Abstract:
A sinus membrane perforation patching material carrying and insertion instrument, comprising a central support for a quantity of a sinus membrane patching material and moveable outer supports spaced laterally outward of the central support for laterally supporting and expanding the patching material as it is forced by the central support upward over the sinus perforation to form a relatively thin laterally extending patch sealed to the sinus membrane and closing and sealing the perforation.

Description:
RELATED PATENT APPLICATIONS 
     The present application claims the benefit of U.S. Provisional Patent application Ser. No. 60/882,940 filed Dec. 31, 2006, which is herein incorporated by reference. The present application also relates to the subject matter of the concurrently filed U.S. patent application Ser. No. 11/895,813, entitled “Internal Procedure For Closing Sinus Membrane Perforations”, now U.S. Pat. No. 7,837,707 issued Nov. 23, 2010, that is incorporated herein by this reference. 
    
    
     BACKGROUND OF INVENTION 
     The procedure described in the above-identified concurrently filed United States patent application, is directed to a sinus membrane patching procedure that may be employed if a sinus membrane perforation should occur during a dental procedure or is discovered as having been previously formed during an independent dental procedure or as a result of a physical accident suffered by the patient. 
     In the membrane patching procedure described in the concurrently filed United Sates patent application, an opening is created in the sinus floor of a patient to expose the portion of the sinus membrane including the perforation. Then, a quantity of a sinus membrane patching material is inserted through the opening to a location adjacent the sinus perforation. Finally, the sinus membrane patching material is laterally expanded and forced against the sinus membrane to seal the perforation. 
     The present invention is directed to an improved version of an instrument for inserting, laterally expanding and forcing sinus patching material against a sinus membrane to seal a perforation in the sinus membrane. 
     SUMMARY OF INVENTION 
     Basically, the instrument of the present invention comprises a central support for a quantity of a sinus membrane patching material and moveable outer supports spaced laterally outward of the central support for laterally supporting and expanding the patching material as it is forced by the central support upward over the sinus perforation to form a relatively thin laterally extending patch sealed to the sinus membrane and closing and sealing the perforation. 
    
    
     
       BRIEF DESCRIPTION OF ACCOMPANYING DRAWINGS 
         FIG. 1  is a perspective of the preferred version of the instrument of the present invention. 
         FIG. 2  is a fragmentary right side view of an upper portion of the instrument of  FIG. 1  showing the central support extending upward beyond a right-side one of the outer supports. 
         FIG. 3  is a fragmentary front view of the upper portion of the instrument shown in  FIG. 2  illustrating the connection for the central support to a left-side one of the outer supports and the normal spacing of the outer supports from the central support. 
     
    
    
     DETAILED DESCRIPTION OF INVENTION 
     As previously indicated, and as described more fully in the above-referenced concurrently filed United States patent application, in order to seal a sinus perforation according to the method described in that patent application, an opening is created in the sinus floor of a patient exposing a portion of the patient&#39;s sinus membrane including the perforation. Next, as shown in  FIG. 3  the above-referenced patent application, the actual patching of the sinus perforation may be preceded by a lifting and separation of the perforated sinus membrane from the sinus floor to form a pocket between a lower surface of the sinus membrane and the sinus floor. The patching of the perforation in the sinus membrane is then accomplished as shown in  FIGS. 4A  and B and  FIG. 5  of the above-referenced patent application where an appropriate standard sinus membrane patching material is introduced through the opening into the pocket using a patching material insertion tool designed to carry the material upward into the pocket to a location adjacent and just below the portion of the sinus membrane including the perforation. Basically, as shown in  FIG. 4A , during insertion of the sinus membrane patching material through the opening and into the pocket, the outer supports and of the insertion tool are moved laterally against the central support and the patching material is carried by the upper surface of the central support and the upper surfaces of the outer supports. Thus supported, the patching material is moved by the insertion tool upward through the opening and into the pocket to a location adjacent to and immediately below the perforation in the sinus membrane. Then, as shown in  FIG. 4B , the insertion tool is moved upwardly until the patching material engages the sinus membrane and extends slightly into the perforation. As this is accomplished, the outer supports are released and moved laterally outward from the central support to aid the central support in laterally extending the patching material to cover the lower surface of the sinus membrane adjacent the perforation and form a patch as shown in  FIG. 5  of the above-referenced patent application. In these regards, patching materials useful in the patching of sinus membrane perforations are usually a semi-solid material as initially mounted on the insertion tool as shown in  FIG. 4A . However, when the patching material engages the moist surface of the sinus membrane it softens and becomes laterally extendable upon the release of the outer supports and shapeable by the central support to form a sticky adhesive patch covering the perforation and the adjacent lower surfaces of the sinus membrane in response to movement of the central support. 
     More specifically, relative to the preferred version of the insertion instrument of the present invention and as illustrated in  FIG. 1  of the present patent application, the preferred insertion tool or instrument  10  comprises a central support  12  and outer supports  14  and  16  laterally spaced from and laterally moveable relative to the central support  12 . The central support may comprise and is illustrated as comprising a ball  18  supported by a vertically extending support rod  20 . 
     As depicted in  FIG. 1 , the preferred design of the insertion instrument  10  resembles surgical forceps or tweezers having a pair of laterally spaced tongs secured to and extending longitudinally upward from a base for inward lateral movement towards each other when lateral forces are simultaneously applied to the tongs to pinch the free ends of the tongs against each other. In such a preferred design, the outer supports  14  and  16  of the instrument  10  correspond to the pair of tongs of surgical forceps or tweezers, the outer supports being secured and extending longitudinally upward from a base  22  of the instrument  10 . 
     However, the illustrated insertion instrument  10  differs in important structural and function features from such standard surgical forceps or tweezers. 
     First, among these several structural and function differences, is the central support  12 , preferably comprising the ball  18  secured to and supported atop the upper end of the vertically extending support rod  20 . As shown in the drawings, the ball  18  extends upward above the upper ends of the outer supports  14  and  16  so that the sinus membrane patching material will drape over the ball and downward onto the outer supports, particularly when the outer supports are moved laterally inward relative to the central support as by an inward pinching of the outer supports. 
     Second, as shown in  FIGS. 1 and 3 , at a mid-portion  21 , the support rod  20  is bent at an acute angle toward the outer support  16 . At a lower portion  23 , the support rod  20  is bent to extend generally parallel to an inner surface of the outer support  16 . Then, at its lower end  25 , the support rod  20  is hook-shaped, looped around and secured (as by welding) to a pin  31  connected to and extending laterally from the outer support  16  to pass through a guide hole  33  in the outer support  14  when the outer supports are pinched together. 
     Also, among the important structural and functional differences between the insertion instrument  10  and prior surgical forceps and tweezers is the angling of the upper portions of the central and outer supports. As shown in  FIGS. 1 and 2 , upper end portions  26  and  28  of the outer support  14  and upper end portions  30  and  32  of the outer support  16  and upper end portions  34  and  36  of the support rod  20  are each first bent rearward and upward at the same acute angle relative to a vertical central longitudinal axis  24  of the instrument  10  and then each bent forward and upward at the same acute angle also relative to the axis  24 . This is most clearly shown in  FIG. 2  where the upper portion  26  of the outer support  14  extending upward from the base connection  22  is bent rearward along an axis  27  at an acute angle of about 10 degrees relative to the instrument axis  24  and then at an upper extension portion  28  is bent forward along an axis  29  at and acute angle of about 35 degrees relative to an axis  38  parallel to the instrument axis  24  or about 125 degrees to the axis  27 . 
     In practice, the above described angling of the central and outer supports aids in the support and lateral extension of the sinus patching material during the application of such material to a sinus membrane and in the forming of the patching material into a relatively thin sealing patch over a perforation in the sinus membrane. 
     While a particular embodiment of the preferred insertion instrument of the present invention has been illustrated and described above, it is appreciated that changes and modifications may be made in the illustrated embodiment without departing from the spirit of the invention. Accordingly, the scope of present invention is to be limited only by the terms of the following claims.