Abstract:
A direct bonding dental arch bar comprised of a flexible base portion having a first side and a second side, which may be comprised of a woven medical grade nylon. This arch bar further comprises a dental positioning device, where said positioning device is an at least one guideline and locking lug, and may utilized to secure this arch bar to a patient&#39;s row of teeth prior to adhesion to the teeth is permitted. Furthermore, a light curable adhesive is used that enables said flexible base portion to be secured to at least one tooth when exposed to light, and in particular a blue light spectrum.

Description:
BACKGROUND OF THE INVENTION  
         [0001]    1. Field of the Invention  
           [0002]    This invention relates to the field of maxillofacial fractures, and more particularly to direct bonding dental arch bars.  
           [0003]    2. Description of the Related Art  
           [0004]    The goals of maxillofacial fracture repair are to obtain good dental occlusion, achieve bony union, preserve mental and facial nerve function, prevent post-traumatic sequelae, and attain optimal cosmesis by retaining teeth and minimizing external scars. Additionally, the teeth should be brought into the best possible relationship so that adequate chewing surface and joint function occur with minimal or no orthodontic manipulation after bony reduction.  
           [0005]    Certain devices that are used in the surgical reconstruction of maxillofacial fractures may be characterized as arch bars. These arch bars may be secured to a patient&#39;s maxilla and/or mandible, or the upper and/or lower teeth. Furthermore, these devices may utilize interdental wiring to secure the arch bar to one or more teeth of a patient&#39;s maxilla or mandible. The use of interdental wiring may provide for an increased risk in lacerating a patient&#39;s gums and mouth and, thereby causing bleeding in the patient&#39;s mouth. Additionally, the likelihood of puncturing the rubber gloves worn by the doctors in surgical procedures may be additionally increased, and which puncture may further cause the puncturing of the doctor&#39;s skin under his gloves. It is this double puncturing of both the patient and the doctor&#39;s protection that may increase the potential for the doctor to be infected with blood born pathogens in the patient&#39;s blood. Additionally, these devices that utilize interdental wiring may be difficult and time consuming to use as they may be difficult for the doctor to apply and secure the arch bar to the patient in a quick and efficient manner.  
           [0006]    Other teachings provide for the application of direct bonding arch bars, and which arch bars may be secured to the patient&#39;s maxilla or mandible without circumdental wiring. However, these devices do not provide for a simplified and efficient manner in which the arch bar may be secured or stabilized to the teeth of the maxilla and/or mandible prior to the adhesive drying. This may prevent the device from staying stationary during the adhesive process and, as such, the movement of the device may cause increased time in application and may further decrease the bonding strength of the arch bar to the maxilla or the mandible. Additionally, many of these devices are manufactured using a metal mesh, in which the application of the metal mesh proves to be difficult to achieve high bonding strength to the patient&#39;s teeth.  
         BRIEF SUMMARY OF THE INVENTION  
         [0007]    Therefore a need has arisen for a maxillofacial dental arch bar that overcomes these and other shortcomings of the related art. A technical advantage of the present invention is to provide a direct bonding arch bar that does not require the use of circumdental wiring to affix the device to the teeth adjacent to either the maxilla or the mandible, wherefrom the danger of wires puncturing gloves and gums may be eliminated. A further technical advantage is that this device may provide for a means of securing placement or stabilizing a dental arch bar prior to adhesion. Another technical advantage of the present invention is that the device may prevent any movement of the fragmented bone around the fracture sight, wherein bone healing may be maximized and infection may be minimized. Another technical advantage of the present invention is that operating time and postoperative patient discomfort may be minimized. Yet another technical advantage is that the device may allow for quick and painless application and removal, further reducing the traumatic effects on the patient&#39;s maxilla or mandible, and may increase patient comfort.  
           [0008]    In an embodiment of the present invention, a direct bonding dental arch bar is described. The arch bar may comprises a flexible base portion having a first side and a second side, wherein said base portion may comprise a woven medical grade nylon, a dental positioning device, wherein said positioning device may be an at least one guideline and locking lug, and an adhesive that enables said flexible base portion to be secured to at least one tooth. In an exemplary embodiment, dental arch bar may comprise a flexible base portion manufactured from medical grade nylon.  
           [0009]    In still yet another embodiment the dental arch bar may further be comprised of a dental positioning device, which positioning device may be comprised of a guideline used in connection with a locking lug. Furthermore, the flexible base portion may utilize interwoven fixation clips extending through the second side of said flexible base portion, and wherein said fixation clips may be utilized for vertical oriented guide wires.  
           [0010]    Other objects, features, and advantages will be apparent to persons of ordinary skill in the art in view of the following detailed description of the invention and the accompanying drawings. 
       
    
    
     BRIEF DESCRIPTION OF THE SEVERAL VIEWS  
       [0011]    [0011]FIG. 1 shows a front view of the direct bonding dental arch bar according to an embodiment of the present invention.  
         [0012]    [0012]FIG. 2 a  shows a front view of the flexible base portion according to an embodiment of the present invention.  
         [0013]    [0013]FIG. 2 b  shows a side view of the flexible base portion according to an embodiment of the present invention.  
         [0014]    [0014]FIG. 3 a  depicts the method of use according to the preferred embodiment of the present invention.  
         [0015]    [0015]FIG. 3 b  depicts the method of use according to the preferred embodiment of the present invention.  
         [0016]    [0016]FIG. 3 c  depicts the method of use according to the preferred embodiment of the present invention.  
         [0017]    [0017]FIG. 3 d  depicts the method of use according to the preferred embodiment of the present invention.  
         [0018]    [0018]FIG. 3 e  depicts the method of use according to the preferred embodiment of the present invention.  
         [0019]    [0019]FIG. 4 a  depicts the method of use according to another embodiment of the present invention.  
         [0020]    [0020]FIG. 4 b  depicts the method of use according to another embodiment of the present invention. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0021]    Preferred embodiments of the present invention and their advantages may be understood by referring to FIGS.  1 - 4   b , like numerals being used for like corresponding parts in the various drawings.  
         [0022]    Referring to FIG. 1, a direct bonding dental arch bar  100  according to a preferred embodiment of the present invention is described. Arch bar  100  according to an embodiment of the present invention may serve as a means of securing the teeth of the mandible or maxilla of a patient in a fixed position such that fragmented bone of either the maxilla or mandible may be maintained in a fixed position. Arch bar  100  may be comprised of a flexible base  101 , dental positioning device, and an adhesive. Base portion  101  may be manufactured from material from a group of materials consisting of medical grade nylon, Kevlar®, woven metal mesh, or the like. In an embodiment, flexible base  101  may be of a width of about 4.6 mm. In another embodiment, the width of flexible base  101  may be no greater than about 8.5 mm. Further according to an embodiment of the present invention, flexible base  101  may be manufactured so as to be impregnated or coated with a general adhesive, whereas the general adhesive may provide for a preliminary method of securing arch bar  100  to the teeth of a patient, and wherein said adhesive may further be light curable.  
         [0023]    In an embodiment of this invention positioning device may be comprised of guideline  103 , which guideline  103  may be of a medical grade nylon, such as dental floss, and whereas dental positioning device may further be comprised of locking lug  104 . Guideline  103  and locking lug  104  may interact together, such that guideline  103  may looped and inserted into slide catch  105 , whereas slide catch  105  may provide a means for securing guideline  103  at a designated position within locking lug  104 , and wherefrom the securing of guideline  103  may provide for a loop that upon being placed in slide catch  105  may provide for a method of retaining the position of guideline  103 .  
         [0024]    Referring to FIGS. 2 a  and  2   b , another embodiment of the present invention is shown depicting fixation clips  107 . Fixation clips  107  may be comprised of a medical grade stainless steel, titanium, plastic, or the like, and whereas fixation clips  107  may be manufactured in a design so as to provide for multiple support elements that may extend through the second side of said flexible base portion  101 . According to this embodiment of the present invention, fixation clips  107  may be utilized for securing vertical oriented guide wires to promote stabilization of the mandible relative to the maxilla.  
         [0025]    In another embodiment (not shown), dental positioning device may comprise an elongated handle, wherein said handle may be attached to said flexible base portion  101 , and wherein said handle may be used to stabilize and retain said base portion  101  in a desired location.  
         [0026]    [0026]FIGS. 3 a -  3   e  show the preferred method of securing arch bar  100  to at least one row of teeth  108  according to this invention. A method of securing an at least one direct bonding dental arch bar  100  to an least one row of teeth  108  may be comprised of first removing excess plaque  109  from the exterior tooth surface of a first row of teeth  108 , wherein plaque  109  removal may be facilitated through the utilization of prophylaxis paste applied to teeth  108  with a standard type toothbrush  117 . After plaque  109  has been removed from teeth  108 , then guideline  103  may be placed circumdentally around a tooth on said first row of teeth  108 .  
         [0027]    Subsequent to attaching guidelines  103 , an acid etching gel  111  may be used on the outer surface of teeth  108 , which may then provide for micro-mechanical retention, wherein acid etching gel  111  may be of a material such as phosphoric acid etchant. In another embodiment, teeth  108  may be cleansed further in another step, wherein chlorohexadine gluconate may be used on teeth  108 , thereby further removing any remaining substances on the surface of teeth  108 .  
         [0028]    Following the application of etching gel  111  and after teeth  108  have been substantially dried, guidelines  103  may be used to tie down the posterior ends of said arch bar  100 , wherein said guidelines may be secured around the secondary premolars of said patient. In an embodiment, teeth  108  may be dried, wherein compressed nitrogen may be applied to the exterior surface to facilitate the complete drying of teeth  108 .  
         [0029]    An adhesive primer  118  may be applied to the outer surface of dry teeth  108  along with the application of curable adhesive  112  to the first side of arch bar  100 . Curable adhesive  112  may be an adhesive that is light curable, and more specifically, said curable adhesive  112  might be particularly responsive from the application of blue light. In another embodiment, arch bar  100  may be pre-impregnated with adhesive  112 .  
         [0030]    After teeth  108  have been properly primed with primer  118  and curable adhesive  112  applied to arch bar  100 , then arch bar  100  may be placed across the patient&#39;s teeth, such that said flexible base  101  extends from the first molar on one side of patient to the first molar on a second side of the patient. Additionally, arch bar  100  may retain its initial desired position before being permanently cured, since primer  118  and adhesive  112  may begin to cure immediately upon being exposed to any light.  
         [0031]    According to this method of application, after guideline  103  has mechanically secured arch bar  100  to teeth  108 , then blue light  113  may be used to cure and harden said adhesive  112 , whereby blue light  113  may be applied uniformly over the entire length of flexible base  101  and facilitating rapid and secure bonding.  
         [0032]    Referring to FIGS. 4 a - 4   b , another embodiment of the present method is described wherein a second arch bar  100  may be secured to a second row of teeth  116  in accordance with the method described herein and depicted in FIGS. 3 a - 3   e.    
         [0033]    Referring to FIGS. 4 a , another embodiment of the present invention, a method comprising securing a first arch bar  100  vertically to second arch bar  100  is described, wherein said method may vertically and horizontally stabilize a mandible and maxilla. First arch bar  100  and second arch bar  100  may be vertically attached through the use of integrated fixation clips  107 , whereby a flexible wire  114  may be used to secure the fixation clips  107  of the first arch bar  100  to the second set of fixation clips  107  of the second arch bar  100 .  
         [0034]    Alternatively, as shown in FIG. 4 b , the first set of fixation clips  107  may be vertically secured to the second set if fixation clips  107  through the use of heavy elastic bands  115 . The vertical attachment of the first and second fixation clips may therefore provide for a method of establishing immobility of the first set of teeth  108  relative to the second set of teeth  116 .  
         [0035]    While the invention has been described in connection with preferred embodiments, it will be understood by those of ordinary skill in the art that other variations and modifications of the preferred embodiments described above may be made without departing from the scope of the invention. Other embodiments will be apparent to those of ordinary skill in art from a consideration of the specification or practice of the invention disclosed herein.