ENDODONTIC INSTRUMENT

Abstract: An endodontic instrument includes a slightly tapered working portion (20) defined on a flexible shaft. The working portion (20) includes a plurality of helical rotationally bi­ directional cutting edges (24, 26, 28) thereon. The instrument includes a tapered tip (74) defined on the flexible shaft and intersecting an end of each of the cutting edges. The tapered tip (74) is shaped such that the sharp cutting points which are normally present at an intersection between the ends of the cutting edges and a standard 75° included angle conically tapered tip are substantially eliminated so that lateral transportation of the instrument when cutting a curved root canal is reduced.

Description: The present invention relates to endodontic instruments such as files and reamers. The field of endodontics involves the cleaning of the root canals of human teeth for the purpose of removing organic material and any extraneous material present, and the enlarging of the root canal, so that it may be filled. To perform such an operation, an opening is cut in the upper part of the tooth to open up the hollow portion of the tooth, and small endodontic instruments are then utilized to clean and enlarge the long narrow tapered root canals. One very commonly used such instrument is known as a K-type file and is shown for example in US-A-4299571 and is constructed by axially twisting a tapered triangular cross-section shaft to form three spiral cutting edges along the tapered portion of the shaft. A K-type file normally has a conical tapered tip ground on the end thereof, which in accordance with standards set up by the American Dental Association and other standardizing bodies has an included angle of 75° with an allowable tolerance of plus or minus 15°. At the intersection of this tip with the ends of the three spiral cutting edges, relatively sharp points are created which extend laterally from the axis of the endodontic instrument. While these standard K-type files perform entirely satisfactorily when cleaning and enlarging a straight root canal, a serious problem is often encountered when using such files on a curved root canal. Since a very large portion of the root canals encountered by a practising endodontist are curved this problem is a significant one for the profession. While cleaning and enlarging a root canal, the operation is performed using a set of similar endodontic files of sequentially increasing diameter. Typically an operation is begun with a file having an outside diameter at its smaller end of 0.25 millimeters. The subsequently used instruments have diameters of 0.30, 0.35, 0.40, 0.45, 0.50, 0.55, and 0.60 millimeters. Still further instruments are available with diameters increasing in steps of 0.10 millimeter up to 1.40 millimeters for the largest size in common usage. Also, some smaller instruments are available which are sometimes used, and which have diameters of 0.10, 0.15 and 0.20 millimeters. File sizes correspond to diameter, and thus a No. 25 file has an outside diameter at its smaller end of 0.25 millimeters. The 0.25 millimeter diameter and other smaller instruments are relatively flexible and can easily be inserted into the canal and will easily bend to fit any curved shape of the canal. With increasingly larger sizes, however, the instrument becomes significantly less flexible and becomes more and more difficult to insert through the curved portion of the canal. When utilizing the instrument to enlarge the curved portion of the canal, the force exerted along the axially outermost portion of the instrument against the root canal is very much greater against that part of the outside than against the inside of the curve in the root canal. Indeed, in many cases, the instrument will cut only on the outside of the curve along those portions of the root canal near the apex. Thus, when this problem is first encountered, the instrument will tend to cut a ledge along the outside of the curve at the forwardmost point in the root canal which is reached by the instrument. The succeeding instruments of greater diameter then encounter even more difficulty in conforming to the curved shape of the canal, since it is difficult and sometimes impossible to move the tip of the next larger instrument past the ledge created by the previous instrument. Accordingly, the ledge is enlarged by each successively larger instrument, and ultimately the instruments very much enlarge the root canal at the point of forwardmost extent of the instruments, and in severe cases the instruments may even perforate the side of the tooth causing serious consequences for the patient. The problem just described is often referred to as "transportation" of the instrument tip, since the tip is transported or moves laterally away from the original root canal. This problem of transportation is also present to some extent in endodontic instruments other than the standard K-type instrument, although it is generally most severe with the K-type instrument. For example, this problem is also encountered utilizing a Hedstrom instrument which is constructed by machining one or two cutting grooves in a round tapered shaft. The Hedstrom instrument differs substantially from the K-type instrument in that it can only cut in a single rotational direction, whereas the K-type instrument has spiral cutting edges which are rotationally bi-directional in that they may cut when rotated either clockwise or counterclockwise. Although the prior art has appreciated the fact that transportation does occur when using endodontic instruments, and it is known that this is a serious problem which many persons have tried for a long period of time to correct, it is not believed that prior to the present invention anyone has appreciated the primary cause of lateral transportation in a K-type instrument. The present invention provides an improved construction for K-type files in which the tapered tip portion at the location whhere it joins the cutting edges is continuously curved or has a profile of rotation (86) at least partly defined by a plurality of intersecting straight lines (88,90) from the forwardmost end (4, 8, 74) thereof to the adjacent ends (4, 6, 96) of the cutting edges, causing the tapered tip to be substantially free from any sharp cutting points at said location. By removing these sharp points, the high stress concentration previously created where the points engaged the tooth material is eliminated and the forces exerted by the axially forwardmost part of the instrument against the wall of the root canal is spread over a much greater area of the tooth material and no sharp ledges are created. In a preferred embodiment of the invention, the tapered tip includes an axially outermost tapered portion which is substantially conical in shape and has an included angle in the range of 60° to 90°, and includes an axially innermost tapered portion which is substantially frusto-conical in shape and has an included angle of substantially less than 75°. In order that the features and advantages of the present invention will be readily apparent to those skilled in the art, the following description is given, merely by way of example, reference being made to the accompanying drawings, in which: FIG. 1 illustrates a typical prior art K-type endodontic file; FIG. 2 is a very much enlarged illustration of the axially outermost portion of the prior art K-type file; FIG. 3 is a view similar to FIG. 2 of one embodiment of endodontic instrument according to the present invention; FIG. 4 is a view similar to FIG. 3 of a second embodiment of instrument according to the present invention; FIG. 5 is a cross-sectional view of a blank shaft of the type used to construct a standard K-type file, prior to the axial twisting of that shaft to form the spiral cutting edges; FIG. 6 is a view similar to FIG. 5 of the section after twisting; FIG. 7 is a cross-sectional schematic view of a human tooth having a curved root canal, prior to the cleaning and enlargement of the root canal; FIG. 8 is a similar view showing the tooth which has been cleaned and enlarged with standard K-type endodontic instruments of the prior art; and FIG. 9 is a similar view showing the tooth which has been cleaned and enlarged utilizing the improved endodontic instruments of the present invention. The typical prior art K-type file 10 shown in FIG. 1, includes a flexible tapered shaft 12, having attached to one end thereof a handle 14 constructed to be grasped by the dentist between the thumb and forefinger of one hand. The shaft 12 has a working portion 16 formed thereon by axially twisting the shaft. Prior to axially twisting, the untwisted working portion 16 has a polygonal cross-section which is preferably shaped as an equilateral triangle as seen in FIG. 5. After twisting, the cross-section appears somewhat as shematically shown in FIG. 6, wherein the sides 18, 20 and 22 have become somewhat concave due to the deformation of the shaft as it is twisted. In the following disclosure, the shape after twisting is referred to as being generally polygonal, recognizing that the sides may be slightly deformed from the straight lines. The sides 18, 20 and 22 of the shaft 12 join at sharp edges 24, 26 and 28, which after twisting are helical and may be referred to as helical rotationally bi-directional cutting edges, since they will cut when the shaft 12 is rotated in either a clockwise or counterclockwise direction. This is in contrast to another very commonly used file known as a Hedstrom file, which has one or more helical grooves machined in a round tapered shaft to form a rotationally uni-directional cutting edge. The present invention applies only to instruments having rotationally bi-directional cutting edges, because the particular manner in which those instruments are constructed as described above creates the sharp laterally extending points which cause lateral transportation. Either of these types of instruments can be and often are utilized by axially reciprocating the instrument in the root canal to cut the tooth material, rather than by rotational cutting motion. As seen in FIG. 2, a standard prior art K-type file 10 includes a tapered tip 30 which has a length 31 and an included angle 32. In accordance with standards set out by the American Dental Association and other standardizing bodies as are recited for example in Ingle and Beveridge. Endodontics , Second Edition, pages 174-175 (1976), the included angle 32 is required to be 75° with an allowable tolerance of plus or minus 15°, i.e., in the range of 60° to 90°. The standard K-type file 10 has three sharp cutting points, two of which are seen in FIG. 2 and designated 34 and 36, at the intersection between the ends of the cutting edges 24, 26 and 28 with the conically tapered tip 30. The sharp point 34 is shown substantially in profile and it is apparent that this provides a sharp gouging point which can cut into the tooth material of a root canal. FIG. 3 shows only the axially forwardmost portion of the shaft of a first embodiment of endodontic instrument 38 according to the invention, it being understood that the remaining portions are identical to those of the prior art instrument 10 just described. The endodontic instrument 38 includes a tapered working portion 40 which includes the three spiral rotationally bi-directional cutting edges 24, 26 and 28 previously described. The instrument 38 further includes a tapered tip 42 having a length 44 extending from the zone where it intersects the ends of the cutting edges, such as end 46 of cutting edge 28, to the axially forwardmost end 48 of the tapered tip 42. The tapered tip 42 has a much greater angle of taper than does the tapered working portion 40. The angle of taper of the tapered working portion 40 is defined as the included angle between imaginary lines such as 50 and 52 which define the outside diameter of the working portion 40. In accordance with the previously mentioned standards, the taper of the working portion 40 of the shaft must be dimensioned such that there is a gain in diameter of 0.02 millimeter per millimeter of length of the working portion 40. The angle of taper of the tapered tip 42 is defined as the included angle between lines tangent to two diametrically opposed sides of the tapered tip 42 at any point along its length. Thus it is seen that the angle of taper of the tip 42 is greater than the angle of taper of the working portion 40. The tapered tip 42 is shaped such that the sharp cutting points, such as 34 and 36 shown in FIG. 2, are substantially eliminated, so that lateral transportation of the instrument 38, when cutting a curved root canal, is reduced. Preferably, the tapered tip 42 is continuously tapered from the forwardmost end 48 thereof to the ends, such as 46, of the cutting edges 24, 26 and 28. FIG. 7 shows schematically, in cross-section, a root portion 50 of a human tooth having an elongated tapered root canal 52, which typically tapers to an apex 54, which is also referred to as the apical opening or apical foramen of the root canal 52. The root 50 illustrated in FIG. 7 is shown in its natural state prior to any operation thereon. It is seen that the root canal 52 is curved and the walls of the root canal 52 include an inside of the curve portion 56 and an outside of the curve portion 58. The tapered tip 42 can be described as having a curved profile of rotation which is substantially tangential where it joins the ends, such as end 46, of each of the cutting edges, such as cutting edge 28. In FIG. 3, the instrument 38 is oriented, so that the end 46 of cutting edge 28 is substantially centered and it is the only one of the three ends which can be seen in FIG. 3. It will be understood that the ends of the other cutting edges 24 and 26 will be located at elevation 62, which is the dividing line between the working portion 40 and the tapered tip 42, and will be located at angles of 120° about the axis of the instrument 38 from the end 46. The tapered tip 42 of instrument 38 includes a reduced diameter cutting means 64 immediately adjacent the ends, such as end 46, of the cutting edges 24, 26 and 28. This cutting means 64 can automatically cut a step back or countermark, in the root canal 52 as the instrument 38 is operated to enlarge the root canal 52. The cutting means 64 are formed as edges, such as 66 and 68 illustrated in FIG. 3, which are formed where the smooth portion of tapered tip 42 intersects with the sides 18, 20 and 22 of the generally triangular shaped shaft. These cutting edges are not as sharp as the helical cutting edges 24, 26 and 28, but they can still cut. The cutting means 64 of tapered tip 42 defines an axially innermost part of the curved profile of rotation 60 of tapered tip 42. FIG. 4 shows an alternative embodiment 20 of the present invention, and which includes a working portion, the axially forwardmost part 72 of which is shown. The instrument 70 further includes a tapered tip 74, having a length 76, and comprising an axially outermost conical portion 78 having a length 80, and includes an axially innermost frusto-conical portion 82 having a length 84. This construction of the tapered tip 74 has a profile of rotation 86 at least partially defined on each radical side thereof by a plurality of intersecting straight lines such as 88 and 90. The conical portion 78 has an included angle 92 in the range of 60° to 90°, and the frusto-conical portion 82 has an included angle of substantially less than 75°, preferably in the range of about 20° to 50°, and most preferably is approximately 35°. It has been determined that a 35° included angle for frusto-conical portion 82 approximates the shape of the continuously curved tapered tip 42 adjacent the ends of the cutting edges 24, 26 and 28 sufficiently that the instrument 70 with the tapered tip 74 performs in approximately the same manner as the instrument 38 having the continuously curved tapered tip 42. The conical part 78 of tapered tip 74 has a base 94 having a diameter approximately one-half of an outside diameter of the working portion 72 at the ends, such as end 96, of the cutting edges 24, 26 and 28. When a standard K-type file as shown in FIG. 2 is modified to have a tapered tip as shown in FIG. 3 or 4, the location of the ends of the cutting edges 24, 26 and 28 is changed since a portion of the cutting edges is removed. Since the working portion of the instruments is itself slightly tapered, the outside diameter of the working portion at the ends of the helical cutting edges varies slightly as the length of the tapered tip is varied. It has been determined that when the base 94 has a diameter approximately one-half of this outside diameter of the working portion at the ends of the spiral shaped cutting edges, the overall profile of the tapered tip 74 most closely approximates the profile 60 of the tapered tip 42 of FIG. 3. As illustrated in FIG. 4, the conical portion 78 is immediately adjacent and intersects the frusto-conical portion 82, which includes a reduced diameter cutting means 98 which is comprised of cutting edges 100 and 102 analogous to the cutting edges 66 and 68 previously described with regard to FIG. 3. This reduced diameter cutting means 98 is entirely a part of the frusto-conical portion 82. The frusto-conical portion 82 can be described as having a maximum outside diameter end at elevation 104 immediately adjacent the ends, such as end 96, of the helical cutting edges 24, 26 and 28, and equal in diameter to the outside diameter of the working portion 72 at the ends of the cutting edges 24, 26 and 28. It may also be described as having a minimum outside diameter end 106 coincident with the base 94 of conical portion 78. The standard K-type endodontic file 10 of the prior art illustrated in FIG. 2 is constructed by axially twisting the shaft 12, of polygonal cross-section as seen in FIG. 5, thereby forming on the shaft 12 the working portion 16 having a plurality of rotational bi-directional helical cutting edges thereon, as seen in FIG. 1. Then the standard tapered tip 30 is formed on the end of the shaft 12 by holding the shaft 12 at an angle of 37½ to a moving abrasive surface while rolling the instrument 10 about its longitudinal axis, thus grinding the 75° included angle conical tip 30. The continuously curved tapered tip 42 illustrated in FIG. 3 is formed by modifying a conventional prior art K-type file 10 by regrinding the tapered tip thereof. This has been done by utilizing an oscillating flat abrasive surface and holding the endodontic instrument by hand while engaging the tip thereof with the oscillating surface in a controlled manner. The tip is originally held so that the points such as 34 and 36 are engaged with the oscillating abrasive surface to grind those points off and lengthen the tapered tip so that it is substantially tangential to the cutting edges 24, 26 and 28 at its intersection therewith. The instrument 38 is rotated about its longitudinal axis while the tip is being held against the oscillating abrasive surface. Then, while continuing to rotate the instrument 38 about its longitudinal axis, the angle of the axis of the instrument 38 to the oscillating flat abrasive surface is steadily increased from approximately 0° to approximately 90° thus grinding the curved profile of rotation 60 shown in FIG. 3 on the tip of the instrument. While this continuously curved tapered tip 42 as shown in FIG. 3 is preferred since it eliminates entirely the points at the intersection of the tapered tip with the ends of the cutting edges 24, 26 and 28, it will be appreciated that the manual forming of these continuously curved tapered tips is a tedious operation. Also, it will be appreciated that the automated machinery to construct such curved tips would be rather complex. The alternative embodiment of FIG. 4 provides an approximation of the continually curved surface shown in FIG. 3, which is much easier to form on the instrument. The tapered tip 74 of the instrument 70 shown in FIG. 4 may be formed by taking a conventional prior art K-type file such as the file 10 shown in FIG. 2, and holding the file so that its longitudinal axis is at an angle of 17½ to a flat oscillating surface and then holding the instrument against the tapered surface and rolling it about its longitudinal axis so as to grind off the sharp points such as 34 and 36 and form the frusto-conical shaped axially innermost portion 82. As previously discussed, a serious problem is encountered when utilizing standard K-type files such as the instrument 10 shown in FIG. 2 to clean and enlarge a curved root canal such as the root canal 50 illustrated in FIG. 7. As larger and larger sizes of instruments are used to enlarge the canal, a ledge 108 as shown in FIG. 8 is often created due to the tendency of the standard K-type file to cut toward the outside curve 58 of the root canal 52 at the forwardmost extent of the file. Many examples of such problems are described and illustrated for example in the text Ingle and Beveridge, Endodontics , at Chapter 3, pages 101-215 entitled "Endodontic Cavity Preparation" (1976). It is believed that the primary cause of this lateral transportation of prior art K-type files such as the file 10 of FIG. 2 is the presence of the sharp points such as 34 and 36 which create very high stress concentrations applied to the tooth material along the outside curve of the root canal 52. These sharp points gouge the tooth material to form the ledge 108. As larger and larger sizes of the standard K-type files are utilized, a larger ledge is created, and if allowed to go to the extreme, the instruments will actually perforate the side of the tooth root 50 at approximately the location 110 shown in FIG. 8. By eliminating the sharp points at the ends of the spiral cutting edges, the force exerted by an axially outermost part of the working portion and by the reduced diameter cutting means of the present invention is spread over a much larger area of tooth material and thus no sharp ledges are created. Furthermore, the elongated tapered shape of the tapered tips 42 and 74 causes the tapered tip to be wedged into an uncut portion of the root canal as the instrument is advanced and thereby substantially centers the forwardmost part of the instrument in the root canal 52, thus further aiding in cutting material from both the inside 56 and the outside 58 of the curve of the root canal 52. Lateral transportation of the instrument when cutting a curved root canal is also very much reduced. By using the improved instruments 38, 70 of the present invention, as shown in FIG. 9, the root canal 52 is cleaned and enlarged to a final shape 52A, having enlarged inside and outside curves 56A and 58A, respectively. Furthermore, the tapered reduced diameter cutting means 64, 98 of the instruments 38, 70 automatically cut in the root canal 52A a step back 112, which is a surface facing away from the apex 54 of the root canal 52A and it provides a restriction against which filler material such as gutta percha may be compacted. With prior art instruments such as the file 10 illustrated in FIG. 2, it is generally necessary to decrease the depth to which successively increasing diameter files are inserted in order to form a step back. Prior art procedures for forming step backs using standard K-type files are described in the Ingle and Beveridge text cited above, and are illustrated at page 200 thereof. The cutting strokes used in endodontics can generally be described as filing or reaming. A filing stroke refers to the axial reciprocation of the cutting instrument to file the interior walls of the root canal. A reaming stroke refers to the act of rotating the instrument about its longitudinal axis. One variation of a remaining stroke, which is itself a part of the prior art, includes the use of reciprocating rotational motion wherein the file is rotated clockwise through an angle in the range of about 90° to 270°, so as to advance the instrument into a portion of the root canal previously uncut by that particular instrument. Then while holding a downward pressure on the instrument to keep it from backing out of the root canal, the instrument is rotated counterclockwise through an angle of at least 120° (the angle between cutting edges), so that the material from the walls of the root canal is actually cut. This is repeated one or more times so that the instrument is alternately rotated clockwise to advance it into the root canal and then counterclockwise to cut material from the root canal. A final cutting stroke is typically made with one to two revolutions clockwise to aid in debris removal once the desired portion of the root canal has been cut with counterclockwise cuts. It has been found that this operating stroke of rotationally reciprocating the instrument is preferable for use with the endodontic instruments of the invention, although the latter may also be used with a filing stroke where the instrument is advanced, preferably by clockwise rotation, then axially withdrawn to cut the tooth material. One other significant advantage provided by the present invention is that there is no need to precurve the instruments 38 or 70 when cleaning a curved root canal. A very common prior art method of dealing with curved root canals is to bend or precurve the instrument to approximate the curvature of the canal prior to insertion of the instrument into the root canal. Such precurved instruments are then most often used with a solely axially reciprocating filing stroke, because when a precurved instrument is rotated the cyclic bending stresses often lead to breakage of the instrument. The present invention provides an instrument which can readily clean and enlarge a curved root canal while using a rotational cutting stroke. Laboratory tests were conducted utilizing instruments such as the instrument 38 illustrated in FIG. 3 and comparing their performance to otherwise similar instruments having a standard tip 30 such as illustrated in FIG. 2. Testing was performed with acrylic canal models such as those designated as Model 001 available from Richard W. Pecina & Associates, Inc., Waukegan, Illinois. These models are formed from clear acrylic material and each model has a similar elongated tapered curved canal cast therein to simulate a curved root canal of a human tooth. Utilizing a standard K-type file such as illustrated in FIG. 2, lateral transportation typically began at instrument size 35 and became significant by size 40 or 45. It was essential with those standard instruments to utilize a step back procedure, wherein the instruments of increased diameter were inserted to a reduced depth in the tooth, in order to prevent lateral transportation and creation of a ledge. Files such as file 38 shown in FIG. 3 of the invention were then utilized on substantially identical test blocks and it was found that canals could be enlarged using files up to size 55 along the entire length of curvature to form an enlarged canal such as illustrated in FIG. 9 without any significant lateral transportation. It was not required to use a step back procedure. Subsequently, after developing the alternative embodiment shown in FIG. 4, it was possible to produce instruments in sufficient quantity to allow clinical testing on live patients, which were found to produce superior instrument tip control and to produce apparently the same results clinically as were observed in the acrylic laboratory models. The results of these tests conclusively show that endodontic instruments having the modified tips of the present invention provide dramatically improved performance when cleaning and enlarging curved root canals. The problem of lateral transportation of the instrument in the curved root canal is substantially eliminated and the canals may be uniformly enlarged throughout their entire length so as to provide a superior root canal preparation for filling. The preferred embodiment of the present invention utilizes a file constructed by axially twisting a triangular shaped shaft to form a file with three spiral rotational bi-directional cutting edges thereon. It will be understood, however, that the invention is equally applicable and useful on endodontric instruments having other cross-sectional shapes, such as a square cross-sectional shape so that it has four spiral rotationally bidirectional cutting edges. Another instrument to which the present invention is applicable is an instrument having a cross-section in the shape of an oblique parallelogram such as is disclosed and described in U.S. Patent No. 4,260,379 to Groves et al. Further, U.S. Patent No. 1,067,015 to Fowler shows an instrument having a rectangular shape cross-section. Generally, any instrument which is constructed by axially twisting a shaft of polygonal cross-section so as to form a plurality of spiral rotationally bi-directional cutting edges thereon may be improved by the use of the tapered tip of the present invention.

Claims: 1. An endodontic instrument comprising a tapered working portion (16) defined by a flexible shaft (12) including a plurality of helical, bi-directional cutting edges (24, 26, 28) thereon and a tapered tip (30,42,74, 78,82) defined on said shaft and having a greater angle of taper than that of the working portion (16), characterised in that: at the location where said tapered tip joins said cutting edges, said tapered tip is continuously curved or has a profile of rotation (86) at least partly defined by a plurality of intersecting straight lines (88,90) from the forwardmost end (4, 8, 74) thereof to the adjacent ends (4, 6, 96) of the cutting edges, causing said tapered tip to be substantially free of any sharp cutting points. 2. An instrument according to claim 1, characterised in that the tapered tip defined by said lines includes an axially innermost frusto-conical portion (82) and an axially outermost conical portion (78). 3. An instrument according to claim 2, characterised in that the axially outermost conical portion (78) has an included angle of between 60° and 90°. 4. An instrument according to claim 2 or 3, characterised in that the axially innermost frusto-conical portion (82) has an included angle of between 20° and 50°. 5. An instrument according to claim 2 or 4, characterised in that the axially innermost frusto-conical portion (82) has an included angle of approximately 35°. 6. An instrument according to claim 2, 3, 4 or 5 characterised in that said axially outermost conical portion (78) has a base diameter approximately one half of the outside diameter of said working portion (16) at the ends (86) of the cutting edges. 7. An instrument according to any preceding claim, characterised in that the working portion (16) is generally polygonal in cross-section, said cutting edges (24,26,28) being defined by the intersection of adjacent sides (18,20,22) of said polygonal cross-section. 8. A method of forming an endodontic instrument according to any preceding claim, including the steps of providing a polygonal cross-section flexible elongate tapered blank, axially twisting the blank to provide the tapered working portion (16), and to form thereon the helical, bi-directional cutting edges (24,26,28), forming a tapered tip (3) on the end of the working portion, so that the tapered tip intersects said cutting edges (24,26,28), characterised in that said tip is formed so that its longitudinal axis is at an angle smaller than the angle of said tapered tip to a flat oscillating surface and rolling it about its longitudinal axis so as to grind off the sharp fine points and to form a frusto-conically shaped axially innermost portion (82).

Inventors: ROANE, JAMES B.
Applicants: ROANE, JAMES B.
Application year: 1984
Main classification: A61C5
IPC codes: A61C1, A61C3, A61C5