US 3705585 A
A preformed surgical sponge particularly for use after oral surgery involving extraction of a tooth is preformed to specifically fit over and around the gum area containing a cavity from which a tooth has been extracted. The sponge body is formed with a tapering trough that receives and compresses the gum. A pair of longitudinally extending flange portions on the body are adapted to overlie adjoining teeth and to be clamped between such teeth and opposed teeth to retain the preformed sponge in position. In another embodiment the sponge body is made of a preformed folded strip.
Claims available in
Description (OCR text may contain errors)
United States Patent Safiro [451 Dec. 12,1972
 PREFORMED SURGICAL SPONGE  Inventor: Dennis W. Salim, 10158 Hollow Glen Circle, Los Angeles, Calif. 90024  Filed: July 15,1971
 Appl. No.: 162,927
Related [1.8. Application Data  Continuation-impart of Ser. No. 874,448, Nov. 6,
 U.S. Cl. ..l28/303.1, 32/34, 128/296, 128/325  lnt.Cl ..A61i7/l2, A6lfl3/00, A611) 17/12  Field of Search ...32/34, 35, 36; 128/3011, 156, 128/296, 325
 References Cited UNITED STATES PATENTS 5/1914 Bridges..............................l28/303.1 3/1950 Shrontz ..l28/156X 2,396,203 3/1946 Robinson ..l28/325 FOREIGN PATENTS OR APPLICATIONS 745,770 5/1946 Germany ..l28/325 Primary Examiner-Channing L. Pace Attorney-Gausewitz, Carr & Rothenberg  ABSTRACT A preformed surgical sponge particularly for use after oral surgery involving extraction of a tooth is preformed to specifically fit over and around the gum area containing a cavity from which a tooth has been extracted. The sponge body is formed with a tapering trough that receives and compresses the gum. A pair of longitudinally extending flange portions on the body are adapted to overlie adjoining teeth and to be clamped between such teeth and opposed teeth to retain the preformed sponge in position. In another embodiment the sponge body is made of a preformed folded strip.
12 Claims, 9 Drawing Figures PATENTED DEC 1 2 I972 3. 705, 585
SHEEI 1 [IF 2 INVENTOR DEV/W5 n. 54/7790 PREFORMED SURGICAL SPONGE REFERENCE TO RELATED APPLICATION This is a continuation-in-part of my co-pending application, Ser. No. 874,448, filed on Nov. 6, 1969, for Pre-Formed Surgical Sponge now abandoned.
BACKGROUND OF THE INVENTION 1. Field of the Invention This invention relates to the field of oral surgery and specifically concerns a method and apparatus for treatment of the site of a tooth extraction to assist in reduction of swelling and post-operative bleeding.
2. Description of Prior Art It is common practice in post-operative treatment of tooth extraction sites to provide the patient with a gauze or cotton pad that is rolled or otherwise formed to fit into place by the doctor or his assistant. Such a pad is normally held in place by a clamping action of the opposing teeth. The particular mating of such a pad to the post-operative site is haphazard at best, and fails to provide optimum retention of the tissue in close approximation after surgery. Adequate pressure on the tissue is difficult to obtain with such devices. Further, it often occurs that bleeding of the tissue will recur after the patient has left the dentists office. While it is desirable to be able to reuse or replace the compression pad, conventional devices employed for this purpose cannot be readily reused. Therefore, either the patient will be forced to return to the doctors ofl'ice or, if such recurrence of bleeding is anticipated, an additional supply of conventional gauze pads may be provided. Nevertheless, even in the latter situation, it will be necessary for the patient himself to emplace the pad, a task that would require, at the very least, prior knowledge and experience.
SUMMARY OF THE INVENTION The present invention, according to a preferred embodiment thereof, comprises a prefonned surgical pad for post-operative surgery involving extraction of a tooth which provides improved compression and positioning of tissue, is more readily emplaced, and may be easily cleaned and reused without difficulty by the patient himself.
A preformed surgical pad comprises a body of resilient material having a width greater than the width of the gum and having a length substantially equal to the extent of the extraction site between a pair of adjoining teeth on either side of the site. A pair of integral furcations extending the full length of the body from oppositely disposed edge portions provide an inwardly tapering through that is adapted to receive and compress toward each other the sides of an extraction cavity. In one embodiment a pair of clamping flanges, also formed integrally with the pad body, extend from respectively opposite end portions of the body for a distance sufficient to permit a secure clamping of these flanges between opposing teeth that adjoin the extraction site. In another embodiment, the flanges are formed by expansion of the sponge body over adjoining teeth when the sponge is placed at the extraction site and wetted.
The sponge is formed in a number of different sizes, each particularly configured to closely approximate contours and sizes of different teeth and gum areas.
DESCRIPTION OF THE DRAWINGS FIG. 1 comprises a pictorial illustration of a preformed surgical sponge according to principles of this invention,
FIG. 2 is a cross-sectional view taken through an oral cavity and showing the sponge of the present invention emplaced,
FIG. 3 shows a side view of the device of this invention in place between opposing teeth,
FIG. 4 is a side view of a modified form of the invention,
FIG. 5 is an end view of the modified arrangement of FIG. 4,
FIG. 6 is a pictorial view of an embodiment employing a folded strip of sponge material,
FIG. 7 illustrates a strip of material that is folded to provide the sponge of FIG. 6,
FIG. 8 shows the sponge of FIG. 6 in place at an extraction site, and
FIG. 9 is an illustration of another embodiment of the invention.
DESCRIPTION OF THE PREFERRED EMBODIMENT An essential aspect of post-operative care of most types of surgery includes adequate retention of the adjoining tissue in a suitably fixed position during the healing process. An additional consideration, particularly useful to stop post-operative bleeding, is the compression of the tissue areas adjoining the surgery. Ac cordingly, a resilient pad as illustrated in FIG. I is specifically preformed and sized to closely mate with the tissue area adjoining an oral surgery involving tooth extraction. This provides both optimum positioning of the adjoining tissue and compression of the tissue areas for the purpose of minimizing the bleeding.
The preformed sponge has a resilient body 10 formed with a width indicated as a that is greater than the width of the gum from which a tooth has been extracted. The body has a length b that is substantially equal to the extent of the extraction site between adjoining teeth. Integrally formed with he body 10 and extending downwardly in FIG. 1 from oppositely disposed side portions thereof are a pair of furcations l2 and 14 having facing walls or sides 16 and 18 tapering outwardly to provide a widening trough 20 that is formed to straddle and compress the gum at an extraction site. The furcations l2 and 14 and the trough 20 formed thereby extend for the full length I: of the resilient body which thus provides a pressure exerting side of the device.
Integrally formed with the body 10 and extending from respectively opposite ends of the body for a distance sufficient to overlie at least a portion of the tooth adjoining the extraction site are a pair of clamping flanges 22 and 24. Collectively, the flanges 22 and 24, together with the sponge both therebetween, have a length 0 that is sufficient to substantially span three adjoining teeth, as best illustrated in FIG. 3. As shown in this Figure, these flanges together with the side of the body 10 that is disposed oppositely with respect to the trough 20 provide a pressure receiving side of the sponge pad.
Although the sponge flanges are shown as extending for the full distance of adjoining teeth on either side of the cavity, these flanges may be made considerably shorter. As will be described in connection with another embodiment of the invention, each of these flanges may overlap the teeth adjoining the cavity by only a relatively small amount.
As will be seen in FIG. 2, the gum 28 at the extraction site includes a cavity 30 from which a tooth has been removed. The furcations l2 and 14 are placed downwardly over the sides of the gum compressing the adjoining tissue area and firmly positioning the tissue for proper healing. The sponge pad and its furcations fit between the adjoining cheek tissue 32 and the side of the tongue 34 but is, nevertheless, held firmly in place by the pressure exerted by opposing teeth 36, 38, 40 which are in contact with the upper or pressure-receiving side of the sponge pad as illustrated in FIG. 2.
In the side view of FIG. 3, it can most readily be seen that the flanges 22 and 24 are each clamped between opposing pairs of teeth 36, 42 and 40, 44 to retain the device firmly in position. The opposing tooth 38 intermediate teeth 36 and 40 provides a firm pressure on the pressure-receiving side of the sponge pad directly over the body portion thereof to press such body portion and the trough thereof downwardly over the gum portion 28 for optimum retention of the gum tissue in close approximation.
Opposing tooth 38 will operate to exert a clamping pressure against the pressure receiving side of the sponge pad because of the dimension of the pad (as measured along the axis of the tooth). The pad is formed with an overall height between the innermost portion of the trough and the upper pressure receiving side of the pad so that this pressure receiving side will extend above the gum line by an amount greater than the corresponding extension of adjoining teeth 42 and 44 above the gum line. Accordingly, upon closing of the mouth opposing tooth 38 will contact the pressure receiving side of the sponge pad even if the flanges 22 and 24 only partially overlap adjoining teeth 42, 44.
Illustrated in FIGS. 4 and 5 is an edentulous design specifically adapted for patients having no teeth in the area of the opposing jaw immediately opposite the extraction cavity. In this embodiment, the preformed sponge includes substantially all of the portions, shapes, sizes, and configurations of the sponge in FIG. 1. Thus the sponge pad of this embodiment includes a pair of furcations 1 l2 and 114 depending from edges of a body 100 that includes integral flanges 122 and 124, all constructed and arranged as described in connection with the corresponding components illustrated in FIG. I. In this embodiment, however, for the purpose of insuring and obtaining proper pressure and retention of the sponge pad in the mouth of the patient having an edentulous (toothless) ridge, there is provided a raised portion or protrusion 50 that extends upwardly, as illustrated in FIGS. 4 and 5, from the body 100 between the flanges 122 and 124. The flange has a width it somewhat less than the width 0 of the main sponge body, in order to better conform with the relatively narrow edentulous ridge, and has a length i substantially equal though slightly less than the length b of the body portion I0 so as to provide a pressure-receiving side for the body portion that is substantially coextensive therewith.
It will be readily appreciated that where a patient has had a prior extraction immediately opposed to the extraction which is to be treated with the sponge pad of this invention, there may be lacking a tooth such as that illustrated at 38 in FIG. 3 to provide the required pressure upon the sponge body 10. Any one or more of these teeth 36, 38, and 40 may be lacking. Accordingly, the edentulous protrusion 50 will enable the opposing toothless ridge to contact the sponge body and apply the necessary retaining force and pressure thereto.
Sponges built according to the present invention may be made of either preformed cotton gauze or preformed, absorbent, moderately firm to extra firm foam rubber. Generally, the particular degree of resilience provided can be widely varied within the specific desires of individual dentists. Foam rubber sponges of the present invention can be readily cleaned, rinsed, and reused by the patient himself, if necessary or desirable. It is contemplated that sponges of the type described herein will be pre-sterilized and, preferably, refrigerated just prior to use by the dentist so that the sponge when applied will cool the tissue adjoining the surgery to reduce swelling.
Since the improved tissue positioning and pressure exertion available with the sponge of this invention is particularly due to the specified configuration, it is desirable to make the sponge in a number of different sizes each of which would be most efficiently sized and configured for a different tooth area and different size patients. For example, a small size may be employed for lower anterior teeth, medium size for upper anterior teeth, and upper and lower bicuspids, large size for upper and lower molars, extra large size for multiple extractions and larger surgical sites, and edentulous size for an extraction site with no opposing occlusion.
Typical dimensions (in millimeters) for different sponges of the several sizes are set forth in Table I. It is noted that the various dimensions are identified in FIGS. 1,4 and 5. Although any given dimension may be indicated on the drawings as applied to the edentulous design or the non-edentulous design of FIG. I, it will be readily appreciated that the specific dimensions apply for the sponge pad portions that are common to the two illustrated embodiments.
TABLE I Dimension size a b c d e f g h I Small 8 8 20 6 23 I8 6 Medium l0 I0 25 8 26 20 6 Large l2 I2 28 I0 3! 25 6 Extra Large 12 25 40 8 26 20 6 Edentulous I2 25 40 8 26 20 6 I0 23 Illustrated in FIGS. 6, 7 and 8 is a modified form of the sponge shown in FIGS. 1, 2 and 3. The sponge of FIGS. 6, 7 and 8 may be more readily fabricated with less expensive tooling and from relatively thin sheet material. In this embodiment, the sponge is made from a relatively elongated strip I10 of sponge or similar material having a width 0 corresponding to the width of the sponge of FIG. 1 and having a length b that is greater than the sum of the length of the extraction site and twice the distance that adjoining teeth (such as teeth 42, 44 of FIG. 8) extend from the gum. The strip has a thickness 1 that is one-half the length of the extraction site. As best seen in FIG. '7, the ends of strip lD60l0 om 110 are formed with mutually congruent troughs -a and 20-b that are defined by legs 12a and 140 on the one end of the body and by legs 12b and 14b on the other end of the body.
When the strip is to be used, it is folded about a transverse axis 111 to the form illustrated in FIG. 6. Upon such folding, the congruent troughs 20a and 20b, and legs, pairs 14a and 14b and 12a and 12b are aligned to provide furcations 212 and 214 that are structurally and functionally similar to furcations 12 and 14 of the sponge pad of FIG. 1. Just as with the previously described furcations, those shown in FIG. 6 will straddle and compress the gum at the extraction site, forming a trough 220 that extends for the full length of the sponge body. This trough provides a pressure exerting side of the device.
The sponge material of which strip 110 is formed, will expand when wet. Accordingly, when positioned at an extraction site, as shown in FIG. 8, the sides of the central portion of the folded strip 110, sides 222 and 224, will expand to partially overlap the adjoining teeth 42 and 44, thus providing a pair of clamping flanges of limited extent but similar in structure and function to the clamping flanges 22, 24 of FIG. 1 and flanges 122 and 124 of FIG. 4. As previously described, the length of the strip 110 is greater than the sum of the length of the cavity and twice the extent of the teeth above the gum line. Accordingly, when the strip 110 is folded to form the pad shown in FIGS. 6 and 8, the pressure receiving surface of the pad extends well beyond the grinding surface of teeth 42, 44. Thus, when the sponge is wet, it may freely expand, but only at portions above the teeth 42, 44 (as viewed in FIG. 8), to at least partially overlap these teeth. Thus, all of the opposing teeth 36, 38 and 40 may cooperate to some extent to insure retention of the pad at the cavity site.
Although the embodiment of FIG. 6, 7 and 8 is preferably fon'ned of a relatively thin strip folded in two, as described above, it will be readily appreciated that this embodiment may also be made in a unitary preformed configuration substantially identical to the folded configuration illustrated in FIG. 6.
For large extraction sites and particularly for situations where upper and lower teeth on the same side are extracted, the sponge pad is preformed of a resilient material in the configuration illustrated in FIG. 9. This sponge pad has a width 0 that is substantially the same as the width of the previously described embodiments, and has a length b that is considerably greater. As will be readily understood, this pad may be cut to any smaller size as desired or required for a particular extraction. The arrangement of FIG. 9, being adapted for use where both upper and lower teeth are extracted, is formed with two oppositely disposed and directed troughs 320a and 320b, each extending the full length of the sponge body and each defined by a pair of furcations 3120, 312D and 312e, 312d. Accordingly, the furcations and troughs will straddle and compress the gum at the extraction site for both upper and lower jaws when the pad is placed at the cavity and the jaws are closed.
It will be readily understood that the particular dimensions of the embodiments of the FIGS. 6 through 9, like dimensions of earlier described embodiments, will vary with the type and number of extractions and age and size of the patient. Nevertheless, exemplary dimensions of typical pads of the embodiments of FIGS. 6, 7, 8 and 9 are shown in Table II. These dimensions are all given in millimeters and, as with the previous table, are approximate dimensions only. Obviously other sizes, whether larger or smaller, may be employed for the described sponges as deemed necessary or desirable.
TABLE II Dimension Size a b t x y 2 h Small 13 19 5 3 3 6 Medium 16 25 5 4 4 9 Large 16 25 4 4 9 16 There has been described a preformed surgical sponge that is easy to handle, convenient and aesthetic to use, and which will provide an improved tissue compression and positioning for post-oral surgery to thus reduce bleeding and to aid in healing.
1. A preformed surgical sponge for use after extraction of a tooth comprising a body having a pressure-receiving side of a length sufficient to substantially span three adjoining teeth, said body having a pressure-exerting side oppositely disposed with respect to said pressure-receiving side and having a length substantially equal to a cavity from which a tooth has been extracted, said pressure-exerting side being formed with a longitudinally extending trough adapted to receive a portion of the gum containing said cavity.
2. The sponge of claim 1 wherein said trough has facing walls that are inwardly tapered toward each other,
whereby as the sponge is emplaced at the site of an extraction, the sides of the gum are compressed toward each other and toward the supporting jaw by the wedging action of the tapering trough walls.
3. The sponge of claim 2 wherein said pressure receiving side includes a portion projecting therefrom and having a length substantially equal to the length of said pressure-exerting side,
whereby the sponge may be retained in place by pressure exerted thereon by contact of said projecting portion with an edentulous ridge that is opposite said cavity.
4. The sponge of claim 3 wherein the width of said projecting portion is less than the width of said pres sure-receiving side.
5. A preformed surgical pad for treatment of an ex traction site after oral surgery comprising a body of resilient material having a width greater than the width of a gum and having a length sub stantially equal to the extent of the extraction site between adjoining teeth on either side thereof, said body having a pair of integrally formed furcations each extending for the full length thereof from oppositely disposed edge portions of the body, said furcations tapering outwardly from each other to provide a widening trough adapted to receive and compress toward each other the sides of an extraction cavity, and
a pair of clamping flanges integrally formed with said body; each flange extending from respectively opposite ends of the body for a distance sufficient to permit secure clamping of the flange between a first tooth adjoining the extraction site and a second tooth opposed thereto.
6. The pad of claim including a protuberance integrally formed with said body and extending therefrom between said flanges in a direction opposite to the extent of said furcations,
whereby the pad may be retained in place by pressure exerted thereon by contact of said protuberance with an edentulous ridge that is opposite said cavity.
'7. A method of treating an extraction site after oral surgery comprising the steps of forming a sponge body with a pressure-receiving side having a length sufficient to bridge the site and a tooth on either side of the site,
further forming said body with a pressure-exerting side having a length substantially equal to the extent of said site between said teeth on either side and with a full length trough in said pressure exerting side having tapering walls,
fitting said body to the extraction site with the walls of said trough straddling opposite sides of and compressing the gum containing the extraction site, and with said pressure-receiving side overlying a tooth on either sideof said site, and
applying a force to clamp said pressure-receiving side against the teeth which it overlies, whereby the gum at the extraction area is compressed by and between the walls of said trough.
8. The method of claim 7 including the step of refrigerating said formed sponge body before fitting the body to the extraction site, whereby the gum at the extraction area is also cooled by the walls of said trough.
9. A preformed surgical pad for treatment of an extraction site after oral surgery comprising a body of resilient material having a width greater than the width of a gum and having a length substantially equal to the extent of the extraction site between adjoining teeth on either side thereof, said body having a pair of furcations each extending for the full length thereof from oppositely disposed edge portions of the body, said furcations tapering outwardly from each other to provide a widening trough adapted to receive and compress toward each other the sides of an extraction cavity, said body having a depth greater than the distance that teeth adjoining the extraction site extend from the gum whereby said sponge body when wet will expand over adjoining teeth at the extraction site and provide a pair of clamping flanges extending from respectively opposite ends of the body to at least partly overlap said adjoining teeth so that an opposing tooth may press upon said body and force it against said cavity and against said adjoining teeth. 10. The pad of claim 9 wherein said pad is formed of a strip having a thickness of about one half the length of said body,
said strip having both of its opposite end portions formed with a trough defining first and second pairsof legs, said strip being folded In two so that said end portion troughs are aligned with each other and said pad body is thereby formed of a single strip of folded material.
11. The pad of claim 9 wherein said body has a second pair of furcations each extending for the full length thereof from oppositely disposed edge portions of the body, each extending in a direction opposite to the extent of said first mentioned pair of furcations and toward a second extraction site that is directly opposed to said first mentioned extraction site, the furcations of said second pair tapering outwardly from each other to provide a widening trough adapted to receive and compress toward each other the sides of said second extraction site.
12. A preformed surgical pad for treatment of an extraction site after oral surgery comprising a strip of sponge material adapted to be folded in two and applied to the extraction site, said strip comprising a body having a width greater than the width of the gum at the extraction site, having a length greater than the sum of the length of said site and twice the distance that teeth adjoining said site extend from the gum, and having a thickness of about one half the length of said site, said strip having opposite ends thereof each having a central portion cut away to form a trough bounded by first and second legs, whereby when said strip is folded in half said troughs and legs at opposite ends are aligned with each other to form a unitary trough adapted to receive a portion of the gum at the extraction site, and whereby the central portion of said strip extends beyond the teeth adjoining said site so as to be subject to compression against the site and against adjoining teeth by pressure of a tooth opposite said site.
II! I i I i