JPH0453550A - Method and device for surgical treatment - Google Patents

Abstract

PURPOSE: To fill an opening of a tooth or a bone material by filling the opening of the tooth or the bone material with paste composed of liquid and apatite hydroxide containing powder and irradiating a laser ray on the paste. CONSTITUTION: A filling material for a tooth is constituted of a mixture obtained from a liquid component composed of phosphoric acid and water, and a powder component composed of ceramic and apatite hydroxide and these components are mixed at some rate, supported by themselves, and have such viscosity as being left in a right place. A laser ray irradiated in a treatment has a wavelength 1.06μm and it is preferable if it is composed of a pulse having an energy of approximately 0.4ms duration, approximately 50Hz repeatability, and 20 or 100mJ range per a pulse. Irradiation of the laser ray on the filling material accelerates the growth of a crystal structure in its material and generates strong joint force between the apatite hydroxide and the tooth material surrounding it.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to surgical and dental treatment methods that utilize laser beams. More particularly, the present invention relates to surgical and dental procedures and instruments that utilize laser light for the removal of teeth and gingival tissue.

BACKGROUND OF THE INVENTION In dental procedures, it is often desirable to remove portions of tooth enamel and dentin, and in some cases gingival tissue, in a precisely controlled manner, and techniques for performing these procedures are There is increasing interest in the use of laser beams.

The use of laser light is attractive because, especially with the aid of optical fibers, this laser light can be focused into a very small area and is thus compatible with the dimensional scale of dental procedures. Furthermore, treatment with laser beams can be performed without relying on anesthetics.

[Problem to be solved by the invention] Several devices of this type have been proposed so far, but
There is no proof that these devices are practical, especially since the most effective of these devices that have been proposed are only useful under very finely defined and finite conditions.

Tooth enamel and dentin have hydroxyapatite as one component, and this hydroxyapatite is amorphous in dentin and crystalline in enamel. These parts of the tooth also have organic tissue and water, but no vascular system.

Healthy dentin is mineralized, but decayed dentin is demineralized. Dentin has a relatively high proportion of organic tissue, about 40%, and also a high proportion of water.

These proportions are considerably increased in carious dentin.

The dental pulp and the gingiva surrounding the tooth are composed of vascularized organic tissue containing both hemoglobin and water. Each of these components responds differently to laser light.

9, such as that produced by a carbon dioxide laser.
0,5 to 1.0 with a wavelength range of from 10μ to 10μ and or a wavelength that can be generated by a YAG laser
It has been found that hydroxyapatite absorbs laser radiation in the 6μ wavelength range.

The absorption of the laser beam by different parts of the tooth at different wavelengths is affected by the absorption of the laser beam's energy by its moisture. The greater the absorption by water, the less energy is absorbed by other components. Because the wavelength of the laser beam emitted by a carbon dioxide laser is highly absorbed by water, this laser beam has minimal cutting effect on enamel or dentin, and is more likely to cut into mineralized dentin than into demineralized dentin. The effect decreases.

On the other hand, with a laser beam having a wavelength of 1.06μ, the absorption by water decreases, so the effect on the petrified tissue becomes even greater. Laser light at a wavelength of 0.532μ is not absorbed by all hot water and is sufficiently high that it can therefore be effective against mineralized tissue when using dangerous power levels.

For vascularized tissues, the laser beam with the wavelength generated by the carbon dioxide laser has an effective cutting action due to absorption by water, the laser beam with the wavelength of 0.6μ has no effect, and the laser beam with the wavelength of 0.532μ has no effect. A laser beam of this wavelength has a cutting effect on soft tissue. This is because this laser beam is well absorbed by hemoglobin, even if it is not absorbed by water.

Although certain wavelengths may inherently have a cutting effect on enamel or dentin, the practical use of laser beams at such wavelengths for dental treatment depends on the energy level,
It has been discovered that, in terms of pulse duration and repetition rate, it is highly dependent on the shape in which the laser beam is applied. In particular, efforts to apply this laser beam in the form of high-energy pulses with short duration have led to
It has been discovered that this results in a highly localized increase in temperature, thereby creating differential thermal expansion that can cause mechanical damage to the teeth as well as vascular damage to the gingival tissue. Conversely, long duration, low energy pulses further heat the teeth, making the patient uncomfortable and damaging the gums due to heating.

For the treatment of various dental and other medical conditions, it is often necessary to remove bone, dentin, cementum, or root material and may have secondary adverse effects on the patient. It is desirable to remove it without any damage.

Often, when performing medical procedures in the oral cavity, practitioners encounter metal objects introduced by previous dental work.

The metal body is comprised of metal filling material, metal pins, and chromium alloy posts used to secure the dental prosthesis in place.

It is then necessary to cut these metal bodies without producing harmful side effects.

Dental practitioners also often encounter cysts and granulomas that develop in the gums near the tips of the teeth. These growths need to be destroyed or at least substantially reduced.

Additionally, some tooth filling materials are currently available that are capable of filling not only cavities but also cavities present and formed in the aggregate, and the hardness of the natural materials being replaced. There continues to be a need for materials that have a stiffness comparable to , and that form strong bonds with the walls of cavities or openings.

It is an object of the present invention to effectively use laser light in a variety of surgical procedures, including cutting both teeth and gum tissue, as well as other vascularized body tissue, by vaporization.

Another object of the present invention is to eliminate significant deficiencies of previously proposed laser treatment systems.

Yet another object of the invention is to provide a single laser treatment device capable of performing a variety of surgeries.

Yet another object of the present invention is to perform dental treatment using laser light in a manner that minimizes or completely eliminates undesirable side effects of the treatment.

A particular object of the present invention is to use a laser beam to cut mineralized tooth tissue without the need for high energy levels.

Another specific object of the invention is to use laser light to cut soft tissue without the need for high energy levels.

A more particular object of the present invention is to provide a method for treating the patient without adverse side effects and without particularly burning tissue in the vicinity of the area being treated.
It is the use of a laser beam to selectively cut bone, dentin, cementum and root material as well as metal bodies during the day.

Another object of the invention is to provide a new filling material for filling cavities or openings in both teeth and bones, and to use laser light to accelerate the hardening of this filling material.

Yet another object of the invention is to provide an improved treatment for cysts and granulomas in bone and gums.

SUMMARY OF THE INVENTION According to one aspect of the invention, the above object is achieved by forming a paste consisting of a liquid and a hydroxyapatite-containing powder, and creating an opening in tooth or bone material with the paste. Filling of an opening in tooth or bone material, characterized in that: filling and irradiating a laser beam onto the paste filling said opening to adhere hydroxyapatite to the material surrounding said opening; This is accomplished by a method.

According to another aspect of the invention, the above object provides a method for treating cysts or granulomas in the gingiva or bone at the distal end of a tooth root canal, comprising: opening the root canal to the vicinity of the distal end of the tooth root canal; An optical fiber with an output end is inserted into the root canal so that the output end is located at the tip of the root canal, and a laser beam is emitted from the output end and hits the hole to open the hole. and then introducing a series of pulses of laser light through an optical fiber so as to at least reduce the cyst or granuloma.

According to yet another aspect of the invention, the above object provides a method for cutting bone, dentin, cementum and root material in the body, which comprises generating a laser beam having a wavelength suitable for cutting these materials. , generate a series of pulses of a laser beam having an energy level, pulse duration and repetition rate selected to cut this material without producing harmful side effects; This is achieved by the method described above, which is characterized in that the laser beam is focused on a sufficiently small point of the material and that a cooling fluid is applied to said point simultaneously with this focusing step.

According to yet another aspect of the present invention, the above object provides a method for cutting a metal object in the mouth of a patient, in which a laser beam having a wavelength suitable for cutting the metal object is generated and harmful side effects are avoided. Generate a series of pulses of a laser beam having an energy level, pulse duration and repetition rate selected to cut this metal body without causing the metal body to sever a sufficient amount of this metal body. This is achieved by the method described above, which is characterized in that the laser beam is focused on a small point and that a cooling fluid is applied to said point simultaneously with this focusing step.

EXAMPLE The present invention provides a method for using a laser beam to cut both tooth and gingival material as well as other vascularized tissue by vaporization, especially when specific parameters for the laser beam are established. It is essentially based on the discovery that it is possible to use

According to the invention, the defects mentioned hereinabove are eliminated or at least substantially minimized and an effective cutting action can be achieved by using a laser beam. In this case, the laser beam is preferably in the form of a pulse with an energy content between lomJ and 100 mJ, at a wavelength of 1,06μ, for about 100 microseconds to 30
Preferably, it has a pulse duration of 0 microseconds, a repetition rate of about 50 Hz, and is focused at a point of treatment location of about 200 microseconds to 600 microseconds.

Pulse durations of 100 μsec to 300 μsec have been found to be long enough to avoid thermal shock to the tissue being treated, but short enough to allow effective control of the heating effect to be maintained.

According to the present invention, a laser beam with a wavelength of 1.06μ, which can be generated by a Nd-YAG laser, demineralizes, i.e. cuts or cuts carious enamel and dentin, without endangering the gingival tissue. It can be used to evaporate. Laser light at a wavelength of 0.532μ, which can be generated by a Nd YAG laser, can also be used, but great care must be taken as laser light at this wavelength has also been found to cut gingival tissue. .

Therefore, a laser beam of this wavelength can be used when it is desired to cut gingival tissue.

Furthermore, the Applicant has discovered that one method for cutting healthy or mineralized dentin and healthy enamel, which was previously not considered possible, if a black colored area is first provided at the starting point of the cut. It has been discovered that it is possible to create a laser beam with a wavelength of .06 microns. In particular, 1,0 due to black material
It has been discovered that energy absorption at a wavelength of 6PLμ allows a laser beam with a suitable energy level to create a plasma sufficient to vaporize dentin tissue. Applicants further believe that once a plasma cloud is established in the black colored area that allows the evaporation of dentin, this plasma cloud remains intact and that the laser beam is applied so that the evaporation of healthy dentin continues. discovered that they can be moved at controlled speeds from their black colored areas.

■ To cut dentin and enamel.

A laser beam with a wavelength of 0.6 μm should be used.

It has been found that laser radiation at a wavelength of 0.532μ is only effective when applied at dangerously high energy levels.

Since the 0.0532μ laser beam can efficiently cut vascularized tissue, this laser beam can be used for general surgical treatment.

In this case, the radiation pulse has an energy level not higher than 1O+nJ and a pulse duration of 100 μs to 3°.
06 seconds. The laser beam has a diameter of 2 (t
It may be possible to converge to a point between oμ and 600μ. The pulse repetition rate used is approximately 50H
It may be z.

The drawing shows a handpiece for providing a laser beam of suitable shape to carry out the operations described above. The housing 2 is provided in a manner customary for handpieces, the housing of which is formed in a manner known in the art to facilitate operation. The interior of the housing 2 has an optical fiber 4 whose input end is connected to the
．． It is connected to a monochromatic light source 6, such as a Nd YAG laser, which emits a laser beam with a wavelength of 0.6 μm. The light source 6 is connected to an operating power supply 8, which supplies sufficient pulses to cause the light source 6 to generate light pulses having the desired parameters.

The free end of the optical fiber 4 near the free end of the housing 2 is supported by a suitable support plate 10 to direct the laser beam to a curved mirror 12 which directs the laser beam to the receiving end of another optical fiber 14. Move to. The curved mirror 12 connects the optical fiber 4 to a point within the optical fiber 14, preferably near its output end.
It also performs a converging action that can converge the laser beam generated from the laser beam. This helps ensure that the light emanating from optical fiber 14 can be focused on a sufficiently small spot on the tooth being treated. Optical fiber 14 preferably has a very small diameter, perhaps 250μ.

The housing 2 has a hollow tube 16 which is connected to a source 18 of water and/or air to direct the flow of fluid supplied by this source 18 to the area of the tooth to be irradiated with the laser beam. It has an outlet end positioned to point proximally.

According to a particular novel feature of the invention, a plate 20 is slidably attached to the light source 6, which is capable of influencing the laser beam so as to double its frequency;
A plate 20 is placed in the optical path between the light source 6 and the optical fiber 4.
The control handle 22 is configured to be slidable by operation of the control handle 22 between the illustrated position in which the plate 20 is inserted and a retracted position in which the plate 20 does not intersect the optical path.
is connected to. This simple configuration gives the handpiece the ability to deliver either 1.06μ or 0.532μ laser light to the area to be treated, so that only a single laser device can deliver laser light of either wavelength. It would be good if selective treatment performance could be given.

Optical fiber 1 is used to perform endofungal therapy within the root canal.
4 is given an appropriate length and diameter to be introduced into the root canal, and a laser beam can be applied to the wall of the root canal to enlarge the root canal and prepare it for filling.

According to a particular embodiment of the invention, the necessary black dots can be easily formed by providing a small amount of graphite, such as is used in pencils, with the help of a small amount of glue. In fact, it has been found that it is possible to achieve the desired result by applying a small amount of glue to the tip of a sharpened pencil and then rubbing the tip of the pencil at the desired location.

To remove caries, the laser beam has a wavelength of 1.06μ and can have the pulse shape described above.

To dissipate the heat generated by the laser beam, a spray of water and/or air should be applied to the tooth near the irradiated point. The fluid flow rate depends on the extent to which the fluid absorbs this laser beam. For example, water absorbs a 1.06μ laser beam to a much lower extent than it absorbs a 0.0532μ laser beam. Water is therefore delivered at a higher velocity when this latter wavelength of laser light is used.

When this laser beam is applied to de-Bed or abnormal dentin, a sunspot is not necessary, a plasma is formed at the point of irradiation, and the diseased material is evaporated at and around the point. Although the plasma spread tends to increase over a short period of time, this gives the possibility of reducing the pulse energy between lomJ and 20o+J.

When cutting normal tissues, the wavelength of the laser beam can be 1.06μ, which requires the provision of black spots and does not affect soft tissues, or hard tissues, i.e. dentin and enamel or soft tissues. Any vascularized tissue can be cut with 0,532 PLμ. Each wavelength is desirable for its particular purpose.

Thus, the present invention provides four modes of operation to meet different needs: 1) a wavelength of 1.06 μ, an energy level of 20 to 50 mJ and a wavelength of 1.06 μ for cutting demineralized enamel and abnormal dentin; A laser beam with the previously mentioned pulse parameters is used. It is not necessary to indicate by a sunspot.

2) To cut normal enamel and dentin,
The emitted laser beam has the same parameters as in operating mode 1), but the starting point is marked with a black dot.

3) The same parameters as in operating mode 1) are used to cut any tissue and are marked with black dots when possible.

4) To cut mineralized tissue, including gums and other soft tissues, without the need for black dot indication, a wavelength of 0.5 consisting of pulses with an energy level not exceeding lomJ.
A 32μ laser beam is used.

In dental procedures, cooling sprays are used whenever the procedure generates sufficient levels of heat.

The laser beam irradiation in all of the methods described below can be carried out in the apparatus described above and shown in the drawings.

According to the invention, the tooth filling material is composed of a mixture obtained from a liquid component consisting of phosphoric acid and water and a powder component consisting of ceramic and hydroxide apatite, these components being mixed in a certain proportion. It has a viscosity such that it can be acted upon to fill the aperture with a spaticle and is sufficiently self-supporting to remain in place. The mixture is then cured by irradiation with a laser beam having the properties described below, and it is bonded to the tooth. The proportions of the mixture are not critical, but the following are preferred:

Liquid: Phosphoric acid 40% water
60% Powder: Ceramic 80% Hydroxylated Apatite 20% As the proportion of hydroxylated apatite increases, more energy is required to harden the mixture. If that proportion is reduced, the strength of the resulting bond is reduced.

The ceramic component may be, for example, corde
rHe), silica or silicon oxide or aluminum oxide. The powder component has a particle size commonly used for tooth filling materials.

The liquid component and the powder component shall be mixed together immediately prior to introduction into the opening to be filled.

The laser beam irradiated during this treatment has a wavelength of 1.06 μ and preferably a duration of about 0.4 ms, a repetition rate of about 50 Hz and a frequency of 2° to 1° Om.
Preferred are pulses with an energy per pulse in the range of J. However, in contrast to the various cutting procedures described in more detail below, the laser beam is here defocused so that it is at least approximately coterminous with the exposed surface of the filling material. This can be easily accomplished by varying the air gap between the laser beam output surface of the handpiece and the surface of the tooth. The area irradiated with this laser beam is easily visible.

Irradiation of the filling material with a laser beam stimulates the growth of a crystalline structure within the material and a strong bond is created between the hydroxyapatite and the surrounding tooth material.

The laser beam is applied until a crystalline structure appears, which generally requires irradiation of the laser beam for a period of 10 to 30 seconds.

The filling materials and laser beams described above can be used to fill cracks or gaps in bone material.

According to another aspect of the invention, a laser beam with the above characteristics can be used to treat cysts or granulomas near the tips of teeth or in bones. For this purpose, after the root canal has been drilled into the hole, a thin optical fiber with a diameter of approximately 200 μ, for example, is inserted into the root canal up to the hole, and a laser beam with the above-mentioned properties for cutting the soft tissues is introduced. It is sent through an optical fiber to cut the hole and remove the cyst or granuloma.

This surgery preferably uses a wavelength of 1.06μ, approximately 0
．． It is better to use a laser beam with a pulse duration of 4 ms, a pulse repetition rate of about 50 Hz and an energy content per pulse of 5 to 4 buttons.

Further according to the invention, bones, roots can be cut for a period of the order of seconds by irradiating a laser beam of the above type with cleaning with a water/air mixture to control the thermal laser beam cutting action, without combustion. , can cut dentin and cementum. In this case, the wavelength of the laser beam is 1.06μ, the pulse duration is about 0.8 to 1.2 ms, and the pulse repetition rate is 30 to 5.
0 Hz and the energy content per pulse is between 20 and 400+nJ. This can be done without first forming a black spot in the case of the first irradiation of the laser beam. However, the application of sunspots increases the absorption of energy, thus speeding up the cutting action. Additionally, black dots can be applied when desired to preliminarily mark or delineate the location to be cut with a low energy beam.

Furthermore, a laser beam having the above-mentioned shape for bone cutting can also serve to cut metal parts such as metal fillings, pins or chromium alloy dental prosthesis posts. For this purpose, a laser beam is generated and directed in the manner described above onto the material to be cut.

In all implementations of the cutting operations described above, the bright outer surface of the handpiece is preferably positioned to focus the laser beam on a small spot with a diameter of about 200 to 600 μ.

When dentin is cut with the help of an optical fiber in contact with the dentin, the end of the optical fiber in contact with the dentin is destroyed. Therefore, it is desirable to use relatively long optical fibers that are replaced after a period of use. Although the above description relates to specific embodiments of the invention, it will be appreciated that many changes may be made without departing from the spirit of the invention. It is intended that the following claims cover such modifications as fall within the true scope and spirit of the invention.

Accordingly, the embodiments disclosed herein are to be considered in all respects as illustrative and not restrictive, with the scope of the invention being defined by the claims set forth above rather than by the above description. Therefore, all changes that come within the meaning and range of equivalency of these claims are to be embraced within their scope.

[Brief explanation of the drawing]

The drawing is a cross-sectional view of a preferred embodiment of a laser beam treatment device according to the invention. DESCRIPTION OF SYMBOLS 2... Housing, 4... Optical fiber, 6... Monochromatic light source, 8... Operating power source, 10... Indication board, 1
2... Curved mirror, 14... Optical fiber, 16...
・Pipe, 18... Source of water and/or air, 20...
Board, 22...control handle. Field engraving (no change in content) Procedural amendment (method) Indication of the case 1990 Patent Application No. 163951 2゜Name of the invention Surgical treatment method and device 3゜Relationship with the case

Claims (1)

[Scope of Claims] (1) Generating a laser beam at a wavelength that is more strongly absorbed by hydroxyapatite than water and selected to cut tooth tissue without producing harmful side effects. generating a series of pulses of the generated laser beam at an energy level, pulse duration, and repetition rate, and concentrating the pulses of the laser beam at a sufficiently small point on the tooth tissue to cause the tooth tissue to be cut; A surgical procedure method for cutting dental tissue characterized by: (2) The surgical treatment method according to claim (1), wherein the wavelength of the laser beam is between 0.5 and 1.1 μ. (3) The wavelength of the laser beam is at least about 0.532μ
and 1.06μ, the surgical treatment method according to claim 2. (4) The surgical treatment method according to claim (2), wherein the wavelength of the laser beam is 1.06μ. (5) Each pulse applied to the tooth tissue is about 10 mj to 5
Surgical method according to claim 1, characterized in that it has an energy content of between 0 mJ. (6) Each pulse applied to the tooth tissue is about 20 mj to 5
Surgical treatment method according to claim 5, characterized in that it has an energy content between 0 mj. (7) The stage of concentrating the laser beam pulses is about 250
Surgical method according to claim 1, characterized in that it is carried out to limit the laser beam to a point with a diameter not exceeding μ. 8. The method of claim 7, wherein said point has a diameter of between about 200μ and 600μ. 9. The surgical method of claim 1, wherein the pulses have a repetition rate of about 50 Hz. 10. The surgical method according to claim 1, wherein the pulse has a duration of about 100 .mu.sec to 300 .mu.sec. (11) The surgical treatment method according to claim (1), further comprising a preliminary step of coloring black dentin at a point where the laser beam is focused, and cutting healthy dentin. (12) The surgical treatment method according to claim (11), wherein the preliminary step includes applying a black substance to the dentin. (13) The surgical treatment method according to claim (11), wherein the wavelength of the laser beam is 1.06μ. 14. The method of claim 1, further comprising the step of concentrating the pulses of the laser beam and simultaneously supplying a cooling fluid to the point area. (15) Claim (1) characterized in that the fluid is water.
14) The surgical treatment method described. (16) means for generating a laser beam of a wavelength that is more strongly absorbed by hydroxide apatite than water, and connected to the generating means to cut dental tissue without harmful side effects; means for causing said generating means to generate a series of pulses of said generated laser beam at an energy level, pulse duration and repetition rate selected to cause said generated laser beam to dissect said dental tissue; Surgical treatment device for cutting dental tissue, characterized in that it has means for focusing pulses of laser light onto a sufficiently small point of the tooth. (17) The dental tissue cutting device according to claim 16, wherein the wavelength of the laser beam is between 0.5 and 1.1μ. (18) The wavelength of the laser beam is approximately 0.532μ and 1
．． 18. The surgical treatment device according to claim 17, wherein the surgical treatment device is any one of 0.06μ. (19) The surgical treatment apparatus according to claim 16, wherein the means for concentrating the laser beam comprises an optical fiber. (20) The surgical treatment apparatus of claim (19), wherein the optical fiber has a diameter sufficiently small to enable insertion of the optical fiber into a root canal. 21. The method of claim 1, further comprising means arranged to concentrate the pulses of the laser beam and at the same time supply a cooling fluid to the region of the point.
6) The surgical treatment device described above. (22) generating radiation at a wavelength of at least about 0.532 microns, and at an energy level, pulse duration, and repetition rate selected to ablate dental tissue without producing harmful side effects; cutting vascularized tissue, comprising the steps of: generating a series of pulses of a laser beam and focusing the pulses of radiation onto a sufficiently small point on the dental tissue to cause cutting of the vascularized tissue; Surgical treatment method for. 23. The method of claim 22, wherein each pulse applied to the vascularized tissue has an energy content of no more than about 10 mj. (24) forming a paste consisting of a liquid and a hydroxyapatite-containing powder, filling an opening in the tooth or bone material with the paste, and adhering the hydroxide apatite to the material surrounding the opening; 1. A surgical method for filling an opening in tooth or bone material, characterized in that a laser beam is irradiated onto the paste filling said opening in order to fill the opening. (25) The step of irradiating the laser beam includes defocusing the laser beam so that at least a substantial portion of the exposed surface of the paste filling the opening is covered by the laser beam. Surgical treatment method. 26. The method of claim 25, wherein the laser beam is sufficiently defocused to cover the entire exposed surface of the paste filling the opening. (27) The surgical treatment method according to claim (25), wherein the laser beam has a wavelength of about 1.06μ. (28) The laser beam has a duration of about 0.4 ms and a duration of about 5
A surgical method according to claim 27, characterized in that the pulses have a repetition rate of 0 Hz. (29) Claim (29) characterized in that the laser beam has an energy content of about 20 mj per pulse.
28) The surgical treatment method described. (30) Laser beam has 260 to 1 pulse per pulse
26. Surgical treatment method according to claim 25, characterized in that it has an energy content in the range of 00 mj. (31) The surgical treatment method according to claim (24), wherein the paste liquid contains water and phosphoric acid. (32) The surgical treatment method according to claim (31), wherein the paste liquid consists essentially of water and phosphoric acid. (33) The surgical treatment method according to claim (32), wherein the paste liquid has a content of approximately 40% phosphoric acid and 60% water. (34) The surgical treatment method according to claim (31), wherein the paste powder contains ceramic and hydroxyapatite. (35) The surgical treatment method according to claim (34), wherein the paste powder consists essentially of ceramic and hydroxide apatite. 36. The method of claim 34, wherein the paste powder has a content of at least about 80% ceramic and 260% hydroxyapatite. (37) In a surgical treatment method for treating cysts or granulomas in the gums or bones at the tip of a root canal, the root canal is opened to near the tip of the root canal, and the output end is held inside the root canal. An optical fiber is inserted so that its output end is located at the tip of the root canal, and a laser beam is emitted from the output end that hits the hole, opens the hole, and then hits the cyst or granuloma and at least reduces it. A method of surgical treatment comprising introducing a series of pulses of laser light through an optical fiber to cause (38) The surgical treatment method according to claim (37), wherein the laser beam has a wavelength of about 1.06μ. (39) The laser beam has a duration of about 0.4 ms and about 5
39. A surgical method according to claim 38, characterized in that the pulses have a repetition rate of 0 Hz. (40) The laser beam has about 50 to 4 pulses per pulse.
The surgical treatment method according to claim 39, characterized in that it has an energy content of 00 mj. (41) In a surgical procedure for cutting bone, dentin, cementum, and tooth root materials in the body, a laser beam having a wavelength suitable for cutting these materials is generated without producing harmful side effects. generate a series of pulses of a laser beam with an energy level, pulse duration and repetition rate selected to cut this material; A method of surgical treatment characterized in that a cooling fluid is applied to said point simultaneously with the focusing step. (42) The surgical treatment method according to claim (41), wherein the laser beam has a wavelength of about 1.06μ. (43) Laser beam is about 0.8ms to 1.26m
43. A method according to claim 42, comprising pulses having a duration of s and a repetition rate in the range from 30 Hz to 50 Hz. (44) Laser beam is approximately 2600mj per pulse
Surgical treatment method according to claim 43, characterized in that it has an energy content of between 400 mj and 400 mj. (45) The surgical treatment method according to claim (41), wherein the cooling fluid is a mixture of air and water. (46) A method for cutting a metal object in the mouth of a patient, in which a laser beam having a wavelength suitable for cutting the metal object is generated and selected to cut the metal object without producing harmful side effects. generating a series of pulses of a laser beam having an energy level, pulse duration and repetition rate, and focusing the laser beam on a sufficiently small point on the metal body to cause the metal body to be cut; A method of surgical treatment characterized by simultaneously applying a cooling fluid to said points. (47) The surgical treatment method according to claim (46), wherein the cooling fluid is a mixture of air and water.