JP2018064670A - Dental treatment device and cutting tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a compact dental treatment device and a compact cutting tool that allow dental treatment to be performed while a cutting part is visually recognized, while causing a treatment direction to coincide with a direction of visual recognition.SOLUTION: A dental treatment device includes a dental handpiece having a vibration generation part and a cutting tool 20 mounted on the dental handpiece. The cutting tool 20 is formed with a hollow part 23 having an opening 25 on a side face between the side mounted on the dental handpiece and the tip in the opposite direction, and the hollow part 23 is internally mounted with an endoscope probe 35 with the lateral side of the cutting tool as a visual field from the opening 25. The cutting tool 20 is provided with a reflection member 26 for reflecting incident light from the opening 25 onto the endoscope probe 35.SELECTED DRAWING: Figure 4

Description

  The present invention relates to a dental treatment device and a cutting tool, and more particularly to a dental treatment device and a cutting tool that enable treatment by visually recognizing an affected area.

  Periodontal diseases caused by dental plaque and calculus adhering to the periodontal pocket are treated by mechanically removing the causative periodontal disease bacteria with an instrument. This treatment removes tartar and plaque with periodontal disease bacteria attached to the surface. The surface of the tartar / plaque has fine irregularities, and bacteria such as periodontal disease bacteria living on the irregularities adhere to the irregularities, so it is necessary to remove all the tartar and plaque. Since tartar and plaque are very hard, they are removed with an ultrasonic scaler or a cutting tool called an air scaler.

  Periodontal pocket is the groove between the teeth and gums (gingiva), the depth of this groove is 1-2mm in healthy gums, 3-5mm with moderate periodontitis, periodontal disease progressed In this case, it becomes 6 mm or more. On the other hand, since the width of the groove does not normally reach 1 mm, the treatment for excision of calculus and plaque involves many difficulties. In other words, it is necessary to insert the cutting tool completely into the periodontal pocket, and further, whether or not the insertion has been completely performed must be judged from the sense of the operator's hand and the patient's reaction. The patient could be very painful.

  Therefore, for the problem that the affected area or the surrounding area cannot be visually recognized at the time of treatment, an endoscope probe is externally attached to a dental vibratory handpiece such as an ultrasonic scaler, and an image of the treatment site is transmitted to the endoscope monitor Techniques are known (see Patent Document 1 and Patent Document 2).

JP 2012-239726 A JP 2012-239727 A

  The handpieces disclosed in Patent Documents 1 and 2 externally attach an endoscope probe to a dental vibratory handpiece, and are arranged in parallel with a cutting tool (chip) attached to the handpiece. Therefore, a blind spot is generated in the visual field range, and the cutting direction is sometimes limited. In addition, the size of the cross section may be larger than the end of a normal cutting tool due to external attachment. Furthermore, it was difficult to visually recognize the side surface of the tooth in the periodontal pocket to be treated. For this reason, when the handpiece disclosed in Patent Documents 1 and 2 is used, there is a possibility that an error may occur in the treatment position although it is visible.

  Therefore, in the techniques disclosed in Patent Documents 1 and 2, the tooth quality and gums are damaged, or an excessive cutting range is required, which may increase the burden on the patient to be treated.

  The present invention has been made in view of these circumstances, and provides a compact dental treatment apparatus and cutting tool capable of performing dental treatment while visually recognizing the side surface of the tooth in the periodontal pocket. For that purpose.

  In order to solve the above-mentioned problems, the invention of claim 1 is a dental treatment device comprising a dental handpiece having a vibration generating portion and a cutting tool attached to the dental handpiece, wherein the cutting In the tool, a hollow portion having an opening is formed on a side surface between a tip portion and a base portion to be attached to the dental handpiece, and the hollow portion includes a hollow portion having an opening. The imaging member provided with the endoscope probe which makes a visual field to the side is comprised internally.

  According to a second aspect of the present invention, in the first aspect of the invention, the imaging member includes the endoscope probe built in the cutting tool and incident light from the opening of the cutting tool. And a reflecting member that reflects toward the surface.

  According to a third aspect of the present invention, in the first aspect of the invention, the imaging member includes a hollow cylindrical member extending from the base portion of the cutting tool toward the tip portion, and the cylindrical member is formed of the cutting tool. The endoscope probe disposed inside the base side, an imaging window formed so as to face the opening, and a reflection part that reflects incident light from the imaging window to the endoscope probe. It is characterized by comprising.

  According to a fourth aspect of the present invention, in the invention according to any one of the first to third aspects, an anti-vibration member is interposed between the cutting tool and the imaging member. .

  According to a fifth aspect of the present invention, in the first aspect of the present invention, the endoscope probe includes an image guide and one or more light guides. .

  According to a sixth aspect of the present invention, in the first or second aspect of the present invention, the endoscopic probe includes a conduit that discharges liquid toward the opening.

  The invention of claim 7 is the invention according to any one of claims 1 to 6, wherein the cutting tool is formed with a discharge hole at a position having a predetermined distance from a tip portion of the cutting tool, A conduit for discharging liquid from the discharge hole to the tip portion side is provided.

  The invention according to claim 8 is a cutting tool attached to a dental handpiece having a vibration generating portion, and the cutting tool includes a tip portion and a base portion attached to the dental handpiece. A hollow portion having an opening is formed on a side surface of the imaging member, and an imaging member including an endoscope probe that has a visual field from the opening to the side of the cutting tool is provided in the hollow portion. It is characterized by.

  ADVANTAGE OF THE INVENTION According to this invention, a dental treatment can be performed, visually recognizing the tartar and plaque of the tooth which becomes an affected part with the endoscope probe built in the hollow part. Further, since vibration transmitted to the endoscope probe is attenuated through the vibration isolation member, blurring of an image captured by the endoscope probe can be suppressed. Furthermore, a cut partial image in the visible region can be acquired by changing the wavelength of light transmitted through the light guide. Further, it is possible to select and apply a liquid discharge port and a direction for cleaning a cutting portion according to a treatment portion and a method.

It is the whole external view for demonstrating one Embodiment of the dental treatment apparatus which concerns on this invention. It is principal part sectional drawing of one Embodiment of the dental treatment apparatus which concerns on this invention. It is a perspective view explaining connection with an ultrasonic vibrator and an ultrasonic tip. It is principal part sectional drawing of an ultrasonic chip. It is sectional drawing of an endoscope probe. It is a figure for demonstrating the treatment example using the dental treatment apparatus which concerns on this invention. It is principal part sectional drawing of the ultrasonic chip which concerns on the 2nd Embodiment of this invention. It is principal part sectional drawing of the ultrasonic chip which concerns on the 3rd Embodiment of this invention.

(First embodiment)
Hereinafter, preferred embodiments of a dental treatment apparatus and a cutting tool according to the present invention will be described with reference to the drawings. In the following description, the configurations denoted by the same reference numerals in different drawings are the same, and the description thereof may be omitted.

  FIG. 1 is an overall external view for explaining an embodiment of a dental treatment apparatus 1 according to the present invention. Referring to FIG. 1, a dental treatment apparatus 1 is an example of an ultrasonic handpiece 10 as an example of a dental handpiece having a vibration generating unit, and a cutting tool that is detachably attached to the ultrasonic handpiece 10. The ultrasonic scaler 20 has an ultrasonic chip 20 as an endoscope, and further includes an endoscope device 30 that acquires an image of a treatment site by an imaging member built in the ultrasonic chip 20, and a liquid supply unit 40 that cleans the treatment site. It consists of.

  FIG. 2 is a cross-sectional view of an essential part of one embodiment of the dental treatment apparatus 1 according to the present invention, and FIG. 3 is a perspective view for explaining the connection between the ultrasonic transducer 11 and the ultrasonic chip 20. 2 and 3 together with FIG. 1, the ultrasonic handpiece 10 includes an ultrasonic vibrator 11 and an ultrasonic vibrator 12 integrally connected to the ultrasonic vibrator 11. A power line 13 for exciting the ultrasonic transducer 11 is provided. A shaft hole 14 is provided on the distal end side of the ultrasonic vibrator 12, and a female screw 15 is formed on the inner wall of the shaft hole 14. When the male screw 22 provided on the ultrasonic chip 20 is screwed into the female screw 15, the vibration of the ultrasonic vibrating body 12 is transmitted to the ultrasonic chip 20. Here, the ultrasonic transducer | vibrator 11 and the ultrasonic vibrating body 12 are corresponded to the vibration generation part of this invention.

  The ultrasonic tip 20 is a scaling tip that serves as a cutting tool or a tooth cutting file, and cuts the affected part by vibration transmitted from the ultrasonic vibrator 12. FIG. 4 is a cross-sectional view of the main part of the ultrasonic tip. Referring to FIGS. 1 to 4 together, a hollow portion 23 is formed in the ultrasonic tip 20, and a probe introduction hole 21 is drilled in the side surface of the hollow portion. ing.

  The endoscope device 30 includes an endoscope probe 31 and an endoscope probe 31 that are installed in a hollow portion 23 formed in the ultrasonic chip 20 via a vibration isolation member 36, and illumination light and reflected light with respect to the endoscope probe 31. And the endoscope main body device 34 for transferring and the like. In the present embodiment, an integrated endoscope probe 35 in which the endoscope probe 31 and the liquid supply tube 41 are integrally formed is inserted into the hollow portion 23, and the endoscope probe 31 will be described later. And an optical waveguide for transmitting light.

  The periphery of the integrated endoscope probe 35 is covered with a vibration isolating member 36 formed so as to be in close contact with the inner wall of the ultrasonic chip 20 so as to be easily embedded in the hollow portion 23. The vibration isolation member 36 attenuates vibration transmitted from the ultrasonic chip 20 to the integrated endoscope probe 35.

  As shown in FIG. 4, the ultrasonic chip 20 is formed with an opening 25 provided on a side surface between a base portion attached to the ultrasonic vibrator 12 and a tip portion in the opposite direction. The ultrasonic chip 20 is provided with a reflecting member 26 at a position facing the opening 25. The reflection member 26 is configured to reflect incident light incident through the opening 25 toward the base portion side opposite to the tip portion of the ultrasonic chip 20. The tip of the integrated endoscope probe 35 faces the reflecting member 26 with a gap. The imaging member of the present invention means a mechanism for obtaining incident light from the opening 25 and transmitting the incident light to the endoscope body device 34. In the present embodiment, the imaging member and the integrated endoscope probe 35 The reflecting member 26 corresponds to the imaging member of the present invention.

  FIG. 5 is a cross-sectional view of the integrated endoscope probe 35. Referring to FIG. 5, the integrated endoscope probe 35 illuminates an image guide 51 for image transmission and a treatment site having tartar and plaque. A plurality of light guides 52 are arranged for this purpose. The image guide 51 and the light guide 52 are coupled to the endoscope main body device 34 via the integrated endoscope probe 35 and the endoscope probe 31, and transmit illumination light and incident light. The light guide 52 can pass light from a light emitting element that emits normal white light, blue light, or laser light of a specific wavelength, depending on the situation of imaging.

  The light guide 52 can be applied with near infrared laser light of approximately 0.7 μm to 1.2 μm in addition to illumination in a normal visible light region. Near-infrared laser light can pass through the body about 30 mm from the surface, so that tartar and plaque hidden in the gingiva can be detected. In addition, after the treatment site is washed, sterilization can be performed by irradiating laser light or LED light with a strong power of about 405 nm wavelength.

  The illumination light emitted from the light guide 52 is changed by 90 ° by the reflecting member 26, and irradiates the affected part through the opening 25. Further, the reflected light from the irradiated part is incident on the image guide 51 after the optical axis is changed by 90 ° by the reflecting member 26 through the opening. The reflected light incident on the image guide 51 is guided to the endoscope main body device 34 and converted into a video signal by an image pickup device provided in the endoscope main body device 34, and then is displayed as an image of the affected part on a display device (not shown). Is displayed.

  The liquid supply unit 40 sends the liquid to the hollow portion 23 of the ultrasonic chip 20 through a liquid supply tube 41 from a liquid freezing device or the like (not shown). The liquid may be a cleaning solution, a cooling solution, or a chemical solution.

  The liquid sent through the liquid supply tube 41 is discharged toward the opening 25 of the ultrasonic chip 20 through the conduit 55 and the discharge port 56 provided in the integrated endoscope probe 35. With this configuration, it is possible to discharge cleaning water, cooling water, chemicals, or the like to the treatment unit.

  In the present embodiment, the liquid supply tube 41 and the endoscope probe 31 are configured as a single integrated endoscope probe 35 by combining them. Such a configuration can facilitate the work of introducing the probe into the probe introduction hole 21. It is desirable that a vibration isolating member 24 such as a rubber is interposed between the integrated endoscope probe 35 and the probe introduction hole 21. This is to prevent the integrated endoscope probe 35 from being damaged by vibration.

  In addition, a cylindrical member using a hard material such as metal is cantilevered and supported by a vibration isolating member 24 in the hollow portion 23 of the ultrasonic chip 20, and the integrated endoscope probe 35 is fixed in the cylindrical member. It can also be made into such a form. With such a configuration, the integrated endoscope probe 35 can maintain a non-contact state with the inner wall of the hollow portion 23, and vibration from the inner wall of the ultrasonic tip 20 in the vicinity of the opening 25 is not transmitted. It is also possible to omit the vibration isolation member 36.

  Next, a treatment example using the dental treatment apparatus according to the present invention will be described with reference to FIG. Referring to FIG. 6, there is a periodontal pocket 63 between a patient's tooth 60 and gingiva 62 (not shown). The periodontal pocket 63 is a cause of periodontal disease, and refers to a state in which the groove between the teeth and gums is deep like a pocket. In the periodontal pocket 63, the teeth 60 and the gums 62 are in close contact with each other when they are in a healthy state to prevent the invasion of bacteria. Is peeled off to create a bag-like gap like a pocket. Tartar and plaque 61 are formed on the surface of the tooth 60 in the periodontal pocket 63. Here, plaque is also called a plaque, which is a lump of bacteria, and tartar is a set of bacteria that is combined with saliva components and hardened like stone.

  In one periodontal disease treatment, a treatment for removing tartar / plaque 61 is performed, but as described above, the periodontal pocket is extremely difficult because the treatment site is extremely small. In the dental treatment apparatus 1 according to the present embodiment, the condition of the calculus / plaque 61 incident from the integrated endoscope probe 35 is visually confirmed through the opening 25 serving as a window provided on the side surface of the ultrasonic chip 20. Can do. Based on this visual recognition, the ultrasonic chip 20 can be brought into contact with the tartar / plaque 61 and the tartar / plaque 61 can be removed.

  As described above, the dental treatment apparatus 1 according to the present invention does not damage the gum 62 or the healthy tooth 60 by visually recognizing the affected calculus / plaque 61, thereby reducing the burden on the patient to be treated. Can do.

(Second Embodiment)
Next, a second embodiment will be described with reference to FIG. Note that the present embodiment is a modification according to the form of liquid ejection, and portions that overlap with the above-described embodiment will be omitted, and description will be made with a focus on differences.

  Referring to FIG. 7, the integrated endoscope probe 35 in which the liquid supply tube 41 and the endoscope probe 31 are bundled is inserted into the probe introduction hole 21 of the ultrasonic tip 70. The integrated endoscope probe 35 is separated into the liquid supply tube 42 and the endoscope probe 31 in the hollow portion 23. The endoscope probe 31 is fixed to the ultrasonic chip 20 at a position facing the opening 25 as in the first embodiment. On the other hand, the liquid supply tube 42 is disposed in a discharge port 71 formed in a side surface of the ultrasonic chip 70.

  From the discharge port 71, cleaning water, cooling water, chemical solution, or the like is discharged toward the tip of the ultrasonic chip 20. The ejection direction can be adjusted by arbitrarily setting the angle of the ejection port 71 with respect to the ultrasonic chip 70. In the first embodiment, in addition to the discharge port 56, the liquid supply tube 41 may be further branched from the conduit 55 to provide the discharge port 71.

(Third embodiment)
Next, a third embodiment will be described with reference to FIG. Note that this embodiment is a modification of the imaging portion, and portions that overlap with the above-described embodiment will be omitted, and description will be made with a focus on differences.

  Referring to FIG. 8, in the present embodiment, a hollow tube extending from the probe introduction hole 21 drilled on the base portion side attached to the ultrasonic handpiece 10 to the tip portion from the base portion side of the ultrasonic chip 20. The shaped member 80 is inserted and fixed. The endoscope probe 31 is fixed to the base portion side of the cylindrical member 80 through a vibration isolation member 86.

  An imaging window 81 is formed in the cylindrical member 80 so as to face the opening 25, and the incident light incident from the imaging window 81 passes through the hollow interior 83 of the cylindrical member 80 and is an endoscope. A reflecting member 82 is provided so as to reflect the probe 31. With this configuration, the endoscope probe 31 can be disposed at a location where the influence of vibration of the ultrasonic tip 20 is small. Here, the cylindrical member 80 interposes the vibration isolating members 84 and 85 between the probe introduction hole 21 and the inner wall of the ultrasonic chip 20 in the vicinity of the opening 25, so that the cylindrical member 80 is viewed from the ultrasonic chip 20. It is good also as a structure which further suppresses the vibration to the mirror probe 31. FIG. In this embodiment, the cylindrical member 80 provided with the reflecting member 82 and the endoscope probe 31 correspond to the imaging member of the present invention.

  In addition, the aspect of this invention is not restricted to the said embodiment, For example, you may apply to an air scaler as a dental handpiece which has a vibration generation part.

DESCRIPTION OF SYMBOLS 1 ... Dental treatment apparatus, 10 ... Ultrasonic handpiece, 11 ... Ultrasonic vibrator, 12 ... Ultrasonic vibrator, 13 ... Power supply line, 14 ... Shaft hole, 15 ... Female screw, 20 ... Ultrasonic tip, 21 DESCRIPTION OF SYMBOLS ... Probe introduction hole, 22 ... Male screw, 23 ... Hollow part, 24, 36, 84, 85, 86 ... Vibration isolator, 25 ... Opening part, 26, 82 ... Reflective member, 30 ... Endoscope apparatus, 31 ... Endoscope probe, 34 ... endoscope main body device, 35 ... integrated endoscope probe, 40 ... liquid supply unit, 41, 42 ... liquid supply tube, 51 ... image guide, 52 ... light guide, 55 ... conduit, 56, 71 ... discharge port, 60 ... teeth, 61 ... dental plaque, 62 ... gum, 63 ... periodontal pocket, 70 ... ultrasonic chip, 80 ... cylindrical member, 81 ... imaging window, 83 ... hollow interior.

Claims (8)

A dental handpiece having a vibration generator;
A dental treatment device comprising a cutting tool attached to the dental handpiece,
In the cutting tool, a hollow portion having an opening is formed on a side surface between a distal end portion and a base portion attached to the dental handpiece,
The dental treatment apparatus, wherein an imaging member including an endoscope probe having a field of view from the opening to the side of the cutting tool is provided in the hollow portion.   The imaging member includes the endoscope probe housed in the cutting tool, and a reflection unit that reflects incident light from the opening of the cutting tool to the endoscope probe. Item 2. The dental treatment device according to Item 1. The imaging member includes a hollow cylindrical member extending from the base portion of the cutting tool toward the tip portion,
The cylindrical member includes the endoscope probe disposed inside the base portion of the cutting tool, an imaging window formed to face the opening, and incident light from the imaging window. The dental treatment apparatus according to claim 1, further comprising a reflecting portion that reflects to the endoscope probe.   The dental treatment apparatus according to any one of claims 1 to 3, wherein a vibration isolating member is interposed between the cutting tool and the imaging member.   The dental treatment apparatus according to any one of claims 1 to 4, wherein the endoscopic probe includes an image guide and one or more light guides.   The dental treatment apparatus according to claim 1, wherein the endoscope probe includes a conduit that discharges liquid toward the opening side.   The cutting tool has a discharge hole formed at a position having a predetermined distance from the tip portion of the cutting tool, and includes a conduit for discharging liquid from the discharge hole to the tip portion side. The dental treatment device according to any one of claims 1 to 6. A cutting tool to be attached to a dental handpiece having a vibration generator,
In the cutting tool, a hollow portion having an opening is formed on a side surface between a distal end portion and a base portion attached to the dental handpiece,
The hollow tool is provided with an imaging member including an endoscope probe having a field of view from a side of the cutting tool from the opening.