JP2009268614A - Depth measuring instrument of periodontal pocket and depth measuring system of periodontal pocket - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a depth measuring system of a periodontal pocket suppressing the irregularity of a result caused by the individual difference of a tester, having high safety, used by the sensation approximate to the test of the periodontal pocket mainly manually performed at the present time and easy to use for automatic recording or the display of an image. <P>SOLUTION: A structure producing no force exceeding a predetermined maximum value is set in the control of the insertion force of a probe by a spring to make it possible not only to certainly prevent predetermined insertion force even if there is an individual difference in a force applying way but also to prevent dangerous force from being added to the affected part. Further, by transferring image data obtained by an imaging system to a computer while adding the addition data of a sensor and a switch, an image necessary for a test can be certainly selected and, by providing the function of controlling and displaying the image, the confirmation of the elapse of medical treatment or the explanation to patient is easy to carry out. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

The present invention relates to hardware and software for performing periodontal pocket depth measurement in the field of dentistry.

Recently, the number of patients with periodontal disease has been increasing due to the progress of an aging society in Japan (Non-Patent Document 1 (http://mhlab.jp/malab_calendar/2006/12/17_16566.html)). Periodontal disease has a tendency to increase the number of patients not only in the elderly but also in young people, and once suffered, long-term treatment is required. It is necessary.

One of the important tests for grasping the state of periodontal disease is periodontal pocket depth measurement. In the periodontal pocket depth measurement, the depth of the periodontal pocket generated between the tooth and the gum is measured with a dedicated thin probe, and measurement is performed at 2 to 6 locations for each tooth. This inspection is usually performed depending on the sense of the hand of the inspector holding the probe. However, the probe insertion force required for the inspection is not so large as about 20 to 30 g, so a dedicated probe is used. It is necessary to train to push the scale and apply a certain force. In this way, since the current inspection method relies on the sense of the hand, it has been reported that the inspection results and diagnosis results vary even for the same affected part by the inspector (Japanese Dental Education Journal Vol.15). , No.2, pp.322-326).

  There are many products that have been developed and marketed to suppress the variation in the measurement results of periodontal pocket depth due to individual differences in sensation. One example is a sleeve structure in which a probe is inserted into a periodontal pocket and a spring is covered, and the insertion force of the probe is detected by the contraction of the spring, and the displacement of the spring at that time is detected to detect the tooth. There is a method for measuring the circumferential pocket depth. The principle of this product is described in detail in the following patent document.

The above product is a system that includes recording of test results, but the periodontal pocket depth is measured based on the difference between the probe part that lies in the periodontal pocket and the sleeve structure that covers it. At the same time, the mechanism itself in which the force is adjusted by a spring has been described in JP-A-10-165425 and the like.

The above product is a system that includes recording of test results, but the periodontal pocket depth is measured based on the difference between the probe part that lies in the periodontal pocket and the sleeve structure that covers it. At the same time, the mechanism itself in which the force is adjusted by a spring has been described in the following patent document.

In addition, there are some devices that are devised only for the purpose of suppressing the variation in the inspection results, as the periodontal pocket depth measurement is performed visually. Since the largest cause of the variation in the inspection results is due to individual differences in probe insertion force, it is only necessary to suppress this as much as possible. For example, according to the following patent document, by devising the structure of the probe base, when the force applied to the probe reaches a certain value, no force exceeding the certain value is applied even if the probe is continuously pressed thereafter. It has become.
However, when the periodontal pocket measuring device is actually manufactured by the method according to the above-mentioned literature, the frictional force between the spring surface and the probe end is dominant rather than the repulsive force due to the spring. It is difficult to apply power. Also, if the probe is pushed more than a certain amount, it will hit the external case on the way, so that even greater force will be output as it is, but no solution has been clarified.

Although it is not easy to apply a constant insertion force to the examination site in this way, it is easy for the examiner or system to detect that the insertion force necessary for the examination has been applied for safety. Some have been devised. For example, in the following patent document, a predetermined force is applied by using an elastic body at the tip of a probe that comes into contact with an examination site and detecting a change in optical characteristics due to a certain deformation when the force is applied. You can recognize that.
In addition, with a simpler configuration, the displacement of the probe that occurs when a constant force is applied generates a mechanical contact sound or vibration, which allows the inspector to know that the required force has been applied. Some are devised to be able to. For example, what is disclosed in the following patent document is actually used as a product.
However, in order to use the method disclosed in Patent Document 4 (Japanese Patent Application Laid-Open No. 2007-152004), the probe must be formed of a transparent body excellent in photoconductivity, and the object on the back side can be seen with the naked eye. It may be difficult to measure. Further, in the configuration disclosed in Patent Document 5 (Japanese Patent Application No. 9-301178), the vibration for notification is very weak, and it is not always possible to notify in a dental clinic environment where noise is high.

  So far, in the measurement of periodontal pocket depth, we have given examples of techniques related to the control method of probe insertion force, which is mainly required for inspection, but since measurement of periodontal pocket depth is the final purpose, measurement There are many inventions aimed at automating or increasing the accuracy of the above. As described above, if the displacement of the probe is mechanically generated, it is not so difficult to obtain the depth by reading the displacement.

  However, when the pocket depth is measured using the mechanical displacement in this way, a part that contacts the bottom of the pocket and a part that secures a position that becomes the origin of the pocket depth (for example, the upper end of the gum) are required. Therefore, there is a problem in terms of ease of handling such that the probe is difficult to miniaturize compared to a method of simply visually checking the probe, and the tip of the probe is hidden behind the sleeve structure and cannot be seen. In order to solve this problem, there has been described a method of optically reading the pocket depth instead of mechanically reading the pocket depth. For relatively old ones, the following patent documents can be cited.

  In this document, a method is disclosed in which light is conducted through a pocket probe and the amount of light emitted from the probe measurement unit is detected by a photodiode. When a part of the probe is embedded in the periodontal pocket, the amount of light detected by the photodiode changes according to the length of the probe, so that the periodontal pocket depth can be measured with this change in the amount of light. It is. With this method, the probe is not required to have a special shape, and the periodontal pocket depth can be measured with a very simple configuration.

Recently, a photodiode array (image sensor) in which photodiode elements are two-dimensionally arranged can be used at low cost, so the image sensor and pocket probe are integrated, and the image obtained by photographing the probe is analyzed. By doing this, the length of the probe portion not submerged in the periodontal pocket can be obtained, and the periodontal pocket depth can be measured in the same manner as the principle disclosed in Patent Document 6 (US Pat. No. 4,883,425). The system that came to be seen. For example, in the following Patent Document 7 (Japanese Patent Laid-Open No. 11-226035), a system for photographing a necessary portion of a dental treatment device or a measuring device with an integrated camera is widely described. It has also been proposed to use a pocket probe. Further, in the following Patent Document 8 (Japanese Patent Laid-Open No. 2001-170088) and Patent Document 9 (Japanese Patent Laid-Open No. 2007-152004), a scale is specifically given to the probe, and this is photographed by an imaging means such as a camera, and image analysis is performed. A configuration is described in which the periodontal pocket depth can be automatically measured by reading the scale using the.
http://mhlab.jp/malab_calendar/2006/12/17_16566.html Journal of Japanese Society for Dental Education Vol.15, No.2, pp.322-326 JP-A-10-165425 Japanese Patent Application No. 3-329737 JP2007-82609 JP2007-152004 Japanese Patent Application No. 9-301178 U.S. Pat. No. 4,883,425 (1989) JP-A-11-226035 JP2001-170088 JP2007-152004

As already mentioned, it is meaningless as a test if the measurement results vary depending on the individual of the examiner, so periodontal pockets that can obtain uniform results without requiring repeated practice or special techniques. It is a first problem of the present invention to realize a depth measuring device. For this purpose, not only a means for ensuring that the probe insertion force is appropriately applied, but also a means for notifying the inspector himself that the necessary insertion force has been applied and for safely terminating the inspection.

The first issue, uniformity of results and safety, is an indispensable requirement for a measuring instrument for inspection purposes, but it should satisfy these requirements and make the inspection system as easy to use as possible. This is the second problem of the present invention. Specifically, it can be used as close as possible to the current manual inspection. If only the insertion force is applied accurately to the probe, it may be a method of applying a certain force using some mechanical driving force, but this is a completely different usage method from the conventional inspection method. Therefore, it is necessary to practice until you get used to it. In addition, it is difficult to apply a mechanical force to the sensory movements of applying force quickly to a part that seems to be visually inconspicuous and slowly applying force to a part that seems to be performed carefully. . As explained in the patent literature, if a sleeve structure is used to detect the insertion force, the force applied by hand can be detected. There are problems such as difficulty. In the periodontal pocket depth measuring device of the present invention, force detection can be executed with a simple configuration almost the same shape as a probe used by hand. Furthermore, in the periodontal inspection systems that are commercially available, many examiners themselves determine that the probe has been properly inserted, and the measured values are recorded by stepping on the foot pedal. In the measurement of periodontal pocket depth, there are about 200 inspection spots at the maximum, and the operation of recording all of them by stepping on the foot pedal is very troublesome. Considering such problems, the periodontal pocket depth measurement system according to the present invention aims to record measurement results almost automatically without requiring any special operation.

Further, as a third problem of the present invention, the image can be used to the maximum extent. Regarding a system having a function of displaying a moving image showing the state of an inspection and a function of displaying auxiliary information such as a site to be inspected at the same time in an easy-to-understand manner, Patent Document 7 (Japanese Patent Laid-Open No. Hei 11-) introduced earlier. 226035), the function itself from the imaging to the display is not limited to the dental inspection system but is widely performed in the medical inspection system. In the periodontal pocket depth measurement system of the present invention as well, the function of displaying moving image information obtained by the imaging means is adopted as a basic function, but moving image information is measured by utilizing the fact that moving image information is always acquired. It is also used as a means of Patent Documents 7 to 9 describe that the probe is analyzed using image information, but in practice, if the image information at the moment when the insertion force necessary for the inspection is applied is not analyzed, a correct inspection is performed. Cannot be guaranteed. Since the method for synchronizing the probe insertion force detection mechanism and the image information required for this purpose is not specifically described in Patent Documents 7 to 9, it is insufficient to realize a configuration that can withstand practical use.

Further, in order to obtain an image necessary for periodontal pocket depth measurement, it is not sufficient to simply integrate the pocket probe and the camera. For example, the arrangement of photographing the probe measurement part (part hidden in the periodontal pocket) from the front with an imaging system such as a camera is the simplest, but the periodontal pocket needs to be measured up to about 12 mm, and the back tooth is 10 mm. If the depth exceeds the depth, obstacles such as front teeth and lips enter between the measurement unit of the probe and the imaging system, and the probe cannot be imaged. In Patent Documents 6 to 9, since the positional relationship between a specific probe and an optical system (imaging system) is not clearly described, such a problem remains. In the above simple arrangement, the direction in which the inspector views the inspection site does not coincide with the direction in which the optical system incorporated in the measuring instrument captures the inspection site, so the inspector thinks that the inspector was able to measure appropriately. However, a case where an appropriate image cannot actually be obtained can easily occur. In the periodontal pocket depth measurement system of the present invention, it is an object of the present invention to realize a practical system that can appropriately cope with these situations in which it is difficult to obtain an inspection image.

Hereinafter, means for solving the above-described problems will be described in detail using the periodontal pocket depth measurement system of the present invention.
First, a method for realizing uniformity of results and safety as the first problem will be described. The biggest factor that the test results vary for the same test site is due to individual differences in how the force is applied during the test, so in the process where the tester applies the force to insert the probe, It is important to notify the inspector as easily as possible when the insertion force necessary for the inspection is reached. After a state in which a predetermined insertion force is reached, a constant force may be applied as it is, but this is never easy as described with reference to Patent Document 3 (Japanese Patent Application Laid-Open No. 2007-82609). Not a thing. As long as it is a measuring instrument to be used by an inspector in hand, it does not make sense to increase the weight and size due to the complexity of the mechanism, so the periodontal pocket depth measuring instrument of the present invention is relatively A method of notifying the moment when a predetermined insertion force is reached is adopted with a simple configuration.

For this purpose, the periodontal pocket depth measuring device of the present invention does not keep the insertion force of the probe constant at the maximum value but applies a predetermined force at the maximum (maximum). That is, the periodontal pocket depth measuring instrument has a structure in which the insertion force of the probe applied to the examination site reaches the maximum value or the maximum value when the displacement amount of the probe reaches a predetermined value. In this case, when the displacement exceeds the maximum or maximum value, the force applied to the examination site decreases even if the probe is continuously pressed, but a negative force (force to pull up the probe) acts. This does not mean that the inserted probe will not come off and the test will be performed properly. As a specific configuration for realizing such a function, the probe or the fixture of the probe has a rotating mechanism and is in contact with the spring, and the spring is deformed in accordance with the rotational displacement of the probe, whereby the examination site The insertion force of the probe applied to is controlled. A torsion spring, a leaf spring, or the like can be used as the spring. At this time, a structure in which the amount of deformation of the spring is changed by sliding the contact point between the probe or the probe fixture and the spring according to the rotational displacement of the probe. The method disclosed in Patent Document 3 (Japanese Patent Application Laid-Open No. 2007-82609) is the same in that the end of the probe and the spring are in point contact, but the method disclosed in Patent Document 3 (Japanese Patent Application Laid-Open No. 2007-82609) uses the probe. Since the displacement direction and the deformation direction of the spring (the direction of the repulsive force of the spring) are orthogonal, the spring repulsive force acts to restore the probe displacement after reaching the maximum amount. Therefore, the probe insertion force cannot be controlled by the spring. In the present invention, as will be described later, the displacement direction of the probe and the deformation direction of the spring are the same, and the probe insertion force can be reliably controlled by the repulsive force of the spring.

Further, in the process of sliding the contact point between the probe fixture and the spring, if the spring deformation is set to the maximum value or the maximum value, the maximum force is applied to the inspection site at this time. It will be. Specifically, since a rotational force acts on the probe in the process of pushing the inspection site with the tip of the pocket probe, the spring that is in contact is pushed and deformed. When such a rotation mechanism is used, the line connecting the rotation axis and the contact point and the plane (line segment) including the contact point of the spring are vertical in the process of sliding the contact point. The displacement of the spring is maximized and the probe insertion force is maximized (or maximized). Therefore, by adjusting the maximum or maximum value of the probe insertion force at this time to be a value suitable for periodontal pocket depth measurement, a certain amount (insertion force) As long as the probe is pushed until it is maximized or maximized, the optimum force can be easily applied to the inspection. With the configuration as described above, it is only necessary to provide a rotating shaft in the probe system and to install a spring in point contact with the probe system, so that a predetermined insertion force can be reliably applied with an extremely simple configuration. While being able to do so, it is possible to prevent a dangerous force from damaging the affected area. Note that the force suitable for periodontal pocket depth measurement is a value between 20 g and 30 g, so if the spring is selected or adjusted so that such a force becomes the maximum value or the maximum value. Good.

It is also possible to use a configuration that can detect that the pocket probe has been displaced by a certain amount using a sensor, that is, that a predetermined insertion force has been applied. In this case, the maximum insertion force of the probe can be used. The value or the maximum value may not be a force determined by the inspection, but may be adjusted so as to be a maximum value allowable for safety. The maximum value allowable for safety can be determined as a value between 35 g weight and 70 g weight, for example. In this case, it is convenient to notify the user by sounding a buzzer when the displacement amount of the probe reaches a predetermined value. As described above, a large force exceeding the allowable range of safety is not applied without actually giving a notification, but a notification with a clear buzzer sound that is not disturbed by a loud noise in the dental clinic. If so, the examiner and the patient can also confirm that the test is being performed without problems.

  As described above, the maximum force physically applied is adjusted to be the insertion force determined in the inspection, or that a predetermined insertion force is applied as a certain amount of displacement of the probe By detecting and notifying with a sensor, it becomes easy for the inspector to properly apply the predetermined insertion force to the inspection site, and variation in test results due to individual differences in how the inspector's force is applied is suppressed. become. In the contents described so far, the insertion force applied from the probe to the examination site is obtained by detecting the displacement of the probe (the amount of deformation of the spring) with a sensor. If the pressure sensor is used, it is possible to detect the magnitude of the force even if the probe itself is hardly displaced. Such a configuration is also practically considered, and examples of the pressure sensor include a conductive sensor and an atmospheric pressure sensor using an elastic body whose conductivity changes depending on the compressibility. The reason why this method is not used in the present invention is that an elastic body such as rubber is somewhat uneasy in terms of accuracy, durability, and response speed, and it can withstand practical use depending on the situation.

  In the case of only the above-described configuration, a predetermined insertion force can be reliably applied, but the periodontal pocket depth must be visually measured by the inspector, so the probe needs to be scaled. . In the measurement of periodontal pocket depth, since the treatment policy generally changes with the depths of 3 mm and 6 mm as boundaries, it is preferable that scale lines or scale pattern boundaries exist at these positions. However, as will be described later, the scale is not necessary when the length of the probe is obtained by image analysis instead of visual observation.

Practically, it is more useful to combine a periodontal pocket depth measuring device and a computer and use a periodontal pocket depth measuring system that can analyze, display, and manage information obtained by the measuring device. The periodontal pocket depth measurement system of the present invention mainly includes a measuring instrument for inspecting a necessary portion in the oral cavity of the examinee held by the inspector, a computer connected to the measuring instrument and a cable, and an appropriate necessity. A display for displaying various information and software installed on a computer for information communication with the measuring instrument. The measuring device incorporates a small camera and a light source, and information necessary for inspection can be acquired as a moving image or a still image. The periodontal pocket depth measuring instrument is equipped with a resin probe for insertion into the periodontal pocket as an inspection tool. Since this resin probe has a high possibility of coming into contact with the bleeding site of the examinee, in principle, the resin probe should be sterilized and disposable so that the examiner can easily attach and detach it.

Here, the whole structure of the periodontal pocket depth measurement system of this invention is demonstrated using FIG. The measuring instrument 101 is used by an inspector to hold a hand and inspect a necessary part of the patient, and a probe 102 is actually attached to the inspection part to make contact with it and apply force. The measuring device 101 incorporates a camera and a lens for photographing an inspection location and recording it as image data, and the obtained image data is transmitted to the computer 104 through the communication cable 103. A USB cable is preferably used as the communication cable 103, but there may be a configuration in which data communication is performed without using a cable by incorporating a wireless communication function. The computer 104 displays the received image data on the display 105. Actually, it also has a function of facilitating the inspection or preventing misdiagnosis by displaying the tooth number currently being inspected and information on the location where the inspection has already been completed. Even if the test has the same purpose, the contents of the test differ from patient to patient (for example, more test sites are given to patients with more severe symptoms). Information is grasped by the software installed in the computer 104. Therefore, an instruction to sound the end sound of the inspection or change the imaging mode needs to be transmitted from the computer 104 to the measuring instrument 101 through the communication cable 103. In addition to periodontal pocket depth measurement, it is usual to perform various tests on a single patient, so various measuring devices and treatment devices can be connected as a system (software), and patient data can be collected at once. Preferably it can be managed. Since it is troublesome for a user to start a corresponding program according to a plurality of measuring instruments, the corresponding program needs to be automatically started at the same time as the measuring instrument is connected to a computer. Therefore, a plurality of measuring instruments that can be connected to the system, including the periodontal pocket depth measuring instrument, each have a unique identification code, and when the system is connected to the system, the identification code is automatically transmitted. It is desirable to provide a periodontal inspection system having a function of automatically starting an operation program corresponding to the measuring instrument.

Information that needs to be manually input by the examiner, such as patient information and treatment policy, regardless of the device, is input using a general input device such as the keyboard 106 and mouse 107. In places where inspections are actually performed, there is often no space to install such a large input device, so if you want to manually enter numerical values during inspection or select specific operations, use the numeric keys and direction You may use the keyboard which has only. Many recent dental chairs are pre-systemized with a computer, display, mouse, etc., so install the software in such a system and connect the measuring instrument 101 for use. Is also possible.

As described above, the periodontal pocket depth measuring device according to the present invention can also employ a probe for measuring the periodontal pocket depth, and a configuration having a function of imaging a site being inspected using the probe. . A small CMOS camera or CCD camera is used as the photographing means and is incorporated inside the measuring instrument. As shown in Patent Documents 7 to 9, when image information of an examination region is obtained, it is theoretically possible to obtain an examination value by analyzing the image information. However, in order to accurately execute an inspection by image analysis, it is necessary to accurately acquire an image when a predetermined insertion force is applied. Even if the probe and the test site are shown in the acquired image, if the system cannot recognize the insertion force at that time, it will try to pull out the probe from the image or test site while the probe is being inserted into the test site. This is because there is a possibility that the image is on the way. As already described, the periodontal pocket depth measuring device of the present invention may also have a configuration having a function of detecting by a sensor that an insertion force necessary for the inspection is applied by a probe. Therefore, it is possible to use the sensor information to automatically perform imaging of the examination site when the insertion force of the probe applied to the examination site reaches a predetermined value. Appropriate images that can be used are acquired.

The CMOS camera or CCD camera incorporated in the periodontal pocket depth measuring device of the present invention has a function of constantly repeating image acquisition about 30 times per second and transferring it to a computer. The computer that has received these images can continuously display the images on the display to show the state of the examination as moving image information to the examiner or the patient. Since the camera repeats image acquisition at high speed in this way, images used for analysis, that is, images at the moment when a predetermined insertion force is applied, are not always captured instantaneously in conjunction with the sensor, but are always sensored. It is easier to use a method of monitoring the state of the image and selecting an image at the moment when the predetermined value is reached. Strictly speaking, it does not become an image at the moment when the sensor reaches a predetermined value, but if an image is acquired 30 times per second, the image can be obtained at a short interval of 33 milliseconds. It is possible to select an accurate image without any problem. As a specific processing method, when transferring image information from the periodontal pocket depth measuring device to the computer at intervals of 33 milliseconds, sensor information necessary for selecting an image is also added to the image information and transferred to the computer. To do. In general, instead of transferring image information to a computer at once, a method of transferring image information divided into rows or columns is adopted, so additional information transfer is added to the first or last transfer However, sensor information may be included in this additional information. For the receiving computer, the size of the image information is increased by an additional amount, but a series of reception operations are performed as an image, and then processing for separating the original image information and additional information is performed. Since the additional information is synchronized with each image, if the sensor information included in the additional information is monitored on the computer side, the image when the predetermined value is reached can be selected.

  As a result, an image obtained when a predetermined force is applied in the inspection can be accurately acquired and analyzed as a system. As is clear from the above description, since the additional information has the amount of information for one line of the image information, if not only sensor information but also switch information is included in the additional information, the switch is pushed. It is also possible to realize an arbitrary shooting operation such as selecting and storing the captured images. As described above, the image information obtained by the imaging function is added with additional information including sensor information and / or switch information and transferred to the computer, thereby realizing the operation necessary for the inspection. This is a feature of the circumferential pocket depth measurement system. Such a system that can be managed by adding additional information to image information can be applied not only to dental examinations but also to safety management systems and crime prevention systems if temperature sensors, voice sensors, infrared sensors, etc. are used as sensors. Is. The sensor information can be substantially incorporated into the image itself, instead of adding the sensor information to the image information and transferring it. For example, if a specific light emission signal enters a specific position of an image at the moment when a predetermined force is reached, only that position is always monitored, and only images containing a specific signal are selected. Processing is also possible.

If the images necessary for the inspection can be selected, the next problem is how to analyze them. In the periodontal pocket depth measuring instrument of the present invention, since the probe and the imaging function (camera) are both incorporated in the measuring instrument, the relative positional relationship between them is substantially constant, and is approximately at the center of the photographed image. The probe is always shown. Therefore, the periodontal pocket depth can be obtained by detecting the length of the probe included in the image obtained by this imaging function. In other words, the probe is shown in the image, and the positional relationship with the imaging system is almost constant, so the probe length on the image is converted to the actual length with a constant ratio even if there is no scale. can do. Since the portion that has entered the periodontal pocket does not appear in the image, the length of the probe detected from the image is shortened by the depth of the periodontal pocket. Since the length of the original probe is known in advance, the periodontal pocket depth can be obtained as a difference between these lengths. If the above operations are performed, it is not necessary for the examiner to visually measure the periodontal pocket depth. From the analysis to the data recording, the test site is simply pushed with the probe in the same manner as in a normal examination. Automatically executed. Therefore, the purpose of the easy-to-use system that can be used with a familiar feeling, which has been mentioned as the second problem, is also achieved. In Patent Documents 8 to 9, the length of the probe is obtained by reading the scale given to the probe as an image. However, as described above, the positional relationship between the probe and the imaging system is fixed. And, if the color of the probe is different from other colors existing in the oral cavity and only the probe region can be clearly extracted from the image, such a scale is unnecessary. In the periodontal pocket depth measurement system of the present invention, a scale is added to the probe so that the examiner can confirm with the eye, but the scale is not used for the image analysis itself. In addition, since a probe that can be bent depending on how the force is applied, such as a resin, is used, the probe may appear partially oblique in the image. In this case, since the direction in which the probe length is detected in the image may be ambiguous, the error is smaller when the probe area is calculated instead of the probe length and the probe length is calculated from this area. That is, the probe length may be detected by counting the number of pixels that can be determined to be the color of the probe included in the image information and using a method that is performed based on the number of pixels.

In addition, it has already been realized in the functions described above that the inspection result mentioned as the third problem is stored as an image. That is, since the depth analysis is performed using an image in which a part of the probe is embedded in the periodontal pocket, if this image is stored as it is, the examination image of the affected part is stored as a result. . Practically, it is necessary to have a function of storing an image acquired by the photographing function and reproducing and displaying the image on a display in accordance with a user instruction. For example, it has a function to display the examination result together with the tooth illustration on the display, and when a specific tooth or examination site is specified by clicking with a mouse, the examination image corresponding to that is displayed. . In addition, since the examination is often performed for the purpose of confirming the effect of the treatment in addition to the purpose of determining the treatment policy, this reproduction display function can be executed simultaneously on a plurality of images acquired at different examination dates and times. Necessary. Thereby, each test result can be easily compared not only as a numerical value but also as an image, and the effect of treatment can be confirmed. The support based on the image information makes it easy to explain the treatment policy and treatment effect to the patient, and the patient can also make an appropriate decision.

In addition, since these images are inspection images acquired by appropriately using a measuring instrument, it is also evidence that the inspection has actually been performed. At present, there is a problem of fraudulently charging for medical expenses by conducting a test, even though the test is not actually performed. Such fraudulent behavior can also be suppressed.

  The periodontal pocket depth measuring instrument according to the present invention is configured so that the probe insertion force takes the maximum value or the maximum value using a spring, and by combining detection of the probe displacement by the sensor, it is accurately inspected without any particular practice. A predetermined insertion force can be applied to the site. Thereby, the dispersion | variation in the test result by the individual difference of an inspector's power can be suppressed. In addition, since it can be handled with the same operation as an inspection that is normally performed manually, it is an easy-to-use measuring instrument. Although image information is used for periodontal pocket depth analysis, additional information such as sensor information is added to the image information for management, so that an image necessary for inspection can be accurately acquired. In addition, since the images are used for analysis, an image of the affected area is inevitably obtained, and it is easy to check the treatment process and explain to the patient by managing it and redisplaying it as necessary. Can be run on.

Hereinafter, the specific form for implementing the periodontal inspection system of this invention is demonstrated using figures.
As described above, the periodontal inspection system of the present invention has a safety mechanism that prevents the insertion force applied from the probe to the inspection site from exceeding a certain value, and realizes a means capable of sufficiently performing notification even in a noisy dental clinic. I was able to do it. FIG. 2 shows an example of the appearance, and a probe 202 to be inserted into the periodontal pocket is actually connected to the casing 201 of the periodontal pocket measuring instrument in contact with the gingiva that is the examination site. Since the probe is likely to come into contact with the patient's blood, it is desirable to make it disposable in order to eliminate the risk of infection. For this purpose, since it is necessary to easily attach and detach the probe, it is preferable to provide a probe fixture 203 and fix the probe 202 to this. As will be described below, the probe fixture 203 is also used for the purpose of measuring the force applied to the probe. Furthermore, since it is not easy to observe the inside of the oral cavity only with room illumination, white illumination 204 using a white light emitting diode or the like is also necessary. A white light-emitting diode is suitable as a light source for white illumination, but a light guide member formed of a transparent resin or the like may be disposed in front of the light source if condensing on the probe is necessary. In order to illuminate the probe 202 and the examination site as uniformly as possible, white illumination 204 may be disposed on the left and right sides of the probe 202. Since the portion close to the tip of the measuring instrument enters the patient's mouth and is sometimes used to spread the cheek, it is sterilized from the position near the fixing portion of the probe 202 to the measuring instrument housing 201. It is desirable to attach the cover 205. The cover 205 is to be replaced for each patient together with the probe 202 and may be manufactured integrally with the probe in some cases. However, the cover 205 is sandwiched between the patient's cheek and the measuring instrument, so Since it may become unable to move with a predetermined force, basically, it is preferable to be made of a flexible material such as polyethylene. About this cover, it is preferable to use also about the example of a measuring device shown in FIG. Note that the example of FIG. 2 does not include an image capturing function because the main purpose is to eliminate the influence of individual strength of the examiner.

  In FIG. 3, the internal block diagram of said periodontal pocket depth measuring device is shown. In order to connect and fix the probe 302 to the housing 301 of the measuring instrument, a probe fixing tool 303 is provided. The probe fixing tool 303 is provided with a probe fixing protrusion 304. It has a circular shape. On the other hand, a hole is also provided in the base portion of the probe 302, and when the probe is fixed, the hole and the probe fixing protrusion 304 are engaged with each other, so that the force does not come off against the force in the front-rear direction. ing. The cross section of the probe 303 is basically circular, but only a portion provided with a hole for meshing with the probe fixing projection 304 has a cross section such as a semicircle. The reason for this will be described with reference to FIG. When the probe 401 is inserted into the probe fixture 402 after being rotated 180 degrees from the normal use state, the root portion of the probe 401 has a semicircular cross section. Thus, the fixing hole 403 provided there does not mesh with the probe fixing projection 404 of the probe fixture 402, and the probe can be inserted smoothly. When the probe 401 is rotated 180 degrees from this state, the fixing hole 403 meshes with the probe fixing projection 404 and is fixed firmly. With such a structure, the probe can be easily attached and detached by simply rotating the probe 180 degrees.

A description will be given with reference to FIG. 3 again. The probe fixture 303 is fixed to the housing 301 by a rotating shaft 305, and can be rotated up and down around this axis. A spring 306 is disposed behind the probe fixture 303, and a rear portion of the probe fixture 303 that is in contact with the spring 306 is cut off at a predetermined angle. 307 is formed. The rear end 307 is in point contact with the spring 306, and the spring 306 presses the rear end 307 with its restoring force.
As the spring, a torsion spring, a leaf spring, or the like can be used. When the probe is pushed by the tip of the probe 302, when the probe tries to rotate, the spring 306 that is in contact with it is pushed. The restoring force of the spring 306 opposes this pushing force, and the probe fixing tool. The movement of 303 is prevented and fixed.
When the measurer inserts the tip of the probe 302 into the periodontal pocket and applies further force, the bottom of the pocket or the inner wall of the pocket pushes back the probe 302, and the probe fixture 303 connected to the probe 302 moves the rotating shaft 305. Attempts to pivot to the center and pushes spring 306 strongly.
The spring 306 functions to prevent the rear end 307 from rotating due to its restoring force, and the amount of rotation of the rear end 307 increases and the restoring force of the spring 306 also increases. When the amount of rotation exceeds a certain value, the restoring force is rather reduced by the rotation of the rear end 307.
Further, when a force is applied from the housing 301 to the probe, when the rear end 307 eventually exceeds the end 306M of the spring 306, as shown in FIG. The contact state that becomes a force that promotes the rotation of the probe fixture 303 is formed, the probe 302 is pushed upward, and the tip of the probe 302 is separated from the periodontal pocket, Excessive irritation to the periodontal pocket is avoided.
When such a rotation mechanism and contact structure are used, even if a force exceeding a predetermined value is applied, the contact point between the rear end 307 and the spring 306 accompanying the rotation of the probe moves on the spring 306 to fix the probe. The position of the contact point between the rear end 307 of the tool 303 and the spring 306 is changed, and the force applied from the housing 301 to the probe 302 is kept constant.
As the probe rotates, when the line connecting the rotating shaft 305 and the contact point becomes perpendicular to the surface including the contact point of the spring 306 (or the straight line portion forming one end), the displacement of the spring is maximized, and inspection is performed. The force applied to the part is also maximized.

  The above mechanism will be described in detail with reference to FIG. FIG. 5A shows a state where no force is applied to the pocket probe. In the figure, the line segment XX ′ indicates the direction of the straight line portion forming one end of the torsion spring, and the line segment YY ′ indicates the direction of the line segment connecting the probe rotation axis and the contact point of the spring. ing. When the test site is pushed with the tip of the probe from this state, the line segment XX ′ and the line segment YY ′ become vertical as shown in FIG. ) Has the maximum displacement, so that the maximum insertion force is applied to the examination site. When the probe is further pushed, the state shown in FIG. 5 (c) is obtained, and since the displacement of the spring (the straight portion forming one end thereof) is smaller than in the state (b), an insertion force smaller than the maximum is applied. Will be. Therefore, by using such a mechanism, the insertion force applied to the examination site does not exceed a certain maximum value, so safety can be ensured, and this maximum value becomes the insertion force necessary for the inspection. If adjusted in this way, it is possible to easily apply a predetermined insertion force to the examination site without requiring any practice.

Practically, the strength of the spring and the position of the contact point are selected so that when the probe tip is lifted by about 1 mm, an insertion force of about 25 g necessary for inspection is applied. Note that there are some variations in the spring characteristics, and the required characteristics may not be obtained simply by arranging them. Therefore, when a torsion spring is used as the spring 306, the side having the contact point and the rotating shaft 306K are used. The spring adjuster 308 is in contact with one end on the opposite side of the center. The spring adjuster 308 is also rotatable about the rotation shaft 308K while having elasticity with a restoring force, and the spring adjuster 308, the spring 306, The contact position can be changed.
For example, when the spring adjustment screw 309 is turned, the spring adjustment screw 309 advances toward the spring adjustment tool 308 and pushes it.
The spring adjuster 308 rotates with elasticity around the rotation shaft 308K, and pushes down the contact portion with the spring 306 downward. The spring 306 whose one end is pressed down pushes the opposite side through the center 306K upward by the reaction, thereby pushing the rear end 307 more strongly, and the probe insertion force can be made stronger.
On the contrary, when the spring adjustment screw 309 is turned in the opposite direction and moved in the opposite direction, the force for pushing the spring adjustment tool 308 is weakened, and the spring adjustment tool 308 is restored by the elasticity around the rotation shaft 308K. When the force to push the spring 306 is weakened, the force pushing the rear end 307 via the rotating shaft 306K is weakened, and the probe insertion force is also weakened.
Thereby, since the initial displacement of the spring 306 can be adjusted, it is possible to perform adjustment so as to obtain a predetermined characteristic even if the spring characteristic varies.

Even if it was possible to adjust the relationship between the displacement and force of the probe as described above and it was easy to apply the insertion force required for the inspection, the actual insertion person applied the predetermined insertion force. It is easier to understand if there is a notification means that can grasp this. This is because even if the risk of applying an excessive force is avoided, sufficient inspection cannot be performed unless the probe is pushed and applied until the force reaches its peak. Therefore, as shown in FIG. 3, the displacement detection sensor 310 is arranged behind the probe fixture 303 so that the sensor 310 reacts at the moment when the probe fixture 303 is displaced by a predetermined amount (that is, when a predetermined force is applied). A special mechanism is provided. Specifically, a non-contact sensor such as a photo interrupter is used as the displacement detection sensor 310, and the sensor detection protrusion 311 provided behind the probe fixture 303 is displaced by a predetermined amount of the probe fixture 303 ( By applying a change to the sensor 310 such that the sensor unit of the photo interrupter is blocked by rotation, it is possible to detect that a necessary displacement has occurred (that is, a predetermined insertion force has been applied). Although various sensors such as pressure sensors can be used in practice, a non-contact type sensor such as a photointerrupter is also required because it is necessary to perform a test of a little less than 200 points per patient. It is preferable to use and avoid mechanical wear. However, micro switches with proven durability can withstand repeated use sufficiently, so contact the probe fixture with the switch so that it is in the ON state when a predetermined force is applied to the probe. A sensor may be substituted.

The sensor 310 is connected to a control board 312 incorporated in the measuring instrument so that the state of the sensor can always be grasped. The electric power necessary for the operation of the control board 312 is supplied from a power source 313 such as a dry battery incorporated in the measuring instrument. As will be described later, if the measuring instrument is connected to the computer, power may be obtained from the outside through a cable. When the control board 312 senses that a predetermined insertion force has been applied, the buzzer 314 connected to the board can be sounded to give a voice notification to the user. By the voice notification, the examiner pulls out the probe from the examination site and moves to the next examination site. The tester's response to the voice notification is slow, and even if the probe is pushed excessively, as described above, the structure does not apply a force exceeding the predetermined insertion force, making it extremely safe and easy. It is an inspection device that can be used. Moreover, the white illumination 315 for illuminating the inside of the oral cavity is necessary as already described with reference to FIG. In addition, since a configuration that is sensitive to liquids, such as a control board, is built in the measuring instrument, in fact, a cover as shown in FIG. 2 is used to protect the liquid from entering, and also in the measuring instrument. It is better to have a structure that can secure a certain degree of waterproofing, such as sealing the portion behind the center portion of the spring (the portion that does not affect the force applied to the probe) with silicon rubber or the like. 2 and 3, the image acquisition and the inspection result automatic recording described as the features of the present invention cannot be performed, but it can be said that this is a sufficiently convenient periodontal pocket depth measuring device.

If an appropriate storage element is provided on the control board 312, it is possible to temporarily store the inspection result. Therefore, by transferring the stored data by connecting to the computer after the inspection, It is possible to realize almost the same convenience as the method of automatically recording the inspection result. In this case, it is better to have a function that reads out by voice which tooth of which tooth is being examined during the examination. If the computer supports voice input, the operator can read out the measurement result and perform an operation close to automatic recording. In addition, even if the imaging function is not incorporated in the measuring instrument, if the inspector wears a photographing camera on the head to show the examination site and this image information is transmitted to the computer, it is predetermined. It is possible to determine the periodontal pocket depth when image force is applied from image analysis. In this case, if a function that illuminates the tip of the probe is detected by a sensor or a switch that detects the state of reaching a predetermined force, the specific light emission state is confirmed in the image. By selecting the inspection image as the inspection image, it is possible to appropriately acquire the inspection image without directly transferring the sensor information to the computer. An inspector-mounted camera used for such a purpose has an eye tracking function, so that the inspector can be surely photographed as long as the inspector looks at the inspection site, which is convenient. .

  FIG. 6 is a horizontal sectional view of the configuration of FIG. 3 as viewed from above. Here, the contents described with reference to FIG. 3 will be supplemented. The sensor detection protrusion 602 of the probe fixture 601 is a structure for detecting the displacement of the probe by the sensor. However, since the photo interrupter 603 is used as a sensor in FIG. 6, the sensor detection protrusion 602 is a photo interrupter. A predetermined displacement is generated when the detection unit 603 is blocked. As described above, even if the probe is kept pressed even after the sensor has reacted, the purpose is to realize a safety mechanism in which an excessive force is not applied, so the sensor detection protrusion 602 and the photo interrupter 603 do not contact each other. Thus, the arrangement is as shown in FIG. 6 shows an example in which a torsion spring 604 is used as the spring, and the spring adjustment tool 605 presses one end of the torsion spring 604 on the opposite side to the probe fixing tool 601. The repulsive force of the spring is adjusted.

  When the displacement is detected using a sensor such as a photo interrupter as described above, it is necessary to notify the inspector that the probe insertion force has reached a predetermined value using a buzzer or a light emitting element. In the case where notification is performed using an optical signal like a light emitting element, there may be a configuration in which a sensor is not actually required. For example, as shown in FIG. 7, the probe 701 is fixed to the probe fixture 702, and the light source 703 is disposed behind the probe 701. The probe 701 is formed of a material having high photoconductivity such as a transparent resin, and the probe fixture 702 is similarly formed of a material having high photoconductivity, or a hole so that light from the light source 703 can reach the probe 701. Keep open. However, in the state where no insertion force is applied to the probe 701, the direction of the handle (base portion) of the probe 701 and the direction of the light source 703 do not coincide with each other, and the amount of light reaching and conducting the probe 701 is reduced. Keep it. As the light source 703, a white light emitting diode or the like having a relatively large directivity is used. When an insertion force is applied to the probe 701 with such a configuration, the probe fixture 702 rotates about the axis, and the direction of the handle portion of the probe 701 coincides with the direction of the light source 703. At this time, the probe 701 Therefore, the probe 701 emits the brightest light. Since the probe 701 is made of a material having high photoconductivity up to the tip, the entire probe emits light. Therefore, if the spring is adjusted so that the insertion force determined by the inspection is obtained when the direction of the handle portion of the probe 701 coincides with the direction of the light source 703, the probe 701 can be used without using a sensor. The inspector can visually recognize that a predetermined force has been applied by visually checking the intensity of light emission.

  As shown in FIG. 8, the probe 801 can be rotated by using a fulcrum instead of providing a rotating shaft. For example, the probe is provided with a recess 802 for receiving a fulcrum, and a probe rotation fulcrum 804 is formed near the front of the measuring instrument housing 803. Further, a probe support spring 805 is provided on the opposite side, and the probe 801 is pressed against the probe rotation fulcrum 803. In such a configuration, when the probe 801 is inserted into the measuring instrument from the outside, there is a feeling that the probe 801 is firmly fixed at a position where the recess 802 and the probe rotation fulcrum 804 mesh with each other. It is easy to prevent such an error. Similar to the method described with reference to FIG. 3, a force control spring 806 for controlling the probe insertion force is disposed behind the probe. Further, if the configuration is such that the probe displacement detection sensor 807 is blocked (reacted) when the force control spring 806 is pushed, the back of the probe 801 is covered with a waterproof member 808 made of rubber or the like. Therefore, it is possible to make the structure more resistant to failure. Such a configuration can also be employed in the periodontal pocket depth measuring device of the present invention.

As described above, the periodontal inspection system of the present invention is characterized by displaying an image, and therefore the periodontal pocket depth measurement system having an image acquisition function will be described below. FIG. 9 is an example of the appearance of a configuration having such a function. Similar to the case of FIG. 2, force can be controlled and detected by connecting the probe 902 to the housing 901 and rotating the probe fixture 903. An imaging unit 905 is incorporated in the measuring instrument in order to capture a range necessary for the inspection including the measurement unit 904 of the probe 902. The imaging unit 905 is mainly composed of a transparent window for protecting the surface, a lens for enlarging an examination site, and a camera for actually taking an image. For photographing, white illumination 906 is necessary as in the case of observation. Image information acquired by the imaging unit 905 is transferred to a computer via the cable 907 and used for display and analysis.

  The first thing to consider when using a camera is the positional relationship between the probe 902 and the imaging unit 905. The simplest is a method in which an imaging unit is arranged below the probe and the measurement unit 904 of the probe is photographed from the front. In Patent Documents 6 to 9, the position of the imaging unit is not particularly specified. However, in the drawing, it is drawn as if the imaging unit is arranged below the probe. However, in this case, if the probe goes deep into the periodontal pocket, there is a high possibility that obstacles such as other teeth and lips will enter between the examination site and the imaging unit and the examination site cannot be imaged. Strictly speaking, the method of Patent Document 6 (US Pat. No. 4,883,425) is a light amount detection type rather than an image pickup unit, but it is difficult to measure the light amount accurately due to the presence of such an obstacle. The essence is the same. When the imaging unit is arranged on the lower side of the probe, the vertical width of the imaging unit needs to be considerably small so that sufficient imaging can be performed from above even if an obstacle is present, specifically, 6 mm or less. It must be within a certain width. However, in general, as shown in FIG. 10, the probe measuring unit 1001 and the probe working unit 1002 (portion entering the oral cavity) form an angle close to a right angle, and the working unit 1002 is 30 degrees from the middle. Many are bent to a certain extent. This is easier to operate by hand from outside the oral cavity, but because of the bending point of the working unit 1002, the blind spot is large for the camera 1003, and the camera 1003 is moved slightly away from the probe as shown in FIG. 10 (a). If it is not installed (that is, if the center of the camera is not installed below the line XX ′), the measuring unit 1001 cannot be photographed sufficiently. This makes it easier for obstacles to get in between, so the meaning of downsizing the camera is diminished. On the other hand, if the working unit 1005 is formed in a straight line without bending as shown in FIG. 10B, the blind spot is eliminated. Therefore, if the camera 1006 is arranged as close to the probe as possible, the measuring unit 1004 can be sufficiently photographed. . In this case, it is convenient to make the camera 1006 as small as possible so that it can be photographed from above, because obstacles are difficult to be seen. However, since the working unit 1005 and the measuring unit 1004 have a wide angle in the entire region, it is difficult to keep the measuring unit perpendicular to the gums during the inspection, and it is somewhat difficult to perform the inspection accurately.

Therefore, consider a configuration in which the shape of the housing 1101 is changed as shown in FIG. 11 and a probe for measuring the periodontal pocket depth and an imaging unit for performing imaging are arranged in the horizontal direction. If the image is taken by the imaging unit 1106 from the side of the probe 1102, the position of the camera can be increased without reducing the size of the camera so much that the obstacle is less likely to be obstructed. In addition, since the imaging unit is arranged at a position close to the examiner's line of sight, it is easy to obtain an image that matches the sense of the examiner. In this case, it is better to devise the shape of the probe 1102, for example, in FIG. 11, the probe working unit 1104 is bent toward the imaging unit so that the probe measuring unit 1103 is positioned in front of the imaging unit 1106. Make the structure. Bending the working unit 1104 to the imaging system side loses flatness and takes up a little extra volume on the packaging. The advantage is that the width can be made smaller. If there is a margin in the housing width, the probe may be formed planarly as in the prior art, and the direction of the imaging unit may be tilted toward the measurement unit of the probe. When the probe is bent toward the imaging unit in this way, the configuration of the white illumination 1105 needs to be devised. The white illumination 1105 can be illuminated even in a configuration in which a light source such as a light emitting diode is directly arranged near the surface of the measuring instrument. However, in order to collect a larger amount of light near the measuring unit 1103 of the probe, the light source is Directivity is higher and efficiency is better when it is housed inside and light is propagated from the light source to the measuring instrument surface with a member having excellent light guiding properties such as acrylic or optical fiber. This will be described later with reference to FIG. In the example of FIG. 11, the probe fixing member is not exposed on the surface, and the probe base cover 1107 is used for the purpose of improving waterproofness. This will also be described later with reference to FIG.

  FIG. 12 is an example of a shape in which the probe is bent toward the imaging unit. FIG. 12 (a) shows the probe viewed from the side. When the probe is normally used, the side (profile) of the patient is visible at this time. A generally used periodontal pocket probe has almost the same shape as viewed from the side. That is, the working portion 1202 extends in the coaxial direction from the handle portion 1201 of the probe, and the working portion 1202 is curved upward from the middle. The angle α formed by the central axis X-X ′ of the handle 1201 and the central axis Y-Y ′ of the curved portion of the working part is often about 30 degrees. This is because when the probe measurement unit 1203 is inserted into the examination site, it is easier to handle by hand from a slightly oblique direction, and the field of view becomes wider. In many cases, the angle β formed by the central axis Y-Y ′ of the curved portion of the working unit and the central axis Z-Z ′ of the measuring unit 1203 is substantially a right angle. This is because the measurement unit 1203 is preferably inserted parallel to the tooth axis, and such insertion can be easily performed if the curved portion of the working unit is aligned with the upper surface of the tooth. . When the material of the probe is resin, it is better to form a beam 1204 for reinforcement. The probe used in the periodontal pocket depth measuring device (measurement system) of the present invention preferably has a side surface having a general shape as shown in FIG. As already described, in order to rotationally fix the probe to the probe fixing member, the fixing hole 1205 is provided in the base of the probe, which is a feature of the present invention.

On the other hand, FIG. 12 (b) is a view of the probe used in the periodontal pocket depth measuring device (measurement system) of the present invention as viewed from above, but this is greatly different from a general probe. . That is, a general periodontal pocket probe has a substantially linear planar shape when viewed from above, whereas in FIG. 12 (b), the working part 1203 extending from the probe handle 1201 is greatly curved. ing. This is a device for arranging the imaging unit in the horizontal horizontal position of the probe to improve the field of view, and by bending the probe working unit 1203 in the horizontal direction, the measuring instrument itself can be enlarged without increasing the size. It becomes possible to arrange the measurement unit of the probe in front of the imaging unit. The angle θ formed by the central axis XX ′ of the probe handle and the central axis AA ′ in the horizontal direction of the working part is preferably in the range of about 5 to 40 degrees.
FIG. 12C is a diagram obtained by inverting FIG. 12A by 180 ° C. (reversed rear view when FIG. 12A is a front view). FIG. 12D is a diagram viewed from the front in the long axis (XX ′) direction (left side view when FIG. 12A is a front view), and FIG. 12E is the long axis direction. The figure seen from the rear surface (when FIG. 12A is a front view, the right side figure) and FIG. 12F are the figures seen from the lower surface direction.

  The above effects will be described with reference to FIG. FIG. 13A shows a case in which a camera (imaging unit) 1302 is simply arranged below the probe 1301, but when the probe 1301 goes deep into the gingiva 1303 as shown in the figure, the examination site 1304 is imaged by the camera 1302. In this case, there is a high possibility that the dentition 1305 and the lips that are not related to the examination site block the view of the camera. Periodontal pockets are not always formed vertically, and accurate measurement is often not possible unless the probe is inserted obliquely. In such a case, it is very difficult to image the examination site. On the other hand, if the camera (imaging unit) 1307 is arranged in the horizontal direction of the probe 1306 as shown in FIG. 13B, the viewpoint of the camera becomes high, so there is almost no influence of obstacles such as the tooth row 1309, and the probe 1306. It is easy to image the examination site 1308 even when the camera is deeply submerged. As already described, if the probe 1308 is bent toward the camera 1307 side, it is still easier to photograph.

  As a method for improving the field of view for photographing, an image transmission member such as an endoscope may be used in addition to changing the position of the imaging unit as shown in FIG. In other words, instead of placing a lens in front of the camera, an image transmission member formed of glass or optical fiber is disposed, and the obstacle of the image transmission member is approached by about 10 to 20 mm from the examination site. It does not interfere with imaging. In this method, although the manufacturing cost is higher than that of the lens, the video transmission member also has a function of eliminating obstacles such as lips and tongue, so that the ease of handling is improved. Although a structure in which the imaging camera itself is close to the examination site is possible, it is not an excellent means because it is impossible to make the camera disposable or high-temperature sterilization in terms of cost.

  FIG. 14 is a view of the periodontal pocket depth measuring device shown in a three-dimensional view in FIG. 11 as viewed from three directions. FIG. 14A is a front view seen from the probe side, and it can be seen that the measurement unit 1402 of the probe 1401 is arranged in front of the imaging unit 1403. In addition, even if the measuring instrument is held at a position close to the patient's mouth, the state in the oral cavity needs to be well visible, so the measuring instrument width W is 30 mm or less, and the measuring instrument thickness (height) D is 26 mm. It is desirable to be within the following range. In addition, the distance between the imaging unit 1403 and the probe measurement unit 1402 is preferably ensured so that the imaging unit does not enter the oral cavity, for example, 65 mm or more. Note that the light source 1404 provided concentrated on the camera side is also necessary for the measurement. FIG. 14B is a top view of the measuring instrument, and it can be seen that the working unit 1405 of the probe 1401 is bent toward the imaging unit as described above. FIG. 14 (c) is a left side view of the measuring instrument. From the viewpoint of easy handling as a handpiece, the length L of the measuring device is preferably about 150 mm or less (excluding the communication cable 1406). In FIG. 14, (a) is enlarged twice as much as (b) and (c).

  FIG. 15 shows an internal configuration of a periodontal pocket depth measuring device in which an imaging unit is also incorporated. This figure corresponds to a cross-sectional view of the measuring instrument of FIG. 11 when viewed from the Y direction (above). A probe fixture 1503 for connecting and fixing the probe 1502 is incorporated in the measuring instrument housing 1501, and the probe fixture 1503 can be rotated by a rotating shaft 1504. The relationship between the rotational displacement of the probe and the magnitude of the force is controlled by a spring 1505 such as a torsion spring, and a certain amount of displacement is detected by a displacement detection sensor 1506 such as a photo interrupter. Further, fine adjustment of the spring 1505 is performed by a spring adjustment tool 1507 and a spring adjustment screw 1508. Since it is as having demonstrated using FIG. 3 so far, it abbreviate | omits for details. Considering the fact that the periodontal pocket depth measuring device is used in an environment that is relatively easy to come into contact with the liquid of the patient's oral cavity, consideration must be given to waterproofness. In the periodontal pocket depth measuring device of the present invention, the probe 1502 is provided with a probe base cover 1509 at the base, thereby enhancing waterproofness. It is made of a material such as thin silicon and can be easily deformed even with a slight force. By attaching this cover to the housing 1501 of the measuring instrument, only the waterproof property can be improved without affecting the probe insertion force necessary for the inspection. In addition, white illumination is also required for measurement, but if a light source such as a white light emitting diode is arranged directly on the surface of the measuring instrument, wiring space is also required, making it difficult to downsize the measuring instrument. Therefore, as shown in FIG. 15, the light source 1511 is housed inside the measuring instrument, and the light from the light source 1511 is propagated from the light source by a light guide 1512 formed of acrylic, optical fiber, or the like, and guided to the measuring instrument surface. Use. Since the directivity of light increases during propagation, if the light guide 1512 is bent near the measuring instrument surface in the direction of the measuring part of the probe, it can be efficiently condensed near the measuring part. A plurality of light sources 1511 may be used as necessary, and a plurality of light guides 1512 may be used correspondingly. Since power to the light source 1511 is supplied from the control board 1510, it is easy to control to turn off the light source in a state where measurement or photographing is not performed.

The imaging unit is arranged in parallel with the periodontal pocket depth measurement system described above. This is mainly because of the imaging window 1513 installed on the surface of the housing 1501, and the imaging lens 1514 and camera arranged inside the imaging window 1513. 1515. Since the photographing window 1513 needs to be colorless and transparent, it is basically incorporated later into the housing 1501. However, when the housing 1501 itself is formed of a colorless and transparent resin, the housing 1501 and the photographing window 1513 are used. It is also possible to mold them by integrating them. The photographing lens 1514 is made of glass or resin and desirably has a diameter of 10 mm or less. Even if it is such a size, it is difficult to see when it comes to a position close to the examination site. In order to capture an image of the examination site as large as possible, the lens has a characteristic such that a field of view with a diameter of about 15 to 25 mm is obtained with respect to the position of the measurement unit of the probe 1502. As already described with reference to FIG. 11, when the imaging units are arranged side by side in the horizontal direction of the probe 1502, the case width is smaller when the working unit of the probe 1502 is bent toward the imaging unit. It becomes easy to see even when used. For example, the bending angle θ of the working part is in the range of 5 to 40 degrees. Since the camera 1515 needs to be incorporated in the measuring instrument, it is required to be small and lightweight. Therefore, it is preferable that the camera is a small camera module using a CMOS image sensor or a CCD image sensor, and the size is preferably about 6 mm square only by the camera portion. Since the distance between the photographing lens 1514 and the camera 1515 needs to be strictly determined, it is preferable to fix each of them to the camera lens fixture 1516. In many cases, the camera 1515 is originally provided with a tap structure for lens connection. Therefore, it is preferable to provide a tap on the camera lens fixture side so as to be engaged therewith. However, the camera lens fixture 1516 is not necessary when the housing 1501 is provided with a structure capable of securely fixing each of the housings 1501 or when the photographing lens 1514 can be directly fixed to the camera 1515.

Image information obtained by the camera 1515 is transferred to the control board 1510 to which the camera is connected. As already described, the transfer of image information is repeatedly executed at a rate of about 30 times per second, and if these image information are continuously displayed, they can be used as moving image information. A displacement detection sensor 1506, a light source 1511 such as a light emitting diode, a switch 1517, a buzzer, and the like are also connected to the control board 1510. As described above, in the inspection using an image, it is important to secure image information at the moment when a condition necessary for the inspection is satisfied. Are transferred together with the sensor value of the displacement detection sensor 1506 and the ON / OFF state of the switch 1517. Data transfer from the control board 1510 to the computer is performed through the cable 1518. However, if the USB cable is used as the cable 1518, the versatility is high, and the power necessary for the operation of the measuring instrument can be obtained through the cable. Note that the switch 1517 is not frequently pressed during a normal examination. For example, when the examination is performed again on the examined part or when only the imaging is performed regardless of the examination, the examination flow is performed. Used for special operations such as changing

  Here, an algorithm for actually measuring the periodontal pocket depth using the periodontal pocket depth measuring device will be described with reference to FIG. In order to actually perform a periodontal pocket examination, it is necessary to perform patient information input 1602 after performing system startup 1601. If the patient has already been examined, the registered information may be called. Patient information includes name, age, gender, address, insurance information, chronic illness, past treatment records, presence or absence of artificial teeth or missing teeth, and other precautions. Furthermore, the measurement point input 1603 must be performed on the patient to determine the site to be examined. The simplest method is to measure one point at the inside (lingual side) and outside (lip cheek side) of each tooth, but it is necessary to measure 4 or 6 examination sites according to the symptoms. Is determined in advance. Following this, an examination site measurement order input 1604 is performed. The order here refers to the order of the teeth to be measured and the order of a plurality of inspection sites for each tooth. By inputting or recalling information about the above, the system can grasp the order in which all examination sites are measured, so that it is possible to display and notify by voice which site should be examined during operation. The input up to this point can be omitted by calling data executed in the past.

  After completion of necessary information input, a measurement program start 1605 is performed. As already described, in the periodontal pocket depth measurement system of the present invention, since data obtained by connecting devices other than the periodontal pocket depth measuring device can be collectively managed, each measurement that can be used in the system is performed. Each device has a unique identification code. When the device is connected to the computer or when the connected device is automatically recognized, the identification code is automatically transferred from the device to the computer. The corresponding measurement program should be started. When the program is started, the illumination is automatically turned on, and first, test shooting 1606 is performed. If there is an abnormality in the imaging function built into the measuring instrument, image data cannot be obtained, or even if it is obtained, image data that is clearly abnormal in color will be obtained. Notice. Even if there is no abnormality in the imaging function, the inspection cannot be performed unless the probe necessary for the inspection is properly connected. Therefore, here, it is necessary to perform a probe state check 1607 to confirm whether the probe is properly reflected in the image. Since the connection state of the probe can be determined from the image information, the image data obtained by the test photographing 1606 is analyzed, and when the color of the predetermined probe cannot be detected or the probe is not present at an appropriate position even if it is detected In this case, a probe reconnection request 1608 is made. This is an operation for alerting the inspector by displaying a message to properly connect the probe again. Even if the probe is formed in a color that exists in the oral cavity such as white, it is possible to recognize the probe area by extracting the contour, but in order to improve the reliability of the inspection, the probe is It is preferable that coloring such as light blue which does not exist in the surface is given. When it is determined that the probe position is appropriate, the probe position calibration 1609 as a system is performed. If the probe is manufactured by resin molding or the like, it is inevitable that there will be some variation in shape, and in addition, minute deformation and positional displacement will occur due to the force when the inspector connects the probe. However, if the position of the probe is accurately recognized before the inspection, the inspection can be performed accurately. Specifically, the calibration is performed by recognizing the position of the probe in the initial state by analyzing the coloring of the probe and / or the position of the specific shape and / or the specific mark included in the image information. In Patent Documents 8 to 9, it is described that the measurement is performed by reading the scale attached to the probe as an image. However, when the positional relationship between the imaging system and the probe is fixed within an allowable range. As long as it is possible to recognize the probe region, no scale is necessary.

When the preparation up to here is completed, the process proceeds to the actual measurement operation. Since each examination site has already been given a measurement number, first, a measurement number n is set to 1 by number designation 1610, and measurement is performed in order from the first examination site. The measurement program is set to the n-th examination part measurement mode 1611, and an instruction by coloring or blinking on an illustration, text or voice is executed so that the part is the current measurement target.

First of all, it is necessary to recognize the moment when the probe contacts the inspection site (probe contact recognition 1612). As described above, since the periodontal pocket depth measurement system of the present invention acquires images about 30 times per second, the moment when the probe touches the examination site and is slightly displaced is also a change on the image. Can be caught.

  Since this change can be detected if only a part of the probe having a characteristic shape or only a specific mark provided is monitored, it can be sufficiently processed within an image acquisition interval. Similar to the processing in which the position of the probe is recognized as a system in the calibration operation described above, the coloring of the probe included in the image information and / or the change of the specific shape and / or the position of the specific mark from the initial state are detected. Thus, it can be recognized that the probe has contacted the patient. If an electrode is also connected to the patient, it is possible to physically recognize contact with the patient by detecting human resistance, but it does not require a special hardware configuration and recognizes contact by image analysis. If possible, that method is the best. In the case of detecting human resistance, there is a drawback that if a probe is made of metal, it becomes expensive, and if a probe is made of resin, there are many black ones, making it difficult to recognize blood adhesion. Note that an image at the moment of contact with the patient is stored as an initial image for use in later image analysis (initial image acquisition 1613).

  If contact with the patient is recognized and the examiner applies force to the probe as it is, the probe will continue to be displaced to a position where a certain amount, that is, the insertion force necessary for the inspection is applied. In this process, it is continuously checked whether the probe has returned to the initial position (position at the time of calibration). If it is recognized that the probe has returned to the initial position, the state is reset once and again. The operation of initial image acquisition 1613 from the probe contact recognition 1612 must be performed. This is because, for example, the contact was recognized because the probe accidentally contacted other teeth instead of the patient's examination site, so the examiner intentionally separated the probe from the patient and contacted the examination site again. This is applicable when performing an operation that attempts to If a notification is given with a short buzzer sound or the like at the time of contact detection, it becomes easy to notice that there was an erroneous contact. Since recognition at the time of probe contact is a very important process, such probe position confirmation 1614 is indispensable. If such a reset operation does not occur and the insertion force can be smoothly applied to the examination site, the constant displacement detection 1615 of the probe is performed using a displacement detection sensor or the like, and the moment when the predetermined insertion force is applied. Is recognized. Since the image obtained at this moment is an image in a completed state necessary for inspection, it is acquired and stored as a completed image (completed image acquisition 1616).

  Once the initial image and the completed image are acquired, these can be analyzed to determine the periodontal pocket depth. As a process necessary for this, the probe front-rear determination 1619 in the initial image is executed. Specifically, the probe length in the initial image is first obtained by analysis (probe length analysis 1617 in the initial image). If the distance between the probe and the imaging system is substantially fixed, the probe length can be easily obtained by analyzing the probe region shown in the image from the color and determining the length or area thereof. Similarly, the probe length in the completed image is also obtained (probe length analysis 1618 in the completed image). Usually, if it is an image at the moment when the probe contacts the examination site, the tip of the probe will not be hidden in the periodontal pocket, and the entire measurement part of the probe should be reflected in the image. However, when the probe turns to the back side of the tooth as viewed from the examiner (imaging system side), a part of the probe is hidden by the teeth, so the probe is not in the periodontal pocket at all. However, the entire measurement part of the probe is not reflected in the image, and the probe length is as short as the hidden part of the tooth.

  Therefore, first, the probe length in the initial image (the image at the moment when the probe touches the examination site) is analyzed, and if the length exceeds a certain standard, the probe is determined to be in front of the tooth (before the examiner). If the length does not exceed a certain standard, it is determined that the probe is on the back of the tooth (the back for the examiner). When it is determined that the probe is in front of the tooth, the probe length in the completed image is a value obtained by subtracting the partial length that has entered the periodontal pocket from the original probe length. Since it is known, a periodontal pocket depth calculation 1620 from the probe length in the completed image is possible. On the other hand, if it is determined that the probe is on the back of the tooth, assuming that the portion where the probe is hidden in the teeth in the initial image and the portion where the probe is hidden in the teeth in the final image are the same, Periodontal pocket depth calculation 1621 from the difference in probe length in the two images is possible. That is, this difference may be the length (periodontal pocket depth) embedded in the periodontal pocket. Since the case where the probe is hidden behind the teeth can easily occur, such a determination process is essential.

In summary, in the periodontal pocket depth measurement system of the present invention, as described above, first, there is a means for acquiring an image of the moment when the probe contacts the patient, and based on the probe length detected from the image. The probe has a function of determining whether the probe is in front of or behind the target tooth. Furthermore, when the determination function determines that the probe is behind the tooth, the probe length in the image at the moment when the probe contacts the patient and the moment when the predetermined probe insertion force necessary for the inspection is applied. Each probe length in the image is obtained, and the difference between these probe lengths is used as the periodontal pocket depth. By devising such an algorithm, it is possible to accurately measure the periodontal pocket depth that cannot be obtained simply by combining an imaging function with a probe. In addition, as shown in the flow of FIG. 16, as the caution determination 1622, it is checked whether or not the value of 3 mm or more having a diagnostic attention as the periodontal pocket depth in a state where the probe is on the back of the tooth, If the distance is 3 mm or more, it is better to display a message or the like requesting re-measurement at a position where the probe appears on the front surface of the tooth (re-measurement request 1623 from the front surface).

  This is because if the tip of the probe is not directly reflected in the image, the reliability is somewhat inferior, and if the probe straddles the teeth against a deep periodontal pocket, the probe hits the upper surface of the tooth. This is because there is a possibility that the measurement has not been performed correctly. Even if the probe is located on the back of the tooth, if the necessary part of the probe is reflected on the mirror, etc. and is captured by the image of the imaging system, the function that analyzes the image reflected on the mirror You may have.

  Actually, even a slight displacement at the moment when the probe contacts the inspection site is caused by a very small force applied to the probe, and strictly speaking, this is not a zero point state. However, since the probe shape or the position of the specific pattern in the zero point state can be obtained from the image when no force is applied, it is possible to correct the depth calculation result. However, in a situation where the state of the examination site is very poor and the probe is inserted deeply into the periodontal pocket before slight probe displacement occurs, accurate correction of the periodontal even if such correction is performed. Pocket depth is not required. To cope with this situation, two types of springs are used to control the force of the probe, and it is slightly displaced even with a small force immediately after contact, and it is displaced in contact with a normal spring from the middle. A method may be adopted. Instead of preparing two types of springs, it is possible to realize such a two-stage method by inserting a cushion material having a repulsive force sufficiently smaller than the spring between the spring and the probe fixture. .

  Note that the image sensor method as described above can be used not only for the moment when the probe contacts the examination site but also for detecting that the probe is displaced by a certain amount (that is, that a certain force is applied). For example, if the probe is displaced 1 mm upward when a force of 25 g weight necessary for inspection is applied, this displacement also appears as a change in the probe position on the image. Therefore, if a color monitoring area is provided at the position where the printed pattern of a probe or a given mark should come when a predetermined force is applied, the predetermined force can be applied without using a physical sensor. This can be detected from the image. With this method, it is not necessary to use a displacement detection sensor as described above, and the measuring instrument is further reduced in size and weight. Although it is necessary to set a plurality of monitoring areas on the image for the purposes of contact detection and force detection, since all of them are limited areas, image processing can be executed without any problem. In the periodontal pocket depth measurement system of the present invention, a sensor for detecting displacement is used as a precaution, but this is because when the displacement of the probe cannot be recognized in the image at all due to some reason, the entire image is displayed. This is because there is a possibility that the operation of software may be completely stopped in the method of determining by processing.

  When the periodontal pocket depth is accurately obtained by the above processing, it is preferable to notify the measurement value by voice notification 1624. At the same time, the measurement value and image recording 1625 of the examination site are executed so that the display can be confirmed later. The completed image is not only an image necessary for obtaining the periodontal pocket depth but also the most important information of the affected area. When proceeding with the treatment, if the images of the same affected area can be compared, it is expected that the treatment effect can be easily confirmed. Since the measurement of the target inspection site of the target tooth is completed by the processing so far, the measurement completion confirmation 1626 of all the inspection sites is performed here. Transition. If the measurement of all the examination parts is completed, the measurement result is displayed and saved 1628, and the examination is terminated.

  Here, the most important periodontal pocket depth measurement algorithm will be described in detail with reference to the drawings. First, FIG. 17 specifically shows the probe front-rear determination 1619 in the initial image in the measurement flow of FIG. The tip of the probe shown in FIG. 17 is formed in a spherical shape, and has a shape that relieves irritation to the periodontal pocket.

FIGS. 17 (a) and 17 (b) are images (initial images) at the moment when the probe contacts the examination site. In FIG. 17A, since the probe 1701 is reflected in front of the inspection target tooth 1702, the probe detection length 1703 is the length of the original measurement unit of the probe. Actually, even a slight insertion force may cause only a part of the tip to enter the periodontal pocket, but in any case, the value is almost the length of the measurement unit. The acquisition of the initial image is preferably performed by detecting the timing at which the probe 1701 slightly moves upward by the resistance force received when the probe 1701 contacts the gingiva on the screen.
The timing is exemplified by detecting the timing at which the movement of a specific position of the probe slows down the movement when receiving resistance against the insertion movement of the probe.

  On the other hand, in FIG. 17 (b), since the probe 1704 is reflected behind the inspection target tooth 1705, the probe detection length 1706 is more than the length of the original probe measurement part, because it is hidden by the inspection target tooth 1705. Shorter. In the case where it is difficult to insert the probe from the front if the inspector does not change the standing position as in the case of the back teeth, the possibility of inserting the probe with the teeth straddling is increased. Since the probe detection length in the initial image is clearly different between FIGS. 17 (a) and 17 (b), for example, if the probe detection length in the initial image is 80% or more of the length of the original probe measurement unit, the probe Can be determined to be behind the tooth to be inspected if it is less than 80% before the tooth to be inspected. If the probe is colored such as light blue that does not exist in the oral cavity, and the auxiliary graduation pattern for visual observation is colored in a color that does not exist in the oral cavity such as dark blue, probe detection is performed by image analysis. It is easy to determine the detection length. However, since the image also includes a working unit above the measuring unit, it is necessary to detect a scale pattern or a characteristic shape that indicates the upper limit of the measuring unit and to detect only the measuring unit. Even if the probe is not colored or scaled, the probe can be extracted by limiting the area close to the center of the image or by extracting the characteristic shape provided on the probe. Detection may be performed. In any case, the periodontal pocket depth measurement system of the present invention has means for acquiring an image at the moment when the probe contacts the inspection site, performs processing for detecting the probe region from the image, and the probe is the inspection object. By having the feature of determining whether the tooth is located before or after the tooth, it is possible to ensure information necessary for accurately obtaining the periodontal pocket depth.

  If it is possible to determine whether the probe is in front of or behind the tooth to be inspected, an image (completion image) of the moment when the probe insertion force necessary for the inspection is applied is acquired, and the probe reflected in this image is acquired. What is necessary is just to detect. This corresponds to periodontal pocket depth calculation 1620 in the measurement flow of FIG. When the probe appears in front of the tooth to be inspected, image processing for obtaining the probe detection length is performed on the completed image, and the length obtained by subtracting the probe detection length from the original measurement unit length is the gingiva. This is the length of the probe that has entered inside, that is, the periodontal pocket depth. On the other hand, when the probe is reflected behind the tooth to be inspected, it is necessary to use both the initial image and the completed image.

  FIG. 18A shows an initial image when the probe is shown in the back. First, probe detection processing is performed on this image, and a probe detection length 1801 in the initial image is obtained. Since this is a process that is always performed for the front-rear determination of the probe, it is not a special process. Similarly, a probe detection length 1802 in the completed image is obtained for a completed image obtained using a probe displacement detection sensor or the like. This is also a process performed regardless of the probe front-rear determination result. The difference is that when it is determined that the probe is in front of the tooth to be inspected, the periodontal pocket depth is obtained using only the probe detection length 1802 obtained from the completed image, whereas the probe Is determined to be behind the tooth to be examined, the periodontal pocket depth is obtained as the difference between the probe detection length 1801 in the initial image and the probe detection length 1802 in the completed image. Since the partial lengths of the probes hidden by the teeth to be examined in these images can be regarded as equal, this process can accurately increase the periodontal pocket depth even when the probes are behind the teeth to be examined. It can be sought. As already mentioned, in the periodontal pocket depth measuring device (measurement system) of the present invention, the probe performs rotational displacement by the rotation shaft, and the amount of insertion is accurately controlled by controlling the amount of displacement using a spring. Since the mechanism is added, the camera position is relatively low with respect to the probe when the probe is pressed with a predetermined insertion force. Therefore, although the center coordinate Y2 of the inspection target tooth in the completed image is higher than the center coordinate Y1 of the inspection target tooth in the initial image, the relative position of the probe with respect to the tooth does not change due to factors other than the periodontal pocket, Does not affect the measurement. Rather, it is also possible to recognize from the image the insertion force applied to the probe without using a sensor by detecting a change in the center position of the inspection target tooth. Such processing is not actively employed in the present invention because there is a possibility that the function may be completely stopped when the probe does not appear in the image at all for an unexpected reason. It is an effective means for conversion.

  In practice, after the probe is inserted into the periodontal pocket, an operation called “walking” in which the probe is moved up and down in small increments may be performed. In this case, when the probe is moved upward, the probe position is reset, but when the probe is considered to have contacted the examination site by applying the insertion force again, the probe has already been in some periodontal period. The probe length in the initial image is determined to be shorter than the actual length because it has entered the pocket. If it is determined that the probe is behind the tooth, it is absolutely impossible to correctly determine the probe length in this situation, so the probe must be fully pulled out and measured again. Display a message.

  If the initial image is acquired with the probe behind the tooth and already in the periodontal pocket, the probe length will be detected much shorter than the original length. The request message may be displayed when the probe length determination in the initial image is less than 30% of the length of the original probe measurement unit, for example. In this example, that is, if the probe length in the initial image is 90% or more of the length of the original measurement portion, the front of the tooth, if it is 30% or more and less than 90%, the rear of the tooth, and if less than 30%, re-measurement. A determination process such as requesting is performed. However, this is not sufficient, and even if the probe is in front of the tooth, if the probe is lurking in the periodontal pocket by the walking operation from the beginning, it is erroneously determined that the probe is behind the tooth. . In order to cope with such a case, image determination may be added in the probe length determination of the initial image.

  Specifically, since the lower limit position of the probe can be determined in the probe length determination, the boundary region on the left and right sides of the lower limit position (side the probe) is obtained. As the boundary region, a boundary between a tooth and a gum or a boundary between a tooth and a space such as a cheek can be considered. The boundary area can be easily obtained by differentiating the brightness change in the vertical direction of the image, but the brightness decreases from the top to the bottom (that is, the differential coefficient becomes negative) at the boundary between the teeth and gums. There is a difference that the luminance increases from the upper side to the lower side (that is, the differential coefficient becomes positive) at the boundary between the teeth and the space such as the cheeks. The fact that the left and right boundaries of the lower limit of the probe are the boundary between the teeth and the gums indicates that the probe is in front of the teeth. It is sufficient to calculate using Thus, by combining the probe length determination in the initial image and the boundary determination by image processing, it is possible to correctly determine the periodontal pocket depth even when a walking operation is performed.

  FIG. 19 shows the contents displayed on the display when the periodontal pocket depth measurement is executed by the periodontal pocket depth measurement system of the present invention. One of the major features of this system is a function for displaying a moving image 1901 of an examination site acquired by a camera. Since this moving image is enlarged and displayed on the display as compared with the actual visual observation, the state of the examination site is easily grasped. If there is no particular problem, it is sufficient to apply the probe directly without looking at the enlarged display. It is possible to perform the inspection safely. Since both the camera and the probe 1902 are incorporated in the measuring instrument, the measurement unit of the probe 1902 is always reflected in the center of the image and is easy to check.

  As already mentioned, it is possible to determine the periodontal pocket depth from the probe length analysis even if the probe 1902 has no scale, but the inspector can visually confirm the depth, and even if only looking at the image later Since an effect such as easy understanding of the depth can be expected, the probe may be provided with a scale pattern 1903. The scale pattern 1903 is preferably formed so that the boundary of the pattern or the scale line is located at these positions so that the positions of 3 mm and 6 mm (or 7 mm) from the tip are particularly easy to understand. This is because the treatment policy generally changes when the periodontal pocket depth exceeds 3 mm or 6 mm (or 7 mm). Furthermore, since it is desired to set the upper limit of the depth to be measured to 11 mm or 12 mm, it is preferable that there is a pattern boundary or graduation line at this position.

  For image analysis, not only printing of a pattern for clarifying these boundaries but also coloring of the material of the probe 1902 makes it easier to recognize the probe, and the analysis can be executed reliably. Since information on whether blood adheres to the tip of the probe is also important for diagnosis, it is better to use a light color that makes it easy to understand the attachment of blood at least up to a position of 3 mm from the tip. As the color used for probe coloring and pattern printing, it is easier to distinguish the colors that are usually present in the oral cavity, such as teeth and gums. Therefore, for example, the material color of the probe 1902 is light blue or light green. For example, the print color of the pattern 1903 may be dark blue, dark green, or black. Since the ink used for pattern printing requires biological safety, it was mixed with a pigment such as brilliant blue FCF and carbon black, a naturally-derived binder such as shellac, and absolute ethanol for dissolving it. Use things.

As a device for identifying the probe, a method of performing two-color printing instead of a combination of coloring and printing of the material can be used. Moreover, it is also possible to add a device for the shape instead of printing or coloring. For example, the probe is thickened in the upper part from the upper limit position to be measured, and grooves or dents are formed at particularly important positions. It becomes possible to measure the pocket depth. In addition, when performing automatic recognition using color, a mechanism for stably illuminating the measuring portion of the pocket probe is also necessary. For example, a method of illuminating by incorporating a white light emitting diode in a periodontal pocket depth measuring device can be considered. If power is supplied to the light source from a control board connected to the camera, stable illumination is possible by controlling the current.

  In actually performing the inspection, the inspector himself knows which tooth is currently being inspected, but there is some indication as to whether it matches the tooth recognized by the system. Without it you can't confirm. In view of this, the system has a function of displaying moving image information and information for clarifying the examination site currently being examined. That is, as shown in FIG. 19, a tooth illustration 1904 is displayed during the examination. In addition, the tooth 1905 under examination in the tooth illustration 1904 is displayed by coloring or blinking so that it is easy to grasp which tooth is currently inspected (the tooth recognized by the system). An enlarged illustration 1906 is displayed at the center of the illustration, and a tooth display 1907 familiar to the examiner is also displayed. Usually, since there are a plurality of examination parts for one tooth, a measurement value 1908 is displayed for a part that has already been examined around the enlarged illustration 1906.

  The measured numerical value 1908 may be a color mark color-coded according to the pocket depth. In addition, a cursor 1909 is displayed for an examination site currently being examined, and it is made easy to recognize by blinking if necessary. In addition to these ingenuity on the display, if there is a function for notifying the examination site to be examined next by voice, a mismatch between the examiner and the examination site of the system is prevented, and misdiagnosis is less likely to occur. Depending on the patient, teeth may be missing or artificial teeth may be used.If these information are entered in advance, they can be recognized by displaying these illustrations on the display. It is possible to make it easier.

If the display device for grasping the examination site is devised as described above, it is possible to positively introduce a function that enables irregular operations that do not follow the normal order. For example, the function that allows the inspector to input the measured values of the examination part that is difficult to see on the camera by pressing the numeric key, the function that skips the part that does not need to be inspected by pressing a specific key on the switch or keyboard A function to reexamine a part that has already been completed by a special operation such as pressing the upper surface of the tooth with a probe, and after a certain period of time with the probe inserted in one periodontal pocket, the adjacent part of the part or the same tooth A function of automatically inputting data on the assumption that the other pockets have the same pocket depth is also conceivable. Since these irregular operations are possible, the inspection can be efficiently advanced.

  In addition, since there may be items to be noted during the examination, such as the patient's condition and drug use, a comment field 1910 is also prepared so that an arbitrary comment text can be input and displayed. It is desirable that personal information such as the patient's name is also displayed as the information, which is not limited to the comment field 1910 and may be displayed at the top of the screen.

  Finally, we will supplement additional functions and usage. Another useful feature supported by the software is checking for bleeding. The tip of the pocket probe is made to have a color that is clearly different from blood, such as light blue, light green, and white, so if blood adheres to it, it can be easily recognized on the image. is there. Therefore, when the pocket probe is pulled out of the periodontal pocket (when the sensor that senses that a predetermined force is being applied stops responding), image analysis of the probe tip is automatically performed on the probe. When blood color is detected, it is possible to realize a function of recording that there is bleeding at the examination site where the examination is performed. In this case, if there is a function of notifying the examiner by voice if bleeding is confirmed, the work of wiping off the adhering blood can be surely performed before the next site is inspected.

  Similarly, a periodontal plaque inspection function is also conceivable as a function that can be realized by analyzing colors on an image. In this examination, a dedicated colorant is used to examine the degree of plaque adhesion to the tooth, and therefore it is easy to obtain the ratio of the colorant color in the tooth image by image analysis. Thus, by having a periodontal plaque inspection function, it becomes a system that enables more accurate determination.

  The periodontal pocket depth measuring device and the periodontal pocket depth measuring system of the present invention are mainly used in dental clinics to conduct examinations for the purpose of grasping the pathological condition of a patient's periodontal disease.

The figure which shows the whole structure of the periodontal pocket depth measurement system of this invention. The figure which shows an example of the periodontal pocket depth measuring device of this invention The figure which shows an example of the internal structure of the periodontal pocket depth measuring device of this invention The figure which shows an example of the fixing method of the probe in the periodontal pocket depth measuring device of this invention The figure which shows an example of the probe insertion force control method in the periodontal pocket depth measuring device of this invention The figure which shows an example of the internal structure of the periodontal pocket depth measuring device of this invention The figure which shows an example of the internal structure of the periodontal pocket depth measuring device of this invention The figure which shows an example of the internal structure of the periodontal pocket depth measuring device of this invention The figure which shows an example of the structure which has an imaging function of the periodontal pocket depth measuring device of this invention Diagram showing the relationship between position and field of view when a camera is combined with a probe for periodontal pocket inspection The figure which shows an example of the structure which has an imaging function of the periodontal pocket depth measuring device of this invention The figure which shows an example of the probe shape used with the periodontal pocket depth measuring device of this invention The figure which shows the effect of the visual field improvement by the periodontal pocket depth measuring device of this invention The figure which shows an example of the shape of the periodontal pocket depth measuring device of this invention The figure which shows an example of the internal structure of the periodontal pocket depth measuring device of this invention The figure which shows the measurement flow of the periodontal pocket depth measurement system of this invention The figure which shows the process required in order to obtain | require depth in the periodontal pocket depth measurement system of this invention The figure which shows the process required in order to obtain | require depth in the periodontal pocket depth measurement system of this invention The figure which shows an example of the display screen of the periodontal pocket depth measurement system of this invention

Explanation of symbols

101 Periodontal pocket depth measuring device 102 Probe 103 Communication cable 104 Computer 105 Display 106 Keyboard 107 Mouse 201 Housing 202 Probe 203 Probe fixture 204 White illumination 205 Cover 301 Housing 302 Probe 303 Probe fixture 304 Probe fixing projection 305 Rotating shaft 306 Spring 307 Probe fixing tool rear end 308 Spring adjusting tool 309 Spring adjusting screw 310 Displacement detection sensor 311 Sensor detection protrusion 312 Control board 313 Power supply 314 Buzzer 315 White illumination 401 Probe 402 Probe fixing tool 403 Fixing hole 404 Probe fixing protrusion 601 Probe fixture 602 Sensor detection projection 603 Photo interrupter 604 Torsion spring 605 Spring adjustment tool 701 Probe 702 Probe fixing Tool 703 Light source 801 Probe 802 Dent 803 Case 804 Probe rotation fulcrum 805 Probe support spring 806 Force control spring 807 Displacement detection sensor 808 Waterproof member 901 Housing 902 Probe 903 Probe fixture 904 Measurement unit 905 Imaging unit 906 White illumination 907 Cable 1001 Measurement Unit 1002 working unit 1003 camera 1004 measuring unit 1005 working unit 1006 camera 1101 housing 1102 probe 1103 measuring unit 1104 working unit 1105 white illumination 1106 imaging unit 1107 probe base cover 1201 handle 1202 working unit 1203 measuring unit 1204 beam 1205 fixing hole 1301 Probe 1302 Camera 1303 Gingival 1304 Inspection site 1305 Dental row 1306 Probe 1307 Camera 1308 Probe 1309 Teeth row 1401 Lobe 1402 Measuring unit 1403 Imaging unit 1404 Light source 1405 Working unit 1406 Communication cable 1501 Housing 1502 Probe 1503 Probe fixture 1504 Rotating shaft 1505 Spring 1506 Displacement detection sensor 1507 Spring adjuster 1508 Spring adjustment screw 1509 Probe base cover 1510 Control board 1511 Light source 1512 Light guide 1513 Shooting window 1514 Shooting lens 1515 Camera 1516 Camera lens fixture 1517 Switch 1518 Cable 1601 System activation 1602 Patient information input 1603 Measurement point input 1604 Test site measurement sequence input 1605 Measurement program activation 1606 Test imaging 1607 Probe status check 1608 Probe reconnection request 1609 Probe position calibration 1610 Number designation 1611 Number n Eye inspection site measurement mode 1612 Probe contact recognition 1613 Initial image acquisition 1614 Probe position confirmation 1615 Probe constant displacement detection 1616 Complete image acquisition 1617 Probe length analysis 1618 in the initial image Probe length analysis 1619 in the initial image 1620 Periodontal pocket depth calculation from the probe length in the completed image 1621 Periodontal pocket depth calculation from the difference in probe length in the two images 1622 Attention determination 1623 Re-measurement request from the front 1624 Audio notification 1625 Measurement value and image of the examination site Record 1626 Confirmation of measurement completion of all examination sites 1627 Measurement number change 1628 Measurement result display and storage 1701 Probe 1702 Inspection target tooth 1703 Probe detection length 1704 Probe 1705 Inspection target tooth 1 706 Probe detection length 1801 Probe detection length 1802 in initial image Probe detection length 1901 in completed image Moving image 1902 Probe 1903 Scale pattern 1904 Tooth illustration 1905 Inspected tooth 1906 Enlarged illustration 1907 Tooth formula display 1908 Measurement value 1909 Cursor 1910 Comment field

Claims (20)

A periodontal pocket depth measuring device having a structure in which the insertion force of the probe applied to the examination site reaches a maximum value or a maximum value when the displacement amount of the probe reaches a predetermined value. The probe or the fixture of the probe has a rotation mechanism and is in contact with the spring, and the insertion force of the probe applied to the examination site is controlled by deformation of the spring according to the rotational displacement of the probe. Periodontal pocket depth measuring device. The periodontal pocket depth measurement according to claim 2, wherein the amount of deformation of the spring is changed by sliding of a contact point between the probe or the fixture of the probe and the spring according to the rotational displacement of the probe. vessel. The periodontal pocket depth according to claim 1 or 3, wherein a deformation amount of the spring takes a maximum value or a maximum value in a process in which a contact point between the probe or the probe fixture and the spring slides. Measuring instrument. The periodontal pocket depth measuring instrument according to claim 1 or 4, wherein the maximum value or maximum value of the insertion force of the probe is a value suitable for periodontal pocket depth measurement. The periodontal pocket depth measuring device according to claim 5, wherein the value suitable for the periodontal pocket depth measurement is a value between 20 g and 30 g. The periodontal pocket depth measuring instrument according to claim 1 or 4, wherein a maximum value or a maximum value of the insertion force of the probe is a maximum value that is acceptable for safety. The periodontal pocket depth measuring instrument according to claim 7, wherein the maximum value allowable for safety is a value between 35 g and 70 g. 9. The periodontal pocket depth measuring device according to claim 1, wherein when the displacement amount of the probe reaches a predetermined value, the user is notified by sounding a buzzer. A probe for measuring periodontal pocket depth, and a periodontal pocket depth measurement system having a function of photographing a region where an examination is performed using the probe. The periodontal pocket depth measurement system according to claim 10, which has a function of automatically performing imaging of a test site when an insertion force of a probe applied to the test site reaches a predetermined value. 12. The periodontal pocket depth measurement system according to claim 10, wherein additional information including sensor information and / or switch information is added to the image information obtained by the photographing function and transferred to a computer. The periodontal pocket depth measurement system according to claim 10, wherein the periodontal pocket depth is obtained by detecting a length of a probe included in an image obtained by the imaging function. 14. The periodontium according to claim 10, wherein the detection of the length of the probe is performed based on the number of pixels that can be determined to be the color of the probe included in the image information, and based on the number of pixels. Pocket depth measurement system. A periodontal pocket depth measuring device in which a probe for measuring periodontal pocket depth and an imaging unit for performing imaging are arranged in a horizontal direction. The periodontal pocket depth measuring device according to claim 15, wherein the probe working unit is bent toward the imaging unit so that the measurement unit of the probe is positioned in front of the imaging system. Recognizing that the probe has contacted the patient by detecting the coloring of the probe and / or the change of the specific shape and / or the position of the specific mark from the initial state included in the image information obtained by the imaging function. The periodontal pocket depth measuring device and periodontal pocket depth measuring system according to claim 10 to 16. It has means for acquiring an image at the moment when the probe contacts the patient, and has a function of determining whether the probe is in front of or behind the tooth to be inspected based on the probe length detected from the image. The periodontal pocket depth measuring device and periodontal pocket depth measuring system according to claim 10 to 17. When it is determined by the determination function that the probe is behind the tooth, the probe length in the image at the moment when the probe contacts the patient and the moment when the predetermined probe insertion force necessary for the inspection is applied. 19. The periodontal pocket depth measurement device and periodontal pocket depth measurement system according to claim 18, wherein the probe lengths in the images are respectively obtained and the difference between these probe lengths is used as the periodontal pocket depth. Multiple measuring instruments that can be connected to the system each have a unique identification code. When the measuring instrument is connected to the system, it automatically transmits the identification code to automatically start the operation program corresponding to the measuring instrument. Periodontal inspection system with function.

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