Vacuum drawn irrigation followed by instant obturation of a root canal system using a single staging assembly
Embodiments of this disclosure provide a staging assembly for negative pressure, multi-canal irrigation of a root canal system followed by obturation. The staging assembly may be part of a kit that includes a plurality of catheters sized for insertion into the root canal system. To hold the catheter in its proper position in the canal, the catheter may include a stop and the staging assembly may include a corresponding stop hold. The distal end of the catheter can be positioned 2 mm to 5 mm from the terminus end of the root canal. The staging assembly is then sealed, creating a closed system. Irrigating solution is vacuum-drawn out the ends of the catheters and debris is evacuated through a vacuum port of the stating assembly. During irrigation, no hands on time is required by the clinician. After irrigation, vacuum is reversed to dry the canal. Obturation occurs through the vacuum.
1 . A system for use in irrigation of a human tooth root canal system, the system comprising:
a staging assembly ( 10 ) including:
a staging skirt ( 11 ); and
a staging ring ( 13 ) adjacent, and connected to, the staging skirt;
the staging skirt made of a first material and flexible, the staging ring made of a second material and rigid;
the staging skirt further including flaps ( 12 ) defining a cavity ( 15 ) having a predetermined size for connection to a human tooth;
the staging ring further comprising:
a catheter fence ( 17 ) including, at a forward end, a plurality of spaced-apart catheter-slots ( 29 );
wherein, the catheter fence defines an open, fenced-in area ( 47 );
a top plate ( 45 ) sized for insertion into the open, fenced-in area of the catheter fence, the top plate including a port ( 49 ), wherein the top plate is located within the catheter fence rearward of the plurality of catheter slots and forms a single chamber containing at least one catheter when the at least one catheter is inserted into a corresponding one of the plurality of catheter slots;
wherein the system does not require an electrical source for operation.
2 . The system of claim 1 , further comprising:
the top plate including a pair of outrigger pegs ( 48 );
the staging ring including a pair of alignment slots ( 39 );
wherein when top plate is connected to the staging ring, the outrigger pegs reside in the alignment slots.
3 . The system of claim 1 , further comprising:
a vacuum line ( 46 , 85 ) connected to the port of the top plate.
4 . The system of claim 1 , the at least one catheter being a thin-walled catheter ( 55 ) in range of 29 to 31 gauge and having a blunt cut end ( 51 ) with radiused edges ( 53 ), a proximal portion ( 56 ) of the thin-walled catheter being housed by a tube ( 57 ) having a different gauge and being harder than the thin-walled catheter.
5 . The system of claim 1 , further comprising, at least one syringe ( 71 , 81 ) containing either a dental sealant including a light cure polymer, a liquid solution containing ethylenediaminetetraacetic acid, or a bio-ceramic.
6 . The system of claim 5 , further comprising a three-way valve ( 73 ), one end of the three-way valve connectable to a vacuum pump, another end of the three-way valve connectable to an IV bag containing an irrigant solution including sodium hypochlorite, and yet another end of the three-way valve connectable to the syringe.
7 . The system of claim 1 , further comprising;
an IV bag ( 83 ) containing an irrigant solution including sodium hypochlorite, the IV bag being connected to the at least one catheter.
8 . The system of claim 1 , further comprising a portion of the forward side of the catheter fence containing the plurality of catheter slots is oblique to the top plate.
9 . A staging assembly ( 10 ) for use in irrigation of a human tooth root canal system, the staging assembly including:
a staging skirt ( 11 ); and
a staging ring ( 13 ) adjacent, and connected to, the staging skirt;
the staging skirt made of a first material having a first flexibility, the staging ring made of a second material having a second flexibility different from that of the first;
the staging skirt further including flaps ( 12 ) defining a cavity ( 15 ) having a predetermined size for connection to a human tooth;
the staging ring further comprising a catheter fence ( 17 ), the catheter fence including a plurality of spaced-apart catheter slots ( 29 ) located along a forward side of the catheter fence, the forward side having a greater height than a rearward side of the catheter fence, the catheter slots being open toward the rearward side of the catheter fence, the catheter fence defining an open, fenced-in area ( 47 ) between the forward and rearward sides; and
a top plate ( 45 ) including a vacuum/filling port ( 49 ) extending upwardly above the top plate, the top plate being rearward of the plurality of spaced-apart catheter slots and surrounded by the catheter fence, the vacuum/filling port ( 49 ) facing the forward side of the catheter fence;
the vacuum/filling port and the plurality of spaced-apart catheter slots being in communication with the open-fenced-in area.
10 . The staging assembly of claim 9 , further comprising:
the forward side of the catheter fence including a plurality of catheter stop holds; and
at least one catheter ( 50 ), the at least one catheter including a catheter stop ( 37 ) sized for capture by a catheter stop hold of the plurality of catheter stop holds, the catheter stop being moveable along a length of the at least one catheter such that a single length of the at least one catheter can translate in or out of the open, fenced-in area of the catheter fence.
11 . The staging assembly of claim 9 , further comprising at least one catheter, the at least one catheter being a thin-walled catheter ( 55 ) in range of 29 to 31 gauge and having a blunt cut end ( 51 ) with radiused edges ( 53 ), a proximal portion ( 56 ) of the thin-walled catheter being housed by a tube ( 57 ) having a different gauge and being harder than the thin-walled catheter.
12 . The staging assembly of claim 11 , wherein the top plate forms a sealed single chamber containing the at least one catheter.
13 . The staging assembly of claim 9 , further comprising:
the top plate including a pair of outrigger pegs ( 48 );
the staging ring including a pair of alignment slots ( 39 );
wherein when top plate is connected to the staging ring, the outrigger pegs reside in the alignment slots.
14 . The staging assembly of claim 9 , further comprising:
a vacuum line ( 46 , 85 ) connected to the vacuum/filling port of the top plate.
15 . The staging device of claim 9 , further comprising:
an IV bag ( 83 ) containing an irrigant solution including sodium hypochlorite, the IV bag being connected to the at least one catheter.
16 . The staging device of claim 9 , further comprising a portion of the forward side of the catheter fence containing the plurality of catheter slots is oblique to the top plate.
17 . A staging assembly for use in irrigation of a human tooth root canal system, the staging assembly having only one port and only one chamber, the staging assembly comprising:
a staging skirt made of a first material and flexible and including flaps defining a cavity having a predetermined size for connection to a human tooth;
a staging ring made of a second material and rigid and located adjacent, and connected to, the staging skirt; the staging ring further comprising a catheter fence including, at a forward end, a plurality of spaced-apart catheter-slots, the catheter fence defining an open, fenced-in area;
a top plate located within the open, fenced in area rearward of the plurality of spaced-apart catheter slots, forming the only one chamber and including the only one port.
18 . A method for irrigation of a root canal system of a human tooth using the staging assembly of claim 17 , the method comprising:
luting the staging assembly onto a cavo surface of the human tooth after an access cavity to the root canal system has been prepared;
positioning, through the staging assembly, at least one single length catheter into a respective canal of the root canal system, the at least one single length catheter passing through one of the catheter slots of the staging assembly and into the root canal system, a distal end of the at least one single length catheter being in a range of 2 to 5 mm from an apical end a root canal of the root canal system, wherein the at least one single length catheter is adjustably held within the one catheter slots such that the at least one single length catheter can translate in or out of the one catheter slot for positioning within the root canal;
sealing the staging assembly to form a closed system consisting of the only one chamber;
connecting, to a three-way valve, the at least one single length catheter, a supply of irrigant solution containing sodium hypochlorite, and a syringe containing ethylenediaminetetraacetic acid;
attaching a vacuum line to the only one port of the staging assembly;
flushing the at least single length catheter with the ethylenediaminetetraacetic acid;
after the flushing, irrigating the root canal system by providing the irrigating solution through the at least one single length catheter, the irrigant solution being drawn out the ends of the at least one single length catheter by applying a vacuum to the vacuum line, the irrigating being in a range of 10 minutes to 30 minutes;
during the irrigating, evacuating the irrigant solution delivered by the at least one single length catheter along with tissue dissolved by the irrigant solution from the root canal system by the applying of the vacuum, the irrigating and the evacuating occurring continuously and simultaneously with one another;
after the irrigating and the evacuating, drying the root canal system by disconnecting the supply of irrigant solution from the three-way valve,
removing the syringe containing the ethylenediaminetetraacetic acid from the valve,
detaching the vacuum line from the staging assembly and connecting the vacuum line to the three-way valve; and
applying a vacuum to the at least one single length catheter through the vacuum line;
wherein the method does not require a source of electrical power.
19 . The method of claim 18 , the at least one single length catheter is a thin-walled catheter in range of 29 to 31 gauge and having a blunt cut end with radiused edges, a proximal portion of the thin-walled catheter being housed by a tube having a different gauge and being harder than the thin-walled catheter.
20 . The method of claim 18 , wherein, the at least one single length catheter includes a catheter stop, the catheter stop being movable along a length of the at least one single length catheter, wherein the positioning includes moving the catheter stop along the length of the at least one single length catheter.
21 . The method of claim 18 , wherein,
the top plate of the staging assembly includes a pair of outrigger pegs;
the staging ring of the staging assembly includes a pair of alignment slots;
wherein when top plate connected to the staging ring, the outrigger pegs reside in the alignment slots.
22 . The method of claim 18 , further comprising, aerating the irrigant solution, heating the irrigant solution, or aerating and heating the irrigant solution.
23 . The method of claim 18 , wherein, the luting includes first positioning the staging assembly onto the human tooth by way of a placement tool, the placement tool including a head shaped complementary to the open, fenced-in area of the staging ring and a tine that passes through the open, fenced-in area.
24 . The method of claim 18 , further comprising, after the drying, obturating the root canal system through the staging assembly by connecting a syringe containing a bio-ceramic filler to the three-way valve and syringing the bio-ceramic filler into a pulp chamber of the human tooth.