Abstract: A system for manipulating energy transferred by members defining a joint. The system includes a first attachment structure configured to be attached to a first member of the joint and a second attachment structure configured to be attached to a second member of the joint. There is also an adjustable energy absorbing device attached to the first attachment structure and second attachment structure, wherein adjusting the energy absorbing device changes the load manipulating characteristics of the energy absorbing device.

Abstract: A stabilization device is provided including an axle and a portion that can be affixed to a bone. The device is used to stabilize a joint while allowing motion of the joint along its natural trajectory and it is placed internally in order to prevent pin tract problems. Additionally, methods for using the device are provided that include, in various sequences, inserting the axle into a bone of a joint, adjusting the geometry of the device and attaching the fixable portion to another bone of the joint. The device can be provided as part of a system including an axis trajectory guide useful for locating the axis of rotation of the joint prior to insertion, adjustment and attachment of the device.

Abstract: A spinal adjustment system which includes at least three implant modules, wherein each implant module includes: an engagement apparatus for engaging the implant module with a vertebra; and a semirigid, resilient elongated force application means which in use is secured to said engagement apparatus and extends from one implant module to the or each adjacent implant module; wherein: said force application means in use engages said the or each adjacent implant module such that said force application means can slide relative thereto in the plane of the force application means; each force application means in use applies a lifting force to the corresponding implant module and said at least three implant modules together in use apply a rotational force to said system; and the force application means extending from one implant module to an adjacent implant module extends alongside the force application means extending from said adjacent implant module to said one implant module.

Abstract: A bone screw, such as a pedicle screw, comprises an anchor portion and a sleeve portion, the anchor portion including an angled or curved portion and an externally threaded portion. The sleeve portion having an external thread for engaging bone, and a threaded internal bore for engaging the externally threaded portion of the anchor portion.

Abstract: A polyaxial spinal screw including a head and a threaded body. The head is defined by a portion of a first sphere that has a first center and a portion of a second sphere that has a second center, wherein the second center is approximately concentric with the first center. The threaded body extends from the portion of first sphere, wherein the portion of the first sphere is compressible approximately through the first center via compression of the portion of the second sphere.

Abstract: The present application is directed to devices and methods for treating vertebral fractures with one or more bone pins. In one embodiment of a method, a fractured vertebral body may be accessed through a pedicle portion and an opening may be created therethrough. One or more bone pins may be inserted through the opening. In one embodiment, at least one of the inserted bone pins is inserted to extend across a fracture zone with a proximal portion of the pin engaging a first bone segment and a distal portion engaging a second bone segment. The pin or pins may be manipulated to immobilize the first and second portions of the fractured vertebra.

Abstract: Certain embodiments of the invention provide plates for treating periarticular fractures or other non-full body weight bearing applications that combine polyaxial fixation with a low profile and enhanced contouring that more closely conforms to bone. Such plates can be designed to achieve buttressing effect and/or to be used in a reinforcement mode. Other features can be combined with these. Such plates can be created for use on bone sites such as on a tibia, fibula, metatarsal, calcaneous, other foot bone, humerus, radius, ulna, spinal, maxillofacial, as well as sites on other bones.

Abstract: Methods and devices for correcting hallux valgus and tailor's bunion are disclosed. An implant includes a bone engaging feature on each end connected by an intermediate portion. The implant is configured to be positioned on the dorsal side of the metatarsals and stabilizes two adjacent metatarsals toward one another, thereby decreasing the intermetatarsal angle. Depending on the severity of the deformity, a single or multiple implants may be used. In addition, the implant may be used as an adjunctive device in combination with other surgical procedures.

Abstract: Plates for patella fracture reduction and fracture reduction devices are described. More particularly plates and devices for patella reduction that are universally fit to a front surface or perimeter of a patella and include a plurality of attachment holes disposed therein for receiving a fastener. In some embodiments, the plates include removable tab members.

Abstract: A first method, for reducing and stabilizing at least one of a fracture in, a dislocation of, and a subluxation of at least one bone, includes forming a hole in the at least one bone. The first method also includes anchoring a first portion of a cable relative to the at least one bone and positioning a second portion of the cable in the hole in the at least one bone. With the second portion of the cable positioned in the hole in the at least one bone, the method includes both tensioning the cable to a measurable and adjustable tension and, with the cable tensioned to the measurable tension, anchoring a third portion of the cable relative to the at least one bone.

Abstract: Apparatus and methods are provided for the approximation of two bones, the apparatus including a first anchor that is rotationally driven into a first bone by a second bone anchor, which receives driving torque from a driver tool. After the first anchor is secured in the first bone, the second anchor is disengaged from the first anchor but remains connected to the first anchor by a flexible link of a designed length. The second bone anchor is secured in the second bone and has provisions to be lengthened or shortened to adjust the overall length of the implant, thereby adjusting the approximation between the two bones.

Abstract: A torsional-mode ultrasonic vibration generator is manufactured with longitudinal slots extending along its horn which damp unwanted vibrational modes and allow it to be made significantly smaller than previous apparatus. The torsional-mode ultrasonic generator is operable with a suite of surgical tools, to perform portions of an orthopaedic arthroplasty revision procedure. Three of the tools are for removing bone cement from within a bone cavity on a prosthesis cemented into the bone cavity. Three other tools are for separating an uncemented prosthesis from ingrown bone by cutting the bone between the prosthesis and walls of the bone cavity. The seventh tool is provided with sensors to determine a separation between a bone-cutting tool head and a metal prosthesis, feedback from the sensors being used to control servo motors of an articulated mounting for the seventh tool, to maintain the separation at a desirable value.

Abstract: A surgical bender for use in bending and/or plastically deforming a variety of types and/or shapes of materials in medical and/or surgical applications. Various embodiments include a compact and easily sterilizable multiple fulcrum arrangement that utilizes a series of interlocked actuating lever arms to greatly multiply an actuating force applied to a pair of handles for application to an intended material.

Abstract: The present invention discloses an alignment guide apparatus, system, and method. The alignment guide apparatus includes a body, a fixation insert, a guide pin, and a screw. The body may include an arm with a first end and a second end, an attachment portion at the first end, and an alignment portion at the second end. The fixation insert may be configured to pass through the attachment portion and the guide pin may be configured to pass through the alignment portion. The screw may be configured to engage the guide pin. The alignment system may include a bone plate, an alignment guide, a screw, at least one first fastener, and at least one second fastener. A method for moving a joint is also disclosed.

Abstract: A variable length interstitial probe apparatus includes: a probe for effecting thermal therapy and/or cryotherapy to a tissue; a flexible umbilical sheath permanently affixed to the probe, including at least one interface for supplying energy, cooling fluid, cooling gas, heating fluid, and/or heating gas to the probe; and an adjustable depth stop configured to slide along a length of a shaft region of the probe, and lock to the shaft region at a selected position. The adjustable depth stop is configured to engage a probe driver and/or a skull mount apparatus to stabilize positioning of the probe and to control a depth of entry of the probe into a patient. The probe may be configured to effect temperature modulation therapy, where processing circuitry activates a modulation pattern of thermal therapy emission and cryogenic therapy emission for applying a thermal dose to the tissue.

Abstract: An electrosurgical apparatus includes a generator system configured to generate a radio-frequency electric signal, and a handpiece to be gripped by an operator and having an end fitted with an active electrode electrically connected to the generator system. The signal is capable of polarizing the active electrode so as to generate a glow plasma discharge in the atmosphere when the active electrode is in the proximity of the tissue mass, without propagation of electric current through the patient's body (B).

Abstract: A device for vaporizing a hole in tissue, including a vaporizing element, a heating element, configured to heat the vaporizing element, and a mechanism configured to advance the vaporizing element into a specific depth in the tissue and retract the vaporizing element from the tissue within a period of time long enough for the vaporizing element to vaporize the tissue and short enough to limit diffusion of heat beyond a predetermined collateral damage distance from the hole. Related apparatus and methods are also described.

Abstract: Switches for electrosurgical devices comprising a plurality of electrode sets and related devices, systems, and methods. In some embodiments, a first electrode set may be configured to deliver CUT radiofrequency energy and a second electrode set configured to deliver COAG radiofrequency energy. A switch assembly may be configured to allow for selection between at least three modes, the at least three modes comprising a first, neutral mode, in which the electrosurgical device is configured such that no radiofrequency energy is delivered to either the first electrode set or the second electrode set, a second, CUT mode, in which the electrosurgical device is configured such that CUT radiofrequency energy may be delivered to the first electrode set through the switch assembly, and a third, COAG mode, in which the electrosurgical device is configured such that COAG radiofrequency energy may be delivered to the second electrode set through the switch assembly.

Abstract: A method for manufacturing an end effector assembly includes providing first and second jaw members moveable relative to one another about a pivot between a first, spaced-apart position and a second, approximated position. One of the first and second jaw members includes a cavity defined therein and the other of the first and second jaw members includes a stop member configured to be inserted into the cavity. A gap-setting gauge is grasped between the first and second jaw members to define a gap-distance between the jaw members equivalent to a thickness of the gap-setting gauge. The first and second jaw members are set such that the jaw members are prevented from approximation beyond the gap-distance.

Abstract: An electrosurgical device comprising: forceps including: (i) a first working arm; (ii) a second working arm; (iii) a blade electrode; wherein the electrosurgical device is capable of being switched between a first electrical configuration so that the electrosurgical device delivers a first therapy current through the first working arm, the second working arm, or both, and a second electrical configuration so that the electrosurgical device delivers a second therapy current through the blade electrode; and wherein the electrosurgical device includes a heat pipe in the first working arm, the second working arm, or both.

Abstract: A forceps includes first and second shafts, each having a jaw member disposed at a distal end thereof. At least one jaw member is moveable from an open to a closed position for grasping tissue therebetween. At least one jaw member is configured for reciprocation of a blade therethrough. A trigger assembly includes a trigger and at least one linkage coupled to the trigger and to the blade such that rotation of the trigger translates the blade between the retracted and the extended position. An interference member moveable between a locked position and an unlocked position is also provided. The interference member is configured to engage the linkage(s) when in the locked position to inhibit translation of the blade from the retracted to the extended position.

Abstract: A vessel sealer has a stepped jaw that allows the jaw to have an overall shape and a width that provides desired strength, shape, and functionality while permitting a smaller raised portion to apply the sealing pressure. The smaller area applying the sealing pressure allows an actuating mechanism to apply a clinically desired sealing pressure without exceeding the force or torque limitations of the actuating mechanism and can limit thermal spread during a sealing procedure.

Abstract: An endoscopic forceps is provided and includes a housing having a shaft that extends therefrom. An end effector assembly is operatively connected to a distal end of the shaft and includes a pair of pivotably coupled first and second jaw members. One of the jaw members is movable relative to the other jaw member. A drive mechanism includes a driving structure in operative communication with a cam slot operably disposed on one of the first and second jaw members. The driving structure includes a detent.

Abstract: An electrosurgical apparatus for treating tissue comprises an elongate shaft including a proximal region, a distal region having an electrically conductive region and one or more lumens through the shaft. A stylet is located within one of the lumens for obturating at least a portion of an opening defined by a distal end of the elongated shaft. The stylet distal end has a sensor and may include an occluding component substantially surrounding and affixed to it. The elongated shaft and the stylet can possibly be configured to allow passage of fluid through the lumen while the stylet is located within the lumen. Related stylet configurations are also disclosed.

Abstract: An electrosurgical tool includes an electrically powered handpiece with a detachable electrode at one end and a power connection at the other. A mechanism for connecting the detachable electrode to the handpiece includes a keyed electrical connection to power the electrode. The handpiece includes a feedback controller incorporated in the tool to adjust operational characteristics of the electrosurgical tool.

Abstract: Methods and devices that displace bone or other hard tissue to create a cavity in the tissue. Where such methods and devices rely on a driving mechanism for providing moving of the device to form a profile that improves displacement of the tissue. These methods and devices also allow for creating a path or cavity in bone for insertion of bone cement or other filler to treat a fracture or other condition in the bone. The features relating to the methods and devices described herein can be applied in any region of bone or hard tissue where the tissue or bone is displaced to define a bore or cavity instead of being extracted from the body such as during a drilling or ablation procedure.

Abstract: A medical device includes an elongated sleeve having a longitudinal axis, a proximal end and a distal end. A cutting member having a plurality of sharp edges is formed from a wear-resistant ceramic material is carried at the distal end of the elongated sleeve. A motor drive is coupled to the proximal end of the elongated sleeve to rotate the sleeve at cutting member at high RPMs to cut bone and other hard tissue. An electrode is carried in a distal portion of ceramic cutting member for RF ablation of tissue when the sleeve and cutting member are is a stationary position. In methods of use, (i) the ceramic member can be engaged against bone and then rotated at high speed to cut bone tissue, and (ii) the ceramic member can be held in a stationary (non-rotating) position to engage tissue and RF energy can be delivered to the electrode to create a plasma that ablates tissue.

Abstract: The invention relates to electrodes used in ablation catheter devices, where the electrodes contain two or more thermal sensors at different positions within the electrode that are capable of detecting temperature differences along the external surface of the electrode. In preferred embodiments, the thermal sensors are separated by one or more thermal insulating members and the thermal sensors are positioned near the external surface of the electrode at about the same distance from the end of the electrode, so that temperature measurements can indicate the position of the electrode with respect to the tissue desired to be ablated.

Abstract: Intra-cardiac voltage data display systems display a plurality of data sets derived at least from intra-cardiac voltage data sampled by an electrode. In some embodiments, at least some of the data sets are derived from a portion of the intra-cardiac voltage data that excludes an excludable portion of the intra-cardiac voltage data having a relationship with an occurrence of a particular cardiac event to facilitate identification of the existence of a transmural lesion in tissue adjacent the electrode. In some embodiments, the particular cardiac event is the occurrence of an R wave in the cardiac cycle, and the excludable portion is a V wave in the cardiac cycle.

Abstract: A system for monitoring ablation size includes a power source including a microprocessor for executing one or more control algorithms. A microwave antenna is configured to deliver microwave energy from the power source to tissue to form an ablation zone. A plurality of spaced-apart electrodes is operably disposed along a length of the microwave antenna. The plurality of spaced-apart electrodes is disposed in electrical communication with one another and each of the plurality of spaced-apart electrodes has a threshold impedance associated therewith corresponding to the radius of the ablation zone.

Abstract: A method for treating a stenosis includes providing a laser ablation system including a laser catheter, the laser catheter including a distal end having a plurality of laser emitters; positioning the distal end of the laser catheter within the subject proximate the target vascular portion; delivering laser energy to the laser catheter and emitting the laser energy from the plurality of laser emitters to ablate the stenosis; withdrawing the laser catheter from the subject; providing a balloon system including a drug-coated balloon, the balloon carrying at least one therapeutic agent, the therapeutic agent being a restenosis inhibitor; positioning the balloon within the subject proximate the target vascular portion; expanding the balloon to engage the target vascular portion; delivering the therapeutic agent from the balloon to the target vascular portion; delivering the therapeutic agent from the balloon to the target vascular portion; and withdrawing the balloon from the subject.

Abstract: Embodiments include a system for determining cardiovascular information for a patient. The system may include at least one computer system configured to receive patient-specific data regarding a geometry of the patient's heart, and create a three-dimensional model representing at least a portion of the patient's heart based on the patient-specific data. The at least one computer system may be further configured to create a physics-based model relating to a blood flow characteristic of the patient's heart and determine a fractional flow reserve within the patient's heart based on the three-dimensional model and the physics-based model.

Abstract: A data processing method, performed by a computer, for determining implant positions of two implant components relative to two bones, wherein each of the implant components is to be attached to one of the bones such that the implant components form a joint between the bones, and wherein an implant position is a relative position between the implant component and the corresponding bone, said method comprising the steps of: a) acquiring a set of target poses, wherein a target pose represents a relative position to be achieved between the two bones; b) calculating a set of virtual poses for a pair of virtual test implant positions, wherein the set of virtual poses comprises one virtual pose for each of the target poses and wherein a virtual pose represents a relative position between the two bones if the virtual test implant positions were applied as the implant positions; c) calculating a pose deviation value for each of the target poses, wherein a pose deviation value represents the difference between a target

Abstract: A robotic surgical systems and methods of operating the same are provided. The system comprises a surgical tool, a manipulator having a plurality of joints and supporting the surgical tool, and a controller. A virtual simulation represents the surgical tool as a virtual rigid body having a virtual mass including an inertia about at least one of the joints. The controller determines an expected joint torque for the joint. The expected joint torque is compared to an actual joint torque of the joint to determine a joint torque difference. The inertia of the virtual mass about the joint is determined. An angular acceleration about the joint is computed using the joint torque difference and the inertia. The angular acceleration is projected to the virtual mass to determine an external force. The controller simulates dynamics of the surgical tool in the virtual simulation in response to the external force.

Abstract: Automated systems and methods for creating a plan for performing a procedure (for example, hair transplantation) are provided. In some embodiments, the plan is generated automatically by a processor. A user interface may be configured to allow a user to input one or more of the parameters of the plan. In certain embodiments, the hair transplantation plan takes into consideration existing hair.

Abstract: A method for visualizing ablation includes displaying to a user a three-dimensional (3D) tube that visually represents a region for ablation in tissue of a patient. Ablation information, which specifies one or more ablation locations along the 3D tube and one or more respective ablation configurations for ablating in the ablation locations, is received from the user. An estimated impact of the ablation in the tissue is displayed to the user on the 3D tube based on the ablation locations and the corresponding ablation configurations.

Abstract: A method of implanting a hip joint prosthesis into a patient can include obtaining image data of hip joint anatomy of the patient. Physical activities that the patient desires to participate in subsequent to implanting the hip prosthesis can be determined. A size and an initial placement of the hip joint prosthesis based on the image data can be determined. A desired range of motion of the hip joint prosthesis based on the determined physical activities can be determined. A plan can be created comprising a desired implanted location of the hip joint prosthesis and based on the desired range of motion. The plan can be incorporated onto a guide. The plan can be executed with the guide thereby implanting the hip joint prosthesis into the patient at the desired implanted position.

Abstract: Disclosed are systems, devices, and methods for performing treatment along a lumen network, an exemplary method comprising receiving image data of a patient's lungs, mapping one or more luminal networks inside the patient's lungs based on the received image data, identifying a treatment target in the image data, determining a luminal pathway to the treatment target via at least one of the luminal networks, configuring treatment parameters for treatment of the treatment target and at least one of the luminal networks, navigating a tool inside at least one of the luminal networks to the treatment target, treating the treatment target with a primary treatment modality, and treating the luminal pathway of at least one of the luminal networks leading to or from the treatment target with a secondary treatment modality.

Abstract: Systems and methods for articulation calibration of a surgical tool configured to be coupled to a robotic surgical system are provided. The tool including a tool shaft with an end effector has at least one linkage member extending along the shaft and operably coupled to the end effector such that force selectively applied to the linkage member is able to cause articulation of the end effector. The tool can also include a homing mechanism. To perform articulation calibration of the end effector, it can be constrained, force can be applied to the linkage member to attempt articulation of the end effector until a resistance against further articulation exceeds a threshold, and a home position of the end effector can be determined based on a force at which the resistance has exceeded the threshold.

Abstract: Devices, systems, and methods for providing commanded movement of an end effector of a manipulator while providing a desired movement of one or more joints of the manipulator. Methods include augmenting a Jacobian so that joint movements calculated from the Jacobian perform one or more auxiliary tasks and/or desired joint movements concurrent with commanded end effector movement, the one or more auxiliary tasks and/or desired joint movements extending into a null-space. The auxiliary tasks and desired joint movements include inhibiting movement of one or more joints, inhibiting collisions between adjacent manipulators or between a manipulator and a patient surface, commanded reconfiguration of one or more joints, or various other tasks or combinations thereof. Such joint movements may be provided using joint velocities calculated from the pseudo-inverse solution of the augmented Jacobian. Various configurations for systems utilizing such methods are provided herein.

Abstract: In some embodiments, correcting an alignment error between an end effector of a tool associated with a slave and a master actuator associated with a master in a robotic system involves receiving at the master, master actuator orientation signals (RMCURR) representing the orientation of the master actuator relative to a master reference frame and generating end effector orientation signals (REENEW) representing the end effector orientation relative to a slave reference frame, producing control signals based on the end effector orientation signals, receiving an enablement signal for selectively enabling the control signals to be transmitted from the master to the slave, responsive to a transition of the enablement signal from not active state to active state, computing the master-slave misalignment signals (R?) as a difference between the master actuator orientation signals (RMCURR) and the end effector orientation signals (REENEW), and adjusting the master-slave misalignment signals (R?) to reduce the alignmen

Abstract: A medical assembly, preferably a sterilized one, includes a medical article (5) and a package containing the article, the package including a hollow support element (2) inside which the article (5) is free, a first protective element (3), called a stopper, which can be coupled to the support element (2) of the article, such that the support element (2) has a grip part (20) that protrudes from the stopper (3), and a second hollow protective element (4), called a cover. The cover can be coupled to the stopper (3) in such a way as to delimit, in cooperation with the stopper (3), a chamber (8) inside which there extends the grip part (20) of the support element, and, in the state when the cover is coupled to the stopper, a part of the stopper (3) protrudes from the cover (4).

Abstract: Embodiments provide a water-resistant VAD bag including an upper unit having the shape of a cylinder, a lower unit having the shape of a cylinder, a controller sleeve, a battery sleeve, two inserted sleeves positioned in between the controller sleeve and the battery sleeve, an inner sleeve, and an inner layer. The upper unit includes a first elongated strap with a clip and second elongated strap without a clip, a cover on top of the upper unit with a handle sewn into the cover, and a zipper around a bottom of the cover. The lower unit includes a connecting strap and a third elongated strap with a receptacle for the clip on the first elongated strap from the upper unit, where the zipper is on the top of the lower unit, and where the connecting strap and second elongated strap are sewn into the lower unit and the upper unit.

Abstract: A probe having a temperature sensor on its distal portion is introduced into a fluid-filled body cavity of a subject, and an irrigating fluid passed through the probe. The temperature of the irrigating fluid exiting the probe differs from the temperature of the body cavity. Temperature readings of the irrigating fluid exiting the probe are recorded. A determination is made from the temperature readings that predetermined contact criteria between the probe and the interior wall of the body cavity are satisfied.

Abstract: A measurement instrument for joint surgery may relatively move a first bone and a second bone, which are connected by soft tissue at a joint, in directions other than directions in which these bones are separated from each other, and measure the stability of a connection state between these bones. A housing may be fixed to a first bone. A slider may slide relative to the housing, and abut against a second bone. A position display portion displays the position of the slider relative to the housing. A measurement instrument for joint surgery relatively moves the second bone relative to the first bone along a joint face by the slider sliding relative to the housing. The stability of a state of connection between the first bone and the second bone is measured based on the position of the slider relative to the housing displayed by the position display portion.

Abstract: An alignment device for aligning an orthopedic plate with a bone attachment site includes one or more one light sources that are secured to an orthopedic plate holder with a mounting interface and in a location spaced from the orthopedic plate that is releasably secured to the distal end of the plate holder. The light sources are configured to project an illuminated indication pattern onto the plane the orthopedic plate and aligned with the primary axis of interest of the orthopedic plate, and which indication pattern extends a sufficient lateral distance away from the plate holder to allow the medical professional to align the axis of interest of the orthopedic plate with an out-of-view bone attachment site using at least one superficial anatomic landmark on the exterior of the patient and remote from the bone attachment site.

Abstract: The present disclosure generally relates a fiducial marker deployment system configured for controlled deployment of at least one of a plurality of preloaded specially-configured fiducials in a controlled serial manner to a desired target site. The deployment system generally includes a deployment device configured to deploy at least one of a plurality of preloaded fiducials to a target site within a patient via a rotational deployment mechanism. Each fiducial generally includes a pellet-like body having a groove helically formed along an outer surface thereof and the deployment device includes a deployment catheter having an internally threaded lumen configured to engage the helical groove of each fiducial so as to allow rotational loading and deployment of each fiducial.

Abstract: An improved system and method for the design, creation and installation of implant-supported dental prostheses is provided. A network accessible portal facilitates communication among a dental professional, a scanning center, a manufacturing center and others in the design and production of a dental drill guide and prosthesis, utilizing cone beam imaging, a rotatable 3-dimension representation of a patient's jaw, virtual placement of one or more implants and virtual testing prior to manufacture. Dental professionals may access the portal on a subscription or non-subscription basis.

Abstract: Provided is a guide pin for dental implant surgery, providing guidance so that a practitioner easily determines a location and angle of an alveolar bone of a patient when forming an implant hole in the alveolar bone to place an implant in the alveolar bone. By using the guide pin for dental implant surgery according to the inventive concept, a practitioner may perform the surgery by determining an accurate location and shape of the alveolar bone of the patient when drilling an implant hole in the alveolar bone, and thus, the success rate of the implant surgery may be increased.

Abstract: A dental instrument with an interchangeable frustum roller with a fixed apical tip for unobstructed viewing a working surface on a tooth and for rapidly, precisely and homogenously distributing a restorative material on the surface of a tooth while avoiding adherence of an applied restorative material to the dental instrument.