EP1330179A2 - Procede et dispositif pour detecter des caries, de la plaque dentaire, des depots ou une attaque bacterienne sur des dents - Google Patents

Procede et dispositif pour detecter des caries, de la plaque dentaire, des depots ou une attaque bacterienne sur des dents

Info

Publication number
EP1330179A2
EP1330179A2 EP02747364A EP02747364A EP1330179A2 EP 1330179 A2 EP1330179 A2 EP 1330179A2 EP 02747364 A EP02747364 A EP 02747364A EP 02747364 A EP02747364 A EP 02747364A EP 1330179 A2 EP1330179 A2 EP 1330179A2
Authority
EP
European Patent Office
Prior art keywords
radiation
optical fibers
probe
examined
tooth
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP02747364A
Other languages
German (de)
English (en)
Inventor
Thomas Hennig
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ferton Holding SA
Original Assignee
Ferton Holding SA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ferton Holding SA filed Critical Ferton Holding SA
Publication of EP1330179A2 publication Critical patent/EP1330179A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0088—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for oral or dental tissue

Definitions

  • the present invention relates to a method and a corresponding device for detecting caries, plaque, concretions, bacterial infection, etc. on teeth.
  • the tooth be irradiated with a wavelength of 410 nm and that the fluorescence radiation of the tooth be used by means of two filters to detect a first wavelength of 450 nm and a second wavelength of 610 nm, ie in the blue and red spectral range, for example with the aid of photodetectors.
  • the fluorescence radiation intensities detected by this arrangement are subtracted, so that a healthy tooth area can be distinguished from a carious tooth area on the basis of the difference intensity obtained thereby.
  • DE 42 00 741 AI proposes that the fluorescence of the tooth be generated by excitation radiation with a wavelength in the range from 360 nm to 580 nm and that the fluorescence radiation produced on the irradiated tooth be filtered out in the wavelength range between 620 nm and 720 nm. This measure ensures that the distance between the wavelength of the excitation radiation and the received fluorescence radiation is sufficiently large that the excitation radiation cannot falsify the evaluation results by superimposing the fluorescence radiation.
  • a common feature of the known examination methods and devices described above is that to excite the fluorescence on a tooth to be examined, air excitation radiation with a relatively short wavelength, ie. H. smaller than 580 nm is used.
  • this enables a relatively high cross section for the generation of fluorescence radiation to be achieved, especially when using wavelengths in the ultraviolet and blue spectral range, but the absolute fluorescence radiation from healthy tooth tissue in the red spectral range of the fluorescence spectrum is stronger than that of carious lesions.
  • the present invention is based on the object of further increasing the evaluation reliability for the detection of caries, plaque, concretions or bacterial infection on teeth.
  • misdiagnoses due to fluorescent dental filler materials should be avoided.
  • the expenditure on equipment for the detection of pathological changes in the tooth should be simplified, and simple battery operation should be possible.
  • this object is achieved by a method having the feature of claim 1 or an apparatus having the features of claim 25.
  • the subclaims describe preferred and advantageous embodiments of the present invention, which in turn contribute to improved sensitivity or to a construction of the device according to the invention that is as simple and compact as possible.
  • the invention is based on the discovery that reflection signals can be used to detect caries, plaque, concretions or bacterial infection on teeth.
  • the reflection of cement that is, of healthy tooth substance
  • the reflection of cement is approximately equal to the reflection of a thin layer of concrement.
  • the reflection of cement is greater than the reflection of a thin layer of concrement.
  • the reflection of a thick layer of concrement is considerably greater in the wavelength range above about 600 nm than the reflection of cement.
  • the reflection of cement is again larger than the reflection of a thick layer of concrement.
  • Reflection signals offer a significantly higher signal intensity than fluorescence signals, so that no complex lighting and detection systems are necessary. If the fluorescence signal is split and assessed in two different spectral ranges, the disadvantage of a low detection intensity is in at least one, namely the red spectral range.
  • the present invention circumvents this disadvantage in that the fluorescence emission is detected over its entire spectral range or at least in a region of high signal intensity and, instead of a weaker fluorescence signal, it is related to one or two substantially stronger reflection signals.
  • the absolute height of the measured reflection is determined by the distance between the probe and the sample.
  • An angle between the probe and the sample leads to a reduction in the measured reflection, preferably in the long-wave spectral range. Because reflection signals are noticeable due to the surface geometry the sample and the angle of incidence are influenced, it is advantageous to assess at least two wavelengths by reflection spectroscopy, so that standardization is achieved.
  • an analysis of a generated fluorescence radiation can also be evaluated in order to support the evaluation in critical areas.
  • the low photon yield and thus the low signal / noise ratio are the main problem with autofluorescence measurements.
  • immersion should be used.
  • Water or physiological saline appears suitable for in vivo measurements (N.A. in the visible spectral range, 37 ° C> 1.33).
  • the signal quality is influenced by the appropriate amplifier technology. Fluorescence excitation can take place with modulated or pulsed excitation.
  • a lock-in amplifier is suitable for detecting modulated signals in a specific frequency and phase. All non-synchronous noise e.g. Backlight from the surgical lamp is effectively eliminated, resulting in rediscovery of signals that were buried more than 60 dB in noise.
  • Wavelength range from 400 nm to 750 nm, the tooth to be examined being irradiated with wavelengths within the entire range
  • 2 shows intensity profiles of the radiation returned from healthy tooth substance and from a concrement layer in the wavelength range from 350 nm to 800 nm, the tooth to be examined being irradiated with wavelengths around 370 nm and around 770 nm
  • 3 shows a preferred exemplary embodiment of a device according to the invention for detecting caries, plaque, concretions or bacterial infection on teeth
  • FIG. 4 shows a preferred exemplary embodiment of a device according to the invention for detecting caries, plaque, concretions or bacterial infection on teeth
  • FIG. 5 shows a preferred exemplary embodiment of a device according to the invention for detecting caries, plaque, concretions or bacterial infection on teeth
  • FIG. 6 shows a cross section through a preferred exemplary embodiment of a probe according to a device according to the invention
  • FIG. 7 shows a side view of a preferred exemplary embodiment of a probe according to the invention.
  • FIG. 8 shows a side view of a further preferred exemplary embodiment of a probe according to the invention.
  • FIG. 1 shows a reflection spectrum of healthy tooth substance, of a thin stone layer and of a thick stone layer in the wavelength range from 400 nm to 750 nm.
  • the reflection of cement ie of healthy tooth substance
  • the reflection of cement is approximately the same the reflection of a thin layer of concrement.
  • the reflection of cement is greater than the reflection of a thin layer of concrement.
  • FIG. 1 also shows that the reflection of a thick layer of concrement is already considerably greater than the reflection of cement in the wavelength range above approximately 600 nm.
  • the reflection of cement is again greater than the reflection of a thin layer of concrement.
  • the tooth is exposed to radiation consisting of two wavelengths or two wavelength ranges approximately in the blue or ultraviolet light range from 320 nm to 520 nm, in particular 370 nm, and with red or near infrared light above 600 nm, in particular 770 nm, irradiated, and the reflection intensities of the same wavelength ranges are measured.
  • the tooth to be examined being irradiated with wavelengths in the spectral ranges around 370 nm and around 770 nm.
  • the radiation intensities within the two wavelength ranges were chosen so that the signal level of the reflection signal from healthy cement is approximately the same in both wavelength ranges, that is to say that the radiation intensity in the near UV spectral range is approximately twice as high as the radiation intensity in NIR spectral range.
  • concrement shows a lower reflection in the near UV spectral range and a higher reflection in the NIR spectral range in relation to healthy cement.
  • cement shows fluorescence radiation in the blue-green spectral range with a maximum around 470 nm; a concrement layer shows almost no fluorescence.
  • the measured reflection intensity at a wavelength of 770 nm is set in relation to the measured reflection intensity at a wavelength of 370 nm.
  • the fluorescence effect can be used to confirm the result of the reflection analysis or to serve as another relevant criterion for the existence of concretion in doubtful cases.
  • the radiation used to analyze the reflection behavior can also be used to excite the fluorescence, as in the present case.
  • the fluorescence is excited by radiation with a wavelength around 370 nm, so that overall only one irradiation with two wavelength ranges is necessary.
  • the absolute height of the measured reflection is determined by the distance between the probe and the sample. An angle between the probe and the sample that deviates from 0 ° leads to a reduction in the measured reflection. Since reflection signals are noticeably influenced by the surface geometry of the sample and the angle of incidence, it is also advantageous to compare reflection spectroscopy to assess at least two wavelengths. Standardization makes it possible to achieve a high level of evaluation reliability regardless of the absolute level of the measured individual signals.
  • the measured intensity at 770 nm thus serves as a relative reference value, so that normalization is possible. This makes a comparison with healthy neighboring tooth substance superfluous, since a certain result can already be obtained at certain points.
  • the point-by-point measurement is of particular advantage if the tooth neck area is examined in tooth pockets, since it should be possible to insert a probe with the smallest possible diameter between the tooth neck and the gums in order to cut open the gums for an examination whether the area is pathological at all to avoid.
  • a combined detection of scattering, absorption and fluorescence takes place according to the present invention in the most signal-intensive areas: high preferential absorption in the ultraviolet range, high fluorescence signal intensity in the blue-green spectral range and almost diminished reflection in the near infrared spectral range.
  • the use of short-wave stimulation Ambient light leads to a high cross section for the generation of fluorescence radiation in the blue-green spectral range and thus also to high signal intensity. In this area, healthy areas fluoresce much more strongly than modified tooth areas.
  • Simple narrow-band lighting sources such as narrow-band LEDs can be used.
  • the detection can also be carried out in a very simple manner by means of commercially available 3-element color sensors, which in particular have sensors for the primary colors red, green and blue, that is to say so-called RGB photodiodes. Within the three spectral ranges red, green and blue, the most informative range for evaluation can be selected by the appropriate irradiation.
  • the three sensors for the primary colors red, green and blue are usually arranged within a circle, with each sensor being assigned a segment of a circle at 120 ° for a respective primary color.
  • wavelength ranges For clear discrimination between pathologically changed tooth areas and dental filling materials, it is advantageous to use more than two wavelength ranges for the evaluation. Either two wavelength ranges can be used for the reflection analysis and one wavelength range for the fluorescence analysis, as is the case in the preferred exemplary embodiment described above, or three or more reflected wavelength ranges and / or fluorescence wavelength ranges can be used.
  • the absorption of radiation in biological materials is negligible.
  • There is a so-called biological window so that the reflected radiation is only determined by the scattering properties and not by the absorption of the examined tooth area.
  • the radiation of healthy tooth substance reflected from the tooth surface is approximately the same in this spectral range in comparison to thin concretions (cf. FIG. 1), so that in addition to the intensity of the reflection reduced, it is reflected blue or ultraviolet radiation, the intensity of the fluorescent radiation can be normalized to this value. Due to the increased transmission of the lower-lying healthy tooth areas compared to lower-lying bacterially modified tooth areas, lower-lying layers of healthy tooth substance hardly reflected, whereas lower-lying concrement layers still make a significant contribution to the reflection signal.
  • a light source 1 generates radiation 9, which is guided via a coupling lens system 2 and a feeding light guide 3 to an area 5 of a tooth 4 to be examined.
  • the tooth 4 is irradiated with radiation 9 which, according to a preferred embodiment, consists of two separate wavelength ranges.
  • the first wavelength range can be in the blue or ultraviolet light range from 320 nm to 520 nm, in particular around 370 nm.
  • the second wavelength range can preferably be in the red or in the near infrared wavelength range above 600 nm, in particular above 770 nm.
  • the radiation 9 causes a reflection radiation 10 on the tooth 4 which lies in the same wavelength ranges.
  • fluorescence radiation of the tooth is excited, which can also be evaluated according to a preferred embodiment.
  • the reflection radiation 10 can be fed to the detection device 8 via a light guide 6. After the detection of the measured reflection signals, the evaluation according to the invention explained above follows.
  • the light source 1 preferably comprises one or more light-emitting diodes, in particular narrow-band light-emitting diodes, which generate light in the wave range around approximately 370 nm or approximately 770 nm.
  • one or more lasers can also be used.
  • FIG. 4 it is possible in these embodiments to use one or more beam splitters 13 in order to pinpoint radiation from further light-emitting diodes or from further lasers into the supplying ones Coupling the light guide.
  • a light source which generates radiation with a wavelength range from approximately 320 nm to approximately 900 nm, in particular a wavelength range from white light.
  • a spectral filter 12 can also be used in order to obtain desired wavelength ranges for the radiation 9.
  • the detection device 8 comprises one or more sensors, each of which has its maximum sensitivity in different wavelength ranges. It is particularly advantageous to use the three sensors to measure the intensities of the first reflected wavelength range, the second wavelength range and the fluorescence wavelength range, the sensors being adapted to these wavelength ranges. It has been shown that commercially available RGB photodiodes with three light-sensitive sensors for the primary colors red, green and blue are suitable for the device according to the invention. A spectrally selective element 7 can also be arranged in front of the detection device 8.
  • FIG. 4 shows a further exemplary embodiment of a device according to the invention for the detection of caries, plaque, concretions or bacterial infection on teeth.
  • a mirror 11 is used which has a round or elliptical opening in its center.
  • the radiation 9 is coupled into a light guide via the coupling lens system 2 through the opening of the mirror, and the reflection radiation 10 is passed on to the detection unit 8 via the mirror 11 and via a further coupling lens system 12. This ensures that only a single optical fiber can be used.
  • FIG. 5 shows a further exemplary embodiment of a device according to the invention for detecting caries, plaque, concretions or bacterial infection on teeth.
  • this device one or more outgoing light guides 6 are placed in the middle of a probe, and one or more ingoing ones Light guides 3 are arranged around the outgoing light guides 6 distributed over the circumference. This arrangement is only possible because the evaluation of reflection signals has a significantly higher signal intensity compared to fluorescence signals.
  • FIG. 6 shows a cross section in the region of a probe according to the invention.
  • An outgoing optical fiber 3 is arranged in the middle, whereas ten incoming optical fibers 6a are arranged around the outgoing optical fiber 3.
  • the corresponding beam profiles are shown in FIG. 7.
  • a spot measurement is achieved through these arrangements of the outgoing optical fibers, so that the measurement accuracy is further increased.
  • areas with healthy tooth substance and areas with concrements can be mixed at the same time and thus lead to further sources of error.
  • the probe can be designed to be very compact, so that it is suitable for being inserted into the gum pocket between the tooth neck and the gums. This eliminates the need to cut the gums for an examination.
  • a coupling lens system 20 is arranged on the probe, which in this exemplary embodiment is a lens in the shape of a hemisphere.
  • a spacer 22 is advantageously used so that the area to be examined is not shaded with the optical fibers.
  • This spacer 22 is either hollow or solid made of quartz glass and can be provided with a reflective surface around its cylindrical circumference.
  • a mirror surface (21) can also be provided in the tip region of the probe in order to ensure lateral deflection of the radiation.
  • a device for supplying a liquid can also be provided on the probe tip in order to supply the probe tip with this liquid, in particular a rinsing channel with an outlet opening.
  • this ensures that blood is flushed away from the probe.
  • the refractive index can be influenced favorably when the radiation emerges from the probe.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Physics & Mathematics (AREA)
  • Dentistry (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Audiology, Speech & Language Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Investigating Or Analysing Materials By Optical Means (AREA)

Abstract

La présente invention concerne un procédé et un dispositif pour détecter des caries, de la plaque dentaire, des dépôts ou une attaque bactérienne sur des dents. Selon cette invention, un faisceau lumineux est produit à l'aide d'une source lumineuse, est dirigé sur une dent à examiner, puis induit un rayonnement de réflexion au niveau de cette dent. Ce rayonnement de réflexion est détecté puis analysé au moyen d'un système de détection. Le rayonnement est avantageusement émis dans au moins deux domaines de longueurs d'onde. Les intensités de réflexion mesurées des deux domaines de longueurs d'onde sont mises sous forme de rapport servant de valeur caractéristique de la présence de caries, de plaque dentaire, de dépôts ou d'une attaque bactérienne. Une analyse de rayonnement fluorescent peut également apporter une aide.
EP02747364A 2001-07-10 2002-06-10 Procede et dispositif pour detecter des caries, de la plaque dentaire, des depots ou une attaque bacterienne sur des dents Withdrawn EP1330179A2 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE10133451 2001-07-10
DE10133451A DE10133451B4 (de) 2001-07-10 2001-07-10 Vorrichtung zum Erkennen von Karies, Plaque, Konkrementen oder bakteriellem Befall an Zähnen
PCT/EP2002/006335 WO2003005892A2 (fr) 2001-07-10 2002-06-10 Procede et dispositif pour detecter des caries, de la plaque dentaire, des depots ou une attaque bacterienne sur des dents

Publications (1)

Publication Number Publication Date
EP1330179A2 true EP1330179A2 (fr) 2003-07-30

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP02747364A Withdrawn EP1330179A2 (fr) 2001-07-10 2002-06-10 Procede et dispositif pour detecter des caries, de la plaque dentaire, des depots ou une attaque bacterienne sur des dents

Country Status (5)

Country Link
US (1) US20030156788A1 (fr)
EP (1) EP1330179A2 (fr)
JP (1) JP2004521714A (fr)
DE (1) DE10133451B4 (fr)
WO (1) WO2003005892A2 (fr)

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Also Published As

Publication number Publication date
DE10133451A1 (de) 2003-01-30
JP2004521714A (ja) 2004-07-22
WO2003005892A2 (fr) 2003-01-23
DE10133451B4 (de) 2012-01-26
WO2003005892A3 (fr) 2003-05-01
US20030156788A1 (en) 2003-08-21

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