JP5857277B2 - Dental vibratory handpiece device with endoscope probe - Google Patents

Description

  The present invention relates to a dental vibratory handpiece device with an endoscopic probe that enables a dentist to perform a dental treatment while observing an area to be treated with an endoscope.

In the medical field, it is possible to directly reach and treat a lesion while diagnosing the lesion using an endoscope having a plurality of channels having different functions.
However, in the field of dental treatment, treatment with an endoscope is not performed. This is because it is difficult to incorporate a working tool of a dental turbine handpiece or a dental vibrating handpiece into the channel of the endoscope probe. Therefore, when treating a carious tooth or a damaged root canal, it is necessary to reach a lesion that is not directly visible to the dentist, and the dentist performs treatment while confirming the treatment site many times with a dental mirror. Is the actual situation. For this reason, work becomes a craftsmanship technique that relies on experience and intuition, and skill is required.
In addition, it is difficult to find subgingival lesions with a dental mirror, and it is difficult to see the subgingival calculus that causes periodontal disease.

  In the prior art, it has been proposed to incorporate a light guide, an image guide, and an image sensor into an ultrasonic scaler and perform scaling while remotely observing (Japanese Patent No. 3151209). However, this ultrasonic scaler is not designed to allow the tip of the image guide to be inserted into the periodontal pocket, so it is difficult to scale while observing the calculus under the gingival margin. .

  In Japanese Patent No. 3244273, it has been proposed to incorporate an endoscope into a sharp sharpening device for subgingival treatment. This curettage has a problem that the curettage cannot be replaced because the optical transmission path and the image transmission path are provided inside the elongated handle. In addition, since manual curettage must be performed, the patient and dentist are burdened and the treatment takes a long time.

An object of the present invention is to provide a power-driven dental vibratory handpiece with an endoscopic probe that makes it possible to treat a tooth while observing an area to be treated with an endoscope.
Another object of the present invention is to provide a dental vibratory handpiece with an endoscopic probe that allows the subgingival calculus to be removed while endoscopically observing.
Another object of the present invention is to provide a dental vibratory handpiece with an endoscopic probe that makes it possible to perform a treatment while observing an area to be treated in a root canal with an endoscope.

The present invention provides a power-driven dental vibratory handpiece device with an endoscopic probe that makes it possible to treat a tooth while observing a treated portion endoscopically.
This handpiece device includes: a vibration source driven by a drive medium (compressed air or electric power) supplied from a dental unit or the like when connected to a dental unit or the like by a dental hose or the like, and a vibration transmission relationship to the vibration source A dental vibratory handpiece with an elongated dental vibrating tool coupled with a self-supporting (i.e., waistless) with an image guide for transmitting an image of the treated area to an endoscopic monitor ) And an endoscopic probe; and for holding the vibrating tool and the endoscopic probe side by side at the distal end of the endoscopic probe (referred to as the end on the patient side). The integrated means of this is provided.
An elongated dental vibration tool has a first “vibration node” of bending vibration that is generated in the vibration tool when vibrated by a vibration source and coincides with the distal end of the endoscope probe, and is far from the endoscope probe. It is set so that the tip of the tool protruding forward from the top end is located at the maximum amplitude portion of vibration. When the vibration tool is vibrated, the tip of the vibration tool acts on the tooth while vibrating by drawing an elliptical motion around the above-mentioned first vibration node.

According to the present invention, the vibration tool of the dental handpiece and the endoscope probe provided with the image guide are integrated side by side at their tips, and the tip working portion of the vibration tool acting on the teeth is the inner part. Since the dentist protrudes forward from the distal end of the endoscope probe, the dentist sees the image of the treatment site sent through the endoscope probe image guide on the endoscope monitor and the tip of the vibration tool. Dental treatment can be performed by causing the action part to act on the treated part. Therefore, a dentist can perform dental treatment accurately and appropriately without relying on experience and intuition, and without using a dental mirror, while viewing an image of a tool acting on a treatment target portion on an endoscopic monitor. it can.
Further, according to the present invention, the dental vibratory handpiece and the endoscope probe are separated except for the distal end portion where the vibrating tool and the endoscope probe are integrated. The vibration tool can be easily replaced by pulling it out of the case.
Furthermore, since the handpiece device of the present invention can be assembled by integrally holding the dental vibratory handpiece and the endoscope probe by the integrated means, the conventional or existing vibratory handpiece and A handpiece device can be manufactured at low cost by using commercially available endoscopic probes and minimal modification.

According to the present invention, the endoscope probe and the dental vibration tool can be made extremely fine. The diameter of the distal end of the endoscope probe is preferably 2.0 mm or less, more preferably 1.5 mm or less, and the diameter of the dental vibration tool at the distal end of the endoscope probe is preferably 1.0 mm or less. More preferably, it is 0.5 mm or less.
With such a size, a vibration tool having a working part in the form of a scaling tip while inserting the distal end of the endoscope probe into the periodontal pocket and observing the tooth surface under the gingival endoscopy Can be used to remove the calculus under the gingival margin, or the distal end of the endoscopic probe is inserted into the root canal and the inside of the root canal can be viewed endoscopically while the file or reamer is removed. A root canal treatment can be performed using a vibrating tool with a shaped working part.

  Preferably, the vibration tool is bent at a node of bending vibration (that is, bending vibration) generated in the vibration tool when being vibrated by a vibration source. In this way, it is possible to minimize the vibration of the bending vibration mode from being attenuated while propagating through the elongated vibration tool.

In a preferred embodiment, the endoscope probe is for supplying a cooling water to the treated part and / or for sucking out the used cooling water or the used washing water from the treated part region. Has a vacuum channel.
Preferably, the endoscope probe further includes a light guide for transmitting light from the light source to the treatment target portion.
Other features and advantages of the present invention will become apparent from the description of the following examples.

It is a partially cutaway side view showing a dental vibratory handpiece device of the present invention. FIG. 2A shows sine wave vibration generated in a straight vibration tool, and FIG. 2B shows a state where the vibration tool is bent at a vibration node. 3 (a) is an enlarged view of a part of the broken-line circle A in FIG. 1, and FIG. 3 (b) is a cross-sectional view taken along the line BB in FIG. It is CC sectional view expanded by CC arrow. Fig. 4 (a) shows the removal of the subgingival calculus using a dental vibration tool in the form of a scaler, and Fig. 4 (b) treats the root canal using a dental vibration tool in the form of a file. Indicates where to do. 5 (a) is a partially cutaway side view showing a variation of the dental vibratory handpiece device shown in FIG. 1, and FIG. FIG. 5 and FIG. 5C are enlarged cross-sectional views of the holding cylinder for integration shown in FIG. FIG. 6 is a partially cutaway side view showing still another variation of the dental vibrating handpiece device shown in FIG. 1.

FIG. 1 shows a dental vibratory handpiece device 10 of the present invention. The handpiece device 10 can be composed of a dental vibration handpiece 12 and an endoscope probe 14 of any type, and both are separably bound using, for example, a screw 16 or other binding tool. Yes.
In the illustrated embodiment, the dental handpiece 12 is a compressed air driven dental vibrating handpiece commercially available from the Applicant under the trade name “Rooty 560”. The handpiece 12 includes an elongated cylindrical handle 18 for gripping by hand, and a female joint 24 for inserting a male joint 22 attached to the front end of the dental hose 20 is provided at the rear of the handle 18. . The male joint 22 and the female joint 24 include conventional ball lock mechanisms 23 and 25. When the female joint 24 and the male joint 22 are connected, compressed air is supplied from the dental unit (not shown) to the handpiece 12 through the dental hose 20.

  A compressed air driven vibrator 26 is arranged in the handle 18 as a vibration source. The vibrator 26 can be the one described in FIGS. 3 and 4 of US Pat. No. 4,453,919, the disclosure of which is incorporated herein, and a detailed description of the vibrator 26 is omitted. As shown in FIG. 4 of the above-mentioned U.S. Pat. No. 4, the vibrator 26 includes a vibration chamber that accommodates a disk-shaped vibrator. Vibration is generated by the child hitting the side wall of the vibration chamber. The compressed air passes through the compressed air supply port 28 of the male joint 22, the compressed air supply passage 30 in the handpiece 12, the compressed air filling chamber 32, and the compressed air inlet port pierced tangentially in the casing of the vibrator 26. 26 is injected into the vibration chamber 26 to generate a swirl flow in the vibration chamber.

  The vibrator 26 includes an output shaft 34 that is integral with the vibration chamber casing. The output shaft 34 is prevented from rotating with respect to the handle 18 by a rotation stopper pin 36. The vibrator 26 is elastically supported by the handle 18 by an anti-vibration O-ring 38 fitted to the output shaft 34.

  An elongated dental vibration tool 40 is connected to the vibrator 26 in a vibration transmission relationship. For this reason, the output shaft 34 of the vibrator 26 is provided with a female screw hole, and the male screw portion 42 of the vibration tool 40 is screwed into the female screw hole so that the vibration tool 40 is detachably mounted. In the illustrated embodiment, the vibration tool 40 is formed in the shape of a scaler for removing tartar.

As can be seen from FIG. 1, the vibration tool 40 is formed to be considerably elongated as compared with the conventional scaler.
Further, in order to place the distal end of the endoscope probe 14 and the distal end of the vibration tool 40 side by side, the vibration tool 40 is bent slightly downward at a predetermined position 44 in the length direction as illustrated.

Referring to FIG. 2, the vibration mode of the vibration tool 40 will be described. When the vibrator 26 is operated, vibration generated in the vibrator 26 is transmitted to the vibration tool 40 that is screwed to the output shaft 34, and the elongated vibration tool. In each part 40, vibration in a bending vibration mode as shown by a sine curve in FIG. In the case of such a sinusoidal bending vibration, a maximum amplitude portion 45 where the maximum amplitude displacement occurs along the length of the elongated vibration tool 40 and a portion where the displacement is zero (referred to as a “vibration node”). 47 or 47 exist (FIG. 2A).
The material, geometric shape, and length of the vibration tool 40 are such that the maximum amplitude portion 45 is located at the tip action portion (and the connecting portion 42) of the vibration tool 40, and the bending position 44 is at any vibration node 47. Must be set to come.
When the tip 41 of the vibration tool 40 is set at the maximum amplitude portion 45, the tip 41 of the vibration tool 40 performs an elliptical motion as indicated by reference numeral 46 in FIG. Do.
On the other hand, if the vibration tool 40 is bent at any vibration node 44 as shown in FIG. 2B, the vibration energy is lost as thermal energy, thereby minimizing vibration attenuation. can do. As a result, vibration is effectively transmitted to the tip 41 of the bent vibration tool 40.

  Referring to FIG. 1 again, the handpiece device 10 further includes an endoscope probe 14. An example of an endoscopic probe suitable for use in the handpiece device 10 of the present invention is “Solid Fiberscope MS-611” commercially available from Fibertech, or an equivalent thereof.

As shown in FIG. 3 in an enlarged manner, an image guide 48 for image transmission and a light guide 50 for illuminating the treatment area are extended in the endoscope probe 14, and the treatment area is cooled and cleaned. A water supply channel 52 for supplying water and a vacuum channel 54 for sucking out used cleaning cooling water from the treated portion are formed. The distal end of the image guide 48 is sealed by a lens 64.
When the handpiece device 10 is used, as shown in FIG. 1, the image guide 48 and the light guide 50 of the endoscope probe 14 are connected to an endoscope monitor 56 and an illumination light source 58, respectively. The channel 52 and the vacuum channel 54 are respectively connected to the pressure water source 60 and the vacuum source 62 via a stepping-off shut-off valve. The endoscope monitor 56 may be a stationary monitor or a body-mounted monitor that is attached to the head or arm of a dentist.

Preferably, the front portion of the endoscope probe 14 is bent slightly downward as shown in FIG. 1 so that the front portion of the vibration tool 40 and the bent front portion of the endoscope probe 14 extend in parallel. It has become.
Since the image guide 48 and the light guide 50 are embedded in a synthetic resin material and covered with a stainless steel sheath 66 as shown in FIG. 3, the endoscope probe 14 is sufficient to maintain its shape. Has waist strength (self-supporting). Therefore, when the distal end of the vibration tool 40 and the distal end of the endoscope probe 14 are integrated as will be described later, the endoscope probe 14 supports the weight of the distal end of the vibration tool 40 and applies a load applied to the distal end. You can counter it.

  When a commercially available endoscope probe is used as the endoscope probe 14, as shown in FIGS. 1 and 3C, the sheath 66 is cut out in a region other than the tip of the endoscope probe 14. Thus, the V groove 68 is formed. By storing the front section of the vibration tool 40 in the V-groove 68, the front section of the vibration tool 40 can be arranged in parallel along the endoscope probe 14 as shown in FIG. Become.

On the other hand, as shown in FIG. 1 and FIGS. 3A and 3B, in the distal end region 70 of the endoscope probe 14, the cross section of the sheath 66 is not notched, and the front portion of the vibration tool 40 Is inserted into the endoscope channel 72 in a detachable manner.
As described above, in the distal end region 70 of the endoscope probe 14, the endoscope probe 14 and the vibration tool 40 are inserted and fitted into the endoscope channel 72 of the endoscope probe 14. The tip region 70 comprises an integral means 70 for holding the endoscope probe 14 and the vibration tool 40 together in the region of the distal end 74 of the endoscope probe 14. It is composed.
As described above, the sheath 66 of the endoscope probe 14 supports the weight of the distal end of the vibration tool 40 and has a waist strength sufficient to counter the load applied to the distal end. By integrating the vibration tool 40 and the endoscope probe 14, the vibration tool 40 is supported at the distal end 74 of the endoscope probe 14.

As described above with reference to FIG. 2, the material, shape, and length of the vibration tool 40 are set so that the maximum amplitude portion of the bending vibration is brought to the tip 41 of the vibration tool 40. .
Further, the vibration tool 40 is preferably set so that the earliest vibration node 49 (see FIG. 2A) is brought around the distal end 74 of the endoscope probe 14. For this reason, it is preferable that the tip 41 of the vibration tool 40 protrudes forward from the distal end 74 of the endoscope probe 14 serving as the vibration node 44 by a length that is ¼ of the wavelength of the bending vibration (see FIG. 2 (a)).

  When the handpiece device 10 of the present invention is used as a scaler to remove subgingival calculus, the distal end 74 of the endoscopic probe 14 can be inserted into the periodontal pocket so that The diameter of the distal end 74 is preferably 1.5 mm or less. For this purpose, the diameter of the section inserted into the endoscope channel 72 of the vibration tool 40 is preferably 0.5 mm or less. The tip working portion 41 of the vibration tool 40 is formed in the shape of a scaling tip.

  When the handpiece device 10 is used, the handpiece 12 is connected to a dental unit (not shown) via the dental hose 20 by connecting the female joint 24 and the male joint 22. Further, the image guide 48 and the light guide 50 of the endoscope probe 14 are connected to the endoscope monitor 56 and the illumination light source 58, respectively, and the water supply channel 52 and the vacuum channel 54 are connected to the pressure water source 60 and the vacuum, respectively. Connect to source 62.

To remove the subgingival calculus, the distal end 74 of the endoscope probe 14 is inserted into the patient's periodontal pocket 76 as shown in FIG. In FIG. 4A, 78 is enamel, 80 is dentin, 82 is gingiva, and 84 is calculus deposited on the surface of root cementum 86 under the gingival margin. If the diameter of the distal end 74 of the endoscope probe 14 is 1.5 mm or less, the probe distal end 74 can be inserted into the periodontal pocket 76.
Since the distal end working portion 41 of the vibration tool 40 and the image guide 48 are aligned with each other, and the distal end working portion 41 of the vibration tool 40 falls within the field of view of the image guide 48, the probe distal end 74 is placed in the periodontal pocket 76. The dentist can observe the action part 41 of the vibrating tool 40 and the treated part of the tooth with the endoscope monitor 56 when the light guide 50 is irradiated with illumination light.

  The shut-off valves of the pressure water source 60 and the vacuum source 62 are opened in advance to supply cleaning cooling water from the water supply channel 52 to the treated portion and supply compressed air while vacuuming the used cleaning cooling water through the vacuum channel 54. When the vibrator 26 is actuated, the tip 41 of the vibration tool 40 is elliptically moved around the distal end 74 of the endoscope probe 14 that becomes the earliest vibration node 49 as shown by a broken line in FIG. Vibrate while drawing. The dentist can appropriately and easily perform scaling of the calculus under the gingival margin while observing the situation in which the distal end working portion 41 acts on the treatment target portion with the endoscope monitor 56.

  When treating the root canal using the handpiece device 10 of the present invention, the file 88 shown in FIG. 4B is used instead of the vibration tool 40 having the tip action portion 41 in the form of the scaling tip described above. It is possible to mount the vibration tool 40 having a tip action portion of the shape. Even in the case of root canal treatment, it is possible to perform root canal treatment while viewing the inside of the root canal with the endoscope monitor 56.

FIG. 5 shows a variation of the handpiece device 10 shown in FIGS. Components common to those shown in FIGS. 1 to 3 are denoted by the same reference numerals, and redundant description is omitted.
Only the difference will be described. In this variation, the dental vibratory handpiece 12 and the endoscope probe 14 are mounted on a cylindrical holder 90 that can be gripped by hand, and the vibration tool 40 of The front part and the distal end 74 of the endoscope probe 14 are integrated by a holding cylinder 92 for integration attached to the front end of the holder 90.

More specifically, the holder 90 has a main body 96 in which a handle 94 of the endoscope probe 14 is fitted, and an upper ring 98 integral with the main body 96, and the front portion of the dental handpiece 12 is attached to the upper ring 98. The handpiece 12 is fixed to the holder 90 by fitting. The cleaning cooling water supply pipe 99 extends from the handle 94.
As shown in an enlarged view in FIG. 5B, an integral holding cylinder 92 with a flange 100 is fitted in the opening at the front end of the holder 90. As shown in FIG. 5 (c), the holding cylinder 92 for integration has two axial holes 102 and 104 formed therein, and as shown in FIG. The vibration tool 40 is inserted, and the endoscope probe 14 is inserted into the axial hole 104.

Similar to the embodiment shown in FIGS. 1 to 3, the distal end 74 of the endoscope probe 14 is terminated at the distal end of the integral holding barrel 92, whereas the vibration tool 40 The tip protrudes from the distal end of the integrating holding cylinder 92 by a length that is 1/4 of the bending vibration wavelength. In addition, the vibration tool 40 is set so that the earliest vibration node is brought to the distal end of the holding cylinder 92 for integration.
Also in this variation, if the holding cylinder 92 for integration is made very thin so that it can be inserted into the periodontal pocket, the gingival margin is observed while observing with the endoscope monitor 56 as shown in FIG. The lower tartar can be removed.

FIG. 6 shows yet another variation of the handpiece device 10 shown in FIGS. Components common to those shown in FIGS. 1 to 3 are denoted by the same reference numerals, and redundant description is omitted.
Only the difference will be described. In this variation, the dental vibratory handpiece 12 includes a piezoelectric ultrasonic vibrator 110 driven by ultrasonic power supplied from a control unit (not shown) as a vibration source. ing.

Experimental example

A device that is almost the same as the handpiece device 10 shown in FIG. This prototype includes a compressed air-driven dental vibrating handpiece manufactured and sold by the applicant under the trade name “Rooty 560”, and an endoscope probe “Solid Fiber” manufactured and sold by Fibertech. The scope MS-611 "is connected using the holder 90 shown in FIG. The difference between the prototype and the handpiece device 10 shown in FIG. 5 is that the integration holding cylinder 92 is arranged coaxially with the holder 90, and for this reason, the vibration tool is bent at two points. .
The free length of the vibration tool used was 100 mm.
First, a vibration tool in a straight state was attached to the vibrator, the vibrator was operated to vibrate the vibration tool, and the position of the vibration node was examined. As a result, 5 mm, 19.6 mm, and 35 from the free end of the vibration tool. There were vibration nodes at the positions of .5 mm, 51.4 mm, 67.3 mm and 80 mm. On the other hand, the free end of the vibration tool was located at the maximum amplitude portion.
Next, the vibration node is bent at two vibration nodes located at 35.5 mm and 67.3 mm from the free end of the vibration tool so that the front part of the vibration tool is parallel to the endoscope probe. did. The vibration tool bent in this way was attached to a vibrator, and the distal end of the endoscope probe and the tip of the vibration tool were integrated by inserting the tip of the vibration tool into the holding cylinder 92 for integration.
While the vibrator was activated and the vibration tool was vibrated at 5,000 Hz, the tip of the vibration tool was pressed against the gypsum plate to test the removal performance of the tartar. In rare cases, satisfactory tartar removal ability was confirmed.

Although specific embodiments of the present invention have been described above, the present invention is not limited to them, and various modifications and changes can be made. For example, as a vibration source, other types of pneumatic vibrators or electrostrictive vibrators can be used. A light guide for transmitting light from the light source to the treatment site may be provided in the handpiece instead of being provided in the endoscope probe.

10: Dental vibratory handpiece device 12: Dental vibratory handpiece 14: Endoscopic probe 20: Dental hose 26: Vibration source (vibrator)
34: Vibrator output shaft 40: Dental vibration tool 41: Tip working portion of vibration tool 45: Maximum amplitude portion 47: Vibration node 48: Image guide 49: Earliest vibration node 50: Light guide 56: Internal view Mirror monitor 58: Light source 70: Integration means 74: Distal end of endoscope probe


Patent applicant Micron Co., Ltd. Attorney Hiroshi Ito

Claims (11)

A dental vibratory handpiece device with an endoscopic probe that allows a dental procedure to be performed while endoscopically observing a treatment site:
A dental vibratory handpiece comprising an elongated dental vibratory tool comprising a vibration source driven by a drive medium supplied from a dental unit or the like and connected to the vibration source in a vibration transmission relationship;
An endoscopic probe comprising an image guide for transmitting an image of a treated portion to an endoscopic monitor , on the one hand being separably fixed to the dental vibratory handpiece ;
Integrated means for holding the elongated dental vibrating tool and the endoscopic probe side by side in the region of the distal end of the endoscopic probe, wherein the endoscopic probe is on the other side Integrated means enabling to support the dental vibration tool ;
The endoscope probe has sufficient self-supporting ability to support the weight of the tip of the vibration tool and to resist the load applied to the tip of the vibration tool when the vibration tool is integrally held by the integration means. And
In the vibration tool, the first vibration node of the bending vibration generated in the vibration tool when being vibrated by the vibration source coincides with the distal end of the endoscope probe, and the distal end of the endoscope probe The tip of the tool that protrudes further forward is set so as to be located at the maximum amplitude portion of the bending vibration, and when the vibration source vibrates, the tip of the vibration tool A dental vibration type handpiece device which acts on a tooth while vibrating by drawing an elliptical motion around a distal end of an endoscope probe serving as a vibration node. The dental probe according to claim 1, wherein a diameter of a distal end of the endoscope probe is smaller than 2.0 mm, and the distal end of the endoscope probe can be inserted into a periodontal pocket. Handpiece device. The dental handpiece device according to claim 2, wherein a diameter of a distal end of the endoscope probe is smaller than 1.5 mm. 4. A dental handpiece device according to claim 1, wherein the diameter of the dental vibration tool at the distal end of the endoscope probe is less than 1.0 mm. The dental handpiece device according to claim 4, wherein the diameter of the dental vibration tool at the distal end of the endoscope probe is less than 0.5 mm. The dental handpiece device according to any one of claims 1 to 5, wherein the vibration tool is bent at a node of another vibration generated in the vibration tool when being vibrated by the vibration source. The dental handpiece device according to any one of claims 1 to 6, wherein the action portion of the vibration tool has a function of any one of a scaling tip, a file, and a reamer. The dental handpiece device according to any one of claims 1 to 7, wherein the endoscope probe has a water supply channel for supplying cooling cleaning water to a treatment target portion. 9. The dental handpiece device according to claim 8, wherein the endoscope probe further includes a vacuum channel for sucking and removing used cooling washing water from the region to be treated. The dental handpiece device according to any one of claims 1 to 9, wherein the endoscope probe further includes a light guide for transmitting illumination light to the treatment target portion. The dental probe according to any one of claims 1 to 10, wherein the endoscope probe is connected to a body-mounted monitor attached to a dentist's head or arm when the dental handpiece device is used. Handpiece device.

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