Patent Application
20190254774
The present invention relates to a root canal treatment apparatus for cutting a root canal of a tooth and enlarging the root canal, a root canal treatment support apparatus for supporting the root canal treatment apparatus, a medium having a program recorded thereon, and a root canal treatment support system including the root canal treatment apparatus, the root canal treatment support apparatus and the medium.
In dental treatment, root canal treatment for cutting and enlarging a root canal of a tooth is performed. In this root canal treatment, a root canal treatment apparatus is used, which includes a handpiece having a head equipped with a cutting tool that is called a file or a reamer. The cutting tool is driven to cut and enlarge a root canal of a tooth. There have been proposals of an apparatus and a system for providing various types of support when root canal treatment is performed by a root canal treatment apparatus. For example, there are an apparatus and a system that are disclosed in Japanese Patent No. 5483518, Japanese Patent No. 5993446, and the like.
In the medical care display apparatus disclosed in Japanese Patent No. 5483518, an X-ray image data is stored in advance in a memory (for example, a hard disk drive, a random access memory (RAM) and the like in a computer) of an image processing unit, so as to allow display of an image obtained by superimposing a real time image of an affected part, data of the position inside a root canal and X-ray image data.
In the system disclosed in Japanese Patent No. 5993446, the position of the inlet into a root canal relative to the occlusal surface of a tooth can be visualized, so that the shape of the access cavity to a pulp chamber can be determined at least based on the position of the inlet into the root canal.
In the conventional apparatus and system for providing support for root canal treatment, only the information for visualizing the shape of a root canal is provided by X-ray computed tomography (CT) and the like, but comprehensive root canal treatment support information such as information about a cutting tool suitable to the shape of a root canal and information about drive control of a cutting tool cannot be provided. Furthermore, the root canal to be treated often has a curved shape. Thus, when the curved root canal is enlarged by a cutting tool, excessive torque may be applied onto the cutting tool, which may break the cutting tool located inside the root canal. When the cutting tool is broken inside the root canal, the tooth itself may have to be pulled in order to remove the broken cutting tool. Accordingly, operators require information not only used for visualizing the shape of a root canal by X-ray CT and the like but also related to comprehensive root canal treatment.
The present disclosure has been made to solve the above-described problems. An object of the present disclosure is to provide: a root canal treatment support apparatus capable of outputting information related to root canal treatment; a medium having a program recorded thereon; a root canal treatment apparatus; and a root canal treatment support system.
A root canal treatment support apparatus for providing information that can be used for root canal treatment according to an aspect of the present embodiment includes: an accepting unit configured to accept image information obtained by imaging a root canal of a tooth; an information generation unit configured to generate information related to root canal treatment suitable to a root canal shape based on the image information accepted by the accepting unit; and an output unit configured to output the information generated by the information generation unit.
A medium having a program recorded thereon for controlling a root canal treatment support apparatus for providing information that can be used for root canal treatment according to an aspect of the present embodiment is provided. The program includes: accepting image information obtained by imaging a root canal of a tooth; generating information related to root canal treatment suitable to a root canal shape based on the image information accepted; and outputting the information generated.
A root canal treatment apparatus used for root canal treatment according to an aspect of the present embodiment includes: a handpiece having a head at which a cutting tool is held in a drivable manner; a drive unit configured to drive the cutting tool held at the head; a controller configured to control the drive unit; and the root canal treatment support apparatus described in the above.
A root canal treatment support system according to an aspect of the present embodiment includes a root canal treatment support apparatus configured to provide information that can be used for root canal treatment, and a root canal treatment apparatus configured to use the information from the root canal treatment support apparatus. The root canal treatment support apparatus includes: an accepting unit configured to accept image information obtained by imaging a root canal of a tooth; an information generation unit configured to generate information related to root canal treatment suitable to a root canal shape based on the image information accepted by the accepting unit; and an output unit configured to output the information generated by the information generation unit. The root canal treatment apparatus includes: a handpiece having a head at which a cutting tool is held in a drivable manner; a drive unit configured to drive the cutting tool held at the head; and a controller configured to control the drive unit. The controller is configured to control the drive unit to drive the cutting tool based on the information output from the output unit.
The foregoing and other objects, features, aspects and advantages of the present invention will become more apparent from the following detailed description of the present invention when taken in conjunction with the accompanying drawings.
(Summary of Present Disclosure)
The root canal shape of a tooth greatly varies depending on the person and the position of his/her tooth. Thus, there are root canals congenitally formed in various shapes such as a largely curved root canal, a branched root canal, a plurality of root canals merging with each other. Furthermore, the shape of the root canal of a tooth may be changed in a posteriori manner such that the root canal becomes clogged due to calcification, the root canal is fractured, pus accumulating in a root apex causes a radicular cyst, and the like.
In this way, the treatment by cutting and enlarging root canals having various shapes is extremely difficult to be done. Furthermore, a large number of suitable root canal treatment apparatuses, cutting tools, drive sequences and the like have been developed in accordance with such various root canal shapes. Thus, each operator needs to make an appropriate choice from among a large number of options for treatment. However, it depends on the operator's experience as to whether an appropriate choice can be made or not. Also, due to developments of the root canal treatment apparatus, the cutting tool, the drive sequence and the like, it is difficult for operators to understand all of new options.
Thus, the present disclosure provides: a root canal treatment support apparatus for supporting a root canal treatment apparatus by appropriately providing an operator with information related to root canal treatment; a medium having a program recorded thereon; and a root canal treatment support system including the root canal treatment support apparatus and the medium. The configuration of the root canal treatment support apparatus may be included in the root canal treatment apparatus. Specifically, the root canal treatment support apparatus is configured to specify a classification of a root canal shape of a tooth and output information related to root canal treatment based on the specified classification. In this case, the information related to root canal treatment may be any information as long as the information is required by an operator for root canal treatment. For example, the information related to root canal treatment includes information about an appropriate root canal treatment apparatus, an appropriate cutting tool, an appropriate drive sequence, and the like. The information related to root canal treatment may of course include information about a procedure for root canal treatment, a method of operating the root canal treatment support apparatus, advice from other operators, and the like.
As the root canal treatment support apparatus outputs the information related to root canal treatment suitable to the root canal shape of a tooth, the operator can perform appropriate root canal treatment while the time required to select a root canal treatment apparatus, a cutting tool and a drive sequence can be shortened. Also, as the root canal treatment support apparatus updates information related to root canal treatment through an external network, the latest information about the root canal treatment apparatus, the cutting tool and the drive sequence can always be obtained. Furthermore, the root canal treatment support apparatus may be able to update the information related to root canal treatment to more appropriate information through machine learning by feedback of the result of root canal treatment.
The summary of the present disclosure as described above will be hereinafter described as further specific embodiments with reference to the accompanying drawings.
The root canal treatment support system according to the first embodiment includes: an image diagnostic apparatus configured to image a root canal of a tooth; a root canal treatment support apparatus configured to support root canal treatment based on image information from the image diagnostic apparatus; and a root canal treatment apparatus configured to use the information from the root canal treatment support apparatus. The root canal treatment support system does not have to include an image diagnostic apparatus but may be configured to cause the root canal treatment support apparatus to read image information about a root canal of a tooth from a server or the like. In this case, the image diagnostic apparatus may be an apparatus capable of imaging image information by which the root canal treatment support apparatus can specify a classification of the root canal shape. For example, the image diagnostic apparatus is an X-ray computed tomography (CT) image diagnostic apparatus, an ultrasonic image diagnostic apparatus, an optical coherence tomography (OCT) image diagnostic apparatus, and the like.
In the root canal treatment support system, root canal treatment apparatus 100 and root canal treatment support apparatus 200 are connected to each other in a wired manner while root canal treatment support apparatus 200 and image diagnostic apparatus 300 are connected to each other in a wired manner. In the root canal treatment support system, however, root canal treatment apparatus 100 and root canal treatment support apparatus 200 may be wirelessly connected to each other while root canal treatment support apparatus 200 and image diagnostic apparatus 300 may be wirelessly connected to each other. Furthermore, root canal treatment apparatus 100 and root canal treatment support apparatus 200 does not necessarily have to be directly connected but may be indirectly connected through a server and the like. Also, root canal treatment support apparatus 200 and image diagnostic apparatus 300 does not necessarily have to be directly connected but may be indirectly connected through a server and the like. Furthermore, information D may be transferred by a person from root canal treatment support apparatus 200 to root canal treatment apparatus 100. For example, a display device 204a of root canal treatment support apparatus 200 may show information D related to root canal treatment, which may be visually checked by a person who then may input the value of information D into root canal treatment apparatus 100. Furthermore, image information P may also be transferred by a person from image diagnostic apparatus 300 to root canal treatment support apparatus 200. For example, image information P stored in image diagnostic apparatus 300 may be copied to a recording medium. Then, a person may cause root canal treatment support apparatus 200 to read image information P from the recording medium.
[Configuration of Root Canal Treatment Apparatus]
Then, the configuration of root canal treatment apparatus 100 will be hereinafter described in greater detail.
Root canal treatment apparatus 100 includes a handpiece 1 provided with: a head 2, a neck portion 3 small in diameter and continuous to head 2, and a grip portion 4 continuous to neck portion 3 and gripped with a hand and fingers. A motor unit 6 for rotatably driving a cutting tool 5 (a file or a reamer) held at head 2 is removably connected to a base portion of grip portion 4. A dental instrument 10 is configured with motor unit 6 being coupled to handpiece 1.
As shown in
Control box 9 includes a controller 11, a comparison circuit 110, a root canal length measurement circuit 12, a motor driver 13, a setting unit 14, an operation unit 15, a display unit 16, a notification unit 17, a communication unit 30, and the like. As shown in
Although lead 19 is pulled out of control box 9, it may be pulled out so as to be branched from a point intermediate in hose 61. Lead 19 has a tip end equipped with a mouth cavity electrode 19a that is configured to be placed over a lip of a patient so as to be electrically connected. Mouth cavity electrode 19a serves as the other electrode of root canal length measurement circuit 12. Furthermore, cutting tool 5 serves as a root canal inner electrode electrically connected to root canal length measurement circuit 12 through signal lead 8 provided inside handpiece 1.
Controller 11 is responsible for overall control of the root canal enlargement and the root canal length measurement system and includes a main portion implemented by a microcomputer. Comparison circuit 110, root canal length measurement circuit 12, motor driver 13, setting unit 14, operation unit 15, display unit 16, notification unit 17, foot controller 18, and communication unit 30 are connected to controller 11. Controller 11 controls the rotation direction of cutting tool 5 cutting an object to be cut. Specifically, controller 11 controls drive to any of forward rotation drive for rotating cutting tool 5 clockwise (also called right rotation), reverse rotation drive for rotating cutting tool 5 counterclockwise (also called left rotation), and twist drive (reciprocal drive) for alternately rotating cutting tool 5 clockwise and counterclockwise. The rotation direction of the cutting tool (clockwise or counterclockwise) is assumed to be defined based on the direction from the side of cutting tool 5 attached to head 2 toward the tip end of cutting tool 5. Controller 11 can control drive for rotating cutting tool 5 by changing parameters including an angle of rotation, a rotation speed, or an angular rotation speed (the number of rotations) in the clockwise direction and an angle of rotation, a rotation speed, or an angular rotation speed (the number of rotations) in the counterclockwise direction.
The angle of rotation used herein may be defined by a time period for rotation (also called a time period for drive) when the angular rotation speed (the number of rotations) is constant. The angle of rotation may be defined by an amount associated with drive of cutting tool 5 such as an amount of a drive current or an amount of torque. Although description will be given below with reference to an angle of rotation, it may be replaced with the number of times of rotation. For example, setting the number of rotations of cutting tool 5 at ½ rotation is the same in meaning as rotation of cutting tool 5 by 180 degrees. Drive of cutting tool 5 for 0.25 second with the constant rotation speed of cutting tool 5 at 120 rotations per minute is the same in meaning as rotation of cutting tool 5 by 180 degrees. Strictly speaking, for example, correspondence between the time period for rotation in terms of control and the actual angle of rotation may have to be corrected depending on the load applied to the cutting tool or the motor. However, the amount of correction is extremely small and hence it is ignorable in implementing the present invention. In subsequent embodiments, the speed of rotation of cutting tool 5 is represented as the number of rotations. The number of rotations is expressed in a unit of revolutions per minute (rpm).
Comparison circuit 110 is necessary for detecting a load applied to cutting tool 5 and can selectively be provided when detection of the load is necessary. Comparison circuit 110 can compare a load applied to cutting tool 5 and a load set by setting unit 14 at any time point during rotation of cutting tool 5 clockwise or counterclockwise by motor driver 13.
Root canal length measurement circuit 12 is necessary for detecting a position of a tip end of cutting tool 5 inside a root canal, and can selectively be provided when detection of the position is necessary. Root canal length measurement circuit 12 forms a closed circuit including: cutting tool 5 inserted into a root canal of a tooth and defined as one electrode; and mouth cavity electrode 19a placed over a lip of a patient and defined as the other electrode. Root canal length measurement circuit 12 can measure a distance from a position of a root apex of a tooth to the tip end of cutting tool 5 by measuring an impedance between cutting tool 5 and mouth cavity electrode 19a by applying a measurement voltage across cutting tool 5 and mouth cavity electrode 19a. When root canal length measurement circuit 12 detects the tip end of cutting tool 5 reaching the position of the root apex, an amount of insertion of the cutting tool, that is, the distance from a root canal opening to the tip end of the cutting tool, can be defined as a root canal length. An electric root canal length measurement method for measuring a root canal length by measuring an impedance between cutting tool 5 and mouth cavity electrode 19a has been known, and all known electric root canal length measurement methods are applicable to root canal treatment apparatus 100 according to the first embodiment.
Motor driver 13 is connected to micromotor 7 through power supply lead 71 and controls power supplied to micromotor 7 based on a control signal from controller 11. Motor driver 13 can control a direction of rotation, the number of rotations, and an angle of rotation of micromotor 7, that is, a direction of rotation, the number of rotations and an angle of rotation of cutting tool 5, by controlling power supplied to micromotor 7.
Setting unit 14 sets the reference for controlling a direction of rotation, the number of rotations and an angle of rotation of cutting tool 5. Setting unit 14 sets a reference load to be compared by comparison circuit 110 with a load applied to cutting tool 5 (a reference for switching a parameter of a drive pattern or a drive sequence, for stopping driving, and the like), timing and the like. Also, using root canal length measurement circuit 12, setting unit 14 can set in advance a position of a root apex and a position at a prescribed distance from the position of the root apex each as a reference position (a reference for switching a parameter of a drive pattern or a drive sequence, for stopping driving, and the like). Root canal treatment apparatus 100 can change parameters including a direction of rotation, the number of rotations, and an angle of rotation of cutting tool 5 or can stop driving when the tip end of cutting tool 5 reaches the root apex position and the reference position, by setting the root apex position and the reference position in advance with setting unit 14.
Operation unit 15 sets parameters including the number of rotations and an angle of rotation of cutting tool 5 and can also set selection as to whether or not to measure a root canal length. Operation unit 15 can allow manual switching between forward rotation drive and reverse rotation drive or switching between forward rotation drive and twist drive.
Display unit 16 shows a position of the tip end of cutting tool 5 inside a root canal or a direction of rotation, the number of rotations and an angle of rotation of cutting tool 5. Also, display unit 16 shows setting details in setting unit 14. Display unit 16 can also show information given from notification unit 17 to an operator. Furthermore, display unit 16 can show the specified classification of the root canal shape and the obtained analysis information about the root canal shape, which will be described later.
Notification unit 17 gives a notification about the state of drive of cutting tool 5 currently controlled by controller 11 through light, sound, or vibration. Specifically, notification unit 17 is provided with a light emitting diode (LED), a speaker, or an oscillator as necessary for giving a notification about the state of drive of cutting tool 5, and changes a color of the LED emitting light or changes sound output from the speaker between forward rotation drive and reverse rotation drive. When display unit 16 can show the state of drive of cutting tool 5 to an operator, notification unit 17 does not have to separately include an LED, a speaker, or an oscillator.
Foot controller 18 serves as an operation unit with which drive and control of cutting tool 5 by micromotor 7 is applied through a stepping operation. Drive and control of cutting tool 5 by micromotor 7 is not limited to drive and control with foot controller 18. An operation switch (not shown) may be provided in grip portion 4 of handpiece 1 and cutting tool 5 may be driven and controlled by using both of the operation switch and foot controller 18. For example, when root canal length measurement circuit 12 detects insertion of cutting tool 5 into a root canal while an operation to step on foot controller 18 is performed, rotation of cutting tool 5 may be started.
Communication unit 30 communicates with root canal treatment support apparatus 200 to receive information D related to root canal treatment from root canal treatment support apparatus 200. Specifically, communication unit 30 receives the information about the drive sequence as information D related to root canal treatment and outputs the drive sequence to controller 11. Controller 11 controls cutting tool 5 to be driven based on the drive sequence received by communication unit 30. The drive sequence includes information such as an angle of rotation in the cutting direction, the number of cutting rotations, an angle of rotation in the non-cutting direction, and the number of non-cutting rotations. Information D transmitted from root canal treatment support apparatus 200 to communication unit 30 may be the drive sequence itself or may be information based on which the drive sequence is specified. In other words, when a plurality of drive sequences are stored in advance in controller 11, information D to be transmitted from root canal treatment support apparatus 200 to communication unit 30 is identification information (for example, the sequence number and the like) used for specifying the stored drive sequence.
Root canal treatment apparatus 100 shown in
Also, control box 9 of root canal treatment apparatus 100 may be incorporated in a tray table or a side table placed at a side portion of a dental treatment couch or may be incorporated in the treatment couch.
[Configuration of Root Canal Treatment Support Apparatus]
Then, root canal treatment support apparatus 200 will be described in detail.
CPU 201 receives an instruction from a user or the like through an input unit 208 such as a keyboard or a mouse, and executes the program to output information D related to root canal treatment and the like to display device 204a through display output unit 204. The above-mentioned components are connected to one another through a bus 202. Interface unit 206 is connected to communication unit 30 of root canal treatment apparatus 100.
Then, the process of root canal treatment support performed in root canal treatment support apparatus 200 having the hardware configuration shown in
Image accepting unit 251 accepts image information P of a root canal of a tooth imaged by image diagnostic apparatus 300. Image accepting unit 251 outputs the accepted image information P to image comparing unit 252. Image comparing unit 252 compares image information P accepted by image accepting unit 251 with the image information for each classification of the root canal shape stored in memory 253 to specify a classification of the root canal shape of image information P. In other words, image comparing unit 252 serves as a classification specification unit for specifying a classification of the root canal shape based on image information P accepted by image accepting unit 251. Based on two images superimposed on one another, image comparing unit 252 detects whether these two images are the same or not, and then, specifies the classification of the image information including a greater number of identical parts as a classification of the accepted image information P. In image comparing unit 252, it becomes possible to apply every known method such as pattern matching for conducting a search for checking whether a specific shape pattern that can be regarded as being the same as the reference image stored in memory 253 exists in the accepted image information P or not.
Memory 253 stores information related to the root canal shape type.
Image comparing unit 252 also serves as a selection unit configured to specify the type of the root canal shape in image information P based on the classification of the root canal shape shown in
Furthermore, tool A and tool B are displayed as a cutting tool type. In the case of root canal shape type E, display device 204a shows only model A as an apparatus type, and shows tool F and tool G as a cutting tool type. Furthermore, various types of cutting tools need to be used for different purposes depending on the material, the length, the diameter, and the cutting manner of the blade (as to whether cutting can be done in the forward rotation or the reverse rotation, and as to whether cutting is done by vibration or not). Also, the cutting tools are different in performance as to how far it can be curved along the curve of the root canal. Generally, the root canal tool is fabricated using a superelastic material made of a nickel-titanium alloy. Accordingly, even in the case of a curved root canal, the root canal tool can be rotated along the curve of the root canal to thereby cut the root canal. Furthermore, there are many operation methods in which an operation is performed using a plurality of cutting tools starting from a thinner cutting tool that is sequentially exchanged with a thicker cutting tool. However, there is also an operation method in which an operation is performed using one cutting tool. When this latter operation method is selected, display device 204a may be configured to show a cutting tool type suitable to each operation method.
Output unit 254 outputs, for example, the information about the drive sequence among information D related to root canal treatment to root canal treatment apparatus 100 connected thereto. In root canal treatment apparatus 100, cutting tool 5 attached to head 2 is driven according to the drive sequence. The drive sequence includes at least one drive pattern.
Specifically, in the drive pattern adopted in SET1 in drive sequence M4, angle of rotation ai in the cutting direction is set to 180 degrees, the number of cutting rotations N1 is set to 300 rpm, angle of rotation β1 in the non-cutting direction is set to 90 degrees, the number of non-cutting rotations N2 is set to 300 rpm, and the number of times of repetition is set to 9. In the drive pattern adopted in SET2, angle of rotation α2 in the cutting direction is set to 90 degrees, the number of cutting rotations N3 is set to 300 rpm, angle of rotation β2 in the non-cutting direction is set to 180 degrees, the number of non-cutting rotations N4 is set to 300 rpm, and the number of times of repetition is set to 3. In the drive pattern adopted in SET3, angle of rotation α3 in the cutting direction is set to 0 degree, the number of cutting rotations N5 is set to 0 rpm, angle of rotation β3 in the non-cutting direction is set to 360 degrees, the number of non-cutting rotations N6 is set to 300 rpm, and the number of times of repetition is set to 1. In the drive pattern adopted in SET4, angle of rotation α4 in the cutting direction is set to 90 degrees, the number of cutting rotations N7 is set to 300 rpm, angle of rotation β4 in the non-cutting direction is set to 180 degrees, the number of non-cutting rotations N8 is set to 300 rpm, and the number of times of repetition is set to 2.
In drive sequence M4, a root canal is cut mainly in the drive pattern adopted in SET1, drive under the balanced force technique is performed in the drive patterns adopted in SET2 and SET4 so as to perform cutting and enlargement in conformity with a shape of the root canal, and bite into the inner wall of the root canal is removed in the drive pattern adopted in SET3. In drive sequence M4, as a result of drive under SET1, cutting tool 5 is rotated by 90 degrees×9 times=810 degrees in the cutting direction, as a result of drive under SET2, cutting tool 5 is rotated by 90 degrees×3 times=270 degrees in the non-cutting direction, as a result of drive under SET3, cutting tool 5 is rotated by 360 degrees in the non-cutting direction, and as a result of drive under SET4, cutting tool 5 is rotated by 90 degrees×2 times=180 degrees in the non-cutting direction.
For example, in the case of root canal shape type A, output unit 254 outputs a drive sequence M1 shown in
Referring back to
[Process in Root Canal Treatment Support Apparatus]
Then, the process in root canal treatment support apparatus 200 will be described with reference to a flowchart.
When CPU 201 determines that image information P has been accepted (step S10: YES), CPU 201 (particularly, image comparing unit 252) compares accepted image information P with the image information for each classification of the root canal shape stored in memory 253 to specify a classification of the root canal shape in image information P (step S11). CPU 201 (particularly, image comparing unit 252) selects information D related to root canal treatment based on the specified classification of the root canal shape, and then reads the selected information D from memory 253 (step S12).
CPU 201 (particularly, output unit 254) outputs the information about the apparatus type among information D related to root canal treatment read in step S12 to display device 204a, and then, causes display device 204a to show the root canal treatment apparatus that can be selected (step S13). CPU 201 outputs the information about the cutting tool type among information D related to root canal treatment read in step S12 to display device 204a, and then, causes display device 204a to show the tool that can be selected (step S14). CPU 201 outputs, to root canal treatment apparatus 100 connected thereto, the information about the drive sequence among information D related to root canal treatment read in step S12, or outputs the information about the drive sequence to display device 204a and causes display device 204a to show a drive sequence (step S15).
Then, CPU 201 determines whether the treatment result has been input or not through input unit 208 (step S16). When the treatment result has been input (step S16: YES), CPU 201 (particularly, update processing unit 256) updates information D related to root canal treatment in memory 253 through machine learning (step S17). When the treatment result has not been input (step S16: NO), CPU 201 determines whether the operation to end the process of root canal treatment support has been accepted or not (step S18). When the operation to end the process of root canal treatment support has not been accepted (step S18: NO), CPU 201 returns the process back to step S10 and then continues the state of waiting for acceptance of image information P. When the operation to end the process of root canal treatment support has been accepted (step S18: YES), CPU 201 end the process.
As described above, the root canal treatment support system according to the present first embodiment includes root canal treatment support apparatus 200 for providing information that can be used for root canal treatment, and root canal treatment apparatus 100 using the information from root canal treatment support apparatus 200. Root canal treatment support apparatus 200 includes: image accepting unit 251 configured to accept image information obtained by imaging a root canal of a tooth; information generation unit 25 configured to generate information related to root canal treatment suitable to a root canal shape based on image information P accepted by image accepting unit 251; and output unit 254 configured to output the information generated by information generation unit 25. Specifically, information generation unit 25 includes: image comparing unit 252 configured to specify a classification of the root canal shape based on the image information accepted by image accepting unit 251; memory 253 in which information D related to root canal treatment is stored for each classification of the root canal shape; and selection unit (image accepting unit 251) configured to select information D related to root canal treatment from memory 253 based on the classification specified by image comparing unit 252. Root canal treatment apparatus 100 includes handpiece 1 having head 2 at which cutting tool 5 is held in a drivable manner, a drive unit (motor driver 13 and the like) configured to drive cutting tool 5 held at head 2, and controller 11 configured to control the drive unit. Based on the information output from output unit 254, controller 11 controls the drive unit to drive cutting tool 5.
Thus, the root canal treatment support system according to the present first embodiment can output information D related to root canal treatment in accordance with each classification of the root canal shape, and can appropriately support the operator's root canal treatment. Furthermore, in the root canal treatment support system, cutting tool 5 can be driven in the appropriate drive sequence in accordance with each classification of the root canal shape.
Furthermore, image comparing unit 252 compares the image information accepted by image accepting unit 251 with the image information (see
The process of specifying the classification of the root canal shape is not limited to the process by image comparing unit 252 comparing several pieces of image information as long as the classification of the root canal shape can be specified by any process. For example, the classification specification unit may compare a specific parameter of the root canal shape specified from the image information accepted by image accepting unit 251 with the parameter of the root canal shape in each classification stored in the memory, to thereby specify the classification of the root canal shape.
Specifically, the following is an explanation about the case where the number of root canals, the number of branches, the branch position, the number of merging points, and the merging position are employed as parameters of the root canal shape.
The parameters of the root canal shape shown in
As information D related to root canal treatment, output unit 254 outputs at least one of: the type information about root canal treatment apparatus 100 that is suitable to the treatment of the root canal having a shape included in the classification specified by image comparing unit 252; and the type information about cutting tool 5 used in root canal treatment apparatus 100. Furthermore, as information D related to root canal treatment, output unit 254 outputs the drive sequence (control information) of root canal treatment apparatus 100 that is suitable to the treatment of the root canal having a shape included in the classification specified by image comparing unit 252. In this case, the drive sequence includes an angle of cutting rotation ai as the angle of rotation in the cutting direction, angle of non-cutting rotation β1 as the angle of rotation in the non-cutting direction, the number of cutting rotations N1 as the number of rotations in the cutting direction, the number of non-cutting rotations N2 as the number of rotations in the non-cutting direction; and the like, as shown in
Root canal treatment support apparatus 200 includes display device 204a or a sound output unit (not shown). Thus, output unit 254 outputs information D related to root canal treatment to display device 204a or the sound output unit, to cause display device 204a to show the information shown in
Image information P accepted by image accepting unit 251 is two-dimensional image information or three-dimensional image information obtained by imaging a root canal of a tooth. Image information P is at least any one of an X-ray CT image, an ultrasonic image and an OCT image.
Root canal treatment support apparatus 200 includes communication unit 255 for establishing a connection to external network 400. Thus, based on the information from the external database connected through communication unit 255, information D related to root canal treatment stored in memory 253 can be updated. Furthermore, root canal treatment support apparatus 200 includes: an input unit 257 through which the information about the treatment result of the root canal treatment performed based on the information output from output unit 254 is input; and an update processing unit 256 for updating information D related to root canal treatment stored in memory 253 through machine learning by using the information about the treatment result input into input unit 257.
Thereby, root canal treatment support apparatus 200 can provide an operator with information D related to more appropriate root canal treatment.
The root canal treatment apparatus according to the present second embodiment will be hereinafter described with regard to the case where control in root canal treatment apparatus 100 as described in the first embodiment is combined with: control based on the load applied to cutting tool 5; or control based on the position of cutting tool 5 obtained from root canal length measurement circuit 12 (the position of the tip end of cutting tool 5 inside the root canal obtained by root canal length measurement circuit 12). The following explanation about the root canal treatment apparatus will be given with regard to the case where only the control based on the load applied to cutting tool 5 is combined and the case where only the control based on the position of cutting tool 5 is combined, but both controls may be combined. Also, since the root canal treatment apparatus according to the present second embodiment is identical in configuration to root canal treatment apparatus 100 according to the first embodiment, the same reference characters will be used for description, but the detailed description thereof will not be repeated.
When the control based on the load applied to cutting tool 5 is combined, the root canal treatment apparatus detects the load applied to cutting tool 5 in a load detector. Specifically, the root canal treatment apparatus is provided with a load detection resistor inside a circuit of motor driver 13 shown in
The following is an explanation about control based on the load applied to cutting tool 5 with reference to a specific example. Initially, controller 11 reads a first drive sequence set in advance and causes cutting tool 5 to be driven sequentially from the drive pattern adopted in SET1 in the read first drive sequence. For example, controller 11 has drive sequence M2 shown in
Then, controller 11 obtains a load applied to cutting tool 5 and detected by the load detector. Controller 11 causes the load detector to detect a load applied at the time when cutting tool 5 is driven to rotate in the cutting direction and thereby obtains the detected load. Then, comparison circuit 110 compares the obtained load with a reference load set by setting unit 14. Thus, application of a load more than necessary onto cutting tool 5 as a result of drive in the first drive sequence can be detected and the drive sequence is switched in order to lower the load.
When it is determined that the obtained load is equal to or higher than the reference load, controller 11 reads the second drive sequence and causes cutting tool 5 to be driven sequentially from the drive pattern adopted in SET1 in the read second drive sequence. For example, when a load equal to or higher than the reference load is applied to cutting tool 5, controller 11 switches the sequence to the second drive sequence that is drive sequence M3 shown in
Although an example in which the drive sequence itself is switched from the first drive sequence to the second drive sequence is shown, the present invention is not limited thereto. For example, when a load equal to or higher than the reference load is applied to cutting tool 5, controller 11 may change parameters such as an angle of rotation, an angular rotation speed, and the number of times of repetition of the drive pattern adopted in the first drive sequence without switching the drive sequence itself or may perform control for driving in the reverse rotation, a switching interval between the forward rotation and the reverse rotation, or driving to a stop operation.
Then, in combination of the control based on the position of cutting tool 5 obtained from root canal length measurement circuit 12, the root canal treatment apparatus obtains the position of cutting tool 5 obtained in root canal length measurement circuit 12.
The following is an explanation about the control based on the position of cutting tool 5 with reference to a specific example. Initially, controller 11 reads a first drive sequence set in advance and causes cutting tool 5 to be driven sequentially from the drive pattern adopted in SET1 in the read first drive sequence. For example, controller 11 has drive sequence M5 shown in
Then, controller 11 obtains a position of cutting tool 5 by root canal length measurement circuit 12. Controller 11 determines whether or not the position of cutting tool 5 obtained from root canal length measurement circuit 12 has reached a reference position (the position of the cutting tool≤the reference position). When it is determined that the obtained position of cutting tool 5 has reached the reference position, controller 11 reads a second drive sequence and causes cutting tool 5 to be driven sequentially from the drive pattern adopted in SET1 in the read second drive sequence. For example, when a position of cutting tool 5 is close to the root apex, controller 11 switches the sequence to the second drive sequence that is drive sequence M6 including twist drive with a small angle of rotation (specifically, angle of rotation α1 in the cutting direction=90 degrees and angle of rotation β1 in the non-cutting direction=90 degrees) and causes cutting tool 5 to be driven in accordance with the drive patterns adopted in SET1 and SET2 in drive sequence M6.
Although an example of switching of the drive sequence itself from the first drive sequence to the second drive sequence has been illustrated, the present invention is not limited thereto. For example, when controller 11 determines that the reference position has been reached, controller 11 may change parameters such as an angle of rotation, an angular rotation speed, and the number of times of repetition of the drive pattern adopted in the first drive sequence without switching the drive sequence itself or may perform control for driving in the reverse rotation, a switching interval between the forward rotation and the reverse rotation, or driving to a stop operation.
The above description has been made with regard to the control for switching a drive sequence or changing a parameter of a drive pattern included in the drive sequence depending on whether or not a reference position has been reached. The present invention, however, is not limited as such, and the root canal treatment apparatus may carry out control for switching a drive sequence or changing a parameter of a drive pattern included in the drive sequence in accordance with a region resulting from division of a root canal of a tooth into a plurality of regions.
Initially, when the tip end of cutting tool 5 is located within the A region, controller 11 causes cutting tool 5 to be driven in accordance with drive sequence M1 shown in
Then, when the tip end of cutting tool 5 is located within the B region, controller 11 causes cutting tool 5 to be driven in accordance with drive sequence M4 shown in
Then, when the tip end of cutting tool 5 is located within the C region, controller 11 causes cutting tool 5 to be driven in accordance with drive sequence M6 shown in
Although the above description has been given with reference to an example in which controller 11 switches the drive sequence itself in accordance with a region where the tip end of cutting tool 5 is located, the present invention is not limited thereto. For example, controller 11 may change parameters such as an angle of rotation, an angular rotation speed, and the number of times of repetition of the drive pattern adopted in the drive sequence in accordance with a region where the tip end of cutting tool 5 is located, without switching the drive sequence itself.
As described above, the root canal treatment apparatus according to the present second embodiment includes the load detector for detecting a load applied to cutting tool 5. Controller 11 changes the control of the drive unit in accordance with the load applied to cutting tool 5 and detected by the load detector. Specifically, when the load applied to the cutting tool and detected by the load detector is equal to or greater than a reference load, controller 11 performs control for driving in the reverse rotation, a switching interval between the forward rotation and the reverse rotation, or driving to a stop operation. The root canal treatment support apparatus may set information D related to root canal treatment output to the root canal treatment apparatus to include information such as a reference load, and a drive sequence at the time when the load is equal to or greater than the reference load.
The root canal treatment apparatus according to the present second embodiment includes root canal length measurement circuit 12 for detecting the position of the tip end of cutting tool 5 located inside the root canal and obtained by electrical root canal length measurement. Controller 11 changes the control of the drive unit in accordance with the position detected by root canal length measurement circuit 12. Specifically, when the position detected by root canal length measurement circuit 12 reaches a reference position, controller 11 performs control for driving in the reverse rotation, a switching interval between the forward rotation and the reverse rotation, or driving to a stop operation. In addition, the root canal treatment support apparatus may set information D related to root canal treatment output to the root canal treatment apparatus to include information such as a reference position and a drive sequence at the time of reaching the reference position.
The root canal treatment apparatus according to the present second embodiment will be described with regard to the case where root canal treatment apparatus 100 as described in the first embodiment includes the configuration of root canal treatment support apparatus 200.
Root canal treatment apparatus 100A shown in
Root canal treatment apparatus 100A and image diagnostic apparatus 300 are connected to each other in a wired manner. However, root canal treatment apparatus 100 and image diagnostic apparatus 300 may be wirelessly connected. Furthermore, root canal treatment apparatus 100 and image diagnostic apparatus 300 does not necessarily have to be directly connected but may be indirectly connected through a server and the like. Furthermore, image information P may also be transferred by a person from image diagnostic apparatus 300 to root canal treatment apparatus 100A. For example, image information P stored in image diagnostic apparatus 300 may be copied to a recording medium. Then, a person may cause root canal treatment apparatus 100A to read image information P from the recording medium.
[Configuration of Root Canal Treatment Support Apparatus]
Then, the configuration of root canal treatment apparatus 100A will be descried in greater detail. Root canal treatment apparatus 100A is identical in configuration to root canal treatment apparatus 100 except that an accepting unit 30A is provided in place of communication unit 30 provided in root canal treatment apparatus 100 shown in
Specifically, controller 11 of root canal treatment apparatus 100A includes image comparing unit 252, memory 253, output unit 254, and update processing unit 256 that are shown in
[Process in Root Canal Treatment Apparatus]
Then, the process in root canal treatment apparatus 100A will be described with reference to a flowchart.
When controller 11 determines that image information P has not been accepted (step S20: NO), it returns the process back to step S20 and then continues the state of waiting for image information P.
When controller 11 determines that image information P has been accepted (step S20: YES), controller 11 compares the accepted image information P with the image information for each classification of the root canal shape stored in the memory, and specifies the classification of the root canal shape of image information P (step S21). Controller 11 reads information D related to root canal treatment from the memory based on the specified classification of the root canal shape (step S22).
Controller 11 outputs the information about the cutting tool type among information D related to root canal treatment read in step S22 to display unit 16 and causes display unit 16 to show a tool that can be selected (step S23). An operator attaches cutting tool 5 displayed on display unit 16 to head 2. Controller 11 drives cutting tool 5 selected in step S23 based on the drive sequence included in information D related to root canal treatment read in step S22 (step S24).
Then, controller 11 determines whether the treatment result has been input or not from operation unit 15 (step S25). When the treatment result has been input (step S25: YES), controller 11 updates information D related to root canal treatment in the memory through machine learning (step S26). When the treatment result has not been input (step S25: NO), controller 11 determines whether the operation to end the process in the root canal treatment apparatus has been accepted or not (step S27). When the operation to end the process in the root canal treatment apparatus has not been accepted (step S27: NO), controller 11 returns the process back to step S20 and then continues the state of waiting for acceptance of image information P. When the operation to end the process in the root canal treatment apparatus has been accepted (step S27: YES), controller 11 ends the process.
As described above, root canal treatment apparatus 100A according to the present third embodiment serves as a root canal treatment apparatus used for root canal treatment and includes: handpiece 1 having head 2 at which cutting tool 5 is held in a drivable manner; a drive unit configured to drive cutting tool 5 held at head 2; and controller 11 configured to control the drive unit. Furthermore, root canal treatment apparatus 100A according to the present third embodiment has a configuration of root canal treatment support apparatus 200 described in the first and second embodiments. Accordingly, root canal treatment apparatus 100A can by itself output information D related to root canal treatment that is suitable to each classification of the root canal shape and can appropriately support the operator's root canal treatment. Furthermore, according to this root canal treatment apparatus, cutting tool 5 can be driven in an appropriate drive sequence suitable to each classification of the root canal shape.
The root canal treatment support system according to the present fourth embodiment will be described with regard to the configuration in which image comparing unit 252 selects information D related to root canal treatment from memory 253 without specifying the classification of the root canal shape based on the image information accepted by image accepting unit 251, as described in the first embodiment. In the following description, the root canal treatment support system according to the present fourth embodiment is identical in configuration to the root canal treatment support system according to the first embodiment, except for the configuration using the root canal treatment support apparatus selecting the information related to root canal treatment from a memory without specifying the classification of the root canal shape. Thus, the same reference characters will be used for description, but the detailed description thereof will not be repeated.
[Configuration of Root Canal Treatment Support Apparatus]
Analysis unit 252A obtains characteristic value of the root canal as analysis information about the root canal shape from image information P accepted by image accepting unit 251. The analysis information about the root canal shape includes, for example, the length of the root canal, the cross-sectional shape of the root canal, the diameter of the root canal, the cross-sectional area of the root canal, the curvature (curvature rate) of the root canal, the change rate of the diameter of the root canal relative to the longitudinal direction of the root canal, the change rate of the cross-sectional area of the root canal, the change rate of the curvature of the root canal, and the like. For analysis unit 252A, every known method such as image analysis for the accepted image information P can be applied. By applying the known method, the analysis information about the root canal shape is obtained. When root canal treatment apparatus 100 includes a root canal length measurement unit for electrically measuring the length of the root canal and can accept the measurement results of the root canal length measurement unit, or when root canal treatment apparatus 100 can accept the measurement results from an apparatus including a root canal length measurement unit, the length of the root canal measured by the root canal length measurement unit may be included in one of the analysis information about the root canal shape obtained in analysis unit 252A. Thereby, analysis unit 252A can obtain the information about the root canal length with high accuracy.
The setting information for each analysis information about the root canal shape is stored in memory 253.
Furthermore,
Based on the obtained analysis information, analysis unit 252A selects an appropriate apparatus type, an appropriate cutting tool type and an appropriate drive sequence from the setting information shown in
[Process in Root Canal Treatment Support Apparatus]
Then, the process in root canal treatment support apparatus 200A will be hereinafter described with reference to a flowchart.
When CPU 201 determines that image information P has been accepted (step S10: YES), CPU 201 (particularly, analysis unit 252A) calculates the length of the root canal, the diameter of the root canal, the change rate of the diameter of the root canal relative to the longitudinal direction of the root canal, the change rate of the curvature of the root canal, and the like based on accepted image information P, so as to be obtained as analysis information about the root canal shape (step S11A). CPU 201 (particularly, image comparing unit 252) selects information D related to root canal treatment based on the analysis information about the obtained root canal shape, and reads the selected information D from memory 253 (step S12A).
CPU 201 (particularly, output unit 254) outputs the information about the apparatus type among information D related to root canal treatment read in step S12A to display device 204a and causes display device 204a to show the root canal treatment apparatus that can be selected (step S13). Since the subsequent steps in the flowchart are the same as those in the flowchart (
As described above, the root canal treatment support system according to the present fourth embodiment includes root canal treatment support apparatus 200A for providing information that can be used for root canal treatment, and root canal treatment apparatus 100 employing the information from root canal treatment support apparatus 200A. Root canal treatment support apparatus 200A includes: image accepting unit 251 configured to accept image information obtained by imaging a root canal of a tooth; information generation unit 25 configured to generate information related to root canal treatment suitable to the root canal shape based on image information P accepted by image accepting unit 251; and output unit 254 configured to output the information generated by information generation unit 25. Specifically, information generation unit 25 includes: analysis unit 252A configured to obtain analysis information about the root canal shape based on image information P accepted by image accepting unit 251; memory 253 in which information D related to root canal treatment is stored for each analysis information about the root canal shape; and selection unit (analysis unit 252A) configured to select the information related to root canal treatment from memory 253 based on the analysis information obtained in analysis unit 252A. Root canal treatment apparatus 100 includes handpiece 1 having head 2 at which cutting tool 5 is held in a drivable manner, a drive unit (motor driver 13 and the like) configured to drive cutting tool 5 held at head 2, and controller 11 configured to control the drive unit. Based on the information output from output unit 254, controller 11 controls the drive unit to drive cutting tool 5.
Accordingly, the root canal treatment support system according to the present fourth embodiment can output information D related to root canal treatment in accordance with the analysis information about the root canal shape without specifying the classification of the root canal shape, and also can appropriately support the operator's root canal treatment. The root canal may extremely rarely have a particular shape. For example, there may be a root canal having a cross section formed in a C-shaped trough, a root canal having a curvature close to 180 degrees with respect to the tooth axis near its root apex, and the like. Even in the above-described cases, by analyzing the root canal shape based on the image information (particularly three-dimensional X-ray CT image information) of a tooth, the information about the cutting tool type or the drive sequence can be supported, thereby avoiding a fracture of a tooth, bite of cutting tool 5 into a root, and a fracture of cutting tool 5. In this way, according to the root canal treatment support system, cutting tool 5 can be driven in the appropriate drive sequence that is suitable to each analysis information about the root canal shape.
The analysis information about the root canal shape obtained in analysis unit 252A may include at least one piece of information of: the change rate of the cross-sectional area of the root canal relative to the longitudinal direction of the root canal and the change rate of the curvature of the root canal relative to the longitudinal direction of the root canal. Thereby, the operator's root canal treatment can be more appropriately supported.
As described in the third embodiment, the configuration of root canal treatment support apparatus 200A may be included in another root canal treatment apparatus 100A. Since the configuration and the block diagram of root canal treatment apparatus 100A including the configuration of root canal treatment support apparatus 200A are the same as those shown in
Then, the process in root canal treatment apparatus 100A including the configuration of root canal treatment support apparatus 200A will be hereinafter described with reference to a flowchart.
When controller 11 determines that image information P has been accepted (step S20: YES), controller 11 calculates the length of the root canal, the diameter of the root canal, the change rate of the diameter of the root canal relative to the longitudinal direction of the root canal, the change rate of the curvature of the root canal, and the like from the accepted image information P, so as to be obtained as analysis information about the root canal shape (step S21A). Controller 11 selects information D related to root canal treatment based on the obtained analysis information about the root canal shape and reads the selected information D from memory 253 (step S22A).
Controller 11 outputs the information about the cutting tool type among information D related to root canal treatment read in step S22 to display unit 16, to cause display unit 16 to show the tool that can be selected (step S23). Since the subsequent steps in the flowchart are the same as those in the flowchart (
(Other Modifications)
According to the description in the first to third embodiments, an apparatus type, a cutting tool type and a drive sequence are included as information D related to root canal treatment. However, information D related to root canal treatment may include information such as the procedure of the root canal treatment, the method of operating a root canal treatment support apparatus, advice from other operators, and the like. For example, when the root canal shape specified based on the image information is classified as the root canal being fractured, information D related to root canal treatment may include the procedure in which the treatment for enlarging the root canal is performed after the fractured part is first bonded with an adhesive. Furthermore, when the root canal shape specified based on the image information is classified as a radicular cyst formed due to accumulation of pus in a root apex, and the like, information D related to root canal treatment may include advice that a special operation such as apicoectomy needs to be performed for cutting and removing a root apex portion to remove a cyst.
The process in root canal treatment support apparatus 200 providing the information that can be used for root canal treatment is controlled by the program executed by CPU 201. The program includes: accepting image information P obtained by imaging a root canal of a tooth; generating information related to root canal treatment suitable to the root canal shape based on accepted image information P; and outputting the generated information. Particularly, generating information related to root canal treatment suitable to the root canal shape may consist of: specifying a classification of the root canal shape based on accepted image information P; and selecting information D related to root canal treatment from memory 253 storing information D related to root canal treatment based on the specified classification for each classification of the root canal shape. Furthermore, generating information related to root canal treatment suitable to the root canal shape may consist of: obtaining analysis information about the root canal shape based on accepted image information P; and outputting information D related to root canal treatment based on the obtained analysis information from memory 253 storing information D related to root canal treatment for each analysis information about the root canal shape.
Each of various processes as described above is defined as being implemented by one CPU 201, but the present invention is not limited thereto. Each of these various functions may be implemented by at least one semiconductor integrated circuit such as a processor, at least one application specific integrated circuit (ASIC), at least one digital signal processor (DSP), at least one field programmable gate array (FPGA) and/or other circuits having a computing function.
These circuits can perform the above-described various processes by reading one or more instructions from at least one tangible readable medium.
Such a medium is provided as an optional type of memory such as a magnetic medium (for example, a hard disk), an optical medium (for example, a compact disk (CD), DVD), volatile memory, and nonvolatile memory, but the present invention is not limited thereto.
The volatile memory may include a dynamic random access memory (DRAM) and a static random access memory (SRAM). The nonvolatile memory may include a ROM and an NVRAM.
Although the present invention has been described and illustrated in detail, it is clearly understood that the same is by way of illustration and example only and is not to be taken by way of limitation, the scope of the present invention being interpreted by the terms of the appended claims.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2017-246149 | Dec 2017 | JP | national |
