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.
During dental procedures, it may be necessary to utilize various surgical techniques on hard tissue and soft tissue in treatment areas in and around the oral cavity. Such techniques may include the cutting and/or removal of either soft or hard tissue. In the past, various traditional surgical tools, such as scalpels, have been utilized to accomplish these techniques. In addition, medicines and antibiotics have been utilized for control of pain, as well as a preventive measure to avoid infection.
In the late 1950's, 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.
Later, mid-infrared lasers became available for the removal of dental hard tissues by means of ablation. These lasers also used a water spray or water mist for cooling of the tooth structures and as a medium which absorbed the mid-infrared wavelength energy emitted by the lasers, thus enhanced the ablation of the dental hard tissues.
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. There are many 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.
While there may be significant benefits associated with the use of a laser-emitting device to perform the above-mentioned treatments, there are also significant challenges. Dental lasers have taken considerable time to find adoption within the community of dental practitioners for a variety of reasons, including cost, the learning curve required to effectively use such devices, complicated setup parameters, difficulty in diagnosis of malfunctioning equipment, limited treatment applications for earlier designs, and institutionalized treatment methods that stayed relatively static for nearly a century, to name just a few. While cost tends to decline as a technology matures, other factors can be significantly mitigated through improvements in the design of the laser-emitting devices, including those described herein.
In one exemplary embodiment of the present invention; a laser-emitting device is described 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.
The detailed description particularly refers to the accompanying figures, in which:
Referring now to
An exemplary embodiment of the laser subsystem 130 is depicted in
In one exemplary embodiment, 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. For example, power supply 120 can be configured to provide high-power peaks of shorter duration to improve performance during hard-tissue ablation procedures. As a further example, 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. As another example, 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. In the illustrative embodiment, 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.
By utilizing multiple therapeutic laser light sources, such as 133a, 133b . . . 133n, 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. In addition, 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.
In one exemplary embodiment, as depicted in
Conventionally, water spray or water mist for both the high speed air rotor handpieces and lasers was generated by combining liquid water and pressurized air. The liquid water and pressurized air were typically mixed in close proximity to a misting or spray orifice and fine particles of water were generated by the rapid expansion of the pressurized air as it escaped from the orifice. While effective for creating a water mist, the conventional technology necessitates two pressurized conduits, at least two meters in length, connected to the dental handpiece, and considerable expense and complexity associated with regulating the pressure to the liquid water and pressurized air. Furthermore, the requisite pressures were generated by pumps internal to the dental device or by connection to the pressurized air supply within a dental office.
In addition to the expense of regulating the air and water pressures within the dental unit or laser, operator error among dental office personnel could cause the air connection to the dental unit to be connected to a water supply in the dental operatory, with very damaging results.
Furthermore, dental offices were known to frequently have contaminated compressed air supplies due to water condensation during the compression process. The condensed water may be held in the compressed air tanks of a dental office for weeks or months and could become a breeding ground for bacteria, mold and other forms of contamination. Spraying contaminated water and air into open operative sites is a known source of infection and disease in the dental profession.
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.
As broadly disclosed herein, the airless mist is referred to water without any air added to it by way of addition of compressed air to the water. However, one of ordinary skill in the art will understand that any suitable liquid, without the addition of a compressed gas, may be used. One example of such 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.
Referring now to
In the illustrative embodiment of
In this illustrative embodiment, 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. Referring to
In the illustrative embodiment, 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. In one such exemplary embodiment, 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. In the illustrative embodiment, indicators 318a-318e each corresponds to a user-selectable button or icon 316 to indicate the currently selected setting. In the illustrative embodiment show, 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
Similarly, in the illustrative embodiment, bank 320 includes five user-selected buttons or icons associated with pre-set parameters for the soft-tissue laser. As in the previous example, 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; and button or icon 326e depicting lines emitting from a surface indicates a “tooth bleaching” or “bio-stimulation” setting. In one such exemplary embodiment, the pre-set parameters indicate to controller 140 that the airless misting unit 200 should not operate during operation of the soft-tissue laser. Furthermore, 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.
In the illustrative embodiment, indicators 328 each correspond to a user-selectable button or icon 326 to indicate the currently selected setting. In the illustrative embodiment shown, 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
Visual display 400 indicates desired information about the status of at least one of laser light sources 133a. For example, in one such exemplary embodiment, 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, and 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
In another exemplary embodiment, a secondary visual display 410, as depicted in
As described in the exemplary embodiment above, each button or icon in bank 310 and bank 320 may be configured to correspond to one or more pulse frequency/laser energy pre-set parameters. Moreover, in one exemplary embodiment, in addition to adjusting the laser parameters to the pre-set parameters in
Furthermore, while reference is made to an operator utilizing bank 310 and bank 320 of buttons or icons to select pre-set parameters for the laser-emitting device 100, an operator may also make selections on smart device 170 through buttons or icons. In one exemplary embodiment, 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.
In addition, smart device 170 may provide alternate methods of selecting an operating mode of laser-emitting device 100. In one such exemplary embodiment, 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. In addition, 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.
Additional functionality is provided by smart device 170. In one exemplary embodiment, smart device 170 not only communicates with controller 140, but is also designed to communicate with other systems apart from laser-emitting device 100. A variety of applications exist for such two-way communication. For example, 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 manufacturer of laser-emitting device 100, or to a third-party service company, to assist in troubleshooting and repair of a malfunctioning unit.
In another exemplary embodiment, smart device 170 would receive software and/or firmware updates from the manufacturer and upgrade laser-emitting device 100. In yet another exemplary embodiment, 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.
In yet another exemplary embodiment, an operator of smart device 170 could initiate a chat, email communication, or online help resource to receive support. In yet another exemplary embodiment, an operator of smart device 170 could order accessories, consumables, new products or upgrade to a newer version of laser-emitting device 100.
Although, in the illustrative embodiment, smart device 170 is described and depicted as an Apple iPad™, it is not limited thereto. For example, smart device 170 could take the form of any brand of cellular telephone including, but not limited to, an Apple brand iPhone™ cellular telephone, Droid™ cellular telephone or Blackberry™ 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.
Further, while in one exemplary embodiment 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. 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.
Similarly, although the exemplary embodiment depicted in
Referring now to
Referring now to
After the connection is established, 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. This can be done in a variety of ways, including by sending an email message to a technician, creating an entry in a service database, sending a text message to a computer or cellular device, or any other known method of sending a message between a web-enabled server and a user, after which the diagnostic and/or telemetry routine ends in step 820. While a web-enabled server is described in the illustrative embodiment, a similar device capable of communication and assessment of the polled data may also be used.
However, should the data provided in step to the web-enabled server in step 750 match a condition found in the troubleshooting database, 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. In addition, other communications could be sent in step 790. In one exemplary embodiment, an email message is transmitted to a distribution list associated with the web-enabled server or similar device. In another exemplary embodiment, an automated phone call is placed to a telephone number or numbers associated with the web-enabled server. In yet another exemplary embodiment, a technician receives a message to contact the operator registered to the dental laser-emitting device to discuss the detected condition.
In another exemplary embodiment, the data polled in step 720 is used to facilitate routine, preventative and/or predictive maintenance. For example, 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.
In certain instances, it may be desirable to shut down the dental laser-emitting device when parameters vary outside of a normal range. In the illustrative embodiment, the diagnostic method determines in step 800 that the dental laser-emitting device should be shut clown 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.
Although the invention has been described in detail with reference to certain illustrated exemplary embodiments, variations and modifications exist within the scope and spirit of the invention.
The present application claims priority to U.S. patent application Ser. No. 13/305,074, filed Nov. 28, 2011, which claims priority to U.S. Provisional Application No. 61/417,685 filed on Nov. 29, 2010.