US 2317648 A
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April 27, 1943. 1. E. SIQVELAND PROCESS AND APPARATUS FOR PRODUCING INTRAOSSEOUS ANESTHESIA Filed July ;8, 1941 4 mlDovmf ATTORNEY fi a drill held in the usual handpiece.
Patented Apr. 27, 1943 PROCESS AND APPARATUS FOR PRODUC- ING INTRAOSSEOUS ANESTHESIA Ivar E. Siqveland, St. Paul, Minn.
Application July 8, 1941, Serial No. 401,509
My invention relates to an improvement in process and apparatus for producing intraosseous anesthesia, wherein it is desired to provide a simple method of injecting anesthesia into the bone, and a simple apparatus to assist in this method.
Intraosseous anesthesia has never become popular for the reason that there has never been a practical technique of making the injections successfully. Also, there has been a general belief that this method is radical, to be resorted to only if nerve block and infiltration anesthesia do not accomplish the desired results. On the contrary, intraosseous injections produce a positive, more profound anesthesia, and. may be made with less pain than either of the other types.
Intraosseous anesthesia has several advantages over nerve block or infiltration methods. There is no feeling of numbness in the tongue, cheek, or lips during or after the injection, and'there is no after pain. The anesthesia is profound and 1 acts immediately, obviating the necessity of waiting for the anesthesia to take efiect, as with the nerve block and infiltration methods. Fur,- thermore, as only a few drops of the anesthesia are injected, there is no feeling of faintness or in; i
serting the needle therein, unless the hole was of .exactly the same size as the needle, the solution would back up through the hole and around the needle as soon as pressure was exerted on the hypodermic plunger.
The object of the present invention is to provide a method or technique of making intraosseous injections which will avoid these former difficulties, and will simplify the injection process. This may be accomplished through the use of a tiny externally threaded sleeve through which a drill, and a hypodermic needle mayeX- tend. This sleeve is provided with a coupler by means of which the sleeve may be rotated with The drill extends through the sleeve to form an opening through which the sleeve may be threaded, the soft material of the bone spreading to a sufficient extent to permit the sleeve to engage within the same in spite of the fact that. the drill must be slightly smaller in diameter than the sleeve. i
It is an object of the present invention to use this hollow sleeve for guiding a hypodermic needle into the bone. This guiding of the needle into the bone obviates the former difficulty experienced in locating the drilled opening in the bone after the drilling process. As the drill moves through the bone, the sleeve is threaded into the cavity formed, to a depth which is usually two or three millimeters. The drill is then stopped, and withdrawn from within the sleeve, providing a. hollow tube extending into the bone for the purpose of guiding the hypodermic needle into proper position.
A further feature of my invention lies in the sealing of the hypodermic needle with respect to the sleeve, so-that the anesthetic material will not back up, and drain through the sleeve around the needle. This means comprises .a resilient sealing means surrounding the needle which engages the outer surface of the sleeve, to seal the space about the needle within the sleeve.
A further feature of the present invention lies in the fact that the sleeve may remain in place during the treatment of the tooth, so that if the I anesthesia wears off, more may be inserted. By
inserting the needle with the bevel of the needle facing toward the tooth to be treated, the anesthetic may be localized more effectively than is commonly possible. This fact is important, as the operator is enabled to anesthetize only the area on which it is desired to work without anesthesia spreading to other parts.
An additional feature of my invention lies in the fact that the sleeve may be readily removed at the end of the treatment by inserting the drill through the sleeve, engaging the sleeve to rotate with the drill, and reversing the direction of rotation of the drill, the sleeve threading itself out quickly and easily.
These and other objects and novel features of my invention will be more clearly and fully set forth in the following specification and claims.
In the drawing forming a part of; my specifie cation:
Figure 1 is a plan view of a handpiece of the usual type, part of which is broken away,and showing the threaded sleeve and drill secured in place thereupon.
Figure 2 is a side elevation view of a contraangle of usual design, a, portion of which is broken away showing a drill and threaded sleeve secure thereto.
Figure 3 is an elevation view of the threaded sleeve and drill in greatly enlarged size, illustrating the construction thereof.
relation to the threaded sleeve, showing the sealincorporated on the hypodermic needle. p
The handpiece I is of any suitable-or-common ing means design and is constructed to engage the shank l l of the drill 12. The drill I2 is provided with a The shank l6 of the drill [5, as well as the shank II, of the drill [2, may be provided With a flattened end 32 and a groove 33, as illustrated in Figures 3 and 5 of the drawing, to permit rotation of the drill and shank by the dental engine. The construction of the drill shank depends upon the construction of the chuck or other drill holding means, and may be made in any manner common to the shanks of other decoupling flange l3 thereupon for a purpose which will be later described in detail. The shank -Il engages into the handpiece l0 and is rotatably supported to be driven by the usual engine in a manner common "to devices or this type. 'Ihe contra-angle M is also designed tosupport a sirnilar drill which is provided' viiith afs'hank it and a coupling sleeve ll, which is driven through the contra-angle I4 in a manner Well known in the art. The drills 12' and 15 are sir'nilar or identical with'the exception that the shank 1-8 may be differently shaped fromthe shank] l in order to be properly rotated. T-he detail-of the construction of 'the hand ieee ill and the contra-angle M is not described herein "as these devices are well known in the art. Figure 3 of the drawing illustrates the drill l5 and the manner in which it is secured through the coupling flange ll. to thecoupling'fl'ange 19 of the threaded sleeve 20. As bes't illustratedin Figures 3-an'd 4 of the drawing, the slee've ZO is e-x ter nally threaded with fine threads 2 and is hollow to provide a passage 22 therethroug-hfrom end to end. The coupling flange I9 is preferably internally-tapered at 23 to QiIide the dFiIl-IB through the opening 22, and the drill 15 is of sufficient length to extend throughout the length "of the sleeve and to project slightly from the end thereof, as best illustrated in Figure 5of'th'e drawing. The coupling flange IT, as best illustrated i Figure-5 of the drawing, is provided with three -angular-1y spaced pins 24 which engage through similarly spaced apertures 25 in the flange 19. Accordingly When the sleeve 2!] is in place encircling the drill 15, the pins 24 extend through the apertures 25, causing rotation of the coupling flanges l1 and T9 in unison. At the same time,
however, 'it will be obvious that when the sleeve -20 isin position extending into the bone to the proper depth, the drill ['5 'maybe withdfiawn by sliding the same axially from"w ithin the sleeve '20, providing an open passage directly into the bone through the sleeve 26. Y I
The hypodermic syringe 26 'is illustrated in Figures -;6 and '7 of the drawing -anddnclud'es a needle 21 which is hollow to permit the new of anesthetic material therethrough. -The syringe i the resilient washer 29 and the chuck 3'l'"of the Syringe 2B.
A seal-may be provided for this means, as will be later described.
the following steps are ordinarily followed.
The-flanged sleeve 20, as well as the hypoderinie needle, is normally maintained in alcohol, or
-in another cold sterilizing solution. These implements are completely sterilized before use.
The instrument is maintained in readiness for operation in the handpiece or contra-angle, and the needle is maintained in the syringe. At the start of the operation, the areato be treated is then sterilized, and a drop-of the solution may be injected to anesthetize the *interpro'Ximal mucous membrane over the tooth to be operated upon :at a pointslightly away from the free margin of'the gum. A topical anesthetic may also be used at the .point'of' insertion of the sleeve. With the sleeve and coupling flange mounted in place encircling the drill in the handpiece or contra-angle, the mucous membrane is punctured with the drill; Slight-pressure isexerted 'upon the :drill and the dental engine is started into rotation until the drill has pierced the outer alveolar plate of dense bone. The rotating sleeve engages into the opening formed by the drill until the threads on the sleeve have caught and entered the cancellous bone for a distance of two or three millimeters. The engine is then stopped and the drill withdrawn,.leaving the threaded "sleeve in place.
"The spring 3!] is then inserted over the tip of the hypodermic needle and the resilient tip or gasket is then inserted onto the needle. The needle 21 is then inserted through the passage 22 and pressed inwardly until the gasket 29 seals against the tapered portion 23 in the coupling flange [f the sleeve 20.
With the hypodermic needle in place, the plunger is operated to deposit a few drops of the anesthetic solution. During insertion of the needle, the beveled tip "end 34 thereof is faced toward the tooth to bepperated 'on. Pressure againstthe hypodermic needle is app'liedgra'dilally to eliminate (pressure pain, and sufficient pressure is used to firmly seal the gasket 29 against the flange 19.
The .needle 21 may then 'be' removed from within the sleeve 28, and this sleeve may remain in place during the treatment of the tooth, so that if the tooth becomes sensitive before the operation is completed, a few more-drops of the solution 'may be injected in *fl'ange I 9 of the sleeve 20. The direction ofrotation bf thedental engine'isthen reversed, causing the sleeve 2fl'to'be unth-readed from the bone "andremoved.
T I have found .that a profound anesthesia may thus' bebbta'ined fora-cavity preparation, or any otherfdesired operation may be done without rpain. ".The intraosse'ousanesthesia is particularlycsuita-ble' for operations performed ;upon: the
teeth and is recommended primarily for operative dentistry, in the preparation of cavities, for crown and bridge abutments, the dev-italization of pulps, or for any work on hypersensitive teeth, either upper or lower. While extractions may also be done with the aid of intraosseous anesthesia, in most cases one of the other methods is preferable. In extractions it is desirable or necessary to anesthetize the soft tissues on the labial or buccal andlingual surfaces of the jaw.
When inserting the flanged sleeve, it is possible to use a fork-shaped holder to press the flesh about the sleeve during movement of the sleeve into the bone. This prevents any tendency for the flesh to wrap about the threads of the sleeve. Such a holder is indicated at 36 in Figure 3.
With my method, a few drops produces profound anesthesia. As a result, a better anesthetic is produced with less solution. For this reason, my method is extremely economical, as well as less painful, than previous methods.
In accordance with the patent statutes, I have described the principles of construction and operation of my method and apparatus for intraosseous anesthesia, and while I have endeavored to set forth the best embodiment thereof, I desire to have it understood that obvious changes may be made within the scope of the following claims without departing from the spirit of my invention.
1. An apparatus for producing intraosseous anesthesia comprising a sleeve having an ex ternally threaded end, a drill extending through said sleeve and projecting beyond said threaded end thereof, and means'for rotating said drill and sleeve in unison to drill an opening in the bone, and to thread the sleeveinto the drilled opening.
2. An apparatu for producing intraosseous anesthesia comprising an externally threaded sleeve, a drill extending through said sleeve, and extending beyond one end of the same, a drill shank on said drill designed for engagement by a drill rotating means projecting from the other end of said sleeve, and coupling means on said drill and said sleeve to permit rotation of said drill and sleeve in unison to drill an opening in the bone, and to thread the sleeve into the drilled opening, and a drill rotating means engaging said drill shank.
3. An apparatus for producing intraosseous anesthesia comprising an externally threaded sleeve, a flange extending outwardly from one end thereof, a drill extendable through said sleeve to project beyond the end thereof, a drill shank on said drill projecting from the other end of said sleeve, a flange on said drill adjacent said shank, and means on said flanges for rotating said drill and sleeve in unison to drill an opening in the bone, and to thread the sleeve into the drilled opening.
4. An apparatus for use in the treatment of teeth comprising a small diameter externally threaded sleeve, a drill extendable through said sleeve and projecting beyond an end thereof, a drill shank on said drill projecting beyond the opposite end of said sleeve, cooperable means on said sleeve and said drill for rotating said sleeve and drill in unison and for permitting separation of said sleeve and drill upon longitudinal movement of said drill with respect to said sleeve, a drill rotating means engaging said shank, and a tapered end on said sleeve to guide the drill into the opening through the sleeve.
5.An apparatus for producing intraosseous anesthesia comprising an externally threaded sleeve threadable into the bone, a hypodermic syringe having a needle of a size to fit through the opening in said sleeve, and sealing means on said needle engageable with the end of said sleeve to seal the end of said sleeve encircling the needle.
6. An apparatus for producing intraosseous anesthesia comprising an externally threaded sleeve threadable into the bone, a hypodermic syringe including a needle extendable through said sleeve and a resilient gasket encircling said needle and in sealed relation thereto, engageable with the end of said sleeve to seal the needle with respect to the sleeve.
'7. An apparatus for producing intraosseous anesthesia comprising an externally threaded sleeve threadable into the bone, a hypodermic syringe including a needle extendable through said sleeve, a sealing gasket slidable on said needle and sealed with respect to said needle and engageable with the end of the sleeve, and resilient means urging said gasket longitudinally and outwardly along said needle and against the sleeve when said needle extends therethrough.
8. .An apparatus for producing intraosseous anesthesia comprising an externally threadedsleeve, a peripheral flange at one end of said sleeve, a hypodermic syringe including a needle extendable through said sleeve, sealing means slidably mounted on said needle and engageable with said flange to seal the needle with respect to the flange, and resilient means urging said gasket longitudinally and outwardly along said needle and against said flange when said needle extends through said sleeve.
9. An apparatus for producing intraosseous anesthesia comprising an externally threaded sleeve threadable into the bone, a flange extending outwardly from said sleeve at one end thereof, a hypodermic syringe including a needle extendable through said sleeve, and resilient gasket means in slidable sealed relation encircling said needle, slidable longitudinally and outwardly along said needle and engageable with said flange when said needle extends through said sleeve.
IVAR E. SIQVELAND.