JP2007111226A - Diagnostic examination device for tooth - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To obtain a clear and reproducible image and to surely carry out diagnostic examination of the tooth by injecting light stably onto the tooth. <P>SOLUTION: A light injection fiber of the diagnostic examination device for the tooth is arranged on a predetermined position of the tooth attachably and detachably via a fixing tool so as to inject light stably onto the tooth. The fixing tool has a pair of clamping sections for clamping the both sides of the tooth and a connecting section connecting the pair of clamping sections. By forming the fixing tool in one piece from an elastic material, the clamping sections are opened and closed by the elastic force of the elastic material and are fixed to the tooth by the elastic force. In addition, a fixing section for an intraoral camera is provided on the connecting section so as to fix the camera attachably and detachably on the fixing section. With such a configuration, the diagnostic examination device for the tooth can be fixed to the tooth and light injection is facilitated and stabilized. Further, a clear image is obtained by the injected light and reproducibility of an image is achieved. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a tooth diagnostic inspection apparatus that injects light into a tooth and diagnoses dental caries and the like based on an image displayed by the transmitted light.

  It is difficult to find caries and the like on the adjacent surface of the tooth. Conventionally, a method of diagnosing a tooth by irradiating it with X-rays has been known as a diagnostic method for early detection. As another diagnostic method, for example, as disclosed in Patent Document 1 and Patent Document 2, an invention is known in which diagnosis is performed by irradiating a tooth with light and displaying an image displayed by the transmitted light.

  However, the conventional diagnostic method using X-ray irradiation has a problem that the subject is particularly exposed. In addition, the tooth can be observed only from one direction, and it is difficult to identify very early caries and cracks on the contact surface of the adjacent tooth. Furthermore, it is very difficult or impossible to determine whether the caries have reached the dentin. In addition, there are problems such as difficulty in observation in real time.

  Moreover, since the invention shown in Patent Document 1 and Document 2 cannot fix the light injection means to the teeth, it is difficult to stably inject light into a predetermined position according to the tooth type. For this reason, there is a problem that it is difficult to find initial caries and cracks. Furthermore, there is a problem that it is very difficult or impossible to determine whether the caries has reached the dentin. Further, in Document 1, since there are many gaps between the tip of the light injection fiber for injecting light into the tooth and the tooth, the directly injected light and the light reflected on the tooth surface cause halation and are displayed on the CCD. There are problems such as being easily blurred.

Furthermore, since the inventions disclosed in Documents 1 and 2 are not provided with the light injection position setting means for setting the light injection position, it is difficult to stably inject light into a predetermined position of the tooth. Therefore, it is very difficult or impossible to inject optimal light, and high reproducibility, stability, high image quality, etc. cannot be obtained. Furthermore, there is no disclosure of means for fixing to the optimum position consisting of six types on the mesial, distal, buccal and lingual sides.

WO 02/43604 A2 publication Japanese Patent No. 3117178

The problem to be solved is that the conventional tooth diagnostic inspection by X-ray irradiation has a problem with exposure, and at the same time, it is difficult to inspect caries on the contact surface of adjacent teeth. The invention of No. 2 is a diagnostic method that transmits light to a tooth, but in this tooth diagnostic test, it is difficult to stably irradiate light at a predetermined position of the tooth because the light injection means cannot be fixed to the tooth. Therefore, an image obtained by light irradiation tends to be unclear and image reproducibility cannot be obtained. Further, since the light injection position setting means is not provided, it is very difficult or impossible to stably inject light into a predetermined position of the tooth, and the image obtained by light irradiation tends to become unclear and the image The reproducibility is not obtained.

  The present invention relates to a dental diagnostic inspection apparatus for performing a reliable diagnostic examination by stably injecting light into a tooth to obtain a clear and reproducible image in a dental diagnostic examination such as caries using light. It is fixed to a predetermined position of the tooth.

The tooth diagnostic inspection apparatus of the present invention is
According to the first to third aspects, the light injection means and the fixing means are very compact and can be easily positioned and fixed at the optimum light injection position of the tooth via the fixing means, so that the light injection is possible. Light can be stably and optimally injected from the means, and a clear image can be obtained and the image can be reproduced without obstructing observation or visual field.
In addition, the fixing means is a small configuration in which the holding part can be opened and closed freely through an elastic body (as an example), and the tooth can be elastically inserted and fixed by the holding part, so that the fixing operation can be performed even in a narrow oral cavity. Easy and quick. Furthermore, since both hands can be released by fixing the tooth diagnostic inspection apparatus to the tooth, there is an advantage that other operations can be performed with a free hand.
Furthermore, camera fixing means of the CCD camera is provided in the fixing means of the tooth diagnostic inspection apparatus, and the CCD camera is fixed, so that camera shake can be prevented and caries and the like can be clearly projected through the CCD camera. Note that there is an advantage that video captured by the camera can be stored in an image recording device, captured in a personal computer for image processing, and explained to the patient using the image.
In this case, for example, a camera position adjustment unit may be provided in the camera installation unit.

According to the fourth aspect, since the light injection means is composed of one or a plurality of light injection fibers, for example, light of different wavelengths can be selectively or combinedly injected from the entrance side of each light injection fiber. That is, the type of light source to be used can be selected and diagnosed.
It is also possible to switch the light injection position to obtain an optimal injection position, perform light injection with less reflection, and adjust stray light. This makes it easy to obtain the best image.

  According to the fifth aspect, the light injection means is provided with the light injection position setting means, so that it is possible to inject light to the most effective position for detecting caries. As a result, the caries image can be observed more clearly and with better reproducibility. Furthermore, light injection into a narrow gap such as a periodontal pocket or a site that is difficult to inspect becomes easier and more accurate.

  According to the sixth aspect, an optimal and clear image can be obtained by adjusting the extra stray light amount other than the light injected by the stray light adjusting means. Further, it is possible to adjust so that an optimum light amount can be obtained when the outline of the tooth is accurately projected or when stray light is used as the reference light. Furthermore, when photographing with a camera, halation can be prevented by adjusting the amount of stray light.

  According to claim 7, a tooth that is difficult to diagnose by X-ray photography or the like by injecting light from one or more of the mesial, distal, buccal, lingual and occlusal surfaces of the tooth There is an effect that the adjacent caries and initial caries can be clearly projected.

  According to claim 8, by injecting light with two pairs of the buccal side cervical part and the lingual side cervical part as a pair, the adjacent surface of the tooth which is considered to be healthy and does not suffer from periodontal disease in the past is also good. An image can be obtained, which is effective in diagnosing caries and medium-term caries.

According to claim 9, by using a plurality of light injection fibers to inject light having the same wavelength and / or light having different wavelengths that can be adjusted, the transmitted light amount of the light injected into the tooth The amount of light reflected upon the internal tissue of the tooth such as caries can be made variable. As a result, it is possible to find an optimum condition in which the carious portion is raised as a shadow. In addition, since the objects that can be observed differ depending on each wavelength by injecting light of different wavelengths, it is possible to observe not only caries but also plaque fluorescence, tooth quality, and bacteria.
Further, a single image or a small number of images can be observed with less blur and combined observation. In addition, an optimal image can be obtained by changing the light injection position, number, light quantity, and wavelength, light injection with less reflection can be performed, and stray light can be adjusted. This gives the best image.

  According to the tenth aspect, it is possible to specify the type of tooth quality and bacteria by connecting a light sensor to the light injection fiber and capturing and spectroscopically analyzing light reflected from the tooth.

  According to the eleventh aspect, by adopting an independent contrast, each AGC (Automatic Gain Control: a circuit that variably controls the gain of the amplifier so that the output signal level becomes constant even when the input signal level changes) It can be provided to obtain the optimum contrast.

  The objective of facilitating and ensuring tooth diagnostic inspection using transmitted light was realized by optimizing the light injection position setting for the tooth in the light injection means of the tooth diagnostic inspection apparatus.

First, before entering this discussion, a technique for injecting light into teeth and diagnosing caries and the like with the transmitted light will be described.
In the diagnosis of a tooth by transmitted light, not the surface of the tooth to be diagnosed, but the pathological structure of the tooth is observed with transmitted light injected into the tooth from a predetermined position of the tooth or transmitted light reflected inside. That is, the diagnosis can be performed by causing the transmitted light to project the initial caries, periodontal disease, or the like as a shadow on the image.
Since the light injected from both sides of the tooth into the tooth is directed in various directions, it hits so-called transmitted light such as straight-like transmitted light and scattered transmitted light obtained from the occlusal surface and tissues inside and outside the tooth. There are three types of internally reflected transmitted light that is transmitted while being reflected, and a total of four types of fluorescence generated by these lights.
In some cases, scattering-like transmitted light or the like is generated as secondary light of the internally reflected transmitted light, and further, internally reflected transmitted light is generated from the scattered-like transmitted light. Furthermore, any one of a straight traveling-like transmitted light, a scattered-like transmitted light, an internally reflected transmitted light, or any combination thereof becomes fluorescence excitation light. In addition, an optimum inspection can be performed by using any one of these lights, or any combination thereof.

Here, when there is a caries or the like, light does not pass through the part, so the caries part rises as a shadow due to the pathological anatomical form and pathological ecology.
Also, the adjacent marginal ridges on the occlusal surface may have a convex lens-like effect, and the grooves in contact with the ridges form an optical boundary, so the adjacent surface caries image is more clearly observed Is done.
Further, the contrast of the carious image on the image plane varies greatly depending on whether or not the caries have arrived at the dentin. That is, when caries is localized in the enamel, there is a sufficient amount of enamel between the boundary at the enamel dentino junction (enamel ivory border) and the caries region, and the interior There is transmitted light such as reflected transmitted light, and the light is transmitted to the occlusal surface side. The caries image projected by the transmitted light is in a low contrast state. In dentin caries, the amount of transmitted light is very little or almost absent, so the contrast on the image plane increases. In other words, the caries image becomes clear as the caries erode the enamel, and when it reaches the dentin, the caries image becomes clearer.

Further, when the dentin becomes carious, the internally reflected and transmitted light generated at the enamel dentinal boundary is remarkably lowered in reflection efficiency due to the change in the refractive index, and is absorbed. As a result, the carious image appears as an irregularly shaped circular image at the apex of the triangle-like image formed by the marginal ridges and fissures on the image plane.
Since the enamel trabeculae run in the vertical direction between the dentin and the caries, the internally reflected transmitted light can efficiently pass through the enamel caries and the contrast is lowered.
The light injection position setting means of the present invention is an optically optimal use of the anatomical form. The fixing means for optimally fixing the light injection position setting means is mainly fixing means on the mesial, distal, lingual, and cheek sides. More preferably, it is a fixing means using an interdental solid space.
In other words, in order to effectively find caries on the adjacent surfaces of the teeth, not only injecting light into the dark clouds, but also the wavelength at the light injection point and the location and number of light injection points. The combination of is important.

  On the other hand, natural light, infrared light, blue, red, and near infrared are selected and used as light injected into the tooth tissue. This is because the object that can be observed differs depending on each wavelength. At present, in the ultraviolet (360 mm to 375 mm), the fluorescence reaction of apatite and periodontal disease bacteria, and in the light around blue (around 450 mm), the fluorescence reaction of plaque and the contour of caries or In the case of caries enamel fluorescence, red (600 nm) and near infrared (800 nm), near infrared and carious dentin fluorescence can be observed. In order to optimally use these wavelengths, optimization including the light injection position setting means is effective.

  The tooth diagnostic inspection apparatus according to the present embodiment includes a light injection unit that injects light into a predetermined position of the tooth, and a fixing unit that fixes the light injection unit to the tooth. As shown in FIG. 1 (top view) and FIG. 2 (side view), the fixing means has a pair of clamping parts 2 for clamping the tooth 1 from both sides, and the clamping part 2 is connected to the elastic material via the connecting part 3. It consists of a fixture 4 integrally formed of (iron, stainless steel, acrylic resin, etc.). And, as shown in FIG. 3, a cushioning material 5 such as soft silicone or rubber is provided on the surface of the clamping part 2 that contacts the tooth 1 and can be easily fixed at the optimum tooth position corresponding to each tooth type. Can be done.

  That is, it can be fixed and held automatically and reproducibly by the elastic force at the same position of the interdental space shown in FIG. The fixing device 4 comprises an interdental space, a pinching portion 2 fixed to the buccal side and the tongue side, and a connecting portion for connecting these, and depending on where the tooth is fixed, there are six types (a mesial tongue). Side interdental space, distal tongue interdental space, mesial buccal interdental space, distal buccal interdental space, buccal area, lingual area) It is possible to form a plurality of fixtures by combining the connecting means. Further, as shown in FIG. 26, FIG. 30, FIG. 14 to FIG. 19 and the like to be described later, the light injection means (the means for inserting the light injection fiber at the injection point) itself may also serve as the fixing means, or purely not fixed. It may be an insertion means for guiding the light injection means.

  Further, a fiber bundle 6 as light injection means is connected to the fixture 4. Each of the plurality of light injection fibers 7 bundled in the fiber bundle 6 is, for example, inserted into a stainless steel pipe or arranged at a predetermined position inside the fixture 4 through a plurality of guide holes (not shown) provided in the fixture 4. It is installed. The tip is directed to the tooth light injection point 8 shown in FIG.

  Further, in this embodiment, the light injection fibers 7 are arranged on both the cheek side and the lingual side of the fixture 4, and one each in the vicinity of the tooth neck of the buccal mesial surface 9 and the buccal centrifugal surface 10 of the tooth. The lingual mesial surface 11 and the lingual distal surface 12 are disposed in the vicinity of the cervical portion at four locations, for a total of four locations. In addition, the light injection point 8 may be two places of the buccal side mesial surface 9 and the lingual side mesial surface 11, or one of them, and can be freely selected by the fixture 4. In this case, if a pair of buccal tongue surfaces of the buccal mesial (centrifugal) surfaces 9 and 10 and the lingual mesial (centrifugal) surfaces 11 and 12 is adopted, a very good caries image can be obtained. And the caries image obtained is useful information for diagnosis of cutting availability because the contrast (shadow) is darker when the caries reach the dentin than when the caries is confined to the enamel. Is obtained. In addition, the arrangement | positioning position and arrangement number of the light injection fiber 7 arrange | positioned at the fixing tool 4 are not limited to a present Example.

In addition, since the fixture 4 is formed of an elastic body such as iron, stainless steel, or plastic, the pair of holding portions 2 can be freely opened and closed via the connecting portion 3 by the elastic force. Yes. In addition, the space | interval between the clamping parts 2 is set to the space | interval which can clamp the tooth 1 with an elastic force.
Further, a small hole 13 is formed in each of the distal end portions of the clamping part 2, and a distal end 15 of an opening / closing attachment 14 shown in FIG. 5 is inserted into the small hole 13. After the pin is opened and pinched at a predetermined position of the tooth 1, the fixing tool 4 can pinch the tooth with its own elastic force by holding the tip 15 of the fixture 14 from the small hole 13, and can hold the fixation. . Therefore, fixing of the fixing tool 4 to the teeth is simple and easy.

Further, the fixture 4 can be reliably diagnosed by injecting light while changing its position depending on the tooth to be diagnosed. For example, when diagnosing caries on the adjacent surface of the tooth 1, the tip of the light injection fiber 7 disposed on the fixture 4 is placed in the vicinity of the tooth neck 16 on the buccal mesial surface 9 of the tooth 1 as shown in FIG. 2. One is set in the vicinity of the tooth neck of the buccal side centrifugal surface 10, one is set in the vicinity of the tooth neck of the lingual mesial surface 11, and one is set in the vicinity of the tooth neck of the lingual distal surface 12.
The fixing means can also be fixed to a hard body (bone, implant, restoration, etc.) other than the tooth in the oral cavity of the measurement subject.

  At this time, the light injection position setting means includes a light injection position fixing setting means and a light injection position variable setting means. The light injection position fixing setting means sets the light injection fiber with an adhesive or uses an adhesive. It may be set or inserted into a pipe and fixed, or may be fixed using resin or metal. Further, a hole may be formed in the fixture 4 and the hole may be inserted into the hole, or a combination thereof may be used. These light injection position fixing setting means are installed on the fixture 4 so as to guide the light injection means to the optimum light injection position described above or later. The fixture 4 is formed in an optimum shape that should be reproducibly fixed to the optimum position of the light injection position setting means with respect to the tooth.

  Further, the light injection position variable setting means may be configured such that the light injection position of the waveguide is variable, such as the tip of the light injection fiber 7 inserted through the hole of the holding part 2 in the fixture 4. That is, as shown in FIG. 16, the light injection fiber 7 may be configured to be slidable via the waveguide guide 32 in the holding portion. As a result, the light injection fiber 7 is slid to move the light injection position back and forth, and a point can be determined at the optimum position by correcting a slight deviation.

The direction of the light injection fiber 7 in this light injection position variable setting means may be directed to the periodontal pocket, or may be directed to the mesial direction or the centrifugal direction. Further, the waveguide guide 32 may be a light injection port position varying means that enables angle adjustment using an elastically deformable material. In this case, the light injection port can be set at an arbitrary position as indicated by an arrow in FIG. 17, which is convenient. Alternatively, inexpensive non-movable light injection position fixing setting means may be employed. Thereby, cost can be reduced.
As described above, in the present invention, the light injection port of the light injection fiber can be positioned in the interdental space (space that is open vertically and cheek-tongue around the contact point between adjacent teeth). One of the features is that it can be done.

  For example, when diagnosing caries on the adjacent surface of only the distal surface of the tooth 1, the fixing position of the light injection fiber 7 provided in the fixture 4 is as shown in FIG. Each of the light-injecting fibers 7 on the lingual side is moved to a position where it can approach the distal surface side of the tooth 1a and the mesial surface side of the tooth 1b and fixed to the tooth 1 to thereby adjoin the tooth 1a and the tooth 1b shown in FIG. It becomes possible to diagnose caries only on the surface.

  On the other hand, the connecting portion 3 of the fixture 4 is provided with a camera fixing portion 20 for detachably fixing the camera as camera installation means. This is to prevent camera shake by fixing the camera to the fixture 4 during shooting. Further, the camera installation means has a camera 21 as shown in FIG. 2 in which the relative positional relationship between the camera shooting position (lens) and the subject to be shot (here, the portion where light transmitted and reflected from the occlusal surface side of the tooth comes out) is shown in FIG. Is fixed so that the occlusal surface of the subject 22 and the occlusal surface of the subject 22 are parallel to each other, and the portion to be photographed is within the angle of view and the focus is achieved based on the relationship between the angle of view of the lens employed in the camera 21 and the focus. Is set in advance.

As the configuration of the camera fixing unit 20 in this camera installation means, for example, there are various methods shown in FIGS. 8 to 13, and these configurations will be described below.
In FIG. 8, concave and convex engaging portions 23a and 23b are provided between the fixture 4 and the camera 21, and the camera 21 is fixed by the engagement of the engaging portions 23a and 23b.
In FIG. 9, a clip 24 is provided on the fixture 4 side, and the camera is fixed by sandwiching the camera with the clip 24.

In FIG. 10, a pair of triangular prisms 25 stand upright in parallel on the fixture 4 side, and a pair of square grooves 26 that engage with the triangular prisms 25 are formed on the camera 21 side. The camera 21 is fixed by engaging the square groove 26.
In FIG. 11, when the fixture 4 is formed of a magnetic material such as iron, or when the fixture 4 is not a magnetic material, a magnetic material (not shown) is fixed to the fixing portion, and a magnet 27 is provided on the camera 21 side. The camera is fixed by fixing to a magnetic material by the magnetic force of the magnet 27.

  In FIG. 12, a pair of semicircular groove walls 28 that are parallel to the vertical direction are provided on the fixture 4 side, and a semicircular convex portion 29 that is engaged with the groove wall 28 is formed on the camera 21 side. The camera is fixed by engaging the projection 29 with the groove wall 28.

In FIG. 13, the ring 30 is fixed to the fixture 4 side, and the camera 21 is fixed by inserting the camera 21 into the ring 30.
Note that the fixture 4 shown in FIG. 1 may be used as a type in which the camera 21 is not fixed.

In the tooth diagnostic inspection apparatus having the above-described configuration, the light injection point is preferably located below the caries in the vertical direction of the tooth (upward on the occlusal surface and downward on the root side). In many cases, the area below the largest ridge is even better. For example, it is better to be lower than the upper edge of the caries 31 as shown in FIG. That is, as shown in FIG. 15, it is preferable to inject light into the caries 31 from obliquely below the horizontal position. Further, in the left-right direction, a portion extending to the left and right of the caries center point is preferable. It is preferable to inject light from at least two directions of the cheek side (lip side) and the tongue side. Of course, it may be observed by injecting it obliquely alone, but it is desirable to inject it at a plurality of locations on the cheek side (lip side) and the tongue side.

FIGS. 1 and 6, or FIGS. 24, 25, and 27 are suitable examples of integrated light injection position setting means that realize light injection into the interdental space. In particular, FIG. 27 shows a three-position integrated light injection position setting and fixing means in which three means of the light injection means, the light injection position setting means and the fixing means are integrated, and is a further preferred example.
If these means are not used, the light injection is difficult or impossible. In addition, light injection from at least two directions on the buccal side (lip side) and lingual side has conventionally been filled with nectar in the interdental area (gingiva etc.) that seems to be healthy without periodontal disease. A structure that cannot be inserted or the like is a healthy interdental structure, that is, there is no gap in the interdental area, or a tooth that has no exposed roots). In this case, in order to obtain the optimum contrast, individual AGC is provided and independent contrast adjusting means (such as AGC circuit adjusts the amount of light in terms of power, or manually adjusts the volume resistance, and adjusts the current amount of the light source. Contrast adjusting means) may be employed to further increase the contrast.

  Here, when there is only one light injection position, it is preferably directly under the caries. Further, the light injection means in this case is preferably a surface or a linear type. And when there is one light injection means, it is very difficult to insert it under the caries of a healthy interdental part not suffering from periodontal disease. The light injection may be a line or a surface instead of a point. In this case, a contrast adjusting means for obtaining an optimal contrast image with an aggregate of a plurality of dots may be used.

Here, as stray light adjusting means (means for adjusting stray light generated by light emitted from the light injection fiber to the camera or the eye), a triangular pyramid shape or an O-ring shape as shown in FIGS. By providing an elastic body (silicone or the like) 33 to block stray light, stray light is prevented from entering the CCD camera and eyes, and the caries contrast is improved.
Further, as shown in FIG. 20, the contact surface with the tooth may be covered with a cylindrical elastic material 33 so that stray light adjusting means prevents the stray light from leaking to the upper part. As shown in FIG. 21, the stray light adjusting means can reduce the reflection of stray light by positioning the light injection point 8 below the sandwiching portion 2 in the fixture 4. Further, the stray light adjusting means may adjust the light shielding amount using materials having different light transmittances. Further, an appropriate amount of stray light may be used to extract a tooth outline, or may be useful for comparison with transmitted light as reference light. The stray light adjusting means is suitable for obtaining an appropriate amount of stray light.

  Next, the use of the tooth diagnostic inspection apparatus of the present embodiment will be described. As shown in FIGS. 1 and 2, first, the fixture 4 is fixed at a predetermined position of the tooth 1, and the light injection port of the light injection fiber 7 disposed on the fixture 4 is the light injection point of the tooth 1 shown in FIG. 4. Turn to 8. Next, light of various wavelengths is selected and incident from the light incident side of the light injection fiber 7 so that light is injected into the tooth 1 from the tip of the light injection fiber 7. As shown in FIG. 22, incident light is transmitted light 34 and reflected light 35 in the tooth as shown in FIG. 22, and the light is obtained in a direction perpendicular to the light injection direction, that is, light obtained from the occlusal surface of the tooth 1. An image is displayed and caries can be diagnosed.

If there is a caries on the adjacent surface of the tooth, light is not transmitted through the carious portion, so that it appears as a shadow (shadow) on the image. In addition, when the caries reaches the dentin, the shadow becomes darker, and as the distance to the dentin increases, the shadow becomes thinner. When the caries reach the dentin, the contrast (shadow) appears to be higher than when the caries is confined to the enamel. Thus, useful information for diagnosing whether treatment is possible can be obtained.
Moreover, you may employ | adopt the contrast output means which outputs a contrast value. In addition, the shape of the shadow, that is, an irregular image is often generated inside the occlusal surface when viewed from the adjacent surface. Based on this, the image processing means compares the normal shape with the comparison means and dentin caries. The possibility may be suggested, or the value may be output as a numerical value.

Furthermore, these images may be visually observed or diagnosed with images taken with an intraoral camera. In the case of using an intraoral camera, the camera 21 is fixed to the fixture 4 through fixing means, so that the camera 21 is prevented from blurring and a clear image is obtained. It is also convenient because images taken with a camera can be stored in a computer or displayed on a computer screen and explained to a patient.
When diagnosing periodontal disease, the light injection fiber 7 is fixed so as to contact the gums and light is injected. Since the injected light is not transmitted to the part with periodontal disease, reflection and absorption different from the surrounding reflection occur, and are reflected as a shadow.
As described above, the tooth diagnostic inspection apparatus according to the present embodiment can set the light injection point at a predetermined position, and thus can obtain an optimum image with stable and clear reproducibility. Further, there is an advantage that the light injection position can be automatically set to the optimum injection point without obstructing the observation and the visual field.

  The tooth diagnostic inspection apparatus of the present embodiment is provided by providing a pair of knobs 36 as shown in FIG. 23 at both ends of the connecting portion 3 that connects the clamping portions in the first embodiment, and pinching the knob 36 with fingers. As shown by the dotted line in FIG. 24, the portion 3 is warped by an elastic force so that the holding portions 2 can be opened and closed.

25, instead of this example, as shown in FIG. 25, one side of the connecting portion 3 that connects between the holding portions 2 is pivotally connected using a side 37 as a fulcrum 37, and between the holding portions 2 below the connecting portion 3. A configuration may be adopted in which the tension spring 38 is provided elastically to open and close the clamping portion 2 against the elastic force of the spring 38 to hold the clamping.
Since the light injection means and the camera installation means are the same as those in the first embodiment, description thereof is omitted. Further, the fixing tool in this case may be used as a type that does not fix the camera.

As shown in FIG. 26, the tooth diagnostic inspection apparatus of the present embodiment has a configuration in which a fixture 4 that sandwiches both side surfaces of the tooth 1 is integrally provided at the distal end portion of the zodiac 39. In this case, the fixture 4 is operated by operating the handle 40 against the elastic force of the spring 41 to open and close between the holding parts 2 around the fulcrum 42 to hold the tooth 1 at the holding part 2. Even when the finger is released, the clamping is held by the elastic force of the spring 41.
In this embodiment, the camera is not fixed to the fixture 4. Since the light injection means is the same as that of the first embodiment, the description thereof is omitted.

  As shown in FIGS. 27 (a) to 27 (g), the tooth diagnostic inspection apparatus of the present embodiment is configured such that a pair of handles 43 are pinched against the elastic force of a spring 45 to center a pair of rotating shafts 44. Optimal fixation is possible by opening and closing between the clamping parts 2 and clamping them between teeth. In addition, it is a fixing means that can hold the teeth by the elastic force of the spring 45 even if the hand is released in the state of being held. In this case, the sandwiching portion 2 is composed of a waveguide guide 32 made of an elastic body, the tip portion is bent and the tip is directed to the light injection position of the tooth. The light injection fiber 7 as a light injection means is inserted into the distal end portion of the waveguide guide 32, and light is injected from the exit port 66 toward the teeth. In this case, the waveguide guide 32 and the insertion hole at the tip end serve as the light injection position setting means.

Here, the change of the clamping portion by the spring is excellent in that the function of the light injection position variable setting means (first) is also exhibited. Further, the insertion portion at the distal end portion of the waveguide guide 32 can also be operated as second light injection position variable setting means.
This embodiment is a three-position integrated light injection position setting / fixing means in which three means of the light injection means, the light injection position setting means, and the fixing means are integrated, and is the most preferable example. The apparatus of this embodiment has operability, good visual field, quickness, versatility, optimal light injection, and the like.
Further, stray light adjusting means may be employed in the clamping unit 2 here. At this time, this means is more convenient because the function of the light injection position variable setting means can be exhibited.

Further, in this case, as shown in FIG. 28, a camera fixing member 46 as camera installation means is provided on the rotation shaft 44 of the handle 43. That is, as shown in FIG. 29, the end of the rotating shaft 44 is protruded, and the recess 47 of the camera fixing member 46 is engaged with this protrusion. The camera 21 can be mounted by engaging the camera mounting portion 48 b with the camera mounting portion 48 a of the camera fixing member 46.
Here, a capsule endoscope, a micro camera, a micro camera head, etc. may be mounted without providing the camera installation means. Furthermore, the camera may be wireless and light injection may be driven by wireless or a built-in battery to improve the operability by making the apparatus completely independent.
A battery may be used as the power source in that case. Further, a wireless power source using electromagnetic induction or a combination thereof may be used. In the case of electromagnetic induction, a flash photographing means for charging with capacitive addition and photographing with synchronous flash of the camera may be employed.
In addition, the camera position adjustment means for changing the position of the camera and teeth can be made with flexible wires, articulated arms, piezos, superelastic materials, superplastic materials, or adjustment means made of viscous materials. May be obtained. Here, the superelastic material and the superplastic material may be automatically positioned by adjusting the temperature.

  In this embodiment, the caries image on the adjacent surfaces of the two teeth can be observed simultaneously. This may sacrifice the contrast of the caries image of either of the two teeth. In that case, contrast adjustment may be performed individually, or optimization may be performed by using a plurality of light injections such as fibers. Independent injection simultaneously provides optimum contrast.

  In the tooth diagnostic inspection apparatus of the present embodiment, as shown in FIG. 30, the fulcrum 49 of the fixture 4 configured to be rotatable against the elastic force of the spring 50 around the fulcrum 49 is fixed to the camera 21 side. As a result, the fixture 4 and the camera 21 are integrally configured. The pair of levers 51 of the fixture 4 is connected to one end of a fixture opening / closing lever 53 provided at its end on the camera side via a wire 52 and rotatably via a fulcrum 54. By rotating the open / close lever 53 about its fulcrum 54, the lever 51 of the fixture 4 can be remotely operated by the wire 52 to open and close the clamping portion, that is, the tip of the light transmitting probe 32 in this embodiment. It becomes. The light injection fiber 7 is inserted into the light transmission probe 32, and light is injected into the teeth from the tip of the light transmission probe 32. The camera lens 56 is located immediately above the light injection position, and the position fixed by the light transmission probe 32 is the imaging position. In this tooth diagnostic inspection apparatus, the fixing tool opening / closing lever 53 is remotely operated and fixed to the tooth, and then the fixing to the tooth is held by the elastic force of the spring even if the hand is released. The camera shown in the present embodiment is not limited to the illustrated camera, and a small camera such as an endoscopic tube camera can also be used.

In this embodiment, the light amount adjusting means in the light injection means of the tooth diagnostic inspection apparatus shown in the above embodiment will be described.
In the diagnosis of a tooth to which light is injected, the success or failure of the diagnosis depends greatly on the amount of light injected into the tooth. For this purpose, for example, in FIG. 1, various fixtures having only one light injection means on one side of the fixture 4, one on each side or two on each side, and three are necessary. It is possible to adjust the amount of light by selecting and using them according to the conditions.

  This light quantity adjustment can also be performed by changing the light injection location by the light injection fiber 7 for injecting light into the teeth. However, when a plurality of light injection fibers 7 are provided, for example, one fixture 4 is shown in FIG. As shown, each light injection fiber 7 of the plurality of light injection fibers 6 is connected to an independent light source such as a laser 62, LED 63, halogen 64, or other light sources or optical sensors of various wavelengths, and each independent light source is electrically connected. The amount of light can be adjusted by turning on / off the light and adjusting the light, or changing the wavelength to change the quality of the light. In other words, the amount of light is adjusted by adjusting the volume resistance manually, adjusting the volume, adjusting the light using an algorithm prepared in advance, regardless of the shooting conditions, or adjusting the power using a known AGC circuit. It is also possible to do. Reference numeral 65 in the figure denotes an optical sensor that identifies the type of tooth and bacteria by capturing reflected light from the tooth and performing spectral analysis.

  Further, in order to prevent the light of the light source itself from entering the fiber while keeping the power constant, a means 57 for changing the light quality is inserted between the injection fiber 7 and the light source as shown in FIG. The amount of light can be adjusted. For example, the amount of light can be adjusted by providing a mirror 58 or prism as shown in FIG. 32 (b) for distribution, or by providing a mechanical shield such as an iris 59 or an optical film as shown in (c). Furthermore, it is also possible to adjust the wavelength so that the optical filter 60 can be selectively switched as shown in FIG. In this case, it may be an independent light source or a single light source. The area through which the iris 59 can transmit light can be made variable, and the iris 59 can be adjusted by driving the iris 59 manually or by electronic control by an actuator typified by a motor. Moreover, as shown in (e), the light can be polarized and dimmed by inserting a polarizing plate 61. Incidentally, in recent years, there is an electronically controllable iris that does not have a mechanical drive using a liquid crystal mechanism.

Here, the halogen light is provided with a filter, which can be used for adjusting the amount of light, but also for producing light of a specific wavelength (ultraviolet, blue, green, red, near infrared).
Next, when `` infrared light is selected as injection light '', `` combined diagnosis of optical sensor and infrared light installed on the incident side (light source side) of the light injection fiber '' and light other than infrared light is selected as the injection light The diagnosis procedure of “diagnosis combining injection light and intraoral camera” will be described.

A. Diagnosis procedure of combination of optical sensor and infrared light installed on the incident side (light source side) of the light injection fiber Attach the fixture to the tooth.
2. Infrared light is injected into the tooth from the light injection position.
3. The injected infrared light is captured by an optical sensor.
4). The electrical signal converted from the optical signal is displayed on the monitor and analyzed.
5. Diagnose based on analysis results.
6). Remove the fixture. (Procedure 6 may be between steps 3 and 4)

B. Diagnosis combining injection light and intraoral camera Attach the fixture to the tooth.
2. Light is injected into the tooth from the injection point.
3. The light transmitted and reflected on the teeth is photographed with an intraoral camera.
4). Display the captured video on the (PC) monitor and analyze the video.
5. Diagnose from the analysis result (you may make a visual diagnosis without performing step 4)
6). Remove the fixture. (Procedure 6 may be between steps 3 and 4)

C. Procedure for simultaneous diagnosis Attach the fixture to the tooth.
2. Infrared light and other injection light are injected from the light injection position to the tooth.
3. The injected infrared light is captured by an optical sensor, and the light transmitted through and reflected from the teeth
Take a picture with an intracavity camera.
4). The image projected by the signal converted from the signal of the optical sensor to the electrical signal
(PC) Display on monitor and analyze video.
5. Diagnose from analysis results.
6). Remove the fixture. (Procedure 6 may be between steps 3 and 4)
As a modification, a fluorescent material may be used for caries diagnosis. Moreover, you may use the dentin determination agent couple | bonded specifically with dentin.

1 is a top view of a tooth diagnostic inspection apparatus according to Embodiment 1. FIG. 1 is a side view of a tooth diagnostic inspection apparatus according to Embodiment 1. FIG. It is a figure which shows a fixing tool. It is a figure which shows a tooth. It is a figure of the attachment tool for opening and closing. It is a figure which shows the fixed position of a fiber. It is a figure which shows the dental caries diagnostic position. It is a figure which shows a camera installation means. It is a figure which shows a camera installation means. It is a figure which shows a camera installation means. It is a figure which shows a camera installation means. It is a figure which shows a camera installation means. It is a figure which shows a camera installation means. It is a figure which shows a light injection position. It is a figure which shows a light injection direction. It is a figure which shows a light injection inlet position variable means. It is a figure which shows a light injection inlet position variable means. It is a side view which shows a stray light adjustment means. It is a top view which shows a stray light adjustment means. It is a figure which shows a cylindrical elastic body. It is a figure which shows a light injection point. It is a figure which shows reflection of injection light. It is a figure of the tooth diagnostic inspection apparatus which concerns on Example 2. FIG. It is a figure which shows opening and closing of a clamping part. It is a figure which shows the other example which shows opening and closing of a clamping part. It is a figure of the tooth diagnostic inspection apparatus which concerns on Example 3. FIG. FIG. 4 is a diagram of a tooth diagnostic inspection apparatus according to Example 4, in which FIG. (A) is a front view, FIG. (B) is a rear view, (c) is an opening operation diagram of a clamping part, (d) and (e) are side views; (f) is a plan view, and (g) is a bottom view. It is a figure which shows a camera installation means. It is a figure which shows a camera fixing | fixed part. It is a figure of the tooth diagnostic inspection apparatus which concerns on Example 5. FIG. It is a figure which shows several optical injection fiber. It is a figure which shows light quantity adjustment. It is a figure which shows an interdental hourglass-shaped space | gap.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Tooth 2 Clamping part 3 Connection part 4 Fixing tool 5 Buffering material 6 Fiber bundle 7 Light injection fiber 8 Light injection point 9 Buccal side mesial surface 10 Buccal side centrifugal surface 11 Tongue side mesial surface 12 Tongue side centrifugal surface 13 Small hole 14 For opening and closing Attachment 15 Tip 16 Near tooth neck of buccal mesial surface 17 Near tooth neck of buccal distal surface 18 Near cervical surface of lingual mesial surface 19 Near cervical surface of lingual distal surface 20 Camera fixing portion 21 Camera 22 Subject 23 Concavity and convexity Engaging portion 24 Clip 25 Triangular prism 26 Square groove 27 Magnet 28 Cross-sectional semicircular groove 29 Cross-sectional semicircular convex portion 30 Ring 31 Caries 32 Waveguide guide 33 Cylindrical elastic material 34 Transmitted light 35 Reflected light 36 Knobs 37, 42 , 49, 54 Support point 38, 41, 45, 50 Spring 39 Zodiac 40 Handle 43 Handle 44 Rotating shaft 46 Camera fixing member 47 Recessed part 48 Mounting part 51 Lever -52 Wire 53 Fixing lever open / close lever 55 Light transmission probe 56 Camera lens 57 Light quality changing means 58 Mirror 59 Iris 60 Optical filter 61 Polarizing plate 62 Laser 63 LED
64 Halogen 65 Light sensor 66 Outlet

Claims (11)

  In an apparatus for transmitting light to a tooth and diagnosing dental caries and the like by the transmitted light, light injection means for injecting light into a predetermined position of the tooth, and fixing means for fixing the light injection means to the tooth A dental diagnostic inspection device comprising:   The fixing means comprises a fixture having a pair of clamping portions that clamp both side surfaces of the tooth, and that can be opened and closed by the elastic force of the elastic body between the pair of clamping portions and can be held. The tooth diagnostic inspection apparatus according to claim 1.   2. The dental diagnosis and inspection apparatus according to claim 1, wherein the fixing means includes camera installation means for detachably attaching a camera that captures an image obtained by transmitted light of light injected into the tooth.   2. The dental diagnosis and inspection apparatus according to claim 1, wherein the light injection means comprises one or more light injection fibers.   2. The dental diagnosis and inspection apparatus according to claim 1, wherein the light injection unit includes a light injection position setting unit.   2. The dental diagnosis and inspection apparatus according to claim 1, wherein the light injection means includes stray light adjustment means for adjusting stray light generated by light injected into the tooth.   The said light injection means inject | pours light from any one place or multiple places of the mesial part of the tooth neck part and / or periodontal pocket, centrifugation, a buccal side, a lingual side, and an occlusal surface. Tooth diagnostic inspection equipment.   2. The dental diagnosis and inspection apparatus according to claim 1, wherein the light injection means injects light at a pair of a buccal side and a lingual side.   2. The dental diagnostic examination according to claim 1, wherein the light injection means injects light having the same wavelength and / or light having different wavelengths that can be adjusted through a plurality of light injection fibers. apparatus.   2. The dental diagnosis and inspection apparatus according to claim 1, wherein the light injection means connects an optical sensor that captures light reflected from the tooth after being injected into the tooth to the light injection fiber.   The tooth diagnostic inspection apparatus according to claim 1, wherein the light injection unit includes an independent contrast adjustment unit.

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