JP2021094323A - Periodontal disease treatment apparatus - Google Patents

Abstract

To improve adhesiveness of a photosensitive substance to pathogenic bacteria.SOLUTION: A periodontal disease treatment apparatus 1 includes: exciting light irradiation means 30 for irradiating a photosensitive substance with light for exciting a photosensitive substance injected in an affected part in the oral cavity of a subject P; a direct current power supply device 10 having positive and negative output terminals 11 and 12; a probe electrode connected to the positive output terminal 11 of the positive and negative output terminals of the direct current power supply device 10 with a lead wire 13 for imparting electric charge of one polarity to the photosensitive substance injected in the affected part; and a subject electrode 17 connected to the negative output terminal 12 of the positive and negative output terminals of the direct current power supply device 10 with a lead wire 14 for imparting electric charge of the other polarity to part of the body of the subject P.SELECTED DRAWING: Figure 1

Description

The present invention relates to a periodontal disease treatment device.

In the treatment of periodontal disease, removal of pathogenic bacteria is the most important therapeutic purpose, and eradication using mechanical means has been conventionally performed. However, since mechanical therapy is not always perfect, various light energies such as high-power lasers are currently used for periodontal pocket treatment as light therapy in a broad sense for eradication, and in recent years, further Antibacterial photodynamic therapy using a photochemical reaction using a combination of light and a photosensitizer is attracting attention as a new means of eradication. Antibacterial photodynamic therapy is a photochemical reaction in which a light-sensitive substance is bound to a bacterial cell and then irradiated with light having a wavelength that specifically excites the substance to generate active oxygen, which damages the bacteria and kills them. A low-power semiconductor laser or LED (light emitting wavelength) is used as a light source.

In Patent Document 1, ultrasonic vibration generated by an ultrasonic vibrator is transmitted to a chip of an ultrasonic scaler to crush tartar and irradiate light in a predetermined wavelength region from the tip of a fiber inserted inside the scaler chip. A scaler device that enhances the bactericidal effect while supplying a liquid such as a hydrogen peroxide solution is described. Tartar is formed by biofilm (plaque) adhering to teeth reacting with calcium and phosphoric acid contained in saliva to calcify, becoming hard like stone and sticking to the surface of teeth. is there.

Japanese Patent No. 5764269

However, in the actual oral cavity, pathogenic bacteria form a biofilm together with the mucus produced by themselves and other bacteria, and it is difficult for light-sensitive substances to penetrate into the biofilm. Therefore, it was difficult to attach the photosensitive substance to the pathogenic bacterium. For example, the scaler device described in Patent Document 1 imparts a light-sensitive substance only to pathogenic bacteria exposed from a destroyed biofilm. Therefore, in the technique described in Patent Document 1, the light-sensitive substance could not be permeated into the biofilm and efficiently applied to all pathogenic bacteria.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a periodontal disease treatment apparatus capable of improving the adhesion of a light-sensitive substance to a pathogenic bacterium.

In order to solve the above-mentioned problems, the periodontal disease treatment apparatus according to the present invention comprises an excitation light irradiation means for irradiating the photosensitizer with light for exciting the photosensitizer injected into the affected portion in the oral cavity of the subject. , A DC power supply device having positive and negative output terminals and one of the positive and negative output terminals of the DC power supply device are connected by a conducting wire, and a charge of one polarity is applied to the photosensitive substance injected into the affected area. A probe electrode to be applied, a subject electrode connected to the other of the positive and negative output terminals of the DC power supply device by a conducting wire, and a subject electrode to apply a charge of the other polarity to a part of the subject's body. To be equipped with.

According to the present invention, the adhesion of a light-sensitive substance to a pathogenic bacterium can be improved.

It is a block diagram which shows typically the periodontal disease treatment apparatus which concerns on 1st Embodiment of this invention. It is the schematic which shows the cross section along the axial direction of the tip of the handpiece of FIG. 1 enlarged. It is a schematic diagram which shows the modification of the affected part contact child. It is a schematic diagram which shows the other modification of the affected part contact child. It is a block diagram which shows typically the periodontal disease treatment apparatus which concerns on the modification of 1st Embodiment of this invention. It is a schematic diagram which shows the use state of the handpiece of the periodontal disease treatment apparatus. It is a block diagram which shows typically the periodontal disease treatment apparatus which concerns on 2nd Embodiment of this invention. It is a block diagram which shows typically the periodontal disease treatment apparatus which concerns on 3rd Embodiment of this invention. It is a schematic diagram of the excitation light irradiation by the periodontal disease treatment apparatus of FIG. It is a block diagram which shows typically the periodontal disease treatment apparatus which concerns on 4th Embodiment of this invention. It is a block diagram which shows typically the periodontal disease treatment apparatus which concerns on a modification.

(First Embodiment)
The configuration of the periodontal disease treatment apparatus according to the first embodiment will be described with reference to FIGS. 1 and 2A. The periodontal disease treatment device 1 is subjected to antibacterial photodynamic therapy utilizing a photochemical reaction by a combination of a photosensitizer injected into the affected part of the tooth T of the subject P and light irradiated to the photosensitizer. It is a device for treating periodontal disease. In FIG. 1, the subject P is schematically shown only by the arm, the tooth T, and the gingiva. Further, in the following, it will be described that the biofilm B is formed in the periodontal pocket between the tooth T and the gingiva, which is the affected part of the subject P.

As shown in FIGS. 1 and 2A, the periodontal disease treatment device 1 includes an excitation light irradiation means 30, a DC power supply device 10, a probe electrode 15 (see FIG. 2A), and a subject electrode 17. ing. The excitation light irradiation means 30 irradiates the light-sensitive substance injected into the affected part of the oral cavity of the subject P with light. The DC power supply device 10 has a positive (plus (+)) output terminal 11 and a negative (minus (−)) output terminal 12, respectively. The probe electrode 15 is connected to, for example, a positive output terminal 11 of the DC power supply device 10 by a conducting wire 13 to impart a positive polar charge to the photosensitive substance injected into the affected area. The subject electrode 17 is connected to, for example, a negative output terminal 12 of the DC power supply device 10 by a conducting wire 14, and imparts a negative polarity charge to a part of the body of the subject P.

The polarity of the electrodes may be reversed. That is, the probe electrode 15 may be electrically connected to the negative output terminal 12, and the subject electrode 17 may be electrically connected to the positive output terminal 11.

The periodontal disease treatment device 1 adds a positive charge or a negative charge from the probe electrode 15 connected to the DC power supply device 10 to the photosensitive substance injected into the affected area, and what is the added charge? The subject P can be charged with an oppositely signed charge. As a result, the charged photosensitive substance permeates into the biofilm B due to the force of attracting the charges of different codes, and the adhesion of the photosensitive substance to the pathogenic bacterium is improved.

Hereinafter, the configuration of each part will be described in detail.
In the present embodiment, the periodontal disease treatment device 1 includes a handpiece 4 whose tip is inserted into the oral cavity of the subject P, and a control device 2. A probe electrode 15 is arranged at the tip of the handpiece 4, and a light emitting port 35 for emitting light is arranged at a predetermined position on the tip side of the handpiece 4. In addition, the periodontal disease treatment device 1 further includes a light-sensitive substance injection means 20.

The handpiece 4 outputs light, current, and a light-sensitive substance, and includes a light guide path 32 leading to a light outlet 35 of the excitation light irradiating means 30, a liquid flow path tube 22 of the light-sensitive substance injection means 20, and a liquid flow path tube 22. A lead wire 13 connected to the probe electrode 15 is built in.

The DC power supply device 10 is built in, for example, the control device 2. The lead wire 13 connected to the positive output terminal 11 of the DC power supply device 10 is arranged so as to pass through the inside of the handpiece 4, and guides the positive charge to the probe electrode 15 arranged at the tip of the handpiece 4. The conductors 13 and 14 are surrounded by an insulating member in the extending direction. The current value and the supply time of the current supplied from the DC power supply device 10 to the probe electrode 15 and the subject electrode 17 are appropriately selected within a range safe for the human body.

The light-sensitive substance injection means 20 has a syringe structure having a liquid flow path tube 22, and the light-sensitive substance is injected into the affected portion via the liquid flow path tube 22. A syringe is a cylindrical conduit through which a liquid or gas flows. Further, the syringe structure may or may not have a power source. The syringe structure is, for example, a structure that sends out a light-sensitive substance like a syringe by manual operation, a structure that sends out a light-sensitive substance by an electric pump, or a structure that sends out a light-sensitive substance by opening a cylinder pressurized with compressed air. May be. When pressurizing, it may be pressurized manually or electrically.

Here, as an example, the photosensitizer injection means 20 includes a tank 21 and a liquid flow path tube 22 connected to the tank 21. The tank 21 stores a light-sensitive substance, and is built in, for example, the control device 2. The photosensitive substance stored in the tank 21 is sent to the liquid flow path tube 22 by an electric pump (not shown). The liquid flow path tube 22 is made of, for example, a synthetic resin tube, is arranged so as to pass through the inside of the handpiece 4, and is a delivery port 25 in which a liquid photosensitive substance is arranged from the tank 21 at the tip of the handpiece 4. Lead to.

The photosensitive substance is a substance that generates active oxygen when excited by the light irradiated by the excitation light irradiation means 30, or a diluted solution of the substance. As the photosensitive substance, for example, indocyanine green, hydrogen peroxide solution, hypochlorous acid, methylene blue and the like can be used.

As shown in FIG. 2A, a probe electrode 15 is provided at the tip of the conducting wire 13 on the tip side of the handpiece 4. Here, the position of the tip 16 of the probe electrode 15 coincides with the position of the tip of the handpiece cover 40. Further, the probe electrode 15 has a ring shape, and the liquid flow path tube 22 is inserted inside the ring. The tip of the liquid flow path tube 22 projects from the tip 16 of the probe electrode 15. The handpiece cover 40 is made of a synthetic resin or a metal member having a predetermined strength, and at least a portion in contact with the probe electrode 15 is formed of an insulating member.

In the handpiece 4, the outlet 25 of the liquid flow path tube 22 is arranged so that the light-sensitive substance delivered from the outlet 25 comes into contact with the tip 16 of the probe electrode 15. In the example shown in FIG. 2A, the tip 16 of the probe electrode 15 is provided with an affected portion contactor 5 capable of directly contacting the affected portion. The affected portion contactor 5 is configured to be removable from the handpiece 4. Here, the tip of the liquid flow path tube 22 has a bulging shape, and a gap portion having a shape corresponding to the tip shape of the liquid flow path tube 22 is formed on the base end side of the affected portion contactor 5. .. By fitting the gap portion of the affected part contactor 5 to the tip of the liquid flow path tube 22, the base end of the affected part contactor 5 is fixed in contact with the tip 16 of the probe electrode 15 and the tip of the handpiece cover 40. Has been done.

The affected area contactor 5 is composed of a sponge, and can absorb and retain an appropriate amount of a light-sensitive substance supplied from the outlet 25 of the liquid flow path tube 22. By providing the sponge-shaped affected portion contactor 5 in this way, the outflow of the photosensitive substance can be prevented, and the time for the photosensitive substance to be in direct contact with the affected portion can be maintained for a long time. Then, the proximal end of the affected portion contactor 5 that has absorbed and held the photosensitive substance is in contact with the tip 16 of the probe electrode 15, so that the probe electrode 15 is exposed to the photosensitive substance in the affected portion contactor 5. Can be charged from. That is, the light-sensitive substance that keeps in contact with the affected part can be continuously charged while the affected part contactor 5 is in direct contact with the affected part. Thus, the handpiece 4 is effective for local treatment. Further, as the material of the sponge constituting the affected portion contactor 5, for example, a porous synthetic resin or a rubber material having abundant water retention, flexibility and elasticity can be used. Further, in order to efficiently irradiate the light-sensitive substance absorbed by the sponge with light, the sponge should be made of a material having high light transmission.

The affected area contactor 5 can be disposable. As a result, it can be used hygienically. Further, the cross-sectional shape of the affected portion contactor 5 is not limited to that shown in FIG. 2A, and may be, for example, a shape shown in FIGS. 2B or 2C corresponding to the shape of the affected portion. The affected part contactor 5B shown in FIG. 2B has a rod shape that is longer than the rod-shaped affected part contactor 5. According to this, the tip of the affected part contactor 5B can reach the deep part of the periodontal pocket. The affected area contactor 5C shown in FIG. 2C has a spherical shape. According to this, more light-sensitive substances can be absorbed and retained than the rod-shaped affected area contactor 5.

The excitation light irradiating means 30 includes an excitation light generating means 31 and a light guide path 32 connected to the excitation light generating means 31. The excitation light generating means 31 generates light that excites a light-sensitive substance to be used, and is built in, for example, the control device 2. The excitation light generating means 31 generates light having a wavelength corresponding to the type of the light-sensitive substance used. The excitation light generating means 31 is composed of, for example, a low-power laser device or an LED light source device. The light guide path 32 is made of, for example, an optical fiber, is arranged so as to pass through the inside of the handpiece 4, and guides the light generated by the excitation light generating means 31 to the light emitting port 35 on the tip end side of the handpiece 4.

In the present embodiment, for example, methylene blue is used as the light-sensitive substance, and the excitation light generating means 31 is a laser output device of an erbium YAG laser (wavelength 2940 nm).
When, for example, hydrogen peroxide solution or hypochlorous acid is used as the photosensitive substance, the excitation light generating means 31 generates light having a wavelength of 400 nm to 420 nm. Hydrogen peroxide solution and hypochlorous acid react with light in this wavelength range to generate hydroxyl radicals, which have the strongest oxidizing power.

As shown in FIG. 1, in the handpiece 4, the light emitting port 35 of the excitation light irradiating means 30 irradiates the tip of the affected part contactor 5 on the affected part side with the light transmitted from the light emitting port 35. Have been placed. As a result, the operator can hold the handpiece 4 with one hand and simultaneously perform the injection of the photosensitizer and the irradiation of the excitation light toward the affected area with one hand. Therefore, the photosensitizer in the affected area contactor 5 can be excited in a state of direct contact with the affected area to efficiently generate an active enzyme in the affected area, injuring bacteria and sterilizing.

A conducting wire 13, a liquid flow path pipe 22, and a light guide path 32 are individually connected between the control device 2 and the handpiece 4. However, at least two of the conductor 13, the liquid flow path tube 22, and the light guide path 32 may be included in the cable between the control device 2 and the handpiece 4.

In the present embodiment, an electrode closing switch 41, a photosensitive substance injection switch 42, and an excitation light irradiation switch 43 are provided at predetermined positions of the handpiece 4, and the DC power supply device 10 can be operated by operating each switch at hand. , The light-sensitive substance injection means 20, and the excitation light irradiation means 30 can be operated, respectively.

In FIG. 1, the intersection of the signal line (broken line) extending from the electrode on switch 41 and the conducting wire 13 schematically shows that the current flowing through the conducting wire 13 can be turned on / off. The current flowing through the conducting wire 13 may be turned on / off by, for example, the DC power supply device 10.

The intersection of the signal line (broken line) extending from the photosensitizer injection switch 42 and the liquid flow path tube 22 schematically indicates that the flow path of the liquid flow path tube 22 can be opened / closed. The flow path of the liquid flow path pipe 22 may be opened / closed by, for example, a valve in the middle of the liquid flow path pipe 22 or a solenoid valve provided in the tank 21.

The intersection of the signal line (broken line) extending from the excitation light irradiation switch 43 and the light guide path 32 schematically shows that the light passing through the light guide path 32 can be opened / blocked. The opening / blocking of the light passing through the light guide path 32 may be performed by operating / stopping the excitation light generating means 31, or a shielding plate capable of opening / blocking the light emitting port 35 may be provided.

The handpiece 4 shown in FIG. 1 is an angle type having an angle between the input shaft and the output shaft, but may be a straight type or a pencil type having the input shaft and the output shaft coaxially.

The control device 2 includes a DC power supply device 10, a tank 21 of the photosensitizer injection means 20, an electric pump (not shown), and a main power switch electrically connected to the excitation light generating means 31 when the control device 2 is provided. be able to. Further, the periodontal disease treatment device 1 may be provided with a display device for displaying these operating states, or the control device 2 itself may be provided with the display device. Alternatively, a DC power supply device 10 or the like having a display unit for displaying an operating state may be used.

In the example shown in FIG. 1, the subject electrode 17 includes a grip 18, and the subject P grips the grip 18 of the subject electrode 17. The subject electrode 17 is not limited to the type that grips the grip 18 as long as it can impart a charge having a polarity opposite to that of the charge imparted from the probe electrode 15 to a part of the body of the subject P. ..

(Modified example of the first embodiment)
The periodontal disease treatment apparatus according to the modified example of the first embodiment will be described with reference to FIG. The periodontal disease treatment device 1A includes a handpiece 4 and a control device 2, and the configuration of the subject electrode 17A is different from that of the periodontal disease treatment device 1 shown in FIG. The same components as those of the periodontal disease treatment device 1 shown in FIG. 1 are designated by the same reference numerals, and the description thereof will be omitted. The shape of the subject electrode 17A is the shape of a pad that can be sandwiched between the buccal side surface and the cheek of the dentition of the subject P. According to the subject electrode 17A, the burden of having the subject P grip the grip is eliminated. Therefore, the periodontal disease treatment device 1A can be applied to a person having a weak grip strength, a child who cannot concentrate on gripping the grip, and the like.

(How to use periodontal disease treatment device)
A method of using the periodontal disease treatment apparatus according to the first embodiment will be described with reference to FIG. 4 (see FIGS. 1 and 2A as appropriate).
First, for example, the main power switch (not shown) of the control device 2 is turned on. The operator D, who is a dentist, causes the subject P, who is a patient, to firmly grasp the subject electrode 17. As a result, the subject P can be charged with a negative charge. As shown in FIG. 4, the operator D handles the handpiece 4 by grasping it with one hand. Operator D turns on, for example, the photosensitizer injection switch 42. As a result, the affected area contactor 5 at the tip of the handpiece 4 sucks and holds the liquid photosensitive substance. Upon holding an appropriate amount of the photosensitizer, the operator D turns off the photosensitizer injection switch 42. The inflow of the photosensitive substance may be stopped after the set time elapses.

The operator D brings the affected area contactor 5 holding the light-sensitive substance into contact with the affected area. As a result, the light-sensitive substance is injected into the affected area. The operator D turns on the electrode on switch 41 with the affected portion contactor 5 in contact with the affected portion. That is, a positive charge is added to the photosensitive substance injected into the affected area from the probe electrode 15 connected to the DC power supply device 10. As a result, the negative charge added to the tooth T of the subject P holding the subject electrode 17 and the positive charge added to the photosensitive substance injected into the affected area are attracted to each other, thereby attracting the photosensitivity. The substance penetrates into the affected biofilm B. The output current from the DC power supply device 10 may be stopped when the set time elapses.

The operator D turns on the excitation light irradiation switch 43. As a result, the photosensitive substance that has penetrated into the biofilm B in the affected area is excited by light to generate active oxygen. In the affected area, the generated active oxygen causes a photochemical reaction that damages bacteria and sterilizes them.
In the above description, the operator D operates the photosensitizer injection switch 42 on and off, the electrode on switch 41 on and off, and the excitation light irradiation switch 43 on, but the present invention is limited to this. It's not a thing. The order in which each switch is handled and the on / off timing can be arbitrarily determined within the range of the therapeutic effect. For example, the electrode-on switch 41 may be turned on after the excitation light irradiation switch 43 is turned on, or the electrode-on switch 41 or the excitation light irradiation switch 43 may be turned on before the photosensitizer injection switch 42 is turned off. ..

(Second Embodiment)
The configuration of the periodontal disease treatment apparatus according to the second embodiment will be described with reference to FIG. The periodontal disease treatment device 1B is different from the periodontal disease treatment device 1 shown in FIG. 1 in that the scaler 6 is further provided as a means for crushing the biofilm B. The same components as those of the periodontal disease treatment device 1 shown in FIG. 1 are designated by the same reference numerals, and the description thereof will be omitted.

The periodontal disease treatment device 1B includes a handpiece 4B and a control device 2B.
The scaler 6 has a tip tip 61 arranged in the affected area and a vibrator 63 that vibrates the tip tip 61 by ultrasonic waves or sound waves. The vibrator 63 is built in the handpiece 4B. The base end of the tip tip 61 is arranged on the side of the vibrator 63, and the tip thereof protrudes from the handpiece 4B and is arranged in the vicinity of the affected portion contactor 5 arranged at the tip of the handpiece 4B. The tip tip 61 is provided as a separate body independently of the light guide path 32 such as an optical fiber. Therefore, as shown in FIG. 5, the position where the tip of the tip tip 61 protrudes from the handpiece 4B is separated from the light emission port 35 of the excitation light irradiation means 30.

The driving means 67 of the scaler 6 is a means for generating a driving force of the vibrator 63, and is built in, for example, the control device 2B. The cable 65 connected to the driving means 67 is arranged so as to pass through the inside of the handpiece 4B, and guides the driving force to the vibrator 63. In FIG. 5, the intersection of the signal line (broken line) extending from the scaler switch 44 and the cable 65 schematically shows that the driving force transmitted by the cable 65 can be turned on / off. The driving force transmitted by the cable 65 may be turned on / off by, for example, the driving means 67 in the control device 2B.

When the scaler 6 is a sound wave scaler, the vibrator 63 is composed of a rotating body whose rotation axis is the axis of the handpiece 4B and a mechanism that converts rotation into vibration. It is preferable to vibrate at a frequency of 2.5 to 4 kHz. Further, in the case of the sound wave scaler, the driving means 67 is a compressor that sends out compressed air that rotates the rotating body, and the cable 65 is a pipe that serves as a flow path for the compressed air.

When the scaler 6 is an ultrasonic scaler, the vibrator 63 is preferably composed of a piezoelectric element, and the tip tip 61 preferably vibrates at a frequency of 25 to 40 kHz due to ultrasonic waves generated by the vibration of the piezoelectric element. Further, in the case of the ultrasonic scaler, the driving means 67 is a power source for sending electricity to vibrate the piezoelectric element, and the cable 65 is an electric wire. By using a material such as polyamide for the tip tip 61, the action of vortices due to cavitation on the solution of the light-sensitive substance due to the three-dimensional vibration with high amplitude not only destroys the biofilm B but also bacteria. It can be expected to have the effect of improving the adhesion to light-sensitive substances to cells. In this embodiment, the scaler 6 is assumed to be, for example, an ultrasonic scaler.

In the periodontal disease treatment device 1B, the charged photosensitizer can permeate into the biofilm B by the force of attracting charges of different codes, and the scaling action can be simultaneously performed toward the affected area. In addition, the operator can hold the handpiece 4B with one hand and simultaneously perform the photosensitizer injection, the excitation light irradiation, and the scaling action toward the affected area with one hand. Moreover, the timing of performing the scaling action is arbitrary.

(Third Embodiment)
The configuration of the periodontal disease treatment apparatus according to the third embodiment will be described with reference to FIGS. 6 and 7. The periodontal disease treatment device 1C includes a control device 2C, a mouthpiece 8 arranged in the oral cavity of the subject P, and an excitation optical cable 7 for connecting the control device 2C and the mouthpiece 8. The same components as those of the periodontal disease treatment device 1 shown in FIG. 1 are designated by the same reference numerals, and the description thereof will be omitted. In FIGS. 6 and 7, the arrangement of the control device 2C and the subject electrode 17 is displayed in a state in which the left and right sides are substantially interchanged with each other as compared with the arrangement of the control device 2 and the subject electrode 17 in FIG. FIG. 6 shows a state in which the excitation optical cable 7 is removed from the mouthpiece 8, and FIG. 7 shows a usage state in which the excitation optical cable 7 is connected to the mouthpiece 8.

In the present embodiment, the electrode on switch 41C, the photosensitive substance injection switch 42C, and the excitation light irradiation switch 43C are provided at predetermined positions of the control device 2C, and by operating each switch, the DC power supply device 10 and the light The sensitive substance injection means 20 and the excitation light irradiation means 30 can be operated, respectively.

The excitation optical cable 7 includes a liquid flow path tube 22 of the light-sensitive substance injection means 20, a lead wire 13 connected to the probe electrode 15, and a light guide path 32 leading to the light emission port 35 of the excitation light irradiation means 30. ..

The light guide path 32 of the excitation light irradiation means 30 is a bundle 33 of optical fibers in the excitation light cable 7. In FIG. 6, as shown by cutting out the base end side of the optical fiber bundle 33, the optical fiber bundle 33 includes a bundle surrounding the liquid flow path tube 22 in the extension direction, and a conductor 13 and a probe electrode 15. It is composed of a bundle that surrounds the circumference in the extension direction. Further, in the present embodiment, the light emitting end of the bundle 33 of the optical fiber constitutes the light emitting port 35 of the light guide path 32.

The excitation optical cable 7 includes a covering member that covers and protects the periphery of the bundle 33 of the optical fiber in the extending direction so as to surround the periphery, but the illustration is omitted. In the sending portion 71 of the excitation optical cable 7, at least a part of the probe electrode 15 on the distal end side protrudes from the light emitting end of the bundle 33 of the optical fiber. Further, in the delivery unit 71, the tip end side of the liquid flow path tube 22 also protrudes from the light emission end of the bundle 33 of the optical fiber.

As shown in FIG. 7, the mouthpiece 8 is injected with the light-sensitive substance 3 flowing through the liquid flow path tube 22 built in the excitation optical cable 7. The probe electrode charges the photosensitive substance injected into the mouthpiece 8. In the present embodiment, when the mouthpiece 8 is connected to the excitation optical cable 7 as shown in FIG. 7, the light-sensitive substance 3 delivered from the outlet 25 of the liquid flow path tube 22 is inside the tray portion 81. In 84, it is arranged so as to come into contact with the tip 16 (see FIG. 6) of the probe electrode 15 inserted through the piping portion 85.

As shown in FIG. 6, the mouthpiece 8 includes, for example, a tray portion 81 and a piping portion 85 connected to the inside 84 of the tray portion 81. The tray portion 81 has a shape that covers the dentition including the affected portion, and the light-sensitive substance 3 can be stored in the inner 84. The tray portion 81 includes a flat bottom surface portion 82 having a horseshoe shape that covers, for example, the dentition in a plan view, and a side surface portion 83 that stands substantially perpendicular to the outer peripheral edge of the bottom surface portion 82 and surrounds the entire bottom surface portion 82. It has. The inside 84 of the tray portion 81 means a space surrounded by the side surface portion 83 on the bottom surface portion 82.

The tray portion 81 can be manufactured by the following method. First, for example, a 3D scanner is used to photograph the tooth pattern of the patient P. Then, the scan data obtained by this photographing is taken into, for example, a 3D printer of a stereolithography method. Then, a dentition model (male type) is created based on the scan data with a 3D printer. Next, the tray portion 81 is completed by thermocompression-bonding a transparent resin plate having a constant thickness to the produced dentition model, trimming the excess resin material, and adjusting the overall shape. Further, the tray portion 81 may be made of a resin material so as to be able to transmit light, and the mouthpiece 8 may be provided by providing the excitation light receiving portion 86 and the piping portion 85 shown in FIG. If it is manufactured using a 3D scanner or a 3D printer in this way, a personal tray portion 81 along the patient's dentition can be manufactured. Therefore, the light-sensitive substance accumulated in the tray portion 81 can be formed along the gums along the tooth pattern. It can be easily guided to the periodontal pocket.

Further, if the fluidity of the light-sensitive substance is high, the light-sensitive substance may be difficult to settle in the gums and periodontal pockets. In such a case, the thickness adjusting material may be mixed with the light-sensitive substance to increase the viscosity of the light-sensitive substance. Here, as the thickening adjusting material, a thickening adjusting food can be used. By increasing the viscosity of the light-sensitive substance accumulated in the tray 81 in this way, the light-sensitive substance can be easily fixed to the gums and periodontal pockets.
Further, a light-transmitting sponge material may be attached to the bottom surface portion and the side surface portion in the inner 84 of the tray portion 81. According to this, by allowing the sponge material attached to the tray portion 81 to absorb the light-sensitive substance, it is possible to easily hold the light-sensitive substance in the inside 84 of the tray portion 81. By using these thickening adjusting materials and sponge materials, it is possible to provide a tray portion 81 that can be used regardless of the upper jaw or the lower jaw.

In the mouthpiece 8, the light-sensitive substance 3 delivered from the outlet 25 of the liquid flow path tube 22 of the excitation optical cable 7 inserted through the piping portion 85 was inserted into the piping portion 85 inside the tray portion 81 84. It is arranged so as to be in contact with the tip 16 of the probe electrode 15. One end of the piping portion 85 is connected to the tray portion 81 at a position corresponding to the center line (midline) of the upper and lower front teeth, and communicates with the inside 84 of the tray portion 81. The tip 16 of the probe electrode 15 can come into contact with the photosensitive substance 3 (see FIG. 7) accumulated in the inside 84 of the tray portion 81.
By storing the light-sensitive substance 3 in the inner 84 of the tray portion 81 of the mouthpiece 8, the light-sensitive substance 3 can permeate the entire periodontal disease. Therefore, the light-sensitive substance 3 can be attached to the bacterial cells of the maxilla or the mandible at the same time. Therefore, it is effective in preventing dental caries and periodontal disease.

In the present embodiment, the piping portion 85 is configured such that the other end portion facing the one end portion is detachably attached to and detachable from the excitation optical cable 7. As shown in FIG. 6, the piping portion 85 includes an excitation light receiving portion 86, a first through hole 87, and a second through hole 88. The excitation light receiving unit 86 faces the light emitting port 35, which is the light emitting end of the bundle 33 of the optical fiber. The probe electrode 15 is detachably inserted into the first through hole 87. The liquid flow path tube 22 is detachably inserted into the second through hole 88. Since the mouthpiece 8 is detachable from the excitation optical cable 7, a disposable type mouthpiece can be used for each subject P, which is hygienic.

The mouthpiece 8 is preferably made of a translucent material. The translucent material can be appropriately selected from the viewpoints of strength, ease of processing, transparency, manufacturing cost, and the like. For example, various plastics such as polyethylene, polyethylene terephthalate, polypropylene, vinyl chloride, and polyurethane can be used.
By forming the entire mouthpiece 8 with a translucent material, it is possible to irradiate the entire photosensitive substance 3 attached to the upper or lower jaw with excitation light at once. Therefore, it is effective as an initial caries treatment method.

(How to use periodontal disease treatment device)
A method of using the periodontal disease treatment apparatus according to the third embodiment will be described with reference to FIG. 7 (see FIG. 6 as appropriate). First, for example, the main power switch (not shown) of the control device 2C is turned on. The operator, who is a dentist, causes the subject P, who is a patient, to firmly grasp the subject electrode 17. As a result, the subject P can be charged with a negative charge. The operator places the mouthpiece 8 in the oral cavity of the subject P. At this time, the tray portion 81 is pressed against, for example, the maxillary dentition, and the subject P is lightly engaged. The operator connects the excitation optical cable 7 to the piping portion 85 of the mouthpiece 8. That is, in the delivery portion 71 of the excitation optical cable 7 shown in FIG. 6, the probe electrode 15 is inserted into the first through hole 87, the liquid flow path tube 22 is inserted into the second through hole 88, and the light of the bundle 33 of the optical fiber is inserted. The exit port faces the excitation light receiving unit 86. The operator then turns on, for example, the photosensitizer injection switch 42C. As a result, the liquid photosensitizer 3 is accumulated in the inner 84 of the tray portion 81 of the mouthpiece 8, and the photosensitizer 3 is injected into the entire maxillary dentition. When an appropriate amount of the light-sensitive substance 3 is accumulated in the inside 84 of the tray portion 81, the operator turns off the light-sensitive substance injection switch 42C.

Subsequently, the operator D turns on the electrode on switch 41C. At this time, the tip 16 of the probe electrode 15 is in contact with the photosensitive substance 3 inside 84 of the tray portion 81, and a positive charge is applied from the probe electrode 15 to the photosensitive substance 3 injected into the maxillary dentition. Will be added. As a result, the negative charge added to the maxillary dentition of the subject P holding the subject electrode 17 and the positive charge added to the photosensitive substance 3 injected into the maxillary dentition are attracted to each other. Then, the photosensitizer 3 penetrates into the biofilm of the entire maxillary dentition.

The operator turns on the excitation light irradiation switch 43C. As a result, the photosensitive substance 3 that has penetrated into the biofilm of the entire maxillary dentition is excited by light to generate active oxygen. As a result, the photochemical reaction for sterilization proceeds. When the treatment is completed, the operator removes the mouthpiece 8 from the oral cavity and discards it. The mandible can be treated as well.

(Modified example of the third embodiment)
The mouthpiece 8 made of a translucent material may have a light reflecting member attached to the outer surface or the inner surface of the bottom surface portion 82 of the tray portion 81. By doing so, in the mouthpiece 8, the light guided from the excitation optical cable 7 is incident on the inner 84 of the tray portion 81 and then reflected by the bottom surface portion 82, and the reflected light is light-sensitive stored in the inner 84. It is incident on the substance 3. Therefore, the leakage of light guided from the excitation optical cable 7 can be reduced, and the photosensitive substance 3 can be efficiently excited. Further, a light reflecting member may be attached to the outer surface or the inner surface of the side surface portion 83 of the tray portion 81. Further, a light reflecting member may be attached to the outer peripheral surface of the piping portion 85. As the light reflecting member, for example, a metal such as silver may be coated, or a white resin or the like may be coated.

(Fourth Embodiment)
The configuration of the periodontal disease treatment apparatus according to the fourth embodiment will be described with reference to FIG. The periodontal disease treatment device 1D is different from the periodontal disease treatment device 1 shown in FIG. 1 in that the periodontal disease treatment device 1D is provided with a photosensitizer injection means 20D that is separate from the handpiece 4D. The same components as those of the periodontal disease treatment device 1 shown in FIG. 1 are designated by the same reference numerals, and the description thereof will be omitted.
The periodontal disease treatment device 1D includes a control device 2D, a handpiece 4D, and a photosensitizer injection means 20D.

The control device 2D includes the excitation light generating means 31 and the DC power supply device 10 as in the control device 2 of FIG.
Similar to the handpiece 4 of FIG. 1, the handpiece 4D includes a light guide path 32 leading to the light emission port 35 of the excitation light irradiation means 30, and a conducting wire 13 connected to the probe electrode 15.
In the present embodiment, in the handpiece 4D, the tip of the probe electrode 15 projects from the tip of the handpiece cover. This is because the liquid flow path tube for injecting the light-sensitive substance is not built in the handpiece 4D, so it is assumed that the affected part contactor 5 having the structure shown in FIGS. 2A to 2C is used. Because it is not.

In the present embodiment, the electrode on switch 41 and the excitation light irradiation switch 43 are provided at predetermined positions of the handpiece 4D, and by operating each switch at hand, the DC power supply device 10 and the excitation light irradiation means 30 can be operated. Each can be activated.

The photosensitizer injection means 20D has a syringe structure similar to that of the photosensitizer injection means 20 shown in FIG. FIG. 8 shows, as an example, a photosensitizer injection means 20D having an appearance like a syringe, but it is light-sensitive by a structure in which a photosensitizer is sent out by an electric pump or by opening a cylinder pressurized with compressed air. It may be a structure that sends out a substance. Here, as an example, the photosensitizer injection means 20D has a structure in which a photosensitizer is delivered like a syringe by a manual operation. In this case, the photosensitizer injection switch 42D is a piston.

(How to use periodontal disease treatment device)
The first to third methods of using the periodontal disease treatment device according to the fourth embodiment will be described with respect to the differences from the usage method of the periodontal disease treatment device 1 according to the first embodiment.
In the first method, for example, the affected area contactor 5 as shown in FIG. 2A is not used. The operator D injects the photosensitive substance directly into the biofilm B between the tooth T and the gingiva from the tip of the photosensitizer injection means 20D. Further, the probe electrode 15 is inserted into the affected portion, and the tip of the probe electrode 15 is brought into contact with the injected photosensitive substance to turn on the electrode on switch 41. The operator D may perform the above steps at the same time by, for example, holding the handpiece 4D with one hand and operating the photosensitizer injection means 20D with the other hand. Since the subsequent operations are the same as those in the first embodiment, the description thereof will be omitted.

In the second method, a cotton-like affected area contactor 5E shown by a circular virtual line in FIG. 8 is used. First, the operator pushes the cotton-like affected area contactor 5E around the biofilm B. Then, the operator injects the light-sensitive substance into the affected contact member 5E from the tip of the light-sensitive substance injection means 20D. Further, the probe electrode 15 is inserted into the affected area contactor 5E, and the tip of the probe electrode 15 is brought into contact with the injected photosensitive substance to turn on the electrode on switch 41.

In the third method, the affected area contactor 5F made of cotton or sponge in the shape of a cap at the tip of the syringe, which is the photosensitizer injection means 20D, is used. First, the operator attaches the affected area contactor 5F to the tip of the photosensitizer injection means 20D, and pushes the affected area contactor 5F around the biofilm B. Then, the operator pushes the photosensitizer injection switch 42D (piston) to inject the photosensitizer into the affected contact 5E. Further, the probe electrode 15 is inserted into the affected area contactor 5F, and the tip of the probe electrode 15 is brought into contact with the injected photosensitive substance to turn on the electrode on switch 41. The operator may impregnate the affected part contactor 5F attached to the tip of the photosensitizer injection means 20D with the photosensitizer and then push the photosensitizer around the biofilm B.

Although each embodiment of the present invention has been described in detail, the present invention is not limited to each of the above-described embodiments, and includes design changes within a range that does not deviate from the gist of the present invention.
For example, in the periodontal disease treatment device 1C of the third embodiment, the mouthpiece 8B shown in FIG. 9 may be used instead of the mouthpiece 8 shown in FIG. The mouthpiece 8B includes a tray portion 81, a piping portion 85B connected to the inside 84 of the tray portion 81, and a piping electrode portion 89 provided in the piping portion 85B. The piping portion 85B of the mouthpiece 8B is formed longer than the piping portion 85 of the mouthpiece 8. The first through hole 87 and the second through hole 88 included in the piping portion 85B are formed longer than the first through hole 87 and the second through hole 88 included in the piping portion 85. However, most of the total length of the first through hole 87 included in the pipe portion 85B is occupied by the pipe electrode portion 89 inserted through the first through hole 87. The piping electrode portion 89 is a linear conducting wire that functions as an electrical extension cord for the probe electrode 15. The end of the pipe electrode portion 89 is arranged so as to come into contact with a photosensitive substance sent from the outlet 25 of the liquid flow path pipe 22 of the excitation optical cable 7 to the tray portion 81. Specifically, the end portion (right end in FIG. 9) of the piping electrode portion 89 is arranged inside 84 of the tray portion 81. Further, when the excitation optical cable 7 is attached to the mouthpiece 8B, that is, the probe electrode 15 is inserted into the first through hole 87 and fitted, and the tip of the liquid flow path tube 22 is inserted into the first through hole 87. When fitted together, the tip 16 of the probe electrode 15 is electrically connected to the other end (left end in FIG. 9) of the pipe electrode portion 89. According to this, since the operator can easily grasp the piping portion 85B of the mouthpiece 8B, the mouthpiece 8B can be easily handled.

Further, in the periodontal disease treatment device 1C of the third embodiment, the excitation optical cable 7 and the mouthpiece 8 are detachable, but the excitation optical cable 7 and the mouthpiece 8 are fixed to control the excitation optical cable 7. It may be configured to be detachably attached to the device 2.
Further, the subject electrode 17A shown in FIG. 3 may be applied to the second embodiment and the fourth embodiment. Further, the scaler 6 shown in FIG. 5 may be applied to the fourth embodiment.

1,1A, 1B, 1C, 1D Periodic disease treatment device 2,2B, 2C, 2D control device 3 Photosensitive substance 4,4B, 4D Handpiece 10 DC power supply device 11,12 Output terminal 13,14 Lead wire 15 Probe electrode 16 Tip 17,17A Subject electrode 18 Grip 20, 20D Photosensitive substance injection means 21 Tank 22 Liquid flow path tube 25 Outlet 30 Excitation light irradiation means 31 Excitation light generation means 32 Light guide path 33 Optical fiber bundle 35 Light emission Mouth 40 Handpiece cover 41, 41C Electrode injection switch 42, 42C, 42D Light sensitive substance injection switch 43, 43C Excitation light irradiation switch 44 Scaler switch 5,5B, 5C, 5E, 5F Affected part contactor 6 Scaler 61 Tip tip 63 Vibration Child 65 Cable 67 Drive means 7 Excitation light cable 71 Sending part 8, 8B Mouthpiece 81 Tray part 82 Bottom part 83 Side part 84 Inside 85, 85B Piping part 86 Excitation light receiving part 87 First through hole 88 Second through hole 89 Piping Electrode part B Biofilm D Operator P Subject T Tooth

In order to solve the above problems, the periodontal disease treatment apparatus according to the first aspect of the present invention irradiates the photosensitive substance with light that excites the photosensitive substance injected into the affected part in the oral cavity of the subject. One of the excitation light irradiation means, the DC power supply device having positive and negative output terminals, and the photosensitive substance injected into the affected area by being connected to one of the positive and negative output terminals of the DC power supply device by a conducting wire. A probe electrode that imparts a charge of the other polarity and a subject that is connected to the other of the positive and negative output terminals of the DC power supply device by a conducting wire and imparts a charge of the other polarity to a part of the subject's body. A light-sensitive substance injection means for injecting the photosensitive substance into the affected area via the liquid flow path tube having a syringe structure having an examiner electrode and a liquid flow path tube, and a light emission port of the excitation light irradiation means. A handpiece containing the light guide path leading to the light-sensitive substance, the liquid flow path tube of the photosensitive substance injection means, and a lead wire connected to the probe electrode, and a handpiece provided at the tip of the probe electrode, which is directly connected to the affected part. The photosensitizer is a substance that generates active oxygen when excited by the light irradiated by the excitation light irradiation means or a diluted solution thereof, and comprises a contactable affected portion contactor. The outlet of the liquid flow path tube is arranged so that the photosensitive substance delivered from the outlet is in contact with the tip of the probe electrode, and in the handpiece, the light of the excitation light irradiation means is used. exit port, that has been arranged so that light sent from the optical irradiation port is irradiated to the affected area side tip of the affected area contacts.
Further, the periodontal disease treatment apparatus according to the second aspect of the present invention is an excitation light irradiation means for irradiating the photosensitizer with light that excites the photosensitizer injected into the affected portion in the oral cavity of the subject. , A DC power supply device having positive and negative output terminals and one of the positive and negative output terminals of the DC power supply device are connected by a conducting wire, and a charge of one polarity is applied to the photosensitive substance injected into the affected area. A probe electrode to be imparted, a subject electrode connected to the other of the positive and negative output terminals of the DC power supply device by a conducting wire, and a subject electrode to impart a charge of the other polarity to a part of the subject's body. A syringe structure having a liquid flow path tube, a photosensitizer injection means for injecting the photosensitive substance into the affected area via the liquid flow path tube, and the liquid flow path tube of the photosensitive substance injection means. An excitation optical cable incorporating a lead wire connected to the probe electrode and a light guide path leading to a light emission port of the excitation light irradiation means, and the photosensitive substance flowing through the liquid flow path tube incorporated in the excitation optical cable. The photosensitive substance comprises a substance or a substance that generates active oxygen when excited by the light irradiated by the excitation light irradiation means, and the substance is diluted, and a thickening adjusting material is mixed to make the substance viscous. The probe electrode charges the photosensitizer injected into the mouthpiece.

Claims (13)

Excitation light irradiation means for irradiating the photosensitizer with light that excites the photosensitizer injected into the affected area of the subject's oral cavity.
A DC power supply with positive and negative output terminals,
A probe electrode connected to one of the positive and negative output terminals of the DC power supply device by a conducting wire to impart a charge of one polarity to the photosensitive substance injected into the affected area.
Periodontal disease treatment including a subject electrode connected to the other of the positive and negative output terminals of the DC power supply device by a conducting wire and imparting a charge of the other polarity to a part of the subject's body. apparatus. It has a syringe structure having a liquid flow path tube, and includes a photosensitive substance injection means for injecting the photosensitive substance into the affected area through the liquid flow path tube.
The periodontal disease treatment apparatus according to claim 1, wherein the photosensitive substance is a substance that generates active oxygen when excited by the light irradiated by the excitation light irradiation means or a solution obtained by diluting the substance. A handpiece including a light guide path leading to an optical emission port of the excitation light irradiation means, the liquid flow path tube of the photosensitive substance injection means, and a conducting wire connected to the probe electrode is provided.
The periodontal disease according to claim 2, wherein in the handpiece, the outlet of the liquid flow path tube is arranged so that the photosensitive substance delivered from the outlet is in contact with the tip of the probe electrode. Disease treatment device. The periodontal disease treatment apparatus according to claim 3, wherein an affected portion contactor capable of directly contacting the affected portion is provided at the tip of the probe electrode, and the affected portion contactor is composed of a sponge capable of absorbing the photosensitive substance. According to claim 4, in the handpiece, the light emission port of the excitation light irradiation means is arranged so that the light transmitted from the light emission port is irradiated to the tip of the affected area contactor on the affected area side. The described periodontal disease treatment device. The periodontal disease according to any one of claims 1 to 5, further comprising a scaler having a tip tip arranged on the affected portion and a vibrator having the tip tip vibrated by ultrasonic waves or sound waves. Disease treatment device. An excitation optical cable containing the liquid flow path tube of the photosensitizer injection means, a lead wire connected to the probe electrode, and a light guide path leading to the light emission port of the excitation light irradiation means.
A mouthpiece in which the photosensitive substance flowing through the liquid flow path tube built in the excitation optical cable is injected.
The periodontal disease treatment apparatus according to claim 2, wherein the probe electrode charges a light-sensitive substance injected into the mouthpiece. The mouthpiece is
A tray portion having a shape that covers the dentition including the affected portion and capable of storing the photosensitive substance inside, and a tray portion.
A piping portion connected to the inside of the tray portion is provided.
The photosensitive substance delivered from the outlet of the liquid flow path tube of the excitation optical cable inserted through the piping portion contacts the tip of the probe electrode inserted through the piping portion inside the tray portion. The periodontal disease treatment apparatus according to claim 7, which is arranged so as to be used. The mouthpiece is
A tray portion having a shape that covers the dentition including the affected portion and capable of storing the photosensitive substance inside, and a tray portion.
The piping section connected to the inside of the tray section and
The piping electrode portion provided in the piping portion is provided.
The tip of the probe electrode inserted through the piping portion is electrically connected to one end of the piping electrode portion.
The photosensitive substance delivered from the outlet of the liquid flow path tube of the excitation optical cable inserted through the piping portion is arranged inside the tray portion so as to come into contact with the other end of the piping electrode portion. The periodontal disease treatment apparatus according to claim 7. The mouthpiece is made of a translucent material
The light guide path of the excitation light irradiation means is composed of a bundle of optical fibers provided around the liquid flow path tube and the conducting wire, respectively.
The light emitting port is composed of a light emitting end of a bundle of the optical fibers.
The piping portion of the mouthpiece
The periodontal disease treatment apparatus according to claim 8 or 9, further comprising an excitation light receiving portion facing the light emitting end of the bundle of optical fibers. The periodontal disease treatment apparatus according to any one of claims 7 to 10, wherein the mouthpiece is detachable from the excitation optical cable. The tooth according to any one of claims 1 to 6, wherein the shape of the subject electrode is the shape of a pad that can be sandwiched between the buccal side surface and the cheek of the subject's dentition. Periodontal disease treatment device. The periodontal disease treatment apparatus according to any one of claims 1 to 11, wherein the subject electrode includes a grip.

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