JP2790872B2 - Root canal laser light irradiation probe - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a laser beam irradiation probe which can be used for sterilization treatment in a root canal in dental treatment.

<Prior Art> Periodontal tissue may be inflamed by bacteria attached to the root canal. In order to treat such inflammation, it is necessary to completely remove bacteria attached to the root canal.

In the conventional dental treatment, the attached bacteria are removed by, for example, enlarging and forming a root canal with a reamer or the like, and the remaining bacteria are killed by disinfecting the root canal. After confirming that the inflammation has healed and that there is no abnormality, the root canal is filled.

Since the above treatment is relatively time-consuming and has a high possibility of recurrence, a technique of irradiating the root canal with sterilizing ultraviolet rays has been developed in order to kill bacteria remaining in the root canal (particularly). JP-A-1-131654).

The above technology has a light emitting portion made of a linear body having a diameter of 1 mm or less and irradiates sterilizing ultraviolet rays into the root canal from the light emitting portion to kill bacteria remaining in the root canal. It is a thing to be done.

<Problems to be Solved by the Invention> In the above technique, by irradiating the root canal with germicidal ultraviolet rays, it is possible to kill bacteria irradiated with the germicidal ultraviolet rays. However, the wall surface of the root canal is not always smooth, and fine irregularities are formed. For this reason, the bacteria attached to the concave portion are not directly irradiated with the germicidal ultraviolet rays, and therefore, there is a possibility that the bacteria remain despite the irradiation with the germicidal ultraviolet rays.

In the above-mentioned root canal treatment, it is preferable to kill the bacteria and to mineralize the root canal wall (pulp) so that the bacteria that have entered the root canal after healing do not grow.

An object of the present invention is to provide an intraroot canal laser beam irradiation probe that can sterilize the inside of the root canal and mineralize the root canal wall during root canal treatment.

<Means for Solving the Problems> In order to solve the above problems, an intra-root canal laser light irradiation probe according to the present invention includes an optical fiber for guiding laser light to an irradiation position, and an optical fiber for protecting the optical fiber. A protection tube, an irradiating means comprising a reflecting mirror or a concave lens or a rod-shaped shielding member provided on the front end side of the optical fiber, and a detection device provided around the protection tube for detecting a distance from a tip of the protection tube. And means.

<Operation> According to the above means, the laser light is guided into the root canal by the optical fiber protected by the protective tube,
By irradiating the laser beam in the axial direction of the optical fiber or the tube wall of the root canal with the irradiation means provided on the front end side of the optical fiber, the inner diameter of the root canal is sterilized, and the organic material of the tube wall (pulp) is treated. The components can be mineralized.

It is known that when a living tissue is irradiated with a laser beam, the living tissue at the irradiation site is affected by the energy of the laser beam from the surface to the deep layer. Immediately, the surface layer at the irradiation site becomes extremely hot and evaporates and evaporates instantaneously. In the layer following the vaporization and evaporation layer, organic components are carbonized to be inorganic. Further, in the layer following the mineralized layer, the proteins are coagulated and the blood is stopped. In the deepest layer of the living tissue at the irradiation site, the nerve tissue in the layer is paralyzed.

Therefore, during root canal treatment, laser light is guided into the root canal by an optical fiber, and the laser light is applied to the root canal wall by a reflecting mirror, thereby vaporizing and evaporating the surface layer of the canal to form the root canal. Further, the layer following the vaporization and evaporation layer can be carbonized to be mineralized. At the same time, it is possible to coagulate a protein which is a layer following the inorganic layer.

When the laser beam is irradiated in the axial direction, even if the apical hole at the end of the root canal is branched into multiple parts, the nerve tissue in each apical hole can be paralyzed .

Further, by providing a detecting means for detecting the distance from the tip of the protective tube around the protective tube, the irradiation position of the laser beam in the root canal can be known.

<Example> An example of an intra-root canal laser light irradiation probe to which the above means is applied will be described with reference to the drawings.

FIG. 1 is an explanatory view of the external appearance of a laser beam irradiation probe according to the present invention, FIG. 2 is a cross-sectional view, FIG. 3 is an explanatory view of an irradiating means, FIG. 4 is an explanatory view of a detecting means, and FIG. It is explanatory drawing of a state.

1 and 2, an irradiation probe A has an optical fiber 1 for guiding a laser beam, a protective tube 2 for protecting the optical fiber 1, and a front end of the optical fiber 1.
It comprises a reflecting mirror 3 serving as an irradiating means provided at a position separated by a predetermined distance from 1a, and a scale 4 serving as a detecting means formed around the protective tube 2.

The rear end 1b of the optical fiber 1 is optically continuous with the oscillation section 5a and the optical system 5b in the laser oscillation device B. Therefore, the laser light oscillated from the oscillation unit 5a is transmitted to the optical system 5b.
And the front end of the optical fiber 1
The light is applied to the reflecting mirror 3 from 1a. Between the laser oscillation device B of the optical fiber 1 and a handle 7 described later, a protective member 6 such as a synthetic resin having flexibility is coated.
It is protected from the outside by the protection member 6.

As the optical fiber 1, a known optical fiber can be used. The characteristics of the optical fiber 1 can be either a step index (SI) type or a graded index (GI) type optical fiber.

A handle 7 is detachably provided on the optical fiber 1. At both ends in the axial direction of the handle 7, a boss 7a having an outer peripheral thread is formed on the laser oscillation device B side, and a boss 7b having an outer peripheral thread formed on the probe A side.
Are formed. A through hole penetrating in the axial direction of the handle 7
7c and 7d are formed. The through hole 7c is formed on the boss 7a side, and has a size slightly larger than the outer diameter of the optical fiber 1. The through hole 7d is formed on the boss 7b side, and has a size slightly larger than the outer diameter of the protective tube 2 described later. The bosses 7a and 7b are formed with a plurality of slits extending from screw portions formed in the bosses 7a and 7b to through holes 7c and 7d. The slit is a boss 7
When the cap nuts 8a and 8b are screwed into the a and 7b, the diameter of the through holes 7c and 7d is reduced by tightening the system of the bosses 7a and 7b, thereby reducing the diameter of the optical fiber 1, the protective tube 2 and the handle 7. Is fixed.

In the handle 7 configured as described above, the optical fiber 1 is inserted into the through holes 7c and 7d, the protective tube 2 is inserted into the through hole 7d, and the bosses 7a and 7b are tightened by the cap nuts 8a and 8b. Thus, the diameters of the through holes 7c and 7d are reduced, so that the handle 7 can be fixed to the optical fiber 1 and the protective tube 2 can be fixed to the handle 7.

The doctor grasps the handle 7 during treatment and holds the probe A
Is to operate.

The protective tube 2 protects the front end 1a side of the optical fiber 1 during treatment, and is mounted on the outer periphery of the optical fiber 1 from the front end 1a side to the handle 7. That is, the front end 2a of the protective tube 2 is disposed at a position substantially equal to the front end 1a of the optical fiber 1, and the rear end 2b is inserted into a through hole 7d formed in the handle 7 so that the inside of the handle 7 The room 7e has been formed.

The protection tube 2 may be made of a rigid metal pipe such as a stainless steel pipe, an aluminum pipe, or a hard chrome-plated copper pipe. In this case, it is possible to selectively use a metal pipe as described above, which is bent at a predetermined angle in advance, or a straight pipe, depending on the tooth to be treated.

As the protective tube 2, a flexible tube formed by spirally winding a metal sheet of stainless steel or the like having a predetermined width can be used. In this case, after the protective tube 2 is attached to the outer periphery of the optical fiber 1, it is necessary to bend according to the tooth to be treated.

Further, as the protective tube 2, it is also possible to use a material other than the above-mentioned metal pipe or tube, for example, a ceramic pipe or a synthetic resin pipe.

When attaching the protective tube 2 to the optical fiber 1, it is preferable to cover the periphery of the optical fiber 1 with an extremely thin synthetic resin sheet having flexibility and then attach the protective tube 2 to the outer periphery of the coating. .

When attaching the protective tube 2 to the optical fiber 1 as described above, the optical fiber 1 can be easily attached because the optical fiber 1 has flexibility.

Generally, the root canal has a size of 1 mm or less. Therefore, in this embodiment, the outer diameter of the protective tube 2 is 0.7 mm.
Stainless steel pipe. After covering the optical fiber 1 with a synthetic resin sheet (not shown), the stainless steel pipe is attached to the optical fiber 1. Further, the protective tube 2 in which the pipe is bent at 30 degrees and 45 degrees in advance and the protective tube 2 formed in a straight line are selectively used depending on the teeth to be treated.

The reflecting mirror 3 refracts the laser light guided through the optical fiber 1 and irradiates the laser light toward the root wall of the root canal and / or the axial direction of the optical fiber 1. For this reason, the reflection mirror 3
Uses a known total reflection mirror or half mirror capable of reflecting laser light selectively.

As shown in FIG. 3, the reflecting mirror 3 is provided with a rotating pin 3a at an end in the width direction of the reflecting mirror 3. The optical fiber 1 is configured to be rotatable with respect to the axis of the optical fiber 1 by being attached to the stay 9 via the rotating pin 3a. The stay 9 is a ring configured to be detachable on the outer periphery of the protection tube 2.
Fixed to 10. The ring 10 is attached to a predetermined position on the outer periphery of the protective tube 2 and the ring 10 is fixed to the protective tube 2 by a fastening screw (not shown), so that the reflecting mirror 3 is separated from the front end 1a of the optical fiber 1 by a predetermined distance. It is arranged in. Therefore, the distance between the center of the reflecting mirror 3 and the front end 1a of the optical fiber 1 can be changed according to the tooth to be treated.

By configuring the reflecting mirror 3 as described above, it is possible to irradiate the laser light guided via the optical fiber 1 toward the tube wall of the root canal. Further, when a total reflection mirror is used as the reflection mirror 3, it is possible to irradiate all of the laser light emitted from the optical fiber 1 toward the root canal wall, and a half mirror is used as the reflection mirror 3. in case of,
It is possible to irradiate the laser light in the axial direction of the optical fiber 1 and in the tube wall direction of the root canal.

The root canal has a minute taper (about 1/100 to 2/100) and has a subtle bent shape. For this reason, it is desirable that the laser light emitted from the probe A be simultaneously irradiated in the axial direction of the optical fiber 1, that is, in the straight direction and the tube wall direction from the probe A. In addition, since the periodontal tissue near the apical hole, which is the end of the root canal, has a natural healing power, it is not preferable to damage the tissue by laser light. Therefore, it is preferable that the reflecting mirror 3 is constituted by a total reflecting mirror or a half mirror, and these are selectively used.

In the following embodiments, a case where a total reflection mirror is used as the reflection mirror 3 will be described.

The graduations 4 serving as detecting means are engraved on the outer periphery of the protective tube 2 at a predetermined pitch as shown in FIG. The scale 4 is for knowing the depth currently being treated, that is, the depth of the reflector 3 in the root canal, when performing the treatment in the root canal. For this reason, it is preferable that the scale 4 is engraved on the basis of the center position of the reflecting mirror 3. However, in this embodiment, since the distance between the reflecting mirror 3 and the front end 1a of the optical fiber 1 can be changed, the scale 4 is engraved on the basis of the front end 2a of the protective tube 2.

Laser light such as a YAG laser, a carbon dioxide laser, or a semiconductor laser can be used as the laser light capable of sterilizing bacteria adhering to the root canal wall and mineralizing the root canal wall. For this reason, as the oscillating section 5 constituting the laser oscillating device B, it is possible to selectively use an oscillating means such as a solid laser oscillating means such as a YAG laser, a gas laser oscillating means such as a carbon dioxide laser, and a semiconductor laser oscillating means. It is possible.

In this embodiment, a YAG laser oscillation unit is used as the oscillation unit 5a.

When endodontic treatment is performed by the probe A configured as described above, a laser beam is oscillated by the oscillating unit 5a, and this laser beam is transmitted through the optical system 5b and the optical fiber 1 to the front end 1a of the optical fiber 1. Lead to. When the probe A is inserted into the root canal 12 as shown in FIG. 5, the laser light is irradiated by the reflecting mirror 3 toward the root wall of the root canal.

The surface of the root canal wall irradiated with the laser beam evaporates and evaporates instantaneously. The layer following the vaporization layer is converted into an inorganic substance by carbonizing the organic component constituting the tube wall by the energy of the laser beam. For this reason, it becomes possible to sterilize bacteria adhering to the root canal wall. Since the sterilization treatment for the bacteria is performed by increasing the temperature, it is possible to completely kill the bacteria attached to the root canal wall without directly irradiating the bacteria with laser light. In addition, by mineralizing the root canal wall, even if bacteria enter after the treatment, it is possible to eliminate the possibility of the bacteria growing.

By irradiating the root canal wall with laser light to mineralize the canal wall, by appropriately adjusting the output of the laser light,
It is possible to control the depth of the vaporized and transpired layer, that is, the root canal size in root canal formation, the depth of the layer to be mineralized, and the like. That is, when the output of the laser beam is increased, it is possible to increase the depth of the layer to be vaporized, evaporated, and mineralized, and when the output is reduced,
It is possible to reduce the depths of the vaporized, transpired and mineralized layers.

When the probe A is inserted into the root canal 12 as described above, the insertion depth of the tip of the probe A is
Can be detected by the scales 4 formed on the outer periphery of. Therefore, by measuring the depth of the root canal 12 by radiographing the affected part in advance, it is possible to insert the tip of the probe A to an appropriate depth to perform treatment.

As described above, the periodontal tissue near the apical hole 13, which is the end of the root canal 12, has a natural healing power unique to living tissue. Therefore, by using the total reflection mirror as the reflection mirror 3 in the present embodiment, there is no possibility that the laser light emitted from the optical fiber 1 goes straight and damages the periodontal tissue near the apical hole 13. In addition, it is possible to paralyze the nerve tissue in the periodontal tissue portion. Further, by adjusting the angle of the reflecting mirror 3 with respect to the axis of the optical fiber 1, it is possible to irradiate the laser light to the vicinity of the apical hole 13 and perform a sterilization treatment, and furthermore, the root canal wall irradiated with the laser light Can be vaporized, evaporated and mineralized.

[Other embodiments]

Probe FIG. 6 is an explanatory diagram of a probe C according to another embodiment. In the figure, the same reference numerals are given to the same portions or portions having the same functions as those in the above-described embodiment, and the description is omitted.

In the probe C according to the present embodiment, the optical fiber 1 and the protection tube 2 are configured to have substantially the same length, and both are integrally configured.

An optical system 14 is provided in a chamber 7e formed inside the handle 7. An optical fiber 15 connected to a laser oscillation device (not shown) is connected to the optical system. A boss 7b formed at the end of the handle 7 in the axial direction is formed with a through hole 7d having a size slightly larger than the outer diameter of the protection tube 2 and a plurality of slits.

In the above configuration, the diameter of the through hole 7d is reduced by inserting the probe C into the through hole 7d, bringing the rear end 1b of the optical fiber 1 into contact with the optical system 14, and tightening the boss 7b with the cap nut 8b. Thus, the probe C can be fixed to the handle 7 by using the same.

The probe C configured as described above can be easily replaced according to the tooth to be treated or according to the patient by loosening the cap nut 8b with respect to the boss 7b of the handle 7.

Irradiating means FIGS. 7A to 7E are explanatory views of an irradiating means according to another embodiment.

In FIG. 1A, a reflector 16 is constructed by intersecting two reflectors 16aA and 16b, and the reflector 16 is attached to a stay 9 fixed to a ring 10 detachably attached to the protective tube 2 and light is reflected. It is arranged on the front end 1a side of the fiber 1. The use of a total reflection mirror or a half mirror as the reflection mirrors 16a and 16b is the same as in the above-described embodiment.

By configuring the reflecting mirror 16 as described above, the optical fiber 1
Can be simultaneously irradiated on the root canal wall in two directions.

FIG. 2B shows a configuration in which a reflecting mirror 16c is embedded in the front end 2a of the protective tube 2. The reflecting mirror 16c has a diameter substantially equal to the inner diameter of the protective tube 2, and a surface facing the front end 1a of the optical fiber 1 is formed as a reflecting surface inclined at about 45 degrees with respect to the axis of the optical fiber 1. Have been. The reflecting surface is disposed at a predetermined distance from the front end 1a of the optical fiber 1, and the rear end of the reflecting mirror 16c is disposed so as to be substantially flush with the front end 2a of the protective tube 2.
Therefore, the protection tube 2 is formed longer than the length of the optical fiber 1 according to the length that can accommodate the reflecting mirror 16c. In addition, a protective tube 2 facing the reflecting surface of the reflecting mirror 16c.
The front end 2a is formed with a window 2 for passing the reflected laser light.

By configuring the reflecting mirror 16c as described above, the probes A and B
Can be reduced in diameter, and the probes A and B can be made to penetrate deeper into the root canal when performing root canal treatment. Therefore, efficient treatment can be performed.

FIG. 4C shows a concave lens 17a on the front end 1a side of the optical fiber 1.
Is arranged. The concave lens 17a,
The optical fiber 1 is held at a predetermined distance from the front end 1 a of the optical fiber 1 while being held by a holding member 18 detachably attached to the protective tube 2.

The laser beam emitted from the optical fiber 1 can be simultaneously irradiated in the axial direction and the radial direction of the optical fiber 1 by the concave lens 17a configured as described above.

FIG. 4D shows a concave lens 17b on the front end 2a of the protective tube 2.
Embedded. The concave lens 17b is disposed substantially in contact with the front end 1a of the optical fiber 1, and the rear end of the concave lens 17b is disposed so as to be substantially flush with the front end 2a of the protective tube 2. Therefore, the protection tube 2 is formed longer than the length of the optical fiber 1 according to the length capable of accommodating the concave lens 17b.

By configuring the concave lens 17b as described above, the probe
The diameters of A and B can be reduced, and the probes A and B can be made to penetrate deeper into the root canal when performing root canal treatment. Therefore, efficient treatment can be performed.

FIG. 5E shows a configuration in which a rod-shaped shielding member 19 is disposed on the front end 1a side of the optical fiber 1. The shielding member 19
Is a holding member 20 detachably attached to the protection tube 2.
And a predetermined distance from the front end 1a of the optical fiber 1.

The laser beam emitted from the optical fiber 1 can be irradiated only in the radial direction of the optical fiber 1 by the shielding member 19 configured as described above.

Detecting means FIGS. 8A and 8B are explanatory diagrams of a detecting means according to another embodiment.

FIG. 2A shows a structure in which a ring member 21 formed in a ring shape from an elastic material such as natural rubber or synthetic rubber is movably mounted on the outer periphery of the protective tube 2 along the outer periphery. is there. The hole 21a formed at the center of the ring member 21 is formed to have a size equal to or slightly smaller than the outer diameter of the protective tube 2. Therefore, when the ring member 21 is moved along the outer circumference of the protective tube 2, the ring member 21 can maintain its stopped position.

The ring member 21 has a function of a stopper in contact with the surface of the tooth to be treated.

At the time of treatment, the depth of the root canal 12 is measured by a radiograph taken in advance or the like, and the ring member 21 is slid along the outer periphery of the protective tube 2 in accordance with the measured depth, and the front end 1a of the optical fiber 1 is measured. Is inserted into the root canal 12. When the insertion depth of the front end 1a increases, the ring member 21 comes into contact with the tooth and prevents the insertion of the front end 1a. For this reason, the front end 1a of the optical fiber 1 is not inserted deeper than necessary into the root canal 12, so that there is no risk of damaging the periodontal tissue near the apical hole 13.

FIG. 2B shows a metal ring 2 provided with a set screw 22a.
2 is mounted on the outer periphery of the protective tube 2. The hole 22b formed in the center of the ring 22 has a size slightly larger than the outer diameter of the protective tube 2. Therefore, the ring 22 can be moved along the outer circumference of the protection tube 2 by loosening the set screw 22a, and the ring 22 can be fixed to a predetermined position on the outer circumference of the protection tube 2 by tightening the set screw.

The ring 22 configured as described above is the same as the ring member 21 described above.
As in the case of (1), it comes into contact with the tooth surface and has a function as a stopper.

For treatment, it is used in the same manner as the ring member 21 described above.

<Effect of the Invention> As described in detail above, the intra-root canal laser light irradiation probe according to the present invention emits the laser light guided by the optical fiber by the irradiation means provided on the front end side of the optical fiber. By irradiating in the tube wall direction and / or the axial direction of the optical fiber, a sterilization treatment inside the root canal can be performed. The root canal is formed by evaporating and evaporating the surface of the canal with laser light applied to the canal of the root canal, and mineralizing by carbonizing the organic components of the layer following the evaporating and evaporating layer. It has features such as being able to be performed.

[Brief description of the drawings]

FIG. 1 is an explanatory view of the external appearance of a laser beam irradiation probe according to the present invention, FIG. 2 is a cross-sectional view, FIG. 3 is an explanatory view of an irradiating means, FIG. 4 is an explanatory view of a detecting means, and FIG. FIG. 6 is an explanatory view of the state, FIG. 6 is an explanatory view of a probe according to another embodiment, FIGS. 7 (A) to 7 (E) are explanatory views of irradiation means according to another embodiment, and FIGS. (B) is an explanatory view of a detecting means according to another embodiment. A and C are probes, B is a laser beam oscillator, 1,15 is an optical fiber, 2 is a protective tube, 3,16 is a reflecting mirror, 4 is a scale,
5a is an oscillating unit, 5b and 14 are optical systems, 7 is a handle, 17a and 17b are concave lenses, 18 and 20 are holding members, 19 is a shielding member, 21 is a ring member, and 22 is a ring.

Claims (1)

(57) [Claims] An optical fiber for guiding a laser beam to an irradiation position, a protective tube for protecting the optical fiber, and a reflecting mirror or a concave lens or a rod-shaped shielding member provided at a front end side of the optical fiber. And a detecting means provided around the protective tube for detecting a distance from a tip of the protective tube.