WO2016166205A1

WO2016166205A1 - Device for dental and oral care

Info

Publication number: WO2016166205A1
Application number: PCT/EP2016/058209
Authority: WO
Inventors: Roland Streckbein; Philipp Streckbein; Sebastian STRECKBEIN
Original assignee: Ocu Research & Development Gmbh
Priority date: 2015-04-14
Filing date: 2016-04-14
Publication date: 2016-10-20

Abstract

The present invention relates to a device for dental and oral care, in particular for persons requiring care in the context of intensive care. To be able to ensure sufficient oral and dental hygiene for persons requiring care, and to be able to do so with minimal effort on the part of personnel, a corresponding device is proposed having a mouthguard (1) which has a treatment chamber (2) and which is intended to be placed onto the teeth of the upper jaw and/or lower jaw of a person requiring care in such a way that the teeth are arranged in the treatment chamber (2), wherein at least one movable treatment medium (3) for treating the teeth and/or the gums is arranged in the treatment chamber (2).

Description

Device for dental and oral care

The present invention relates to a device for dental and oral care according to the preamble of claim 1, wherein the device in particular for the prevention and prophylaxis of (dental) medical complications in critically ill or on professional care people, e.g. on intensive care units, is suitable.

The device comprises a dental splint with a treatment chamber adapted to be placed on the teeth of the maxillary and / or mandibular teeth row of a patient in such a way that the row of teeth is arranged in this treatment chamber, wherein in the treatment chamber at least one movable treatment agent for treating the teeth and / or the gums is arranged.

Corresponding devices are known, for example, from WO 2007/121760 A1 and DE 20 2007 003 791 U1. These known devices are only conditionally usable for patients in intensive care.

The dental care of critically ill people or people dependent on professional care poses a challenge in terms of health policy and health economics. On the one hand, an adequate infrastructure is generally available for the treatment of dental diseases in this patient group. Today, the therapy is mainly performed by dentists with mobile treatment units on site at the bedside or in specially designed practices and clinics. However, in the area of dental diagnostics, prevention and prophylaxis are evident in this patient group - e.g. on intensive / palliative care units or outpatient geriatric care facilities - considerable deficits. In addition, demographic change exacerbates this problem.

It can be seen from the current state of the art that, for example, about 30% of long-term intubated patients come to intensive care units for pneumonia, the so-called ventilator-associated pneumonia (VAP). (See: "S3 Guideline - Epidemiology, Diagnosis and Therapy of Adult Patients with Nosocomial Pneumonia" and "Cochrane Review" Oral Hygiene Care for Critically Ill Patients to Prevent Ventilator-Associated Pneumonia "). This serious complication, which is associated with increased mortality, is due in large part to a strong bacterial load from the area of the oral cavity. Inadequate oral hygiene is considered to be responsible for this increased and altered germination and biofilm formation in the oral cavity. The relevant scientific literature therefore recommends regular efficient hygienic measures of the oral cavity. However, with the well-known - and ultimately developed for the healthy people - aids this necessary professional dental and oral care can not be done efficiently. Moreover, the physicians treating these patient groups often have poor awareness of the problem, which can be attributed to a lack of expertise in the paradontological field. And in the case of nurses caring for these groups of patients, there are often deficits in the field of dental prophylaxis. For example, cleaning the teeth and cleaning the oral cavity of critically ill people or those in need of professional care with a well-known hand or electric toothbrush is far too time-consuming and time-consuming than that in view of the shortage of staff and time, an effective dental prophylaxis would be possible in everyday care. So when using a known hand or electric toothbrush all tooth surfaces and interdental spaces must be recorded and then the toothpaste used to be flushed or sucked. Also, efficient and skilled use of such known adjunctive care devices requires adequate knowledge of dental prophylaxis and a high level of manual skill. In the corresponding education and training curricula, however, there are only a few learning contents on these subject areas - which additionally do not correspond to the current state of dental science. Thus, there is a lack of easy-to-use and automated technical aids with which non-dental prophylaxis nurses can provide effective oral hygiene and germ reduction in the oral cavity quickly and effectively for critically ill or professional caregivers. Against this background, the object of the present invention is to provide a device which, without prior knowledge in the field of dental prophylaxis, presupposes rapid and effective cleaning of the teeth and oral cavity in critically ill or professionally dependent persons, eg on intensive care or palliative care. According to the invention, this object is achieved in that a supply and suction device for a cleaning fluid is provided on the device. Since patients in intensive care are usually neither able to actively support the cleaning process in any way, nor has adequate protection or swallowing reflexes, it is essential that a supplied cleaning liquid, such as water or antibacterial rinse solution Not only the teeth and oral mucous membranes are well-bathed during the cleaning process, but in particular they can be safely extracted. Although optional devices for the supply of a cleaning fluid or toothpaste and the like are provided in the prior art discussed above, it implicitly assumes that the patient or user of the device still has protective and swallowing reflexes and cognitively in the It is possible actively to spit out the liquid or a paste, no suction devices are provided.

The aspiration of the cleaning liquid, even if it is pure or sterile water or even a sterilizing and antibacterial acting liquid, is especially important because a major problem in long-term ventilated patients is that otherwise such a liquid very easily can accumulate above the cuff of a respiratory tube, in the liquid and warm milieu in the trachea, the germ or bacterial count can grow rapidly in a very short time. Since appropriate tubes or their cuffs or cuffs can not guarantee a 100% tightness over time as a rule, these germ-contaminated fluids can enter the lungs following gravity and cause damage. serious complications. This means dramatic loss of quality of life for the affected patient - and, in some cases, Lifetime - enormous costs for the health sector.

The suction device according to the invention prevents from the outset the ingress of liquid from the treatment device into the pharynx, whereby, of course, any liquid should be aspirated from the pharynx and especially from the trachea above a tube cuff even after the treatment, which is anyway the usual standard in artificial ventilated intensive care patients. At the same time, of course, the tooth area as a potential source and settlement area of germs should be cleaned thoroughly and as quickly and effectively as possible, even if the patient is unable to actively support the cleaning process.

In the following, further advantageous embodiments of the device according to the invention are described, which are each shown separately from each other as separate embodiments, but which are also readily combinable and not mutually exclusive. The treatment chamber is expediently provided on the edges of the open side with elastic sealing elements which rest against the alveolar ridge and thus at least seal the treatment space from the environment so that a negative pressure can be generated in the treatment chamber by the suction device, so that the treatment is carried out. lungsfluid is completely sucked out of the treatment chamber and can not escape from the treatment chamber into the oral cavity of the patient.

According to one embodiment, it is provided that the device has a chemical / physical sensor or other bacterial sensor and / or devices for wireless readout of a type of such a sensor provided for this purpose. These include sensors for measuring the pH value. Chemically / physical or bacterial sensors are known in principle and such a wireless readable by electromagnetic waves sensor is known in particular from the online page of Nature Communications ("Graphene-based wireless bacteria detection on tooth enamel"). A suitable sensor can also be found at http://www.medgadget.com/2015/08/ucsd-mouth-guard-tracks-levels-of-uric-acid-without-blood- draws.html.

Such an electronic sensor can be located either on the inner surface of the treatment chamber or on a tooth surface because it is very thin and easily deformable and thus can be attached to almost any surface, including a tooth surface. If necessary, such a sensor can be removed later, when the intensive care of the patient has ended.

in combination with mechanical elements at the open end of the treatment chamber prevented by building up a pressure gradient / negative pressure.

It is also envisaged that, in addition to these direct sensor methods, sensors will also be used which, for example, can indirectly measure or quantify a bacterial attack on the basis of certain metabolic products or a pH change.

In one embodiment, it is provided that the device has a suction line with a two-pipe for sampling. About the branch line can be examined very quickly the extracted liquid after it has washed around the teeth and gums of the patient, so that in this way a quick direct microbiological or laboratory diagnosis is possible, which can also be more than the simple determination of germ count using the mentioned electronic sensors, eg qualitative microbiological findings.

Preferably available or associated with the device facilities for rapid microbiological or laboratory chemical analysis of a sample aspirated liquid may in particular also be designed so that they are the germs or bacteria in the mouth and on the Not only quantitatively but also qualitatively detect teeth or the gums of a patient, so that, for example, suddenly occurring multi-resistant germs can be identified at the earliest possible stage, so-called "germ-shift", and corresponding therapeutic measures can be taken aim to reduce or eliminate the multidrug-resistant germs as quickly as possible before an infection manifests on other organs, such as the lungs.

Furthermore, ports for the addition of diagnostic or treatment agents are provided in or in a supply line to the treatment chamber according to an embodiment of the invention. In particular, color markers are considered as diagnostic agents, which either cause a corresponding color marking in the recirculated and extracted treatment liquid or indicate a specific infestation with bacteria on the tooth or gum surface after the treatment. Particularly suitable treatment agents are locally bactericidal and / or antiviral substances, in particular those substances which could not be administered orally via the digestive tract or via the bloodstream or which would not be effective in this systemic form. For example, substances which attach to bacteria and / or viruses in the manner of markers could also be supplied, the markers in turn preferably absorbing, for example, electromagnetic radiation of specific wavelengths, introducing the corresponding energy into bacteria and / or viruses and thus killing them. In one embodiment, the treatment chamber can in particular have additional devices for reducing the number of germs on teeth and / or gums in the region of the treatment chamber. In particular mechanical auxiliary devices or even movable nozzles, which could be aimed at particularly stubborn plaque, are used for this purpose, as well as light sources which emit light in a certain, preferred wavelength range, in particular in the blue or ultraviolet wavelength range, and thereby act germicidal. This can be done with or without the addition of the markers described above.

As far as nozzles are arranged for supplying a cleaning and / or treatment fluid in the treatment chamber, preferably at least a part of the nozzles is movable, in particular pivotable, arranged, in order in this way an optimum lavage and / or treatment of teeth, interdental spaces and gums to reach. A suction opening for sucking off liquid is preferably located on the inner wall of the treatment chamber. In particular, a suction line extending in the interior of the treatment chamber to its distal end to suck the liquid there. Preferably, a suction line is integrated into the wall of the treatment chamber or bit rail.

The treatment agent may be a particular rotatably mounted cleaning or treatment element. However, the term movable treatment agent also includes, for example, jet-generated or possibly pulsed, water jets or jets produced from a cleaning or treatment fluid.

Furthermore, in one embodiment a device has a drive device for moving, preferably for rotating a treatment element. This is especially true when the treatment element is designed as elongated cleaning roller, preferably with bristles in the manner of a rotating brush, which is arranged in the treatment chamber, that its longitudinal axis extends parallel to the respective row of teeth when the dentition on a row of teeth of Patient is set up. In particular, a plurality of such cleaning rollers may be arranged parallel to one another in a treatment chamber, which need not necessarily be designed as brushes, but optionally may also have other surface configurations which effect a cleaning of the teeth and the gums and may be more gentle than bristles. Insofar as corresponding cleaning brushes are provided, they may in particular each have bristles of different hardness and, in general, in an embodiment of the invention, provision is made for corresponding treatment elements, such as cleaning rollers, to be arranged interchangeably in the respective treatment chamber. In this case, before use of the device, the corresponding treatment element could be exchanged and adapted to the needs of a patient.

A supplement or alternative to the cleaning elements already described may be ultrasound heads, which are arranged in the treatment chamber and can be switched on or off as required, for example to be used in the treatment chamber. B. To remove plaque from the tooth surfaces.

In particular, the device may also include sensors, such as pressure, force, torque and temperature sensors, which provide, on the one hand, additional information that can be logged about the course of the treatment, but which can also be used in particular for automatic control of the device and the safety of use to guarantee. The entire denture splint with the associated treatment chamber is also preferably as exchangeable disposable items designed. Otherwise, if, for example, such a dental splint should be used several times in succession in the same patient, a thorough cleaning and disinfection of the splint should be carried out with the treatment chamber. The bit rail is expediently equipped with an outer handle for the intended arrangement of the bit rail in the mouth of a patient, wherein in one variant the bit rail is releasably attached to the handle. Furthermore, in particular in the detachable arrangement of the handle on the bit rail supply and suction lines may preferably be connected to one end of the handle. An embodiment of the invention has an automated electronic control device for controlling the drive device and / or the feed device and / or the suction device and possibly also for the detection and evaluation of sensor data. This facilitates, in particular, the operation of the device by nursing staff, who can then simply confine themselves to removing a new or disinfected bite rail from a corresponding pack, to connect with the repeatedly usable handle and the leads and to arrange the bite rail in the patient's mouth in a suitable manner , Everything else can then proceed according to a fixed and possibly also for the patient individualized program. It is understood that a corresponding control device is designed to be programmable for such a purpose.

For example, the control device could cause a cleaning roller to rotate at different speeds at intervals and possibly also in different directions. In an expedient embodiment of the invention it is provided that it has an electronic memory as well as devices for the automatic detection and logging of the treatment steps carried out with the device as well as any sensor data. In the course of increasingly demanded quality assurance, it is becoming increasingly important, especially for hospitals, to standardize and also record all procedures, in order to be able to provide proof of appropriate treatment if necessary. Such a logging device, which records all treatment steps and also sensor data, could therefore be of considerable importance for many hospitals and in particular intensive care units, especially as the workload for the staff is thereby considerably reduced, since the device automatically logs the treatment steps.

The device according to the invention makes it possible to clean the entire upper and / or lower jaw row of a patient quickly and effectively, with hardly any on the part of the nursing staff Previous knowledge is needed. The splint must be placed only on the dentate or edentulous ridge to be cleaned and turned on the device.

Advantageously, different sized bite rails for different Kief fergrößen are provided. In one embodiment, the bit rail with the treatment chamber and the at least one treatment element is provided as an exchangeable module of the device. This allows for each patient to select a bite rail of the appropriate size and attach it easily and quickly to the device. In one embodiment, the device is configured such that the denture splint can be attached to or attached to the device in two positions rotated by 180 ° relative to each other. Thus, the denture splint may be attached to the device in a first position for cleaning an upper jaw tooth row. To clean a row of mandibular teeth, it is released and rotated by 180 ° in a second position on the device again. Alternatively, for cleaning the row of mandibular teeth, a second dentition bar can be provided, which is fastened to the device in the second position rotated through 180 °. As a result, each specially adapted to the upper or lower jaw comb teeth rails can be used. In one embodiment, the denticule has a substantially U-shaped profile. In one embodiment, the treatment chamber is formed by a correspondingly sized, also U-shaped groove in the bit rail. In one embodiment, the denture splint is shaped similar to a dental impression tray. In one embodiment, the bit rail and thus the treatment chamber has open ends. In one embodiment, the side walls of the bit rail can have inwardly directed projections at their ends which form abutments for the treatment elements. In one embodiment, the ends of the treatment elements are rotatably mounted in the abutments. Expediently suction openings should be provided at such open ends

In one embodiment, one or more treatment elements by means of a transmission, in particular a bevel gear with bevel gears, driven. In one embodiment, the transmission comprises a plurality of gear elements, which are each formed by a preferably flexible drive shaft, each with a bevel gear on both shaft ends. The drive shafts are by means of holding elements, preferably one to two holding elements, attached to the bite rail. In one embodiment, gear elements are arranged on the outside of the bit rail and protected by means of a, preferably removable, protective cover against the environment. In one embodiment, the treatment element is driven via an electric sound transducer that it performs high-frequency micro-movements. In one embodiment, the treatment element is thereby vibrated at a frequency of 250 to 300 Hertz or more. In one embodiment, the treatment element consists of a flexible shaft with a plurality of bristles extending perpendicular to the longitudinal axis of the shaft for cleaning teeth and / or gums. In one embodiment, the treatment surface of the treatment element for cleaning teeth and / or gums is formed at least partially from foam.

In one embodiment, the cleaning rollers are configured and arranged in the treatment chamber such that they simultaneously clean the entire row of teeth of the upper and / or lower jaw. The cleaning rollers are advantageously arranged so that they reach all surfaces of the teeth and thus clean the row of teeth from all sides, i. Occlusal, lingual and labial.

In one embodiment, at least four treatment elements are provided, which are arranged in the treatment chamber such that at least two treatment elements extend parallel along the left half of a row of teeth of the patient and at least two treatment elements parallel along the right half of the row of teeth during operation of the device.

In one embodiment, treatment elements are provided on the lingual and labial inner wall sections of the treatment chamber. In another embodiment, treatment elements are also provided on the occlusal inner wall portion of the treatment chamber. In particular, the treatment elements also include nozzles for generating liquid or gas jets.

In one embodiment, four treatment elements are provided, in another embodiment, six treatment elements arranged in the treatment chamber so that two or three treatment elements parallel to each other during operation of the device along the left half of a row of teeth of the patient and two or three treatment elements extend parallel along the right half of the row of teeth. In one embodiment, a plurality of nozzles for supplying the dental cleaning and / or gum care solution are arranged in the treatment chamber. In one embodiment, the nozzles are arranged in a row along an inner wall of the bit rail, in particular along a lingual and / or labial inner wall portion.

In one embodiment, the device is designed so that the suction during operation of the device can be carried out simultaneously for supplying a tooth cleaning solution, so that the used tooth cleaning solution is sucked out of the oral cavity immediately after the treatment of the row of teeth or oral mucosa again. In one embodiment, the bite rail for aspirating fluid from the oral cavity via a hose is in fluid communication with a central module.

In one embodiment, a plurality of suction openings are provided in a row along an inner wall of the bit rail, in particular along a lingual and / or labial inner wall portion. In one embodiment, the suction openings are designed slot-shaped, wherein the longitudinal axes of the slots are aligned in particular along the extension direction of the row. In one embodiment, the suction openings are arranged opposite the nozzles in the treatment chamber.

In one embodiment, the dental splint with treatment chamber is designed as a replaceable disposable article. For this purpose, in particular a modular construction of the device is advantageous, in which the bite rail with the treatment chamber and the treatment elements are constructed as an easily replaceable unit. In an embodiment, these units are designed as disposable articles in the sense of a closed hygiene chain and connected, for example, to the device via a simple coupling part. In one embodiment, the coupling part is a part of the bit rail and in particular designed in one piece with this. In one embodiment, the bit rail, the coupling part, the drive gear, the shaft of the treatment element and / or the handle made of plastic.

In one embodiment, the device has a handle for the intended arrangement of the denture splint in the mouth of a patient, wherein the denture splint is preferably releasably attached to the handle.

In one embodiment, the handle closes with the plane of the bite rail an angle in the range 30 ° to 60 ° and in particular an angle of 45 °. In one embodiment is on the handle provided a control for starting and / or stopping an automated cleaning process. In one embodiment, the control element is designed such that individual parameters of the cleaning process can be varied and set. In one embodiment, the device comprises an automated electronic control device for controlling the drive device and / or the feed device.

In one embodiment, the control device is designed such that it controls the drive device of the at least one treatment element in the operation of the device so that the treatment element rotates intermittently and alternately in different directions of rotation.

In one embodiment, the control device is designed such that during operation of the device, after the start of operation, it passes through a predetermined or preselected or selectable program sequence, by which a complete row of teeth is effectively cleaned in a few minutes and thus an effective contribution to biofilm removal and general reduction of microorganisms in the oral cavity. At the same time, this contributes to the general prevention of infection.

Further advantages, features and possible applications of the present invention will become apparent from the following description of preferred embodiments and the associated figures. Show it:

Figure 1 shows a first embodiment of an inventive device for

Care of a maxillary tooth row with control module,

FIG. 2 shows a detailed view of a denture splint with a handle of a second embodiment according to the invention for the care of a row of mandibular teeth,

FIG. 3 shows a second detail view of the bit rail from FIG. 2 from above,

Figure 4 is a third detail view of the splint bar of Figure 2 with transparent

Protective cover from above,

Figure 5 is a fourth detail view of the denture splint of Figure 2 with transparent

Protective cover from above,

FIG. 6 shows a fifth detail view of the bit rail from FIG. 2 without protective cover from above,

7 shows a sixth detail view of the bit rail from FIG. 2 without protective cover from above, FIG.

FIG. 8 shows a seventh detail view of the bit rail from FIG. 2 without protective cover from the front, FIG. 9 shows a detailed view of the bit rail from FIG. 2 from below,

FIG. 10 shows a second detail view of the bit rail from FIG. 2 without bristles from below,

1 1 shows a detailed view of the bit rail from FIG. 1 without bristles from above, FIG. 12 shows a detailed view of the bevel gear units in the treatment chamber,

Figure 13 is a detail view of one end of the treatment chamber with abutments for the treatment elements, and

FIG. 14 shows a horizontal section through the bit rail from FIG. 2 without treatment elements.

FIG. 1 shows a perspective view of an embodiment according to the invention of a device for the care of a row of maxillary teeth with a control module 8. The device has a splint 1, which is shaped similar to a dental impression tray. The bite rail 1 has a longitudinal groove which forms a treatment chamber 2, wherein the bite rail 1 is arranged in the illustrated embodiment on a handle 6 and aligned so that the open side of the groove or the treatment chamber 2 relative to the orientation of the handle 6 after above. The handle 6 is inclined at an angle of, for example, about 45 ° relative to the plane of the bit rail 1 and has relative to the longitudinal opening of the treatment chamber 2 down. In the illustrated orientation, the splint 1 is intended to be introduced into the mouth of a patient during operation of the device by means of the handle 6 and to be pushed or placed from below onto an upper jaw row such that the entire row of teeth is arranged in the treatment chamber 2 is.

In the treatment chamber 2 side treatment elements 3 are provided in the form of elongated cleaning rollers or cleaning brushes. These treatment elements 3 are arranged so that their longitudinal axes extend on both sides, ie lingually and labially, parallel along the upper jaw row of the patient when the denture rail 1 is placed on the corresponding row of teeth of a patient. The denture rail 1 is connected via a supply hose 10 with a control module 8 designed as a central module. The tube 10 extends from the handle 6 to the module 8 and provides the denture track 1 with a dentifrice and / or gum care solution which preferably has an antibacterial effect. For this purpose, the module 8 in the illustrated embodiment, a storage container for the cleaning and care liquid on and a suitable feeder, such as a pump, for supplying the liquid through the hose 10. In one embodiment, the supplied and thus consumed liquid from the device in Operation extracted from the treatment chamber 2 simultaneously again. For this purpose, the hose 10 in one embodiment comprises parallel to a first line for supplying liquid, a second conduit for discharging the used liquid. The two lines are only in fluid communication with each other via the treatment chamber. In addition, the central module 8 advantageously has a collecting container for the extracted liquid in this embodiment.

In one embodiment, the central module 8 further comprises a drive device for moving the treatment elements 3 in the treatment chamber 2. Preferably, the treatment elements 3 are driven via the connecting tube 10 by the drive device so that they rotate about their longitudinal axis.

The control module 8 is an automated electronic control device for controlling the drive device and / or the feed device and has control elements 9 for switching the operation of the device on and off. In one embodiment, the control module 8 is designed such that it controls the drive device of the treatment elements 3 in the operation of the device so that the treatment elements 3 rotate with interval-like direction of rotation changes about their longitudinal axes. Likewise, a control for switching on and off the operation can also be arranged on the handle 6. Preferably, the control module 8 is turned off so that after switching on the operation of a preselected cleaning program runs, so that the nursing staff, which uses the device, hardly needs to have prior knowledge of dental prophylaxis. In one embodiment, different programs for operating the device may be assembled and / or selected.

The control module 8 preferably has an integrated power supply, so that it can be used as a self-sufficient, mobile unit. In the illustrated embodiment, the control module 8 is designed as a mobile container on wheels. In a further embodiment, the central module 8 can also be designed as a portable unit. Similarly, embodiments are conceivable in which the central module 8 is designed so compact that it forms an easy to carry and handle unit together with the handle 6 of the device.

FIG. 1 also shows a bypass valve 10b which is connected to a branch of the suction line 10a and which is opened for the removal of rinsing or treating agent in order to be able to examine separately, for example, the condition and composition of the oral flora. For this purpose, after brief rinsing of the oral cavity with a suitable rinsing solution, for example, physiological saline, the solution contaminated with the bacterial flora of the oral cavity from the suction line in an analysis chamber 10c, for the purpose of qualitative and quantitative Seed regulations. This can be done by automatic process chains in the analysis chamber itself or by transfer of the samples to an analytical laboratory.

FIGS. 2 and 3 show detailed views of a denture splint 1 with handle 6 according to a second embodiment of the device according to the invention for the care of a row of mandibular teeth. In Figure 2, the bite rail 1 is shown from obliquely behind, in Figure 3 obliquely from the front. The bit rail 1 and the handle 6 correspond to the bit rail 1 and the handle 6 of Figure 1. However, the bite rail 1 is rotated by 180 ° arranged on the handle 6, so that the opening of the longitudinal groove or the treatment chamber 2 is oriented relative to the handle 6 down.

The bit rail 1 is provided in the illustrated orientation to be introduced into the operation of the device by means of the handle 6 in the mouth of a patient and pushed from above to a lower jaw tooth row or placed so that the entire row of teeth is arranged in the treatment chamber 2. The connection between the denture splint 1 and the handle 6 takes place via a coupling part 7 arranged on the denture splint 1. This allows a detachable connection between the splint splint 1 and the handle 6, which permits a simple exchange of the splint splint 1 designed as a disposable item. In addition, one and the same bit rail 1 can be released after cleaning a first row of teeth of a patient, rotated by 180 ° and fixed again to the handle 6, so that the row of teeth of the second jaw can be cleaned. In addition, the bit rail 1 has a protective cover 1 1 for protecting the drive mechanism (not shown) running on the outside of the bit rail 1 for the treatment elements 3 arranged in the treatment chamber 2. In Figures 4 and 5, the protective cover 1 1 and parts of the covered therefrom bit rail 1 of Figures 2 and 3 are shown transparently, so that the underlying drive mechanism is visible in the form of dashed lines. In the other figures 6, 7 and 8, the same bit rail 1 of Figures 2 and 3 with removed protective cover 1 1 is shown. In addition, in FIGS. 6 and 8, the ends of the treatment elements 3 provided with bristles 16 can be seen in the treatment chamber 2.

In the illustrated embodiment, four treatment elements 3 are provided in the treatment chamber 2. These four treatment elements 3 are arranged in the treatment chamber 2 so that two treatment elements 3 extend lingually and labially parallel along the left half of a row of teeth of the patient and two treatment elements 3 lingually and labially parallel along the right half of the row of teeth during operation of the device. The drive mechanism for the lingually arranged treatment elements 3 is made of the coupling part 7 out on the outside of the splint 1 along this around to the lingual portion of the outside. There, the transmission elements engage through openings in the treatment chamber 2 inside. The individual gear elements each comprise an elongated drive shaft 12, which is fastened by means of holding elements 13 on the bit rail 1 in a rotatably mounted manner. At the two ends of the shaft 12, a bevel gear 14 for transmitting rotational movements and torques is arranged in each case. In each case, two bevel gears 14 engage each other and thus form a bevel gear. The shaft axes are preferably aligned so that they intersect at a 90 ° angle, with other angles are also conceivable.

To drive the two lingually arranged in the treatment chamber 2 treatment elements 3 are in the illustrated embodiment, two mutually parallel Antriebsbzw. Gear strands led out of the coupling part 7 out around the bit rail 1. In addition, two (not shown) drive or gear trains for driving the two labial arranged in the treatment chamber 2 treatment elements 3 are provided. These two gear trains run directly from the coupling part 7 through the labial wall of the bit rail 1 to the labially arranged treatment elements. 3

FIG. 9 shows a perspective view of the bit rail 1 from FIGS. 2 to 8 from below. To see are provided with bristles 16 treatment elements 3, which extend in the treatment chamber 2 along the side walls thereof. At the two ends of the bit rail 1, the side or groove walls respectively have projections which extend inwardly into the treatment chamber 2 and provide abutments 17 for the treatment elements 3. In these abutments 17, the ends of the treatment elements 3 are rotatably besiege.

The illustration in FIG. 10 corresponds to the representation in FIG. 9, but the treatment elements 3 are shown without bristles 16, so that the flexible elongated shafts 15 can be seen, which form the base of the treatment elements 3 and from which the bristles 16 extend radially outward. The shafts 15 are held rotatably by holding elements 13 on the labial and lingual inner wall sections 20 and 19 of the treatment chamber 2. The groove bottom of the longitudinal groove, which forms the treatment chamber 2, forms the occlusal inner wall portion 18, while the lateral groove walls form the lingual and labial inner wall portions 19 and 20. Also at the ends of the shafts 15 are bevel gears 14 for receiving rotational movements and torques provided by the previously described transmission elements. In addition, in the illustrated embodiment, a plurality of nozzles 4 are provided in a row along the lingual inner wall portion 19 of the treatment chamber 2 for supplying a dental cleaning and / or gum care solution. The denture splint 1 shown in FIG. 11 corresponds to the splint splint 1 shown in FIG. 10 for the purpose of cleaning a row of mandibular teeth. However, the denticule is rotated in Figure 1 1 relative to the orientation of the handle 6 by 180 °, so that it is optimally aligned for cleaning a maxillary tooth row.

FIG. 1 also shows, by way of example, the alternating attachment of nozzles 4a for the supply of rinsing solutions of various types and of light sources 4b for a photodynamic disinfection program. For this purpose, the nurse starts, for example, first for a short time interval, the inflow of a special color solution. During a subsequent exposure time, the bacteria of the oral flora absorb this dye. Thereafter, a light application with a specific wavelength and with a defined duration takes place automatically via the light sources 4b. By light activation of the absorbed dye in the microorganisms (absorption of light) they are physically destroyed. In FIG. 12, the bevel gear transmissions for transmitting rotational movements and torques to the treatment elements 3 arranged on the labial inner wall section 20 of the treatment chamber 2 are shown in a detailed view.

FIG. 13 shows one end of the inventive denture rail 1, the side walls of which are designed as an abutment 17 for the treatment elements 3.

FIG. 14 shows a horizontal section through the bit rail 1 from FIG. 2 without treatment elements. Shown is a plurality of elongated suction slots 5 for aspirating liquids, whose longitudinal axes are arranged in a row along the labial inner wall portion 20 of the treatment chamber 2. In the illustrated embodiment, the suction slots 5 are arranged opposite the nozzles 4 (not visible here), which are distributed in a row along the lingual inner wall portion 19. Clearly visible are also the inwardly projecting projections at the ends of the denture rail 1, in which abutments 17 are provided for the treatment elements 3. The upper edge of the two inner wall sections 19, 20 can each still have an inwardly facing elastic seal (not shown here), in particular a sealing lip, which can engage with the tooth comb to seal the treatment chamber and generate a negative pressure in the treatment chamber to be able to prevent leakage of treatment liquid from the treatment chamber and into the oral cavity.

FIG. 14 also shows an electronic component (chip 4c) arranged in the treatment chamber, which can automatically determine parameters of the oral cavity that are associated with inflammations of the oral cavity mucosa and teeth, such as changes in the pharynx. Value, or due to excessive germ counts. The chip 4c could for example also be designed for the detection of biochemical inflammation parameters.

For purposes of the original disclosure, it is to be understood that all such features as will become apparent to those skilled in the art from the present description, drawings, and claims, even if concretely described only in connection with certain other features, both individually and separately Any combination with other features or groups of features disclosed herein can be combined, unless this has been expressly excluded or technical conditions make such combinations impossible or pointless. On the comprehensive, explicit representation of all conceivable combinations of features is omitted here only for the sake of brevity and readability of the description.

LIST OF REFERENCE NUMBERS

1 denture splint

2 treatment chamber

3 treatment element

4 nozzles

5 suction slot

6 handle

7 coupling part

8 control module

9 control

10 hose

1 1 protective cover

12 drive shaft

13 retaining element

14 bevel gear

15 shaft

16 bristles

17 abutments

18 occlusal inner wall section

19 lingual inner wall section

20 labial interior wall section

Claims

P a n t a n s p r e c h e

A dental and oral care device comprising a dental splint (1) having a treatment chamber (2) adapted to be seated on the dentate or edentulous crest of a patient's upper or lower jaw in such a way that the dentate or denture toothed ridge is arranged in the treatment chamber (2), wherein in the treatment chamber (2) at least one movable treatment means (3) for treating the teeth and / or the gums is arranged, characterized in that the device further comprises means for the supply and the suction of a cleaning and / or treatment fluid are provided in the treatment chamber and out of this.

Apparatus according to claim 1, characterized in that the device comprises at least one sensor as an indicator of bacterial attack and optionally means for wireless readout of a sensor provided for this purpose

Apparatus according to claim 1 or 2, characterized in that the device comprises a suction line with a branch line for sampling.

Device according to one of the preceding claims, characterized in that means are provided for a quantitative or qualitative rapid examination of a sample of aspirated liquid.

Device according to one of the preceding claims, characterized in that it comprises a supply line with ports for the addition of diagnostic and / or treatment agents.

Device according to one of the preceding claims, characterized in that in the treatment chamber additional devices for reducing the number of germs on teeth and / or gums are provided in the region of the treatment chamber

Apparatus according to claim 6, characterized in that the additional device comprises a source of electromagnetic radiation, preferably in the ultraviolet or blue spectral range.

Device according to one of the preceding claims, characterized in that in the treatment chamber (2) a plurality of nozzles (4) for supplying the cleaning and / or treatment fluid is arranged, wherein preferably at least a part of the nozzles is movable, in particular pivotable.

Device according to one of the preceding claims, characterized in that in the inner wall of the treatment chamber at least one suction opening (5) for sucking liquid is arranged.

Device according to one of the preceding claims, characterized in that the treatment chamber has at the edge of its open side elastic sealing elements which abut in use on the alveolar ridge or on the teeth or the gums to the treatment space for generating a pressure gradient relative to the outside of the Seal the treatment chamber.

Device according to one of the preceding claims, characterized in that the device comprises a drive means for moving, preferably rotating, a treatment element (3).

Device according to one of the preceding claims, characterized in that the treatment element (3) as an elongated cleaning roller, preferably as a cleaning brush, is formed, which is arranged in the treatment chamber (2) that its longitudinal axis extends parallel to the row of teeth, when the denture splint (1) is placed on a row of teeth of a patient.

Device according to one of the preceding claims, characterized in that at least four treatment elements (3) are provided, which are arranged in the treatment chamber (2), that during operation of the device at least two treatment elements (3) in parallel along the left half of a To extend the row of teeth of the patient and at least two treatment elements (3) in parallel along the right half of the row of teeth.

Device according to one of the preceding claims, characterized in that it comprises further sensors, such as pressure, force, torque and temperature sensors

15. Device according to one of the preceding claims, characterized in that the bit rail (1) with treatment chamber (2) is designed as an exchangeable disposable article. Device according to one of the preceding claims, characterized in that the device has an outer handle (6) for proper placement of the splint (1) in the mouth of a patient, wherein the splint (1) is preferably releasably attached to the handle (6).

Device according to one of claims 2 to 10, characterized in that the device comprises an automated electronic control device (8) for controlling the drive device and / or the feed device, and optionally for the detection and evaluation of sensor data.

Apparatus according to claim 1 1, characterized in that the control device (8) is designed such that it controls the drive means of the at least one treatment element (3) during operation of the device so that the treatment element (3) rotates with intervals in different directions of rotation.

Device according to one of the preceding claims, characterized in that it comprises an electronic memory and means for automatically detecting, logging and outputting the treatment steps carried out with the device as well as any sensor data.

Device according to one of the preceding claims, characterized in that the treatment means are exchangeable within the treatment chamber