Substances and methods for replacing natural tooth material

Abstract

A substance that sets in a relatively short time for use in general dentistry and in endodontics to replace natural tooth material, the substance comprising untreated mineral trioxide aggregate and milled mineral trioxide aggregate, or comprising untreated mineral trioxide aggregate, milled mineral trioxide aggregate and water. A method of making a substance that sets in a relatively short time for use in general dentistry and in endodontics to replace natural tooth material, the method comprising milling by high shear and impact impingement of particles using high pressure homogenization. A method for use in general dentistry and in endodontics to replace natural tooth material

The following is claimed: 
     
         1 . A method for use in general dentistry and in endodontics to replace natural tooth material, the method comprising:
 a) performing a dental procedure;   b) providing a substance for use in general dentistry and in endodontics to replace natural tooth material, the substance comprising untreated mineral trioxide aggregate and milled mineral trioxide aggregate, where the untreated mineral trioxide aggregate and milled mineral trioxide aggregate together are total mineral trioxide aggregate;   c) using the substance to fill a space in the tooth; and   d) allowing the substance to set.   
     
     
         2 . The method of  claim 1 , where the dental procedure is an endodontic procedure. 
     
     
         3 . The method of  claim 1 , where the dental procedure comprises removing part of the natural tooth material of a tooth. 
     
     
         4 . The method of  claim 1 , where the dental procedure comprises removing material that replaced natural tooth material. 
     
     
         5 . The method of  claim 1 , where the dental procedure is selected from the group consisting of apexification, pulp capping, pulpotomy, regenerative endodontics, root canal filing, root-end filling, root perforation repair and sealer during filling or root canals. 
     
     
         6 . A method of making a substance for use in general dentistry and in endodontics to replace natural tooth material, where the substance sets in a relatively short time, the method comprising:
 a) selecting a material suitable for use in the method to make a substance for use in general dentistry and in endodontics to replace natural tooth material, where the material comprises particle having a median maximum particle diameter;   b) mixing the selected material with a non-aqueous liquid creating a mixture of the material and liquid;   c) providing an instrument for milling by high shear and impact impingement of particles using high pressure homogenization;   d) placing the mixture of material and liquid into the instrument for milling by high shear and impact impingement of particles using high pressure homogenization; and   e) actuating the instrument thereby milling the material within the mixture, thereby reducing the median maximum particle diameter, and thereby making the substance for use in general dentistry and in endodontics to replace natural tooth material.   
     
     
         7 . The method of  claim 6 , where the material is mineral trioxide aggregate. 
     
     
         8 . The method of  claim 6 , where the liquid is selected from the group consisting of methanol, ethanol and isopropanol. 
     
     
         9 . The method of  claim 6 , where the liquid is ethanol. 
     
     
         10 . The method of  claim 6 , where the material is mixed with the liquid in a ratio of between 1 part material to between 1 and 100 parts liquid. 
     
     
         11 . The method of  claim 6 , where the material is mixed with the liquid in a ratio of between 1 part material to between 1 and 20 parts liquid. 
     
     
         12 . The method of  claim 6 , where the material is mixed with the liquid in a ratio of between 1 part material to between 5 and 20 parts liquid. 
     
     
         13 . The method of  claim 6 , where the material is mixed with the liquid in a ratio of between 1 part material to between 5 and 10 parts liquid. 
     
     
         14 . The method of  claim 6 , where the material is mixed with the liquid in a ratio of 1 part material to 9 parts liquid. 
     
     
         15 . The method of  claim 6 , where mixing the material with a liquid comprises using a magnetic stir bar to produce a suspension. 
     
     
         16 . The method of  claim 6 , where placing the mixture of material and liquid into the instrument comprises pouring the mixture into a reservoir of the instrument. 
     
     
         17 . The method of  claim 16 , where the reservoir comprises a device for preventing premature settling of the mixture which would cause a concentration gradient within the instrument or a part of the instrument, and where the method further comprises actuating the device to prevent premature settling of the mixture which would cause a concentration gradient within the instrument or a part of the instrument. 
     
     
         18 . The method of  claim 17 , where the device is an overhead propeller. 
     
     
         19 . The method of  claim 6 , where milling the material within the mixture comprises cycling the instrument between two and one hundred cycles. 
     
     
         20 . The method of  claim 6 , where milling the material within the mixture comprises cycling the instrument between two and fifty cycles. 
     
     
         21 . The method of  claim 6 , where milling the material within the mixture comprises cycling the instrument between two and thirty cycles. 
     
     
         22 . The method of  claim 6 , where milling the material within the mixture comprises cycling the instrument between five and thirty cycles. 
     
     
         23 . The method of  claim 6 , where milling the material within the mixture comprises is using a pressure between 1000 to 70,000 psi. 
     
     
         24 . The method of  claim 6 , where milling the material within the mixture comprises is using a pressure of 30,000 psi. 
     
     
         25 . The method of  claim 6 , where the method further comprises evaporating the liquid from the milled material. 
     
     
         26 . The method of  claim 6 , where the method further comprises collecting the milled material after milling the material. 
     
     
         27 . A substance made according to the method of  claim 6 . 
     
     
         28 . A mineral trioxide aggregate mix that sets in a relatively short time, wherein the mineral trioxide aggregate mix comprises bismuth oxide, dicalcium silicate, tricalcium aluminate, and tricalcium silicate, wherein the mineral trioxide aggregate mix is capable of setting in between five to twenty minutes when mixed with a liquid, wherein the mineral trioxide aggregate mix comprises untreated mineral trioxide aggregate and high shear homogenized mineral trioxide aggregate, and wherein mixing the mineral trioxide aggregate mix with a liquid comprising water produces a dental substance for use in general dentistry and in endodontics to replace natural tooth material, the mineral trioxide aggregate mix comprising:
 untreated mineral trioxide aggregate comprising particles with a median maximum particle diameter; and   high shear homogenized mineral trioxide aggregate comprising homogenized particles with a reduced median maximum particle diameter compared to the particles of the untreated mineral trioxide aggregate, wherein the high shear homogenized mineral trioxide aggregate is homogenized by high shear and impact impingement of particles without the use of grinding media;   wherein the mineral trioxide aggregate mix comprises between about 25 wt. % and about 99.5 wt. % untreated mineral trioxide aggregate,   wherein the mineral trioxide aggregate mix comprises between about 0.5 wt. % and about 75 wt. % high shear homogenized mineral trioxide aggregate,   wherein only a non-aqueous liquid is used in homogenizing the high shear homogenized mineral trioxide aggregate,   wherein the median maximum particle diameter of the untreated mineral trioxide aggregate is between five and thirty times larger than the reduced median maximum particle diameter of the high shear homogenized mineral trioxide aggregate,   wherein the mineral trioxide aggregate mix comprises bismuth oxide, dicalcium silicate, tricalcium aluminate, and tricalcium silicate, and   wherein the mineral trioxide aggregate mix sets in between five to twenty minutes when mixed with a liquid to produce a dental substance for use in general dentistry and in endodontics to replace natural tooth material.   
     
     
         29 . The mineral trioxide aggregate mix of  claim 28 , further comprising tetracalcium alumino-ferrite. 
     
     
         30 . The mineral trioxide aggregate mix of  claim 28 , wherein the median maximum particle diameter of the untreated mineral trioxide aggregate is between five and fifteen times larger than the reduced median maximum particle diameter of the high shear homogenized mineral trioxide aggregate. 
     
     
         31 . The mineral trioxide aggregate mix of  claim 28 , wherein the mineral trioxide aggregate mix comprises between about 45 wt. % and about 99 wt. % untreated mineral trioxide aggregate and between about 1 wt. % and about 55 wt. % high shear homogenized mineral trioxide aggregate. 
     
     
         32 . The mineral trioxide aggregate mix of  claim 28 , wherein the dental substance has a setting time of between about six and about fourteen minutes. 
     
     
         33 . The mineral trioxide aggregate mix of  claim 28 , wherein:
 the untreated mineral trioxide aggregate comprises particles with a maximum particle diameter of between about 0.7 and about 42.2 microns, with a median maximum particle diameter of about 3.8 microns, and with a standard deviation of maximum particle diameter of about 4.1 microns; and   the homogenized mineral trioxide aggregate comprises particles with a maximum particle diameter of between about 0.16 and about 2.45 microns, with a median maximum particle diameter of about 0.49 microns, and with a standard deviation of maximum particle diameter of about 0.5 microns.   
     
     
         34 . A dental substance comprising the mineral trioxide aggregate mix of  claim 28  and a liquid comprising water. 
     
     
         35 . The dental substance of  claim 34 , wherein the dental substance comprises between about 50 wt. % and about 95 wt. % of the mineral trioxide aggregate mix and between about 5 wt. % and about 50 wt. % of the liquid. 
     
     
         36 . A method for using the dental substance of  claim 34  in general dentistry and in endodontics, the method comprising:
 a. performing a dental procedure; 
 b. using the dental substance of  claim 34  to fill a space in a tooth; and 
 c. allowing the dental substance to set in between five and twenty minutes. 
 
     
     
         37 . The method of  claim 36 , wherein the dental procedure is an endodontic procedure. 
     
     
         38 . The method of  claim 36 , wherein the dental procedure comprises at least one of apexification, pulp capping, pulpotomy, regenerative endodontics, root canal filling, root-end filling, or root perforation repair.