JP2021007656A - Periodontal pocket chemical injector - Google Patents

Abstract

To provide a periodontal pocket chemical injector which can make even photosensitive substances which are not applied with positive electric charge processing adhere to biofilm bacteria in a periodontal pocket by a larger amount compared with a conventional injector.SOLUTION: A periodontal pocket chemical injector 100 comprises: a chemical injector 10 which can accommodate a chemical cartridge therein, and has an injection nozzle 11 for injecting a chemical into a periodontal pocket; an ion introducer 20 for generating ions; a grip electrode 30 gripped by a patient; and a sub-electrode 40 which is used by being installed in a mouth. A positive terminal of the ion introducer 20 is connected to the injection nozzle 11 and the sub-electrode 40, and a negative terminal is connected to the grip electrode 30.SELECTED DRAWING: Figure 1

Description

The present invention relates to a periodontal pocket drug solution injector.

Periodontal disease is an infectious disease with chronic inflammation that affects nearly 80% of the Japanese population. Studies have shown that the main cause of periodontal disease is biofilms as a collection of microorganisms that reside in the periodontal pockets. The biofilm is composed of extracellular polysaccharides and adheres to the tooth root surface in the form of a film. The deeper the interior, the more anaerobic it becomes, creating an environment suitable for periodontal disease bacteria, generating proteolytic enzymes and endotoxins, and causing inflammation. On the other hand, since the biofilm is covered with exopolysaccharide, it is difficult to be immunologically recognized as non-self, and a specific antibody is not produced.

Biofilms can hardly invade phagocytic cells, constituents, and disinfectants. In other words, it shows strong resistance to chlorhexidine, which is a bactericidal agent, invasion of surfactants, or phagocytosis by immune cells, and cleaning of periodontal pockets for the purpose of sterilization with chemicals or disinfectant water is only a relief. Is the reality.

Bacteria that have formed biofilms in this way show about 500 times more drug resistance to antibacterial drugs than floating bacteria, and at present, drugs that effectively act on the bacteria that have formed this biofilm. Is said to not exist alone.

Therefore, as a general rule of administration of antibacterial agents for periodontal disease, it is considered effective to administer them after destroying the biofilm by mechanical debridement such as scaling and root planing to make the biofilm unstable. Has been done.

However, although the above measures are effective, there is a risk that problems such as the emergence of resistant bacteria and gastrointestinal disorders during administration may occur due to the use of antibacterial agents. In addition, there is a drawback that the patient feels discomfort such as bleeding and pain in mechanical debridement.

Therefore, recently, antibacterial photodynamic therapy (aPDT), which is painless, harmless, and has few problems even after repeated treatment, has attracted attention. Antibacterial photodynamic therapy is a local treatment method in which a photosensitive substance is injected into a target bacterial cell, then light having a wavelength such as near infrared rays is irradiated, and the photochemical reaction is used to disinfect and sterilize the cells. Examples of the light-sensitive substance include indocyanine green (ICG). Indocyanine green has hydrophilicity and lipophilicity, is extremely safe for living organisms, and is usually used as an angiographic agent in cerebrovascular, liver function tests, ophthalmic fields, and the like. When this light-sensitive substance is irradiated with near-infrared rays having an infrared wavelength of about 700 to 800 nm, it has a light property of absorbing the energy and inducing active oxygen, and the oxidizing power of the generated active oxygen (singlet oxygen). Demonstrate bactericidal power.

The advantages of this antibacterial photodynamic therapy are that the reaction rate is constant and fast compared to a normal chemical reaction, so that a stable effect can be obtained, and the presence time of singlet oxygen in the living body is nm to μm. Since the distance of singlet oxygen moving between them is about 10 nm in seconds, the range of damage is limited to the location of the photosensitizer.

For this reason, it is currently being applied to the treatment of early-stage lung cancer, gastric cancer, esophageal cancer, and uterine cancer, as well as age-related macular degeneration. Thus, antibacterial photodynamic therapy is widely used in the treatment of cancer and tumors.

Recently, a treatment method has been developed that applies this principle of antibacterial photodynamic therapy to periodontal biofilm bacteria. This treatment targets pathogenic bacteria, binds photosensitizers to the bacteria, and irradiates them with an infrared laser with an appropriate wavelength and high-power energy density to generate single-term oxygen and destroy the bacteria. However, it causes oxidative damage to the cell membrane and sterilizes the biofilm.

However, in order to satisfy such conditions, it is necessary to attach a large amount of light-sensitive substances to the biofilm and its bacterial cells.

Therefore, the present invention has been made to solve such a problem, and is effective even by irradiation with an infrared laser and a near-infrared LED using a photosensitive substance such as indocyanine green or methylene blue. It is an object of the present invention to provide a periodontal pocket drug solution injector capable of adhering a light-sensitive substance capable of killing bacteria in a periodontal pocket biofilm to the biofilm.

To kill bacteria in periodontal biofilms using photosensitizers such as indocyanine green and methylene blue as antibacterial optical therapy (aPDT), the location and time of single-term oxygen generated by the photosensitizers is extremely high. Due to its limitations, more photosensitizers need to be attached to the target biofilm.

The periodontal pocket biofilm is an aggregate of bacteria whose surface properties are usually negatively charged. Therefore, conventionally, indocyanine green dripping into the periodontal pocket has been specially processed so as to have a positive charge so as to adhere well to periodontal bacteria. That is, in order to use indocyanine green as a normal photosensitizer as a photosensitizer for the treatment of periodontal disease, indocyanine green is encapsulated in order to give a stronger positive charge to nanoparticles. Two methods have been proposed, either coating or using a diluent of indocyanine green and ultrapure water (which does not contain any minerals).

The sterilization of periodontal biofilm is performed by dropping a small amount of the positively charged photosensitizer into the periodontal pocket of the tooth, thereby attracting and adhering to the negatively charged bacteria in the deep part of the periodontal pocket. By irradiating the adhered portion with a near-infrared laser having a wavelength of about 800 nm to 830 nm, single term oxygen is generated to disinfect and sterilize the biofilm.

According to the present invention, not only positively charged photosensitizers but also positively charged photosensitizers that have not been specially processed can be used in such a treatment method, and more photosensitizers than before can be used. The present invention provides a periodontal pocket chemical injection device capable of obtaining a bactericidal effect even with a near-infrared LED by adhering a light-sensitive substance to biofilm bacteria in the periodontal pocket.

The present invention has taken the following measures to achieve the above object.

The periodontal pocket chemical injector according to the present invention is
A drug solution injector that can store a drug solution cartridge and has an injection nozzle that injects the drug solution into the periodontal pocket,
An iontophoresis device that generates ions and
The grip electrode that the patient holds and
Sub-electrodes installed and used in the mouth and
With
The positive terminal of the iontophoresis device is connected to the injection nozzle and the sub electrode, and the negative terminal is connected to the grip electrode.

Further, in the periodontal pocket chemical injector according to the present invention, a chemical injector capable of storing a chemical cartridge and having an injection nozzle for injecting the chemical into the periodontal pocket,
An iontophoresis device that generates ions and
The grip electrode that the patient holds and
Sub-electrodes installed and used in the mouth and
With
The negative electrode of the iontophoresis device may be connected to the injection nozzle and the sub-electrode, and the positive electrode may be connected to the grip electrode.

Further, in the periodontal pocket drug solution injector according to the present invention, the drug solution injector may be characterized by including an injector lever for intermittently injecting a predetermined amount of the drug solution.

Further, in the periodontal pocket chemical injection device according to the present invention, the chemical cartridge may be characterized in that it contains indocyanine green only mixed with pure water.

FIG. 1 is a conceptual diagram of the periodontal pocket drug solution injector 100 according to the embodiment. FIG. 2 is an exploded side view of the periodontal pocket drug solution injector 100 according to the embodiment. FIG. 3 is a conceptual diagram showing a usage state of the periodontal pocket drug solution injector 100 according to the embodiment. FIG. 4 is a conceptual diagram showing a usage state of the periodontal pocket drug solution injector 100 according to the embodiment.

Hereinafter, the periodontal pocket drug solution injector 100 according to the embodiment of the present invention will be described in detail with reference to the drawings. It should be noted that the embodiments and drawings described below exemplify a part of the embodiments of the present invention, are not used for the purpose of limiting to these configurations, and do not deviate from the gist of the present invention. Can be changed as appropriate in. The corresponding components in each figure are designated by the same or similar reference numerals.

As shown in FIG. 1, the periodontal pocket drug solution injector 100 according to the present invention mainly has a drug solution injection having an injection nozzle 11 for injecting the drug solution into the periodontal pocket 1 (groove at the boundary between the tooth and the tooth gap FIG. 4). It includes a vessel 10, an iontophoresis device 20 for generating ions, a grip electrode 30 gripped by a patient, a sub-electrode 40 attached to the mouth, and an electric wire 60 for electrically connecting these.

As shown in FIG. 2, the chemical injection device 10 is provided in an injector main body 15 to which a chemical solution cartridge 13 filled with a chemical solution having a photosensitive substance is attached, and a periodontal pocket 1 provided at the tip of the injector main body 15. It has an injection nozzle 11 for injecting a chemical solution, and a charge transfer member 17 for applying a charge from an iontophoresis device 20 to the injection nozzle 11.

The injector main body 15 is formed so as to be divisible into a front end side injector main body 15a and a rear end side injector main body 15b. The distal end side injector main body 15a is provided with a hollow portion having an open rear end side, and the chemical solution cartridge 13 is inserted into this hollow portion. In the chemical solution cartridge 13 inserted into the hollow portion, a hollow needle communicating with the injection nozzle 11 is inserted into the inside of the chemical solution cartridge 13 on the tip side of the hollow portion, and the chemical solution can be injected into the periodontal pocket 1 from the injection nozzle 11. it can. The rear end side injector main body 15b has a pressing portion (not shown) for pressing the rear end portion of the chemical solution cartridge 13, and pushes the injector lever 19 provided on the rear end side injector main body 15b. As a result, a predetermined amount of the chemical solution can be injected from the injection nozzle 11 by pushing out the rear end of the chemical solution cartridge 13 by a certain distance.

The chemical solution cartridge 13 contains a chemical solution prepared by mixing a light-sensitive substance with water. Examples of the light-sensitive substance include indocyanine green and methylene blue. It is preferable to use indocyanine green. It is advisable to use a chemical solution in which indocyanine green is mixed with pure water in a volume of 1: 1. At this time, it is not necessary to perform special processing such as ionization on the chemical solution. Of course, an ionized chemical solution may be used.

The injection nozzle 11 is a hollow tubular member, and as described above, the injection nozzle 11 is formed so as to communicate with the hollow needle. The injection nozzle 11 is made of a conductive substance for transferring the electric charge from the iontophoresis device 20 to the chemical solution. Preferably, it is made of metal.

The charge transfer member 17 is a member for transmitting the electric charge from the iontophoresis device 20 to the injection nozzle 11, and has a function of acting as an intermediary with the electric wire 60 connected to the positive side of the iontophoresis device 20. Since the electric wire 60 is flexible, the charge transfer member 17 is for fixing the arrangement of the electric wire 60 because if it is directly attached to the injection nozzle 11, the electric wire 60 may get in the way during the treatment. .. Therefore, the configuration of the charge transfer member 17 is not particularly limited, and the configuration is not particularly limited as long as the charge from the electric wire 60 can be transmitted to the injection nozzle 11.

The iontophoresis device 20 is for passing a weak positive electricity to the chemical solution, the positive electrode is connected to the injection nozzle 11 and the sub electrode 40 by an electric wire 60, and the negative electrode is an electric wire 60. It is connected to the grip electrode 30.

The sub-electrode 40 is attached to the mouth during treatment and is made of a metal material. Preferably, it is formed in a hook shape as shown in FIG. 1 so that it can be easily installed in the mouth. A resistor 80 may be provided between the sub-electrode 40 and the iontophoresis device 20. It is preferable that the tip of the sub-electrode is subjected to an insulating treatment such as providing a rubber cover in order to prevent the electrode from coming into direct contact with the teeth.

A pilot lamp 18 may be arbitrarily connected between the metal portion of the injection nozzle 11 and the iontophoresis device 20 in order to arbitrarily confirm that the tip of the nozzle is energized at the time of injection of the chemical solution.

As shown in FIG. 3, the periodontal pocket drug solution injector 100 produced as described above is installed so that the sub-electrode 40 is hooked in the mouth, and the iontophoresis device 30 is held in the patient's hand. The preparation is completed by turning on the power of 20. The iontophoresis device 20 preferably applies at 0.3 to 0.4 mA and about 5 to 7 V. As a result, a weak current flows through a photosensitive substance such as indocyanine green and positive ionization occurs. In this state, as shown in FIG. 4, the chemical solution is injected from the tip of the injection nozzle 11 into the periodontal pocket 1 by pushing the injector lever 19 in a fixed amount. Then, the positive current from the tip of the injection nozzle 11 positively charges the chemical solution, and the injection nozzle 11 acts as a positive electrode, so that the introduction of positive ions is started at the same time as the injection. Originally, the skin has a barrier zone composed of a charged layer, and it is difficult for chemicals and the like to invade. However, on the minus side, since the patient has the gripping electrode 30, a potential difference occurs, and the barrier zone that the human body originally has. The drug solution that has been temporarily weakened and dropped into the periodontal pocket 1 is sucked into the periodontal pocket 1 while reducing leakage to the outside of the periodontal pocket 1 due to the repulsive force and flow of a weak electric current. Then, the chemical solution also adheres to the biofilm, adheres to the biofilm bacteria existing in the periodontal pocket 1 having a negative charge, and is attracted and permeates so as to be inhaled. At this time, in this treatment method, the drug solution is intermittently injected. Therefore, when the injection nozzle 11 is separated from the patient, a pain due to electrical stimulation may be felt when the injection nozzle 11 is contacted again. According to the periodontal pocket drug solution injector 100 according to the present invention, since the sub-electrode 40 is attached to the mouth, this pain can be alleviated.

Then, the periodontal pocket 1 is irradiated with a near-infrared laser or a near-infrared LED to generate singlet oxygen to disinfect and sterilize the bacteria existing in the biofilm, and the treatment is completed. At this time, as the near-infrared LED, a high-power near-infrared LED (SWIR LED) may be used.

As described above, according to the periodontal pocket drug solution injector 100 according to the present invention, not only the specially processed indocyanine green but also the unprocessed indocyanine green effectively injects the drug solution into the periodontal pocket 1. be able to. Then, the drug solution can be permeated deep into the periodontal pocket 1, and there is a biofilm having a negative charge in the deep part, which can be efficiently attached to the internal bacteria. Since it can be effectively attached to the biofilm with high density, it can efficiently absorb near infrared rays, and it not only irradiates the periodontal pocket 1 directly with an infrared laser, but also has a low absorption rate in the living body. Irradiation from the outer periphery of the periodontal pocket 1 using a near-infrared LED (800 nm to 820 nm) capable of penetrating into a deep part about 10 times as deep as light has the same effect as a laser.

As described above, the periodontal pocket chemical injector 100 according to the present invention is used to disinfect and sterilize the periodontal pocket 1, so that the treatment can be performed by the near-infrared LED without using the near-infrared laser. Therefore, it is safer and can be treated without causing discomfort such as bleeding and pain during treatment.

It goes without saying that the present invention is not limited to the above-described embodiments, and can be implemented in various embodiments as long as it belongs to the technical scope of the present invention.

In the above-described embodiment, the positive electrode of the iontophoresis device 20 is connected to the injection nozzle 11 and the sub-electrode 40 by the electric wire 60, and the negative electrode is connected to the grip electrode 30 by the electric wire 60. However, on the contrary, the negative electrode of the iontophoresis device 20 may be connected to the injection nozzle 11 and the sub electrode 40 by the electric wire 60, and the positive electrode may be connected to the grip electrode 30 by the electric wire 60. By adopting such a configuration, it can be used for injecting a drug solution having a negatively ionized drug.

As shown in the above-described embodiment, it can be industrially used as a therapeutic tool for dental treatment.

10 ... Chemical injector, 11 ... Injection nozzle, 13 ... Chemical cartridge, 15 ... Injector body, 15a ... Tip side injector body, 15b ... Rear end side injector body, 17 ... Charge transfer member, 19 ... Injector lever , 20 ... Iontophoresis, 30 ... Gripping electrode, 40 ... Sub electrode, 60 ... Electric wire, 80 ... Resistance, 100 ... Periodic pocket chemical injector

Claims (4)

A drug solution injector that can store a drug solution cartridge and has an injection nozzle that injects the drug solution into the periodontal pocket,
An iontophoresis device that generates ions and
The grip electrode that the patient holds and
Sub-electrodes installed and used in the mouth and
With
A periodontal pocket drug solution injector, wherein the positive electrode of the iontophoresis device is connected to the injection nozzle and the sub-electrode, and the negative electrode is connected to the grip electrode. A drug solution injector that can store a drug solution cartridge and has an injection nozzle that injects the drug solution into the periodontal pocket,
An iontophoresis device that generates ions and
The grip electrode that the patient holds and
Sub-electrodes installed and used in the mouth and
With
A periodontal pocket drug solution injector, wherein the negative electrode of the iontophoresis device is connected to the injection nozzle and the sub-electrode, and the positive electrode is connected to the grip electrode. The periodontal pocket drug solution injector according to claim 1 or 2, wherein the drug solution injector includes an injector lever for intermittently injecting a predetermined amount of drug solution. The periodontal pocket chemical injector according to claim 1, wherein the chemical cartridge contains indocyanine green that is only mixed with pure water.

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