BACKGROUND OF THE INVENTION [0001] A major focus in the practice of dentistry involves the installation, alteration and removal of dental restorative material and the challenges associated therewith. For discussion herein, dental restorations include, but are not limited to, fillings, caps, veneers, crowns, posts, bridges and inlays. Irrespective of the dental restoration selected, the integrity of the bond between the dental restorative material and the corresponding tooth surface remains critical, which is adversely affected by bubbles formed in the restorative material or the development of voids between the restorative material and the tooth surface. Of course, bubbles and voids weaken the material itself, irrespective of the bonding.

[0002] Dental practice has recently moved away from amalgam to paste-like restorative materials, mainly mercury-free composite resins, and to a lesser extent, glass ionomer cements, composite luting cements, and sealants. Composite resins can include mixing together several constituent materials to form a dental paste, but most commonly, the composite resins come pre-mixed and already in a dispensing carpule for ease of application. That paste is then applied to a tooth surface or into a cavity preparation or other surfaces of teeth and"cures"or hardens by application of light, or passage of time, depending upon the composition. For purposes of discussion herein, these constituent materials are referred to as dental composites, composites, composite resins, or collectively, restorative materials. Since dental restorations may be constructed of composite resins, these terms may be used interchangeably. Similarly, although dental restorative material may be installed along a prepared outside surface or a preparation <BR> <BR> inside a tooth, the term"preparation, ""prepared tooth surface"or"tooth surface"is intended to include all of these arrangements. Composite resins, especially the more viscous mixtures as further discussed below, have also been used as adhesives.

Therefore, as used herein, the term"adhesive"or"cement"may also include viscous composite materials, although it is possible that non-composite adhesives or cements may also exhibit beneficial effects when used with the present invention.

[0003] There typically is a correlation between the viscosity of the composite resin in its uncured state and the strength of the subsequent restoration that has cured in a patient's tooth. Dental restorations of the highest strength are desired since the posterior (back teeth) must withstand three to four hundred pounds per square inch of biting pressure.

However, viscous dental restorative materials are a challenge to work with. Due to their high viscosity, typically a thick wax-like paste, composite resins are difficult to thoroughly mix, which must be done to achieve the desired high strength. Care must also be taken to avoid introducing bubbles during the mixing process which compromises the strength of the mixed composite resin. Further complicating the mixing process, composite resins tend to adhere to the mixing instrument, typically a spatula constructed of metal or plastic. This tendency to adhere to the mixing instrument, even when placed in a prepared tooth surface, can result in the composite resin pulling away from a desired tooth surface, which is known as"pull-back."Further enhancing this tendency is the frequent desirability of applying composite resin in thin layers. An additional complicating factor associated with use of these materials, due both to any combination of high viscosity, pull-back and application layer thickness is the difficulty in eliminating voids between the prepared tooth surface and the composite resins which interfere with the establishment of a high integrity bond, especially along the margins of the prepared tooth surface. Not surprisingly, lower viscosity"flowable"constituents were developed and have been used conventionally for a number of years, both by themselves and combined with high viscosity composite resins. This construction typically involves the introduction of the lower viscosity constituents into the prepared tooth surface which serves as a"liner"for the high viscosity composite resin that is introduced to fill the remainder of the tooth surface. Because the"flowable composite"appears to have a "wetter"surface, it is believed that it adapts better to the bonded surface. It also stands to reason that the lower viscosity"flowables"will flow into all the tiny angles of the cavity preparation better than the higher viscosity"traditional"composites. Vibration reduces this viscosity and converts traditional composites into the"flowable"category. In having to work with a special"flowable"composite, not only does this combination result in additional installation steps and expense for the dental practitioner, or user, but the"less filled"or traditional composite has less strength and is more likely to have bubbles therein. A"filled"composite, or regular composite, has a higher percentage of heavy "filler"particles making it more viscous, and therefore, more difficult to manipulate.

Laboratory studies conducted to evaluate the effects of a clinically acceptable vibrational force on the properties of composite restorative materials have shown that flow of the unpolymerized materials is significantly increased by the imposition of vibration.

Significantly, strength, hardness, density, microstructure and bond strength to dentin are not affected by the application of vibration.

[0004] One way to help eliminate such voids is to expose composite resin to vibration energy. The use of vibrating instruments in dentistry is known in the art for placement of dental filling materials, particularly amalgams, into prepared cavities (U. S. Patent Nos.

2,531, 680 to Gustafson, 3,513, 550 to Ekman and 3,898, 739 to Gayso). Additionally, U. S. Patent Nos. 4,219, 619 to Zarow and 6,139, 320 to Hahn disclose use of ultrasonic vibration for seating dental preparations. A generally accepted frequency range for ultrasonic vibration is from 18-45 kilohertz (kHz). Most notably, the Hahn reference discloses that liquids of high viscosity polymer composites can be thixotropically made liquid under the influence of ultrasonic frequencies. Thixotropy refers to the behavior of a substance to become liquid when sufficiently shaken, stirred or otherwise disturbed, and reset after being allowed to stand. In the context of use in the dental industry, by the application of vibration, the composite resins exhibit thixotropic properties, thereby flowing to more readily fill voids in a tooth surface preparation. However, ultrasonic instruments produce low torque, that is, they often fail to operate properly when placed under a minimal"load"or quantity of dental restorative material or dental restorations.

Ultrasonic instruments also generate heat, requiring water and air cooling sources, and may damage/scratch certain dental preparations, such as those composed of porcelain, especially when used with metal blades or tips. Finally, due to the extremely low torque levels generated by ultrasonic instruments, dentists have great difficulty achieving a proper"feel"in placing the restoration.

[0005] Applicant's U. S. Patent No. 5,839, 895 initially discloses some dental applications for use with low frequency vibration, which are incorporated herein by reference. However, the low frequency vibrating devices available at the time of the invention were similarly underpowered, and incapable of working with the newer filled, viscous composites. Through subsequent research, applicant has discovered that low frequency vibrating devices producing higher torque are capable of producing thixotropic effects with highly viscous composites, which was not previously thought possible.

Preliminary data indicate that vibrational frequencies in the range of about. 02 kHz to about 1 kHz (3,000 to 60,000 RPM) are more effective in increasing flow and that some types of porosity in very highly filled composite restorative materials are reduced by application of vibration prior to polymerization.

[0006] Another problem associated with applying restorative materials, especially in adjacent teeth, is that sometimes, despite the best efforts by the user, a portion of the dental material seeps between the teeth and cures in place. This joining of teeth is seldom, if ever, desirable. Among the adverse effects of this inadvertent tooth joining is the prevention of dental flossing which is highly desirable for dental hygiene and well being. There currently exists no easily workable method to remove cured dental material that has seeped between the teeth.

[0007] There are several apparatus in the art used in an attempt to reestablish this space. One is the use of a stiffer dental floss that utilizes an end of the floss which is to be directed between the remaining interproximal space between the teeth. Another similar apparatus is a plastic loop that is also to be threaded through an existing space between teeth. Additionally, a narrow segment of material, such as plastic, provided with an eyelet threaded with dental floss is also to be directed between the tooth space. None of these apparatus are consistently effective in this application. Furthermore, even if one of these apparatus is successful in opening up the space for use with a conventional blade, the blade must be manipulated from the occlusal or incisal surface with extreme care by the user to avoid gouging the patient's oral tissue, i. e. , cheek or tongue, which becomes more difficult proceeding in a direction toward the molars, as the user is working more deeply in the patient's mouth, and the patient's tongue is incrementally increasing in cross sectional size.

[0008] There is a need in the art for a dental instrument that may be cheaply produced which is capable of inducing thixotropic behavior in dental composite resins, sealants, glass inonomer cements and copolymers to promote thorough mixing and application thereof without adhering to the dental instrument. Highly desirable is the increasing of thixotropism and subsequent flow without the disadvantages associated with operating at ultrasonic frequencies.

[0009] There is a further need in the art for a dental instrument for permitting the introduction of dental floss between adjacent teeth obstructed due to cured dental material without the disadvantages associated with operating at ultrasonic frequencies. Similarly, there is a need in the art for a dental instrument that facilitates access from a gingival direction for removing cured interproximal dental material.

SUMMARY OF THE INVENTION [0010] The apparatus of the present invention includes a multifrequency vibrating mechanism that can be configured to vibrate at a predetermined frequency that is below the ultrasonic range which is connected to a device that vibrates when the vibrating mechanism operates for thoroughly mixing viscous composite resins in preparation for application of the mixture to a tooth. The mixture does not adhere to the device and produces a glossy surface finish.

[0011] In a principal aspect, the present invention includes a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range which is connected to a device that vibrates when the vibrating mechanism operates for placement of at least one temporary dental restoration having a tooth facing surface and an opposed surface against a patient's desired tooth surface. The dental restoration is secured by interproximal retention established between the patient's tooth surface and the tooth facing surface by placing the device in vibratory contact with the opposed surface.

[0012] In another principal aspect, the present invention includes a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range which is connected to a device that vibrates when the vibrating mechanism operates for forming a dental restoration composed of viscous composite resins to a labial surface of an anterior tooth, the dental restoration having a similar contour as compared to the original tooth.

[0013] In another further principal aspect, the present invention includes a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range which is connected to a device that vibrates when the vibrating mechanism operates for forming a contiguous mass of viscous composite resins for bonding to a surface of adjacent teeth for collective support thereof.

[0014] In still another further principal aspect, the present invention includes a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range which is connected to a device that vibrates when the vibrating mechanism operates. The device extends into an abrasive tip for cleaning the fissures of a tooth in preparation for application of a dental sealant, composite resin, or other dental restoration material, the cleaned fissures leaving substantially no residue from the abrasive tip thereon.

[0015] In yet another principal aspect, the present invention includes a method for luting a dental restoration to a tooth by providing a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range; connecting a device to the vibrating mechanism so that the device vibrates when the vibrating mechanism operates, employing a vibrating mechanism, such as a transducer or a magnetostrictive coil; applying a dental adhesive to a tooth facing surface of a dental restoration further having at least one non-tooth facing surface; placing the device in physical contact with the dental adhesive, causing the dental adhesive to develop, at least in a portion of the dental adhesive adjacent to the device, thixotropic properties so that the adhesive is more evenly distributed along the tooth facing surface; placing the tooth facing surface of the dental restoration in physical contact with a desired surface of a tooth; and placing the device for a predetermined period of time in physical contact with the at least one non-tooth facing surface of the dental restoration to further develop thixotropic properties in the adhesive to more evenly distribute the adhesive between the tooth surface and the tooth facing surface.

[0016] In still yet another principal aspect, the present invention includes a method for installing a mechanical dental restoration by providing a vibrating mechanism being configured to vibrate at a predetermined low frequency that is below the ultrasonic range; connecting a device to the vibrating mechanism so that the device vibrates when the vibrating mechanism operates; placing a mechanical dental restoration, such as a dowel or pin, in a desired position at least partially inside a tooth containing a dental adhesive for securing the dental restoration therein; and placing the device in physical contact for a predetermined period of time with the dental restoration for inducing vibration along the length of the dental restoration wherein the dental adhesive developing thixotropic properties so that the mechanical dental restoration can be directed to a desired position and the dental adhesive flows into dentinal tubules.

[0017] In another principal aspect, the present invention includes a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range which is secured within a housing. A device is connected to the vibrating mechanism extending outwardly from the housing which is adapted to be secured to an appendage, such as a finger, of a user.

[0018] In yet another principal aspect, the present invention includes a handle connected to a bow having a proximal end and a distal end. A member having a base end and an exposed end is insertable in an interproximal space between adjacent teeth. The base end of the member is pivotally connected to the proximal end of the handle and is adapted to secure the exposed end of the member, upon insertion of the exposed end between predetermined adjacent teeth.

[0019] In still another principal aspect, the present invention includes a method for securing an installed dental restoration, such as a crown, having at least one loose end without removing the dental restoration from the patient's mouth by: forming a channel in the dental restoration in dental material such adhesive adjacent to a loose end of a dental restoration, the channel being of sufficient depth for securing the loose end by the introduction of a viscous dental luting cement therein; preparing the surface of the channel for securing the viscous dental luting cement thereto; providing a vibrating mechanism, the mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range; connecting a device to the vibrating mechanism so that the device vibrates below the ultrasonic range when the vibrating mechanism operates, the device being sized to pass inside the channel; directing a predetermined amount of the viscous dental luting cement inside the channel; inserting the device for a predetermined period of time inside the channel in physical contact with the channel and/or the viscous dental luting cement, causing the viscous dental luting cement to behave in a thixotropic manner so that the viscous dental luting cement flows to move fluidly under the influence of the vibrating device to more fully fill the channel; repeatedly directing an amount of viscous dental luting cement inside the channel followed by inserting the device inside the channel into contact with the viscous dental luting cement until the channel is sufficiently filled with the viscous dental luting cement.

[0020] In still yet another principal aspect, the present invention includes a dental apparatus for insertion of dental floss in an interproximal space. A cap for placement over an end of an appendage is connected to an elongate member at one end, the opposed end having a taper thereon for insertion between adjacent teeth. The member extends outwardly from the cap and has a channel formed therein between its opposed ends for directing a predetermined length of a dental floss therethrough. The tapered end is incrementally inserted between adjacent teeth until the channel passes through the adjacent teeth.

[0021] In a further principal aspect, the present invention includes a dental apparatus for use with the removal of an installed mechanical dental restoration in a tooth. A vibrating mechanism configured to vibrate at a predetermined frequency that is below the ultrasonic range is connected to a device which vibrates when the vibrating mechanism operates. The device is placed in physical contact for a predetermined length of time with an exposed end of a mechanical dental restoration, such as a dowel or pin, that is secured in a solidified mass of dental cement which is secured in a tooth. The dental restoration has a recess formed in the composite resin adjacent the dental restoration.

The device induces vibration at the predetermined frequency along the length of the dental restoration wherein a portion of the luting cement or resin securing the dental restoration and this vibrational energy loosens the luting material so that the dental restoration may be more easily removed.

[0022] In a still further principal aspect, the present invention includes a method for interdental separation between adjacent teeth by: providing a bow having at least one proximal end and distal end, at least one member having a base end and an exposed end for insertion in an interproximal space between adjacent teeth, the base end pivotally connected to the proximal end, the distal end adapted to secure the exposed end upon insertion of the exposed end between desired adjacent teeth; inserting exposed end into the desired interproximal space; rotating the bow until the exposed end is secured by distal end; and manipulating the bow to effect the desired interdental separation.

[0023] In a still further principal aspect, the present invention includes a dental apparatus for luting a dental restoration to a tooth. A vibrating mechanism configured to vibrate at a predetermined frequency that is below the ultrasonic range is connected to a device that vibrates when the vibrating mechanism operates. A portion of the device is composed of a resilient material for at least partially conforming to the profile of a dental restoration for luting the dental restoration on a desired tooth surface. The dental restoration has a tooth facing surface, a non-tooth facing surface and a layer of dental luting cement interposed between the non-tooth facing surface and the desired tooth surface. The device does not mar the tooth facing surface of the dental restoration when the device is placed in vibratory contact with the tooth facing surface of the dental restoration. The vibratory contact, at least in a portion of the dental luting cement, causes that portion to behave in a thixotropic manner so that the cement is more evenly distributed along the tooth facing surface.

[0024] In an even further principal aspect, the present invention includes a dental apparatus for forming anatomical grooves in a surface of a dental restoration applied to the occlusal or facial surface of a tooth restoration. A vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range is connected to a device that vibrates when the vibrating mechanism operates for forming grooves in a viscous composite resin applied to the tooth surface. The device has a surface to form grooves in the tooth surface without adhering to the restoration.

[0025] In an additional principal aspect, the present invention includes a method for permitting incremental application of dental restorative material into a prepared tooth surface using a dispenser and a dental apparatus by: providing a dental apparatus including a vibrating mechanism being configured to vibrate at a predetermined frequency that is below the ultrasonic range; connecting a device to the vibrating mechanism that vibrates when the vibrating mechanism operates; securing the apparatus to one of a user's fingers; providing a dispenser within the user's hand grasp for expressing an amount of restorative material, the dispenser being secured to the user's hand by any combination of the user's thumb and fingers not previously being used to secure the apparatus; expressing a predetermined amount of restorative material from the dispenser into a prepared tooth surface by actuating the dispenser in response to a compressive force applied by the user's grasp ; removing the dispenser from the user's grasp; actuating the apparatus; placing the device into physical contact with the restorative material, thereby causing the restorative material, at least in a portion of the restorative material adjacent to the device, to behave thixotropically so that the restorative material, while in contact with the device, flows along the interface between the restorative material and the tooth surface; repeating the steps expressing the restorative material and placing the device into physical contact with the restorative material until a sufficient amount of restorative material has been expressed and flowed in the tooth surface, then curing the restorative material.

[0026] In another principal aspect, the present invention includes a dental apparatus for removing an overhang from an interproximal space between adjacent teeth. The dental apparatus includes a cap for placement over an end of an appendage, and a body having a first end that is secured to the cap and a second end. A member having a proximal end a distal end extends outwardly from the cap. The proximal end is adapted to be secured to the second end of the body and a distal end for insertion between adjacent teeth by directed movement of the appendage.

[0027] Referring to Figs. 42-44, a further embodiment of apparatus 500 (Figs. 31A- 31E) utilizes a full circular blade periphery employing a plurality of blade members.

Referring specifically to Fig. 42, apparatus 779 is formed by rotating frame spokes 530 in rotational direction 800 so that the spokes 530 define an acute angle 790 with respect to a center axis 778. Extending from the ends of spokes 530 are corresponding proximal, distal ends 504,506 for securing blade members 508 (not shown for clarity) therebetween as previously discussed. When installed, any portion of each of the blade members 508 are configured to lie substantially within the profile established by spokes 530. In other words, blades members 508 collectively define a lenticular disk defining a convex profile. One end of blade members 508 is removable to access an interproximal space between adjacent teeth as previously discussed. By this novel angled arrangement of spokes 530 which likewise provides an angled arrangement of blade members 508 from the center axis 778, apparatus 779 provides the user with improved comfort, flexibility and vantage point to direct the apparatus 779 slightly out of the parallel orientation otherwise required to remove overhang material from an interproximal space between adjacent teeth.

[0028] In another principal aspect, the present invention includes a dental apparatus for removing overhang material from an interproximal space between adjacent teeth. The dental apparatus includes a body having multiple non coplanar frame portions extending symmetrically outward from a center axis and adapted for driven rotational movement by a rotation source about the center axis. The multiple frame portions are each provided with a proximal end and a distal end for securing opposed ends of an abrasive blade member having abrasive opposed surfaces thereto. The abrasive blade member is controllably removable from the frame portion permitting the insertion of one end of the abrasive blade member into an interproximal space between adjacent teeth. The abrasive surfaces blade member define a lenticular convex profile.

[0029] In yet another principal aspect, the present invention includes a dental apparatus for removing material such as an overhang from an interproximal space between adjacent teeth. The dental apparatus includes a lenticular shaped disk having a pair of opposed convex surfaces, the opposed surfaces joined at an outer periphery forming an edge. The disk being adapted for rotatable connection about an axis. The opposed surfaces being abrasive.

[0030] Among the advantages of the present invention is a dental instrument that may be cheaply produced that is capable of inducing thixotropic behavior in viscous dental materials such as luting cements, composite resins and sealants to promote thorough mixing and application thereof without adhering to the dental instrument and further without the disadvantages associated with operating at ultrasonic frequencies.

[0031] A further advantage of the present invention is the elimination of air bubbles that produce voids in the material, thereby producing a stronger material.

[0032] A still further advantage of the present invention is the ability to produce thin, strong, adherent layers of dental materials when desired.

[0033] An additional advantage of the present invention is the ability to apply increased torque and maintain better control over the application of dental materials.

[0034] A further advantage of the present invention is the ability to manipulate dental materials in less time without sacrificing strength, hardness, density or microstructure or the dentin bonding strength of the materials.

[0035] Other advantages of the present invention are its ability to increase "wettability"and an end result that is more glossy and requires less polishing time.

[0036] Yet, another advantage is the ability to carve uncured resin restorations more easily while producing a better result with a tool employing vibration.

[0037] Other features and advantages of the present invention will be apparent from the following more detailed description of the preferred embodiment, taken in conjunction with the accompanying drawings which illustrate, by way of example, the principles of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS [0038] Fig. 1 is a perspective view of a dental apparatus of the present invention [0039] Fig. 2 is a cross sectional view of the dental apparatus.

[0040] Fig. 3 is an exploded perspective view of the dental apparatus.

[0041] Fig. 4 is a perspective view of an embodiment of the dental apparatus.

[0042] Fig. 5 is a view of a user's hand simultaneously securing a dental dispenser and an embodiment of the dental apparatus.

[0043] Fig. 6 is an exploded perspective view of a further dental apparatus.

[0044] Fig. 7 is a perspective view of the open and closed member positions of the dental apparatus.

[0045] Fig. 8 is a perspective view of the dental apparatus in use between adjacent teeth.

[0046] Figs. 9-11 are embodiments of the blade members usable in the dental apparatus.

[0047] Fig. 12 is a cross sectional view of the blade member used in the dental apparatus.

[0043] Fig. 13 is a perspective view of possible forces that may be applied to the dental apparatus while inserted between adjacent teeth.

[0049] Figs. 14-16 are top views of the member contacting adjacent tooth surfaces in response to different forces being applied thereto.

[0050] Fig. 17 is an elevation view of a further dental apparatus.

[0051] Fig. 17A is an enlarged, partial elevation view of the tip of the dental apparatus.

[0052] Fig. 17B is an enlarged, partial top view of the tip of the dental apparatus prior to disengagement from the dental apparatus.

[0053] Fig. 17C is an elevation view of a further alternate embodiment of the dental apparatus.

[0054] Fig. 18 is an elevation view of the further dental apparatus in use with a vibrating dental apparatus.

[0055] Figs. 18A and 18B are elevation views of the further dental apparatus in use with the vibrating dental apparatus for installing a mechanical dental restoration.

[0056] Fig. 19 is an elevation view of possible angular orientations of the dental apparatus.

[0057] Figs. 20,20A and 21 are elevation views of embodiments of tips for use with the dental apparatus.

[0058] Fig. 22 is an elevation view of lower incisal teeth collectively secured by a contiguous mass of composite resin.

[0059] Fig. 23 is a perspective view of a tip for use with the dental apparatus.

[0060] Fig. 24 is a cross sectional view of the tip of Fig. 23.

[0061] Fig. 25 is a perspective view of a tip for use with the dental apparatus.

[0062] Fig. 26 is an elevation view of an alternate embodiment of the dental apparatus.

[0063] Fig. 27A and 27B are cross sectional views of different bow portions of the dental apparatus of Fig. 26.

[0064] Fig. 28 is an elevation view of the barb construction of the dental apparatus.

[0065] Fig. 29 is an elevation view of a flexible strip for use with the dental apparatus.

[0066] Fig. 30 is an elevation view of the dental apparatus securing the flexible strip.

[0067] Fig. 31 is an exploded perspective view of a still further embodiment of dental apparatus.

[0068] Figs. 31A-31E are elevation views of further alternate embodiments of the dental apparatus.

[0069] Fig. 32 is an elevation view of the dental apparatus securing the flexible strip.

[0070] Fig. 33 is an exploded perspective view of a holder for securing the vibrating dental apparatus therein for protecting oral soft tissue.

[0071] Figs. 33A-33C are perspective views of further holder embodiments, illustrating both open and stowed holder positions.

[0072] Figs. 34 and 35 are respective cross section and perspective views of embodiments of abrasive brushes for use with the dental apparatus.

[0073] Fig. 36 is an elevation view of the apparatus employing a circular bladed dental apparatus having a tilt angle.

[0074] Fig. 37 is an exploded elevation view of the shaft for rotatably securing the bladed dental apparatus.

[0075] Fig. 38 is an exploded perspective view of an embodiment for rotatably securing the bladed dental apparatus.

[0076] Fig. 39 is a perspective view of an alternate embodiment of the dental apparatus.

[0077] Fig. 40 is an enlarged perspective view of yet another embodiment of the dental apparatus.

[0078] Fig. 41 is an enlarged perspective view of a pair of dental apparatus utilized together to form another embodiment of the dental apparatus.

[0079] Fig. 42 is a cross section view of a further embodiment of the lenticular disk.

[0080] Fig. 43-44 are respective cross section views of abrasive lenticular disks for use with the dental apparatus.

[0081] Fig. 45 is an enlarged partial cross section view of the dental apparatus of Fig.

41.

[0082] Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.

DETAILED DESCRIPTION OF THE INVENTION [0083] Referring to the drawings, Fig. 1 illustrates a perspective view of the preferred form of the invention, a dental apparatus 30 for providing preferably low frequency vibration that is below the ultrasonic range to a dental restorative material (not shown).

As used herein, the term ultrasonic range refers to frequencies in the range of 18kHz- 45kHz and the term"below the ultrasonic range"below 18kHz to about 50 Hz. As will discussed in additional detail below, it is also assumed that dental apparatus 30,100 (Fig.

4) additionally have the capability to employ in any combination, vibration, reciprocation or rotating motion, although it may be that only one motion aspect may be emphasized for use with a particular application. Likewise, the term"vibrating mechanism"may also include the capability for any combination of reciprocal or rotating motion. Dental apparatus 30 includes a body 32 having opposed ends 38,40 which preferably secure a vibration device (not shown) and a power source (not shown) therein. End 40 is securely connected to a proximal end 42 of extension 34 which secures a tip 36 at a distal end 44.

The term"tip"may refer collectively to extension 34 and tip 36, such as tip assembly 46, since they may be of unitized construction. Upon actuation of a switch 48, preferably located in an ergonomically favorable location along body 32, vibration device which receives operating power from the power source is urged into operation. Vibration energy is transmitted along extension 34 to tip 36 for application of vibration energy to dental preparations as will be discussed more fully below.

[0084] Referring to Figs. 1-2, body 32 is now further discussed. Preferably, body 32 defines an elongated profile for ease of gripping by a user (not shown). Although body 32 is illustrated as a cylinder having a uniform cross section, any cross sectional profile, such as an equilateral or isosceles triangle, or non uniform cross section may be used. In one embodiment, referring to Fig. 2, a hemispherical recess 50 is formed longitudinally along the length of body 32 to enhance user comfort as a resting place for a user's index finger (not shown).

[0085] Referring back to Fig. 1, adjacent end 38 of body 32 is cap 52 to secure a power source, such as batteries, therein. Alternately, to supply increased amounts to torque to tip 36 for use with its many possible applications, the power source need not be housed within body 32, and via flexible conduit 54, could deliver operating power to vibrating device from pneumatic, electric, hydraulic or any other mechanical power source, the power source driving the motor housed within body 32 which is compatible with the power source. Securely connected to opposite end 40 of body 32 is tip assembly 46 for transmitting vibratory energy to a dental restoration (not shown). For ease of installation, referring to Fig. 3, extension 34 may be provided with a pair of preferably aligned off-center tabs 56 extending longitudinally from end 42, each transitioning into a radially outwardly extending flange 58 for engaging corresponding apertures 60 formed in end 40 of body 32 when respective ends 40,42 are placed in mutual axial alignment along axis 66 and directed into contact therewith, to join extension 34 to body 32. To further aid in installation, preferably centered alignment pin 62, which extends longitudinally from end 40 and is slightly longer than the combined length of tab 56 and flange 58, engages centered aperture 64 formed in end 42. It is also preferred that upon adequate insertion of respective flanges 58 inside apertures 60 an audible"click"is produced to indicate proper connection has been established between extension 34 and body 32. Alternately, a mechanical construction may be employed in which upon axially aligned engagement of extension 34 and body 32, extension 34 is directed into a predetermined rotation with respect to body 32 along the mutual longitudinal alignment axis (not shown) to provide a locking feature that is well known in the art.

[0086] Referring to Fig. 4, a preferred embodiment of apparatus 100 is now discussed. In this embodiment, body 102 is adapted for use with a user's appendage, such as a hand, and more preferably, to a user's index finger. Most preferably, body 102 is adapted for being secured to the second and third segments of the user's index finger.

Although not shown, a recess may be formed along body 102, similar to recess 50 in Fig.

2, serving as a resting place for the user's collective segments although the recess could be any combination of second and third segments of the user's fingers, if desired. To secure body 102 to the user's collective second and third segments, a pair of opposed loops 106 extends outward from body 102. Preferably, loops 106 are formed with an amount of curvature therealong to promote a confonnal fit with the user's finger.

Connecting loops 106 is an elastic band 108 adapted to accommodate a finger size of most adult users. By incorporating further adjustment in band 108, such as velcro@ or a strap and buckle combination or any other mechanical means suitable to vary the effective length of band 108, any size appendage may be accommodated. Alternately, or in addition, loops 106 may employ a spring (not shown) to apply a slight compressive force to help secure apparatus 100 to the user's finger and eliminate the need for band 108. However, it is also contemplated that loops 106 and band 108 may be optional for the user that desires to directly secure body 102 within his grasp.

[0087] Apparatus 100 may be operated with a tip 104 having an axis. The axis may be substantially aligned either parallel or in line with longitudinal axis 118 of body 102. Alternately, tip 104 may be aligned with a divergent axis 120, forming a preselected angle with the longitudinal axis 118, preferably perpendicular to longitudinal axis 118, providing the user with unprecedented flexibility to adapt to the desired application or preference of the user. Tip 104 can incorporate a bend of any angle at any position along the length of tip 104, as desired. Dentists typically prefer axis 120 at a sharp angle such as perpendicular as it provides better visibility of the area being worked. The length of tip 104 can also vary to accommodate any hand size or preference of the user. This novel construction provides the user with essentially unrestricted functional use of the other fingers for additional convenience (e. g. , permitting additional fingertip"perches") and improved control and tactile sense at the end of the finger than is possible with a traditional dental instrument. Due to an end 122 of body 102 coinciding with a base 116 of the second segment of the user's finger, by the user bending his finger, base 116 becomes a stable platform for securing apparatus 100, especially if the dental procedure requires the application of force. Although tip 104 may be of one piece construction such as tip assembly 46 that may be secured by any mechanical means known in the art, such as by a collet, clamp, screw, press fit or snap fit, the tip may be a combination of extension 34 and tip 36 as used in Fig. 3, the combined possibly approaching that of conventional instruments the user is accustomed to using.

[0088] Referring to Figs. 4 and 5, due to the novel compact construction of apparatus 100, a conventional restorative material dispenser 126 well-known in the art and available from a number of sources is often employed to dispense restorative material used with the present invention and can still be easily manipulated with the user's hand grasp employing any combination of the user's thumb, third, and fourth fingers, respectively, while still wearing apparatus 100 on the index finger. This ability for simultaneous manipulation of dispenser 126 by the user without the need to set apparatus 100 down provides advantages over the present technique for applying restorative material from a dispenser 126 to a prepared tooth surface. In other words, the user, simultaneously wearing apparatus 100 and alternately securing dispenser 126 in the same hand, may more efficiently incrementally apply restorative material from dispenser 126 into a prepared tooth surface until the desired level of restorative material has been applied therein using the following novel method. After providing apparatus 100 that is preferably secured to the user's index finger, and alternately securing dispenser 126 within the user's hand grasp, preferably any combination of thumb and fingers secure dispenser 126, the user expresses a predetermined amount of restorative material from dispenser 126 into a prepared tooth surface. After setting dispenser 126 down or transferring dispenser 126 to the user's other hand, the user may then actuate a switch 124 of apparatus 100 in a direction to activate apparatus 100 into vibrating operation, using one of the user's fingers or thumb of the same hand, if desired. The user then places vibrating tip 104 into physical contact with the restorative material, so at least in a portion of the restorative material adjacent to tip 104, thixotropic properties are imparted to the restorative material so that the restorative material flows along the interface between the restorative material and the tooth surface. Dispenser 126 is then again placed in the user's preferred hand, which is assumed to be the same hand wearing apparatus 100, to apply an additional amount of restorative material before again setting aside dispenser 126 prior to again utilizing apparatus 100. The user then repeats the steps of incrementally adding layers of restorative material followed by exposing the restorative material to vibration until the desired level of restorative material has been expressed and flowed in the tooth surface, wherein the user may actuate switch 124 in a direction corresponding to an"off'position, preferably with the same appendages previously used to actuate switch 124 to the"on"position. This method eliminates the need for the user <BR> <BR> to repeatedly select and set down both the placement instrument, i. e. , vibrating tip 104, and dispenser 126, respectively. The restorative material is then permitted to cure within the tooth. An appropriately sized dispenser 126 properly sized to the hand of the user may preclude the need to remove it from the user's hand.

[0089] Referring to Figs. 6 and 7, apparatus 200 is now discussed. Apparatus 200 preferably includes a bow 208 having a proximal end 210 and a distal end 212 for securing a member 213 therein for insertion of an exposed end 216 of member 213 in an interproximal space 230 between adjacent teeth 232 (Fig. 8) as will be discussed in more detail below. For ease of manipulating bow 208, a tab 209 is provided having a recess 211 formed therein adapted to receive at least one of opposed ends 204,206 of a handle 202. Although tab 209 is illustrated preferably along the mid span of bow 208, it is appreciated that tab 209 could be located at any position along bow 208, including a construction in which end 204 inserts in recess 211 adjacent proximal end 210. In this construction, handle 202 aligns with longitudinal axis 222.

[0090] Bow 208 has a slot 220 formed in proximal end 210 adapted for securing a base end 214 therein as illustrated in Fig 7. Preferably, a loop 218 permitting ease of angular flexure of member 213 is substantially contained within proximal end 210.

Member 213 extends in a direction away from loop 218 and base end 214 along a member segment 215, terminating at preferably tapered exposed end 216. Upon sufficient directed rotation of segment 215 in rotational direction 228, which is preferably coplanar with longitudinal axis 222, exposed end 216 may be secured in a keeper 224.

Once exposed end 216 is secured in keeper 224, segment 215 is structurally supported at ends 210,212. In preferred use, referring to Fig. 8, exposed end 216 is directed toward interproximal space 230 between the desired adjacent teeth 232 by use of handle 202 which is connected to bow 208 as previously discussed, preferably from the facial side toward the lingual side adjacent the sulcus as this typically provides the widest space and therefore the highest chance of insertion of member 215 therethrough. To ease insertion, member 215 has a flat, narrow profile, but may be triangular shaped to substantially match the shape of the space typically defined by adjacent teeth at the sulcus. After end 216 is sufficiently inserted through interproximal space 230, it is desirable to secure end 216 in keeper 224. To effect this securement, bow 208 is rotated in direction 228 until end 216 engages keeper 224.

[0091] Once end 216 is secured, bow 208 is manipulated in an effort to further widen/polish interproximal space 230. Also another advantage would be for acceptance of dental floss therebetween. Referring to Fig. 9, this interproximal space widening is accomplished by bringing any combination of upper, lower and lateral surfaces 240,242, 244 of member 215 into abrasive contact with the surfaces between adjacent teeth. To create this abrasive contact, these surfaces may be provided with an abrasive coating, typically comprised of diamond, or by forming discontinuities on these surfaces by exposure to dies under pressure, chemical etching, exposure to high speed particles to cause pitting, or any other method of mechanically changing the surfaces of member 213 so that the surfaces are suitable to remove dental material from between adjacent teeth.

Referring to Fig. 10, upper surface 240 has formed therein a serrated blade 245. Fig. 11 illustrates an embodiment of member 213 having a blade 246 formed on upper surface 240 wherein the width of member 213 measured from upper surface 240 to lower surface 242 incrementally decreases proceeding in a direction along the length of member 213 from adjacent loop 218 to end 216, or with member in its installed position in bow 208, from proximal end 210 to distal end 212 (Fig. 8). Among the advantages of this construction is that in case only a portion of member 213 may be inserted through interproximal space 230, the user may nonetheless be able to reciprocate member 213 to remove composite resin from between the teeth, gradually opening up interproximal space 230.

[0092] Referring to Figs. 11 and 12, although member 213 may be of unitary construction, blade 250 may be secured to a wire 248 by crimping, soldering, adhering, use of mechanical fasteners, or any other electrical, chemical or mechanical bonding method that secures blade 250 to wire 248.

[0093] Referring to Figs. 7 and 11, member 213 is provided with a raised portion 251 that when installed in bow 208 is secured within slot 220 which provides additional lateral support and stability for member 213.

[0094] Referring to Fig. 13, once member 213 is secured within bow 208, the user may apply any combination of horizontal, vertical and torsional forces 252,254, 256, 258,260, 262 thereto to remove composite resin material from between adjacent teeth 232. However, for purposes herein, only those forces for primary use with flexible member 213 will be illustrated. That is, using flexible member 213 and certain directed and torsional forces, flexible member 213 flexes in response to the forces, increasing the amount of surface contact between member 213 and the tooth surface between adjacent teeth, which is especially advantageous for polishing. Referring to Figs. 14-16, member segment 215 is illustrated in its flexed condition between adjacent teeth in response to respective torsional, and horizontal forces 258,254, 255, respectively. In each instance, increased surface area contact regions 260 between adjacent teeth 232 result from the application of these forces in directions that are substantially perpendicular to the direction of member segment 215 when secured between ends 210,212 of bow 208.

Although increased surface area contact regions 260 should result in response to any application of forces to bow 208, more preferably, referring to Fig. 19, a twisting force 272 most beneficially produces contact regions 260 when applied about an axis 278 that is about forty five degrees or less as measured along 276 from axis 274 which corresponds to the direction adjacent teeth 232 extend from gum line 280.

[0095] Although not shown, it is readily apparent that either apparatus 30,100 in Figs. 1,4, respectively, may be connected to bow 208 for providing enhanced insertion capability of end 216 of member 213 in Fig. 8 due to vibrating end 216 inducing thixotropic behavior in composite resin between adjacent teeth.

[0096] Referring to Figs. 17, 17A, 17B and 17C, an additional embodiment for inserting dental floss between adjacent teeth is now discussed. An apparatus 261 includes a cap 262 for placement over an end of an appendage, preferably an index finger of a user. A body 264 composed of a resilient, flexible material is connected to cap 262 at one end 263 and includes an opposed end 265 having a slot 268, or recess, formed therein for securing a member 266, preferably by the parallel walls of slot 268 being spaced such that the walls impose a compressive force to member 266 inserted therein.

Member 266 may be composed of stainless steel or any metal or polymer compatible with dentistry use that is sufficiently strong for such use. Slot 268 may alternately define a concave profile for this purpose. Body 264 may be rotatable with respect to cap 262 so that slot 268 may be arranged at any desired orientation for ease of use. Member 266 has an end 267 for resting inside slot 268 and an opposing tapered end 269 for insertion between adjacent teeth. An aperture 273 is formed between ends 267,269 for threading dental floss 270 therethrough. Similar to the construction of member 213 in Fig. 6, member 266 has a narrow profile adapted for ease of insertion between adjacent teeth.

By forming a curve, such as a"sickle"shape, in member 266 (not shown), member 266 is not only less likely to"stick"the tongue or other soft oral tissue, but is also easier to secure and remove from the interproximal space. To use apparatus 261, the user places cap 262 over the desired finger and directs end 267 of member 266 into slot 268 until member 266 is seated therein. By extending the desired finger, the user may direct end 269 of member 266 into the desired interproximal space between adjacent teeth (not shown). Once member 266 has been sufficiently inserted into the interproximal space, the user may easily disengage cap 262 from member 266 by employing a twisting motion 272 that is directed along a plane substantially parallel to slot 268. Member 266 may then be pulled through the interproximal space by the user which also pulls through floss 270 secured within aperture 273. Referring to Fig. 17C, a handle 275 may be employed instead of cap 262 for the convenience of the user, operating substantially in the same manner as previously described.

[0097] Referring to Figs. 18, 18A, and 18B apparatus 261 (Fig. 17), absent cap 262, could be readily adapted for use with apparatus 100 wherein installation is enhanced due to the application of vibration energy as previously discussed. Alternately, apparatus 261 may be employed to install or remove a restoration 277 such as dowels or pins that may be utilized to secure other dental restorations as is well known in the art. Referring to Fig. 18A, mechanical restoration 277 may be secured within slot 268 and directed into a tooth by employing the following method. Apparatus 100 provides a vibrating mechanism configured to vibrate at a predetermined subultrasonic frequency range as previously described that is connected to cap 264 which is one form of tip 36 so that cap 264 vibrates when the vibrating mechanism operates. Mechanical dental restoration 277 is placed in a desired position at least partially inside a tooth containing a dental restorative material for securing the mechanical dental restoration 277 therein. Placing cap 264 in physical contact for a predetermined period of time with mechanical dental restoration 277 induces vibration along the length of mechanical dental restoration 277 wherein the vibrating restorative material imparts thixotropic properties to the restorative material so that the mechanical dental restoration can be directed to a desired position and the dental adhesive flows into dentinal tubules. Mechanical dental restoration 277 can similarly be disconnected from cap 264 by employing the same twisting force 272 (Fig.

17B) as previously discussed. Referring to Fig. 18B, a tip 279 is secured to cap 264. Tip 279 is provided with a channel 281 for sliding over mechanical dental restoration 277 to provide more focused vibration energy thereto. However, if the depth of channel 281 is greater than the length of mechanical dental restoration 277 protruding outwardly from the dental restorative material, an outer edge 283 will transfer vibrational energy to the adjacent dental restorative material surrounding and securing mechanical dental restoration 277. In either event, the vibration will impart thixotropic properties to the composite material so that it can be removed.

[0098] Referring to Figs. 20 and 21, two tips 282,284, respectively, for especially advantageous use with indirect veneers are now discussed. Tip 282 having a substantially conical profile is composed of a resilient material, such as a soft plastic, for seating an indirect veneer (not shown) wherein tip 282 when connected to apparatus 100 and directed in vibrating contact with the veneer induces thixotropic properties in a dental adhesive applied between the veneer and prepared tooth surface. As previously discussed, due to the induced thixotropic properties, the dental adhesive begins to flow which provides a more even application of adhesive and a thinner layer of adhesive. It has been shown that a thinner adhesive layer is superior to a thicker layer. Similarly, tip 284 is comprised of resilient material having an upper portion 286 for contacting and conforming to preferably a facial tooth surface and a ledge 288 extending from upper portion 286 for conformally contacting and securing an incisal tooth edge. Both tips 282, 284 are constructed to transfer vibratory energy to the veneer without risk of scratching.

Alternately, referring to Fig. 20A, a soft/medium plastic/rubberish preferably conical point may be employed for seating/luting caps (crowns), inlays, and onlays. This point may be typically placed in the middle of the restoration and vibrated. While the range of vibration frequencies for this application has not been fully determined, frequencies exceeding 1,500 RPM have been successfully employed, but all subultrasonic frequencies should be available for use with the proper configuration.

[0099] Referring to Figs. 22-25, several novel tips for use with composite resin splints shall now be discussed. As used herein, a splint is a contiguous mass of composite resin formed for bonding to the surface of adjacent teeth for their collective support, including closing diastemas. Splints are predominantly associated with the lower mandibular incisors, such as illustrated as splint 290 in Fig. 22. Due to the angle defined on the lingual side of these teeth, placement of composite resin is made more difficult, especially when used with composite resin that is highly viscous. Referring to Fig. 25, a tip 292 which is especially useful for initially applying composite resin to these tooth surfaces defines a substantially circular cross section of varying diameter between its proximal and distal ends 296,294, further defining a rounded tip at distal end 294.

More preferably, proceeding in a direction along tip 292 from proximal end 296 to distal end 294, the cross sectional radii incrementally increases to approximately its mid span then incrementally decreases, defining a barrel. When used with apparatus 30 or 100 as previously discussed, tip 292 eases the application of composite resin in bulk to these tooth surfaces.

[00100] Once tip 292 has generally applied composite resin to the tooth surfaces as illustrated in Fig. 22, referring to Figs. 23 and 24, a tip 298 has a novel construction for more precisely locating the composite material between these teeth. Extending from opposed sides of tip 298 are angled surfaces 304 or chevrons defining preferably symmetric angles 306 along tip 298. Angle 306 which measures in the range of about 30 to about 60 degrees, preferably about 45 degrees, provides an excellent interface with composite resin and the embrasure formed between adjacent teeth. Preferably, the length of angled surfaces 304 along tip 298 incrementally increases, proceeding in a direction from proximal end 302 to distal end 300, as the extent of embrasure typically increases along the mandibular incisors in a direction from the incisal edge to the sulcus. When used with apparatus 30 or 100 as previously discussed, tip 298 eases the localized application of composite resin to the embrasures defined between these tooth surfaces by quickly and easily establishing a uniform line of demarcation between the teeth and the dental material. Finally, because dental splints may be applied to either the lingual or labial surface of these teeth, the symmetric construction permits tip 298 to be used on either surface irrespective which tooth surface is used and is compatible for use by both right handed or left handed users without need to obtain another tip.

[00101] Referring to Figs. 26-30, an alternate embodiment of apparatus 200 illustrated in Fig. 6 shall now be discussed. Apparatus 400 includes an adjustable bow comprised of proximal and distal bow portions 404,406 having respective barbs 424 which extend outwardly from bow portions 404, 406 for piercing and securing strip 432.

By actuating adjustment screw 408 in a given direction, bow portions 404,406 are directed into travel along longitudinal axis 430 to either increase or decrease the amount of tension applied to strip 432.

[00102] Further referring to Figs. 26, 27A, 27B, bow portions 404, 406 each include a recess 414 formed therein parallel to bow axis 430 for slidably receiving a pair of opposing flanges 412 extending from a track 402 that is preferably connected to bow portion 404. That is, once engaged in respective recesses 414, bow portion 406 may be directed to slide along axis 430 with respect to track 402. To control the position of bow portion 406, a threaded portion 410 of adjustment screw 408 is slideably received within a channel 418 formed longitudinally in bow portion 406. Threaded portion 410 extends through bow portion 406, threadedly engaging threaded aperture 416 formed in bow portion 404. By actuating head 420 in one direction, threaded portion 410 meshes with threaded aperture 416 for urging head 420 along axis 430 in a direction toward a proximal face 422. By continued actuation of head 420 in the same direction, head 420 abuts face 422 which then urges bow portion 406 into driven movement along axis 430 toward bow portion 404. As bow portion 406 is directed toward bow portion 404, the distance between barbs 424 is decreased to lessen the tension applied to strip 432 due to the space between barbs 424. Similarly, actuating head 420 in the other direction urges head 420 along axis 430 in a direction away from proximal face 422, which increases the distance between barbs 424, thereby increasing the tension applied to strip 432. To ensure bow portion 406 moves in unison with head 420 along axis 430 when head 420 travels away from bow portion 404, referring back to Fig. 26, a radial slot 446 formed in threaded portion 410 rotatably engages a pin 444 which is secured in aperture 445 formed in bow portion 406. In other words, pin 444 prevents movement of head 420 along axis 430 with respect to bow portion 406 while permitting rotational movement of adjustment screw 408 about an axis along channel 418 that is parallel to axis 430 with respect to bow portion 406.

[00103] Referring to Figs. 28-30, flexible strip 432 includes an abrasive region 434 typically composed of a material having a roughened surface or having abrasive particles (not shown) adhering to the opposing surfaces of portion 434, including a coarse sandpaper strip to a fine linen strip. The grit size of the abrasive particles may vary widely to accommodate the desired application. Abrasive region 434 is interposed between two fibrous regions 436. Fibrous region 436 includes a central portion 438 which is composed of soft, resilient fibers for ease of piercing by barb 424 therethrough for securing strip 432 to respective bow portions 404,406. Central portion 438 transitions into an outer portion 442 that is composed of tough, less resilient fibers or cloth for retaining strip 432 along opposing undercuts 428 formed between respective barbs 424 of bow portions 404,406. The composition of these fibers is limited only by their ability to conform with applicable dental industry regulations as well as having sufficient strength to function as intended. Secured by respective undercuts 428 between bow portions 404,406 and opposing ends 426 of barbs 424, the tension of strip 432 is regulated by actuation of adjustment screw 408 as previously discussed. Lessening the tension of strip 432 facilitates use for polishing teeth since increased flexure of strip 432 permits more tooth surface area to be contacted. Due to the extended width W (Fig. 28) defining undercuts 428, as well as the width of barbs 426, the stability of strip 432 is substantially enhanced. Preferably combined widths W and barbs 426 are from about 10 to about 50 percent of the entire width of strip 432. Typically, strip 432 measures from about 1 to 2 inches in length and from about one sixteenth to about one eighth of an inch wide. For ease of piercing central portion 438, substantially parallel slots 440 may be formed therein. Apparatus 400 may be manually manipulated using a tab 448 connected to a handle (not shown) or by a mechanical device which also connects to a tab 448 preferably reciprocating at about 3,000 RPM with a thrust of about 2 to about 3 millimeters, although acceptable results may be achieved with a much broader range of reciprocating frequency and thrust length.

[00104] Referring back to Fig. 26, tab 448 which extends from bow portion 406 is adapted to accommodate apparatus 30,100 (Figs. 1,4) as previously discussed.

Although not specifically shown, it is apparent that additional tabs may extend from any portion of bow portions 404, 406 or track 402. Similarly, adjustment screw 408 may be any of any mechanical construction that permits incremental variation of distance between bow portions 404,406, including, but not limited to turnbuckles, clips, clamps, or telescoping members. Further, track 402 may be integrated into either bow portion 4 049 406 for reduction of parts.

[00105] Referring to Figs. 31 and 32, apparatus 500, which is an alternate embodiment of apparatus 200 in Fig. 6, is now discussed. Apparatus 500 includes a bow 502 having a proximal end 504 for securing a proximal end 512 of blade member 508, and a distal end 506 for securing a distal end 516 of blade member 508 therein. Preferably, a tab 513 of blade member 508 is directed into secure engagement inside a slot 510 formed in end 504, and then end 516 of blade member 508 is directed between a slot 514 formed in a distal end 506 until groove 518 engages a protrusion (not shown) for securing end 516 therein. Blade member 508 preferably maintains the"spring"opening aspect previously described so that when installed, groove 518 is maintained in contact within end 506.

Conceptually, the major difference between apparatus 200 and apparatus 500 is that the profile of apparatus 500 preferably defines a semicircle. More precisely, blade member 508 defines a semicircle. Aperture 520 is preferably positioned at the mid span of bow 502 for adaptably receiving a handle or vibrating apparatus previously discussed, and is substantially positioned in the center of the semicircle. However, as used with apparatus 500, the operating capabilities of vibrating apparatus 30,100 may be advantageously enhanced to include a reciprocal motion capability along the tool-holding axis of each apparatus. More preferably, the extent of reciprocal motion is adjustable, such as 15 degrees in each direction, incrementally increasable to up to about 360 degrees, further being capable of controllably adjustable rotational motion along the tool-holding axis, the apparatus even further having the capability to operate with any combination of vibration, rotating or reciprocating motion. Therefore, as a twisting force 522 is applied about aperture 520 by a handle or vibrating/rotating/reciprocating apparatus operating in reciprocating mode, blade member 508 is directed into a substantially radial movement 524 about aperture 520. Preferably, blade member 508 is sized for an angular range 526 of movement of at least about sixty degrees to each side of reference axis 528, although referring to Fig. 31E9 this range could approach 360 degrees. However, preferably angular range 526 is about forty degrees to each side of reference axis 528 at the lower frequency range of apparatus 30, 100, or alternately, by manual manipulation by the user.

Among the advantages of curved blade member 508 over a"straight"blade is that a curved blade provides additional usable blade length while utilizing the same attach points of the bow.

[00106] Referring to Figs. 31A-31E, alternate embodiments of apparatus 500 may utilize a full circular blade periphery employing 2,3, 4 or more blade members 508 secured to and separated by structural frames 530, or spokes which are preferably, but not necessarily uniformly spaced. Frames 530 may be composed of a resilient material so that upon application of sufficient force by the user, frames may elastically deform, or flex, decreasing the distance between the proximal and distal ends 504,506 securing member 508 therein, thereby permitting an increased amount of surface area contact between the tooth surface of at least one of the adjacent teeth and member 508 as previously discussed in Figs. 14-16. Where bow 502 secures multiple blade members 508, each structural frame may define both proximal and distal ends 504,506, two proximal ends 504 or two distal ends 506. Therefore, although Figs. 31A-31D illustrate an alternating proximal, distal end 504,506 arrangement, any combination may be employed. Blade members 508 preferably are of different thickness and abrasiveness to quickly permit the user to rotate the apparatus and employ the most suitable blade.

Preferably, apparatus 500 defines a circle having a diameter measuring from about 0.50 inches to about 1.25 inches. While a circular blade periphery is preferred due to the constant radial distance from center aperture 520, any number of alternate profiles may be utilized. To provide enhanced safety for the patient, the means to secure blade members 508, which may employ any combination of clamps, screws, cross members, slots, grooves, hooks or any other mechanical construction suitable to secure the blade members to the bow or structural spokes, either one of the means to secure the blades may be designed to disengage from the bow or structural spokes upon exceeding a predetermined load to the blade member so that the blade member does not break, or that the blade member is constructed of materials which causes the blade member to flex to an extent in response to the predetermined blade load such that it cannot be properly used for its intended purpose.

[00107] There are numerous significant advantages associated with this novel construction including: compact operating envelope; patient safety from injury to the tongue or check by a distal tip of the blade; familiarity by users with the curved blade member geometry, since suture needles are generally circular in shape; further familiarity by users with this geometry, since users are adept at working at right angles to the teeth, which is contrary to the conventional straight saws; still even further familiarity by users with this geometry, since users are adept at working with disc-shaped instruments; ease of manipulation of a handle connected to the apparatus, since the user may rotate the apparatus by merely rolling the handle between the thumb and adjacent fingers holding the handle; improved blade member strength due to the dual support; the ability to follow the contours of the teeth toward the incisal or occlusal surfaces; the ability to correct inadvertent fusion between teeth and to reach gingivally located"overhangs"which are typically caused by inadvertent seepage or placement/packing of composite resin, amalgam, or any other restorative material.

[00108] To further assist with overhangs, referring to Figs. 36-38, bladed apparatus 500 may be preferably maintained at a tilt angle 602 from perpendicular with center axis 618. By permitting the user to introduce a desired tilt angle 602, the user can much more easily position bladed apparatus 500 to remove overhangs, irrespective of whether the overhang is manifested in any position in the mouth, including the incisal, occlusal, labial or lingual regions. To permit this variable tilt angle 602, a shaft 600 that both rotatably and pivotally connects shaft 600 to bladed apparatus 500 is required. In other words, bladed apparatus 500 must both be able to rotate or rotatably reciprocate about axis 618 and hingedly pivot about the connection between aperture 520 of bladed apparatus 500 and shaft 600, otherwise bladed apparatus 500 would"wobble"similar to a bent tire rim on an automobile axle. One possible construction to achieve this pivoting connection is to form an opposed pair of spherical portions 604 at the end of a shaft portion separated by a space 608 to permit spherical portions 604 to be inserted inside the corresponding aperture 520 of bladed apparatus 500. Hemispherical grooves 606 are formed in both spherical portions 604. Aperture 520 has a pattern (not shown) formed in its surface to permit a pivotal connection to the hemispherical grooves 606. When spherical portions 604 are directed inside aperture 520, which is made possible due to space 608 being temporarily decreased sufficiently so that the effective diameter of spherical portions 604 is less than the diameter of aperture 520, the corresponding grooves 606 in spherical portions 604 and at least portions of the surface pattern formed in the surface of aperture 520 mesh, effectively forming a ball and socket connection therebetween. Since the hemispherical grooves 606 mesh with the surface pattern formed in aperture 520, when shaft portion 612 is connected to apparatus 30 that may employ any combination of vibration, rotation or reciprocation, driven rotational movement about axis 618 that is generated by apparatus 30 places shaft portion 612 into driven rotational movement about axis 618 which likewise places bladed apparatus 500 into rotational movement about axis 618. More importantly, the corresponding sliding contact between the hemispherical grooves in the spherical portions 604 and the aperture 520 permits continued driven rotational movement of bladed apparatus 500 about an axis 619 which is perpendicular to tilt angle 602. To maintain this driven rotational movement due to sliding contact between spherical portions 604 and aperture 520 under heavier loads, insertion of an object into space 608 may be desirable.

[00109] Alternately, referring to Fig. 38, a resilient bow 622 of bladed apparatus 620 may included a pair of coaxially aligned reduced diameter portions 624 that are separated by a centered portion 626. Rotatably engaging portions 624 are a corresponding pair of axially aligned grooves 632 formed near the end of a pair of tines 631 in a fork 630. By employing this construction, when engaged, bladed apparatus 620 may rotate about axis 642. However, lacking the ball and socket construction of Figs. 36,37, one having skill in the art will appreciate that there are alternate ways to produce the similar desired rotational effect achieved by the engagement of shaft 600 and bladed apparatus 500.

That is, the ability to remove the"wobble"that bladed apparatus 620 would otherwise exhibit if a plane 646 defined by blade member 644 is maintained at an angle that is not perpendicular to center axis 618. One such alternate way is to permit fork 630 to simultaneously actuate 636 as required along axis 618 as fork 630 is being rotated about axis 618. Non-rotational actuation 636 along axis 618 may be achieved by forming a grooved channel 640 in an adjacent shaft portion 614 that may be connected to apparatus 30. Upon insertion of a shaft portion 612 that axially extends from fork 630 into grooved channel 640, a retention device 638, such as a roll pin, may be directed through aperture 648 formed through both shaft portion 614 and shaft portion 612, retention device 638 being adapted not to pass through end 650 of shaft portion 614. Of course, a universal joint construction similar to that typically employed to transfer engine power in the form of a rotating drive shaft to the differential gears for turning automobile tires. It is also apparent that commercially available abrasive or polishing disks adapted for compatibility with shaft 600 or fork 630 may be employed to address overhangs.

[00110] Referring to Fig. 33, a holder 550 which provides an additional advantage of this construction when used with the vibration apparatus is now discussed. Holder 550 includes a body 552 having preferably two paired sets of opposing fingers 554,556 extending therefrom for securing holder 550 to apparatus 30. Fingers 556 maintain a safe working space between the patient's oral tissue, such as the tongue and cheek (not shown), and the rotating apparatus 500, respectively, by effectively surrounding rotating apparatus 500 therein. Fingers 554 may be secured about the body of apparatus 30 without entirely surrounding it, although one skilled in the art will appreciate that fingers 554 must surround more than 180 degrees of the body to secure apparatus 30 therewith if no fasteners are involved. Alternately, it is apparent that holder 550 could also be adapted for use with apparatus 100 or a conventional dental handpiece.

[00111] Referring to Figs. 33A-33C, alternate embodiments of holder 570,580 are illustrated which may require a single pair of fingers 554 for securing the holders to apparatus 30. Preferably, holder 570, 580, as well as holder 550 (Fig. 33), may be secured to apparatus 30 by recesses 558 spaced along the length of the body of apparatus 30. Fingers 554 are engageable in any of recesses 558 for maintaining the holders in an axial direction along the body of apparatus 30. To maintain the holders in a fixed radial direction, that is, to prevent the holders from spinning around apparatus 30, the holders are provided with an radially inward protruding tab (not shown), preferably adjacent fingers 554, for slidably engaging a slot 560 formed in an axial direction along the body of the apparatus 30. With this construction, the holders may be secured in a stowed position (Fig. 33A), in which fingers 556 do not extend past body 32 of apparatus 30, or an open position (Figs. 33B, 33C) in which fingers 556 surround apparatus 500 to protect oral tissues. For ease of use, referring to Figs. 33A, 33B, raised portions 559,561 along respective proximal and distal ends 562,564 permit the user to apply an axial force 566 to either raised portion 559,561, depending upon the user's preference. That is, by application of sufficient force 566 substantially along slot 560 to raised portion 559 in a direction toward apparatus 500, fingers 554 disengage from recess 558 which permits holder 570 to slide along body 32 until fingers 554 engage the adjacent recess 558, extending fingers 556 past the end of body 32 in a surrounding position about apparatus 500. As illustrated in Fig. 33B, fingers 554 may engage/disengage several recesses 558 until fingers 556 are desirably positioned about apparatus 500. Alternately, application of force 566 in a direction away from apparatus 500 to raised portion 564 likewise permits holder 570 to slide along body 32, disengaging fingers 554 from recesses 558 until fingers 556 are desirably positioned with respect to apparatus 500, such as the stowed position.

[00112] Referring to Figs. 33,33A-33C, it is noted that embodiments of holder 550, 570,580 may employ any number of different constructions that may advantageously provide improved visual access (Fig. 33C) so long as fingers 566 or similar extending members provide protection to the soft oral tissues.

[00113] Referring to Figs. 34 and 35, tips for use prior to placing dental sealants shall now be discussed. While sealants may be spread effectively using apparatus 30, 100 (Figs. 1, 4) and appropriate tips, abrasive tips, preferably brush tips 600 may be employed to better prepare a surface for bonding to the sealant. It has been found that sealants adhere better to surfaces, especially recessed occlusal grooves that have been"roughed up."While a diamond bit is most preferred for this task, diamond bits may only be used by dentists. Since dental assistants or dental hygienists, which are both referred as ("DAs"), typically perform sealant placement, an abrasive tool that may be adapted for use by the dental assistant is brush tip 600. Since the DA already has much experience with the use of rotating brushes and the prophy handpiece with its feel, its pressure/torque, and its speeds, there would not have to be a"learning curve"for the DA.

[00114] Brush tip 600 includes a tapered end 602 for aligning abrasive bristles 610 in a focused point 612 having an opposed end 604 that may be adapted for securing to apparatus 30, 100. Abrasive bristles 610 which may be composed of metal wire or other materials having sufficient abrasiveness to roughen-up tooth structure, but not cut into the structure. Bristles 610 should also be capable of being sterilized by conventional means including cold solutions, autoclave or alternately, be disposable. To secure bristles 610 in their aligned position, a retainer 608 having a base 609 engages a circumferential groove 606 to maintain the position between retainer 608 and tapered end 602. A side 611 of retainer 608 and tapered end 602 collectively define a substantially toroidal channel 614 which surrounds bristles 610. By crimping side 611 about abrasive bristles 610 as is well known in the art, bristles 610 are secured having focused point 612 which forms a stronger bristle construction, thereby permitting greater lateral forces to be applied.

Preferably, bristles 610 are of uniform length, but may vary significantly in length, since shorter bristles 610 terminating short of point 612 may provide improved abrasive properties in that region of the brush. Alternately, referring to Fig. 35, bristles 610 are maintained by retainer 608 in a substantially parallel arrangement defining a substantially flat surface which may be advantageously applied for preparing tooth surfaces for other dental restorations such as direct veneers or splinting. Therefore, the following method may be employed, perhaps by the better-trained DA to"roughen-up"the tooth grooves: DA provides an overall cleaning of teeth, including grooves with apparatus 30,100 (Figs.

1,4) or a conventional"prophy"hand piece and prophy paste; DA roughens-up teeth grooves using highly abrasive pointed bristles 610 having a focused point 612 and, in addition if needed, a heavily abrasive prophy paste; DA flushes teeth surface and grooves preferably utilizing sodium hypochlorite or hydrogen peroxide, preferably employing a disposable plastic syringe, optionally using apparatus 30,100 and bristles 610; DA performs etching/bonding in a conventional manner ; DA places and vibrates/flows dental material along grooves with apparatus 30,100 preferably employing a brush tip composed of stiff bristles composed of artificial materials due to superior results obtained. Due to the increased torque levels generated by apparatus 30,100, sealants of higher viscosity than previously thought possible may be employed which results in a more durable, longer lasting sealant layer.

[00115] Referring Fig. 35, it has also been found that stiff bristles 610 composed of synthetic materials when used with apparatus 30,100 (Figs. 1,4) advantageously clean excess dental materials that have been applied, but have not yet cured, including but not limited to, luting cement, composite resin.

[00116] Referring to Figs. 39-41, alternate embodiments of apparatus 261 (Fig. 17) provide further improved treatment of overhangs. Unlike apparatus 261, which loosely secures member 266 within resilient body 264 for release upon sufficient interproximal insertion, apparatus 761 non-releasably secures a member 766 therein. Apparatus 761 includes a cap 762 which slides over an appendage, such as an index finger 760, that is fixably secured to a post 764, or body, at a proximal end 763. Post 764 has an opposed distal end 765 which is securely attached to a proximal end 767 of member 766, preferably by proximal end 767 being embedded in end 765. Member 766 has an opposed end 769 for insertion into an interproximal space. Preferably, post 764 and member 766 are maintained in substantial axial alignment with a central axis 759. Due to the non-resilient construction of post 764, the user may apply an amount of force, if required, to member 766 that is not along central axis 759, or an amount of torque about axis 759 or any other axis to urge member 766 into the desired interproximal position.

[00117] Referring to Fig. 40, an alternate embodiment, apparatus 772, includes releasably securing member 766 therewith by preferably forming a longitudinal slot 774 diametrically through post 764 adjacent distal end 765 for receiving proximal end 767 therein. Upon insertion of proximal end 767 inside distal end 765 between slot 774, the portions of distal end 765 of post 764 separated by slot 774 are brought into securing contact over proximal end 767 by a nut 776 that is threadedly engaged with post 764. By actuating nut 776 in one direction about axis 759, nut 776 is urged into threaded axial movement along axis 759 in a direction away from cap 762 which likewise urges the portions of distal end 765 separated by slot 774 toward each other to compressively secure proximal end 767 therebetween.

[00118] Referring to Fig. 41, a further embodiment of apparatus 761 (Fig. 39) includes an additional apparatus 775 which slides over a different appendage, such as the thumb 770 of the same hand employing index finger 760 used with apparatus 761,772, for improved tactile feel. In this embodiment, end 769 defines a cylindrical or other geometric profile that may be directed into secure contact with a corresponding recess 798 formed in a post 777. This contact may be by press fit, wherein end 769 and recess 798 have corresponding tapered profiles, threaded engagement, detent, cross pins, clamps, adhesives or any number of securing constructions known in the art to maintain a secure but releasable engagement between end 769 and post 777. Alternately, referring to Fig. 45, end 769 is provided with an aperture 794 for secure engagement with a barb 796 that extends along recess 798 outwardly from cap 775 when end 769 is directed inside recess 798. Although end 769 and recess 798 may form a press fit therebetween, barb 796 preferably provides enhanced engagement due to frictional contact with the walls of aperture 794, or partial penetration of barb 796 into the wall of aperture 794 if barb 796 is composed of a material that is of equal or greater density than member 766.

Employing any of these constructions, member 766 may be placed in interproximal contact with overhang 771 while providing the user with unparalleled flexibility and control, since member 766 becomes an extension of the user's fingers. The user has the opportunity to orient the abrasive surface of member 766 at any rotational orientation along axis 759 to permit optimum angular access to overhang 771. To begin removal of overhang material 771 once member 766 has been secured between posts 764,777, whether or not member 766 has been interproximally inserted between adjacent teeth 773, the user need only move his wrists to effectively manipulate member 766 between adjacent teeth 773. That is, by utilizing the wrist, it is not necessary for the user to actuate his respective index finger and thumb 760,770 to likewise actuate member 766.

Rather, the user may advantageously utilize the tactile feel between his index finger and thumb 760,770 to controllably maintain member 766 at a desired tension level, and may controllably reduce the distance therebetween which likewise reduces the tension level in member 766, thereby permitting the user to increase the amount of the abrasive surface of member 766 in contact with overhang 771. Upon completion of removal of overhang material 771 by member 766, end 769 may be separated from post 777 so that member 766 may be retracted from its interproximal position between adjacent teeth 773. Due to the increased tactile feel and manipulative capability acquired by use of this uniquely adaptable construction, member 766 may be composed of metal ribbon in addition to other flexible fibrous materials earlier disclosed, such as 432 strip (Fig. 30), permitting member 766 to be constructed of decreased thickness and width for improved access to overhangs. This construction may be utilized for sawing, sanding or polishing overhangs or other areas and conditions as desired. Another significant benefit of the user's increased tactile control with a single hand is that the user's other hand may be utilized to protectively secure the patient's lip from contact with member 766, significantly reducing the occurrences of the patient's lip being cut by an abrasive, which is a common problem in dentistry.

[00119] Referring to Figs. 42-44, a further embodiment of apparatus 500 (Figs. 31A- 31E) utilizes a full circular blade periphery employing a plurality of blade members.

Referring specifically to Fig. 42, apparatus 779 is formed by rotating frame spokes 530 in rotational direction 800 so that the spokes 530 define an acute angle 790 with respect to a center axis 778. Extending from the ends of spokes 530 are corresponding proximal, distal ends 504,506 for securing blade members 508 (not shown for clarity) therebetween as previously discussed. When installed, any portion of each of the blade members 508 are configured to lie substantially within the profile established by spokes 530. In other words, blades members 508 collectively define a lenticular disk defining a convex profile. One end of blade members 508 is removable to access an interproximal space between adjacent teeth as previously discussed. By this novel angled arrangement of spokes 530 which likewise provides an angled arrangement of blade members 508 from the center axis 778, apparatus 779 provides the user with improved comfort, flexibility and vantage point to direct the apparatus 779 slightly out of the parallel orientation otherwise required to remove overhang material from an interproximal space between adjacent teeth.

[00120] Referring to Figs. 43,44, apparatus 30,100 (Figs. 1,4) may further utilize the advantageously contoured rotating abrasive lenticular apparatus 779 to also work with overhangs that are somewhat more accessible than those located in or along the interproximal space between adjacent teeth. These types of overhangs typically are located adjacent the occlusal tooth surfaces. As used herein, the term rotating includes both rotating and reciprocating motion. Lenticular apparatus 779 defines a convex profile which rotates about center axis 778. To remove overhang material, lenticular apparatus 779 has an abrasive distal convex surface 781 defined by the surface of blade member 508. In this application, the opposed proximal convex surface 783 also defined by the surface of blade member 508 may be non abrasive. The terms proximal and distal are used in reference to the apparatus 100. That is, the term proximal as used herein indicates that the proximal surface faces toward apparatus 100 and that the term distal indicates that the distal surface faces away from apparatus 100. Providing improved access to this overhang material, the blade member 508 extends outwardly from center axis 778 as secured between respective proximal, distal ends 504,506. The acute angle 790 measured from axis 778 to blade member 508 defines the directional sense of blade member 508. That is, blade member 508 extends from axis 778 in a direction slightly toward apparatus 100. Distal surface 781 of blade member 508 is uniquely adapted to remove overhang material that has accumulated along a forward portion 789 of a tooth positioned adjacent a forward portion 785 of the patient's mouth. It is apparent that this lenticular construction permits the user to maintain apparatus 30,100 in a substantially parallel orientation with respect to jaw line 793. This parallel orientation is comfortable for the user to maintain, provides the user with an excellent vantage point and permits the user the flexibility to direct lenticular apparatus 779 slightly out of the parallel orientation as required to remove overhang material.

[00121] Alternately, referring to Fig. 44, is a lenticular apparatus 780 which also defines a convex profile that rotates about center axis 778. To remove overhang material, lenticular apparatus 780 has the abrasive proximal convex surface 783 defined by the surface of blade member 508. The opposed distal convex surface 781 defined by the other surface of the blade member 508 may be non abrasive. Providing improved access to this overhang material, the blade member 508 extends outwardly from center axis 778 as secured between respective proximal distal ends 504,506. The terms proximal and distal retain the meaning previously defined for lenticular apparatus 779. Acute angle 790 measured from axis 778 defines the directional sense of blade member 508. That is, blade member 508 extends from axis 778 in a direction slightly away from apparatus 100.

Proximal surface 783 of blade member 508 is uniquely adapted to remove overhang material that has accumulated along a rearward portion 799 of a tooth positioned adjacent a rearward portion 787 of the patient's mouth. Lenticular apparatus 780 similarly advantageously permits the user to maintain apparatus 30,100 in a substantially parallel orientation with respect to jaw line 793. Thus, by utilizing the appropriate lenticular apparatus 779,780, depending upon the location of the overhang along the tooth (forward or rear tooth surface) and the location of the tooth (forward or rear portion of the mouth), the user may efficiently remove overhang material.

[00122] Although apparatus 100 of the present invention is shown for use with a user's index finger, it is recognized that"appendage"includes limbs other than hands or fingers and that any finger or combination of fingers may be used with or other than the index finger. Further, due to miniaturization, it is also contemplated that apparatus 100 can be sized for use with only the third segment of the user's finger, including a recess for the third segment.

[00123] While the range of vibration frequencies for the many application has not been fully determined, frequencies exceeding 1,500 RPM have been successfully employed for luting. However, vibration frequencies below 1,500 RPM may provide improved control, especially for placement of material in smaller cavity preparations.

[00124] It is apparent to one having skill in the art that the apparatus discussed above may be cold sterilized, autoclaved or even disposable.

[00125] While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted for elements thereof without departing from the scope of the invention. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof. Therefore, it is intended that the invention not be limited to the particular embodiment 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.