The present invention relates to an electrode assembly for passing electrical current through at least part of a tooth.
There is increasing interest in developing techniques for providing an accurate determination of the structure of teeth in both animals and humans. It is well known that the tooth structure, particularly in terms of the hard outer enamel of the tooth, can be affected by wear, by localised chemistry on the tooth surface, and other factors. Such changes in the structure are important in providing diagnosis of dental and medical conditions, and for general research purposes.
One of the techniques under development is that of using electrical impedance to determine the tooth structure. In this technique, an electrical current is passed through the tooth under study and the electrical response of the circuit so formed is then monitored, this response providing information in the form of voltage, current and their respective phase. This information is then used to determine the structure of the tooth itself.
Taking human teeth as an example, it will be appreciated that there are a number of different types of human teeth (incisors, canine, premolar and molar), and some of the tooth surfaces are more accessible than others when positioned in the mouth. There are three general types of tooth surfaces, these being the free smooth surfaces (facing inwardly and outwardly of the mouth), the occlusal surfaces (biting surfaces), and the approximal surfaces (these being between adjacent teeth) . Where it is desired for the determination of tooth structure to be related to dental problems such as dental caries, it is particularly important to provide structure determinations of the tooth enamel on the occlusal and approximal surfaces since this is where caries is more prevalent. There is therefore a need for apparatus which is capable of producing accurate electrical impedance measurements upon the occlusal and/or approximal surfaces in particular.
To date, the apparatus and electrodes used for performing electrical impedance measurements upon any tooth surface have been rather experimental, for example the contact electrode being formed from a conducting metallic wire which is simply pressed against the surface of the tooth under study.
Since the commercial use of the electrical impedance technique is attracting increased interest, there is a desire to provide novel electrode apparatus which is compact, reliable and provides for easy and rapid operation.
In accordance with a first aspect of the present invention, we provide an electrode assembly for passing electrical current through at least part of a tooth, the assembly comprises:
an electrode holder; and
a plurality of resilient projecting elements coupled to the holder, each element comprising one or more electrodes, the assembly being arranged in use such that when the assembly is positioned adjacent a tooth, the electrodes contact respective parts of at least one surface of the tooth.
The present invention therefore conveniently addresses the problems discussed above. We have realised that, by using a plurality of projecting resilient elements, if these elements are provided with or indeed constitute electrodes, then electrical impedance measurements can be carried out upon tooth surfaces which are difficult to access by other means. Furthermore, the use of a plurality of such electrodes allows for multiple measurements to be taken in multiple locations upon the tooth, and these may advantageously be upon more than one surface of the tooth without need for the electrode assembly to be moved. Whilst in many cases it is desired to make electrical impedance measurements on one or more surfaces of one tooth, in some cases such measurements can be made upon one or more surfaces of a plurality of teeth, such as adjacent teeth, without moving the assembly.
The electrodes can be used in a number of different ways depending upon the structure information required. The electrode assembly may therefore be used with each electrode acting as effectively a contact electrode. In this case, current is provided through each contact electrode, with the circuit being completed by the use of an additional counter electrode which may be positioned at another part of the body of the human or animal in question, or touched against another part of the tooth.
Although in principal a direct current may be used for the measurements, it is expected that the electrode assembly of the invention will be used primarily with alternating current of one or more frequencies.
It is advantageous of course to ensure that reliable electrical contact is provided with the desired area of the tooth. In some cases therefore, a number of the electrodes in different elements may be connected together electrically. This ensures that a measurement may be made, even where only one of the elements is in electrical contact with the tooth.
The elements may therefore be arranged in groups with the elements either connected together electrically to form a single electrode, or not connected, so as to form separate electrodes. The elements may be arranged individually or in groups in any desired pattern such as in an array (the elements or the elements within groups either being electrically connected together or otherwise).
Where the electrodes of different elements are desired not to be connected electrically, then preferably the assembly further comprises one or more electrical insulating resilient elements which are positioned between the elements having electrodes.
Alternatively, or in addition, one or more barriers of insulating material may be provided, projecting from the holder so as to prevent contact between the electrically conductive elements on opposed sides of the barrier. The barriers may take the form of strips or plates of an electrically insulating material such as polyethylene teraphthalate (PET).
It will be appreciated that the degree of resilience of the elements (those with and/or without electrodes) depends upon their geometry and material from which they are made. In particular, the function of the resilience is to provide biasing of the element electrodes against the respective tooth surface when in use and/or deflection so as to allow other electrodes to also contact the tooth surface. Were the elements extremely rigid, then the lack of deflection or biassing would likely only allow some electrodes to come into contact with the tooth.
The primary function of the holder is to provide an anchor point for the elements. However it may also be formed so that it may be gripped by a user so that the electrodes can be correctly located against the tooth surface(s). The holder may therefore comprise two or more separable parts one of which may, for example, act as the anchor point for the elements, allowing it to be disposable. By providing suitable electrical and mechanical connections between these separable parts, the part containing the elements can be changed for other such parts, for example for making measurements on different teeth, or upon children rather than adults. If each part containing the elements has similar connections then these can be used interchangeably with the other part(s) of the holder to which they are connected when in use.
A number of different electrode assembly configurations are envisaged, depending upon the type of tooth under analysis, and the surfaces of the tooth in question. The elements may therefore project from the holder in substantially at least one direction. In the case of a single direction, the electrode assembly may take the appearance of a toothbrush and the elements may in this case be particularly suited for measurements upon the occlusal surfaces of teeth. However, since five surfaces of a tooth are accessible, these being one occlusal, two approximal and two free smooth surfaces, then the elements may be arranged to project in substantially two, three, four or five directions, in this case preferably the projection direction being in the direction of the respective tooth surface in question when the electrode assembly is positioned for use.
Of course elements for measuring combinations of any of these surfaces may be provided.
In most cases, the elements have different lengths with respect to one another, depending upon their intended use. These lengths may vary within elements intended for use upon the same surface, and/or between those for use upon different surfaces. Typically the relative lengths are adapted so as to conform generally with the shape of the surface of the tooth being investigated.
In some cases, more than one electrode is provided upon a particular projecting element. These may be connected together electrically for providing multiple contact positions, or more preferably, these may be arranged to form individual electrodes providing different contact locations for respective measurements. Preferably in the latter case, each electrode is arranged such that the part of the electrode that contacts the tooth is substantially a point contact.
In other examples, the projecting element may itself be formed from an electrically conductive material (for example stainless steel) such that the element itself is an electrode, and electrical contact can be made at any point along its length. The material in this case (forming the elements) may be metallic although the use of conductive polymers is also advantageous for cost and biological inactivity. Such polymers may have a matrix formed from materials such as natural rubbers or synthetic elastomers. The matrix is provided with conductive components formed from carbon or metals.
Whilst in some cases the entire element may be formed from a conductive material, in others it may be formed generally from an insulating material that is coated within an electrically conductive material such that again it may act as an electrode by contact at substantially any point along its length. The coating may be provided by a material which can be easily used for coating and has biological inactivity, such as gold, titanium, copper, stainless-steel, bronze and their respective alloys, or carbon. Multi-layers of such materials could be employed. Some of these materials may be sputtered onto the elements whereas the use of conductive paints provides a further alternative. The material that is to be coated, and therefore forming most of the element, may be an insulating material such as various plastics, for example nylon or polyesters such as polybutylene terephthalate or polyethylene terephthalate.
Each of the examples later described herein can be constructed using electrically conductive elements of the various types mentioned above, such as by using solid stainless steel wires as the elements.
Depending upon the configuration of the electrodes, an electrical connection to each of the elements having the electrodes may be provided using a respective conductive wire or track.
The dimensions of the elements themselves is dependent upon the application and materials used, although typically the length of the elements lies in the range of 0.5 millimetres to 10 millimetres. The typical thickness in cross-section of the elements lies in the range 50 to 500 micrometres.
Preferably for hygiene purposes, the electrode assembly is disposable in the sense that it is a “one use only” device or at least a “one use only for each patient” device, the latter meaning that the assembly may be reused with only the same patient (or animal). Preferably therefore, the assembly further comprises a connector having contacts arranged in electrical communication with the electrodes, the connector being adapted to detachably couple electrically to a corresponding connector of a monitoring system which provides the electrical current for the measurements.
For ease of use by a user, preferably the holder is formed having an elongate handle such that the holder may be grasped in use so as to hold the electrodes in position in contact with the tooth. Typically the holder is formed from an insulating material such as a plastics material, for example polypropylene, polyamide or SAN, and may also include elastomer parts. In some example assemblies, first and second sensor elements project in a mutually opposed direction from a central electrically insulating barrier, such that the first and second sets are insulated from each other, this assembly being arranged such that, when in use, the first and second sets contact respective first and second teeth. Such an assembly may be used therefore upon surfaces such as the approximal surfaces. Each of the sets of elements in this case is preferably formed from electrically conducting bristles. The bristles of each set are preferably connected together electrically to all other elements in their respective set. The barrier itself may take a number of forms, although typically it is a substantially planar plate formed from a suitable plastics material. For each of these sets of elements, a corresponding wire is preferably provided which runs along one side of the barrier in each case, the bristles forming the electrode elements thereby being attached to the wire so that an equal electrical potential is provided for all electrodes within a particular set.
The monitoring system in some examples may comprise a self-contained hand-held unit, particularly in the case where relatively simple measurements are made.
In accordance with a second aspect of the present invention we provide a system for monitoring the structure of a tooth comprising:
an electrode assembly according to the first aspect of the invention; and
a monitoring device adapted in use to pass an electrical current through at least one electrode of the assembly and at least a corresponding part of the tooth, and to monitor the electrical response of the circuit.
The electrode assembly according to the first aspect can therefore be used in association with a number of different monitoring devices which may form part of a larger monitoring system. It is envisaged that, in some cases, the assembly and monitoring device may together form a hand-held unit which a dentist could hold in a single hand and use to determine the electrical response of each tooth in question.
Some examples of electrode assemblies according to the present invention will now be described, with reference to the accompanying drawings in which:
a shows groups of elements of the same length;
b shows elements having lengths according to a saw-tooth waveform;
c shows elements having lengths according to a sinusoidal waveform;
Referring to
The electrode assembly 1 in the first example is an “occlusal” electrode assembly in that it is adapted for applying electrical currents to an occlusal surface of a tooth. An upper part of a tooth 6 (including the occlusal surface) is illustrated schematically in
Each of the projecting elements of the present example has a length of about 5 millimetres and a diameter of about 100 micrometres. The elements are substantially circular in cross-section although other geometrical shapes in cross-section are envisaged.
As is illustrated in
Since the exposed surfaces of the conductive elements 5 are arranged to be electrically conducting, each conductive element 5 in the present example is an electrode 10. At the point where each of the elements 5 is anchored to the assembly 1 (for example by an adhesive or by melt bonding), the conductive coating is electrically connected to respective wires 11 which pass within the structure of the holder 2, to the other end of the holder 2 which is remote from the elements. The wires may be formed from copper. They may also run along the outer surface of the holder provided they are suitably insulated. At the distal end of the holder, a connector 12 is provided, this having a series of pins 13, each pin being connected to one of the wires 11. The connector may take any suitable form and be adapted to connect to a corresponding socket connector of a lead cable (not shown in
In
Whilst the extreme ends of the elements may be made to adopt certain geometries, the respective lengths of the elements may similarly be adapted to adopt certain geometries as shown in
In
A second example electrode assembly is now described, this being adapted for providing simultaneous electrical contact of electrodes upon multiple surfaces of a tooth. This example is particularly suited for use with a premolar or molar tooth and is shown in
Each of the optional configurations in association with the first example, including groups of elements, and how they are electrically connected together, are also envisaged with respect to the second example shown in
Along the lower edge of the parts 22 (closest to the gingiva), electrically insulating pads 26 are attached so as to prevent the ingress of saliva between the electrodes 10, and also to prevent electrical contact between the gingiva and the lowermost electrodes. The presence of a large amount of saliva is undesirable since it provides a low impedance path between the electrodes. Similarly insulating pads 27 are provided between the sets of elements of the parts 21 and 22, so as to separate the elements from the surface 21 from coming into contact with those on the surfaces 22.
With reference to
Whilst this second example is adapted for measurements of the occlusal and opposed free smooth surfaces, a modified example is envisaged in which further electrodes are provided for taking measurements upon the approximal surfaces. Since there is normally either contact or a close approach of, adjacent teeth along the approximal surfaces, such a modified embodiment may advantageously be provided with two parts (for each approximal surface) extending downwardly from the part 21 of
It will be understood that, with use of plastics materials for the holder 2, a degree of resilience and flexibility is provided by the holder such that the assembly may be positioned over the desired tooth. The spacing of the elements, together with their length and resilience is adjusted according to the application.
A third example is now described which is capable of providing measurements upon all five surfaces of a tooth. This is illustrated in
The individual contact electrodes 30 may be formed from a suitable spot of metallic material with individual wires 11 being provided in the element 5. This is shown in
In each of the embodiments described the connector 12 has been positioned adjacent the holder 2. However, in some cases it may be beneficial to provide a short length of electrical wire to separate the connector 12 from the holder 2 such that a reliable connection with an external lead of monitoring apparatus can be provided. This can therefore be kept clear of the animal or human mouth in which the electrode assembly is positioned.
The electrode assembly in each case is used in conjunction with a system for applying electrical currents to teeth and monitoring the performance of the localised circuits formed. A schematic representation of such a system 100 is shown in
A display is provided at 203 in the form of red, orange and green LEDs which indicate the condition of the tooth being monitored, green representing a healthy tooth for example. The head portion 202 is detachable from the hand-held unit part and in this case contains electrodes for monitoring two adjacent teeth. The part of the head portion containing the electrodes is angled with respect to the elongation axis of the hand-held portion 201. The head portion 202 forms part of a fourth example assembly of the invention.
The electrodes 5 in this case are provided in the form of two opposed conducting “brushes”. These are indicated at 204a and 204b respectively. The elements of the brushes in this example are formed from stainless steel coated carbon-loaded plastic so as to provide a very low impedance. Each brush electrode 204a, 204b is in the form of half of a “bottle brush” that is, a half of a cylindrical brush in which bristles project from a central region in a radial manner and a large number of such brushes project radially along the axis of the cylinder. The cylinder is divided in half along its axis so the brushes of each electrode 204a, 204b can be thought of as projecting radially through up to 180 degrees of angle about the cylinder axis.
The electrode brushes 204a and 204b are electrically insulated from each other by a central insulating barrier 205. The barrier 205 may take the form of a plastic plate or strip. In the present case the barrier is rectangular in design with a thickness of 80 to 100 micrometres, a height of about 2 millimetres and a length of about 10 millimetres. The upper and lower edges are preferably bevelled (at an angle of typically 60 degrees).
The assembly is shown in more detail in
The electrode wires have a diameter of about 0.3 millimetres. The brush electrode elements are about 0.6 to 0.8 millimetres in length with a thickness of about 0.1 to 0.2 millimetres.
As will be appreciated, a large number of bristles are provided for the electrode brushes, each of these are electrically conducting and may take the form of the various electrodes discussed earlier. In the present example there are up to 20 rows of bristles, the rows being spaced apart by a gap of about 0.5 millimetres. The distal end of the barrier extends beyond the end of the bristles by about 1 millimetre.
The bristles together act effectively as a common electrode such that all bristles have an equal electrical potential for the electrode 204a. Similarly, all points upon the electrode 204b also have an equal electrical potential although the electrodes 204a and 204b are electrically isolated from each other so that they may be used to perform measurements upon adjacent teeth.
The two electrodes 204a and 204b can be operated independently of one another using a switch placed upon the assembly body. A trigger switch is also provided so that an operator can initiate the electrical impedance measurement in question.
By way of further explanation, the barrier (which can be thought of as a separating strip), is aligned approximately orthogonally to the elongation axis of the hand-held portion 201 in each of the “horizontal” and “vertical” planes. When the hand-held portion 201 is held such that the display 203 faces the buccal part of the mouth (away from the teeth), the electrodes are inserted into the interproximal space between the two teeth whose impedance it is desired to measure. The electrodes are pushed lingually into the contact area and thereafter in an occlusal direction until firmly positioned. The mesial of the two brush electrodes contacts the distal surface of one of the two approximating teeth and the distal of the brush electrodes contacts the mesial surface of the other approximating tooth. The assembly of this fourth example allows the bristles to deform and conform to the three-dimensional curvature of the approximating surfaces of the teeth. This facilitates the electrical measurement of each of the two surfaces to be performed independently, with no short-circuit between the two brush electrodes.
When in use therefore, this electrode assembly is suitable for performing separate measurements upon opposed surfaces of adjacent teeth. In particular, it is suitable for performing measurements upon the approximal surfaces, particularly adjacent the gingiva, although it could also be used for the parts of the approximal surfaces which border the respective occlusal surfaces of the adjacent teeth. The arrangement shown in
The system shown in
This system is described only in a schematic and general manner since the electrode assembly may be used in association with many different systems. The electrode assembly can be used to implement many forms of electrical caries detection, including AC Impedance Spectroscopy and Electrical Impedance Tomography amongst others. These systems are riot limited to the monitoring of human teeth and are intended to include systems for monitoring animal teeth. In either case this may be in vitro or in vivo, with the in vivo application of course providing many benefits relating to dental health.
Number | Date | Country | Kind |
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0421885.5 | Oct 2004 | GB | national |
0508469.4 | Apr 2005 | GB | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/GB05/03775 | 9/30/2005 | WO | 00 | 11/15/2007 |