JP2007183281A - Health measurement examination device and method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a device and a method for measuring or examining a health state (risk, gain). <P>SOLUTION: Measurement, examination, diagnosis, treatment, prevention or the like on health are performed by one or a combined means/method from among means and methods, such as a medical examination means and a method, a prescribed flow chart means and a method, a prescribed risk measuring means and a method, a prescribed examination means and a method, a prescribed diagnosis means and a method, a prescribed treatment or prevention means and a method, and a prescribed linkage means and a method. In this case, the final diagnosis, treatment, prevention or the like is determined by an operator, and this invention provides a support means or a method for supporting the operator strongly. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

The present invention is a technique for measuring and examining a risk factor having a health problem based on information from the oral cavity.

Conventionally, there has been a single bacterial culture test in which saliva and plaque are collected and cultured in MSB medium, and the colonies are observed. There was no means (cooperation means) or method in relation to risk factors.

Traditional risk assessments are only about looking at a part of health information, and integrated risk assessments are extremely difficult or impossible, and even if a part of the health condition is measured, a comprehensive diagnosis can be made. It was extremely difficult or impossible to do.
In addition, some new risk measurements that were impossible in the past were not possible because some bacteria were cultured or microscopically observed. That is, the present invention is a new risk (information)
Measurement was possible. In addition, conventional risk (information) measurement and new risk (information) measurement are integrated in a timely manner, enabling more accurate examinations, and further integrating those examinations. Treatment and prevention of caries and periodontal disease, which are diseases, and bad breath caused by the disease, are realized with an accuracy that is impossible with conventional methods.

1 [Means of Claim 1]
The health measurement (examination) device according to claim 1 is:
2. A collection and quantification means capable of quantitatively collecting a sample from the oral cavity; and a medium (means) for culturing the collected material collected from the oral cavity.
The health measurement (diagnosis) device according to claim 2 is:
3. A medium (means) for cultivating a sample collected from the oral cavity, and a gas measuring means for measuring gas generated from the medium (means of claim 3)
The health measurement (examination) device according to claim 3 is:
4. A paper point for collecting a sample from the oral cavity, a collection and quantification means for quantitative conversion from the paper point, and a medium for culturing microorganisms in the collected sample (4).
The medium (means) according to any one of claims 1 to 3,
5 (means of claim 5) characterized by comprising range setting means for performing standardized range setting
The health measurement (diagnosis) device according to any one of claims 1 to 4, wherein the health measurement (diagnosis) device is one of measurement image means, optical measurement means, microorganism measurement means, or reference image means for measuring a living organism cultured in the culture medium. 6 [Means of claim 6]
The health measurement (examination) device according to any one of claims 1 to 5,
7 provided with a colony counter (means of claim 7)
The collection and quantification means according to any one of claims 1 to 3,
8. A straight probe having a straight portion on which the sample can be applied quantitatively on the back of the probe.
The collection and quantification means according to any one of claims 1 to 3,
9 (Means of Claim 9) characterized by being a measuring probe provided with a measuring means for quantitatively collecting a sample by a sampling concave shape
The collection and quantification means according to any one of claims 1 to 3,
It is characterized in that a water absorption inhibitor is applied to the paper point to absorb a certain amount of water.


Means 1 for solving the problem of the previous explanation [Means of claim 1]
The health measurement examination apparatus according to claim 1 comprises:
It is characterized by comprising a predetermined risk measuring means for a predetermined disease from a sample collected from a living body, in particular, plaque, saliva, periodontal exudate from the oral cavity.
2 [Means of claim 2]
The health measurement examination apparatus according to claim 2
It is characterized by comprising a predetermined risk examination means for a predetermined disease from a collected sample such as plaque, saliva, periodontal exudate from a living body, particularly in the oral cavity.
3 (Means of claim 3)
The health measurement examination apparatus according to claim 3 is:
It is characterized in that it is provided with means for collecting and quantifying plaque, saliva, periodontal exudate, etc. from a living body, particularly in the oral cavity.
4 (Means of claim 4)
The health measurement examination apparatus according to claim 4 is:
It is characterized by providing environmental control means.
5 (Means of Claim 5)
The health measurement examination apparatus or method according to claim 5 comprises:
A predetermined cooperation means or a cooperation method is provided.
It is characterized by having.
6 (Means of claim 6)
The health measurement examination apparatus or method according to claim 6 comprises:
A predetermined screening means or screening method is provided.
7 (Means of Claim 7)
The health measurement examination method or method of claim 7 comprises:
A predetermined flow chart means or a flow chart method is provided.

1 [Operation and effect of claim 1]
The health measurement (examination) device according to claim 1 is:
Since it comprises a collection and quantification means capable of quantitatively collecting a sample from the oral cavity and a culture medium (means) for culturing the collected material collected from the oral cavity, quantitative culture can be performed.
2 [Operation and effect of claim 2]
The health measurement (diagnosis) device according to claim 2 is:
Since a culture medium (means) for culturing a sample collected from the oral cavity and a gas measurement means for measuring gas generated from the culture medium are provided, it is possible to quantitatively measure organisms that generate gas.
3 [Operation and effect of claim 3]
The health measurement (examination) device according to claim 3 is:
Since a paper point for collecting a sample from the oral cavity, a collection and quantification means for quantitative conversion from the paper point, and a medium for culturing microorganisms in the collected sample, quantitative culture at the paper point can be performed.
4 [Operation and effect of claim 4]
The medium (means) according to any one of claims 1 to 3,
Since it is provided with a range setting means for performing standardized range setting, quantitative measurement can be performed.
5 [Operation and effect of claim 5]
The health measurement (diagnosis) device according to any one of claims 1 to 4, wherein the health measurement (diagnosis) device is one of measurement image means, optical measurement means, microorganism measurement means, or reference image means for measuring a living organism cultured in the culture medium. Therefore, the biological image measurement, the optical measurement, the microorganism measurement, or the reference measurement based on the reference image can be performed.
6 [Operation and effect of claim 6]
The health measurement (examination) device according to any one of claims 1 to 5,
Since the colony counter is provided, the number of colonies can be determined.
7 [Operation and effect of claim 7]
The collection and quantification means according to any one of claims 1 to 3,
Since it is a straight probe having a straight portion that can apply a sample to the back of the probe, quantitative sampling can be performed.
8 [Operation and effect of claim 8]
The collection and quantification means according to any one of claims 1 to 3,
Since it is a measuring probe provided with a measuring means for quantitatively collecting a sample by the collecting concave shape, it can be quantitatively collected.
9 [Operation and effect of claim 9]
The collection and quantification means according to any one of claims 1 to 3,
Since it is characterized in that a water absorption inhibitor for applying a fixed amount of water is applied to the paper point, quantitative sampling can be performed.



Action and Effect of Invention 1 of the Previous Description [Action and Effect of Claim 1]
The health measurement examination apparatus according to claim 1 comprises:
Because it is equipped with a predetermined risk measurement means for a predetermined disease from collected samples such as plaque, saliva, periodontal exudate from the living body, especially in the oral cavity, it can accurately measure the predetermined risk. Can be examined, diagnosed, treated and prevented.
2 [Operation and effect of claim 2]
The health measurement examination apparatus according to claim 2
It is equipped with a predetermined risk diagnostic means for a predetermined disease from collected samples such as plaque, saliva, periodontal exudate from the living body, especially in the oral cavity, so accurate diagnosis, diagnosis, treatment, prevention Can do.
3 [Operation and effect of claim 3]
The health measurement examination apparatus according to claim 3 is:
Since it is characterized by having a collection and quantification means such as plaque, saliva and periodontal exudate from a living body, particularly the oral cavity, quantitative sample collection is possible. This enables accurate and quantitative examination, diagnosis, treatment, and prevention.
4 [Operation and effect of claim 4]
The health measurement examination apparatus according to claim 4 is:
Since it is equipped with an environmental control means, it is possible to conduct accurate examination, diagnosis, treatment, and prevention.
5 [Operation and effect of claim 5]
The health measurement examination apparatus or method according to claim 5 comprises:
Since it is provided with a predetermined linkage means or linkage method, accurate and quantitative diagnosis, treatment, and prevention can be performed. Risk factors that are unpredictable or difficult for the surgeon,
Examination and diagnosis are possible. In addition, problems that the surgeon himself cannot conceive can be easily detected, and accurate diagnosis, diagnosis, treatment, and prevention can be easily performed even in complicated disease states, treatment systems, and prevention systems.
6 [Operation and effect of claim 6]
The health measurement examination apparatus or method according to claim 6 comprises:
Since it is provided with a predetermined screening means or screening method, it is possible to conduct an accurate examination,
Diagnosis, treatment, prevention. In addition, screening items such as examination items can be confirmed at a glance, and accurate screening can be performed immediately.
7 [Operation and effect of claim 7]
The health measurement examination method or method of claim 7 comprises:
Since a predetermined flowchart means or a flowchart method is provided, accurate examination, diagnosis, treatment, and prevention can be performed. Even beginners can measure, examine, diagnose, treat, and prevent skilled people.

The health measurement examination apparatus of the present invention will be described based on the embodiment or the modification shown in FIGS. An embodiment is to measure (detect) risk information (factors) having a health problem based on information from a living body, particularly the oral cavity. Further, based on the information, further examination, determination, processing, diagnosis, and analysis may be performed.

[Configuration of Example]
As an example, the health measurement examination device (means, method) has as its main means a microbial health examination means, a mechanical examination means, a spatial examination means such as position form, an aesthetic examination means, other hard tissue disease examination means, and other Soft tissue disease examination means, eating habits examination means,
It consists of one or a combination of psychological examination methods. The screening method is integrated. (Here, if necessary, a diagnostic means setting means for adding a new diagnostic means to the diagnostic means or deleting any of the diagnostic means may be provided.)

1 examination means (Fig. 1, Fig. 4, Fig. 38, Fig. 47 as an example)
Microbiological health examination means, mechanical examination means, spatial image examination means such as position form, aesthetic examination means, other hard tissue disease examination means, other soft tissue disease examination means, eating habits examination means, psychological examination means, etc. Either or a combination of the examination means and the linkage means (linkage risk means) (1 of FIG. 1 as an example) dental oral cavity display (input) means (which may also serve as the input means) and patient information management means. (Optional). (FIG. 1 shows an example of display input means of the screening means, and FIG. 4 shows an example of a block diagram of the screening means.)

Here, the dentition oral cavity display (input) means (which may also serve as the input means) as cooperation means is cooperation (means) in the hierarchy of the examination means, and information on each examination means is a tooth, Integrate at the display part of the dentition and oral tissue. Further, response control described later based on the integrated information may be performed. Specifically, the dentition, teeth, or oral cavity is typically displayed (represented) or displayed in a 3D image, etc.
When another treatment or prevention target tissue is designated by a finger, pen, mouse cursor, voice, sign language, etc., its risk value, health measurement value, examination value, diagnosis value, etc. are displayed. (For example, the pull-down menu can be selected by clicking the right mouse button on the tooth icon 1 in FIG. 1).

On the other hand, the patient information management means may be only the information of the title part (patient information display input means displayed on the right part of FIG. 1) and may be linked to another database. As a specific example, access as ActiveX component or shared file, call data from other databases such as MIFS, File Maker, Excel, SQL, etc., and process data from this device with other database software Or Ac
It is used by communication between tiveX. Of course, the health measurement examination device itself may have a database engine and use it, but here the patient information management means basically has a highly independent structure, thereby enabling high-speed measurement and more advanced multitasking , Stability, database speed, high stability, high multitasking, health check measuring device high speed, high stability, high multitasking, and even business mutual independence Let's get big evolution independently.

2 Microbial health examination means (as an example, FIG. 2, FIG. 3, FIG. 5, FIG. 44, FIG. 45, FIG. 4)
7)
The flowchart (means, method) shown in FIG. 2 is an embodiment of the microbial health examination means. (Microbial is a name for diseases that depend mainly on microorganisms, and in this health checkup, not all health checkups depend on microorganisms.)
FIG. 3 shows an example of a connection diagram between the microbial health checkup means and the risk measurement means, and FIG. 5 shows an example of a block diagram of the microbial checkup means. An example of the operation is shown in FIGS. FIG. 33 shows a flow chart means for spectroscopic measurement. )

3 Flowchart means in the microbial health checkup means {hereinafter simply referred to as a flowchart (means). } Figure 2
The flow chart (means) consists of one or more risk measurement means, one or more risk measurement means.
Risk examination means, and one or more linkage means (linkage risk means). If these methods are used, it will be a business model in the clinic.

4 Risk measurement means. (Either is essential.) Each measurement (means) in FIG.
Risk information measurement means (risk measurement means): pH (pH) measurement (means), ammonia measurement (means), H ₂ S measurement (means), indole measurement (means), gas measurement (
Means), microscopic measurement (means), culture measurement (means), microorganism production substance measurement (means)
DNA (RNA) measurement (means) (including PCR method), spectroscopic measurement (means), environmental test (means), sensitivity test (means) which is part of environmental test, and the like. (Representative diagram is Fig. 1)

Here, it is often preferable to use the following sampling quantitative means in the measuring means. In addition, there are times when measurement items are essential. The collection and quantification means has good quantification of a sample from a living body, particularly the oral cavity.
Collecting and quantifying means:

(1)
The sampling and quantifying means in FIG. 6 has a quantitative shape because it has a surface in which the shape of the probe is formed and a part thereof is a flat surface. (Abdominal flat probe) It is easy to collect plaque etc. on the surface. (Fig. 6 as an example)

(2) The collection and quantification means in FIG. 7 is a collection and quantification means having a predetermined collection concave shape. One specific example is a measuring probe. (FIG. 7) Plaque and the like can be collected quantitatively by the collection concave shape (measuring means of FIG. 7). The standard shape is a probe-like shape that can collect a certain amount of sample due to the concave shape. The quantitativeness is higher than the sampling and quantification means of (1). (Fig. 7 as an example)

(3) The collection and quantification means with the sample removal means has a predetermined collection concave shape, and the collection and quantification provided with the sample removal means that allows the sample (sample) to be taken out by a knock-out, slide-type, skid-type, etc. sample-takeout means. means. As one specific example, there is a measuring probe with a taking-out means. The effect of (2) is further facilitated and the measurement becomes rational and accurate. The depth of the measuring means in FIG. 7 is a relationship between the piston and the cylinder, and the piston portion slides to push out the sample. This extrusion is similar to the slide mechanism of a mechanical pen or a ballpoint pen.

(4) The collection and quantification means in FIG. 8 is a collection and quantification means in which the cross section has a smooth curved shape and the orthogonal direction forms a straight line shape. However, the contact portion with the medium may be a surface. In that case, the cross section is a smooth curve including a straight portion. (FIG. 8 has a surface. Of course, it may be a straight line.) As a specific example, there is a straight probe. Since the back of the probe is linear, a certain amount of microorganisms can be applied to the agar medium under the same conditions.
As an example of the movement, trace the tissue to be observed in the oral cavity with the straight part of the back, touch the back to the sampling point of the paper point inserted in the tissue such as periodontal pocket, and slide the back to the medium And so on. As an example, see the example of using the straight probe in FIG.

Furthermore, a pressurizing means may be employed between the straight portion of the probe and the gripping means. As an example, a constant pressure is applied to the medium using a leaf spring, a spring, or the like, and quantitative microorganisms can be applied. (As an example, FIG. 8) At this time, the material of the probe is made of resin, metal, ceramics, etc. However, as an example, it is preferable that the probe is made of platinum or ceramic without being oxidized even if flame sterilized. (Since ceramic is an oxide, there is no further oxidation.) For the other sampling and quantification means, the same material may be used if flame sterilization is performed.

(5) The collection and quantification means is a bent paper point. (Fig. 9)
As an example, from the tip to 10 mm is linear, from the 10 mm point to about 45
For example, a paper point that is linearly bent (single bent) at an angle of degrees. (Any straight part may be bent multiple times, and the bending dimension and shape may be manufactured according to the oral tissue. In this case, the periodontal pockets are further protected, and other than the sampling site of the oral tissue, It is less likely to be contaminated.) Also, the bending angle of the paper point may be different depending on the operator's feeling of use. Further, the length from the bent portion to the tip may be matched to the operator and the size of the medium. (FIG. 9 as an example) Here, since the density of the bent portion increases, water absorption is less than the collection site, and the sample collection amount is quantified. Further, when a water absorption inhibitor such as varnish, resin, oil or fat is applied to the bent portion, the amount collected is further quantified.

This bent paper point can be accurately measured because only the tip is inserted into the periodontal pocket and the other part does not touch the oral tissue. In addition, since the tip has a predetermined length, it is safe without breaking through the pocket bottom of the periodontal pocket at the bacterial level. Furthermore, it is safer because it can be easily inserted obliquely into the periodontal pocket. Furthermore, the exudate easily penetrates to the bent portion, and the infiltrating of the exudate is difficult to exceed or does not exceed the bent portion, so that a certain amount of sample can be collected.

Here, color (tone) changing means that changes color (tone) when exudate or the like penetrates into the paper point may be employed. As an example, the exudate at the site where inflammation is present is often acidic or non-neutral, so that a known pH reagent is immersed in a paper point using this. Then, the color changes only in the part where the exudate penetrates.
This may further increase the accuracy of quantification. This changing means may be attached to the bent portion or may be attached to the whole, but it can be anywhere, but if it is attached in a ring shape from the bent portion or the portion about the pocket depth from the tip, highly accurate quantification can be performed.
There are sampling quantification means such as (1) to (5) above.

5 Risk examination means.
In FIG. 2, each examination means comprising periodontal disease risk examination , halitosis periodontal disease risk examination , caries risk examination . And when the individual examination means is diagnosed as having a high risk, the surgeon uses the diagnosis means to decide the action based on this examination information and makes a diagnosis,
And it shifts to further examination means, treatment means, and prevention means. Through these individual means, a timely periodontal disease risk examination , a bad breath periodontal disease risk examination , and a caries risk examination are performed again. In addition, a carcinogenic risk assessment may be employed.

Here, risk information measurement and examination by spectroscopic measurement means (spectroscopic method), spectroscopic examination means, periodontal disease risk examination , bad breath periodontal disease risk examination , caries risk examination can be integratedly measured and examined. So I made another frame. This may be linked to each periodontal disease risk examination , halitosis periodontal disease risk examination , caries risk examination enclosed in the square (flow box) in FIG. 2, or may function alone. And risk information measurement may be started from any position. Furthermore, each means such as measurement, examination, and diagnosis may be selected in a timely manner according to the patient's pathology, request, and the like.

Here, the spectroscopic measurement (means) may include a part incorporated in these three periodical examinations (means) of periodontal disease risk examination , halitosis periodontal disease risk examination , and caries risk examination . It may be built in as an internal measurement (means) and function as an independent examination means. Furthermore, spectroscopic measurement and medical examination may be part or all of the environmental and sensitivity test measurement and medical examination.

6 Cooperation means (Cooperation risk means)
Cooperation means of screening means hierarchy:
Further, the dentition oral cavity display (input) means (which may also serve as the input means) of FIG. 1 in the examination means is also a cooperation means.

Microbial health checkup means hierarchy linkage means:
Linkage means (linkage risk means) means integrating individual risk information, integrating individual examination information processed by information from risk information, and further integrating diagnosis information. Perform high-level measurement, examination, and diagnosis that cannot be achieved with risk information. (See FIG. 43) On the other hand, the cooperation or convergence relationship between caries and periodontal disease in FIGS. 1 and 2 may be part or all of the cooperation. As an example, there is a response control by a response (control) means in the flow line (flow line), the flow box, and the connection relation of all the flow lines and the flow box. The response relationship with the screening means level is a means for cooperation between layers.

[effect]
Circulating the path of the flow means shown in FIG. 2 or following the path in parallel, the characteristic pH value becomes higher than the pathological state, the bad breath disappears, periodontal pathogenic microorganisms, caries protozoan microorganisms Eliminates and reduces periodontal disease, caries, and diseases caused by pathogenic bacteria. Then, the medical treatment can be carried out rationally, effectively and easily in cooperation with various medical examination means.

The above means are selected, used and manufactured by an operator or manufacturer.

  The first embodiment is a pH measuring means. (PH is hydrogen ion concentration)

[First Embodiment]
The pH measurement means is a sample from a living body, particularly a sample from the oral cavity such as plaque and saliva,
The characteristic (target) pH in any one or a combination of a foreign substance, a standard, or a reference sample is measured. Here, environmental control means may be used, or collection and quantification means may be used. Of course, both may be used. (When the environmental control means described in FIG. 3 or FIG. 18 is used, the environmental control means uses any one or combination thereof in FIG. 18.) Reagents or vibrations applied to the sample It is an example of a control means.

A plaque pH measurement means In plaque, the characteristic pH of plaque can be measured. That is, the (plaque) pH measurement means includes a static pH value of plaque, a minimum pH value of plaque and / or its time, a time pH area value, a delta pH, and a reference time pH value. Output any one or a combination of values. Also, the above-mentioned feature p due to plaque and administration reagent
Measures the pH (double) spectrum of plaque reagent spectrum such as measurement of H value, time pH curve by plaque and administration reagent or / and reagent time pH curve group by pH curve by microorganism and administration reagent type Also good.

In addition, a value obtained immediately after the measurement of the collected sample is used as an initial measurement value particularly at the characteristic pH value. In particular, the maximum value that appears in the initial stage is important. These initial measurements are often meaningful. Specifically, these values characteristically indicate the buffer capacity of saliva, and the larger the value, the lower the risk of caries. (Negative risk, gain.)
Here, except for a special case of the static pH value, that is, except that the collected sample is measured as it is, a reagent means or the like in the environment control means is used.

These characteristics pH also serve as information that is one of judgment criteria in caries risk examination information such as caries risk , restoration maintenance period, and repairability. That is, since caries is said to start by tooth demineralization centered on acid, it is very important to measure the degree of acid in the tooth, that is, pH, and the characteristic pH expresses its risk. . In addition, caries may be caused mainly by acids produced by microorganisms and some factors of microorganisms, such as electromagnetic waves such as infrared rays, or molecular vibrations to apatite, but the main cause is considered to be acids.

B Saliva pH measurement means A characteristic pH change of saliva, that is, saliva buffer capacity can be measured. One of the reference time pH value, delta pH, time pH area value, maximum pH value, or a combination thereof is output.

C Foreign substance pH measurement means Measures the pH of food that is a foreign substance in the oral cavity. Examples include sucrose, juice,
Measure the pH of cakes. This value serves as reference information for caries risk examination information such as dietary guidance. It also serves as information for determining the reagent to be used for A plaque pH measurement.

D Standard or reference sample pH measurement method
St. Measurement in microorganisms and administration reagents including caries bacteria such as Mutans colony.
Characteristic pH by microorganism and administration reagent, time pH curve by microorganism and administration reagent or /
Then, a pH (double) spectrum including a microorganism reagent time pH curve group based on a pH curve depending on the microorganism and the administered reagent type is measured. It becomes one of the judgment information to caries risk examination information such as estimation, identification of dental plaque microorganisms, caries risk treatment, caries prevention.

E Sample pH measurement means from the oral cavity Measurement of A, B, C, etc. can be applied by measuring the pH of tongue coating, pus, tissue, etc.
These pieces of information are information for diagnosing each tissue, lesion state, and health condition.

Here, the surgeon may select any one of the above pH measurement means.

[Configuration of pH measurement means]
The pH measuring means includes the pH sensor module of FIG. 10 (or the sensor module of FIG. 11 + gas permeable membrane, etc.) and individual characteristic pH measuring means (specific pH measuring means) described later such as FIGS. It is composed of either one or a combination thereof. As a modification, there are a pH spectrum measurement (diagnosis) means, a pH double spectrum measurement (diagnosis) means, and the like.

Basically here,
In drawings such as block diagrams, basically the minimum necessary means are indicated by solid lines, and convenient means are indicated by dotted lines. The dotted line in the shape basically represents the hidden line. Basically, the alternate long and short dash line was used for explicit expression, etc., or when the meaning was different from other solid lines.

Characteristic pH measurement means include static pH value measurement means, minimum pH measurement means time which is dynamic pH value measurement means, maximum pH measurement means, time pH area measurement means, delta pH measurement means, reference time pH measurement means, etc. It is. Here, vibration imparting means, which is one of environmental control means for imparting vibration to the sample, such as for accelerating the reaction, may be employed. (Basically, it is not used.) In many cases, the pH measurement means uses a sampling and quantification means. Reagents and reagent administration means are often used.

Here, the operator administers reagent means, which is one of the environmental control means, to the pH measurement part, that is, the part where the sample is placed (in this case, the FET electrode part), and the reagent administration means administers the reagent means. , Often granted. (To be described later) This reagent (means) may be replaced by saliva. In this case, there is no reagent and only a biological sample is used. At this time, there is an advantage that the oral cavity environment is more reflected as a salivary plaque complex, and a disadvantage that individual characteristics cannot be measured independently.
Among these means, including the pH sensor module, it may be incorporated in the caries risk examination means and the health measurement examination apparatus, may be independent, or is distributed to other examination means. Is good, but only the pH sensor module is wireless,
A structure separated by wired or the like is preferable in clinical practice.

In FIG. 10, a pH sensor module using an (IS) FET type electrode as the pH electrode is used as an example of the pH measuring means. (The electrode may be another pH electrode such as a glass electrode.) In FIG. 10, the signal from the pH sensor module is buffered or amplified if necessary, and connected to the subsequent characteristic pH measuring means via the A / D converter. That is, this sensor module outputs a pH value as an analog or digital signal when a sample is placed on the sensor portion.

Characteristic pH Measuring Means Some of the characteristic pH measuring means are described below. Select any one or a combination.

A plaque pH measuring means 1 Static pH value measuring means Storage means (stored by a trigger signal which is a start signal) and initial value setting means.

When using reagents:
Use distilled water, purified water or an aqueous solution of neutral pH 7.0 as the reagent. When these waters are used, the smallest possible amount is preferable.

When reagents are not used:
Further, if there is a large amount of plaque sufficient to fill the gap between the electrodes, only the plaque may be measured. Also, a fixed amount of plaque and a fixed amount of saliva may be measured.

The storage means stores the signal in synchronism with a signal from the pH sensor module or an external trigger signal. The initial value setting means resets the storage means to set its value to 7.0 or the like. This value may be the maximum value of 14.0 or the maximum value that can be taken by dental plaque. Here, the maximum value FF, EOF, etc. of the memory may be set as an error display so that the response (control) means of the cooperation means does not oscillate or diverge.

Here, a static pH value and a dynamic pH value from the same sample may be measured and a difference or the like may be compared.
(Upper figure in FIG. 16) This makes it possible to obtain a value obtained by subtracting background signals such as buffering pH value derived from saliva in plaque and noise of pH measuring means.

2 Types of dynamic pH value measuring means 1 Minimum pH measuring means (measures either one or both of the minimum pH value and the required time) (Fig. 12):
It consists of time generating means, time storage means, comparison means, minimum value storage means, and initial value setting means. The initial value setting means initializes ((pH value) storage means), time generation means, time storage means, (storage means switching means), minimum value storage means, and the like. ((P
H value) storage means), switching means for storage means, etc. are convenient, but not necessary.

Further, it is convenient to know the time when the lowest pH value occurs, but it may be saved. (Omitting time generation means and time storage means.) However, knowing the time when the lowest pH value occurred is to further refine the risk, so it is recommended. That is, if the pH is considerably lower than the critical pH, the low pH lasts for a long time because it means destruction such as demineralization of more teeth.

(A storage means)
The signal from the pH sensor module is stored. There are zero or more storage locations.

b Starts when a trigger signal which is a time generation means start signal is input. Then, time is generated based on the internal clock signal. This time signal passes through the switch means and is output to the time storage means. (Here, if there is a pH storage means, a measurement interval is created by the time generation means based on the internal clock, and this is output to the switching means of the storage means.)

c Time storage means Storage means for holding the time when the lowest pH occurred. The time when the switch means is closed (instructed) by the comparison means within the time from the start of measurement from the time generation means is updated and held. As a result, the minimum pH time (minimum value of the pH curve) is maintained.

(D storage means switching means)
The position of the memory array M is switched according to the measurement interval from the time generating means. And the measured value is memorize | stored in a memory | storage means for every time. The minimum pH value may be obtained by comparison after measurement.

When the number of M is larger than the measured number.
The sequence is switched sequentially, and all pH values are stored. 0, 1, 2, 3, ..., n-1
, N
(N> = 0) (however, when n-1 exists, n> = 1)

e As an example of the comparison means, the initial value setting means is set to 14.0 or FFh as the minimum value storage means as the initial value.
(25.5) will be installed.
The comparison means compares the value stored in the minimum value storage means with the measured value at every time or every measurement, and the comparison means selects a low pH value and updates and holds it in the minimum value storage means. Then, the lowest value storage means stores the lowest pH value during the measurement period.
The opposite is true for the highest value measurement.

In addition, n−1 in the memory array M is compared with the nth memory value, and a smaller value is selected and output.
Any means may be used as long as the lowest value can be measured.

f minimum value storage means,
The value from the comparison means is updated and held.

g Initial value setting means The above means is reset to an initial value. As an example, the pH storage means is 7.0 (7 to 1
4), the switching means of the memory means is 0 at M0, the time signal of the time generating means is 0,
The time storage means is 0, and the minimum value storage means is 7.0 (7 to 14 etc.).

Here, the trigger signal generating means may be adopted or operated by a human,
Employment is convenient because it shortens medical hours and prevents hospital infections. The trigger signal generating means having the lowest pH is set so that the signal from the pH sensor module is 0 or 14 when the FET electrode and the reference electrode are not energized, for example. If the trigger signal is set to min6 and max8, the signal from the pH sensor module is pH
If it is between 6 and 8, the trigger signal generating means outputs the trigger signal and the like.
(The same applies hereinafter)

2 hour pH area measuring means (time pH area value) (FIG. 13)
It comprises a time generating means, a threshold holding means, a threshold comparing means, a multiplying means, an adding means, and an initial value setting means. A storage means switching means and a (pH value) storage means are provided if it is necessary to grasp all pH curves. The initial value setting means initializes ((pH value) storage means), time generation means, time storage means, (storage means switching means), comparison means, and the like. Storage (threshold storage or semi-permanent storage) such as threshold storage means and (pH value) storage means may be held and managed in the same storage array. The same applies to other embodiments and modifications.

aTime generator Starts when a trigger signal, which is a start signal, is input. Then, time is generated based on the internal clock signal. This time signal indicates the operation timing of the multiplication means.

b Threshold value holding means Holds a specific pH value such as the critical pH of a tooth. A storage arrangement of other storage means may be used.

c Threshold comparison means The threshold value from the threshold value holding means is compared with the measured value, and if the measured value is exceeded, a value obtained by subtracting the value from the threshold value is output to the multiplying means. Here, exceeding the threshold value is often in the direction of decreasing in the case of acid side measurement in the case of plaque measurement, and in the direction of increasing in the direction of increasing saliva or the like.

d Multiply means Multiplies the value from the threshold comparison means every unit time.

e Addition means The values from the multiplication means are added.

f time pH area value storage means,
The value from the adding means is updated and held.

g Initial value setting means The above means is reset to an initial value. As an example, the time signal of the time generating means is 0,
The time pH area value storage means is 0, and so on.

If necessary, the storage means is inserted between the pH measurement means and the threshold comparison means.
The signal from the pH sensor module is stored. There are zero or more storage locations.
Storage means switching means The position of the storage array M is switched according to the measurement interval from the time generation means.
When the number of M is 1 or more.
Switching is performed in a ring shape. 0 → 1 → 0 → 1… ..

The same applies to 3 or more. However, in the case of 2, either one may be an initial value and the next storage means may be a dynamic pH value.
When the number of M is larger than the measured number.
The sequence is switched sequentially, and all pH values are stored. 0, 1, 2, 3, ..., n-1
, N
(N> = 0) (however, when n-1 exists, n> = 1)

3 Delta pH measurement means (Figure 14)
(PH value) storage means, time generation means, time storage means, storage means switching means,
It comprises a difference division means, a maximum value storage means, and an initial value setting means. The initial value setting means initializes (pH value) storage means, time generation means, time storage means, storage means switching means, comparison means, and maximum value storage means. (PH value) The storage means may have one pH value as one unit and two or more units. (M in the figure is 2 or more) The difference division means is (
pH value) Any value of the storage means can be selected. Delta is originally expressed as a symbol as shown in FIG. 14, but it was not included in the JPO regulations, so it was deliberately named “Delta”. Improvement is expected.

a Storage means Stores a signal from the pH sensor module. There are two or more storage locations.

b Starts when a trigger signal which is a time generation means start signal is input. Then, time is generated based on the internal clock signal. This time signal passes through the switch means and is output to the time storage means. Then, based on the internal clock, a measurement interval is created by the time generation means, and this is output to the switching means of the storage means.

c Time storage means Storage means for holding the time when the maximum delta pH occurred. The time instructed by the switch means is updated and held by the comparison means within the time from the start of measurement from the time generating means. As a result, the time when the maximum delta pH occurs is retained.

d Storage means switching means The position of the storage array M is switched according to the measurement interval from the time generation means.

When M is 2 or more When M is smaller than the number of measurements, or less.
Switching is performed in a ring shape. 0 → 1 → 0 → 1… ..
The same applies to 3 or more. However, in the case of 2, either one may be an initial value and the next storage means may be a dynamic pH value.

When M is larger than the number of measurements.
The sequence is switched sequentially, and all pH values are stored. 0, 1, 2, 3, ..., n-1
, N
(N> = 0) (however, when n-1 exists, n> = 1)

e Subtracts n−1 and the nth stored value in the difference division means storage array M, and divides the value by the measurement time interval. Delta pH = O (Mn-1) -O (Mn) / delta t, O (Mn) is the value of the nth storage means, and delta t is the measurement interval time.

f Maximum value storage means The value from the difference division means is updated and held. At this time, the larger one of the previous value (initial value) and the current value is selected and stored. When the storage is updated, that is, when the current value is larger than the previous value (initial value), the maximum value storage means closes the switch means so as to store the time in the time storage means.

g Initial value setting means The above means is reset to an initial value. As an example, the pH storage means is 7.0 (7 to 1
4), the switching means of the memory means is 0 at M0, the time signal of the time generating means is 0,
The time storage means is 0, the maximum value storage means is 0, and so on.

4 Reference time pH measurement means (Figure 15)
The time generation means, the time comparison means, the reference time setting means, the reference time pH storage means, and the initial value setting means. The initial value setting means initializes the time generation means, the reference time pH storage means, and the like.

aTime generator Starts when a trigger signal, which is a start signal, is input. Then, time is generated based on the internal clock signal. This time is output to the time comparison means.

b Reference time setting means It is set how many minutes from the start of measurement how to look at the pH at a predetermined reference time. This may be a permanent memory, an input value from the operator input means, or a semi-permanent memory value.

c Time comparison means When the time from the time generation means reaches the set time of the reference time setting means, the switch means is closed and stored in the reference time pH storage means as the reference time pH value.

d reference time pH storage means Stores the pH value of the time set by the reference time setting means.

Here, as an example, a handy type pH meter that informs the pH at a predetermined time such as 10 minutes with a buzzer or the like may be manufactured as the reference time pH measuring means. When plaque is placed on the electrode, the trigger can be used to automatically display the pH value of the reference time together with the buzzer on a display means such as a liquid crystal screen when the measurement time is automatically set to 10 minutes. Moreover, it can be easily used anywhere by using a battery as a power source. A stand-alone pH meter may be used in which the surgeon examines and diagnoses by viewing this display. Other types of pH may be manufactured in this type.
Here, it is more convenient to have a wireless external communication means such as BlueTooth or a wired external communication means such as USB. Other embodiments may be conveniently equipped as well.

Each of these means may be configured by software on a computer,
Each means may be realized only by hardware.

B Saliva pH measurement means 1 highest pH
The difference in setting or configuration of the minimum pH is different from the setting or configuration in which the comparison unit compares the value of the maximum value storage unit with the measured value and always stores a large value in the maximum value storage unit.
The subsequent means or setting of means is the same configuration and setting as the minimum pH measuring means.
(2) pH value measuring means for 2 reference times The 4 4 reference time pH measuring means of plaque pH measuring means is used. Where the reagent is
Use acidic aqueous solution.
3 delta pH measuring means The 2 3 delta pH measuring means of plaque pH measuring means is used. Here, an acidic aqueous solution or the like is used as the reagent.
4-hour pH area measuring means The 2-hour pH area measuring means of 2 of plaque pH measuring means is used. Where the reagent is
Use acidic aqueous solution.
From the above measurements, the buffer capacity of saliva to prevent caries is known.

C Foreign substance pH measuring means One static pH value measuring means of plaque pH measuring means is used.

D Standard or reference sample pH measuring means This measuring means is the same as each means of plaque except that the sample object such as plaque and standard or reference microbial colony changes. Since plaque is a kind of microbial colony, there is no change in measuring means. However, not all of the higher-level examination methods are the same.

E Sample pH measurement means from the oral cavity
Use the measuring means from A to D according to the sample.

[Operation of Example]
Set Sw to On to activate. As an example, plaque is collected from the last molar at the upper right, and a fixed amount of plaque is collected by a quantification means (here, measuring probe, FIG. 7). Then, the collected plaque is placed on the pH electrode (FET electrode). Then, 50 μl of the reagent is dropped as an example, and dropped so that the reference electrode and the pH electrode are energized as shown in FIG. As an example, a 5% sucrose solution was used as a reagent.

As an example, one of the following reagents is used.
Reagent 1 Sucrose 5% solution Use in a range of greater than 0 to ~ 20%. It may be used neutral by administration of an appropriate alkaline reagent. As an example, NaOH is added dropwise to make pH 7.0 neutral. In the case of a neutral reagent, it is suitable for theoretical value measurement such as initial value inspection described later, but in fact, it does not ingest NaOH and sucrose, and measuring the risk of a single substance is equivalent to element reduction principle. Therefore, sucrose alone is primarily suitable.

Reagent 2 Sucrose, NaCl (about 0.9% as an example)
Reagent 3 Sucrose, NaCl, NaHCO ₃ (second risk parameter means) 1 mM as an example
degree.
NaHCO ₃ (second risk parameter means) lowers the pH value as the amount of CO 2 produced by the microorganism increases. However, NaHCO ₃ (second risk parameter means) has a negative risk or gain when the concentration is high.
Reagent 4 Distilled water or purified water. This is used when measuring the raw pH value of plaque. (It is desirable to perform dilution correction with water.) In this case, the raw plaque pH value can be measured without correction if the electrodes can be energized without a reagent.

As an example, the operation of the lowest pH measurement that is considered to be the most important information for caries risk examination at present will be described. Here, the surgeon selects the lowest pH value and time of the dynamic pH value. (The pH measuring means is controlled by the operator input means.) Then, the pH of the plaque decreases with time and rises again at a certain value. At this time, the lowest pH value is stored in the lowest value storage means in FIG. However, the minimum pH is
Since measurement time is required, it is often not suitable for real-time diagnosis and treatment. In such a case, the reference time pH measurement is selected. This gives an approximate good value.

More specifically, the comparison unit sequentially compares the measured value with the stored value of the lowest value storage unit, and the low value is always stored in the lowest value storage unit.

At this time, as an example, the time value is also updated and held. Then, when the polarity of the delta pH value is reversed, the minimum value and the time are determined. Here, the comparison means, storage means, minimum value storage means, time generation means, etc. may be constructed by computer storage means, control means, etc., or all may be constructed by hardware. May be.

Here, the initial value stored in the initial value storage means as the initial value P0 of the dynamic pH value may be treated as a static pH value. The pH sensor module is 0 or 14
Is started as an initial value. Here, the initial value is set to 0, and the maximum of the changing pH value starting from when the sample is placed on the FET electrode and energized with the reference electrode is detected using the maximum detection means (minimum pH value). The operation of the comparison means may be changed so that the maximum value is selected, or the lowest pH measurement means and the highest pH measurement means are connected to one sensor module output to obtain the highest pH value and the lowest pH value. The initial value in the measured pH value may be used as the initial maximum value. In this case, plaque containing a large amount of phosphate buffer in saliva (a lot of saliva is mixed at the time of collection, or a lot of phosphate buffer is mixed purely only by diffusion) This initial maximum is large. This initial maximum is a defense factor against teeth. (Negative risk, ie gain.)

As an example, the measured value of the lowest pH measuring means is described.
When 5% sucrose aqueous solution pH 6.5 is used as a reagent.

Time to reach minimum pH (minutes), minimum pH value, 10 minute value, initial value, vibration
A 16 4.3
B 30 3.8
C 27 5.2 5.8 6.7 No change
D 34 3.9 4.2 Lower
E 1 5.7 5.8
F 20 4.9 5.0 8.4

(A, B, C ... are omitted)

Aqueous solution with 5% sucrose, 0.9% NaCl, 1 mM NaHCO3, pH about 7.7
Here, NaCl is an impedance lowering means. NaHCO3 is p from CO2 such as microorganisms.
CO2 pH change detection means for adding H change value. It is also an alkaline means to make the solution weakly alkaline. Furthermore, it can also be used as a second risk parameter assuming the case of ingestion as a foreign substance.

Time to reach minimum pH (minutes), minimum pH value
G 21 4.2
H 8 5.6
I 20 6.2
J 12 5.7
K 25 5.4

The output value of the pH measuring means may be examined by the caries risk examining means and converted into a risk level.

The following characteristic pH measuring means may calculate each measured value based on the pH value stored when the lowest pH is measured, or may be manufactured as an independent means.

2 hour pH area measuring means When measuring the area below the critical pH of enamel and dentin, the critical pH value of enamel and dentin is used as a threshold holding means. When the total area is used, the initial value is used as a threshold holding means. When the area is less than pH 7, and the area is more than pH 7, 7 is set as the threshold value holding means.

Then, with the critical pH as a threshold value, the pH value is compared with the threshold value comparing means every time unit of the measured pH value, for example, every 10 seconds. That is, the threshold value comparing means, the multiplying means, and the adding means are compared with each other. PH below the threshold in the means
With respect to the values, the multiplying unit multiplies 10 (seconds) individually, and the adding unit calculates the total value (area) of the values.
As an example
K 23.8 (pH * t)

3 Delta pH (1 and 2 may be predicted)
Sequential pH values are stored in the storage means, and the stored pH value is defined as O (Mn). The value is stored in the storage means by the storage means switching means and the storage means at intervals of 10 seconds as an example, and as an example, at this time, O (Mn-1) and O (Mn)
The value obtained by dividing the difference pH value of the unit by the difference dividing means in unit time, 10 seconds here is the delta pH
Then, the value is sequentially stored in the maximum value storage means.
As an example, Delta pH (minimum pH value, reference value)
K 0.08 5.1
M 0.18 4.2

4 pH of reference time (1 and 2 may be predicted)
An arbitrary set time from the start of measurement, for example, 10 minutes, and the pH value at that time is closed to the reference time by the reference time setting means, the time generation means and the time comparison means, and the reference time pH value storage means Remembers the current pH.
As an example, pH value after 10 minutes (minimum pH value, reference value)
C, E 5.8
K 5.4 5.1
L 5.1 4.5
M 4.5 4.2
N 4.2 4.0

Operation of B saliva pH measurement means In the case of saliva, an acid solution reagent of about pH 1 to pH 5 is used. 6.8 to 6.1
It seems that the pH is better than that.
As an example, 40 μl of HCl aqueous solution is dropped on the pH electrode portion. Prior to this, pH is about 1 to 6.0, and pH is 2.2 (as an example, titrated from low pH, 2.2).
Stop at the moment when ) Adjust the HCl concentration beforehand. Then, 5 μl of saliva is dropped on the electrode part with a pipette or the like, and the measurement of the pH value at the reference time, the delta pH measurement, and the 3-hour pH area measurement similar to those of dental plaque are performed.

An example of pH value of initial value saliva as an example of measurement 7.7
Initial value of HCl addition 2.2
Final value 7.2 (20 seconds)
The first caries risk examination means in the latter stage makes the risk smaller as the final value is higher or closer to the value of the saliva alone, and as the recovery time is shorter.

C Foreign substance pH measurement means See the operation of 1 static pH value measurement means in plaque pH measurement means. Sample collection is different.
An example is a 5% sucrose solution pH value: 6.5.
Saliva may be administered to this as a reagent. For example, it rises to about 8 in a few seconds and returns to the value of saliva alone.

D Standard or reference sample pH measurement means Measurement that becomes a characteristic pH reference value of known microbial colonies and the like.
This measuring means is the same as each means of plaque, except that the plaque and the standard or reference microbial colony sample are changed. Since plaque is a kind of microbial colony, there is no change in measuring means. The difference in operation is that a microorganism sample obtained by separation culture, reference or standard strain restoration is applied to the pH electrode part, and an environmental control means such as a reagent is used as necessary in the same manner as plaque.

Application to microbial identification from characteristic pH values:
As an example, each characteristic pH value of a Str. Mutans colony cultured on an MSB agar medium is measured in the same manner as the plaque. A microbial identification unit may be used in which the correlation unit calculates a correlation value with the plaque characteristic pH based on the feature pH and estimates or identifies the microorganism in the plaque. Moreover, you may use the microorganism identification means of a cooperation means. The latter is p
In addition to the H reference value, the reference value of the standard microorganism is further provided, and the comparison means of the cooperation means compares the correlation and identifies the microorganism. Diseases may be identified based on the same principle.
Based on this pH curve, a correlation coefficient is calculated by a known correlation means between the plaque pH curve (pH spectrum), and a microorganism (pH) identification means is used to estimate plaque microorganisms. Also good. (Refer to pH (multiple) spectrum measurement means below)

Actinobacillus cultured in TSBV medium
When measuring actinomycetemcomitans, a sugar such as glucose may be used as a reagent. Specifically, as described above, a colony of TSBV medium (using aerobic CO2 tablets) is placed on the pH electrode in the same manner as dental plaque, and 50 μl of 5% glucose aqueous solution is administered as described above. Then Actinobacillus
If actinomycetemcomitans is cultured, the pH will decrease. Further, the pH is similarly lowered in fructose, galactose, maltose and mannose. On the other hand, lactose and raffinose do not show a decrease in pH. Using these sugars as reagent means, the characteristic pH is measured and stored as a reference value. Then, using the same reagent means, measure the feature pH of plaque and colonies of cultured colonies, and use the microorganism identification means that compares the feature pH with the previous reference feature pH and estimates or identifies the microorganism. May be. Here, the comparison means uses correlation, difference, and division means.

From this information, Actinobacill is used in the sugar-acid relationship as a reference value by microorganism identification means.
A comparison value that satisfies the conditions of us actinomycetemcomitans is output. Specifically, the comparison means compares the correlation with the reference value and the measured value, and as an example, this value is 0.
. If it is 90 or more, it is displayed as a match. This may be displayed by the display means, or may be transmitted to the risk examination means as a signal. Also Porphyromo
nas
A colony of gingivalis (hereinafter referred to as PG) is placed on the pH electrode in the same manner as the above-mentioned plaque. G. Aspartic acid or glutamic acid, which is a required nutrient of E. coli, was added dropwise as the reagent, and the produced NH ₃ was observed. G. It may be used for identification. More specifically, the pH (double) spectrum of known microorganisms is measured and used as a reference value, and the reference spectrum is compared with the measured spectrum. (Refer to pH (multiple) spectrum measurement means described later)

Here, the microorganism identification means uses, as a reference value, a reference value such as acid production by sugar and generation intensity, and the like, and the comparison value is compared with the measurement value to identify or estimate the microorganism.

E Sample pH measurement means from the oral cavity
Use the measuring means from A to D according to the sample.

Application to environmental tests from characteristic pH values:
Similarly, depending on the added reagent, environmental test means may be used to identify the positive direction substance and the negative direction substance for the microorganisms in the sample by changing the characteristic pH value of the sample. In this case, it is a suppressor and helps to control pathogenic microorganisms. In the case of +, it is found as a substance for enhancing symbiotic microorganisms, and if used, it acts as a symbiotic microorganism enhancement (the suppression of pathogenic microorganisms thereby). These results provide powerful support for therapeutic drugs and treatment methods.

Application to susceptibility testing from characteristic pH values: (Part of environmental testing, but important because it is important)
Antibiotics such as antibiotics, fluorine, etc., sterilizing, bactericidal and bacteriostatic substances are used as reagent means. At this time, each characteristic pH has a higher value, a smaller area value, and a smaller delta pH, if the added substances act on microorganisms in a sample such as dental plaque. Of course, the reference time pH value is also close to the initial value, and the pH fluctuation itself becomes less. Sensitivity test means for outputting a value with or without sensitivity by any one or a combination thereof may be provided.

The dynamic pH in the lower diagram of FIG. 16 may be compared by a comparison means. As an example, measure dental plaque as a sample. The other is measured using saliva as a sample. The value is compared by the comparison means. At this time, the environment control means supplies acid to the saliva so that the output of the comparison means (here, the difference is used) becomes zero. Then, the approximate amount of plaque acid that is close to the actual environment can be estimated by the acid concentration from the environmental control means.

Modified Example of First Example Ammonia Measurement (Means) (NH ₃ )
Ammonia measurement means (alkali gas or de-H proton gas measurement means)
The pH sensor module, gas permeable membrane, and reagent are the main components. (Fig. 11)
As the gas permeable membrane, a hydrophobic membrane with pores used in the second embodiment is used. Here, a hydrophobic membrane having pores of about 0.8 μm was used. The subsequent processing system uses either the characteristic pH measuring means or the pH (multiple) spectrum measuring means described later.

Then, 50 μl of a weakly acidic solution as a reagent is dropped on the pH measuring means.
An aqueous solution prepared by adjusting the Cl aqueous solution to about 2 to 6 is used. A gas permeable membrane (a porous membrane with pores) is placed on the electrode of the pH sensor module of FIG. 11 so as to be in contact with the aqueous solution like a cover. At this time, plaque is applied or placed on a hydrophobic film (gas permeation means) with a measuring probe or the like, and the top is held in advance by a sample holding means.
The reagent may be acidic water or alkaline water, or H that can measure pH instead of 14
Any liquid, fluid, or solid that can measure pH, such as proton-compatible liquid and gel.

Then, pH measurement is started. At this time, the more NH _{3, the} higher the pH.
This measuring means can measure only an alkaline gas such as NH ₃ gas without being affected by the acid of the sample. Of course, when it is desired to measure the total pH of the sample, it may be measured without a hydrophobic cover.

At this time, if the sample holding means is used, the gas diffusing from the sample efficiently permeates the reagent. (Use a gas impermeable resin film, plate, etc. This may be a structure that can be opened and closed by attaching a hinge.) Furthermore, between the gas permeable film and the sample holding means, the environmental control means is in contact with the sample. As one, reagent means may be installed. As an example, it is made of a hydrophilic or hydrophobic film or paper infiltrated with environmental factor drugs such as urea, amino acid, nitric acid and nitrous acid. As a result, if urease bacteria, nitrate-reducing bacteria, nitrite-reducing bacteria, amino acid-utilizing bacteria, etc. are present in the sample, the pH is shifted to the alkali side. Based on this value, bacteria can be confirmed, identified, and estimated. This is because the pH examination means or the pH spectrum measurement examination means described later, or pH
It can be realized using a multispectral measurement examination. Further, if necessary, a buffer may be mixed with the reagent means and used.

Microscope pH detection A chemical supply means (one or more places) is provided on the slide glass. (The medicine supply slide glass of FIG. 25 may be used.) (When a reagent is administered to this circular depression, the reagent passes through the reagent supply path, and the reagent penetrates between the cover glass and the slide glass to control the environment of the sample. To change.)

From there, a pH indicator, which is one of the environmental control means, is administered to the sample, and the color change is observed with a microscope.

At this time, sugar such as sucrose may be supplied from the chemical solution supply means to observe the color change. As an example, if sucrose is administered and the color tone changes, a risk similar to that of the pH sensor can be detected.

More specifically, a known color tone pH conversion means (for example, the colorimetric means of FIG. 20 can also be used) converts the color tone into a pH value. This value can be entered into the flow chart means and processed in the same way as the risk examination .

As an example, the color tone pH conversion unit stores the color tone from pH1 to pH14 as a reference value in the colorimetric unit of FIG. 20, and the color tone and the measured color tone value are compared by the comparison unit. The pH value corresponding to is output. Of course, the pH value may be not only every 1 but also in increments of 0.1 or less.
In this case, the change in the pH value can be investigated at an arbitrary 1Dot or more of CCD.

PH measurement in medium measurement such as MSB medium
The pH change of the MSB liquid medium may be measured with a pH indicator or the above pH measuring means. In the case of a liquid medium pH indicator, the operator may enter the color tone into the caries risk examination means using the operator input means, or use a colorimeter to enter the caries risk examination means. May be.

pH spectrum measurement (Fig. 17, Fig. 18)

[Embodiment]
An embodiment is to measure the pH spectrum. What is pH spectrum?
It is a time pH fluctuation curve seen when a reagent such as sugar or amino acid is added to plaque, microbial colonies, etc. as in the case of plaque measurement. This includes observations in the frequency space using FFT.

[Constitution]
The pH spectrum measuring means is the main component, and pH spectrum examining means is adopted as necessary.
α: The pH spectrum measuring means includes a pH sensor module and a pH spectrum means. If necessary, (spectrum) comparison means may be adopted.
The pH spectrum means comprises pH (spectrum) value storage means, storage means switching means, and time generation means. You may employ | adopt means, such as a time memory | storage means and a trigger signal generation means, as needed.

The pH value storage means is made of a storage element that stores the pH value, and the storage location can be switched by the switching means of the storage means. Some or all of the storage locations may be used as reference value storage means as required. (See (1) and (2) in Fig. 18)
The switching means of the storage means switches the storage location in the storage element that stores the pH value. Switching takes place at every measurement time by the time generating means. Moreover, you may switch manually.

The time generation means manages the timing to measure. In the case of manual operation, it is inconvenient if it is unnecessary.

The time storage means stores a measurement interval time, a T (n) value, a fixed value, and the like.

The measurement interval value stores a measurement time for each measurement. This value is adopted when using a delta pH time interval measuring means for changing the measuring time according to the delta pH value. As a result, sampling can be performed densely in measurement with a large change and sparse in measurement with a small change.

For the T (n) value, the time of the memory value at the nth is calculated by the function T, and the function T
Is stored in the time storage means.

The fixed value sets a certain arbitrary time. As an example, if a fixed value is measured every 1 minute, the stored value is 1 minute. As a result, the n-th time that is the storage location of the storage means is n minutes. If the stored value of n × time interval value (value of the time storage means) is 0.5 minutes, it is 0.5n.
It is.

(Spectrum) comparison means

The comparison means calculates the difference between the pH storage value of 1 in FIG. 18 and the pH storage value of 2 in FIG.
Perform division, correlation, manual comparison, etc. Here, the comparison means uses either automatic comparison or manual comparison or both.
The comparison value storage means is means for storing the comparison value. This is not necessary, but is inconvenient.

Manual comparison means Here, manual comparison means in which the operator performs the comparison means with the operator input means may be employed.
In the manual comparison, the reference pH spectrum and the measured pH spectrum are displayed by the display means, and the operator sees the display and inputs them by the comparison value display input means. (For example, it is input to the comparison value portion in the list box of FIG. 17 or the operator input means of FIG. 3, FIG. 4, FIG. 5 etc. is used.) Such display input means is convenient.

Example of automatic comparison means (as an example, activated by the automatic button in FIG. 17)
In the difference comparison, the difference between the reference pH spectrum and the measured pH spectrum is calculated.
In the division comparison, the reference pH spectrum and the measured pH spectrum are divided.
In the correlation comparison, a correlation value between the reference pH spectrum and the measured pH spectrum is calculated.

β: pH spectrum examination means (diagnosis in FIG. 17) includes a risk conversion means for converting a comparison value and a measured value (including a reference value) into a risk. Here, it is more convenient to have risk value storage means.

[Operation]
As an example of operation, a Mutans colony cultured in MSB medium is placed on a pH sensor module in the same manner as dental plaque, and 50 μl of 5% sucrose is dropped as a reagent. Then, the storage means switching means stores the pH value while switching the storage location of the pH storage means at the timing generated by the time generation means (measurement for each measurement time). The pH storage means stores this as a reference value. This may be automatically performed by an internal trigger or the like, or may be operated using measurement command display input means (MCC FIG. 17).

Similarly, plaque is put on the pH sensor module and measurement is started as described above.
Then, the comparison means compares the reference value and the measured value. At this time, the switching means of the storage means operates so as to compare the stored pH values at the same time in order from the measurement start time 0. The compared values are stored in the comparison value storage means. This may be examined by the pH spectrum examination means, or the value as it is may be displayed.

As an example, the time generating means adopts 1 second as a fixed value. And according to the value p
Measure H over time. This time pH curve is the pH spectrum.

The pH spectrum examination means conducts examination using any one of the following comparison means or a combination thereof.

In the automatic pH spectrum examination means difference comparison, the measured object is closer to the reference material as the difference between the reference pH spectrum and the measured pH spectrum is close to zero. At this time, the feedback means operates so that the sensitivity adjustment is terminated when the intensity of the reference substance increases or decreases by the automatic sensitivity adjustment and becomes closest to zero.

In the division comparison, the reference pH spectrum and the measured pH spectrum are divided. The closer the value is to a certain value such as 1, the closer the measurement substance is to the reference substance. At this time, the feedback means may be operated so that the sensitivity adjustment is terminated when the intensity of the reference substance is increased or decreased by automatic sensitivity adjustment and is closest to 1, or a comparison means for calculating the variation rate of the division result. Also good. In this case, the lower the variation rate, the closer the measurement substance is to the reference substance.

In the correlation comparison, the correlation value between the reference pH spectrum and the measured pH spectrum is calculated, and the closer the value is to 1, the closer the measured substance is to the reference substance.
and so on.
That is, the output of the pH spectrum examination means is obtained by quantifying the closeness and similarity to the reference substance, that is, the possibility of being a living organism in the case of a microorganism.

In manual pH spectrum examination means,
FIG. 17 shows display input means in the pH spectrum measurement examination apparatus. Here, the pH value storage means has a pH spectrum of a colony that has been purely cultured. This is displayed by the measured pH value display means. Further, the pH spectrum of the reference substance is called up by the reference value display input means.

And it is displayed by the reference value display means. The operator compares the reference value with the measured value,
If it is recognized that it is, +, if it is different,-, if not, enter ±. The difference, division, and correlation are performed manually. As an example, the difference between the reference value and the measured value is taken little by little, compared in the middle, and when the difference is over, addition is performed for comparison. If the amount is larger, ++ may be used. If the amount is further larger, ++ may be used.

Based on these spectra, the characteristic pH calculation means calculates the minimum pH value and the time pH.
An area value, a delta pH value, a reference time pH value, and the like may be calculated. The characteristic pH calculating means includes any one or a combination of the comparing means in FIG. 12, the threshold comparing means and the multiplying means in FIG. 13, the difference multiplying means in FIG. 14, and the time comparing means in FIG. This may be performed automatically by the measurement set by the environment setting means, or may be manually or automatically operated using the measurement command display input means (MCC FIG. 17).

[effect]
Since each microorganism exhibits a characteristic pH spectrum, microorganisms can be identified and estimated. In addition, the degree of invasion (risk) in detail to tissues such as teeth can be understood. To date, sugar or amino acid utilization has only been a binary representation such as + or a fixed value at a single time. By expressing it as a metabolic change, ie, a pH spectrum, it is possible to identify and estimate microorganisms with high accuracy. It can also be used for general microorganism testing. In this case, in the past, it was merely binarized evaluation of acids +, −, etc., but measurement, examination, and identification with a very large amount of information by this pH spectrum enables identification of microorganisms with high accuracy and little. Microorganisms can be identified by examination items (one glucose item, one sucrose item, etc.). It also contributes to the attributes of microorganisms.

pH double spectrum measurement (Fig. 17, Fig. 18)
[Embodiment]
An embodiment is to measure a pH double spectrum.

[Constitution]
The configuration of the pH double spectrum measurement means is used, and the environment control means is used dynamically. That is, in the pH spectrum, the spectrum was measured using the environmental control means without changing during the measurement, such as continuously using a single or a plurality of reagents. On the other hand, the pH double spectrum measurement measures a complex spectrum by changing the environment control means during the measurement. This is the main configuration, and pH double spectrum examination means is adopted as necessary.

The environment control means includes any one or a combination of reagent means, atmosphere adjustment means, electromagnetic wave irradiation means, medium wave applying means, and the like. (See Figure 18)
In addition, the environmental control means is used, for example, during a sensitivity test, a microbial requirement nutrient test, a microbial environmental test, or a manual examination. Here, the environment setting means (or button) determines the operation and parameters of each means, and does not control the measurement environment.

Environmental testing means (automatic, manual),
The environmental test means is the substance (microbe product, reaction) specified by the reference value display input button (list) for the substance (gas, solid, liquid) given to the (microorganism) sample by the environmental control means. The reaction of the microorganisms to the environment can be measured by measuring one or both of the reference substances and the substances applied to the (microorganism) sample by the environmental control means. Based on the measured values, microorganisms can be identified and estimated, growth promoting substances can be identified, and inhibitory substances can be identified. Of course, it may be automatically activated.

[Operation]
Although it is the same as the pH spectrum, the type concentration of the reagent initially administered during the measurement is changed by the environmental control means. As a result, the pH spectrum varies. At this time, the time when the environment control means is operated is stored in the time storage means as the environment switching time.

[effect]
Since each microorganism exhibits a characteristic pH double spectrum, microorganisms can be identified and estimated more accurately than the pH spectrum. In addition, a more detailed degree of invasion (risk) to tissues such as teeth can be understood.

As described above, the pH measurement is performed by the operator through the operator input means, or automatically or semi-automatically with respect to the caries risk examination means or the pH measurement means. Then, individual pH measurement values are obtained. This value may be examined by the caries risk examination means and converted into a continuous or gradual risk value. These may be automatically performed by an internal trigger or the like, or may be operated using a measurement command display input means (MCC FIG. 17).

Furthermore, if the diagnostic means outputs that the caries risk value is large, after diagnosis, identification of individual microorganisms in the subsequent stage (identification of causative bacteria) is started (described later), and as a result, causative microorganisms with high concentrations are diagnosed. Later, it can be treated, sterilized, or reduced by a doctor's treatment or preventive measures. (Figure 2)

The output of the pH measurement means may be transmitted and communicated to other means and devices via communication means by analog or digital output.

[Effects of Examples]
An acid producing bacterium in the oral cavity uses sucrose to generate an acid, which causes caries due to the acid. Since this can be obtained a very important and direct risk information to caries risk exploratory by measuring, exploration due to high caries risk precision, ie precise examination, diagnosis and exact treatment with it, Can prevent. In addition, it is possible to measure values that lead to prompt and direct risk examination . In addition, periodontal disease risks such as NH3, identification of microorganisms by environmental tests (including susceptibility tests) and discovery of therapeutic agents can be performed.

[Second Embodiment]
The second embodiment is a gas measurement means such as NH ₃ , ammonia measurement (means), and H ₂ S measurement means. (Fig. 19)

Embodiment
Measurement of gaseous components such as NH ₃ and H ₂ S is an embodiment.

〔Constitution〕
NH ₃ measurement by hydrophobic membrane (see Fig. 19)
Gas reaction means (H (proton) reaction means)
Gas permeation means (hydrophobic membrane with pores)
Sample holding means Impermeable so-called seal (resin film)
Framework means Transparent plastic Sample reaction means (optional) Hydrophilic membrane + reagent, reagent, etc.

As a H (proton) reaction means as a gas reaction means, a filter paper (hydrophilic membrane) dyed with a solution of BPB (bromophenol blue) and dried is used.
Here, using a phosphate buffer solution, which is one of sample reaction means, and adjusting the sample so that it is almost neutral, it is better to use a single sample such as dental plaque. When this is not used, it will be an examination under the saliva buffer capacity, and reflect the current oral condition, and it is also possible to collect dental plaque with increased buffer capacity by picking up the gum and check the situation. . The gas affected by the pH pays attention to the environmental pH such as buffer capacity. The sample reaction means may be only a reagent, or may be one in which a reagent is permeated into a hydrophilic membrane.

The gas permeation means uses a hydrophobic membrane.
At this time, the porosity was 0.8 μm. This size may be any value as long as molecules and substances other than gas do not pass through, but is preferably about 1 μm or less.

The sample holding means is obtained by applying an adhesive means to a hydrophobic or hydrophilic film.
This preferably uses a gas or liquid impermeable hydrophobic membrane to prevent leakage of the sample. A so-called seal may be used. As the bonding means, those used for known seals were used. At this time, the adhesive means was applied only to the end of the seal so that the adhesive means was not added to the sample.

Framework means Made of transparent plastic.
On this transparent plastic plate having a thickness of about 15 mm × 30 mm and a thickness of about 0.3 mm, an H (proton) reaction means 10 mm × 10 mm is placed as a gas reaction means, and a gas permeation means 15 mm × 15 mm is placed on it, with a margin of 2 mm (all outer circumferences). ) And fix it. The sample holding means may be bonded to the frame means temporarily attached to a temporary mount, or may be prepared separately.

[Operation of Example]
Saliva or plaque is collected with a collection means such as a toothbrush, interdental brush, or a measuring probe.
At this time, it is preferable to use a sampling and quantification means (such as a metering probe) to quantify.
Then, a collected sample such as dental plaque is applied in the vicinity of the center of the gas permeable film in FIG.
Then, the sample is fixed on the gas permeable membrane by the sample holding means.
The whole is inverted, and the color tone of the H (proton) reaction means is observed with the naked eye or a known colorimeter.

If a blue component is generated, it is positive. This color tone change may be measured with a colorimeter, and the continuous value may be transmitted to the microbial health examination means. Here, a CCD camera and an image measuring means may be used.
With this value and the value of pH, the caries risk can be made more accurate. Also Porphyr
omonas
A colony in which aspartic acid or glutamic acid of gingivalis (hereinafter referred to as PG) was dropped as a reagent was applied in the same manner as the above-mentioned plaque, and the produced NH ₃ was observed. G. It may be used for identification.

As shown in FIG. 20, the CCD camera and the ring light source means (any of those standardized by the reflection light source may be used), preferably, the CCD camera and the light source in a light-shielded box. Provided with a device to be measured. Here, the measured object installation means is
The object to be measured, the camera, and the light source are fixed at fixed positions.

Only the gas reaction means and the framework means of the ammonia measuring means are used.
Then, the gas reaction means and the framework means of the ammonia measuring means titrated for the quantified ammonia are placed on the measured object setting means, and the color image and the ammonia concentration are stored in the storage means. As a result, a reference image and a reference value of the ammonia concentration are created. The (color) comparison means compares this reference value with the measured data to calculate the ammonia concentration. (See Figure 20)

Here, the average value means calculates the average value of the measured images, the color comparison means compares the value with the reference value, and outputs the closest value. And the density value is 0, ±, +
, ++ four-value output. Of course, values of 0, 1, 2, and 3 may be used, and values of n gradations (n> 0) may be adopted. This colorimetric means can perform colorimetry on ammonia, H ₂ S, indole, colony, and pH by switching the reference values as shown in the figure.

Further, if a known RGB image processing means is used, for example, when the gas reaction means is blue, the concentration of ammonia may be set to the intensity of B (blue image storage means). In this case, if the accuracy is further increased, JP-A-2001-0
78206 specific wavelength extraction device, JP-A-11-261844 signal expansion device, high dynamic range image receiving device, JP-A-11-258049 color identification device, color storage device, color tracking device, color code identification device, color code storage device, encoder device JP-A-11-287711 wavelength image observation apparatus, 2001-319197 information medium, information detection apparatus, information medium writing apparatus, and its use method may be used.

For the naked eye.
If a blue color develops, it is considered positive. If there is no color, it is negative.

[Effects of Examples]
Ammonia in dental plaque is one cause of bad breath. It can also be used as an index for periodontal disease. In addition, the caries risk can be further increased by NH ₃ and pH measurement values. Furthermore, ammonia and H ₂ S are reducible, and thus protect periodontal disease bacteria from oxidation, and periodontal disease bacteria themselves are ammonia and H ₂ S acid bacteria, so they are also indicators of periodontal disease risk.

[Modification]
Arginine, aspartic acid, glutamic acid or the like may be used as a reagent to record NH ₃ productivity. This helps to identify microorganisms.
The reagent used was BPB (bromophenol blue) or HCl, but other reagents may be used if possible. Phenol red and HCl, pH test paper, BTB, PR, AZY, CR, T
B may be used. Indole may be measured with Kovac reagent.
In any case including the above embodiment, it is better to adjust the ammonia detection sensitivity as a risk factor.

Here, the H (proton) reaction means having the above structure may be changed to a gas reaction means, and H ₂ S detection may be performed as follows.

As an example, the H ₂ S measuring means
Gas reaction means (such as ferrous sulfate)
Gas permeation means (hydrophobic membrane)
Sample holding means Framework means Transparent plastic Sample reaction means (optional) Consists of hydrophilic membrane + reagent, reagent, etc. (See Figure 19)

As a gas reaction means, a filter paper (hydrophilic membrane) dyed with a ferrous sulfate solution and dried. Here, the sensitivity can be adjusted by adjusting the ferrous sulfate concentration.

The gas permeation means uses a hydrophobic membrane. As an example, the hourly porosity is about 0.8 μm.
This size may be any value as long as molecules and substances other than gas do not pass through, but is preferably about 1 μm or less.

The sample holding means is obtained by applying an adhesive means to a hydrophobic or hydrophilic film.
This preferably uses a hydrophobic membrane to prevent sample leakage.
As the bonding means, those used for known seals were used. At this time, the adhesive means was applied only to the end of the seal so that the adhesive means was not added to the sample.

Framework means Made of transparent plastic.
H (proton) reaction means 10 mm × 10 mm is placed on the plastic plate of about 15 mm × 30 mm thickness 0.3 mm, and gas permeation means 15 mm is placed thereon.
× 15 mm is pasted and fixed at a margin of 2 mm (all outer periphery). The sample holding means adheres the temporary attachment to the temporary attachment sheet to the frame means.

[Operation of Example]
Saliva or plaque is collected with a collection means such as a toothbrush, interdental brush, or a measuring probe.
At this time, it is preferable to use a sampling and quantification means (such as a metering probe) to quantify.
Then, a collected sample such as dental plaque is applied in the vicinity of the center of the gas permeable film in FIG.
Then, the sample is fixed on the gas permeable membrane by the sample holding means.
The whole is inverted and the color tone of the gas reaction means is measured by the naked eye or colorimetric means.

If a black component is generated, it is positive, and the continuous value may be transmitted to the microbial health examination means.
Here, the CCD camera and image measuring means may be used.

For the naked eye.
If black color develops, it is considered positive. If there is no color, it is negative.

Here, indole production may be observed using a Kovac reagent in the gas reaction means.
However, care should be taken because this reagent is sensitive to light and concentrated hydrochloric acid is used at a high concentration.

[Effects of Examples]
H ₂ S in plaque is one cause of bad breath. It can also be used as an indicator of pathogens of periodontal disease. Similarly, indole and ammonia are pathogenic substances of periodontal disease.

[Third embodiment]
The third embodiment includes Str. (Mutans) measurement (means), Lactobacillus measurement (means), Can
dida measurement (means), Actinomyces measurement (means), Porphyromonas
gingivalis measurement (means), Actinobacillus actinomycetemcomitans measurement (means)
, Bacteroides
forsythus measurement (means), Treponema denticola measurement (means), Capnocytophaga measurement (means), Prevotella
intermedia measurement (means), Campylobacter rectus measurement (means), Selenomonas measurement (means), Eikenella
Corrodens measurement (means), Fusobacterium nucleatum measurement (means), etc.

Among the above microorganisms such as Treponema, there is a case where the culture method is not always optimal clinically, but culture may be performed if necessary.

Embodiment
Here, culture is an embodiment.

〔Constitution〕
It consists of a selective culture medium of the microorganism, a collecting means (mainly a collecting and quantifying means) and a microorganism measuring means. When using it by manual measurement, two of a selective culture medium and a collection means may be sufficient. This result is input to the health measurement examination apparatus by the operator input means.

1 Selection medium for the microorganism

2 sampling means (mainly sampling quantification means)
A paper point (especially bent paper point)
B Weighing probe
C There is a straight probe.

As an example of the three microorganism measurement means, the microorganism measurement means includes a known CCD camera, a known image input means, and a culture measurement (control) means. The risk examination means may be a risk examination means in the flow means, or may be equipped with a culture measurement (control) means if necessary. As an option, a part of the risk examination means may be incorporated, or a sensitivity test means may be adopted. (Fig. 22)

Culture measurement (control) means
One of the measurement image means and the automatic colony counting means or the manual colony counting means or a combination thereof is provided. (FIGS. 21 and 22)

As an example, the automatic colony counting means binarizes the colony image into 0 and 1,
For example, the number of zero parts is counted. More specifically, the scanning means scans the memory value (0 or 1) at the upper left of the screen, and the value 0 is continuously 0 on the screen.
The area that is being scanned is set with the scanning completion flag set, and one pixel does not set the flag.

Then, the next scan line is repeated and the same scan is repeated for the left and right to set the scan completion flag. If this continuous scanning is stopped, one colony is recognized.

If one colony is found, rescan is performed from the pixel next to the pixel for which the value of 0 is first found. At this time, the pixels having the scan completion flag are skipped. Then, the entire screen is scanned. Use such a colony operator,
Count the number of colonies on the screen.

At this time, if a plurality of colonies are overlapped and are often counted as one, that is, if the colony level is a high density such as 2 or 3, the correct number may be counted by correcting by the correcting means.

Here, if range setting means for specifying a pixel on which the colony operator operates is used, highly accurate measurement can be performed. In other words, with the dorsal probe, trace the medium in a straight line in the lateral direction of the dorsal probe (Fig. 8) (standard inoculation method), and specify the traced rectangular range with the range setting means. Therefore, the accuracy is high, and a standardized value based on the same standard can be obtained no matter who does it.

This range setting means moves the mouse with the left button down from the coordinates specified by the designation means such as the mouse cursor (left button down state), specifies a rectangular area on the screen, and presses the button at the end point Range setting means such as releasing may be used.
At this time, in order to adapt the rectangular area to the inoculation area on the culture medium, the area is dragged with the mouse and rotated by rotating means (rotating and moving with respect to the upper left coordinate axis, etc.) or dragged with the mouse to move linearly The region may be moved up and down, left and right by means. And the upper left coordinate of this rectangular area is given to the colony operator,
Scanning starts from the coordinate value.

At this time, the colony operator measures the total area of the colony, that is, the number of scan completion flags in each colony pixel. Furthermore, the colony level (density) may be displayed by the ratio of the pixels of the entire screen and the colony area in the scanned range. This determination has no error due to the colony overlap.

As an example, if the colony area / scanning area is C (%),
Colony level
0 <= C <24: 0
25 <= C <50: 1
50 <= C <75: 2
75 <= C <= 100: 3

In the manual colony counting means, as shown in FIG. 21, the operator collects the colonies in the measurement image and inputs them to the colony value display input means.

A part of the risk examination means may also be used (details are described in the ninth embodiment etc.).
Either colony risk conversion means or manual risk input means, or a combination thereof, and risk display (input) means are provided. (FIG. 21, FIG. 22) Here, the manual risk input means may be operated by a risk input button in the window of the reference image.
As an example, if PG is found at level 3 by the known colony determination method described later from the periodontal pocket, risk +++ is input.

As an example, an operator may perform a known colony density measurement. Then, the value may be input to the microbial health checkup means using a keyboard or a mouse. Such measurement is also a microorganism measurement means.

Here, the determination is based on the amount of colonies.
1 As a known determination method, the amount of colonies is determined in four stages of 0, 1, 2, 3 and the like. The density colony determination conversion means calculated from the value of 5 may be used, or the measurement image may be manually input by the operator.
2 Number of colonies Colony pixels counted manually or manually.
3 Colony area Total number of colony pixels counted by the colony operator.
4 Colony size and number distribution. Distribution spectrum with the number of colony pixels counted by the colony operator on the horizontal axis and the number on the vertical axis.
5 Colony density. As an example, colony pixels / medium pixels in the scanning area.
Use one of the indicators. It may be designated by the environment setting means of FIG. 21, displayed and input by the colony value display input means, or automatically displayed by the automatic colony counting means.

When using a sensitivity test (measurement control) means (fourth embodiment),
An automatic stop circle measuring means or a manual stop circle measuring means is provided. (FIGS. 21 and 22)

[Operation of Example]
As an example, a known selective medium (BG) of Porphyromonas gingivalis (hereinafter referred to as PG)
A). Remove the plaque on the margin with a sterile surface ball, etc., and insert a paper point into the periodontal pocket. As a specific example, a paper point (first sampling and quantifying means) is inserted into the periodontal pocket for 10 to 30 seconds, preferably about 10 seconds.

Then, the point is placed on a known PG selection medium. Then, using the quantification probe (back straight probe) that is the second sampling and quantification means, touch the back of the paper point sampling part inserted into the periodontal pocket with the straight part of the back of this straight probe. For example, and slide the spine over the medium.

At this time, the first run is performed linearly and at least once. Then, microorganisms are imparted on the medium lying next to the medium by conventional sliding. Standardized measurement can be performed by setting a range in a straight line at a time using the range setting means. And this width is
The vertical length of the dorsal probe should be used. (Here, a more detailed colony density can be measured by tracing in a straight line only once in the order of 1 → 2 → 3 → 4 as in the use example of the straight probe in FIG. 8.)
And this is anaerobically cultured for 2 days.

Here, only the first collection and quantification means may be traced on the medium for quantification. In that case, operability and quantitativeness are better when the tip of the paper point (first sampling quantitative means) is bent at an angle of 45 degrees or the like. As a specific example, a paper point having a tip of 10 mm and bent at 45 degrees is used.

Incubate for 48 hours. Then, the vicinity of the linear sliding portion is measured with a known CCD camera, and an image obtained by performing image processing with a known image input means is measured with a culture measurement control means. Here, the number of colonies, the area of the colony, the size and distribution of the colonies, the density, etc. are calculated in correspondence with the quantified colony processed by the sampling and quantification method, and transmitted to the risk examination means.

The image in FIG. 21 is an example of actual measurement, the number of colonies, the area of the colonies,
Colony size, number distribution, and density are processed into images that can be calculated. Specifically, in the case of the known PG selection medium (red), the gray level is white above the threshold, black below the threshold, or black in the blue image, white above the threshold, black below the threshold, and gray-white colonies are white, red The medium is converted into a black binary image, and the number, area, size, or distribution of the white is measured by a known image processing means.

Here, the CCD camera and the ring light source means (any of those standardized by the reflection light source may be used), preferably, the CCD camera and the light source in the light shielding means (light-shielded box), It is good to have a measurement object installation means. Here, the measured object installation means fixes the measured object, the camera, and the light source at fixed positions. Further, if the medium is transparent, a diffuse reflection preventing means may be used as the background. Further, a transmission light source means may be used to capture changes in the medium components.

Outline of operation of the latter means:
(The periodontal disease risk examination means performs a known colony counting process. The colony density is further converted into four values of 0, 1, 2 and 3 at a colony density peculiar to the means. 0
, +, ++, +++, etc., or text values such as no risk, low risk, high risk, and high risk. )

[Modification]

Spectroscopic measurement, DNA, and PCR measurement may be used for the measurement means.
Actinobacillus
(Actinomycetemcomitans) As a measurement (means), aerobic culture of TSBV medium (1
A known CO ₂ additive is used in about 2 days from the day).

Bacteroides forsythus measurement (means) uses an anaerobic culture by known TSBV. Here, traditional Bacteroides
Although forsythus has been considered to be very difficult to culture, it can now be easily cultured. Specifically, the PG selection medium (Porphyromonas
Collect the sample from the pocket in the same way as the gingivalis selection medium) and apply to the TSBV agar medium in the same way. And this is anaerobically cultured for about 2 days. Here, Aneropack (Mitsubishi Gas Chemical) which is a resin-made sealed bag for anaerobic culture as anaerobic culture means and Anerokenki (Mitsubishi Gas Chemical) as an anaerobic agent were used. (This is also one of the environmental control means.) Then, trypsin activity of the cultured colonies and morphological measurement by microscopic measurement were performed. A large number of fusiform bacteria could be observed with a microscope with trypsin activity +. However, on the TSBV agar medium, other bacteria-like images were observed, but there were many images mainly composed of spindles.

Porphyromonas
The microorganism identification means may identify gingivalis. As an example, the microorganism identification means is:
Shape (using microscope measurement means described later), trypsin-like (enzyme) activity, hydrogen sulfide, indole, (ammonia), catalase, oxidase, etc. are measured using measurement means. Using measurement means), trypsin-like (enzyme) activity, hydrogen sulfide, indole, (ammonia) +, and catalase, oxidase-are compared to the reference value. And if the same value, Porphyromonas
Display or output gingivalis.

Actinobacillus
(Actinomycetemcomitans) is a CO ₂ tablet method in an aerobic atmosphere of TSBV. (Tablets are (
Ishizuka Co., Ltd.)
As a reference value, the shape is short bacillus (uses microscopic measurement means described later), oxidase +, catalase +, acid production with a predetermined sugar is measured with the pH measurement means, and the microorganism identification means estimates and identifies with a pH curve .

Bacteroides forsythus is TSBV anaerobic culture, and spindle fungi (using microscopic measurement means described later), esculin degradability +, non-sugar degradability, and trypsin activity + are stored as reference values.

Candida uses, for example, chromoagar (Nikken Biological Co., Ltd.).
Str. (Mutans) uses MSB medium (oral care), and other Str uses MS medium.
In the sampling and quantification method, plaque is collected using a straight probe, and one of them is applied. One coating may be a straight one coating or a curved one coating, but a straight one coating is recommended.
For Lactobacillus, saliva is applied to oral care LB or SL medium or applied with a straight probe.
Actinomyces applies saliva or plaque to BHI medium with a dorsal probe.
Treponema denticola is not recommended because the culture method requires much labor and time for microscopic measurement, but it may be used.
Capnocytophaga uses Nihonsui's sheep blood agar and ID test HN-20 rapid, or TBBP medium. (Because it does not grow on Drigalsky modified medium, it may be used as a confirmation medium.) Use only bent paper point and dorsal probe or dorsal probe.
Prevotella intermedia uses bent paper points and a straight probe on blood agar. After that, check with a check medium.
Campylobacter rectus uses a modified skilow medium. Use bent paper points and a straight probe.
Selenomonas uses a bent paper point and a straight probe in a thioglycolate medium.
Eikenella corrodens uses tryptocase soi agar medium supplemented with lincomycin and ovine defibrinated blood. Use only bent paper points and dorsal probes or dorsal probes.
Fusobacterium nucleatum uses CVE media and uses a bent paper point and a dorsal probe or only a dorsal probe.

[Effects of Examples]
Since the back of the probe is linear, a certain amount of microorganisms can be applied to the agar medium under the same conditions. In the case of the PG selective medium, the amount of Porphyromonas gingivalis, which is the most ecologically aggressive bacterium of periodontal disease bacteria, is quantitatively determined. Other selective media can also be used for quantitative measurement of microorganisms according to the risk, so that highly accurate examinations can be made. If an image processing means is used, more accurate measurement can be performed. It can also be used for other microscopic measurements, sensitivity tests, ammonia, H ₂ S measurements, etc., so it is highly versatile.

[Fourth embodiment]
The fourth example is a sensitivity test means (cultivation method) for determining the susceptibility to microbial colonies in the culture means mainly used in the third example.

Embodiment
Administration of sensitive drugs to microorganisms propagated by culture, etc. to prevent their growth (
Measuring the degree) is an embodiment.

〔Constitution〕
The microorganism measuring means and the microorganism preventing means which is one of the environmental control means are employed. Here, the microorganism measuring means may be combined with the measuring means of the third embodiment or may be independent.
(Fig. 22)

[Operation of Example]
Cultivation is carried out on a medium in the third embodiment by placing a paper disk (microbe prevention means) in which an antibacterial agent desired to be sensitive to the coated surface is infiltrated at a predetermined concentration. Then, the inhibition circle (inhibition zone) is measured by the image processing means and the CCD camera. The size (diameter, area, etc.) of this circle is measured by the image measuring means and transmitted to the sensitivity test examination means. Then, there is sensitivity by cooperation with the environment control means, none or minimum inhibition concentration conversion is performed, and the value is displayed on the display means. The operator evaluates this value to determine the type of antimicrobial agent to be administered.

In the case of automatic measurement and automatic measurement by the automatic inhibition circle measurement means, when the automatic button in FIG. 21 is pressed, the contour extraction means processes the image data, and the contour of the circle is extracted. Then, the multiplication means multiplies the calibration value V calibrated by the actual image scale means. As a result, the diameter of the blocking circle is stored in the storage means.

Manual measurement by manual blocking circle measuring means A circle icon is selected in FIG. Then click the arrow cursor and a circle will appear. Place the circle on the blocking circle, and click and drag to change the size of the circle and adjust it to the blocking circle. The diameter of this circle is stored in dot conversion, and the multiplication means multiplies the calibration value V calibrated by the actual image scale means. As a result, the diameter of the blocking circle is stored in the storage means.

[Effects of Examples]
A highly sensitive antibacterial agent can be selected. Moreover, the appearance of resistant bacteria can be suppressed. At this time, since the sensitivity is measured using the sampling and quantification means, the sensitivity can be evaluated with high quantitativeness.

[Modification]
PCR, DNA, spectroscopy (described later) may be used.

[Fifth embodiment]
The fifth embodiment is a microscopic measurement (means).

Embodiment
An embodiment is to measure a sample of plaque, saliva, tongue coating, tissue, pus, etc. collected from the oral cavity with a microscope.

〔Constitution〕
It consists of a microscope, a CCD camera, image input means, and microscope measurement means. (See Figure 24)
Here, identification, estimation, environmental factors, sensitivity, and the like of microorganisms may be measured using environmental control means. Reference image means may be provided.

The microscope measurement means employs measurement image means. Here, an optical measuring means may be used in combination. The optical measuring means is composed of any one of colorimetric means, spectroscopic means, and diffraction means, or a combination thereof. As the colorimetric means, the one shown in FIG. 20 may be used. The spectroscopic means of the eighth embodiment may be used in the configuration of FIG. Also, the optical circuit of the diffracting means may be used by adjusting only the focal point using FIG.

Measurement image means
A Static measurement means
aWhen measuring with geometric measurement means such as correlation coefficient and pattern matching.
b When comparing and estimating on the screen.

B Dynamic measurement means Detects fluctuations in spatial frequency, and responds to changes in reference or standard microbial patterns, or calculates correlation coefficients to estimate specific microorganisms.

Index 1 Caries, Periodontal Invasion Factor Use of Reagent Means for Environment Control Means In the following two examples, the medicine supply slide glass (one of the environment control means) in FIG. 25 may be used. In FIG. 25, the medicine supply is one place, but any number of places may be installed.
For example, sucrose and amino acids are added from one supply channel, and pH reagent is added from another supply channel.

In the case of caries, sugar such as sucrose is used as a reagent means, and a sample such as plaque is administered to the sample from the drug supply path (drug supply means) of the slide glass for drug supply, and the pH reagent is administered from another supply path. An image from the measurement image is analyzed by colorimetric means (means of FIG. 20). In other words, the comparison means compares the measured value at an arbitrary pixel with the reference pH tone value to find the corresponding pH value. Here, a reagent such as sucrose used in the pH measuring means may be added to observe the pH trend. When amino acids such as glutamic acid and aspartic acid are used, NH ₃ that is an approximate risk value for periodontal disease can be roughly measured.

b In the case of periodontal disease, trypsin-like enzyme activity reagent is administered by reagent means, the image from the measurement image is analyzed by colorimetric means (means of FIG. 20), and compared with the reference trypsin-like enzyme activity reagent color tone value Microorganisms may be identified and estimated by means more than the means compared and corresponding.

2 Caries, periodontal protection factor (periodontal invasion factor)

a In the case of caries, the pH reagent is administered from the drug supply route, and saliva collected from another supply route is introduced. As a result, the pH indicator shifts from the acid side to neutral or alkaline side. This amount is measured by the pH measuring means. You may convert into a risk value by the risk examination in 1st Example.

b In case of periodontal disease Inflammatory cell infiltration-related especially white blood cells (including neutrophils , lymphocytes, monocytes, plasma cells
The presence / absence and concentration of white blood cells, particularly neutrophils, are particularly important for determining periodontal disease risk in microscopic measurement. That is, neutrophils appear when an infection of a microorganism such as PG occurs in a living body. The concentration varies depending on the degree of infection. There appears to be a lot of neutrophils at high concentrations of infection. Also, it seems to be less at low concentrations.

Here, the concentration of leukocytes may be measured by microscopic measurement, and the concentration of PG in the pocket may be measured by the culture measurement, and then compared by comparison means (correlation). Since high correlation exits may risk converted by transmitting the risk exploratory means neutrophils microscope measurement as an approximation concentration of PG risk exploratory means. (Since there is infection with other microorganisms, it may be a risk value with a high risk factor.)

In addition, the presence of many white blood cell destruction products, lymphocytes, plasma cells, etc. suggests that periodontal disease may continue. This may also be converted by a risk examination means.

Blood-related hemolysis (red blood cells) This may be made independent as a periodontal invasion factor or the like.

3. Pathogenic microorganisms such as periodontal disease and caries
Treponema (denticola) is determined mainly by manual (optical) values and is converted to risk.

Diffraction means:
Adjust Porhpyromonas gingivalis (PG) and PG in the microscopic image to the target of diffraction means (+). Then, a laser having a wavelength of 400 nm, or even a shorter wavelength, is focused by the focusing optical system shown in FIG. At this time, if there are diffractive elements such as pili on the surface of the cells, significant diffracted light is captured by the CCD camera.

Spectroscopic means:
Str.Mutans (Mutans Streptococci) in dental plaque shows the spectroscopic measurement of the eighth example in FIG.
7 optical circuit. At this time, the operating wavelengths are 1038 cm-1 and 1080 cm.
−1 (such as 3300 cm −1 and 1650 cm −1). The activity of Str. Mutans can be measured by the ratio of infrared absorption intensity of these two wave numbers. The operation is to match Str. Mutans in the microscopic image with the target (+ sign) of the spectroscopic means.
Here, the difference between the optical circuit of FIG. 37 in spectroscopic measurement and the optical circuit of FIG. 37 in diffracting means is that the diffracting means measures diffracted light or the spectroscopic means observes the absorption intensity of reflected and transmitted light. It is a difference.

[Operation of Example]
First, a sample such as plaque is collected from a tooth or the like by a collection and quantification means. Place the sample on a slide glass, wash with water or saline, and press with a cover glass. At this time, the medicine supply slide glass of FIG. 25 may be used. When used, environmental control means can be easily used.

An image of the sample is formed on a CCD camera, and the measured image means displays the image through a known image input means.

Manual Mode In FIG. 23, an image, that is, an example of a measurement command display means is displayed. Next to the button to display means such as microorganisms and risk values (preferably, still images and videos of microorganisms to be selected are pasted to the button by the environment setting means), and the list form of living body, invasion, There are defense, microorganism name display selection means, RD button (operation button for risk examination screen display means), etc. Also, video, still image, reference value display, colorimetry, spectroscopy, diffraction, environmental control means,
Back, Flow, MDB, Cooperation means Environmental test, Susceptibility test, Microbial identification,
A button corresponding to the above may be set by environment setting means (activated by a button).
Here, the display selection means may be a pull-down menu or a list box.

Automatic mode (automatic measurement is performed by using an automatic button in FIG. 23 or an internal trigger)
Placing the plaque collected with a measuring probe and probe-like sampling and quantification means according to the conventional method, set it on the microscope. This image is measured by a CCD camera and image measuring means. You may display this image on a screen sequentially. Here, the dynamic spatial frequency pattern is converted to a high spatial frequency (1 // by a pixel difference measuring means for detecting temporal changes of pixels at predetermined coordinates of the image.
A continuous 3D spectrum in a space of 5 to 15 μ with respect to a certain direction such as a horizontal direction or a vertical direction, with fluctuations in the range of 0.5 to 1 / 1.5 (particularly higher spatial frequency). If the fluctuation pattern of is measured, a suspicion of Treponema is displayed. This is easy using known light spot tracking information blocks.

The surgeon also checks the Treponema on the screen. If confirmed, it is input to the second periodontal disease risk examination means described later.

[Effects of Examples]
Since Treponema, which is good as a degree of periodontal disease and a treatment index, can be detected, it is suitable for treatment and prevention.

[Modification]
The pixel difference measurement means can be used for Campylob if a rapid variation of a short continuous pattern is observed at low spatial frequencies (1/1 to 1/2 (1 / μm)).
acter
Display suggesting the possibility of rectus. Low spatial frequency (1/1 to 1/2 (1 / μm
), If there is a gradual fluctuation in a space of 4 to 8 μm in any constant direction such as continuous and horizontal or vertical, Capnocytophaga is indicated.

In microscopic measurement,
Candida, Bacteroides forsythus, Treponema, Capnocytophaga, Campylobacte
r rectus, Selenomonas Fusobacterium nucleatum, Propionibacterium (V.K3 production), Leptotrichia
Rothia etc. can be measured well or approximately (note that you can and cannot make a definitive diagnosis). Actinomyces is very unclear but may be observable to some extent.

These microorganisms may be compared by reference image means. Specifically, when a standard image button (FIG. 23) is pressed, a pre-measured reference microorganism image is displayed.
At this time, this image may be displayed in a transmissive overlapping manner on a measurement image such as plaque, or may be displayed in parallel.

These measurements are examined by a periodontal disease risk examination means, which will be described later, and converted into a degree of risk.

Further, identification and estimation of microorganisms may be performed using a fluorescence coloring method or the like.
7 may be used together with spectroscopic measurement (eighth embodiment) to identify and estimate microorganisms.

[Sixth embodiment]
The sixth embodiment is DNA (RNA) measurement (means) (including PCR method).

Embodiment
Measurement of DNA (RNA) (including PCR) of cariogenic microorganisms and periodontal disease microorganisms is an embodiment.

〔Constitution〕
The DNA measuring device is composed of sampling and quantifying means and DNA measuring means.
Here, as the DNA measuring means, a known PCR measuring means is used.
Of course, RNA may be used as an index.
The bent quantification means uses bent paper points. Here, 10m from the tip
up to m is linear and bent at an angle of about 45 degrees from the 10 mm point (
It is a paper point that is single-bent. Here, the bending position may be manufactured with various values according to the pocket, and the bending shape according to the oral tissue may be curved.

[Operation of Example]
Insert a bent paper point in the periodontal pocket at the collection site.
The collected sample from the bent paper point (collection quantification means)
Measure with CR identification means (DNA measurement means).

As an example
Porphyromonas
gingivalis 0
Actinobacillus
actinomycetemcomitans 0
Bacteroides
forsythus 4,400
Prevotella
intermedia 0
Etc. results are obtained. (The detection sensitivity of this PCR method is about several.)

[Effects of Examples]
Since the collection and quantification means is used for the known DNA measurement means, the quantification is high.
Furthermore, only the tip of the bent paper point is inserted into the periodontal pocket, and the other part does not touch the oral tissue, so that accurate measurement can be performed. In addition, since the tip has a predetermined length, it is safe without breaking through the pocket bottom of the periodontal pocket at the bacterial level. Furthermore, the exudate easily penetrates to the bent portion, and the infiltrating of the exudate is difficult to exceed or does not exceed the bent portion, so that a certain amount of sample can be collected.

[Seventh embodiment]
The seventh embodiment is a disclosure of a microbial product measuring means.

Embodiment
Measurement of substances produced in microorganisms of pathogenic substances such as enzymes and toxins is the main embodiment.

〔Constitution〕
The microorganism-producing substance measuring device comprises a collection and quantification means and a microorganism product measuring means.
Here, a known trypsin-like enzyme activity measuring means is used as the microorganism-producing substance measuring means.
The bent quantification means uses bent paper points. Here, 10m from the tip
up to m is linear and bent at an angle of about 45 degrees from the 10 mm point (
It is a paper point that is single-bent.

[Operation of Example]
Insert a bent paper point in the periodontal pocket at the collection site.
A sample collected from the bent paper point (collection quantification means) is measured by a known trypsin-like enzyme activity measurement means.

Here, as an example, the CCD camera, image processing means, and colorimetric measurement means used in the second and third embodiments are used. In this case, when a CCD camera and an image processing means are used for a microscope measurement means, a culture measurement means, etc., the measurement means having the same configuration can be used with them, which is efficient.

The result is measured by colorimetric means such as FIG. Then, the value is input to the first periodontal disease risk examination means. At this time, the first periodontal disease risk examination means converts it into three values, negative (0), positive (+), and strong positive (++), and outputs it. As a specific example, the color of a reagent obtained by reacting a trypsin-like enzyme 0.01 to 1.00 (TryU / ml) with a predetermined time (for example, 15 minutes) is stored as a reference value of the colorimetric means. It is memorized as a reference value in the means. Then, the comparison means compares the reference value with the measured value, and the trypsin-like enzyme concentration is selected from the measured value based on the measured value.

As an example, a CCD camera and a ring light source means (any one that is standardized with a reflective light source) may be used.
A light source and measurement object installation means are provided. Here, the measured object installation means fixes the measured object, the camera, and the light source at fixed positions. The CCD is stored as image data in the storage means by the image processing means. As a more specific example, R,
A / D conversion is performed so that a plane of 8 bits gradation of each color of G and B is stored in the storage unit. (
FIG. 20 is used. Of course, 12-bit gradation is of course better.

Specifically, a vial obtained by reacting trypsin-active enzyme with a reaction reagent is placed in front of the irregular reflection preventing means, and an image is measured using the image processing means. Among the captured images, the threshold means selects an intensity distribution equal to or higher than the reference threshold in the blue component image, and uses the total intensity as a comparison value.

Statistical values such as maximum value, average value, and median may be adopted.

[Effects of Examples]
For trypsin-like activity (+) or higher, Porphyromonas gingivalis (PG), Bact
eroides forsythus (BF), Treponema
The existence of either denticola (TD) becomes clear. In addition, the use of either or both of the collection quantification means such as the bending point, the image processing means, or both of them dramatically increases the quantification ability, and the microbial risk can be quantified.

In addition, the conventional risk judgment with low risk, such as the sensitivity is too low and negative, but the use of colorimetric measuring means in the image processing means increases the sensitivity and enables highly accurate invasive measurement. Increased accuracy. Furthermore, the colorimetric measuring means provides a highly accurate quantitative property by reducing an artificial visual error. In addition, when used in combination with microscopic measurements, differential diagnosis with PG, BF, and TD is possible in many cases. (Ca
Attention should be paid to some bacterial species of pnocytophaga, but Capnocytophaga can be easily distinguished by microscopic measurement. )

[Modification]
A non-pathogenic substance may be measured and used as an index. One example is measuring non-pathogenic polysaccharides produced by pathogenic microorganisms and examining the estimation and identification of microorganisms. As an example, α13 glucan is measured and Str. Mutans is identified.
As a result, measurement of microbial products is a good indicator of pathogenic bacteria that are risk factors in the oral cavity.

[Eighth embodiment]
The eighth embodiment mainly discloses spectroscopic measurement (means).
Further, here, the spectroscopic measurement (means) in the environmental test (special sensitivity test) of the special measurement examination (means) is also disclosed. (Fig. 26 to Fig. 37) Special measurement examination (
Microorganism identification for identifying microorganisms by special measurement examination (means) based on information obtained from the environmental test of means) may be employed. (Here, identification of microorganisms is possible only by measuring means without using special measurement examination.)

In general, susceptibility testing is thought to mean against pathogenic microorganisms, but here it is against all microorganisms. It can also be used as a biogain (negative risk) as a means for testing antimicrobial susceptibility to pathogenic microorganisms. Means for testing drug susceptibility to symbiotic bacteria are included in biological risks. Biological risks include not only substances that have harmful factors to living organisms (including living and non-living organisms), but also protecting living organisms,
Include symbiotic organisms and substances (negative risks).

[Embodiment]
Using light (electromagnetic waves such as visible, ultraviolet, and infrared) and measuring living body risk, risk information related to living body, and the like is an embodiment.

--- Constitution -----------------------------
―――
[Constitution]
Spectral Measurement Examination Apparatus The spectroscopic measurement examination apparatus is composed of one spectroscopic measurement means and two spectroscopic examination means.
Here, the surgeon may perform an examination using only the spectroscopic measurement means, or the examination value may be input to the risk examination means by a general-purpose input (output) means.

1. The spectroscopic measurement means comprises (1) sample measurement means and (2) comparative spectroscopic measurement means. (Fig. 2
(See 6, 27, 34, 35, etc.)

The comparative spectroscopic measurement (control) means includes at least a measurement value storage means, a reference value storage means, and a comparison means. (See FIG. 26, FIG. 27, FIG. 34, FIG. 35, etc.)

Here, it is preferable that the reference value display means, the measurement value display means, and the comparison value display means are provided in that the operator visually recognizes each value and grasps the measurement content, and can perform a more accurate examination, but not necessarily. Not necessary. Further, reference value / measured value wave number matching means for matching the reference value wave number and the measured value wave number may be employed. (FIGS. 32 and 36)

Furthermore, it is preferable to provide a reference value display input (control) means, a spectroscopic measurement start button, a reference value write button, etc., because the operator can visually recognize the contents of measurement and perform a more accurate examination, but not necessarily. Not necessary. (FIGS. 26, 32, and 36)
)

Reference value display means, measurement value display means, comparison value display means, reference value display input (control) means, spectral measurement start button, reference value write button, etc.
Although it is not always necessary, it is preferable to prepare for the above-mentioned confirmation of the surgeon and the prediction of the nature of further pathological conditions, and it is effective because advanced medical care can be performed. (FIGS. 26 and 3
2, Fig. 36)
Of course, it goes without saying that a power switch is required to start the device.
Although everything may operate automatically thereafter, it is not preferable for the confirmation of the surgeon and further prediction of the disease state, but it is needless to say that the surgeon is the choice.

The comparison means, which is the main means of the comparative spectroscopic measurement means, is manual comparison, difference (addition) comparison,
Any of a combination of multiplication (division) comparison, correlation comparison, window function comparison, or a combination thereof can be employed. In other words, the comparison means are these manual comparisons,
Any one or a combination of means (difference (addition) comparison, multiplication (division) comparison, correlation comparison, window function comparison, etc.) or a combination thereof is selected or manufactured.

For example, these means may be switched by buttons as shown in FIGS. 32 and 36, or may be switched automatically, or any one or combination thereof may be selected or manufactured at the time of manufacture or operation. good. In a specific example, the correlation means is used as the comparison means, or the difference and the correlation are adopted as the comparison means.

2. Spectroscopic examination means include risk means, environmental test means (automatic and manual), sensitivity test (measurement control) means (automatic and manual) which are part of environmental test means, microorganism identification means (
Automatic, manual), or a combination thereof. Here, the risk means may be equipped with any means in a screening means or a combination thereof (linkage means, microbial health examination means, each means of microbial health examination means, etc.). (FIGS. 26, 32, and 36)

The risk means employs one of spectral value risk conversion means (automatic), manual risk input means, or a combination thereof. (FIG. 26) Here, the two spectral value risk conversion means (automatic) and the manual risk input means may be switched by a risk manual automatic examination button or the like. (Manual automatic diagnosis (button) in Fig. 32 and Fig. 36)

At this time, the state where the manual automatic examination button is pressed is automatic and the state where the manual automatic check button is not pressed may be determined by the environment setting means, and the operator can turn on and off with two buttons. It may be determined by the environment setting means.

The manual risk input means should preferably be adopted, and the surgeon uses an operator input means such as an examination display input means while referring to any one or a combination of measured values, reference values or comparison values. Is what you enter. (Diagnosis screen (Diagnosis display input means) in the following figure in FIG. 32 and FIG. 36)
This examination display input means can display (name of examination, standard, measurement, risk, etc.) name, risk value (degree), remarks, and the like, and further, the operator can rewrite the contents.
This is effective because it is suitable for the operator's confirmation and predicting the nature of the disease, and it is effective because it allows advanced medical treatment, and the operator can perform highly accurate examinations by grasping the contents of the examination. Although it is preferable, it is not always necessary.

And here, the spectral value risk conversion means (automatic) automatically displays the contents of the examination on the examination screen, but here again the surgeon adds and changes the contents using the display input means on this screen it can.

The examination display (input) means may be a display alone or a diagnosis display input means having both display and input. Each means such as environmental test means (automatic, manual), sensitivity test (measurement control) means (automatic, manual), microorganism identification means (automatic, manual), which are part of environmental test, are automatic, manual or both May be provided. (Fig. 26
, FIG. 32, FIG. 36)

In the above apparatus, method, and means, any one or a combination thereof is selected and manufactured and operated.

―――――――――――― １． Spectroscopic measurement means ―――――――――――――
――――
1. Spectroscopic measurement means

(1) Sample measuring means (Either A extracorporeal sample measuring means or B biological measuring means is adopted.) (FIGS. 26, 27, 34, and 35)

A. In vitro sample measurement means.
The extracorporeal sample measuring means mainly includes a known spectroscopic measurement module and an extracorporeal measuring means. (FIGS. 27, 34, and 35)

α: The spectroscopic measurement module measures and outputs the amount of absorption and light emission at a predetermined wavelength of the sample using a light source, a sensor, and a control means. This can utilize output light and the sensor part which measures the light. The light is adjusted from the light output portion so as to be incident on the sensor portion in the form of a beam. If an object to be measured (sample) is placed in this beam optical path, spectroscopic measurement can be performed. In addition, the control part is controlled to adjust the light intensity, wavelength, frequency, amplitude, duty ratio, degree of modulation,
What can control coherency, a carrier wave, etc. from the outside is desirable. (Fig. 28)

β: Extracorporeal measuring means The extracorporeal measuring means comprises at least a framework means and a sample holding means. (FIG. 31) Moreover, you may install in a spectroscopic measurement module using an arbitrary movement table and a frame fixing means. (FIG. 29) As a specific example, the extracorporeal measurement means comprises the frame means and the sample holding means in FIG. 31, and is installed in the spectroscopic measurement module as shown in FIG. In FIG. 31, the sample holding means is fixed to the frame means by fitting or bonding, and the gap between the two sample holding means becomes the sample insertion means for inserting the sample. A frame means is installed so that the inserted sample does not leak from the side surface.

Here, as shown in FIG. 31, two (plural) sample holding means are employed, and a sample is inserted into the gap (sample inserting means), but one sample holding means as shown in FIG. 29 (solid line portion). A sample may be applied to and measured. Further, here, the collection and quantification means may be used to increase the quantification.

Of course, it is also possible to measure by inserting three or more samples into a plurality of gaps. At this time, the inter-insertion means transportation means may be installed between the respective insertion means of the sample holding means, and the diffusion and transportation of the sample in each insertion means may be performed. The inter-insertion means traffic means may be a hole, or may be a selective insertion interstage traffic means in which a traffic volume control means such as a valve is installed in the hole or a filter is inserted into the hole. These insertion labor steps can dynamically and automatically measure the reaction and response of a sample by administering a reagent or the like to the sample. When these are used, it is possible to remove a high molecular matrix (glucan, etc.) such as dental plaque and measure low molecular components, or to measure a sample obtained by filtering bacteria with a porosity filter of about 0.2 μm. As another example, the structure of FIG. 48 may be adopted.

Sample holding means The sample holding means is means for holding a sample as shown in FIG. Here, it is made of BaF ₂ (barium fluoride). As an example, the dimensions are 10 x 10 mm and 1 m thickness
m (1-2 mm). When sugar is measured, a thickness of about 1 mm or less is good. Of course, the absorption intensity correction may be performed to use a thicker one, or the absorption intensity correction may be performed by an examination means.

Here, the material of the sample holding means may be changed according to the wavelength. CaF ₂ as an example,
Examples thereof include Si (silicon), Ge (germanium), KRS-5 (TlBr-TlI), zinc selenium, quartz, borosilicate glass, polyethylene, and polypropylene.

Framework means The framework means is made of resin, metal, ceramics or the like.

Installation of the extracorporeal measuring means The extracorporeal measuring means is installed in an available part of the beam optical path. In a specific example, the sample holding means in FIG. 31 is fixed to a Z-axis moving table or the like, and the measurement site such as the center of the sample holding means is positioned on the measurement beam of the spectroscopic measurement module.
FIG.

B. Biological measuring means The biological measuring means mainly comprises a known spectroscopic measurement module and a biological probe.
The living body probe employs any one of a single optical path probe, a double optical path probe (two optical paths in the figure), a mirror probe, a waveguide probe, or a combination thereof. (
(Fig. 30)
At this time, a mirror or a beam splitter is used as the optical path of the electromagnetic wave diagnostic apparatus for the beam optical path, and the optical path is formed so that the light of the spectroscopic measurement module is guided to the probe and the light from the probe is guided to the sensor unit. (FIG. 30) As an example, the optical probe in FIG. 30 is made of the above-mentioned spectral wavelength transmissive material, and a black portion is coated with a spectral wavelength reflection film such as gold, aluminum, chromium, etc. Only part of the coating is not reflective. Then, the beam from the spectroscopic measurement module passes through the waveguide, and this beam passes through the grip portion, and is absorbed and reflected by the external contact tissue at the sensor means portion. The wavelength absorption intensity at this time is reflected by the reflecting means, receives the same absorption intensity again, passes through the gripping means, and returns to the spectroscopic measurement module.
Here, the probe tip may be a coating type such as a, b, c, d, e, f, and may be used according to the purpose.

The C environment control means includes any one or a combination of reagent means, atmosphere adjustment means, electromagnetic wave irradiation means, medium wave applying means, and the like.
The environmental control means includes the A. Used when necessary for extracorporeal sample measuring means, B biological measuring means, especially A means. For example, it is used for microbial environmental tests, susceptibility tests, microbial requirement nutrient tests, or microbial identification that are part of environmental tests. Of course, it may be used for manual examination, manual and automatic measurement. It goes without saying that the environmental control means may be used in other embodiments.

α: As an example of reagent means,

a Antibacterial agent Used mainly for susceptibility testing. It is administered to a biological microbial sample or a standard microbial sample, and the amount of one or both of the required nutrients and metabolites is comparatively measured, and the activity, that is, the sensitivity to an antibacterial agent, is observed. Or, it is used when measuring changes in specific proteins, sugars, and lipids in microorganisms and measuring them as sensitivity. Furthermore, identification and estimation of microorganisms can be performed.
Etc.

b Requirement nutrients To measure and detect nutrients required by microorganisms, administer them to microbial samples. Thereby, identification and estimation of microorganisms can be performed.

c pH reagent Administered to measure the pH of the sample. pH is OH- or NH without the use of a pH reagent.
A shift amount such as ₃ may be measured. In addition, microorganisms can be identified and estimated.

d pH adjuster Controls the pH value of the sample, controls the reaction, finds the optimum pH, and uses it for identification and estimation of microorganisms.

e Medium component agent Only specific microorganisms are selectively cultured by administering specific selective medium components. In addition, microorganisms can be identified and estimated. Non-selective medium components may be used for a wide range of microorganisms.

f Atmospheric conditioner Adjusts the liquid and gas components of the sample. Thereby, growth of microorganisms or pathogenicity promotion, and conversely, growth and suppression of pathogenicity can be measured. Then, identification, estimation, treatment or prevention of microorganisms can be performed.

g Microbial agents other than the measurement target Microorganisms other than those contained in the sample are administered to the sample. The reaction differs depending on whether the microorganism is a symbiotic microorganism or an antagonistic microorganism. Examples of coaggregating microorganisms include PG and BF. P as a microorganism that suppresses Str.
.G. Etc. These reactions enable identification, estimation or risk prediction of microorganisms.

Promotes or inhibits the growth and pathogenicity of other microorganisms such as the microbial product bacteriocin, NH ₃ , and acids. These can also be used for bacterial flora control, which is one of the environmental controls.
Identification, estimation and risk prediction of microorganisms. As an example, PG etc. decreased and Str.
The development is promoted and as a result, the caries risk increases. The reverse is also true.

β: Atmosphere adjusting means The atmosphere adjusting means is means for applying a gas, liquid, solid preparation to the sample, or the selective permeation means in the sample holding means, and the atmosphere adjusting means.

Specifically, the optical path (beam) portion in FIG. 23 is covered with a blocking means for blocking from the outside, and the atmosphere of this chamber is controlled. As an example, it is covered with a metal or resin blocking means, and the inside is sucked with a vacuum pump and then replaced with CO ₂ . An example of this gas, and the like _{85% N 2, 10% H} 2, 5% CO 2.

γ: electromagnetic wave irradiation means The electromagnetic wave irradiation means is means for irradiating the sample with electromagnetic waves such as radio waves, visible light, ultraviolet light, and infrared light.

Only a specific reaction can be selected by promoting or suppressing a specific reaction. Moreover, the wavelength, intensity | strength, amplitude etc. which can be used for a treatment can be discovered and selected by this result.

δ: Medium wave applying means The medium wave applying means is means for applying vibration, sound wave, ultrasonic wave or the like to the sample.
The sample non-uniformity can be made uniform. The reaction rate can be increased. Only certain reactions can be accelerated. Moreover, the wavelength, intensity | strength, amplitude etc. which can be used for a treatment can be discovered and selected by this result.

The above information can be used for treatment, prevention, diagnosis and the like. Moreover, what can be used as a therapeutic agent can be discovered. For example, using environmental control means, measuring the response of pathogenic microorganisms, and if the pathogenic microorganisms can be suppressed, they can be considered as therapeutic or preventive drugs.

(2) Comparative spectroscopic measurement means In FIGS. 26, 27, 34, and 35, the comparative spectroscopic measurement means comprises at least a spectral value storage means, a reference value storage means, and a comparison means. Then, any one or a combination of comparison value storage means, time generation means, storage means switching means, time storage means, threshold value means, trigger signal generation means, etc. may be selected, manufactured, and incorporated. If necessary, a measurement value display means, a reference value display means, and a comparison value display means are provided. At this time, each display means may be a display input means, or an input means may be provided separately.

A. Spectral value storage means The spectral value storage means is a storage means for storing spectral values from the spectral measurement module.

B. Reference value storage means The reference value storage means stores the spectral values from the spectral measurement module and the external input means. In particular, a sample such as a microorganism or a known drug is stored and compared with a measured value.

C. Comparison means
Manual comparison means, difference (addition) comparison means, multiplication (division) comparison means, correlation comparison means,
Any of window function comparison means or a combination thereof may be employed. The standard value and the measured value are compared by the means, and the sensitivity test, environmental test, microorganism identification, risk examination, etc. are performed. Each of the comparison means is a comparison with the same wave number. However, the wave number shift comparison means may be used in combination to compare different wave number values or value groups. Further, an amplifying means for amplifying the intensity of the reference value or the measured value (| G |> 0) may be used.

α: Manual comparison means As an example, the manual comparison means activates the reference value display means when one of the reference value display input means is selected in FIG. Then, the operator compares the reference value of the reference value display means with the measurement value of the measurement value display means, and compares both values. In this case, the reference value display means may perform semi-transmissive display by the semi-transmissive means.

β: Difference (addition) comparison means The difference (addition) comparison means calculates a difference between measurement values or a difference between a reference value and a measurement value. It may be an addition of a negative value.

γ: Multiplication (division) comparison means The multiplication (division) comparison means calculates a ratio between measured values or a ratio between a reference value and a measured value.

δ: correlation comparison unit The correlation comparison unit calculates a correlation (coefficient) between measured values or a correlation (coefficient) between a reference value and a measured value. In addition, the correlation comparison means may use an intensity adjustment means for amplifying the intensity of the measured value or the reference value to maximize the correlation coefficient.

ε: Window function comparison means The window function comparison means multiplies (divides) a measured value as a window function and the measured value.
Alternatively, multiplication (division) with the measurement value is calculated using the reference value as a window function.

Useful options:
Oa comparison value storage means The comparison value storage means stores the output value from the comparison means.
When the surgeon compares the reference value displayed by the reference value display means with the measurement value displayed on the measurement value display means and inputs a risk value or a risk factor, the comparison value storage means is not necessarily required. If there is, it is convenient.

Ob time generation means The time generation means generates (measurement) time from before and after the start of measurement. There may also be a pre-trigger function that operates before measurement.

Switching means of the Oc storage means The switching means of the storage means switches the location of the storage means for storing the spectral values.

Od time storage means The time storage means stores the time when the spectral value is stored and the time when the comparison means calculates the comparison value.

The Oe threshold value threshold value means stores the output value in the comparison value storage means when the output value of the comparison means exceeds the threshold value. Then, the time at that time may be stored in the time storage means.

Of trigger signal generating means The trigger signal generating means outputs a signal so that the comparative spectroscopic measurement is started when the spectral value is output. When equipped, the measurement can be automatically started and ended when a sample signal is generated, such as when the sample is touched with the probe or when the sample holding means is installed in the optical path. In this case, measurement or examination can be performed with only the power switch.

Og Start signal (input) means The start signal (input) means receives a start command from the outside and starts measurement.

When equipped, the diagnostic value display means, standard value display (input) means, and comparative value (input) display means as useful options that enable further examination of the disease state, risk, etc .:

D Measured value display means A means for displaying the memorized measurement value in the result of measurement manually or automatically by the spectral measurement start button or the trigger. (See FIG. 26, FIG. 32, FIG. 36, etc.) As shown in FIG. 32, measurement 1, measurement 2, measurement 3, etc. are displayed for each measurement (each time the spectroscopic measurement Start button is pressed). Here, as an example, the screen is erased by pressing the spectroscopic measurement button for 5 seconds. Of course, you can create an erase button or insert it into a pull-down menu. The buttons, list, menu, etc. can be changed by the environment setting means according to the operator's preference like other buttons and lists. You can,
The arrangement of this embodiment is recommended.

E Reference value display (input) means
The reference value display input means selects and displays the reference value stored in the reference value storage means. As an example, there are an operation by a button means and an operation by a list means.
The operation of the reference value designated by the button means can be changed by the button changing means in the environment setting means. The list means can search, select and change all reference values.

An example of the button means is the reference value display button in FIG. As an example α1
When the 3 button is pressed, the α13 glucan value (absorption intensity curve or spectrum) is displayed on the reference value display means. This display can also be performed on the measurement screen by the environment setting means.

An example of the list means is a list box displaying the reference value display text in FIG. Here, the left is a reference value display, and the right is a display of comparison value display means. Furthermore, a slider is equipped on the right end. These displays can be changed, added, and deleted by the environment setting means. (Same as other buttons, lists, screens, etc.)

When this reference value display text is selected, the same display as the button means can be performed. It goes without saying that if you operate the slider to the right of this list box, you can slide and check more reference values and make selections.
Furthermore, this reference value display text also supports input as a reference value display input means when settings that can be added or changed by the operator can be made by the environment setting means.

As an example,
α13 glucan, α16 glucan, fructan, POx, OH, Ig (antibody), A1 (
Amide 1), A2 (amide 2), NH ₃ , H ₂ S, COx, Sac (sugar), AmA (amino acid)
, Lip (fatty acid), Vt (vitamin), Nuc (nucleic acid), Ref

“Here, amide 1 and amide 2 usually use the numbers written in the drawings (FIGS. 32, 33, 36, etc.), but they are outside the provisions of the JPO. In this regard, we call for improvement. "

There is a standard value. One selection may be made or, of course, a plurality may be selected. In that case, the overlap display may be performed on the reference value display means, or the (peak) composite value by the composite means may be displayed. These display settings are also made by the environment setting means.

When entering the reference value,
(1) When storing a measured value as a reference value As an example, the measured value stored in the measured value storage means is stored in the reference value storing means by pressing a reference value writing button. At this time, the reference name in the reference value display text of the list means is displayed with a default title of “new reference value” as an example. The surgeon replaces the default name with the name of the substance corresponding to the reference value and saves it.

(2) When inputting from outside through general-purpose input / output means.
General-purpose input means from FD, MO, CD, DVD, etc. are used and stored in the reference value storage means.

Here, the reference value display means is
The reference value designated by the reference value display (input) means is displayed. When a plurality of reference values are designated, the overlap means may display the overlap, or the (peak) composite value by the composite means may be displayed.
The operator registers in the environment setting means whether or not the reference value display means is activated when the reference value display button of the reference value display input means or the reference value display text in the list means is pressed.

F Comparison Value Display (Input) Means The display of the comparison value display means is, for example, the comparison value portion of the list box in FIG. In this place, the comparison value is basically displayed. The surgeon can input, change, add, and delete. These settings are also made by the environment setting means.

―――――――――――― １． Spectroscopic examination means ―――――――――――――
――――
2. Spectroscopic examination means

A Risk means (spectral value risk conversion means, manual risk input means)
As an example, the risk means starts with the button means of the reference value display input means,
Convert spectral values to risk values manually or automatically.
The spectral value risk conversion means is activated when the reference value display input means designates a specific reference value and the automatic button is pressed, and automatically calculates the risk value while comparing the spectral value with the reference value or threshold value.
The manual risk input means is activated together with the reference value display means as an example, and the button means of the manual risk input means is displayed in the display frame. Then, the reference value and the measured value are compared manually or automatically, and the surgeon selects a risk value.

Here, when performing an examination while checking the measured value, reference value, and comparison value, the measured value display means, reference value display (input) means, comparison value display (input) means, etc. are used. It is preferable to do this.

B Examination display (input) means,
The examination display (input) means displays the reference value or the risk substance and the risk value corresponding to the reference value. Here, if the surgeon has a problem with the risk value, it can be changed. (Refer to FIG. 32, FIG. 36, etc.)

Describes environmental tests as special measurement diagnostics as useful options, and susceptibility tests that are a part of them, and microbe identification (means) using them.

C Environmental testing means (automatic, manual),
The environmental test means is the substance (microbe product, reaction) specified by the reference value display input button (list) for the substance (gas, solid, liquid) given to the (microorganism) sample by the environmental control means. Production, etc.), control and environmental control means (
The reaction of the microorganism to the environment of the microorganism can be measured by measuring either or both of the substances applied to the sample.

Of course, using an unknown substance as an index, activity evaluation means that evaluates the activity of the microorganism as 0 when the activity of the microorganism is large, medium, small, or no reaction when there is any peak or reaction may be adopted. At this time, especially when the administered substance is set as an antibiotic, it is called a susceptibility test, but this is very important for infectious diseases, so it was an independent button although it was part of the environmental test. Similarly, there are cases in which microorganisms can be identified as a result of environmental tests, but since microorganism identification is very important in dentistry, it was also made independent. Here, microorganisms can be identified and estimated from the measured values and the like, and further, growth promoting substances useful for microbial treatment, prevention, and flora control can be identified, and inhibitory substances can be identified.

D Sensitivity test (measurement control) means (automatic, manual),
The sensitivity test (measurement control) means mainly tests the sensitivity of the antibacterial agent to microorganisms.
Test the susceptibility to microorganisms by administering an antibacterial agent to the medium means inserted in the sample holding means and the microbial sample, and spectroscopically comparing the required nutrients, products and structural changes between time and reference values Is.

The selection of the motion sensitivity reference value is input to the reference value display input means by the reference value display input button (list). Then, the sample and the medium means are installed in the sample holding means, and measurement is started. For example, if a certain threshold is not exceeded within a certain time, it is determined that there is sensitivity. Alternatively, a measurement test may be automatically performed by pressing a sensitivity test button.

Then, in the case where the case where the antibacterial agent is not administered is used as a reference value, if the measured value at a predetermined time decreases as shown in Measurement 1, Measurement 2, and Measurement 3 in FIG. To do. Of course, a sensitivity test means for automatically calculating the degree of sensitivity, time, etc. may be used. As an example, a structure that indicates that there is sensitivity when the value falls below a threshold in a comparison value with a reference value when no antibacterial agent is administered is adopted. These may be means in a virtual space or may be complete hardware.
In another example, a means may be employed in which the presence or absence of a metabolite of a microorganism causes no sensitivity when it is present (poor) and when it is absent.

E Microorganism identification means (automatic, manual),
The microorganism identification means searches for a microorganism that corresponds to the substance or the like specified by the reference value display input button (list) (difference comparison, wave number comparison, correlation comparison, window function comparison, manual comparison).

F Manual examination means Manual examination means
A means for performing display input for the operator's confidence to manually perform the examination while the operator visually recognizes the measured value by the measured value display means and the reference value by the reference value display means for the environmental test of the microorganism identification sensitivity test, etc. is there.

――― Operation ―――――――――――――――――――――――――――――
―――
[Operation of Example]
1. Operation by flowchart means:
As an example, spectroscopic measurement and spectroscopic examination operate according to the screening means of FIG. 1 and the flowchart means of FIGS. Of course, an independent device may be used, but the functionality of diagnosis, treatment, and prevention is higher when controlled by a screening means or a flowchart means.

Turn on the health measuring device. Then, the screening means is activated, the screening means display input means is displayed on the screen, and a standby state is entered. (Figure 1)
Then, the microbial health examination (button) of the examination means is selected. A screening box for microbial health checkup (screening-microbial health checkup interface) is actively displayed, and a microbial flow chart means is displayed. (Fig. 2, Fig. 33)

A. Launching a screening procedure from a microbial health checkup
(1) The microbial health checkup means starts from the selection checkup means for caries, periodontal disease, and carcinogenic factors, and starts from the check box of the flow chart means in FIG. Choose a caries or periodontal disease or a parallel flow. Here, carcinogenic factor measurement may be used in combination or independently. As an example, the flow is selected and a command is input by pressing a flow line displayed on the flowchart means.

(2) Invasion, measurement of defense factors (spectral measurement activation, parameter transmission)
When the biological factor, the defense factor, and the factor in the biologically invasive factor in FIGS. 33 and 44 are selected, a pull-down menu is displayed as an example, from which a spectroscopic measurement is selected. Then, the flowchart means transmits this parameter to the spectroscopic measurement means, and measurement starts.
The reference value storage means stores reference values such as biological factors, defense factors, and biologically invasive factors. Further, the comparison value is compared with the reference value stored in the reference value storage means by using the measurement value measured by the measurement means, and the comparison means performs comparison of correlation, difference, etc., and outputs a value for estimation or identification. This value is examined by the examination means described later and converted into a risk value (risk degree).

(3) First risk examination (spectral value or invasive defense factor concentration-risk value conversion means)
The first risk examination outputs a large risk if the invasive substance or protective substance (including cells) measured by the spectroscopic measurement exceeds the level of a healthy person. Spectroscopic examination means may be performed, or general-purpose first risk examination means described later may be performed.
If the risk is high, proceed to Diagnosis 1 or Diagnosis 4. If the risk is small, return to the screening box of the microbial health checkup (screening-microbial checkup interface). From here, the screening means may be returned, or the flow means of the microbial health examination means may be continued.

(4) Diagnosis (Diagnosis 1, Diagnosis 4)
Diagnosis 1 and diagnosis 4 determine whether invasive substances and protective substances (including cells) identify microorganisms that cause a large risk, or whether to prevent or treat without specifying them. This is mainly determined by the operator using the operator input means, and the flow proceeds. Specifically, a diagnostic display input unit is displayed, and the direction in which the flow proceeds is input. As an example, if you press the line segment of the flow that proceeds, you can enter that flow.

(5) Pathogenic microorganism measurement (spectral measurement activation, parameter transmission)
When identification of the causative microorganism is instructed from diagnosis 1 and diagnosis 4 through the flow line, measurement of pathogenic or symbiotic microorganisms starts. As an example, Phase 1 (Priority 1) to P
The operator selects and inputs the microorganism measurement at each stage up to hase 3 to the microorganism measurement input means. This parameter is transmitted to the spectroscopic measurement means, and measurement starts. Further, the linked risk examination means of the flowchart means may determine the name of the microorganism estimated to correspond from the spectroscopic measurement such as an invasive factor, and the spectroscopic measurement may be automatically started. As an example, “Sa
c ”button (Sac: sugar), select sucrose from it, Sac
-Sucrose degradation value +++ and / or α13 glucan generation value +++ and tooth invasion measurement value are input to the risk means linkage If the microorganism identification means is activated according to the flow, the Str. Mutans automatic measurement is linked Risk assessment means identify and estimate.

(6) Second risk examination (spectral value or microbial concentration-risk value conversion means)
The second risk diagnostic means converts the value of the pathogenic or symbiotic microorganism into a risk value.
Spectroscopic examination means may be performed, or general-purpose first risk examination means described later may be performed.

(7) Diagnosis (Diagnosis 2, Diagnosis 5)
The examination display input means displays the examination contents. The surgeon sees it and makes a diagnosis. As an example, since the caries risk is very high, therapeutic preventive measures are taken. Since the risk of periodontal disease is low, maintenance is continued. If you have time, test the flora and check the risk value. Etc. Based on this result, whether to proceed to flow prevention / treatment or diagnosis 6 to diagnosis 3 is input to the flowchart means using the operator input means. When proceeding to Diagnosis 3 or Diagnosis 6, there is a display of diagnostic display input means (or an operator presses the Diagnosis 3 (6) button to activate), screening means, caries risk examination, periodontal disease risk examination , carcinogenesis. The surgeon instructs the flow chart means using the surgeon input means to flow any factor combination or a combination thereof.

(8) Treatment, prevention, diagnosis (treatment, diagnosis at the time of prevention, comprehensive diagnosis)
If it is decided from the diagnosis 2 or diagnosis 5 that treatment or prevention is performed, this button is pressed. (The automatic start-up treatment / prevention menu may be displayed by the treatment / prevention / diagnosis display input means.)

(9) Environmental test and susceptibility test Here, susceptibility test means and environmental test means are used if necessary to investigate drugs effective for pathogenic microorganisms, meals, and the like.

2. Operation independent of flowchart:
Start spectroscopic measurement and spectroscopic examination from the shortcut button of the screening means.
Then, measurement and examination are performed according to the operator's idea.
――――――――――――― Main routine ―――――――――――――
-

―――――――――――――― Sub routine ――――――――――――――
―――
In the flowchart means, the spectroscopic measurement means of the spectroscopic examination device is activated by the command and parameters from the invasion and defense measurement of (2) and the microbe measurement of (5) above, and the means and processing according to the passed parameters The measurement display input unit of the spectroscopic examination apparatus may be activated without parameters, and parameters may be input again using the reference value display input unit.

The parameters are values such as {reference value, measurement microorganism name, invasion, defense, biological factor name, microorganism identification, environmental test, sensitivity test, manual examination}. When the parameter is transmitted to the spectroscopic measurement means, the measurement display input means is activated, and the reference value specified by the parameter becomes active. Of course, the operator may reduce or add the reference value as necessary.

A sample is collected by a collection and quantification means or the like, and the sample is applied and inserted into the sample holding means of the extracorporeal measurement means. Alternatively, the living body probe is brought into contact with and inserted into the tooth and periodontal pocket.
Then, the spectroscopic measurement module starts the operation in response to a command from the comparative spectroscopic means or an operator's operation.

Basic operation of comparative spectroscopic measurement The comparative spectroscopic measurement in FIG. 27 compares the reference value with the measured value.
The spectroscopic measurement module performs spectroscopic measurement, and the spectroscopic value is stored in the spectroscopic value storage means. The comparison value is compared with the reference value stored in the reference value storage means. The value is stored in the comparison value storage means. Alternatively, the data may be output without being stored, but it may be recorded if there is a storage means.

2. The comparing means compares the intensity of a certain wavelength or the intensity of a certain spectrum pattern every predetermined time, and stores the comparison value in the comparison value storage means. Further, the time when the comparison value is stored may be stored in the time storage means at the same time. (Fig. 34)
The spectroscopic measurement module performs spectroscopic measurement, and the spectroscopic value is stored in the spectroscopic value storage means. At this time, the switching means of the storage means operates by the time generation means so that the measurement value is stored for each measurement time. The measured values are stored for each measurement time. The measured value at a certain time and the measured value at a certain time are compared by the comparison means. (As an example, changes such as Measurement 3, Measurement 2, and Measurement 1 in FIG. 36 can be measured.)
In FIG. 34, the measurement value is compared with the measurement value of the previous time. However, the measurement value may be n times before or a plurality of arbitrary measurement values may be compared. The value is stored in the comparison value storage means.

3. When the output of the comparison means exceeds the threshold value as shown in FIG. 35, the comparison value is stored in the storage means. The stored time value may also be stored in the time storage means.
The spectroscopic measurement module performs spectroscopic measurement, and the spectroscopic value is stored in the spectroscopic value storage means. At this time, the switching means of the storage means operates by the time generation means so that the measurement value is stored for each measurement time. The measured values are stored for each measurement time. The measured value at a certain time and the measured value at a certain time are compared by the comparison means. (In the figure, it is compared with the measured value of the previous time.
Any plurality of measured values may be compared. Then, when the value processed by the comparison means exceeds or falls below the threshold value of the threshold value means, the value is stored in the comparison value storage means. The threshold value and the conditions at this time (the directionality such as whether the value is above or below the threshold value, the threshold property such as whether the value is included or not included, or a Schmitt trigger) are set by the environment setting unit.

Here, the comparison means is any one of or a combination of manual comparison means, difference (addition) comparison means, multiplication (division) comparison means, correlation comparison means, window function comparison means, etc., and is transmitted from the examination means and flowchart means. The selected parameter may be selected and operated. The examination means may be a general-purpose examination means described later.

A. Tooth invasion and defense measures in the flow chart means:

As an example of using manual comparison means or difference comparison means, α13 glucan wave number (intensity X) and phosphate-related substance wave number as reference values (example)
Select intensity Y) and compare the intensity with a comparison means. If the value is X> Y, the comparison value input means at the upper part of the display section of the reference value display means is 0, ±, + (1
), ++ (2), ++++ (3). At this time, when the A button is pressed, the risk value risk examination means is automatically started, X and Y are automatically compared, and converted into risk values +, ++, and +++. This result is displayed on the examination display (input) means through the risk conversion means. For example, Str.M. 3 × 3 is a value of 9c, or a correlation coefficient of 0.95 is a value of 2.85 × 3, a caries risk +++, and the like. At this time, Mutans' Rx for caries risk was set to 3. Here, α13 glucan is described as an indirect invasive factor, not a direct invasive factor.

As another example, the generation value of Sac and lactic acid or α13 glucan is passed as a parameter, the button of the reference value display input means of the measurement display input means becomes active, and the reference value display means is displayed. At this time, the risk may be input by selecting a manual button, or automatic risk conversion may be performed by pressing the automatic button or the A button.

Other examples disclose susceptibility testing or microbial identification. That is, PG is separated and cultured in a known selective medium (liquid). (Refer to the section of culture measurement) Then, the culture solution is inserted into the sample holding means in the figure. At that time, amide 1 (and 2) of the first measured value
Is stored in the storage means. Then, the n-th (n> = 1) measurement value and the comparison means sequentially compare. (See figure)

“In this case, amide 1 and amide 2 were originally expressed in numbers as shown in FIG. 32, FIG. 33, and FIG.

Here, when the comparison means is the correlation means (including the reference value storage means), the correlation coefficient is 0.9.
Identification is made at a point exceeding zero. In addition, the same value is considered to be sensitive. Even in this example or other examples, it is recommended that final judgment (diagnostic action such as identification) and confirmation be performed by a doctor, and that these mechanisms should be a support operation to the last.

In the case of these measurements, the quantitative value may be stored in the storage means together with the risk value.
In that case, this reference value is input to the reference value-amount corresponding value storage means,
The quantification means searches the measurement value and the reference value so that the difference comparison means converges to an output of 0, and makes it correspond. At this time, the quantitative means may use multiplication comparison or correlation comparison instead of the difference.

Example using window function comparison means:
The window function comparison means uses a certain measurement value as a window function and multiplies it with the measurement value or
The multiplication with the measured value is calculated using the reference value as a window function.
As an example, the measured value of Str. Mutans is used as a window function. Then in the collected plaque
If Str.Mutans dominates, the value in the comparative spectroscopic measurement means using the window function means increases. Here, Str. Sobrinus sanguis mitior
Use a function such as mitis milleri salivarius and compare the ratio by calculating the ratio. Further, an absorption curve of α13 glucan and α16 glucan which are main polysaccharides of dental plaque may be used as a window function. Furthermore, a window function with a Gaussian distribution curve of 1038 cm −1 may be used.

Example using correlation comparison means:
The window function comparison means uses a certain measurement value as a reference number, correlates it with the measurement value, or
The correlation between the reference value and the measured value is calculated.
As an example, the measured value of Str. Mutans is stored in the reference value storage means as a reference value. Then, if Str.Mutans predominates in the collected dental plaque, that is, the value in the comparative spectroscopic measurement means using the correlation comparison means between the measured value of the plaque and the reference value is about 1. Here, Str. Sobrinus sanguis mitior
A correlation value may be obtained using a function such as mitis milleri salivarius. Further, an absorption curve by α13 glucan and α16 glucan which are main polysaccharides of dental plaque may be used as a reference value. Furthermore, a reference value based on a Gaussian distribution curve of 1038 cm −1 may be used.

A correlation coefficient between a reference value and a measured value in a specific microorganism strain, biological defense factor, biological factor, or the like may be calculated.

Example using multiplication (division) comparison means:
Obtain the value of the bacterial product α13 glucan from the measurement means,
The value of the internal reference material is obtained from the measurement means, and the two values are divided by the comparison means (multiplication (division) comparison means). Specifically, α13 glucan intensity value (intensity at 1038 cm −1) / internal reference substance value (intensity at 1080 cm −1), where f =
α13 strength / 1080 cm-1 strength. And if f> 1, the risk is +
And so on. If f = 1, output ±, if f <1, output low risk.

An example when the parameters include environmental tests and sensitivity tests.
The comparison means compares the intensity of a certain wavelength or the intensity of a certain spectrum pattern every predetermined time, and stores the difference in the difference storage means. The time when the difference value is stored is also stored in the time storage means at the same time. Here, when the threshold means is used and the output of the comparison means exceeds the threshold, the time and value at that time may be stored in the storage means. In that case, it is convenient to perform judgment of the environmental test and the sensitivity test in binary. Further, multi-value determination may be performed.

Here, it is also possible to quantitatively and qualitatively measure biologically produced inflammatory substances, identify them, and perform risk conversion.

The reference value may be a value input from an external input means, a mathematically created value,
It can be a function.

In the flowchart means in FIG. 33, an example of the environment control means (parts different from the flowchart means in FIG. 2) is described in each flow box. As an example, with regard to periodontal protection, bromophenol is used as an environmental control means for measuring the antibody concentration by measuring the displacement of the three-dimensional structure of the antibody in order to measure the concentration of the antibody released from the living body. If the shift of amide 2 is measured at this time, the diagnostic means will judge that the higher the concentration of antibody production +, the greater the risk. Others described the main environmental control means. For bacteria, correlations (comparisons) are useful for all types of bacteria, so the correlations were listed together with environmental control means.

“Here again, amide 2 is normally represented in FIGS. 32, 33 and 36.”

[Modification]
A spectroscopic examination device may be attached to the microscope as shown in FIG. In this case, visual recognition and spectroscopic measurement can be performed on the same sample at the same time. In this case, the slide glass (under the cover glass) is made of a transmission material for spectroscopic analysis, and the cover glass is coated with gold, aluminum, chrome, etc. on the slide glass side. The coating is visible enough to transmit visible light from the bottom (not shown) and pass through the objective lens, and is thick enough to reflect light from the bottom such as IR, visible, and ultraviolet for spectroscopic analysis. Is adopted. This circuit is particularly useful in IR.

Here, in the case of IR, the slide glass is made of BaF2, CaF2, KRS-5 (TlBr-TlI), zinc selenium, or the like. The cover glass may be made of any material as long as it transmits visible light.

[Effects of Examples]
Spectral measurement and examination can be performed for most measurements and examinations of microbial health measurement examinations with a single device. It can also measure and examine health with excellent accuracy, sensitivity, and speed. Furthermore, there is little waste such as consumables used for inspection.
Measurement and examination of major diseases such as caries, periodontal disease, bad breath, and carcinogenic factors can be performed at once. Moreover, since sensitivity tests, microorganism identification tests, required nutrients, microbial products, and the like can be measured, disease treatment and prevention can be performed with high accuracy.

Difference comparison, multiplication comparison, correlation comparison, and window function comparison mainly consist of sensitivity tests, identification of pathogenic microorganisms such as environmental factors or symbiotic microorganisms, or the risk of product of these microorganisms, required nutrients, pathological conditions, etc. Very useful for examining. In addition, manual comparison enables more advanced risk measurement and examination according to the experience of the operator.

[Ninth embodiment]
The ninth embodiment is an explanation of the skeleton part of a health (measurement) examination apparatus. That is, it is a description of means for integrating and controlling part or all of the measuring means and the examination means. (FIGS. 1 to 5 and FIGS. 38 to 47)

Health (measurement) examination device
Microbiological (health) examination means,
Mechanical (health) examination means,
Spatial image (health) examination means such as position form,
Aesthetic (health) examination means,
Other hard tissue disease (health) examination means,
Other examination methods for soft tissue diseases (health),
Eating habits (health) examination means,
Consists of psychological (health) examination means. It is the screening method that integrates it. (Figure 1)
Here, if necessary, an environment setting unit for adding a new examination unit to the examination unit or deleting one of the examination units may be provided.
Here, the microbial health examination means, which is one of the examination means, will be described below.

[Embodiment]
The flowchart (means, method) shown in FIG. 2 is an embodiment of the microbial health examination means. (Microbial is a name for diseases mainly related to microorganisms. In this health check, not all health check-ups depend on microorganisms.)
Here, in the flow (chart) means of FIG. 2, a part of the flow (chart) means is manufactured, for example, by producing only the caries flow means or by selecting and producing only the periodontal disease flow means. Alternatively, the environment setting means may display or input the display input means for only the necessary flow means.

[Constitution]
――――――――――――― Outline of Flowchart Method ―――――――――
-
The flow chart (means) consists of one or more risk measurement means, one or more risk measurement means.
Risk examination means. When there are one or more measurement values, reference values, comparison values, risk values, diagnosis values, etc., it is convenient that one or more linkage (risk) means are provided. (Refer to FIG. 47) The measuring means can output a value of one or a combination of a measured value, a reference value, and a comparison value. The risk examination means can output a risk value. The diagnostic means has a diagnostic value.
If these methods are used, it will be a business model in the clinic.
Here, the risk measuring means uses the above-described measuring means or known measuring means.
The risk examination means will be described later.
The cooperation (risk) means will be described later.

Further detailed means for realizing these are shown in FIGS. 1 to 48. FIG.
pH measuring means, gas measuring means, microscope measuring means, culture measuring means, microbial product measuring means, PCR measuring means, DNA measuring means, RNA measuring means, spectroscopic measuring means, ammonia measuring means, H ₂ S measuring means, indole measuring Means, environmental test means, susceptibility test means (sensitivity measurement means), microbial identification means, etc., or any combination thereof, input means, output means, control means, storage means, here further display means Equipped with surgeon input means. Furthermore, it is convenient to equip the trigger means.

Here, the measurement means may use other measurement means, such as risk checkup and linked risk checkup , etc. Microbiological health checkup (such as connecting or controlling other measurement means like OS of microbial health information ( Means and methods) may be used flexibly.

Here, the flowchart means is displayed on the display means via the output means, and the flow box and the connection line flow line (line) which are the processing means (squares) as the constituent elements are used as the display input means. This input / output (display) means is a necessary element of the flowchart means. Of course, you can use interactive input / output means like a conventional dialog box, but this flow chart means you can grasp current information (position) in a complicated flow and large information more easily. It is recommended because it is easy to do. (See Figure 44)

Here, the flowchart (means) in FIG.
May be used as an operator input means unique to the present invention. As an example of the configuration operation, each means is activated by clicking a square portion (flow box) in the drawing and a flow line (flow line) which is a connection line with a mouse or a pen. (Fig. 44)
By default, when the right button is clicked on the flow box, a pull-down menu appears, and the target measurement is started with the left button. When the flow line is double-clicked, the cooperation means is activated. These operations can be added, deleted, and changed by the environment setting means, but this style is recommended.
Then, the current position, that is, the position representing the current state of treatment, prevention, examination, etc. of the patient is used as the position of the flowchart (position of the flow box or flow line), and the situation display means transmits it to the surgeon by changing the brightness and color. Further, the status display means may distinguish the past status by color.

When the surgeon clicks the flow box of the flowchart means with a pen or a mouse, a pull-down menu shown as an example in FIG. 45 is displayed, and when one of them is selected and activated, a measurement command display input means (MCC) (measurement value, reference 1 or any combination thereof (FIG. 17, FIG. 21, FIG. 23, FIG. 32, FIG. 36), etc. are activated. Of course, only one measurement command display input means may correspond to the flow box, or the environment setting means may be set so that only the examination value is seen by automatic measurement or automatic examination.

The environment setting means is convenient because the setting can be changed according to the skill from beginner to expert, but in the flowchart means of the microbial health checkup means, at least either caries or periodontal disease, Preferably, both of them are to be selected by the environment setting means. Because the dentist's main job is dentistry 2
This is because it is in the prevention and treatment of caries and periodontal disease, which are major diseases.

On the other hand, when the flow line is double-clicked or the like, the cooperation means (see FIGS. 44 and 43) is activated, and examination information (FIG. 40), diagnosis information (FIG. 41), treatment prevention information (FIG. 4).
2) Coordination (risk) information (Fig. 43) and progress information (current guidelines, their history, etc.) (Details are displayed in Fig. 39 and sorted by date. History is also shown in the remarks column. Is displayed.) Is displayed.

Here, it is possible to proceed from this current position where the luminance is changing, or to stop at this position while checking the progress. In addition, the first visit patient has the chief complaint, inspection, X
The flow chart may be advanced by the surgeon freely selecting the Start button from a medical examination such as a line. Of course, it is possible to enter from the examination button (means) at the first examination. When the response control in the cooperation (means) cannot be received, the examination (diagnosis) information which is lacking by the cooperation (risk) response correction means may be input to receive the service.

When the operator clicks a predetermined part (FIG. 38) of the screening means (FIG. 1) with a pen or a mouse, measurement information (any one or combination of measurement value, reference value, comparison value) (FIG. 39) , Examination information (FIG. 40), diagnosis information (FIG. 41), treatment prevention information (FIG. 42), cooperation (risk) information (FIG. 43), and progress information (current guidelines, their history, etc.) (FIG. 39) You can see the history by detail display and sorting by date.
In the remarks column, describe the findings such as guidelines. 40, 41, and 42 can also be displayed in detail by the environment setting means. ) Is displayed.

―――――――― Cooperation (Risk) Means ――――――――――――――――
―――
Then, connection of the flowchart {requires connection of any input (means), output (means), or input / output (means) of each process as a necessary condition, and if it is necessary to perform response control of their mutual operation, response control (Means) are also required. } Is cooperation (means). The linkage (risk) means is an interface at some times, a connection to conduct specific microbial item inspections such as microbial identification at other times, and a response control means that sometimes applies a known servo loop or feedback loop theory. . (here
The linkage (risk) means for conducting a risk examination is the linkage risk examination means. This is part of the linkage (risk) means. )

Cooperation (risk) means (cooperation means) can freely operate and display two values. One is a value (CV, MV, RV, DV, TPV) in each layer, and the other is a response control value (Response Value: Res. V.). However, the response control value is
This is optional because it is unnecessary if there is only one measured value or if treatment prevention wishes do not loop.
CV (CV for short): Clinical
value
MV (MV for short): Measuring
value
RV (RV for short): Risk
value (If negative, that is, include Gain.)
DV (DV for short): Diagnostic
value
TPV (TPV for short): Treatment
& Prevention value
Furthermore, it may have a reference value for microorganisms (required nutrients, products, inhibitors, etc.) and a reference value for diseases (biochemical reference values, image values, physical values, etc.) as reference values. In that case, a comparison means for comparing with the measured value is provided. Thereby, microorganism identification and disease identification become possible.

Specifically, screening means, flow line of flowchart means, each measurement command display input means (MCC), each measurement display input means (MDB), each examination (risk value) display input means (RDB), diagnostic display input means It can be activated by pressing a cursor, pen, etc. from a treatment prevention display input means or the like to a display input means such as a button, line, picture, list or text, or by double-clicking. When activated, the value of the activated hierarchy is displayed as shown in FIG. Here, when activated from the flow line, the history of the normal flowchart, that is, all past recorded values measured, examined and diagnosed as shown in the flowchart are displayed. For other activations, the value of the activated hierarchy is normally displayed. This display setting is also performed by the environment setting means. Past flow line history? Similarly, whether to go back in the year is set by the environment setting means.

Response control value (Response Value: Res.
V.) (ResV for short) can be activated from a linked (risk) means as an example. Of course, it is also possible for the environment control means to set only the response control value to be activated from the flow line.

In other words, the structure and effect of the cooperation (risk) means is
1) When both risks become oscillating in the mutual servo loop (including feedback loop) of caries risk examination and periodontal disease risk examination , the risk can be effectively converged to the optimum value.
2 Use as a feedback loop for risk assessment ,
3 Collecting, analyzing, and judging microorganism identification factors as an example in cooperation with each measuring means. Disease identification as a frequent example.

As an example, the response control means in the linkage (risk) means antibacterial factors against periodontal disease caries bacteria, factors such as acid mitigation of tooth invasive substances by ammonia generation, antibacterial factors against carious periodontal bacteria For example, the servo loop and the feedback loop are adjusted so that the caries risk and periodontal disease risk converge optimally as a servo loop having conflicting factors.

As a specific example, periodontal treatment reduces NH3 and antibacterial factors such as bacteriocin against caries microorganisms. As a result, there is a risk of caries. Decreasing caries microorganisms also reduces the antibacterial factors for periodontal disease bacteria and increases the risk of periodontal disease. Both are best reduced and converged with non-pathogenic resident bacteria, in which case the convergence condition of the servo loop, which is one of the response controls of the linkage (risk) means, is unnecessary.

As another example of the response control means in the cooperation (risk) means, the trypsin enzyme activity measuring means that measures periodontal invasion factor outputs a positive reaction, and the microscopic measurement that measures periodontal defense invasion factor is treponema, spindle fungus If the presence of a white blood cell is not detected, and a white blood cell is detected, the cooperation (risk) means can connect these three inputs to each other and examine it. And it is possible to search for the possibility of existence of Porphyromonas gingivalis that is not directly measured. Thus, each value or diagnostic value of the measuring means input to the health examination means is always compared and estimated by the microorganism identification means of the linkage (risk) means based on the microorganism identification table as one of the reference values. Can be identified and monitored. Further, the disease finding value may be stored in the storage means as a reference value, and the measurement value and the examination value may be compared by the comparison means to identify and estimate the disease.

The linkage (risk) means is used as a kind of feedback loop for a single examination such as periodontal disease risk examination , and it is connected so that the prevention and treatment of the disease converge to the best state from the bad state. Also good. A loop constant may be set in the response control means of the cooperation (risk) means so that the disease converges by this feedback.

Individual constituent means of the flowchart (means)
Risk examination
Risk examination (means) is a means to convert measurement values into risk, risk level, risk value,
Is the method.

In the examination screen (diagnosis display input means) in FIG. 17, FIG. 21, FIG. 23, FIG. 32, and FIG. Specifically, a risk conversion means prepared for each measurement is used.
Risk (conversion) means (0 to 4 are automatic)

As an example, risk value =
0. Rx x comparison value, (measured value, reference value)
As an example, in FIG. 21, the comparison values are colony density, 0, 1, 2, 3, etc., where Rx is 1
It is.
In FIG. 23, the density of the object in the image. (PG density, etc.) As an example, the PG area ratio in one screen, in this case, Rx uses a multistage threshold value conversion means of 0-25-50-75-100%. More specifically, the number of PG pixels / total pixels x R
x etc.

At this time, Rx is 0 or more and less than 25 0
25 or more, less than 50 1
50 to less than 75 2
75 or more but less than 100 3

In FIG. 17, Rx takes a multi-step threshold conversion means, for example (minimum pH).
For example, a value of −0.5) × −2, (reference time pH value−5.5 + correction value) × −2, and a correction value such as −0.5 is adopted as an example.
1. Rx x correlation value x (measured value / reference value)
2. Rx x correlation value x difference value
3. Rx x difference value
4. Rx x (Measured value / Reference value)
5. Manual risk input value
In FIG. 17, FIG. 32 and FIG. 36, Rx takes a value peculiar to this value.

Rca: caries invasive risk converter Rcm: caries protozoan risk converter
Rpa: Periodontal disease risk converter Rpm: Periodontal pathogenic microorganism risk converter
Rot: A real number that takes a value such as other risk transformers.
Vector values with different dimensions (dimensions). Therefore, if the dimension of the comparison value or the measurement value is Dm and the dimension of the risk value is dm, the dimension is dm / Dm. Since the dimensions are different here, a coefficient that eliminates the difference between the individual dimensions may be created, and the total value may be calculated as the total oral risk value.

―――――――――――――――― Caries Risk Examination ――――――――――
―――
1 Caries risk examination (means)
A treatment-necessary hierarchy First caries risk examination (means)
Tooth invasion, defense factor measurement (means)
The first caries risk examination (means) inputs a specific pH value from the pH measurement means.
The specific pH value is a static value, a dynamic value of the lowest pH, a time to reach the lowest pH value, a time pH area, a delta pH, a reference time pH, and the like.
And it converts into a risk, a risk degree, or a risk value, and outputs any one or the combination of the value.

B preventive hierarchy second caries risk examination (means)
Mutans streptococci
(Streptococcus Mutans etc.) Phase 1

Lactobacillus
Phase 2

Candida
Phase 3 (1)
(Especially Candida
albicans Final Phase )

Actinomyces Phase 1 priority 2 in the dentin

Phase 1 priority3 as other microorganism
Streptococcus sanguis
Streptococcus mitis
The measurement value of any one or combination thereof is input, and any one or combination of risk, risk degree, risk value, etc. is output.
Specifically, compared with a reference such as a reference substance (including microorganisms), comparison values such as density and concentration are measured by the measuring means. Of course, 7.0, such as pH, may be a reference value, and the measured value may be a direct comparison value, or the comparison value may be output as a measured value using the critical pH value as a reference value. A value obtained by risk-converting these comparison values (measured values) is a risk value. The risk value may be expressed simply as the text of risk, may be expressed as the degree of risk, or may be expressed as a value such as a real value or integer value as the risk value. If selected, various arithmetic processes can be used for examination and diagnosis, which is advantageous for high-precision examination, diagnosis, unknown risk, and statistical processing. The risk level and risk are convenient for human beings to understand. These may be used after timely conversion.

The risk is a text value in the normal human conversation format of the risk of getting a disease. An example is “You are very at risk of getting caries”. Here, (1) No risk, singing, small, large, large.
(2) The degree of risk is an evaluation value other than numerical values (excluding 0) such as 0 for no risk, + for small risk, ++ for large risk, and ++ for maximum risk.
(3)
Here, the risk value is a stepwise numerical value, and n stages (n, 0, 1, 2, 3)
> = 0) may be an integer value or a real number.

As a specific example, the comparison value often takes n-stage values (n is an integer) such as 0, 1, 2, 3, 4 and the like. (In many cases, human beings take multi-step values such as colony area and pH value, but it is recommended to convert to a step value (standard value) by colony level or critical pH (as a comparison value by comparison means). is there.

However, a risk converter specific to each measurement is prepared to standardize the risk value (
It may be a normalized value. The former is easy to understand because the scale of the value is the same even in various measurements, and the latter is easy to see the pure value of the measurement itself. These values may be displayed side by side, or may be selected and displayed.
These settings are made by the environment setting means. )
Specific conversion will be described later.
―――――――――――――――― Caries Risk Examination ――――――――――
―――

―――――――――――――――― Periodontal Disease Risk Examination ――――――――
―――
2 Periodontal disease risk examination (means)
A Therapeutic hierarchy First periodontal risk examination (means)
Inflammatory substances, factors (measurement means)
The first periodontal risk examination (means) inputs a value from the periodontal defense factor measurement means or the tooth invasion factor measurement means.
And it converts into a risk, a risk degree, or a risk value, and outputs any one or the combination of the value.

B preventive hierarchy Second periodontal risk examination (means)
Phase 1
Priority1
Porphyromonas
gingivalis
Bacteroides
forsythus

Priority2 ( Phase 1)
Prevotella
intermedia
Actinobacillus
actinomycetemcomitans
Treponema
denticola
Capnocytophaga

Priority3 ( Phase 1)
Campylobacter
rectus
Selenomonas
Eikenella
corrodens
Fusobacterium
nucleatum

Here, Actinobacillus actinomycetemcomitans and Bacteroides forsythus may be in reverse order. These priorities are changed by the environment setting means as soon as pathogenicity becomes clear.

Priority4 ( Phase 1)
Prevotella
Prevotella melaninogenica
Peptostreptococcus
Peptostreptococcus micros
Streptococcus
Streptococcus constellatus
Streptococcus intermedius
Streptococcus anginosus
Streptococcus sanguis
Streptococcus mittis
Streptococcus salivarius
Streptococcus acidominimus

Staphylococcus aureus
Staphylococcus epidermidis
Actinomyces
Pseudomonas
Neisseria
Veillonella
Klebsiella
Enterococcus
Enterobacter
Serratia
Clostridium
Pasteurella
Peptococcus

Propionibacterium
Rothia
Corynebacterium
Leptotrichia
Eubacterium

Planococcus
Ruminococcus
Coprococcus
Sarcina

Phase 2
Lactobacillus

Phase 3 (1)
Candida especially Candida albicans
Final Phase

The measurement value of any one or combination thereof is input, and any one or combination of risk, risk degree, risk value, etc. is output.
Specific conversion will be described later.
―――――――――――――――― Periodontal Disease Risk Examination ――――――――
―――

―――――――――――――――― Caries Risk Examination ――――――――――
―――

Here, the caries risk examination will be described in detail. The input value and output value of the first caries risk examination means are:
Input value: Output value

A plaque Basically, 4-level output from 0 to 3 as a multistage threshold conversion means (of course, n stages are possible, n> = 2).
Risk Risk level Risk value
(pH 5.5 + correction value) or more: Small risk (0)
(0)
Less than (pH 5.5 + correction value) (pH 5 + correction value) or more: Risky (+), (1)
Less than (pH 5 + correction value) (pH 4 + correction value) or more:
Large risk (++), (2)
Less than (pH 4 + correction value): Large risk (+++), (3)
However, the threshold is different in the reagent, the amount of plaque, and the measurement item. The correction means may add the following correction value to the threshold value. In that case, more accurate examination can be performed.

The risk value and the threshold value are examples, and the risk value and the threshold value can be changed by an operator here. Further, it may be sequentially changed by an operator input means with reference to a sample such as a document. Furthermore, the learning means may obtain an optimum value from the clinical value examined. In this case, the optimum value for each region can be found. Furthermore, environmental problems for oral diseases such as caries and periodontal disease in the area can be discovered, so that further advancement of regional medicine can be achieved.

1. Static pH measurement correction value is 0
2. The minimum pH measurement correction value is
a Reagent 5% Sucrose only aqueous solution pH 6.5
+0.5
b Aqueous solution with 5% sucrose, 0.9% NaCl, 1 mM NaHCO3, pH approx. 7
. 7
0
c 5% sucrose, pH 7.0 aqueous solution with NaOH as pH adjuster 0
However, the above correction value is when the reagent amount is 50 μl and the quantitative plaque of the sampling quantitative means is 0.28 mm ³ in volume. These correction values may be changed by the surgeon as appropriate.
7
3. The reference time correction value is 0.

For measurements with different dimensions,
The threshold value in the time pH area value area measurement is (pH 5.5 + correction value), where (the correction value is
Represents the correction value of the above reagent.
0 means low risk (0)
If the value is positive, there is a risk (1)
You may set more finely.

Delta pH:

Second caries risk examination means
When there is an input from the Start unit or the diagnostic unit, the display unit displays whether or not the Phase 1 microorganism measuring unit is activated or whether there is a past measurement value as a minimum operation. Of course, all items of microorganisms may be displayed.
Murans, a Phase 1 microorganism
streptococci level (input value): output value 0: risk value 0
1: Risk value 1 +
2: Risk value 2 ++
3: Risk value 3 +++

Level (input value) of Lactbacillus which is a Phase 2 microorganism: Output value When the risk value of periodontal disease is 0: Risk value 0
1: Display of investigation of risk value 1 + dentin, secondary caries restoration.
2: Risk value 2 ++ Dentin, secondary caries restoration, investigation, if any, display treatment.
3: Risk value 3 +++ Shows treatment of dentin, secondary caries restoration.
In addition, in risk 2 and 3, excessive intake of sucrose and the like is investigated.
When periodontal disease is present and the degree of risk is 2 or more, the treatment of periodontal disease is displayed.

Phase 3 (1) Level of Candida (input value): Output value 0: Risk value 0
1: Shows the survey of risk value 1 + dentine, secondary caries restoration.
2: Risk value 2 ++ Investigation of dentin and secondary caries restorations, and displays the treatment if the result.
3: Risk value 3 +++ Shows treatment of dentin and secondary caries restoration.
Pay special attention to root surface caries. Is displayed.

Actinomyces
0: Risk value 0
1: Risk value 1 +
2: Risk value 2 ++
3: Risk value 3 +++
The display pays attention to dentin and root surface caries.

B saliva 5.5 or less Risk value 3 ++++ 3
7.1 or more and less than 7.5 Risk value 0
7.5 or more and less than 8.0 Risk value -1-(Gain)
8.0 or more Risk value -2-(Gain)

1 standard time pH value
2 Maximum value pH (Including initial maximum value of plaque pH measurement)
3 delta pH measurement means 4 hour pH area measurement means

C Foreign substance pH measurement means Ingested food (pH 5.5 + correction value) or higher: Small risk (0) (0)
(PH 5 + correction value) or more and less than (5.5 + correction value): risk (+), (1
)
Less than (pH5 + correction value) (pH4 + correction value) or more: Large risk (++), (2
)
Less than (pH 4 + correction value): Large risk (+++), (3
)
The correction values here correspond to food and dental plaque microorganisms.

As an example,
5% sucrose aqueous solution pH 6.5
Correction value = (0 + Str. Mutans level value), where Str. Mutans level value is 0,
Four values of 1, 2, 3.
As an example, at Str.Mutans level 3, the correction value is +3: Risk +++.

Here, on the examination screen (diagnosis display input means) in FIG. 17, FIG. 21, FIG. 23, FIG. 32 and FIG.
2) or continuous value evaluation may be adopted, but it seems that evaluation of about 4 or 5 levels may be easy to understand. (The risk value here may be a multi-stage value or a continuous value, and the overall risk value may be an n-level evaluation such as a 4- to 5-level evaluation. In this case, the overall risk may be viewed while comparing the risks here. However, it requires considerable skill of the surgeon, but a highly accurate examination can be performed.) This display value can also be changed by the individual operator using the environment setting means.

D Standard or reference sample pH measurement means Same input / output values and correction values as plaque pH.

E Sample pH measurement means from the oral cavity
Use the measuring means from A to D according to the sample.
―――――――――――――――― Caries Risk Examination ――――――――――
―――

―――――――――――――――― Periodontal Disease Risk Examination ――――――――
―――
The periodontal disease risk examination (means) will now be described in detail.

The input value and output value of the first periodontal disease risk examination means are:
Input value: Output value Value from periodontal disease protective factor measurement means Inflammatory cell infiltration Especially leukocytes (especially neutrophils , lymphocytes, monocytes, plasma cells, eosinophils, etc.):
+++
Examination information for treatment and prevention may be output in association with the stage of inflammation and the individual white blood cells .
Antibody: ++

Value from periodontal disease invasive factor measurement means Trypsin-like enzyme: +, ++ Concentration value toxin: Concentration risk is set according to the type.
Other products: Set concentration risk according to type.
These concentration risks are added, multiplied, subtracted, and divided for output. This is because destruction does not occur unless the invasive factors generally exceed the defense factors of the living body.

When there is an input from the Start unit or the diagnostic unit, the display unit displays whether or not the measurement unit of the Priority 1 microorganism of Phase 1 is activated or whether there is a past measurement value as a minimum operation. Of course, all items of microorganisms may be displayed. It goes without saying that whether or not to display these or which measurement to select is an operator's decision.

As an example, the input value and output value of the second periodontal disease risk examination means are input value: output value
Detection of Phase 1 Priority 1 microorganisms: Risk per species +++ or 3
Detection of Phase 1 Priority 2 microorganisms: 1 risk + + or 2 per species
Detection of Phase 1 Priority 3 microorganisms: 1 risk + or 1
Addition value obtained by adding the above scores to the microorganism measurement, or concentration risk value that uses the total value of the detected microorganisms weighted by the microorganism concentration, or Phase X Prio
If the rityY microorganism is detected, the risk value in the table, the multistage threshold conversion means, or a combination thereof may be calculated as the risk value. At this time, the maximum value may be set or the maximum value may be infinite.
Detection of Phase 2 microorganisms: Risk unknown Risk-Maybe.
Detection of Phase 3 microorganisms: Risk 1.5

The degree of periodontal disease P1, P2, P3, P4, P1, P2, and P3 use Phase 1 Priority 1 or Priority 2 or Priority 4 or a combination thereof, and P4 cases have Phase 3 risk. May be used.
As described above, if the risk of Phase 3 or Final Phase microorganisms is determined according to the phase of the infectious disease, a more accurate diagnosis can be made. However, as an example, Phase 1 to Phase 3 may occur instantaneously depending on the vitality of the organization. In such a case, all of Phase 1 to Phase 3 are used. Specifically, it is the case of life-threatening such as immunodeficiency and terminal cancer.
As another example, P1 and P2 use Phase 1 Priority 2 to Priority 3, and P3 Pha
Use se1Priority4.
Phase 2 may be used together.

here,
Detection of Phase 1 Priority 1 microorganisms: 1 in Rx
Detection of Phase 1 Priority2 microorganisms: Rx 2/3
Detection of Phase 1 Priority3 microorganisms: Rx 1/3
It is also good.

As an example,
Phase 3 executing the flowchart means presence or absence of dental caries, or Phase 3 whether caries (
(Measurement) may be input to the tooth type corresponding to the measurement tooth of the dentition oral cavity expression means such as the examination means, and the result may be displayed on the examination value display input means as 0 or none. Phas
If e3 caries is detected, follow the flow chart means and further measure and examine.

As another example, the following display may be displayed on the diagnostic value display input unit by the cooperation unit.
When Phase 1 Priority1 microorganisms are present and caries is not present:
Periodontal disease risk factor +++ 4
When Phase 1 Priority 2 microorganisms are present and caries is not present:
Periodontal disease risk factor +++ 3
When there are no phase 1 microorganisms and no caries:
Periodontal disease coefficient 2
As above, the above coefficient may be applied to the risk value of periodontal disease.
Here, an upper limit may be set in the calculation of the risk value, or may not be set, but it is easy to understand within about 5 stages.
It is up to the operator to decide which risk calculation value should be stored and adopted in the examination means.
―――――――――――――――― Periodontal Disease Risk Examination ――――――――
―――

――――――――――――― Caries prevention treatment (means, method) ――――――――
-
If the result of the second caries risk examination means is risky or more than risk 1, the countermeasure in the examination result is displayed and the result is input (standby).
Take Phase 1 as an example,
Mutans streptococci Level 3 is displayed and the countermeasure is displayed.
If the risk of Mutans is large, drugs such as NaF, SnF2, and chlorhexidine, and PTC are displayed.
And the fact that it was used is input to the preventive treatment means. Then, the flowchart means proceeds to “diagnosis”. Here, the surgeon determines whether to continue the caries risk examination , return to the screening means, or proceed to the periodontal disease risk examination . If you click this diagnostic (button) means at this time, the history (caries risk information, periodontal disease risk information, linkage (risk) information, other examinations, diagnostic information, etc.) to determine which route is optimal is displayed. Is done. Based on this, the surgeon selects the route of the flowchart means. Here, this diagnosis may be performed by artificial intelligence means, but the last confirmation (button) means should be provided to the operator.

――――――――――――― Periodontal disease prevention treatment (means, method) ――――――――
-
If the result of the second periodontal disease risk examination means is risky or more than risk 1, the countermeasure in the examination result is displayed and the result is input (standby).
If the output of a periodontal disease risk check is large, (++++), 3 or large, (++), 2,
As an example, the use of antibacterial agents and the removal of plaque, tartar and inflammatory substances are output, and risk information (history) is displayed as necessary. If medium (+), risk information (history) is displayed.

Once treatment and prevention measures are determined, the surgeon performs treatment and prevention. As an example, scaling, SRP, and (PMTC) are performed sequentially. At this time, this process is carried out within one week of administration of antibacterial agents (azithromycin dithromac, new quinolone spara, etc.). Then, after one week, it proceeds to the input position of periodontal disease risk examination through the FeedBack loop which is a cooperation (risk) means. At this time, the diagnostic means displays that the route to the screening and the caries risk examination has a low priority.
A periodontal disease risk examination is performed as described above. As a result, if the risk is high, the flow (periodontal disease risk examination ) is performed through periodontal defense and invasive factor measurement.

After the periodontal disease examination, the flowchart means proceeds to “diagnosis”. Here, the operator determines whether to continue the periodontal risk examination , return to the screening means, or proceed to the caries risk examination . If you click this diagnostic (button) means at this time, the history (caries risk information, periodontal disease risk information, linkage (risk) information, other examinations, diagnostic information, etc.) to determine which route is optimal is displayed. Is done. (For other examinations and diagnostic information,
Based on this, the surgeon selects the route of the flowchart means. Here, this diagnosis may be performed by artificial intelligence means, but the last confirmation (button) means should be provided to the operator.

[Operation]
Screening means in virtual space on a computer and screening means realized with complete hardware. In any case, it is preferable to use display input means as shown in FIG.

The screening method realized with complete hardware is
It is desirable to prepare as many screening means as the number of patients so that there is no data interference for each patient, and activate and operate the following screening means.

The screening method in the virtual space on the computer is
As an example, an executable file and a patient management folder are created in the virtual space of the computer as shown in FIG. Here, there is a screening means as an executable file (application file), which is used for the first activation. (Fig. 47)

When this screening means is double-clicked (selection activation) or the like, a screening means object is created. At this time, a dialog box requesting the patient's name at the minimum is generated. When the patient's name is entered in this dialog box, the patient's name is displayed in the title bar of the screening means, and the file name is the patient name data file (as an example) An extension .DNF (Diagnostic Navigation File) is generated in a name management folder such as a tree on an OS such as Windows. If the name is Tomoyo Nonomura, it will be generated in the “Nayuki” holder. This will be activated from the next time. In addition, when the same name is input, if the same person is the same person, the DNF file may be activated, and if another person with the same name has the same name, the same name may be used.

In addition to the name, an integer value may be used as the ID for requesting the lowest source, but the name is more human.

Data is managed by the name as the ID, that is, only one person's data (.DNF) is managed and processed by one execution file or one program called a screening means, so it is unlikely to be confused with other people's data. In other words, it is safe because personal data is not confused only by communication between applications.

Of course, if other databases are used as the above-mentioned patient information management means, and functions such as statistics between patients are used in other programs, it may be possible to confuse data between patients, Create a safety means in other programs, or install a duplicate data matching means that always duplicates and matches the same data as the DNF, which is a dedicated data file for the examination means, in the examination means, and references this duplicate file externally If two changes are made, the consistency is checked by the consistency means, and if there is a change, a warning is displayed and the surgeon is asked whether to correct the original value or a new value. Ask and select one with the decision button, etc., and match the DNF and the duplicate file. As an example, the dedicated data file for screening means is a .DNF file,
Replicated data files referenced by external databases are CSV.txt, .mdb, .xls, v
For example, use cf.

Once the screening means is created for a patient, it can be added or changed by activating the screening means with the name generated in the name management folder as described above.

Start-up and operation of the screening means After the above-described operation, when the screening means is started up by starting a screening execution file for the patient name or by pressing the screening start button, the input display means of the screening means is displayed.
As the examination means, various means such as various examination buttons, diagnosis (information), a collection of Start buttons, an example of a display input means of a cooperation means based on a tooth type (2D, 3D display) in FIG. 1 can be selected.

At this time, as an example, if any measurement means such as pH measurement means is activated and a trigger signal is input to the examination means, the trigger is transmitted to any examination means such as a microbial health examination means in the examination means, An event-triggered operation may be performed such that the measurement means in any of the examination means is activated and measurement starts. (
Multitasking is even more convenient. )

FIG. 2 is a flowchart (means) which is an input display means which is activated when a microbial health check is selected. The square part (flow box) of this display is a button that is activated by clicking, touching, or the like. (FIG. 38) And it has a status display means for displaying the current status by color or brightness.

―――――――――― Flowchart (means) operation ――――――――――
-
The beginning of this flowchart is a “Start” portion or a “examination” portion. In this case, it is better to perform PTC, that is, professional-to-screening after the actual screening. In FIG. 2, there are five Starts and one “examination”. Start from one of these Starts. As an example, when any item in the Start (button) collection in the examination means is selected, it is activated. The “examination” starts with a microbial health examination (button) of the examination means.

When Start from periodontal invasion and defense factor measurement is started, the periodontal invasion and defense factor measurement in the examination means are selected, and the periodontal invasion and defense factor measurement means are activated. As an example, the measurement command display input means such as FIG. 21 (FIGS. 20 to 24, FIG. 26, FIG. 27, and FIG. 32 to FIG. 37) is activated through FIG. 44, FIG. 45, and FIG. Here, the environment setting means may be set so that only the examination result is confirmed by the examination display input means using automatic measurement and automatic examination. In this case, the examination value can be viewed without displaying the progress.

Inflammatory substances are detected by periodontal invasion, defense factor measurement means, or tissue destruction substances,
If the factor is detected by the measuring means above a certain threshold value, the diagnostic output that the periodontal disease risk examining means is in a pathological state is performed. In a specific example, leukocytes were measured (observed) in the upper or lower marginal plaque, which is a sample from the patient, by microscopic measurement in FIGS. This result is transmitted to the periodontal disease risk means. Then, the value of risk magnitude (++++) is output. This value is judged by a diagnostic means (the judgment of the operator or a diagnostic means in which a threshold value is determined by a statistical value created by the surgeon).
Instruct the identification of causative bacteria (downward arrow), administer a broad spectrum of periodontal susceptibility antibacterial agents, perform surgical procedures, etc., and output instructions (arrow to the right).

On the other hand, if the periodontal disease risk examination means operates so as to detect the microorganism that causes the diagnosis, the periodontal disease microorganism measuring means is activated.
In a specific example, if the periodontal disease microorganism measurement is activated by the above-mentioned event, and the detected microorganisms of Priority 1 and Priority 2 of Phase 1 are detected, the risk of necessity of sterilization and sterilization is particularly large. Output of (++++) (Priority 1)
, Large risk of sterilization and sterilization (++) (Priority 2), output of risk of sterilization and sterilization as needed (Priority 3) (+).

More specifically, the paper point inserted into the periodontal pocket is placed in a culture medium (for example, a PG selection medium) of the culture measurement means. Then, a straight probe as a sampling and quantification means is brought into contact with the tip portion of the paper point infiltrated with exudate to which microorganisms adhere. Then, the medium is traced linearly once in the straight part. Then follow the medium section and make a curved surface.

This medium is subjected to anaerobic culture for 2 days, and the colonies are imaged by an image measuring means such as a CCD camera to calculate the colony density. As an example, the colony density at this time is measured on the basis of the density measurement of reports such as 0, 1, 2, 3 and the like. In particular, it is possible to measure the density with reproducibility for a part traced once with a straight probe. In addition, colonies with curved surfaces can be conveniently used for culturing methods for sensitivity tests.

If the output of a periodontal disease risk check is large, (++++), 3 or large, (++), 2,
As an example, the surgeon uses antibacterial agents and removes plaque, tartar and inflammatory substances. If it is medium (+), the concentration and the risk in the treatment hierarchy will be examined by the output value from the periodontal disease risk examination means, and the surgeon will judge (diagnose). The diagnosis may be output from the display means of the health check-up means using the diagnosis means created from the experience of the surgeon. The surgeon may see this and proceed with the diagnosis.

Once treatment and prevention measures are determined, treatment and prevention are performed. As an example, scaling, SRP, and (PMTC) are performed sequentially. At this time, this process is carried out within one week of administration of antibacterial agents (azithromycin dithromac, new quinolone spara, etc.). Then, after one week, it proceeds to the input position of periodontal disease risk examination through the FeedBack loop which is a cooperation (risk) means. A periodontal disease risk examination is performed as described above. As a result, if the risk is high, the flow (periodontal disease risk examination) is performed through periodontal defense and invasive factor measurement.

If the risk is small, the diagnostic means is advanced to the examination or the caries risk examination . Here, the caries risk examination is the first stage examination of dental invasion and protection factor measurement (pH
Measurement) may be performed immediately, or may be started after about one month has passed since the administration of the antibacterial agent. After this, it is the same as Start from the caries risk examination .

Start from caries risk examination
As an example, suppose that it starts from the start of tooth invasion and defense factor measurement (pH measurement, etc.).
If the plaque pH (hydrogen ion concentration) is smaller than the threshold value determined from the critical pH of the tooth, etc.
The diagnostic means operates to detect the microorganisms that cause the pH to be reduced (
Down arrow). Then, the detected microorganism is sterilized. Then, you can proceed to a dental caries risk examination again, or you can proceed to a periodontal disease risk examination .

If the caries risk check is performed again and the risk is low, the cooperating (risk) means strongly suggests that you proceed to the periodontal disease risk check . The surgeon makes a decision (diagnosis) and proceeds to a periodontal disease risk examination. If the risk is high, the periodontal disease risk examination process is performed, and if necessary, treatment and prevention are performed.

Both risks are reduced by performing a periodontal disease risk examination and a caries risk examination individually or alternately. And if both risks are small or 0 and each examination means examines, it will be a regular examination (return to the examination means).
At the time of regular examination, the examination means is activated, and if the microbial health examination is selected, the flowchart means starting from the examination button means is sequentially performed. Of course, you can do a medical checkup from each Start button.

Here, when the risk of both caries and periodontal disease antibacterial factors, the risk of caries increases from low to high when the risk of periodontal disease is low, and vice versa. When an oscillation state such as a periodontal disease risk increases, a linked risk diagnosis response control means may be used to perform a linked examination so as to converge to an optimum value.

[effect]
In this way, all the flows in the health checkup are displayed on the screen, and it is possible to select them sequentially and proceed with the medical treatment, so it is quick and very efficient (at a level that is impossible with one person's memory). In addition, examination, diagnosis, treatment, and prevention can be performed with high accuracy. Linkage risks can also find connections (such as pathologies, treatments, and preventions) that humans cannot normally find.

[Modification of this embodiment]
Here, the flowchart rewriting means may always change the flowchart to a new high-quality configuration and information by the artificial intelligence means based on internal information or information from the outside. Alternatively, the surgeon may use the surgeon input means to change the internal examination reference value to the flow.

Bacterial flora control examination (treatment prevention hierarchy) (see Figure 42)
If an extract such as bacteriocin collected from plaque of symbiotic flora or gingival crevice is used, pathological flora can be changed to symbiotic flora.

Spatial image examination
As shown in FIG. 43, it may be used by the cooperation means and the screening means, and the invasion site of the pathogenic microorganism may be confirmed by a photograph or an X-ray.

At this time, the mechanical examination may be called out by a cooperative means, and the load on the pathological site may be examined to increase the efficiency of pathogenic microorganism control.

Eating habits checkup (Use this method from the checkup method or call it through the link method.)
Brown rice vegetarian diet improves self-cleaning in the mouth and reduces caries and periodontal disease bacteria. Of course, caring pathogenicity and proliferation of caries will be extremely low if guidance is given to eliminate sucrose intake. In addition, microbial health checkup means the reference value for guidance such as the possibility that periodontal pathogens such as PG and FN will be less likely to grow if guidance is given to reduce direct aspartic acid and glutamic acid intake. It is reasonable to cooperate through cooperation means.

Psychological examination This creates a parasympathetic dominant environment, increases saliva secretion, contributes to the prevention of caries such as increased antibacterial factors and buffering capacity, periodontal disease, or establishment of commensal bacterial flora. Together with this guidance, the microbial health examination means may be measured and examined by the cooperation means to embody the effects of psychological examination.
In this case, the psychological examination displays the step of the autonomous training method, and the effect is embodied by the measurement and the examination value of the microbial health examination means, and the cooperation means inputs the display so as to proceed to a higher step.

Voice input or sign language input may be performed and used as an operator input means.

[General modification]
In the above embodiment, many means have been disclosed, but this may be used as a method.
In the case of the method, clearly a significant part is the medical service of the dentist. This is the business model (in the dental office) that is referred to in the general industry.

The pH measuring means may measure a colony or liquid pH of the culture test.

As the reagent for the pH measurement means, sucrose or the like was used as a reagent, and pH was measured. Ribose, rhamnose, trehalose, inulin,
PH measurement may be performed using salicin, esculin, xylose, starch, or the like. Here, various sugars or glycosides are used, and the dental caries risk examination means stores the pH fluctuation curve of dental plaque.

Here, the same measurement is performed for each known microorganism type, and the correlation between the known microorganism-derived pH fluctuation curve and the plaque pH fluctuation curve is determined in the correlation means. (If n kinds of sugars are measured, n pH fluctuation curves are obtained. This is also a decomposition curve of microorganisms for each sugar. It is also a temporal expression of sugar requirement.) Identification and estimation of microbial species in dental plaque. In the measurement operation, plaque was placed on the pH electrode, whereas a purely cultured microbial colony was placed on the pH electrode. Other operations are the same as those for dental plaque.

Moreover, you may link with the culture | cultivation measurement of a postscript. As an example
Porphyromonas
gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides forsythus
Are expressed as PG, AA, and BF, respectively.
PG AA BF
Glucose − + −: Measured with pH measuring means.
Trypsin + − +: Measured with a microorganism product measuring means.
Esculin − − +: Measured by culture measurement

Therefore, the colony generated by the culture measurement by the pH measurement means is measured by the same operation as the Mutans. And differential diagnosis of PG, AA and BF can be performed with trypsin-like enzyme activity (Tr) and esculin degradability (Esc).

Actinobacillus actinomycetemcomitans may be differentiated from other Actinobacillus. In that case, an aqueous solution of raffinose, mannose, glucose, galactose or the like is used, and the pH measuring means is used in the above operation.

When the periodontal treatment is performed, antibacterial factors such as NH ₃ and bacteriocin decrease. As a result, there is a high possibility that the caries risk will increase. Therefore, it is desirable that the linked risk examination means display or output that it is better to conduct the caries risk examination .

Here, the oxidation-reduction potential that is one of αp in FIG. 45 may be used as one of the measuring means. In this case, one electrode of a high impedance electrometer such as an FET input is placed in the pocket and the other electrode is placed on the gingiva or mucous membrane for measurement. In this case, the electrode in the pocket is preferably an electrode whose tip can be energized and the other is made of an insulator.

Treatment, prevention (means), (method) in diagrams such as FIG.
These treatments, preventive measures and methods are at the discretion of the operator in the present invention and are only examples. In other words, each treatment and prevention only described one known means and method,
The means and method here may be any treatment or prevention. The linked risk examination and diagnosis (means) (method) may treat these treatments and preventions as black boxes. Of course, it may not be enforced due to the patient's convenience and wishes.

Each of the measuring devices described above may be an independent risk measuring means in which an operator performs an examination and diagnosis.

When the cooperation means is manually operated, a tracking storage means for automatically tracking and storing the hierarchy, processed values, and the like may be provided. Further, the link means may be equipped with link line display means for associating the measurement examination site and the measurement diagnosis information. Furthermore, a folder may be used instead of a line for distinguishing values such as the hierarchy in FIG. 43 (when tiling is displayed in the following diagram).
In these cases, anyone can use the cooperation of experts, so even beginners can make advanced diagnoses.

As an example of adopting a window function means for multiplying the value measured by the comparison means in the spectroscopic measurement with a window function and taking a difference, the measurement value of Str. Mutans is used as the window function. Then, if Str. Mutans predominates in the collected plaque, the value in the comparative spectroscopic measurement means using the window function means increases. Here, Str.
Use a function such as sobrinus sanguis mitior mitis milleri salivarius and compare the ratios calculated by the ratio means. Α, which is the main polysaccharide in plaque
An absorption curve by 13 glucan and α16 glucan may be used as a window function. Furthermore, a window function with a Gaussian distribution curve of 1038 cm −1 may be used.

As a reference material such as spectroscopic measurement,
α13 glucan, α16 glucan, fructan, Sac (sugar), POx, OH, antibody, A
Ref button may be adopted as mA (amino acid), A1 amide 1, A2 amide 2, NH3, H2S, COx, Lip (fatty acid), Vt (vitamin), Nuc (nucleic acid), and other reference substances.

Two pieces of BaF ₂ may be used as the sample holding means, and a donut-shaped spacer may be sandwiched between them and fixed by the frame means. At this time, a spacer may also be inserted on the frame means side. Here, since the upper part is opened, the upper part becomes the insertion means.
At this time, silicon rubber is used for the spacer. As this material, other resins such as polyethylene and polypropylene, wax and the like may be used as appropriate.
When two sheets are used at this time, gas may be measured by using a part of the two sheets as a gas permeable membrane. As an example, the structures of the second and third embodiments are used.

As an example of an identification test by spectroscopic measurement: Mutans is estimated by the occurrence of a peak dependent on α13 glucan along with the degradation time and speed of the Suc peak and the decrease of the Suc peak.

As a susceptibility test by spectroscopic measurement or gas measurement: The generation of H ₂ S in PG is monitored.

Selectivity of the selective medium, added chemicals, CO2, degassing, dehydration, deionization, demoleculeization, etc. may be options for the environmental control means.
Also, microorganism action promoters (functions (growth, toxin production, entry into the body, motor function etc.) etc.)
Action antagonist (function (growth, toxin production, penetration into the body, motor function, etc.)
May be an option of the environmental control means.

As described above, each means of the present invention may be configured by software on a computer,
Each means may be realized only by hardware. Of course, you may apply to another Example and modification.

As further effects of the embodiment and the modified example, even a novice dentist can diagnose a skilled person and can also disclose information to a patient through communication or the like, which is convenient for reducing the number of visits and grasping the state of treatment. In addition to dentistry, it can be used in various fields such as medical departments, general identification of microorganisms, food, and environmental hygiene.

The means in the above-described embodiment or modification may be created entirely by hardware, or may be created by virtual means or software by the storage means and the control means.

The above embodiments or modifications may be implemented alone or in combination. Moreover, you may use for another use. As an example, each means and method in the linkage (risk examination), (risk) examination, diagnosis, and measurement in FIG. 1 is performed by selecting the means to be implemented according to the patient's pathological condition and health condition. . Also, checkup,
Needless to say, the final decision on the diagnosis is made by a doctor.

It can examine, diagnose and measure caries and periodontal disease, and can perform advanced prevention and treatment.

An example showing display input (means) of a screening means. An example of a flowchart (means). An example of a health (measurement) examination device. (Block Diagram) An example of a screening means. (Block Diagram) An example of a microbial health examination method. (Block Diagram) An example of sampling and quantification means. (Belly flat probe) An example of sampling and quantification means. (Weighing probe) An example of sampling and quantification means. (Straight tip) An example of sampling and quantification means. (Bending paper point) An example of a pH sensor module. An example of a pH sensor module. An example of gas measurement. (Mainly ammonia gas) An example of minimum pH measurement means. An example of time pH area measuring means. An example of delta pH measurement means. An example of a reference time pH measurement means. An example of pH measurement means by combination. Comparison pH measurement example between static pH and dynamic pH, and dynamic pH and dynamic pH. An example of a measurement command display input means. (Example of display input means of pH (multiple) spectrum measurement means.) An example of pH (double) spectrum measurement means. (Block Diagram) An example of gas measurement means such as ammonia, H ₂ S, indole. It is an example of a colorimetric means (apparatus). An example of a measurement command display input means. An example of the display input means in a culture measurement means and a sensitivity test means. An example of the block diagram in a culture | cultivation measurement means and a sensitivity test means. An example of a measurement command display input means. An example of the display input means in a microscope measurement means. An example of the block diagram in a microscope measurement means. An example of the medicine supply slide glass as a reagent means. An example of a spectroscopic examination device. (Block Diagram) An example of sample measuring means and comparative spectroscopic measuring means. (Comparative Spectrometer) An example of a spectroscopic measurement module. An example of an extracorporeal sample measuring means. (Spectroscopic measurement module and extracorporeal measurement means). An example of a biological measurement means and an example of a probe used for it. (Spectroscopic measurement module and biological probe) Single optical path probe As an example, a probe having the same optical path for irradiation and optical path for light reception. Double optical path probe: 2 optical path probe As an example, a probe in which an optical path for irradiation and an optical path for light reception are independent. Multiple optical path probes A plurality of optical paths are formed by combining two optical path probes or a single optical path probe. An example of an extracorporeal measuring means. An example of a measurement command display input means. An example of the display input means of a spectroscopic measurement examination means. An example of the flowchart means of the microbial health examination in a spectroscopic measurement examination apparatus. Examples of frequently used comparison means and reagent means of main environmental control means are described as examples. An example of sample measuring means and comparative spectroscopic measuring means. (Comparative spectroscopic measurement device) An example of comparing measured values, mainly used for environmental tests. An example of sample measuring means and comparative spectroscopic measuring means. (Comparative spectroscopic measurement device) This example is mainly used for sensitivity tests, in which measured values are compared with each other, and when the comparison value exceeds or falls below a threshold value. Of course, it can also be used for environmental tests. An example of a measurement command display input means. An example of the display input means of a spectroscopic measurement examination means. The number and value of buttons can be changed by the environment setting means. An example of displaying the comparison of FIGS. 34 and 35 in terms of time. An example of means for performing spectroscopic measurement and microscopic measurement simultaneously on the same part of a sample. (Of course, other parts can also be measured.) An example of the operation of the screening means. An example of the measurement button operation of the screening means. An example of the examination button operation of the examination means. An example of diagnostic button operation of a screening means. An example of the treatment prevention button operation of the screening means. An example of operation | movement of a cooperation means. An example of operation | movement of a flowchart means. An example of the operation of the flow box in the flowchart means. Full screen display example. (Microscope measurement) An example of a patient management holder. An example of a block diagram (lower left figure) of health (measurement) examination means. An example of environmental control means and sampling quantification means. (General variations)

Explanation of symbols

1 An example of display input means of cooperation (risk) means.
(Display input means applying dental and oral image display.)

Claims (9)

Health measurement (examination) device
A health measurement (examination) device comprising a collection and quantification means capable of quantitatively collecting a sample from the oral cavity and a culture medium (means) for culturing the collected material collected from the oral cavity. Health measurement (examination) device
A health measurement (examination) device comprising a culture medium (means) for cultivating a sample collected from the oral cavity and a gas measurement means for measuring gas generated from the culture medium. Health measurement (examination) device
A health measurement (examination) device comprising a paper point for collecting a sample from the oral cavity, a collection and quantification means for quantitative conversion from the paper point, and a medium for culturing microorganisms in the collected sample. The medium (means) according to any one of claims 1 to 3,
A range setting means for performing a standardized range setting is provided.
The health measurement (diagnosis) device according to any one of claims 1 to 4, wherein the health measurement (diagnosis) device is any one of measurement image means, optical measurement means, microorganism measurement means, or reference image means for measuring a living organism cultured in the medium. A health measurement (examination) device characterized by comprising the combination. The health measurement (examination) device according to any one of claims 1 to 5,
It is provided with a colony counter.
The sampling and quantifying means according to any one of claims 1 and 3,
It is characterized in that it is a dorsal probe having a dorsal portion on which the sample can be applied quantitatively on the back of the probe. The sampling and quantifying means according to any one of claims 1 and 3,
The measuring probe is provided with a measuring means for quantitatively collecting a sample by a collecting concave shape. The sampling and quantifying means according to any one of claims 1 and 3,
The paper point is characterized in that a water absorption inhibitor for applying a fixed amount of water is applied.

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