Technical Field

This invention is an implementation and/or training system which is produced using three-dimensional printing technology and allows the implementation of regenerative endodontic treatment procedures in dental education.

Prior Art

Teeth become visible in the mouth before the root development is completed during their physiological development, the tooth root continues to develop after the tooth is begun to be used and reaches maturity after a while, and this is called maturation in the literature. During the transition from primary dentition to permanent dentition, damage to the special connective tissue called pulp may occur due to etiological reasons such as a trauma to the teeth, caries occurring in the teeth, and chronic traumas caused by anatomical malformations, while the permanent tooth roots have not yet formed. If the pulp cannot tolerate this damage due to insufficient physiological space in the tooth, the veins entering and leaving the pulp being from the same region, and the vessels in the pulp containing very dense anastomoses inside the tooth, necrosis may occur in the pulp. In this case, a tooth the root development of which is incomplete will lose its vitality and root development cannot continue. Insufficient root development makes it impossible to perform root canal treatment with standard methods. In addition, as these teeth having thin and short canal walls, they cannot meet the chewing forces increasing with age, and tooth fractures that require tooth extraction may occur. In order to overcome these clinical difficulties, treatment methods that can be considered within the scope of tissue engineering studies in dentistry have been defined.

These treatment methods are performed in order to restore the vitality of the teeth by providing components such as stem cells, appropriate scaffolds and growth factors. When the curricula of dentistry in our country are examined, it is seen that only theoretical education is given on this subject during undergraduate education. In recent years, with the increasing importance of the subject, practical trainings are tried to be given with pre- and post- graduation practices. In the practical trainings given, the implementation model is not used or extracted teeth are used as the implementation model. The biggest disadvantage of using extracted teeth is the risk of cross contamination. Moreover, it does not make it possible to visually see the root canals. For this purpose, a different, transparent plastic-based mechanism is needed. In the state of the art, training in the mouth of the patient is also given without simulating the training, or human and animal teeth extracted for different reasons are used to simulate this clinical situation.

That being said, revitalisation treatment model was also introduced in a study published in 2018 (M. Widbiller, S. Ducke, A. Eidt, W. Buchalla & K. M. Galler 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd ) International Endodontic Journal, 51, e301-e308, 2018). In this product, plastic opaque teeth, used in restorative and prosthetic dentistry, are fixed to jaws that can be attached to open-mouthed human models called phantom models. Blood-like fluid is imitated with the plastic reservoir specially placed in the jaw with the root of the tooth, and regenerative endodontic treatment skill training was provided to the students with this model during undergraduate education. These plastic models are matte in colour. It does not allow the visualization of the results of the process steps during training. The teeth used are not special teeth designed for root canal treatment, but plastic teeth used in dentistry for all kinds of procedures. The most important disadvantage of this product is that its use is dependent on phantom models. Phantom models are costly and are available in limited numbers even in faculties of dentistry. The biggest limitation of this product is that physicians cannot use it in the environment where they want, especially in the continuing dental education.

In the use of extracted teeth, there is a risk of disease transmission as the risk of cross contamination is not always suitable for the students' level, and ethical problems arise due to the reasons of the extraction of teeth. In addition, there is no bleeding simulation in the extracted tooth models, and since the teeth are not transparent, it is not possible for the treatment steps to be followed and for the students to both reflect and receive appropriate feedback.

In the research conducted on endodontic training devices in the state of the art, an international patent application titled "Endodontic training device and relative method of utilization" with the publication number of W02007108030 (Al) was found. In this application, an endodontic training device, which is suitable for positioning the apex of the canals of the teeth and for making radiographs of the teeth during various shaping and subsequent filling process of the canals is disclosed, and said device allows "in vitro" endodontic training and all operations on the tooth without the need to remove the tooth from its slot. This device is used for training in cleaning and shaping tooth roots and subsequent fillings with specific materials. When the structure of the device is examined, it is seen that it is far from the configuration of the implementation or training system and does not include the technical benefits it provides .

In another application document titled "Dental articulator with endodontic module" subject to the American patent registration with the publication number of US2009123898 (Al), a dental articulator for use in dental education is disclosed. It simulates the human mouth and has an adjustable hinge that connects the upper and lower carrier trays for movement from and to a closed position.

In another application document titled "Teeth model for endodontic treatment training dental model and module including the teeth model" subject to the Korean patent registration with publication number KR20190143108 (A) relates to a module for root canal training, a mouth model and a dental model comprising thereof. The dental module for root canal treatment training includes the following: dental crown with pulp cavity and a protective film on the outside of the pulp cavity; a tooth root segment having a root canal therein to be connected to the pulp cavity and comprising at least one tooth root elongated in one direction from one end of the crown, a permanent magnet formed on one side of the root canal of the root portion of the tooth and a hall sensor tooth root portion formed in a position facing the permanent magnet based on the root canal and measuring a voltage value according to the magnetic field change between the permanent magnet and a processing instrument made of a conductor to be inserted into the root canal. According to this device, a pile placed in the root portion of the tooth can be detected.

In the documents in the state of the art and in the products on the market, a device containing the technical advantages provided by the implementation system of the invention and having the same technical configuration has not been encountered.

The problems encountered above in the prior art and the insufficiencies of the developed solutions, and the necessity of developing an invention in which only these treatments can be practically trained, encouraged the inventor to make a development in this field.

Description of the Invention

The aim of the invention is to develop an implementation and/or training system which overcomes above problems in the prior art, is produced using three-dimensional printing technology and allows the implementation of regenerative endodontic treatment procedures in dental education.

Another aim of the invention is to provide a material where students can improve their psychomotor skills during the education of regenerative endodontic treatments.

Another purpose of the invention is, by means of its transparency, to contribute to visual learning in dental education by showing the results of the procedure in real cases during the treatment steps. In addition, by the help of the transparency of the product, it allows the students to see the applications they have made during the process steps, allowing them to see and correct the results of faulty applications more clearly. Another advantage of the invention is that, by means of its mobile and independent design, it provides persons with the opportunity to practice the treatment steps and reinforce these skills in the laboratory and in the environment, where they want, without the need for additional equipment.

Another advantage of the invention is that it contributes to the development and mastery of the psychomotor skills of the students in the remaining regenerative endodontic treatments, without having to apply these treatments on the patient.

Another advantage of the invention is that it allows repeated implementation.

Description of Drawings

Figure 1: Side view of the implementation system that is the subject of the invention Figure 2: Front view of the implementation system that is the subject of the invention Figure 3: perspective view of the implementation system that is the subject of the invention Figure 4: Cross-sectional view of the dental canal model

Description of Reference Numbers:

No Piece / Part Name

1 Central tooth model

2 Support mechanism

3 Reservoir

4 Piston

5 Dental canal model

Detailed Description of the Invention

The invention is basically an implementation and/or training system that enables it to be applied practically on the procedures for the purpose of teaching regenerative endodontic treatment procedures.

The implementation system that is the subject of the invention comprises the central tooth model (1) made of three-dimensional printing technology having transparent filaments in its structure and an unclosed apex, reservoir (3) where the artificial blood fluid is stored, support mechanism (2) positioned between the central tooth model (1) and the reservoir (3) portion ensuring the implementation and/or training system to be stable, artificial tooth canal model (5), which is associated with the reservoir (3) portion, imitating the structure of the tooth canal where the treatment will be applied, and piston (4) that allows the user to manually initiate bleeding during the application of treatment procedures on the implementation and/or training system.

The central tooth model (1) here is transparent because transparent filaments are used. By this way, it allows the user to see the process during the implementation and to see the root canals. The internal structure of the central tooth model (1) is in an immature structure with incomplete root development. In addition, the central tooth model (1), whose apex is not closed, contains the artificial tooth canal model that imitates the tooth canal structure where the treatment will be applied.

The support mechanism (2) positioned between the central tooth model (1) and the reservoir (3) ensures that these remain stable while the treatment steps are being applied on the system. The support mechanism (2) is made of three-dimensional printing technology. It was designed and printed as three-dimensional.

The reservoir (3) in the implementation and/or training system that is the subject of the invention is the structure where the blood-like fluid obtained by diluting the blood powder to be used in the bleeding simulation is stored. It is connected with the tooth channel model (5). It mimics the alveolar tissue in the jaw and the blood vessels in this tissue.

The system that is the subject of the invention is completely transparent. Thanks to its transparency, the invention also contributes to visual learning in dental education by showing the results of the procedure in real cases during the treatment steps. In addition, by the help of the transparency of the product, it allows the students to see the applications they have made during the process steps, allowing them to see and correct the results of faulty applications more clearly.

One of the most important features of the system is that it comprises a piston (4) that allows the user to manually initiate bleeding during the implementation of the treatment procedures on the implementation and/or training system. The piston (4) here was positioned on the reservoir (3) structure. The students need to perform ovarian instrumentation in the root canal in order to initiate bleeding during the implementation of the treatment steps on the model. When this procedure is applied on the patient, bleeding occurs in the tooth. After applying this process, it is expected for the people who receive the training to commence the bleeding manually with the help of this piston (4). After the bleeding simulation is completed, the control of this piston is left to the user to allow the re use of the obtained model. When the process is completed, the blood-like fluid in the tooth canal model (5) can be drawn back into the reservoir (3) by pulling the piston back to its original place. This movement capacity also gains the model the feature to be used repetitively. By this way, this skill ensures that people who are thought to have reached the level of mastery gain the competence to use the relevant skill on the patient. In the operation principle of the implementation and/or training device that enables practical application of procedures on it for the purpose of teaching the regenerative, endodontic treatment procedures, first of all, before beginning the treatment procedure, the implementation system becomes ready for training by the user drawing blood-like artificial fluid into the reservoir (3) with the help of the piston (4) pulling outwards through the dental canal model (5).

In the first stage of the training applied on the implementation system, the central tooth model (1), whose apex is not closed, is closed with the help of a suitable rubber cover.

In the first session of the treatment, the canal length determination is made with the help of inspection and the irrigation phase is commenced. Here, the user is expected to inject suitable solutions in appropriate quantities into the immature tooth canal model (5) for irrigation. Then, the drying process of the tooth canal model (5) is done with canal drying papers. After the irrigation process, the canal medicament (calcium hydroxide or antibiotic paste) is expected to be placed in the same dental canal model (5) with the help of lentulo. To complete the first session, the opening of the tooth canal model (5) is covered with a suitable temporary filling material.

For the second session, firstly, the temporary filling material is removed. The medicament in the dental canal model (5) is irrigated and removed. The simulated apical tissue is stimulated by using a file longer than the length of the dental canal model (5) in order to create a bleeding focus within the dental canal model (5). At this stage, by pushing the piston (4) in, the blood-like fluid will move out of the tooth canal model (5) and bleeding will be simulated. If the user, who takes the bleeding under control, will practice advanced tissue engineering studies, s/he can apply procedures such as stem cell transplantation or placing a different material into the canal (thrombocyte-rich fibrin, etc.). Afterwards, it is expected for a sealant such as MTA/biodentin to be placed in the canal and a permanent filling material to be placed on it for sealing purposes.

The implementation and/or training system that is the subject of the invention and enables practical application of procedures on it for the purpose of teaching the regenerative, endodontic treatment procedures comprises the simulation of anterior incisors and additionally the anterior incisor central tooth, the development of which are intended to be induced intensively in the clinic. With tissue engineering studies and regenerative medicine gaining importance, it is seen that these treatments have also begun to be applied in multi-rooted teeth.

In addition, these models can be developed by using different filament structures and more tooth-like materials in terms of biomimetics and can be used in the system that is the subject of the invention.