US20180028276A1 - Dental laser for the treatment of soft tissue - Google Patents

Dental laser for the treatment of soft tissue Download PDF

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Publication number
US20180028276A1
US20180028276A1 US15/549,884 US201615549884A US2018028276A1 US 20180028276 A1 US20180028276 A1 US 20180028276A1 US 201615549884 A US201615549884 A US 201615549884A US 2018028276 A1 US2018028276 A1 US 2018028276A1
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US
United States
Prior art keywords
laser
dental
light
laser light
outlet point
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US15/549,884
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English (en)
Inventor
Ralf Sutter
Bernd Oehme
Steffen Muller
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Dentsply Sirona Inc
Original Assignee
Dentsply Sirona Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dentsply Sirona Inc filed Critical Dentsply Sirona Inc
Publication of US20180028276A1 publication Critical patent/US20180028276A1/en
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/0046—Dental lasers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00321—Head or parts thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2015—Miscellaneous features
    • A61B2018/202—Laser enclosed in a hand-piece
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2035—Beam shaping or redirecting; Optical components therefor
    • A61B2018/20351—Scanning mechanisms
    • A61B2018/20359—Scanning mechanisms by movable mirrors, e.g. galvanometric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2065—Multiwave; Wavelength mixing, e.g. using four or more wavelengths
    • A61B2018/2075—Multiwave; Wavelength mixing, e.g. using four or more wavelengths mixing three wavelengths
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation
    • A61B2218/003—Irrigation using a spray or a foam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/06—Implements for therapeutic treatment
    • A61C19/063—Medicament applicators for teeth or gums, e.g. treatment with fluorides

Definitions

  • the invention relates to a dental laser that is designed for the treatment of soft tissue and that comprises a handpiece having an application tip for emitting the laser light.
  • the soft tissue in particular, the gum is cut with a dental laser, which has more power than a dental laser for disinfecting periodontal pockets or root canals.
  • the prior art discloses the use of dental lasers that are designed to cut soft tissue and that use laser light in the infrared range. Typical wavelengths of such laser light are 810 ⁇ 15 nm, 940 nm or 975 ⁇ 15 nm.
  • the laser beams are introduced into an optical waveguide of the application tip; and the distal end of the optical waveguide is brought into contact with the soft tissue.
  • power levels in a range of 2 to 6 W are used at the distal end of the application tip, so that the result is intense heating of the tissue not only in the actual operating area, but also in the adjacent tissue.
  • WO 2009/003014 A2 discloses a plurality of dental lasers, for example, a diode laser, which is provided for the treatment of soft tissue with a large coagulation zone for better homeostasis and which has a wavelength in the range of 500 to 1,350 nm and a power output of 1 to 100 W.
  • a dental laser which is known from WO 2009/003014 A2 and which is provided for the treatment of soft tissue with a minimum zone of effectiveness and precise tissue cutting, has wavelengths of 300 to 450 nm or 1,350 to 3,000 nm and a power output of 0.1 to 100 W.
  • the published document WO 2009/003014 A2 discloses yet another dental laser, which has several wavelengths of 410 nm, 577 nm, 975 nm, 1,470 nm, 1,890 nm and 2,940 nm; and these wavelengths match different maxima of the blood absorption and the water absorption, with the water considered to be the main absorber in the soft tissue of the mouth.
  • the laser beams exit the handpiece through a tip.
  • it is known from other lasers for cutting hard dental tissue, such as Er:YAG, Er:YSGG that liquid is supplied for cooling or for facilitating the process, cooling the preparation site with water is always ruled out, when the wavelength that is employed is especially well absorbed by water. Therefore, in the case of diode lasers, in which the wavelengths that are used have a high water absorption, no cooling is provided.
  • All of the dental diode lasers known to date are operated in the so-called “contact mode”, which means that the application fiber is in direct contact with, i.e., touches, the tissue that is to be cut.
  • the cutting of the tissue is carried out mainly by means of the thermal effect of the application fiber.
  • the high temperature, which is required at the application fiber for the cutting is achieved, on the one hand, by providing a sufficient laser power output and, on the other hand, by conditioning the application fiber prior to treatment.
  • the fiber can be conditioned, for example, by blackening the surface of the fiber, for example, by means of paper. For this purpose, the fiber and the paper are brought into direct contact; and the laser is activated.
  • the now blackened surface of the application fiber absorbs more light from the laser source and; as a result, the fiber is heated up with a higher degree of intensity.
  • the cutting of the tissue is also facilitated by the absorption of the laser radiation, issuing from the application fiber, in the tissue.
  • This absorption depends, among other things, on the wavelength of the laser light.
  • a dental laser of the invention comprises a handpiece having a grip region and a treatment tip with an outlet point, arranged at a distal end, for laser light and, furthermore, comprises a light conduction means, arranged in the handpiece, for providing laser light at the outlet point, with said laser light coming from a light source, arranged inside or outside the handpiece.
  • the laser light has a wavelength of 445 ⁇ 20 nm, in particular, 445 ⁇ 10 nm and more particularly 445 ⁇ 5 nm, and the optical power output is provided at the outlet point in a power range of no less than 2 W to no more than 5 W, advantageously at least 3 W and, in particular, 3.5 W.
  • the thermal degradation is minimized, in particular, by the fact that the heat input by the heated application fiber itself is absent and only contributes heat owing to the absorption of the laser radiation in the tissue in order to heat the tissue. Five watts are considered to be the upper limit to ensure a sufficient distance from a power output level that will damage the soft tissue.
  • the fiber does not make contact with the preparation site and the absorption of the laser light in water is very low, it is also possible to use external water cooling for the cutting site in such a way that just the treatment instrument alone causes evaporation, i.e., a decrease in the cooling capacity.
  • the cooling medium such as, for example, water
  • the cooling medium can be fed to the application fiber at the proximal end of the application fiber and from there can flow, for example, due to gravity, to the distal end of the application fiber.
  • the soft tissue can be cut particularly well, efficiently and gently at a wavelength of 445 nm and an optical power output in the range starting from 2 W and, in particular, at 3.5 W.
  • the optical power output at the outlet point can be advantageously changeable to a different power range, with the different power range running from at least 1 W to less than 2 W.
  • the dental laser can be used in contact mode.
  • the result is a therapeutic window that lends itself to the use of a blue diode laser having a laser power output in the range of 1 to 3.5 W and even higher.
  • Another subject matter of the present invention is a dental laser, as described above, but in this case the laser light has a wavelength of 410 ⁇ 10 nm, and an optical power output is provided at the output point in a power range of no less than 1 W to no more than 2 W.
  • the light source may comprise at least one laser diode, preferably at least two, and, in particular, three.
  • This aspect makes it possible to provide a handpiece that is compact and permits easy handling.
  • the laser diodes can be located in a device that transmits the laser radiation to the handpiece by means of a light guide. However, it is also possible to integrate the laser diode, required to generate the light, or the necessary diodes directly into the handpiece.
  • the light conduction means for providing laser light at the outlet point may have application fibers between 150 and 350 ⁇ m in diameter.
  • the advantage of the fiber between 150 and 350 ⁇ m is that at these diameters the power level is relatively high in relation to the exit surface.
  • the small diameter also enables small cutting widths, especially if the fiber is guided over the tissue to be cut without making contact, since the divergence of the radiation, which is primarily a function of the material of the light guide, has to be taken into account.
  • a coolant line can be arranged in the handpiece; and there may be an outlet opening, from which the coolant, directed to the preparation site, issues.
  • the amount of coolant ranges preferably from 0.1 to 10 ml/min.
  • the coolant may have a disinfecting effect. This feature makes it possible not only to cool, but also to disinfect the preparation site.
  • a dental laser is provided that can be used in the surgical treatment of the human or animal body, and, as a result, the side effects are reduced; and it can be assumed that the wound will heal much faster.
  • FIG. 1 shows a schematic diagram of an inventive dental laser with an outlet point of the laser light from an application fiber
  • FIG. 2 shows the dental laser from FIG. 1 with an outlet point of the laser light in a free jet.
  • FIG. 1 shows a dental laser with a handpiece 100 for the treatment of the human or animal body by means of laser beams 102 .
  • the laser beams 102 are generated in a laser module 106 by means of one or more laser diodes 103 with laser light of a wavelength 104 of 445 ⁇ 20 nm, preferably 445 ⁇ 10 nm, in particular, preferably 445 ⁇ 5 nm and are transmitted to the handpiece 100 by means of a light guide 108 .
  • the handpiece 100 has a housing 101 with a grip region 100 a and a treatment tip 101 with an outlet point 101 a , disposed at a distal end, for the laser light 102 .
  • three laser diodes which are arranged in a laser module 106 separate from the handpiece 100 and which have a wavelength of 445 nm ⁇ 20 nm, each having an optical power output of 1.6 W, are coupled to a laser beam 102 and are guided in the handpiece 100 by means of a light guide 108 .
  • the power output that remains available at the distal end of the treatment tip is only about 3.5 W.
  • a free laser beam 102 travels inside the handpiece 100 and issues from the handpiece at an outlet point 101 a after a beam deflection by means of an optical component 113 , like a mirror.
  • Downstream of the light conduction means 105 means 114 may be provided, for example, optical means, such as lenses, which lend themselves to reducing the divergence of the laser radiation. In this way it is possible to extend the necessary working distance from the outlet point 101 a to the preparation site 112 , so that the distance, at which it is easy to work, extends over an enlarged area.
  • the electric power output of the laser module is 17.2 W, i.e., 3 ⁇ 4.8 V ⁇ 1.2 A.
  • the handpiece 100 may have a coolant line 109 , through which a coolant 110 may be fed to an outlet opening 111 , where the coolant 110 exits in such a way that it is directed to the preparation site 112 .
  • the amount of coolant can be preferably between 0.1 and 10 ml/min.
  • the cooling can be carried out preferably by means of water or a physiological saline solution.
  • the blue light is not primarily absorbed by the water, but rather the hemoglobin, which is also in the tissue.
  • the absorption coefficient for hemoglobin is 10 5 times higher than the absorption coefficient for water. This absorption behavior makes it possible to cut, even without the thermal transmission of energy from the fiber to the tissue.
  • the tissue is processed by just the energy alone that is generated in the tissue by the radiation.
  • the laser light which is used for cutting, may also be provided due to the fact that the laser diode sits directly in the handpiece and that the application fiber is coupled to the laser diode.
  • the invention is independent of the generation and transmission of the laser light.
  • this laser diode may be used directly in the handpiece. If the laser diode is placed in the handpiece, the transmission losses are very low, since there is only one interface to the application fiber.

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  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Optics & Photonics (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Epidemiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Electromagnetism (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Laser Surgery Devices (AREA)
US15/549,884 2015-03-04 2016-03-04 Dental laser for the treatment of soft tissue Abandoned US20180028276A1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE102015203881.5A DE102015203881A1 (de) 2015-03-04 2015-03-04 Dentallaser zur Behandlung von Weichgewebe
DE102015203881.5 2015-03-04
PCT/EP2016/054616 WO2016139332A1 (fr) 2015-03-04 2016-03-04 Laser dentaire pour le traitement des tissus mous

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2016/054616 A-371-Of-International WO2016139332A1 (fr) 2015-03-04 2016-03-04 Laser dentaire pour le traitement des tissus mous

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US17/024,966 Continuation US20210000567A1 (en) 2015-03-04 2020-09-18 Dental laser for the treatment of soft tissue

Publications (1)

Publication Number Publication Date
US20180028276A1 true US20180028276A1 (en) 2018-02-01

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Application Number Title Priority Date Filing Date
US15/549,884 Abandoned US20180028276A1 (en) 2015-03-04 2016-03-04 Dental laser for the treatment of soft tissue
US17/024,966 Pending US20210000567A1 (en) 2015-03-04 2020-09-18 Dental laser for the treatment of soft tissue

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Application Number Title Priority Date Filing Date
US17/024,966 Pending US20210000567A1 (en) 2015-03-04 2020-09-18 Dental laser for the treatment of soft tissue

Country Status (6)

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US (2) US20180028276A1 (fr)
EP (1) EP3265013B1 (fr)
JP (1) JP2018507054A (fr)
CN (1) CN107427335A (fr)
DE (1) DE102015203881A1 (fr)
WO (1) WO2016139332A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11338154B2 (en) 2018-09-28 2022-05-24 Ivoclar Vivadent Ag Bacteria removal laser

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Publication number Priority date Publication date Assignee Title
CN108742889B (zh) * 2018-04-11 2020-10-23 电子科技大学 激光备牙机器人中的光斑轨迹调控装置

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Also Published As

Publication number Publication date
EP3265013A1 (fr) 2018-01-10
US20210000567A1 (en) 2021-01-07
WO2016139332A1 (fr) 2016-09-09
DE102015203881A1 (de) 2016-09-08
JP2018507054A (ja) 2018-03-15
EP3265013B1 (fr) 2019-12-04
CN107427335A (zh) 2017-12-01

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