Drug – bio-affecting and body treating compositions – Preparations characterized by special physical form – Implant or insert
Patent
1991-12-10
1994-11-08
Page, Thurman K.
Drug, bio-affecting and body treating compositions
Preparations characterized by special physical form
Implant or insert
424434, 433224, 4332281, 433229, 514782, A61K 914, A61K 4736, A61C 502
Patent
active
053624955
DESCRIPTION:
BRIEF SUMMARY
The present invention has for its object an insert material useful for widening the gingival sulcus, substantially without bleeding or oozing.
It is known that the gingival sulcus is a virtual space, located between the tooth and the gum, which it is necessary to widen for example prior to making an impression or for effecting various treatments, such as for example bondings, seals or the treatment of caries in sub-gingival zone, in order to obtain a clean, dry operative field.
The presently known techniques for widening the gingival sulcus may be divided into two groups depending on whether widening is obtained by gingival eviction or retraction.
Gingival eviction is effected either with the aid of an electric bistoury or with the aid of a diamond-charged drill moved by a turbine (rotary curetting).
When an electric bistoury is used, an incision is made, starting from the summit of the gingival scallop and directed towards the bottom of the gingival groove, also called sulcus. The incized tissues are eliminated.
Although leading to a widening of the gingival sulcus with a suitable haemostasis, this method is mutilating and painful and generally requires a local anaesthesia. In addition, it causes a retraction of the gum.
When a diamond-charged drill is used, gingival eviction is effected by dilacerating the marginal gum by the action of the drill, to which is imparted a movement inside the sulcus in order to make a bevel at the level of the limit of the preparation.
This method which is used only in certain specific cases, presents the same drawbacks as the one described previously with reference to the electric bistoury. Bleeding is more prolific and requires a secondary haemostasis.
The processes of gingival retraction are characterized by the positioning in the gingival sulcus of an insert material.
The most current method consists in using a stranded or plaited cotton cord impregnated or not with a solution intended to promote retraction.
This cord is inserted with the aid of a metal double-bend instrument into the sulcus beyond the limit of preparation, before or after the cut of the tooth depending on the methods and type of limit sought.
However, this method suffers from various drawbacks.
Firstly, the positioning of the cord over the whole periphery of the tooth is delicate.
In addition, this process is relatively painful and generally requires a local anaesthesia. Moreover, a frequent lesion is observed of the epithelial attachment as well as haemorrhages or oozing upon withdrawal of the cord for making the impression.
Another method of gingival retraction consists in using, as insert material, a ring made with the aid of a spongy material which may be impregnated with various solutions (haemostatic, astringent, etc. . . ).
The results and drawbacks of this method are identical to those described previously with reference to the use of a cotton cord.
A third method of gingival retraction consists in placing on the prepared tooth a cap made of a spongy material which may be impregnated with various solutions and ensuring retraction by application of an occlusal pressure.
Although rapid and easy to carry out, this method is imprecise and does not ensure a sufficient retraction. It is therefore used at present only to ensure haemostasis after a procedure of gingival eviction.
Finally, it has also been proposed to use, as insert materials, compositions of which certain are used for impression-making, taking the form of an injectable fluid product capable of hardening either by chemical reaction (prior mixture with a hardener) or by physical swelling (absorption of water).
This state of the art is illustrated in particular in documents DE-A-3 737 552, DE-A-3 736 155 and EP-A-0.092 329.
However, such fluid compositions are very difficult to place in the gingival sulcus which is a virtual space whose widening can be obtained only under the effect of a relatively high force.
In addition, it is impossible, with the aid of these "hardening" compositions, to obtain a controlled retraction of the gum and the
REFERENCES:
patent: 4650665 (1987-03-01), Kronenthal et al.
Azpuru C.
Page Thurman K.
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