This invention relates generally to intraoral phototherapy devices for receiving light from an associated light source and propagating the light into the oral cavity of a patient by total internal reflection and emission for phototherapy treatment of targeted regions of the oral cavity.
Currently there are two known methods for administering phototherapy for the treatment of various phototherapy treatment conditions of the mouth including, but not limited to Oral Mucositis (OM), low level laser therapy and light emitting diode (LED) arrays. Oral Mucositis is one of the most common and highly significant toxicities of cancer therapy.
Barriers to the acceptance of low level laser therapy include the cost of laser equipment and the labor intensiveness. Additionally, there are problems with interoperator variability and the need for specialized training. Also patients receiving this form of treatment are required to hold their mouths open for long periods of time which is uncomfortable and becomes extremely painful as the Mucositis progresses.
LED arrays utilize a plurality of LEDs to irradiate larger areas of tissue externally. The light from these arrays penetrates the skin to stimulate the mucosal membrane. LED arrays have the advantage of irradiating a large surface area, are simpler to implement than spot laser systems, and are more comfortable to the patient. The main disadvantages of using LED arrays for administering phototherapy treatment is that they lack dose control because they must transilluminate cheek tissue and have difficulty reaching all regions of the oral cavity, including the tonsillar and palatal regions which are highly susceptible to OM. Also variability in tissue thickness between different buccal regions and different patients makes it impossible to accurately monitor and control the dose of light administered to the mucosa.
The present invention relates to intraoral phototherapy devices that can achieve greater accuracy of phototherapy dose control compared to the use of LED arrays and spot laser therapy by directly delivering light to targeted regions of the oral cavity.
In an embodiment, the intraoral phototherapy device comprises a light guide that receives light from an external light source, the light guide comprising a main body portion made of an optically transparent soft flexible biocompatible polymeric material sized and shaped to conform to contours of the oral cavity to direct the light to targeted regions of the oral cavity.
In an embodiment, the main body portion comprises a pair of laterally spaced side wings sized and shaped to be received between a patient's teeth and cheeks on opposite sides of the oral cavity for transmitting and directing the light to targeted regions of the oral cavity.
In an embodiment, the side wings support one or more solid side light channels integrally molded with the side wings, the side light channels being generally cylindrical in shape and selectively tapered along their length for controlled light emission therefrom.
In an embodiment, the side light channels utilize splitting to more evenly distribute the light to targeted regions of the oral cavity.
In an embodiment, the main body portion further comprises a center flap that can go on top of the patient's tongue for tonsillar projection and hard and soft palate phototherapy treatment or under the tongue.
In an embodiment, one or more light sources are optically coupled to rearwardly protruding end portions of the device.
In an embodiment, the light source comprises one or more LEDs that are embedded in rearwardly protruding end portions of the side light channels and center flap.
In an embodiment, the light source is remotely coupled to the device via a fiber optic cable.
In an embodiment, the remote light source comprises a plurality of LEDs or a laser.
In an embodiment, the device further comprises integral top and bottom flaps that fit between a patient's gums and lips to help stabilize the device against rotation in the oral cavity during phototherapy treatment.
In an embodiment, the device further comprises bite pads for securing the side wings in the oral cavity during phototherapy treatment.
Referring now more particularly to the drawings, wherein the same reference numbers are used to designate like parts, and initially to
The intraoral phototherapy device may be used in a number of applications, several examples of which include oral mucositis, acute necrotizing ulcerative gingivitis (ANUG), periodontal diseases, trismus, decreasing recovery time from oral surgery, light delivery for orthodontics, and photodynamic light therapy, e.g., to activate a chemical mouthwash.
In the embodiment shown in
In any of the embodiments, a reflective coating 24 may be provided on the inwardly facing sides of the side wings to reflect light out through the outwardly facing sides of the side wings.
In any of the embodiments, the side wings may have a curvature that is contoured to mandibular and maxillary buccal surfaces of the oral cavity for emitting light thereto.
In an embodiment, each of the side light channels 44, 46 utilizes splitting to more evenly distribute the light to the targeted regions of the oral cavity. For example, each of the side light channels 44, 46 may have two or more branches 52, 54 to more evenly distribute the light to the targeted regions of the oral cavity. Also each of the branches 52, 54 may have two or more additional branches 56, 58 to further more evenly distribute the light to the targeted regions of the oral cavity.
In an embodiment, each of the side light channels and/or branches is selectively tapered and/or has disruptions or lenses along their length for controlled light emission therefrom. Also in any of the embodiments, a reflective coating 24 may be applied to the inwardly facing sides of the side wings to reflect light outwardly through the outwardly facing sides of the side wings/side light channels including the side light channel branches.
In the embodiment shown in
In an embodiment, at least one of the sides of the center light channels 62, 64 may have disruptions or lens patterns along their length to cause light to be emitted therefrom in a controlled manner.
In all of the embodiments, one or more portions of the main body portion protrude rearwardly beyond the side wings for optically coupling of a light source 72 thereto. In the embodiments shown in
In other intraoral phototherapy embodiments 80 and 82 shown in
In an embodiment, the remote light source 73 comprises one or more LEDs or a laser.
In an embodiment, a cooling system 98, 100 is provided for extracting heat away from the light source 72 (see
In the embodiment shown in
In the embodiment shown in
In any of the embodiments, the intraoral phototherapy devices may include integral arcuate flexible top and bottom flaps 106, 108 that protrude upwardly and downwardly from the arcuate joined rearward ends of the side wings for insertion between a patient's gums and lips to help stabilize the devices against rotation during phototherapy treatment.
In any of the embodiments, the intraoral phototherapy devices may include bite pads 110 on the inwardly facing sides of the side wings intermediate the height thereof adjacent the innermost ends of the side wings as shown for example in
In any of the embodiments, the intraoral phototherapy device comprises a controller 112 (see
In any of the embodiments, the controller 112 may deliver constant light, pulsating light and/or multiple wavelengths of light to the light guide.
In any of the embodiments, the controller may include one or more sensors 114 (see
In any of the embodiments, the controller 112 may transmit data wirelessly from the oral cavity during phototherapy treatment.
In any of the embodiments, the controller 112 may monitor light output from the light source and change input power to the light source to self-calibrate the light output from the light source.
To maintain uniform light delivery to the patient, an air gap may be provided around the intraoral phototherapy device. When the intraoral phototherapy device is placed in the mouth, the air gap around the intraoral phototherapy device may be inconsistent depending on the volume and location of saliva in the mouth and the location of contact with tissue. When an air gap is present, the lower index of refraction of air results in light being maintained in the intraoral phototherapy device due to total internal reflection (TIR). However, the index of refraction of saliva and tissue is higher than air and, for this reason, at the points of contact between the intraoral phototherapy device and saliva or tissue may result in light being emitted from the intraoral phototherapy device at the points of contact. The variability in the contact between the intraoral phototherapy device and saliva and tissue (both between patients and between sessions for a single patient) may make uniform light delivery a challenge. For this reason, an air gap may be maintained between the intraoral phototherapy device and tissue and saliva in order to maintain TIR.
As shown in
The interior surface of the sleeve or a surface of the intraoral phototherapy device at the point of contact between the sleeve and the intraoral phototherapy device (e.g., on the exterior of the intraoral phototherapy device) may be modified by adding separating features (e.g., roughening the surface as shown in
As will be understood by one of ordinary skill in the art, adding separating features may include adding or removing material from the sleeve or the intraoral phototherapy device. For example, the separating features may include (but are not limited to) standoffs, bosses, ridges, or hexagonal protrusions. As an example, the external surface of the intraoral phototherapy device may have a surface finish between 23 microns (SPI-B2) to 58 microns (SPI-C3) to maintain an airgap between the intraoral phototherapy device and the sleeve.
A spacing layer may be included between the sleeve and the intraoral phototherapy device. For example, the spacing layer may comprise a low-optical-interference fabric or a porous, soft, flexible mesh. The spacing layer may be located between the sleeve and the intraoral phototherapy device in order to trap air between the sleeve and the intraoral phototherapy device. The spacing layer may be attached to one or more of the intraoral phototherapy device or the sleeve Alternatively, the spacing layer may not be attached to either of the intraoral phototherapy device or the sleeve.
As an alternative to or in addition to the sleeve, a hydrophobic foam coating may be used to maintain the airgap.
As shown in
The cladding layer may be configured to prevent/reduce contact between saliva/tissue and the intraoral phototherapy device. The cladding layer may have a refractive index that is less than or equal to 1.33 (e.g., lower than saliva and tissue). Alternatively, the cladding layer may have a refractive index between 1.33 and 1.5 and may be selectively added or removed in a controlled fashion. The cladding may be selectively added or removed to allow light to escape at locations where there is no cladding present.
The intraoral phototherapy device may include an identifier for differentiating between intraoral phototherapy devices. For example, the intraoral phototherapy device may include an RFID, serial number, barcode, 2D barcode, or any other suitable means for differentiating between different intraoral phototherapy device. For example, the identifier may be used to identify a particular intraoral phototherapy device associated with a particular patient.
Turning to
Turning to
Although the invention has been shown and described with respect to certain embodiments, it is obvious that equivalent alterations and modifications will occur to others skilled in the art upon the reading and understanding of the specification. In particular, with regard to the various functions performed by the above-described components, the terms (including any reference to a “means”) used to describe such components are intended to correspond, unless otherwise indicated, to any component which performs the specified function of a described component (e.g., that is functionally equivalent), even though not structurally equivalent to a disclosed component which performs the function of the herein illustrated exemplary embodiments of the invention. In addition, while a particular feature of the invention may have been disclosed with respect to a particular embodiment, such feature may be combined with one or more other features as may be desired or advantageous for any given or particular application.
Any one or more of the below listed aspects may be combined.
Aspect 1. An intraoral phototherapy device for receiving light from an associated light source and propagating the light into an oral cavity of a patient, the device comprising:
Aspect 2. The device of aspect 1 further comprising a controller for delivering the light to the light guide in a controlled manner.
Aspect 3. The device of any one of aspects 1-2 wherein the main body portion comprises a pair of laterally spaced side wings sized and shaped to be received between a patient's teeth and cheeks on opposite sides of the oral cavity for transmitting and directing the light to targeted regions of the oral cavity.
Aspect 4. The device of aspect 3 wherein the side wings support one or more solid side light channels integrally molded with the side wings for transmitting and directing the light to targeted regions of the oral cavity.
Aspect 5. The device of aspect 4 wherein at least some of the side light channels are generally cylindrical in shape and are selectively tapered along their length for controlled light emission therefrom.
Aspect 6. The device of any one of aspects 4-5 wherein at least some of the side light channels have at least two branches to more evenly distribute the light to the targeted portions of the oral cavity.
Aspect 7. The device of aspect 6 wherein at least some of the branches have at least two additional branches to more evenly distribute the light to the targeted regions of the oral cavity.
Aspect 8. The device of any one of aspects 6-7 wherein at least some of the branches are selectively tapered for controlled light emission therefrom.
Aspect 9. The device of any one of aspects 4-8 wherein at least some of the side light channels have disruptions or lenses along their length for controlled light emission.
Aspect 10. The device of any one of aspects 4-9 further comprising a reflective coating on inwardly facing sides of the side wings to reflect light outwardly through outwardly facing sides of the side light channels.
Aspect 11. The device of any one of aspects 4-10 wherein at least some of the side light channels utilize splitting to more evenly distribute the light to the targeted regions of the oral cavity.
Aspect 12. The device of any one of aspect 4-11 wherein rearwardly protruding ends of the side light channels protrude outwardly beyond the side wings, and the light source is optically coupled to the protruding ends of the side light channels.
Aspect 13. The device of aspect 12 wherein the light source comprises one or more LEDs that are embedded in the rearwardly protruding ends of the side light channels.
Aspect 14. The device of any one of aspects 1-13 wherein the light source is remotely coupled to the device via a fiber optic cable.
Aspect 15. The device of any one of aspects 1-14 wherein the light source comprises one or more LEDs.
Aspect 16. The device of any one of aspects 1-14 wherein the light source comprises a laser.
Aspect 17. The device of any one of aspects 3-16 wherein the side wings have a curvature that is contoured to mandibular and maxillary buccal surfaces of the oral cavity.
Aspect 18. The device of any one of aspects 3-17 wherein the main body portion further comprises a center flap intermediate the side wings for transmitting and directing the light to targeted regions of the oral cavity.
Aspect 19. The device of aspect 18 wherein the center flap includes one or more solid center light channels.
Aspect 20. The device of aspect 19 wherein the one or more center light channels have two or more branches to more evenly distribute the light to targeted regions of the oral cavity.
Aspect 21. The device of any one of aspects 18-20 wherein a forwardly facing end of the one or more center light channels projects light to a patient's tonsillar region.
Aspect 22. The device of any one of aspects 18-21 wherein the one or more center light channels are selectively tapered for controlled light emission therefrom.
Aspect 23. The device of any one of aspects 3-22 wherein one or more portions of the main body portion protrude rearwardly beyond the side wings.
Aspect 24. The device of aspect 23 wherein the light source is optically coupled to the protruding portions of the main body portion.
Aspect 25. The device of any one of aspects 23-24 wherein the light source comprises one or more LEDs that are embedded in the protruding portions of the main body portion.
Aspect 26. The device of any one of aspects 23-24 wherein the light source is remotely coupled to the protruding portions of the main body portion via a fiber optic cable.
Aspect 27. The device of any one of aspects 23-26 wherein the light source comprises one or more LEDs.
Aspect 28. The device of any one of aspects 23-26 wherein the light source comprises a laser.
Aspect 29. The device of any one of aspects 3-17 further comprising integral arcuate flexible top and bottom flaps that protrude upwardly and downwardly from arcuate joined rearward ends of the side wings for insertion between a patient's gums and lips to help stabilize the device against rotation during phototherapy treatment.
Aspect 30. The device of any one of aspects 3-17 further comprising bite pads on inwardly facing sides of the side wings intermediate the side wings' height adjacent innermost ends of the side wings for engagement by a patient's molar teeth to secure the side wings in place during phototherapy treatment.
Aspect 31. The device of aspect 18 wherein the center flap includes one or more solid center light channels.
Aspect 32. The device of aspect 31 wherein the center light channels have at least two branches to more evenly distribute the light to targeted regions of the oral cavity.
Aspect 33. The device of aspect 31 wherein one or more of the center light channels are selectively tapered for controlled light emission therefrom.
Aspect 34. The device of any one of aspects 31-33 wherein one side of the one or more center light channels has a flat reflective portion for reflecting light out the other side of the center light channels.
Aspect 35. The device of any one of aspects 31-34 wherein at least one of the one or more center light channels has disruptions or lens patterns to cause light to be emitted therefrom in a controlled manner.
Aspect 36. The device of any one of aspects 1-35 wherein the light source is contained in a housing attached to a rearwardly protruding end of the main body portion.
Aspect 37. The device of aspect 36 further comprising a cooling system for extracting heat away from the light source inside the housing.
Aspect 38. The device of aspect 37 wherein the cooling system is a liquid cooling system.
Aspect 39. The device of aspect 37 wherein the cooling system is a heat sink.
Aspect 40. The device of aspect 39 further comprising a fan for moving air past the heat sink.
Aspect 41. The device of any one of aspects 2-40 wherein the controller delivers constant light to the light guide.
Aspect 42. The device of any one of aspects 2-40 wherein the controller delivers pulsing light to the light guide.
Aspect 43. The device of any one of aspects 2-40 wherein the controller delivers multiple wavelengths of light to the light guide.
Aspect 44. The device of any one of aspects 2-40 wherein the controller includes sensors that monitor temperature in the oral cavity during phototherapy treatment.
Aspect 45. The device of any one of aspects 2-40 wherein the controller includes sensors that monitor one or more of pH, salinity, moisture, humidity, conductivity and resistivity in the oral cavity during phototherapy treatment.
Aspect 46. The device of any one of aspects 2-40 wherein the controller transmits monitored data from the oral cavity wirelessly during phototherapy treatment.
Aspect 47. The device of any one of aspects 2-40 wherein the controller monitors light output from the light source and changes input power to the light source to self-calibrate the light output from the light source.
Aspect 48. An intraoral phototherapy device for receiving light from an associated light source and propagating the light into an oral cavity of a patient, the device comprising:
Aspect 49. The device of aspect 48 further comprising one or more solid center light channels intermediate the side wings for transmitting and directing light to targeted regions of the oral cavity.
Aspect 50. The device of aspect 49 wherein the side light channels and center light channels have at least two branches that more evenly distribute light to the targeted regions of the oral cavity.
Aspect 51. The device of any one of aspects 49-50 wherein the side light channels utilize splitting to more evenly distribute light to the targeted regions of the oral cavity.
Aspect 52. The device of any one of aspects 49-51 wherein rearward ends of the side light channels and center light channels protrude rearwardly beyond the side wings.
Aspect 53. The device of aspect 52 wherein the light source is optically coupled to the rearwardly protruding ends of the side light channels and center light channels.
Aspect 54. The device of aspect 53 wherein the light source comprises a plurality of LEDs embedded in the rearwardly protruding ends of the side light channels and center light channels.
Aspect 55. The device of aspect 52 wherein the light source is optically coupled to the rearwardly protruding ends of the side light channels and center light channels via a fiber optic cable.
Aspect 56. The device of any one of aspects 48-55 wherein the light source comprises one or more LEDs.
Aspect 57. The device of any one of aspects 48-55 wherein the light source comprises a laser.
Aspect 58. The device of any one of aspects 52-53 wherein the light source is contained in a housing attached to the rearwardly protruding ends of the side light channels and center light channels.
Aspect 59. The device of any one of aspects 48-58 further comprising bite pads on inwardly facing sides of the side wings intermediate the side wings' height adjacent innermost ends of the side wings for engagement by a patient's molar teeth to secure the side wings in place during phototherapy treatment.
Aspect 60. The device of any one of aspects 48-58 further comprising integral arcuate flexible top and bottom flaps that protrude upwardly and downwardly from arcuate joined rearward ends of the side wings for insertion between a patient's gums and lips to help stabilize the device against rotation during phototherapy treatment.
Aspect 61. The device of any one of aspects 48-60 further comprising a controller for delivering the light to the light guide in a controlled manner.
Aspect 62. The device of aspect 61 wherein the controller delivers constant light to the light guide.
Aspect 63. The device of aspect 61 wherein the controller delivers pulsating light to the light guide.
Aspect 64. The device of any one of aspects 61-63 wherein the controller delivers multiple wavelengths of light to the light guide.
Aspect 65. The device of any one of aspects 61-64 wherein the controller includes sensors that monitor temperature in the oral cavity during phototherapy treatment.
Aspect 66. The device of any one of aspects 61-65 wherein the controller includes sensors that monitor one or more of pH, salinity, moisture, humidity, conductivity and resistivity in the oral cavity during phototherapy treatment.
Aspect 67. The device of any one of aspects 61-66 wherein the controller transmits monitored data from the oral cavity wirelessly during phototherapy treatment.
Aspect 68. The device of any one of aspects 61-67 wherein the controller monitors light output from the light source and changes input power to the light source to self-calibrate the light output from the light source.
Aspect 69. A sleeve for maintaining an airgap around the intraoral phototherapy device of any of aspects 1-68, wherein the sleeve forms at least part of a boundary of an interior volume and the sleeve is of a shape to receive the main body portion of the intraoral phototherapy device within the interior volume.
Aspect 70. The sleeve of aspect 69 or the intraoral phototherapy device of any of aspects 1-68, further comprising a separating feature on an interior surface of the sleeve and/or on an external surface of the main body portion of the intraoral phototherapy device, wherein the separating feature is configured to maintain the airgap between the sleeve and the main body portion by blocking contact between the sleeve and the main body portion when the main body portion is located within the sleeve.
Aspect 71. The sleeve of aspect 70 or the intraoral phototherapy device of aspect 70, wherein the separating feature includes at least one of standoffs, bosses, ridges, or protrusions from the internal surface of the sleeve and/or the external surface of the main body portion.
Aspect 72. The sleeve of any of aspects 69-71 or the intraoral phototherapy device of any of aspects 70-71, further comprising:
Aspect 73. The intraoral phototherapy device of any of aspects 1-68 or 70-72, further comprising a cladding layer applied to an external surface of the main body portion.
Aspect 74. The intraoral phototherapy device of aspect 73, wherein the cladding layer has an index of refraction of less than or equal to 1.33 or between 1.33 and 1.5.
Aspect 75. The intraoral phototherapy device of any of aspects 73 or 74, wherein the cladding layer is applied to selective portions of the external surface of the main body portion.
This application claims priority to U.S. Ser. No. 15/758,586 filed on Mar. 8, 2018, which claims the benefit of International Application No. PCT/US2016/051259 filed Sep. 12, 2016, which claims the benefit of U.S. 62/216,825 filed Sep. 10, 2015. All of which are herein incorporated by reference in their entirety.
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Parent | 15974741 | May 2018 | US |
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Parent | 15758586 | US | |
Child | 15974741 | US |