JP2004024621A - Method for extracting debris from root canal treatment instrument and tool therefor - Google Patents

Abstract

The present invention provides a method and a tool for removing fragments that can easily remove fragments of instruments remaining in a root canal.
In a method for extracting a fragment of a root canal treatment instrument broken during root canal treatment, a head CH of a fragment C in a root canal is put into a concave portion 11 at a distal end of a flexible shaft provided in a cutting and expanding tool 1. The step of rotating the flexible shaft in the reverse direction to expand the pulp cavity by the cutting blade 13 provided at the distal end portion, and the concave portion 21 at the distal end of the ultrasonic cutting tool 15 is opposed to the fragment C, and A step of applying ultrasonic vibration to cut and remove the dentin around the head CH of the fragment C to further expand it; and a linear member 37 protruding from the tip of the pipe material 31 provided in the fragment extracting tool 23. And a step of tightening the head CH of the fragment C by the loop portion 35 and extracting the fragment C.
[Selection diagram] Fig. 1

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
TECHNICAL FIELD The present invention relates to a method for extracting debris when a debris remains in a root canal due to breakage of a root canal treatment instrument in root canal treatment such as cavity treatment, and a tool used in each step of the method.
[0002]
[Prior art]
2. Description of the Related Art Conventionally, for example, in the treatment of cavity, it has been practiced to fill a pulp cavity with a root canal filler after removing a pulp (nerve) and to aseptically close the cavity. As described above, when removing the pulp, the tool for removing the pulp may be broken, and fragments may be left in the root canal.
[0003]
As an instrument for extracting the above-mentioned debris, there is an instrument of a type in which a head of the debris is gripped by the chuck and a debris is pulled out in a debris instrument having a freely openable and closable chuck at a distal end of a gripping portion. Further, as described in Japanese Patent Application Laid-Open No. 2001-269356, an annular locking portion for hooking the head of a debris is provided at the distal end of a handle member bent at the distal end of the grip portion. There are appliances with different configurations.
[0004]
[Problems to be solved by the invention]
In a device provided with a chuck that can freely open and close the head of a debris at the tip of the gripping part, when the head of the debris is gripped by the chuck, the positional relationship between the head of the debris and the chuck is reduced. There is a problem that it is not possible to visually check whether or not it is appropriate.
[0005]
In the device described in JP-A-2001-269356, when the annular locking portion is hung on the head of the fragment, the positional relationship between the fragment and the locking portion can be visually checked. Is formed in a teardrop shape by continuously providing a large-diameter communication hole and a small-diameter hold hole for holding fragments.
[0006]
Therefore, considering the elasticity and the like of the material (wire) constituting the locking portion, not only is the formation of the shape of the locking portion troublesome, but also the fragment is simply locked in the hold hole. There is a problem that it may come off from the hold hole.
[0007]
[Means for Solving the Problems]
SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and an invention according to claim 1 is a method for extracting debris from a root canal treatment instrument broken during root canal treatment by cutting and expanding the head of the debris in the root canal. A step of inserting the concave portion at the distal end of the flexible shaft provided in the open tool, reversely rotating the flexible shaft, and expanding the pulp cavity with the cutting blade provided at the distal end portion, and removing the concave portion at the distal end of the ultrasonic cutting tool. Opposing the fragment, applying ultrasonic vibration to the ultrasonic cutting tool to delete the tooth material around the head of the fragment, further expanding the periphery of the head, and preparing a fragment removal tool. And a step of tightening the head of the fragment by a loop portion of a wire member protruding from the tip of the pipe material to remove the fragment.
[0008]
According to a second aspect of the present invention, a fine flexible shaft having flexibility is provided at a distal end portion of a shaft body provided with a mounting portion to a rotation actuator, and a root canal treatment is provided at the distal end portion of the flexible shaft. A cutting and expanding tool having a concave portion into which a head of a fragment of an instrument can enter, opened to the distal end side, and a cutting blade which performs a cutting action at the time of reverse rotation is inclined at a side of the concave portion.
[0009]
The invention according to claim 3 is an ultrasonic cutting tool provided with a mounting portion to an ultrasonic generator, wherein a shaft body long provided in a direction intersecting the axis of the mounting portion has a tip end side. The ultrasonic cutting tool is provided in a tapered shape having a narrow portion, and a concave portion corresponding to a fragment of a root canal treatment instrument is formed on a peripheral surface of a distal end portion of the shaft body.
[0010]
According to a fourth aspect of the present invention, in the long pipe member provided at the tip of the handle member, a wire member having a loop formed at a portion protruding from the tip end of the pipe member is movably provided, and the wire member swings on the handle member. It is a debris extracting tool provided by connecting the wire member detachably to a slide member movably provided.
[0011]
According to a fifth aspect of the present invention, in the debris extracting tool according to the fourth aspect, the hole shape at the tip end of the pipe material is formed in a shape in which one of two circular holes overlaps. It is a debris extraction tool.
[0012]
BEST MODE FOR CARRYING OUT THE INVENTION
For example, in the treatment of cavity, etc., it has been practiced to fill the pulp cavity, which has become hollow by removing the pulp (nerve), with a root canal filler to aseptically close the pulp cavity. As described above, when the pulp is removed, the pulp cavity A becomes narrower toward the distal end of the root B as shown in FIG. 1 (A), so that the instrument breaks and the fragments C are left inside. Sometimes.
[0013]
To extract the fragment C, first, as shown in FIG. 1B, the pulp cavity A near the head CH of the fragment C is expanded. Then, as shown in FIG. 1 (C), when the head CH of the fragment C is shifted to one side of the pulp cavity A in a state where the fragment C is slightly pulled out, the dentin around the head CH is removed. The head CH is positioned substantially in the middle of the pulp cavity A as shown in FIG.
[0014]
Thereafter, as shown in FIG. 2 (B), the head CH of the fragment C is tightened by a loop portion of a wire member provided in the extracting tool, and the fragment C is extracted.
[0015]
As described above, a plurality of steps are required to extract the fragments C. Therefore, tools used in each step will be described in detail.
[0016]
Referring to FIG. 3, FIG. 3 shows a cutting and expanding tool 1 for expanding a pulp cavity A around a head CH of the fragment C. The cutting and expanding tool 1 is, for example, a dental tool. In this configuration, a fine flexible shaft 7 having flexibility is provided at a distal end of a shaft 5 provided with a mounting portion 3 to a rotation actuator (not shown) such as an electric engine.
[0017]
The distal end of the flexible shaft 7 is provided with a plate-shaped enlarged portion 9 having a shape that is thinner toward the distal end and has a larger width, and the enlarged portion 9 has a head CH of the fragment C. A recess (notch portion) 11 that can enter is formed to open in the thickness direction of the distal end side and the enlarged portion 9. On both outer sides of the concave portion 11, cutting blades 13 for performing a cutting action at the time of reverse rotation (left rotation) are formed to be inclined.
[0018]
Therefore, when the mounting portion 3 of the shaft body 5 is mounted on the rotation actuator and rotated in the reverse direction and inserted into the pulp cavity A, the inner surface near the head of the debris C in the pulp cavity A is cut by the cutting blade 13. It will be expanded. At this time, even when the pulp cavity A is slightly curved, the flexible shaft 7 bends in the direction of smaller cutting resistance, so as to follow the curvature of the pulp cavity A. As the cutting of the inner surface of the pulp cavity A by the cutting blade 13 progresses, the head CH of the fragment C relatively enters the concave portion 11 of the enlarged portion 9 as shown in FIG. That is, following the counterclockwise rotation of the enlarged portion 9, the debris C is also slightly counterclockwise rotated and tends to escape though slightly.
[0019]
As described above, the pulp cavity A near the head CH of the fragment C is expanded by the cutting and expanding tool 1, and the tip of the shaft 5 of the cutting and expanding tool 1 is moved in a state in which the fragment C slightly comes out. When the enlarged portion 9 is extracted from the dental pulp cavity A, the head CH of the debris C tends to fall so as to contact the inner surface of the expanded dental pulp cavity A, as shown in FIG.
[0020]
Therefore, the ultrasonic cutting tool 15 is used to adjust the head CH of the debris C so as to be located substantially at the center of the expanded pulp cavity A. As shown in FIG. 4, the ultrasonic cutting tool 15 has a mounting portion 17 to an ultrasonic vibrator provided in an ultrasonic generator (not shown), and a shaft 19 of the ultrasonic cutting tool 15. Is long in the direction intersecting the axis of the mounting portion 17, and is formed in a tapered shape so that the front end side becomes thinner to about 0.4φ.
[0021]
A recess 21 corresponding to the outer periphery of the head CH of the fragment C is formed at the tip of the shaft 19. The concave portion 21 is formed in an arc groove shape, and a cutting blade 21B is formed at an intersection of the arc surface 21F and the peripheral surface of the arc groove, and a tip end surface 21E is formed as a cutting blade. .
[0022]
According to the above configuration, the ultrasonic cutting tool 15 is inserted into the dental pulp cavity A such that the concave portion 21 at the distal end of the shaft body 19 faces the head CH of the fragment C, and applies ultrasonic vibration to the shaft body 19. As a result, the cutting blade 21B and the tip end surface 21E cut and remove the dentin around the head CH of the fragment C, and the periphery of the head CH of the fragment C is as shown in FIG. Then, the space is further expanded to form a relatively large space.
[0023]
The difference between FIGS. 4A and 4B is that the position of the concave portion 21 provided at the front end of the shaft body 19 is different from whether it is located outside or inside the bent shaft body 19. The different pieces are used depending on the difference in the inclination direction of the head CH of the fragment C.
[0024]
As described above, the debris extraction tool 23 is used to extract the debris C whose head CH is positioned substantially at the center of the expanded dental pulp cavity A. As shown in FIG. 5, the debris extracting tool 23 has a cylindrical handle member 25, and a joining cap 29 is removably fitted to a tip end of a fitting hole 27 of the handle member 25. It is.
[0025]
A thin and long pipe material 31 is integrally attached to the joining cap 29. The tip of the pipe material 31 has a hole 33 at the tip having a shape of one of two circular holes as shown in FIG. The portions are crushed from both sides so as to exhibit a hole shape in which the portions overlap, that is, an approximately 8-shaped shape. In other words, the hole 33 is divided into two parts by crushing the tip of the pipe material 31 from both sides. Then, both ends of the wire member 37, which is guided by the partitioned portion of the hole 33 and forms a loop 35 at a portion protruding from the front end of the pipe material 31, and folded back, are the pipe material 31 and the partial cap. 29, and is fixed to the locking piece 39.
[0026]
The distance between the closest parts when the hole 33 is crushed is smaller than the diameter of the wire member 37 so that the wire member 37 does not enter the hole 33.
[0027]
The locking piece 39 is removably engaged with a locking portion 43 of a slide member 41 provided slidably in the fitting hole 27 provided in the handle member 25. An operation slide trigger 47 movably engaged with a longitudinal slot 45 formed in the handle member 25 is integrally attached to the slide member 41 via a bolt. Then, the elastic member 49 such as a coil spring elastically mounted between the slide member 41 and the bottom of the fitting hole 27 constantly urges the slide member 41 in a direction in which the slide member 41 comes into contact with the fitting cap 29. ing.
[0028]
In the above configuration, the loop 35 is formed in a portion where the wire member 37 protrudes from the tip of the pipe member 31 in a normal state, and the slide trigger 47 is operated to oppose the urging force of the elastic member 49. When the slide member 41 is moved inward of the fitting hole 27 and the wire member 37 is pulled in, the diameter of the loop 35 gradually decreases.
[0029]
Since the wire member 37 is guided by a substantially figure-eight hole formed at the distal end of the pipe material 31, the portion protruding from the distal end of the pipe material 31 is not twisted, and 35 can be formed large.
[0030]
Therefore, as described above, when the head CH of the debris C is positioned substantially at the center of the pulp cavity, the tip of the pipe material 31 of the debris extraction tool 23 is moved to the pulp cavity. Put in A. Then, as shown in FIG. 2 (B), after the head CH of the fragment C is put into the loop 35 protruding from the distal end of the pipe material 31 and formed large, the slide trigger 47 is operated as described above. Then, the loop 35 is gradually reduced, and the head CH of the fragment C is fastened by the loop 35 of the wire member 37. Thereafter, the fragments C can be extracted by taking out the fragments extraction tool 23 to the outside.
[0031]
In addition, even if the loop 35 is reduced due to an erroneous operation of the slide rig 47, the line member 37 does not enter the hole 33. It's easy.
[0032]
In the debris extracting tool 23, the joining cap 29 is detachable and replaceable with respect to the fitting hole 27 of the handle member 25, and the locking piece 39 connecting the end of the wire member 37 is used to lock the slide member 41. Since the wire member 37 is detachable and replaceable with respect to the portion 43, the joint cap 29 on the distal end side can be detached when necessary, such as when the wire member 37 is broken or used several times, or in a sanitary manner. It can be detached and replaced, and can always maintain a good state.
[0033]
As already understood, when the instrument is damaged during root canal treatment and the debris C remains in the root canal part, the cutting blade 13 surrounds the vicinity of the head of the debris C with the cutting and spreading tool 1. To expand the dental pulp cavity A and cut and remove the dentin around the head CH of the fragment C with the concave portion 21 of the ultrasonic cutting tool 15 facing the head of the fragment C. Is further expanded, the head CH of the shard C is tightened by the loop 35 of the wire member 37 provided in the shard extraction tool 23, and the shard C is extracted. Therefore, the shard C is reliably extracted. Things.
[0034]
Since the cutting blade 13 performs a cutting action when the cutting and spreading tool 1 rotates counterclockwise, even if the cutting blade 13 rotates in a direction in which the debris C is extracted, the cutting blade 13 rotates in the embedding direction (clockwise rotation). It is possible to satisfactorily expand the pulp cavity A without any problem.
[0035]
Further, in the ultrasonic cutting tool 15, the concave portion 21 provided at the tip portion is opposed to the head CH of the fragment C to perform a cutting and removing action of the tooth material around the head CH of the fragment C by ultrasonic vibration. Therefore, it is possible to easily perform the widening cutting action for hanging the loop 35 of the wire member 37 on the fragment C.
[0036]
Further, in the fragment removal tool 23, the head C of the fragment C is removed in a state where the head CH of the fragment C is tightened by the loop 35 of the wire member 37, so that the head CH of the fragment C comes off from the loop 35. Without such a problem, the debris can be reliably removed.
[0037]
【The invention's effect】
As will be understood from the above description, according to the present invention, it is possible to easily remove the fragments of the instrument remaining in the root canal part, and to solve the conventional problems as described above.
[Brief description of the drawings]
FIG. 1 is an explanatory view of a step of extracting pieces of the instrument remaining in a root canal part.
FIG. 2 is an explanatory view of a step of extracting pieces of the instrument remaining in a root canal portion.
FIG. 3 is an explanatory view of a cutting spread tool.
FIG. 4 is an explanatory view of an ultrasonic cutting tool.
FIG. 5 is an explanatory view of a debris extracting tool.
FIG. 6 is an explanatory diagram of a hole shape at a tip portion of a pipe material.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Cutting expansion tool 5, 19 Shaft 7 Flexible shaft 9 Enlarged portion 11, 21 Recess 13 Cutting blade 15 Ultrasonic cutting tool 23 Debris extraction tool 25 Handle member 27 Fitting hole 29 Joining cap 31 Pipe material 33 Hole 35 Loop 37 wire member 39 locking piece 41 slide member 47 slide trigger 49 elastic member

Claims (5)

In the method of extracting debris of a root canal treatment instrument damaged during root canal treatment,
(A) Put the head of the debris in the root canal into the concave portion at the tip of the flexible shaft provided in the cutting and spreading tool, rotate the flexible shaft in the reverse direction, and expand the pulp cavity with the cutting blade provided at the tip. Opening, (b) facing the debris with the concave portion at the tip of the ultrasonic cutting tool, applying ultrasonic vibration to the ultrasonic cutting tool to delete the tooth material around the head of the debris, The process of further expanding around the head,
(C) a step of tightening and removing the head of the fragment by a loop portion of a wire member protruding from a tip end portion of the pipe material provided in the fragment removal tool;
A method for extracting debris from a root canal treatment instrument, comprising the steps of: A fine flexible shaft having flexibility is provided at the distal end of the shaft provided with a mounting portion to the rotation actuator, and the head of the fragment of the root canal treatment instrument enters the distal end of the flexible shaft. A cutting-expanding tool, characterized in that a possible concave portion is opened to the front end side, and a cutting blade that performs a cutting action at the time of reverse rotation is provided at an angle to a side of the concave portion. An ultrasonic cutting tool provided with a mounting portion to an ultrasonic generator, wherein a shaft body long provided in a direction intersecting with the axis of the mounting portion is provided in a tapered shape in which a tip portion side becomes thinner. An ultrasonic cutting tool, wherein a concave portion corresponding to a fragment of a root canal treatment instrument is formed on a peripheral surface of a distal end portion of a shaft body. In a long pipe member provided at the tip of the handle member, a wire member having a loop formed at a portion protruding from the tip portion of the pipe member is movably provided, and a slide member movably provided on the handle member is provided. A debris extraction tool, wherein the wire members are provided so as to be detachably exchangeable. 5. The fragment removing tool according to claim 4, wherein the shape of the hole at the tip end of the pipe material is formed in a shape in which one of two circular holes overlaps. .

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