Abstract:
The invention describes rubber dam punches that punch the entire slit or central opening in a rubber dam membrane in order to prepare the conventional rubber dam for the slit-dam technique. The invention further describes rubber dam punches capable of lengthening the central opening in a rubber dam that is specifically designed for general field isolation. The rubber dam punches of the invention include a series of embodiments having upper and lower arm members, each arm member further having a gripping handle at one end of the arm member and an operative end extension at the opposite end of the arm member. The arm members are pivotally connected and have male and female slits dies attached to the operative end extensions which are used punch slits and/or holes of varying widths in dental rubber dam membranes in order to create or lengthen existing central openings in general field isolation rubber dams.

Description:
BACKGROUND OF THE INVENTION  
         [0001]    1. Field of the Invention  
           [0002]    This invention relates to rubber dam punches used to prepare rubber dam membranes for use in dentistry, and more particularly the invention relates to rubber dam punches used to prepare rubber dam membranes used in general field isolation in dentistry and alternatively in medical specialty procedures.  
           [0003]    2. Background  
           [0004]    Rubber dam punches are commonly known in the dental prior art as devices used to punch small holes, generally in the range of 0.025″ to 0.100″, in rubber dams for the purpose of sequentially isolating individual teeth with the rubber dam membrane in what is commonly referred to as the conventional method of rubber dam isolation. The small round perforations that the rubber dam punch provides in the rubber dam allows the elastic rubber dam membrane to be stretched over individual teeth in such a manner that the clinical crowns of the teeth protrude from one side of the membrane where an operative procedure is to be performed. The end result is that a dentist may isolate the clinical crowns of the teeth in order to perform dental procedures necessary to treat dental diseases such as the removal of dental caries, which very often appears as a white chalky area on the enamel and later softens the enamel before the tooth structure breaks down.  
           [0005]    Until recently, the conventional application of the rubber dam to isolate the clinical crowns of teeth, the crown being the visible portion of the tooth above the gum line, has been used exclusively in dentistry. Recently, however, new techniques and methods have evolved to isolate not only the clinical crowns of teeth, but also the gingival soft tissues. A technique, called the slit-dam technique, has evolved in which a dentist punches two holes located a required distance apart, and then cuts between the holes with a scissors to form a slit. This technique allows the dentist to stretch the rubber dam between a front and back tooth, thus isolating a series of teeth at a single time, rather than isolating each tooth individually. This slit-dam technique, while serving to quickly apply the rubber dam to a given segment of teeth, is generally inadequate in isolating the soft tissues simultaneously with the clinical crowns, due to the elastic rubber snapping back to the level of the gum line upon application. Further this technique of making a ‘make-shift’ slit in the dam with a pair of scissors has demonstrated a need for the preparation of alternative forms of perforations.  
           [0006]    More recently, general field isolation rubber dams have been introduced to overcome the inherent limitations in the slit-dam technique in being able to isolate both the clinical crowns of the teeth and their associated soft tissues simultaneously. General field isolation rubber dams have prepared central openings that are slits of varying widths in order to be able to quickly isolate groups of teeth simultaneously. In some cases, general field isolation rubber dams are supplied without central openings so that a clinician may prepare both holes and slits in the dams in order to customize an application. In addition, some general field isolation rubber dams are available which have slits already prepared, but may require the slits to be lengthened by the clinician in order to customize an application. The invention of rubber dam punches which: perforate a rubber dam with openings such as slits, slots, elongated ovals, and elongated rectangular openings is needed to keep pace with the evolving art of practice of clinical isolation of the operative site in dentistry with general field isolation rubber dams. In addition, it is sometimes required by the clinician that either holes or alternatively slits be prepared in a rubber dam in succession, such that a hybrid application of the rubber dam be accomplished.  
           [0007]    The prior art of rubber dam punches used in dentistry consists exclusively of punches that are capable of punching small holes, usually in the range of 0.025″ to 0.100′ in diameter for conventional isolation of the clinical crowns of individual teeth only. There are not any references in the prior art literature that refer to rubber dam punches that punch slits, slots, or other configurations of perforations for general field isolation in dentistry. In addition, there is no mention of any similar rubber dam punch in the prior art literature for punching perforations of any configuration for alternative medical uses in other medical specialties. Therefore, a need exists for a rubber dam punch capable of punching slits as well as hole perforations for use in the preparation of rubber dam membranes in general field isolation dentistry.  
         SUMMARY OF THE INVENTION  
         [0008]    The invention pertains to a series of embodiments of rubber dam punches having upper and lower arm members, each arm member further having a gripping handle at one end of the arm member and an operative end extension at the opposite end of the arm member. The arm members are pivotally connected and have male and female slits dies attached to the operative end extensions which are used punch slits of varying widths in dental rubber dam membranes in order to create or lengthen existing central openings in general field isolation rubber dams. The invention describes rubber dam punches that punch the entire slit or central opening in a rubber dam membrane in order to prepare the conventional rubber dam for the slit-dam technique. The invention further describes rubber dam punches capable of lengthening the central opening in a rubber dam that is specifically designed for general field isolation. In addition, the disclosure describes embodiments that may punch more than one configuration of perforation in the rubber dams, such as, but not limited to, both holes, and slits in the same instrument.  
           [0009]    These and other objects of the present invention will become apparent to those skilled in the art upon reference to the following specification, drawings, and claims. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0010]    [0010]FIG. 1 is a top view of a rubber dam punch, showing the gripping handles and the cutting table which houses the female die elements.  
         [0011]    [0011]FIG. 2 is a side view of a rubber dam punch showing the gripping handles from the side, and a side view of the male slit die engaging the cutting table.  
         [0012]    [0012]FIG. 3 is an end view of the rubber dam punch showing the male slit die engaging the cutting table.  
         [0013]    [0013]FIG. 4 is the male slit die from an end view, a bottom view, and an isometric view.  
         [0014]    [0014]FIG. 5 is a top view of the cutting table, showing four variable width female slit dies machined into the cutting table.  
         [0015]    [0015]FIG. 6 is an isometric view of a rubber dam punch designed to exclusively punch slits in rubber dams.  
         [0016]    [0016]FIG. 7 is a top view of a rubber dam punch designed to punch both slits and holes in a rubber dam, showing the gripping handles from the top, and also the cutting table which houses both the female slit dies and the female hole dies.  
         [0017]    [0017]FIG. 8 is a side view of a rubber dam punch designed to punch either slits or holes in a rubber dam, showing the gripping handles from the side and two male dies mounted on a pivoting carriage, and also the cutting table from a side view.  
         [0018]    [0018]FIG. 9 is an end view of a rubber dam punch designed to punch either slits or holes in a rubber dam, showing a male slit die engaging the cutting table.  
         [0019]    [0019]FIG. 10 is an isometric view and a bottom view of a male slit die.  
         [0020]    [0020]FIG. 11 is an isometric view and a bottom view of a male hole die.  
         [0021]    [0021]FIG. 12 is a top view of a cutting table machined with variable width female slit dies and variable width female hole dies.  
         [0022]    [0022]FIG. 13 is an isometric view of a rubber dam punch designed to punch either holes, or slits in rubber dam membranes, with two male dies mounted to a pivoting carriage (above) and female slit dies and female hole dies machined into a pivoting cutting table (below).  
         [0023]    [0023]FIG. 14 is a top view of a rubber dam punch designed with male and female slit dies on cylindrical carriages, showing one of the gripping handles and the upper male slit dies mounted on a pivoting cylindrical carriage.  
         [0024]    [0024]FIG. 15 is a side view of a rubber dam punch designed with cylindrical carriages with male slit dies (above) articulating with female slit dies (below).  
         [0025]    [0025]FIG. 16 is an end view of a rubber dam punch designed with cylindrical drums with male slit dies (above) articulating with female slit dies (below).  
         [0026]    [0026]FIG. 17 is an illustration of a rubber dam punch being used to lengthen a slit in a field isolation rubber dam.  
         [0027]    [0027]FIG. 18 is an isometric view of an alternative embodiment of a rubber dam punch using a male slit die on a cylindrical plunging mechanism and female slit dies machined into a cutting table to punch variable width slits in a rubber dam membrane.  
         [0028]    [0028]FIG. 19 is an isometric view of a male slit die associated with the cylindrical plunging mechanism.  
         [0029]    [0029]FIG. 20 is a top view of the cutting table with four variable width female slit dies as used with the cylindrical plunging mechanism.  
         [0030]    [0030]FIG. 21 is an isometric view of an alternative embodiment of a rubber dam punch which punches a single width slit only, with a single male slit die and a single female slit die 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0031]    This invention pertains to a rubber dam punch  100 , as seen generally in FIGS.  1 - 3  and  6  that is designed to punch slits of varying widths in a rubber dam membrane  50  (see FIG. 17). The rubber dam punch  100  is comprised of a pair of arms  110 ,  112 , each arm including a gripping handle  114 ,  116  located at one end of the arms  110 ,  112  and an operable end extension  118 ,  120  located at the opposite end of the arms  110 ,  112 . A pivoting center connector  122  is used to pivotally attaching the upper arm  110  to the lower arm  112 . Seen in FIG. 2, on the operable end extension  118  of the lower arm  110 , a male die mechanism  124  is mounted on the end opposite the pivoting center  122 , and on the operable end extension  120 , of the upper arm  112  a circular planar die mechanism called a cutting table  126 , is mounted by a pivoting connector  128  on the corresponding end extension  120 , radially from the pivoting center  122  of the arms  110 ,  112 .  
         [0032]    [0032]FIG. 4 shows the male die mechanism  124  mounted on a shaft  114 , with a base  132  (see FIG. 3), that attaches to the upper operable end extension  118 . FIG. 5 shows four variable width female slit dies  134   a - 134   d  machined into the cutting table  126 , which has its own pivoting center  128 . The pivotable cutting table  126  allows a dentist or clinician to rotate the cutting table  126  with finger pressure until one of the female slit dies  134   a - 134   d  is properly aligned with the male die  124 . In FIG. 2, a locator pin  142  mounted in the lower operable end extension  120 , engages a dimpled concave recess (not shown) in the bottom face of the cutting table  126 , for the purpose of locking the cutting table  126  in proper position for the alignment of one of the female slit dies  134   a - 134   d . The male slit die  124 , is reciprocally mounted with respect to the location of the female slit dies  134   a - 134   d , such that the male die  124  predictably inserts into one of the properly aligned female dies  134   a - 134   d  when the cutting table  126  is locked into proper position by the positioning pin  142 .  
       EXAMPLE 1  
       [0033]    As seen in FIG. 17, when a rubber dam membrane  50  is interposed between the complementary male die  124  and any one of the single female slit dies  134   a - 1   34   d  of the cutting table  126 , and the male  124  and female  134   a - 134   d  complementary dies are subsequently brought together by leveraged hand pressure applied to the gripping handles  114 ,  116 , a perforation is made in the rubber dam membrane  50  in the shape of the corresponding female slit dies  134   a - 134   d . The rubber dam punch  100  may also be used to lengthen a slit in the rubber dam membrane  50  in the same way it forms a perforation (discussed above). In this embodiment, the male slit die mechanism  124  is rigidly fixed in position on the upper operable end extension  118  of the lower arm  112  of the punch, while the female slit die mechanisms  134   a - 134   d  are located on the cutting table  126  and are capable of pivoting with the movements of the cutting table  126 .  
         [0034]    [0034]FIG. 4 shows male die slit element  124  as a wedge shaped structure with cutting surfaces  144  positioned at an acute angle with respect to the reciprocating planar surface of the cutting table  126  and also at an acute angle with the long axis of the male die&#39;s mounting shaft  130 . Since the male die  124  has this configuration, its cutting surfaces  144  contact different width female die slits  134   a - 134   d  at a different position, thus maintaining a variable but complementary relationship with the alternative width female die slits  134   a - 134   d . This configuration of a stationary male die  124  with angular cutting surfaces  144  and variable width female dies  134   a - 134   d  mounted on a pivoting cutting table  126  allows a variety of different width slits to be cut in a rubber dam  50 . The type of slit in this application may be a linear slit, a curved slit, a slot, an elongated oval, or other configuration for dental applications or alternative forms utilizing the same basic principles of design for alternative medical use. Variations in the shapes and forms of dies for alternative uses should be considered to be fully within the spirit and scope of this disclosure. A resilient mounted opening spring  146  may be mounted between the gripping handles  114 ,  116  (seen in FIGS. 2 and 6) and used to maintain the rubber dam punch  100  in an open position between operations. The mounted opening spring  146  may alternatively be mounted between the operable end extensions,  118 ,  120 .  
         [0035]    As seen in FIGS.  7 - 9  and  13 , an alternative rubber dam punch  200 , used to punch both holes and slits in a hybrid design. The punch features a pivoting mounting carriage  248  connected to the operable end extension  218  of the lower arm  210  by means of a pivoting connector  220 . Two male die elements  224  and  252  are mounted on the ends of the pivoting mounting connector  250 , as shown in the side view, seen in FIG. 8. These include a male slit die  224 , with its mounting shaft  230 , mounted on one end, while a male hole die  224 , with its mounting shaft  230  mounted on the other end of the pivoting carriage  248 . In this embodiment of a rubber dam punch  200 , configured with both a male slit die  224  and a male hole die  252 , which pivots 180 degrees on the pivotable mounting carriage  248  such that either die  224  or  252  may be selectively positioned opposite the reciprocating cutting table  226 , which houses two female slit dies  234   a  and  234   b  and also has four female holes dies  254   a - 254   d , as illustrated in FIG. 12. The mounting carriage  248  which houses the two types of male dies  224  and  252  and pivots 180 degrees with finger pressure, to position either of the two male dies  224  and  252  opposite a reciprocal female die  234  or  254  has two dimpled recesses on the surface (not shown) contacting the operative end extension  218 , to which it is mounted, such that a positioning pin  256 , may engage said dimples, in order to predictably position a selected male die  224  or  252  in the precise position in order to engage its complementary female die  234  or  254 . FIG. 8 shows that on the planar surface of the mounting carriage  248  facing the operable arm extension  218  to which it is mounted, is a concave dimpled depression (not shown) which receives a positioning pin  256 , mounted within the operable arm extension  218  which locks the pivotable mounting carriage  248  in position such that the male die  224  or  252  is properly positioned opposite a corresponding female die  234  or  254  on the opposing arm extension  220 , when the pivotable mounting carriage  248  is locked in alignment. On the opposing arm extension  220  is mounted a cutting table  226  which has both female slit dies  234   a  and  234   b  and female hole dies  254   a - 254   d  machined into positions for articulation with the appropriate male dies  224  and  252  respectively.  
         [0036]    When a male die  252  for punching holes is aligned with any one of the reciprocating female hole dies  254   a - 254   d  and the corresponding male  252  and female dies  254   a - 254   d  are brought together under pressure with a rubber dam membrane  50  interposed between the dies  252  and  254 , as in FIG. 17, a circular hole perforation is made in the elastic membrane of a rubber dam  50  corresponding to the form and size of the dies  252  and  254  aligned at the time of perforation. When a male slit die  224  is brought into alignment with either one of the two female slit dies  234   a  or  234   b  with a rubber dam membrane  50  interposed between the complementary dies  224  and  234 , a slit perforation is made in the rubber dam membrane  50 . Thus this embodiment allows for the punching of either holes or slits by one instrument, and allows a dentist the option of quickly changing the form of perforation required for a given application of the rubber dam  50 . This alternative configuration may be expanded to more than two male dies  224  and  252  mounted on a pivotal carriage  248  and may be varied according to the form of perforation required for alternative uses of preparation of rubber dams  50  in medical applications in specialty areas other than dentistry. The configuration described above is illustrative of the principles of the basic design elements comprising the elements of the invention only. Obvious alterations of design may occur to individuals skilled in the art, which, while being somewhat different from the aforementioned design and equally efficacious, would be considered to be fully within the spirit and scope of this disclosure.  
       EXAMPLE 2  
       [0037]    [0037]FIGS. 14, 15, and  16  depict another alternative rubber dam punch  300  which punches long slits in rubber dam membranes  50 , with male slit dies  324   a - 324   d  mounted on an upper cylindrical drum  358  and female slit dies  334   a - 334   d , the  334   a - 334   d  female slit dies are arranged at 90 degree separation from one another (not shown), mounted on a lower cylindrical drum  360 . This rubber dam punch  300  has an upper arm member  310  and a lower arm member  312 , each with their respective gripping handles  314 ,  316  and each with their respective operative end extensions  320 ,  318 . As shown in FIG. 14, the operative end extensions  318 ,  320  bifurcate into a square “U” configuration. Thus end extension  318  bifurcates into two leg extensions  318   a  and  318   b , while the end extension  320  bifurcates into two leg extensions  320   a  and  320   b . Each of the leg extensions,  318   a  and  318   b  has upper pivoting connectors  362   a  and  362   b , for the attachment of the cylindrical drum  358 , housing the male slit dies  324   a - 324   d . The leg extensions  320   a  and  320   b  also have lower pivoting connectors  364   a  and  364   b  for attachment of the lower cylindrical drum  360 , housing the female slit dies  334   a - 334   d . The female dies  334   a - 334   d  and the male dies  324   a - 324   d  are sequentially mounted at 90 degree intervals on their respective pivoting cylindrical drums  360  and  358 , with a locator pin mechanism  342  located in the arm extensions  318   a  and  320   a  respectively, to engage dimpled concave recesses (not shown) on each of the cylindrical drums  358  and  360  to lock the cylindrical drum(s)  358  and  360  in place when they are in a properly aligned correct position.  
         [0038]    When complementary male  324   a - 324   d  and female die elements  334   a - 334   d  are in proper position, and brought together under pressure with a rubber dam membrane  50  interposed between the die elements  324   a - 324   d  and  334   a - 334   d , a perforation is made in the configuration of the die elements  324   a - 324   d  and  334   a - 334   d . The cylindrical mounting drums  358  and  360  may be mounted with their axes in alternative configurations with respect to the long axis of the extension arms  318  and  320  upon which they are mounted and still be within the spirit and scope of this disclosure.  
       EXAMPLE 3  
       [0039]    [0039]FIG. 18 is an isometric view of a third alternative embodiment of a rubber dam punch  400 , which has a male slit die  424  connected to a cylindrical plunging mechanism  464  by means of a mounting shaft  430 . This embodiment has an upper arm member  410 , and a lower arm member  412 , pivotally connected to each other at their operable ends  418 ,  420 , by means of a pivoting connector  422 . Both the upper arm member  410  and the lower arm member  412 , have gripping handles  414 ,  416  respectively. Pivotally connected to the upper arm member  410  is an intervening compensating connector  466 , which pivotally connects to a cylindrical plunging mechanism (not shown) with a male slit die  424 , connected to the other end of the cylindrical plunging mechanism by means of a shaft  430 . A compressible spring  468  is mounted on the cylindrical plunging mechanism and interposed between the intervening compensating connector  466 , and the operable end  420 , of the lower arm member  412 .  
         [0040]    [0040]FIG. 18 shows that pivotally mounted on a projection  470 , of the lower arm member  412 , and opposite a slotted recess  472 , is a cutting table  426 , which has variable width female die slits  434   a - 434   d  machined into the cutting table  426 . A detailed illustration of the cutting table  426  with the four variable female slit dies  434   a - 434   d  is seen in FIG. 20. Due to the location of the cylindrical plunging mechanism (not shown) substantially near the pivoting connector  422 , pressure applied to the gripping handles  414 ,  416  of the upper and lower arms  410 ,  412 , is leveraged, such that the male slit die  424 , forcibly engages a reciprocating female slit die  434   a - 434   d  when it is in proper alignment. The cutting table  26  pivots such that variable width female slit dies  434   a - 434   d  may be individually selected to punch variable width slits in a rubber dam membrane  50 . The cutting table  426 , has a dimpled recesses on the surface (not shown) which contacts the projection  470 , to which it is attached, receives a positioning pin  442  located within the projection  470 , which predictably aligns the selected female slit die  434   a - 434   d  in position for receiving the male slit die  424  when in use.  
       EXAMPLE 4  
       [0041]    [0041]FIG. 21 depicts a fourth embodiment of the rubber dam punch  500  capable of creating a single width slit. This embodiment has an upper arm member  510  and a lower arm member  512 , connected to each other with a pivoting connector  522 . The upper arm  510  has a gripping handle  514  and an operative end extension  520 , to which is connected a transverse mounting plate  526 , with a single female slit die  534  machined into it. The lower arm member  512  has a gripping handle  516  on one end, and an operative end extension  518 , on its opposite end. Connected to the operative end extension  518  of the lower arm member  512  is a transverse mounting plate  574  with a single male slit die  524  attached. A spring mechanism  546  is attached to both the upper  510  and lower arm members  512 , such that the spring mechanism  546  maintains the rubber dam punch  500  in an open position when not in use. When reciprocal pressure is applied to the gripping handles  514 ,  516  the upper and lower arm members  510 ,  512 , pivot about the pivoting center  522 , causing the male slit die  524  and the female slit die  534  to come together. If a rubber dam membrane  50  is interposed between the two complementary dies  524  and  534  and enough pressure is applied, a perforation in the form of a slit is made in the rubber dam membrane  50 .  
         [0042]    With respect to the above described embodiments, it is to be realized that the general configurations and embodiments of the invention are illustrative of the function and the manner of operation of said invention, and the assembly and use of said invention should be readily apparent to one skilled in the art of dentistry. Equivalent relationships to those illustrated in the drawings and described in the specifications expressing variations in size, materials, shape, form, function, and manner of operation, but which describe equivalent relationships to those illustrated in this disclosure are to be considered to be within the spirit and scope of the invention. Further, since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation shown and described, and accordingly, all suitable modifications and equivalents falling within the spirit and scope of the invention may be resorted to by the inventor. By way of example, the preferred material composition of the inventions described is stainless steel, and in the case of the cutting components, a tempered tool steel or hardened stainless steel. Alternatively, other metals could be used, and conceivably, the use of space-age plastics or composites might be substituted in some or all parts to decrease the overall cost of manufacturing the instruments. Regardless of the substitution of materials, the resulting rubber dam punches would fall within the spirit and scope of this disclosure. By way of another example, parts and components of the different alternative embodiments could be combined into a hybrid instrument, such as a single long male slit die  124 , of instrument  100 , manufactured into the configuration of instrument  300 , with a reciprocal cylindrical drum  360 , into which variable width female slit dies  334   a - 334   d  are machined. This would produce a rubber dam punch  100 , which punches long slits in a rubber dam membrane  50 , which is a hybrid of the embodiments described in this disclosure, but still fall within the spirit and scope of this disclosure. The embodiment described as instrument  200 , which punches both circular hole perforations and also slits, could be designed to punch alternative configurations of perforations, such as squares and rectangular openings, just to cite an example. This same configuration could be configured to punch more than two alternatives; three, four, etc. Another example of an alternative embodiment would be the design of a rubber dam punch which punches quite large perforations of triangular, square, rectangular, pentagonal, heptagonal, septagonal, octagonal, or circular configuration for isolation of intestinal segments during anastomosis in abdominal surgery.  
         [0043]    Further, the use of rubber dams in gastroenterology for the purpose of isolating intestinal segments to prevent the dissemination of microorganisms in the peritoneal cavity, thus decreasing the post-operative risk of peritonitis, is an excellent example of a specific application of rubber dams and the need for rubber dam punches in medicine. Other medical applications include vascular surgery during grafting procedures. The use of rubber dam in order to isolate the cut ends of the vas deferens during vasectomy has been reported in the medical literature. Since rubber dam punches have never been specifically designed for medical surgical purposes, the range of configuration of rubber dam punches to be designed for medical purposes within the spirit and scope of this disclosure is quite broad.  
         [0044]    The foregoing description and drawings comprise illustrative embodiments of the present inventions. The foregoing embodiments and the methods described herein may vary based on the ability, experience, and preference of those skilled in the art. Merely listing the steps of the method in a certain order does not constitute any limitation on the order of the steps of the method. The foregoing description and drawings merely explain and illustrate the invention, and the invention is not limited thereto, except insofar as the claims are so limited. Those skilled in the art who have the disclosure before them will be able to make modifications and variations therein without departing from the scope of the invention.