Borehole shield for performing endodontic surgery and method of use thereof

Abstract

The borehole shield is useful for performing endodontic surgery, which involves removing a portion of a subject's alveolar bone to create a borehole for accessing a treatment site. The borehole shield of the present disclosure includes a body configured to fit into the borehole and a sealable opening disposed on the body. The present disclosure discloses a method for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, the method including the steps of creating a borehole on the subject's alveolar bone to expose the treatment site, placing a borehole shield within the borehole so that the sealable opening forms a seal around the treatment site, and applying a treatment operation to the treatment site. A method for preventing ambient fluids from entering an endodontic treatment site is disclosed. An endodontic surgery kit including instructions reciting a method for performing periradicular surgery is also disclosed.

Description

[Technical Field]

[0001] (Related Applications) This application claims priority to U.S. Provisional Patent Application No. 63 / 349,142, filed June 5, 2022, entitled "A device enabling attachment of instruments and its method of usage in apical surgery," which is hereby incorporated by reference in its entirety for all purposes.

[0002] The present disclosure relates to a borehole shield useful for performing endodontic surgery, particularly periradicular surgery around the root of a tooth, which can form a seal around the treatment site to prevent surrounding biological fluids from entering the treatment site. [Background technology]

[0003] More than 15 million root canal procedures are performed in the United States each year, and under normal circumstances, the long-term success rate of root canal treatment ranges from 80 to 90%. In some failed cases, inadequate endodontic treatment contributes to apical periodontitis. In certain circumstances, when inflammation or infection persists in the bony area around the apical end of a tooth, endodontic surgery is required to remove the diseased tissue surrounding the root apex and to resect the tip of the root apex.

[0004] The endodontic surgery process includes steps such as flap lifting, apical resection, removal of diseased tissue and infection, filling with appropriate materials, and closing the incision. Dentists typically use a dental operating microscope and / or a mouth mirror to check whether all diseased periapical tissue has been removed. However, traditional surgical methods have several drawbacks. 1. The procedure must be frequently interrupted to check the removal of soft tissue around the apex, making the procedure long and labor-intensive. 2. Bleeding often obstructs the operator's view and the surgical field, necessitating frequent flushing and cleaning. This moist environment not only increases the risk of postoperative infection but also increases the possibility of recontamination from surrounding biological fluids (e.g., saliva, blood), which can lead to surgical failure and further complications.

[0005] Several inventions have been proposed in an attempt to solve this problem, but none of them satisfy the desired surgical procedure without frequent stops to check the condition, preventing biological fluids from entering the treatment site, and providing a relatively dry environment and clear surgical visibility. Summary of the Invention

[0006] In response to the above-mentioned problems, the present disclosure provides a borehole shield that allows for hands-free attachment of endoscopic accessories, thereby shortening the procedure time interval and reducing the burden on the surgeon, while at the same time blocking foreign bodies and / or preventing biological fluids (e.g., saliva, blood) from entering the procedure site and affecting the surgical field of view.

[0007] Thus, the borehole shield is useful for performing endodontic surgery, which involves removing a portion of a subject's alveolar bone to form a borehole for accessing a treatment site, and the borehole shield of the present disclosure includes a body configured to fit into the borehole and a sealable opening disposed on the body. The endodontic surgery is periradicular surgery, and the treatment site is a tooth root. The sealable opening can form a seal around the treatment site to prevent surrounding biological fluids from entering the treatment site. The body allows for attachment of a mirror to reflect an image of the treatment site.

[0008] Furthermore, the body of the borehole shield is hollow and / or has a tubular, cylindrical, conical, bullet-shaped, truncated conical, or customized shape. A portion of the body is made of an elastic material. The body has a length of about 0.2 cm to about 10 cm, an interior size of about 0.2 cm to about 10 cm, and a thickness of about 0.1 mm to about 3 mm. The sealable opening of the borehole shield has a size of about 3 mm to about 15 mm. The sealable opening of the borehole shield has a polygonal or circular shape.

[0009] Thus, the body of the borehole shield further includes a slit and / or guide mechanism for guiding a surgical instrument to gain access to the treatment site, the guide mechanism being operably connected to the body via the fixation element, and the guide mechanism further comprises an annular portion configured to allow the surgical instrument to pass therethrough to gain access to the treatment site.

[0010] Furthermore, the fixation element connects the guide mechanism to the body through a slit disposed thereon, and the guide mechanism is slidable along the slit. The surgical instruments disclosed herein may be endoscopes, photography devices, light sources, lasers, curettes, ultrasonically-powered tips, irrigation devices, and suction devices.

[0011] Accordingly, a method for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery is disclosed, the method comprising the steps of creating a borehole on the subject's alveolar bone to expose the treatment site, placing a borehole shield within the borehole so that the sealable opening forms a seal around the treatment site, and applying a treatment operation to the treatment site.

[0012] Accordingly, a method of preventing ambient fluids from entering a treatment site in a tooth is also disclosed, the method comprising the step of positioning a borehole shield at the treatment site such that a sealable opening in the borehole shield forms a fluid-tight seal surrounding the treatment site.

[0013] Thus, the endodontic surgery kit includes instructions reciting a method for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, the method including the steps of creating a borehole on the subject's alveolar bone to expose the treatment site, placing a borehole shield in the borehole so that the sealable opening forms a seal around the treatment site, and applying a treatment operation to the treatment site. The endodontic surgery kit can further include a borehole shield useful for performing endodontic surgery including removing a portion of the subject's alveolar bone to form a borehole for accessing the treatment site, the borehole shield can further include a body configured to fit into the borehole and a sealable opening disposed on the body, the guide mechanism being operably connected to the body via a fixation element. The endodontic surgery kit can further include the borehole shield and a guide mechanism for guiding a surgical instrument to access the treatment site, the guide mechanism being operably connected to the body via a fixation element.

[0014] Additionally, the endodontic surgery kit further includes one or more endodontic surgical instruments. The endodontic surgical instruments may be an endoscope, a photography device, a light source, a laser, a curette, an ultrasonically driven tip, an irrigation device, and a suction device. Additionally, the endodontic surgery kit further includes one or more endodontic surgical instruments. The endodontic surgical instruments may be an endoscope, a photography device, a light source, a laser, a curette, an ultrasonically driven tip, an irrigation device, and a suction device.

[0015] Other aspects and advantages of the present disclosure will become apparent from the following detailed description taken in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0016] [Figure 1A] FIG. 1 is a schematic diagram of a borehole shield according to an embodiment of the present disclosure. [Figure 1B] FIG. 1 is a schematic diagram of a borehole shield according to an embodiment of the present disclosure. [Figure 1C] FIG. 1 is a schematic diagram of a borehole shield according to an embodiment of the present disclosure. [Figure 1D] FIG. 1 is a schematic diagram of a borehole shield according to an embodiment of the present disclosure. [Figure 2A] 1 is a schematic diagram of a borehole shield according to an embodiment of the present invention; [Figure 2B] 1 is a schematic diagram of a borehole shield according to an embodiment of the present invention; [Figure 2C] 1 is a schematic diagram of a borehole shield according to an embodiment of the present invention; [Figure 2D] 1 is a schematic diagram of a borehole shield according to an embodiment of the present invention; [Figure 3A] FIG. 1 is a schematic diagram of a borehole shield having a guide mechanism according to an embodiment of the present invention. [Figure 3B] FIG. 1 is a schematic diagram of a borehole shield having a guide mechanism according to an embodiment of the present invention. [Figure 4] FIG. 1 is a schematic diagram of a borehole shield having a slit according to an embodiment of the present invention; [Figure 5A]FIG. 1 is a schematic diagram of a borehole shield having slits and guide features according to an embodiment of the present invention; [Figure 5B] FIG. 1 is a schematic diagram of a borehole shield having slits and guide features according to an embodiment of the present invention; [Figure 6] FIG. 1 is a schematic diagram of a borehole shield with a mirror according to an embodiment of the present invention. [Figure 7A] 1 is a schematic flow chart illustrating the steps for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, according to one embodiment of the present invention. [Figure 7B] 1 is a schematic flow chart illustrating the steps for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, according to one embodiment of the present invention. [Figure 8A] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8B] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8C] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8D] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8E] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8F] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8G] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8H]1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8I] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8J] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8K] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 8L] 1A-1C are schematic diagrams illustrating a process of performing periradicular surgery using a borehole shield according to an embodiment of the present invention. [Figure 9] 1 is a schematic diagram illustrating an endodontic surgery kit according to one embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0017] The terms used in the description provided below are intended to be interpreted in their broadest reasonable manner, even when the terms are used in conjunction with the detailed description of certain embodiments of the present technology. Certain terms may be further emphasized below, but any terms intended to be interpreted in any limited manner are specifically defined as such in this detailed description section. Components and achievements of the borehole shield according to the present disclosure may be shown in the following drawings and embodiments. However, the size and shape shown in the drawings of the borehole shield are not intended to limit the features of the present disclosure.

[0018] An embodiment of the present disclosure provides a borehole shield useful for performing endodontic surgery. Referring to FIGS. 1A and 1B , endodontic surgery is required to remove diseased tissue surrounding the apex 111 and infected root canal walls of a patient's tooth 110 and / or an improper root canal filling 112 (the crown portion of the tooth is omitted for clarity). The endodontic surgery involves removing a portion of the target's alveolar bone 100 to form a borehole 120 for accessing a treatment site 130. FIGS. 1C and 1D are schematic diagrams illustrating a borehole shield according to one embodiment of the present disclosure. The borehole shield 200 includes a body 210 configured to fit into the borehole 120 and a sealable opening 220 disposed on the body. The sealable opening can form a seal around the treatment site 130 to prevent surrounding biological fluids from entering the treatment site. The endodontic surgery may be periradicular surgery, and the treatment site may be a tooth root. The biological fluid may be blood or saliva.

[0019] 2A-2D are schematic diagrams of borehole shields according to embodiments of the present disclosure. In some embodiments, the body of the borehole shield (200-203) may be hollow. The body may have a tubular, cylindrical (211), conical, bullet-like (210), frusto-conical (212), or customized shape (e.g., computer-generated according to the patient's individual condition). The cross section of the body may be circular (as shown in FIGS. 2A, 2B, and 2D) or polygonal (e.g., rectangular, as shown in FIG. 2C). Portions of the body may be made of elastic materials, such as rubber, latex, silicone rubber, and thermoplastics. Other materials, such as metallic materials (e.g., aluminum, titanium, steel, and their alloys) or plastic materials, may also be used. The body of the borehole shield has a length of about 0.2 cm to about 10 cm, an internal dimension of about 0.2 cm to about 10 cm, and a thickness of about 0.1 mm to about 3 mm. The sealable opening may have a circular shape (220) or a polygonal shape (e.g., a rectangle 221 shown in FIG. 2B). Other shapes, such as a star shape, an oval shape, a pentagon shape, or a customized shape (e.g., computer designed according to the patient's individual condition), are also applicable. The sealable opening in the borehole shield may have a size of about 3 mm to about 15 mm.

[0020] 3A-3B are schematic diagrams of a borehole shield having a guide mechanism according to one embodiment of the present disclosure. The borehole shield 300 further comprises guide mechanisms (310 and 311) for guiding surgical instruments (e.g., a light source 330 and an irrigation device 331 shown in FIG. 3B) to access a treatment site. The guide mechanisms are operably connected to the body via fixation elements (320 and 321). The guide mechanisms can move along the body to adjust the access position and angle of the surgical instruments. Portions of the guide mechanisms and / or fixation elements are made of elastic materials, such as rubber, latex, silicone rubber, and thermoplastics. Different materials, such as metallic materials (e.g., aluminum, titanium, steel, and alloys thereof) or plastic materials, can also be used.

[0021] FIG. 4 is a schematic diagram of a borehole shield with a slit according to one embodiment of the present disclosure. The borehole shield 400 further includes a slit 410. The slit allows for adjustment of the internal size of the body through a compressible structure. When the borehole shield with a slit is compressed and placed within a borehole, it expands, and the expanded structure not only conforms to the borehole but also creates strain, increasing the pressure applied to the borehole wall, further halting bleeding and thereby reducing the amount of surrounding biological fluid. The width of the slit may be from about 0.5 mm to about 5 mm.

[0022] 5A-5B are schematic diagrams of a borehole shield having a slit and a guide mechanism according to one embodiment of the present disclosure. The borehole shield 500 includes a body 213 configured to fit into a borehole, a sealable opening 221 disposed in the body, and a guide mechanism 510 for guiding a surgical instrument to access a treatment site. The guide mechanism 510 is operably connected to the body via a fixation element 511. The guide mechanism 510 includes an annular portion 512 configured to allow passage of a surgical instrument, thereby guiding the surgical instrument's access to the treatment site. The annular portion may have an internal size of approximately 0.5 mm to approximately 5 mm. As shown in FIG. 5A, the body 213 further includes a slit 410 disposed thereon, and the fixation element 511 connects the guide element 510 to the body 213 via the slit 410. The guide mechanism 510 is slidably movable along the slit 410. To guide a surgical instrument's access to the treatment site, the annular portion 512 may have an access angle of about 5 degrees to about 15 degrees relative to the horizontal axis of the guide mechanism 510 (shown in FIGS. 5A and 5B as dotted lines). As shown in FIG. 5B, the guide mechanism 510 includes an annular portion configured to allow a surgical instrument (e.g., an endoscope 520 or an ultrasonically driven tip 530) to pass therethrough, thereby guiding the surgical instrument's access to the treatment site. The surgical instruments disclosed herein may be endoscopes, photography devices, light sources, lasers, curettes, ultrasonically driven tips, irrigation devices, and suction devices.

[0023] 6 is a schematic diagram of a borehole shield with a mirror according to one embodiment of the present disclosure. The body 210 of the borehole shield 600 further comprises a mirror 610 adapted to reflect an image of the treatment site. Such a structure provides flexibility for certain angles that are difficult to observe, allowing the dentist to observe the image of the treatment site directly through the mirror or by using an endoscope as previously disclosed. The size, angle, and position of the mirror can be adjusted according to the patient's condition, e.g., the location of the treatment site and the depth of the borehole.

[0024] FIG. 7A is a schematic flowchart illustrating steps for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, according to one embodiment of the present disclosure, and lists the steps of creating a borehole on the subject's alveolar bone to expose the treatment site, placing a borehole shield within the borehole so that the sealable opening forms a seal around the treatment site, and applying a treatment operation to the treatment site.

[0025] Thus, the steps for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery are shown in Figure 7A. These steps include:

[0026] Step 710: A borehole is formed in the alveolar bone of a subject suffering from a pathological condition to expose the treatment site. The location for creating the borehole can be identified by preoperative x-ray (e.g., 3D cone-beam computed tomography). The borehole may be created by osteotomy using a standard drill, bone trephine, or alveolar bone expander. In some embodiments, a portion of the pathological tissue and / or the root apex may be removed during creation of the borehole. If some remnants of the pathological tissue and / or the root apex are not removed during the drilling process, they can be removed using a bone curette or tip. Bleeding from the cortical plate, tissue, or bone may be reduced by using laser cauterization and hemostatic cotton. The size of the borehole may be gradually increased, for example, from a 1.5 mm pilot hole to 3.3 mm, 3.5 mm, 5.7-6 mm, and so on. Prior to borehole expansion, the location, direction, and depth of the pilot hole can be confirmed by X-ray (e.g., 3D cone-beam computed tomography). The size of the borehole can be controlled by the size of a drill, trephine burr, or dilator, which is a standard process for those skilled in the art. The size of the borehole can be determined by the bleeding conditions; for example, if bleeding is severe at a size of 5.7 mm, it should not be expanded further.

[0027] Step 720: The borehole shield disclosed above is placed within the borehole so that the sealable opening forms a seal around the treatment site. The interior size of the borehole shield may be slightly larger than the size of the borehole, allowing the borehole shield to apply pressure against the borehole walls and against the hemostatic cotton to stop bleeding. The sealable opening may align with the treatment site and form a seal around it to prevent surrounding biological fluids (e.g., blood and saliva) from entering the treatment site. The borehole shield may be modified before or after placement within the borehole. Modifications include, but are not limited to, creating an opening, adjusting the opening size, adjusting the sealable opening size, and cutting the borehole shield. For example, a portion of the body can be removed to improve accessibility of the ultrasonically driven tip (see also recess 805 in FIG. 8G). A guide mechanism for guiding a surgical instrument to access the treatment site may be operably connected to the body of the borehole shield before or after placement within the borehole. The guide mechanism can be adjusted to provide a desired position and angle for the surgical instrument to access the treatment site.

[0028] Step 730: A treatment procedure is applied to the treatment site, including but not limited to endodontic surgery, periradicular surgery, apicoectomy, apicoectomy, retrograde filling, and root-end filling.

[0029] FIG. 7B is another schematic flowchart showing steps for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, according to one embodiment of the present disclosure, which shows a detailed embodiment of the schematic flowchart shown in FIG. 7A.

[0030] Thus, steps for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery are shown in Figure 7B. These steps further include:

[0031] Step 700: A flap of tissue can be elevated and held in position for creation of a borehole in the next step 710. An appropriate flap can provide adequate access and post-operative healing. Flaps may include, but are not limited to, full mucoperiosteal flaps (e.g., two-sided (triangular), three-sided (rectangular, trapezoidal), envelope, and limited mucoperiosteal flaps (e.g., semilunar, Luebke-Ochsenbein).

[0032] Step 731: Surgical instruments may be attached to the borehole shield prior to the procedure. The surgical instruments disclosed herein may be an endoscope, a photography device, a light source, a laser, a curette, an ultrasonically driven tip, an irrigation device, and a suction device. In one embodiment, the use of an endoscope offers the following advantages: (1) the endoscope can still observe the treatment site even in a liquid environment. The exposed treatment site can be cleaned or irrigated without suction, and the borehole shield prevents surrounding biological fluids from entering the treatment site, ensuring visibility of the surgical field; (2) the required size of the borehole is relatively small compared to traditional methods (using a microscope and / or a mouth mirror), which may carry the risk of removing excessive bone, thereby maximizing the preservation of root structure and occlusal function; and (3) the bone window (and wound size) is much smaller with endoscopic observation than with a traditional microscope and / or a mouth mirror. A smaller bone window and a smaller wound size result in shorter healing time.

[0033] Step 732: Inappropriate root canal filling material is removed and / or infected root canal walls are cleaned. Using an ultrasonically driven tip can provide advantages such as deeper preparation, preservation of root structure, and cleaning the root end cavity from debris and smear layers. In another embodiment, a laser (e.g., an Er-YAG laser) can also be used to remove inappropriate root canal filling material and / or clean infected root canal walls.

[0034] Step 733: The cavity created in step 732 and the borehole in step 733 are filled. Retrograde filling materials for root-end cavities may include, but are not limited to, amalgam, ZOE (zinc oxide eugenol cement), IRM (intermediate restorative material, ZOE reinforced with polymethyl methacrylate), Super EBA (ZOE reinforced with ethoxybenzoic acid), and MTA (mineral trioxide aggregate, a calcium silicate-based filling material). The borehole is filled with bone graft material. Several small boreholes can be created prior to filling with the material to enhance strength and increase healing rate as well as blood supply.

[0035] Step 734: After surgery, the flap is replaced in place and the incision is sutured.

[0036] 8A-8L are schematic diagrams illustrating a process for performing periradial surgery using a borehole shield according to one embodiment of the present disclosure. FIG. 8A illustrates step 700, in which a tissue flap 801 is elevated and held in position for creating a borehole in the next step 710. FIGS. 8B-8D illustrate step 710, in which a pilot hole 803 is created on the alveolar bone 100 of the diseased tissue 802 surrounding the apex 111 (FIG. 8B). A borehole 120 is then formed to expose the treatment site 130 (FIG. 8C). A portion of the pathological tissue 802 and the apex 111 are removed while creating the borehole. Some of the pathological tissue 802 is removed with a bone curette or tip, and bleeding from the cortical plate, tissue, or bone may be reduced by using laser cauterization and hemostatic cotton 804 (FIG. 8D). 8E-8G illustrate step 720, in which the previously disclosed borehole shield 500 is placed within the borehole 120 so that the sealable opening 221 forms a seal around the treatment site 130. The borehole shield 500 exerts pressure against both the borehole wall and the hemostatic cotton 804 to stop bleeding (FIG. 8E). After being placed within the borehole, the borehole shield 500 is cut to the desired length, and the exposed portion of the body can prevent blood (mostly from the cortical plate) from entering the treatment site (FIG. 8F). A portion of the body 213 can be removed to form a recess 805 to improve accessibility for the ultrasonic driving tip 530 (see also FIG. 8I). The width of the recess can be approximately 0.5 mm to approximately 5 mm. A guide mechanism 510 for guiding a surgical instrument to access the treatment site is operably connected to the body 213 of the borehole shield 500. To guide surgical instruments to the treatment site, the annular portion 512 may have an access angle θ of about 5 degrees to about 15 degrees relative to the horizontal axis (dashed line) of the guide mechanism 510 (FIG. 8G). FIGS. 8H-8L show steps 730-734, where in step 731, the endoscope 520 is attached to a borehole shield that passes through the annular portion 512 of the guide mechanism 510 prior to the treatment operation (FIG. 8H). In step 732, improper root canal filling material 806 is removed and / or infected root canal walls are cleaned with the ultrasonically driven tip 530 (FIG. 8I).In step 733, the cavity created in step 732 is filled with retrograde filling material 807 (FIG. 8J). The borehole 120 is filled with bone graft material 809, and several small boreholes 808 may be created prior to filling with the material to increase strength, healing rate, and blood supply (FIG. 8K). In step 734, the flap 801 is replaced in place, and the incision 810 is sutured after the procedure (FIG. 8L).

[0037] Thus, according to one embodiment of the present disclosure, there is disclosed a method of preventing ambient fluids from entering an endodontic surgical treatment site, the method comprising positioning a borehole shield at the treatment site such that a sealable opening in the borehole shield forms a fluid-tight seal surrounding the treatment site.

[0038] FIG. 9 is a schematic diagram illustrating an endodontic surgery kit according to one embodiment of the present disclosure. The endodontic surgery kit 900 includes instructions 901 reciting a method for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring surgery, as previously disclosed. The instructions 901 may be in paper or electronic form (e.g., an electronic document, audio-recorded instructions). The endodontic surgery kit 900 may further include a borehole shield as previously disclosed, such that the borehole shield 400 includes a slit 410. The endodontic surgery kit 900 may further include a guide mechanism as previously disclosed, such as guide mechanism 510 including a fixation element 511 and an annular portion 512. The endodontic surgery kit 900 may include one or more endodontic surgical instruments, including, but not limited to, an endoscope 520, a photography device, a light source, a laser, a curette, an ultrasonically driven tip, an irrigation device, and a suction device.

[0039] Various modifications to these embodiments will be readily apparent to those skilled in the art, and the novel principles and subject matter disclosed herein may be applied to other embodiments without the use of innovative faculty. The claimed subject matter set forth in the claims is not intended to be limited to the embodiments shown herein, but is to be accorded the widest scope consistent with the principles and novel features disclosed herein. Additional embodiments are contemplated within the spirit and true scope of the disclosed subject matter. Accordingly, the present disclosure is intended to cover modifications and variations that come within the scope of the appended claims and their equivalents.

Claims

1. 1. A borehole shield useful for performing endodontic surgery, the endodontic surgery including removing a portion of a subject's alveolar bone to create a borehole to access a treatment site, the borehole shield comprising: a body configured to fit into the borehole; a sealable opening disposed in the body; Equipped with The borehole shield, wherein the sealable opening is capable of forming a seal around the treatment site to prevent surrounding biological fluids from entering the treatment site.

2. The borehole shield of claim 1 , wherein the endodontic surgery is periradicular surgery and the treatment site is a tooth root.

3. The borehole shield of claim 1 , wherein the body is hollow.

4. 10. The borehole shield of claim 1, wherein the body has a shape selected from the group consisting of tubular, cylindrical, conical, bullet, frustum, and a customized shape.

5. The borehole shield of claim 1 , wherein a portion of the body is made of a resilient material.

6. The body includes: a length of about 0.2 cm to about 10 cm; An internal size of about 0.2 cm to about 10 cm; a thickness of about 0.1 mm to about 3 mm; 2. The borehole shield of claim 1, wherein

7. The borehole shield of claim 1 , wherein the sealable opening has a size of from about 3 mm to about 15 mm.

8. The borehole shield of claim 1 , wherein the sealable opening has a polygonal or circular shape.

9. The borehole shield of claim 1 , wherein the body further comprises a slit.

10. 10. The borehole shield of claim 1, further comprising a guide mechanism for guiding a surgical instrument to access the treatment site, the guide mechanism operably connected to the body via a fixation element.

11. The borehole shield of claim 10 , wherein the guide mechanism further comprises an annular portion configured to allow passage of a surgical instrument therethrough to guide the surgical instrument in accessing the treatment site.

12. The borehole shield of claim 11 , wherein the body further comprises a slit disposed thereon.

13. The borehole shield of claim 12 , wherein the fixing element connects the guide mechanism to the body through the slit.

14. The borehole shield of claim 13 , wherein the guide mechanism is slidably movable along the slit.

15. 15. The borehole shield of claim 14, wherein the surgical instrument is selected from the group consisting of an endoscope, a photography device, a light source, a laser, a curette, an ultrasonically driven tip, an irrigation device, and a suction device.

16. The borehole shield of claim 1 , wherein the body further comprises a mirror adapted to reflect an image of the treatment site.

17. 1. A method for performing periradicular surgery on a subject suffering from a pathological condition at a treatment site requiring periradicular surgery, comprising: creating a borehole on the subject's alveolar bone to expose the treatment site; placing the borehole shield of claim 1 within the borehole such that the sealable opening forms a seal around the treatment site; applying a treatment operation to the treatment site; A method comprising:

18. 1. A method for preventing ambient fluids from entering an endodontic surgical procedure site, comprising: placing the borehole shield of claim 1 at the treatment site such that the sealable opening of the borehole shield forms a fluid-tight seal surrounding the treatment site; A method comprising:

19. Instructions reciting the method of claim 17. An endodontic surgery kit comprising:

20. 20. The endodontic surgery kit of claim 19, further comprising the borehole shield of claim 1.

21. 20. An endodontic surgery kit according to claim 19, further comprising the borehole shield of claim 10.

22. 20. The endodontic surgery kit of claim 19, further comprising one or more endodontic surgery instruments.

23. 23. The endodontic surgery kit of claim 22, wherein the endodontic surgery instrument is selected from the group consisting of an endoscope, a photography device, a light source, a laser, a curette, an ultrasonically driven tip, an irrigation device, and a suction device.

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