Dental packing instruments

There is provided an apparatus for pressing into place, in the sub-gingival area, packing to separate a tooth and the soft tissue, or sulcus, in preparation for carrying out dental procedures. In a first embodiment, a mechanically driven packing hammer is provided for pressing conventional cord packing into place. The packing hammer comprises a reciprocating drive, a hammer comprising an elongated shank operatively and directly, but removably, connected to the reciprocating drive, and a hammer head rigidly secured to the shank; the hammer head is secured to the shank end distal from the reciprocating drive. The end surface of the hammer head is concave and extends substantially transverse to the axis of the shank. An external guide, rotatably secured to the reciprocating drive at a first end, extends along the length of, and substantially coaxial with and surrounding, the hammer. The external guide means has an opening at the second end, distal from the reciprocating drive so as to permit reciprocal movement of the hammer end surface from a first position inward of the guide to a second position substantially coterminous with the second end of the guide.

BACKGROUND OF THE INVENTION: 
This invention relates to dental accessories, and more particularly to 
apparatus, and a method for utilizing the apparatus, for deflecting the 
gingival area about a tooth prior to, and in order to render more 
accurate, the forming of negative impressions of relevant teeth in a 
patient's mouth. 
In the restoration or replacement (by a prosthesis), of teeth or portions 
of teeth, as by the production of crowns or dental bridges and the like, 
it is common procedure to form an elastic mold from which a model is made 
for the formation of the dental prosthesis, or a cap or crown. This mold, 
or dental model, is generally formed as a negative impression, as an 
imprint of a prepared tooth and the surrounding gum area. The mold is then 
used in the construction of a model or case on which replacement teeth are 
made for the patient. 
The prosthesis is formed from the negative impression in the mold. It is 
clear, therefore, that this mold impression must be accurate, in order to 
form the desirably accurate prosthesis. A sufficiently accurate mold for 
forming the prosthesis, must include not only impressions of the normally 
visible portions of the tooth to be molded, but also that portion of the 
tooth which normally extends just below the gum line or gingiva, i.e., the 
so-called "margin", of the tooth. Conventionally, this is obtained by 
packing a woven cord, or thread, around the margin of the tooth, so as to 
hold aside the soft tissue and to also dry out this socket adjacent the 
tooth, i.e., the sulcus. This is normally a laborious task where the 
dentist manually pushes in a strand of cord into the sulcus utilizing a 
dental probe moving around the circumference of the tooth. An alternative, 
where possible is to cut away the gum line from the tooth in order to gain 
access to the terminal portion of the prepared tooth. 
SUMMARY OF THE INVENTION: 
It is an object of the present invention to provide improved apparatus to 
pack, more quickly and accurately, and with less discomfort for the 
patient, the sub-gingival area surrounding a prepared tooth to be molded, 
for the formation of a dental prosthesis. It is yet another object of the 
present invention to provide means to pack thread into the sub-gingival 
area quickly and directly without requiring a separate cutting operation. 
A further object of the present invention is to provide mechanical means 
for packing a tooth with thread utilizing conventionally available 
reciprocating drive means, which can be manually powered or powered by 
compressed air or electricity, for example. It is a further object of the 
present invention to apply to the sub-gingival area a material which forms 
a solid in situ within the volume of the sulcus. 
In accordance with the present invention, there is first provided 
mechanically driven means for pressing into place, in the sub-gingival 
area, conventional cord packing. This mechanically driven packing means 
comprises reciprocating drive means; a hammer means comprising an 
elongated shank member operatively and directly, but removably, connected 
to the reciprocating drive means, and a hammer member rigidly secured to 
the shank member so as to reciprocate therewith, the hammer member being 
secured to the shank end distal from the reciprocating drive means, the 
end surface of the hammer member being formed with a concave surface 
extending substantially transverse to the axis of the shank means; and 
external guide means rotatably secured to the reciprocating drive means at 
a first end thereof and extending along the length of and substantially 
coaxial with the hammer means, the external guide means substantially 
surrounding the hammer means along the length thereof and being provided 
with an opening at a second end distal from the driving means and 
surrounding the distal end surface of the hammer member, to permit 
reciprocal movement of the hammer surface from a first position inward of 
the guide second end to a second position substantially coterminous with 
the guide second end. The tip of the guide is so formed with rounded end 
edges as to be able to push aside the gum and other soft tissue adjacent 
the margin of the tooth. The guide means has at least one substantially 
planar external surface extending longitudinally along the guide from the 
open second end, and has a cross-section such that the width of the planar 
surface is greater than the width of the side external surfaces transverse 
to the planar surface. 
In a second embodiment of the present invention, there is provided a 
syringe packing tool means designed to be secured to a syringe, or other 
pressurable reservoir, in place of the usual syringe needle point, the 
tool comprising a tool barrel portion having a first open end and a second 
end, reservoir, e.g., syringe fluid connection means in fluid flow 
connection between the reservoir and the second end of the tool barrel, 
the tool barrel being rotatably connected thereto. Preferably, the tool 
barrel portion extends transverse to the axis of the fluid connection 
means, e.g., the syringe barrel. 
The tool barrel comprises a first external planar surface extending axially 
along the barrel portion from the open, first end inwardly towards the 
syringe connection, the open end of the barrel being shaped so as to 
permit insertion of the end of the barrel into the space between a tooth 
and its adjacent soft tissue, or gingiva, and having openings at the outer 
end facing transversely of the longitudinal axis of the barrel. 
Elastomeric material, which can form in situ, can be introduced through 
the tool barrel from the syringe, and into the space between a tooth and 
the soft tissue, or sulcus. 
The mechanized dental packing tool of the present invention can be used 
with and powered by a conventional, commercially available reciprocating 
drive head, usually powered by electricity or a pressurized fluid, to 
which this device can be connected in a conventional manner. Such a drive 
head comprises conventional driving elements which do not, in themselves, 
form a part of the present invention and, thus, need not be illustrated in 
greater detail. Examples of suitable reciprocating drive means are shown 
for example in U.S. Pat. Nos. 3,552,022 to Axelsson and 4,629,426 to Levy. 
Conventionally available such dental driver handpieces are of a 
sufficiently slender, and elongated nature, often having a contra-angle 
head, to enable the dentist to easily and without injury to the patient, 
manipulate the device within the mouth and, most particularly, even with 
respect to the rearmost molars. Because of its conventional nature, the 
hand-held driver device need not be described in greater detail than is 
shown in the drawings, as such detail can be determined from the prior 
disclosures, e.g., as referred to above. 
Alternatively, power for the hammer tool can be provided by manually 
operated means, such as a spring-loaded triggering mechanism or a 
foot-treadle operated device.

Referring to FIGS. 1 through 7, the mechanized packing hammer of the 
present invention comprises an outer guide barrel, generally indicated by 
the numeral 10, and including a barrel portion 11 having a substantially 
rectangular, but rounded out, cross-section wherein the wider sides 8 are 
substantially planar but the narrower sides 9 have a convex shape serving 
as a rounded point. The outer end of the barrel is open and the major 
sides 8 have rounded or chamfered ends 15. 
An outwardly tapered or funnel-shaped transition portion 12 is secured to 
and integral with the second end of the barrel 11 and is pivotally 
connected to a support frame, generally indicated by the numeral 20. The 
wider end 13 or the transition portion is substantially circular in 
cross-section and includes a reentrant portion 18 which interlocks, or 
mates, with a similar circular reentrant portion 21 of the frame 20 to 
maintain the pivoting connection. 
Extending coaxially within the guide member 10 is a reciprocable hammer 
tool, generally indicated by the numeral 30, which extends from within, or 
beyond, the distal end of the handpiece head, generally indicated by the 
numeral 40, to the open distal end 15 of the guide barrel 11. The hammer 
tool 30 comprises the cylindrical drive shank portion 31, a hammer shank 
portion 32 and the hammer head 33. The drive shank 31 has a slot formed at 
its driving end and the remaining material, i.e., forming two legs 31a, 
31b, are flexibly elastic and can be pressed together to enable the shank 
to be pressed into the handpiece head 40; when the drive shank 31 is in 
place, and the two legs 31a, 31b spring apart to their normal position, 
the drive shank 31 cannot be pulled out of the handpiece head 40, in 
either axial direction until the two legs 31a, 31b are again pinched 
together. A circumferential welt 34 on the outer surface of the legs 31a, 
b, fits into a mating slot 42 in the handpiece head drive piston 44. 
The hammer shank 32 extending towards the second end of the hammer piece 30 
is substantially rectangular in cross-section, its sides being 
substantially parallel to the sides of the guide barrel 11. An 
intermediate transition portion 38 flares inwardly from the circumference 
of the drive shank 31 to the shape and size of the hammer shank 32, 
substantially coaxially with the transition portion 12 on the guide 
barrel. 
The second end of the reciprocating hammer member 30 includes the hammer 
head 33. The hammer head 33 has a somewhat enlarged cross-section compared 
to the cross-section of the hammer shank 32, especially along the narrower 
dimension. In addition, the hammer end surface 133 includes a concavity 
defined by curved surface 37, to provide better control over any thread to 
be packed. 
It is normal dental practice, after a tooth is prepared and as part of the 
procedure for applying a dental prosthesis, to prepare an impression of at 
least the portion of the mouth surrounding the prepared tooth. In making 
the impression, or mold, it is generally necessary to also include the 
gum, or soft tissue, surrounding the tooth, and to separate the soft 
tissue from the lower portion, or margin, of the tooth and to dry out that 
immediate portion of the soft tissue, i.e., the sulcus, which would 
otherwise be in contact with the lower tooth surface or margin. It is 
generally understood that the term "margin" refers to that portion of the 
lower part of the tooth, normally beneath the gum, but which must be in 
intimate contact with, the open end of the crown or cap. 
In accordance with the method of use of the present invention, the 
procedure normally requires first pressing the open end 15 of the guide 
barrel 10 against the gum line of the tooth, so as to separate the gum, or 
soft tissue, from the tooth surface. A packing thread (T, in FIG. 6) is 
placed in that location and the handpiece turned on such that the hammer 
head surface 133 pushes the thread down into the sulcus, or space between 
the gum and the tooth surface. 
The shape of the guide barrel 10, specifically its narrow rounded ends and 
flat sides, permits the operator to push the guide piece around the tooth, 
keeping one wide flat surface 11 against the gum surface to separate the 
gum tissue from the tooth surface as the hammer head 33 presses additional 
packing thread, which is simultaneously being fed in between the tooth and 
the gum. The axis of the hammer shank 32 is maintained substantially 
parallel to the axis of the tooth, and the flat wide sides 11 of the guide 
10 are maintained in contact with the gum, and the tooth surface when the 
gum is close to the tooth. This is shown, more clearly in FIGS. 1 and 2; 
in FIG. 2, a partially packed tooth is shown, and the changing orientation 
of the swivelling guide member 10 as the operator moves the tool around 
the tooth surface packing the thread into place, is shown by phantom 
lines. As the guide member 11 is moved around the tooth, the pressure of 
the planar guide surface 8 against the gum surface causes the guide member 
11 to swivel and thus to maintain the desired alignment. 
In the simplest case shown in FIGS. 1 through 7, the hammer shank 32 
swivels together with the guide barrel 11, as the shape of the hammer 
shank is similar to that of the rectangular guide barrel. However, if 
desired, as shown in FIG. 8, a manual wheel 51 can be secured into the 
slot between the drive shank legs 31a,b, and used to turn the hammer piece 
30 manually to a desired orientation, either during the packing operation 
or initially. 
As shown in the drawings, a portion of a commonly available reciprocating 
handpiece is shown having a drive barrel portion 44, which is gripped by 
an elastic spring-loaded clip 25, forming a part of the frame 20 of the 
packing tool. The clip 25 is spring-loaded so as to tightly grip the 
barrel 44, thus securing the device in place. A secondary support member 
26 is provided resting against the front end of the handpiece head 40 to 
further stabilize the guide during use. 
To provide some general background, the conventional reciprocating drive 
handpiece shown provides means to convert the rotary motion of a shaft 43, 
having an eccentrically arranged drive tip 48, into reciprocating motion, 
by virtue of the action of the tip 48 against the sleeve piston 45: The 
eccentric tip 48 moves, back and forth between the enlarged top and bottom 
flanges 46, 47, thus pushing the sleeve 45 and thus the hammer 30 in an 
axially reciprocating motion. 
It has been found preferable to provide a concavity in the hammer head 
surface 33, having a radius of curvature at least twice that of the radius 
of the packing cord. The total width of the hammer head, in the dimension 
encompassing the curved portion is preferably no greater than 1.4 mm, 
i.e., the narrower dimension. The wider dimension of the guide member is 
preferably about 2.4 mm, and the narrow dimension about 1.8 mm; the 
interior barrel chamber within the guide barrel 11 is preferably similar 
in cross-section to the cross-section of the hammer member, but 
sufficiently larger not to obstruct the axial movement of the hammer. Most 
preferably, the narrower cross-section dimension of the guide is not 
larger than the major cross-section dimension of the hammer, so that 
pivoting either member causes the other member to follow. Preferably, at 
least the guide tip portion 15 is somewhat thickened along one of the 
major surfaces 8, which should be the side facing the tooth surface. This 
maintains a suitable distance to prevent the hammer from striking the 
tooth. 
The packing thread is usually impregnated with a drying agent to aid in 
drying the soft tissue surrounding the prepared tooth. The packing thread 
is removed prior to placing the impression material around the tooth, to 
prepare the mold impression. A supply of packing thread, as on a spool, or 
roller, can be rotatably secured about its axis to the tool frame 20, or 
to another portion of the handpiece, if desired. 
In accordance with a further aspect of the present invention, the mold 
material, for obtaining an accurate impression of the tooth margin, can be 
applied using a special tapered syringe barrel, in accordance with this 
invention, after the packing is removed, but before the gum has a chance 
to retract and remoisten itself. 
In accordance with the second aspect of this invention, a conventional 
syringe is modified by the substitution for the usual needle tip, of a 
curable elastomeric material dispensing tool, generally indicated by the 
numeral 100, having a tip designed to pack in a ribbon shape the curable 
resinous material between the soft surrounding gum and the margin of the 
tooth. 
The ribbon forming packing tool of the present invention comprises a tool 
barrel, generally indicated by the numeral 110, opening outwardly at one 
end 108 and integrally connected at its second end to an outwardly tapered 
or funnel-shaped transition portion 116, which has a substantially 
circular second end cross-section 117. The second end 117 of the 
transition portion is pivotally and sealably connected to the tool head 
118, which is in turn transversely connected, preferably perpendicularly, 
to a feed tube 119, designed to be connected to the outlet from a syringe 
barrel 130. 
The tool barrel 110 preferably has a substantially constant oval or rounded 
rectangular cross-section along most of its length; and has two opposed 
major surfaces 109, 111, at least one of such major surfaces 109, 111 
preferably is substantially planar along its entire length between the 
junction with the connecting portion 116 and the outer tip, generally 
indicated by the numeral 108. The two opposing narrower sides of the tool 
barrel 110 have a preferably rounded, convex shape to provide a relatively 
mild point curve 114, or prow, to aid in pushing aside soft tissue, as the 
barrel is moved around the tooth. 
At the outer tip 108 of the barrel, the opposing narrower sides 114 of the 
tool barrel are partially cut away to form the pointed tips 124, 128: The 
tip 124 at the end of the flat major surface 111 is cut away to a 
relatively narrow point 124, defined by curved surface 127, and curves 
radially inwardly towards the second major surface 109. The tip 128 of the 
second major surface 109 comes to a more rounded end defined by curved 
surface 125, and is generally broader and more spade-like in appearance as 
compared to the shorter end 124. In addition, the more spade-like tip 128 
extends beyond the end of the shorter point 124 and curves inwardly so as 
to extend beyond and around the shorter point 124. These inwardly curving 
tips 124, 128 surround sideward facing openings, which are defined by the 
curved edge surfaces 125, 127, for expelling the resin in a ribbon-like 
form. 
The entire resin packing tool 100, is secured to the syringe barrel 130 at 
the usual syringe tip connection 131 via feed tube 119. The feed tube 119 
extends into the side of the tool barrel head 118 preferably substantially 
perpendicularly to the axis of the tool barrel 110. The swivel connection 
117 between the funnel portion 116 and the tool barrel head 118 is 
designed to be substantially fluid tight to prevent loss of any material 
transmitted from the syringe through the tool, and is similar in 
construction to that shown for the hammer guide in FIG. 4, above. 
In the preferred embodiment shown in the drawings, there is also provided a 
pistol-type grip for the syringe barrel. The simple grip shown in FIG. 9, 
generally indicated by numeral 160, forms a slidable snug fit around the 
syringe barrel 130. The rearward grip portion 162 is braced against the 
hilt 163 of the syringe, and the forward grip portion 154 is spring loaded 
against the outer surface of the syringe barrel 130. 
The more preferred embodiment of FIG. 10 includes clamping means 176, 179 
for gripping the syringe barrel 130, which rests upon the grip platform 
portion 177. The clamping means 176, 177, 179 are integral with the grip 
handle, generally indicated by the numeral 170, and which includes a 
forward handle portion 173, in immediate connection with the clamping 
means finger 179 and the clamping platform 177. The clamping finger 179 is 
braced against the syringe hilt 163. The rear handle portion 174 is 
integral with and in immediate connection with the pressure hammer 178, 
which is pressed against the syringe plunger head 165. 
The syringe plunger 162 and barrel 130 are of substantially conventional 
manufacture as shown in the drawings. 
In accordance with conventional dental practice, after a tooth is prepared 
to accept a crown or cap, and the surrounding soft tissue has been freed 
and deflected from the tooth margin surface, and the sulcus dried, using 
the packing thread as described above, for example, the packing thread is 
removed and the syringe tool tip 108 is inserted into the sulcus space 
between the soft tissue and the tooth surface, as shown for example in 
FIG. 16. The relatively flat tool barrel surface 111 is pressed against 
the tooth surface and the rounded major surface 109 is pressed, at its 
lower spade end 128, against the soft tissue, forcing it away from the 
tooth surface. 
The syringe can be filled with a self-curing elastomeric precursor material 
of a type conventionally used for the formation of dental impressions. 
Such curable material is generally a resinous precursor of an elastomeric 
polymer, which is safely curable in situ in the mouth of a patient. The 
syringe plunger 162 is depressed while moving the tool barrel tip 110 
around the tooth margin. The planar tool barrel surface 111 is maintained 
pressed against the outer surface of the tooth to maintain the tool barrel 
110 in the desired orientation. As the tool barrel 110 is moved around the 
tooth, the barrel 110 can swivel, thereby permitting the continuous 
circumferential movement around the tooth, without lifting up the tool, 
thus providing for a continuous and smooth application of the molding 
resin. As the tool barrel 110 is pushed around the tooth surface, the 
relatively pointed side surfaces 114 act to push away the soft tissue from 
the tooth to make way for the resin. 
The pistol grip 160 or 170 provides for comfortable and accurate movement 
of the tool around the tooth. The simpler grip 160 of FIG. 9 is held by 
one hand while the thumb of that hand presses against the syringe plunger 
head 165. The cross piece 168 prevents the two halves 154, 161 of the 
handle grip 160 from being squeezed together when holding the grip. When 
utilizing the grip of FIG. 10, squeezing the handle portions 174, 173 
together, results in the depression of the syringe plunger 162, as the 
handle hammer portion 147 is pressed against the plunger head 165. In both 
embodiments, the other hand is free to guide, or to provide extra support, 
for the tool barrel 110.