WO1990011729A1 - Appareil medical manuel - Google Patents

Appareil medical manuel Download PDF

Info

Publication number
WO1990011729A1
WO1990011729A1 PCT/EP1990/000518 EP9000518W WO9011729A1 WO 1990011729 A1 WO1990011729 A1 WO 1990011729A1 EP 9000518 W EP9000518 W EP 9000518W WO 9011729 A1 WO9011729 A1 WO 9011729A1
Authority
WO
WIPO (PCT)
Prior art keywords
handpiece
button
treatment beam
marking element
treated
Prior art date
Application number
PCT/EP1990/000518
Other languages
German (de)
English (en)
Inventor
Rudolf Steiner
Ulrich Keller
Raimund Hibst
Original Assignee
Aesculap Ag
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 Aesculap Ag filed Critical Aesculap Ag
Publication of WO1990011729A1 publication Critical patent/WO1990011729A1/fr

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Classifications

    • 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
    • A61B18/201—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 with beam delivery through a hollow tube, e.g. forming an articulated arm ; Hand-pieces therefor
    • 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

Definitions

  • the invention relates to a medical handpiece, in particular for dental medicine, with an outlet opening for an electromagnetic treatment beam, which is focused by optical means in the handpiece outside the outlet opening.
  • Medical handpieces of this type can be used to apply electromagnetic radiation to a body part to be treated, for example with the radiation from a treatment laser. It is known, for example, that tooth substance can be removed by a pulsed Er: YAG laser (R. Hibst et al in "Laser in Medicine and Surgery” - MZV-Verlag 4: 163-165 (1988)).
  • the treatment beam is normally focused outside of a handpiece, and the tissue to be removed is destroyed in this focus area. Difficulties arise when the treatment beam is invisible, as is the case with most treatment processes. Although it is known to then make this radiation visible by means of a pilo beam, the treating person, even when using a pilot beam, cannot determine where the focal point of the treatment beam is, in which the treatment effect is greatest by far is.
  • a medical handpiece which is characterized by a marking element, the position of which relative to the handpiece changes as a function of the distance between the outlet opening of the handpiece and the surface of the body part to be treated, the change in position changing the position of the handpiece Size of the marking element or the position of a marking actuated by the marking element changes relative to the handpiece.
  • Such a marker element regularly shows the treating person the exact distance of the outlet opening of the handpiece from the surface of the body part to be treated, and from this the treating person can easily estimate where the focal plane of the treatment beam is located.
  • a specific position of the marking element represents the positioning of the focal plane directly on the surface of the delenden body part, each change in the position of the marking element shows the treating person how far above or below the surface of the body part to be treated is the focal plane of the treatment beam.
  • the marking element is a button which rests on the surface of the body part to be treated and is displaceably mounted on the handpiece and is resiliently pressed away from the handpiece.
  • This button is thus held resiliently in the system on the surface of the body part to be treated.
  • the person performing the treatment can determine from the displacement of the button relative to the handpiece how the distance between the handpiece and the surface shifts. This is also a measure of the respective position of the focal plane of the treatment beam.
  • the button carries a pointer that moves along a scale on the handpiece when the button is moved. Conversely, it can also be provided that the button carries a scale that moves along a pointer on the handpiece when the button is moved.
  • the button is resiliently displaceable against a stop and ends in the focal plane of the treatment beam.
  • the treating person knows immediately that the end of the button coincides with the focal plane of the treatment beam if the button does not lie on the body surface.
  • the size of the shift thus directly shows the depth of the focal plane below the surface of the body part to be treated.
  • the button carries a foot that surrounds the treatment beam in a ring. The button also marks the lateral position of the treatment beam.
  • the marking element is a light projected onto the surface of the body part to be treated by a light which is not visible through a parallel bundle. Because the projected light beam is not parallel, the size of the projected image on the surface of the body part to be treated changes with the distance of the handpiece from this surface. This change in size is a measure of this distance for the person treating, so that the size can be used to estimate again how far the focal plane of the treatment beam is above or below the surface of the part of the body to be treated. It is advantageous if the treatment beam and the visible light for projecting the image are focused by the same optical elements.
  • the projected image may be the treatment beam um ⁇ imaging circle whose size on the surface of the treated body part * with the depth of the focal plane of the treatment beam changes. At the same time, this circle indicates the area of impact of the treatment beam, so that the person treating the patient can also position it sideways.
  • FIG. 1 a perspective view of a partially broken open dental handpiece with a mechanical button for determining the distance
  • Figure 2 a sixth view of the front part of the
  • FIG. 3 shows a longitudinal sectional view of a further preferred exemplary embodiment of a medical handpiece with an optical marking element
  • Figure 4 is a perspective view of the rear portion of the handpiece of Figure 3 as seen from the plane 4-4 in Figure 3;
  • Figure 5 is an enlarged side view of the
  • FIG. 6 a view similar to FIG. 5 when the treatment beam is focused in the interior of the tooth below the tooth surface.
  • a handpiece with a handle 1 and an L-shaped housing 2 which connects to the handle 1 with one leg 3, while the second leg 4 protrudes vertically downward at the end facing away from the handle 1.
  • a light guide not shown in the drawing, which can be connected at a connection point 5 of the handle 1 to a light guide, also not shown in the drawing, for example a glass fiber cable, via which a treatment beam is supplied.
  • This treatment beam can be a laser beam, for example the pulsed radiation of an ErrYAG laser with a wavelength of 2.94 micrometers is particularly favorable for dental treatment.
  • the treatment beam brought about by the light guide arranged in the handle 1 is collected by a convex lens 6 arranged on the handle end of the housing 2 and via a deflecting mirror 7 arranged at 45 ° to both legs 3 and 4 through the exit opening 8 trained open end of the leg 4 led out of the housing 2 and focused outside the housing 2 in a focal point 9.
  • the focal point 9 is normally a few millimeters from the outlet opening 8, for example between 10 and 20 millimeters.
  • a rod-shaped button 10 is slidably mounted parallel to the direction of the treatment beam 11. This rod-shaped button 10 is pressed away from the housing by a spring 12 until the further movement is limited by a stop 13 (FIG. 2). In the most extended position (shown in solid lines in FIG. 2), the free end of the button 10 is located in the focal plane of the treatment beam 11.
  • the button 10 carries at its free end a foot 14 which surrounds the treatment beam 11 in a ring, and which is thus in the position in which the stop 13 is the other Movement of the button 10 prevents exactly the focal point 9 of the treatment beam 11 is marked.
  • the handpiece is placed on the tooth surface in such a way that the foot 14 rests on this surface.
  • This inevitably results in the treatment beam, which is generally invisible, being focused precisely in the tooth surface, so that in this area, a very intensive and locally limited irradiation of the tooth material and thus evaporation of the tooth material can take place in this area.
  • the treating person can also position the focal point of the treatment beam 11 in planes below the surface of the tooth 15. To achieve this, it is sufficient to position the handpiece at a smaller distance above the surface of the tooth 15.
  • the button 10 is inevitably moved against the action of the spring 12, so that the focal point 9 is then just as far below the plane of the foot 14 and thus the surface of the tooth as the button 10 is moved against the action of the spring 12.
  • This displacement of the button relative to the housing 2 can be monitored in a simple manner, for example by means of a scale 16 on the rod-shaped part of the button 10, which indicates the displacement of the button relative to the housing relative to a fixed part of the housing 2.
  • the button could carry a pointer element which moves along a scale fixed to the housing when the button is displaced.
  • the person performing the treatment can easily estimate from the displacement of the button, which is always supported on the surface of the body part to be treated, how deep below this surface of the body part to be treated is the focal plane of the treatment beam. although the treatment beam itself is not visible.
  • the foot 14 of the treating person surrounding the treatment beam additionally shows the exact lateral position of the treatment beam.
  • the mechanical button is replaced by an optical marking element 20 in the form of a ring concentrically surrounding the treatment beam 11.
  • the handpiece like that in FIGS. 1 and 2, comprises a handle 21 and an L-shaped housing 22 with legs 23 or 24 which are perpendicular to one another.
  • a central light guide 25 arranged in the handle 21 guides the treatment beam, which, like the exemplary embodiment in FIGS. 1 and 2, exits the housing through a convex lens 26 and a deflecting mirror 27 through an outlet opening 28 and is focused at a focal point 29 outside the housing.
  • the central light guide 25 is concentrically surrounded by a larger number of optical fibers 30, which are arranged in a ring overall. Visible light directed through it is likewise bundled by the convex lens 26 and, after being deflected at the deflecting mirror 27, emerges from the outlet opening 28.
  • This marking beam is focused due to the different refraction of the convex lens 26 (dispersion) depending on the wavelength.
  • the focal point 29 in a further focal point 32.
  • the marking beam 31 is expanded again accordingly and projects an image of the ring-shaped optical fibers 30 into this plane, that is to say an image concentrically surrounding the treatment beam 33 , visible ring.
  • the size of the ring projected onto a surface changes with the distance of this surface from the outlet opening 28.
  • This effect is used in this preferred embodiment of a handpiece to treat the patient Person to display the position of the treatment beam and the focal point of the treatment beam.
  • the ring-shaped optical marking element In the focal plane defined by the focal point 29 of the treatment beam 33, the ring-shaped optical marking element has a certain size, which is an indication to the person treating the patient that the image of the ring is located exactly in the focal plane of the treatment beam.
  • the ring-shaped optical marking element is projected onto the surface of the tooth and can be observed there by the person treating it.
  • this ring increases, this is an indication that the focal plane of the treatment beam is arranged above the surface of the tooth; if the ring is reduced, as shown in FIG. 6, this is for the treating person Indicates that focus 32 is below the surface of the tooth.
  • the respective size of the ring-shaped optical marking element 20 is thus a measure for the treating person for the immersion of the treatment beam and for the depth of the focal plane below the surface of the tooth to be treated. Since the marking element is always on the surface of the tooth, it also indicates the position of the invisible treatment beam. This arrangement has the advantage over the arrangement of FIGS. 1 and 2 that no parts restricting the view are arranged between the outlet opening and the tooth, so that the treating person is given a clear view of the treatment area.

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  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Optics & Photonics (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Otolaryngology (AREA)
  • Electromagnetism (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Laser Surgery Devices (AREA)
  • Radiation-Therapy Devices (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

Grâce à cet appareil médical manuel, on peut vérifier à tout moment la position d'un rayon de traitement et en particulier de son foyer, même lorsqu'il s'agit de rayons invisibles. L'appareil comporte un orifice de sortie pour un rayon de traitement électromagnétique, qui est focalisé à l'extérieur de l'orifice de sortie par des moyens optiques situés dans l'appareil manuel. Cet appareil est caractérisé par un élément de marquage dont la position par rapport à l'appareil manuel varie en fonction de la distance entre l'orifice de sortie de l'appareil manuel et la surface de la partie du corps à traiter; ce changement de position modifie la taille de l'élément de marquage ou la position d'un marquage effectué par l'élément de marquage par rapport à l'appareil manuel.
PCT/EP1990/000518 1989-04-11 1990-04-02 Appareil medical manuel WO1990011729A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP3911853.3 1989-04-11
DE19893911853 DE3911853C3 (de) 1989-04-11 1989-04-11 Medizinisches Handstück

Publications (1)

Publication Number Publication Date
WO1990011729A1 true WO1990011729A1 (fr) 1990-10-18

Family

ID=6378425

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1990/000518 WO1990011729A1 (fr) 1989-04-11 1990-04-02 Appareil medical manuel

Country Status (3)

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EP (1) EP0467907A1 (fr)
DE (1) DE3911853C3 (fr)
WO (1) WO1990011729A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2670106A1 (fr) * 1990-12-05 1992-06-12 Kaltenbach & Voigt Piece a main dentaire permettant le traitement des dents au moyen de rayons laser.
WO1998041355A1 (fr) * 1997-03-14 1998-09-24 Lms Laser Medical Systems Erzeugung Und Vertrieb Medizinisch Technischer Geräte Gesellschaft Mbh Dispositif pour l'application de rayons laser

Families Citing this family (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4032860A1 (de) * 1990-10-12 1992-04-16 Zeiss Carl Fa Kraftgesteuerter kontaktapplikator fuer laserstrahlung
US5300067A (en) * 1991-08-23 1994-04-05 Hoya Corporation Laser treatment device
EP0530574B1 (fr) * 1991-08-28 1997-11-05 Siemens Aktiengesellschaft Dispositif pour l'usinage par laser des matériaux biologiques à haute densité, en particulier l'email
US5458594A (en) * 1991-08-28 1995-10-17 Siemens Aktiengesellschaft Method and apparatus for the treatment of hard biological material, such as hard dental material, using lasers
DE4239073C1 (de) * 1992-11-20 1994-04-21 Aesculap Ag Medizinisches Handstück
US20060240381A1 (en) 1995-08-31 2006-10-26 Biolase Technology, Inc. Fluid conditioning system
US20100151406A1 (en) 2004-01-08 2010-06-17 Dmitri Boutoussov Fluid conditioning system
JP2008509756A (ja) * 2004-08-13 2008-04-03 バイオレーズ テクノロジー インコーポレイテッド レーザ・ハンドピース・アーキテクチャ及び方法

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4289378A (en) * 1978-06-21 1981-09-15 Ernst Remy Apparatus for adjusting the focal point of an operating laser beam focused by an objective
EP0073617A1 (fr) * 1981-08-25 1983-03-09 Peter John Pembery Pièce à main dentaire pour laser
US4503853A (en) * 1981-09-04 1985-03-12 Kabushiki Kaisha Morita Seisakusho Contra angle handpiece for dental treatment by laser beams

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3038225A (en) * 1960-05-27 1962-06-12 Ausnit Steven Separable fastener
US3559292A (en) * 1968-07-16 1971-02-02 Bernard Weissman Dental gauge
IL40602A (en) * 1972-10-17 1975-07-28 Panengeneering Ltd Laser device particularly useful as surgical scalpel
DE2744536C3 (de) * 1977-10-04 1982-01-07 Fizičeskij institut imeni P.N. Lebedeva Akademii Nauk SSSR Ophthalmologische Lasereinrichtung
JPS5552750A (en) * 1978-10-12 1980-04-17 Mochida Pharm Co Ltd Laser knife* which can be detected* of tumor portion
CH651153A5 (de) * 1980-02-07 1985-08-30 Orbisphere Corp Tastenfeld und dessen verwendung.
US4571183A (en) * 1982-10-06 1986-02-18 Syntex (U.S.A.) Inc. Vibratory endodontic device
AT388283B (de) * 1987-08-24 1989-05-26 Buermoos Dentalwerk Zahnaerztliches handstueck

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4289378A (en) * 1978-06-21 1981-09-15 Ernst Remy Apparatus for adjusting the focal point of an operating laser beam focused by an objective
EP0073617A1 (fr) * 1981-08-25 1983-03-09 Peter John Pembery Pièce à main dentaire pour laser
US4503853A (en) * 1981-09-04 1985-03-12 Kabushiki Kaisha Morita Seisakusho Contra angle handpiece for dental treatment by laser beams

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2670106A1 (fr) * 1990-12-05 1992-06-12 Kaltenbach & Voigt Piece a main dentaire permettant le traitement des dents au moyen de rayons laser.
WO1998041355A1 (fr) * 1997-03-14 1998-09-24 Lms Laser Medical Systems Erzeugung Und Vertrieb Medizinisch Technischer Geräte Gesellschaft Mbh Dispositif pour l'application de rayons laser

Also Published As

Publication number Publication date
EP0467907A1 (fr) 1992-01-29
DE3911853C2 (fr) 1991-12-19
DE3911853C3 (de) 1996-02-08
DE3911853A1 (de) 1990-10-25

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