DENTAL DEVICES FOR EXTRACTION SITE RECONSTRUCTION
20230181293 · 2023-06-15
Inventors
Cpc classification
International classification
A61C8/00
HUMAN NECESSITIES
Abstract
The extraction socket devices are designed to protect the extraction socket immediately after tooth extraction. These devices protect the socket from oral bacteria and food, support a space to prevent collapse of the alveolar ridge during healing, contain any bone graft material inside of the socket, and provide comfort to patient during the healing process. Procedures are also disclosed for placing the devices in an extraction site to obtain the benefits of the disclosed devices.
Claims
1. A dental socket cap for placement in an extraction site comprising: a dome-shaped a lop portion having a first diameter greater than a second diameter of a solid bottom portion, wherein a combination of the dome-shaped top portion and the solid bottom portion forms a sealing edge about a periphery of an opposing underside of the dome-shaped top portion, wherein the dome-shaped top portion and the annual solid bottom portion are integrally joined, and a suture passage laterally traversing the dome-shaped top portion of the dental socket cap for attachment or the socket cap to a plurality of points in soft tissue proximate to the socket cap.
2. The dental socket cap of claim 1, further comprising a suture traversing the suture passage.
3. The dental socket cap of claim 1, wherein the socket cap comprises grooves disposed in the dome shaped top portion.
4. The dental socket cap of claim 3, wherein the the grooves are proximate to the suture passages and are formed on opposite sides of the dome-shaped portion.
5. The dental socket cap of claim 1, wherein a height of the solid bottom portion is the same about a periphery thereof and the opposing underside surface is concave.
6. The dental socket cap of claim 5, wherein the solid bottom portion comprises cylindrical walls.
7. The dental socket cap of claim 1, wherein the sealing edge is annular.
8. The dental socket cap of claim 7, wherein the dental socket cap is further comprised of a base plate affixed to the solid bottom portion.
9. A dental extraction site socket cage comprising: first and second series of horizontal beams sized for each of a facial and lingual inner portion of a single tooth extraction site, each beam of the first and second series of horizontal beams having two terminal ends and a curve along a length thereof to yield pre-defined spaces between the horizontal beams, wherein an arc of the curve of each horizontal beam between the two terminal ends is substantially equivalent and orients the horizontal beams to form a conical structure having a vertical axis from an upper portion to a lower portion relative to the vertical axis of the single tooth extraction site; and at least one vertical strut extending from the upper portion to the lower portion and integral with the horizontal beams.
10. The socket cage of claim 9 wherein the upper portion of the socket cage has a larger diameter than a lower portion to form a tapered diameter along a height of the socket cage.
11. The socket cage of claim 10, wherein the at least one vertical strut is a single member connecting each of the horizontal beams.
12. The socket cage of claim 10, wherein the at least one vertical strut is a pair of vertical struts.
13. The socket cage of claim 10, wherein the series of horizontal beams and the at least one vertical strut are integrally formed from a single material.
14. The socket cage of claim 9, further comprising a plurality of projections extending radially away from the central axis of the socket cage.
15. The socket cage of claim 10 wherein the arc of a majority of the horizontal beams is greater than 120°.
16. The socket cage of claim 14, wherein at least one of the first and second series of horizontal beams, the at least one vertical strut, and the plurality of projections are formed of a bioresorbable material.
17. A combination comprising of an assembly of: a dental socket cap for placement in an extraction site comprising: a dome-shaped top portion having a first diameter greater than a second diameter of a solid bottom portion, wherein a combination of the dome-shaped top portion and the solid bottom portions forms a sealing edge about a periphery of an opposing underside of the dome-shaped top portion, wherein the dome-shaped top portion and the annular solid bottom portion are integrally joined, a suture passage laterally traversing the dome-shaped top portion of the dental socket cap for attachment of the socket cap to a plurality of points in soft tissue proximate to the socket cap; and a dental extraction site socket cage comprising: first and second series of horizontal beams sized for each of a facial and a lingual inner portion of a single tooth extraction site, each beam of the first and second series of horizontal beams having two terminal ends and a curve along a length thereof to yield pre-defined spaces between the horizontal beams, wherein an arc of the curve of each horizontal beam between the two terminal ends is substantially equivalent and orients the horizontal beams to form a conical structure having a vertical axis from an upper portion to a lower portion relative to the vertical axis of an the single tooth extraction site; at least one vertical strut extending from the upper portion to the lower portion and integral with the horizontal beams.
18. The dental extraction site socket cage of claim 9, wherein the at least one vertical strut is a pair of vertical struts oriented to be equally spaced from the two terminal ends of each of the first and second series of horizontal beams.
Description
DESCRIPTION OF THE FIGURES
[0011]
[0012]
DETAILED DESCRIPTION OF INVENTION
[0013] The first embodiment of the invention is an extraction socket cap that is shaped and sized to seal an extraction site about the periphery thereof during a healing period. The shape of the socket cap can be rounded square, rounded triangle, circular, oval, or any desired shape depending on the anatomic characteristics of the extraction sites. The design incorporates features to allow the surgeon to advantageously place and position the socket cap on the extraction site while insuring that proper positioning and effective sealing about the gingival margin is secure prior to affixing the cap by suture attachment, adhesives, or fixation screws to the surrounding soft tissue.
[0014] The general dimensions and orientation of the structures shown in
[0015] The bottom portion of the cap may also be comprised of a series of panels formed into a unitary structure that provides an intact housing extending downward and generally perpendicular from the plane formed by the outer edge of the top portion. In this configuration, the attachment and seal between the top portion and the bottom portion effectively form a sealing enclosure for the internal volume of the extraction site separating the volume therein from the remainder of the oral cavity. Moreover, the bottom portion may be sealed about the bottom circumference and may have a sealed intaglio surface that prevents any fluid or material from entering the housing, i.e. the space formed by the volume between the inside of the top portion and the internal volume formed by the panels of the bottom portion and the intaglio surface. By removable attachment of the socket cap to the extraction site, a temporary seal is provided wherein an internal volume of the extraction site is maintained for further treatment while fluid and debris is prevented from entering the extraction site by the removable attachment to the tissue. In this configuration, the combination of the outer edge of the cap, engaging the circumference of the extraction site along an outer edge or an annular bottom portion thereof, together with the volume disposed by the bottom portion, creates a sealed inner volume within the extraction site such that the volume of the bottom portion extends into the extraction site and displaces at least a portion thereof to create a space. This, together with a sealing engagement of the top portion with the soft tissue around the extraction site, the socket cap provides both a fluid-tight seal about the periphery and a finite disposition of a volume within the extraction site. In another embodiment, the bottom portion will be made of solid construction with cylindrical walls of varying length, which extend into extraction sockets and an intaglio surface that may be flat, concave or convex in order to create a desired contour for the healed alveolar ridge. This will aid in fabrication of a future prosthesis which will replace the extracted tooth.
[0016] Turning to
[0017] The top portion 2 is preferable solid across its entire surface except for the presence of the attachment means, i.e., grooves 3 and suture passages 4 or other attachment fixtures for screws, staples, clips or other mechanical expedients used to affix removable metal or synthetic materials to soft tissue, adjacent teeth or bone. As shown in
[0018] Referring again to
[0019] As will be appreciated from the diagonal view of
[0020] Referring to
[0021] The downward projections found in the bottom portion 6 features enough openness or perforations 7 such that the exchange of blood and fluids across the gingival sulcus to the inner area of the extension site is facilitated. The perforations 7 are preferably formed in the extensions 6 wherein the extensions are fabricated from conventional resorbable material such that any selected structure can dissolve during the healing process.
[0022] The general orientation of the bottom portion 6 includes a hollow cylindrical housing 8 comprised of panel structures 9 extending downward from the top portion 2 and preferably interior to the peripheral edge 5 such that a diameter of the housing 8 is less than the top portion 2 as defined by the diameter of the sealing edge 5. The height of the structures forming the bottom portion 6 is approximately equal to provide structural integrity and sealing about the periphery of the interior of the extraction site. The housing 8 may be substantially cylindrical or conformed to the shape of the top portion 2 of or the sealing edge 5. The housing 8 extends into the extraction socket to serve as a barrier between the mucosa and the socket lumen, which may be exposed as a result of dehiscence. Bone graft material inserted into the extraction site. The housing 8 prevents soft tissue from infiltrating the internal volume of the extraction site, which can contain bone graphed material.
[0023]
[0024] Referring to
[0025] The entire structure of the socket cap 1 and any element thereof are fabricated from a variety of biocompatible materials including, but not limited to, polytetrafluoroethylene (PTFE), polypropylene, titanium, zirconia, polylactide, polylactic acid (PLA), polyglycolide, polyglycloic acid (PGA) or Polycaprolactone (PCL). In one embodiment, the top portion 2 of the cap device 1 comprising the top portion 2 and the sealing edge 5 are formed of non-degradable material, whereas the housing 8 and optimally the base plate 9 are fabricated from biodegradable material.
[0026] The overall structure of the socket cap may be fabricated from a variety of biocompatible resorbable or non-resorbable materials including, but not limited to, polytetrafluoroethylene (PTFE), polypropylene, collagen, hydroxyl apetite (HA), tricalcium phosphate, polyurethane, titanium, zirconia, polylactide, polylactic acid (PLA), polyglycolide, polyglycloic acid (PGA), Polycaprolactone (PCL), alginate, gelatin, hyaluronic acid or a combination of these material. In a preferred embodiment, the portion of the overall device comprising the top portion 2 and the sealing edge 5 are formed of non-degradable material, whereas the downward extensions and the housing 8 are fabricated from resorbable material that may be dissolved during healing of the extraction site. As noted above, the top portion 2 is typically a rounded square or rectangle and is preferably selected from sizes including 8 mm by 9 mm, 6 mm by 6 mm and 4 mm by 4 mm, although a variety of sizes are possible without departing from the spirit of the present invention. The thickness of the dome shaped portion is preferably thicker than 1/100th of an inch and thicker than the housing 8, although the panels 9 when formed from a resorbable material may necessarily be thicker and perforated, preferably ranging from 5 to 8/100ths of an inch.
[0027] Referring to
[0028] Referring to
[0029] As with the perforations in the embodiment described above, the curved outer surface 12 and optionally the vertical strut 11 have longitudinal spaces 14 that completely traverse the width of the beams 15 to provide for the passage of blood or other fluids within the extraction site. These spaces 14 also allow for exchange of vascular supply while preventing gingival soft tissues from proliferating into the socket. The socket cage 10 is preferably fabricated from the biocompatible and resorbable or non-resorbable materials listed above. In some embodiments, the extraction socket cap of
[0030] The sizing of the socket cage 10 is appropriate to accommodate the inner potions of typical extraction sites and include, but are not limited to, 11 mm by 11 mm, 8 mm by 9 mm, 6 mm by 6 mm and 4 mm by 4 mm. The longitudinal spaces 14 formed between the horizontal beams 15 of the cage 10 are roughly equivalent in shape between closely adjacent beams 14 to maintain the substantially equivalent curvature of adjustment horizontal beams 15 and all create the rib-like appearance of the overall structure.
[0031] Referring to
[0032] Referring to
[0033] The method of the present invention is to surgically place either or both an extraction socket cap 1 and an extraction cage 10 in an extraction site. Following extraction of a tooth or removal of a failed implant by conventional methods, the dentist or surgeon will prepare for an aseptic placement of the extraction cap 1 and/or cage 10 by examining the dimensions of the extraction site and determine whether any of the socket walls are defective. In case the socket walls have dehiscence, the cage will be applied. An appropriately sized cage will be selected and if necessary adjusted in dimensions. One method of adjustment may be to remove portions of the cage walls that may extend beyond the alveolar bone crest. If the cage is made of thermoplastic material, the cage will be heated to a temperature necessary to mold the cage to the geometry of the extraction socket. The cage is inserted with slight pressure inside the socket so that the sharp projects can engage the alveolar bone walls to stabilize the cage within the socket. The clinician may decide whether or not it is necessary to fill the socket with additional biomaterial. Such biomaterial may be osseoconductive to simply provide a matrix for bone growth or may include osseoinductive biomaterial to accelerate and enhance bone fill within the extraction socket. This method has significant advantages over current practices of treating extraction sockets. Currently, extraction sockets and grafts placed within the sockets are covered by resorbable or non-resorbable membranes. Such membranes are typically flat sheets of material ,which may be cut into a size suitable for the site. Membranes are typically either 1) positioned at the socket opening, while their margins are folded inward and are stabilized with sutures, or 2) positioned between periosteum and bone around the periphery of the extraction socket after a mucoperiosteal flap has been relected and then attached with suture. Disadvantages of current material and their application are 1) technical difficulty of adapting a flat membrane to the complex geometry of extraction socket opening, 2) generally poor seal made at the opening of sockets, 3) reduction of the bone crest after healing, as a results of utilizing flat membranes, 4) ineffectiveness of membranes in cases where extraction socket walls exhibit dehiscence, because membranes are flexible and their micromotion during healing favors fibrous tissue rather than bone formation and 5) potential for early loss of membranes, exposing the socket or the graft material contained within the socket, thereby compromising the outcomes. In contrast, the extraction socket caps and cages described herein offer significant advantages in each of the areas outlined, including, 1) extraction socket caps and cages are substantially easier to apply because of their prefabricated shape which can accommodate a variety of extraction socket morphologies, 2) extraction socket caps are designed for optimal sealing of the socket opening due to their conformation to typical socket gingival margins, 3) the dome shape of socket caps allow for bone graft to be placed and maintained at or above bone crest thereby minimizing the potential for alveolar ridge atrophy during the healing process, 4) socket cage due to its rigid construction can maintain and reconstruct the lost socket walls during the healing process and 5) the socket caps feature improved methods for stabilization, ensuring their stability during the entire healing period.
[0034] The placement of extraction socket cap 1 is initiated by measuring the dimensions of the extraction socket opening to select an appropriate size cap. The extraction socket may be prepared as deemed appropriate by the clinician. The extraction socket cap 1 may be adjusted to better fit the dimensions of the socket. This may entail reducing some of the peripheral rim or projections of the cap. If the cap is made of thermoplastic material, the cap will be heated to a temperature necessary to mold the cap to the geometry of the extraction socket. The engaging edge forms an effective fluid seal around the periphery of the site at the gingival sulcus. Next, the cap is fixated to the extraction socket. Under one embodiment, the socket cap is attached to extraction socket by means of suture. In this case, sutures will engage soft tissues surrounding extraction socket and passed through the suture channels incorporated into the design of the cap. Another embodiment may have sutures that are already incorporated and contiguous with the cap for ease of fixation. Another embodiment may utilize other means to anchor the cap to the extraction socket. This may entail utilization of fixation screws, hooks, adhesives or other mechanical, physical or chemical means to attach the cap to the extraction socket.
[0035] While the present invention has been particularly shown and described with respect to certain preferred and illustrative embodiments, it will be understood by those skilled in the art that variations and modifications may be made therein without departing from the spirit and scope of the present invention.