WO2018227094A1

WO2018227094A1 - Tooth or tooth replica holding sleeve for use with an paex locator

Info

Publication number: WO2018227094A1
Application number: PCT/US2018/036666
Authority: WO
Inventors: Stephen L. Buchanan
Original assignee: Buchanan Stephen L
Priority date: 2017-06-08
Filing date: 2018-06-08
Publication date: 2018-12-13

Abstract

Embodiments of this disclosure include a tooth holding sleeve (4) having a tooth holding socket (20), a conductive gel cavity (11) located below the tooth holding socket (20), and a passageway (10) extending from an outer wall (22) of the tooth holding sleeve (4) to the conductive gel cavity (11). Conductive gel may be injected into the passageway (10) to the gel cavity (11) and a ground rod (8) may be inserted into the passageway (10) to complete a circuit with an apex locator lead (7). The tooth holding sleeve (4) may also include a calibration sphere cavity (21 ) with a passageway (17) leading to it. The sleeve (4) may removeably or permanently retain a tooth or tooth replica (3). The tooth replica (3) may be 3D printed replica including an anatomical challenge encountered in human tooth anatomy. The printed replica may also include a radio opaque ink. A graphical or pictorial array of procedural outcomes ranging from best to worst may be provided for comparison and self-assessment.

Description

TOOTH OR TOOTH REPLICA HOLDING SLEEVE FOR USE WITH AN APEX LOCATOR BACKGROUND

This disclosure is in the field of dental testing and training using tooth replicas that have a predetermined anatomic form of at least one human tooth structure, including a root canal system.

SUMMARY

Embodiments of this disclosure include at least one tooth holding sleeve housing a socket located an upper end of the sleeve and sized to receive a tooth and hold it in place; a cavity located below, and in fluid communication with, the socket; and at least one passageway in fluid communication with the cavity. The sleeve may also house a calibration sphere cavity and include a passageway that leads to it.

The tooth may be a 3D-printed tooth replica that simulates human dentin structure. In some embodiments, the tooth replica includes an area of decay. Depending on whether training, practice, or testing is involved, the tooth or tooth replica can be removably inserted or permanently embedded in the sleeve. When permanently embedded, the sleeve and tooth combination may include a unique identification number that provides tracking for testing purposes.

The tooth replica also may be 3D printed using an ink that includes a radio opaque additive. A ceramic material may be placed over the replica to simulate a crown. When in use the tooth holding sleeve is arranged as part of a dental jig such as a typodont module.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an embodiment of a system and method of dental testing and training that includes a replica sleeve for use with an apex locator. The sleeve, along with the tooth replica, can be made of a radio opaque material. FIG. 2A is an embodiment of the replica sleeve that includes a first half and a second half that are mirror images of one another and separable from one another. The replica sleeve includes a socket located at an uppermost end and sized to securely receive and hold a tooth, a cavity located below the socket for receiving a conductive gel, and at least one passageway in fluid communication with the cavity. At least an apical portion of a tooth received by the socket contacts the gel housed by the cavity.

FIG. 2B is an embodiment of the replica sleeve illustrating the two halves receiving a tooth replica prior to insertion into a dental typodont module.

FIG. 2C is an embodiment of the replica sleeve when inserted into the dental typodont module.

FIG. 3A is an embodiment illustrating a syringe with conductive gel inserted into the first passageway. After the cavity is filled with the conductive gel, an apex locator ground lead is inserted into the first passageway. A second passageway to the cavity may be located on a side opposite that of the first passageway.

FIG. 3B is an embodiment illustrating the apex locator file ground lead inserted into the first passageway. An endodontic file that is connected to an apex locator file lead is inserted into the tooth replica.

FIG. 4A is an embodiment of a one-piece replica sleeve with a tooth replica embedded it in for testing purposes. The replica sleeve and tooth combination comes with a unique identification number embedded on the sleeve.

FIG. 4B is an embodiment of the replica sleeve of FIG. 4A inserted into a dental typodont module.

FIG. 5 an enlarged view of a replica sleeve with an embedded tooth replica for testing purposes. Another cavity of the sleeve houses a metal sphere for calibration purposes. FIG. 6 A is an x-ray of an embodiment including a milled or molded crown on the tooth replica, showing the apical cavity, passageway for conductive gel, and a calibration sphere.

FIG. 6B is another x-ray of the embodiment of FIG. 6A.

FIG. 7 is an embodiment of a 3D-printed tooth replica and much enlarged 3D-printed tooth replica.

FIG. 8 is an embodiment of a 3D-printed jaw section mounted in a jig.

FIGS. 9A-9D is a table listing the preferred anatomies for use in a system of this disclosure. Overall, there may be approximately 250 potential anatomies for use in this system and selected portions of those anatomies can be printed or reproduced in one or more of the training devices.

FIG. 10 is a flow chart of a system for use when training. The system includes interactive means, which can be computer means and video means, that permit a student or practitioner to measure his or her performance on a particular anatomy and receive feedback on that performance via remote means. A novel feature is that an array of outcomes are graphically or pictorially presented to a student, the outcomes ranging from best to worst, so that the student may self-assess performance by visually comparing her or his outcome to that of the array.

FIGS. 1 1 A is an example graphical user interface of the system of FIG. 8.

FIG. 1 IB is another example of a graphical user interface of the system of FIG. 8.

Elements and Numbering Used in the Drawings and Detailed Description

Typodont module

2 Apex locator

3 3D-printed tooth replica (printed dentin simulation structure)

4 Replica sleeve or replica holding sleeve

4A, First half 4B Second half

5 Apex locator file lead

6 Endodontic file

7. Apex locator ground lead

8 Ground rod

9 Syringe with conductive gel

10 First passageway

1 OA First passageway entrance opening or port

10B First passageway exit opening or port

11. Conductive gel cavity

12 Tooth replica 3 embedded in replica sleeve 4 for use in testing

13 Milled or molded crown for access procedure

14 Milled or molded crown for operative procedure

15 Unique identification number

16 Second passageway

17 Third passageway

18. Closed bottom end

19. Open upper end

20 Tooth-receiving socket

21 Calibration sphere cavity

22 Wall

DETAILED DESCRIPTION

For the purpose of this disclosure, embodiment means an example or an arrangement. A person of ordinary skill in the art would recognize that features of one embodiment of this disclosure may be combined with features of another embodiment of this disclosure even if that specific combination was not described in detail here.

Embodiments of this disclosure provide a system for dentistry testing and training that includes at least one tooth or tooth replica holding sleeve 4 housing a socket 20 located at an uppermost end 19 of the sleeve 4 that is sized to securely (permanently or removably) receive at least a portion of a tooth or tooth replica 3, a conductive gel cavity 1 1 located below and in fluid communication with the socket 20, and at least one passageway 10 in fluid communication with the conductive gel cavity 1 1. The passageway 10 includes an entrance opening or port 10A located along a wall 22 of the sleeve 4 and an exit opening or port 10B located at the conductive gel cavity 1 1 . A circuit is completed when a ground rod 8 is inserted into the cavity 1 1 and contacts the gel and an apex locator lead 5 is inserted into the tooth or tooth replica 3 and contacts the gel. The sleeve 4 may be made of a rubber material or its equivalent. The tooth or tooth replica 3 when housed by the sleeve 4 appears the same or similar as it would appear in analogous human anatomy (e.g. a certain portion visible and a certain portion not visible).

When in use the at least one replica sleeve 4 is arranged as part of a dental jig or typodont module 1. At least an apical portion of the tooth 3 contacts the conductive gel. The passageway 10 may be used to inject conductive gel into the cavity 1 1 as well as insert a ground rod 8 of an apex locator ground lead 7. When used with a apex locator lead 5, the lead 5 and ground rod 8 are in contact with the conductive gel, thereby completing a circuit. Optionally, a second passageway 16 to the conductive gel cavity 1 1 may be included on an opposite side of sleeve 4. Similar to first passageway 10, second passageway 16 includes corresponding exit and entrance openings.

In some embodiments, the replica sleeve 4 includes a calibration sphere cavity 21 along with a passageway 17 to it. This cavity 21 may house a metal sphere (not shown) of a kind known in the art. Passageway 17 includes an entrance opening along a wall 22 of the sleeve 4 along with a corresponding exit opening at the sphere cavity 21.

The replica sleeve 4 may be a one-piece sleeve or may include a first half 4A and a second half 4B that are mirror images of one another and separable from one another. The tooth replica 3 may be removably secured in the socket 20, with the sleeve 4 being reusable as might be done when used in training. When a procedure is done on the replica 3, a user or student can retrieve the replica 3 from the sleeve 4 and examine his or her results. The tooth replica 3 may be permanently secured in the sleeve 4, as might be done for testing purposes. A unique identifying number 15 may be embedded on the sleeve 4 for identification and tracking purposes..

By way of examples, for teaching extraction one end 18 of the sleeve 4 can be secured in the typodont module 1 in such a way that the only way to remove the training device from the sleeve 4 is to conduct an extraction procedure. For Board and qualification testing, one end 18 of the sleeve can be such that after the training device is placed into the jaw section or typodont module 1, neither the sleeve 4 nor the tooth replica 3 can be removed from it. This one end 18 may be glued into the holder 1 and the tooth replica 3 can be glued into the sleeve 4. This feature is beneficial for maintaining the integrity of examination or testing situations. An X-ray may then be taken of the student's work.

Unlike extracted teeth, the tooth replicas permit each student to practice a given challenge as many times as needed to achieve competence in that root form. Entire jaw sections of humans— either in classic form or replicated from a patient— may be used to provide the student or practitioner with a realistic practice medium prior to performing a procedure. After practice, students can be tested using an opaque tooth replica having the same anatomy. This is a significant advantage to the use of the replica. Unlike a real tooth, whose anatomic structure differs from person to person, the training devices' anatomic structure is repeatable. Because many dentistry techniques involve "touch" and "feel," being able to provide a student or practitioner with the exact same anatomy more than once is very beneficial in helping that student or practitioner master a particular technique.

The tooth replica may include a predetermined anatomic form of at least one human tooth structure including a root canal system (see e.g. Table 1). By basing the replica on human tooth anatomy radiographically-captured by microCT scanning and 3D printing the replica, the printed dentin simulation structure is complete with the true anatomic form of a human tooth's root canals, including all of its organic anatomic complexities and irregularities such as but not limited to lateral fins, loops, lateral canals, canal bifurcations, and trifurcations. Because the replicas can be repeatedly built on a precise one-to-one scale, the replicas are ideal for training, practice, and testing purposes. The replica may also be printed to show a tooth structure or anatomy after one or more dental procedural steps have been performed.

The replica may also include a crown made of a different material, a different hardness, or a different material and hardness than that of the tooth replica. In some embodiments, the crown is a milled or molded ceramic. The crown may be arranged for an access procedure or an operative procedure. In some embodiments the tooth replica and crown combination includes at least one

Table 1. Classic anatomical challenges that may be printed

19. Mandibular molar with C-shaped canal

1. Straight canal with small apical with severely curved DL root,

diameter, 20. Mandibular molar with relatively

2. Straight canal with a large apical straight disto-lingual root,

diameter, 21. Mandibular molar with a single mesial

3. Straight canal with lateral fins, canal,

4. Straight canal with mid-root 22. Mandibular molar with three mesial bifurcation, canals,

5. Straight canal with apical bifurcation, 23. Mandibular molar with moderately

6. Straight canal with cervical bifurcation calcified pulp chamber,

and apical confluence, 24. Mandibular molar with severely

7. Canal with slight apical curvature, calcified pulp chamber,

8. Canal with moderate apical curvature, 25. Mandibular premolar with three canals

9. Canal with severe apical curvature, 26. Mandibular incisor with two canals

10. Canal with mid-root curvature and 27. Maxillary molar with separate MB2 apical reverse bend, canal,

1 1. Canal with cervical curvature in one 28. Maxillary molar with MB2 canal that is direction and an apical curvature in a apically confluent,

different plane, 29. Maxillary molar with MB2 that

12. Relatively straight canal with abrupt bifurcates mid-root,

apical curvature, 30. Maxillary molar with three MB canals,

13. Canal with abrupt cervical curvature 31. Maxillary molar with four canals

14. Ovoid canals that become round as they 32. Maxillary molar with two palatal exit the root canals,

15. Ovoid canals that bifurcate into two or 33. Maxillary premolar with three canals more apical openings, 34. Maxillary molar with moderately

16. Mandibular with C-shaped canal-from calcified pulp chamber,

orifice to apex, 35. Maxillary molar with severely calcified

17. Mandibular molar with C-shaped canal pulp chamber,

with separate mesio-lingual canal, 36. Maxillary incisor with moderately

18. Mandibular molar with C-shaped canal calcified pulp chamber, and

with moderately curved DL root, 37. Maxillary incisor with severely calcified pulp chamber.

Because each tooth replica is of a known dental or endodontic anatomy, its use allows for complete standardization of grading— not a small problem in dental schools. The anatomic fidelity to endodontic anatomy of these replicas will be of great advantage to State and National Board Examinations for Endodontics, who also struggle with giving exam-takers equivalent endodontic anatomies. Overall, there may be approximately 250 potential anatomies for use in this system and selected portions of those anatomies can be printed or reproduced in one or more of the replicas (see FIGS. 9A-D)..

Because the replica is not a real tooth, special handling is typically required to realize the maximum benefits of using the device as a training aid:

• Alcohol works well as an irrigant in the canals and also helps clear the outside surface prior to and during use.

• Ideal high-speed handpiece setting during access is about half speed (e.g., 1,000 rpm with no torque limit);

• Ultrasonic tips are not ideal but work best when wet;

• Negotiate as with a lubricant, however, using alcohol or aqueous ethylenediaminetetraacetic acid ("EDTA") improves visibility during shaping and irrigation;

• Shape canals using normal rpm and torque settings;

• A side-vent needle and NaOCl will clear the canals but depends on adequate irrigation time (e.g. 40 minutes of NaOCl after shaping is completed, similar to vital case irrigation times);

• Use a carrier-based obturation technique ;\

• Heat plugger techniques work ideally at about 175°C as opposed to 200°C;

• When taking a radiograph, use the shortest exposure time and a lowered kilovolt peak ("kVp," if adjustable), lighten the image 3-5 "clicks" and then sharpen it. Different polymer printing inks may be used to print the tooth replica. The polymer ink may be transparent, translucent, or opaque. When set hard, the inks are heat-resistant and replicate, to a remarkable degree, the dentin of a tooth. In some embodiments, a dissolvable softer polymer ink may be used (see e.g. US 8822590 B2 to Hermes et al.) in conjunction with a harder polymer ink as part of the final 3D-printed model. The softer polymer may be printed on the inside of a canal printed using the harder polymer and it may be colored to more resemble the color of dental pulp found in a human tooth root canal. The softer polymer may be designed to be dissolvable with NaOCl or NaOH solution to simulate the dissolution of pulp tissue out of primary and lateral canals using the same irrigating solutions as those used in endodontic practice. Printed in the same manner, or added after printing of the hard-setting polymer, an even harder material can be used to simulate the enamel shell above the gingival (gum) tissues that covers the dentin understructure. For example, a milled or molded ceramic material may be used.

In some embodiments, the printed anatomic structure behaves similarly to dentin encountered in a human tooth root canal. Human dentin typically has a hardness in the range of 3 to 4 mohs, and, preferably, the dentin portion of the device approximates this (about 2.5 to 4.5 mohs). For training purposes, the dentin portion may be transparent or translucent (i.e., nonopaque). After a certain level of skill is obtained, or for testing purposes, the dentin portion may be opaque. Other portions of the replica may resemble enamel (about a hardness of 5 moh) and cementum parts of a tooth. The size of a replica may be within the typical range of sizes for the particular human tooth that the training device is intended to present (see e.g., Dentsply Prosthetics, IPN® Teeth Mould Chart (2003), which is hereby incorporated by reference) or can be larger, thereby permitting an instructor to show students a larger replica or model of the same tooth structure for which each student will perform a required procedure. By way of example, multiple copies of each tooth anatomy such as those listed in Table 1 can be reproduced so that each student has a realistic anatomic challenge, which endodontic training blocks cannot provide, as well as the same anatomic challenge as all other students in the class, which extracted teeth cannot provide. The anatomy of the tooth devices— which can vary in difficulty level {e.g., 1 - easiest, 5 - most difficult)— may also combine one or more of the following features, depending on the intended training purpose: increasingly smaller pulp chambers, increasing or decreasing exit point foramen, decreasing thickness of the root structure, or increasingly greater impediments along the canal. The anatomy can be left unprepared or with the entryway already opened, the access canal already shaped, or the crown cut off as if traumatized or decayed.

3D printing may be used in a different embodiment to replicate whole sections of a patient's jaw in order to train dentists in different surgical methods. The jaw sections may be 3D printed with materials simulating gingival soft tissues, bone, the medullary soft tissue inside boney trabecula, tooth roots and crowns, pulp tissue, periodontal ligament and diseased tissue as well. All of these materials can be printed simultaneously, or printed in part, then assembled. In some embodiments, soft tissue may be colored red, periodontal ligament and intra-trabecular medullary tissue polymers may be colored blue, teeth may be colored light yellow, and bone and enamel may be printed in white model medium. The jaw sections may be mounted in jigs and positioned just as patients are positioned during dental treatment, and dental students can do various procedures on them, including but not limited to; incisions, implant placement, osteotomy, apical section of roots, retro-instrumentation and retro-filling of the ends of root canals, as well as bone grafting and suturing. A 3D printing ink comprising a radio-opaque additive and a polymer ink may be used. X- rays of anatomic replicas created with the 3D printing ink appear very similar to x-rays of organic hard tissues, thereby enhancing procedural training for health care professionals. The polymer ink may be vinyl acetate ink, anilide ink, or any other polymer ink that is known in the art. The polymer ink may be transparent or opaque. The radio-opaque additive may be bismuth neodecanoate ("Bi- NDE", CAS 34364-26-6, Bi(CioH|₉0₂)3). Bi-NDE is an organo-metallic compound commercially available in liquid form from sources such as Sigma- Aldrich. Bi-NDE, also known as bismuth trineodecanoate and neodecanoic acid bismuth salt, has a refractive index of n20/D 1.479, a boiling point of 300°C, and a density of 1.145 g/mL at 25 °C.

Bi-NDE is an ideal radio-opacifier in polymer inks, preferably UV-cured polymer inks, due to the following properties:

1. Bi-NDE, when added in a range of about 6% to about 20% by weight to a polymer ink such as vinyl acetate ink or anilide ink, does not significantly affect the hardness or heat resistance of the printed replicas;

2. Bi-NDE is a clear, syrup-like solution; and

3. Bi-NDE, while relatively thick in consistency, disburses through the microjet printing block ports of ink-jet printers without inordinately clogging the jets.

Table 2 discloses embodiments of a radio-opaque 3D printing ink that has a Bi-NDE content ranging from about 6% to about 20% by weight and by volume.

Table 2. Embodiments of 3D printing ink including a radio opaque additive. g % Wgt. mL % vol.

Bi-NDE 250 6.67 218.34 5.48

Vinyl Acetate 3500 93.33 3763.44 94.52

Total 3750 100.00 3981.78 100.00 g % wgt. mL % vol.

Bi-NDE 500 12.50 436.68 10.40

Vinyl Acetate 3500 87.50 3763.44 89.60

Total 4000 100.00 4200.12 100.00 g % gt. mL % vol.

Bi-NDE 600 14.63 524.02 12.22

Vinyl Acetate 3500 85.37 3763.44 87.78

Total 4100 100.00 4287.46 100.00 g % wgt. mL % vol.

Bi-NDE 700 16.67 61 1.35 13.97

Vinyl Acetate 3500 83.33 3763.44 86.03

Total 4200 100.00 4374.79 100.00 g % wgt. mL % vol.

Bi-NDE 800 18.60 698.69 15.66

Vinyl Acetate 3500 81.40 3763.44 84.34

Total 4300 100.00 4462.13 100.00 g % wgt. mL % vol.

Bi-NDE 900 20.45 786.03 17.28

Vinyl Acetate 3500 79.55 3763.44 82.72

Total 4400 100.00 4549.47 100.00 g % wgt. mL % vol.

Bi-NDE 1000 22.22 873.36 18.84

Vinyl Acetate 3500 77.78 3763.44 81.16

Total 4500 100.00 4636.8 100.00 g % wgt. mL % vol.

Bi-NDE 1100 23.91 960.7 20.34

Vinyl Acetate 3500 76.09 3763.44 79.66

Total 4600 100.00 4724.14 100.00 Experimentation shows that less than 6% Bi-NDE in the radio-opaque 3D printing ink by weight does not provide sufficient radio-opaque properties for the anatomic replicas to mimic organic hard tissue upon X-ray. Experimentation also shows that more than 20% Bi-NDE in the printing ink causes the jets of the printer to clog too frequently, with cleaning required during each printing cycle. Approximately 12% Bi-NDE by weight seems to strike a good balance between the amount of radio-opacity provided and good printing performance. Ideally, the printer jets should be cleaned about halfway through the printing cycle.

Embodiments of the system and method are useful for remote and hands-on training in a variety of dental practice areas such as general procedures (e.g., oral examinations, prophylaxis, sealants, radiographs), endodontic procedures, prosthodontic procedures, and pre-and postoperative procedures such as but not limited to removing a filling or caries. The tooth replica may be that of a healthy tooth or one that exhibits a known dental disease or pathology such as but not limited to dental caries. In all cases, the anatomy of each training device is selected to present one or more anatomic structures or challenges encountered in dental practice and, because subsequent copies of each training device are exact copies of the first, to provide a realistic example of that structure for repeated practice by a single student or to all students in need of practice on that structure.

The tooth replica may be used for research purposes, such as but not limited to root canal instrumentation, irrigation, and obturation. For two of those purposes, irrigation and obturation, the device may be improved by having temperature control means such as heating elements of a kind known in the art to bring the device to body temperature (or to reduce their temperature depending on the intended purpose). Gauge devices or data collection means, such as but not limited to pressure transducer of kinds known in the art may also be included, which is useful for irrigation and obturation. Along these same lines, or more surfaces of the training device can be optically flattened and polished to enhance microscopic visualization.

Referring now to FIGS. 10-1 IB, an embodiment of a user interface for a web-based system made according to this disclosure includes a home page for an Internet site with an icon or button for do-it-yourself/continuing education ("DIY/CE"). When a user clicks on the DIY/CE button, the user is taken to a page dedicated to this program. A video explaining the program in full may be provided.

The DIY/CE page includes a list of all the different training device offerings and provides the user with the opportunity to review each device. The page also provides an icon or button to purchase a particular training device (or set of replicas) and its associated course or learning module. After an online payment method (e.g. PayPal) has draft-captured payment, a code is instantaneously e-mailed to the user in order for the user to gain access to the program, course or module. The program provider is copied on this email in case the user loses his or her access code. After the user has received the training device (or replicas), the user enters the code and gains access to the program.

Once the code is entered, a video box appears below the tooth training device in question. This initial video helps to introduce the actual model. Below this video are two separate videos. The first video sets expectations for the user (and for his or her assistant) and makes sure that he or she has the correct materials on hand to proceed with the course. The second video discusses the training device's anatomy and sets the stage for each individual interactive training module to follow. This video also provides guidelines for the user for regarding how to proceed. Each subsequent video covers a specific procedure in root canal therapy, and these procedures are covered in a separate section for each tooth training device. In order, these interactive learning modules or sections include: Access, Negotiation, Cleaning, Shaping, and two Obturation sections - (i) carrier-based and (ii) cone-fitting with the System-B Heat Source. The user may select between the two Obturation sections.

In the Access section, a video describes and demonstrates the ideal procedure for that particular training device. In one preferred embodiment, the Access section presents five example models or images "A" to "E" with "A" being perfect and receiving a score of 5 to "E" being poor and receiving a score of 1. In another preferred embodiment, the section presents three examples "A" to "C", with "A" being perfect and scored a 5 and "C" being poor and scored a 1. After the images are presented, the user is asked to perform the procedure and, after performing the procedure, selects the model that most closely resembles his or her results.

This "self-grading" process repeats throughout each of the sections. For example, after successfully completing the Access section for a particular anatomy, the Negotiation section presents five models or images "A" to "E", the user performs the procedure, and then grades her- or his-self against the models. Although this self-grading does not count as a final grade for academic or continuing education credit, it does serve as a benchmark for the user as the user progresses through each section. For example, if the user clicks on "A" or "B" in the Access section, a video appears instructing the user to go to the Negotiation section. If the user clicks on any of the other models ("C" to "E") in the Access section, a video appears which includes a review of the procedure and how to do things correctly. The user is then given another chance (or chances) to practice and grade her or his performance against the models.

Upon completion of one of the Obturation sections, the user is given a cumulative score based upon the self-grading. For continuing education credit, the user can submit one or more radio-graphical images of the completed training device for official grading. Upon submission of the radio-graphical images, the user's course code is obsolete.

Although the use of a training device for endodontic procedures has been discussed, the endodontic procedure example is by way of illustration only. The scope is defined by the following claims, including elements which are equivalent to those in the claims, and the training device may be configured and printed for other types of dental procedures, including general procedures, prosthodontic procedures, and pre-and post-operative procedures.

Embodiments of a system for dentistry testing and training include one or more of the following features.

1. A tooth holding sleeve housing a socket having at least one opening located at an upper end of the socket and sized to receive at least a portion tooth.

2. A conductive gel cavity located below and in fluid communication with the socket.

3. At least one passageway in fluid communication with the conductive gel cavity, the passageway including an opening or port located along a wall of the sleeve and an exit opening or port at the conductive gel cavity

4. When in use the tooth holding device is arranged as part of a dental jig.

5. At least one passageway being a conductive gel injection passageway.

6. At least one passageway being a ground rod passageway.

7. A second passageway located opposite the at least one passageway and in fluid communication with conductive gel cavity.

8. A second passageway being a conductive gel injection passageway.

9. A second passageway being a ground rod passageway.

10. A tooth holding sleeve housing a calibration sphere. 11. A tooth holding sleeve housing a calibration sphere cavity and a passageway in fluid communication with the calibration sphere cavity.

12. A tooth holding sleeve including two halves that are mirror images of one another and separable from one another.

13. A tooth replica including a predetermined anatomic form of at least one human tooth structure including a root canal system.

14. A tooth replica including at least one spot of decay.

15. A tooth canal including a pupal material printed along an inside wall of the root canal system.

16. A tooth canal including pulpal material dissolvable with a NaOCl or NaOH based endodontic irrigation solution.

17. A tooth replica being radio opaque.

18. A tooth replica including a crown, the crown being a different material, a different hardness, or a different material and hardness than that of the tooth replica.

19. A crown that is a ceramic material.

20. A crown arranged for an access procedure.

21. A crown arranged for an operative procedure.

22. A tooth replica removably secured in the socket.

23. A tooth replica being permanently secured in the socket.

24. A tooth holding sleeve including a unique identifying number.

25. An apex locator.

26. An apex locator ground rod.

27. A conductive gel. 28. A syringe housing the conductive gel.

29. A socket narrowing in size toward the conductive gel cavity.

30. A training device being printed from a CAD model and in a first and a second polymer by a 3D printer and a self-assessment for use with the training device, the first polymer being harder than the second polymer, the second polymer dissolvable with a NaOCl or NaOH based endodontic irrigation solution.

31. A first polymer non-dissolvable with an NaOCl or NaOH based endodontic irrigation solution and the second polymer dissolvable with the endodontic irrigation solution.

32. A training device comprising a predetermined anatomic form of at least one human tooth structure, the tooth structure having analogous physical properties to real human tooth material including a root canal system and a pulpal material, the root canal system being printed using the first polymer, the pulpal material being printed along an inside wall of the root canal system using the second polymer.

33. A self-assessment comprising a pictorial array of procedural outcomes of a procedural step so a student can identify which image in the pictorial array best represents the student's own procedural outcome of the procedural step performed by the student on the training device.

34. A CAD model of the training device altered to represent at least one step of a dental procedure having been performed before the training device is printed.

35. A training device including an additional polymer, the additional polymer having analogous physical properties to real human tooth material different than that of the predetermined anatomic form. 36. A different tooth structure selected from the group consisting of an enamel tooth layer, a gingival soft tissue, a bone, a medullary soft tissue inside boney trabecula, a tooth root, a tooth crown, pulp tissue, a periodontal ligament, and diseased tissue.

37. An ink used to print a first portion of the training device is a different ink than an ink used to print a second portion of the training device.

38. A first polymer being non-opaque.

39. A first polymer being opaque.

40. A first polymer being radio-opaque.

41. A first polymer being transparent.

42. A second polymer colored to resemble a color of dental pulp found in a human tooth root canal.

43. A third polymer overlying a portion of the first polymer, the third polymer having analogous physical properties to real enamel structure of a human tooth material.

44. A training device including temperature control means.

45. A training device including data collection means.

46. A portion of a surface of the training device is optically flattened.

47. A second training device printed from a CAD model in a polymer by a 3D printer and having a same predetermined anatomic form as the first-mentioned training device, wherein a portion of the predetermined anatomic form of a first training device is viewable and a same portion of the predetermined anatomic form of the second training device is not viewable. 48. A second training device printed from a CAD model in a polymer by a 3D printer and having a different predetermined anatomic form than the predetermined anatomic form of a first training device.

49. A first-mentioned training device and a second training device each selected to provide a different level of difficulty than the other.

50. A tooth holding sleeve, the sleeve sized to fit around the training device for insertion of the training device into a holder.

51. A tooth holding sleeve wherein one end of the sleeve prevents removal of the training device from the holder.

52. A tooth holding sleeve one end of the sleeve prevents removal of the sleeve from the holder.

53. A holder or jig including at least a portion of a model of a human jaw section.

54. A training device sized to fall within a range of human tooth sizes.

55. A self-assessment array of possible outcomes presented in print form.

56. A self-assessment array of possible outcomes presented in video form.

57. A self-assessment array of possible outcomes presented by an interactive computer system.

58. A self-assessment array of possible outcomes presented by an interactive computer system over the internet or a network.

59. At least one feedback instruction based upon the self-assessment.

60. A training device being one training device in a set of training devices printed from a CAD model in at least one polymer by a 3D printer, the set of training devices covering a range of predetermined anatomic forms. 61. A portion of a human jaw structure is selected from the group consisting of gingival soft tissue, bone, medullary soft tissue inside boney trabecula, periodontal ligament, and diseased tissue.

62. Inks used to 3D print the predetermined anatomic forms are selected to simulate the corresponding human structure.

63. Ink used to 3D print a first portion of the training device is different than an ink used to print a second portion of the training device.

64. Inks of different colors.

65. Ink including a radio opacifier.

66. Ink including bismuth neodecanoate.

Technical features of the embodiments may include, but are not limited to, a tooth or tooth ica holding sleeve that provides one or more of the following:

reusability with multiple teeth or tooth replicas for training purposes;

single, permanent use for testing purposes;

means for adding a conductive gel needed to complete a circuit including an apex locator; means for inserting a ground rod into a conductive gel cavity to complete the circuit; means for adding a calibration sphere;

means for uniquely tracking the sleeve;

means for permanently or removeably retaining a tooth or tooth replica;

use of a 3D printed tooth replica including anatomy analogous to human anatomy and its corresponding challenges;

a 3D printed tooth replica including different polymer inks mimicking differences encountered in human anatomy; means for self-assessment based upon a visual comparison between a user's procedural outcome and a graphical or pictorial array of outcomes ranging from best to worst; and

radio opacity of at least a portion of the sleeve, the tooth replica, or both the sleeve and the tooth replica.

While embodiments have been described, modifications could be made by a person of ordinary skill in the art to the tooth replica sleeve for use with an apex locator and the system for dentistry testing and training that makes use of a tooth replica without departing from the scope of this disclosure or the following claims. The claims include the full range of equivalents to which recited element is entitled.

Claims

WHAT IS CLAIMED

1. A tooth holding sleeve (4) comprising:

a tooth holding socket (20),

a conductive gel cavity (1 1) located below and in communication with the tooth holding socket (20), and

a passageway (10) extending from an outer wall (22) of the tooth holding sleeve (20) to the conductive gel cavity (1 1).

2. The tooth holding sleeve (4) of claim 1, further comprising a calibration sphere cavity (21).

3. The tooth holding sleeve (4) of claim 2, further comprising a passageway (17) extending from the outer wall to the calibration sphere cavity (21).

4. The tooth holding sleeve (4) of claim 1 , further comprising the tooth holding sleeve (4) including two halves (4A, 4B) that are mirror images of one another and separable from one another.

5. The tooth holding sleeve (4) of claim 1, wherein the tooth is a tooth replica (3) including a predetermined anatomic form of at least one human tooth structure including a root canal system. 6. The tooth holding sleeve (4) of claim 5, further comprising the tooth replica (3) including at least one radio opaque portion.

7. A tooth holding sleeve (4) comprising:

a socket (20) having at least one opening located at an upper end

(19) of the tooth holding sleeve (4), the socket (20) sized to receive at least a portion of a tooth,

a conductive gel cavity (11) located below and in communication with the socket (20), and

at least one passageway (10) including an entrance opening (10A) located along a wall (22) of the tooth holding sleeve (4) and an exit opening (10B) located at the conductive gel cavity

(11).

8. The tooth holding sleeve (4) of claim 7, further comprising the at least one passageway being configured to receive a conductive gel injection needle.

9. The tooth holding sleeve (4) of claim 7, further comprising the at least one passageway being configured to receive a ground rod (8).

The tooth holding sleeve (4) of claim 7, further comprising a calibration spher (21).

11. The tooth holding sleeve (4) of claim 7, further comprising:

a calibration sphere cavity (21), and

a passageway (10) in communication with the calibration sphere cavity (21 ).

12. The tooth holding sleeve (4) of claim 7, further comprising the tooth holding sleeve (4) including two halves (4A, 4B) that are mirror images of one another and separable from one another.

13. The tooth holding sleeve (4) of claim 7, wherein the tooth is a tooth replica (3) including a predetermined anatomic form of at least one human tooth structure including a root canal system.

14. The tooth holding sleeve (4) of claim 7, further comprising the tooth replica (3) including at least one radio opaque portion.

15. The tooth holding sleeve (4) of claim 1 , further comprising the tooth holding sleeve (4) including a unique identifying number (15) located along a wall of the tooth holding sleeve (4).