WO1994012116A1 - Piece a main medicale - Google Patents

Piece a main medicale Download PDF

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Publication number
WO1994012116A1
WO1994012116A1 PCT/EP1993/003107 EP9303107W WO9412116A1 WO 1994012116 A1 WO1994012116 A1 WO 1994012116A1 EP 9303107 W EP9303107 W EP 9303107W WO 9412116 A1 WO9412116 A1 WO 9412116A1
Authority
WO
WIPO (PCT)
Prior art keywords
medical handpiece
marking
handpiece according
prism
partial beams
Prior art date
Application number
PCT/EP1993/003107
Other languages
German (de)
English (en)
Other versions
WO1994012116A9 (fr
Inventor
Christof Donitzky
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 WO1994012116A1 publication Critical patent/WO1994012116A1/fr
Publication of WO1994012116A9 publication Critical patent/WO1994012116A9/fr

Links

Classifications

    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/10—Beam splitting or combining systems
    • G02B27/12—Beam splitting or combining systems operating by refraction only
    • G02B27/126—The splitting element being a prism or prismatic array, including systems based on total internal reflection
    • 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
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
    • B23K26/035—Aligning the laser beam
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/18—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00 for optical projection, e.g. combination of mirror and condenser and objective
    • G02B27/20—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00 for optical projection, e.g. combination of mirror and condenser and objective for imaging minute objects, e.g. light-pointer
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/40—Optical focusing aids
    • 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
    • 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
    • A61B2018/2025—Miscellaneous features with a pilot laser

Definitions

  • the invention relates to a medical handpiece, in particular for dental medicine, with an optical system that focuses an electromagnetic treatment beam on a focal point located outside the handpiece and a visible marking beam for marking the treatment beam in the area of the focal point of the treatment beam directs.
  • Medical handpieces of this type can be used to apply electromagnetic radiation to a body part to be treated.
  • tooth substance can be removed very well with the radiation emitted by an Er: YAG aser with a wavelength of 2.94 ⁇ m.
  • Infrared radiation is also increasingly used to coagulate or burn body tissues and then vaporize them.
  • the electromagnetic treatment beam is focused on a focal point located outside the handpiece, and the treatment of the body part takes place in this focus area.
  • Using electromagnetic radiation with wavelengths in the infrared spectral range results in but with the difficulty that the treatment beam is invisible and its focus is therefore difficult to determine.
  • German patent specification 29 10 760 it is known to couple a visible marking beam into the treatment beam in such a way that it is guided in a collinear manner with the treatment beam in the handpiece and is irradiated to the focal point region of the treatment beam. Since in this case the patient is additionally given a substance which can be excited to fluorescence by the marking light, the marking beam serves on the one hand to mark the position of the treatment beam and on the other hand to make pathologically overgrown tissue visible in which the administered rich substance is preferentially deposited. With the aid of this marking beam, however, it is not possible to determine the position of the focal point of the invisible treatment beam.
  • a medical handpiece is known from German patent specification 39 11 853, in which the treatment beam is surrounded by a divergent visible marking beam outside the housing, so that the marking beam projects into the focal plane of the treatment beam a visible ring concentrically surrounding the treatment beam . Since the marking beam is divergent outside the housing, the size of the ring projected onto a surface changes with the distance of this surface from the outlet opening of the handpiece. This effect is used in this handpiece to inform the person treating the position of the treatment beam and the focus of the treatment beam. In the focal plane of the treatment beam, the ring of the marking beam has a certain size, which gives the person under treatment an indication that the image of the ring is exactly in the focal plane of the treatment beam.
  • the object of the invention is to improve a generic medical handpiece in such a way that the position of the focal point of the treatment beam can be clearly ascertained and the image projected onto the body part by the marking beam can be clearly recognized even without the use of a powerful marking beam source.
  • the medical handpiece comprises the visible marking beam into a bundle of a plurality of separate optical beams which are arranged at a distance from one another and which focuses the partial beam bundle on a focal point adjacent to the focal point of the treatment beam.
  • Optical means are thus arranged in the medical handpiece according to the invention, which split the visible marking beam into several separate partial beams.
  • the marking beam projects an image in the form of individual, separate points onto the body part to be treated.
  • the optical means of the handpiece according to the invention additionally focus the partial beam bundle on a focal point which is adjacent to the focal point of the treatment beam, the mutual distance between the points of the image projected by the marking beam decreases as the image plane approaches the focal point of the Treatment beam.
  • the points projected by the marking beam onto the body part lie one above the other. The superimposition of the points thus gives a clear indication of the position of the focal point of the treatment beam. No additional information is necessary for the treating person in order to clearly determine the position of the focal point of the treatment beam from the image projected by the marking beam.
  • the radiation energy of the marking beam is not distributed over a large area, so that the distance from the Marking beam projected onto the body part no high radiation power and therefore no powerful marking beam source is required.
  • the focal point of the marking beam and thus adjacent to the focal point of the treatment beam a clearly recognizable image results due to the superposition of the partial beams of the marking beam even with low power of the marking beam source.
  • a preferred embodiment of the invention is characterized in that the optical means of the medical handpiece allow the diameter of the individual partial beams to be changed.
  • Another embodiment is characterized in that the optical means of the medical handpiece allow the diameter of the partial beam to be changed. Without changing the diameter of the individual partial beams, the mutual distance of the points projected by the marking beam onto the body part can thus be adapted to the respective requirements.
  • a further advantageous embodiment of the invention is characterized in that the optical means of the medical handpiece guide the partial beam so that that this surrounds the treatment beam. This enables the treating person to recognize the position of the treatment beam at any time from the position of the points projected onto the body part by the marking beam, since the treatment beam is in all cases between these points.
  • the partial beam bundle surrounds the treatment beam asymmetrically with respect to a reflection on the treatment beam axis. If the distance between the medical handpiece and the body part is changed such that the body part is once in front of the focal plane of the marking beam and once behind its focal plane, the arrangement of the points projected by the marking beam onto the body part changes. The image behind the focal plane of the marking beam results from reflection on the treatment beam axis. If the partial beam bundle surrounds the treatment beam in an arrangement that is asymmetrical with respect to reflection at the treatment beam axis, the point distribution in front of the focal plane differs from the distribution that results behind the focal plane. The arrangement of the points projected from the marking beam onto the body part can thus be used to infer the position of the focal point of the marking beam and thus also the position of the focal point of the treatment beam.
  • a special embodiment of the invention is characterized in that the optical means of the medical handpiece divide the marking beam into three partial beams.
  • the optical means of the medical handpiece comprise a prism which divides the marking beam into a bundle of several separate partial beams and which has a plurality of flat, obliquely arranged surfaces on a pointed side form a tip in the form of a common boundary point and which is delimited on the opposite flat side by a flat surface, the prism being positioned such that the beam axis of the marking beam is directed towards the tip of the prism.
  • the marking beam surrounds the tip of the prism uniformly, and different sectors of the marking beam cross section meet flat surfaces which are arranged differently relative to the marking beam axis and on which they are each broken.
  • the refraction of the individual sectors of the marking beam cross-section on differently oriented surfaces causes the marking beam to be divided into separate partial beams, which spread in different directions depending on the orientation of the surfaces on which they are broken.
  • a particularly simple course of the partial beams is obtained if the flat side of the dividing prism is positioned perpendicular to the marking beam axis.
  • the position of the marking beam axis coincides with the surface normal of the flat side of the dividing prism, so that when the marking beam strikes the vertically oriented flat side of the dividing prism, the marking beam is not refracted.
  • a regular arrangement of the individual partial beams of the marking beam results from the fact that all surfaces of the pointed side of the dividing prism have the same angle of inclination with respect to the plane defined by the flat side.
  • the same angle of refraction results on all surfaces due to the inclination angle being the same for all surfaces, and therefore the same angle between the partial beams and for all partial beams the extension of the marking beam axis in the direction of propagation.
  • a special embodiment of the invention is characterized in that the tip side of the dividing prism is formed from three flat, obliquely arranged surfaces.
  • the marking beam is broken into three partial beams by the three obliquely arranged surfaces of the tip side of the dividing prism. Since the marking beam is divided into individual separate partial beams by refraction, the distribution takes place essentially without radiation losses, ie the sum of the radiation power of the individual partial beams coincides practically with the total radiation power of the non-split marking beam.
  • a special embodiment of the invention is characterized in that a circular diaphragm with a variable opening diameter is arranged at the tip of the dividing prism.
  • the tip of the dividing prism points in the direction of propagation of the marking beam, then in the area of the tip outside the prism, due to the refraction of the marking beam on the surfaces arranged at an angle to one another, the partial beams propagating in different directions are superimposed. If the circular aperture with variable opening diameter is positioned in the intersection of the partial beams, the diameter of all individual partial beams can be changed simultaneously with the help of a circular aperture.
  • a further embodiment of the invention is characterized in that an optical element parallelizing the partial beams is arranged in the region of the separate partial beams at a distance from the dividing prism. With the help of this optical element, the divergent partial beams of the marking beam are deflected so that they then run parallel to one another.
  • the parallelizing optical element can be a converging lens or a corresponding lens system, but it is particularly expedient if the optical element is formed from a parallelizing prism whose shape corresponds to the dividing prism.
  • the parallelizing prism has the same shape and the same orientation relative to the beam path of the marking beam as the splitting prism, so that the diverging partial beams due to the refraction at the boundary surfaces of the parallelizing prism are deflected into a parallel beam path.
  • the use of a parallelizing prism has the advantage that the diameter of the partial beam can be changed continuously by changing the distance between the dividing prism and the parallelizing prism. By varying the distance between the two prisms, the partial beam can thus be widened without changing the diameter of the individual partial beams.
  • a further embodiment is characterized in that the partial beam and the treatment beam are focused by the same optical focusing elements. This ensures that the focal point of the marker beam is immediately adjacent to the focal point of the treatment beam. By suitable coupling of the treatment beam it can be achieved that the two focal points lie one above the other and thus the focal point of the visible marking radiation directly indicates the focal point of the treatment beam.
  • a preferred embodiment of the invention is characterized in that the marking beam is formed by the visible laser radiation emitted by a laser diode. Since due to the division of the marking beam into several separate partial beams and the associated clear recognition of the image projected from the marking beam onto the body part, no strong marking beam source must be used, the visible laser radiation emitted by a laser diode can be used as the marking beam. It is particularly advantageous if the laser diode used as the marking beam source is arranged in the medical handpiece. The laser diode can be positioned, for example, in the handle of the medical handpiece according to the invention. It is particularly advantageous if the radiation emitted by the laser diode is radially limited by a luminescent diaphragm that defines the beam cross section.
  • the radiation emitted by the laser diode generally has an inhomogeneous intensity distribution and a rectangular beam cross section.
  • a luminescent diaphragm with a circular opening cross section With the aid of a luminescent diaphragm with a circular opening cross section, the edge areas of the rectangular beam cross section of the laser radiation emitted by the laser diode can be masked out, as can the luminescent radiation also emitted by the laser diode.
  • a visible marking beam with a circular beam cross section is thus defined with the aid of the luminescent diaphragm. This circular marking beam is then directed onto the tip of the dividing prism and divided into several partial beams.
  • 1 a perspective view of a partially broken open dental handpiece with a marking beam divided into three partial beams and 2: a schematic representation of the beam guidance of the marking beam.
  • a handpiece 10 is shown with a handle 11 and an L-shaped housing 12 which adjoins the handle 11 with one leg 13, while the second leg 14 protrudes vertically downward at the end facing away from the handle 11.
  • the handle 11 of the handpiece is shown with a handle 11 and an L-shaped housing 12 which adjoins the handle 11 with one leg 13, while the second leg 14 protrudes vertically downward at the end facing away from the handle 11.
  • the marking beam there is a laser diode, not shown in FIG. 1, the emitted visible radiation of which is used as the marking beam.
  • the marker beam is divided into three sub-beams as described below.
  • the partial beams are collected with the aid of a convex lens 15 arranged in the housing 12 and guided out of the housing 12 via a deflecting mirror 16 arranged at 45 ° to both legs 13 and 14 through the open end of the leg 14 designed as an outlet opening 17 and outside of the housing 12 in a focal point 18 in order to subsequently strike a tooth 19 as the body part to be treated.
  • FIG. 2 shows a schematic representation of the beam guidance of the marking beam. In the middle of the figure, with dash-dotted lines, the arrangement of the optical elements used and the beam path of the marking beam are shown, while at the top the optical elements are shown in the beam direction and at the bottom the beam geometry at different cutting planes is shown. All of the optical elements listed below are located in the handle 11 or in the housing 12 of the handpiece 10.
  • a laser diode 21 serves as the source for the visible marking beam, to which a luminescent diaphragm 22 with a circular opening cross-section connects.
  • the radiation emitted by the laser diode essentially has a rectangular beam cross section.
  • a circular marking beam cross section is defined by the opening of the luminescent diaphragm.
  • the marking beam After passing through the luminescent diaphragm 22, the marking beam strikes a splitting prism 23, through which the marking beam is divided into a total of three partial beams. To simplify the illustration, only two of these partial beams are shown in FIG.
  • the prism 23 has a flat underside 24 oriented perpendicular to the marking beam axis and an upper side 25 pointing in the direction of propagation of the marking beam.
  • the upper side 25 is formed from three flat, equally large surfaces 26 which are opposite the plane defined by the underside are each inclined by the same angle of inclination. In each case two surfaces 26 form a common straight edge 29, so that the top 25 has a total of three edges 29, the common intersection of which forms a tip 30.
  • the tip which is arranged centrally on the upper side 25 of the dividing prism 23, is positioned in the beam axis of the marking beam, so that the marking beam strikes the flat surfaces 26 surrounding the tip with circular sectors of the same size of its circular cross section.
  • a circular diaphragm 27 with a circular opening cross-section is positioned, through which the partial beams of the marking beam pass.
  • the diverging partial beams meet a parallelizing prism 28 at a distance from the circular diaphragm 27.
  • the prism 28 has the same shape as the dividing prism 23 and also the same orientation relative to the beam axis of the marking beam.
  • the convex lens 15 At a distance from the parallelizing prism 28 in the beam direction is the convex lens 15, also shown in FIG. 1, through which the partial beams of the marking beam are focused on the focal point 18.
  • the marking beam emitted by the laser diode 21 and having a circular cross section due to the luminescent diaphragm strikes the underside 24 of the dividing prism (23) perpendicularly and then the tip 30. While there is no refraction on the underside 24 due to the vertical direction of incidence If the result is that the marking beam is broken into three equally large partial beams on the flat surfaces 26 surrounding the tip 30, so that the marking beam behind the tip 30 has a beam cross section in the form of three circular sectors.
  • the billing is carried out Weil in the direction of the beam axis of the marking beam, so that the three partial beams intersect in an area immediately after the tip 30 of the dividing prism 23.
  • the circular diaphragm 27 is positioned in this area.
  • a variation in the opening diameter of the circular diaphragm 27 causes a uniform change in the three diameters and the shape of the partial beams.
  • the diverging partial beams hit the parallelizing prism 28. Due to the refractions at the top and bottom thereof, the partial beams are deflected onto a parallel beam path. If the distance between the two prisms 23 and 28 is changed, the diameter of the bundle of the three partial beams is varied. A reduction in the distance between the two prisms results in a reduction in the diameter of the partial beam.
  • the convex lens 15 adjoining the parallelizing prism 28 focuses the three partial beams on the focal point 18, so that the three partial beams overlap in the focal point.
  • the projection of the marking beam, which is divided into three partial beams, into a plane in front of or behind the focal plane results in an image consisting of three separate points, while the image projected into the focal plane consists of a single point.
  • the image projected into a plane behind the focal plane results from the image projected into a plane before the focal plane by mirroring the point arrangement on the marking beam axis. Is thus on the surface of the body part to be treated, for example the tooth 19, with a If an image of the marking beam is projected, the position of the focal plane with respect to the body surface can be clearly determined from the arrangement of the points.
  • the image projected by the marking beam onto the body surface is clear even when using a marking beam source with low power, for example when using the laser diode 21 recognizable.

Abstract

Pour améliorer une pièce à main, destinée en particulier à la médecine dentaire, comportant une optique qui focalise un rayon de traitement électromagnétique sur un foyer situé en dehors de la pièce à main et qui dirige un rayon de marquage visible pour marquer le rayon de traitement dans la zone du foyer du rayon de traitement, de sorte que la position du foyer du rayon de traitement puisse être établie sans équivoque, l'image projetée par le rayon de marquage sur la partie du corps étant clairement visible même sans utilisation d'une source de rayons de marquage puissante, il est proposé que la pièce à main comporte des moyens optiques permettant de diviser le rayon de marquage visible en un faisceau de rayons situés à une certaine distance les uns des autres et de focaliser ce faisceau sur un foyer proche du foyer du rayon de traitement.
PCT/EP1993/003107 1992-11-20 1993-11-06 Piece a main medicale WO1994012116A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE4239073A DE4239073C1 (de) 1992-11-20 1992-11-20 Medizinisches Handstück
DEP4239073.7 1992-11-20

Publications (2)

Publication Number Publication Date
WO1994012116A1 true WO1994012116A1 (fr) 1994-06-09
WO1994012116A9 WO1994012116A9 (fr) 1994-08-18

Family

ID=6473288

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1993/003107 WO1994012116A1 (fr) 1992-11-20 1993-11-06 Piece a main medicale

Country Status (2)

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DE (1) DE4239073C1 (fr)
WO (1) WO1994012116A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE29705934U1 (de) * 1997-04-03 1997-06-05 Kaltenbach & Voigt Diagnose- und Behandlungsvorrichtung für Zähne

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2019115523A (ja) * 2017-12-27 2019-07-18 日機装株式会社 光照射装置

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0073617A1 (fr) * 1981-08-25 1983-03-09 Peter John Pembery Pièce à main dentaire pour laser
EP0198959A2 (fr) * 1985-04-25 1986-10-29 Richard M. Dwyer Appareil et procédé pour chirurgie au laser
DE3911853A1 (de) * 1989-04-11 1990-10-25 Aesculap Ag Medizinisches handstueck
US5163936A (en) * 1991-01-22 1992-11-17 Reliant Laser Corp. Endoscopic mirror laser beam delivery system and method for controlling alignment

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5552750A (en) * 1978-10-12 1980-04-17 Mochida Pharm Co Ltd Laser knife* which can be detected* of tumor portion
DE3620744A1 (de) * 1986-06-20 1987-12-23 Rodenstock Instr Vorrichtung zur behandlung des auges mit einem laser
EP0435506A3 (en) * 1989-12-19 1991-08-14 Pfizer Hospital Products Group, Inc. Infrared delivery system with aiming component

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0073617A1 (fr) * 1981-08-25 1983-03-09 Peter John Pembery Pièce à main dentaire pour laser
EP0198959A2 (fr) * 1985-04-25 1986-10-29 Richard M. Dwyer Appareil et procédé pour chirurgie au laser
DE3911853A1 (de) * 1989-04-11 1990-10-25 Aesculap Ag Medizinisches handstueck
US5163936A (en) * 1991-01-22 1992-11-17 Reliant Laser Corp. Endoscopic mirror laser beam delivery system and method for controlling alignment

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE29705934U1 (de) * 1997-04-03 1997-06-05 Kaltenbach & Voigt Diagnose- und Behandlungsvorrichtung für Zähne
US6135774A (en) * 1997-04-03 2000-10-24 Kaltenbach & Voigt Gmbh & Co. Diagnosis and treatment device for teeth

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