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Rice, Brian D; McHenry, Angela; Sinka, Katy; Payne, Lara JC; Baster, Kathleen; Patel, Bela; Evans, Barry G
From the Communicable Disease Surveillance Centre, Health Protection Agency, London, UK.
Correspondence to Brian Rice, MSc, HIV and STI Division, CDSC, Health Protection Agency, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Tel: +44 (0) 20 8200 6868 ext. 4420; fax: +44 (0) 20 8200 7868; e-mail: firstname.lastname@example.com
Received: 31 July 2003; revised: 12 November 2003; accepted: 8 December 2003.
Objective: To predict trends in diagnosed HIV prevalence by extrapolation to 2004 using data from the annual surveys of individuals receiving HIV-related care in England, Wales and Northern Ireland from 1996 to 2001.
Methods: Data from the annual surveys of prevalent HIV infections diagnosed (SOPHID) were adjusted for under-reporting and non-attendance and separately extrapolated for infections acquired homosexually, heterosexually and by other routes. The data were extrapolated using negative binomial and linear regression models based on the 1996 to 2001 annual surveys.
Results: The negative binomial model predicted an increase of 56% in diagnosed HIV prevalence in England, Wales and Northern Ireland between 2001 and 2004. The linear model predicted an increase of 25% for the same time period. The predicted increases are mostly driven by the large rise in the number of new diagnoses, in particular in individuals infected heterosexually.
Conclusion: Increases in HIV prevalence in England, Wales and Northern Ireland have diverged from a linear trend. Negative binomial modelling of the data predicts that large rises in prevalence will continue during the early 2000s.
In 2001 the number of people living with diagnosed HIV infection in England, Wales and Northern Ireland rose by 16% from the previous year. This rise is the largest proportional annual increase since 1995 when comparable data were first collected through the annual survey of prevalent HIV infections diagnosed (SOPHID). To predict future HIV-related care burden extrapolation of the data was undertaken.
The reduction in AIDS incidence and HIV-related deaths, due to the widespread use of anti-retroviral drugs, and the growing impact of the global epidemic, have contributed to a curvi-linear rate of growth in the number of HIV patients seen for care by 2001. This has led us to explore models, other than the previously used linear regression model [1], to extrapolate the data. In this paper we present the methodology used to adjust the annual survey results and to extrapolate the data, and present estimates for 2002 to 2004, using a negative binomial model, and for comparison, a linear model.
The SOPHID survey was established in 1995 to satisfy the growing need for residence-based data for individuals with diagnosed HIV infection [2,3]. It aims to include every individual in England, Wales and Northern Ireland with diagnosed HIV infection who has attended statutory services for HIV-related treatment or care within a calendar year.
The SOPHID survey collects information on patient residence and provides local health planners with estimates of the number of individuals within their local population who have diagnosed HIV infection. No names are collected. De-duplication is achieved by use of soundex code of surname [4], sex and date of birth. Strict attention to confidentiality at every stage of data collection, analysis and storage has established and maintained the confidence of participants in the surveys.
The annual survey figures for 1996 to 2001 were adjusted to estimate the number of people with diagnosed HIV infection for each year and used as the basis for extrapolation to 2004. Only adults (15 years of age or above) resident in England, Wales or Northern Ireland were included in the analysis. For the 5% of records where route of exposure to HIV infection was not reported, exposures were proportionally allocated on the basis of sex, region and ethnicity to the exposure groups 'sex between men', 'heterosexual sex' and 'other'. Patient residence was summarized as 'within' or 'outside' London. Estimates by exposure and patient residence combination were produced. Matching to estimate both under-reporting and non-attendance was based on soundex code [4], date of birth and sex.
An annual adjustment for under-reporting to SOPHID was calculated by comparing the SOPHID data to other sources of HIV reporting data that indicate that a patient has attended treatment and care services during the year and therefore qualified for inclusion in SOPHID. The two sources used were the national reports of new diagnoses of HIV infections or AIDS, and the national CD4 surveillance data.
An adjustment for the number of individuals with diagnosed HIV not attending statutory services in a single year is calculated at the end of each SOPHID survey, using the data for that year and the two previous ones. The 2001 non-attendance adjustment, for example, was based on the number of individuals seen for care in both 1999 and 2001 but not 2000, as a proportion of the 2000 SOPHID total. The proportion not seen for care in 2000 was then applied to the 2001 data on the assumption that it provided the best available estimate of non-attendance for that survey.
Using the annual adjustments a combined adjustment for under-reporting and non-attendance of 13.5% was calculated for 1996 to 2001. Combined adjustment figures were then calculated for each exposure by patient residence groups by applying proportional allocation. To obtain end of year prevalence (instead of the period prevalence for the whole year) individuals who were reported to have died, and any additional deaths identified through the HIV/AIDS reporting system, were removed from the final adjusted datasets.
STATA 7.0 (Stata Corp., College Station, Texas, USA) was used for statistical analysis. The plot of the adjusted counts, particularly for the heterosexually infected group, looked exponential in character, rather than the previously seen linear relationship.
A number of model diagnostic and fitting techniques were applied to the 1996 to 2001 adjusted counts to find a model that yielded a good fit. The linear regression model, previously used to provide extrapolation estimates [1], was shown to no longer adequately fit the data. The curvature was modelled using quadratic, Poisson and negative binomial models. A negative binomial model was found to be the most appropriate to model the temporal trend for each of the exposure by patient residence groups.
Model adequacy was explored by plotting residuals against the predicted values and the residuals were tested for autocorrelation. Point interval estimates of the extrapolated counts from the negative binomial model, and for comparison linear regression, are presented. These have only been projected to 2004 due to the uncertainty that the large increase in new diagnoses seen in 2001 will continue.
Table 1 shows the adjusted data (1996 to 2001) and the extrapolated data (2002 to 2004) by route of infection for within and outside London and for England, Wales and Northern Ireland as a whole. The increase in diagnosed HIV prevalence between 1996 and 2001 in London was 89% (8529 to 16 136) and outside London 103% (5351 to 10 839). For the whole of England, Wales and Northern Ireland the increase was 94% (13 880 to 26 975). During this period the number of diagnosed HIV infections ascribed to sex between men increased by 62% (8791 to 14 234), and to heterosexual sex by 213% (3550 to 11 129). The number of infections attributed to other routes, including injecting drug use, increased by only 3% (1539 to 1612).
The negative binomial model predicted an increase of 56% (26 975 to 42 047) in diagnosed HIV prevalence in England, Wales and Northern Ireland between 2001 and 2004. In comparison the linear model would have predicted an increase of 25% (26 975 to 33 680). Figure 1 shows the best-fit curves, using the negative binomial model, by route of infection within London and outside London for 1996 to 2004.
The negative binomial model predicted a lower rate of increase between 2001 and 2004 in the number of individuals with HIV infection resident within London [54% (16 136 to 24 805)] than outside London [60% (10 839 to 17 367)]. In contrast, the linear model would have predicted a higher rate of increase within London [26% (16 136 to 20 270)] than outside London [24% (10 839 to 13 410)].
The negative binomial model predicted a 34% increase in prevalent diagnosed HIV infections among individuals infected through sex between men (14 234 to 19 011) between 2001 and 2004 and a 92% increase in those infected heterosexually (11 129 to 21 335). The linear model would have predicted a 22% increase in individuals infected through sex between men (14 234 to 17 344) and a 32% increase in those infected heterosexually (11 129 to 14 638).
The negative binomial model predicted that in 2004, for the first time, there will be in total more heterosexually infected individuals (21 335) receiving HIV-related care than individuals infected through sex between men (19 011). The linear model would have predicted diagnosed HIV infections acquired through sex between men to remain the larger number in 2004 (17 344 compared with 14 638 heterosexually acquired infections).
The observed increase in diagnosed HIV prevalence in the survey data 1996 to 2001 can be partially explained by the continuing role of anti-retroviral drugs in delaying death. In England, Wales and Northern Ireland the reported deaths of HIV-infected adults were at their highest in 1995 at 1530, compared with 332 deaths which were identified through the HIV/AIDS reporting system for 2001 (deaths reported by end of March 2003) [5]. However, the main explanation for the increase is the large rise in the number of new diagnoses, in particular individuals who have acquired HIV heterosexually.
Among 4724 adult individuals newly diagnosed in England, Wales and Northern Ireland in 2001 (reported by end March 2003), 34% (1605) were reported as infected through sex between men and 58% (2747) as infected heterosexually [6]. Of the individuals infected heterosexually, and for whom a probable country of infection had been recorded (2614), 90% (2348) acquired HIV outside the United Kingdom, and for 81% (2117) this acquisition was in an African country [7].
A large rise in heterosexually acquired HIV infections, as compared with a steadier rise in infections acquired through sex between men, resulted in reports of newly diagnosed individuals infected through heterosexual sex overtaking those infected through sex between men in 1999 [6]. The negative binomial model predicts that the same will happen for prevalent diagnosed HIV infections in 2004. The linear model would not have predicted this change.
Alongside the large increase in the number of heterosexually acquired HIV infections the SOPHID data show another trend. Between 1996 and 2001 there was a small decrease in the proportion of HIV-infected individuals who were resident in London compared with those resident outside London, falling from 62 to 60%. The negative binomial model predicts that this gradual decrease in the proportion of individuals with HIV infection resident in London will continue, falling to 59% in 2004. However, any change in proportional distribution of residence is dwarfed by the large increases in actual numbers of diagnosed HIV-infected individuals.
We have chosen a simple approach to categorizing geography. Within both areas of residence the prevalence of diagnosed HIV infections varies. To adjust the observed data at smaller level geography however, would be problematic because of small numbers.
Inspection of the 2001 values found that when compared with the adjusted data both the negative binomial and linear models underestimate the prevalence of diagnosed heterosexually acquired HIV infections, in particular for individuals resident outside London. The negative binomial model was shown to provide a better fit than the linear model to the adjusted data for the heterosexual group. Therefore, the 92% increase in heterosexually acquired HIV infections predicted by the negative binomial model is probably more realistic than the 32% increase predicted by the linear model. For infections acquired through sex between men and other routes the results from the two models were similar.
Extrapolations for future numbers of diagnosed HIV infections, and their geographical distribution, are subject to many uncertainties. These have been emphasized previously [1,8] and, having been reviewed, currently are:
The movement of HIV-infected people between countries with a high prevalence of HIV (particularly from sub-Saharan Africa) and the UK.
The dispersal of new migrants, including asylum seekers, to different parts of the country.
How long highly active anti-retroviral therapy (HAART) will continue to delay death.
The incidence of new HIV infections within the UK.
The number of those with previously undiagnosed infection that are recognized as a result of developing an HIV-related illness.
The number of those with previously undiagnosed infection that are recognized as a result of promotion of HIV testing, including antenatal diagnoses.
The increases following either of the models will have serious implications for service providers. In particular, the predicted increases in diagnosed HIV will have an impact on GUM clinics in terms of workload, adding to the burden caused by the rising numbers of other sexually transmitted infections.
The SOPHID survey would not be possible without the SOPHID advisory team, the active collaboration of nominated facilitators and service providers and the Department of Health for funding. Their participation is gratefully acknowledged. The help and advice of Janet Mortimer and the statistical support of Andre Charlett and Daniella De Angelis is also gratefully acknowledged.
This article has been cited 1 time(s).
prevalent HIV; diagnosed infections; extrapolation; care burden; England Wales and Northern Ireland; negative binomial
© 2004 Lippincott Williams & Wilkins, Inc.
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Duquesne to Launch New Minor in African Studies This Fall
Through studying Africa-its traditions, cultures, and contemporary and historic issues-students will gain cross-cultural perspectives that are invaluable in the global marketplace.
"We live in a very globalized context in which products crisscross the world on a regular basis," said Dr. Gerald Boodoo, director of the Center for African Studies. "Engaging Africa through this program will help our students understand a part of the world that we don't often study. It will give them an edge in their studies and in their careers."
Kayla Witkowski, a junior nursing student, will take Introduction to African Studies in Spring 2014 and will travel to Ghana for a study-abroad course, Faith and Reason, to be led by Boodoo next May.
"This is a perfect opportunity for broadening my intercultural perspective," Witkowski said. "The African culture really interested me, especially because of the sense of community, striving for the betterment of the whole versus the individual. I think that perspective is really going to help me in my career as a nurse."
The summer breakaway course fulfills the University core curriculum theme area of Faith and Reason. Boodoo will lead students for two weeks through locations such as the slave fortresses on the Cape Coast, the Ashanti Kingdom in Kumasi and the capital city of Accra.
Beyond benefits to individual students, the new program also furthers Duquesne's strategic goal of placing a new emphasis on Africa and the African diaspora.
"It's an initiative to re-engage the African context on an academic level and also on a relational level through student engagement, study abroad and faculty involvement," Boodoo said.
Duquesne University
Founded in 1878, Duquesne is consistently ranked among the nation's top Catholic research universities for its award-winning faculty and tradition of academic excellence. The University is nationally ranked by U.S. News and World Report and the Princeton Review for its rich academic programs in nine schools of study for nearly 10,000 graduate and undergraduate students, and by the Washington Monthly for service and contributing to students' social mobility. Duquesne is a member of the U.S. President's Higher Education Community Service Honor Roll with Distinction for its contributions to Pittsburgh and communities around the globe. The U.S. Environmental Protection Agency and the Princeton Review's Guide to Green Colleges acknowledge Duquesne's commitment to sustainability.


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Tuesday, November 20th 12:22 PM IST
# Nepal gold # Negosida # Tihar festival
According to Nepal Gold and Silver Dealers Association (Negosida), people are buying gold with a premium of Rs 1,000 per tola (11.664 gm) over the daily price fixed by it.
KATHMANDU(BullionStreet): Wedding season demand boosted gold in Nepal but the acute shortage of the commodity forced customers to buy the metal with a high premium of Rs 1000 per tola.
According to Nepal Gold and Silver Dealers Association (Negosida), people are buying gold with a premium of Rs 1,000 per tola (11.664 gm) over the daily price fixed by it.
Gold is also being used as a mode of payment to Indian traders due to shortage of Indian currency, analysts said.
Nepalese importers have been using gold to make payments for goods being imported from India for the last three months, leading to shortage of the yellow metal despite recent hike in gold prices.
Nepal is highly dependent on India for import of foreign goods and it is estimated that three-fourth of Nepalese imports comes from India.
The Association said some jewelers took advantage of the situation as there is a demand for more than 30 kg of gold a day but the supply has remained below 15kg.
Analysts said shortage of gold in Nepal's markets remained the major cause for price hike this season with the banks failing to supply gold this week due to Tihar holidays.
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The traders have been demanding the government increase the gold quota, saying that the provision of 15 kg a day was insufficient.
The central bank provision requires banks importing gold to distribute 60 percent of the daily quota of 15 kg in Bagmati Zone and the remaining in other parts of the country.
Daily demand for gold during the wedding season in Nepal ranges from 30 to 40 kg a day but commercial banks are permitted to sell only 15 kg, remaining demand is being partially fulfilled by gold imported illegally, analysts said.
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Results 1 to 4 of 4
- 06-21-2014, 06:11 PM Thread Author #1
Music app question
My built-in music app is unable to locate my mp3 files. Where do I have to put them in order to make it work? I would really want to use sound equalizer, but with VLC player I think I cannnot. I'm trying to move my mp3 files from my pc to my phone, by the way. I tried ti clear the cache and everything, didn't work.
Can you guys help me out? Thank you in advance!
- 06-21-2014, 07:11 PM Thread Author #2
- Posts
- 76,065 Posts
- Global Posts
- 76,103 Global Posts
Re: Music app question
Welcome to Android Central! I'm not familiar with Samsung Link, so I can't help you there. When I transfer music files from my PC to my phone, I just use the "Music" folder (or create one). It shouldn't matter what folder they go to--the system's Media Scanner should find music files and add them to its database of media files present on the phone.
If the music files that you moved over are on the external SD card, then be aware that there seem to be more complaints about Samsung devices than any other brand when it comes to reading SD cards. What happens if you move your music file to a folder in Internal Storage? Does your phone have any problems finding them there?
- 06-22-2014, 02:36 PM Thread Author #4
Re: Music app question
Thank you for your reply and your welcome message.
Well I don't have an SD card (yet) ... I also think that it should find my mp3s wherever I put them, but that's not the case. Well, its not a big problem anymore, since Samsung Link works pretty well... But I found no other solution to this problem yet. It's a thing I can live with
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|Publication number
|Publication type
|Application number
|Publication date
|Sep 4, 1990
|Filing date
|Apr 8, 1988
|Priority date
|Apr 8, 1988
|Fee status
|Also published as
|Publication number
|Bernard Weissman
|Original Assignee
|Bernard Weissman
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (6), Referenced by (17), Classifications (57), Legal Events (7)
|External Links: USPTO, USPTO Assignment, Espacenet
The present invention relates to a motor-driven, reciprocating dental tool which provides means to safely prevent undesirable rotation of the tool during use and further provides sanitary means for simultaneously applying a fluid medium, such as dental cleaning paste, to teeth while mechanically treating, such as cleaning or polishing the teeth by abrasion, and more particularly while mechanically providing reciprocating motion to an abrasive member through which the fluid paste is simultaneously applied.
There has previously been successfully provided a mechanically driven hand tool, which can be readily powered by a conventional rotary dental drill, to provide reciprocating motion of the type preferably used when abrading or filing teeth or removing excess restorative material, such as hardened dental amalgamsor dental composite materials. Such abrasive methods, depending upon the hardness of the abrasive material and the rapidity and pressure with which the abrading surface is applied, can be used to either remove hardened amalgam or dental enamel or to merely remove plaque and to clean and polish teeth surfaces, including both the major lingual and facial surfaces of teeth as well as the proximate faces bordering the teeth interspaces.
The reciprocating handpiece, such as the device described in U.S. Pat. No. 3,552,022 to Axelsson, and commercially available as a Dentatus EVA Reciprocating Motor Driven Handpiece, has been used for both purposes, together with the dental abrasive tools formed of, e.g., hardened or diamond coated metal blades or plastic blades with or without embedded abrasives.
It is also known to utilize a syringe type of device to apply toothpaste and the like material for dental hygienic cleaning prior to application of either a mechanically driven or manually operated tooth cleaning means, whether for clinical use or for home use. Such a device is shown, for example, in U.S. Pat. No. 4,411,623 to Axelsson.
It is an object of the present invention to provide a means for simultaneously applying a cleaning or abrading fluid or other therapeutic medium to teeth while mechanically abrading or polishing the teeth using a mechanically driven tool. It is a further object of the present invention to continuously administer such fluid medium through a disposable mechanically driven abrading tool which can be hygienically filled and refilled during a single continuing procedure. The tool can be molded sufficiently economically for a one-time use, thus further reducing any risk of contagious infection.
It is also an object of the present invention to restrain rotation of the blade under normal therapeutic force, so as to permit accurate positioning and manipulation of the tool, while preventing injury from the accidental application of excessive force.
The fluid dispensing and reciprocating abrading tool of the present invention for simultaneously applying, e.g., a cleaning fluid, paste, medicament, such as a fluoride solution, or a cooling fluid, and providing the reciprocating abrading action, comprises a mechanically driven dental handpiece for providing reciprocating drive means, and a removable, hollow, dental abrading tool, the dental tool comprising a shank, operatively, directly, but removably connected to the dental handpiece and having a central channel extending axially therealong, and a blade member secured to the shank and comprising an interior plenum chamber in fluid flow connection with the shank channel and a multitude of with fluid outlet perforations through the blade surface. Fluid pressure means are provided for causing the flow of cleaning fluid from the shank channel through the blade plenum and out the perforations. When the outer opening of the shank channel is closed off, pressing the flexible walled hollow blade between two teeth will cause discharging of fluid, such as a cleaning paste.
Limited restraining means are provided in another preferred embodiment of this invention for restraining rotation of the blade during operation, while providing for movement upon the application of a greater then maximum permitted force; at such greater force, the restraint breaks away and the tool blade is permitted to rotate to avoid injury to the patent. Such rotation restraint is provided by interaction between the tool blade and the reciprocating dental handpiece.
Preferred embodiments of this invention are further described below, by way of example and not exclusion, by reference to the accompanying drawings which display certain portions of the present invention in schematic form. The details of such schematically shown portions will be readily known to those skilled in the art based upon the following verbal descriptions. Referring to the drawings:
FIG. 1 is an isometric view of a reciprocating file tool combined with a reciprocating driver handpiece operating to clean the interdental spaces;
FIG. 2 is an isometric view showing a fluid dispensing file blade in accordance with the present invention and the head of a reciprocating dental handpiece;
FIG. 2a is an exploded view of the device of FIG. 2;
FIG. 3 is an isometric view of another embodiment of a fluid dispensing file blade in accordance with the present invention;
FIG. 4 is a front elevation view of the tool of FIG. 3,
FIG. 4a is a side view of the tool of FIG. 3;
FIG. 5 is a top view of the tool of FIG. 3;
FIG. 6 is an isometric view of an alternative type of fluid-dispensing file blade installed in the head of a reciprocating dental handpiece with an alternative form of a rotation-restraining means;
FIG. 7 is a partial isometric view showing the rotation-restraining means in a retracted position;
FIG. 8 is a partial isometric view of a further alternative embodiment of the fluid-dispensing dental tool of the present invention;
FIGS. 9a and 9b are isometric views of yet another alternative embodiment of a fluid dispensing dental
FIG. 10 is an isometric view of a dental tool fabricated of metal and having rotation-restraining means;
FIG. 11 is a bottom view of the tool of FIG. 10;
FIG. 12 is an isometric view of an alternative embodiment of a metal abrasive tool having twin file surfaces;
FIG. 13 is a bottom view of the tool of FIG. 12;
FIG. 13a is an end view taken along lines A--A of FIG. 12;
FIG. 14 is a cross-sectional schematic diagram of a fluid dispensing tool of the present invention inserted in a reciprocating sleeve;
FIGS. 15 and 16 are partial schematic cross-section views depicting the insertion and securing of a dental tool into a reciprocating sleeve in accordance with the present invention;
FIG. 17 is a cross-sectional view of the head of a dental handpiece showing a further embodiment of a rotation preventing device in accordance with the present invention;
FIG. 18 is a view taken along lines A--A of FIG. 17
FIG. 19 is an enlarged partial side elevation view enlarged to show the tapered notch and spur rotation-restraining means;
FIG. 20 is a cross-section view of a dispensing reservoir for a dental tool of the present invention;
FIG. 21 is an isometric view of a syringe filling a dental tool in accordance with the present invention;
FIG. 22 is an exploded isometric view showing a further means for filling a dental tool with paste directly from a commercially available tube;
FIG. 23 is a cross-sectional view showing the filling means of FIG. 22 in place; and
FIG. 24 is a side elevation view showing a manually pressed button cap.
The dental tool of the present invention is to be used and applied in combination with a conventional commercially available drive head which is improved in accordance with the present invention. Such a drive head comprises conventional driving elements which do not, in themselves, form a part of the present invention and, thus need not be illustrated in great detail. Examples of suitable driving means are shown, for example, in U.S. Pat. Nos. 3,552,022 to Axelsson and 4,629,426 to Levy. Such a device is generally of a sufficiently slender and elongated nature, often having a contra-angle head, to enable a dentist to easily and without injury to the patient, manipulate the device within the mouth and, most particularly, against even the rear molars. However, as such a device is conventional, it will not be described herein in greater detail than is shown in the drawings and can be determined from the prior disclosures.
Referring to FIGS. 1-5 and 14-15, as a group, the dental tool itself, generally indicated by the numeral 4, is elongated, pointed and flat in cross-section, such that a longitudinal but slanted edge 28 is formed between the two major surfaces 27 of the blade 7. The tool, including both the shank 10 and stiffening spine 8 and the blade 7, is hollow to provide a reservoir and channel for the passage of fluid material. As shown, the stiffening spine 8 of the blade 7 does not extend to the end of the blade; the flat blade portion 7 extends both longitudinally and laterally outwardly from the spine 8. The blade 7 has substantially parallel sides 27, although the sides 27 can be slightly convergent towards the edge 28, if desired. Along the blade edge 28 and the blade side surfaces 27, are provided perforations 18 extending fully through the blade material and into the interior hollow space, defined by the interior surfaces 17 within the blade 7. This interior space 17 is directly open to the hollow channel defined by shank channel surfaces 16 extending to the top of the shank 10. Preferably, the minimum width at the blade edge 28 should not be less than about 0.01 in., if outlets 18 are provided at the edge 28, in order to provide sufficient interior space for passage of a fluid.
The material forming the shank 10 is molded such that it is sharply thinner at least at two locations to define grooves 12. These grooves 12 permit easy folding together of the shank 10 when it is being inserted into the sleeve 3; the grooves 12 are covered by a thin membrane, preferably coextensive with the outer surface of the shank 10, to maintain the integrity of the fluid flow by preventing leakage of fluid from the central channel 16. Around the top of the shank 10 is a retaining lip 11. The dental tool 4 is slip fitted into a sleeve 3 reciprocatingly held within a head 2 of a dental handpiece 1, for example, as shown in FIGS. 14 and 15, which provides for reciprocating movement. The tool holding sleeve 3 is in the form of a hollow cylinder defining a bore into which the tool shank 10 is fitted.
In the embodiment shown in FIG. 2, the tool holding sleeve 3 is provided with one or more notches at its end proximal the tool blade 7, defined by concave surfaces 6. When the tool 4 is installed in the sleeve 3, a resilient spur 5 formed on one side of the shank 10 adjacent the blade 7 is juxtaposed within the notch 6 (as shown in detail in FIG. 19) to prevent rotation of the tool 4 during use.
The manner of driving the reciprocating sleeve 3 is shown for example, in U.S. Pat. Nos. 3,552,022 or 4,629,426. It is also known to prevent rotation of the tool holding sleeve 3, as described in U.S. Pat. No. 4,582,060during reciprocating motion.
The tool is preferably formed of a polymer or elastomer and the thickness of the walls 27 of the blade 7 is preferably not greater than about 0.015 in. and most preferably in the range of from about 0.005 to about 0.01 in. This thickness, together with the reinforcing spine 8, is sufficient to prevent excessive flexibility or folding during use of the major part of the blade, whereas the outer point 37 is of greater flexibility as it extends beyond the end of the spine 8. Such thin, flexible blade is well adapted to being inserted into the dental interspaces for e.g., polishing, cleaning, abrading and shaping, or applying medication.
A pressure feed cap generally indicated by the numeral 19 is formed integral with the tool via a strap 29 extending from the flange 129 intermediate the blade 7 and the shank 10. The cap 19 comprises a plunger 13, and an outer button 39 secured thereto and having a flat outer surface. The plunger 13 also includes splines 15 which extend longitudinally along and radially outwardly from the plunger 13 and are juxtaposed so as to engage the grooves 12 through the shank 10, when the plunger 13 is slip-fitted within the central shank channel 16; the plunger 13 creates a piston action as it is pressed into the channel 16 by finger pressure on the cap outer surface 39. The outer cap surface 39 preferably is shaped and textured for improved fingertip control.
An alternative form of fluid pressure means is provided by the flexible reservoir, generally indicated by the numeral 49, in FIG. 20. Reservoir 49 has a spout 51 which is inserted into the end of a tool shank 10. The spout 51 can be secured to the shank 10 by a threaded joint or by a tight slip fit. The reservoir 49 includes a corrugated wall 149, forming a bellows, on the lateral wall adjacent the handpiece head 2, (as shown in FIG. 20) or as the circumferential wall 249, to permit reciprocating movement of the sleeve 3 and the tool 4, while maintaining the cartridge 49 in a stationary position against the top of the head 2. By maintaining finger pressure along the thin wall membrane 53 at the distal end of the cartridge 49, the reciprocating movement itself will provide a pumping action to force any fluid material, such as tooth paste from within the cartridge 49 into the shank 10 and out the blade perforations 18.
The anti-rotation spur 5 on the tool is preferably tapered, as shown in the enlarged partial cross-section view of FIG. 19, to a narrower thickness at the outer edge. The notch 6 is tapered in a matching fashion to receive the spur 5. This taper, preferably having an angle of from about 10� to about 30�, together with a judicious selection of desired material of construction, permits selecting the desired breakaway turning moment, beyond which the tapered spur 5 will break out of the tapered notch 6 and permit rotation of the tool blade 7, as a safety means to prevent injury to a patient's teeth or mouth.
The tool can be made of polymers or elastomers, such as polypropylene, silicone rubber, or polyurethane. In these preferred embodiments the entire hollow tool 4, including the shank 10 and the blade spine 8 and the blade 7, together with the interior spaces, and perforations, are formed integrally from a single material, as by molding procedures well known to the art.
The major surfaces 27 and leading edge 28 of the tool blade 7 can be formed so as to provide a desired effect. For example, the major surfaces 27 can be formed with a rough grainy surface, or with embedded particles of a harder material than the polymer or elastomer, or even molded with tiny fibers, or tendrils, on the surface, e.g., in the manner in which a so-called Velcro surface is formed.
In another alternative embodiment, as shown in FIGS. 6 and 7, the rotation-restraint can be manually disengaged. A spring leaf 22 can, for example, be slidably secured to the dental handpiece 1 by a pair of resilient arms 21. At the distal end of the spring leaf 22 from the arms 21 is a cleft 122, and at the apex of the cleft 122 are tapered teeth 24 extending outwardly from the surface of the spring leaf 22 towards the handpiece 1. The end of the collar 11 is provided with matching tapered notches 123 also tapered inwardly. In the engaged position, the leaf spring slides until the tapered teeth 24 are juxtaposed with the shank collar 23 to mate with the notches formed by the concave surfaces 123. When rotational restraint is not desired, the spring leaf 22 can be slidably moved laterally away from the head 2, to disengage the teeth 24 and notches 123. The resilience of the spring leaf 22 and of the collar material 23 can be selected to provide for release of the restraint when a movement greater than the restraint maximum is exerted.
In addition, if desired, the spring teeth 24 and mating notches 123 can be angled in a clockwise or counterclockwise direction, respectively, permitting rotating movement in one direction but restraining movement in the opposite direction of rotation, thus providing a pawl and ratchet effect.
FIGS. 8 and 9 depict an alternative molded tool wherein the plunger is secured via a double strap to the tool shank. In this embodiment, the double straps fold up along the side of the plunger 113, and mate with the grooves formed in the shank 110 of the tool, when the plunger 113 is inserted into the shank channel.
The size of the perforations through the tool blade surfaces are determined based upon the fluid intended to be dispensed. Thus, a thin, non-viscous fluid being passed through the blade preferably should be used with a tool wherein the perforations are not larger than 0.05 mm. in diameter, and most preferably in the range of from 0.03 mm. to 0.05 mm. in diameter. Alternatively, a highly viscous material, such as toothpaste, including the type which contains dispersed abrasive particles, should have larger perforation openings, limited primarily by the particle size of the abrasive particles dispersed within the, e.g., toothpaste. In general, commercially available such materials, e.g., toothpaste, have abrasive particles of a size not larger than about 10 to about 40μ, and thus the perforations should have diameters sufficient to pass such pastes or gels containing such particles without clogging. Preferably, at least five outlet perforations are provided along the slanted blade edge 28, and preferably additional ones are provided over the principal blade surface 27, especially adjacent and at the tip 37.
FIGS. 21 through 23 depict alternative means for filling the dental tools with fluid material FIG. 21 shows a syringe-type device having an outlet stub of a diameter to fit tightly within the shank channel of a dental tool having a thin resilient membrane covering the grooves 12. When the syringe plunger 150 is depressed, paste within the syringe is pushed into an attached tool 4.
In FIGS. 22 and 23, a dispenser cap 160 is threadedly secured onto the external threaded opening stub 162 to a conventional toothpaste tube 164. The other end of the cap 160 has a plug opening which can receive the open end of a tool shank 10. The plug opening can be closed by a plug cap 165, hingedly secured to the dispenser cap 160.
The dental tool 4 after being filled with paste, can be pushed into and through the reciprocating sleeve 3 by squeezing the grooved shank 10 as shown in FIG. 15a, until the collar 11 protrudes beyond the distal end of the sleeve 3. The collar restrains the tool 4 from falling, or being pulled, out accidentally. The tapered spur 5 mates with the sleeve notch 6. The plunger 13 is lightly inserted into the shank channel 16 and the handpiece power is activated causing the tool 4 to reciprocate. Pressing downwardly against the outer cap surface 39 forces the plunger 13 into the shank channel 16, which causes the paste, or other fluid, to flow out through the perforations 18.
When the blade 4 is inserted into teeth interspaces, as shown in FIG. 1, the blade surfaces 27 will, e.g., polish the tooth surfaces. If the blade becomes lodged, and an excessive rotational moment is exerted, the spur 5 will flex and break away out of the notch 6, permitting rotation of the tool and preventing injury to the teeth. For this purpose, the spur should have a suitable flexural elastic modulus and thickness.
The tool 4 had been previously filled with a dosage of polishing paste, such as toothpaste, utilizing a tube cap dispenser, as shown in FIGS. 22 and 23.
The alternative embodiment of FIGS. 6 and 7 is prepared, filled with paste, and inserted into the handpiece in the same manner. If rotation restraint is desired, the sliding spring 22 is moved into engagement with the notched collar 23. If the dentist prefers a freely rotating tool, the spring can be left in the disengaged position, shown in FIG. 7, during use.
The limited rotation restraining means of the present invention can be used with tools fabricated from metal, and where there is no provision for dispensing of a fluid material.
Referring to FIGS. 10 through 13, a file tool 104 is formed of stainless steel sheet material with a reinforcing groove 105, or corrugation, along the central axis of blade 106. The blade 106 is generally triangular in shape, tapering to a rounded apex 109 at its outer end. The blade also preferably is tapered towards its side edges 108. As shown in FIGS. 10 through 13, the major surfaces 107 of the blade can be coated with fine abrasive particles (such as diamond particles) on one complete side of the blade (FIG. 12) or on alternate surfaces (FIG. 10).
The shank 110 of this metal tool, can be shaped to provide a limited rotation restraint. As shown in FIG. 13a, the shank has an "S" configuration, being formed of an elastic spring metal, such as stainless steel.
The metallic shank of the tool 104 is preferably sufficiently long so as to extend slightly beyond the distal end of the sleeve 3, such that the end of the shank 110 protrudes from the distal end of the sleeve 3 and a collar 111 is provided at the end of the shank 110 to prevent accidental removal. For this embodiment, the top of the shank can be provided on insert 225, inserted into the S-shaped shank 110, and including radiating bars 226, as is shown in FIGS. 17 and 18, or with a slot, facing upwardly. Rotation of this tool can be prevented by the spring leaf 22 (FIGS. 17 and 18), or by a manually pressed button cap 222, as shown on FIG. 25, (teeth or prongs 24, 322 project into the top opening of the shank 110. The end of the shank 110 can also be closed off and provided with slot or groove, opening outwardly towards the button cap 222 or spring leaf 22.
In yet another embodiment of this invention, the shank is preferably formed to have a normal diameter slightly larger than the internal diameter of the sleeve 103. When this S-shaped shank 110 is pressed into the sleeve 103, the lateral spring action of the shank preferably presses against the internal surface of the sleeve 3, preventing relative rotation between the sleeve 3 and the tool 104. The shank 110 extends to just below the end of the sleeve 103. Extending across, and connected to, the circumference of that distal end of the sleeve 3 is a series of radiating bars 130. The spaces between the bars 130 are sufficiently large to permit passage of the spring teeth 24, which prevent rotation of the sleeve 103, as explained above.
The effective flexibility of the spring leaf 22 can be varied manually by the provision of a second, and movable, set of holding arms 121, slidably secured to and on the outer surface of the spring leaf 22. By changing the linear location of the arms 121, i.e., along the major axial direction of the spring leaf 22, the length of the flexing leaf 22 is varied.
The force required to flex the leaf 22 is inversely proportional to its length, i.e., the distance from the apex of the cleft 122, or of the teeth 24, to the retention arms 21, 121. In this embodiment, the second set of holding arms 121 acts as a movable fulcrum for the flexible spring leaf 22, such that when the arms 121 are holding the leaf 22, adjacent the teeth 24, the effective flexibility of the spring leaf is at its minimum, but when the holding arms 121 are adjacent the stationary holding arms 21, or removed completely, the flexibility of the spring leaf is at its maximum.
|Cited Patent
|Filing date
|Publication date
|Apr 29, 1930
|Mar 24, 1931
|Homer Mazie B
|Dispensing attachment for collapsible tubes
|Feb 8, 1940
|Nov 3, 1942
|Goldenberg Alexander M
|Dental cleansing device
|Nov 5, 1973
|Dec 30, 1975
|Surgical Design Corp
|Ultrasonic transducers
|Dec 19, 1977
|Nov 13, 1979
|Leopold Paul Lustig
|Interchangeable tool operating apparatus with plural motion
|Jul 30, 1979
|May 12, 1981
|Fuller Warden
|Rotary dental polishing apparatus
|Jun 30, 1986
|Nov 1, 1988
|Kaltenbach & Voight Gmbh & Co.
|Clamping arrangement, especially for dental instruments
|Citing Patent
|Filing date
|Publication date
|Nov 9, 1990
|Mar 10, 1992
|Abrasive Technology, Inc.
|Abrasive polishing composition
|Feb 14, 1994
|Apr 9, 1996
|Dentatus Ab
|Colleted adjustable flat dental tool
|Jan 18, 1995
|Jun 25, 1996
|Vlacancich; Tanya
|Dental tool driving device
|Dec 4, 1996
|Apr 18, 2000
|Braun Aktiengesellschaft
|Electrically powered dental cleansing apparatus
|May 21, 1999
|Jul 31, 2001
|Kaltenbach & Voigt Gmbh & Co.
|Medical or dental-medical instrument for material-removing working of body tissue and tool for such an instrument
|Apr 17, 2003
|Apr 5, 2005
|Combination rotating dental cleaning brush and paste device
|Mar 9, 2005
|Oct 18, 2011
|Daniel Edward Tarr
|Combination rotating dental cleaning brush and paste device
|Apr 29, 2010
|Dec 6, 2011
|Danville Materials, Inc
|Teeth separating apparatus
|Oct 17, 2011
|Mar 26, 2013
|Daniel Edward Tarr
|Combination rotating dental cleaning brush and paste device
|Mar 5, 2010
|Nov 25, 2014
|Gebr. Brasseler Gmbh & Co. Kg
|System for preparing and displacing tissue
|Mar 12, 2013
|Jul 26, 2016
|Sdc Switzerland Sa
|Oscillating dental angle handpiece
|Mar 9, 2005
|Jul 21, 2005
|Tarr Daniel E.
|Combination Rotating Dental Cleaning Brush and Paste Device
|Apr 23, 2009
|Oct 29, 2009
|Unicep Packaging, Inc.
|Dispensing and applicator devices
|Mar 5, 2010
|Jan 19, 2012
|Stefan Neumeyer
|System for preparing and displacing tissue
|Nov 6, 1991
|May 29, 1992
|Abrasive Technology, Inc.
|Abrasive polishing composition viscous carrier
|Apr 23, 2009
|Oct 29, 2009
|Unicep Packaging, Inc.
|Dispensing and applicator devices
|Mar 12, 2013
|Sep 19, 2013
|Sdc Switzerland Sa
|Oscillating dental angle handpiece
|U.S. Classification
|433/80, 433/128, 433/125, 433/118, 433/90, 433/87
|International Classification
|Cooperative Classification
|European Classification
|Mar 3, 1994
|Fee payment
Year of fee payment: 4
|Mar 31, 1998
|Maintenance fee reminder mailed
|Jun 15, 1998
|Surcharge for late payment
|Jun 15, 1998
|Fee payment
Year of fee payment: 8
|Mar 19, 2002
|Maintenance fee reminder mailed
|Sep 4, 2002
|Surcharge for late payment
Year of fee payment: 11
|Sep 4, 2002
|Fee payment
Year of fee payment: 12


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Hong KongHong Kong
Hometown: London
July 27, 2012
Yes, I've been sceptical that there are many here until now.
On top of music and comedy ones, for science stuff I like the Infinite monkey cage and the Nature podcasts.
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Professional sceptic (scientific editor and data nerd) relocated to HK this year. Was a big fan of this back in London, so glad its finally followed me to Asia!
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Results 1 to 1 of 1
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