WO2008101655A1

WO2008101655A1 - Dental laser treatment instrument comprising a light decoupling element and integrated wetting system

Info

Publication number: WO2008101655A1
Application number: PCT/EP2008/001241
Authority: WO
Inventors: Alexander Hack; Bernd Liebermann; Ursula Schmitt; Thomas JÄGGLE
Original assignee: Kaltenbach & Voigt Gmbh
Priority date: 2007-02-19
Filing date: 2008-02-18
Publication date: 2008-08-28
Also published as: EP2114284A1; DE102007008115A1

Abstract

The invention relates to a dental laser treatment instrument comprising a hand piece (1) that is to be connected to a supply tube for supplying laser radiation and a treatment fluid, and an elongate decoupling element (30) for releasing the laser radiation is arranged on the front end (4) thereof. Said decoupling element (30) comprises an elongate optical fibre (31) and a cylindrical or sleeve-shaped holder (32, 33) which surrounds the optical fibre (31) at a distance, at least in one area that faces the front end (31b) of the fibre (31), in order to form a fluid channel (22). Said fluid channel (22) is in contact with a supply line (8, 9) that extends through the hand piece (1). The connection between the fluid channel (22) and the supply line (8, 9) is established by means of a single through opening (34) formed in the wall of the cylindrical or sleeve-shaped holder (32, 33).

Description

Dental laser treatment instrument with light decoupling element and integrated water humidification

The present invention relates to a dental laser treatment instrument according to the preamble of claim 1, which comprises a handpiece and an elongated decoupling element located at the front end of the handpiece for emitting the laser radiation. Such a treatment instrument can be used in particular in periodontology.

In addition to the classic processing of tooth tissue by means of mechanical processing, the use of so-called dental lasers has recently become increasingly established. With such devices, the tissue to be processed, for example. The

Tooth tissue is irradiated with a high-energy electromagnetic radiation, which ultimately has a thermal heating and finally evaporation of the irradiated tissue result. As with the use of a traditional dental drill can be removed in this way materials, for example, to remove carious sites or incorporate cavities in a tooth.

Especially in dental medicine, so-called solid-state lasers of the Er: YAG type have become established. These lasers have a wavelength which has the special property of being in accordance with the maximum of the absorption spectrum of water, which ultimately leads to a high removal efficiency with minimal thermal influences due to the fact that the tissue to be treated usually also contains water. The performance of the Er: YAG laser is such that they are usually operated in a pulse mode.

Special advantages in dentistry bring the use of laser technology in particular when jobs are to be edited or treated, which are not easily accessible via a dental drill or other mechanical tools. In this context, so-called periodontology laser handpieces have been found to be particularly effective, which were designed for the treatment of subgingival sites. These have a protruding from the handpiece Lichtauskoppelelement over the rectangular exit surface a homogeneous beam profile is generated, which allows to treat the preparation site surface contact. With such handpieces, for example, the epithelial lining of the periodontal pockets treated become. Here, infected soft tissue can be efficiently removed, whereby the root surface of a tooth is largely protected.

Due to the heating that occurs when using a laser on the treated material, it is necessary to provide during the treatment for a corresponding cooling of the surrounding tissue. In particular, when used in periodontal pockets, it is also helpful if a regular rinsing of the bag is taken care of to be able to perform the treatment in an optimal manner. In this context, it is already known to provide the laser handpiece with an integrated water supply. In this case, water is supplied in the context of a supply line such that the decoupling element is washed around.

A solution for realizing such an integrated water supply is known, for example, from US Pat. No. 6,567,582. Here, a specially designed sleeve-shaped holder is provided for supporting the Lichtauskoppelelements, which surrounds a radiation provided for the purpose of optical fiber at least in a front end of the fiber facing area at a distance. As a result, an annular channel extending in the longitudinal direction of the optical fiber is formed, via which ultimately an air-water mixture in the form of a spray is to be dispensed. This elongated annular channel is over several

Through holes in the wall of the sleeve-shaped retaining element connected to an annular channel, which is formed by a groove in the outer wall of the retaining element. This annular channel in turn is at least one through hole in a provided on the handpiece guide member for supporting the light output element with extending through the handpiece

Supply line connected. In the solution described in US Pat. No. 6,567,582, in particular two media are supplied through the handpiece, which are mixed in the annular channel formed in the outer wall of the sleeve-shaped retaining element, so that ultimately the above-mentioned spray is formed, which is then dispensed in the longitudinal direction of the optical fiber.

Starting from the known from US 6,567,582 solution for the realization of a fluid supply, the present invention seeks to provide a further improved embodiment, which is particularly suitable for use in periodontal laser handpieces. In this case, in particular the most effective flushing of water in the periodontal pockets should be achieved. The object is achieved by a laser treatment instrument having the features of claim 1. Advantageous developments of the invention are the subject of the dependent claims.

The solution according to the invention is based on the finding that an effective rinsing of the periodontal pockets can only be achieved if the light fiber of the decoupling element flows around water evenly and without interference as far as possible. It has now been found that this is known from US 6,567,582 known solution of water supply is insufficient, since due to the multiple through holes, which are provided in the wall of the sleeve-shaped retaining element, turbulence occur, which prevent the formation of a uniform flow of water. To avoid this problem, it is provided in the solution according to the present invention that in the wall of the holder only a single Durchgangsöffhung is formed.

According to the invention, a dental laser treatment instrument is accordingly proposed that is to be connected to a supply tube for supplying a laser radiation and a treatment fluid and at the front end of an elongated coupling element for emitting the laser radiation is arranged. The decoupling element has an elongate optical fiber and a cylindrical or sleeve-shaped holder which surrounds the optical fiber at a distance in a region facing the front end of the fiber to form a fluid channel, the fluid channel having a supply line extending through the handpiece is in contact, and wherein according to the invention it is provided that the connection between the fluid channel and the supply line via a single formed in the wall of the cylindrical or sleeve-shaped holder Durchgangsöffhung.

Preferably, the decoupling element is rotatably arranged on the handpiece. In this case, a guide member for receiving the decoupling element is provided in the head region of the handpiece, wherein on an inner wall of the guide member an adjacent to the passage opening annular channel is formed. This annular channel, which allows a continuous fluid connection in each rotational position of the decoupling element, so in contrast to the teaching of US 6,567,582 not on the outer wall of the sleeve-shaped holder, but instead on the opposite

Inner wall of the guide part formed. The advantage of this design is that there is no weakening of the sleeve-shaped holder through the annular channel and, accordingly, a stable and secure mounting of the optical fiber in the coupling element is made possible. On the outer wall of the guide channel can then further be formed a further annular channel, which is on the one hand with the extending through the handpiece supply line and on the other hand with the adjacent to the feed-through ring channel in contact. Both annular channels can in this case be connected to one another in particular via a plurality of passage openings extending through the guide part.

The decoupling element is preferably arranged at an angle of about 100 ° to the longitudinal axis of the handpiece. In this case, a particularly ergonomic handling results for the treating dentist. In turn, the optical fiber may preferably be wedge-shaped in order to emit the laser radiation in the manner suitable for carrying out the treatment in the periodontal pockets.

The invention will be explained in more detail with reference to the accompanying drawings. Show it:

FIG. 1 a perspective view of a dental laser treatment instrument according to the invention;

FIG. 2 shows the front head region of the laser treatment instrument in FIG

-Cut;

Figure 3 shows the embodiment of the light output element;

Figure 4 shows the sectional view of a guide member for holding the

Decoupling element in the head region of the laser treatment element;

FIG. 5 shows a further enlarged representation of the area of the fluid

Implementation and

Figure 6 is a representation to illustrate a with the invention

Laser treatment instrument performed treatment.

The laser treatment instrument according to the invention shown in Figure 1 and generally provided with the reference numeral 1 has an elongated handpiece 2, which is equipped at its rear side 3 with coupling elements, not shown, which connects the handpiece 2 with a to a Supply unit leading supply hose allow. About this supply hose on the one hand, the laser radiation is supplied, on the other hand, there is also the supply of a fluid, such as water. The laser radiation used is preferably the radiation of an ErYAG laser which emits radiation in the region of 2.94 μm.

The laser radiation is emitted by means of a decoupling element 30, which is mounted in the head region 4 of the handpiece 2 and extends in particular at an angle of approximately 100 ° to the longitudinal axis of the handpiece. The decoupling element 30 has - as will be explained in more detail below - a wedge-shaped or chisel-shaped optical fiber, which was designed especially for the treatment of subgingival sites. This light fiber with a rectangular exit surface for lateral light emission produces a homogeneous beam profile, which is particularly suitable for treating a preparation site under contact.

A main field of application of the laser treatment instrument 1 according to the invention, as shown in FIG. 6, is the treatment of the epithelial lining of periodontal pockets. As shown in FIG. 6, for this purpose the decoupling element 30 is introduced into the pocket 51 of a tooth 50, with the aid of the radiation then being able to efficiently remove infected soft tissue. The germicidal effect of the laser in this case ensures an improved healing, whereby in the pocket 51 accumulating concretions are gently and largely painlessly removed. Here, in particular, the root surface 52 of the tooth 50 is protected as well as possible.

The treatment shown in FIG. 6 is particularly effective, in particular, when cooling is achieved by means of water moistening, wherein water is continuously conveyed to the treatment site as sterile coolant during the treatment. This is achieved in the laser treatment instrument of the present invention in that the light fiber of the decoupling element 30 is washed with water. The measures provided for this purpose to supply the water, which constitute the main component of the present invention, will be explained in more detail below.

It should be noted in advance, however, that the supply of water into the pocket 51 of the tooth 50 does not affect the effect of the laser radiation. It has been shown that in this case, a special effect occurs, on the one hand ensures effective cooling and irrigation, on the other hand, however, also allows optimal treatment of the soft tissue. As soon as with the help of Decoupling element 30 laser radiation is emitted, this generates a first of the decoupling element 30 from forming air bubble, which eventually extends to the soft tissue to be treated. Subsequently, the laser radiation is directed directly through this bubble or the air duct on the soft tissue, without this process interfering with water or located in the water

Particles would be affected. Through this so-called "Moses effect" can thus be a particularly effective but gentle treatment.

The specific measures for implementing the water cooling will now be explained with reference to FIGS. 2 to 5. In this case, FIG. 2 initially shows the front handpiece region in cross section, wherein it can be seen that the laser radiation is supplied via a channel 5 extending through the handpiece longitudinal axis and directed onto a mirror 7 with the aid of a lens arrangement 6. The mirror 7 in turn ensures a deflection and corresponding coupling of the laser radiation in the optical fiber 31 of the coupling element. The laser radiation is in this case coupled via the end face 31a of the fiber 31 in this.

Preferably, the decoupling element 30 is rotatably arranged in the head region 4 of the handpiece 2, which is achieved by means of a special guide member 10, the further embodiment of Figure 4 can be removed. This guide member 10 has a central passage opening 11 for releasably receiving the decoupling element 30 and is screwed into the head portion 4 of the handpiece by means of a thread 12. By means of corresponding O-rings 13, a seal between guide part 10 and handpiece 2 is achieved. In the inner wall of the guide member 10, a further groove 14 for receiving a third O-ring 15 is further formed, which ensures a corresponding seal with the coupling-out element 30.

The coupling element itself in turn consists of the wedge-shaped or chiselike optical fiber 31 and two cylindrical or sleeve-shaped holders 32 and 33. The inner sleeve 33 firmly surrounds the frontal end of the optical fiber 31, while the outer sleeve 32, the fiber 31st surrounds with a certain distance. In this way, an elongated annular space 22 surrounding the fiber 31 is formed, which serves as a channel for discharging the water. During subsequent operation of the handpiece, the fiber 31 is thus flushed over this channel 22, so that the supply of water into the tooth pocket can take place.

Object of the present invention is to make the supply of water in this surrounding the fiber 31 annular space 22 as possible so that the water can be fed effectively and smoothly to a continuous and effective To allow rinsing. The measures provided for this purpose will be explained below.

A first special feature is that, in contrast to the solution of US Pat. No. 6,567,582, the supply of the water into the annular space surrounding the fiber 31, which is designated 22 in FIG. 5, takes place via a single passage opening 34 in the wall of the sleeve 32. It has been found that in this case, a particularly uniform flow of water can be achieved, whereas in the prior art, the plurality of openings provides turbulence. These are quite desirable in the solution of the prior art, since a mixing of at least two media should be done here, for example, to form a spray. In the handpiece according to the present invention, however, no such mixing is desired because anyway only a single medium is supplied. Instead, the goal is to achieve as even a flow as possible. This is supported by the use of the single through-hole 34.

The arrangement of the decoupling element 30 in the guide part 10 can be taken from the representations of Figures 2 and 5. It can also be seen that on the inner wall of the guide member 10, a groove 17 is formed, which forms an annular channel 21 which corresponds to the passage opening 34. This annular channel 21 is in turn connected via a plurality of obliquely through the guide member 10 extending through holes 16 with a further annular channel 21 which is formed on the outside of the guide member 10 and is approximately triangular in cross section. This annular channel 20 is then in contact with the extending through the handpiece 2 through holes 8 and 9, which are used for the supply of water.

In the case of the operation of the handpiece 2 so the water supply takes place according to the arrows shown in Figure 5. First, the water supplied via the bore 9 in the head region 4 of the handpiece 2 enters the annular channel 20 formed on the outer side of the guide part 10 and then flows through the plurality of through-holes 16 into the annular channel 21 on the inside of the guide part 10. From this annular channel 21st in turn, the water can then flow via the single through-hole 34 into the interior of the sleeve-shaped holder 32 into the free space 22 and then run along the outside of the fiber 31 along the treatment site.

As already mentioned, a particular advantage of the solution according to the invention is that by using the single through-hole 34 a particularly uniform flow within the space 22 is achieved. As a result, the flushing and cooling of the tooth pocket is supported in a special way. A further constructive difference to US Pat. No. 6,567,582 also consists in that the annular channel 21 corresponding to the passage opening 34 is not formed on the outer wall of the sleeve 32 but instead on the inner wall of the guide part 10. As a result, weakenings in the wall of the sleeve 32 are avoided, so that ultimately a secure and reliable central support of the fiber 31 is made possible.

Ultimately, these measures contribute to the fact that the laser treatment instrument according to the invention can be used in a particularly effective manner for treatments in the field of periodontology.

Claims

claims

1. A dental laser treatment instrument with a handpiece (1), which is to be connected to a supply tube for supplying a laser radiation and a treatment fluid and at the front end (4) an elongate coupling-out element (30) for emitting the laser radiation is arranged, wherein the Decoupling element (30) has an elongated optical fiber (31) and a cylindrical or sleeve-shaped holder (32, 33) which, for forming a fluid channel (22), the optical fiber (31) at least in one of the front end (31 b) of the fiber ( 31) facing the area at a distance, and wherein the fluid channel (22) with a through the handpiece (1) extending supply line (8, 9) is in contact, characterized in that the connection between the fluid channel (22) and the supply line (8, 9) via a single in the wall of the cylindrical or sleeve-shaped holder (32, 33) formed Durchgangsöffhung (34).

2. Dental laser handling instrument according to claim 1, characterized in that the decoupling element (30) is rotatably mounted on the handpiece (1).

3. Dental laser treatment instrument according to claim 2, characterized in that the handpiece (1) has a guide part (10) for receiving the decoupling element (30), wherein on an inner wall of the guide part (10) to the Durchgangsöffhung (34) adjacent Ring channel (21) is formed.

4. Dental laser treatment instrument according to claim 2, characterized in that on the outer wall of the guide part (10), a further annular channel (20) is formed, on the one hand with the through the handpiece (1) extending supply line (8, 9) and on the other hand with the at the Durchgangsöffhung (34) adjacent annular channel (21) is in contact.

5. Dental laser treatment instrument according to claim 4, characterized in that the two annular channels (20, 21) are connected to one another via a plurality of passage openings (16) extending through the guide part (10).

6. Dental laser treatment instrument according to one of the preceding claims, characterized in that the decoupling element (30) is arranged at an angle to the longitudinal axis of the handpiece (1).

7. Dental laser treatment instrument according to claim 6, characterized in that the angle is about 100 °.

8. Dental laser treatment instrument according to one of the preceding claims, characterized in that the optical fiber (31) is wedge-shaped or meißeiförmig.

9. Dental laser treatment instrument according to one of the preceding claims, characterized in that water is supplied as the treatment fluid.