POWERED SURGICAL INSTRUMENTS

Cross-Reference to Related Applications

[0001] This application is a continuation- in-part of U.S. Patent Application Serial

No. 10/890,711, filed July 13, 2004 and entitled "Powered Surgical Instrument." The

complete disclosure of that application is herein incorporated by reference for all

purposes.

Background of Disclosure

[0002] A tooth may need to be extracted from the mouth for a variety of reasons.

For example, in some situations it may be desirable to extract a tooth that is decayed,

damaged or loose. Other times, teeth may be extracted for 'orthodontic' reasons, such

as to provide room for other teeth, enable other teeth to grow, etc.

[0003] In its most basic form, a tooth includes a crown, which is the upper,

visible portion of the tooth, and a root structure, which is hidden from view in the

boney substructure of alveolar bone comprising the socket. A tooth is secured in

place by a combination of factors, including the structural relationship between the

root structure and the alveolar bone of the gums and the periodontal ligaments

connecting the tooth root structure to the alveolar bone.

[0004] Depending on the type of extraction, removal of a tooth may require the

skills of dentists, oral surgeons, or similar professionals. As used herein, such

professionals are referred to as dental professionals. The term "dental professional"

should be read broadly to include any individual trained or skilled to extract teeth

from a human or animal.

[0005] When a tooth includes a sufficient amount of sturdy crown to enable a

dental professional to grip the tooth, the tooth may be removed by rocking the tooth

until it is released from the socket. The rocking motion accomplishes at least two

purposes. First, the rocking motion expands the alveolar bone in the region

circumscribing the tooth socket. That rocking motion changes the structural

relationship between the tooth root structure and the alveolar bone. Prior to rocking

the tooth, the root structure and the alveolus are associated such that the alveolar bone

provides a substantial amount of the retentive force on the tooth. The rocking motion

compresses the alveolar bone surrounding the root structure, expanding the tooth

socket away from the root structure.

[0006] Additionally, the rocking motion stretches the periodontal ligaments that

extend from the root structure to the alveolar bone. The stretching of the ligaments

may break some or all of the periodontal ligaments from the bone. In other cases, the

periodontal ligaments may be stretched, but still intact, after completing the rocking

motion to expand the tooth socket. In those cases, the dental professional may be able

to break the tooth free from the ligaments by pulling on the tooth.

[0007] While the rocking technique allows a dental professional to remove a

tooth, the procedure is not ideal. The procedure typically requires the dental

professional to exert a great deal of force on the tooth to compress the alveolar bone.

Additionally, the limited space in the mouth in which the dental professional must

complete this rocking technique complicates the procedure. Furthermore, in some

circumstances, the rocking motion can be applied with too much force damaging the

crown of the tooth before the socket is sufficiently expanded or resulting in damage or

breaks in the alveolar bone. If the crown is sufficiently damaged, the tooth may need

to be treated as a surgical extraction to accomplish the removal. A surgical extraction

traditionally required the removal of bone utilizing a rotary instrument or chisel.

Further, broken alveolar bone may complicate the installation of a dental implant

immediately after extraction, sometimes requiring bone grafts and subsequent implant

placement at a later date.

[0008] The rocking procedure briefly described above may be difficult to perform

when there is little or no crown for the dental professional to grip. For example, in

some patients, the crown may be sufficiently deteriorated, or not sufficiently extended

above the alveolar bone to enable a dental professional to grip the crown. In these

cases, specialized tools may be used to remove bone to allow gripping of the

remaining tooth structure. For example, a drill may be used to drill into the alveolar

bone in the space surrounding the tooth being removed to expose more of the tooth.

Drilling the bone may result in undesired bone removal. In some cases, the drilled out

bone material must then be replaced with graft material and the patient must wait for

the damaged alveolar bone to heal. For example, when a patient is to receive a dental

implant, the patient may have to return after the tooth socket has healed to receive the

implant. The pain and potential complications associated with the bone graft

procedure and the delay in installation of the implant may be undesirable for both the

patient and the dental professional.

[0009] Some dental professionals use manual periotomes during extraction of a

tooth. Manual periotomes may be configured with a shaped tip disposed at an end of

a shaft. In use, the tip may be placed at the base of the crown adjacent the periodontal

ligament space. The dental professional then applies force on the shaft to force the tip

into the periodontal space. A great amount of force may be required to use the manual

periotome and the dental professional's hand and arm may be fatigued by the process.

[0010] As described above, a variety of special tools and techniques have been

developed to improve tooth extraction. Such tools may be specialized for single

purpose use. For example, in a tooth extraction and implantation procedure, separate

instruments may be required to extract the tooth, collect the bone graft material,

prepare the implant site and install the implant. The variety of tools may require the

dental professional to be familiar with and own multiple different instruments. More

than just inconvenient, the use of several different instruments may be expensive for

the dental professional.

Summary of Disclosure

[0011] A powered surgical instrument is provided. In some embodiments, the

powered surgical instrument may include a housing having a proximal end portion and

a distal end portion; a receiver having a proximal end portion and a distal end portion,

at least a portion of the receiver is movably received within the housing, the distal end

portion of the receiver being configured to receive an expander adapted to expand a

tooth socket within a treatment area, wherein the receiver is configured to move

between a first receiver position in which the distal end portion of the receiver is

adjacent the distal end portion of the housing, and a second receiver position in which

the distal end portion of the receiver is spaced from the distal end portion of the

housing relative to the first receiver position; a bias assembly operatively connected

to the receiver and configured to urge the receiver towards the second receiver

position; and an actuator disposed within the housing and configured to move the

receiver at least from the first receiver position to the second receiver position,

wherein the receiver is configured to be selectively moved between the first and

second receiver positions independent of the actuator.

[0012] In some embodiments, the powered surgical instrument may include a

housing having a proximal end portion and a distal end portion; a receiver having a

proximal end portion and a distal end portion, at least a portion of the receiver is

movably received within the housing, the distal end portion of the receiver being

configured to receive an expander adapted to expand a tooth socket within a treatment

area, wherein the receiver is configured to move between a first receiver position in

which the distal end portion of the receiver is adjacent the distal end portion of the

housing, and a second receiver position in which the distal end portion of the receiver

is spaced from the distal end portion of the housing relative to the first receiver

position; a bias assembly operatively connected to the receiver and configured to urge

the receiver towards the second receiver position, wherein the receiver is configured

to be moved from the second receiver position to the first receiver position by pushing

the expander against the treatment area against urging from the bias assembly; and an

actuator disposed within the housing and configured to move the receiver at least from

the first receiver position to the second receiver position, wherein the actuator is

configured to allow a user to tactilely discriminate when the receiver moves from the

first receiver position to the second receiver position and to tactilely discriminate a

rigidity of a portion of the treatment area that the expander has contacted relative to a

rigidity of at least another portion of the treatment area that the expander has

contacted.

[0013] In some embodiments, the powered surgical instrument may include a

housing having a proximal end portion and a distal end portion; a receiver having a

proximal end portion and a distal end portion, at least a portion of the receiver is

slidingly received within the housing, the distal end portion of the receiver being

configured to receive an expander adapted to expand a tooth socket within a treatment

area, wherein the receiver is configured to slide between a first receiver position in

which the distal end portion of the receiver is adjacent the distal end portion of the

housing, and a second receiver position in which the distal end portion of the receiver

is spaced from the distal end portion of the housing relative to the first receiver

position; a bias assembly operatively connected to the receiver and configured to urge

the receiver towards the second receiver position, wherein the receiver is configured

to be slid from the second receiver position to the first receiver position by pushing

the expander against the treatment area against urging from the bias assembly; and an

actuator disposed within the housing and configured to slide the receiver at least from

the first receiver position to the second receiver position, wherein the actuator

includes a plunger configured to slide from a first position in which the plunger is

spaced from the proximal end portion of the receiver, to a second position in which

the plunger contacts the proximal end portion of the receiver when the receiver is in

the first receiver position, and to a third position in which the plunger slides the

receiver from the first receiver position to the second receiver position when the

plunger contacts the proximal end portion of the receiver in the second position.

Brief Description of the Drawings

[0014] Fig. 1 is a perspective view of an embodiment of a powered surgical

instrument of the present disclosure.

[0015] Fig. 2 is a cross-sectional view along line 2-2 schematically illustrating

some components of the embodiment shown in Fig. 1.

[0016] Fig. 3 is a perspective view of another embodiment of a powered surgical

instrument of the present disclosure.

[0017] Fig. 4 is a cross-sectional view along line 4-4 schematically illustrating

some components of the embodiment shown in Fig. 3.

[0018] Fig. 5 is a perspective view of another embodiment of a powered surgical

instrument of the present disclosure.

[0019] Fig. 6 is a schematic view of a surgical instrument according to another

aspect of the present disclosure.

[0020] Fig. 7 is a cross-sectional view of the expander in Fig. 5.

[0021] Fig. 8 is a schematic illustration of a dental implant site preparation device

according to an embodiment of the disclosure.

[0022] Fig. 9 is a cross-sectional view of an alternative dental implant site

preparation device that may be used in cooperation with a powered surgical

instrument of the present disclosure.

[0023] Fig. 10 is a perspective view of another dental implant site preparation

device that may be used in cooperation with a powered surgical instrument of the

present disclosure.

[0024] Fig. 11 is a perspective view of one embodiment of a powered surgical

instrument of the present disclosure.

[0025] Fig. 12 is a cross-sectional view of the embodiment shown in Fig. 11.

[0026] Fig. 13 is a perspective view of one embodiment of a powered surgical

instrument of the present disclosure.

[0027] Fig. 14 is a partial cross-sectional view of the embodiment shown in Fig.

13 taken along lines 14 — 14 on Fig. 13, showing a plunger in a first position and a

receiver in a first receiver position.

[0028] Fig. 15 is the partial cross-sectional view of Fig. 14, showing the plunger

in the first position and the receiver in the second receiver position.

[0029] Fig. 16 is the partial cross-sectional view of Fig. 14, showing the plunger

in a second position and the receiver in the second receiver position.

[0030] Fig. 17 is the partial cross-sectional view of Fig. 14, showing the plunger

in a third position and the receiver in the first receiver position.

[0031] Fig. 18 is a partial view taken along line 18 in Fig. 14 showing the

receiver in the first receiver position.

[0032] Fig. 19 is a partial view taken along line 19 in Fig. 15 showing the

receiver in the second receiver position.

Detailed Description of the Disclosure

[0033] Fig. 1 illustrates, somewhat schematically, a perspective view of a

powered surgical instrument according to one embodiment of the present disclosure.

The powered surgical instrument described below may be used in any suitable dental

or medical application, including, for example, extraction of teeth and dental implant

procedures. Further, such powered surgical instrument may be used in both human

medical and dental applications, as well as veterinary medical and dental applications.

[0034] The drawings depict a plurality of embodiments for the powered surgical

instrument and reference characters may refer to corresponding elements throughout

multiple views. Similarly, the drawings are intended to show illustrative

embodiments that depict a variety of elements and subelements. The elements and/or

subelements described may be selectively embodied in devices according to the

present disclosure alone or in combination with one or more other elements and/or

subelements, regardless of whether the particular selected element, subelement, or

combination thereof is specifically illustrated in the figures. For example, the

powered surgical instrument disclosed herein may include any of the described and/or

illustrated actuation controls, actuators, power supplies, tips, etc., regardless of the

particular combination shown in a specific figure.

[0035] As shown in Fig. 1, powered surgical instrument 10 may include a

housing 12. Housing 12 may be configured as a cylindrical body as shown or it may

have other suitable configurations. At least a portion of housing 12 may be contoured

to be comfortably held in the hand of a dental professional. For example, the housing

may be ergonomically designed to substantially correspond to a user's grip.

Additionally, housing 12 may be provided with gripping features and/or padding to

increase the dental professional's comfort and/or ability to grip the housing. Although

not described in detail herein, housing 12 may include additional features to increase

its functionality and/or its cooperation with other dental instruments and apparatus,

such as holders, chargers, power supplies, etc.

[0036] Housing 12 may include a proximal end portion 14 and a distal end

portion 16. Distal end portion 16 may be configured to receive an expander 18. In

some embodiments, distal end portion 16 may be configured to selectively receive one

of a plurality of tools configured to perform one or more surgical functions. Expander

18, as well as the plurality of selectively receivable tools, will be described in more

detail below.

[0037] Additionally, housing 12 may include an inner portion 15 and an outer

portion 17. The inner portion may be adjacent the expander and/or the receiver, while

the outer portion may be adapted to be held by a user (as discussed above). Inner

portion 15 and/or outer portion 17 may be configured to transmit one or more forces

from the expander and/or receiver to the user. For example, the inner and/or outer

portions may at least substantially be made of one or more metals, such as stainless

steel and/or titanium. Additionally, or alternatively, the inner and/or outer portions

may be at least substantially free from one or more dampening members that are

adapted to absorb one or more forces transmitted by the expander and/or the receiver,

such as rubber guards, etc.

[0038] Although inner portion 15 and outer portion 17 are discussed to be at least

substantially made of stainless steel and/or titanium, one or both of those portions may

alternatively, or additionally, be at least substantially made of any suitable materials

configured to transmit one or more forces from the expander and/or the receiver to the

user holding the outer portion. Additionally, although inner portion 15 and outer

portion 17 are discussed to be at least substantially free from one or more dampening

members, one or both portions may include one or more dampening members.

[0039] Powered surgical instrument 10 also may include a receiver 20 having a

proximal end portion 19 and a distal end portion 21. The distal end portion may be

configured to selectively receive an expander in addition to, or as an alternative to, the

distal end portion of the housing. In some embodiments, receiver 20 may be adapted

to receive one or more of a variety of tools of different dimensions and configurations.

[0040] A locking mechanism may be incorporated in distal end portion 16 of

housing 12 and/or into distal end portion 21 of receiver 20 to accommodate receipt

and securement of the various tools to the instrument. For example, housing 12 and/or

receiver 20 may include at least one locking mechanism similar to the adjustable

chuck customarily used on power drills in the hardware industry. Additionally, or

alternatively, the locking mechanism may include one or more components of the bit

holders described in U.S. Patent Application Serial No. 11/595,540 entitled "Bit

Holders," which was filed on November 9, 2006. The complete disclosure of that

application is herein incorporated by reference for all purposes. Alternatively, or

additionally, distal end portion 16 and/or receiver 20 may include other clamping

mechanisms that will be recognized as suitable for securing differently-sized tools.

[0041] With reference to Fig. 2, powered surgical instrument 10 may include an

actuator 22 disposed within housing 12. As used herein, the term "actuator" includes

a device configured to move one or more other components of the surgical instrument,

such as expander 18 and/or other tool secured by receiver 20 and/or distal end portion

16. In some embodiments, the actuator may additionally, or alternatively, move at

least a portion of the receiver. The movement caused by the actuator may be linear in

one direction or it may be linear in a reciprocating, back and forth motion. When

actuator 22 causes reciprocating movement, actuator 22 may be referred to as a

"reciprocator." Powered surgical instrument 10 may include an actuator 22

configured to move expander 18 in a forward linear motion, such as from a first

position to a second position offset from the first position, such as indicated by

forward directional arrow 32 in Fig. 2. Alternatively, actuator 22 may be adapted to

move expander 18 in a reverse linear motion, such as indicated by reverse directional

arrow 34. Thus, the expander may be driven away from the housing 12, toward

housing 12 or in both directions. In some embodiments, actuator 22 may be

configured to allow a user to select the direction of linear motion, forward 32, reverse

34, or both. In other embodiments, actuator 22 may be configured to alternatingly

move expander 22 in both the forward direction and the reverse direction.

[0042] Actuator 22 may be any suitable linear driving device. For example,

actuator 22 may be a solenoid actuator, a pneumatic actuator, a mechanical actuator, a

motor actuator, a sonic actuator (such as an air turbine driven actuator), a

magnetorestrictive ultrasonic actuator, a piezoelectric ultrasonic actuator, and/or other

suitable actuator(s) capable of causing linear and/or non-linear motion. Fig. 2

illustrates a solenoid actuator 26, which may include a solenoid coil 28 and a plunger

30 configured to slidingly engage the coil. In an illustrative embodiment, solenoid

actuator 26 may be configured to move plunger 30 in the forward direction, shown by

arrow 32, and allow the force of the dental professional pushing instrument 10

towards one or more portions of the treatment area to move plunger 30 in the reverse

direction, shown by arrow 34. Alternatively, solenoid actuator 26 may be adapted to

move plunger 30 in the reverse direction or in reciprocating forward and reverse

directions. Examples of suitable solenoid actuators include solenoid actuators

manufactured by .

[0043] Solenoid actuator 26 may be configured to reciprocatingly move plunger

30 in the forward direction 32 and the reverse direction 34. Such a configuration may

be achieved by using a biasing member to drive the plunger in the reverse direction.

Any suitable biasing mechanism may be used, including a spring, a bumper, such as a

gasket, a reversal of the polarity of the solenoid coil, and/or by other means. In the

embodiment illustrated in Fig. 2, a rubber gasket 33 is illustrated forward of plunger

30. Rubber gasket 33 may be configured to rebound plunger 30 in the reverse

direction preparing it for subsequent movement in the forward direction by actuator

22.

[0044] In some embodiments, a bi-directional solenoid may be incorporated

within the housing. The bi-directional solenoid may decrease the fatigue experienced

by a dental professional and may allow for increased functionality of the instrument.

In an embodiment of surgical instrument 10 where the solenoid is bi-directional,

solenoid actuator 26 may be operatively coupled to expander 18 such that the reverse

motion of plunger 30 also pulls expander 18 in the reverse direction 34.

[0045] Actuator 22 may be configured to linearly drive expander 18 to enable a

dental professional to more easily remove a tooth or perform other surgical functions

within a treatment area. For example, expander 18 may be configured to be

positioned along the periodontal ligament space. In some embodiments, expander 18

may be sized such that it is slightly larger than the periodontal ligament space.

[0046] As the actuator moves expander 18 linearly, the alveolar bone surrounding

the tooth socket is compressed or compacted, thus expanding the socket along the

periodontal ligament space. Expander 18 is thus adapted to expand the tooth socket.

The linear driving motion of the powered surgical instrument operates with sufficient

force to compress the bone surrounding the tooth socket. As a byproduct of the

compression of the bone surrounding the tooth socket, the periodontal ligaments may

be severed or otherwise broken. Once the bone is sufficiently compressed and the

socket is sufficiently expanded, the tooth may be gripped and removed. The linear

motion of the powered surgical instrument facilitates the expansion of the tooth socket

while minimizing the fatigue that would occur if such a procedure was attempted

manually.

[0047] With reference to Figs. 1 and 2, surgical instrument 10 also may include a

power supply. The power supply may be external to housing 12, such as an electrical

connection between surgical instrument 10 and a standard alternating circuit power

supply. Alternatively, the power supply may be disposed within housing 12. In such

an embodiment, the power supply may include batteries, either rechargeable or non-

rechargeable.

[0048] Surgical instrument 10 also may include a power control 38. Regardless

of how power is supplied to surgical instrument 10, power control 38 may be

configured to allow the dental professional to turn the instrument on or off. Surgical

instrument 10 may be considered to be "on" when power is flowing from the power

supply to another component of powered surgical instrument 10, such as actuator 22.

Power control 38 may be disposed on housing 12 as shown in Figs. 1 and 2.

Alternatively, power control 38 may be disposed external to housing 12, such as on an

external control box or other component.

[0049] Surgical instrument 10 also may include an actuation or reciprocation

control 40. Actuation control 40 may be disposed on or within housing 12 or it may

be external to housing 12, such as on an external control box, as will be seen in other

embodiments described below. Actuation control 40 is in communication with

actuator 22. Actuation control 40 may be configured to enable a user, such as the

dental professional, to selectively adjust one or more properties of the actuator and/or

other component(s) of the surgical instrument 10.

[0050] Actuation control 40 may include a variety of user interfaces and controls,

including analog systems and/or digital systems. Actuation control 40 may be a

mechanical controller and/or an electronic controller. For example, in Figs. 1 and 2,

surgical instrument 10 is shown with an electronic controller 42. Electronic controller

42 may include one or more LED displays (or other type of electronic display), one or

more user input devices, such as touch pads, sliders, or dials, and one or more digital

processors to convert the user input into electronic signals.

[0051] Actuation control 40 may include other control systems, including analog

systems incorporating dials and electrical circuitry rather than digital processing,

combinations of analog and digital systems, etc. For example, actuation control 40

may include a combination of digital and analog systems working cooperatively to

enable a user to selectively control or adjust the linear motion as generated by actuator

22. Examples of these and other alternative embodiments will be better understood

with reference to the description below.

[0052] Actuation control 40, in whatever embodiment it is implemented, may be

configured to adjust the linear motion induced by actuator 22. For example, actuation

control 40 may control one or more of the following characteristics or other like

characteristics: the frequency of the linear motion, the intensity of the linear motion,

the stroke-length of the linear motion, and/or other characteristic(s) of the motion.

With continued reference to the embodiment shown in Fig. 1, expander 18 will move

at a given speed (frequency), will travel a certain distance in each direction with each

motion (stroke-length), and will travel with a certain force conveyed by actuator 22

(intensity). Other characteristics that may be controlled by actuation control 40 may

include such things as modifying one or more of these characteristics over time to

create actuation and/or reciprocation patterns. As one example of an actuation pattern,

a user may prefer a lower frequency, intensity, and/or stroke-length at the beginning

of the procedure to ensure proper placement of the instrument and prefer a higher

frequency, intensity, and/or stroke-length after the expansion is underway and the

expander is at least partially maintained in the proper placement by the surrounding

tooth and bone.

[0053] As an illustration of the use of actuation control 40 to enable a user to

selectively control characteristics of the motion generated by actuator 22, the

following examples are provided. In some embodiments, actuation control 40 may

allow a user to select the frequency at which actuator 22 drives expander 18. In some

embodiments, the range of selectable frequencies may range from about 0 Hz to about

40.0 kHz, or anywhere there between. In some embodiments, the upper frequency

limit may be 20 kHz, 10 kHz, or 1.0 kHz. Embodiments with a narrower range of

selectable frequencies also may be configured. For example, in some embodiments,

the selectable range of frequencies may span from about 0 Hz to about 100 Hz. In still

other embodiments, the selectable range may span from about 0 Hz to about 60 Hz.

Actuation control 40 may be configured to allow a user to select a desired frequency

in the range. Alternatively, actuation control 40 may be indexed so that a user can

select from a collection of predetermined frequencies within the range.

[0054] In some embodiments, actuation control 40 may allow a user to operate

actuator 22 such that the actuator moves the expander and/or the receiver at one or

more frequencies adapted to allow a user to tactilely discriminate one or more

movements of the expander, the receiver, and/or the plunger, such as when the

expander moves from the first position to the second position, when the expander

moves from the second position to the first position, when the receiver moves from a

first receiver position to a second receiver position, when the receiver moves from a

second receiver position to a first receiver position, when the plunger moves in the

forward direction, and/or when the plunger moves in the reverse direction. For

example, the one or more frequencies may include frequencies at or above

approximately 5 Hz and/or frequencies at or below approximately 60 Hz. In some

embodiments, those frequencies may allow a user to tactilely discriminate when, for

example, the receiver moves from the first receiver position to the second receiver

position.

[0055] Additionally, or alternatively, the one or more frequencies at which the

actuator moves the expander and/or the receiver may be adapted to allow a user to

tactilely discriminate a rigidity of a portion of a treatment area that the expander has

contacted relative to a rigidity of at least another portion of the treatment area that the

expander has contacted. For example, the one or more frequencies may include

frequencies at or above approximately 5 Hz and/or frequencies at or below

approximately 60 Hz. In some embodiments, those frequencies may allow a user to

tactilely discriminate when, for example, the expander has contacted a tooth socket

relative to contacting gum tissue, cartilage, and/or bone because a patient's bone may

be more rigid than the patient's cartilage, which may be more rigid than the patient's

tooth socket, which may be more rigid than the patient's gum tissue.

[0056] Although the actuator is discussed to be configured to move the expander

and/or the receiver at frequencies between approximately 5 Hz and approximately 60

Hz, the actuator may be configured to move the expander and/or the receiver at

frequencies above 60 Hz and/or below 5 Hz. Additionally, although the frequencies

of the actuator are discussed to allow a user to tactilely discriminate particular

movements of one or more components of the powered surgical instrument, those

frequencies may additionally, or alternatively, allow the user to tactilely discriminate

other movements of one or more components of the powered surgical instrument.

Moreover, although the frequencies of the actuator are discussed to allow a user to

tactilely discriminate when the expander has contacted a patient's tooth socket, the

patient's gum tissue, the patient's cartilage, or the patient's bone, those frequencies

may allow the user to tactilely discriminate a rigidity of other portions of the treatment

area relative to at least another portion of the treatment area.

[0057] Additionally, or alternatively, actuation control 40 may allow a user to

select the intensity at which actuator 22 drives the receiver and/or expander 18. In

some embodiments, the actuator may drive the expander with up to about 1.5 pounds

of force. A user may be able to select an intensity ranging from 0 pounds-force to

about 1.5 pounds-force. Alternatively, actuation control 40 may provide an index of

selectable intensities within the range (and/or outside that range). In other

embodiments, actuator 22 may drive expander 18 with a lower maximum force, such

as 0.75 pounds-force or 1.0 pounds-force. Although the actuator is discussed to drive

the receiver and/or the expander with particular force(s), the actuator may be

configured to drive the receiver and/or the expander with any suitable force(s), such as

one or more forces greater than 1.5 pounds-force.

[0058] In some embodiments, actuation control 40 may enable a user to select the

stroke-length that actuator 22 provides expander 18. As described above, in the

embodiments where a solenoid actuator is used, actuation control 40 may adjust the

stroke-length by modifying the extent to which plunger 30 is driven in the forward

direction (represented by arrow 32), by modifying the amount of rebound force

provided by a biasing force, and/or by adjusting the position of the solenoid actuator

26 within housing 12. In some embodiments, the user may be able to select a stroke-

length ranging from about 0.01 mm to about 1.0 mm or anywhere there between. In

other embodiments, the stroke-length may be selectable within a range from about

0.01mm to about 0.5 mm. Although actuation control 40 is discussed to adjust stroke-

length between particular ranges, the actuation control may be configured to adjust

stroke-length among any suitable ranges, including ranges outside the particular

ranges described above.

[0059] Referring back to the figures, in some embodiments, housing 12 may be

configured with an operational control 39. Operational control 39 may be disposed on

housing 12 to provide additional control and convenience to the dental professional

performing the surgical procedure. For example, operational control may be

configured to temporarily halt the motion of expander 18 without requiring the dental

professional to modify other settings or reach for other controls. The operational

control may be configured to cooperate with a portion of actuator 22 or with a portion

of expander 18 or both. In some embodiments, operational control 39 may cooperate

with power control 38 and/or with actuation control 40. Although shown at the distal

end portion 16 of housing 12, operational control 39 may be disposed on any suitable

location on the housing of the instrument or accessible component of the instrument.

[0060] Referring now to Figs. 3 and 4, an alternative embodiment of a powered

surgical instrument is illustrated in a somewhat schematic perspective view. As

described above, components of this embodiment may be interchangeable with the

earlier and later described embodiments and are not limited to the combinations as

shown in the illustrative figures. As in Figs. 1 and 2, the powered surgical instrument

110 of Figs. 3 and 4 includes a housing 112 with a proximal end portion 114, a distal

end portion 116, an inner portion 115, and an outer portion 117. Distal end portion

116 may be configured to receive an expander 118. Surgical instrument 110 also may

include a receiver 120 having a proximal end portion 119 and a distal end portion 121

as described above. The expander 118 in Fig. 3 has a slightly different configuration

than expander 18 of Fig. 1. That difference will be discussed in detail below.

[0061] The embodiment shown in Figs. 3 and 4 also includes an actuator 122 to

move expander 118. Like in the embodiment shown in Figs. 1 and 2, actuator 122

may be configured to move expander 118 in a linear motion. However, actuator 122

of the embodiment illustrated in Figs. 3 and 4 is a pneumatic actuator 126 as opposed

to solenoid actuator 26 of Figs. 1 and 2. Pneumatic actuator 126 may include one or

more pneumatic devices, represented schematically at 128, capable of pneumatically

moving plunger 130 to move expander 118 in a linear motion. As with solenoid

actuator 26, pneumatic actuator 126 may be configured to drive plunger 130 in the

forward direction, shown by arrow 132, in the reverse direction, shown by arrow 134,

or in both the forward and the reverse directions, either selectively or alternatingly.

[0062] Surgical instrument 110 incorporating pneumatic actuator 126 also may

include a compressed air supply 144 in communication with pneumatic actuator 126.

Compressed air supply 144 may supply a stream of compressed air to an actuation

control 140. For example, as shown in Fig. 3, actuation control 140 may have an air

input 146 and an air output 148. Alternatively, compressed air supply 144 may

provide compressed air directly to housing 112 and pneumatic actuator 126. In some

embodiments, pneumatic actuator 126 or actuation control 140 may be configured

with a plurality of valves, channels, and other components adapted to allow a user to

selectively control the linear motion provided by the actuator, such as forward only,

reverse only, or reciprocating motion.

[0063] Air from compressed air supply 144 may be directed into instrument 110.

For example, as shown in Fig. 4, pneumatic actuator 126 may include a housing air

inlet 154, an air feed 150, and an air vent 152. Housing 112 also may include an air

vent 156. In some embodiments, actuation control 140 will control the air supply to

pneumatic actuator 126 to cause plunger 130 to drive expander 118 in a linear motion.

Alternatively, a steady stream of compressed air may be provided to pneumatic

actuator 126 and the pneumatic actuator may control the movement of plunger 130.

[0064] As shown in Fig. 3, actuation control 140 may include one or more

controls to allow a user to selectively adjust the linear motion as described above. For

example, in the illustrated embodiments, actuation control 140 may include user-

maneuverable dials that may be selectively adjusted during a procedure. Similar to

the embodiments shown in Figs. 1 and 2, actuation control 140 may be used to

selectively control the frequency of actuation, the intensity of actuation, or the stroke-

length, as well as other characteristics. Actuation control 140 may be part of a

separate control box 158 or, in some embodiments, one or more of the controls may

be disposed on housing 112. Additionally, compressed air supply 144 may be a

separate component as shown in Fig. 3 or it may be incorporated into control box 158.

[0065] When powered surgical instrument 110 is pneumatically driven as in Figs.

3 and 4, the power supply and power control may be different from the power supply

and power control described in connection with the embodiment illustrated in Figs. 1

and 2. For example, there may be several power controls that cooperate to determine

when pneumatic actuator 126 actually moves or drives expander 118. For example, in

some embodiments, there may be a power control on compressed air supply 144, a

power control on control box 158, a power control associated with actuation control

140, a power control on housing 112, a power control associated with pneumatic

actuator 126, a power control associated with more than one of these components, etc.

One or more power controls may cooperate to control when actuator 122 moves

expander 118 in a linear motion. Additionally, one or more of these power controls

may be configured as an operational control 139 (as discussed above in regards to

operational control 39) to temporarily secure expander 118 in a fixed location while

not interfering with the operation of the remaining components.

[0066] Fig. 5 illustrates another embodiment of the powered surgical instrument

of the present disclosure. As described above, components of this embodiment may

be interchangeable with the earlier and later described embodiments and are not

limited to the combinations as shown in the illustrative figures. In Fig. 5, both

actuation control 240 and power source 236 are external to housing 210. Further,

actuation control 240 is shown as a digital readout, but the dials of Fig. 3 or other like

controls may be used without departing from the scope of the disclosure.

[0067] Fig. 5 further illustrates an embodiment wherein powered surgical

instrument 210 includes a pressure sensitive device, such as foot pedal 260. The

pressure sensitive device may be a foot pedal as shown, but also may include other

pressure sensitive devices, such as a touch pad disposed on housing 212. In some

embodiments, foot pedal 260 may cooperate with actuation control 240 to allow a user

additional control over the linear motion during the surgery or procedure. In this way,

pressure sensitive device 260 is similar to operational control 39, 139. However, in

addition to the start/stop functions of operational control 39, foot pedal 260 may be

adapted to allow a user to variably control one or more characteristics, such as

frequency, intensity, etc.

[0068] For example, foot pedal 260 may be configured to allow a user to adjust

the frequency of the motion by applying more or less pressure. In some embodiments,

powered surgical instrument may be provided with more than one pressure sensitive

device, such as a foot pedal and a touch pad. The pressure sensitive device that may

be a component of powered surgical instrument 210 may be adapted to cooperate with

actuation control 240 to allow adjustment up to set maximum. For example, when

foot pedal 260 is used to adjust the frequency of linear motion, actuation control 240

may be adapted to allow a user to set a maximum frequency and foot pedal 260 may

be configured to allow the user to vary the frequency between 0 Hz and the maximum

frequency set on actuation control 240.

[0069] Figs. 6-10 illustrate an embodiment of powered surgical instrument

adapted to prepare a tooth socket for a dental implant. As described above,

components of this embodiment may be interchangeable with the earlier and later

described embodiments and are not limited to the combinations as shown in the

illustrative figures. As in the embodiments described above, the surgical instrument

of Fig 6 may include a housing 312. Housing 312 may include a receiver (indicated

generally at 320) configured to selectively receive a dental implant site preparation

device 318. The actuator (as indicated by general arrow 322) may be any suitable

actuator configured to drive the dental implant site preparation device 318 linearly.

[0070] Fig. 6 illustrates a dental implant site preparation device 318 somewhat

schematically. The expander described above is an example of a dental implant site

preparation device 318 and that the above description of surgical instruments,

actuators, and expander motion also may describe the surgical instrument of Fig. 6

and dental implant site preparation device 318.

[0071] The procedure for installing a dental implant often begins with extraction

of the natural tooth to make way for the implant. However, the natural tooth socket is

generally not naturally prepared to receive a dental implant. For example, the alveolar

bone material around the tooth socket may not be able to securely hold the implant or

the tooth socket may not be properly shaped to receive the implant.

[0072] Illustrative steps for preparing a dental implant site are summarized in box

370 of Fig. 6. For example, such steps may include removing or extracting a resident

tooth, expanding the tooth socket, collecting bone graft material, compacting bone

graft material into the tooth socket and forming the tooth socket to the proper shape.

Additionally, when bone graft material is utilized, the dental professional may treat

the placement area to facilitate proper healing. For example, the bone graft placement

area may be covered with a protective membrane that is secured to the surrounding

bone using bone tacks.

[0073] As illustrated in Fig. 6, a powered surgical instrument may be used to

prepare a dental implant site by selectively securing a dental implant site preparation

device 318 to housing 312. One illustrative dental implant site preparation device

may include an osteotome. The osteotome as an implant site preparation device may

be used in several applications, such as for soft bone to form the site by compressing

the bone lateral, which causes a denser bone to implant interface rather than removing

valuable bone from the surgical site, and/or ridge splitting and/or expansion. A

variety of additional site preparation devices may be used in cooperation with the

disclosed powered surgical instrument, some of which include an expander 372, a

harvester 374, a compacter 376, and a shaper 378. A single site preparation device

may be configured to perform more than one function, such as compaction of bone

material and shaping of the tooth socket.

[0074] Expander 372 may be used to extract the tooth from the tooth socket, as

discussed above. For example, expander 372 may be configured to have a width

slightly larger than the width of the periodontal ligament space. When expander 372

is slightly larger than the periodontal ligament space, the linear motion of the

expander compresses or compacts the alveolar bone surrounding the tooth socket

expanding the socket. Additionally, as the socket expands and expander 372 is moved

further into the periodontal ligament space, expander 372 may be adapted to cut or

sever the periodontal ligaments. Embodiments of expander 372 are illustrated in Figs.

1, 3, and 5 as expander 18, 118, and 218 respectively. Expander 372 may be adapted

to have a relatively flat distal end portion as shown in Fig. 1.

[0075] Alternatively, expander 372 may have a contoured distal end portion as

shown in Figs. 3 and 5. A cross-section of the contoured distal end portion is

illustrated in Fig. 7, which is a cross-sectional view of expander 218 in Fig. 5.

Contoured expander 218 may be adapted to substantially correspond with the contours

of an average tooth. Contoured expander 218 may be formed in a u-shaped

configuration having a bottom portion 262 and a pair of raised portions 264a, 264b.

[0076] Additionally, expander 372 may be configured with a bayonet tip as

shown in Fig. 5. Some embodiments of the implant site preparation device include

one or more bends in the shaft. Such bends in the shaft may be similar to those shown

in Fig. 5 or may include other bends and configurations of the shaft to enable the

dental professional to better access the surgical site.

[0077] Expander 372 may include a variety of devices configured to facilitate

removal of a tooth and/or preparation of a tooth socket for a dental implant. Expander

372 is adapted to expand the periodontal ligament space and may be configured to

have width at the distal end portion greater than the width of the periodontal ligament

space. On average, the periodontal ligament space ranges from 0.25 mm to 0.4 mm.

Expanders 372 of the present disclosure may have a width at the distal end portion

ranging from about 0.25 mm to about 0.75 mm.

[0078] With continued reference to Fig. 6, the powered surgical tool disclosed

herein also may be used with a harvester. Harvester 374 may be used to collect bone

fragment material. An illustrative harvester is illustrated in Fig. 8 and includes a shaft

382 having a distal end portion 384 and a proximal end portion 386. Harvester 374

also may include one or more scrapers 388 disposed adjacent to distal end portion

384. In use, harvester 374 may be used to collect bone fragment material by placing

scrapers 388 in contact with a surface of a bone

[0079] Harvester 374 may be received within the powered surgical instrument

described herein such that the harvester is driven in a collection direction (e.g. toward

the housing) to coincide with the configuration of scrapers 388. However, harvester

374 also may be used in cooperation with a surgical instrument configured to drive in

a forward direction if scrapers 388 were configured accordingly. The driven motion

of harvester 374 coinciding with the configuration of scrapers 388 allows the harvester

to collect bone graft material with less effort and fatigue for the dental professional.

[0080] A compacter 376 also may be received within the disclosed powered

surgical instrument. Compacter 376 may be configured to perform one or more

functions. For example, compacter 376 may be configured to pack bone graft material

into a tooth socket. Additionally, compacter 376 may be configured to compress bone

material surrounding the tooth socket to increase the density of the bone to implant

interface to better receive an implant. As mentioned above, an empty tooth socket is

not generally naturally prepared for receipt of an implant. Bone graft material is often

used to provide the dental professional with material to form a more preferred implant

site. The graft material may be compacted into place, such as by repeated impacts

from compacter 376.

[0081] A shaper 378 also may be received within powered surgical tool 318.

Shaper 378 of Fig. 6 may include a set of site shaping devices 390 illustrated in Fig. 9.

A set of site shaping devices 390 may include one or more shapers 392, 394, 396.

Each shaper 392, 394, 396 may be configured to perform one or more functions

similar to those of compacter 376. For example, site-shaping devices 390 may be

configured to pack bone graft material into a tooth socket. Additionally, site-shaping

devices may be configured to compress bone material surrounding the tooth socket to

densify the bone to implant interface. As shown, the shapers have a rounded distal

end portion but the distal end portion may be configured to meet particular needs or

desires of patients or dental professionals. For example, the shapers may be tapered to

form the site into the proper shape for receiving the dental implant. The difference

between shaper 378 and compacter 376 will be better understood with reference to the

following discussion.

[0082] Once the graft material is compacted into the socket or when graft

material is not used, it may still be desirable to shape the tooth socket. A natural tooth

socket may be oblong or elliptical and many dental implants are circular.

Accordingly, dental implant site preparation may include forming the tooth socket to

correspond with the dental implant. For example, bone graft material may be

compacted into a socket leaving a socket opening that may be smaller than required to

receive the implant. A hole the size of the implant may be drilled into the graft

material but the edges of the hole may not be dense enough or stable enough to secure

an implant.

[0083] A compression and expansion process may be used to form the tooth

socket for receiving an implant and to increase the density of socket. In such a

process, a hole smaller than the diameter of the implant may be drilled to start the

forming process. For example, the dental implant may have a diameter of 5.0

millimeters and a 2.0 millimeter hole may be drilled in the filled-in tooth socket.

Subsequently, a 3.5 mm diameter shaper 392 may be driven into the 2 mm hole. Each

of the shapers 392, 394, 396 may have a tapered distal end portion to allow the larger

compactor to start into the hole prepared by the smaller compacter. The impact of the

larger diameter shaper into the hole compresses the bone graft material outwardly,

densifying the bone and forming the implant site. Shaper 392 may be driven by

powered surgical instrument in a forward direction or in reciprocating motion to

reduce the fatigue on the dental professional. Shaper 392 will form a 3.5 mm hole in

the filled-in tooth socket. Shaper 394 may then be driven into the filled-in tooth

socket by the surgical instrument. Shaper 394 may have a 4.3 mm diameter and may

compress the bone enlarging the tooth socket to 4.3 mm in diameter. The process of

expanding a hole in the fllled-in tooth socket may continue until the hole reaches the

desired diameter. For example, shaper 396 may have a diameter of 5.0 mm to prepare

a dental implant site for a 5.0 mm diameter implant.

[0084] Another dental implant site preparation device 318 is illustrated in Fig. 10.

Tack driver 350 may be adapted to drive tacks into bone surrounding a bone-graft

placement area. For example, typically, once bone graft material is placed in the

implant site from a collection area, the placement area needs to heal. As discussed

above, a dental professional may place a protective membrane over the placement area

to allow the bone to grow back (rather than being displaced by faster growing soft

tissue). The protective membrane may be secured to the bone with bone tacks.

[0085] Tack driver 350 may facilitate the securement of the protective material

through the repetitive linear motion of the powered surgical instrument disclosed

herein. Tack driver 350 may be configured to have a blunt head 352 as shown in Fig.

10. Blunt head 352 may have a flat surface or it may be configured with a slight

concavity 354 as illustrated. Blunt head 352 also may be configured with a plurality

of flanges 356 within concavity 354. A tack may be positioned within concavity 354

on blunt head 352. Flanges 356 may secure the tack. The powered surgical

instrument may then be positioned to drive the tack into place. Once the bone tack is

started into the bone, the flanges will release the tack and the actuator will continue to

smoothly drive the tack into the bone.

[0086] Figs. 11 and 12 illustrate an alternative embodiment of a powered surgical

instrument. The instrument shown in Figs. 1 1 and 12 are illustrative only and may be

combined with one or more of the features and aspects described above and below.

Fig. 11 illustrates a perspective view of powered surgical instrument 410 according to

the present disclosure. As shown in Fig. 11, powered surgical instrument 410 includes

a housing 412 having a proximal end portion 414, a distal end portion 416, an inner

portion 415, and an outer portion 417. The powered surgical instrument also may

include a receiver 420 having a proximal end portion 419 and a distal end portion 421.

[0087] Fig. 12 illustrates a cross-sectional view of the embodiment illustrated in

Fig. 11. Receiver 420 may include a tool holder portion 441 and a shaft portion 443.

The tool holder portion may include any suitable structure configured to removably

hold and/or secure an expander and/or other tool(s). For example, tool holder portion

441 may include one or more components of the tool holders described in U.S. Patent

Application Serial No. 11/595,540 entitled "Bit Holders," which was filed on

November 9, 2006. The complete disclosure of that application has been incorporated

by reference for all purposes.

[0088] Shaft portion 443 may include any suitable structure operatively

connected to the housing. For example, the shaft portion may be movably received

within the housing, such as slidingly, pivotally, and/or rotatably received.

Additionally, or alternatively, shaft portion 443 may be configured to move (such as

slide) among a plurality of positions. For example, shaft portion 443 may be

configured to move between a first receiver position in which distal end portion 421 of

receiver 420 may be adjacent distal end portion 416 of housing 412, and a second

receiver position in which the distal end portion of the receiver may be spaced from

the distal end portion of the housing relative to the first receiver position, as shown in

Fig. 12.

[0089] In some embodiments, the receiver may be configured to be selectively

moved between the first and second receiver positions, which may be independent of

an actuator. For example, surgical instrument 410 may include at least one bias

assembly 445, which may be operatively connected to the receiver and may be

configured to urge the receiver towards the first receiver position and/or the second

receiver position.

[0090] In some embodiments, the bias assembly may allow a user to selectively

move the receiver between the first and second receiver positions, which may be

independent of an actuator moving the expander and/or receiver. Additionally, or

alternatively, the bias assembly may allow a user to selectively move the receiver

between the first and second receiver positions, which may be independent of a user

holding the expander and/or the receiver to move the expander and/or the receiver.

For example, a user may move the receiver from the second receiver position to the

first receiver position by pushing the instrument and/or expander against the treatment

area against urging from the bias assembly, and/or may move the receiver from the

first receiver position to the second receiver position by releasing the instrument

and/or expander from the treatment area and allowing the bias assembly to urge the

receiver from the first receiver position to the second receiver position.

[0091] Although the receiver is discussed to move between first and second

receiver positions, the receiver may be configured to move among any suitable

positions. Additionally, although the receiver is shown to include tool holder portion

441 and shaft portion 443, the receiver may include any suitable structure configured

to removably hold or secure a tool.

[0092] Within the housing 412, powered surgical instrument 410 is illustrated as

including an actuator 422 operatively associated with receiver 420 to move dental

implant site preparation devices that may be received therein. Actuator 422 is

illustrated as a solenoid actuator 426, including a solenoid coil 428 and a plunger 430.

Additionally, actuator 422 is shown including biasing member 433 to drive the reverse

linear motion of plunger 430. In the embodiment of Fig. 12, biasing member 433

includes one or more springs. The actuator may be configured to move the receiver

between the first receiver position to the second receiver position.

[0093] Additionally, or alternatively, the actuator may be configured to allow a

user to tactilely discriminate particular operation(s), movement(s), force(s), and/or

other operating parameter(s), such as when the receiver moves from the first receiver

position to the second receiver position, and/or a rigidity of a portion of the treatment

area that a expander has contacted relative to a rigidity of at least another portion of

the treatment area that the expander has contacted. For example, the plunger may be

configured to move from a first position in which the plunger may be spaced from the

proximal end portion of the receiver, to a second position in which the plunger may

contact the proximal end portion of the receiver when the receiver is in the first

receiver position, and to a third position (shown in Fig. 12) in which the plunger may

move the receiver from the first receiver position to the second receiver position when

the plunger contacts the proximal end portion of the receiver in the second position.

In some embodiments where the plunger includes one or more positions in which it

does not contact the receiver, the actuator may be referred to as being "decoupled"

from the receiver and/or having a "decoupled structure." In some embodiments, the

decoupled structure may allow a user to tactilely discriminate particular operation(s),

movement(s), force(s), and/or other operating parameter(s), such as those discussed

above.

[0094] Figs. 13-19 illustrate an alternative embodiment of a powered surgical

instrument. The instrument shown in Figs. 13-19 is only an illustrative example and

may be combined with one or more of the features and aspects described above. Fig.

13 illustrates a perspective view of powered surgical instrument 510 according to the

present disclosure. As shown in Fig. 13, powered surgical instrument 510 may

include a housing 512 having a proximal end portion 514 and a distal end portion 516.

Additionally, the powered surgical instrument may include a receiver 520 having a

proximal end portion 519 and a distal end portion 521.

[0095] Figs. 14-19 illustrate a cross-sectional view of the embodiment illustrated

in Fig. 13. Housing 512 may include any suitable structure configured to contain one

or more other components of the surgical instrument and/or to provide tactile feedback

to a user holding the housing. For example, housing 512 may include an inner portion

515 and an outer portion 517. The inner portion may be adjacent at least a shaft

portion of the receiver and/or may be configured to transmit one or more forces from

the receiver to outer portion 517. For example, the inner portion may be at least

substantially made of one or more metals, such as stainless steel and/or titanium.

Additionally, or alternatively, the inner portion may be at least substantially free from

one or more dampening members.

[0096] Additionally, or alternatively, the inner portion of the housing may

include one or more support members 524, which may include any suitable structure

configured to support at least a shaft portion of the receiver and/or to transmit one or

more forces from the receiver to the outer portion of the housing. For example, the

support members may include one or more flange bushings 525. The flange bushings

may at least substantially include any suitable materials, such as polyetheretherketone.

[0097] Although flange bushings 525 are discussed to at least substantially

include polyetheretherketone, the flange bushings may alternatively, or additionally,

include any suitable materials. Additionally, although support members 524 is shown

to include flange bushings 525, the support members may alternatively, or

additionally, include any suitable structure configured to support at least a shaft

portion of the receiver and/or to transmit one or more forces from the receiver to the

outer portion of the housing.

[0098] Moreover, although inner portion 515 is discussed to be at least

substantially free from one or more dampening members, the inner portion may

include one or more dampening members. Furthermore, although inner portion 515 is

discussed to include one or more metals, such as stainless and/or titanium, the inner

portion may additionally, or alternatively, include any suitable material(s).

[0099] Outer portion 517 may be configured to be held by a user and/or may be

configured to transmit one or more forces from inner portion 515 to the user. For

example, the outer portion may be at least substantially made of one or more metals,

such as stainless steel and/or titanium. Additionally, or alternatively, the outer portion

may be at least substantially free from one or more dampening members.

[00100] Although outer portion 517 is discussed to be at least substantially free

from one or more dampening members, the outer portion may include one or more

dampening members. Additionally, although outer portion 517 is discussed to include

one or more metals, such as stainless and/or titanium, the outer portion may

additionally, or alternatively, include any suitable material(s). Moreover, although

housing 512 is discussed to include particular structures configured to provide tactile

feedback, the housing may additionally, or alternatively, include any suitable

structure(s) configured to provide tactile feedback.

[00101] Within housing 512, powered surgical instrument 510 may include at

least one actuator 522, which may include any suitable structure operatively

associated with receiver 520 and configured to move one or more bits or dental

devices (such as an expander 518) that may be received by the receiver. Additionally,

or alternatively, the actuator may include any suitable structure configured to allow a

user to tactilely discriminate one or more movements of the expander and/or the

receiver, such as when the receiver moves from the first receiver position to the

second receiver position, and/or a rigidity of a portion of a treatment area that the

expander contacted relative to a rigidity of at least another portion of the treatment

area that the expander has contacted. For example, actuator 522 may include a

solenoid actuator 526, including at least one solenoid coil 528, at least one plunger

530, and at least one biasing member 537, as shown in Figs. 14-17.

[00102] Plunger 530 may move among a plurality of positions. The plunger may

be decoupled and/or spaced from the receiver in one or more of those positions. For

example, the plunger may move among a first position F, a second position S, and a

third position T. In the first position, the plunger may be spaced from proximal end

portion 519 of receiver 520. The plunger may be spaced in that position regardless on

whether the receiver is in a first receiver position or a second receiver position (further

discussed below). In the second position, plunger 530 may contact proximal end

portion 519 of receiver 520 when the receiver is in a first receiver position. In the

third position, plunger 530 may move receiver 520 from a first receiver position to a

second receiver position. Although plunger 530 is shown to move among first

position F, second position S, and third position T, the plunger may alternatively, or

additionally, be configured to move among any suitable position(s).

[00103] The actuator may move the receiver at one or more frequencies adapted to

allow a user (such as a user holding the housing) to tactilely discriminate one or more

movements of the expander and/or the receiver, such as when the receiver moves from

the first receiver position to the second receiver position. Additionally, or

alternatively, the actuator may move the receiver at one or more frequencies adapted

to allow a user to tactilely discriminate a rigidity of a portion of the treatment area that

the expander has contacted relative to a rigidity of at least another portion of the

treatment area that the expander has contacted. For example, the actuator may move

the receiver at frequencies between approximately 5 Hz to approximately 60 Hz.

Although particular frequencies are discussed, the actuator may move the receiver at

frequencies below approximately 5 Hz and/or above approximately 60 Hz.

[00104] Biasing member 537 may include any suitable structure configured to

drive motion of plunger 530. For example, solenoid coil 528 may drive plunger 530

from the first position to the second position and/or to the third position, while biasing

member 537 may drive the plunger from the third position to the second position

and/or to the first position. Biasing member 537 may include one or more springs,

and/or other biasing structures.

[00105] Although solenoid actuator 526 is shown to include coil 528, plunger 530,

and biasing member 537, the solenoid actuator may include any suitable structure

configured to move one or more bits that are secured by receiver 520. Additionally,

although actuator 522 is shown to include a solenoid actuator, the actuator may

alternatively, or additionally, include any suitable actuator, such as one or more of the

other actuators described above.

[00106] Receiver 520 may include any suitable structure configured to removably

hold and/or secure a tool (such as expander 518) and/or to be moved by actuator 522.

For example, receiver 520 may include a tool holder portion 541 and a shaft portion

543. The tool holder portion may include any suitable structure configured to

removably hold and/or secure expander 518. For example, tool holder portion 541

may include one or more components of the tool holders described in U.S. Patent

Application Serial No. 11/595,540 entitled "Bit Holders," which was filed on

November 9, 2006. The complete disclosure of that application has been incorporated

by reference for all purposes.

[00107] Shaft portion 543 may include any suitable structure operatively

connected to the housing. For example, the shaft portion may be movably received

within the housing. Additionally, or alternatively, shaft portion 543 may be

configured to move (such as slide) among a plurality of positions. For example, shaft

portion 543 may be configured to move between a first receiver position R in which

distal end portion 521 of receiver 520 is adjacent distal end portion 516 of housing

512 (as shown in Figs. 15-16 and 19), and a second receiver position C in which the

distal end portion of the receiver is spaced from the distal end portion of the housing

relative to the first receiver position (as shown in Fig. 14 and 17-18).

[00108] Additionally, or alternatively, in the first receiver position, proximal end

portion 519 of receiver 520 may be adjacent plunger 530 of solenoid actuator 526. In

some embodiments, the plunger may be able to contact the proximal end portion of

the receiver and/or move the receiver from the first receiver position to the second

receiver position. Additionally, or alternatively, proximal end portion 519 of receiver

520 may be spaced from plunger 530 of solenoid actuator 526 in the second receiver

position. In some embodiments, the plunger may not contact and/or move the receiver

when the receiver is in the first receiver position regardless of the position of the

plunger. In some embodiments, the plunger and the receiver may be referred to as

being "decoupled" when the receiver is spaced from the plunger, and "coupled" when

the plunger contacts and/or moves the receiver.

[00109] Although a substantial portion of the receiver is shown to be slidingly

received within housing 512, one or more portions of the receiver may alternatively,

or additionally, be pivotally, rotatably, and/or received by the housing in any suitable

way. Additionally, although receiver 520 is configured not to be moved by plunger

530 in the second receiver position, the receiver may be configured to be moved by

the plunger in the second receiver position. Moreover, although shaft portion 543

and/or receiver 520 is shown to move between the first and second receiver positions,

the shaft portion and/or the receiver may alternatively, or additionally, move among

any suitable positions. Furthermore, although the plunger and the receiver is

discussed to be decoupled in at least one of the plurality of positions, the plunger and

the receiver may be coupled in all of the plurality of positions.

[00110] Powered surgical instrument 510 also may include a bias assembly 545, as

shown in Figs. 18-19, which may include any suitable structure operatively connected

to the receiver and/or configured to urge the receiver towards the second receiver

position. For example, the bias assembly may include at least one wave spring 547

that may be configured to urge the receiver towards the second receiver position. The

wave spring may be positioned in any suitable location, such as between tool holder

portion 541 and housing 512. In some embodiments, the bias assembly may allow a

user to maintain the expander at a selected portion of the treatment area while the

receiver is moving between the first and second receiver positions.

[00111] In some embodiments, the bias assembly may allow a user to selectively

move the receiver between the first and second receiver positions, which may be

independent of an actuator moving the expander and/or receiver. Additionally, or

alternatively, the bias assembly may allow a user to selectively move the receiver

between the first and second receiver positions, which may be independent of a user

holding the expander and/or the receiver to move the expander and/or the receiver.

For example, a user may move the receiver from the second receiver position to the

first receiver position by pushing the instrument and/or expander against the treatment

area against urging from the bias assembly, and/or may move the receiver from the

first receiver position to the second receiver position by releasing the instrument

and/or expander from the treatment area and allowing the bias assembly to urge the

receiver from the first receiver position to the second receiver position. In some

embodiments, the ability to selectively move the receiver between the first and second

receiver positions may allow a user to ensure hold the instrument in position while the

receiver and/or expander moves among the plurality of positions.

[00112] Although bias assembly 545 is shown to include wave spring 547, the bias

assembly may include any suitable structure configured to urge the receiver towards

the second receiver position. For example, the bias assembly may alternatively, or

additionally, include leaf spring(s), spiral spring(s), cantilever spring(s), Belleville

spring(s), torsion spring(s), gas spring(s), rubber band(s), etc. Additionally, although

bias assembly 545 is shown to be configured to urge the receiver towards the second

receiver position, the bias assembly may alternatively, or additionally, be configured

to urge the receiver towards the first receiver position and/or other suitable position(s).

Moreover, although powered surgical instrument 510 is shown to include housing

512, receiver 520, actuator 522, and bias assembly 545, the powered surgical

instrument may include alternatively, or additionally, include any suitable structure

configured to removably receive one or more bits and/or move those bits in suitable

direction(s).

[00113] In operation, the receiver of powered surgical instrument 510 may initially

be in the second receiver position and the plunger of the solenoid actuator may

initially be in the first position (such as when the solenoid actuator is in a de-energized

state), as shown in Figs. 14 and 18. A user may grasp the outer portion of the housing

and may move the instrument in position in the treatment area, such as positioning the

expander in the tooth socket. Positioning the instrument and/or resistance from one or

more portions of the treatment area may move the receiver from the second receiver

position to the first receiver position against the urging of the bias assembly, as shown

in Figs. 15 and 19.

[00114] The user may activate the solenoid actuator, which may move the plunger

from the first position to the second position in which the plunger may contact the

proximal end portion of the receiver, as shown in Fig. 16. The plunger may continue

to move from the second position to the third position in which the plunger may move

the receiver from the first receiver position to the second receiver position, as shown

in Fig. 17. The plunger may return to the first position responsive, at least in part, to

de-energizing the solenoid actuator and/or urging from the biasing member, as shown

in Fig. 15. Additionally, or alternatively, the receiver may move from the second

receiver position to the first receiver position responsive, at least in part, to urging

from one or more portions of the treatment area, as shown in Fig. 15. The plunger

may again move towards the receiver to move the receiver.

[00115] One or more components of the instrument, as discussed above, may

allow the user to tactilely discriminate when the receiver moves from the first receiver

position to the second receiver position, from the second receiver position to the first

receiver position, from the second receiver position to the third receiver position,

and/or from the third receiver position to the second receiver position. In some

embodiments, that ability to tactilely discriminate movements of the receiver may

allow the user to estimate how many times the expander has contacted the treatment

area.

[00116] Additionally, or alternatively, one or more components of the instrument,

as discussed above, may allow a user to tactilely discriminate a rigidity of a portion of

a treatment area (and/or other portions of the treatment area) that the expander has

contacted relative to a rigidity of at least another portion of the treatment area (and/or

other portions of the treatment area) that the expander has contacted. In some

embodiments, that ability to tactilely discriminate rigidities of different portions of the

tooth socket and/or treatment area may allow the user to properly position the

expander in desired portion(s) of the treatment area (such as the tooth socket) without

the need to visually verify the proper placement of the expander.

[00117] Although the present disclosure includes specific embodiments, specific

embodiments are not to be considered in a limiting sense, because numerous

variations are possible. The subject matter of the present disclosure includes all novel

and nonobvious combinations and subcombinations of the various elements, features,

functions, and/or properties disclosed herein. The following claims particularly point

out certain combinations and subcombinations regarded as novel and nonobvious.

These claims may refer to "an" element or "a first" element or the equivalent thereof.

Such claims should be understood to include incorporation of one or more such

elements, neither requiring nor excluding two or more such elements. Other

combinations and subcombinations of features, functions, elements, and/or properties

may be claimed through amendment of the present claims or through presentation of

new claims in this or a related application. Such claims, whether broader, narrower,

equal, or different in scope to the original claims, also are regarded as included within

the subject matter of the present disclosure.

[00118] Reference in the specification to "one embodiment" or "an embodiment"

means that a particular feature, structure, or characteristic described in connection

with the embodiment is included in at least one embodiment of the invention. The

appearances of the phrase "in one embodiment" in various places in the specification

are not necessarily all referring to the same embodiment and such features, structures

and/or characteristics may be included in various combinations with features,

structures and/or characteristics of other embodiments.

[00119] In the foregoing specification, the invention has been described with

reference to specific embodiments thereof. It will, however, be evident that various

modifications and changes can be made thereto without departing from the broader

spirit and scope of the invention. The specification and drawings are, accordingly, to

be regarded in an illustrative rather than a restrictive sense.