Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C19/00—Dental auxiliary appliances
  • A61C19/003—Apparatus for curing resins by radiation
  • A61C19/004—Hand-held apparatus, e.g. guns
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/24—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the mouth, i.e. stomatoscopes, e.g. with tongue depressors; Instruments for opening or keeping open the mouth
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
  • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
  • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
  • A61B17/8802—Equipment for handling bone cement or other fluid fillers
  • A61B17/8833—Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means
  • A61B17/8836—Osteosynthesis tools specially adapted for handling bone cement or fluid fillers; Means for supplying bone cement or fluid fillers to introducing tools, e.g. cartridge handling means for heating, cooling or curing of bone cement or fluid fillers
• • 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
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/48—Other medical applications
  • A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
  • A61B5/4839—Diagnosis combined with treatment in closed-loop systems or methods combined with drug delivery
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/74—Details of notification to user or communication with user or patient ; user input means
  • A61B5/7405—Details of notification to user or communication with user or patient ; user input means using sound
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/0007—Control devices or systems
  • A61C1/0015—Electrical systems
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/0046—Dental lasers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/02—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design characterised by the drive of the dental tools
  • A61C1/06—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design characterised by the drive of the dental tools with electric drive
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/08—Machine parts specially adapted for dentistry
  • A61C1/088—Illuminating devices or attachments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C5/00—Filling or capping teeth
  • A61C5/50—Implements for filling root canals; Methods or instruments for medication of tooth nerve channels
  • A61C5/55—Implements for filling root canals; Methods or instruments for medication of tooth nerve channels with heating means, e.g. for heating gutta percha
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C5/00—Filling or capping teeth
  • A61C5/60—Devices specially adapted for pressing or mixing capping or filling materials, e.g. amalgam presses
  • A61C5/62—Applicators, e.g. syringes or guns
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements

Definitions

• the present invention relates to a composite application device, according to the preamble of claim 1, as well as a method according to the preamble of claim 23.
• Polymerization Transition of the still plastic or flowable composite into a rigid state, in which it can withstand chewing loads.
• Carpule Commercial container filled with composite, from which the composite can be pressed out with a punch.
• the carpule may be provided with a short or longer ejection tube 1.
• Cavity, dental cavity cavity in dental technology, in dentures and in the dental crown
• Cavity wall Hard substance that limits the cavity of a cavity.
• Composite, filling material, composite material material that serves to fill cavities and seals them permanently.
• Measuring unit Device for measuring the quantity of composites applied per unit of time.
• Control unit Device for controlling the light intensity of the light source according to the invention as a function of the quantity of the composite applied per unit time.
• the control unit processes the data of the measuring unit and controls the light intensity of the light source.
• Tensile stress Mechanical stress, which stresses the bond existing there at the contact surface between the cavity wall and the composite, and when exceeding the Strength of the bond can destroy it.
• filling materials in addition to a variety of different materials (such as gutta-percha, amalgam, gold) also used composite. These are mixtures of a polymerisable plastic matrix with organic and inorganic fillers. Polymerization of these composites is initiated by exposure to visible blue or ultraviolet light after the composite has been applied to the cavity.
• the currently customary method consists in first applying the composite into the cavity and then curing the composite by irradiation with light.
• a known method for reducing the tensile stress of photocurable composites is to introduce the composites successively in small portions (with layer thicknesses of about 1, 0 to 2.0 mm thickness) in the cavity to be filled and Harden each portion separately by light irradiation.
• layer thicknesses of up to 4.0 mm are possible. This means that although the filling of a cavity can be completed more quickly, the greater the layer thickness, the greater the stresses generated during curing.
• the object of the present invention is to provide a device and a method for the application of composites according to the preambles of claims 1 and 23, by which both a time-saving processing of photopolymerisable composites is possible as well as the gap formation of the composite during the polymerization is reliably prevented during the filling of cavities.
• the second part of the shrinkage takes place while the composite is already solid and accounts for the smaller part of the total shrinkage.
• This part of the shrinkage is unavoidable and therefore always contributes to the formation of tension.
• gel and post-gel shrinkage occur side by side:
• the method according to the invention therefore already provides so much light during the introduction of the composites into the cavity that the composite flows into the cavity walls and immediately thereafter the gel shrinkage is triggered so that the gel shrinkage already takes place before the composite is subsequently replaced by a poly polymerization lamp is finally polymerized. It is particularly advantageous to control the light intensity already during the application of the composite in such a way that the light intensity is increased with faster application (ie with the application of a larger amount of composite per unit of time) and with a slower application (ie with the application of a smaller Amount of composite per unit time), the light intensity is reduced.
• the device according to the invention preferably consists of a combination of a spray gun or other composite application device which serves to push the composite out of a suitable storage container, for example a commercially available carpule (preferably through the discharge tube of the carpule, and a suitable light source, for example a light-emitting diode.
• a suitable storage container for example a commercially available carpule (preferably through the discharge tube of the carpule, and a suitable light source, for example a light-emitting diode.
• the light source must have a suitable light intensity and spectral distribution of the wavelength of light suitable to initiate the first phase of the polymerisation of the composite (and thus the gel shrinkage of the composite) while at the same time introducing the composite into the cavity (The measuring unit according to the invention), the amount of the applied composite per unit time is measured and transmitted as a measured value to the control unit according to the invention.
• the control unit uses this reading to regulate the light intensity of the light source.
• a potentiometer particularly preferably a sliding potentiometer, is used as the measuring unit.
• the light source according to the invention already radiates during the filling of the cavity with composite as a function of the amount of the applied composite per unit of time.
• the light source according to the invention can still continue to be blasted after the filling of the cavity has been completed in order to achieve the final strength of the composite.
• the light source according to the invention can already emit light colors during the filling of the cavity with composite, which do not contribute to the polymerisation of the composite.
• light colors are used that are perceptible to the human eye and allow the practitioner (dentist) to gain a better overview of the treatment field (cavity, tooth and its surroundings).
• these light colors can be switched on and off independently of the composite application.
• the power supply of the light source can be made via one or more batteries or accumulators or via a connection of the device according to the invention to the power grid.
• the application of the composite according to the invention requires that it has a certain flowability in the unexposed state, so that when the cavity is filled, the composite comes into contact with the cavity walls and thus adheres to the hard tooth substance.
• the liquid composite applied or introduced by the application device which still has numerous monomers and free radicals in this state, is very thin and can drip into the cavity in this state and form a thin layer. Due to the thin liquid, ie a state of the liquid with a very low viscosity, preferably between 1, 0 and 1.8 cPs, the composite also fills fine cracks and gaps in the cavity.
• the composite After completion of the pre-gel phase, the composite has a gel tensile strength or flexural strength of about 20 MPa, with a strength gradient between the surface of the layer in question and its deeper regions. For example, for a 2 mm layer, the strength at the surface may be 30 MPa and at 2 mm depth only 10 MPa.
• this strength gradient is exploited by refilling gaps and fissures in the cavity by pressure, be it through the tool tip of the applicator or through the subsequent layer, with the lower-viscosity regions.
• the composite After the final polymerization, the composite still achieves a final strength of 90 to 100 MPa, thus meeting the requirements of EN ISO 4049 even for occlusion-bearing areas.
• control device for the transfer of the composite in the gel state sets a light dose corresponding to a predetermined proportion of the light dose for Vollpoiymermaschine the relevant composite amount, the gelling light dose 20 to 90, preferably 40 to 65 and in particular corresponds to about 50 percent of the total polymerizing light dose.
• the polymerization per phase, ie pre-gel and post-gel phase is between 1 and 10 sec, depending of course on the available power of the light source and the resulting irradiance, but also on the size and shape of the pro Layer applied composites.
• the irradiance is favorably less than 100 mW / cm 2
• the post-gel phase preferably more than 500 mW / cm 2 .
• a heat source is preferably attached to the dispensing nozzle, for example a heating coil surrounding a metallic nozzle tube, or any other heating, e.g. an induction or a microwave heating.
• the extremely thin-bodied composite which preferably comprises microfiller filler as filler, is gelled by the applied polymerization radiation.
• this pre-gel phase arises 90% or up to 95% of the total shrinkage, which may be 1 to 6% by volume of commercially available composite.
• the applied layer can be processed by the application nozzle of the application device which is designed as a tool, for example in the manner of a spatula.
• the application nozzle of the application device which is designed as a tool, for example in the manner of a spatula.
• an edge gap sealing of the composite takes place in the gel state.
• nachf pollutiondes composite Even without tools pressure according to the invention is exerted by nachf pollutiondes composite on the lower layer. After the lower layer is in the gel state, microscopically small gaps are refilled thereby, while at the same time the next layer gels and solidifies with increasing surface tension.
• the "repressing" of the subsequently flowing composite preferably results in fillings in the lower jaw region, but also in the upper jaw region a re-compaction by the dispensing nozzle is detectable.
• FIG. 1 is a schematic view of a Kompositap bearings- device according to the invention.
• FIG. 2 shows a circuit diagram of a part of the control unit for the composite application device according to FIG. 1, in block diagram form;
• FIG. 3 shows a detailed circuit diagram of the control unit according to FIG. 2; FIG. and
• FIG. 4 shows various embodiments of the dispensing nozzle for the composite application device according to FIG. 1 in the embodiments of FIGS. 4a, 4b and 4c.
• a light source 2 for example in the form of a light emitting diode, mounted.
• the light source can be fixed or detachable. If the light source is detachably attached, then it can be removed for cleaning the device according to the invention.
• the lever mechanism 10 of the spray gun 3 By actuating the lever mechanism 10 of the spray gun 3, the composite 4 is introduced from the carpule 5 into the cavity 6 of the affected tooth (7).
• the measuring unit 8 is activated, for example, by moving the slider of a sliding potentiometer, whereby the resistance of the potentiometer changes.
• This change is registered in the control unit 9 and converted into a current flow through the light source 2, in such a way that with a fast movement of the lever mechanism 10, a larger current is generated than in a slow motion, so that the light source with brighter motion brighter Light throws into the cavity as if it moves slowly.
• An exact dosage of the light dose is required, depending on the amount of composite applied per unit of time.
• An excessively high light dose prevents the composite from flowing into the cavity wall due to immediate gelling; a too small dose of light can not trigger the gelling process.
• the light source may be a light-emitting diode which is mounted in spatial proximity to the ejection tube of the carpule 1.
• the light source can also be placed at any other location on the spray gun and the light can be irradiated via a light guide into the cavity.
• the light source must have contacts or other suitable optical or electrical connections to the control unit, so that the light source is generated by the control unit - lower tensile stresses than with the conventional coating technique (Table 1).
• the dentist can introduce the composite into the cavity under good light conditions. While when applying the layer technique, the field of work may be illuminated only sparsely in order to prevent premature polymerization of the composite, so much light is deliberately supplied here that the composite goes into the gel state and can no longer flow away. It is therefore also possible to advantageously design the light source such that it emits not only blue light suitable for polymerization but, for example, white light with a high blue content, as emitted by commercially available white light-emitting diodes. Then a filling of the cavity under good, glare-free illumination is possible.
• the composite used is one having a matrix based on acrylate plastics, such as HEMA or TEGDMA.
• acrylate plastics such as HEMA or TEGDMA.
• glasses such as barium-aluminum glass, glass ceramics, silicates or silicon dioxides which have both a low proportion of macro-fillers with a mold size of more than 5 ⁇ m and, to a large extent, microfillers a mold size of less than 0.2 ⁇ m are provided.
• the high proportion of microfillers gives a good polishability.
• microfillers 30 to 50 percent and it is also the use of nanoparticles, ie fillers with particle sizes below 20nm possible. These can make up to 50 percent by weight, with the particular advantage that the viscosity is not changed by these, so it remains very low.
• the light source 2 is switched on during the application of the composite.
• the application of the composite and the polymerization via the switching on of the light source 2 done alternately, for example, with a frequency of change of one hertz, so that so
• the light source can apply pulsed light, for example with a pulse / pause ratio of 1: 1.
• pulse width modulation the power of the light source can be adjusted lossless in a conventional manner.
• the composite may include, for example, camphorquinone as a photoinitiator.
• the light source or at least one LED chip of the light source has an emission maximum in the vicinity of 440 nm wavelength, and the main emission range of the LED chips is then between 400 and 500 nm.
• the light source 2 has at least one LED chip, which emits visible light in the range between 530 and 700 nm and, as it were, illuminates the composite when applied. It is also possible to turn on the illumination radiation during the application and the polymerization radiation in application pauses.
• LED chips and laser diodes according to the invention can be used as light sources 2.
• the viscosity of the composite during application can be reduced according to the invention.
• the ejection tube 1 may also be heated in order to reduce the viscosity further and to increase the reactivity of the monomeric composite. When heating, for example, to 30 or 32 ° C, the double bond conversion can be increased in the polymerization of the matrix.
• the discharge of the composite is supported by a mechanical drive, which can be realized as an electric motor or by a pneumatic pressure source.
• the control unit 9 then controls both the light source 2 and the mechanical drive.
• an application pen can also be used, and the light source, but also the composite source can be formed far away from a handpiece, so that the composite is supplied to the handpiece of the composite application device via a composite line, and the light is transmitted via a corresponding light guide.
• the inventive application or introduction of the composite into the cavity takes place in such a way that initially a prepolymerization takes place.
• a special gelling light dose is applied, which corresponds to between 20 and 80 percent, preferably about 50 percent of the total polymerizing light dose.
• the composite gels and according to the invention it is possible, if desired, to realize a reworking via the tool-like dispensing nozzle according to FIG. 4. Only then does the final polymerization take place.
• the amount of the applied composite is thus known, and it can be determined on the energy balance then necessary time for the final polymerization, and by the light source - or by the heat source in the ejection tube 1 - are applied.
• both the filling can be carried out in two steps to form a single layer, but it is also possible to cyclically repeat the prepolymerization and the final polymerization per layer.
• FIG. 4a shows a possible form of a dispensing nozzle 14 according to the invention can be seen.
• the end of the ejection tube 1 is surrounded by a tool 16.
• the tool 16 will pass from a discharge channel 18, which has the same inner diameter as the ejection tube 1, or optionally towards the end of a nozzle-like tapered cross-section.
• the part of the tool 16 surrounding the ejection tube 1 is also provided by an optic 20 of the source 2 surround.
• the optic 20 may be hollow tube, which is mirrored inside, for example, and bundles light to the tool 16 and thus to the application site. But it can also be equipped in a conventional manner with optical fibers.
• the end of the optic 20 is then provided with a concave end surface 20, which has an additional bundling effect.
• the optic 20 transmits both light from the LED chips emitting polymerization radiation and light from the illumination LED chips.
• the tool 1 6 is formed in a conventional manner of an elastic plastic.
• the processing tip 24 which is formed in the manner of a soft spatula, the surface of the applied composite can be smoothed and pressed, which improves the adhesion of the composite in the cavity benefits.
• FIG. 4b A modified embodiment of the tool 16 can be seen in FIG. 4b.
• the dispensing passage 1 8 passes through the tool 16 centrally and coaxially with the ejection tube 1.
• the optics 20 can also surround the ejection tube 1 and the upper part of the tool 1 6 here.
• the tool 16 is preferably interchangeable. It may be designed as a disposable part, or is also cleanable.
• its upper end is clamped on the ejection tube 1, so that it is not accidentally lost.
• FIG. 4c Another modified embodiment of a tool 16 can be seen in FIG. 4c.
• the tool 1 6 is carried out coaxially to the Ausbringrohr 1 and extends bluntly thereafter. It is held by the surrounding optic 20 and in turn will pass from the dispensing channel 18, which in this embodiment laterally terminates at the tool 16 to provide a well-functioning tool tip 24.

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• Health & Medical Sciences (AREA)
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• Animal Behavior & Ethology (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
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• Engineering & Computer Science (AREA)
• Epidemiology (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
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• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Optics & Photonics (AREA)
• Orthopedic Medicine & Surgery (AREA)
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• Pharmacology & Pharmacy (AREA)
• Water Supply & Treatment (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
• Polymerisation Methods In General (AREA)

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• 2012
  • 2012-09-18 DE DE102012018384.4A patent/DE102012018384A1/de not_active Withdrawn
• 2013
  • 2013-09-18 CN CN201380047435.5A patent/CN105611895A/zh active Pending
  • 2013-09-18 EP EP13765707.8A patent/EP2897552A1/de not_active Withdrawn
  • 2013-09-18 US US14/428,757 patent/US9883931B2/en not_active Expired - Fee Related
  • 2013-09-18 WO PCT/EP2013/069383 patent/WO2014044711A1/de active Application Filing

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