US 1328459 A
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A. E. SMITH.
INSTRUMENT FOR PRODUCING INTRA-OSSEOUS ANESTHESIA. APPLICATION FILED OCT. 18. I918.
Patented Jan. 20, 1920.
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ARTHUR E. SMITH, OF CHICAGO, ILLINOIS.
INSTRUMENT FOR PRODUCING INTRA-OSSEOUS ANESTHESIA.
Specification of Letters Patent.
Patented Jan. 20, 1920.
. Application filed October 18, 1918. Serial No. 258,706.
To all whom it may concern Be it known that I, ARTHUR E. SMITH, a citizen of the United States, residing at Chicago, in the county of Cook and State of Illinois, have invented certain new and useful Improvements in Instruments for Producing Intra-Osseous Anesthesia, of which the following is a specification.
This invention relates to a means for producing intra-osseous anesthesia and particularly to the provision of improved instruments therefor, said instruments being of a nature to co-act with each other in a novel manner hereinafter set forth. In order that the important advantages of this invention may be understood and appreciated it may be stated that I contemplate the provision of (1) adouble bladed lancet which, with the blades held together makes a minute and clean incision in the tissue after which the blades are permitted to move apart to expose the external alveolar plate of the bone;
(2) a tubular guide or templet havlng a sharp inner end which is then placed in position between the blades of the lancet, its sharp inner end resting against the bone; (3) a drill bearing a definite relation, as to size, to the guide or templet and by which the bone may be partially pierced, the
guide properly locating the drill during its penetration (4) a hypodermic needle having an end of such shape or of such diameter with respect to the diameter of the drill and the hole formed by said drill, that a tight joint may be effected between the needle and the walls of the opening drilled in the bone,
whereby escape of the anesthetizing fluid rearwardly past the needle is effectually prevented.
The superiority of the foregoing agencies will be appreciated when it isunderstood that heretofore it has been. customary to employ an ordinary dental bur or drill, said drill being forced through the soft tissues, periosteum and bone, which resulted in producing a great deal of trauma, hemorrhage and laceration. An ordinary-hypodermic needle having no definite relation to the size of the drill was next employed and it was attempted to find the opening previously drilled, with such needle. In many cases the opening could not be found due to the hemorrhage, etc. In case the opening could not be found when a small drill or bur was employed, a larger bur or drill would then be employed, thus enlarging the opening and increasing the destruction of tissue. After the opening in the bone was found, no fluid tight contact between the needle and the walls of the bone could be established and when it was attempted to inject the solution a great deal of the solution would run back between the needle and the bone and the operator would not know how much of the solution had been injected and'how much of it had been lost. Furthermore, the operator was greatly inconvenienced by the solution running down into the patients mouth or into the operators hand. The bur used actually destroyed tissue and a. gap was left which in many cases caused infection. As this description proceeds it will be seen that by virtue of the instruments devised by me, nerve blocking or local anesthesia of an intra-osseous nature may be produced with a minimum of laceration of the tissue, without inconvenience to the operator and under circumstances which will enable the operator to know with certainty just how much of the anesthetic has been injected.
Further objects and advantages of the invention will be set forth in the detailed description which now follows.
' In the accompanying drawing:
Figure 1 is a perspective view of a double bladed lancet hereinafter described;
Fig. 2 is a side elevation of the guide or templet;
Fig. 3 is a detail view of the drill;
Fig. 4 is a detail view of the hypodermic needle;
Fig. 5 is a greatly magnified View illustrating the drill passing through the guide or templet; and
Fig. 6 is a detail view of the point of the hypodermic needle illustrating the lower end thereof and its relation to the opening edges 8. A rivet 9 passes through the blades 6 and limits the degree of separation of sald blades. The material of the lancet is spring steel and the blades 6 tend to spring apart, after the manner of tweezers. 10 designates the handle of a guide or templet which has 'a reduced neck extension 11 carrying a tapering tubular guide 12. The small end of this guide is sharpened as indicated at 13.
The drill indicated at 15 is adapted to be inserted in a shank 16 of usual and known form and to be operated by the ordinary dental engine. This drill is adapted to pass through the bore 17 of the guide 12, said guide then serving to properly locate the drill, it being understood that the drill conforms very closely in diameter to the interior of the bore 17. A hypodermic needle 18 is adapted to fit upon a hypodermic syringe of usual form (not shown) and this needle is similar to needles heretofore employed, but its lower portion is of such diameter, with relation to the diameter of the drill 15, that when this lower portion of the needle is ins'erted in the hole indicated at 20, a fluid tight joint is provided. In'other words, the needle is slightly larger in diameter than the drill, and when the lower end of the needle is inserted in the hole formed by the drill and given a slight turn, a tight joint is provided which will permit the injection of the anesthetizing fluid without the escape of any of'such fluid between the wall of the hole drilled in the bone, and the needle.
In carrying out my invention I proceed as follows: An antiseptic or germicidal solution is first applied to the mucous membrane at the point where the incision is to be made. With a hypodermic syrin e and a very fine needle I then inject into t e tissue at such point an anesthetic containing suprarenin or adrenalin. This produces anemia of the circumscribed part and renders the area bloodless when the lancet and drill are later used. The parts are then ready for the incision.
I may state that my invention is particularly adapted for use .in dental surgery, though not necessarily limited thereto. When used in this relation, the proper place for making the incision and injection depends upon the tooth or teethtobe operated upon or removed. Of course the nature of the operation governs the location and application of the anesthetizing injection. In a broad sense it can be stated that the proper place to make the injection or in ections, for dental surgery, is above and between the apices of the teeth in the upper jaw near or in the mucous fold, and in the lower jaw the same thing holds good, but instead of being above and between the apices of the teeth it is below the apices of the teeth of the lower jaw. In proceedin with the incision and injection the double El aded lancet is grasped and the two blades are squeezed together between the thumb and index finger until the two cutting ends come in contact, thus making a single bladed lancet. lVhile the cutting edges are in contact the lancet is pushed through the tissue at the proper location, entering the mucous membrane at the fold between the cheek or lip and gum tissue and also passing through the periosteum. The end of the lancet now rests upon the external alveolar plate of the superior maxillary bone, or the inferior maxillary bone as the case may be. The blades '6 are then released and spring apart to the degree determined by the rivet 9 which is sufficient to allow the guide or templet 12 to be inserted between the bent extensions 7 of the blades 6 with the sharp inner end 13 of the guide resting upon the outer face of the plate of the bone and not upon soft tissue. It will therefore be seen that the clean separation of the tissue by the double bladed lancet prevents the laceration and destruction of the tissue. The guide or templet 12 is then pressed firmly against the bone and i the lancet is removed. The sharp edge 13 of the guide 12 prevents accidental slipping of the same and this is important as will be presently set forth. The drill 15 actuated b the dental engine of usual type (not shown) is then passed through the bore 17 of the guide 12 and quickly passes through the thin hard outer plate of bone into the soft middle plate of bone. As soon as this is accomplished the drill is withdrawn. A hypodermic syringe carrying the needle 18 is then employed, and this needle is passed through the bore 17 and its inner end enters the opening formed in the bone, it being understood that the guide 12 at this time serves 3 to locate the inner end of the needle in the opening and rendersit unnecessary for the operator to hunt around to locate the open- The anesthetizing liquid is then injected 3 and leakage of the same past the needle is effectually revented in the manner already set forth. Xfter the proper amount of solution has been injected to properly treat the cancellous bony tissue the needle is with- I drawn and just at the time that the guide is removedan antiseptic solution such as tincture of iodin isapplied to the area which is involved while making the injection.
From the foreoing description it will be I seen that the present invention eliminates trauma for the tissues are merely separated by the lancet and then the guide is employed for guiding the drill and needle. After the solution has been injected and the instru- 1 ments removed, the incised edges of the veryminuteopening drop together and it is seldom that one can tell, where the injection was made. Anesthesia is secured immediately following the injection so that teeth, 1
nerves, sections of bone or the likermay be 1 immediately removed.
Having described my invention, what I claim is:
1. In combination, the following cooperative instruments, a double bladed lancet adapted to make an incision in the tissue and to separate the same, a tubular guide of such size as to enter between the blades of the lancet, a drill of such size as to pass through the tubular guide and a hypodermic needle bearing such definite relation to the drill as to form a fluid tight joint with the walls of the opening formed by said drill.
' 2. In combination, the following co6perative instruments, a double bladed lancet adapted to make an incision in the tissue and to separate the same and a drill guide of such size as to fit between the blades thereof.
3. In combination, a drill and a hypodermic needle'having such definite relation as to size that the needle will form a fluid tight joint with the walls of the opening formed by the drill. g
4. In combination, a tubular guide, a drill and a hypodermic needleJaI-I bearing such definite relation as to size to each other that the guide guides the drill and the needle forms a fluid tight joint in the opening formed by the drill.
5. In combination, the following cooperative instruments, a double bladed lancet adapted to make an incision in the tissue and to separate the same,a tubular guide of such.
size as to enter between the blades of the lancet and a drill bearing a definite-relation as to'size with respect to the said guide, all cooperating as and for the purposes set forth. I
6. In combination the following cooperative instruments, a lancet comprising a handle and a pair of spring blades which extend substantially at right angles to the said handle and tend to spring apart and are provided with cutting edges -at the extremity of said right angular portions, a drill guide comprising a handle and a tubular guide carriedby said handle and lying at an angle with respectthereto and of such size as to enter between the blades of the lancet and a drill bearing a definite relation as to size with respect to said tubular guide, all cooperating as and for the purposes set forth.
In testimony whereof I aflix my signature.
ARTHUR E. SMITH.