Patent Publication Number: US-2011070556-A1

Title: Micro evacuator and method of use

Description:
RELATED APPLICATIONS 
     This application claims the benefit of U.S. Provisional Patent Application Ser. No. 61/214,838, filed 29 Apr. 2009. 
    
    
     BACKGROUND OF THE INVENTION 
     The present invention relates to medical and dental equipment for use in irrigating and evacuating a surgical or dental site, and more particularly to evacuation devices for use in areas of limited space. 
     During evasive practices, such as during surgeries and some dental procedures, the ability to properly view the area being operated on is essential. This is usually done with irrigation or evacuation devices, where a liquid, such as water, and a suction device are used in combination to clean the area. In procedures of a larger scale, this is generally a relatively straightforward process. However, for procedures performed in smaller areas, irrigation and evacuation of the area of interest is a more arduous task, which may result in less than ideal treatment. 
     Endodontic treatment (root canal treatment of infected teeth) usually requires shaping, cleaning and disinfection of the root canal system inside the affected tooth to initiate healing of the destructed bone, which has been caused by a bacterial infection in the root canal. There are, however, a number of cases where conservative treatment of the root canal is not sufficient to bring about healing, and the infection persists. Reasons for such persistent infections are often either anatomical or microbiological or both. In any case, endodontic surgery is required to create favorable conditions for healing in such situations. 
     The goal of endodontic surgery is usually to cut and remove a few millimeters from the root tip (referred to as an apicoectomy), prepare a retrograde cavity at the apex using highly specialized instruments, and fill this “micro cavity” with a retrograde filling material such as mineral trioxide aggregate (MTA), intermediate restorative material (IRM) or zinc oxide (Super EBA) cements. One of the remaining challenges during an apicoectomy is that, in many cases, bleeding from the granulation tissue (soft tissue grown to the area of bone cavity during infection) or from the surrounding bone makes it difficult to keep the retrograde cavity clean and dry when placing the filling cement. Moisture and blood from the surrounding tissue would either destroy or weaken the favorable properties of the retrograde filling. 
     Various types of surgical suction tips are used to control the bleeding and keep the cavity or cavities dry during the filling. However, due to often limited visibility and the fact that the suction tips can only address the problem of bleeding at one site (i.e. where the tip is placed), bleeding from other areas can reach the cavity and cause continuous delays during the surgical procedure. A device that provided evacuation from many areas, such as a suction loop, could remove blood or other liquids from all sides of the root tip continuously. 
     SUMMARY OF THE INVENTION 
     The present invention is an evacuation and irrigation device for use in medical areas, preferably confined dental areas, such as the jaw area below and around teeth and roots. The device generally comprises an adaptor section for connecting the device to a medical evacuation source. The adaptor section comprises a fluid pathway connecting a hook-like or arced evacuation needle to the evacuation source. The evacuation needle has a plurality of ports located on the needle, which allow for multi-directional or circumferential evacuation from the dental area. 
     The evacuation/irrigation device is also designed so that it may be arranged within a dental area to provide an essentially hands free operation. The shape and dimensions of the device allow positioning around the teeth and gums, wherein the device would be supported by the surrounding area. 
     The evacuation/irrigation device also has the benefit that it removes blood or other liquids in the area from all sides of the root tip, thus giving continuous, “all-around” protection against bleeding. By doing this, the device reduces the time required for invasive surgical operations, including dental operations, As an example, for a surgical apicoectomy, the device can assist in improving the quality of retrograde fillings, securing optimal conditions for their placement. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1A  is a perspective view of an evacuation and irrigation device developed according to the present invention. 
         FIG. 1B  is a top planar view of the device of  FIG. 1A . 
         FIG. 1C  is a side elevation view of the device of  FIG. 1A . 
         FIG. 2  is an exploded view of the evacuation and irrigation device of  FIG. 1 . 
         FIG. 3  is a perspective view of a person&#39;s teeth and gums that will be prepared for an apicoectomy procedure. 
         FIG. 4  is a perspective view of the teeth and gums of  FIG. 3 , with the gums being operated on with surgical cutting tools. 
         FIG. 5  is a perspective view of the teeth and gums of  FIG. 4 , demonstrating the area around the teeth and gums being filled with bodily fluids resulting from the surgical procedures shown and discussed in  FIG. 4 . 
         FIG. 6  is a perspective view of the teeth and gums of  FIG. 3 , with the evacuation and irrigation device of the present invention being inserted into the teeth and gums area and around the root tip. 
         FIG. 7  is a perspective view of the device shown in  FIG. 6 , with the device being used to irrigate the teeth and gums. 
         FIG. 8  is a perspective view of the evacuation and irrigation device of the present invention, demonstrating the ability of the device to be held in place hands-free. 
         FIG. 9  is a further perspective view of the evacuation and irrigation device, providing an alternative arrangement for holding the device in place hands-free. 
         FIG. 10  is a perspective view of the device of the present invention interacting with a single tooth, with the device having an alternate arrangement for holding the device in place. 
         FIG. 11  is a perspective view of an alternate use of an evacuation and irrigation device of the present invention. 
     
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     Although the disclosure hereof is detailed and exact to enable those skilled in the art to practice the invention, the physical embodiments herein disclosed merely exemplify the invention which may be embodied in other specific structures. While the preferred embodiment has been described, the details may be changed without departing from the invention, which is defined by the claims. 
       FIG. 1A  provides a perspective view of an evacuation and irrigation device  10  according to the present invention. The device  10  can be used for irrigation, evacuation, and aspiration of a specific area, or a combination of the above for that area. The device  10  generally comprises a first portion  12  and a second portion  14 . The first portion  12  comprises a supporting body, which has a first end  16 , that allows the device  10  to be connected to a dental tool  18 , and a second end  20  connecting the first portion  12  to the second portion  14 . The second portion  14  generally comprises a dental tip  22  having a plurality of openings or vacuum ports  24  located on the dental needle or tip  22 . The dental tip  22  generally has a hook-like structure. The dental tool  18  is preferably an evacuation device, such as a device connected to a vacuum source. 
       FIGS. 1B and 1C  provide elevation views of the device  10 . As previously stated, the first end  16  of the first portion  12  provides means for connecting the device  10  to the dental tool  18 . Preferably, the first end  16  comprises a threaded section  26 , which can be threaded onto the dental tool  18 . The dental tool  18  has a pathway  28  that provides fluid to the device  10 . The pathway  28  is in fluid communication with a througbore  30  located within the first portion  12 , which is in fluid communication with a hollow passageway  32  located in the dental tip  22 . Thus, fluid and other materials will be able to pass from the plurality of openings  24  located on the dental tip to the dental tool  18 . The second portion  14  can be connected to the first portion  12  in any manner that will allow communication between the passageway  32  and the throughbore  30 , such as by press-fitting the sections together or the use of adhesives. 
     Referring further to  FIGS. 1B and 1C , the dental tip  22  has a multi-directional design, which provides improved evacuation capabilities compared to prior designs. The openings  24  located on the dental tip  22  are spaced apart so that they will be directed inwardly towards the localized dental area, which will be discussed in more detail with respect to  FIGS. 6 and 7 . As previously stated, the second portion  14  comprises a dental tip  22  comprises a curved or hook-like structure. The dental tip  22  is connected to an angled section  34  that is connected to the first portion  12 , which allows the dental portion  22  to be axially aligned within a plane that is distinct from the plane that the first portion  12  of the device  10  is located. As shown in  FIG. 1C  one preferable arrangement shows the first portion  12  and the dental tip  22  to be aligned in spaced apart planes that are substantially parallel with one another. As will be demonstrated further with respect to  FIG. 7 , this design of the dental tip  22  and the second portion  14  allows for the device  10  to be used and positioned without the user needing to necessarily hold the device  10 . 
       FIG. 2  provides a perspective view of the device  10  removed from the dental tool  18 , which is preferably a vacuum source or a device capable of connecting to a vacuum source. The first end  16  of the first portion provides the connecting means for connecting the device  10  to the dental tool  18 , which is shown as a threaded section  36  to mate with a threaded section  38  located on the dental tool  18 . The threaded section  36  is shown as an externally threaded, but an internally threaded arrangement mating with an externally threaded arrangement on the dental tool  18  is also contemplate. Further, other arrangements for mating the device  10  with the dental tool  18  could be employed, as well. Provided that the connecting means allows communication between the dental tool  18  and the device  10 , the connecting means would fall within the scope of the present invention. 
       FIG. 3  provides a perspective view of a mouth  100  prior to having a surgical procedure performed within the mouth  100 , such as an apicoectomy or a procedure to remove a lesion from the mouth  100 . The mouth  100  has gums  102  supporting a plurality of teeth  104 . As shown in  FIG. 4 , a scalpel  5  is inserted into the flesh of the gums  102  to from an incision  106 . The incision  106  allows access to the internal area of the gums  102 , such as below or around the root tip  103  of a tooth  104  to remove potential necrotic or infected material within the gums  102 , root  103 , tooth  104 , or the surrounding jaw area. 
     As  FIG. 5  demonstrates, once the incision  106  is made, the area around the incision  106  can quickly fill with blood, which may make it difficult to view the area around the incision  106 . This can inhibit proper removal of unwanted material and, also, inhibit the refilling of the area with a cement or sealing material. 
     Removal of the excess blood can be accomplished by using the device  10 , as shown in  FIG. 6 . The device  10  is inserted into the mouth  100 , with the first portion  12  being positioned proximally to the incision  106 , with the device  10  being spatially orientated upwardly with respect to the mouth  100 . The dental tip  22  is situated generally within the incision  106 , with the angle section  34  being positioned around a tooth  104  so that the first portion  12  is loosely fitted or positioned near the general contour of where the tooth  104  meets the gums  102 . The dental tip  22  is preferably positioned around the end of the root tip  103  where the material needing removal is located. 
       FIG. 7  shows the device  10  being used to remove fluids and excess material from the area around the incision. Because of the shape of the dental tip  22  and the positioning of the device  10  around the tooth/incision area, the device  10  is capable of evacuating the area in a multi-directional fashion, with each of the openings  24  being directed inwardly toward the localized area being operated upon, thereby more efficiently removing fluid and debris from the area. The multi-directional functionality of the dental tip  22  allows more consistent and precise removal of fluids and material during procedures. 
       FIG. 8  demonstrates a further advantage of the device  10 . The shape of the dental tip  22  allows the device  10  to be situated around a tooth  104 , with the angled section  34  being positioned where the gums  102  and the exterior of the tooth  104  meet. The arrangement allows the ability of the device  10  to be held in position without a person having to hold the device  10  in that position, while still maintaining evacuation directed towards a specific, localized area. 
     The device  10  can be fit around the individual tooth  104 , either by fitting the dental tip  22  into the area around the tooth  104 , or by using another structure to hold the device  10  in place  10 . For example,  FIG. 9  shows the device  10  being held in place with the use of a ring  40 , which will be shaped to be positioned around the tooth  104 . Alternatively, fasteners, such as screws  42  may be used to hold the device  10  in place by fastening the device to the tooth  104  or the surrounding jaw. The screws  42  may be used alone or in combination with the ring  40  as is necessary. Provided that a device allows for mounting or positioning of the device so that it will be held in place essentially “hands-free”, the device should be considered as falling within the scope of the present invention. For example, the second portion  14  of the device  10  may be angled in a more perpendicular fashion, thereby forming a step that would sit on the area where the gums  102  and the exterior of the tooth  104  meet. Likewise, the device  10  could be designed with a horizontal extension member that could be used to anchor the device  10  in place. 
     As an example, of an alternate arrangement to anchor the device in place,  FIG. 10  shows the dental tip  22  ending in anchoring member  140 , which can be inserted into the bone and ligament material of the jaw surrounding the root  103  of the tooth  104 . The anchoring member  140  could potentially be tacked within the periodontal ligament tissue  108 , sufficiently enough to hold the device  10  in place. 
     The ability for the device  10  to provide multi-directional evacuation or irrigation for a localized area has benefits in other surgical procedures, as well, including dental and medical procedures. The multi-directional capability of the device  10  is an advantage in a wide range of procedures. For example,  FIG. 11  shows the use of the device  10  on another area  200  of a body with an incision  206  formed on the area  200 . Possible examples of such surgical procedures would include a laparoscopic procedure or in cosmetic surgeries, such as rhinoplasty. Such a procedure does not provide much room for a person to navigate and potentially limited viewing of the actual area that is being operated upon. Many times actual viewing is done indirectly with the use of an inserted endoscope, which inhibits manipulation of tools around the area, since it is not always easy to pinpoint and localize the operation area. The device  10  of the present invention assists in such situations by providing an evacuation arrangement that can be directed specifically towards the precise area being operated upon. The openings  24  will be able to remove fluid and materials in a multi-directional fashion, while the hook-like structure of the tip  22  can be used as a slight barrier between the operating area and the surrounding areas, thereby further limiting the amount of excess fluid that will get in to the operating area. Similarly, with the openings  24  facing inwardly toward the localized area, the amount of fluids that will be pulled in from the surrounding area will be minimized compared to previous evacuation devices. As used in  FIG. 10 , it may be desirous that the device is held in place with an adhesive so that it can be used as a hands-free device. 
     The ability to apply multi-directional irrigation according to the present invention can also be used for a larger localized surgical area, if necessary. For example, if the ports  24  on the tip  22  were designed on the outside of the tip  22 , the device  10  could provide irrigation that would be directed outwardly from the tip  22  if the ports  24  were located on the outside of the tip  22 . This would be advantageous in irrigating a larger localized surgical area, if desired. 
     The foregoing is considered as illustrative only of the principles of the invention. Furthermore, 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. While the preferred embodiment has been described, the details may be changed without departing from the invention, which is defined by the claims.