WO2020210442A1 - Hollow-point condensing-compaction tool - Google Patents
Hollow-point condensing-compaction tool Download PDFInfo
- Publication number
- WO2020210442A1 WO2020210442A1 PCT/US2020/027401 US2020027401W WO2020210442A1 WO 2020210442 A1 WO2020210442 A1 WO 2020210442A1 US 2020027401 W US2020027401 W US 2020027401W WO 2020210442 A1 WO2020210442 A1 WO 2020210442A1
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- WO
- WIPO (PCT)
- Prior art keywords
- rotary tool
- shank
- flute
- cutting
- tool
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1644—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1655—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for tapping
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C3/00—Dental tools or instruments
- A61C3/02—Tooth drilling or cutting instruments; Instruments acting like a sandblast machine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
- A61C8/0089—Implanting tools or instruments
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
- B23B—TURNING; BORING
- B23B51/00—Tools for drilling machines
- B23B51/04—Drills for trepanning
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
- B23B—TURNING; BORING
- B23B2251/00—Details of tools for drilling machines
- B23B2251/64—Drills operating in the reverse direction, i.e. in the unscrewing direction of a right-hand thread
Definitions
- the invention relates generally to tools for preparing a hole to receive a screw-in fixture, and more particularly to rotary tools and methods implemented thereby for expanding a hole in bone to receive an implant or other fixation device.
- Bone implants are implants of the type placed into the bone of a patient. Bone implants may be found throughout the human skeletal system, including dental implants in a jaw bone to replace a lost or damaged tooth, joint implants to replace a damaged joint such as in hips and knees, and reinforcement implants installed to repair fractures and remediate other deficiencies like pedicle screws used in spinal stabilization, to name but a few.
- the proper placement of an implant often requires expert preparation using precision drills with highly regulated speed to prevent burning and pressure necrosis of the bone.
- osseodensification is a procedure for enlarging an osteotomy using a specially designed, multi-fluted, rotary tool or bur.
- An example of a suitable rotary tool is described in the above-mentioned US Patent No 9,326,778.
- Rotary tools configured to achieve osseodensification for dental applications are marketed as Densah ® Burs under license through Versah, LLC of Jackson, Michigan USA.
- osseodensification excavates little if any bone tissue while forming a hole suitable to receive a screw-in fixture. Rather, the majority of bone tissue is simultaneously compacted in outwardly expanding directions from the osteotomy and auto-grafted (i.e., directly re-patriated). When rotated at high speed in a reversed, non-cutting direction with steady external irrigation, osseodensification burs form a strong and dense layer of bone tissue along the walls and base of the osteotomy. Dense compacted bone tissue produces stronger purchase for the implant and may facilitate faster healing.
- socket shield technique is an example of a dental procedure that has yet to be adapted for osseodensification.
- the socket shield technique was first introduced in 2010 by Hurzeler. Hurzeler suggested that instead of extracting the whole tooth, the buccal aspect of the root could be left intact to preserve the buccal plate of bone and prevent post extraction resorption, at the same time an immediate implant is placed; this would lead to an optimal stable esthetic result after the final delivery of the restoration.
- Hurzeler advocated use of a fissure bur to cut the tooth mesiodistally, after which the lingual aspect of the tooth is extracted leaving a socket where the implant is to be placed.
- a bone trephine may be used to take out the remaining root leaving a space to receive an implant.
- the socket shield technique is not currently considered a widely accepted practice due in part to its reputation as being of limited applicability. Those of skill in the art will welcome advances and improvements that expand the applicability of the socket shield technique.
- the invention pertains to a rotary tool that is configured to be turned at high speed in both condensing and cutting rotary directions (e.g., clockwise and counter-clockwise) to accomplish different effects while forming a hole in a host material.
- the host material can be bone or not bone.
- the rotary tool comprises a shank that will establish a longitudinal axis of rotation.
- the shank is an elongated shaft having upper end and lower ends.
- a body extends axially from the lower end of the shank.
- the body has an apical end which is remote from the shank.
- a plurality of flutes are disposed about the body.
- Each flute has a cutting face on one side thereof defining a cutting rake angle and a densifying face on the other side thereof defining a densifying rake angle.
- Each flute has an axial length and a radial depth.
- a land is formed between each adjacent pair of flutes. Each land has a substantially margin-less working edge along the cutting face of one the flute.
- a cavity is disposed in the body. The cavity extends axially within the body and opens through the apical end.
- a plurality of spurs are disposed on the apical end of the body. The spurs are located around the opening of the cavity.
- the present invention represents an improvement of the rotary tool designed to densify when used in a non-cutting direction (typically the counter-clockwise direction when viewed from the surgeon’s perspective), as described in US Publication No. 2019/0029695.
- the tool can be used in densifying mode with easier application and less vertical force compared with the design of US 2019/0029695. Therefore, this tool can be used in a wider variety of applications, including but not limited to bone preparation applications.
- Figure 1 shows in side elevation a kit of three rotary tools according to one embodiment of the invention, each tool being a different size to enable hole formation in a progressive sequence;
- Figure 2 is a longitudinal cross-section through a rotary tool of the type shown in Figure l ;
- Figure 3 is an apical end view of a rotary tool of the type shown in Figure 1 ;
- Figure 4 is a view as in Figure 3 but emphasizing the apical end in which spur formations can be identified as having close-offset and far-offset qualities;
- Figure 5 is a fragmentary perspective view of the apical end of a rotary tool of the type shown in Figure 1 ;
- Figure 6 is a highly magnified perspective view of the apical end of a rotary tool of the type shown in Figure 5;
- Figures 7A-H describe a sequential operation in which a pilot drill forms a pilot hole which is then expanded using progressively larger rotary tools of the type shown in Figure 1;
- Figure 8 represents an optional finishing step using a prior art style osseodensification bur after forming a hole as per the example of Figures 7A-H;
- Figure 9 is a longitudinal cross-sectional view as in Figure 2 but portraying an alternative embodiment in which an irrigation duct is integrated into the shank of the rotary tool;
- Figures 9A and 9B depict alternative embodiments of an irrigated tool like that shown in Figure 9;
- Figure 10 is a perspective view of a rotary tool according to another embodiment of this invention in which the body is straight-sided (i.e., not tapered) and irrigation ducts are integrated into the body of the rotary tool; and
- Figure 11 is a cross-section taken generally along lines 11-11 in Figure 10.
- the present invention represents an improvement of the rotary tool designed to densify when used in a non-cutting direction, as described in US Publication No. 2019/0029695 to Huwais, published January 31, 2019, the entire disclosure of which is hereby incorporated by reference and relied upon in jurisdictions recognizing the practice.
- a tool according to one embodiment of this present invention is generally shown at 20 throughout the Figures.
- the rotary tool 20, which may be referred to as a bur or osteotome when configured for use in surgical applications, is designed to be turned at high speed in alternative condensing and cutting rotary directions to accomplish different effects in the host material.
- the host material is bone.
- the host material could be wood, plastic, solid metal, foam metal, solid plastic, cellular plastic, and the like.
- the tool 20 has a shank 22 and a body 24.
- references to the surgical application dominate the following descriptions. And in this context, the host material may occasionally be referred to as bone and any hole therein an osteotomy. Despite these application-specific references, it is to be understood that the tool 20 may be used in suitable non- surgical applications.
- the shank 22 establishes a longitudinal axis of rotation A for the tool 20.
- the shank 22 is an elongated shaft, typically (but not necessarily) cylindrical in shape, having an upper end and a lower end.
- a drill motor engaging interface 26 is formed at the upper end of the shank 22 for connection to a drill motor (not shown).
- the particular configuration of the interface 26 may vary depending on the type of drill motor used, and in some cases may even be merely a smooth portion of the shank 22 against which the jaws of a collet grip.
- the body 24 joins to the lower end of the shank 22, which joint may be formed with a tapered or domed transition 28.
- the transition 28 acts like flow diffuser as the surgeon irrigates with water during a procedure.
- FIGS 1 and 2 evidence the inclusion of an optional annular locking notch 30 disposed in the shank 22 between its upper and lower ends.
- the notch 30 may be used for various purposes, including to couple a depth-stop device like that shown, for example, in WO2018071863A1 to Huwais, published April 19, 2018.
- the body 24 extends axially from the lower end of the shank 22.
- the body 24 has a leading or apical end located remote from the shank 22.
- the body 24 is configured with a conically tapered exterior profile.
- the outside shape of the body 24 can be seen as decreasing from a maximum diameter adjacent the shank 22 to a minimum diameter adjacent its apical end.
- the body 124 may be non- tapered (i.e., straight or cylindrical).
- Figure 10 shows an example where the body 124 has a generally straight exterior profile that maintain a generally constant diameter along its entire length.
- the working length or effective length of the body 24 is proportionally related to its taper angle and to the size and number of tools 20 in a kit.
- Figure 1 shows three tools 20, each members of the same kit.
- all tools 20 in a kit will have the same taper angle, or approximately the same taper angle.
- Taper angles between about 1° and 5° (or more) are possible depending upon the application. More preferably taper angles between about 2°-3° will provide satisfactory results.
- a taper angle of about 2°36’ is known to provide outstanding results for dental applications when the body 24 length is between about 11mm and 15 mm.
- the diameter at the upper end of the body 24 for one tool 20 is approximately equal to the diameter adjacent the apical end of the body 24 for the next larger size tool 20. That is to say, the diameter at the upper end of the body 24 for the lowermost/smallest tool 20 is approximately equal to the diameter adjacent the apical end of the body 24 for the middle tool 20. And then the diameter at the upper end of the body 24 for the middle tool 20 is approximately equal to the diameter adjacent the apical end of the body 24 for the uppermost/largest tool 20.
- these dimensions are only suggested as examples.
- a plurality of grooves or flutes 32 are disposed about the body 24.
- the flutes 32 may or may not have common axial length and common radial depths. That is to say, it is possible that the flutes 32 could, in some configurations, not all be identical.
- the flutes 32 are preferably, but not necessarily, equally circumferentially arranged about the body 24. The diameter of the body 24 may influence the number of flutes 32.
- the flutes 32 are formed with a helical twist. If the cutting direction is in the right-hand (clockwise) direction, then preferably the helical spiral is also in the right-hand direction.
- Each flute 32 has a cutting face 34 on one side thereof defining a cutting rake angle, and a densifying face 36 on the other side thereof defining a densifying rake angle. That is, each flute 32 has a densifying face 36 and an opposing cutting face 34.
- a rib or land 38 is formed between adjacent flutes 32, in alternating fashion (i.e., flute-land-flute-land-flute, etc.). Each land 38 bridges the densifying face 36 of the flute 32 on one side to the cutting face 34 of the flute 32 on its other side.
- the sharp interface between each land 38 and its associated cutting face 34 is referred to as a working edge 40.
- the working edge 40 either functions to cut bone or compact (densify) bone. That is, when the tool 20 is rotated in the cutting direction, the working edges 40 slice and excavate bone (or other host material). When the tool 20 is rotated in the densifying (non-cutting) direction, the working edges 40 compress, compact, and radially displace bone (or other host material) with little-to-no cutting whatsoever. This compaction and radial displacement is exhibited as gentle pushing of the osseous structure laterally outwardly in a condensation, i.e., compaction, mechanism.
- the working edges 40 are shown throughout the illustrations as being substantially margin-less.
- margin-less is defined as the entire portion of each land 38 is cut away behind the working edge 40 to provide complete clearance.
- margins are incorporated behind the cutting edge to help guide the drill in the hole and maintain the drill diameter.
- the working edge 40 can be seen helically twisting about the body 24.
- the working edges 40 wind about the body 24 in a direction that turns away from a non-cutting direction. This is perhaps best perceived from the full side views of Figure 1.
- the conically tapered profile decreases in diameter, i.e., moving toward the apical end, the working edges 40 twist about the body 24 in the same direction as the cutting direction.
- the cutting face 34 establishes the cutting rake angle for each respective working edge 40.
- the cutting rake angle can be any one of several forms. In some embodiments the cutting rake angle remains continuously negative angle along its entire length. In some cases, the pitch of the continuously negative cutting rake angle fluctuates along the length of each flute 32 with a total variance of less than 30°. In other cases, the pitch of the continuously negative cutting rake angle may fluctuate with greater than 30° total variance. In those examples where the cutting rake angle fluctuates (and yet remains continuously negative angle along its entire length), changes in pitch along the length of the flute 32 can be progressive or, regressive. A progressive pitch becomes sharper (closer to 90°), whereas a regressive pitch becomes flatter.
- the densifying rake angle for each working edge 40 will remain continuously negative angle along its entire length. This is to maximus the condensing attributes of the tool 20 when operated in the densifying direction.
- the densifying rake angle established between the working edge 40 and the land 38 may lie at a large negative angle in the order of about 55°-89°.
- the large negative densifying rake angle of the working edge 40 (when rotated in a densifying direction) applies outward pressure at the point of contact between the wall of the osteotomy and the working edge 40 to create a compression wave ahead of the point of contact, loosely akin to spreading butter on toast. Osseodensification may also be loosely compared to the well-known process of burnishing metal to improve metal surface quality.
- the densifying rake angle can any one of several forms. In one embodiment, the densifying rake angle is generally constant along the length of each flute 32. In another embodiment, the densifying rake angle fluctuates along the length of the flutes 32 with a total variance of less than 30°.
- each flute 32 has an axial length and a radial depth.
- the smooth, non-fluted portion of the body adjacent the domed transition 28 is referred to as a stopper section 42.
- the stopper 42 is that section of the body 24 disposed between the flutes 32 and the shank 22. In cutting mode, once the stopper section 42 enters an osteotomy all excavated bone debris becomes trapped in the flutes 32, which enables some advantageous compaction activity.
- the axial lengths of the flutes 38 are shown in the drawings to be generally equal, however other options are available.
- the axial length of one or some flutes 38 could be shortened to provide certain effects.
- the radial depth of the flutes 38 are also subject to modest manipulation. In one example.
- the radial depth of each flute 38 remains generally constant along its length.
- the radial depth of each flute 38 has a regressive characteristic, in that the depth measure adjacent the apical end is largest moving progressively shallower toward the stopper section 42.
- the applied forces can be decomposed into two components: one normal to the bone surface, pressing it outwardly, and the other tangential, dragging or smearing it along the inner surface of the osteotomy.
- the working edge 40 will start to slide along the bone.
- the normal force will deform the softer bone material. If the normal force is low, the working edges 40 will rub against the bone but not permanently alter its surface. The rubbing action will create friction and heat, but this can be controlled by the surgeon by altering, on-the-fly, the rotation speed and/or pressure and/or irrigation flow.
- the surgeon may at any instant during the surgical procedure lift the working edges 40 away from contact with the surface of the bone to allow cooling. This can be done in a controlled“bouncing” fashion where pressure is applied in short bursts with the surgeon continuously monitoring progress and making fine corrections and adjustments.
- a distinguishing characteristic of the tool 20 as compared to that described in US 2019/0029695 is a cavity 44 disposed in the body 24 and passing through its apical end. That is, the cavity 44 extends axially within the body 24 and opens at the apical end, creating the appearance of a hollow point. The presence of the cavity 44 removes a substantial portion of the formations at the apical end, leaving only the radially outermost features.
- the cavity 44 extends into the body 24 of the tool 20 about as deep as the flutes 32 extend along the exterior surface. That is to say, the cavity 44 and the exterior flutes 32 are generally/approximately co-extensive, with both terminating near the conical transition region of the body 24 below the tool shank 22.
- the cavity 44 may have a short axial length than the axial length of the flutes 32, or alternatively may have a longer axial length than the axial length of the flutes 32 along the exterior surface of the body 24.
- the cavity 44 may have a frusto-conical profile. Its conical shape being widest adjacent the apical end and narrowest adjacent the shank 22. In this sense, the frusto-conical profile can be considered the negative or opposite of the tapered exterior profile of the body 24. In some embodiments, it has been found advantageous to form the frusto- conical taper angle of the cavity 44 generally equal, albeit negative, to the conically tapered exterior profile of the body 24. That is, the cavity 44 may be formed with a frusto-conical taper that matches, or generally approximates, the exterior taper angle of the working end of the tool 20. However, this is only a general preference.
- the frusto-conical taper angle of the cavity 44 is not matched to the conically tapered exterior profile of the body 24. Indeed, straight side wall exteriors as well as cavities are entirely possible and, in some cases, may even be preferred. See for example the embodiment of Figures 10 and 11.
- Figures 5 and 6 offer enlarged views of the apical end, which is also distinguished in configuration from the aforementioned US 2019/0029695 by a plurality of spurs 46 disposed on the apical end of the body 24.
- the spurs 46 are arranged around the opening of the cavity 44. While four spurs 46 are shown in these examples, it is contemplated that a tool 20 could have fewer or more spurs 46. In particular, smaller diameter burs 20 might have just two or three spurs 46, whereas larger burs might have six or eight or any suitable number of spurs 46.
- Each spur 46 has a grinding edge 48 in the shape of a ridgeline. On one side of each grinding edge 48 is a leading flank 50, and on the other side is a trailing flank 52.
- the terms “leading” and“trailing” are in refence to the non-cutting condensing direction which is indicated in Figure 5. (Naturally, when the tool 20 is rotated in the cutting direction, these“leading” and “trailing” designations will be antithetical.)
- each spur 46 has a grinding edge 48 that forms the ridgeline between leading 50 and trailing 52 flanks.
- the included angle between the leading 50 and trailing 52 flanks (B + C in Figure 6) may be between about 45-135 degrees.
- Figures 1-6 illustrate contemplated configurations where the flanks 50, 52 are each angled so that the resulting grinding edges 48 are also angled thereby forming an apex 54 at the radially inward most end of each grinding edge 48, adjacent the cavity 44. Furthermore, the manufacturing is carried out in such a way that each apex 54 is disposed in a common plane that perpendicularly bisects the longitudinal axis. That is to say, if the tool 20 were placed apical end down on a flat surface, all of the apexes 54 would make point-contact with the horizontal surface at the same time.
- flanks 50, 52 are formed so that placement of the tool 20 apical end down on a flat surface will result in only one or some of the apexes 54 making point-contact with the horizontal surface while the remaining apexes 54 hover above the flat surface.
- each apex 54 could either lay in a common plane that perpendicularly bisects the longitudinal axis, or alternatively only one or some of the apexes 54 lay in a common perpendicular plane.
- flanks 50, 52 may be ground so that the resulting grinding edges 48 all lay in a common plane that perpendicularly bisects the longitudinal axis. In this variation, there would be no point-like apex. When the tool 20 is stood point-down on a flat surface, its grinding edges 48 will either be in line contact with the horizontal surface or hover parallel above the surface. [0047] All of these variations are considered viable alternatives having beneficial application in different scenarios.
- each trailing flank 52 is abruptly truncated by a steep face 56.
- the steep faces 56 each lay in a plane that is parallel to, or nearly parallel to, the longitudinal rotary axis A of the tool 20.
- Each steep face 56 can be observed intersecting the leading flank 50 of the next adjacent the spur 46, to form a gullet 58 therebetween.
- the steep face 56 of one spur 46 merges with the long sloping leading flank 50 of the next adjacent spur 46 at a gullet 58.
- a gullet 58 exists between each spur 46.
- the number of gullets 58 equals the number of spurs 46.
- a tool 20 with four spurs 46 will have four gullets 58; a tool 20 with six spurs 46 will have six gullets 58; and so forth. When the tool 20 is used in the cutting direction, the gullets 58 will collect bone debris.
- At least some of the flutes 32 will be positioned so as to open directly into a respective gullet 58.
- a respective gullet 58 In an eight fluted tool 20 having four spurs 46 and four gullets 58, one, two, three or four flutes 32 will open directly into a respective gullet 58. It is acceptable for the tool 20 to have more gullets 58 than flutes 38 (as in the example of Figure 10), so long as at least one flute 38 opens directly into one gullet 58. Also, it is preferable that at least one flute 32 opens directly onto a leading flank 50. A flute 32 opening onto a leading flank 50 can be either just behind the associated grinding edge 48 (as visible in Figure 6) or partially overlapping the grinding edge 48 (as visible in Figure 5).
- the tool 20 is fashioned with eight flutes 32 and four spurs 46/gullets 58. Every other flute 32 opens into a respective gullet 58, whereas the intervening flutes 32 each intersecting a respective leading flank 50 just behind a grinding edge 48. In this manner, bone debris is directly and efficiently channeled up the flutes 32 regardless of whether the tool 20 is used in the cutting direction or in the non-cutting condensing direction.
- a four-flute 32 tool 20 may be optimized with either four or two spurs 46.
- An eight-flute 32 tool 20 may be optimized with two, four or eight spurs 46.
- a six-flute 32 tool 20 may be optimized with three or six spurs 46.
- a twelve-flute 32 tool 20 may be optimized with two, three, four, six or twelve spurs 46. And so forth.
- the spurs 46 may be identical to one another or of two or more different styles.
- the illustrated examples depict spurs 46 of two different styles set in alternating pattern: close-offset spurs 46A and far-offset spurs 46B.
- at least one spur is a close-offset spur 46A and/or at least one spur is a far-offset spur 46B.
- the suffix“A” here denotes features of the close- offset spurs 46A, whereas suffix“B” denotes features of the far-offset spurs 46B.
- the grinding edges 48A of the close-offset spurs 46A are indicated by extension lines 60A. From these extension lines 60A, it can be seen that each grinding edge 48A is offset a short distance 62A from the longitudinal axis of rotation A of the tool 20. Consequently, none of the grinding edges 48A lay along radials from the longitudinal axis of rotation A. Also, it is noteworthy that the offset 62A is in the cutting direction, which will result in a more aggressive grinding action when the tool 20 used in the cutting direction, and a less-aggressive grinding action when the tool 20 is used in the condensing action. Still considering Figure 4, the grinding edges 48B of the far-offset spurs 46B are indicated by extension lines 60B.
- each grinding edge 48B is offset a relatively large distance 62B from the longitudinal axis of rotation A of the tool 20. Consequently, none of the grinding edges 48B lay along radials from the longitudinal axis of rotation A. As in the case of the close-offset spurs 46A, the offset 62B is also in the cutting direction. This difference in offsets 62A:62B is optional and considered generally helpful to enhance the aggressiveness of cutting action. For instance, with none of the grinding edges 48A/B laying along radials from the longitudinal axis of rotation A, and offset in the cutting direction, particles of host material ground and/or displaced by the grinding edges 48A/B will be directed into the surrounding host material with a wiping action.
- the offset grinding edges 48A/B will further contribute to, and even enhance, the autografting function of the tool 20.
- the invention also contemplates and fully embraces an apical end in which the grinding edges 48 all share a common offset distance 62 as well as grinding edges 48 radially arranged from the longitudinal axis of rotation A.
- an osteotomy is required to receive a bone implant.
- this invention is not limited to dental applications but may be applied across a wide spectrum of applications. Human (orthopedic) applications are typical, but animal applications are equally plausible and fully within the scope of this invention.
- the invention is not limited to bone applications, but may be used to prepare holes in non-organic materials for industrial and commercial applications, including but not limited to wood, metal foam plastics and other materials both solid and cellular alike.
- a series of steps are required to accomplish the fully formed osteotomy.
- the series of steps include first boring a pilot hole (Fig. 7A) into the recipient bone to form the initial osteotomy, and then incrementally expanding the osteotomy using progressively wider bur devices or tools 20, as shown in Figures 7B-8, until a final intended diameter is achieved.
- the implant or fixture (not shown) is screwed into place. The procedure of forming an osteotomy is described, generally, below.
- the series of steps include first extracting a portion of a tooth to form the initial osteotomy, then incrementally expanding the osteotomy using progressively wider bur devices or tools 20 until a final intended diameter is achieved. Once the osteotomy has been prepared, the implant or fixture is screwed into place.
- the invention is not limited to socket shield procedures. In some applications, it will be desirable to use the improved tool 20, such as in certain hard bone and socket shield conditions. Referring again to Figures 7C-H, it can be observed that while the tool 20 continues to provide much the same osseodensification attributes known from US 2019/0029695, the hollow point configuration allows a small quantity of bone debris to collect inside the cavity 44. This can be beneficial for many reasons, including a desire to limit or subdue expansion, or to facilitate penetration when the host material is especially hard.
- FIG. 9-11 show alternative embodiments in which irrigation ducts may be integrated into the rotary tool 20.
- Osseodensification is a method to preserve bone and its collagen content. Osseodensification is effective because it enhances the plasticity of the host material. Osseodensification allows for enlarging an osteotomy by compacting (and/or by cutting when rotation is reversed) with a bur tool 20 in preparation for a subsequently placed implant or fixture.
- the basic steps of the method begin with the provision of a host material, which in the illustrated embodiment is bone however in other contemplated applications could a non-bone material.
- a precursor hole is also created in the host material as depicted in Figures 7A. This precursor hole may be a pilot hole drilled with a relatively small diameter standard twist drill 64 or a hole formed by other methods.
- the precursor hole has an interior surface (i.e., sidewall) that extends between a generally circular entrance in an exposed surface of the host material and a bottom that is closed, most commonly by the host material itself.
- the bottom of the precursor hole may have a generally conical shape as created by the tip of the pilot drill 64.
- the method further includes the step of providing a tool 20 configured to be turned at high speed in either a cutting or densifying direction. Whether the tool 20 is enlarging by compacting or by cutting, it rotates at high speed as opposed to low-speed oscillating/rocking motions as taught by some prior art systems. To achieve high speed rotation, the tool 20 is operatively connected to a surgical motor, with its rotation speed set somewhere between about 200-2000 RPM. For dental applications, the torque setting may be about 5-80 Ncm.
- copious irrigation is provided in the form of a continuous stream of a substantially incompressible liquid (e.g., saline) onto the rotating body 24 adjacent the entrance to the precursor hole as suggested in Figures 7B.
- a substantially incompressible liquid e.g., saline
- the body 24 of the tool 20 is continuously rotated in a densifying direction while its apical tip is forcibly advanced into the entrance of the precursor hole.
- Continued advance results in an enlargement of the precursor hole as shown in Figure 7D.
- the rotating body 24 has been by forcibly pushed so that its working edges 40 sweep against the interior surface of the precursor hole to gently expand the bone by incremental plastic deformations that cause a progressive enlargement of the precursor hole beginning adjacent the entrance and developing in a frustoconical pattern downwardly toward the bottom of the hole.
- This enlarging step preferably includes axially stroking or pumping the rotating body 24 within the precursor hole so that the working edges 40 alternately lap against the bone interior surface with downward motion and then separate from the interior surface with upward motion in ever deepening movements that cause a progressive plastic deformation of the interior surface of the precursor hole.
- the working edges 40 are in physical contact with the bone or dentin (tooth)
- the surgeon can manually apply variable axial pressure depending on the haptic sensed responsiveness of the bone.
- the enlarging step also includes lapping the working edges 40 against the interior surface of the precursor hole without the working edges 40 cutting into the surrounding bone, and in a manner where the rate of advance toward the bottom of the precursor hole is independent of the rate of rotation of the body 24. This latter characteristic contrasts with some prior art systems that couple tool rotation with the rate of advance.
- Figures 7E and 7F show of the osteotomy using a slightly larger tool 20. Whether this further enlargement is required will be dictated by the specific protocol on a case-by-case basis. If even greater enlargement is needed, a still larger tool 20 can be used to expand the osteotomy, as illustrated in Figures 7G and 7H. Indeed, the number of expansion steps required to achieve the correct size osteotomy is dictated by the implant to be placed and the conditions of the host material.
- the surgeon may choose a traditional osseodensification tool like that shown in US 2019/0029695 to perform the final expansion/densification step. This will assure that all remaining bone debris in the osteotomy is re-patriated/auto-grafted directly into the side walls of the osteotomy in preparation to receive an implant or anchor.
- the tool 20 is configured with an internal duct 66 to conduct a flow of irrigating fluid longitudinally through the shank 22 to a downstream outlet 67 and/or 67’ located at a suitable position on or within the body 24.
- Figure 9 shows the outlet 67 as in internal feature discharging directly into the narrow breach end of the cavity 44.
- the irrigation duct 66 is in direct and exclusive fluid communication with the cavity 44. The flow of irrigating fluid will naturally urge debris out of the cavity 44, thus encouraging maximum autografting.
- the irrigation duct 66 is routed externally to two or more circumferentially distributed outlets 67’ in the stopper section 42 similar to that shown, for example, in PCT/US 19/59964 filed November 6, 2019, the entire disclosure of which is incorporated by reference in jurisdictions permitting the practice. In this latter case, the irrigation duct 66 is not in direct fluid communication with the cavity 44.
- the irrigation duct 66 discharges directly into the breach of the cavity 44 through outlet 67, but also includes two or more circumferentially distributed spur outlets 67’ like those shown in Figure 9A.
- FIG 10 is a perspective view of a rotary tool 120 according to another embodiment of this invention in which the body 124 is straight- sided (i.e., not tapered).
- Figure 11 is a cross- section taken generally along lines 11-11 in Figure 10.
- the flutes 132 are shaped with cutting 134 and densifying 136 faces, lands 138 and working edges 140 to provide osseodensification when operated in the densifying mode.
- the number of flutes 132 is not necessarily correlated to the number of gullets 158 in this embodiment, resulting in only some of the flutes 132 opening directly into a gullet 158. And likewise, only some of the flutes 132 open directly onto a leading flank 150 in this variation of the tool 120.
- This rotary tool 120 includes other unique attributes mentioned previously as optional or alternative features.
- the grinding edges 148 are offset in the densifying direction of rotation. This creates a significantly more aggressive cutting characteristic than the design of Figures 1-6.
- the apex 154 of each grinding edge 148 appears at the radially outmost position. Again, this design cuts more aggressively in the cutting mode than the design of Figures 1-6.
- Another distinguishing feature of the embodiment of Figures 10-11 can be seen in the cavity 144, which has straight cylindrical sidewalls to match the outside shape of the body 124.
- irrigation ducts 166 are integrated into the body 124 of the rotary tool 120 rather than axially through the shank 122 as in Figures 9, 9A and 9B.
- the irrigation ducts 166 are formed in the valleys of each flute 132. Those of skill in the art will appreciate other placements, including straight axial designs, circular or oval holes, and the like. In whatever form, the irrigation ducts 166 facilitate externally applied irrigation fluid to enter the cavity 144 in the lateral direction through the body 124. The flow of irrigating fluid through the ducts 166 will naturally urge debris out of the cavity 144, thus encouraging autografting.
- the present invention when operated with a continuous supply of irrigating fluid, may be used to form holes in many different types of materials in addition to bone.
- malleable metals, wood and plastics may be used at the host material.
- the irrigating fluid in these circumstances may be an oil or cutting-fluid substance rather than water or saline.
- the non bone host material is cellular, like in the case of foam metals, wood and some polymers, the host material may behave somewhat like bone.
- the host material in not cellular but rather solid, displaced stock will have a tendency to mound above and below the hole rather than being auto-grafted into the sidewalls of the hole.
- This mounding represents malleable material that is plastically displaced by the compression wave of the working edge 40.
- the effective stock thickness around a hole formed in non-cellular material will be substantially greater than the original stock thickness, which is considered beneficial to provide greater purchase for an anchor screw.
- the torque for use can be as high as 80ncm for dental applications. Possibly higher for non-dental orthopedic applications.
- This tool 20 can be used in reverse and act as an osseodensifying bur with easier application and less vertical force as compared with the design of US 2019/0029695. Therefore, the hollow-point shape can be used in all bone preparation applications, including but not limited to socket shield procedures.
- the tool 20 may have multiple spurs 46 to grind the bone prior to compaction by the working edges 40 in non-cutting rotation. And the cavity 44 contributes positively to reduce the vertical force needed to advance the tool 20 into an osteotomy.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Dentistry (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Epidemiology (AREA)
- Mechanical Engineering (AREA)
- Surgical Instruments (AREA)
- Dental Prosthetics (AREA)
- Percussive Tools And Related Accessories (AREA)
Abstract
Description
Claims
Priority Applications (10)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2021559416A JP7496624B2 (en) | 2019-04-09 | 2020-04-09 | Hollow point type condensation and compaction device |
EP20788181.4A EP3952760A4 (en) | 2019-04-09 | 2020-04-09 | Hollow-point condensing-compaction tool |
CA3136327A CA3136327A1 (en) | 2019-04-09 | 2020-04-09 | Hollow-point condensing-compaction tool |
AU2020271845A AU2020271845A1 (en) | 2019-04-09 | 2020-04-09 | Hollow-point condensing-compaction tool |
BR112021020264A BR112021020264A2 (en) | 2019-04-09 | 2020-04-09 | Hollow Tip Condensing-Compacting Tool |
KR1020217036528A KR20220021905A (en) | 2019-04-09 | 2020-04-09 | Hollow-Point Consolidation-Compacting Tool |
CN202080042318.XA CN114072079A (en) | 2019-04-09 | 2020-04-09 | Hollow point compaction tool |
US17/602,685 US20220160371A1 (en) | 2019-04-09 | 2020-04-09 | Hollow-point condensing-compaction tool |
IL287075A IL287075A (en) | 2019-04-09 | 2021-10-07 | Hollow-point condensing-compaction tool |
ZA2021/08753A ZA202108753B (en) | 2019-04-09 | 2021-11-08 | Hollow-point condensing-compaction tool |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201962831303P | 2019-04-09 | 2019-04-09 | |
US62/831,303 | 2019-04-09 |
Publications (1)
Publication Number | Publication Date |
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WO2020210442A1 true WO2020210442A1 (en) | 2020-10-15 |
Family
ID=72751702
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2020/027401 WO2020210442A1 (en) | 2019-04-09 | 2020-04-09 | Hollow-point condensing-compaction tool |
Country Status (12)
Country | Link |
---|---|
US (1) | US20220160371A1 (en) |
EP (1) | EP3952760A4 (en) |
JP (1) | JP7496624B2 (en) |
KR (1) | KR20220021905A (en) |
CN (1) | CN114072079A (en) |
AU (1) | AU2020271845A1 (en) |
BR (1) | BR112021020264A2 (en) |
CA (1) | CA3136327A1 (en) |
IL (1) | IL287075A (en) |
TW (1) | TWI745922B (en) |
WO (1) | WO2020210442A1 (en) |
ZA (1) | ZA202108753B (en) |
Cited By (5)
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CN112274273A (en) * | 2020-10-20 | 2021-01-29 | 成都贝施美生物科技有限公司 | Drill bit for dental implantation |
EP3876864A4 (en) * | 2018-11-06 | 2022-07-20 | Huwais IP Holding LLC | Autografting tool for deep reach applications |
US20220233274A1 (en) * | 2021-01-28 | 2022-07-28 | Medimecca Co., Ltd. | Drill for dental implant procedure |
US11583294B2 (en) | 2016-01-14 | 2023-02-21 | Huwais IP Holding LLC | Autografting tool with enhanced flute profile and methods of use |
US20230329726A1 (en) * | 2022-04-19 | 2023-10-19 | Shukla Medical | Trephine |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
KR102174426B1 (en) * | 2018-04-23 | 2020-11-04 | 주식회사 트루어버트먼트코리아 | A drill for dental implant |
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- 2020-04-09 WO PCT/US2020/027401 patent/WO2020210442A1/en unknown
- 2020-04-09 CA CA3136327A patent/CA3136327A1/en active Pending
- 2020-04-09 US US17/602,685 patent/US20220160371A1/en active Pending
- 2020-04-09 BR BR112021020264A patent/BR112021020264A2/en unknown
- 2020-04-09 KR KR1020217036528A patent/KR20220021905A/en unknown
- 2020-04-09 AU AU2020271845A patent/AU2020271845A1/en active Pending
- 2020-04-09 TW TW109111922A patent/TWI745922B/en active
- 2020-04-09 EP EP20788181.4A patent/EP3952760A4/en active Pending
- 2020-04-09 CN CN202080042318.XA patent/CN114072079A/en active Pending
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- 2021-11-08 ZA ZA2021/08753A patent/ZA202108753B/en unknown
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EP3876864A4 (en) * | 2018-11-06 | 2022-07-20 | Huwais IP Holding LLC | Autografting tool for deep reach applications |
CN112274273A (en) * | 2020-10-20 | 2021-01-29 | 成都贝施美生物科技有限公司 | Drill bit for dental implantation |
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Also Published As
Publication number | Publication date |
---|---|
KR20220021905A (en) | 2022-02-22 |
TWI745922B (en) | 2021-11-11 |
US20220160371A1 (en) | 2022-05-26 |
IL287075A (en) | 2021-12-01 |
EP3952760A1 (en) | 2022-02-16 |
JP7496624B2 (en) | 2024-06-07 |
CN114072079A (en) | 2022-02-18 |
EP3952760A4 (en) | 2022-12-21 |
AU2020271845A1 (en) | 2021-11-11 |
JP2022526622A (en) | 2022-05-25 |
CA3136327A1 (en) | 2020-10-15 |
ZA202108753B (en) | 2023-04-26 |
BR112021020264A2 (en) | 2021-12-07 |
TW202042755A (en) | 2020-12-01 |
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