Patent Publication Number: US-2022218454-A1

Title: Cheek retractor with aerosol suction

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of U.S. provisional application Ser. No. 63/135,050 filed Jan. 8, 2021, the disclosure of which is hereby incorporated in its entirety by reference herein. 
    
    
     TECHNICAL FIELD 
     Various embodiments relate to a cheek retractor with suction for aerosols, such as for use in dental procedures. 
     BACKGROUND 
     During dental examinations, procedures, or treatments the patient is in a dental chair with the dentist, hygienist, or other dental professional in close proximity to the patient. During a dental procedure, a saliva ejector is often used to remove liquids from the inside of a patient&#39;s mouth or oral cavity, including saliva. However, the saliva ejector does not remove aerosols, including particles, aerosolized fluid particles, droplets, and the like that may be created during the dental procedure, or as exhaled air via the patient&#39;s mouth or nose. These aerosols may contain bioaerosols, that contain viruses, bacteria, or other pathogens, and the dental professional may be exposed to these aerosols during a procedure, especially when in close proximity to a patient&#39;s mouth and nose. 
     SUMMARY 
     In an embodiment, a cheek retraction device includes a member forming an arm extending between and connecting a first retractor and a second retractor. The first and second retractors are opposed to one another, with each of the first and second retractors sized to receive a portion of a lip of a patient. The first retractor defines a first internal passage and a first aperture, and the second retractor defines a second internal passage and a second aperture. A nasal tube defines a third internal passage, with the nasal tube extending between and mechanically coupling the first retractor and the second retractor. The nasal tube is in fluid communication with the first and second passages, is opposite to the arm, and defines a third aperture. A fluid connector is supported by the arm and in fluid communication with the first and second passages, with the fluid connector to connect the cheek retraction device to a remote vacuum source. The first aperture and the second aperture face towards one another such that aerosols flow from an oral cavity of a patient into the first and second passages via the first and second apertures. The third aperture faces away from the arm such that aerosols flow from a nasal passage of the patient into the third passage via the third aperture. 
     In another embodiment, a cheek retraction device includes a member forming an arm extending between and connecting a first retractor and a second retractor, with the first and second retractors opposed to one another. Each of the first and second retractors are sized to receive a portion of a lip of a patient. The first retractor defines a first internal passage and a first aperture, and the second retractor defines a second internal passage and a second aperture. A fluid connector is supported by the arm and is in fluid communication with the first and second passages. The fluid connector connects the cheek retraction device to a remote vacuum source. The first aperture and the second aperture face towards one another such that aerosols flow from an oral cavity of a patient into the first and second passages via the first and second apertures. 
     In yet another embodiment, a cheek retraction device includes a member forming an arm extending between and connecting a first retractor and a second retractor, with the first and second retractors opposed to one another. Each of the first and second retractors are sized to receive a portion of a lip of a patient. The first retractor defines a first internal passage extending between first and second tube connectors and a first series of apertures extending transversely therethough and intersecting the first internal passage, and the second retractor defines a second internal passage extending between third and fourth tube connectors and a second series of apertures extending transversely therethough and intersecting the second internal passage. A nasal tube extends between and mechanically couples the first retractor and the second retractor, with the nasal tube being opposite to the arm. The nasal tube has a first end connected to the first tube connector and a second end connected to the third tube connector. The nasal tube defines a third internal passage in fluid communication with at least one of the first and second passages, a pair of apertures extending radially through the nasal tube, and a third series of apertures extending radially through the nasal tube. A fluid connector is supported by the arm to connect the cheek retraction device to a remote vacuum source, with the fluid connector in fluid communication with the first and second internal passages. The first series of apertures, the second series of apertures, and the third series of apertures face towards an inner central region of the cheek retraction device one another such that aerosols flow from an oral cavity of a patient into the first, second, and third passages via the first, second, and third series of apertures, respectively. The pair of apertures face away from the arm and away from the inner central region of the cheek retraction device such that aerosols flow from nasal passages of the patient into the third passage via the pair of apertures. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  illustrates a dental chair and appliance for use with the device according to the present disclosure. 
         FIG. 2  illustrates a first perspective partial view of a cheek retraction device according to the present disclosure; 
         FIG. 3  illustrates a second perspective view of a cheek retraction device according to the present disclosure; 
         FIG. 4  illustrates a top view of a cheek retraction device according to the present disclosure; 
         FIG. 5  illustrates an end view of a cheek retraction device according to the present disclosure; 
         FIG. 6  illustrates a side view of a cheek retraction device according to the present disclosure; 
         FIG. 7  illustrates a third perspective view of a cheek retraction device according to the present disclosure; 
         FIG. 8  illustrates a fourth perspective view of a cheek retraction device according to the present disclosure; 
         FIGS. 9A-E  illustrate various plan, elevation, and perspective schematic views of a member and a vacuum connector fitting according to the present disclosure, and for use with the cheek retraction device of  FIG. 2 ; and 
         FIGS. 10A-D  illustrate various perspective, plan, and elevation schematic views of a member of a cheek retraction device according to another embodiment of the present disclosure; and 
         FIGS. 11A-F  illustrate various views of the member of  FIG. 10 . 
     
    
    
     DETAILED DESCRIPTION 
     As required, detailed embodiments of the present disclosure are provided herein; however, it is to be understood that the disclosed embodiments are merely examples and may be embodied in various and alternative forms. The figures are not necessarily to scale; some features may be exaggerated or minimized to show details of particular components. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a representative basis for teaching one skilled in the art to variously employ the present disclosure. 
     As used herein, a dental procedure, treatment, or examination includes dental cleanings and examinations, dental procedures such as bonding, bridges or implants, fillings or repairs, crowns and caps, extractions, as well as endodontic procedures, periodontal procedures, oral and maxillofacial surgery, orthodontic procedures, and the like. Likewise, a dental professional as used herein includes dentists, hygienists, oral and maxillofacial surgeons, orthodontists, endodontists, assistants, and the like. 
     As used herein, an aerosol refers to particles, aerosolized fluid particles, droplets, and the like that are suspended in or carried by gas, e.g. are airborne, and that may be created during the dental procedure. In one example, an aerosol is provided as exhaled air or an exhaled breath via the patient&#39;s mouth and/or nose. These aerosols may contain bioaerosols, that contain viruses, bacteria, or other pathogens, and the dental professional may be exposed to these aerosols during a procedure, especially when in close proximity to a patient&#39;s mouth and nose. Due to the close proximity, there is a risk of airborne transmission from the patient to the dental professional. According to one non-limiting example, an aerosol may contain a virus such as an RNA virus, including a coronavirus such as COVID-19, SARS, or MERS; an influenza virus, including influenza A or B; a rhinovirus, or the like. 
     Although the dental professional may wear or use personal protective equipment such as a mask, face shield, goggles, or the like, the patient&#39;s nose and mouth are exposed due to the nature of a dental procedure. The present disclosure provides for a cheek retraction device that may be used as a dental apparatus, or dental retractor, that reduces aerosols emitted by a patient breathing, and also reduces aerosols created during the dental procedure itself. For example, an aerosol may be created by a dental tool, including those operated using compressed air and/or water. The present disclosure provides for a dental apparatus that reduces droplets and/or aerosols associated with a patient&#39;s mouth, and also reduces droplets and/or aerosols going to and from the patient&#39;s nose. The apparatus or cheek retraction device according to the present disclosure may be used in conjunction with mouth or intra-oral suction devices or solely on its own as an aerosol suction device. 
     With reference to  FIG. 1 , during a dental procedure the patient is seated in a dental chair  50 , and the dental professional is on either the left- or right-hand side of the patient. The dental chair  50  has a seat with leg supports, a seat back, armrests, and is typically positioned in a central region of a room. 
     The dental chair  50  may be adjacent to, provided with, or incorporated into a chair-side appliance  52  with a pneumatic and/or mechanical power source for dental handpieces. The chair-side appliance  52  also is provided with a vacuum system  54  with one or more suction hoses or lines, a compressed air source and a water source for with an irrigation nozzle or the like. 
     The vacuum system  54  in the appliance  52  has one or more suction line connectors  56  that are adjacent to the chair  50  and dental workstation or instrument tray. A suction tool may be connected via a hose to a suction line connector of the vacuum system. The vacuum system  54  has a vacuum pump and one or more separators or traps that are connected to the suction line connectors and provide a source of vacuum or low pressure. The vacuum system  54  may be periodically cleaned or sterilized, e.g. by cleaning the traps, running disinfectant and/or detergent through the lines, etc. According to one non-limiting example, the vacuum system  54  provides a vacuum level of 70 mmHg at the suction line connectors  56 . For comparison, ambient pressure is at or near a standard atmospheric pressure of 760 mmHg. 
     A cheek retraction device  100 , which may also be referred as a dental device  100  or dental retractor  100  according to various non-limiting examples, is provided according to the present disclosure, and is shown in  FIGS. 2-9 . The retractor  100  may be used with the dental chair  50  and vacuum system  54  as described above with reference to  FIG. 1 . Alternatively, the retractor  100  may be used in conjunction with other mouth or intra-oral suction devices or solely on its own as an aerosol suction device. The retractor  100  may be used during a dental procedure to move or retract the lips or lips and cheeks and provide improved access to and visibility of the oral cavity. The retractor  100  may additionally reduce contact of a dental instrument or tool with cheek tissue. 
     The retractor  100  has a member  102  that forms an arm  104 , a first retractor  106  and a second retractor  108 , e.g. as an integrally formed component. In one example, the member may  102  be formed from an autoclavable material. In another example, the member  102  may be formed from a material to be disposable and intended for single use. In one example, the member  102  may be formed from a three-dimensional printing process using a thermoplastic polymer, for example, a polyethylene terephthalate (PET) filament. 
     The arm  104  extends between and connects the first retractor  106  and the second retractor  108 . The arm  104 , first retractor  106 , and second retractor  108  may generally cooperate to form a U-shaped or C-shaped member  102 . 
     The first retractor  106  is sized to receive a portion of a lip and/or cheek of a patient. The first retractor  106  has or defines a first tube connector  110  and a second tube connector  112  at opposite ends of the first retractor  106 . In one non-limiting example, the first and second tube connectors  110 ,  112  are provided by male barbed tube fittings. 
     The first retractor  106  has a first flange  116  and a second flange  118  extending from a first central region  114 . The first and second flanges  116 ,  118  extend away from the second retractor  108  and define a recessed area therebetween to receive a portion of a patient lip. 
     The first retractor  106  defines a first internal passage  120  that extends longitudinally along the first retractor and between the first and second tube connectors  110 ,  112 . The first internal passage  120  may extend for the entire length of the first retractor  106  according to one example, and as shown. The first internal passage  120  of the first retractor extends along the first central region  114 . 
     The first retractor  106  also defines a series of first apertures  122 . The first apertures  122  may extend transversely or radially through the first retractor  106 , and intersect the first passage  120 , such that the first apertures act as inlets to the first passage. The series of first apertures  122  may be provided with any number of apertures. The first apertures  122  are spaced apart from one another along the length of the first retractor. In one example, the first apertures  122  are spaced equidistant from one another along the first retractor  106 . In another example, the first apertures  122  may be variably spaced along the first retractor  106 . The first apertures  122  may be circular in cross-sectional shape, may have a rectangular or other slotted shape, or may have another shape. The first apertures  122  may have the same cross-sectional area as one another, and in another example, the first apertures may be provided with varying cross-sectional areas. 
     The second retractor  108  is opposed to or opposite to the first retractor  106 . The second retractor  108  may be a mirror image of the first retractor  106  according to one example. The second retractor  108  is sized to receive another portion of a lip and/or cheek of a patient. The second retractor  108  has or defines a third tube connector  130  and a fourth tube connector  132  at opposite ends of the second retractor  108 . In one non-limiting example, the third and fourth tube connectors  130 ,  132  are provided by male barbed tube fittings. 
     The second retractor  108  has a third flange  136  and a fourth flange  138  extending from a second central region  134 . The third and fourth flanges  136 ,  138  extend away from the first retractor  106  and define a recessed area therebetween to receive a portion of a patient lip. The arm  104  is connected to the first and third flanges  116 ,  136 . 
     The second retractor  108  defines a second internal passage  140  that extends longitudinally along the second retractor  108 , and between the third and fourth tube connectors  130 ,  132 . The second internal passage  140  may extend for the entire length of the second retractor  108  according to one example, and as shown. The second internal passage  140  of the second retractor  108  extends along the second central region. 
     The second retractor  108  also defines a series of second apertures  142 . The second apertures  142  may extend transversely or radially through the second retractor  108 , and intersect the second passage  140 , such that the second apertures  142  act as inlets to the second passage. The series of second apertures  142  may be provided with any number of apertures. The second apertures  142  are spaced apart from one another along the length of the second retractor  108 . In one example, the second apertures  142  are spaced equidistant from one another along the second retractor  108 . In another example, the second apertures  142  may be variably spaced along the second retractor  108 . The second apertures  142  may be circular in cross-sectional shape, may have a rectangular or other slotted shape, or may have another shape. The second apertures  142  may have the same cross-sectional area as one another, and in another example, the second apertures may be provided with varying cross-sectional areas. 
     The series of first apertures  122  and the series of second apertures  142  generally face towards one another, or face inwardly towards a central inner region of the device  100  such that aerosols flow from an oral cavity of a patient into the first and second passages  120 ,  140  via the first and second apertures. 
     The device  100  has a nasal tube  150  extending from a first end to a second end and defining a third internal passage  152 . The nasal tube  150  extends between and mechanically couples the first retractor  106  and the second retractor  108 . The first end of the nasal tube  150  is connected to the first tube connector  110 , and the second end of the nasal tube is connected to the third tube connector  130 . The nasal tube  150  is in fluid communication with the first passage  120  and/or the second passage  140 . The nasal tube  150  is positioned generally opposite to the arm  104 . 
     The nasal tube  150  defines a third aperture or a pair of apertures  154  extending radially though the nasal tube  150  and intersecting the third passage  152 . The pair of apertures  154  faces away from the arm  104  and outwardly and away from the inner central region of the device  100  such that aerosols flow from a nasal passage of the patient into the third passage  152  via the third apertures  154 . 
     The nasal tube  150  may also define a series of fourth apertures  156  extending through the nasal tube and intersecting the third passage  152 . The fourth apertures  156  face towards the arm  104  such that aerosols flow from the oral cavity of the patient into the third passage  152  via the fourth aperture  156 . 
     For the device  100 , the first, second, and fourth apertures  122 ,  142 ,  156  face towards an inner central region of the device  100  such that aerosols flow from an oral cavity of a patient into the first, second, and third passages  120 ,  140 ,  152 , via the first, second, and fourth apertures, respectively. The nasal tube  150 , the first and second retractors  106 ,  108 , and the arm  104  may collectively define the inner central region of the device  100 . 
     The device  100  has a fluid connector  160  that is supported by or connected to the arm  104 . The fluid connector  160  is in fluid communication with the first and second passages  120 ,  140 . The fluid connector  160  is used to connect the dental device to a remote vacuum source, such as a vacuum source in a vacuum system associated with a dental chair or room. 
     In one example, and as shown, the device includes a fifth tube connector  162  and a sixth tube connector  164  that are in fluid communication with the fluid connector  160  via a fourth internal passage  166  that extends transversely through the arm  104 . The fifth and sixth tube connectors  162 ,  164  may be adjacent to one another and furthermore, may be angled towards a respective one of the first and second retractors. The fifth and sixth tube connectors  162 ,  164  and the fourth internal passage  166  may be integrally formed with the arm  104 . In one non-limiting example, the fifth and sixth tube connectors  162 ,  164  may be provided by male barbed tube fittings. 
     A vacuum connection tube  168  is connected to the dental device and to the arm  104  and fluid connector  160 , and is shown in  FIGS. 2-8 . The vacuum connection tube  168  has a vacuum system fitting  170  on a distal end, and is configured to couple to a corresponding connector on the remote vacuum source. 
     In a further example, the fluid connector  160  includes a swivel joint or swivel connection. The vacuum connection tube  168  may be connected to the member  102  via the swivel joint. The swivel joint allows for rotation about an axis  172  extending through the arm  104  and extending between the first and second retractors  106 ,  108 . During a dental procedure, the swivel joint allows for the vacuum connection tube  168  to go to either the right-hand side of the dental chair (taken from a patient perspective) or to the left-hand side of the dental chair. This allows the same dental device to be used by a right-handed or left-handed dental professional who may be seated on one side of the dental chair or the other. 
     The device  100  has a first chin tube  180  and a second chin tube  182  according to one example and as shown in  FIGS. 2-8 . The first chin tube  180  fluidly connects the first passage  120  of the first retractor to the fluid connector  160 . The first chin tube  180  extends from a first end to a second end, with the first end connected to the second tube connector  112 , and the second end connected to the fifth tube connector  162 . 
     The second chin tube  182  fluidly connects the second passage  140  of the second retractor to the fluid connector  160 . The second chin tube  182  extends from a first end to a second end, with the first end connected to the fourth tube connector  132 , and the second end connected to the sixth tube connector  164 . 
     In one example, the first and second chin tubes  180 ,  182  may be provided without apertures that extend transversely or radially though a sidewall, e.g. each chin tube may have a continuous sidewall without apertures for suction of aerosols. Alternatively, one or both of the first and second chin tubes  180 ,  182  are provided with one or more apertures that extend transversely or radially though a sidewall of the associated chin tube for suction and removal of aerosols from a patient mouth. 
     In another example, the device  100  is provided without the chin tubes, and the arm  104  forms internal passages that fluidly connect the first and second internal passages  120 ,  140  to the fluid connector  160 . 
     According to various examples, the nasal tube  150 , the first and second chin tubes  180 ,  182 , and the vacuum connection tube  168  may be provided from the same tubing or from different type or diameter tubing. The use of the nasal tube and the first and second chin tubes allows the device to remain flexible for insertion and removal from a patient mouth, and also for patient comfort. The nasal tube, the first and second chin tubes, and the vacuum connection tube may be provided by flexible polymer tubing, such as TYGON tubing, and may be a medical or surgical grade of tubing. 
     In use, the nasal tube  150 , the first and second chin tubes  180 ,  182 , and the vacuum connector tube  168  are all attached to the member  102  to collectively provide the dental device or retractor assembly  100 . 
     The member  102  is then bent or elastically deformed for insertion into a patient mouth. The first and second retractors  106 ,  108  receive portions of the patient&#39;s lip, and then the member  102  is released to return towards its initial shape. 
     The nasal tube  150  is adjacent to the patient&#39;s nose and nasal passages, and may be above or adjacent to the patient&#39;s upper lip. The first and second chin tubes  180 ,  182  and the arm  104  may be adjacent to the patient&#39;s chin, and may be below the patient&#39;s lower lip. 
     The swivel joint of the fluid connector  160  may then be used to position the vacuum connector tube  168  on the side of the patient corresponding to the chair-side appliance and the vacuum system, based on the location of the dental professional, and to minimize interference with the dental professional during the procedure. The device  100  may then be connected to the vacuum system via the vacuum system fitting. 
     When the vacuum line on the vacuum system corresponding to the device  100  is turned on by the dental professional, the vacuum system provides suction to and draws a vacuum on the device. Air, including aerosols, in the region of the oral cavity and patient mouth, are drawn into the third passage  152  in the nasal tube  150  by the series of fourth apertures  156 . Likewise, air, including aerosols, in the region of the oral cavity and patient mouth, are drawn into the first and second passages  120 ,  140  in the first and second retractors  106 ,  108  via the series of first and second apertures  122 ,  142 . 
     Air, including aerosols, in the region of the nasal passages and patient nose, are drawn into the third passage  152  in the nasal tube  150  by the pair of apertures  154 . 
     Air, including aerosols, flows from the third passage  152 , into the first and/or second passage  120 ,  140 . From the first passage  120 , air, including aerosols, flows into the first chin tube  180 , to the fluid connector  160 , to the vacuum tube  168 , and to the vacuum system. From the second passage  140 , air, including aerosols, flows into the second chin tube  182 , to the fluid connector  160 , to the vacuum tube  168 , and to the vacuum system. Aerosols are removed from the patient&#39;s mouth and oral cavity by the device  100  during a procedure, and the dental professional has reduced exposure to aerosols. 
     After use, vacuum to the device  100  is turned off. The device  100  is then removed from the patient&#39;s mouth. For a disposable device  100 , the device is then discarded. For a reusable device  100 , the tubes  150 ,  168 ,  180 ,  182  may be removed, and the member  102  is then placed in an autoclave for cleaning and sterilization, with clean or new tubes subsequently used with the device. In other examples, the tubes are also autoclavable, and the entire device is placed in the autoclave. 
     The retractor device  100  may remove over ninety percent of aerosols from a patient when connected to the vacuum system, remove over eighty percent of aerosols from a patient when connected to the vacuum system, or remove over fifty percent of aerosols from a patient when connected to the vacuum system. 
     The retractor device  100  may be provided in multiple sizes, for example, for use with patient&#39;s with different size oral cavities, e.g. pediatric, adult small, adult large, and the like. 
     Unlike a saliva ejector, which connects to the vacuum system and collects liquids from within the patient&#39;s mount or oral cavity, the retractor device  100  according to the present disclosure collects aerosols, vapor, and gas from the patient&#39;s mouth as well as from the patient&#39;s nose. 
     The retractor device  100  may be used in place of or in conjunction with a stand-alone unit for air filtering and cleaning that is positioned within the room. The retractor device  100  may reduce the filtration and cleaning load on the stand-alone unit, improve room disinfection between patients, reduce transmission to the dental professional based on its positioning on the patient, uses less space within the room, and is a lower cost alternative or enhancement. 
     The device  100  according to the present disclosure may be used in conjunction with or in place of a dental dam. If the retractor  100  replaces a dental dam, the retractor device  100  may be more comfortable for a patient than the dental dam. 
       FIGS. 10-11  illustrates a member  202  according to another embodiment and for use with a cheek retraction or dental device, such as device  100 . Elements in  FIGS. 10-11  that are the same as or similar to those described with respect to  FIGS. 2-9  are given the same reference numbers for simplicity, and unless otherwise described below, the member  202  is formed similarly to that described above for member  102 . 
     The arm  104  of the member  202  is formed with internal passages  204  that fluidly connect the first and second internal passages  120 ,  140  to the barrel connector  206 . The first and second internal passages may be integrally formed within the member  202 . These internal passages may take the place of the two chin tubes described above. Note that the member  202  may be used with a nasal tube  150  as described above, or without a nasal tube. 
     The member  202  has first and second tube extensions  208 ,  210  that include the first and second passages  120 ,  140  of the first and second retractors. The first and second passages  120 ,  140  may intersect the end of the first and second tube extensions  208 ,  210  as shown. In one example, the first and second passages  120 ,  140  may be plugged or otherwise closed at the respective ends of the first and second tube extensions  208 ,  210  using caps or plugs to prevent fluid flow through the ends of the first and second tube extensions  208 ,  210 , and such that the member  202  is used in a cheek retraction or dental device without any chin tube. In other examples, the first and second tube extensions  208 ,  210  may be used as connectors for a single chin tube that defines apertures to provide additional suction from the mouth of a patient into the device. The single chin tube has a first end connected to the first tube extension  208  and a second end connected to the second tube extension  210  such that the single chin tube extends between and fluidly couples the first tube extension to the second tube extension. 
     Furthermore, the member  202  may be provided with a barrel connector  206  as shown, where the barrel connector  206  does not provide for rotational movement of the vacuum connection tube within the barrel connector  206  and relative to the barrel connector. Alternatively, the member  202  may be provided with a swivel connector as described above in place of the barrel connector  206 . 
     In addition to the features as described above,  FIGS. 2-9  illustrate the cheek retraction device  100  and member  102  having an overall ornamental appearance according to a first embodiment, while  FIGS. 10-11  illustrate another member  202  for a cheek retraction device  100  having an overall ornamental appearance according to a second embodiment. 
     While exemplary embodiments are described above, it is not intended that these embodiments describe all possible forms of the disclosure or invention. Rather, the words used in the specification are words of description rather than limitation, and it is understood that various changes may be made without departing from the spirit and scope of the invention. Additionally, the features of various implementing embodiments may be combined to form further embodiments of the invention.