Apparatus and methods for treating root canals of teeth

Abstract

Apparatus and methods for endodontic treatment of teeth provide effective cleaning of organic material (such as pulp and diseased tissue) from the root canal system. In an embodiment, a compressor system generates high pressure liquid (e.g., water) that flows through an orifice to produce a high-velocity collimated jet of liquid. The high-velocity jet is directed toward a surface of a tooth, for example, an exposed dentinal surface, and impingement of the jet onto the surface generates an acoustic wave that propagates throughout the tooth. The acoustic wave effectively detaches organic material from dentinal surfaces and tubules. The detached organic material is flushed from the root canal system by the liquid jet and/or by additional irrigation.

1 . (canceled) 
     
     
         2 . An apparatus for treating a tooth, the apparatus comprising:
 an enclosure having a mounting surface configured to be positioned against a tooth surface adjacent a treatment region of the tooth, the enclosure defining a chamber outside the tooth adjacent the treatment region and including an access opening in fluidic communication with the treatment region;   an inflow opening to provide a liquid to the chamber and to the treatment region through the access opening to treat the treatment region, the chamber being filled with the liquid when the enclosure is positioned against the tooth; and   a laser configured to direct light to the tooth.   
     
     
         3 . The apparatus of  claim 2 , further comprising an outflow opening to permit organic material and the liquid to be evacuated from the chamber and the treatment region. 
     
     
         4 . The apparatus of  claim 2 , further comprising a handpiece sized and shaped to be gripped by an operator, the enclosure being defined by a distal member supported at a distal portion of the handpiece. 
     
     
         5 . The apparatus of  claim 4 , further comprising a distance sensor configured to indicate a distance between a distal end of the handpiece and a surface of the tooth, the distance sensor comprising the laser. 
     
     
         6 . The apparatus of  claim 5 , wherein the distance sensor comprises a second laser, each laser configured to direct an optical beam that intersects the other beam at a predetermined distance from the handpiece. 
     
     
         7 . The apparatus of  claim 4 , wherein the distal member is configured to be attached to and detached from the distal portion of the handpiece. 
     
     
         8 . The apparatus of  claim 4 , further comprising additional distal members to be coupled to the distal portion of the handpiece. 
     
     
         9 . The apparatus of  claim 2 , further comprising a pressure wave generator exposed to at least a portion of the chamber of the enclosure, the pressure wave generator configured to generate pressure waves in the liquid. 
     
     
         10 . The apparatus of  claim 9 , wherein the pressure wave generator comprises a liquid jet device configured to direct a liquid jet into or onto the enclosure. 
     
     
         11 . The apparatus of  claim 10 , wherein the liquid jet device comprises an orifice that forms the liquid jet and that functions as the inflow opening. 
     
     
         12 . The apparatus of  claim 9 , wherein the pressure wave generator comprises an elongate member having a distal end extending into the chamber. 
     
     
         13 . The apparatus of  claim 9 , wherein the pressure wave generator is configured to generate pressure waves having frequencies comprising widespread acoustic noise. 
     
     
         14 . The apparatus of  claim 9 , wherein the pressure wave generator is configured to generate pressure waves having frequencies in a range from about 1 Hz to about 10 MHz. 
     
     
         15 . The apparatus of  claim 9 , wherein the pressure wave generator is configured to deliver greater than about 20 J of energy to the interior of the tooth. 
     
     
         16 . The apparatus of  claim 9 , wherein the pressure wave generator is configured to direct an energy beam along a beam axis and into the liquid. 
     
     
         17 . The apparatus of  claim 16 , wherein the energy beam has an energy flux in a range from about 50 kW/cm 2  to about 1000 kW/cm 2 . 
     
     
         18 . The apparatus of  claim 9 , wherein the pressure wave generator is configured to generate pressure waves within the liquid having sufficient energy to remove infected or decaying material from the tooth, including at locations remote from the pressure wave generator. 
     
     
         19 . The apparatus of  claim 9 , wherein the pressure wave generator comprises a vibrating mechanical device. 
     
     
         20 . The apparatus of  claim 9 , wherein the pressure wave generator comprises an ultrasonic or megasonic generator. 
     
     
         21 . The apparatus of  claim 9 , wherein the pressure wave generator comprises a piezoelectric transducer. 
     
     
         22 . The apparatus of  claim 2 , further comprising a fluid source configured to be filled with and to deliver a substantially gas-free liquid to the inflow opening and the chamber. 
     
     
         23 . The apparatus of  claim 22 , wherein the substantially gas-free liquid includes less than 1% dissolved gases by volume. 
     
     
         24 . An apparatus for treating a tooth, the apparatus comprising:
 an enclosure having a mounting surface configured to be positioned against a tooth surface adjacent a treatment region of the tooth, the enclosure defining a chamber outside the tooth adjacent the treatment region and including an access opening in fluidic communication with the treatment region;   an outflow opening to permit organic material and liquid to be evacuated from the chamber and the treatment region; and   a laser configured to direct light to the tooth.   
     
     
         25 . The apparatus of  claim 24 , further comprising an inflow opening to provide a liquid to the chamber and to the treatment region through the access opening to treat the treatment region, the chamber being filled with the liquid when the enclosure is positioned against the tooth. 
     
     
         26 . The apparatus of  claim 24 , further comprising a handpiece sized and shaped to be gripped by an operator, the enclosure being defined by a distal member supported at a distal portion of the handpiece. 
     
     
         27 . The apparatus of  claim 26 , further comprising a distance sensor configured to indicate a distance between a distal end of the handpiece and a surface of the tooth, the distance sensor comprising the laser. 
     
     
         28 . The apparatus of  claim 27 , wherein the distance sensor comprises a second laser, each laser configured to direct an optical beam that intersects the other beam at a predetermined distance from the handpiece. 
     
     
         29 . The apparatus of  claim 26 , wherein the distal member is configured to be attached to and detached from the distal portion of the handpiece. 
     
     
         30 . The apparatus of  claim 24 , further comprising a pressure wave generator exposed to at least a portion of the chamber of the enclosure, the pressure wave generator configured to generate pressure waves in the liquid. 
     
     
         31 . The apparatus of  claim 30 , wherein the pressure wave generator comprises a liquid jet device configured to direct a liquid jet into or onto the enclosure.