JP2007521119A - Dispersion of electromagnetic energy in electromagnetic induction fracture cutting - Google Patents

Abstract

  The output light energy distribution disclosed in the present application allows the cutting device to cut a target surface, such as body tissue, preferably without any detrimental secondary damage to the target surface. To. The device can cut the target surface without the need for additional fluid addition, i.e., cutting the target tissue can be done with only the output energy or fluid particles placed on the target surface. Or by thermal energy in combination with disruptive (eg, mechanical, thermal power, and other) energy imparted on or within the target surface around it.

Description

  The present invention relates generally to electronic devices, and more particularly to laser output light energy dispersion.

(Mutual citation of related applications)
This application claims priority from US Provisional Patent Application No. 60 / 535,004, filed Jan. 8, 2004, the contents of which are expressly incorporated herein by reference. This application is also a part of US patent application Ser. No. 08 / 522,503, filed Aug. 31, 1995 and now entitled “Atomized Fluid Particles in Electromagnetic Induction Cutting”, US Pat. No. 5,741,247. US patent application Ser. No. 08 / 903,187, filed Jun. 12, 1997, now entitled “Electromagnetic Energy Dispersion in Electromagnetic Induction Machine Cutting”, which is US Pat. No. 6,288,499. June 6, 2002, which is a continuation of US patent application Ser. No. 09 / 883,607, filed Jun. 18, 2001, entitled "Electromagnetic energy distribution in electromagnetic induction machine cutting" November 18, 2004, which is a continuation of US patent application Ser. No. 10 / 164,451 entitled “Electromagnetic Energy Dispersion in Electromagnetic Induction Machine Cutting” filed on the This is a continuation-in-part of US patent application Ser. No. 10 / 993,498, entitled “Electromagnetic Energy Dispersion in Electromagnetic Induction Machine Cutting”, filed on the same day, all of which are commonly assigned and their contents. Is expressly incorporated into the present application by reference.

  Various electromagnetic laser energy generation architectures existed in the prior art. For example, solid state laser systems typically include a laser rod for emitting coherent light and a source for directing the laser rod to emit coherent light. Typically, a flashlamp is used as a guide source in mid-infrared lasers between 2.5 μm and 3.5 μm, such as Er, Cr: YSGG and Er: YAG laser systems. The flash lamp is driven by a flash lamp current having a predetermined pulse shape and a predetermined frequency.

  The flash lamp current drives the flash lamp at a predetermined frequency, thereby creating a dispersion of output flash lamp light having substantially the same frequency as the flash lamp current. This dispersion of output flash lamp light from the flash lamp drives the laser rod to produce coherent light at a predetermined frequency substantially the same as the flash lamp current. The coherent light generated by the laser rod generally has an output light energy distribution over a time corresponding to the pulse shape of the flashlamp current.

  The pulse shape of the output light energy dispersion over time typically includes energy that rises relatively slowly, increasing to maximum energy, and energy that then decreases over time. The typical output light energy dispersion pulse shape can provide relatively efficient operation of the laser system, which is a relatively high ratio of average output light energy to average power input into the laser system. Corresponding to

  Prior art pulse shapes may be suitable for the cutting process, for example, where output light energy is directed onto the target surface to induce cutting of the contact tissue. However, using certain conventional procedures, when using thermal cutting, undesirable secondary damage can occur, such as charring or burning of surrounding structures or tissues. However, newer cutting procedures may not rely entirely on laser-induced thermal heating. In particular, a cutting mechanism such as that disclosed in US Pat. No. 5,471,247 allows the output light energy from a laser system to be initially sprayed into an amount of space above the target surface. Direct to particle dispersion. A breaking (eg, machine, thermal power, and others) cutting force can then be applied on the tissue. In certain implementations, at least a portion of the output light energy will interact with the atomized fluid particles to expand the atomized fluid particles, at which time electromagnetically induced destructive forces will be imparted on the target surface. As a result of the inherent interaction of the output light energy with the atomized fluid particles, many prior art output light energy delivery pulse shapes and frequencies are optimal, eg, cutting, removal, abrading, cleaning and others. It has not been particularly suitable for providing electromagnetic induction breakdown (eg, mechanical, thermal power, and other) processes. Specialization of output light energy dispersion, for example, to cause the transmission of pulse energy that combines the output light energy first into a highly absorbing molecule of the spray fluid particle and then into the highly absorbing molecule of the material to be cut In addition, it can be advantageous for optimal cutting when directed to the dispersion of atomized fluid particles.

(Summary of the Invention)
The dispersion of output light energy disclosed in this application includes a relatively high energy suppression due to a relatively steep leading edge at the beginning of each pulse. The slope of the one or more pulses is preferably greater than or equal to 5. Further, the full width at half maximum (FWHM) of the output light energy dispersion is greater than 0.025 microseconds. More preferably, the full width at half maximum is between 0.025 microseconds and 250 microseconds, and more preferably between 10 microseconds and 150 microseconds. In the illustrated embodiment, a full width at half maximum of about 70 microseconds. A flash lamp is used to drive the laser system and current is used to drive the flash lamp. The flashlamp current generation circuit comprises a solid core inductor having an inductance in the range of about 30 to about 70 microhenries and a capacitor having a capacitance in the range of about 30 to about -70 microfarads.

  The output light energy distribution disclosed in the present application allows the cutting device to cut a target surface, such as body tissue, preferably without any detrimental secondary damage to the target surface. To. The device can cut the target surface without the need for additional fluid addition, i.e., cutting the target tissue can be done with only the output energy or fluid particles placed on the target surface. Or by thermal energy in combination with disruptive (eg, mechanical, thermal power, and other) energy imparted on or within the target surface around it. The output light energy from the laser system is first directed to the dispersion of atomized fluid particles placed in a certain amount of space directly above the target surface and then to the material where it has a steep slope Exposing the absorbing molecule to a pulse that rises very rapidly, local expansion of that component of the material, and in some embodiments, subsequent addition of minimal thermal heating into the material, or thermal heating The removal of the material without any loss. The apparatus can also include a filter to spatially and temporally change the electromagnetic energy transmitted from the electromagnetic energy source. The filter can include a fluid such as water and can also be provided as a dispersion of atomized fluid particles.

  The present invention can further include a method of remodeling tissue. By performing the method, a pulse of electromagnetic energy is directed to the surface of the tissue, and the pulse can be adjusted to achieve local lysis or regeneration of the target surface and / or tissue.

  As a further aspect of the present invention, a method for delivering ions to a target surface is disclosed. This aspect allows the particles to be projected onto the target surface, which can be regenerated by one or more embedded ions that are mechanically held within the surface.

  The invention, together with further features and advantages thereof, may best be understood by referring to the following description, taken in conjunction with the accompanying illustrative drawings.

(Detailed Description of the Invention)
With particular reference to the drawings, FIG. 1 shows a plot of flash lamp drive current versus time according to the prior art. Initially, the flash lamp drive current 10 increases to a maximum value of 12. The initial ramp 14 typically comprises a ramp between 1 and 4 (current divided by time). After reaching the maximum value 12, the flash lamp drive current 10 decreases with time, as indicated by the decreasing current portion 16. Further, the prior art flash lamp drive current 10 can typically have a pulse width of about 300 microseconds. The full width at half maximum of the flash lamp driving current 10 is typically between 250 and 750 microseconds. The full width at half maximum is defined as the value of time corresponding to the length of the full width at half maximum plotted against the time axis. The range of full width at half maximum is the time axis from the start time when the amplitude first reaches 1/2 of the peak amplitude of the entire pulse to the end time when the amplitude reaches 1/2 of the peak amplitude, which is the last time in the pulse Is defined. The full width at half maximum is the difference between the start time and the end time.

  FIG. 2 shows a plot of energy versus time for the output light energy of a typical prior art laser. The output light energy distribution 20 generally includes a maximum value 22, an initial ramp 24, and a diminishing output energy portion 26. The micropulse 28 corresponds to a vibration relaxation process that is associated with a change in the inversion distribution in the laser rod when coherent light is generated by stimulated radiation. The average power of a laser can be defined as the power delivered over a given time, which typically includes a number of pulses. The efficiency of a laser system can be defined as the ratio of the laser output optical power to the input power into the system required to drive the flash lamp. A typical prior art laser system is designed with a flash lamp drive current 10 and an output light energy dispersion 20 that optimizes the efficiency of the system.

  FIG. 3 shows an analog flash lamp driving circuit 30 according to an embodiment of the present invention. The flash lamp driving circuit 30 includes a high voltage power supply 33, a capacitor 35, a rectifier 37, an inductor 39, and a flash lamp 41. The capacitor 35 is connected between the high voltage power supply 33 and the ground, and the flash lamp 41 is connected between the inductor 39 and the ground. The high voltage power supply 33 preferably comprises a power supply of 1200 to 1500 volts with a charge rate of 1500 joules per second. The flash lamp 41 can comprise a source of 450-900 torr, and preferably comprises a source of 700 torr. Capacitor 35 comprises a 30-70 microfarad capacitor, preferably a 50 microfarad capacitor, and rectifier 37 preferably comprises a silicon controlled rectifier. The inductor 39 preferably comprises a 30-70 microhenry solid core inductor, or equivalent thereof, and preferably comprises a 50 microhenry solid core inductor, or equivalent thereof. In alternative embodiments, inductor 39 may comprise an inductance of 13 microhenries or an inductance of 10-15 microhenries. In yet another alternative embodiment, inductor 39 may comprise an inductance value of 13 microhenries, or 10-15 microhenries, in a solid core inductor or equivalent. To the practical extent, circuit 30 can include digital elements. For example, as described below, other values for the inductor 39 and the capacitance 35 can be implemented to obtain a flash lamp drive current with a relatively fast rise time.

  FIG. 4 shows the flash lamp drive current 50 of the present invention, which passes from the inductor 39 to the flash lamp 41. The flash lamp drive current of the present invention preferably has a pulse width greater than about 0.25 microseconds, and more preferably has a pulse width in the range of 50-300 microseconds. In the described embodiment, the pulse width is about 200 microseconds. The flash lamp driving current 50 includes a maximum value 52, an initial increasing portion 54, and a decreasing current portion 56. The flash lamp 41 preferably includes an anode, a cathode, and a cylindrical glass tube having a gas such as xenon or krypton between them. When the flash lamp driving current 50 is applied to the anode of the flash lamp 41, the potential between the anode and the cathode increases. As indicated by the initial increase 54, the potential increases as the flash lamp drive current increases. Current flows through the gas in the flash lamp 41, resulting in the flash lamp 41 emitting bright incoherent light.

  For example, the flash lamp 41 can be tightly coupled to a laser rod (not shown), which preferably comprises a cylindrical crystal. The flash lamp 41 and the laser rod are preferably arranged in parallel to each other with a spacing of 1 cm between them. The laser rod is attached to two dishes and is not electrically connected to the flash lamp drive current circuit 30. The flash lamp 41 comprises preferred means for guiding the laser rod, but other means are also contemplated by the present invention. For example, a diode can be used as an excitation source instead of a flash lamp. The use of diodes to generate optical amplification by stimulated emission is discussed in a book published in 1996 by Walter Koechner, Solid State Laser Engineering 4th Extended Revision and Update, the contents of which are incorporated by reference Is expressly incorporated into the present application.

  The incoherent light from this preferred flash lamp 41 strikes the outer surface of the laser rod. As incoherent light penetrates the laser rod, atoms or ions in the laser rod absorb the penetrating light and subsequently emit coherent light through a stimulated emission process. The atoms or ions can include erbium and chromium, and the laser rod itself can include a crystal such as YSGGG. This preferred laser system is an Er, Cr: YSGG solid state laser that produces electromagnetic energy having a wavelength in the range of 2.70-2.80 microns, or erbium that produces electromagnetic energy having a wavelength of 2.940 microns. , Yttrium, or aluminum garnet (Er: YAG) solid state laser. As preferred, the Er, Cr: YSGG solid state laser has a wavelength of approximately 2.789 microns, and the Er: YAG solid state laser has a wavelength of approximately 2.940 microns. According to an alternative embodiment, the laser rod may comprise a YAG crystal and the impurities may include erbium impurities. There are various other possibilities, some of which are shown in the book “Solid State Laser Engineering 4th Extended Revision and Update” by Walter Koechner, published in 1996, mentioned above. The contents are expressly incorporated into this application by reference. Other possible laser systems are erbium, yttrium, scandium, gallium garnet (Er: YSGGG) solid state lasers that generate electromagnetic energy with wavelengths in the range of 2.70-2.80 microns. Erbium, yttrium, aluminum garnet (Er: YAG) solid state lasers that generate electromagnetic energy with a wavelength of micron, chromium, thulium, erbium, yttrium, aluminum garnet (CTE) that generate electromagnetic energy with a wavelength of 2.69 microns : YAG) solid state lasers, erbium, yttrium, orthoalumina (Er: YAL03) solid state lasers that generate electromagnetic energy with wavelengths in the range of 2.71 to 2.86 microns, with wavelengths of 2.10 microns Electromagnetic energy Holmium, yttrium, aluminum garnet (Ho: YAG) solid state laser producing 266, neodymium, yttrium, aluminum garnet (quad Nd: YAG) solid state laser producing electromagnetic energy having a wavelength of 266 nanometers, 193 Argon fluoride (ArF) excimer laser that generates electromagnetic energy with a wavelength of nanometer, xenon chloride (XeCl) excimer laser that generates electromagnetic energy with a wavelength of 308 nanometers, electromagnetic energy with a wavelength of 248 nanometers A krypton fluoride (KrF) excimer laser that produces, and carbon dioxide (CO2) that produces electromagnetic energy with a wavelength in the range of 9-11 microns.

  Particles, such as electrons, associated with atoms or ions absorb energy from impinging incoherent radiation and rise to higher valence states. Particles that have risen to a metastable level remain at this level for some time, for example until the energetic particles of radiation excite induced transitions. Induction of particles at metastable levels by energetic particles results in the decay of both particles to ground and the emission of bicoherent photons (energy particles). A bicoherent photon can resonate through the laser rod between mirrors at both ends of the laser rod and induces other particles on the metastable level, thereby subsequently producing a bicoherent photon emission. Can be generated. This process is called light amplification by stimulated emission of radiation.

  The amplification effect will continue until the majority of the particles that have been raised to the metastable level by the incoherent light induced from the flash lamp 41 decay back to a lower state. The decay of the majority of particles from a metastable state to a lower state results in the generation of a large number of photons, which corresponds to a small pulse rising upward (eg, 64 in FIG. 5). As particles on the ground level are again guided back to the metastable state, the number of emitted photons decreases, which corresponds to, for example, a downward slope in the micropulse 64. Corresponding to the decrease in coherent photon emission by the laser system, the micropulses continue to decrease. The number of particles induced to a metastable level increases to the amount that stimulated emission occurs at a level sufficient to increase the number of coherent photons generated. As the generation of coherent photons increases and the particles above the metastable level decay, the number of coherent photons increases, which corresponds to a small pulse rising upward.

  The output light energy distribution over time of the laser system is shown at 60 in FIG. The output light energy distribution of the present invention preferably has a pulse width greater than about 0.25 microseconds, and more preferably has a pulse width in the range of 50-300 microseconds. In the illustrated embodiment, the pulse width is about 200 microseconds. The output light energy dispersion 60 includes a maximum minute pulse value 62, a number of minute leading pulses 64, 66, 68, and a portion of the light energy 70 that generally decreases.

  According to the present invention, the output light energy dispersion 60 has a large scale. This large scale corresponds to one or more sharply rising micropulses in the rising edge of the pulse. As shown in FIG. 5, the micropulse 68 includes a maximum value 62 just at or near the start of the pulse. Furthermore, the full width at half maximum of the output light energy dispersion in FIG. 5 is approximately 70 microseconds compared to the prior art full width at half maximum, typically in the range of 250-300 microseconds, and in other embodiments, It can be between 40-65 microseconds. Applicant's invention contemplates pulses with full width at half maximum greater than 0.025 microseconds, preferably in the range of 10-150 microseconds, although other ranges would also be possible. Further, for example, Applicants' invention contemplates pulse widths between 0.25 and 300 microseconds, as compared to typical prior art pulse widths greater than 300 microseconds, for example. A further aspect of the invention is the combination of a pulse width range between 0.25 and 300 microseconds with a pulse width range between 300 and 800 microseconds. Furthermore, a frequency of 1-20 Hz is preferred here. Alternatively, a frequency of 20 to 150 Hz can be used. Applicant's invention generally contemplates frequencies between 1-150 Hz. For diode-pumped Q-switched lasers, the frequency can be as high as in the KKz range.

  As mentioned above, the full width at half maximum range is from the start time when the amplitude first rises above half the peak amplitude to the end time between the pulse widths, where the amplitude falls below half the peak amplitude. Until the time. The full width at half maximum is defined as the difference between the start time and the end time.

  Compared to the pulse width, the position along the time axis of the full width at half maximum is closer to the beginning of the pulse than to the end of the pulse. The position of the full width at half maximum is preferably within the first half of the pulse along the time axis, and more preferably within about one third of the first of the pulse. Other positions in the full width at half maximum are also possible according to the invention. The rise time of the pulse preferably occurs within the first 5-35 microseconds, and more preferably within the first 12.5 microseconds from the start of the pulse. The start time is preferably realized within the first 1/10 of the pulse width.

  Another distinguishing feature of the output light energy dispersion 70 is, for example, that the micropulses 64, 66, 68 comprise approximately 1/3 of the maximum amplitude 62. It is more preferable that the minute leading pulses 64, 66, 68 have an amplitude that is approximately 1/2 of the maximum amplitude 62. On the other hand, the amplitude of the prior art minute leading pulse as shown in FIG. 2 is relatively small.

  The slope of the output light energy dispersion 60 is greater than or equal to 5, and in other embodiments greater than about 10. In the illustrated embodiment, the slope is about 50. In contrast, the slope of the output light energy dispersion 20 of the prior art is about 4.

  In further embodiments of the invention, such as embodiments that use energy to improve soft tissue cutting, the slope of the pulse may be less steep. For example, the shape of the pulse can be smoother than the shape described above. By utilizing pulses with a less steep initial slope, it may be possible to achieve improved coagulation of the cut tissue, for example.

  In certain embodiments, as shown in FIG. 6, alternating short and long pulses achieve the effect of cutting, coagulation, and / or tissue remodeling. In the illustrated embodiment of FIG. 6, the short pulse has a relatively large amplitude compared to the long pulse. For example, a cutting effect can be obtained by providing a series of pulses in various sequences of short and long pulses. In one embodiment, the train of pulses can include alternating short pulses and long pulses. In other embodiments, the train of pulses can include a sequence of pulses such as long, long, short, or short, short, long. Additional patterns or sequences can also be utilized. By utilizing alternating or varying pulse shapes, it would be possible to obtain a coupling effect that cannot be achieved with any single pulse shape. For example, by utilizing a combination of short pulses and long pulses, it would be possible to create deep cuts with relatively strong coagulation. Typically, shorter pulses tend to produce relatively deep cuts with moderate coagulation, and longer pulses tend to produce relatively shallow cuts with strong coagulation. it can. As used in this application, a “long” pulse is a pulse with a less steep slope and a longer tail compared to a shorter pulse. In certain embodiments, the long pulse can have a duration of about 700 microseconds.

  FIG. 7 shows an enlarged view of the short pulse shown in FIG. The pulse of FIG. 7 has a maximum amplitude of approximately 800 millivolts.

  FIG. 8 shows an enlarged view of the long pulse shown in FIG. The pulse of FIG. 8 has a maximum amplitude of approximately 120 millivolts. However, the pulse of FIG. 8 has a substantially longer duration than the pulse of FIG. For example, the long pulse of FIG. 8 can have a duration of approximately 1650 microseconds (250 μs / div * 6.6), whereas the short pulse of FIG. 7 can be from about 750 microseconds to about 1000 microseconds. Can have a duration of seconds. In the illustrated embodiment, the area under each of the pulses shown in FIG. 7 and each of the pulses shown in FIG. 8 is substantially equal. However, in modified embodiments, the areas can vary from one another. As those skilled in the art understand, each area can be calculated by specifying the integral under voltage tracking in each pulse. Thus, in the illustrated embodiment, the energy of the short pulse and the energy of the long pulse can be substantially equal. By generating pulses of various maximum amplitudes and durations, for example, cutting, coagulating the target material, compared to a system that utilizes only a single pulse format with substantially equal energy in the illustrated embodiment, Or it would be possible to obtain improvements in retrofits.

  Figures 9 and 10 show further enlarged views of the short and long pulses, respectively. Each voltage trace for the pulse is provided on a different scale.

  In certain embodiments, the devices disclosed in this application can include two high voltage power supplies. In one embodiment, one power source charges one pulse forming network (eg, an LC circuit) and a second power source charges a second pulse forming network (eg, an LC circuit). Each pulse forming network can then be discharged through the same lamp.

  The output light energy dispersion 60 of the present invention will help to maximize the cutting effect of an electromagnetic energy source, such as a laser, directed at the target surface. Cutting and / or grinding effects will occur on or at the target surface, within the target surface, and / or above the target surface. Using the light energy dispersion disclosed in this application, it is possible to destroy the target surface by directing electromagnetic energy to the target surface such that a portion of that energy is absorbed by the fluid. The fluid that absorbs energy can be on the target surface, in the target surface, on the target surface, or a combination thereof. In one embodiment, the fluid that absorbs energy can include water and / or can include hydroxyl groups. When the fluid contains hydroxyl groups and / or water that absorbs electromagnetic energy highly, these fluid molecules can begin to vibrate. As the molecule vibrates, local heating is created that results in expansion that leads to failure (eg, mechanical, thermodynamic, or other type of mechanism). Absorption of impacted electromagnetic energy by other molecules on the target surface can also cause other types of destructive effects. Thus, the cutting effect brought about by energy absorption can be due to thermal properties (eg, thermal cutting), or thermodynamic effects, and molecules that do not significantly heat the target surface (eg, target It can also be due to absorption of energy by water on the surface). In certain embodiments in which cutting is performed in combination with fluid output, and also in certain embodiments that do not use fluid output, the use of electromagnetic energy distribution disclosed in this application may include targets such as carbonization or combustion. Secondary damage to the surface can be reduced. Thus, part of the cutting effect caused by electromagnetic energy can be due to thermal energy, and part of the cutting effect can be caused by the destruction of molecules that absorb electromagnetic energy (eg, mechanical Thermodynamic, or other types of effects).

  An apparatus used to impart a destructive force on a target surface or to cut and solidify or modify the target surface directs electromagnetic energy to the target surface such that at least a portion of the energy is absorbed by the fluid. Configured. One apparatus for providing a destructive force on a target surface is disclosed in US Pat. No. 5,741,247 entitled “Atomized Fluid Particles for Electromagnetic Induction Cutting”. Not only can the cutting effect of the device be brought about by the atomized fluid particles on the target surface, but instead or in addition, the cutting effect is brought about by absorption of energy by the fluid on or in the target surface. You can also. In one embodiment of the apparatus, the effect of energy absorption by a fluid placed above the target surface, a fluid placed on the target surface, or a combination of fluids placed within the target surface provides a cutting effect. . In one embodiment, about one third of the impacted electromagnetic energy passes through the fluid particles and impacts on the target surface, so that a portion of the impacted energy cuts the target surface or cuts the target surface. Can act to contribute.

  The device is also provided with a filter that allows the electromagnetic energy transmitted from the electromagnetic energy source to be spatially reduced in one or more respects without delay compared to the electromagnetic energy transmitted to the target surface without the filter. The target surface can be changed to be destroyed by a different method. Depending on the spatial and / or temporal configuration of the filter, the spatial and / or temporal distribution of the electromagnetic energy can be varied. For example, the filter can comprise a fluid; in one embodiment, the filter varies spatially over a period of its characteristics (eg, size, dispersion, velocity, configuration) and impacts on the target surface. Is a dispersion of atomized fluid particles that can vary in amount. As an example, a filter can be placed on the target intermittently to change the intensity of the impinging energy, thereby providing some form of pulse effect. In such an example, a spray of water can be applied intermittently to cross the impinging radiation. In some embodiments, the use of a filter reduces the secondary heating / damage typically associated with thermal cutting of prior art lasers without a filter or without secondary overheating / damage, Cutting of the target surface can be realized. The filter fluid may include water. As with other fluid outputs, energy sources, and other structures and methods disclosed in this application, the output from the filter can be found in US Pat. No. 6,231,567 entitled “Material Stripper and Method”. Any of the fluid outputs described and other structures / methods can be included, the entire contents of which are hereby incorporated by reference to the extent they are compatible and not mutually exclusive.

  The high intensity microleading pulses 64, 66, and 68 can provide some high peak amounts of energy directed to the target surface. Direct energy to the target surface to achieve the desired cutting effect. For example, in some instances, directing energy into atomized fluid particles and on fluids and / or OH molecules present on or in target surface materials that can include water or other biocompatible fluids, Thereby expanding the fluid and inducing a breaking (eg machine) cutting force on the target surface or inducing a target surface destruction (eg mechanical failure, thermopower or any other form) Can do. It has been found that the micro trailing pulse after the maximum micro pulse 68 helps to remove material. According to the present invention, a single large microleading pulse 68 can be generated, or alternatively two or more large microleading pulses 68 (or 64, 66, for example) can be generated. According to one aspect of the invention, a relatively steeper slope of the pulse and a shorter pulse can reduce the amount of residual heat created in the material.

  The flash lamp current generation circuit 30 of the present invention generates a relatively narrow pulse, for example about 0.25 to 300 microseconds. Further, the full width at half maximum of the light output energy dispersion 60 of the present invention can occur within the first 30 to 70 microseconds, for example, compared to the prior art full width at half maximum that occurs within the first 250 to 300 microseconds. The relatively fast frequency of light energy and the relatively large initial dispersion in the leading portion of each pulse of the present invention results in relatively efficient cutting (eg, mechanical cutting, thermopower, or other type). be able to. The output light energy dispersion of the present invention can be made to cut, shape, remove, coagulate, or modify tissue and material, and further within spray fluid particles above the target surface, or on the target surface or Electromagnetic energy can be provided in other fluid particles placed therein. The cutting effect obtained by the output light energy distribution of the present invention is both complete and strong, and can further provide a consistent cutting or other destructive force on the target surface.

  The apparatus disclosed in this application can be used to apply a cutting force on a biological target or a non-biological target. In most embodiments, one or more pulses can be used to generate a force effective to cut, coagulate, or remodel body tissue such as teeth, bones, or cartilage. As explained above, it may be possible to obtain improved or different cutting performance by utilizing a train of variable pulse shapes. For example, it may be possible to cut the tooth surface with short, high intensity pulses and promote closure of the dental tubules by a “melting” effect associated with longer, lower intensity pulses. Such an effect may be caused by erosion of one or more teeth in the gingiva to treat desensitization, such as root canal treatment, or tubule closure or melting to treat desensitization, It can be particularly useful. Alternatively, or in addition, pulse trains can be used to melt-modify tooth enamel, or dentin, to reduce or suppress cavities. As explained above, it may also be possible to cut and coagulate deep tissue such as vascular tissue by providing a train of long and short pulses.

  According to further embodiments of the present invention, a target modification can be achieved using a flux amount of electromagnetic energy (eg, pulses of electromagnetic energy) directed to the target (eg, tissue). FIG. 11 is a flowchart illustrating the implementation of a method for modifying a target (eg, tissue) according to the present invention. This implementation includes, in step 100, directing a pulse of electromagnetic energy to the surface of the tissue. The tissue according to one example can be a dental enamel, or an upper layer of dentin tissue. Implementation of the illustrated method continues at step 105 by adjusting the pulse to achieve a modification, which may include, for example, local melting and / or modification of tissue and / or other targets.

If the target comprises hard tissue, the remodeling increases the tissue's structural rigidity, making the tissue more resistant to, for example, acids with low pH in the mouth or acids made by bacteria. can do. The adjustment can include changing the parameters of the electromagnetic energy pulse (eg, the steepness of the slope, or the duration of the pulse), as described in this application. In general, a pulse with a relatively steep slope as described above is a specific example of transferring energy into tissue to achieve a relatively fast and effective remodeling of the upper layers of hard tissue, for example. In this example, it can be considered to be more effective. In certain embodiments, a short pulse may be effective for cutting and remodeling in some implementations, while a long pulse is more effective for remodeling in some implementations. Sometimes If a short pulse is used for cutting, a higher flux can be used in certain examples. Adjustments can include, for example, changing the duration of various types of pulses, where in one example the term “duration” refers to the “full width at half maximum” as described in this application. Intended to include and in other examples is intended to include the pulse length. For example, an ultrashort pulse can range in duration from about 0-30 μs, a short pulse can have a duration in the range of about 30-150 μs, and a long pulse can range from about 150 to about 800 μs. Can have a duration of range. As an example, other tuning techniques may be applied in certain embodiments including simultaneous emission of short (or ultrashort) and long pulses. According to further embodiments, one type can be followed by another type, e.g., long pulse, short pulse, and the pulses can alternate. Furthermore, other embodiments may alternate the train of pulses, such that a first number of one type of pulse alternates with a second number of other types of pulses. Table 1 lists some examples of pulse train formats that can be used. Each entry in the table can represent a basic pair of pulses that occur once and / or repeat or repeat periodically, for example, in any order (ie, A + B, or B + A).
Table 1

  In remodeling, a thin layer of tissue can be affected (e.g., softened, e.g., melted) and allowed to improve (e.g., after cooling). For surface modification, the layer of tissue to be melted can range from about 0 to 50 μm. For deeper modifications, the tissue to be melted can be in the range of about 50-500 μm. Even deeper modifications, such as up to about 750 μm, can be implemented in some embodiments.

  The remodeling procedure itself selects the appropriate (eg, optimal) thickness necessary to remodel the tissue so that it is not more susceptible to acid attack, which may result in desalination, for example. May be important in certain implementations. Therefore, the pulse structure of the applied electromagnetic energy should be given careful consideration in advance according to one embodiment. Further, in applications involving desensitization and corrosion inhibition, some or all pulse shapes and / or magnitudes can be selected to stay below the cutting threshold.

According to one embodiment, for effective modification can be a flux amount setting is in the range of about 0.1 J / cm ² ~ about 25 J / cm ^2. In other embodiments, the fluence settings may range from about 0.1 J / cm ² ~ about 10J / cm ^2. In yet another embodiment, the fluence settings may range from about 0.1 J / cm ² ~ about 5 J / cm ^2. In the example of this embodiment, a spot size of about 50 μm to about 1500 μm can be used.

It should be understood that in some implementations, setting a higher flux rate may result in a greater increase in the temperature of the tissue being treated, eg, tooth enamel. For example, in order to reduce the temperature rise under the surface layer of the tissue, a procedure for controlling the temperature rise and cooling the tissue can be implemented. In certain implementations, any known technique, or any other combination at the same time, eg, to control temperature rise and cool tissue and / or prevent harmful heat transfer to living tissue (Eg water) and / or air can be used. In general, in certain implementations, cooling air can be added to limit the temperature rise and, alternatively, or alternatively, air / water spraying can lower the tissue temperature and thereby For example, harmful heat transfer to living tissue can be prevented. For example, using only air, it can be directed to the surface at a rate of about 0-15 L / min. Alternatively or subsequently, air in combination with water can be used, the air being added at the same rate, and / or the water being added at a rate of about 0-60 ml / min. In general, for short pulse delivery, according to one embodiment, in combination with about 0-10 ml / min of water, the rate of air addition can range from about 0-7 L / min. In long pulse delivery, the air velocity can vary from about 0-15 L / min, and the rate of water addition can range from about 0-60 ml / min. In some instances, adding too much water may prevent the effect of the laser on the tissue. Table 2 shows the cooling technique in an embodiment using, for example, a 2.789 micron Er, Cr: YSGG solid state laser with a 600 μm diameter tip at a distance of about 2 mm from the enamel for a duration of about 10 seconds. Thus, the effects of adding air and water are summarized.
Table 2

  For example, in conjunction with devices and methods for treating (eg, grinding) caries or for the purpose of desensitization, the remodeling techniques described in this application can be utilized. An example of such an apparatus and method is disclosed in US Provisional Patent Application No. 60 / 601,415, filed Aug. 12, 2004, entitled “Dual Pulse Width Medical Laser with Preconfiguration”. The entire contents of which are incorporated herein by reference.

  The modification can be effective to modify the surface after cavity preparation. Specifically, after removing the tissue and preparing the cavity, a remodeling process can be applied to the final cut surface. A synthetic repair can then be inserted. Subsequently, if a leak occurs, a gap can be formed between the composite and the cutting surface, bacteria can enter into the gap, and then remodeled under the restoration The surface can exhibit a tendency to reduce mineral loss and secondary corrosion.

  According to a further aspect, modifications can be made to prevent the formation of caries in areas where caries are likely to occur. For example, the tissue can be melted and expanded to fill small gaps and to modify indentations and defects on the mating surface. In a modified embodiment, sealant can be added after modification. With further implementation, the surface of the cervical tooth can be modified to reduce the formation of caries.

By carrying out the present invention for preventing dental caries, the amount of flux can be set in the range of about 0 J / cm ^{2 to} 25 J / cm ² . In some embodiments, the fluence settings may range from about 0 J / cm ² ~ about 10J / cm ^2. In these embodiments, a spot size of about 50 μm to about 1500 μm can be used.

  A further aspect of the invention can include a method of delivering ions to a target surface. FIG. 12 is a flow chart summarizing the implementation of this aspect of the invention. Particles that can include selected types of ions can be projected onto the target surface in step 110. In accordance with exemplary embodiments, particles (eg, ions or ionic compounds) are placed on the target surface using air spray, fluid spray, or a combination spray of both air and a fluid such as a biocompatible fluid (eg, water). To allow the particles to adhere or adhere (eg, micromachined adhesion) to the target surface. The surface can then be modified as described in step 115 of the present application, where the modified tissue layer can be more resistant to caries. Furthermore, the process can induce the formation of secondary dentin or make the surface exhibit antibacterial properties. According to a further aspect of the present invention, a lamination layer can be added over the target tissue surface such that the tissue surface is covered with a thin layer of various ionic compounds and then laser modified. In a modified implementation of the method, the tissue is simultaneously covered with a thin layer and modified. A layer of ions is implemented in the tissue surface using either a wet or dry environment.

  As an example, ions from the series consisting of fluoride, calcium, phosphorus, and hydroxide (OH) can be selected, which can enhance caries prevention. As further examples, compounds containing ions such as sodium fluoride, tin fluoride, copper fluoride, titanium tetrafluoride, amine fluoride, calcium hydroxide, hydroxyapatite, calcium phosphate, etc. can be selected. . That some of these compounds may be compatible with soft tissue, and some may be compatible only with dentin, enamel, or bone. You should be careful. In particular, a compound having fluoride ions can be said to be effective as an anti-corrosion and desensitizing agent. By way of example, fluoride can act to desensitize dental tissue, for example, to the effects of heating and cooling. In a modified embodiment, for example, a compound comprising calcium can help form an antimicrobial surface. In still further embodiments, the use of calcium hydroxide or zinc oxide can enhance the remineralization of the affected dentin. These compounds can be delivered through water or other biocompatible fluids that are sterile or low in bacteria, including salts.

  Simultaneously with the application of the laser beam, an ionic compound can be added, thereby realizing ion placement, and at the same time, remodeling the surface tissue and filling the remodeled tissue layer with ions. Alternately, the area to be treated is first sprayed with one or more ion retaining compounds, such as a local fluoride preparation, followed by subsequent laser energy application.

Table 3 summarizes examples of desired fluoride concentrations extracted from known literature. These concentrations have been shown to be effective in preventing tooth decay.
Table 3

  While exemplary embodiments of the present invention have been shown and described, without departing from the scope of the present invention, those skilled in the art will recognize many other changes, modifications, in addition to those set forth in the above paragraph. And substitutions can be made. For example, the methods disclosed in this application can be used in the treatment of teeth or bones. As described in this application, bone growth inducers such as bone morphogenetic proteins can be added to help promote bone regeneration and repair bone defects. As will be apparent from the context, the description, and the knowledge of those skilled in the art, any feature described in this application, or any combination of features, and any features included in any such combination are consistent with each other. Are included within the technical scope of the present invention.

2 is a plot of flash lamp drive current versus time according to the prior art. 2 is a plot of output light energy versus time in a laser system according to the prior art. FIG. 3 is a schematic circuit diagram showing a circuit for generating a flash lamp driving current according to the present invention. 4 is a plot of flash lamp drive current versus time according to the present invention. 2 is a plot of output light energy versus time in a laser system according to the present invention. A series of short and long pulse plots. It is an enlarged view of the short pulse shown in FIG. It is an enlarged view of the long pulse shown in FIG. It is the further enlarged view of the short pulse shown in FIG. FIG. 7 is a further enlarged view of the long pulse shown in FIG. 6. 6 is a partial flowchart illustrating the implementation of a method for remodeling tissue according to the present invention. 4 is a partial flowchart illustrating the implementation of a method for delivering ions to a target surface according to the present invention.

Claims (69)

A device for applying destructive force on a target surface,
(A) an electromagnetic energy source configured to direct electromagnetic energy to a target surface and to provide a destructive force on the target surface;
(B) a flash lamp current generation circuit for generating at least one current pulse to drive the electromagnetic energy source;
Wherein the current pulse has a full width at half maximum range substantially within the first half of the current pulse and uses energy absorbed by the fluid to destroy the target surface from the electromagnetic energy source An apparatus characterized by being configured to generate electromagnetic energy. The apparatus is configured to place a fluid on the target surface;
The apparatus of claim 1, wherein at least a portion of the electromagnetic energy generated by the current pulse is absorbed by the fluid on the target surface. The apparatus of claim 2, wherein at least a portion of the electromagnetic energy generated by the current pulse is absorbed by a fluid placed in the target surface. The apparatus is configured to place a fluid over the target surface;
The apparatus of claim 3, wherein at least a portion of the electromagnetic energy generated by the current pulse is absorbed by the fluid placed on the target surface. The apparatus is configured to place the fluid as atomized fluid particles on the target surface;
The electromagnetic energy generated by the current pulse is substantially absorbed by the fluid placed on the target surface to provide a destructive force on the target surface. Equipment. The apparatus of claim 3, wherein at least some of the fluid in the target surface that absorbs the electromagnetic energy is not supplied from the apparatus. The target surface includes hard tissue or soft tissue,
The apparatus according to claim 6, wherein the fluid in the target surface comprises water. The apparatus is configured to place a fluid over the target surface;
At least a portion of the electromagnetic energy generated by the current pulse is absorbed by the fluid placed on the target surface;
The device according to claim 7, characterized in that: The apparatus is configured to place the fluid as atomized fluid particles on the target surface;
9. The electromagnetic energy generated by the current pulse is substantially absorbed by the fluid placed on the target surface to provide a destructive force on the target surface. The device described. The apparatus of claim 1, wherein at least a portion of the electromagnetic energy generated by the current pulse is absorbed by a fluid placed in the target surface. The apparatus of claim 3, wherein at least some of the fluid in the target surface that absorbs the electromagnetic energy is not supplied from the apparatus. The target surface includes hard tissue or soft tissue,
The apparatus according to claim 6, wherein the fluid in the target surface comprises water. The apparatus is configured to place a fluid over the target surface;
The apparatus of claim 12, wherein at least a portion of the electromagnetic energy generated by the current pulse is absorbed by the fluid placed on the target surface. The apparatus of claim 1, wherein at least a portion of the electromagnetic energy generated by the current pulse is absorbed by a fluid placed on the target surface. The apparatus is configured to place the fluid over the target surface as atomized fluid particles;
15. The electromagnetic energy generated by the current pulse is substantially absorbed by the fluid placed on the target surface to provide a destructive force on the target surface. The device described. The current pulse of the flash lamp current generation circuit is:
(I) Reading with a slope of at least 5 defined as y divided by x (y / x) on the pulse plot, where y is the current in amperes and x is the time in microseconds Edge,
And (ii) a full width at half maximum in the range of about 0.025 to about 250 microseconds. The apparatus according to claim 1, further comprising a fluid output that outputs a fluid between an output of the electromagnetic energy source and the target surface. The apparatus of claim 17, comprising a filter that includes fluid output from the fluid output, wherein the filter absorbs a portion of the energy generated by the electromagnetic energy source. The apparatus of claim 18, wherein the fluid is water spray particles. The apparatus of claim 1, wherein the destruction of the target surface is caused in part by energy generated by the electromagnetic energy source rather than by the energy absorbed by the fluid. The electromagnetic energy source comprises an erbium, yttrium, scandium gallium garnet (Er: YSGGG) solid state laser, or an erbium, yttrium, aluminum garnet (Er: YAG) solid state laser. Equipment. (A) An apparatus including the electromagnetic energy source and a flash lamp current generation circuit is disposed near the target surface so that the electromagnetic energy generated by the electromagnetic energy source can be transmitted toward the target surface. Steps,
(B) generating at least one current pulse in the flash lamp current generation circuit, the current pulse having a full width at half maximum located within substantially the first half of the current pulse; and On the target surface, the current pulse drives the electromagnetic energy source to provide electromagnetic energy that destroys the target surface by interacting with a fluid on or within the target surface. How to give destructive power. (C) placing a fluid on the target surface and filtering the electromagnetic energy to reduce the brightness of at least a portion of the electromagnetic energy before the portion of the electromagnetic energy destroys the target surface. The method according to claim 22, wherein: 24. The method of claim 23, wherein the fluid is provided as a dispersion of fluid particles emanating from a fluid output. 25. The method of claim 24, wherein the fluid absorbs a portion of the electromagnetic energy prior to destroying the target surface. The method of claim 22, wherein the fluid is water. The method of claim 22, wherein the fluid is disposed within the target surface. (C) emitting a spray dispersion of the fluid particles from the fluid output of the device on the target surface such that a portion of the spray dispersion of fluid particles traverses the electromagnetic energy on the target surface. The method of claim 22, further comprising: destroying the target surface. A device for applying destructive force on a target surface,
(A) the laser in communication with an optical fiber to direct electromagnetic energy from the laser to the target surface;
(B) a flash lamp current generation circuit that generates at least one current pulse to drive the laser to generate electromagnetic energy from the laser;
The current pulse is characterized in that the full width at half maximum is located within substantially the first half of the current pulse;
(C) when transmitting electromagnetic energy from the optical fiber, further comprising a filter disposed between the optical fiber and the target surface, and compared to electromagnetic energy transmitted to the surface without the filter, The apparatus is characterized in that the filter is configured to spatially alter the electromagnetic energy near the target surface so as to destroy the target surface in different ways. 30. The apparatus of claim 29, wherein the filter comprises a dispersion of fluid particles that absorb at least a portion of the electromagnetic energy emanating from the optical fiber. 31. The filter includes spatially dispersed fluid particles and the device is configured to vary the spatial and temporal dispersion of the fluid particles. The device described in 1. The apparatus of claim 30, wherein the fluid comprises water. The flash lamp current generation circuit comprises:
(I) a solid core inductor having a rated inductance of about 50 microhenries;
(Ii) a capacitor coupled to the inductor having a capacitance of about 50 microfarads;
(Iii) a flash lamp coupled to the solid core inductor;
30. The apparatus of claim 29, comprising: 30. The apparatus of claim 29, wherein the laser is an Er: YSGG or Er: YAG solid state laser. While maintaining the ability of the electromagnetic energy emitted from the optical fiber, a portion of the electromagnetic energy is filtered to provide a destructive force on the target surface by absorption of energy by the fluid on or within the target surface. 30. The apparatus of claim 29, wherein the filter is configured. A method of remodeling an organization,
Directing a pulse of electromagnetic energy to the surface of the tissue;
Adjusting the pulse to achieve local melting and remodeling of the tissue. 37. The method of claim 36, wherein the melting comprises melting the tissue to a depth in the range of about 0 to about 50 [mu] m. 37. The method of claim 36, wherein the melting comprises melting the tissue to a depth in the range of about 50 [mu] m to about 500 [mu] m. 37. The method of claim 36, wherein the melting comprises melting the tissue to a depth of about 750 [mu] m or less. The method of claim 36, wherein the adjustment includes changing a duration of the pulse. 41. The method of claim 40, wherein the adjustment further comprises changing an energy density of the pulse. Change of the energy density, characterized in that it comprises selecting the energy density in the range of about 0.1 J / cm ² ~ about 25 J / cm ^2, The method of claim 41. Change of the energy density, characterized in that it comprises selecting the energy density in the range of about 0.1 J / cm ² ~ about 10J / cm ^2, The method of claim 41. Change of the energy density, characterized in that it comprises selecting the energy density in the range of about 0.1 J / cm ² ~ about 5 J / cm ^2, The method of claim 41. 41. The method of claim 40, wherein the changing comprises selecting a duration from a group comprising ultrashort pulses, short pulses, and long pulses. 46. The method of claim 45, wherein the selection of a very short duration includes selecting a duration in the range of about 0 to about 30 [mu] s. 46. The method of claim 45, wherein the selection of a short duration includes selecting a duration in the range of about 30 [mu] s to about 150 [mu] s. 46. The method of claim 45, wherein the selection of a long duration includes selecting a duration in the range of about 150 [mu] s to about 800 [mu] s. 46. The method of claim 45, wherein the adjustment includes emitting a short pulse and a long pulse simultaneously. The method of claim 36, further comprising: performing a cooling procedure. 51. The method of claim 50, wherein the implementation includes directing air toward the surface. 52. The method of claim 51, wherein the induction of air includes directing air at a rate of about 0-15 L / min. 51. The method of claim 50, wherein the implementation includes directing water to the surface. 54. The method of claim 53, wherein the induction of water comprises directing water at a rate of about 0-60 ml / min. 37. A method according to claim 36, characterized by treating caries. 37. The method of claim 36, wherein the modification is applied to the surface after the cavity preparation. 37. The method of claim 36, wherein the modification inhibits corrosion formation. 58. The method of claim 57, wherein the modification is applied to a mating surface. A method for delivering ions to a target surface,
Projecting particles onto the target surface;
Remodeling said surface. 60. The method of claim 59, wherein the projecting includes promoting micromechanical adhesion of the particles to the surface. 60. The method of claim 59, wherein the projection includes delivering ions to the target surface using one of an air spray and a fluid spray. 62. The method of claim 61, wherein the use of the fluid spray includes using a water spray. 60. The method of claim 59, wherein the projection comprises delivering ions to the target surface using a combined spray of both air and fluid. 64. The method of claim 63, wherein the projecting comprises projecting particles comprising ions selected from the group comprising fluoride, calcium, phosphorus, and hydroxide. Said projecting projecting particles comprising a compound comprising an ion selected from the group comprising sodium fluoride, tin fluoride, copper fluoride, titanium tetrafluoride, amine fluoride, and calcium hydroxide. 64. The method of claim 63, comprising. The method according to claim 64, wherein the projection of fluoride ions suppresses the formation of caries. 66. The method of claim 64, wherein the projection of fluoride ions desensitizes tooth tissue. 65. The method of claim 64, wherein the projection of calcium ions helps form an antimicrobial surface. 66. The method of claim 64, wherein the projection of one of calcium hydroxide ions and zinc oxide ions enhances dentin remineralization.

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