Patent Publication Number: US-2023149133-A1

Title: Novel surgical incision device for dental implant placement

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     The present non-provisional patent application is related to U.S. Provisional Patent Application No. 63/280,619 filed Nov. 18, 2021, the contents of which are incorporated herein in their entirety. 
    
    
     FIELD OF THE DISCLOSURE 
     The present disclosure relates to novel surgical incision device for dental implant placement on partially edentulous patients. More particularly, the invention relates to a placement device that is capable of incision of various sizes along curved and straight surfaces found on patients&#39; intraoral gingival tissues. 
     BACKGROUND 
     Implantalogy has been a fast-growing field of interest for many patients, general dentists, periodontists and oral surgeons. This method may include application of specific blade device along desired gingival edentulous areas between two teeth. 
     Traditional blade device is known as scalpel need a strong, steady and precise hand to apply and incise gingiva to the crest of bone. The development of tissue punch biopsies of various sizes has been adapted to take the place of scalpel (blade #15) in order to uncover implants at the time of healing abutment placement. 
     Some dental specialists use a punch biopsy in order to place implants. However, that method does not reveal visibility of actual bone width in order to make more predictable and successful implant placement. Therefore, most dental practitioners today rely on a more conventional incision techniques using #15 blade to expose enough bone in order to place implant in a more precise position i.e., surrounded by bone. 
     #15 Blade is a typical device for the above-mentioned conventional technique. However, #15 Blade use or other scalpel also requires a long procedural time, a skilled hand and more patient&#39;s blood loss in order to ensure a uniform precise incision. Therefore, both punch biopsy device and #15 Blade scalpel have many drawbacks. 
     Punch biopsy has most important drawback for implant placement-lack of precise implant placement due to lack of bone visibility. Lack of bone visibility will possibly lead to implant failure, especially in hands of a novice implantalogist. On the other hand, conventional scalpel incision has many drawbacks; a long procedural time, more patient&#39;s blood loss, skilled surgical hand, more patient anxiety (patient seeing blade), difficult manual incision, but more predictable for implant survival due to visibility of bone. 
     Therefore, a need exists in the field for novel incision placement device capable of eliminating most drawbacks existing in two above-mentioned devices. 
     SUMMARY 
     The present disclosure comprises a novel incision device generally consisting of 3 blades in one tool adjustable for depth and height of edentulous area between two teeth, which is capable of conforming to gingival contours performing incision, specifically double papillae sparing incision. Double papillae sparing incision is advantageous over other types of incision due to prevention of gingival recession, thus giving more esthetic results. 
     Also, another advantage is for second stage of implant surgery where mobilization of tissues may be required. Esthetic results are especially important when a front tooth is missing. Therefore, double papillae sparing incision is advantageous over many incision types. This novel device will have various prefabricated widths similar to punch biopsy device that come in various diameters or widths. 
     In prototype A, two half-elliptical blades are parallel to each other. In center of device on its cutting surface half rounded blade is perpendicular to both half-ellipses. All 3 blades are secured well on rectangular foundation resembling a skateboard. Skateboard surface having two finger rests for both index finger and thumb opposite to each other. 
     In prototype B, two wheel-like blades parallel to each other and perpendicular to the center of rotation of device when viewed from cutting surfaces up. Two parallel wheels capable of rotation around their common axis. Surface on the opposite side to blades has a “cap” or cover protecting patient and operator from unwanted or iatrogenic injuries. 
     “Cap” or cover also acts as finger rests for index finger and thumb besides preventing iatrogenic injuries. In prototype C, one quarter-round blade secured well on skateboard-like surface. Skateboard surface has two finger rests for thumb and index finger. 
    
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         FIG.  1    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  2    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  3    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  4    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  5    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  6    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  7    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  8    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
         FIG.  9    is a diagram of a novel surgical incision device for dental implant placement according to an embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     The present disclosure is to be considered as an exemplification of the invention and is not intended to limit the invention to the specific embodiments illustrated by the figures or description below. 
     The present invention will be described by referring figures.  FIGS.  1 ,  2  and  3    depict exploded views of the elements that comprise device for double papillae sparing incision in prototype A. 
       FIG.  1    depicts exploded parts of prototype A with blades facing down.  101  is half elliptical blade.  104  is thumb rest.  105  is index finger rest.  106  is concave surface, resembling skateboard. 
       FIG.  2    depicts exploded illustration of view of prototype A with blades facing up. Blades  201  and  202  are parallel to each other.  203  is perpendicular to both  201  and  202 .  204  is thumb rest and  205  index finger rest. 
       FIG.  3    depicts exploded illustration of side view of prototype A with blades pointed to the right side. Blades  301  and  302  parallel to each other. Blade  303  is half round blade perpendicular to  301  and  302 .  304  and  305  represent finger rests with slight concavities in form of typical thumb and index fingers, respectively for improved grip and safety.  306  is concave surface.  307  is distance between blades  301  and  302 .  307  will come in various standard widths similar to present day punch biopsy devices (like 6, 7, 8, 9.10 mm). 
     To determine correct size  307  for a specific missing tooth need to measure distance between two teeth intraorally. Thus, for illustrative purposes “G” is distance between two teeth. To ensure preservation of both papillae “G” has to be at least slightly longer than  307 . Then after determining  307  from measuring “G”, try device between two teeth to make sure the fit is correct. 
     Try slightly rolling device without placing pressure by securely holding at rests to buccal side to see whether vertical incisions do not undermine both papillae. To make incision apply apical pressure while holding at rests with both thumb and index finger with significant pressure until feel crestal bone between teeth. Afterwards, apply light rolling motion to the buccal side while applying pressure on top of bone. Roll until reaching desired length for vertical incisions. 
     Please refer to  FIGS.  4 ,  5  and  6    for parts in Prototype B.  FIG.  4    depicts exploded view of Prototype B with blades facing down.  401  is full round blade parallel to the other blade (not shown due to view) capable of rotary motion around their common axis,  403 .  403  is center of rotation for both blades  401  and  402 .  404  is thumb rest,  405  is index finger rest.  407  is a protective cap, to protect from unwanted injuries and to hold the device. 
       FIG.  5    depicts an exploded view of Prototype B with blades facing up. Round blades  501  and  502  are parallel to each other.  503  is center of rotation.  504  is thumb rest and  505  is index finger rest. 
       FIG.  6    depicts exploded side views of Prototype B with blades pointed to the right side. Round blades  601  and  602  are parallel to each other.  604  is thumb rest and  607  is distance between blades  601  and  601 . 
     Main differences between Prototypes I and II are as follows. Two parallel blades are half-elliptical and stationary in Prototype A. Two parallel blades are circular and revolving in Prototype B. 
     Cover or “cap” in Prototype B protects both patient and operator and also acts as finger rests. Instructions on use for Prototype B are similar as above-mentioned use for Prototype A. However, since crestal incision is missing in Prototype B, need #15 Blade to do crestal incision after performing incision with Prototype B. 
     Prototype A PROS vs #15 Blade.
         More ergonomic design   Easier incision   Less procedural time   Less blood loss   Less patient anxiety (patient does not see blade or scalpel)       

     Prototype B PROS vs #15 Blade are as follows:
         More ergonomic design   Easier incision   Less procedural time   Less blood loss (because of less procedural time)   Less patient anxiety (no blade or scalpel visible to patient)   Less effort (Newton&#39;s third law)       

     Prototype A and B CONS
         May need adjustment with #15 Blade. Just like #15 blade is used to adjust the cut if tissue is still attached after initial incision.   Prototype B always need #15 Blade to make crestal incision.   Prototype A and Prototype B may not work ideally if have severe bone loss and/or irregular bone anatomy.       

     The present disclosure is described by referring figures.  FIG.  7   ,  FIG.  8    and  FIG.  9    depict exploded views of the elements that comprise device for crestal and vertical incisions in Prototype C.  FIG.  7    depicts view of Prototype C with blade facing down. Component  701  is quarter-round blade. Component  704  is thumb rest. Component  705  is index finger rest. Component  706  is incision start point. Component  707  is incision end point. 
       FIG.  8    depicts view of Prototype C with blade facing up. Component  801  is quarter-round blade. Component  804  is thumb rest. Component  805  is index finger rest. 
       FIG.  9    depicts side view of Prototype C with blade pointed to the left side. Component  901  is quarter-round blade. Component  904  is thumb rest. To make incision, place index finger on index finger rest and thumb on thumb rest. With significant apical pressure start incision with 90-degree angle at blade point  706  until feel crest of bone. Then, firmly but slowly roll till reaching desired length of incision, or maximum length to point,  707 . Prototype C can be used in crestal as well as vertical incisions. 
     Prototype C PROS vs #15 Blade
         More ergonomic design   Easier incision   Less procedural time   Less blood loss   More clear cut (single continuous cut instead of increments by #15 blade)   Faster longer incision (then incremental incision by #15 blade)   More accurate cut (single continuous cut instead of increments by #15 blade)       

     These Prototypes A, B, and C very similar to punch biopsy devices in terms of simple use and multiple prefabricated sizes. However, these prototypes are more accurate then punch biopsy devices, because bone visibility is possible. These devices may become valuable due to multiple factors. Their simple use and design may just make them very popular for general dentists, periodontists and oral surgeons.