ULTRASONIC NEGATIVE PRESSURE IRRIGATION AND EVACUATION HIGH-PERFORMANCE POLYMER MICRO-CAPILLARY CANNULA

Abstract

The present invention describes an endodontic high-performance polymer micro-capillary cannula for use with a dental tool having an ultrasonic/sonic energy generator, and providing concomitantly irrigation, activation of the irrigation liquid and evacuation of the root canal content. The micro-capillary cannula provides continuous delivery of an irrigant from the ultrasonic or sonic handpiece while vibrating inside canal, allowing the activation of the irrigant. Energy generated by an ultrasonic or sonic generator is translated into movement of the cannula to provide optimum cleaning to the root canal. Simultaneously, negative pressure is formed at the tip end of the cannula by a tubing connection at the proximal end of the cannula, which is connected to the suction dental unit. The evacuation at the end of the cannula helps irrigant movement from the coronal part of the canal to the apical part, while avoids apical extrusion of the irrigant.

Claims

1. An endodontic micro-cannula configured for simultaneous irrigation, ultrasonic or sonic intracanal activation of an irrigant, and evacuation of root canal contents, wherein said micro-cannula comprises: i) an open proximal end, a distal end having at least one opening, and at least two interior lumenal diameters, wherein a lumenal diameter of said distal end is smaller than that of said proximal end; ii) having a non-tapered shape or substantially tapered shape about a long axis such that a first lumen within said micro-cannula is configured to be a conduit for evacuation of root canal contents; iii) a portion of an outer diameter adjacent to said proximal end configured to engage an attached insert of an ultrasonic or sonic handpiece; iv) a body made of polymer materials that effectively vibrates at a frequency provided via said ultrasonic or sonic handpiece, and optionally which attached insert is configured to position an annulus formed from a second lumen within said attached insert at an oblique angle relative to the top of the open proximal end; and v) a tubing connector at said open proximal end configured to attach to evacuation tubing.

2. The micro-cannula of claim 1, wherein said adjacent outer diameter portion is configured to be threaded into an attached insert of said ultrasonic or sonic handpiece.

3. The micro-cannula of claim 1, wherein said distal end comprises two or more openings.

4. The micro-cannula of claim 1, wherein the micro-cannula comprises a first polymer tube attached to a second polymer tube by a means selected from the group consisting of mechanical engagement, chemical attachment, glue, over molding and combinations thereof.

5. The micro-cannula of claim 4, wherein said first polymer tube has a first outer diameter and said second polymer tube has a second outer diameter which said second outer diameter is different from said first outer diameter, and optionally wherein a portion of said second polymer tube covers a proximal portion of said first polymer tube via a tight superimposed connection.

6. The micro-cannula of claim 2, wherein said distal end vibrates at a resonance frequency of greater than about 6 kHz via said handpiece, which frequency provides sufficient force to transport said irrigant externally and passively through at least one opening of said distal end.

7. The micro-cannula of claim 6, wherein said resonance frequency is between about 25 and about 30 kHz.

8. The micro-cannula of claim 1, wherein said open proximal end is configured to connect to a first tubing, which first tubing is configured to connect to a suction unit attached to said ultrasonic or sonic handpiece, whereby negative pressure is created by said suction unit at said at least one distal end opening of the micro-cannula, which at least one distal end opening evacuates root canal contents as said micro-cannula is vibrating and said attached insert is irrigating the root canal via said annulus.

9. The micro-cannula of claim 1, wherein said attached connector insert is configured to contain a threaded receiving slot, and wherein said micro-cannula is positioned and maintained in said receiving slot by said attached insert.

10. The micro-cannula of claim 2, wherein vibrations induced by ultrasonic or sonic energy through said micro-cannula are amplified due to free vibration at a distal end extremity.

11. The micro-cannula of claim 1, wherein said irrigant is selected from the group consisting of tissue dissolving agents, antibacterial agents, chelating agents and combinations thereof.

12. The micro-cannula of claim 1, wherein said irrigant is selected from the group consisting of distilled water, sodium hypochlorite, EDTA, ClO.sub.2, MTAD, HEBP, citric acid, maleic acid, chlorhexidine (CHX), green tea, triphala and combinations thereof.

13. A consumable endodontic micro-cannula adapted for simultaneously irrigation, ultrasonic or sonic intracanal activation of an irrigant, and evacuation of root canal content, wherein said micro-cannula comprises: i) an open proximal end, an open distal end, and at least two interior lumenal diameters, wherein a lumenal diameter of said open distal end is smaller than that of said open proximal end; ii) a substantially tapered shape about a long axis such that a first lumen within said micro-cannula is configured to be a conduit for evacuation of root canal contents; iii) an outer diameter adjacent to said proximal end configured to be self-threading into an attached insert of an ultrasonic or sonic handpiece; iv) a body made of polymer materials that effectively vibrates with a frequency provided by said ultrasonic or sonic handpiece, and which attached insert is configured to position an annulus formed from a second lumen within said attached insert at an obtuse angle relative to the top of the proximal end; and v) a tubing connector at the proximal end configured to attach to evacuation tubing.

14. The consumable micro-cannula of claim 13, wherein said distal end of said micro-cannula vibrates at a resonance frequency of greater than about 6 kHz via said ultrasonic or sonic handpiece, which frequency provides sufficient force to transport said irrigant externally and passively through said distal end of said micro-cannula.

15. The consumable micro-cannula of claim 14, wherein the resonance frequency is between about 6 and about 30 kHz.

16. A endodontic procedure comprising: a) making an opening through the crown of a tooth to enter a pulp chamber of a subject; b) removing infected or diseased pulp from said pulp chamber; c) inserting a micro-cannula connected to an ultrasonic or sonic handpiece into said pulp chamber of step (b), wherein said micro-cannula comprises: i) an open proximal end, a distal end having at least one opening, and at least two interior lumenal diameters, wherein a lumenal diameter of said distal end is smaller than that of said open proximal end; ii) a non-tapered shape or substantially tapered shape about a long axis such that a first lumen within said micro-cannula is configured to be a conduit for evacuation of root canal contents; iii) an outer diameter adjacent to said proximal end configured to engage an ultrasonic or sonic attached insert of a handpiece; iv) a body made of polymer materials that effectively vibrates with a frequency provided by the ultrasonic or sonic handpiece, wherein said attached insert is configured to position an annulus formed from a second lumen within said attached insert at an obtuse angle relative to the top of the proximal end, and wherein said lumen conducts irrigant from a reservoir to the root canal; and v) a tubing connector at the proximal end configured to attach to evacuation tubing, and d) applying negative pressure, irrigant and ultrasonic or sonic energy via said handpiece, wherein remaining root canal contents from step (b) are substantially removed.

17. The endodontic procedure of claim 16, wherein said adjacent outer diameter is threaded to engage the attached insert of said ultrasonic or sonic handpiece, and wherein ultrasonic or sonic energy activates irrigant released from said attached insert.

18. The endodontic procedure of claim 16, wherein said distal end of said micro-cannula vibrates at a resonance frequency of greater than about 6 kHz, which frequency provides sufficient force to transport the irrigant externally and passively through the distal end of the micro-cannula.

19. The endodontic procedure of claim 16, wherein the irrigant is selected from the group consisting of tissue dissolving agents, antibacterial agents, chelating agents and combinations thereof.

20. The endodontic procedure of claim 16, wherein the irrigant is selected from the group consisting of distilled water, sodium hypochlorite, EDTA, ClO.sub.2, MTAD, HEBP, citric acid, maleic acid, chlorhexidine (CHX), green tea, triphala and combinations thereof.

21. An ultrasonic or sonic connector insert attachment configured to contain a first proximal and second distal threaded receiving slot, wherein a polymer cannula positioned therein is reversibly-affixed in the first proximal threaded receiving slot by the ultrasonic or sonic connector insert attachment.

22. The ultrasonic or sonic connecter inset attachment of claim 21, wherein the ultrasonic or sonic connector insert attachment is configured to connect to an ultrasonic or sonic handpiece, and wherein ultrasonic or sonic vibrations are transmitted through the polymer cannula, and thereby, affording concomitant irrigation from an irrigant reservoir on the ultrasonic or sonic handpiece.

23. The ultrasonic or sonic connecter inset attachment of claim 21, wherein the ultrasonic or sonic connector insert attachment further comprises a passage way that is configured to allow for a single continuous flow path of irrigant, and wherein the flow path projects the irrigant at an external surface of the polymer cannula through an opening located proximate to the first proximal receiving slot.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0046] FIG. 1 is a perspective view of a portion of a dental tool with a polymer cannula attached to a threaded ultrasonic insert and ultrasonic or sonic handpiece.

[0047] FIG. 2 is an enlarged perspective view of the polymer cannula attached to a threaded ultrasonic insert.

[0048] FIG. 3 is a top side view of an embodiment of the polymer cannula.

[0049] FIG. 4 is a lateral side view of an embodiment of the polymer cannula.

[0050] FIG. 5 illustrates the tip detail with lateral opening of an alternate embodiment of the present invention.

[0051] FIG. 6 is a top side view of a separate embodiment of the polymer cannula.

[0052] FIG. 7 illustrates the attachment of the two-polymer parts detail of the separate embodiment of the present invention.

[0053] FIG. 8 is a longitudinal cross-section view of the separate embodiment of the present invention.

[0054] FIG. 9 illustrates the insert and screw direction of an embodiment of the present invention on the ultrasonic or sonic connector.

[0055] FIG. 10 depicts the irrigation fluid direction and canal content evacuation direction of an embodiment of the present invention.

[0056] FIG. 11 illustrates an embodiment of the present invention positioned inside the root canal with representations of the irrigation fluid being expressed inside the pulp chamber/root canal, and evacuation.

[0057] FIG. 12 illustrates a side view of an embodiment of the present invention.

[0058] FIG. 13 illustrates a side view of an embodiment of the present invention when attached onto a handle as support for inserting the cannula.

DETAILED DESCRIPTION OF THE INVENTION

[0059] Before the present composition, methods, and methodologies are described, it is to be understood that this invention is not limited to particular compositions, methods, and experimental conditions described, as such compositions, methods, and conditions may vary. It is also to be understood that the terminology used herein is for purposes of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only in the appended claims.

[0060] As used in this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise. Thus, for example, references to “an irrigant” includes one or more irrigants, and/or compositions of the type described herein which will become apparent to those persons skilled in the art upon reading this disclosure and so forth.

[0061] Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the invention, as it will be understood that modifications and variations are encompassed within the spirit and scope of the instant disclosure.

[0062] As used herein, “about,” “approximately,” “substantially” and “significantly” will be understood by a person of ordinary skill in the art and will vary in some extent depending on the context in which they are used. If there are uses of the term which are not clear to persons of ordinary skill in the art given the context in which it is used, “about” and “approximately” will mean plus or minus <10% of particular term and “substantially” and “significantly” will mean plus or minus >10% of the particular term. In embodiments, composition may “contain,” “comprise” or “consist essentially of” a particular component or group of components, where the skilled artisan would understand the latter to mean the scope of the claim is limited to the specified materials or steps “and those that do not materially affect the basic and novel characteristic(s)” of the claimed invention.

[0063] As used herein, “endodontic procedure” means a treatment sequence for the infected pulp of a tooth which is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion.

[0064] As used herein, “irrigant” (or irrigating fluid) means a fluid used in an endodontic procedure which has one or more of the following properties: broad antimicrobial spectrum; high efficacy against anaerobic and facultative microorganisms organized in biofilms; ability to dissolve necrotic pulp tissue remnants; ability to inactivate endotoxin; ability to prevent the formation of a smear layer during instrumentation or to dissolve the latter once it has formed; systemically nontoxic when they come in contact with vital tissues, non-caustic to periodontal tissues, and with little potential to cause an anaphylactic reaction, including tissue dissolving agents, antibacterial agents, chelating agents and combinations thereof. For example, MTAD (a mixture of 3% doxycycline, 4.25% citric acid, and detergent (Tween-80)); HEBP (1-hydroxyethylidene-1, 1-bisphosphonate); sodium hypochlorite, EDTA, ClO.sub.2, citric acid, maleic acid, chlorhexidine (CHX), green tea, triphala and combinations thereof are included as examples of such irrigants.

[0065] As used herein, “lumenal” means the cavity or channel within a tube.

[0066] As used herein, “engage,” including grammatical variations thereof, means to interlock with, such as by mechanical means, chemical means and the like.

[0067] As used herein, “oblique angle” means an acute or obtuse angle.

[0068] As used herein, “annulus” means a ring-shaped object, structure, or region.

[0069] As used herein, “ultrasonic” means of or involving sound waves with a frequency above the upper limit of human hearing.

[0070] As used herein, “sonic” means denoting, relating to, or of the nature of sound or sound waves.

[0071] As used herein, “polymer” means a substance that has a molecular structure consisting chiefly or entirely of a large number of similar units bonded together, e.g., many synthetic organic materials used as plastics and resins.

[0072] As used herein, “effectively” means in such a manner as to achieve a desired result.

[0073] As used herein, “subject” means a person or organism that is the object of treatment.

[0074] According to an embodiment of the invention, a polymer cannula having an open proximal end, a distal end, and a slight taper along its length from the proximal end to the distal end is disclosed. The cannula includes a bored opening in its distal end or tip, so that debris of the canal can be removed through the opening. The cannula opening in the embodiment is located at the end of the distal end or tip, or in a second alternate embodiment one or two openings at the lateral surface on the last millimeters of the distal end, close to the tip.

[0075] In an embodiment, the polymer cannula is made in one single piece, being substantially cylindrical with a slight taper until the proximal end. In an alternative embodiment, the cannula can be made in two parts connected by chemical attachment, medical grade glue or over molding.

[0076] The proximal end of the cannula has a cylindrical tapered design that allows a connection to an insert to be attached to a dental tool. The insert will cooperate with the polymer cannula to transfer ultrasonic/sonic vibrations from the ultrasonic/sonic handpiece. The insert will be connected to the ultrasonic handpiece providing ultrasonic vibrations to the cannula and should deliver concomitant irrigation coming from the ultrasonic reservoir. In a preferred embodiment, the polymer cannula proximal end opening will be engaged to the insert slot, threadedly, located at the insert distal end. The insert provides irrigation passageways so the irrigation fluid will be delivered from the ultrasonic reservoir to the pulp chamber and root canal. The vibration provided and transferred to the polymer cannula will carriage the irrigation fluid throughout the canal extension, alongside the cannula external surface, and be recollected at the distal end of the cannula via described cannula opening. The proximal end of the cannula will be connected to the evacuation tubing, creating negative pressure. Depending on the configuration of the tubing, the tubing may be made from plastic, rubber, or other known materials for tubing. The negative pressure created at the distal end of the polymer cannula will provoke the dynamic unidirectional movement of the liquid from the pulp chamber to the apical third of the root canal. The proximal end of the canula has a tube receiving projection proximate to the proximal end. The tube receiving projection has a circumferentially extending barb which cooperates with tubing to maintain the tubing in position on the tube receiving projection.

[0077] Another aspect of the invention is directed to the polymer cannula connection for use with a dental tool. The dental tool has an energy generator positioned therein. Although this energy generator is usually an ultrasonic energy generator, other energy generators may be used, such as example a sonic energy generator. In embodiments, the polymer cannula oscillates at approximately 25-30 kHz, which allows the cannula to vibrate at an effective resonant frequency, thereby activating the irrigation liquid to provide optimum cleaning. The resonant frequency of various polymers can vary, but can be calculated, using the length of the cannula, the stiffness of the materials and the assembly, and the geometry of the tip assembly. Generally, the frequency is above 6 kHz.

[0078] The polymer cannula attaches to the dental tool insert using a self-threading connection to a metallic connector insert. The connector insert has a passage-way that provides a single continuous flow path for delivering irrigation liquid from a reservoir to the pulp chamber and root canal, projecting the fluid at the external surface of the polymer cannula through an opening located proximate to the threading housing. The insert cooperates with the polymer cannula to transfer energy from the energy generator through the insert to the cannula. The fluid has the energy imposed thereon as it passes externally in contact with the outer surface of the cannula that is being energized by the vibration from the insert/handpiece. Another aspect of the invention is directed to the polymer cannula connection for use with a dental tool. The dental tool has an energy generator positioned therein. Although this energy generator is usually an ultrasonic energy generator, other energy generators may be used, such as for example a sonic energy generator. The polymer cannula attaches to the dental tool insert using a self-threading connection to the metallic connector insert. The insert has a passage-way that provides a single continuous flow path for delivering fluid from a reservoir to the pulp chamber and root canal, projecting the fluid at the external surface of the polymer cannula through an opening located proximate to the threading housing. The insert cooperates with the polymer cannula to transfer energy from the energy generator through the insert to the cannula. The fluid has the energy imposed thereon as it passes externally in contact with the outer surface of the cannula that is being energized by the vibration from the insert/handpiece.

[0079] The invention described herein has many advantages. The polymer cannula has a single continuous evacuation path which creates negative pressure, allowing the irrigation fluid flow too reach the apical third without being extruded. The configuration of the polymer cannula assembly transfers ultrasonic vibration and energy in the plane of motion, which provides proper activation of the irrigation fluid. The use of the ultrasonic energy allows the irrigation fluid to be delivered to the root canal at a low stream velocity. As will be appreciated by those skilled in the art, the energy transferred to the irrigation fluid, especially sodium hypochlorite and EDTA, destroys microorganisms present within the root canal and dissolves organic tissue, and other debris from the affected area, thereby allowing for a more effective endodontic treatment. The dental tool insert provides continuous irrigation flow in an automated way, not requiring secondary assembly with a syringe or irrigation pump. The polymer cannula is disposable, and the dental tool connector insert can be cleaned, sterilized properly and reused.

[0080] The shaping and cleaning process is a crucial procedure in root canal treatment. The initial debridement of root canals is commonly performed by instrumentation, which removes a large bulk of the pulp tissue, necrotic debris, bacterial biofilm, or previous root canal fillings. Such removal may occur through mechanical instrumentation protocols.

[0081] Mechanical instrumentation is performed using either stainless steel hand files or engine-driven nickel-titanium (NiTi) rotary and/or reciprocation files, neither of which is expected to completely clean the canal when used alone; instead, they are used to create a space that will be filled by irrigants that will provide the cleaning effect. It seems paradoxical that the shaping process generates debris and adds more noxious volume of intracanal content that will need to be removed, but this is the most common procedure performed.

[0082] Irrigation is an essential part of root canal treatment because it enhances the debridement and disinfection of areas insufficiently cleaned by instruments. Irrigation is mainly performed by a syringe and a needle (or cannula), but this simple method is unable to clean remote areas of the root canal system. Even in the main canal, instruments have been shown not to reach all areas of the canal walls. This happens because of factors related to instrument features and/or canal anatomy. For instance, preparation based on final instruments that are smaller than the initial canal diameter is expected to leave more areas untouched. As for anatomy, a curvature introduces a complexity for instrumentation because the cutting action of the instruments along the curved canal is concentrated more on some walls than on others. Consequently, some areas may remain untouched by the instruments. In addition, C-shaped and oval/flattened canals have an irregular morphology that is inconsistent with round preparations provided by rotary instrumentation systems. Therefore, unsurprisingly, canals with these morphologies exhibit a large amount of uninstrumented areas following preparation, as the instruments may not reach all recesses.

[0083] The main reason for bacterial persistence is the inability of current techniques and medications to disinfect the entire extent of the root canal system. Uninstrumented areas and untouched recesses may potentially harbor remnants of bacterial biofilms. One might assume that even if the instruments fail to reach all canal walls, these areas would be permeated by NaOCl used for irrigation, which could dissolve necrotic tissue remnants and kill residual bacteria. In this case, the irrigation liquid should reach the uninstrumented areas at an effective concentration and volume and remain therein long enough for it to take effect. Current instrumentation systems fail to predictably touch all canal walls and reach these areas distant from the main canal. Therefore, there is an urgent need to develop strategies to improve infection control not only in the main canal lumen, but also in the entire root canal system.

[0084] Thus, several more elaborate irrigation and activation methods have been developed. Optimized effects of chemomechanical procedures include final canal rinse with different chemical antiseptic liquids, mechanical, sonic, or ultrasonic activation of sodium hypochlorite and EDTA, photodynamic therapy, and photon-induced photoacoustic streaming using Er:YAG laser energy at subablative power levels.

[0085] Mechanical, sonic, or ultrasonic activation of sodium hypochlorite and EDTA following preparation has been recommended. Mechanical activation of irrigants has shown good results in terms of enhancing disinfection. There are also strategies that serve as an alternative to conventional chemomechanical procedures and include instruments especially designed to adjust to the root canal anatomy, system for negative pressure irrigation, and the multisonic wave system. Studies shown that all aforementioned methods alone are not effective to remove tissue remains and bacteria biofilm from the uninstrumented areas following preparation.

[0086] For this reason, a procedure has arisen joining many aspects of the partially successful aforementioned techniques, as ultrasonic activation with transient cavitation, constant flow chemical repositioning, and negative pressure irrigation. With a streamlined technique of use, the method is simple, intuitive, and a low-cost application.

[0087] With reference to FIGS. 1 and 2, and according to the first embodiment of the present invention, a consumable high-performance polymer micro-capillary cannula 10 for use with threaded connector insert 11 for cooperating with an ultrasonic or sonic handpiece 12, a consumable commercially available evacuation tubing 13 which engages with a tube-receiving projection 17 from which tubing extends. The handpiece 12 has a proximal end that communicates with the threaded insert 11. In an embodiment, the handpiece includes an ultrasonic or sonic generator transducer (not shown) positioned in the handpiece proximate to the proximal end.

[0088] As best illustrated in FIGS. 1 and 2, a threaded insert 11 includes a proximal threaded housing with a planar surface 16 which is attached to the ultrasonic or sonic handpiece when the dental device is in operation. The threaded standard insert may be made from brass, aluminum, low carbon steel, or other metals and/or polymers which have the strength and stability characteristics to mount the ultrasonic or sonic handpiece 12 and withstand the vibration applied thereto. The polymer cannula 10 is self-threaded at the distal threaded slot 14 of the aforementioned standard insert 11.

[0089] As referred in FIGS. 3 through 5, the polymer cannula 10 preferably is made from one or two polymers' types rigid enough to transmit the vibration, but flexible enough to go through the root canal curvature.

[0090] In a first embodiment, the polymer cannula 10 is made in one single polymer type. Polypropylene polymer, polyethylene polymer, polyether ether ketone (PEEK), polycarboxylate, amorphous thermoplastic polyetherimide; a polymeric alloy or XENOY® resin, which is a composite of polycarbonate and polybutyleneterephthalate or LEXAN® plastic, which is a copolymer of polycarbonate and isophthalate terephthalate resorcinol resin, liquid crystal polymer, polyamide, nylon, or any other suitable resin plastic or composite that is sufficiently strong at smaller diameters can be used. From the distal 19 to proximal end 17, the polymer cannula 10 is substantially cylindrical with a slight taper 21, and an increase tapered funnel type portion 22. The proximal end has a tubing receiving projection 17. The tip 19 diameter of the cannula is preferably 0.35 (±0.25) mm at the distal end 19, increasing to the proximal end 17. The cannula opening 19 is located at the tip end on a first embodiment, but on a second alternative embodiment is located laterally 23/23A at the tip end.

[0091] In an alternative second embodiment referred on FIGS. 6 through 11, the polymer cannula is formed to have a generally straight format, and a generally one polymer tube 24 attached to a second polymer part 26 by means of chemical attachment, glue or over molding. In one of the embodiments, two different diameters are used, the distal end has a cylindrical non-tapered portion 24 that is attached to a second polymer portion 25 as described. Second polymer portion partially covers the proximal portion of the first cylindrical tube 26, in a tight superimposed connection. Chemical attachment, over molding or medical grade glue is used to guarantee immobilization of the two parts. The proximal second polymer portion is slightly tapered on the first 10 (±5) mm of its distal part 27 and, at the first proximal section, has funnel shape design 28 with two wing projections laterally 29, mainly used to facilitate the self-threading installation to the standard insert threading 11 slot 14. The polymer cannula has a passageway 30 which extends through the entire length of the cannula from its proximal end 31 to its distal end 19. The pathway provides a single continuous, uninterrupted flow path for suction evacuation of the canal content.

[0092] In the embodiment shown, the distal end portion of the cannula 24 is made from PEEK (Polyether ether ketone) thermoplastic high-performance biomaterial polymer, although other thermoplastic polymers can be used as well. The described second polymer distal portion 25 of the cannula is made from thermoplastic polypropylene polymer, although other thermoplastic polymers can be used as well. The cannula distal end tip 19 is blunt.

[0093] The tube receiving projection 17 is located proximate the proximal end 31 of the polymer cannula. The tube receiving projection has a circumferentially extending barb 17 which cooperates with the tubing to maintain the tubing 13 in position on the tube receiving projection 17. Tubing 13 is used to evacuate fluid and root canal content to a standard dental evacuation system. A standard commercially available vacuum connector, positioned at the end of the tubing, is attached to the standard dental unit evacuation system. The tubing 13 may also have other configurations, including but not limited to a fluid line which is positioned internally to the ultrasonic or sonic handpiece. Tubing may be manufactured from silicone, plastic or a similar material.

[0094] Before use, the connector insert 11 must be properly assembled onto the ultrasonic or sonic handpiece 12. An exemplary method for insert assembly includes the following steps. First, threaded insert 16 is threaded onto ultrasonic or sonic handpiece 12. As will be appreciated by those skilled in the art, ultrasonic handpiece is typically attached to a separate power supply and may be any of a variety of ultrasonic devices that are commercially available.

[0095] After the connector insert 11 has been assembled to the ultrasonic or sonic handpiece 12, the polymer cannula is installed by placing the cannula inside the insert threaded distal slot 14 from the top part of the insert threading slot to down, and gently self-threaded by turning the cannula clockwise until the two wing projections touches the insert distal end threating slot top surface 14A. One end of tubing 13 is attached to the tube receiving projection 17 and the other end of the tubing assembly is attached, to a dental unit evacuation system. A portion of the tubing 13 may be secured to ultrasonic or sonic handpiece by silicone holders (not part of the invention). Silicone holders may act as a strain relief for the tubing and helps to keep the tubing close to the ultrasonic or sonic handpiece, thereby preventing entanglements and kinks in the tubing.

[0096] Once the polymer cannula has been assembled to the insert 11 and tubing 13, the distal portion of polymer cannula 19 is placed within the root canal to an appropriate length in which the tip of the cannula is positioned slightly off the foramen position 34. The penetration depth should be equal or less than the working length used during the mechanical enlargement of the root canal in the mechanical instrumentation phase. The ultrasonic or sonic handpiece 12 is activated by the user at a power level ranging from 10 to 100 percent of the full amplitude (also known as power). Ultrasonic or sonic energy passes from the handpiece 12 through the threaded insert 11 and to the cannula. The planar insert/cannula configuration acts similarly to a tuning fork. The vibrations induced by the threaded insert 11 are amplified due to the free vibration at distal end 19 of the cannula. The irrigation fluid stored at the ultrasonic or sonic unit reservoir is then pumped through the insert passageway 33 to the pulp chamber 35/root canal simultaneously with ultrasonic or sonic handpiece 12 activation. The cannula's vibration helps the irrigation fluid travel the canals' entire length, externally to the cannula's surface, up to the apical third, without, however, exerting any pressure in the apical direction, avoiding the forced extrusion of the irrigation fluid beyond the limits of the canal 36. The use of the ultrasonic or sonic energy allows the irrigation liquid to be delivered to the root canal at a relatively low stream velocity, preventing the undesired extrusion, since endodontics irrigation fluids are noxious to the organic tissues that surrounds the tooth, like the periodontal ligament or the apical bone 36. As will be appreciated by those skilled in the art, this energy field helps to neutralize microorganisms present within the root canal and plays as a catalyst to the chemical reactions involved on tissue dissolution and debris removal from the affected area, thereby allowing for a more efficient endodontic treatment.

[0097] Ultrasonic or sonic handpiece 12 vibrations are most effective when they are translated to the polymer cannula in a single plane. The shape of the cannula and the insert creates a geometry that generates movement of the polymer cannula's tip 19 in a direction which is planar to the longitudinal axis of the cannula. This planar motion is maintained over cycles, due to the tight self-threading cannula's surface and threaded insert relation 14, thereby allowing the motion of the ultrasonic or sonic handpiece 12 to be properly transferred to the cannula with minimal distortion.

[0098] The negative pressure exerted by the suction action achieved by connecting the tubing with the proximal end of the cannula 17, and consequently with the dental evacuation suction unit, leads the irrigation fluid dispensed externally to the cannula's surface to cover the entire root canal extension. The tip of the polymer cannula 19 will limit the penetration of the irrigation liquid and determine its penetration limit. The correct positioning of the polymer cannula up to the working length, next to the position of the apical foramen 34, control the penetration of the irrigating fluid in the entire length of the canal, again without forcing the irrigation fluid beyond the limits of the root canal.

[0099] Additionally, the present invention is useful to dry the root canal space previously to the obturation phase by turning the handpiece off but keeping the evacuation suction on.

[0100] FIG. 1 shows the present invention 10 installed. The polymer cannula is shown screwed to the ultrasonic or sonic insert 11, the insert 11 screwed to the handpiece 12, and tubing 13 attached to the cannula 10.

[0101] FIG. 2 depicts the present invention preferred embodiment details. The distal end or tip 19, the tubing connection barbed projection on the proximal end 17, and a part 18 that contains two wing-shape projections sideways. The illustration also depicts the ultrasonic or sonic connector with the distal threaded slot top opening 14, distal threaded slot down opening 15, and the proximal end 16.

[0102] In an alternative embodiment (FIG. 12), the proximal end of the polymer cannula 18 is open to receive an approximately 120° angled polymer connector 39 that has the distal projection 37 to be inserted and fit on the polymer cannula proximal open space 18. The proximal end of the polymer angled connector 38 has a circumferentially extending barb projection which will be inserted on the distal end of the tubing. Tubing 13 is used to evacuate fluid and root canal content to a standard dental evacuation system. A connector, positioned at the proximal end of the tubing, is attached to the standard dental unit evacuation system. The tubing 13 may also have other configurations, including but not limited to a fluid line that is positioned internally to the ultrasonic or sonic handpiece. Tubing may be manufactured from silicone, plastic, or a similar material.

[0103] In an additional embodiment (FIG. 13), the described polymer cannula 10 will be coupled to a polymer or metal approximately 150° angled polymer or metal handle 40 that will serve as support for manually inserting the cannula in the desired position inside the root canal. The proximal end of the polymer or metal handle 41 has a threaded distal slot from the top part of the threading slot to down, and gently self-threaded by turning the cannula clockwise until the two wing projections touch the handle distal end treating slot top surface 42. In this case, the polymer cannula will not be activated by the ultrasonic or sonic apparatus, but it will still generate a negative pressure inside the canal when connected to the tubing and the evacuation system, ensuring the flow of irrigating liquid from the coronal third or pulp chamber up to the working length without offering the danger of extravasation of this liquid beyond the limits of the root canal.

[0104] While exemplified embodiments of the invention have been described and illustrated above, it should be understood that these are exemplary of the invention and are not to be considered as limiting. Therefore, it is intended that the invention not be limited to the particular embodiments disclosed as the best mode contemplated for carrying out this invention, but that the invention will include all embodiments falling within the scope of the appended claims. All references are incorporated by reference herein.