JP7136501B2 - Periodontal disease treatment device - Google Patents

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 treatment objective, and conventionally, sterilization using mechanical means has been performed. However, since mechanical therapy is not always perfect, various light energies, including high-power lasers, are currently being used for periodontal pocket treatment as broadly defined phototherapy for eradication of bacteria. Antibacterial photodynamic therapy, which utilizes a photochemical reaction in combination with light and photosensitizers, is attracting attention as a new means of sterilization. Antibacterial photodynamic therapy is a photochemical reaction that damages and kills bacteria by generating active oxygen by irradiating light with a wavelength that specifically excites the substance after binding a photosensitive substance to bacterial cells. A low-output semiconductor laser or LED (light emitting diode) is used as a light source.

In Patent Document 1, ultrasonic vibrations generated by an ultrasonic transducer are transmitted to a tip of an ultrasonic scaler to pulverize dental calculus while irradiating light in a predetermined wavelength range from the tip of a fiber inserted into the scaler tip, A scaler device is described that enhances the sterilization effect while supplying a liquid such as hydrogen peroxide. Calculus is formed when the biofilm (plaque) that adheres to the teeth reacts with calcium and phosphoric acid contained in saliva, calcifies, becomes hard like stone, and adheres to the surface of the teeth. be.

Japanese Patent No. 5764269

However, in the actual oral cavity, pathogenic bacteria form a biofilm together with their own mucilage and other bacteria, which makes it difficult for photosensitizers to permeate into the biofilm. Therefore, it has been difficult to attach photosensitizers to pathogenic bacteria. For example, the scaler device described in Patent Document 1 applies a photosensitizer only to pathogenic bacteria exposed from destroyed biofilms. Therefore, with the technique described in Patent Document 1, it was not possible to allow the photosensitizer to permeate into the biofilm and efficiently apply the photosensitizer to all pathogenic bacteria.

SUMMARY OF THE INVENTION It is an object of the present invention to provide a periodontal disease treatment device capable of improving the adhesion of a photosensitizer to pathogenic bacteria.

In order to solve the above-described problems, the periodontal disease treatment apparatus according to the present invention includes excitation light irradiation means for irradiating the photosensitizer with light that excites the photosensitizer injected into the affected area in the oral cavity of the subject. a DC power supply device having positive and negative output terminals, respectively; and a conductive wire connected to one of the positive and negative output terminals of the DC power supply device to charge the photosensitizer injected into the affected area with one polarity of electric charge. 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 with a lead wire and applying a charge of the other polarity to a part of the subject's body; a syringe structure having a liquid channel tube, the photosensitizer injection means for injecting the photosensitizer into the affected area through the liquid channel tube; the liquid channel tube of the photosensitizer injection means; an excitation light cable incorporating a conductor connected to the probe electrode and a light guide path leading to a light exit port of the excitation light irradiation means; and the photosensitive substance flowing through the liquid flow tube incorporated in the excitation light cable. is injected into the mouthpiece, and the photosensitizer is a substance that generates active oxygen when excited by the light irradiated by the excitation light irradiating means or a diluted substance thereof, and is mixed with a thickening agent to make it viscous and the probe electrode imparts a charge to a photosensitizer injected into the mouthpiece.

According to the present invention, the adhesion of a photosensitizer to pathogenic bacteria can be improved.

1 is a configuration diagram schematically showing a periodontal disease treatment device according to a first embodiment of the present invention; FIG. FIG. 2 is a schematic diagram showing an enlarged cross-section along the axial direction of the distal end of the handpiece of FIG. 1; FIG. 10 is a schematic diagram showing a modification of the affected part contactor; FIG. 11 is a schematic diagram showing another modification of the affected part contactor; FIG. 4 is a configuration diagram schematically showing a periodontal disease treatment apparatus according to a modification of the first embodiment of the present invention; FIG. 4 is a schematic diagram showing the state of use of the handpiece of the periodontal disease treatment device. FIG. 2 is a configuration diagram schematically showing a periodontal disease treatment apparatus according to a second embodiment of the present invention; FIG. 3 is a configuration diagram schematically showing a periodontal disease treatment apparatus according to a third embodiment of the present invention; FIG. 7 is a schematic diagram of excitation light irradiation by the periodontal disease treatment apparatus of FIG. 6 ; FIG. 4 is a configuration diagram schematically showing a periodontal disease treatment apparatus according to a fourth embodiment of the present invention; FIG. 3 is a configuration diagram schematically showing a periodontal disease treatment device according to a modification;

(First embodiment)
The configuration of the periodontal disease treatment device according to the first embodiment will be described with reference to FIGS. 1 and 2A. The periodontal disease treatment device 1 performs antibacterial photodynamic therapy using a photochemical reaction caused by a combination of a photosensitizer injected into the affected area of the tooth T of the subject P and light irradiated on the photosensitizer. A device for treating periodontal disease. In addition, in FIG. 1, the subject P is schematically illustrated only with the arm, the tooth T, and the gingiva. In the following description, it is assumed that a biofilm B is formed in a periodontal pocket between a tooth T, which is an affected part of the subject P, and the gingiva.

As shown in FIGS. 1 and 2A, the periodontal disease treatment apparatus 1 includes an excitation light irradiation means 30, a DC power supply 10, a probe electrode 15 (see FIG. 2A), and a subject electrode 17. ing. The excitation light irradiation means 30 irradiates the photosensitizer injected into the affected part in the oral cavity of the subject P with light. The DC power supply 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, the positive output terminal 11 of the DC power supply 10 via a lead wire 13, and imparts a positive electric charge to the photosensitive material injected into the affected area. The subject electrode 17 is connected to, for example, the negative output terminal 12 of the DC power supply 10 via a lead wire 14, and applies a negative electric charge to a part of the subject P's body.

Note that 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 apparatus 1 adds a positive charge or a negative charge to the photosensitizer injected into the affected area from the probe electrode 15 connected to the DC power supply 10, and the added charge is A subject P can be charged with a charge of opposite sign. As a result, the charged photosensitizer permeates into the biofilm B due to the attraction of charges of different signs, and the adhesion of the photosensitizer to pathogenic bacteria is improved.

The configuration of each unit will be described in detail below.
In this embodiment, the periodontal disease treatment apparatus 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 exit 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 photosensitizer injection means 20 .

The handpiece 4 outputs light, current, and a photosensitive substance, and includes a light guide path 32 leading to a light exit port 35 of the excitation light irradiation means 30, a liquid channel pipe 22 of the photosensitive substance injection means 20, and a conducting wire 13 connected to a probe electrode 15 are incorporated.

The DC power supply device 10 is built in the control device 2, for example. A conducting wire 13 connected to the positive output terminal 11 of the DC power supply 10 is arranged to pass through the inside of the handpiece 4 and leads positive charges to the probe electrode 15 arranged at the tip of the handpiece 4 . The conductors 13 and 14 are covered with an insulating member along the extension direction. The current value and supply time of the current supplied from the DC power supply 10 to the probe electrode 15 and the subject electrode 17 are appropriately selected within a safe range for the human body.

The photosensitizer injection means 20 has a syringe structure having a liquid channel tube 22 and injects the photosensitizer into the affected area through the liquid channel tube 22 . A syringe is a cylindrical conduit through which a liquid or gas flows. Also, the syringe structure may or may not have a power source. The syringe structure is, for example, a structure that delivers the photosensitive substance by manual operation like a syringe, a structure that delivers the photosensitive substance by an electric pump, or a structure that delivers the photosensitive 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 photosensitive substance injection means 20 includes a tank 21 and a liquid flow pipe 22 connected to the tank 21 . The tank 21 stores the photosensitive material, and is built in the control device 2, for example. The photosensitive material stored in the tank 21 is sent to the liquid channel tube 22 by an electric pump (not shown). The liquid passage tube 22 is made of, for example, a synthetic resin tube, and is arranged to pass through the interior of the handpiece 4. The liquid photosensitive material is delivered from the tank 21 to a delivery port 25 arranged at the tip of the handpiece 4. lead to

The photosensitizer is a substance that generates active oxygen when excited by the light emitted by the excitation light irradiation means 30, or a diluted solution of the substance. Examples of photosensitizers that can be used include indocyanine green, hydrogen peroxide, hypochlorous acid, and methylene blue.

As shown in FIG. 2A, a probe electrode 15 is provided at the tip of the lead wire 13 on the tip side of the handpiece 4 . Here, the position of the tip 16 of the probe electrode 15 is aligned with the position of the tip of the handpiece cover 40 . The probe electrode 15 has a ring shape, and the liquid channel tube 22 is inserted through the inside of the ring. The tip of the liquid channel tube 22 protrudes from the tip 16 of the probe electrode 15 . The handpiece cover 40 is made of a synthetic resin or metal member having a predetermined strength, and at least the portion that contacts the probe electrode 15 is made of an insulating member.

In the handpiece 4 , the delivery port 25 of the liquid channel tube 22 is arranged so that the photosensitive material delivered from the delivery port 25 contacts 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 the affected part contactor 5 capable of directly contacting the affected part. The affected part contactor 5 is detachably attached to the handpiece 4 . Here, the tip of the liquid channel tube 22 has a swollen shape, and a gap having a shape corresponding to the shape of the tip of the liquid channel tube 22 is formed on the proximal end side of the affected part contactor 5. . By fitting the gap of the affected part contactor 5 to the distal end of the liquid channel tube 22, the proximal end of the affected part contactor 5 is fixed in contact with the distal end 16 of the probe electrode 15 and the distal end of the handpiece cover 40. It is

The affected part contactor 5 is made of sponge and can absorb and hold an appropriate amount of the photosensitive substance supplied from the delivery port 25 of the liquid channel tube 22 . By providing the sponge-like affected part contactor 5 in this way, it is possible to prevent the outflow of the photosensitizer and to keep the photosensitizer in direct contact with the affected part for a long time. Since the proximal end of the affected part contactor 5 that absorbs and holds the photosensitive substance is in contact with the distal end 16 of the probe electrode 15, the probe electrode 15 absorbs and holds the photosensitive substance in the affected part contactor 5. charge can be imparted from That is, while the affected part contactor 5 is in direct contact with the affected part, it is possible to continuously electrify the photosensitive material that continues to contact the affected part. Thus, handpiece 4 is effective for local treatment. Moreover, as the material of the sponge constituting the affected part contactor 5, for example, a porous synthetic resin or rubber material having excellent water retentivity, flexibility and elasticity can be used. In order to efficiently irradiate light onto the photosensitive material absorbed by the sponge, the sponge should preferably be made of a material with high light transmittance.

The affected contact 5 can be disposable. This allows hygienic use. Also, the cross-sectional shape of the affected part contactor 5 is not limited to that shown in FIG. 2A, and may be, for example, a shape shown in FIG. 2B or 2C corresponding to the shape of the affected part. The affected part contactor 5B shown in FIG. 2B has a rod-like shape that is longer than the rod-shaped affected part contactor 5B. According to this, the tip of the affected part contactor 5B can reach the deep part of the periodontal pocket. The affected part contactor 5C shown in FIG. 2C is spherical. According to this, it is possible to absorb and hold a larger amount of photosensitizer than the rod-shaped affected part contactor 5 .

The excitation light irradiation means 30 includes an excitation light generation means 31 and a light guide path 32 connected to the excitation light generation means 31 . The excitation light generating means 31 generates light that excites the photosensitive material to be used, and is built in the control device 2, for example. The excitation light generating means 31 generates light having a wavelength corresponding to the type of photosensitizer used. The excitation light generating means 31 is composed of, for example, a low output laser device or an LED light source device. The light guide path 32 is made of, for example, an optical fiber and is arranged to pass through the interior of the handpiece 4 to guide the light generated by the excitation light generating means 31 to the light exit port 35 on the tip side of the handpiece 4 .

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

As shown in FIG. 1, in the handpiece 4, the light exit port 35 of the excitation light irradiation means 30 is arranged so that the light emitted from the light exit port 35 is irradiated to the tip of the affected part contactor 5 on the affected part side. are placed. Thereby, the operator can hold the handpiece 4 with one hand and simultaneously perform the injection of the photosensitive substance and the irradiation of the excitation light toward the affected area with one hand. Therefore, it is possible to excite the photosensitizer in the affected part contactor 5 in direct contact with the affected part, efficiently generate active enzymes in the affected part, and injure and sterilize bacteria.

Conducting wires 13 , liquid flow pipes 22 , and light guide paths 32 are individually connected between the control device 2 and the handpiece 4 . However, between the control device 2 and the handpiece 4, at least two of the conducting wire 13, the liquid flow tube 22, and the light guiding path 32 may be enclosed in a cable.

In this embodiment, an electrode switch 41, a photosensitizer injection switch 42, and an excitation light irradiation switch 43 are provided at predetermined positions of the handpiece 4. By operating each switch at hand, the DC power supply 10 , the photosensitive substance injection means 20 and the excitation light irradiation means 30 can be operated.

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

The intersection of the signal line (broken line) extending from the photosensitive substance injection switch 42 and the liquid channel tube 22 schematically indicates that the channel of the liquid channel tube 22 can be opened/closed. Opening/closing of the channel of the liquid channel pipe 22 may be performed by, for example, a valve in the middle of the liquid channel pipe 22 or an electromagnetic valve or the like 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 indicates that the light passing through the light guide path 32 can be opened/blocked. 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 exit port 35 may be provided.

Although the handpiece 4 shown in FIG. 1 is of an angle type having an angle between the input shaft and the output shaft, it may be of a straight type or a pencil type having the input shaft and the output shaft coaxial.

If the control device 2 includes the DC power supply device 10, the tank 21 of the photosensitizer injection means 20, an electric pump (not shown), and the excitation light generation means 31, it includes a main power switch electrically connected to them. 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 for displaying the operating state may be used.

In the example shown in FIG. 1 , the subject electrode 17 has a grip 18 , and the subject P holds 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 apply an electric charge having a polarity opposite to the electric charge applied from the probe electrode 15 to a part of the subject P's body. .

(Modified example of the first embodiment)
A periodontal disease treatment device according to a modification of the first embodiment will be described with reference to FIG. A periodontal disease treatment apparatus 1A includes a handpiece 4 and a control device 2, and differs from the periodontal disease treatment apparatus 1 shown in FIG. 1 in the configuration of subject electrodes 17A. The same components as those of the periodontal disease treatment apparatus 1 shown in FIG. The shape of the subject electrode 17A is the shape of a pad that can be sandwiched between the buccal side of the teeth of the subject P and the cheek. According to the subject electrode 17A, the burden of having the subject P grasp the grip is eliminated. Therefore, the periodontal disease treatment device 1A can be applied to people with weak grip strength, children who cannot concentrate on grasping the grip, and the like.

(How to use periodontal disease treatment device)
A method of using the periodontal disease treatment device according to the first embodiment will be described with reference to FIG. 4 (see FIGS. 1 and 2A as needed).
First, for example, the main power switch (not shown) of the control device 2 is turned on. An operator D, who is a dentist, causes a subject P, who is a patient, to firmly grip the subject electrode 17 . Thereby, the subject P can be charged with a negative electric charge. As shown in FIG. 4, the operator D grips the handpiece 4 with one hand and handles it. The operator D turns on the photosensitizer injection switch 42, for example. As a result, the affected part contactor 5 at the tip of the handpiece 4 sucks and holds the liquid photosensitive material. After holding an appropriate amount of photosensitizer, operator D turns off photosensitizer injection switch 42 . It should be noted that the inflow of the photosensitizer may be stopped after a set time has elapsed.

The operator D brings the affected part contactor 5 holding the photosensitizer into contact with the affected part. This injects the photosensitizer into the affected area. The operator D turns on the electrode switch 41 while the affected part contactor 5 is in contact with the affected part. That is, a positive charge is added from the probe electrode 15 connected to the DC power supply 10 to the photosensitizer injected into the affected area. 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 increasing the photosensitivity. The substance penetrates into the biofilm B of the affected area. Note that the output current from the DC power supply device 10 may be stopped after the set time has elapsed.

The operator D turns on the excitation light irradiation switch 43 . As a result, the photosensitizer 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 promotes a photochemical reaction that damages and kills bacteria.
In the above description, the operator D turns the photosensitizer injection switch 42 on and off, turns the electrode insertion switch 41 on and off, and turns on the excitation light irradiation switch 43 in this order. not a thing The order of handling each switch and the timing of turning on and off can be arbitrarily determined within the range of therapeutic effects. For example, the electrode application switch 41 may be turned on after the excitation light irradiation switch 43 is turned on, or the electrode application switch 41 and 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 device according to the second embodiment will be described with reference to FIG. A periodontal disease treating device 1B is different from the periodontal disease treating device 1 shown in FIG. The same components as those of the periodontal disease treatment apparatus 1 shown in FIG.

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

The driving means 67 of the scaler 6 is means for generating driving force for the vibrator 63, and is built in the control device 2B, for example. A cable 65 connected to the drive means 67 is arranged to pass through the interior of the handpiece 4B and guides the drive force to the vibrator 63. As shown in FIG. 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. Turning on/off the driving force transmitted by the cable 65 may be performed, for example, by the driving means 67 in the control device 2B.

When the scaler 6 is a sonic scaler, the vibrator 63 is composed of a rotating body whose rotational axis is the axis of the handpiece 4B and a mechanism that converts the rotation into vibration. It is preferred to vibrate at a frequency of 2.5-4 kHz. In the case of the sonic scaler, the driving means 67 is a compressor that sends out compressed air for rotating 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 composed of a piezoelectric element, and the distal tip 61 is preferably vibrated at a frequency of 25 to 40 kHz by ultrasonic waves generated by vibration of the piezoelectric element. Further, in the case of an ultrasonic scaler, the driving means 67 is a power supply for sending out electricity for vibrating the piezoelectric element, and the cable 65 is an electric wire. In addition, by using a material such as polyamide for the tip 61, the three-dimensional high-amplitude vibration is applied to the solution of the photosensitizer by the action of the vortex caused by cavitation. The effect of improving the adhesion of photosensitizers to cells can be expected. In this embodiment, the scaler 6 shall be an ultrasonic scaler, for example.

The periodontal disease treatment device 1B can cause the charged photosensitive substance to permeate into the biofilm B and perform a scaling action toward the affected area at the same time, due to the attraction of charges of different signs. Further, the operator can hold the handpiece 4B with one hand and simultaneously perform the injection of the photosensitive substance, the irradiation of the excitation light, and the scaling action toward the affected area with one hand. Also, the timing of performing the scaling action is arbitrary.

(Third embodiment)
The configuration of the periodontal disease treatment device according to the third embodiment will be described with reference to FIGS. 6 and 7. FIG. The periodontal disease treatment apparatus 1C includes a control device 2C, a mouthpiece 8 placed in the oral cavity of the subject P, and an excitation light cable 7 connecting the control device 2C and the mouthpiece 8 . The same components as those of the periodontal disease treatment apparatus 1 shown in FIG. In FIGS. 6 and 7, the arrangement of the control device 2C and the subject electrodes 17 is displayed in a state in which the left and right sides are generally reversed compared to the arrangement of the control device 2 and the subject electrodes 17 in FIG. 6 shows a state in which the excitation light cable 7 is removed from the mouthpiece 8, and FIG. 7 shows a use state in which the excitation light cable 7 is connected to the mouthpiece 8. FIG.

In this embodiment, an electrode switch 41C, a photosensitizer injection switch 42C, and an excitation light irradiation switch 43C are provided at predetermined positions of the control device 2C. The sensitive substance injection means 20 and the excitation light irradiation means 30 can be operated respectively.

The excitation light cable 7 incorporates the liquid channel tube 22 of the photosensitive substance injection means 20, the lead wire 13 connected to the probe electrode 15, and the light guide path 32 leading to the light exit port 35 of the excitation light irradiation means 30. .

A 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 the base end side of the optical fiber bundle 33 , the optical fiber bundle 33 includes a bundle that surrounds the periphery in the extending direction of the liquid channel tube 22 , the conducting wire 13 and the probe electrode 15 . It consists of a bundle surrounding the perimeter in the direction of elongation. Further, in this embodiment, the light exit end of the bundle 33 of optical fibers constitutes the light exit port 35 of the light guide path 32 .

The excitation light cable 7 includes a covering member that covers and protects the periphery of the optical fiber bundle 33 in the extending direction, but the illustration is omitted. In the sending portion 71 of the excitation light cable 7 , at least a portion of the tip side of the probe electrode 15 protrudes from the light emitting end of the bundle 33 of optical fibers. In addition, in the delivery portion 71 , the tip side of the liquid channel tube 22 also protrudes from the light emitting end of the optical fiber bundle 33 .

The mouthpiece 8 is injected with the photosensitive material 3 flowing through a liquid channel tube 22 built into the excitation light cable 7 as shown in FIG. A probe electrode imparts an electric charge to the photosensitive material injected into the mouthpiece 8 . In this embodiment, when the mouthpiece 8 is connected to the excitation light cable 7 as shown in FIG. At 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 pipe portion 85. As shown in FIG.

The mouthpiece 8 includes, for example, a tray portion 81 and a pipe portion 85 connected to an inside 84 of the tray portion 81, as shown in FIG. The tray part 81 has a shape that covers the dentition including the affected part, and can store the photosensitive material 3 inside 84 . The tray portion 81 has a flat bottom portion 82 in the shape of a horseshoe covering, for example, a row of teeth in a plan view, and side portions 83 erected substantially vertically from the outer peripheral edge of the bottom portion 82 and surrounding the entire bottom portion 82 . It has An interior 84 of the tray portion 81 means a space surrounded by the side portions 83 on the bottom portion 82 .

The tray portion 81 can be manufactured by the following method. First, for example, a 3D scanner is used to photograph a tooth impression of a subject P, who is a patient. Then, the scan data obtained by this photographing is taken into, for example, a stereolithography 3D printer. Then, a dentition model (male model) is produced based on the scan data with a 3D printer. Next, a transparent resin plate having a uniform thickness is thermo-compression bonded to the prepared dental model, and the excess resin material is trimmed to adjust the overall shape, and the tray portion 81 is completed. Further, the mouthpiece 8 may be formed by providing the tray portion 81 with an excitation light receiving portion 86 and a pipe portion 85 shown in FIG. If a 3D scanner or a 3D printer is used in this way, the tray part 81 for personal use can be manufactured along the tooth row of the patient. It can be made easy to lead to the periodontal pocket.

In addition, if the fluidity of the photosensitivity substance is high, there is a possibility that the photosensitizer will be difficult to adhere to the gums and periodontal pockets. In such a case, the photosensitive material may be mixed with a thickening agent to increase the viscosity of the photosensitive material. Here, a thickening-adjusting food can be used as the thickening-adjusting material. By increasing the viscosity of the photosensitive material accumulated in the tray portion 81 in this manner, the photosensitive material can be easily fixed to the gums and periodontal pockets.
Also, a sponge material having optical transparency may be applied to the bottom surface and side surfaces of the interior 84 of the tray portion 81 . According to this, by allowing the sponge material attached to the tray portion 81 to absorb the photosensitive material, the photosensitive material can be easily held in the interior 84 of the tray portion 81 . By using these thickness adjusting materials and sponge materials, it is possible to provide the tray portion 81 that can be used regardless of whether it is the upper jaw or the lower jaw.

In the mouthpiece 8, the photosensitive material 3 delivered from the delivery port 25 of the liquid channel tube 22 of the excitation light cable 7 inserted through the piping portion 85 is inserted through the piping portion 85 in the interior 84 of the tray portion 81. It is arranged to contact the tip 16 of the probe electrode 15 . One end of the pipe portion 85 is connected to a position corresponding to the center line (median line) of the upper and lower front teeth in the tray portion 81 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 material 3 (see FIG. 7) accumulated in the interior 84 of the tray portion 81 .
By accumulating the photosensitive substance 3 in the inside 84 of the tray portion 81 of the mouthpiece 8, the photosensitive substance 3 can permeate the entire periodontal region. Therefore, it becomes possible to simultaneously attach the photosensitizer 3 to the bacterial cells of the maxilla or the mandible. Therefore, it is effective for caries prevention and periodontal disease prevention.

In this embodiment, the piping part 85 is configured so that the other end opposite to the one end can be attached to and detached from the excitation light cable 7 . The piping portion 85 includes an excitation light receiving portion 86, a first through hole 87, and a second through hole 88, as shown in FIG. The excitation light receiving part 86 faces the light exit port 35 which is the light exit end of the bundle 33 of optical fibers. The probe electrode 15 is detachably inserted into the first through hole 87 . The liquid channel tube 22 is detachably inserted into the second through hole 88 . Since the mouthpiece 8 is detachable from the excitation light cable 7, a disposable 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, for example, strength, ease of processing, transparency, and manufacturing cost. For example, various plastics such as polyethylene, polyethylene terephthalate, polypropylene, vinyl chloride, and polyurethane can be used.
By forming the entire mouthpiece 8 from a translucent material, it is possible to irradiate the entire photosensitive material 3 attached to the upper or lower jaw at once with excitation light. Therefore, it is effective as an initial dental 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 also FIG. 6 as necessary). 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 grip the subject electrode 17 . Thereby, the subject P can be charged with a negative electric charge. The operator arranges the mouthpiece 8 in the subject's P oral cavity. At this time, the tray part 81 is pressed against, for example, the maxillary dentition, and the subject P is lightly engaged. The operator connects the excitation light cable 7 to the piping portion 85 of the mouthpiece 8 . 6, the probe electrode 15 is inserted into the first through-hole 87, the liquid channel tube 22 is inserted into the second through-hole 88, and the light of the optical fiber bundle 33 is The exit port faces the excitation light receiving section 86 . After that, the operator turns on the photosensitizer injection switch 42C, for example. As a result, the liquid photosensitizer 3 is accumulated in the interior 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 photosensitive substance 3 is accumulated in the interior 84 of the tray portion 81, the operator turns off the photosensitive substance injection switch 42C.

Subsequently, the operator D turns on the electrode switch 41C. At this time, the tip 16 of the probe electrode 15 is in contact with the photosensitive material 3 in the interior 84 of the tray part 81, and positive charges are applied from the probe electrode 15 to the photosensitive material 3 injected into the maxillary dentition. 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 attract each other. , the photosensitizer 3 penetrates into the biofilm throughout the maxillary dentition.

The operator turns on the excitation light irradiation switch 43C. As a result, the photosensitizer 3 permeated 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. After completing the treatment, the operator removes the mouthpiece 8 from the oral cavity and discards it. The mandible can be similarly treated.

(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 portion 82 of the tray portion 81 . By doing so, in the mouthpiece 8, the light guided from the excitation light cable 7 is incident on the inside 84 of the tray portion 81 and then reflected by the bottom portion 82. Incident on substance 3 . Therefore, leakage of light guided from the excitation light cable 7 can be reduced, and the photosensitive material 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 . Furthermore, a light reflecting member may be attached to the outer peripheral surface of the pipe 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 applied.

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

The control device 2D includes an excitation light generating means 31 and a DC power supply 10, like the control device 2 of FIG.
The handpiece 4D incorporates a light guide path 32 leading to a light exit port 35 of the excitation light irradiation means 30 and a lead wire 13 connected to the probe electrode 15, similarly to the handpiece 4 of FIG.
In this embodiment, in the handpiece 4D, the tip of the probe electrode 15 protrudes from the tip of the handpiece cover. Since the handpiece 4D does not have a built-in liquid channel tube for injecting a photosensitive substance, it is assumed that the affected part contactor 5 having the structure shown in FIGS. 2A to 2C is used. not due to

In this embodiment, an electrode switch 41 and an 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 are turned on. can be operated individually.

The photosensitive substance injection means 20D has the same syringe structure as the photosensitive substance injection means 20 shown in FIG. FIG. 8 shows an example of a photosensitive material injection means 20D that looks like a syringe. A structure for sending out substances may also be used. Here, as an example, the photosensitive substance injection means 20D is assumed to have a structure for delivering the photosensitive substance like a syringe by manual operation. In this case, the photosensitizer injection switch 42D is a piston.

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

The second method uses a cotton-like affected contact 5E shown in circular phantom lines in FIG. First, the operator pushes the cotton-like affected part contactor 5E around the biofilm B. As shown in FIG. Then, the operator injects the photosensitizer into the affected part contactor 5E from the tip of the photosensitizer injection means 20D. In addition, the probe electrode 15 is inserted into the affected part contactor 5E, and the tip of the probe electrode 15 is brought into contact with the injected photosensitive substance to turn on the electrode switch 41. FIG.

In the third method, an affected part contactor 5F made of cotton or sponge is used in the form of a tip cap of a syringe, which is the photosensitizer injection means 20D. First, the operator attaches the affected part contactor 5F to the tip of the photosensitive substance injection means 20D and pushes the affected part contactor 5F around the biofilm B. As shown in FIG. Then, the operator pushes the photosensitizer injection switch 42D (piston) to inject the photosensitizer into the affected part contactor 5E. Also, the probe electrode 15 is inserted into the affected part contactor 5F, the tip of the probe electrode 15 is brought into contact with the injected photosensitive substance, and the electrode closing switch 41 is turned on. 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 it around the biofilm B. FIG.

Although each embodiment of the present invention has been described in detail, the present invention is not limited to each embodiment described above, and includes design changes and the like within the scope of the present invention.
For example, the periodontal disease treatment apparatus 1C of the third embodiment may use a mouthpiece 8B shown in FIG. 9 instead of the mouthpiece 8 shown in FIG. The mouthpiece 8B includes a tray portion 81, a pipe portion 85B connected to the inside 84 of the tray portion 81, and a pipe electrode portion 89 provided in the pipe portion 85B. The pipe portion 85B of the mouthpiece 8B is formed longer than the pipe portion 85 of the mouthpiece 8. As shown in FIG. The first through-hole 87 and the second through-hole 88 provided in the piping portion 85B are formed longer than the first through-hole 87 and the second through-hole 88 provided in the piping portion 85B. However, most of the entire length of the first through hole 87 provided in the pipe portion 85B is occupied by the pipe electrode portion 89 inserted through the first through hole 87 . The pipe electrode part 89 is a straight wire that functions as an electrical extension cord for the probe electrode 15 . An end portion of the pipe electrode portion 89 is arranged so as to come into contact with the photosensitive material delivered to the tray portion 81 from the delivery port 25 of the liquid channel tube 22 of the excitation light cable 7 . Specifically, the end portion (the right end in FIG. 9 ) of the pipe electrode portion 89 is arranged inside 84 of the tray portion 81 . Also, when the excitation light cable 7 is attached to the mouthpiece 8B, that is, the probe electrode 15 is inserted into the first through hole 87 and fitted therein, and the tip of the liquid channel tube 22 is inserted into the first through hole 87. When they are fitted together, the tip 16 of the probe electrode 15 is electrically connected to the other end (the left end in FIG. 9) of the pipe electrode portion 89 . According to this, the operator can easily handle the mouthpiece 8B because the piping portion 85B of the mouthpiece 8B can be easily gripped.

In the periodontal disease treatment apparatus 1C of the third embodiment, the excitation light cable 7 and the mouthpiece 8 are detachable. It may be configured to be detachable from the device 2 .
Furthermore, the subject electrode 17A shown in FIG. 3 may be applied to the second embodiment and the fourth embodiment. Also, the scaler 6 shown in FIG. 5 may be applied to the fourth embodiment.

Reference Signs List 1, 1A, 1B, 1C, 1D Periodontal disease treatment device 2, 2B, 2C, 2D Control device 3 Photosensitizer 4, 4B, 4D Hand piece 10 DC power supply device 11, 12 Output terminals 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 Channel Tube 25 Delivery Port 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 insertion switch 42, 42C, 42D Photosensitive substance injection switch 43, 43C Excitation light irradiation switch 44 Scaler switch 5, 5B, 5C, 5E, 5F Affected part contact 6 Scaler 61 Tip 63 Vibration Element 65 Cable 67 Driving 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 Pipe Electrode part B Biofilm D Operator P Examinee T Tooth

Claims (6)

excitation light irradiation means for irradiating the photosensitizer with light that excites the photosensitizer injected into the affected area in the oral cavity of the subject;
a DC power supply device having positive and negative output terminals, respectively;
a probe electrode that is connected to one of the positive and negative output terminals of the DC power supply device by a lead wire and imparts a charge of one polarity to the photosensitive material injected into the affected area;
a subject electrode that is connected to the other of the positive and negative output terminals of the DC power supply device with a lead wire and imparts an electric charge of the other polarity to a part of the subject's body;
a photosensitive substance injection means, which has a syringe structure having a liquid channel tube, for injecting the photosensitive substance into the affected area through the liquid channel tube;
an excitation light cable incorporating the liquid channel pipe of the photosensitive substance injection means, a conducting wire connected to the probe electrode, and a light guide path leading to the light exit port of the excitation light irradiation means;
a mouthpiece into which the photosensitive material flowing through the liquid flow tube built in the excitation light cable is injected;
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 and adding a thickening agent to increase the viscosity,
The periodontal disease treatment device, wherein the probe electrode charges the photosensitive material injected into the mouthpiece. The mouthpiece is
a tray part having a shape that covers the dentition including the affected part and capable of storing the photosensitizer inside;
and a piping section connected to the inside of the tray section,
The photosensitive material sent from the delivery port of the liquid channel tube of the excitation light cable inserted through the piping portion contacts the tip of the probe electrode inserted through the piping portion inside the tray portion. 2. A periodontal disease treatment device according to claim 1, arranged to: The mouthpiece is
a tray part having a shape that covers the dentition including the affected part and capable of storing the photosensitizer inside;
a piping section connected to the inside of the tray section;
and a piping electrode section provided in the piping section,
a tip of the probe electrode inserted into the pipe portion is electrically connected to one end of the pipe electrode portion;
The photosensitive material delivered from the delivery port of the liquid channel tube of the excitation light cable inserted through the piping section is arranged inside the tray section so as to be in contact with the other end of the piping electrode section. The periodontal disease treatment device according to claim 1. 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 channel tube and the lead wire,
The light exit port is composed of the light exit end of the bundle of optical fibers,
The pipe portion of the mouthpiece is
4. The periodontal disease treatment apparatus according to claim 2, further comprising an excitation light receiving part facing the light emitting end of the bundle of optical fibers. The periodontal disease treatment apparatus according to any one of claims 1 to 4, wherein the mouthpiece is detachable with respect to the excitation light cable. The periodontal disease treatment apparatus according to any one of claims 1 to 5, wherein the subject electrode comprises a grip.

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