylindrical upper portion 723 fits within cylindrical
upper portion 711 such that no space is formed between them, for example
preventing
fluid from flowing between the two upper portions of the cones. In some
embodiments,
a diameter of cylindrical upper portion 723 is only slightly smaller than a
diameter of
15 cylindrical upper portion 711. For example, a diameter of cylindrical
upper portion 723
ranges between 2-18 mm and a diameter of cylindrical upper portion 711 ranges
between 3-20 mm.
In some embodiments, a top 725 of cylindrical upper portion 723 is open. In
some embodiments, if cylindrical portion 723 of internal cone 703 extends to
the same
20 height as cylindrical portion 711, covering lid 721 may cover both
internal and external
cones.
In some embodiments, a tip 727 of internal cone 703 is closed, to avoid fluid
from passing through. In some embodiments, tip 727 extends to exit aperture
715,
and/or extends beyond exit aperture 715, for example 1 mm beyond.
25 In some
embodiments, a slanted tube 707 extends between an inner lumen of
internal cone 703 and a lumen 709 between an external face of internal cone
703 and an
internal face of external cone 705. Optionally, the entrance 729 to slanted
tube 707
serves as the exit aperture for the fluid exiting internal cone 703.
Optionally, exit 731 of
slanted tube 707 is configured at the lowest point along a face of the
cylindrical upper
30 portion 723, such that it leads to lumen 709.
In some embodiments, the size of lumen 709 is determined according to a
difference in diameters of narrowing portions 733 and 735 of external cone 705
and
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internal cone 703 respectively. For example, an initial diameter of narrowing
portion
733 is 3 mm and an initial diameter of narrowing portion 735 is 0.3 mm. In
some
embodiments, a distance between the internal and external cones forming lumen
709 is
constant, for example a distance of 1 mm. In some embodiments, a distance
between the
internal and external cone changes, for example increases along a vertical
axis.
In some embodiments, the flow in lumen 709 increases in velocity as it
advances
from the upper part of the lumen (e.g close to exit 731), distally towards the
lower part
of lumen 709.
In some embodiments, fluid, optionally including liquid, air, and/or abrasive
powder or combinations of the above, flows through recess 713 of external cone
705,
into entrance aperture 719 of internal cone 703, and into a lumen of internal
cone 703.
In some embodiments, as the fluid accumulates within internal cone 703,
pressure may
rise and the fluid may be forced through entrance 729 into slanted tube 707.
Once the
fluid exits slanted tube 707 through exit 731, the fluid circulates within
lumen 709
between the internal and external cones. Optionally, the circulation is
helical.
Optionally, as the lumen narrows, the velocity of the flow of fluid increases.
In some
embodiments, the helical circulation causes the fluid to exit nozzle 701
through exit
aperture 715 of external cone 705 in the form of one or more angled fluid jets
as
describe above. In some embodiments, helical circulation continues once the
fluid exits
the nozzle, for example, the helical circulation continues in air (e.g. before
impact with
the root canal wall and/or fluid within the root canal). For example, in some
embodiments, helical circulation continues in the root canal. In some
embodiments,
helical circulation continues due to surface tension of the flow (e.g. jet).
In some embodiments, a suction pulse is short enough in duration so that
rotation in the root canal does not stop and/or does not reduce to below 10%
of a
maximum. In some embodiments, rotation of fluid in the root canal is stopped
and/or
reduced to zero e.g. by discharge of fluid at an opposing direction to
rotation and/or by
suction.
In some embodiments, rotating and/or helical movement of fluid within the
nozzle continues when the fluid is discharged from the nozzle, and/or
continues when
the fluid enters a root canal which optionally contains or is full of fluid.
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In some embodiments, due to the ratio between air and liquid, for example 90%
air and 10% liquid, the fluid entering lumen 709 is an aerosol. A potential
advantage of
the aerosol includes reducing the friction created between the surface of the
cones and
the fluid, which may optionally allow for a higher velocity of the fluid
(aerosol).
In some embodiments, any of the cones may be nonsymmetrical and/or
otherwise distorted. In some embodiments, a needle-like tube can be assembled
onto the
nozzle, for example onto the exit aperture.
Exemplary systems for treating a root canal, according to some embodiments of
the invention
Figure 8A and 8B are schematic diagrams of exemplary systems for treating a
root canal, according to some embodiments of the invention.
In some embodiments, the system comprises a liquid tank 801, for example for
storing liquid such as water, disinfectant, and/or medicine. Optionally, more
than one
liquid tank is used, for example for storing medicine separated from water, or
disinfectant separated from medicine. In some embodiments, the capacity of the
liquid
tank ranges between 0.2-50 L. In some embodiments, the liquid tank may be made
of
aluminum, steel, plastic, or any material capable of containing the liquid and
withstanding air pressure. In some embodiments, liquid tank 801 may comprise a
mixing element, such as a mechanical, hydraulically, or electrical whirling
element for
continuous mixing of the liquid.
In some embodiments, liquid tank 801 is connected to an air compressor 803. In
some embodiments, the air compressor pushes air into liquid tank 801. In some
embodiments, the pressure created by the air compressor ranges between 5-500
PSI, 1-
100 PSI, 100-200 PSI. Optionally, as the air compressor pushes air into the
liquid tank,
the pressure rises within the tank and liquid is forced through an exit
aperture of the
tank. In some embodiments, the exit aperture of the tank is connected a handle
805 of
an apparatus as described above, for example connected by a pipe.
In some embodiments, the system comprises a collection tank 809. Optionally,
collection tank 809 is used for the returning fluid exiting the root canal,
which may
comprise organic substance, nonorganic substance, and/or debris. In some
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embodiments, collection tank 809 is connected to a pump 811 and/or to a
venturic
connector. In some embodiments, the pump is used for suctioning the returning
fluid,
for example through a suctioning cone of a nozzle (not shown in this figure),
through
handle 805, and through one or more pipes leading to collection tank 809.
Optionally, a
suction cap may be placed on the tooth and/or inside the mouth for collecting
returning
fluid, saliva, and/or debris.
In some embodiments, as shown in figure 8B, a powder tank 813 is used for
storing the abrasive powder. In some embodiments, powder tank 813 is connected
to air
compressor 803.
Air, liquid, abrasive powder and/or any combinations of them may pass through
one or more pipes of the system.
In some embodiments, as shown in figure 8A, a pipe connected to air
compressor 803 and a pipe connected to liquid tank 801 are joined at any point
along a
path leading to handle 805, so that the air and liquid are mixed together
before entering
handle 805. In some embodiments, as shown in figure 8B, a plurality of pipes
may lead
air, liquid, abrasive powder and air, liquid and air and/or any combination of
them into
handle 805. In some embodiments, liquid and air or any other combination may
flow
through co-centered pipes.
In some embodiments, a pipe includes micro pores, for example allowing air to
flow inside but preventing liquid from exiting the pipe.
In some embodiments, any of the above described components and/or
combinations of them are passed separately, and mixed together only at a lumen
of the
nozzle (not shown in this figure).
In some embodiments, a control panel 815 is used for example for controlling
the passing of air, liquid, and/or abrasive powder. In some embodiments,
pressure,
velocity, volume, flow rate and/or any other parameters may be controlled. In
some
embodiments, the duration of treatment is controlled using control panel 815.
In some
embodiment, control panel 815 may be connected to a power supply 817.
In some embodiments, two or more components of the system such as the liquid
tank, air compressor, pump, and/or any other components are connected by an
electrical
circuit 819. In some embodiments, control panel 815 is used for activating
electrical
circuit 819 to control the functioning of one or more components of the
system. For
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example, an electrical signal may be sent using control panel 815 to activate
air
compressor 803, to release liquid from liquid tank 801, to pass fluid into the
handle,
open a valve along a pipe or junction, and/or any other functions of the
system.
In some embodiments, the system is configured for connecting to a standardized
pressurized air and/or gas source which may be available in a dental clinic,
for example
replacing and/or in addition to air compressor 803.
In this figure, the thin lines connecting between components may represent
control and/or sensing connections, such as electrical connections, while the
thick lines
represent a pipeline in which liquid, gas, powder, or any combination thereof
are
delivered to and from the nozzle.
Various structures of a nozzle of the apparatus, according to some embodiments
of
the invention
Figures 9A-9D illustrate an embodiment of a conical nozzle 901 comprising a
pipe 903, extending between handle 905 and exit aperture 907 of nozzle 901.
Figure 39,
as described above, illustrates an additional exemplary nozzle comprising a
pipe.
Figures 9A and 9B illustrate two embodiments including pipe 903. Figure 9B
shows conical nozzle 901 having a narrow tip portion 911 as previously
described.
Figure 9A conical nozzle 901 having flat tip portion 913. Figure 9C is a cross
section
of a nozzle similar to the one described in the above figures that further
includes pipe
903. Figure 9D is a side view of an internal cone of that nozzle.
In some embodiments, longitudinal pipe 903 is used for passing air, abrasive
powder, liquid and/or combination of them flow through nozzle 901. In some
embodiments, flowing is performed through pipe 903 in parallel to a fluid
flowing
through a main path of nozzle 901, as described above.
In some embodiments, a distal portion of pipe 903 protrudes from exit aperture
907. In some embodiments, for example as shown in figure 9B, if narrow tip
portion
911 is inserted into at least a portion of the root canal, pipe 903 may be
used for
delivering any of the above materials into a location within the root canal.
In some embodiments, pipe 903 affects the direction of the discharged angled
fluid jets by diverting them.
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In some embodiments, a proximal end of pipe 903 is connected to any of the
above described components of the system, such the fluid tank, the air
compressor, the
powder tank and/or any of the pipes.
In some embodiments, the internal and external cones comprising nozzle 901
5 include an aperture 915 for the passing of pipe 903, for example
configured along a face
of the upper cylindrical potion of both cones, such as above or below a recess
917 and
entrance aperture 919 of the external and internal cones respectively.
In some embodiments, as shown on figures 9C and 9D, pipe 903 passes on a
parallel plain to slanted tube 909. In some embodiments, pipe 903 intersects
tube 909,
10 for example to enable mixing of the fluid with the substance passing
through pipe 903.
In some embodiments, nozzle 901 does not include an internal cone.
Figure 10A illustrates a nozzle comprising a suction cone 1001, as previously
mentioned, and Figure 10B illustrates a horizontal cross section of the
nozzle.
15 In some
embodiments, suction cone 1001 is shaped and/or sized according to an
external cone and/or an internal cone of the nozzle.
In some embodiments, suction cone 1001 is assembled externally to the nozzle.
In some embodiments, suction cone is attached to the nozzle during a molding
process.
In some embodiments, other mechanical means such as pins or screws are used
for
20 attaching the suction cone.
Optionally, a lumen 1011 is formed between the narrowing portions of suction
cone 1001 and an external cone 1013 of the nozzle. In some embodiments, this
lumen
comprises channels or tubes.
In some embodiments, the distal tip of the nozzle 1015 protrudes from suction
25 cone 1001.
In some embodiments, suction cone 1001 has one or more exit apertures 1005
and/or 1007. Optionally, exit apertures 1005 and/or 1007 are configured along
a
cylindrical upper portion 1009 of suction cone 1001. In some embodiments, exit
apertures 1005 and/or 1007 are connected to handle, optionally through pipes.
In some
30 embodiments, the pipes are connected to a pump such as a vacuum pump for
sucking
the returning fluid upwards through the nozzle and through the handle to
dispose it, as
previously described in figure 8.
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In some embodiments, the sucked fluid may pass through suction cone 1001 in a
lumen between an internal face of the suction cone and an external face of the
external
cone of the nozzle. In some embodiments, if the lumen comprises channels or
tubes, the
fluid may be sucked directly through the tubes.
In some embodiments, the fluid returning upwards through the root canal may
contain the removed organic and/or inorganic substances such as pulp tissue,
nerve
tissue, blood vessels, abrasive powder, and/or other debris removed by the
flow.
In some embodiments, suction cone 1001 is covered by a lid, which is
optionally
screwed on top of a lid of the external cone of the nozzle to prevent fluid
from exiting
through the top of suction cone 1001.
Figure 10B shows a horizontal cross section of the nozzle along line AA. A
central circular lumen 1017 is the lumen formed between the internal and
external
cones. The three arched lumens 1019 are the lumens formed between the external
cone
and suction cone 1001. In some embodiments, a space 1021 between arched lumens
includes anchors for attaching suction cone 1001 to the narrowing portion of
the nozzle.
Figure 11A-B show two embodiments of a nozzle including one or more
directing channels for creating the one or more angled fluid jets, according
to some
embodiments of the invention. Figure 11A includes a nozzle 1101, a horizontal
cross
section of the distal end of the nozzle 1105, and a longitudinal cross section
of the
nozzle 1107. Figure 11B includes a conical nozzle 1101, a horizontal cross
section 1109
of the distal tip of the nozzle (exit aperture), and a horizontal cross
section 1111 of the
proximal tip of the nozzle.
In some embodiments, a nozzle 1101 of an apparatus may comprise one or more
channels for directing the angled fluid jets. In some embodiments, the
channels are
formed as tubes 1103. In some embodiments, nozzle 1101 is a cylinder. In some
embodiments, tubes 1103 are configured along the internal wall of nozzle 1101.
In some embodiments, an angle of the tube is determined according to a
resulting angle of the fluid jet formed by the tube. In some embodiments, the
configuration (such as angle) of the tube is adjustable, for example by
connecting a back
plate of a tube using a screw to the wall of nozzle 1101.
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In some embodiments, tubes 1103 have a similar diameter. In some
embodiments, tubes 1103 have various diameters. In some embodiments, a single
tube
may change in diameter.
Figures 12A-12C are drawings of a nozzle comprising at least one valve for
controlling the flow through the nozzle, according to some embodiments of the
invention. In figure 12A, the nozzle has conically shaped outline 1219, and in
figure
12B, the nozzle has an elliptically shaped outline 1221. In both figures 12A
and 12B,
the nozzle is formed as one piece, for example formed using molding methods.
In
Figure 12C, the nozzle may be formed of separate components, for example cones
connected together, as will be further explained.
In some embodiments, a valve 1201 is used for controlling flow, for example
the
flow of air (or any other gas), liquid, abrasive powder and/or combinations of
those into
the nozzle. In some embodiments, as shown in figures 12A and 12B, valve 1201
is
positioned between the end of a pipe 1203 passing through the handle, and the
lumen
1205 formed between an external and internal cones of the apparatus. In some
embodiments, as shown in figure 12C, valve 1201 is positioned between the end
of pipe
1203 and a connecting lumen 1217. Optionally, when the valve is in open
position, a
flow of any of the above substances and/or combinations of them enters
connecting
lumen 1217, from which it then passes to lumen 1205. Additionally and/or
alternatively,
at least one valve may be positioned between connecting lumen 1217 and lumen
1205.
Additionally and/or alternatively, a valve is positioned at any junction,
entrance
aperture, exit aperture, along a pipe, a lumen of the nozzle, or any other
portion of the
nozzle.
In some embodiments, valve 1201 comprises a sealing element 1207. In some
embodiments, the sealing element prevents fluid and/or any other substance
from
flowing upwards into pipe 1203.
In some embodiments, valve 1201 comprises a spring 1209. In some
embodiments, the spring extends or compresses due to air and/or liquid
pressure. In
some embodiments, spring 1209 and/or sealing element 1207 is controlled using
other
means, such as mechanical means (for example by connecting valve 1201 to a
lever
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controlled from the handle), hydraulic means (operated for example by the
pressure of
fluid passing through) and/or electrical means.
In some embodiments, when spring 1209 extends, it pulls sealing element 1207
into an open position. Optionally, in the open position, a material such as
air, liquid,
abrasive powder and/or combinations of them may flow into lumen 1205.
Additionally and/or alternatively, a valve 1211 is used for controlling the
flow
of fluid from a lumen of the internal cone into lumen 1205 between the
external and
internal cones. Optionally, sealing element 1213 of the valve is positioned at
the end of
slanted tube 1215. In some embodiments, this valve is used for controlling the
treatment
duration, for example by periodically pushing the valve to a closed position.
In some embodiments, other elements such as a cord may be used instead of a
spring. In some embodiments, only sealing element 1207 may be used, for
example
formed as a flap which opens due to air pressure.
A potential advantage of using valve 1201 or similar includes the ability to
add
any substance to the fluid immediately before the fluid enters the root canal.
In one
example, abrasive powder that may dissolve in fluid, such as salt, may be
passed (with
or without air) through pipe 1203, and enter lumen 1205. Optionally, since the
addition
of salt to the fluid is performed at a relatively short time before entering
the root canal, a
portion of the salt does not dissolve and can be used as abrasive powder for
the removal
of soft tissue from the root canal.
Figures 13A-13D illustrate a nozzle comprising a cone 1301 with a pin shaped
element 1303 occupying at least a portion of the internal lumen of cone 1301,
according
to some embodiments of the invention. Figure 13B is a horizontal cross section
along
line AA of the nozzle. Figure 13C shows an enlarged view of pin shaped element
1303.
In some embodiments, a distal end of tube 1305 passes into a lumen 1307 of
cone 1301 which is not occupied by pin shaped element 1303. In some
embodiments,
other elements, for example a cylinder, may be used for occupying a portion of
the
nozzle, to create a lumen which may be used for flowing fluid in a specific
flow pattern
and/or direction.
In some embodiments, pin shaped element 1303 has a diameter smaller than the
diameter of cone 1301. In some embodiments, fluid passes within lumen 1307. In
some
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embodiments, a distance between a face of the rod portion 1309 of pin shaped
element
1303 and an internal face of cone 1303 ranges between 0.2-3 mm.
In some embodiments, as seen on figure 13A, rod portion 1309 is shaped as a
cylinder comprising a rounded elliptical tip 1315. In some embodiments, as
seen on
figure 13D, rod portion 1309 is shaped as a narrowing cone, having a sharp
pointed tip
1317.
In some embodiments, a head 1311 of pin shaped element 1303 fits within cone
1301 such that an upper portion of cone 1301 is fully occupied by head 1311.
Optionally, this prevents fluid from passing through. In some embodiments,
head 1311
is disposed on a long axis end of rod portion 1309. In some embodiments, pin-
shaped
element is inserted into a nozzle, providing an inner cone (inner cone is not
necessarily
cone shaped) within the nozzle. In some embodiments, head seals and/or closes
a nozzle
lumen.
In some embodiments, tube 1305 may be connected at its proximal end to a
pipe in the handle (not shown in this figure). In some embodiments, fluid such
as liquid,
air, and/or abrasive powder or combinations of them may pass through tube
1305. In
some embodiments, the fluid circulates within lumen 1307, for example in a
helical
flow. Optionally, the helical flow is caused by rod portion 1309, since fluid
is forced to
pass around it. In some embodiments, the fluid exits the nozzle through exit
aperture
1313 in the form of an angled jet due to the helical flow.
In some embodiments, tube 1305 has an elliptical cross section 1319.
Alternatively, tube 1305 has a circular cross section, a rectangular cross
section, or any
other shape. In some embodiments, tube 1305 twists around rod 1309, for
example
adjacent to the rod.
In some embodiments, as seen on 13A, cone 1301 has a narrow elongated tip
portion 1315. In some embodiments, as seen on 13D, cone 1301 has a flat-shaped
tip
portion 1317.
Figure 14 shows an exemplary assembly of a nozzle, according to some
embodiments of the invention.
In some embodiments, the nozzle comprises an internal cone 1401, an external
cone 1403, a suction cone 1405, and one or more lids 1407. In some
embodiments, for
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example during manufacturing, internal cone 1401 is inserted into an external
cone
1403. In some embodiments, internal cone 1401 is assembled within external
cone
1403, and optionally both cones are assembled within suction cone 1405.
In some embodiments, at least two of the cones are connected by mechanical
5 means, such as pins or screws. In some embodiments, the cones are
connected by
molding means, for example by casting at least two of the cones together using
a
designated mold. Optionally, any two and/or all cones are molded together, for
example
creating a nozzle made of one piece.
In some embodiments, any of the cones is detachable, for example to enable
10 cleaning.
Figure 15 is an illustration of a nozzle including exit flow shaping elements
for
creating the one or more angled fluid jets. In some embodiments, the exit flow
shaping
elements may be shaped as wings 1505.
15 In some
embodiments, nozzle 1503 includes one or more wing elements 1505.
In some embodiments, wing elements 1505 are used for diverting the fluid
exiting
nozzle 1503 to create one or more angled jets, for example, as previously
described.
In some embodiments, the fluid passes in a parallel flow through the
cylindrical
nozzle 1503, and wing elements 1505 shunt the parallel fluid to an angled
direction. In
20 some embodiments, nozzle 1503 comprises parallel tubes, and wing
elements 1505 are
positioned at a distal end of the tubes.
In some embodiments, wing elements 1505 are configured along an exit aperture
of nozzle 1503.
25 Additional features of the system and/or apparatus, according to some
embodiments of the invention
Figures 18A-18B illustrate a conical nozzle configured for modifying a
positioning of an internal cone with respect to an external cone, according to
some
embodiments of the invention. In some embodiments, an internal cone
orientation is
30 modified. In some embodiments, an inner cone is non-symmetrical and/or
can be
rotated. In some embodiments, an inner cone includes at least a portion with
textured
surface e.g. grooves. In some embodiments, internal cone 1801 is movable with
respect
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to external cone 1803. Optionally, movement of cone 1801 modifies a volume of
lumen
1805 formed between the cones, for example reducing the volume. Optionally,
modifying the volume includes changing an angle of positioning of internal
cone 1801
with respect to external cone 1803. In some embodiments, movement of the
internal
cone reduces the spacing between the cones and increases the pressure and/or
the
rotation speed and/or the turbulence of the fluid in the lumen.
Optionally, modifying the volume affects the path of fluid. In some
embodiments, cone 1801 is movable along the longitudinal axis of the nozzle,
for
example movable in the proximal and/or distal directions. Figure 18A shows
cone 1801
in a retracted position, closer to a proximal end of the nozzle. Figure 18B
shows cone
1801 in an advanced position, closer to a distal end of the nozzle, in which
the shape of
lumen 1805 is modified For example, cone 1801 is advanced towards exit
aperture 1807
of the nozzle, reducing a size of a passage 1809 formed between the internal
and
external cones through which fluid advances to exit the nozzle. Optionally,
cone 1801 is
advanced in the distal direction by a distance ranging between 0.7-3mm, or 0.1-
0.9 mm,
such as 0.3 mm, 0.5 mm, 0.7 mm or any intermediate, larger or smaller ranges
and/or
values. Optionally, tip 1819 of cone 1801 is advanced towards exit aperture
1807, and
in some embodiments may level with the exit aperture. Optionally, by modifying
a
shape of lumen 1805, for example reducing a size of passage 1809, a velocity
of fluid
circulating between the cones (e.g. vertical and/or angular velocity
components of the
fluid) is increased. Optionally, by modifying a shape of lumen 1805, the fluid
pressure
of fluid approaching exit aperture 1807 may change. A potential advantage of
increasing a velocity of the fluid circulating within the nozzle and/or within
a guide tube
assembled onto the nozzle may include increasing the velocity of the flow
within the
root canal. Optionally, the respective positioning of internal cone 1801 with
respect to
external cone 1803 is determined such as to change the velocity of the fluid
circulating
between the cones, for example increasing the velocity along some portions
and/or
decreasing the velocity along other portions of the nozzle. Optionally, the
angle of a jet
exiting the nozzle is modified as a result of modifying the lumen between the
cones.
Optionally, a diameter of a jet exiting the nozzle changes as a result of
modifying the
lumen, for example by modifying the lumen to change a velocity of the
flownwhich
may increase or decrease the jet diameter. Optionally, the jet diameter is
determined by
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the ratio between air and liquid in the flow. In some embodiments, the fluid
jet may
have a higher velocity, for example as a result of the lumen modification. A
potential
advantage of a jet having high velocity may include a higher eroding ability
of the jet
when entering and flowing within the root canal.
In some embodiments, when cone 1801 is advanced in the distal direction, for
example as shown in figure 18B, a passage of the fluid is narrowed. If the
flow pressure
is maintained at a constant level, the velocity of the flow (e.g. the axial
velocity
component, the vertical velocity component, the angular velocity component
and/or the
total combined velocity changes. In some embodiments, a change in the angular
velocity component and/or a change in the vertical velocity component of the
flow may
cause a change in the tangential velocity component of the flow exiting the
nozzle.
In some embodiments, modifying the lumen changes the angle in which the jet
hits the root canal wall and/or hits fluid within the root canal. Optionally,
modifying the
lumen includes changing a cross section shape and/or size of the lumen,
thereby
optionally affecting the flow rate.
Various mechanisms can be utilized for moving internal cone 1801. For
example, a stepper motor 1811 is utilized for advancing and retracting cone
1801 along
the longitudinal axis of the nozzle. Optionally, internal cone 1801 is
connected to motor
1811, which in turn rotates in predetermined intervals for advancing and/or
retracting
cone 1801. Optionally, stepper motor 1811 is activated through a control panel
of the
system. In some embodiments, stepper motor 1811 is coupled to cone 1801 by a
threaded element 1817. Optionally, stepper motor 1811 is configured to rotate
a
predefined step (i.e. rotate a certain angle) to lower and/or retract cone
1801.
In some embodiments, movement of nozzle parts, for example, the internal cone
is manual e.g. where a user manually moves one or more part (e.g. by pressing
a button
mechanism optionally including a spring to move the internal cone).
In some embodiments, as shown at the transverse cross section profile along
line
BB, a track 1813 (only a cross section is shown here) extends along a portion
of the
internal wall of external cone 1803. A respective projection 1815 formed along
the
external wall of internal cone 1801 is received within the track, for example
for
preventing rotation of the cones with respect to each other during advancement
and/or
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retraction of internal cone 1801. Optionally, the track prevents rotational
movement of
the internal cone when threaded element 1817 is rotated by motor 1811.
Figures 19A-B illustrate an additional configuration of an internal cone 1901
movable with respect to external cone 1903, according to some embodiments of
the
invention. Figure 19A shows cone 1901 in a retracted position, closer to a
proximal end
of the nozzle. Figure 19B shows cone 1901 in an advanced position, closer to a
distal
end of the nozzle, in which the shape of lumen 1905 is modified.
In some embodiments, a radial distance between internal cone 1901 and external
cone 1903 remains constant. Alternatively, the radial distance changes, for
example
increases and/or decreases, for example decreasing in the proximal direction
as shown
by the following figure.
In this configuration, advancement of cone 1901 changes a position of lumen
1907 in which fluid accumulates before passing through tube 1909, with respect
to the
entrance 1911 to lumen 1907.
In some embodiments, advancing cone 1901 causes a modification of lumen
1905, for example of a distal portion 1903. In some embodiments, a passage
within
portion 1913 is reduced in size, for example narrowed. The narrowing may cause
a
change in flow parameters such as: the flow velocity, the flow pressure, the
flow rate,
the angle of the one or more jets exiting the nozzle, the shape of a beam of
jets exiting
the nozzle, the flow pattern within the nozzle, speed of circulation/rotation
of fluid
within the lumen, acceleration of flow within the lumen, or other flow related
parameters.
Cross section A-A shows fluid entrance 1911 leading into lumen 1907.
Figures 20A-B illustrate an additional configuration of an internal cone 2001
movable with respect to external cone 2003, according to some embodiments of
the
invention. This configuration also includes a suction cone 2005, for example
as
described above. Optionally, suction cone 2005 is movable with respect to
external cone
2003, for example it can be lifted or lowered such as by being connected to
stepper
motor 2007. Optionally, lumen 2009 between the cones is shaped such that a
radial
distance between the cones changes, for example with the narrowing of the
cone.
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Optionally, a varying distance between the cones is obtained by the internal
cone 2001
having an angle 0 different than angle Z5 of external cone 2003. Optionally,
one or both
angles range between 10-85 degrees, such as 20 degrees, 35 degrees, 60
degrees, 70
degrees or intermediate, larger or smaller angles. In some embodiments,
internal cone
2001 is advanced in the distal direction such that tip 2011 enters narrow
needle portion
2013 of external cone 2003. The modification of lumen 2009 may cause a change
in the
axial (vertical) fluid velocity, the angular velocity, the flow pressure, the
circular
acceleration of the flow, the velocity of the exiting jet (e.g. vertical,
angular, and/or
tangential velocity components), the angle of the exiting jets, the shape of
the beam of
jets exiting the nozzle, and/or other flow related parameters.
Cross section B-B shows a locking configuration of internal cone 2001 to
external cone 2003, whereby notch 2015 is received within a respective channel
2017
for example for preventing rotation of cone 2001 when motor 2007 is operated
(e.g.
rotated a certain step) to advance the internal cone.
Figures 21A-C illustrate an internal cone comprising an expandable portion,
according to some embodiments of the invention. Figure 21A shows the non
expanded
configuration, figure 21B shows the expanded configuration, and figure 21C
shows a
non expanded configuration in which the internal cone is advanced in the
distal
direction. In some embodiments, internal cone 2101 comprises at least one
portion 2103
adapted for expanding within lumen 2105 between the cones. Optionally, portion
2103
is formed of an elastic material, such as rubber. Optionally, expandable
portion 2103 is
configured for extending radially outwards, such as to occupy a larger volume
with
lumen 2105. Optionally, portion 2103 expands to occupy at least 10%, 30%, 40%,
60%
or another larger, smaller, or intermediate percentage of lumen 2105.
Optionally,
expandable portion 2103 affects the flow of fluid along at least a portion of
lumen 2105,
for example a portion in proximity to the exit aperture of the nozzle.
Optionally, by
expanding portion 2103, the angle of the fluid jet discharged by the nozzle
changes, for
example a tangential angle of the jet with respect to the exit aperture may be
modified.
Optionally, by expanding portion 2103, the flow rate of fluid passing through
may
change. Optionally, expansion of portion 2103 affects the velocity of the
flow.
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In some embodiments, portion 2103 is caused to expand by a rigid structure,
for
example comprising a rod 2107, a conical portion 2109 and a conical tip 2111.
Optionally, rod 2107 is coupled only to tip 2111. Tip 2111 may be positioned
at various
locations within lumen 2105.
5
Optionally, the structure is advanced and/or retracted by a stepper motor
2113.
Optionally, advancement of the structure in the distal direction causes
conical tip 2111
to press against the elastic walls of expandable portion 2103, thereby
occupying a larger
volume within lumen 2105. Optionally, expansion of portion 2103 is combined
with
modifying a positioning of internal cone 2101 with respect to external cone
2103, to
10 define a shape of lumen 2105.
In some embodiments, cone 2115 is movable with respect to the external cone,
by being coupled to motor 2213 for example by a threaded element. In some
embodiments, by activation of motor 2213, radial expansion and/or movement of
the
internal cone can be obtained, simultaneously or separately.
15 In some
embodiments, a distal portion 2115 of lumen 2105 is modified, for
example the local expansion of portion 2103 narrows down the passage in which
fluid
flows. Optionally, this increases the velocity of the fluid, for example if
the fluid
pressure is maintained at a constant level. Optionally, this changes the angle
in which
the one or more jets exit the nozzle. Optionally, parameters such as the flow
pressure,
20 fluid
velocity, and/or the angular velocity of the fluid within lumen 2105, and/or
the
shape of the beam of angled jets discharged by the nozzle are affected by the
modification of lumen 2105.
In some embodiments, internal cone 2101 comprises one or more narrowing
portions (not shown in this figure), which may modify a shape of lumen 2105.
Figure 22 shows an additional configuration of an internal cone 2213
comprising an expandable portion 2203. Figure 22A shows the internal cone in a
non-
expanded configuration, and figure 22B shows the internal cone expanded
radially in
the lumen between the cones, in the direction of the external cone.
Optionally,
expandable portion comprises a smaller cone 2201 constructing internal cone
2213. In
this example, the expandable portion 2203 extends longitudinally within lumen
2205 so
that when expanded radially, it may occupy most of the volume of lumen 2205,
such as
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51%, 70%, 80% or 90% of lumen 2205. Optionally, the expandable portion is an
elastic
layer surrounding cone 2201 of internal cone 2213. In some embodiments, as
shown in
this figure, the expansion is operated by a rod 2207 having a proximal end
connected to
a threaded element 2209, which in turn is coupled to a stepper motor 2211, and
a distal
end of the rod is connected to cone 2201. Optionally, motor 2211 is also
connected to
internal cone 2213, for example through a second threaded element 2215, for
being
movable for example in the distal and/or proximal directions within the
external cone.
Optionally, the distal tip 2217 of cone 2213 is advanced is in the distal
direction
towards exit aperture 2219 of the nozzle, any may optionally level with the
aperture.
In some embodiments, by activation of motor 2211, the radial expansion and/or
the movement of internal cone 2213 can be obtained, simultaneously or
separately.
In some embodiments, lumen 2205 is modified by the radial expansion of
portion 2203. Additionally or alternatively, lumen 2205 is modified by the
movement of
cone 2213. Optionally, a distal portion of lumen 2205, for example in
proximity to exit
aperture 2219, is reduced in volume. The modification of lumen 2205 may cause
a
change in the axial (vertical) velocity of the fluid within the nozzle.
Additionally or
alternatively, the modification of lumen 2205 may cause a change in the
angular
velocity of the fluid within the nozzle. Additionally or alternatively, the
modification of
lumen 2205 may cause a change in the angle of the jet exiting the nozzle.
In some embodiments, the modification of lumen 2205 is changed to cause a
change in the flow regime, for example it is controlled by a dentist.
Optionally, lumen
2205 is modified to suit a certain type of treatment, for example, a
modification that
causes a beam of jets having a relatively narrow profile or a wide profile may
be more
efficient when treating a root canal, for example a wide beam may be more
suitable for
treating a wide root canal, and a narrow beam may be more suitable for
treating a
narrow or complex canal, such as istmus or webs canal. A wider beam may be
more
efficient when treating a complex shaped root canal, for example a root canal
having
many tubules, a root canal connected to a second root canal (webs canal or
istmus
canal), or other canal forms.
Figure 23A illustrates a conical nozzle 2303 comprising one or more internal
channels 2301, according to some embodiments of the invention. In some
embodiments,
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channels 2301 are formed in a spiral configuration. Alternatively, channel
2301 is
formed in other configurations such as parallel to the walls of nozzle 2303,
parallel to a
longitudinal axis of nozzle 2303, or transversely extending within nozzle
2303. In some
embodiments, nozzle 2301 comprises more than one internal channel, such as 2,
4, 6, 8
or a larger or intermediate number. Optionally, a channel conducts a component
such as
liquid, gas (e.g. air), and/or abrasive powder and/or disinfection material
and/or
irrigation solutions. In some embodiments, exit aperture 2305 of channel 2301
is
positioned close to an internal wall of cone 2303, so that flow exiting
channel 2301 will
flow along the walls of cone 2303 and optionally circulate at a high velocity
along the
walls, advancing towards exit aperture 2307. In some embodiments, the exit
aperture
2305 of channel 2301 is positioned in proximity to exit aperture 2307 of
nozzle 2303,
for example to conduct abrasive powder. Such a channel may be especially
useful if a
powder that is dissolvable in liquid over time is used, such as salt, in order
to mix it into
the fluid right before the fluid enters the root canal. Optionally, channel
2301 is
movable with respect to the internal lumen of nozzle 2303, for example by
being
connected at its proximal end to a stepper motor.
In some embodiments, as illustrated in figure 23A, channels 2301 includes more
than one channel. In some embodiments, as illustrated in figure 23A channels
merge
into a single channel and the separate flows merge in a combined channel. In
some
embodiments, separate flows merge after emerging from separate channel exit
apertures
e.g. in some embodiments separate exit apertures are in close proximity (e.g.
within
lmm of each other) and the flows mix substantially immediately after emerging
from
the channels. Merging can occur at any point within the channel and/or nozzle.
Optionally, channel/s 2301 are movable with respect to the internal lumen of
nozzle 2302, e.g. distally-proximally and/or by rotation. In some embodiments,
movement of channel/s 2301 is by connection of the channel/s to a stepper
motor. In
some embodiments, movement of channel/s 2301 is manual.
Figure 23B illustrates a conical nozzle combining one or more internal
channels
2305, a pipe 2307 movable along a longitudinal axis of the nozzle, and a
movable
internal cone 2309, for example as described herein.
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In some embodiments, channel 2305, for example having a spiral configuration,
conducts liquid, gas and/or abrasive powder and/or disinfection solution
and/or
irrigation solution. Optionally, channel 2305 is connected to a pipe
configured within
the handle, and/or connected to a fluid-receiving lumen 2311 within the
nozzle. In some
embodiments, a cross section profile of the channel is circular, for example
having a
diameter ranging between 0.2-4 mm. Alternatively, the cross section of the
channel is
elliptical or otherwise shaped.
In some embodiments, channels 2305 are formed by hollows in a solid
component, for example, inner cone 2309.
In some embodiments, channels 2305 are formed by hollows in a non-solid
component, for example channels 2305 being pipes supported by a mesh.
In some embodiments, movable pipe 2307 delivers at least one of liquid, gas,
abrasive powder. Optionally, pipe 2307 delivers a disinfection solution (e.g.
solution
including antibacterial agent/s) and/or other medication and/or a flushing
solution. In
some embodiments, pipe 2307 is connected to a pipe configured within the
handle.
Optionally, pipe 2307 is movable along the longitudinal axis of the nozzle,
for example
it can be lifted up in the proximal direction (e.g. using the stepper motor)
or lowered in
the distal direction. Optionally, a distal end 2313 of pipe 2307 is positioned
in proximity
to exit aperture 2315. Optionally, the location of distal end 2313 with
respect to external
cone 2317 and/or with respect to exit aperture 2315 affects the flow of fluid
within the
nozzle and/or the angle or beam shape of fluid exiting the nozzle. Optionally,
movement
of pipe 2307, the flow within channel 2305, and/or movement of internal cone
2309
with respect to the external cone are combined to form a desired flow regime.
Optionally, activation of the one or more components of the nozzle is
performed using a
controller.
In some embodiments, e.g. as illustrated in Figure 23B, channel 2305 includes
more than one channel (in the figure two channels are illustrated). In some
embodiments channels 2305 merge into a single channel (in Figure 23B channels
2305
merge at cross section C-C) and the separate flows merge in a combined
channel.
In some embodiments, separate flows merge after emerging from separate
channel exit apertures in inner cone 2309. In some embodiments separate exit
apertures
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are in close proximity (e.g. within lmm of each other) and the flows mix
substantially
immediately after emerging from the channels.
In some embodiments, inner cone 2309 includes a portion 2309a adapted to
move independently from inner cone: For example, to rotate at a different
speed and/or
in a direction and/or to move distally and proximally independently from inner
cone
2309.
Figures 24A-B are two configurations of a handle 2401 comprising a fluid
mixer 2403 for mixing between components of the fluid, such as gas, liquid
and/or
abrasive powder, in accordance with some embodiments of the invention.
In some embodiments, handle 2401 comprises a cartridge 2405, for example
filled with abrasive powder. Alternatively, cartridge 2405 is filled with
liquid such as
medication, or any other component and/or particles intended to be delivered
into the
nozzle. Optionally, cartridge 2405 is replaceable and/or disposable, for
example it can
be replaced between patients and/or between treatments. Optionally, cartridge
2405 is
refillable. Optionally, by mixing between components of the fluid within the
handle, the
need for external containers in which mixing is performed can be reduced,
thereby
optionally reducing the number of system components In some embodiments, the
volume of the cartridge ranges between 0.5 CC- 20 CC.
Figure 24A shows a pipe 2407 configured for delivering air and/or powder into
the nozzle, in accordance with some embodiments of the invention. Optionally,
a valve
is placed for example at the entrance to the nozzle to control the flow. Pipe
2409, also
leading into the nozzle, may deliver air and/or powder, or liquid, into the
nozzle. Pipe
2411 connects to fluid mixer 2403, and delivers, for example liquid. Pipe 2413
connects
to fluid mixer 2403, delivering, for example, air and powder. In some
embodiments,
flows from pipes 2411, 2413 mix within fluid mixer 2403 (e.g. the flows mix
uniformly
to produce a uniform composition flow exiting the mixer).
Pipe 2423 is a suction pipe which delivers fluid and/or debris in an opposite
direction from the nozzle. In some embodiments, each of pipes 2407, 2409,
2413, 2411
deliver one or more of gas (e.g. air) and/or fluid and/or powder and/or
disinfection
solution and/or irrigation liquid. In some embodiments, flows from pipes 2407,
2409,
2413, 2411 join and mix in a lumen 2425 (e.g. a region of lumen 2425 proximal
to a
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nozzle exit aperture) of a nozzle 2427 before passing out of nozzle 2427
through a
nozzle exit aperture.
In Figure 24B, suction pipes 2415 lead fluid and/or debris away from the
nozzle, pipe 2417 leads air and/or powder into cartridge 2405. The air and
powder may
5 be mixed within cartridge 2405 at dry conditions, where no moisture or
humidity exist.
Optionally, a valve is installed at junction 2419 for example for preventing
fluid from
fluid mixer 2403 entering cartridge 2405. Pipe 2421 leads fluid into fluid
mixer 2403
where, in some embodiments, flow from pipe 2421 and flow from cartridge 2405
merge
and flow into mixer 2403 for mixing. The mixed flow including liquid, air and
abrasive
10 powder then flows from mixer 2403 into the nozzle lumen 2427. In some
embodiments,
each of pipes 2417, 2421 deliver one or more of gas (e.g. air) and/or fluid
and/or
powder and/or disinfection solution and/or irrigation liquid.
The above exemplary pipeline configurations can be coupled to any type of
nozzle, such as, for example, described herein.
Figures 25A-C illustrate various configurations of a powder cartridge supply
system, according to some embodiments of the invention. Optionally, the
cartridge is
disposable. Optionally, the cartridge is replaceable, and can be assembled or
detached
from the handle for example through a designated opening. In some embodiments,
the
powder cartridge supply system is configured for supply and mixing abrasive
particles
with gas immediately before the fluid enters fusing tank (e.g. fluid mixer
2403) before
entering the nozzle. Optionally, the cartridge comprises a predefined amount
of abrasive
powder, for example suitable for performing 1, 3, 5, 10 or another number of
treatments. Figure 25A shows abrasive powder 2501 contained within the
cartridge,
prior to mixing with gas. The cartridge comprises a cylinder formed with a
plurality of
internal cylinders, as will be explained in figure 25C. Optionally, the one or
more
internal and/or external cylinders comprise holes. Optionally, the one or more
cylinders
are coated with a flexible cover.
Figure 25B shows powder 2501 once gas and/or liquid have entered the
cartridge, and the cross section B-B shows the direction in which air flows
into the inner
lumen 2513 for mixing with the powder. In some embodiments, a volume of the
cartridge ranges between 0.2-10 cc, 5-15 cc, 10-25 cc, 25-60 cc, or
intermediate, larger
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or smaller volumes. In some embodiments, the cartridge is formed of a metal,
PPM,
plastic, or any material that can withstand the pressure.
In some embodiments, gas such as air is compressibly forced into the
cartridge,
for example through opening 2509. In some embodiments, air is forced into the
cartridge at a pressure ranging between 2-300 PSI. In some embodiments, the
compressed air generates a circulation, turbulence or other swirling motion of
the
powder within the cartridge.
In some embodiments, as shown for example in figure 25C, the cartridge
comprises one or more cylinders positioned one within the other. Optionally,
the
cylinders comprise one or more openings 2503, 2511, 2505 for enabling the
passing of
certain components through and blocking the passage of other components
through.
Optionally, a diameter of an opening may range between 40 p.m- 30011., or 100
p.m- 2
mm or 20 p.m - 5mm. For example, an internal cylinder 2505 may be formed with
holes
that allow powder 2501 to exit through in the radial direction, for example
when air
flows into the cartridge. Optionally, external cylinder 2507 comprises
openings shaped
as X shaped slots 2511 that enable only the passing of air entering the
cartridge (e.g.
blocking powder cartridges from returning). In some embodiments, x-shaped
slots act as
a one way valve. In some embodiments, external cylinder 2507 is formed of an
elastic
material. Figures 25 E and F show an X shaped slot 2511 in its closed
configuration (E)
and expanded star shaped configuration (F) in which air is allowed into the
cartridge,
blocking powder cartridges from returning (e.g. one way valve). In some
embodiments,
the air passes through one or more openings 2503, 2511 in the cylinders and
mixes with
the powder, for example within lumen 2513a. In some embodiments, prior to
entry of
gas such as air into the lumen of the cartridge, the powder particles remain
at a bottom
of lumen 2513. In some embodiments, even when the pressurized air supply to
the
cartridge is reduced or stopped, the powder does not sink back to the bottom
of the
cartridge for example as shown in figure 25A.
In some embodiments, entrance 2509 to the cylinder is sealed by an external
cylinder 2500 and/or by cover 2507 so that gas such as air which enters
through
entrance 2509 is forced to pass through slots 2511 to enter the internal
cylinder 2502,
for example through holes 2503. In some embodiments, fluid ejected through
holes
2505 flows through lumen 2513 to a fusion tank within a handle connected to a
nozzle.
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Optionally, the fluid comprising the powder is then delivered to a fusion tank
within the handle.
Figure 25D shows an exemplary configuration of a handle in which the air and
powder supply, for example being mixed together in powder cartridge system
2509, are
delivered into the nozzle separately from liquid (for example delivered
through
mixer/tank 2511). Optionally, by separating the liquid from the air and powder
mixture,
each component can be delivered separately into the nozzle, for example,
mixing within
the nozzle and/or root canal. For example, the nozzle may deliver only air and
powder
into the canal, and/or deliver only liquid into the canal.
In some embodiments, tube 2510 may be used for delivery of air, liquid, and/or
powder and/or irrigation fluid and/or disinfection solution.
In some embodiments, suction tube 2512 is used to extract fluid and/or debris
(e.g. from the root canal).
Alternatively, in some embodiments, suction tube 2512 in the handle may be
used for discharge (e.g. of gas, liquid, and/or powder) instead of suction.
In some embodiments, the handle may be used with different types of nozzles,
such as, for example, described herein.
In some embodiments, each of pipes 2531, 2533, 2535, 2537 deliver one or
more of gas (e.g. air) and/or fluid and/or powder and/or disinfection solution
and/or
irrigation liquid.
Figures 26 and 27 are schematic diagrams of exemplary system for treating a
root canal, according to some embodiments of the invention. Figure 26, for
example,
includes the system described in Figure 8 above, further including a fluid
mixer, a
disinfecting fluid tank connected to a pump, and a liquid filter. Optionally,
liquid flows
directly into the handle and nozzle. Alternatively, fluid is first passed
through the fluid
mixer.
In some embodiments, one or more liquid tubes connects between the liquid
tank and the fluid mixer, and/or connects the liquid tank directly to the
handle. In some
embodiments, one or more air tubes connect between the air compressor to the
powder
mixer, and/or from the air compressor directly to the handle.
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Figure 27 further includes a powder mixer, which mixes air and powder together
for example before entering the handle. Optionally, one or more components of
the
system are activated through a control panel connected to a controller. In
some
embodiments, the components of the system are separately controllable and can
be
operated with or without other components (for example, the air pump may be
operated
independently of the fluid mixer).
Figure 28, now made reference to, illustrates a nozzle 2800 comprising a
turbine 2801 for imparting spin to a working fluid, according to some
exemplary
embodiments of the invention.
In some embodiments of the invention, there is provided a turbine 2801,
operable to impart momentum to flow exiting the nozzle aperture 2802. The
turbine
design potentially allows transfer of energy from, for example, a pressurized
gas supply,
into a working fluid for cleaning and/or eroding of a root canal. In some
embodiments,
combining of turbine-driven and direct pressure-driven working fluid sources
that meet
in flow coming from 2827 into the lumen between the internal cone and external
cone.
Fusion of these flows potentially allows control to achieve a broadened range
of exit jet
and angles properties at the meeting between two flows 2806.
In some embodiments, the turbine 2801 is activated by a flow of air, for
example
from inlet 2804. Optionally, the flow of air enters through pipe 2804
configured within
the handle. In some embodiments, the turbine is operable at one or more
frequencies in
a range of, for example: 2000-10,000 RPM, 5,000-25,000 RPM, 10,000-100,000
RPM,
10,000-400,000 RPM, 2000-400,000 RPM, or another range of rotational
frequencies.
In some embodiments, the pressure of air for driving the turbine is, for
example: 10-20
PSI, 15-25 PSI, 10-30 PSI, 30-40 PSI, 30-60 PSI, or another range of driving
pressures.
In some embodiments, turbine 2801 is operable to rotate pipe 2807, which
extends from a fluid inlet in the region of the turbine toward a distal end of
the nozzle
2800. In some embodiments, the turbine is operable to spin fluid that enters
pipe 2807,
provided, for example, through pipe 2805. Additionally or alternatively, fluid
(provided,
for example, from pipe 2803) flows into lumen 2825, and optionally passes
through the
slanted tube 2827. In some embodiments, turbine 2801 causes an axial rotation
of pipe
2807, thereby spinning the fluid contained within. Optionally, the fluid
exiting pipe
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2807 has a helical flow profile. In some embodiments, spinning of the fluid
within pipe
2807 affects a velocity and/or pressure of the fluid.
In some embodiments of the invention, pipe 2807 is provided with a helically
formed lumen. A helically formed lumen provides a potential advantage for
imparting
directionality to fluid therein, by urging the fluid along the length and/or
around the axis
of pipe 2807.
In some embodiments, turbine 2801 is coupled to motor 2809, for being
movable, for example, in the proximal and/or distal directions. In some
embodiments,
motor 2809 comprises a stepper motor. Optionally, coupling is through threaded
element 2811 and/or rods 2813. In some embodiments, motor 2809 comprises,
additionally or alternatively, a driving means for moving internal cone 2815
in distal
and proximal directions, optionally coupled through threaded element 2811
and/or for
moving pipe 2807 in distal and proximal directions. Optionally, movement of
internal
cone 2815 and pipe 2807 in distal and proximal directions is independent for
example,
at different speeds and/or directions and/or frequencies e.g. as internal cone
2815 moves
distally, pipe 2807 moves proximally. Alternatively, movement of internal cone
2815
and pipe 2807 is synchronized.
In some embodiments, movement of the internal cone and/or pipe is manual, e.g.
where a user manually moves one or more part (e.g. by pressing a button
mechanism
optionally including a spring) to move the internal cone and/or pipe.
The cross section along line A-A shows rods 2813. The cross section along
lines
C-C, for example, shows the internal cone 2815, external cone 2817, a lumen
2819
within the internal cone 2815, pipe 2807, a lumen 2823 of pipe 2807 through
which
fluid passes, and a suction cone 2821 positioned externally to both cones.
In some embodiments, the turbine is sealed by a sealing element 2830, for
example preventing fluid and/or air to pass in the proximal direction.
In an example of nozzle operation, fluid injected into pipe 2803 finds its way
to
region 2806 from tube 2807, having acquired during its transit a pattern of
flow which
may be, for example, helical. Some control of flow pattern properties is
optionally
exercised by relative motion of inner cone 2815 relative to external cone
2817, driven,
for example, by stepper motor 2809. In some embodiments, fluid injected into
pipe
2805 finds it way, optionally simultaneously, through pipe 2807, also reaching
region
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2806. In some embodiments, the two fluid flows are combinable at region 2806.
In
some embodiments, advancing or retracting pipe 2807 potentially allows control
of
parameters of fluid flow patterns exiting from aperture 2802. Parameters
adjustable potentially include, for example, the cone exit angle and/or the
vertical
5 and/or
horizontal velocity components of exiting fluid. In some embodiments, fluid of
different compositions is supplied to pipes 2805 and 2803 (or one of pipes
2805, 2803),
and control of mixing is provided, for example, by positioning of pipe 2807
and inner
cone 2815.
It should be noted that the turbine and its related features such as the frame
10
connecting to the motor can be assembled in nozzles of various configurations,
such as
nozzles having a geometry other than conical (for example, cylindrical).
Figure 29, now made reference to, illustrates a nozzle comprising a turbine
2901, according to some exemplary embodiments of the invention.
15 In some
embodiments of the invention, turbine 2901 is driven by pressurized air,
for example as described in connection with Figure 28, hereinabove.
In some embodiments the nozzle does not comprise an internal and external
cone, but rather one solid cone 2903 which is optionally positioned within a
suction
cone 2905. In this figure, fluid entering the nozzle¨for example, through pipe
2907 in
20 the
handle flows into pipe 2909 which is coupled to turbine 2901, for example as
described hereinabove.
In some embodiments corresponding to Figure 29, fluid passes to the nozzle tip
only through pipe 2909. In some embodiments, pipe 2909 is axially rotated by
turbine
2901, causing fluid passing through it to spin. Potentially, the spun fluid
within pipe
25 2909
exits nozzle tip 2902 at an angle imparted by its momentum. In some
embodiments, stepper motor 2911 is coupled to turbine 2901 and/or to pipe 2909
for
moving one or both of them in the proximal and/or distal directions. The cross
section
along line C-C shows cone 2903, pipe 2909, a lumen 2913 formed within pipe
2909
through which fluid passes, and the external suction cone 2905.
30 In some
embodiments, the turbine is operable at one or more frequencies in a
range of, for example: 2,000-10,000 RPM, 5,000-25,000 RPM, 10,000-100,000 RPM,
10,000-400,000 RPM, 2,000-400,000 RPM, or another larger or smaller range of
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rotational frequencies. In some embodiments, the pressure of air for driving
the turbine
is, for example: 10-20 PSI, 15-25 PSI, 10-30 PSI, 30-40 PSI, 30-60 PSI, or
another
larger or smaller range of driving pressures.
In some embodiments, pipe 2909 is smooth-bored. Potentially, spinning motion
is imparted to fluid passing therethrough by viscous forces acting between the
fluid and
the lumenal wall of pipe 2909. Advancing and retraction of pipe 2909 relative
to nozzle
aperture 2902 potentially regulates the characteristics and/or parameters of
flow exiting
aperture 2902, for example, by changing its pathway through the nozzle chamber
between a distal end of pipe 2909 and aperture 2902.
In some embodiments, the adjustment up and down of motor 2911 (e.g. moving
pipe 2909) increases or decreases the vertical velocity and pressure in the
space under
the exit of the distal end of tube 2907 in the conical lumen.
Figure 30, now made reference to, illustrates a nozzle comprising a turbine
3001 coupled to an internal cone 3003 for rotating the cone around its axis,
according to
some exemplary embodiments of the invention. Figure 30 is an example of using
a flow
to rotate a flow modifying element.
In some embodiments, the internal cone 3003 is formed from a single solid
piece
comprising inner channels 3005 through which the fluid flows. In some
embodiments,
fluid enters the nozzle through pipe 3007 within the handle. In some
embodiments,
turbine 3001 rotates cone 3003 fast enough so that a centripetal force causes
the fluid to
flow along the walls of channels 3005 and/or causes fluid within the channels
to spin
and/or rotate. In some embodiments of the invention, momentum, potentially
including
angular momentum, is transferred from the motion of the turbine to the working
fluid
passing through cone 3003 before it is ejected from the nozzle. In some
embodiments,
fluid ejected from the nozzle is spinning/rotating/has helical flow.
Potentially, fluid exiting the nozzle does so at an angle which is broadened
by
the tangential component of its momentum at the exit aperture of the nozzle.
Cross section A-A shows rotating cone 3003, channels 3005, and an external
cone 3007. The cross section also shows a lumen 3009 between the rotating cone
3003
and external cone 3007.
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It should be noted that fluid exiting the distal aperture of cone 3003 is
potentially in direct association with fluid external to the nozzle, the
distal aperture
being isolated from the surrounding tissue only by a relatively short
sheathing length of
the nozzle's outer wall. In some embodiments, this potentially improves the
efficiency
of energy transfer from the nozzle interior to the exteriorly acting working
fluid.
Figures 31A-31B, now made reference to, show a conical nozzle in which only
the narrowing portion 3101 of internal cone 3103 is movable with respect to
external
cone 3105, according to some exemplary embodiments of the invention.
In some embodiments, inner walls of a (optionally needle-like) nozzle tip have
a
helical shape and/or grooves.
In some embodiments, different geometry of a nozzle tip, for example shape
and/or diameter affect beam and/or angle jet axial velocity.
In some embodiments, geometry of the cross section of the nozzle tip has
different geometries which affect fluid flow parameters.
In some embodiments of the invention, portion 3101 is connected to one or more
rods 3107 which are distally/proximally positionable by stepper motor 3109.
Optionally, rods 3107 are coupled to a threaded element 3111. In Figure 31A,
narrowing portion 3101 is shown lifted in the proximal direction, while in
Figure 31B,
narrowing portion 3101 is shown advanced in the distal direction. Optionally,
movement of the narrowing portion 3101 modifies a lumen between the cones, as
described hereinabove.
In some embodiments, movement of the internal cone and/or pipe is manual, e.g.
where a user manually moves one or more part (e.g. by pressing a button
mechanism
optionally including a spring) to move the internal cone and/or pipe.
In some embodiments, there is, for example, a ratchet or rotation of a
rotating
element via thread sets in different locations.
Figures 32- 37 show various modes of operation of a system in accordance with
some embodiments of the invention. Such modes are optionally achieved by
varying
parameters of the system such as one or more of pulse time, duty cycle, pulse
rate,
air/liquid ratio, and/or added powder.
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Figures 32-34 show the operation of a system, in accordance with some
embodiments of the invention, where a plurality of jets 4301 (optionally a
part of, or in
the form of, a continuous cone of fluid or other beam shape) are discharged by
the
nozzle. As shown in a first condition in Figure 32, a root canal 4315 has
fluid up to a
level 4421, in parameter conditions where a fluid level is formed. Jets 4301
hit a wall
4303 of root canal 4315 and form a cyclone 4313. In some embodiments, the
cyclone
comprises an aerosol combination of fluid droplet and gas.
In a second condition shown in Figure 33, after a brief time (which may be,
for
example, 10-20 msec, 10-50 msec, 25-100 msec, 50-200 msec, or another larger
or
smaller interval of time), an evolution of conditions has occurred.
Potentially, a density
of fluid has increased above fluid level 4421, as fluid is injected into the
root canal. In
some embodiments, gas which initially exited the nozzle has been displaced by
heavier
fluid exiting the nozzle during the interval of evolution. In some
embodiments, fluid
which initially exited the nozzle has lost a portion of its velocity to
interactions with the
environment of the root canal. Potentially, less energetic fluid is displaced
toward the
center of the developing cyclone as new fluid is injected. A counterflow
upwards
potentially also begins as additional fluid is introduced from above with
sufficient axial
velocity to force its way downward. In some embodiments, the energetic fluid
also
begins to set up turbulent zones, which potentially change their position,
velocity,
and/or size over time.
In a third condition, shown in Figure 34, a fully developed cyclone has
arisen. In
some embodiments and conditions, the fully developed cyclone arises after
brief
interval from the situation shown in Figure 33. The interval is, for example,
10-20 msec,
10-50 msec, 25-100 msec, 50-200 msec, or another larger or smaller interval of
time. In
some embodiments of the invention, the cyclone develops to reach an apex 4319
of the
root canal.
In some embodiments, the cyclone comprises fluid that was previously below
the fluid level 4421 which has received energy transferred to from the
injected fluid.
Additionally or alternatively, the fluid injected form the nozzle carries
sufficient energy
to force its way down to the tip. In some embodiments of the invention and
conditions,
a counterflow develops such that fluid which reaches the apex 4319 is forced
upward
again in a counterflow by new fluid following behind it. Optionally, this flow
occurs in
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addition to or instead of rotation caused by fluid traveling along the wall.
In some cases,
fluid below the fluid level 4421 are turbulent and include significant flow
vectors other
than parallel to and along the wall of the root canal 4315. Optionally, the
turbulence
helps remove debris, dentine, and/or soft tissues from the wall, tubules,
and/or out of the
canal. In some embodiments, a fluid level can be achieved, theoretically, even
when the
tooth is turned upside down.
It should be understood that the interactions of air and water (gas and fluid)
in
the root canal potentially create a condition in which inertial forces
strongly dominate
viscous forces (a high Reynolds number). As new air/water mixture is injected
into the
root canal, energetic and potentially turbulent flow is carried with
relatively great
freedom throughout the region being irrigated, as losses due to viscosity
become
relatively negligible. It should be understood that the boundaries of various
relative
fractions of gas and fluid at various depths of the root canal are potentially
continuous
and/or indistinct during active irrigation, as turbulence and other activity
cause
fluctuations in flow. In some embodiments, the boundary deeper than which
(reaching
into the root canal) the total volume of fluid and air in the channel is at
least 50% fluid
is, for example, about 3-4 mm, about 4-5 mm, about 4-8 mm, about 6-9 mm, or
another
larger or smaller depth. The conditions of initial gas/fluid mixing associated
with these
depths are, for example, selected from among those described in connection
with Table
1, hereinabove.
Figures 35-37 show the operation of a system, in accordance with some
embodiments of the invention, where fluid is delivered through a needle-like
cylinder
5401. Optionally, cylinder 5401 is axially rotated within the nozzle, for
example by a
turbine as described above. Optionally, a distal end of the cylinder is
positioned above
root canal entrance 5425. Alternatively, a distal end of cylinder 5401 is
entered, at least
partially, into the root canal, as in Figures 35-37. Optionally, an exit
aperture of cylinder
5401 is leveled with a level of fluid 5421 within the canal. Alternatively,
the exit
aperture of cylinder 5401 is advanced into the fluid within the canal, for
example 0.1
mm, 0.5 mm, 1 mm, 2 mm, 4 mm. or intermediate, larger or smaller distances.
In some embodiments, the rotating cylinder 5401 directly couples to fluid
within
the canal to rotate it (for example, as in Figure 36). In some embodiments,
the helical
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flow exiting cylinder 5401 induces a helical, rotational and/or turbulent flow
within the
canal, for example when the hitting fluid that accumulated within the canal
(Figure 35),
and additionally or alternatively by replacement of the accumulated fluid with
fluid
and/or air that has been energetically injected into the root canal. In some
embodiments,
5 the rotating cylinder forms a cone shaped beam of fluid exiting the
cylinder. In some
embodiments, the flow of the cone shaped beam has an angular component (i.e.
not only
a vertical component) so that the conical beam is effectively formed of a
plurality of
angled jets.
In some embodiments, flows, counterflows, turbulence, and other features of
the
10 motion of fluid described hereinabove in relation, for example, to
Figures 32-34, are
induced. In particular, helical and/or turbulent flow potentially propagates
all the way to
the apex 5319 of the root canal. Potentially, full penetration of the root
canal is assisted
by high energy and relatively low viscosity of an air/water mix ejected from
the tip of
the nozzle.
Figure 38 shows various configurations of needle-like tubes which can be
assembled onto a nozzle, for example assembled on a distal exit aperture of
the nozzle.
The various configurations are suitable for use with root canals having
different
anatomical structures. The various configurations may comprise different
lengths,
different profiles of exit apertures, different diameters. In some
embodiments, a
proximal end of the needle like tube is coupled to a distal end of a nozzle.
Optionally,
the needle like tube is attachable by a threaded connection. In some
embodiments, a
nozzle is structured such as to connect, such as by fastening means (a screw,
clasp or
other) by adhesive means, and/or by a structural geometrical connection to one
or more
types of needle-like tubes. In some embodiments, the needle like tubes form
different
types of beams and flow patterns. Optionally, a needle like tube is selected
to affect the
velocity of the flow, for example between the angular velocity of the fluid
circulating
within the nozzle and the tangential velocity of the flow exiting the nozzle.
In some
embodiments, the distal aperture of the needle like tube comprises a circular
profile, an
elliptical profile, an oval profile, a beveled form, a trapezoid profile, a
triangular profile
or any other profile and/or geometry.
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Figure 39A is a simplified schematic cross sectional view of a nozzle 3901
lacking an internal cone, according to some embodiments of the invention. In
some
embodiments, one or more angled jet (e.g. a jet at an angle which does not
intersect a
vertical axis of the nozzle) is discharged from a cone lacking an internal
cone. In some
embodiments, fluid discharged from a jet without an internal cone intensifies
or causes
rotation of fluid within an at least partially filled root canal.
In some embodiments, fluid flows through a nozzle lumen lacking an inner cone
with a helical and/or rotating path and/or the fluid flows in contact with
lumen walls.
In some embodiments, a pipe 3903 (optionally, in some embodiments, more
than one pipe) carrying material (e.g. fluid including one or more of liquid,
air, abrasive
powder, disinfection component/s) extends into nozzle lumen 3907 and pipe 3903
includes a pipe outlet 3909 which is proximal to a portion nozzle lumen walls
3916. In
some embodiments, the pipe and/or pipe outlet is angled and/or positioned
and/or
shaped such that a flow 3911 (e.g. jet) of fluid from pipe 3903 impacting a
portion of
nozzle lumen walls 3916 flows in a radial and/or centrifugal and/or helical
and/or spiral
manner, e.g. spiraling downwards through nozzle lumen 3907. In some
embodiments,
an angle of the flow (e.g.) exiting pipe 3907 is at an angle which does not
intersect a
vertical axis of the nozzle.
In some embodiments, flow speed and/or pressure and/or composition contribute
to helical flow of fluid within the nozzle and/or characteristics and/or
parameters of j et/s
discharged from the nozzle.
In some embodiments, pipe 3903 is runs through a handle 3904 attached to
nozzle 3901.
In some embodiments, flow 3911 substantially remains in contact with the
nozzle lumen wall (e.g. flowing within 5mm of, or within 2mm of, or within lmm
of, or
within 0.5 mm of, or within 0.1mm of or within 0.01mm, of the walls or
smaller, or
larger, or intermediate measurements. In some embodiments, flow 3911 exits
nozzle
3901 through a nozzle outlet (also termed nozzle exit aperture) 3913.
Optionally, nozzle 3901 includes a narrow, needle like tip 3915, e.g. with a
diameter of, for example, less than 5mm, or less than 2mm, or less than lmm,
or less
than 0.5mm, or less than 0.2mm, or less than 0.1mm, or less than 0.05mm, or
less than
0.01mm. Alternatively, in some embodiments, nozzle tip 3915 is larger e.g.
with a
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diameter of more than 0.5mm, or more than lmm, or more than 2mm, or more than
5mm, or more than lOmm.
Optionally, at least a portion of an inner surface of nozzle lumen walls 3916
is
textured (e.g. grooved), potentially assisting and/or enabling helical flow of
the fluid. In
some embodiments, grooves are helical and/or spiral downward towards nozzle
outlet
3913. In some embodiments, grooves are other than helical, for example in some
embodiments, grooves form a double helix, in some embodiments grooves form two
opposing helixes. Optionally, in some embodiments, nozzle outlet 3913 is
textured (e.g.
grooved) potentially assisting and/or enabling helical flow of the fluid as it
exits
through outlet 3913.
In some embodiments, helical and/or spinning and/or rotating of the flow
within
the nozzle results in emission from the nozzle outlet of angled fluid jet/s.
Optionally, nozzle 3901 includes one or more inlet through which material is
removed from the tooth, e.g. by suction. In an exemplary embodiment, nozzle
3901
includes a suction cone 3917 which, in some embodiments, is a structure
(optionally
cone-shaped) at least partially surrounding the nozzle lumen walls where there
is a
lumen 3921 (optionally cone shaped) between the nozzle lumen walls 3916 and
suction
cone 3917. In some embodiments, lumen 3921 connects to an extraction pipe 3923
within handle 3904 and suction of material through inlets 3919a, 3919b is
applied by
pressure reduction at extraction pipe 3923 (e.g. using a pump connected to
extraction
pipe 3923).
Figure 39B is a simplified schematic cross sectional view of a nozzle 3901
lacking an internal cone, according to some embodiments of the invention.
Figure 39B
shows a cross section perpendicular to the cross section illustrated in Figure
39A taken
along the line A-A illustrated on Figure 39A. In some embodiments, as
illustrated in
Figure 39B, the portion of pipe 3903 which extends into nozzle lumen 3911 is
curved
and/or bent, for example, bending so that the pipe is in close proximity to
nozzle lumen
walls 3916.
In some embodiments, one or more inlet into a nozzle lumen moves, for
example, rotates. Figure 40A is a simplified schematic cross sectional view of
a nozzle
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4001 including a rotating inlet element 4005, according to some embodiments of
the
invention.
In some embodiments, fluid is inserted into a nozzle through a rotating inlet
element 4005. In some embodiments, rotating inlet element 4005 includes one or
more
exit aperture (e.g. two exit apertures 4023) through which fluid is inserted
into a nozzle
lumen 4007. In some embodiments, each exit aperture 4023 is located on a
rotating inlet
element arm 4025. In some embodiments, fluid (e.g. including one or more of
liquid,
gas (e.g. air), abrasive powder, disinfection component/s, and flushing fluid)
is supplied
to rotating inlet element 4005 through a pipe 4003 connected to rotating inlet
element
4005. In some embodiments, pipe 4003 runs through a handle 4037 connected to
the
nozzle 4001.
In some embodiments rotating inlet element 4005 is disposed within a nozzle
lumen 4007 where the lumen is a space between an inner cone 4019 and an outer
cone
including nozzle lumen walls 4021. In some embodiments, nozzle 4001 includes a
nozzle tip 4041 through which fluid is discharged. Alternatively, the nozzle
does not
include an inner lumen and the rotating element is disposed inside a nozzle
lumen
defined by nozzle lumen walls 4021.
In some embodiments, rotation and/or movement of rotating element 4005
and/or the shape of the conical lumen causes the fluid to flow in a rotating
and/or helical
downwards motion.
In some embodiments, rotating element 4005 and fluid flow within the nozzle is
not exposed to the atmosphere, a potential benefit being that fluid flowing
through the
nozzle is not exposed to the atmosphere, for example, preventing degradation
of the
fluid and/or component/s of the fluid e.g. by exposure to atmospheric
contaminants such
as dirt, bacteria, e.g. by exposure of reactive component/s to atmospheric
oxygen.
In some embodiments of the invention, momentum, potentially including
angular momentum, is transferred from the motion of the rotating element 4005
to the
working fluid passing through lumen 4007 before it is ejected from nozzle. In
some
embodiments, fluid ejected from the nozzle is spinning/rotating/has helical
flow.
Potentially, fluid exiting the nozzle does so at an angle which is broadened
by
the tangential component of its momentum at the exit aperture of the nozzle.
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Optionally, in some embodiments, nozzle 4001 includes one or more additional
pipe, e.g. a second pipe 4003a through which air flows into an air turbine
4043. In some
embodiments, rotating inlet element 4005 is rotated by air turbine 4043.
Alternatively,
rotating inlet element 4005 is rotated by mechanical and/or electrical means
e.g. by a
stepper motor connected to the rotating inlet element.
Optionally, in some embodiments, a second material is inserted into lumen
4007. In some embodiments, the second material is air and/or pressurized gas
(e.g.
pressurized air) which optionally pushes fluid towards a nozzle outlet 4015.
Optionally,
movement and/or rotation of rotating inlet element 4005 mixes the second
material with
the fluid inserted through pipe 4003.
Optionally, in some embodiments, an additional pipe, a third pipe 4003b
inserts
material and/or fluid into a second conical lumen 4029. In some embodiments,
third
pipe discharges disinfecting fluid and/or flushing fluid.
Optionally, nozzle 4001 includes one or more inlet through which material is
removed from the tooth, e.g. by suction. In an exemplary embodiment, nozzle
4001
includes a suction cone 4017 which, in some embodiments, is a structure
(optionally
cone-shaped) at least partially surrounding the nozzle lumen walls 4021 where
there is a
lumen 4031 between nozzle lumen walls 4021 and suction cone 4017 through which
material is extracted. In some embodiments, lumen 4031 connects to an
extraction pipe
4033 within handle 4037 and suction of material is by pressure reduction at
extraction
pipe 4033 (e.g. using a pump connected to extraction pipe 4033).
In some embodiments, suction of material from the root canal reduces pressure
in a root canal apex and/or an apical area (portion of the root canal proximal
to the
apex).
In some embodiments, movement of nozzle parts, for example, movement of the
internal cone, is manual e.g. where a user manually moves one or more part
(e.g. by
pressing a button).
In some embodiments, suction can be used to control an extent of rotation
and/or
fluid within a root canal. For example, in some embodiments, increased suction
reduces
a length and/or strength (e.g. velocity of flow) of a water column within the
root canal.
Figures 40B-40C are simplified schematic cross sectional views of a nozzle
including a rotating inlet element 4005, according to some embodiments of the
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invention. Figures 40B and Figure 40C show cross sections perpendicular to the
cross
section illustrated in Figure 40A taken along the line A-A and line B-B
illustrated on
Figure 40A respectively. In some embodiments, as illustrated in Figure 40C,
lumen
4007 is optionally divided by one or more divider 4035 for dividing the flow
through
5 lumen 4007. Optionally, in some embodiments, dividers are located along
the length of
lumen 4007.
In some embodiments, a rotating element mixes and/or agitates fluid flowing
through a nozzle lumen. Figure 41 is a simplified schematic cross section of a
nozzle
10 4101 including a rotating element 4105, according to some embodiments of
the
invention.
In some embodiments, rotating element 4105 rotates 4141 around a rotating
element long axis. In some embodiments, rotating element 4105 includes one or
more
protruding element, e.g. blades 4119. In some embodiments, blades have a
flattened
15 shape, for example, where a thickness of the blade is less than half, or
a quarter, or a
tenth or smaller, larger or intermediate proportions, of a length and/or a
depth of the
blade. In some embodiments, the blades provide a large surface area of contact
between
the rotating element and fluid flowing through the nozzle, potentially
increasing energy
and/or momentum transfer between the rotating element and the fluid.
20 In some
embodiments, the blade/s are shaped such that the blades push and/or
pump the fluid through the nozzle toward a nozzle exit aperture 4121, for
example, the
rotating element acts as an impellor. For example, in some embodiments, one or
more
blade is at an angle to a vertical axis of the nozzle where a length-depth
plane of the
blade is at an angle to the vertical axis of the nozzle e.g. by at least 2
degrees, or 10
25 degrees, or 25 degrees, or 45 degrees, or 90 degrees, or smaller, or
larger, or
intermediate angles.
In some embodiments, fluid (e.g. including one or more of liquid, air,
abrasive
powder, disinfection component/s) is inserted into the lumen through a fluid
pipe 4103.
In some embodiments, rotating element is rotated by an air turbine 4123 where
30 air is supplied to the turbine through a second pipe 4103a.
In some embodiments, a second material, for example, air and/or another gas is
inserted into the lumen through pipe 4103. In some embodiments, pressurized
material
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inserted through pipe 4103 (e.g. pressurized air) pushes fluid inside lumen
4143 towards
outlet 4121 and/or rotating element blades 4119.
In some embodiments, movement of rotating element 4105 mixes material
inserted into nozzle lumen 4143. For example, mixing fluid inserted through
pipe 4103.
For example, in some embodiments, materials are inserted separately, e.g.
through pipe 4103 where different materials are inserted in alternative
pulses, e.g.
through pipe 4103 and optionally through additional pipe/s.
In some embodiments, helical and/or spinning and/or rotating of the flow
within
the nozzle results in emission from the nozzle outlet of angled fluid jet/s.
A potential benefit of mixing materials within a nozzle lumen is that the
materials are not exposed to the atmosphere, for example, preventing
degradation of the
materials e.g. by exposure to atmospheric contaminants such as dirt, bacteria,
e.g. by
exposure of reactive materials to atmospheric oxygen.
Optionally, nozzle 4101 includes one or more inlet through which material is
removed from the tooth, e.g. by suction. In an exemplary embodiment, nozzle
4101
includes a suction cone 4117 which, in some embodiments, is a structure
(optionally
cone-shaped) at least partially surrounding the nozzle lumen walls 4121 where
there is a
lumen 4131 between nozzle lumen walls 4121 and suction cone 4117 through which
material is extracted. In some embodiments, lumen 4131 connects to an
extraction pipe
4133 within handle 4125 and suction of material is by pressure reduction at
extraction
pipe 4133 (e.g. using a pump connected to extraction pipe 4133).
Optionally, rotating element 4105 includes a hollow portion through which
material is inserted into lumen 4143.
Optionally, nozzle 4101 does not include an internal cone.
Additionally and/or alternatively, rotating element 4105 moves within lumen
4143, e.g. proximally-distally.
In some embodiments, nozzle 4101 includes a nozzle tip 4145 through which
fluid is discharged.
In some embodiments the pressure in apical area and apex is controlled (e.g.
kept low), for example, by spreading or dividing the flow of fluid. In some
embodiments, fluid is discharged into a root canal such that the fluid does
not directly
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impact the apex and/or apical area. For example, in some embodiments, fluid is
discharged such that fluid hits a wall of the root canal above (coronal) an
apical area of
the root canal. For example, in some embodiments, fluid is discharged at an
angle at
least 10 degrees, or at least 30 degrees, or at least 90 degrees from an angle
of a straight
line connecting a discharge point of the fluid from the nozzle and the apex.
A potential benefit of helical flow of fluid within a root canal is that fluid
is less
likely to directly impact the apex and/or apical region, for example, in a
time period at a
beginning of a treatment and/or at a beginning of discharging of fluid (e.g.
the first 0.1s,
0.5s, or is, or 5s or higher, lower or intermediate times) into a root canal
before the root
canal fills with fluid. In some embodiments, a root canal is filled with fluid
e.g.
manually and/or through the nozzle (e.g. at a low speed and/or pressure and/or
flow
rate) potentially protecting the apex.
In some embodiments, a needle tip 4241 including a needle tip lumen which
increases in cross sectional area distally towards a nozzle aperture 4243. The
liquid
exiting from the nozzle through tip 4241 exits with a wide angle of, for
example, 20-70
degrees, or lower, or higher, or intermediate angles, flowing and filling the
root canal
e.g. from the apex of the canal upward (coronal), with wide angle of flow,
meaning that
the pressure of the flow is divided along the wall surface e.g. as a non-
direct flow.
In some embodiments, pulsed suction and/or discharging reduces pressure of
fluid flow at the apex and/or apical area e.g. fluid is extracted before it
reaches the apex
and/or apical area. In some embodiments, for example, due to the narrow space
in the
apical area pressure reduction from suction is more rapid than in the
remainder of the
root canal (e.g. at 1.5x the rate, or at double the rate, or at triple the
rate).
Figure 42A is a simplified schematic cross sectional view of a nozzle 4201
treating a root canal 4203, controlling apical parameters, according to some
embodiments of the invention. Figure 42B is an enlarged view of a portion of
Figure
42A.
In some embodiments, flow of fluid within a root canal is controlled and/or
balanced by control of insertion of fluid into the root canal and suction of
material from
the root canal. In some embodiments, depth of penetration (e.g. to the apex,
e.g. not past
the apex in the apical direction) of flow into the root canal is controlled.
In some
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embodiments, pressure of flow and/or amount of abrasion at an apex of a root
canal is
controlled.
In some embodiments, pressure inside a root canal is controlled and/or
balanced,
for example, by controlling insertion of fluid into the root canal (increasing
pressure in
the canal) and suction of material from a root canal (decreasing pressure in
the canal).
In some embodiments, rhythms and/or durations of pulses of insertion (jetting)
and/or
suction control pressure in the canal e.g. with suction and jetting
independently and/or
simultaneously, e.g. with suction and/or jetting periodically.
A potential benefit of controlling pressure within the canal is the ability to
control pressure at the root canal apex e.g. reducing pressure at the apex,
e.g. potentially
preventing rupture of the tooth e.g. at the root canal apex.
In some embodiments, suction and/or insertion of fluid is controlled to reduce
pressure inside the root canal e.g. at and/or including pressure at the apex
of the root
canal. A potential benefit of reduced pressure within the root canal is a
reduction in risk
of breaking and/or rupturing the root canal and/or tooth.
In some embodiments, the root canal is sealed such that material can only
enter
or exit the root canal through a nozzle (e.g. the root canal is sealed at a
coronal opening
of the root canal). In some embodiments, control of pressure within the canal
is
enhanced by sealing of the root canal. In some embodiments, sealing of the
root canal
enables the nozzle to apply higher and/or lower pressures to the root canal.
In some embodiments, a nozzle 4201 and a sealing element 4207 are placed at
an entrance to a root canal 4203, sealing the root canal, for example, only
allowing
movement of material in and out of the root canal through nozzle 4201 (e.g.
only
allowing movement of material out of the root canal through a suction cone
4217).
In some embodiments, sealing element 4207 surrounds the nozzle, for example,
is ring-shaped. In an exemplary embodiment, the sealing element includes
rubber e.g.
silicone rubber. In some embodiments, sealing element 4207 is a separate
component.
In some embodiments, sealing element is coupled to and/or forms part of the
nozzle.
In some embodiments, nozzle 4201 introduces fluid (e.g. fluid jet/s optionally
including air and/or abrasive material) into the root canal 4203, for example,
to clean
the root canal. In some embodiments, nozzle 4201 includes a suction cone 4217
which
extracts material through channel 4235, where suction cone inlets 4239 are
apical of
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sealing element 4207. In some embodiments, a cross sectional area of a nozzle
tip 4241
enlarges distally.
In some embodiments, the jet does not flow straight downwards towards the
apex of the root canal e.g. the jet flows along the canal walls cleaning the
walls. In some
embodiments, one or more jet meets the root canal wall at an angle of 20-45
degrees, or
30-45 degrees to the root canal wall. Jet flow along the wall potentially
reduces pressure
at the apex, for example, as pressure of the jet is spread over a surface of
the root canal
wall.
Figure 42C is a simplified schematic cross sectional view of a nozzle
surrounded by a sealing element 4207, according to some embodiments of the
invention. Figure 42C shows a cross section perpendicular to the cross section
illustrated in Figure 42A taken along the line A-A illustrated on Figure 42A.
Visible in
Figure 42C is sealing element 4207 surrounding the nozzle. Also visible is a
nozzle
inner cone 4245.
Optionally, nozzle 4201 includes an internal cone with a lumen e.g. as
illustrated
in Figure 31A.
In some embodiments, nozzle 4201 includes a pipe 4231 for supplying fluid to a
nozzle lumen 4237.
In some embodiments, a wide or fan-like beam of fluid is discharged. For
example, a wide or fan-like beam is discharged from a nozzle tip where a tip
lumen
cross sectional areal (perpendicular to nozzle tip long axis) increases
distally. For
example, a wide or fan-like beam where the beam broadens as a distance between
the
beam and nozzle exit aperture increases e.g. at least doubles in cross
sectional area
(cross section perpendicular to nozzle vertical axis) at 0.01 mm, or 0.1mm, or
0.5mm.
or lmm. or lmm. or 5mm from the nozzle exit aperture.
In some embodiments, a wide and/or fan-like beam has lower pressure.
Potentially reducing pressure at a root canal apex or apical area.
In some embodiments, the lumen walls and/or the internal cone include a hollow
portion, for example, increasing a length of a path of fluid within the
nozzle.
Figure 43A is a simplified schematic side view of a nozzle 4301 including an
external cone 4305 with a hollow portion 4303 and an internal cone 4311 with a
hollow
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portion 4309, according to some embodiments of the invention. Figure 43B is a
simplified schematic cross sectional view of a nozzle 4301 including external
cone 4305
with a hollow portion and an internal cone 4311 with a hollow portion,
according to
some embodiments of the invention. Figure 43B shows a cross section
perpendicular to
5 the
cross section illustrated in Figure 43B taken along the line A-A illustrated
on Figure
43A.
In some embodiments, external cone 4305 includes hollow walls and internal
cone 4311 includes hollow walls: A first lumen 4303 is within external cone
4305 and a
second lumen 4309 is within internal cone walls 4311.
10 In some
embodiments, internal cone 4311 is smaller than and located within a
lumen within external cone, forming a third lumen 4350 in the space between
the
external cone and the internal cone. In some embodiments, internal cone 4311
includes
a fourth lumen 4315. In some embodiments, an additional internal cone 4311a is
located
inside internal cone 4311.
15
Referring now to Figure 43B, In some embodiments, external cone and/or
internal cone 4311 rotate, for example, to increase energy and/or momentum of
discharged fluid from the nozzle (e.g. to enhance rotation of fluid within the
root canal
and/or enhance cleaning of the root canal). Optionally, external cone 4305 and
internal
cone 4311 rotate at different times and/or with different speeds and/or with
different
20
direction of rotation, for example, to increase mixing of the fluid from the
internal and
external cone when the flows meet.
In some embodiments, fluid is inserted into lumens 4303, 4309 is supplied by
pipes 4303p, 4309p respectively.
Referring now to Figure 43B, fluid inserted into the hollow portion of the
inner
25 cone
(lumen 4309) flows radially and/or helically through the hollow portion of
inner
cone to the lumen between the inner cone and the additional inner cone (lumen
4315).
Fluid inserted into the hollow portion of the external cone (lumen 4303) flows
radially
and/ or helically through the hollow portion of external cone to the lumen
between the
external cone and the inner cone (lumen 4305).
30 In some
embodiments, flows emerging from lumens 4350 and 4315 merge
and/or mix in a central lumen 4345 before being discharged.
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In some embodiments, fluid is inserted into lumens 4303, 4309 concurrently
and/or in a pulse pattern e.g. where material is inserted into one or more
lumen
intermittently. In some embodiments, fluid inserted into lumens 4303, 4309
combines
and/or mixes adjacent to a nozzle tip 4319.
Optionally, nozzle 4301 includes one or more lumen 4317 through which fluid
is extracted.
Optionally, nozzle 4301 includes an additional cone 4319 external to external
cone 4305, and fluid from pipe 4341 (e.g. flushing and/or disinfecting fluid)
is inserted
into the tooth through a lumen 4343 between additional cone 4319 and external
cone
4305.
In some embodiments, fluid flows through one or more lumen with helical
movement. In some embodiments, rotation of the cone/s and/or a shape of the
lumen/s
causes emission from the nozzle outlet of angled fluid jet/s and/or a flow
with helical
flow.
In some embodiments, a system for cleaning and/or abrading a root canal
operates without an external compressor. In some embodiments, the system
includes
one or more pressurized container.
Figure 44 is a simplified schematic cross sectional view of a system including
a
supply apparatus 4403 connected to a nozzle 4401, according some embodiments
of the
invention.
In some embodiments, a supply apparatus is disposable and/or includes one or
more disposable part. In some embodiments, a supply apparatus including one or
more
chamber containing pressurized gas, is located within a handle connected to a
nozzle,
forming a hand held endodontic cleaning device. A potential benefit being high
portability and/or maneuverability of the device and/or a cleaning device
which operates
without any other infrastructure (e.g. compressor and/or external power
supply).
Alternatively, in some embodiments, a supply apparatus is not located in the
handle, e.g. supply apparatus includes a standing box.
In an exemplary embodiment, supply apparatus 4403 includes a first chamber
4405 which holds pressurized gas and fluid 4405a. Optionally, the chamber
comprises a
predefined amount of gas and fluid, for example suitable for performing 1, 3,
5, 10, 20,
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50, 100 or another number of treatments. Upon opening first chamber 4405, the
pressurized gas forces dispensing of fluid from the chamber (operation e.g.
similar to an
aerosol canister). In some embodiments, the gas includes air and/or CO2.
In some embodiments, the chamber is opened by pressing a button 4407 which
opens a valve 4409 between first chamber 4405 and a second chamber 4411 and
opens a
second valve 4413. In some embodiment, button 4407 is connected to a rod 4447
which
pushes element 4449 towards valve 4409, opening valve 4409. In some
embodiments,
second chamber is enclosed inside a housing 4441. In some embodiments, pushing
button 4407 compresses a spring 4445. In some embodiments, spring 4445 returns
button 4407 to an original position after the button is released.
In some embodiments, second chamber 4411 holds abrasive powder and
optionally pressurized gas. Optionally, the chamber comprises a predefined
amount of
abrasive powder and/or fluid, for example suitable for performing 1, 3, 5, 10,
20, 50,
100 or another number of treatments. Gas and fluid flow from first chamber
4405
through second chamber 4411, collecting and/or mixing (optionally, mixing
uniformly)
with abrasive material from second chamber 4411. The fluid mixture of gas,
fluid and
abrasive material then travels through pipe 4415 to a handle 4417 connected to
nozzle
4401. Optionally, in some embodiments (e.g. so that the user can switch the
flow on and
off at a location near to the nozzle) flow through handle 4417 (e.g. passing
through a
pipe 4453 in handle 4417) is upon activation of the handle, e.g. by sliding a
switch 4419
on the handle to an on position. The fluid mixture then flows through the
nozzle,
passing through a nozzle tip 4457, and is discharged through a nozzle exit
aperture
4459. In some embodiments, nozzle 4401 includes outer walls 4455.
In some embodiments, pressure inside one or both chambers 4405, 4411 is 100-
120 PSI, or 50 ¨ 200 PSI or higher, or lower or intermediate pressure ranges
or values.
In some embodiments, a starting pressure of the first chamber is sufficient to
dispense
all of the fluid within the first chamber. In some embodiments, as a chamber
empties a
chamber size is reduced (e.g. second chamber moves towards first chamber) so
that a
chamber internal pressure is maintained.
In some embodiments, a ratio of gas to fluid within first chamber 4405 is 75%
air 25% fluid, or 50% fluid 20% air, or 90% air 60%, or lower, higher or
intermediate
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ratios. In some embodiments, the fluid mixture dispensed from supply apparatus
through pipe 4415 includes 3-5% abrasive material (e.g. abrasive powder).
In some embodiments, the supply apparatus is and/or includes a part (e.g. a
chamber) which is designed for single use, for example the apparatus or part
is disposed
after a single treatment. Alternatively, the supply apparatus and/or a part of
the supply
apparatus contains sufficient materials for 1, or 2, or 3, or 4, or 5, or, 10,
or 50, or 100
treatments, or lower, or higher, or intermediate numbers of treatments.
In some embodiments, the supply apparatus weighs 20g-3kg, or 50g-lkg, or
50g-500g, or 50g-200g, or lower, higher or intermediate weights. In some
embodiments, the supply apparatus is light enough so that it can be maneuvered
by a
user e.g. with one hand.
Optionally, in some embodiments, one or more chamber is refilled when empty.
In some embodiments, one or more chamber and/or the supply apparatus is
changed
when empty and/or between treatments and/or between patients. A potential
advantage
of a supply apparatus operating using pressurized gas is that the nozzle need
not be
connected to a compressor and/or electricity supply.
Optionally, in some embodiments, a supply apparatus includes less than or more
than two chambers, each chamber including one or more of gas, fluid, abrasive
powder,
and disinfecting material.
In some embodiments, two or more flows of material mix within a lumen of a
nozzle, e.g. before discharge of the mixed flow into a root canal. In some
embodiments,
flows which mix inside the lumen of the nozzle are supplied by a supply
apparatus
including more than one pressurized chamber.
Figure 45 is a simplified schematic cross sectional view of a supply apparatus
4503 supplying two separate flows to a nozzle 4501, according to some
embodiments of
the invention.
In an exemplary embodiment, supply apparatus 4503 includes two chambers
supplying two flows of material to the nozzle, for example, through two
separate
channels (e.g. pipes) which connect the chambers to the nozzle. In some
embodiments,
pressure within one or more chamber is 100-120 PSI, or 50 ¨ 200 PSI or higher,
or
lower or intermediate pressure ranges or values.
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In some embodiments, a first chamber 4505 contains pressurized gas (e.g. air)
and a second chamber 4507 contains pressurized gas and fluid. In some
embodiments,
activating first chamber 4505, for example by pressing on first button 4509
opens the
chamber (e.g. by opening a first chamber valve 4511) allowing flow of air from
first
chamber 4505 (optionally through a pipe 4541) through valve 4511 into chamber
4549,
and then to exit chamber 4549 through an opening 4547 connected to first pipe
4513.
In some embodiments, first button 4509 is attached to a rod 4553 and pushing
the first button pushes element 4545 towards valve 4511, opening the valve.
Flow then flows through a powder cartridge 4573 optionally located in a nozzle
handle 4570 and passes to the nozzle 4501. The powder and air mix with fluid
in a
lumen 4501a of nozzle 4501. Fluid in lumen 4501a flows through nozzle, and
through a
nozzle tip 4569 before being discharged through nozzle exit aperture 4567.
In some embodiments, pressing on a second button 4517 opens a second
chamber valve 4519, allowing flow of air and fluid from second chamber 4507
(optionally through a pipe 4565) to flow into chamber 4559 and then to pass
through
opening 4557 connected to a second pipe 4521, and then through a pipe 4515 in
handle
4570 to the nozzle lumen mixing with the abrasive powder and air in the nozzle
lumen.
Optionally, one or more flow is controlled by an activation element (e.g.
slide switch
4523) on the handle. Optionally, one or more of the flows passes through a
powder
cartridge 4573 (optionally located in the handle), collecting and/or mixing
with abrasive
material which the flow then carries to the nozzle lumen.
In some embodiments, second button 4517 is attached to a rod 4579 and pushing
second button 4517 pushes an element 4561 towards valve 4519, opening the
valve. In
some embodiments, pipes 4513 and 4521 can be closed by valves 4551 and 4577
respectively. In some embodiments, the chambers include a housing 4543.
In some embodiments, more than two flows emanating from more than one
chamber mix within the nozzle where each chamber contains one or more of gas,
fluid,
abrasive powder, and disinfecting material.
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Experimental Examples
Reference is now made to the following examples, which together with the
above descriptions illustrate some embodiments of the invention in a non
limiting
fashion.
An experiment for testing the feasibility of an apparatus and method for
endodontic treatment using angled fluid jets
The inventors conducted an experiment for testing the feasibility of a system
which comprises an apparatus for cleaning, abrading, and/or disinfecting a
root canal as
described above.
Experimental design
41 human teeth specimens were extracted from patients. The specimens included
a group of molars having 2-4 root canals, and a group of incisors having a
single root
canal. In total, 182 root canals were tested in the experiment. Each tooth
specimen had
one or various types of root canals, as indicated below.
5 types of root canals were tested: a standard root canal (53 specimens), a
curved
root canal (40 specimens), a sharp curved root canal (32 specimens), a root
canal with
an enlarged opening at the apex, ranging between 2-3 mm, which was created
naturally
as a result of calcification (33 specimens), and specimens with an extremely
narrow root
canal (24).
11 teeth specimens having 2-3 root canals each were extremely narrow, having
an entrance aperture with a diameter smaller than 0.5 mm.
Immediately after the extraction, the specimens were placed in a 10% bleach
solution, containing 10% chlorine and 90% water, (other solutions may also be
used), to
prevent dehydration of the root canals.
The following procedure was performed for each specimen. At first, an access
cavity was drilled through the crown of the tooth to enable access through the
pulp
chamber to the root canal. An entrance to the root canal was exposed, and the
specimen
was placed back in the bleach solution. The specimen was then removed from the
solution, and placed in a rubber mold. At this stage, the specimen was imaged
using a
320 slices CT imaging device. Optionally, other imaging devices may be used.
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An apparatus and system for example as described in figure 8 above were used
for cleaning, abrading, and disinfecting each of the specimens. A nozzle of
the
apparatus was inserted through the pulp chamber and positioned such that an
exit
aperture of the nozzle was configured vertically above the entrance to a root
canal, at an
approximate distance of 1-3 mm.
The fluid used for the treatment of the root canals contained water, air, and
glass
powder (used as an abrasive powder). The pressures used were a water pressure
of 80
PSI, and an air pressure of 80 PSI. The fluid passed through the pipeline of
the system,
for example through pipes in the handle of the apparatus, reaching the nozzle
and
exiting through the exit aperture in the form of angled fluid jets, as
previously
described.
Cleaning, abrading and disinfecting of the root canal of each specimen was
achieved by the flow of fluid advancing along the root canal wall, removing
organic
substance such as nerve tissue, pulp tissue, and/or debris, as previously
described.
The treatment duration for each of the specimens was determined according to
parameters such as the existence of a narrowing portion, the existence of
curvature, the
length of the root canal, and/or other parameters or combinations of them. The
treatment
duration used in this experiment was 15 seconds (applied to 13 specimens), 30
seconds
(applied to 15 specimens), and 45 seconds (applied to 13 specimens).
Optionally, other
durations may be used.
Imaging of each specimen using a 320 slices CT imaging device was performed
again at the end of the process.
Each specimen was tested for apex penetration (referred to in this example as
further widening of a natural, normal opening of the apex), grade of apex
penetration (if
occurred), penetration along the canal wall, and the thickness of the eroded
layer.
To prove that the root canals of the specimen are clean, an electro- scan
microscope image was acquired from each specimen, as will be further
explained.
Data analysis and results
Figure 16A-B is a table of the experiment results. The table shows that in all
tested root canals, the apex was not penetrated (i.e. an initial natural
opening was not
widened). The table also shows that in all tested root canals, the root canal
wall was not
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penetrated as well. The thickness of the removed dentin layer ranged between
100-200
p.m for all tested root canals.
Figure 17 shows an image of the dentin layer and dentinal tubules of one of
the
specimens, taken at the end of the experiment described above. This image was
taken
by an electro scan microscope, using a magnification of x5000.
Before acquiring the image, the specimen was stored in the bleach solution.
Once the specimen was removed from the solution, it was sliced along a
longitudinal
cross section, to expose the internal lumen of the root canal. This exemplary
image
shows that the dentin layer 1701 and the tubules 1703 shave been cleaned and
cleared
by the flow of fluid, and do not have a smear layer.
General
It is expected that during the life of a patent maturing from this application
many
relevant endodontic apparatuses will be developed and the scope of the term
endodontic
apparatuses is intended to include all such new technologies a priori.
The terms "comprises", "comprising", "includes", "including", "having" and
their conjugates mean "including but not limited to".
The term "consisting of' means "including and limited to".
The term "consisting essentially of' means that the composition, method or
structure may include additional ingredients, steps and/or parts, but only if
the
additional ingredients, steps and/or parts do not materially alter the basic
and novel
characteristics of the claimed composition, method or structure.
As used herein, the singular form "a", "an" and "the" include plural
references
unless the context clearly dictates otherwise. For example, the term "a
compound" or
"at least one compound" may include a plurality of compounds, including
mixtures
thereof.
Throughout this application, various embodiments of this invention may be
presented in a range format. It should be understood that the description in
range format
is merely for convenience and brevity and should not be construed as an
inflexible
limitation on the scope of the invention. Accordingly, the description of a
range should
be considered to have specifically disclosed all the possible subranges as
well as
individual numerical values within that range. For example, description of a
range such
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as from 1 to 6 should be considered to have specifically disclosed subranges
such as
from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6
etc., as well
as individual numbers within that range, for example, 1, 2, 3, 4, 5, and 6.
This applies
regardless of the breadth of the range.
Whenever a numerical range is indicated herein, it is meant to include
any cited numeral (fractional or integral) within the indicated range. The
phrases
"ranging/ranges between" a first indicate number and a second indicate number
and
"ranging/ranges from" a first indicate number "to" a second indicate number
are used
herein interchangeably and are meant to include the first and second indicated
numbers
and all the fractional and integral numerals therebetween.
As used herein the term "method" refers to manners, means, techniques and
procedures for accomplishing a given task including, but not limited to, those
manners,
means, techniques and procedures either known to, or readily developed from
known
manners, means, techniques and procedures by practitioners of the chemical,
pharmacological, biological, biochemical and medical arts.
As used herein, the term "treating" includes abrogating, substantially
inhibiting,
slowing or reversing the progression of a condition, substantially
ameliorating clinical
or aesthetical symptoms of a condition or substantially preventing the
appearance of
clinical or aesthetical symptoms of a condition.
It is appreciated that certain features of the invention, which are, for
clarity,
described in the context of separate embodiments, may also be provided in
combination
in a single embodiment. Conversely, various features of the invention, which
are, for
brevity, described in the context of a single embodiment, may also be provided
separately or in any suitable subcombination or as suitable in any other
described
embodiment of the invention. Certain features described in the context of
various
embodiments are not to be considered essential features of those embodiments,
unless
the embodiment is inoperative without those elements.
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Various embodiments and aspects of the present invention as delineated
hereinabove and as claimed in the claims section below find experimental
support in the
examples.
Although the invention has been described in conjunction with specific
embodiments thereof, it is evident that many alternatives, modifications and
variations
will be apparent to those skilled in the art. Accordingly, it is intended to
embrace all
such alternatives, modifications and variations that fall within the spirit
and broad scope
of the appended claims.
All publications, patents and patent applications mentioned in this
specification
are herein incorporated in their entirety by reference into the specification,
to the same
extent as if each individual publication, patent or patent application was
specifically and
individually indicated to be incorporated herein by reference. In addition,
citation or
identification of any reference in this application shall not be construed as
an admission
that such reference is available as prior art to the present invention. To the
extent that
section headings are used, they should not be construed as necessarily
limiting.
