Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/0046—Dental lasers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
  • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
  • A61B18/201—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser with beam delivery through a hollow tube, e.g. forming an articulated arm ; Hand-pieces therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
  • A61N5/00—Radiation therapy
  • A61N5/06—Radiation therapy using light
  • A61N5/0613—Apparatus adapted for a specific treatment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/0007—Control devices or systems
  • A61C1/0015—Electrical systems

Definitions

• This invention relates to the field of medical lasers and, in particular, lasers used in the provision of dental treatment of hard tissue and soft tissue, including gingival tissue, skin, muscle, connective tissue, bone, tooth enamel, and tooth dentin.
• the high speed air rotor was developed for the removal of dental hard tissue, including enamel, dentin and dental caries.
• the high speed air rotor offered faster removal of hard tissue while also being more comfortable for the patient and easier to use for the dentist, compared to available electric belt drive dental drills. While offering advantages, the high speed air rotor was found to create excessive heat and high frequency vibration which was injurious to the vital tissues in the tooth; and a water spray or water misting system was developed in parallel with the high speed air rotor. The water spray or water mist was directed toward the operative site while the air rotor was spinning and a burr was in contact with tooth structure, thus safely cooling the tooth structure and dampening the injurious high frequency vibration.
• Laser-emitting devices are beginning to achieve increased popularity as tools to perform the above-described functions. Such laser-emitting devices may be used to cut and cauterize skin, including treatment areas on or around the lips and gums, and high power laser-emitting devices may be used to ablate bone, tooth dentin and tooth enamel.
• Laser-emitting devices may further be used in the debridement, denaturalization and sterilization of root canal surfaces.
• benefits to using a laser-emitting device over traditional methods of performing these operations including a significant reduction in the post-operative healing time, improved control over bleeding due to the simultaneous cauterization of the soft-tissue at the time of cutting, the opportunity to provide less-invasive treatments by making smaller and more precise cuts, the ability to treat with less anesthesia and possibly no anesthesia, the ability to gain access to and effectively treat otherwise inaccessible areas (e.g., sterilization and debridement of necrotic tissue, such as within periodontal pockets), and promotion of a potentially better surface for subsequent bonding procedures due to the lessened need to chemically etch tooth surfaces after drilling.
• a laser- emitting device which comprises a housing, a power supply,, two or more laser light sources, a controller configured to modulate one or more of the laser light sources; a memory operatively coupled to the controller to store device settings; a connection used to operatively couple a smart device to the controller, a handpiece for applying laser light to the area of treatment, an airless misting unit to apply a fine water mist to the area of treatment, and an articulated arm operatively coupling the laser light source to the handpiece.
• FIG. 1A is an isometric view of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. IB is a detail view of an exemplary embodiment of a secondary visual display described herein;
• FIG. 2 is a front elevation view of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. 3 is a side elevation view of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. 4 is a top elevation view of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. 5 is a rear elevation view of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. 6 is an schematic depicting the components of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. 7 is a detailed view of the laser light subsystem of an exemplary embodiment of the dental laser-emitting device described herein;
• FIG. 8 is a diagram depicting the components of the airless misting unit described herein;
• FIG. 9 is a line drawing depicting an exemplary embodiment of the user interface for the dental laser-emitting device described herein;
• FIG. 10 is a flow chart depicting one exemplary embodiment of a method wherein the controller responds to user input
• FIG. 11 is a flow chart depicting one exemplary embodiment of a method wherein a diagnostic program is executed.
• laser-emitting device 100 includes a housing 110; a power supply 120; laser subsystem 130; a controller 140 configured to modulate one or more of the laser light sources; a memory 150 operatively coupled to the controller to store device settings; a connection 160 used to operatively couple a smart device
• housing 110 includes a front handle 112 and a rear handle 114.
• Laser subsystem 130 includes a laser source 131 producing a visible aiming beam 132, and at least two therapeutic laser light sources 133a, 133b...133n and emitting laser beams 134a, 134b... 34n, wherein one or more of the therapeutic laser light sources may be designed to operate at a lower power for procedures conducted on soft tissue, such as skin or gum tissue, and one or more of the other therapeutic laser light sources may be designed to operate at a higher power for procedures on hard tissue, such as tooth enamel, tooth dentin, or bone.
• laser light source 133a is a Neodymium/YAG or semiconductor diode laser having a power range adjustable between about 0 to about 15 Watts, such as from about 0.1 to about 15 Watts, and used for soft-tissue applications and laser light source 133b is an Erbium/YAG diode-pumped solid-state laser or a flashlamp- pumped solid-state laser used for hard-tissue applications.
• Laser beams 134 are collected in optical coupler 135 whereby any of laser beams 132 and 134 emit from a single location and exit laser subsystem 130 as beam 136.
• power supply 120 includes insulated- gate bipolar transistors, which may allow an operator or technician to set a variable pulse width for therapeutic laser light source 133a and/or therapeutic laser light source 133b, in order to modify the power yield as a function of time.
• power supply 120 can be configured to provide high-power peaks of shorter duration to improve performance during hard-tissue ablation procedures.
• power supply 120 can be configured with high repetition rates and medium duration pulses to cause cavitation within root canals to remove softer tissue and sterilize the interior of the canal.
• power supply 120 can be configured to provide longer duration power of lower peaks to improve comfort, consistency and/or quality of soft-tissue cutting and cauterizing procedures.
• laser-emitting device 100 also includes foot pedal 195 that is operatively coupled to controller 140 using a wireless communication link. While foot pedal 195 uses a wireless link in the illustrative embodiment, it may also be operatively coupled to controller 140 using a wired connection.
• a wide variety of dental procedures may be performed on both soft-tissue and hard tissue.
• the list of soft-tissue procedures includes, but is not limited to, gingival troughing for crown impressions, gingivectomy and gingivoplasty, gingival incision and excision, soft-tissue crown lengthening, hemostatis and coagulation, excisional and incisional biopsies, exposure of unerupted teeth, fibroma removal, frenectomy and frenotomy, implant recovery, incision and drainage of abcess, leukoplakia, pulpotomy as an adjunct to root canal therapy, operculectomy, oral papilectomies, reduction of gingival hypertrophy, treatment of canker sores, herpetic and aphthous ulcers of the oral mucosa, and vestibuloplasty.
• Additional periodontal procedures include sulcular debridement, including removal of diseased, infected, inflamed and necrosed soft-tisuse in the periodontal pocket to improve clinical indices including gingival index, gingival bleeding index, probe depth, attachment loss and tooth mobility; laser soft-tissue curettage, laser removal of diseased, infected, inflamed and nectrotic soft-tissue within the periodontal pocket; removal of highly-inflamed edematous tissue affected by bacterial penetration of the pocket lining and junctional epithelium.
• the list of hard-tissue procedures includes, but is not limited to, laser drilling, bone ablation, tooth enamel and/or dentin ablation, and the desensitization of nerves within the tooth pulp by firing low power laser pulses through the relatively translucent tooth enamel and dentin.
• the use of laser light sources 133a and 133b allows laser-assisted whitening/bleaching of teeth and bio-stimulation of both hard-tissue and soft-tissue, as desired.
• airless misting unit 200 described above includes a water source 210, a reservoir 215, a high-pressure pump 220, a supply line 230, and an atomizing nozzle 240.
• a check valve 250 may also be included to restrict the flow of water from nozzle 240 when airless misting unit 200 is not in operation.
• Atomizing nozzle 240 is designed to cause a fine mist of water to be ejected and mixed with the air present outside the nozzle when high-pressure pump 220 is activated by controller 140.
• atomizing nozzle 240 includes orifices of between about 200 microns and about 500 microns and is manufactured by a laser drilling process which allows the airless mist generated by the unit to be optimized to provide efficient misting of the treatment area.
• the airless misting system disclosed herein eliminates much of the complexity, expense, contamination risk and infection risk by producing a fine water mist or spray without the addition of compressed air.
• the use of a single, small high pressure water pump and a removable and cleanable water container allows the airless misting and improves the ease of operation of the laser system and also improve its safety.
• the airless mist is referred to water without any air added to it by way of addition of compressed air to the water.
• any suitable liquid without the addition of a ' compressed gas, may be used.
• a suitable liquid may be a medicament liquid.
• Any suitably liquid may be used so long as it is capable of cooling the treatment area and focusing the laser beam emitted by the disclosed device and also does not include any compressed or pressurized gas, such as air.
• FIG. 9 an exemplary embodiment of user interface
• each user-selectable button or icon causes the controller to set the laser energy and pulse frequency to a pre-determined setting stored in controller memory 150.
• user interface 300 includes a bank 310 of user-selected buttons or icons 316 associated with pre-set parameters for the hard-tissue laser and a bank 320 of user-selected buttons or icons 326 associated with pre-set parameters for the soft-tissue laser.
• bank 310 includes an icon 312 that indicates that it relates to the hard tissue laser operations
• bank 320 includes an icon 314 that it relates to the soft tissue laser operations.
• bank 310 of user interface 300 includes five user-selectable buttons or icons 316a-e and bank 320 includes five user-selectable buttons or icons 326a-e.
• user interface 300 also provides additional buttons or icons and each button or icon may have its own corresponding indicator, such as an LED or similar device.
• buttons/icons and indicators are depicted: on/off button or icon 330, up arrow button or icon 340, down arrow button or icon 350, "function" button or icon 360 with “function” indicator 362, light button or icon 370 with light indicator 372, sound button or icon 380 with sound indicator 382, and standby button or icon 390 with standby indicator 392.
• On/off button or icon 330 powers on or powers off laser-emitting device 100.
• Light button or icon 370 and sound button or icon 380 may be used to toggle one or more sound and visual indicators, respectively.
• Standby button or icon 390 places laser-emitting device 100 into or out of standby mode.
• Up arrow button or icon 340 and down arrow button or icon 350 allow a user to manually adjust the power settings from the pre-set parameters associated therewith.
• bank 310 and bank 320 are each shown to include five buttons or icons in the illustrative embodiment, the number of buttons or icons associated with each bank is not limited thereto, but may encompass fewer or more buttons or icons, as necessary.
• the user interface may include an optional bank of buttons or icons directed to the control of endodontic procedures, such as preparing a tooth for and conducting a root canal. As one of ordinary skill in the art will understand, such additional buttons or icons for endodontic procedures may be placed on the user interface by any suitable method.
• bank 310 of the hard-tissue controls includes user-selectable button or icon 316a depicting a rabbit indicative of a "speed” setting; button or icon 316b depicting a "smiley face” indicative of a “comfort” setting; button or icon 316c depicting scissors indicative of a hard-tissue cutting or ablation setting; button or icon 316d depicting a set of wavy lines indicative of a "desensitization,” “decontamination,” or curettage setting; and button or icon 316e depicting a bone indicative of an osseous setting for ablating bone.
• the pre-set parameters associated with each button or icon of bank 310 indicates to controller 140 that the airless misting unit 200 should operate during operation of the hard-tissue laser.
• indicators 318a-318e each corresponds to a user-selectable button or icon 316 to indicate the currently selected setting.
• indicators 318a-318e are depicted as light-emitting diodes that illuminate when each corresponding button or icon 316a-316e, respectively, is selected. For example, when button or icon 316a is selected by the user, indicator 318a changes to indicate the selection of that selection. While indicators 318 are depicted in FIG.
• LEDs 9 light-emitting diodes
• LCD Liquid Crystal Display
• OLEDs Organic Light Emitting Diodes
• indicators 318a-e are configurable icons on a touch-screen.
• bank 320 includes five user- selected buttons or icons associated with pre-set parameters for the soft-tissue laser.
• button or icon 326a depicting a rabbit indicates a "speed" setting for the soft-tissue laser
• button or icon 326b depicting a smiling face indicates a "comfort” setting
• button or icon 326c depicting a probe entering between a tooth and gum indicates a soft- tissue cutting or curettage setting
• button or icon 326d depicting a set of wavy lines indicates a "desensitization” or "decontamination” or “curettage” setting
• button or icon 326e depicting lines emitting from a surface indicates a "tooth bleaching" or "bio-stimulation” setting.
• the pre-set parameters indicate to controller 140 that the airless misting unit 200 should not operate during operation of the soft-tissue laser.
• button or icon 326d could indicate to controller 140 that one set of laser parameters including pulse frequency and laser energy should be set, or button or icon 326d could be programmed to cycle through three or more different settings having different pulse frequencies and laser energy, but providing settings that are effective in one or more of the desensitization, decontamination or curettage procedures.
• indicators 328 each correspond to a user-selectable button or icon 326 to indicate the currently selected setting.
• indicators 328 are depicted as light-emitting diodes that illuminate when each corresponding button or icon 326, respectively, is selected. For example, when button or icon 326a is selected by the user, indicator 328a changes to indicate the selection of the related pre-set laser parameters. While indicators 328 are depicted in FIG.
• LEDs 9 light-emitting diodes
• LCD Liquid Crystal Display
• OLEDs Organic Light Emitting Diodes
• indicators 328 are configurable icons on a touch-screen.
• Visual display 400 indicates desired information about the status of at least one of laser light sources 133a.
• visual display 400 indicates the operating power of therapeutic laser 133a corresponding to a selected setting when a button or icon from bank 310 has been selected
• visual display 400 indicates the operating power of therapeutic laser 133b corresponding to a selected setting when a button or icon from bank 320 has been selected.
• Other parameters may be shown on visual display 400, including pulse width, pulse frequency, or another laser parameter of interest to the operator. While visual display 400 is depicted in FIG. 9 as a multi-segment light-emitting diode (LED) display, it is not limited thereto.
• LED multi-segment light-emitting diode
• Visual display 400 could also be a Liquid Crystal Display (LCD), Organic Light Emitting Diode (OLED) or other type of display capable of indicating information about the status of at least one of laser light sources 133a.
• visual display 400 is comprised of configurable icons on a touch-screen.
• a secondary visual display 410 provides a visual indicator of a general status of the laser subsystem 130.
• the illustrative embodiment includes three cold-cathode tubes, wherein controller 140 causes a red cold-cathode tube 420 to illuminate to indicate that the laser-emitting device 100 is in soft-tissue mode, controller 140 causes a green cold-cathode tube 430 to illuminate to indicate that laser-emitting device 100 is in hard-tissue mode, and controller 140 causes a yellow cold-cathode tube 440 to illuminate to indicate that laser-emitting device 100 is in standby mode.
• Secondary visual display 410 provides a quick visual indication of the status of laser-emitting device 100 when an operator may by further away from the system or may not be able to see the other visual indicators. While red-, green- and yellow-colored cold- cathode tubes are used as secondary visual display 410 in this exemplary embodiment, other types and colors of light sources may be used, such as LEDs and OLEDs, or any other light- emitting devices of any color. In yet another exemplary embodiment, secondary visual display 410 is comprised of configurable icons or graphics on a touch-screen.
• each button or icon in bank 310 and bank 320 may be configured to correspond to one or more pulse
• controller 140 is configured to also engage airless misting unit 200 when one of the hard-tissue laser settings of bank 310 is selected, and controller 140 is configured to disengage airless misting unit 200 when one of the soft-tissue laser settings of bank 320 is selected.
• buttons or icons may also make selections on smart device 170 through buttons or icons.
• the screen of smart device 170 mimics user interface 300 to provide a second method of selecting an operating mode of laser-emitting device 100.
• smart device 170 may provide alternate methods of selecting an operating mode of laser-emitting device 100.
• smart device 170 may provide alternate methods of selecting an operating mode of laser-emitting device 100.
• smart device 170 is configured to use speech recognition to detect a verbal command of an operator and communicate with controller 140 to select the applicable pre-set parameters. For example, smart device 170 may listen for the operator to speak verbal commands, such as "soft tissue speed” or “hard tissue comfort,” in response to which smart device 170 would communicate the selection to controller 140 which would make the corresponding selection of pulse frequency and laser energy and would update user interface 300, visual display 400, and secondary visual display 410.
• smart device 170 could also be configured to respond with synthesized speech output to provide an auditory confirmation of the selected operating mode of laser-emitting device 100, regardless of whether the selection was made by voice or through the user interface.
• smart device 170 not only communicates with controller 140, but is also designed to communicate with other systems apart from laser-emitting device 100.
• controller 140 communicates with controller 140
• other systems apart from laser-emitting device 100 A variety of applications exist for such two-way communication.
• a diagnostic program designed to run on smart device 170 could diagnose laser system 100 based upon operating parameters and/or usage data and transmit that information back to the
• smart device 170 would receive software and/or firmware updates from the manufacturer and upgrade laser-emitting device 100.
• smart device 170 could calibrate one or more of the lasers 132 and/or 133 utilizing two-way communication between the manufacturer and laser-emitting device 100. For example, the manufacturer could initiate an upgrade to the laser system 100 through communication with smart device 170 to program power supply 120 to operate at a different pulse width profile based either on new data available to the manufacturer or at the request of the user of laser-emitting device 100.
• an operator of smart device 170 could initiate a chat, email communication, or online help resource to receive support.
• an operator of smart device 170 could order accessories, consumables, new products or upgrade to a newer version of laser-emitting device 100.
• smart device 170 is described and depicted as an Apple iPadTM, it is not limited thereto.
• smart device 170 could take the form of any brand of cellular telephone including, but not limited to, an Apple brand iPhoneTM cellular telephone, DroidTM cellular telephone or BlackberryTM cellular telephone.
• Smart device 170 could also be a tablet computer (or tablet-like computer) of any screen size and capable of being operatively coupled to laser-emitting device 100 via a wired or wireless connection.
• smart device 170 is described as having wireless communication capability compatible with an IEEE 802.11 standard ("WiFi” or "WiFi Direct”), any wireless communication standard is considered within the scope of the present invention.
• WiFi IEEE 802.11 standard
• Other examples of wireless communication capability include, but are not limited to, CDMA, W-CDMA, GSM, 3G or 4G, or WiMAX communication protocols, or any other appropriate wireless communication protocol.
• connection 160 in a "docked configuration”
• the invention is not necessarily limited to that connection type and could also be connected via a cable (not shown) or a wireless connection, such as IEEE 802.11 WiFi, WiFi Direct, Bluetooth, WiMAX, or any other appropriate wireless communication protocol.
• step 610 laser-emitting device detects whether a user has interacted with the user interface to select an operating mode in step 620.
• step 630 the controller retrieves the laser parameters associated with the selected operating mode.
• One of the parameters includes whether airless misting should be administered, which the method determines in step 640. If the laser parameters for a certain operating mode require airless misting, the airless misting unit is engaged in step 650.
• the controller sets the laser energy in step 660 to match the selected parameters retrieved in step 630. Similarly, in step670, the controller sets the laser pulse frequency to match the parameters retrieved in step630. Upon setting the laser energy and pulse frequency, the controller energizes the laser in step 680 and the routine ends in step 690.
• the controller or smart device polls the laser device in step 720 to record operating parameters, such as pulse energy, pulse frequency, pulse width, number of flash-lamp pulses fired, number of laser pulses fired, hours of laser operation in standby mode, hours of laser operation in ready mode, hours of laser operations in operational mode (laser actually firing), coolant temperature, laser head temperature, air temperature within the device, or any other measurable parameter of interest. If the parameters are in a specified range, as determined in step 730, the diagnostic and/or telemetry routine ends in step 820.
• operating parameters such as pulse energy, pulse frequency, pulse width, number of flash-lamp pulses fired, number of laser pulses fired, hours of laser operation in standby mode, hours of laser operation in ready mode, hours of laser operations in operational mode (laser actually firing), coolant temperature, laser head temperature, air temperature within the device, or any other measurable parameter of interest.
• the smart device initiates communications with the device manufacturer or a third-party service company in step 740.
• the communications between the smart device is initiated through a wireless connection to the internet, such as through an IEEE 802.11 standards- based wireless protocol. Another method of connection may also be used, including
• the smart device sends the data polled in step 720 to the manufacturer in step 750.
• a web-enabled server associated with the manufacturer reads the data provided through the communication channel and compares it to that stored in a troubleshooting database in step 760. If the data provided does not match a condition found in the troubleshooting database, in step 770 the web-enabled server initiates a technician review.
• the web-enabled server in step 790 transmits a message back to the smart device.
• Such message may be sent through the same communications method as the original message sent from the smart device to the web-enabled server.
• other communications could be sent in step 790.
• an email message is transmitted to a distribution list associated with the web-enabled server or similar device.
• an automated phone call is placed to a telephone number or numbers associated with the web-enabled server.
• a technician receives a message to contact the operator registered to the dental laser-emitting device to discuss the detected condition.
• the data polled in step 720 is used to facilitate routine, preventative and/or predictive maintenance.
• the communication described in step 790 may include instructions to replace the flash-lamp after a certain number of pulses is reached, to alert the user to change a filter after a certain number of hours of standby, ready, or operational time has passed. While these examples are provided for illustrative purposes, any routine, preventative, or predictive maintenance may be initiated based upon the data polled in step 720, and it is not limited to the examples provided.
• the diagnostic method determines in step 800 that the dental laser-emitting device should be shut down for safety reasons. Once that determination is made, a remote shutdown is initiated in step 810 by sending a command from the web-enabled server to the smart device. Once the command is received by the smart device, the diagnostic program ends in step 820 and the dental laser-emitting device is shut down. In one exemplary embodiment, other activities are triggered by the remote system shutdown, such as the initiation of a service call for the malfunctioning dental laser-emitting device. Said remote diagnostics within the smart device may provide redundancy and back-up to the safeguards and "watchdog" routines within the laser operating software. Should an error condition be detected, the smart device is capable of overriding the control of the laser and shutting the system down - thus providing greater safety for the operator and the patient.

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