U.S. patent application number 15/355491 was filed with the patent office on 2017-10-05 for dental treatment system.
The applicant listed for this patent is SONENDO, INC.. Invention is credited to Bjarne Bergheim, Jennifer Chen, Alexis Dechelette, Mehrzad Khakpour.
Application Number | 20170281305 15/355491 |
Document ID | / |
Family ID | 50185024 |
Filed Date | 2017-10-05 |
United States Patent
Application |
20170281305 |
Kind Code |
A1 |
Bergheim; Bjarne ; et
al. |
October 5, 2017 |
DENTAL TREATMENT SYSTEM
Abstract
A dental treatment system can include a console, a tooth
coupler, and an interface member that provides at least one of
fluidic, electrical, mechanical, and data communication between the
tooth coupler and the console. The tooth coupler (which may
comprise a handpiece or a treatment cap) can act as a working end
of the system to administer a suitable treatment procedure, such as
a cleaning procedure, an obturation procedure, a restoration
procedure, etc. The tooth coupler can removably engage the
interface member such that the clinician can easily engage and
disengage the tooth coupler and interface member.
Inventors: |
Bergheim; Bjarne; (Mission
Viejo, CA) ; Khakpour; Mehrzad; (Laguna Hills,
CA) ; Chen; Jennifer; (Irvine, CA) ;
Dechelette; Alexis; (Del Mar, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
SONENDO, INC. |
Laguna Hills |
CA |
US |
|
|
Family ID: |
50185024 |
Appl. No.: |
15/355491 |
Filed: |
November 18, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14172809 |
Feb 4, 2014 |
9504536 |
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15355491 |
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61760620 |
Feb 4, 2013 |
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61767741 |
Feb 21, 2013 |
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61767746 |
Feb 21, 2013 |
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61805110 |
Mar 25, 2013 |
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61864393 |
Aug 9, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61C 17/02 20130101;
A61C 5/40 20170201; A61C 17/0217 20130101; A61C 17/0202 20130101;
A61C 17/028 20130101; A61C 1/087 20130101; A61C 2204/005 20130101;
A61C 1/0061 20130101 |
International
Class: |
A61C 1/00 20060101
A61C001/00; A61C 17/02 20060101 A61C017/02; A61C 1/08 20060101
A61C001/08 |
Claims
1. An apparatus for delivering degassed pressurized liquids, the
apparatus comprising: a reservoir configured to be at least
partially filled with liquid; a degassing system in fluid
communication with the reservoir, the degassing system configured
to reduce the gas content of the liquid; a pressurization system
configured to pressurize the degassed liquid; and a fluid path
configured to convey the pressurized fluid to an interface.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. patent
application Ser. No. 14/172,809, filed Feb. 4, 2014, entitled
"DENTAL TREATMENT SYSTEM;" U.S. Provisional Patent Application No.
61/760,620, filed Feb. 4, 2013, entitled "METHODS FOR MAKING
ORIFICE FOR USE IN DENTISTRY;" U.S. Provisional Patent Application
No. 61/767,741, filed Feb. 21, 2013, entitled "APPARATUS AND
METHODS FOR TREATING ROOT CANALS OF TEETH;" U.S. Provisional Patent
Application No. 61/864,393, filed Aug. 9, 2013, entitled "APPARATUS
AND METHODS FOR TREATING ROOT CANALS OF TEETH;" U.S. Provisional
Patent Application No. 61/767,746, filed Feb. 21, 2013, entitled
"APPARATUS AND METHODS FOR SEALING TEETH;" U.S. Provisional Patent
Application No. 61/805,110, filed Mar. 25, 2013, entitled
"APPARATUS AND METHODS FOR SEALING TEETH;" each of which is hereby
incorporated by reference herein in its entirety and for all
purposes
BACKGROUND
Field of the Invention
[0002] The field relates generally to dental treatment systems,
and, in particular, to dental treatment systems having a dental
apparatus connected to a console.
Description of the Related Art
[0003] In conventional dental and endodontic procedures, mechanical
instruments such as drills, files, brushes, etc. are used to clean
unhealthy material from a tooth. For example, dentists often use
drills to mechanically break up carious regions (e.g., cavities) in
a surface of the tooth. Such procedures are often painful for the
patient and frequently do not remove all the diseased material.
Furthermore, in conventional root canal treatments, an opening is
drilled through the crown or side of a diseased tooth, and
endodontic files are inserted into the root canal system to open
the canal spaces and remove organic material therein. The root
canal is then filled with solid matter such as gutta percha or a
flowable obturation material, and the tooth is restored. However,
this procedure typically does not remove all organic material from
the canal spaces, which can lead to post-procedure complications
such as infection. In addition, motion of the endodontic file
and/or other sources of positive pressure may force organic
material through an apical opening into periapical tissues. In some
cases, an end of the endodontic file itself may pass through the
apical opening. Such events may result in trauma to the soft tissue
near the apical opening and lead to post-procedure complications.
Accordingly, there is a continuing need for improved dental and
endodontic treatments.
SUMMARY
[0004] Various non-limiting aspects of the present disclosure will
now be provided to illustrate features of the disclosed apparatus,
methods, and compositions. Examples of apparatus, methods, and
compositions for endodontic treatments are provided.
[0005] In one embodiment, a dental apparatus configured to treat a
tooth is disclosed. The apparatus can include a housing having a
proximal portion and a distal portion, the distal portion
configured to couple to the tooth. The apparatus can include a
fluid jet assembly coupled to the housing and configured to
generate a jet of fluid. The apparatus can include a high pressure
fluid supply line disposed in the housing and in fluid
communication with the fluid jet assembly. The high-pressure fluid
line can be adapted to convey pressurized liquid to the liquid jet
assembly. A connector can be disposed near the proximal portion of
the housing. The connector can be configured to removably couple to
an interface member in fluid or electrical communication with the
dental treatment system. The connector can include a shank and an
interior receiving chamber configured to receive a portion of the
interface member. The shank can include an engagement structure
disposed on its exterior surface and configured to interact with a
corresponding engagement structure on the interface member, the
receiving chamber extending distal of at least a portion of the
engagement structure on the shank.
[0006] The connector can further comprise threaded engagement
features configured to threadably couple to the interface member.
The threaded engagement features can comprise external threads
formed on an outer surface of the connector. The connector can
further comprise a first opening proximal to and in fluid
communication with the high-pressure fluid line and a second
opening disposed proximal the first opening. The second opening can
be larger than the first opening and configured to receive the
interface member. In some embodiments, a filter can be disposed
proximal a proximal end of the fluid supply line. One or more
gaskets can be disposed proximal the filter between the filter and
a proximal end of the apparatus. The one or more gaskets can
comprise at least one of a polyether ether ketone (PEEK) ring and
an ethylene propylene diene monomer (EPDM) rubber o-ring. In some
embodiments, the apparatus can comprise a handpiece. In other
embodiments, the apparatus can comprise a treatment cap configured
to attach to the tooth.
[0007] In another embodiment, a dental treatment system is
disclosed. The system can include an interface member configured to
connect a dental treatment apparatus to a console to provide at
least one of fluid and electrical communication between the console
and the treatment apparatus. The treatment apparatus can be
configured to couple the system to a tooth and comprising a
connector. The interface member can comprise an engagement
structure disposed at a distal portion of the interface member and
configured such that, when the engagement structure engages a
corresponding engagement structure of the connector, the interface
member and the dental treatment apparatus are secured along a
longitudinal direction of the system. The interface member can
include a swivel member disposed proximal the engagement structure,
the swivel member configured to permit relative rotation between
the interface member and the dental treatment apparatus.
[0008] In some embodiments, the treatment apparatus can comprise a
dental handpiece. In some embodiments, high pressure tubing can
extend through the distal portion and can be configured to engage
the dental treatment apparatus to provide fluid communication
between the tubing and a high pressure fluid supply line of the
treatment apparatus. The engagement structure of the interface
member can comprise an internal thread. The interface member can
include an outer shell and an inner shell. The swivel member can
comprise a projection extending inwardly from the outer shell into
a recess of the inner shell
[0009] In another embodiment, a dental treatment system is
disclosed. The system can include one or more fluid reservoirs
configured to supply fluid to the system. A pump can be configured
to pressurize the one or more fluids supplied to the system. The
system can comprise an interface configured to provide mechanical,
fluidic, or electronic communication with a tooth coupler
configured to couple to a tooth. The system can further include a
processing unit. The processing unit can comprise a controller
module configured to control the operation of the pump and a
management module configured to manage data related to one or more
dental treatment procedures performed by the system.
[0010] In some embodiments, the system can include a console,
wherein the fluid reservoirs, the pump, the interface, and the
processing unit are housed in or on the console. The processing
unit can further comprise a communications module configured to
communicate over a network with one or more external systems. In
some embodiments, the communications module can be configured to
send to or receive from the one or more external systems the data
related to the one or more treatment procedures. In some
embodiments, the communications module can be configured to
communicate with at least one of an emergency system, an imaging
system, a patient data management system, an office inventory
system, and a patient scheduling system. The communications module
can be configured to communicate with the office inventory system
to indicate when system components or materials should be ordered.
In some embodiments, the tooth coupler can include a handpiece. The
system can further include a degassing system in fluid
communication with the one or more fluid reservoirs, the degassing
system configured to remove dissolve gases from the fluid supplied
to the system. The system can also include a mixing system in fluid
communication with the one or more fluid reservoirs, the mixing
system configured to mix a plurality of fluids together.
[0011] In another embodiment, a dental treatment apparatus for
treating a tooth is disclosed. The apparatus can comprise a housing
and a treatment assembly coupled to the housing. The treatment
assembly can be configured to perform a treatment procedure on the
tooth. The apparatus can include a communications chip coupled to
the housing. The communications chip can be configured to
communicate information about at least one of the treatment
procedure and the dental treatment apparatus to a communications
reader.
[0012] In some embodiments, the housing can be configured to
removably couple to a console. The communications chip can comprise
a wireless chip, and the wireless chip can be configured to
wirelessly transmit the information to the reader. In various
embodiments, the wireless chip can comprise a radio frequency
identification (RFID) chip, and the reader can comprise a RFID
reader. The communications chip can be configured to communicate
information related to a number of treatment procedures performed
by the dental treatment apparatus. If the number of treatment
procedures performed by the dental treatment apparatus is greater
than a predetermined number, one of the communications chip and the
reader can be configured to disable the dental treatment apparatus.
In some arrangements, the predetermined number can be one. The
communications chip can be configured to communicate identifying
information regarding the particular dental treatment apparatus.
The identifying information can comprise at least one of serial
number, lot number, date of manufacture, and name of manufacturer.
In some embodiments, if the identifying information indicates that
the dental treatment apparatus is an unauthorized apparatus, one of
the communications chip and the reader can be configured to disable
the dental treatment apparatus.
[0013] In some embodiments, the communications chip can be
configured to communicate status information relating to a status
of a treatment procedure. The communications chip can be configured
to communicate information about the treatment procedure relating
to at least one of treatment type, treatment duration, patient
name, treatment outcome, and degree of completeness of procedure.
In some embodiments, the housing can comprise a dental handpiece.
The communications chip can be configured to communicate
information related to a type of the handpiece. In some
embodiments, the treatment assembly can comprise a pressure wave
generator, which can be a fluid jet device in some embodiments.
[0014] In yet another embodiment, a dental treatment system is
disclosed. The system can include a console and one or more
conduits coupled to the console. The system can include a reader in
data communication with the console. The system can include a
dental treatment apparatus configured to removably couple to the
one or more conduits, the one or more conduits providing at least
one of fluidic, electrical, and data communication between the
console and the dental treatment apparatus when coupled to the
dental treatment apparatus. The dental treatment apparatus can
comprise a memory device coupled thereto. The memory device can be
configured to communicate information about at least one of the
treatment procedure and the dental treatment apparatus to the
reader.
[0015] In some embodiments, the memory device can comprise a
communications chip. The communications chip can comprise a
wireless chip, the wireless chip configured to wirelessly transmit
the information to the reader. In some embodiments, the wireless
chip comprises a radio frequency identification (RFID) chip, and
the reader comprises a RFID reader. The communications chip can be
configured to communicate information related to a number of
treatment procedures performed by the dental treatment apparatus to
the reader. If the number of treatment procedures performed by the
dental treatment apparatus is greater than a predetermined number,
the reader can be configured to communicate with the console to
prevent the dental apparatus from being used in a treatment
procedure. The predetermined number can be one in some embodiments.
The communications chip can be configured to communicate
identifying information regarding the particular dental treatment
apparatus to the reader. The identifying information can comprise
at least one of serial number, lot number, date of manufacture, and
name of manufacturer. If the identifying information indicates that
the dental treatment apparatus is an unauthorized apparatus, the
reader can be configured to communicate with the console to prevent
the dental apparatus from being used in a treatment procedure.
[0016] In some embodiments, the communications chip can be
configured to communicate status information relating to a status
of a treatment procedure. The communications chip can be configured
to communicate to the reader information about the treatment
procedure relating to at least one of treatment type, treatment
duration, patient name, treatment outcome, and degree of
completeness of procedure. The reader can be configured to
communicate to the console information about the treatment
procedure relating to at least one of treatment type, treatment
duration, patient name, treatment outcome, and degree of
completeness of procedure. The console can be configured to
communicate the information about the treatment procedure to a
patient data management system.
[0017] In another embodiment, an apparatus for treating a tooth is
disclosed. The apparatus can include a handpiece and an occlusal
magnet configured to be attached to the tooth. The apparatus can
include a handpiece magnet coupled to the handpiece, the handpiece
magnet configured to magnetically couple to the occlusal magnet to
substantially seal or attach the handpiece to the tooth.
[0018] In some embodiments, the apparatus can include one or more
spacer magnets configured to be disposed between the occlusal
magnet and the handpiece magnet, the one or more spacer magnets
configured to magnetically couple to the occlusal magnet and the
handpiece magnet. The occlusal magnet can have an opening formed
therethrough that defines an inner diameter. The one or more spacer
magnets each may have an opening formed therethrough that defines
an inner diameter. The inner diameter of the occlusal magnet may be
substantially the same as the inner diameter(s) of the one or more
spacer magnets.
[0019] A pressure wave generator can be coupled to a distal portion
of the handpiece. The pressure wave generator can be configured to
pass through an opening of the handpiece magnet, the opening(s) of
the spacer magnet(s), and the opening of the occlusal magnet. In
some embodiments, a magnetic strength between the occlusal magnet
and a spacer magnet adjacent the occlusal magnet can be less than a
magnetic strength between the handpiece magnet and a spacer magnet
adjacent the handpiece magnet. A magnetic strength between the
occlusal magnet and a spacer magnet adjacent the occlusal magnet
can be less than a magnetic strength between two adjacent spacer
magnets. The one or more spacer magnets can be configured to align
the occlusal magnet with the handpiece magnet. The one or more
spacer magnets can be configured to offset the handpiece from a
portion of the tooth by a separation distance.
[0020] In yet another embodiment, an apparatus for treating a tooth
is disclosed. The apparatus can include a handpiece and an
attachment member configured to be attached to the tooth. An
alignment member can be configured to align a distal end portion of
the handpiece with the attachment member when the attachment member
is attached to the tooth. The alignment member and the attachment
member can be configured to seal the tooth the handpiece.
[0021] In some embodiments, the attachment member can comprise an
occlusal magnet, and the alignment member can comprise a handpiece
magnet coupled to the handpiece. One or more spacer magnets can be
configured to couple the handpiece magnet to the occlusal magnet.
In various embodiments, the alignment member and the attachment
member can be configured to seal the tooth to the handpiece when
the user rotates the handpiece relative to the tooth. In other
embodiments, the alignment member and the attachment member can be
configured to disengage when the user rotates the handpiece. In
some embodiments, the user can engage the magnets to couple to the
tooth by translating the alignment member towards the attachment
member.
[0022] In another embodiment, a method of manufacturing a nozzle
for a liquid jet device is disclosed. The method can comprise
forming a first hole through a first plate. The method can include
forming a second hole through a second plate, the second hole
larger than the first hole. The method can include attaching the
first plate to the second plate such that the first hole is aligned
with the second hole, wherein a perimeter of the first hole is
completely within a perimeter of the second hole.
[0023] In some embodiments, forming the first hole can comprise
cutting through a thickness of the first plate such that side walls
of the first hole have a first surface roughness, and forming the
second hole can comprise cutting through a thickness of the second
plate such that side walls of the second hole have a second surface
roughness, the second surface roughness being rougher than the
first surface roughness. In some embodiments, forming the first
hole can comprise cutting the first hole using a laser. In some
embodiments, forming the first hole can comprise cutting the first
hole using electric discharge machining (EDM). In some embodiments,
forming the second hole can comprise cutting the first hole using a
mechanical tool.
[0024] In another embodiment, a method of manufacturing a nozzle
for a liquid jet device is disclosed. The method can comprise
forming a top trench partially through a thickness of a plate in a
top side of the plate. The method can further comprise forming a
bottom trench partially through the thickness of the plate in a
bottom side of the plate until the bottom trench meets the top
trench to define a through hole between the top and bottom sides of
the plate. The top trench can have a width smaller than a width of
the bottom trench.
[0025] In some embodiments, the top and bottom trenches can
comprise substantially circular trenches.
[0026] In another embodiment, a dental apparatus configured to
treat a tooth is disclosed. The apparatus can include a housing
having a proximal portion and a distal portion, the distal portion
configured to couple to the tooth. The apparatus can include a
liquid jet assembly coupled to the housing and configured to
generate a jet of liquid. The apparatus can include a high-pressure
fluid line disposed in the housing and in fluid communication with
the liquid jet assembly, the high-pressure fluid line adapted to
convey pressurized liquid to the liquid jet assembly. The apparatus
can include a connector disposed near the proximal portion of the
housing, the connector configured to removably couple to an
interface member in fluid or electrical communication with the
dental treatment system.
[0027] In some embodiments, the apparatus comprises a first opening
proximal to and in fluid communication with the high-pressure fluid
line, and a second opening disposed proximal the first opening, the
second opening larger than the first opening and configured to
receive the interface member. In some embodiments, the dental
apparatus can comprise a dental handpiece. In other embodiments,
the apparatus can comprise a treatment cap. The engagement feature
can comprise a recess formed in an outer surface of the connector.
The recess can be a groove.
[0028] In one embodiment, a method for engaging a dental treatment
apparatus with an interface member in communication with a dental
console is disclosed. The dental apparatus can be configured to
treat a tooth and can have a connector. The method can include
inserting one of the connector and the interface member into the
other of connector and the interface member. The method can further
include securing the connector to the interface member by
translating the connector and the interface member towards one
another until the connector and the interface member are secured
together. The method can further include after securing the
connector to the interface member, releasing the connector from the
interface member by rotating the interface member relative to the
connector and translating the connector and interface member
towards one another to disengage the connector and interface
member.
[0029] In another embodiment, a dental treatment system is
disclosed. The system can include an interface member configured to
connect a tooth coupler or dental treatment apparatus to a console
to provide at least one of fluid and electrical communication
between the console and the tooth coupler, the tooth coupler
configured to couple the system to a tooth and comprising a
connector. The interface member can comprise an inner shell and an
outer shell rotatably engaged with the inner shell, the outer shell
comprising a projection on an inner surface of the outer shell. The
interface member can comprise a slider disposed at least in part in
the outer shell. When the connector is translated towards the outer
shell, the connector can cause the slider to translate relative to
the outer shell until the projection of the outer shell engages a
recess of the connector to secure the outer shell to the connector.
When the inner shell is rotated relative to the outer shell and
urged towards the outer shell, the projection of the outer shell
can disengage from the recess of the connector to release the
interface member from the connector.
[0030] For purposes of this summary, certain aspects, advantages,
and novel features of certain disclosed inventions are summarized.
It is to be understood that not necessarily all such advantages may
be achieved in accordance with any particular embodiment of the
invention. Thus, for example, those skilled in the art will
recognize that the inventions disclosed herein may be embodied or
carried out in a manner that achieves one advantage or group of
advantages as taught herein without necessarily achieving other
advantages as may be taught or suggested herein. Further, the
foregoing is intended to summarize certain disclosed inventions and
is not intended to limit the scope of the inventions disclosed
herein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0031] The foregoing and other features, aspects, and advantages of
the embodiments of the apparatus and methods of cleaning teeth are
described in detail below with reference to the drawings of various
embodiments, which are intended to illustrate and not to limit the
embodiments of the invention. The drawings comprise the following
figures in which:
[0032] FIG. 1A is a schematic diagram of a system, in accordance
various embodiments disclosed herein.
[0033] FIG. 1B is a schematic diagram of a system that includes
components capable of removing unhealthy or undesirable material
from a treatment region on an exterior surface of the tooth and/or
gums.
[0034] FIG. 1C is a schematic diagram of a system in which the
tooth coupler comprises a dental handpiece.
[0035] FIG. 1D is a schematic diagram of a system in which the
tooth coupler comprises a treatment cap.
[0036] FIGS. 2A and 2B are graphs that schematically illustrate
possible examples of power that can be generated by different
embodiments of a pressure wave generator.
[0037] FIG. 2C is a graph of an acoustic power spectrum generated
at multiple frequencies by pressure wave generators disclosed
herein.
[0038] FIG. 3A illustrates images of root canals that compare the
use of non-degassed liquid and degassed liquid in the disclosed
pressure wave generators.
[0039] FIG. 3B is a plot comparing the power output for techniques
using non-degassed and degassed liquids.
[0040] FIG. 4 is a schematic perspective view of an example
console.
[0041] FIG. 4A is a schematic perspective view of a console in
accordance with another embodiment.
[0042] FIG. 5A is a schematic system diagram of a dental treatment
system, according to some embodiments.
[0043] FIG. 5B is a schematic system diagram of the system,
according to another embodiment.
[0044] FIG. 5C is a schematic system diagram of the system
according to some embodiments.
[0045] FIG. 5D is a schematic system diagram of a system, according
to another embodiment.
[0046] FIG. 5E is a schematic system diagram of an evacuation
system configured to apply vacuum pressure to various components of
the system.
[0047] FIG. 5F is a schematic diagram of a processing unit,
according to some embodiments.
[0048] FIG. 5G is a schematic diagram of the system and various
network relationships the system may have with external
systems.
[0049] FIG. 5H is a front perspective view of a system having a
console comprising a housing, according to one embodiment.
[0050] FIG. 5I is a rear perspective view of the system shown in
FIG. 5H.
[0051] FIG. 6 is a schematic side view of a tooth coupler
comprising a liquid jet device.
[0052] FIGS. 7A-7C are schematic, side cross-sectional views of a
nozzle, in accordance with various embodiments.
[0053] FIG. 8A is a perspective view of a nozzle with a
substantially cylindrical orifice.
[0054] FIG. 8B is a top plan view of the nozzle in which edges of
the orifice are relatively rough.
[0055] FIG. 8C is a side cross-sectional view of a nozzle in which
edges of the orifice are relatively sharp and the walls of the
orifice are relatively smooth.
[0056] FIG. 8D is a side cross-sectional view of the nozzle of FIG.
8B with rough edges.
[0057] FIG. 8E is a side cross-sectional view of the nozzle, in
which the edges of the nozzle are removed and/or rounded.
[0058] FIGS. 9A-9I are side cross-sectional views of example nozzle
profiles, according to various embodiments.
[0059] FIGS. 10A-10C are side cross-sectional views of a nozzle at
various stages of an example manufacturing process.
[0060] FIG. 11 is a schematic side cross-sectional view of a
partially fabricated nozzle, according to another embodiment.
[0061] FIG. 12A is a schematic side view of a handpiece, in
accordance with one embodiment.
[0062] FIG. 12B is a side cross-sectional view of the handpiece
shown in FIG. 12A.
[0063] FIG. 12C is a schematic side view of a handpiece, in
accordance with another embodiment.
[0064] FIG. 12D is a side cross-sectional view of the handpiece
shown in FIG. 12C.
[0065] FIG. 13 is a schematic side view of a system in which the
tooth coupler comprises a treatment cap 3B.
[0066] FIG. 14A schematically illustrates an example of a sizer
inserted into a tooth chamber of an example tooth.
[0067] FIG. 14B schematically illustrates another example of a
sizer inserted into the tooth chamber of a tooth.
[0068] FIG. 15A is a schematic side view of a tooth coupler
comprising a handpiece coupled to a tooth for a root canal
treatment procedure.
[0069] FIG. 15B is a schematic side cross-sectional view of a
distal end of the handpiece illustrated in FIG. 15A.
[0070] FIG. 15C is an enlarged cross-sectional view of the distal
end of the handpiece shown in FIG. 15B.
[0071] FIG. 16A is a perspective, exploded view of one embodiment
of a handpiece configured to couple to a treatment tooth by way of
a magnetic seal assembly.
[0072] FIG. 16B is a schematic side view of the handpiece coupled
to the tooth with the magnetic seal assembly.
[0073] FIG. 16C is a side cross-sectional view of the handpiece and
magnetic seal assembly shown in FIG. 16B.
[0074] FIG. 17A is a perspective, exploded view of one embodiment
of a handpiece configured to couple to a treatment tooth by way of
a magnetic seal assembly.
[0075] FIG. 17B is a schematic side view of the handpiece coupled
to the tooth with the magnetic seal assembly.
[0076] FIG. 17C is a side cross-sectional view of the magnetic
sealing assembly disclosed in FIG. 17B.
[0077] FIG. 18 is a schematic side view of a handpiece coupled to a
treatment tooth.
[0078] FIG. 19 is a schematic illustration of a multipoled magnet
configured for use in various magnets of the disclosed magnetic
assemblies.
[0079] FIG. 20A is a three-dimensional perspective view of an
interface member, according to one embodiment.
[0080] FIG. 20B is a three-dimensional perspective, exploded view
of the interface member shown in FIG. 20A.
[0081] FIG. 21 is a three-dimensional perspective view of a
handpiece and interface member prior to engagement.
[0082] FIG. 22A is a side view of the handpiece and the interface
member before inserting the connector into the interface
member.
[0083] FIG. 22B is a side view of the handpiece and the interface
member after aligning the connector with the interface member.
[0084] FIG. 22C is a side view of the handpiece and the interface
member in the engaged configuration.
[0085] FIG. 23A is a side cross-sectional view of the arrangement
shown in FIG. 22A.
[0086] FIG. 23B is a side cross-sectional view of the arrangement
shown in FIG. 22B.
[0087] FIG. 23C is a side cross-sectional view of the engaged
configuration illustrated in FIG. 22C.
[0088] FIG. 24A is a three-dimensional perspective view of the
handpiece coupled to the interface member prior to
disengagement.
[0089] FIG. 24B is a three-dimensional perspective view of the
handpiece when the latch is substantially aligned with the
notch.
[0090] FIG. 24C is a three-dimensional perspective view of the
handpiece and interface member after disconnection.
[0091] FIG. 25A is a three-dimensional perspective, cross-sectional
view of an interface member according to another embodiment.
[0092] FIG. 25B is a three-dimensional perspective view of the
interface member of FIG. 25A in the disengaged configuration.
[0093] FIG. 25C is a three-dimensional perspective view of the
interface member of FIG. 25A in the engaged configuration.
[0094] FIG. 26A is a perspective exploded view of a handpiece and
interface member before engagement, in accordance with another
embodiment.
[0095] FIG. 26B is a perspective, cross-sectional view of the
handpiece and interface member illustrated in FIG. 26A.
[0096] FIG. 26C is a side cross-sectional view of the handpiece of
FIGS. 26A-26B before engagement with the interface member.
[0097] FIG. 26D is a side cross-sectional view of the handpiece of
FIGS. 26A-26B after engagement with the interface member.
[0098] FIG. 27A is a side cross-sectional view of a handpiece and
interface member prior to engagement, according to yet another
embodiment.
[0099] FIG. 27B is a side cross-sectional view of the handpiece and
interface member shown in FIG. 27A after engagement.
[0100] FIG. 28 is a schematic perspective view of a handpiece
having a communications chip coupled thereto and configured to
communicate with a wireless reader.
[0101] Throughout the drawings, reference numbers may be re-used to
indicate a general correspondence between referenced elements. The
drawings are provided to illustrate example embodiments described
herein and are not intended to limit the scope of the
disclosure.
DETAILED DESCRIPTION
[0102] The present disclosure describes systems, apparatus,
methods, and compositions for performing dental and/or endodontic
procedures. Various embodiments disclosed herein can effectively
and safely remove unhealthy material from a treatment region of a
tooth, e.g., from within the tooth and/or from outside surfaces of
the tooth. In particular, the embodiments disclosed herein can
remove unhealthy materials, such as unhealthy organic matter,
inorganic matter, pulp tissue, caries, stains, calculus, plaque,
biofilm, bacteria, pus, decayed tooth matter, and food remnants
from the treatment region without substantially damaging healthy
dentin or enamel. For example, the disclosed systems, apparatus,
methods, and compositions advantageously may be used with root
canal cleaning treatments, e.g., to efficiently remove unhealthy or
undesirable materials such as organic and/or inorganic matter from
a root canal system and/or to disinfect the root canal system. In
other arrangements, the disclosed systems, apparatus, methods, and
compositions advantageously may be used with caries treatments,
hygiene treatments, obturation treatments, and/or restoration
treatments. Organic material (or organic matter) includes organic
substances typically found in healthy or diseased teeth or root
canal systems such as, for example, soft tissue, pulp, blood
vessels, nerves, connective tissue, cellular matter, pus, and
microorganisms, whether living, inflamed, infected, diseased,
necrotic, or decomposed. Inorganic matter includes calcified tissue
and calcified structures, which are frequently present in the root
canal system. In some embodiments, the root canal can be filled
with an obturation material (e.g., a flowable obturation material
that can be hardened into a solid or semi-solid state, gutta percha
or other solid or semi-solid materials) after treatment of the root
canal.
[0103] Various systems disclosed herein can include a console and a
tooth coupler configured to couple to a tooth to perform a
treatment procedure. An interface member can connect the tooth
coupler to the console to provide mechanical, fluidic, data and/or
electrical connection between the tooth coupler and the console.
The clinician can interact with the console to initiate and control
various treatment procedures.
I. Overview of System and Methods
A. Overview of System Components
[0104] FIG. 1A is a schematic diagram of a system 1, in accordance
with the embodiments disclosed herein. The system 1 shown in FIG.
1A may be configured to perform various types of treatment
procedures, including, e.g., cleaning treatments, obturation
treatments, restoration treatments, etc. In the embodiment shown in
FIG. 1A, the system 1 is illustrated as being coupled to a tooth 10
that is a molar tooth of a mammal, such as a human. However, as
explained herein, the tooth 10 may be any other suitable type of
tooth, such as a pre-molar, bicuspid, incisor, canine, etc.
Furthermore, the system 1 shown in FIG. 1A can include components
capable of removing unhealthy or undesirable materials from a tooth
or surrounding gum tissue, for example, a root canal 13 of the
tooth 10.
[0105] The tooth 10 includes hard structural and protective layers,
including a hard layer of dentin 16 and a very hard outer layer of
enamel 17. A pulp cavity 11 is defined within the dentin 16. The
pulp cavity 11 comprises one or more root canals 13 extending
toward an apex 14 of each root 12. The pulp cavity 11 and root
canal 13 contain dental pulp, which is a soft, vascular tissue
comprising nerves, blood vessels, connective tissue, odontoblasts,
and other tissue and cellular components. Blood vessels and nerves
enter/exit the root canal 13 through a tiny opening, the apical
foramen or apical opening 15, near a tip of the apex 14 of the root
12. It should be appreciated that, although the tooth 10
illustrated herein is a molar, the embodiments disclosed herein can
advantageously be used to treat any suitable type of tooth,
including pre-molars, canines, incisors, etc.
[0106] As illustrated in FIG. 1A, the system 1 can be used to
remove unhealthy materials (such as organic and inorganic matter)
from an interior of the tooth 10, e.g., from the root canal 13 of
the tooth 10. For example, an endodontic access opening 18 can be
formed in the tooth 10, e.g., on an occlusal surface, a buccal
surface, or a lingual surface. The access opening 18 provides
access to a portion of a pulp cavity 11 of the tooth 10. The system
1 can include a console 2, a pressure wave generator 5, and a tooth
coupler 3 adapted to couple to the tooth 10. The tooth coupler 3
can couple to the tooth 10 in any suitable way. In some
arrangements, the tooth coupler 3 can attach to the tooth 10 by way
of a tooth seal 75. In some embodiments, the tooth coupler 3 can
define a chamber 6 configured to retain fluid therein. In some
embodiments, the pulp cavity 11 can define a tooth chamber
configured to retain fluid therein. In some embodiments, the tooth
coupler 3 may not define a chamber, and the tooth chamber defined
at least in part by the pulp cavity 11 can retain fluid.
[0107] A system interface member 4 can electrically, mechanically,
and/or fluidly connect the console 2 with the tooth coupler 3 and
pressure wave generator 5. For example, in some embodiments, the
system interface member 4 can removably couple the tooth coupler 3
to the console 2. In such embodiments, the clinician may use the
tooth coupler 3 one time (or a few times), and may dispose the
tooth coupler 3 after each procedure (or after a set number of
procedures). The console 2 and interface member 4 may be reused
multiple times to removably couple (e.g., to connect and/or
disconnect) to multiple tooth couplers 3 using suitable engagement
features, as discussed herein. The interface member 4 can include
various electrical and/or fluidic pathways to provide electrical,
electronic, and/or fluidic communication between the console 2 and
the tooth coupler 3. The console 2 can include a control system and
various fluid and/or electrical systems configured to operate the
pressure wave generator 5 during a treatment procedure. The console
2 can also include a management module configured to manage data
regarding the treatment procedure. As explained herein, the console
2 can include a communications module configured to communicate
with external entities about the treatment procedures.
[0108] The system 1 can be used in cleaning procedures to clean
substantially the entire root canal system. In other embodiments,
such as obturation procedures, the system 1 can be used to fill
substantially the entire root canal system with an obturation or
filler material. In still other procedures, the system 1 can be
used to restore a tooth 10. For example, in cleaning procedures,
the chamber 6 of the tooth coupler 3 and/or the pulp cavity 11 of
the tooth 10 can be at least partially (or substantially) filled
with a fluid 22. In various embodiments disclosed herein, the
pressure wave generator 5 can generate pressure waves 23 that
propagate through the fluid 22. The generated pressure waves 23 may
be of sufficient power and relatively low frequencies to produce
fluid motion 24 in the pulp cavity 11 of the tooth 10, the root
canal 13, and/or in the chamber 6 of the tooth coupler 4, and/or
the pressure wave generator 5 can generate pressure waves of
sufficient power and relatively higher frequencies to produce
surface effect cavitation and/or microscale fluid motion created by
the impact of the waves on a dental surface, either inside or
outside the tooth 10. That is, for example, the pressure wave
generators 5 disclosed herein can act as fluid motion generators to
generate large-scale or bulk fluid motion 24 in or near the tooth
10, and can also generate smaller-scale fluid motion at higher
frequencies. In some arrangements, the fluid motion 24 in the
chamber 6 can generate induced fluid motion such as vortices,
swirl, etc. in the tooth 10 and root canal 13 that can clean and/or
fill the canal 13. In some arrangements, the pressure waves 23 can
generate normal stress or shear stress or a combination of both
onto the surfaces within the treatment region. Additional systems
and methods for cleaning teeth, e.g., using pressure wave
generators that can include a liquid jet device, (including molars,
pre-molars, etc.) may be found in U.S. Patent Publication US
2007/0248932, in U.S. Patent Publication 2011/0117517, in U.S.
Patent Publication US 2012/0237893 and in U.S. patent application
Ser. No. 14/137,937, filed Dec. 20, 2013, titled "APPARATUS AND
METHODS FOR CLEANING TEETH AND ROOT CANALS," each of which is
incorporated by reference herein in its entirety and for all
purposes.
[0109] FIG. 1B is a schematic diagram of a system 1 that includes
components capable of removing unhealthy or undesirable material
from a treatment region 20 on an exterior surface of the tooth 10.
For example, as in FIG. 1A, the system 1 can include a tooth
coupler 3 and a pressure wave generator 5. The tooth coupler 3 can
communicate with a console 2 by way a system interface member 4.
Unlike the system 1 of FIG. 1A, however, the tooth coupler 3 is
coupled to a treatment region 20 on an exterior surface of the
tooth 10. For example, the system 1 of FIG. 1B can be activated to
clean an exterior surface of the tooth 10, e.g., a carious region
of the tooth 10 and/or remove undesirable dental deposits, such as
plaque, calculus biofilms, bacteria, etc, from the tooth 10 and/or
surround gum tissue. In other embodiments, the system 1 can be
activated to fill a treated region on the exterior surface of the
tooth 10 with a filling or restoration material. As with the
embodiment of FIG. 1A, pressure waves 23 and/or fluid motion 24 can
be generated in the tooth coupler 3 and chamber 6, which can act to
clean and/or fill the treatment region 20 of the tooth 10.
Additional details of systems and methods for treating carious
regions of teeth may be found in International Application
Publication WO 2013/142385 (PCT/US2013/032635), having an
international filing date of Mar. 15, 2013, entitled "APPARATUS AND
METHODS FOR CLEANING TEETH," which is incorporated by reference
herein in its entirety and for all purposes. Additional details of
systems and methods for removing undesirable dental deposits (such
as plaque, calculus, etc.) from teeth and/or gums may be found in
International Application Publication WO 2013/155492 (Application
No. PCT/US2013/036493), having an international filing date of Apr.
12, 2013, entitled "APPARATUS AND METHODS FOR CLEANING TEETH AND
GINGIVAL POCKETS," and in U.S. patent application Ser. No.
13/861,211, filed Apr. 11, 2013, entitled "APPARATUS AND METHODS
FOR CLEANING TEETH AND GINGIVAL POCKETS" each of which is
incorporated by reference herein in its entirety and for all
purposes.
[0110] The tooth coupler 3 disclosed herein can be any suitable
structure or housing configured to couple to the tooth 10 for a
treatment procedure. As used herein, "couple" is meant to include
arrangements in which there is a connection with the tooth 10, as
well as arrangements in which the coupler 3 is placed against or in
the tooth and is held by the clinician in that position. The
pressure wave generator 5 can be coupled to and/or disposed in or
on the tooth coupler 3. For example, FIG. 1C is a schematic diagram
of a system 1 in which the tooth coupler 3 comprises a dental
handpiece 3A. As explained in more detail herein, the dental
handpiece 3A can include a body or housing shaped to be gripped by
the clinician. In some embodiments, the pressure wave generator 5
can be coupled to or formed with a distal portion of the handpiece
3A. Before a treatment procedure (e.g., a cleaning procedure, an
obturation procedure, a restorative procedure, etc.), the clinician
can connect the handpiece 3A to the interface member 4 of the
system 1. The clinician can manipulate the handpiece 3A such that
the pressure wave generator 5 is positioned near the treatment
region on or in the tooth 10. The clinician can activate the
pressure wave generator 5 using controls on the console 2 and/or
the handpiece 3A, and can perform the desired treatment procedure.
After performing the treatment procedure, the clinician can
disconnect the handpiece 3A from the interface member 4 and can
remove the handpiece 3A from the system 1.
[0111] In other embodiments, the tooth coupler 3 can comprise a
treatment cap 3B, as shown in the schematic system diagram of FIG.
1D. In the embodiment of FIG. 1D, the pressure wave generator 5 may
be coupled to or disposed in or on the treatment cap 3B. The
clinician can connect the treatment cap 3B to the interface member
4. For example, in some embodiments, a hose or other type of tube
can connect the treatment cap 3B to the interface member 4. Before
the treatment procedure, the clinician can attach or directly
couple the treatment cap 3B to the treatment region of the tooth
10. For example, in some embodiments, the clinician can attach the
treatment cap 3B over an access opening 18 of the tooth 10 to place
the treatment cap 3B and pressure wave generator 5 in fluid
communication with the pulp cavity 11 and root canal 13 of the
tooth 10. In other embodiments, the clinician can attach the
treatment cap 3B over a treatment region on an exterior surface of
the tooth 10, e.g., over a carious region or a region that includes
unhealthy deposits, such as plaque, calculus, etc. In some
embodiments, the treatment cap 3B may be substantially sealed or
attached to the tooth 10 during the treatment procedure. For
example, after attaching the treatment cap 3B to the tooth 10, the
clinician may not or may only minimally manipulate the treatment
cap 3B relative to the tooth 10 during treatment. In other
arrangements, the clinician may still desire to move or reposition
the treatment cap 3B relative to the tooth 10 during treatment.
Once the treatment procedure is finished, the clinician can
disconnect the treatment cap 3B from the interface member 4 and can
remove the treatment cap 3B from the system 1.
B. Overview of Treatment Procedures
[0112] The system 1 disclosed herein can be used with various types
of treatment procedures. For example, some embodiments disclosed
herein can advantageously remove undesirable or unhealthy materials
from a tooth such that substantially all the unhealthy material is
removed while inducing minimal or no discomfort and/or pain in the
patient. For example, when activated by the clinician, the pressure
wave generator 5 can induce various fluidic effects that interact
with the unhealthy material to be removed, even when the pressure
wave generator 5 is disposed at a position remote from the
treatment region of the tooth, e.g., the region of the tooth that
includes the unhealthy or undesirable material to be removed. The
pressure wave generator 5 can impart energy to a fluid 22 that
induces the relatively large-scale or bulk circulation or movement
24 of liquid in the chamber 6 and/or tooth 10, and that also
generates pressure waves 23 that propagate through the fluid 22 and
tooth 10. The generated fluid motion 24 and pressure waves 23 can
magnify or enhance the properties of the fluid 22 to enhance
cleaning of the tooth 10. In some embodiments, the pressure wave
generator 5 can be used to obturate or fill the root canals and/or
other treated regions of the tooth, and can also be used to restore
or build up a damaged or diseased tooth.
[0113] 1. Enhancing the Cleaning of Teeth
[0114] The system 1 disclosed herein can be used to clean teeth.
For example, the system 1 can be configured to clean organic and
inorganic material, including diseased pulp, bacteria, etc., from
root canals of the tooth 10. In some embodiments, the system 1 can
be configured to remove carious regions of the tooth 10, e.g.,
regions of the tooth 10 that are decayed. The carious regions can
be formed on an exterior surface of the tooth 10 in some
arrangements. Moreover, the system 1 can be configured to clean
undesirable dental deposits from exterior surfaces of the tooth 10,
including plaque, calculus, biofilms, bacteria, and other unhealthy
deposits. In some arrangements, the system 1 can utilize, alone or
in combination, the chemistry of various treatment fluids, pressure
waves generated by the pressure wave generator 5, and fluid motion
24 created in the chamber 6 of the tooth coupler 3 and/or in a
chamber within the tooth 10.
[0115] a. Chemistry of Various Treatment Fluids
[0116] In cleaning procedures, the fluid 22 supplied to the chamber
6 and/or to the pulp cavity 11 of the tooth 10 can comprise a
treatment fluid that can be introduced into the tooth 10 and the
chamber 6 to assist in removing unhealthy or undesirable materials
from the tooth 10. The treatment fluids can be selected based on
the chemical properties of the fluids when reacting with the
undesirable or unhealthy material to be removed from the tooth 10.
The treatment fluids disclosed herein can include any suitable
fluid, including, e.g., water, saline, etc. Various chemicals can
be added to treatment fluid for various purposes, including, e.g.,
tissue dissolving agents (e.g., NaOCl or bleach), disinfectants
(e.g., chlorhexidine), anesthesia, fluoride therapy agents,
ethylenediaminetetraacetic acid (EDTA), citric acid, and any other
suitable chemicals. For example, any other antibacterial,
decalcifying, disinfecting, mineralizing, or whitening solutions
may be used as well. The clinician can supply the various fluids to
the tooth in one or more treatment cycles, and can supply different
fluids sequentially or simultaneously.
[0117] During some treatment cycles, bleach-based solutions (e.g.,
solutions including NaOCl) can be used to dissociate diseased
tissue (e.g., diseased organic matter in the root canal 13) and/or
to remove bacteria, biofilm or endotoxins (Lipopolysaccharide or
LPS) from the tooth 10. One example of a treatment solution
comprises water or saline with 0.3% to 6% bleach (NaOCl). In some
methods, tissue dissolution and dental deposit removal in the
presence of bleach may not occur when the bleach concentration is
less than 1%. In some treatment methods disclosed herein, tissue
dissolution and dental deposit removal can occur at smaller (or
much smaller) concentrations.
[0118] During other treatment cycles, the clinician can supply an
EDTA-based solution to remove undesirable or unhealthy calcified
material from the tooth 10. For example, if a portion of the tooth
10 and/or root canal 13 is shaped or otherwise instrumented during
the procedure, a smear layer may form on the walls of the canal 13.
The smear layer can include a semi-crystalline layer of debris,
which may include remnants of pulp, bacteria, dentin, and other
materials. Treatment fluids that include EDTA may be used to remove
part or all of the smear layer, and/or calcified deposits on the
tooth 10. EDTA may also be used to remove dentin packed into
isthmuses and lateral canals during the instrumentation process.
EDTA may also be used to remove a microscopic layer off enamel and
cleaning and staining purposes. Other chemicals such as citric acid
may also be used for similar purposes.
[0119] During yet other cycles, for example, the clinician may
supply a treatment fluid that comprises substantially water. The
water can be used to assist in irrigating the tooth before, during,
and/or after the treatment. For example, the water can be supplied
to remove remnants of other treatment fluids (e.g., bleach or EDTA)
between treatment cycles. Because bleach has a pH that tends to be
a base and because EDTA is an acid, it can be important to purge
the tooth 10 and chamber 6 between bleach and EDTA treatments to
avoid potentially damaging chemical reactions. Furthermore, the
water can be supplied with a sufficient momentum to help remove
detached materials that are disrupted during the treatment. For
example, the water can be used to convey waste material from the
tooth 10.
[0120] Various solutions may be used in combination at the same
time or sequentially at suitable concentrations. In some
embodiments, chemicals and the concentrations of the chemicals can
be varied throughout the procedure by the clinician and/or by the
system to improve patient outcomes. For example, during an example
treatment procedure, the clinician can alternate between the use of
water, bleach, and EDTA, in order to achieve the advantages
associated with each of these chemicals. In one example, the
clinician may begin with a water cycle to clean out any initial
debris, then proceed with a bleach cycle to dissociate diseased
tissue and bacteria from the tooth. A water cycle may then be used
to remove the bleach and any remaining detached materials from the
tooth 10. The clinician may then supply EDTA to the tooth to remove
calcified deposits and/or portions of a smear layer from the tooth
10. Water can then be supplied to remove the EDTA and any remaining
detached material from the tooth 10 before a subsequent bleach
cycle. The clinician can continually shift between cycles of
treatment fluid throughout the procedure. The above example is for
illustrative purposes only. It should be appreciated that the order
of the cycling of treatment liquids may vary in any suitable manner
and order.
[0121] Thus, the treatment fluids used in the embodiments disclosed
herein can react chemically with the undesirable or unhealthy
materials to dissociate the unhealthy materials from the healthy
portions of the tooth 10. The treatment fluids can also be used to
irrigate waste fluid and/or detached or delaminated materials out
of the tooth 10. In some embodiments, as explained in more detail
herein, the treatment solution (including any suitable composition)
can be degassed, which may improve cavitation and/or reduce the
presence of gas bubbles in some treatments. In some embodiments,
the dissolved gas content can be less than about 1% by volume.
[0122] b. Enhancement of Cleaning Using Pressure Waves and Examples
of Pressure Wave Generators
[0123] A pressure wave generator 5 can remove unhealthy materials
from a tooth by propagating pressure waves 23 through a propagation
medium such as the fluid 22 (e.g., the treatment fluid) to the
treatment region, which can include one or more teeth and/or gums.
Without being limited by theory, a few potential ways that the
pressure waves 23 remove undesirable materials are presented
herein. Note that these principles, and the principles described
above, may be generally applicable for each embodiment disclosed
herein.
[0124] In some arrangements, cavitation may be induced by the
generated pressure waves 23. Upon irradiation of a liquid (e.g.,
water or other treatment fluid) with high intensity pressure or
pressure waves 23, acoustic cavitation may occur. The oscillation
or the implosive collapse of small cavitation bubbles can produce
localized effects, which may further enhance the cleaning process,
e.g., by creating intense, small-scale localized heat, shock waves,
and/or microjets and shear flows. Therefore, in some treatment
methods, acoustic cavitation may be responsible for or involved in
enhancing the chemical reactions, sonochemistry, sonoporation, soft
tissue/cell/bacteria dissociation, delamination and breakup of
biofilms.
[0125] For example, if the treatment liquid contains chemical(s)
that act on a particular target material (e.g., diseased organic or
inorganic matter, stains, caries, dental calculus, plaque,
bacteria, biofilms, etc.), the pressure waves 23 (acoustic field)
and/or the subsequent acoustic cavitation may enhance the chemical
reaction via convection, turbulence, agitation and/or
sonochemistry. Indeed, the pressure waves 23 can enhance the
chemical effects that each composition has on the unhealthy
material to be removed from the tooth. For example, with a
bleach-based treatment fluid, the generated pressure waves 23 can
propagate so as to dissociate tissue throughout the entire tooth
10, including in the dentinal tubules and throughout tiny cracks
and crevices of the tooth 10. As another example, with an
EDTA-based treatment fluid, the generated pressure waves 23 can
propagate so as to remove the smear layer and/or calcified deposits
from the tooth 10, including in the tubules and/or in tiny cracks
and crevices formed in the tooth 10. With a water-based treatment
fluid, the generated pressure waves 23 can propagate so as to flush
and/or irrigate undesirable materials from the tooth, including in
tubules and tiny cracks and crevices. Accordingly, the generated
pressure waves 23 can enhance the removal of undesirable or
unhealthy materials from the tooth 10 by magnifying the chemical
effects of whatever treatment fluid composition is used during a
particular treatment cycle.
[0126] Furthermore, sonoporation, which is the process of using
pressure waves and/or the subsequent acoustic cavitation to modify
the permeability of the bacterial cell plasma membrane, may also
expedite the chemical reaction that removes the microorganisms from
the tooth. It should also be appreciated that generated pressure
waves, and/or the subsequent acoustic cavitation of certain
frequencies, may result in cellular and bacterial rupture and death
(e.g., lysis) as well as removal of decayed and weakened dentin and
enamel. The cellular and bacterial rupture phenomenon may kill
bacteria which might otherwise reinfect the gingival pockets and/or
the oral cavity.
[0127] Generated pressure waves and/or the subsequent acoustic
cavitation may also loosen the bond of the structure of the
unhealthy material (e.g., diseased tissue, calculus, biofilm,
caries, etc.), and/or the pressure waves may dissociate the
unhealthy material from the tooth 10. In some cases, pressure waves
and/or acoustic cavitation may loosen the bond between the cells
and the dentin and/or delaminate the tissue from the tooth.
Furthermore, the pressure waves and/or the subsequent acoustic
cavitation may act on decayed hard tissue (which may be relatively
weak and loosely connected) through vibrations and/or shock waves,
and/or the microjets created as a result of cavitation bubble
implosion, to remove decayed hard tissue from other healthy
portions of the tooth.
[0128] A pressure wave generator 5 can be used in various disclosed
embodiments to clean a tooth 10, e.g., from interior or exterior
portions of the tooth 10 and/or gums. In other embodiments, the
pressure wave generator 5 can be used to fill or obturate a cleaned
root canal or other treatment region of the tooth 10. In some
embodiments, the pressure wave generator 5 can comprise an
elongated member having an active distal end portion. The active
distal end portion can be activated by a user to apply energy to
the treatment tooth 10 to remove unhealthy or undesirable material
from the tooth 10.
[0129] As explained herein, the disclosed pressure wave generators
5 can be configured to generate pressure waves 23 and fluid motion
24 with energy sufficient to clean undesirable material from a
tooth 10. The pressure wave generator 5 can be a device that
converts one form of energy into acoustic waves and bulk fluid
motion (e.g., rotational motion) within the fluid 22. The pressure
wave generator 5 can induce, among other phenomena, both pressure
waves and bulk fluid dynamic motion in the fluid 22 (e.g., in the
chamber 6), fluid circulation, turbulence, vortices and other
conditions that can enable the cleaning of the tooth. The pressure
wave generator 5 disclosed in each of the figures described herein
may be any suitable type of pressure wave generator.
[0130] The pressure wave generator 5 can be used to clean the tooth
10 by creating pressure waves that propagate through the fluid 22,
e.g., through treatment fluid at least partially retained in the
chamber 6. In some implementations, the pressure wave generator 5
may also create cavitation, acoustic streaming, turbulence, etc.
The pressure wave generator 5 (e.g., high-speed liquid jet,
ultrasonic transducer, a laser fiber, etc.) can be placed at the
desired treatment location in or on the tooth 10. The pressure wave
generator 5 can create pressure waves 23 and fluid motion 24 within
the fluid 22 inside a substantially-enclosed chamber 6 and/or in a
tooth chamber of the tooth (e.g., the pulp cavity 11 and/or the
root canal 13). In general, the pressure wave generator 5 can be
sufficiently strong to remove unhealthy materials such as organic
and/or inorganic tissue from teeth 10. In some embodiments, the
pressure wave generator 5 can be configured to avoid substantially
breaking down or harming natural dentin and/or enamel.
[0131] i. Liquid Jet Apparatus
[0132] For example, in some embodiments, the pressure wave
generator 5 can comprise a liquid jet device. The liquid jet can be
created by passing high pressure liquid through an orifice. The
liquid jet can create pressure waves within the treatment liquid.
In some embodiments, the pressure wave generator 5 comprises a
coherent, collimated jet of liquid. The jet of liquid can interact
with liquid in a substantially-enclosed volume (e.g., the chamber
6, the tooth chamber (e.g., pulp cavity 11 and/or root canals 13),
and/or the mouth of the user) and/or an impingement member to
create the acoustic waves. In addition, the interaction of the jet
and the treatment fluid, as well as the interaction of the spray
which results from hitting the impingement member and the treatment
fluid, may assist in creating cavitation and/or other acoustic and
fluid motion effects to clean the tooth.
[0133] In various embodiments, the liquid jet device can comprise a
positioning member (e.g., a guide tube) having a channel or lumen
along which or through which a liquid jet can propagate. The distal
end portion of the positioning member can include one or more
openings that permit the deflected liquid to exit the positioning
member and interact with the surrounding environment in the chamber
6 and/or tooth 10. In some treatment methods, the openings disposed
at or near the distal end portion of the positioning member can be
submerged in liquid that can be at least partially enclosed in the
tooth coupler 3 attached to or enclosing a portion of the tooth 10.
In some embodiments, the liquid jet can pass through the guide tube
and can impact an impingement surface. The passage of the jet
through the surrounding treatment fluid and impact of the jet on
the impingement surface can generate the acoustic waves in some
implementations. The flow of the submerged portion of the liquid
jet may generate a cavitation cloud within the treatment fluid. The
creation and collapse of the cavitation cloud may, in some cases,
generate a substantial hydroacoustic field in or near the tooth.
Further cavitation effects may be possible, including growth,
oscillation, and collapse of cavitation bubbles. In addition, as
explained above, bulk fluid motion, such as rotational flow, may be
induced. The induced rotational flow can enhance the cleaning
process by removing detached material and replenishing reactants
for the cleaning reactions. These (and/or other) effects may lead
to efficient cleaning of the tooth. The rotational flow may also
create sufficient shear stress onto surface which then leads to
dissociation, detachment, and delamination of unhealthy materials.
In some embodiments, the rotational flow may include turbulent
regions working on small scale regions or small scale unhealthy
materials.
[0134] Additional details of a pressure wave generator and/or
pressure wave generator that includes a liquid jet device may be
found at least in [0045]-[0050], [0054]-[0077] and various other
portions of U.S. Patent Publication No. US 2011/0117517, published
May 19, 2011, and in [0136]-[0142] and various other portions of
U.S. Patent Publication No. US 2012/0237893, published Sep. 20,
2012, each of which is incorporated by reference herein in its
entirety and for all purposes.
[0135] As has been described, a pressure wave generator can be any
physical device or phenomenon that converts one form of energy into
acoustic waves within the treatment fluid and that induces normal
and shear stresses as well as small scale flows near a treatment
region in the chamber 6 and/or tooth 10. The pressure wave
generator 5 may also convert the energy into rotational fluid
motion of various length scales in the chamber 6 and/or tooth 10.
Many different types of pressure wave generators (or combinations
of pressure wave generators) are usable with embodiments of the
systems and methods disclosed herein.
[0136] ii. Mechanical Energy
[0137] Mechanical energy pressure wave generators can also include
rotating objects, e.g. miniature propellers, eccentrically-confined
rotating cylinders, a perforated rotating disk, etc. These types of
pressure wave generators can also include vibrating, oscillating,
or pulsating objects such as sonication devices that create
pressure waves via piezoelectricity, magnetostriction, etc. In some
pressure wave generators, electric energy transferred to a
piezoelectric transducer can produce acoustic waves in the
treatment fluid. In some cases, the piezoelectric transducer can be
used to create acoustic waves having a broad band of
frequencies.
[0138] iii. Electromagnetic Energy
[0139] An electromagnetic beam of radiation (e.g., a laser beam)
can propagate energy into a chamber, and the electromagnetic beam
energy can be transformed into acoustic waves as it enters the
treatment fluid. In some embodiments, the laser beam can be
directed into the chamber 6 and/or tooth coupler 3 as a collimated
and coherent beam of light. The collimated laser beam can be
sufficient to generate pressure waves as the laser beam delivers
energy to the fluid. Furthermore, in various embodiments, the laser
beam can be focused using one or more lenses or other focusing
devices to concentrate the optical energy at a location in the
treatment fluid. The concentrated energy can be transformed into
pressure waves sufficient to clean the undesirable materials. In
one embodiment, the wavelength of the laser beam or electromagnetic
source can be selected to be highly absorbable by the treatment
fluid in the chamber, tooth, and/or mouth (e.g., water) and/or by
the additives in the treatment fluid (e.g., nanoparticles, etc.).
The electromagnetic energy can be absorbed by at least one
component and can turn the electromagnetic energy into either heat,
vibration, or pressure waves, for example, through cavitation. For
example, at least some of the electromagnetic energy may be
absorbed by the fluid (e.g., water) in the chamber, which can
generate localized heating and pressure waves that propagate in the
fluid. The pressure waves generated by the electromagnetic beam can
generate light-induced cavitation effects in the fluid. In some
embodiments, the localized heating can induce rotational fluid flow
in the chamber 6 and/or tooth 10 that further enhances cleaning of
the tooth 10. The electromagnetic radiation from a radiation source
(e.g., a laser) can be propagated to the chamber by an optical
waveguide (e.g., an optical fiber), and dispersed into the fluid at
a distal end of the waveguide (e.g., a shaped tip of the fiber,
e.g., a conically-shaped tip). In other implementations, the
radiation can be directed to the chamber by a beam scanning
system.
[0140] The wavelength of the electromagnetic energy may be in a
range that is strongly absorbed by water molecules. The wavelength
may in a range from about 300 nm to about 3000 nm. In some
embodiments, the wavelength is in a range from about 400 nm to
about 700 nm, about 700 nm to about 1000 nm (e.g., 790 nm, 810 nm,
940 nm, or 980 nm), in a range from about 1 micron to about 3
microns (e.g., about 2.7 microns or 2.9 microns), or in a range
from about 3 microns to about 30 microns (e.g., 9.4 microns or 10.6
microns). The electromagnetic energy can be in the ultraviolet,
visible, near-infrared, mid-infrared, microwave, or longer
wavelengths.
[0141] The electromagnetic energy can be pulsed or modulated (e.g.,
via a pulsed laser), for example with a repetition rate in a range
from about 1 Hz to about 500 kHz. The pulse energy can be in a
range from about 1 mJ to about 1000 mJ. The pulse width can be in a
range from about 1 .mu.s to about 500 .mu.s, about 1 ms to about
500 ms, or some other range. In some cases, nanosecond pulsed
lasers can be used with pulse rates in a range from about 100 ns to
about 500 ns. The foregoing are non-limiting examples of radiation
parameters, and other repetition rates, pulse widths, pulse
energies, etc. can be used in other embodiments.
[0142] The laser can include one or more of a diode laser, a solid
state laser, a fiber laser, an Er:YAG laser, an Er:YSGG laser, an
Er,Cr:YAG laser, an Er,Cr:YSGG laser, a Ho:YAG laser, a Nd:YAG
laser, a CTE:YAG laser, a CO.sub.2 laser, or a Ti:Sapphire laser.
In other embodiments, the source of electromagnetic radiation can
include one or more light emitting diodes (LEDs). The
electromagnetic radiation can be used to excite nanoparticles
(e.g., light-absorbing gold nanorods or nanoshells) inside the
treatment fluid, which may increase the efficiency of photo-induced
cavitation in the fluid. The treatment fluid can include excitable
functional groups (e.g., hydroxyl functional groups) that may be
susceptible to excitation by the electromagnetic radiation and
which may increase the efficiency of pressure wave generation
(e.g., due to increased absorption of radiation). During some
treatments, radiation having a first wavelength can be used (e.g.,
a wavelength strongly absorbed by the liquid, for instance water)
followed by radiation having a second wavelength not equal to the
first wavelength (e.g., a wavelength less strongly absorbed by
water) but strongly absorbed by another element, e.g. dentin, dyes,
or nanoparticles added to solution. For example, in some such
treatments, the first wavelength may help create bubbles in the
fluid, and the second wavelength may help disrupt the tissue.
[0143] The electromagnetic energy can be applied to the chamber 6
for a treatment time that can be in a range from about one to a few
seconds up to about one minute or longer. A treatment procedure can
include one to ten (or more) cycles of applying electromagnetic
energy to the tooth. A fluid can circulate or otherwise move in the
chamber during the treatment process, which advantageously may
inhibit heating of the tooth 10 (which may cause discomfort to the
patient). The movement or circulation of treatment fluid (e.g.,
water with a tissue dissolving agent) in the chamber 6 can bring
fresh treatment fluid to tissue and organic matter as well as flush
out dissolved material from the treatment site. In some treatments
using electromagnetic radiation, movement of the treatment fluid
(for example small- or large scale rotational flows or turbulent
flow) can increase the effectiveness of the cleaning (as compared
to a treatment with little or no fluid circulation).
[0144] In some implementations, electromagnetic energy can be added
to other fluid motion generation modalities. For example,
electromagnetic energy can be delivered to a chamber in which
another pressure wave generator (e.g., a liquid jet) is used to
generate the acoustic waves.
[0145] iv. Acoustic Energy
[0146] Acoustic energy (e.g., ultrasonic, sonic, audible, and/or
lower frequencies) can be generated from electric energy
transferred to, e.g., an ultrasound or other transducer or an
ultrasonic tip (or file or needle) that creates acoustic waves in
the treatment fluid. The ultrasonic or other type of acoustic
transducer can comprise a piezoelectric crystal that physically
oscillates in response to an electrical signal or a
magnetostrictive element that converts electromagnetic energy into
mechanical energy. The transducer can be disposed in the treatment
fluid, for example, in the fluid inside the chamber. As explained
herein, ultrasonic or other acoustic devices used with the
embodiments disclosed herein are preferably broadband and/or
multi-frequency devices.
[0147] v. Further Properties of Some Pressure Wave Generators
[0148] A pressure wave generator 5 can be placed at a desired
location with respect to the tooth 10. The pressure wave generator
5 creates pressure waves within the fluid 22 inside the chamber 6
and/or tooth 10 (the generation of acoustic waves may or may not
create or cause cavitation). The acoustic or pressure waves 23
propagate throughout the fluid 22 inside the chamber 6 of the tooth
coupler 3 and/or in a tooth chamber of the tooth 10, with the fluid
22 in the chamber 6 or tooth 10 serving as a propagation medium for
the pressure waves 23. The pressure waves 23 can also propagate
through tooth material (e.g., dentin). It is believed, although not
required, that as a result of application of a sufficiently
high-intensity acoustic wave, acoustic cavitation may occur. The
collapse of cavitation bubbles may induce, cause, or be involved in
a number of processes described herein such as, e.g.,
sonochemistry, tissue dissociation, tissue delamination,
sonoporation, and/or removal of calcified structures. In some
embodiments, the pressure wave generator can be configured such
that the acoustic waves (and/or cavitation) do not substantially
break down natural dentin in the tooth 110. The acoustic wave field
by itself or in addition to cavitation may be involved in one or
more of the abovementioned processes.
[0149] In some implementations, the pressure wave generator 5
generates primary cavitation, which creates acoustic waves, which
may in turn lead to secondary cavitation. The secondary cavitation
may be weaker than the primary cavitation and may be non-inertial
cavitation. In other implementations, the pressure wave generator 5
generates acoustic waves directly, which may lead to secondary
cavitation.
[0150] Additional details of pressure wave generators (e.g., which
may comprise a pressure wave generator) that may be suitable for
use with the embodiments disclosed herein may be found, e.g., in
[0191]-[0217], and various other portions of U.S. Patent
Publication No. US 2012/0237893, published Sep. 20, 2012, which is
incorporated by reference herein for all purposes.
[0151] c. Enhancement of Cleaning Using Large-Scale Fluid
Motion
[0152] In some arrangements, bulk fluid motion 24 (e.g., fluid
rotation, convection, planar flow, chaotic flow, etc.) can enhance
the cleaning of unhealthy material from a diseased tooth. For
example, the fluid motion 24 generated in the chamber 6 and/or
tooth 10 can impart relatively large momentum to the tooth, which
can help dissociate and irrigate unhealthy materials from the
tooth. Furthermore, the fluid motion 24 can induce vortices and/or
swirl in the tooth 10 that can result in negative pressures (or low
positive pressures) near the apical opening 15 of the tooth 10. The
resulting negative pressures at the apical opening 15 can prevent
or reduce an amount of material extruded through the apical opening
15 and into the jaw of the patient. By preventing or reducing the
amount of extruded material, the risk of pain and discomfort as
well as infection can be lowered or eliminated, and patient
outcomes and comfort can be substantially improved.
[0153] In addition, due to relatively short time scales of the
chemical reaction processes between the fluid 22 and the unhealthy
materials as compared to that of diffusion mechanisms, a faster
mechanism of reactant delivery such as "macroscopic" liquid
circulation may be advantageous in some of the embodiments
disclosed herein. For example, liquid circulation with a time scale
comparable to (and preferably faster than) that of chemical
reaction may help replenish the reactants at the chemical reaction
front and/or may help to remove the reaction byproducts from the
reaction site. The relatively large convective time scale, which
may relate to effectiveness of the convection process, can be
adjusted and/or optimized depending on, e.g., the location and
characteristics of the source of circulation. Furthermore, it
should be appreciated that the introduction of liquid circulation
or other fluid motion 24 generally does not eliminate the diffusion
process, which may still remain effective within a thin microscopic
layer at the chemical reaction front. Liquid circulation can also
cause a strong irrigation effect at the treatment site (e.g.
removing diseased tissue deep in the canal 13 and/or tubules and
small spaces and cracks of the tooth 10) and may therefore result
in loosening and/or removing large and small pieces of debris from
the treatment site.
[0154] In some arrangements, various properties can be adjusted to
enhance bulk fluid motion and/or fluid circulation, e.g., fluid
motion in the chamber 6 of the tooth coupler 3. For example, the
position of the pressure wave generator 5 relative to the location
of the treatment site can be adjusted. Furthermore, in some
embodiments, the pressure wave generator 5 can be disposed adjacent
the access opening 18 formed in the tooth and/or adjacent an access
port of the tooth coupler 3. The geometry of the space surrounding
the pressure wave generator 5 and treatment site (e.g., the
geometry of the tooth coupler 3) can also be varied. It should also
be appreciated that circulation may be affected by the viscosity of
the fluid 22 and/or the mechanism of action of the pressure wave
generator 5. For example, the pressure wave generator 5, such as a
jet of liquid ejected through an inlet opening, a stirrer such as a
propeller or a vibrating object, etc., can be selected to enhance
fluid motion of the treatment fluid. In some aspects, the input
power of the source of liquid circulation can also be adjusted,
such as the source of a pump that drives a liquid jet in some
embodiments.
[0155] 2. Enhancement of Other Dental and Endodontic Procedures
[0156] In some embodiments, the pressure wave generators 5
disclosed herein can enhance other dental and endodontic
procedures. For example, after cleaning a tooth (e.g., a root canal
inside the tooth, a carious region on or near an exterior surface
of the tooth, etc.), the treatment region can be filled with an
obturation or filler material. The clinician can also restore
damaged or diseased tooth material by building up the tooth using a
suitable restoration material. In some embodiments, a filler
material can be supplied to the treatment region as a flowable
material and can be hardened to fill the treatment region (e.g.,
the cleaned root canal or carious region, etc.). In some
embodiments, a pressure wave generator 5 can be activated to supply
the obturation material throughout the treatment region.
[0157] For example, after a root canal procedure, the pressure wave
generator can supply the flowable obturation material into the
tooth and root canal. The large-scale fluid movement generated by
the pressure wave generator 5 can assist in propagating the
obturation material throughout relatively large spaces, such as the
main root canal or canals. For example, the pressure wave generator
5 may introduce sufficient momentum such that the flowable
obturation material propagates throughout the canal space without
introducing additional instrumentation into the tooth. For example,
the bulk fluid motion of the obturation material into the canal may
be such that the clinician may not need to or desire to enlarge the
canals. By reducing or eliminating canal enlargement, patient
outcomes and pain levels can be improved. In some arrangements, the
bulk fluid motion of the flowable obturation material can be
generated at relatively low frequencies produced by the pressure
wave generator.
[0158] In addition to generating large-scale or bulk fluid motion
of the obturation material throughout the canal, the pressure wave
generators 5 disclosed herein can generate higher frequency
perturbations to propagate the obturation material into smaller
cracks, spaces, and crevices in the tooth. For example,
higher-frequency effects, such as acoustic cavitation, can assist
in propagating the filler material throughout the tooth.
[0159] Accordingly, the pressure wave generators disclosed herein
can enhance the filling and/or restoration of a treatment region
such as a root canal, carious region of the tooth, etc. For
example, the obturation material can be propagated at a distance
such that it flows into the treatment region from a remote pressure
wave generator 5 (which may be disposed outside the tooth).
Large-scale or bulk fluid motion of the obturation material can
fill larger canal spaces or other treatment regions without further
enlargening the treatment region. Smaller-scale and/or higher
frequency agitation by the pressure wave generator 5 can propagate
the obturation material into smaller cracks and spaces of the
tooth. By filling substantially all the cleaned spaces of the
tooth, the disclosed methods can improve patient outcomes relative
to other methods by reducing the risk of infection in spaces
unfilled by the obturation material.
[0160] 3. Enhancement of Treatment Procedures with Broadband
Pressure Waves
[0161] In various embodiments, disclosed herein, it can be
advantageous to configure the pressure wave generator 5 to create
pressure waves 23 having a broadband spectrum, e.g., including
numerous or multiple frequencies of waves. FIGS. 2A and 2B are
graphs that schematically illustrate possible examples of power
that can be generated by different embodiments of the pressure wave
generator 5. These graphs schematically show acoustic power (in
arbitrary units) on the vertical axis as a function of acoustic
frequency (in kHz) on the horizontal axis. The acoustic power in
the tooth may influence, cause, or increase the strength of effects
including, e.g., acoustic cavitation (e.g., cavitation bubble
formation and collapse, normal and shear stress formation, as well
as microscale flow and microjet formation), acoustic streaming,
microerosion, fluid agitation, turbulence, fluid circulation and/or
rotational motion, sonoporation, sonochemistry, and so forth, which
may act to dissociate organic material in or on the tooth and
effectively clean the undesirable materials, e.g., undesirable
organic and/or inorganic materials and deposits. In some
embodiments, these effects can enhance or enable the obturation or
filling of treated root canals or other treatment regions of the
tooth. For example, the embodiments disclosed herein can
advantageously obturate or fill substantially the entire canal(s)
and/or branch structures therefrom, as explained in greater detail
above. In various embodiments, the pressure wave generator can
produce a pressure wave including acoustic power (at least) at
frequencies above: about 1 Hz, about 0.5 kHz, about 1 kHz, about 10
kHz, about 20 kHz, about 50 kHz, about 100 kHz, or greater. The
pressure wave can have acoustic power at other frequencies as well
(e.g., at frequencies below the aforelisted frequencies).
[0162] The graph in FIG. 2A represents a schematic example of
acoustic power generated by a liquid jet impacting a surface
disposed within a chamber on or around the tooth that is
substantially filled with liquid and by the interaction of the
liquid jet with fluid in the chamber. This schematic example shows
a broadband spectrum 190 of acoustic power with significant power
extending from about 1 Hz to about 1000 kHz, including, e.g.,
significant power in a range of about 1 kHz to about 1000 kHz
(e.g., the bandwidth can be about 1000 kHz). The bandwidth of the
acoustic energy spectrum may, in some cases, be measured in terms
of the 3-decibel (3-dB) bandwidth (e.g., the full-width at
half-maximum or FWHM of the acoustic power spectrum). In various
examples, a broadband acoustic power spectrum can include
significant power in a bandwidth in a range from about 1 Hz to
about 500 kHz, in a range from about 1 kHz to about 500 kHz, in a
range from about 10 kHz to about 100 kHz, or some other range of
frequencies. In some implementations, a broadband spectrum can
include acoustic power above about 1 MHz. In some embodiments, the
pressure wave generator can produce broadband acoustic power with
peak power at about 10 kHz and a bandwidth of about 100 kHz. In
various embodiments, the bandwidth of a broadband acoustic power
spectrum is greater than about 10 kHz, greater than about 50 kHz,
greater than about 100 kHz, greater than about 250 kHz, greater
than about 500 kHz, greater than about 1 MHz, or some other value.
In some cleaning methods, acoustic power between about 1 Hz and
about 200 kHz, e.g., in a range of about 20 kHz to about 200 kHz
may be particularly effective at cleaning teeth. The acoustic power
can have substantial power at frequencies greater than about 1 kHz,
greater than about 10 kHz, greater than about 100 kHz, or greater
than about 500 kHz. Substantial power can include, for example, an
amount of power that is greater than 10%, greater than 25%, greater
than 35%, or greater than 50% of the total acoustic power (e.g.,
the acoustic power integrated over all frequencies). In some
arrangements, the broadband spectrum 190 can include one or more
peaks, e.g., peaks in the audible, ultrasonic, and/or megasonic
frequency ranges.
[0163] The graph in FIG. 2B represents a schematic example of
acoustic power generated by an ultrasonic transducer disposed in a
chamber on or around the tooth that is substantially filled with
liquid. This schematic example shows a relatively narrowband
spectrum 192 of acoustic power with a highest peak 192a near the
fundamental frequency of about 30 kHz and also shows peaks 192b
near the first few harmonic frequencies. The bandwidth of the
acoustic power near the peak may be about 5 to 10 kHz, and can be
seen to be much narrower than the bandwidth of the acoustic power
schematically illustrated in FIG. 2A. In other embodiments, the
bandwidth of the acoustic power can be about 1 kHz, about 5 kHz,
about 10 kHz, about 20 kHz, about 50 kHz, about 100 kHz, or some
other value. The acoustic power of the example spectrum 192 has
most of its power at the fundamental frequency and first few
harmonics, and therefore the ultrasonic transducer of this example
may provide acoustic power at a relatively narrow range of
frequencies (e.g., near the fundamental and harmonic frequencies).
The acoustic power of the example spectrum 190 exhibits relatively
broadband power (with a relatively high bandwidth compared to the
spectrum 192), and the example liquid jet can provide acoustic
power at significantly more frequencies than the example ultrasonic
transducer. For example, the relatively broadband power of the
example spectrum 190 illustrates that the example jet device
provides acoustic power at these multiple frequencies with energy
sufficient to break the bonds between the decayed and healthy
material so as to substantially remove the decayed material from
the carious region.
[0164] It is believed, although not required, that pressure waves
having broadband acoustic power (see, e.g., the example shown in
FIG. 2A) can generate acoustic cavitation or other means of
cleaning and disinfection that is more effective at cleaning teeth
(including cleaning, e.g., unhealthy materials in or on the tooth)
than cavitation generated by pressure waves having a narrowband
acoustic power spectrum (see, e.g., the example shown in FIG. 2B).
One reason is that in a broadband spectrum the energy is delivered
as substantially all length scales covered in the range and
therefore targeting substantially all structures whose dimensions
fall within that range of length scales. Further, broadband
acoustic power can also generate sufficient energy at frequencies
capable of obturating or filling a root canal or other treatment
region (such as a treated carious region on an exterior surface of
the tooth). For example, a broadband spectrum of acoustic power can
produce a relatively broad range of bubble sizes in the cavitation
cloud and on the surfaces on the tooth, and the implosion of these
bubbles may be more effective at disrupting tissue than bubbles
having a narrow size range. Relatively broadband acoustic power may
also allow acoustic energy to work on a range of length scales,
e.g., from the cellular scale up to the tissue scale. Accordingly,
pressure wave generators that produce a broadband acoustic power
spectrum (e.g., some embodiments of a liquid jet) can be more
effective at tooth cleaning for some treatments than pressure wave
generators that produce a narrowband acoustic power spectrum. In
some embodiments, multiple narrowband pressure wave generators can
be used to produce a relatively broad range of acoustic power. For
example, multiple ultrasonic tips, each tuned to produce acoustic
power at a different peak frequency, can be used. As used herein,
broadband frequencies and broadband frequency spectrum is defined
regardless of secondary effects such as harmonics of the main
frequencies and regardless of any noise introduced by measurement
or data processing (e.g., FFT); that is, these terms should be
understood when only considering all main frequencies activated by
the pressure wave generator.
[0165] FIG. 2C is a graph of an acoustic power spectrum 1445
generated at multiple frequencies by the pressure wave generators
disclosed herein. For example, the spectrum 1445 in FIG. 2C is an
example of acoustic power generated by a liquid jet impacting a
surface disposed within a chamber on, in, or around the tooth that
is substantially filled with liquid and by the interaction of the
liquid jet with fluid in the chamber. The spectrum 1445 of FIG. 2C
represents acoustic power detected by a sensor spaced apart from
the source of the acoustic energy, e.g., the pressure wave
generator. The data was acquired inside an insulated water tank
when the distance between the power wave generator and the
hydrophone (e.g., sensor) being about 8 inches. The vertical axis
of the plot represents a measure of acoustic power: Log
(P.sub.acoustic.sup.2), referred to herein as "power units". The
units of P.sub.acoustic in the measurement were .mu.Pa (micro
Pascal). Thus, it should be appreciated that the actual power at
the source may be of a different magnitude because the sensor is
spaced from the acoustic power generator. However, the general
profile of the power spectrum at the source should be the same as
the spectrum 1445 detected at the sensor and plotted in FIG. 2C. It
should also be understood that, although the plot shows frequencies
only up to 100 KHz, the power above 100 KHz was greater than zero
(although not plotted in the figures shown herein). It should
further be noted that, as would be appreciated by one skilled in
the art, the plot and the values would also depend on other
parameters, such as, for example, the size and shape of the tank in
which data was acquired, the insulation of the inner surface of the
tank, the relative distance between the source (e.g., power wave
generator), and the free water surface of the tank.
[0166] As shown in FIG. 2C, the spectrum 1445 can include acoustic
power at multiple frequencies 1447, e.g., multiple discrete
frequencies. In particular, the spectrum 1445 illustrated in FIG.
2C includes acoustic power at frequencies in a range of about 1 Hz
to about 100 KHz. The acoustic power can be in a range of about 10
power units to about 80 power units at these frequencies. In some
arrangements, the acoustic power can be in a range of about 30
power units to about 75 power units at frequencies in a range of
about 1 Hz to about 10 kHz. In some arrangements, the acoustic
power can be in a range of about 10 power units to about 30 power
units at frequencies in a range of about 1 KHz to about 100 kHz. In
some embodiments, for example, the broadband frequency range of the
pressure waves generated by the pressure wave generators disclosed
herein can comprise a substantially white noise distribution of
frequencies.
[0167] Pressure wave generators that generate acoustic power
associated with the spectrum 1445 of FIG. 2C can advantageously and
surprisingly clean undesirable materials from teeth. As explained
above, the generation of power at multiple frequencies can help to
remove various types of organic and/or inorganic materials that
have different material or physical characteristics, and/or
different bonding strengths at various frequencies. For example,
some undesirable materials may be removed from the teeth and/or
gums at relatively low acoustic frequencies, while other materials
may be removed from the teeth at relatively high acoustic
frequencies, while still other materials may be removed at
intermediate frequencies between the relatively low and relatively
high frequencies. As shown in FIG. 2C, lower frequency cleaning
phases can be activated at higher powers, and higher frequency
cleaning phases can be activated at lower powers. In other
embodiments, low frequency cleaning phases may be activated at
relatively low powers, and high frequency cleaning phases may be
activated at relatively high powers. Pressure wave generators that
generate acoustic power at multiple frequencies (e.g., multiple
discrete frequencies) are capable of cleaning undesirable materials
and decayed matter from interior and/or exterior portions of
teeth.
[0168] In the embodiments disclosed herein, treatment procedures
can be activated to generate acoustic power at various frequency
ranges. For example, some treatment phases may be activated at
lower frequencies, and other treatment phases may be activated at
higher frequencies. The pressure wave generators disclosed herein
can be adapted to controllably generate acoustic power at any
suitable frequencies 1447 of the spectrum 1445. For example, the
pressure wave generators disclosed herein can be adapted to
generate power at multiple frequencies 1447 simultaneously, e.g.,
such that the delivered acoustic power in a particular treatment
procedure can include a desired combination of individual
frequencies. For example, in some procedures, power may be
generated across the entire frequency spectrum 1445. In some
treatment phases, the pressure wave generator can deliver acoustic
power at only relatively low frequencies, and in other treatment
phases, the pressure wave generator can deliver power at only
relatively high frequencies, as explained herein. Further,
depending on the desired treatment procedure, the pressure wave
generator can automatically or manually transition between
frequencies 1447 according to a desired pattern, or can transition
between frequencies 1447 randomly. In some arrangements, relatively
low frequencies can be associated with large-scale bulk fluid
movement, and relatively high frequencies can be associated with
small-scale, high-energy oscillations.
[0169] In some embodiments, the treatment procedure may include one
or more treatment phases. In each treatment phase, energy can be
applied at a different frequency or band of frequencies. For
example, in one phase, energy (e.g., pressure or acoustic waves)
propagating at a relatively low frequency (or band of frequencies)
may be generated. The low frequency pressure waves can interact
with the treatment fluid in the chamber and can induce removal of
large-scale dental deposits or materials. Without being limited by
theory, the low frequency pressure waves can remove a substantial
portion of the unhealthy materials in the tooth. For example, the
low frequency waves may have a sufficiently high energy at suitably
low frequencies to remove large deposits or materials from the
tooth. The acoustic power at the relatively low frequencies can
include acoustic power at any suitable low-frequency band of the
power spectrum of the pressure wave generator (see, e.g., FIG. 2A).
For example, in some embodiments, the acoustic power in the first,
low-frequency range can include one or more frequencies in a range
of about 0.1 Hz to about 100 Hz, for example in a range of about 1
Hz to about 50 Hz in some arrangements.
[0170] In another phase, acoustic energy may be generated at
relatively high frequencies. At higher frequencies, the pressure
wave generator can be configured to remove smaller deposits and
debris. For example, at higher frequencies, the pressure waves can
propagate through the treatment fluid. The higher frequency waves
can remove smaller portions from relatively small locations, such
as crevices, cracks, spaces, and irregular surfaces of the tooth.
In some embodiments, degassed liquid can be used to enhance the
removal of matter from these small spaces. When the higher
frequency cleaning is performed after the lower frequency cleaning,
in some embodiments, the high frequency waves (and/or intermediate
frequency waves) can clean the remainder of the unhealthy material
left behind from the low frequency cleaning. In the relatively high
frequency phases, acoustic energy can be generated in a range of
about 10 kHz to about 1000 kHz, e.g., in a range of about 100 kHz
to about 500 kHz.
[0171] In some embodiments, the treatment procedure can progress
from the relatively low frequencies (or bands of frequencies)
toward higher frequencies (or bands of frequencies). For example,
the procedure can move from the relatively low frequency phase(s),
through intermediate frequency phase(s), until the high frequency
phase(s) are reached. Thus, in some embodiments, the treatment
procedure can provide a gradual and/or substantially continuous
transition between relatively low and relatively high frequencies.
As the treatment progresses through the frequencies, unhealthy
dental deposits or materials of varying size and type can be
removed by the pressure wave generator. In other embodiments,
however, the treatment procedure can transition or switch between
frequencies (or bands of frequencies) or phases (e.g., between
high, low and/or intermediate frequencies or bands of frequencies)
at discrete levels. At various intermediate frequency ranges,
acoustic energy can be generated in a range of about 100 Hz to
about 10 kHz. For example, in some embodiments, the various phases
of the treatment procedures described above may be activated by the
user or clinician, or the pressure wave generator can be configured
to automatically transition between the phases. In some
embodiments, for example, the pressure wave generator can randomly
switch between high, low, and intermediate frequencies.
[0172] Various treatment procedures may include any suitable number
of treatment phases at various different frequencies. Furthermore,
although various low- and high-frequency phases may be described
above as occurring in a particular order, in other embodiments, the
order of activating the low- and high-frequency phases, and/or any
intermediate frequency phases, may be any suitable order.
Furthermore, the treatment procedures and phases described herein
can also be used to fill or obturate treatment regions of a tooth
after cleaning. In obturation procedures, the embodiments disclosed
herein can advantageously obturate or fill substantially the entire
canal(s) and/or branch structures therefrom, as explained in
greater detail herein.
[0173] 4. Enhancing Treatment Procedures with Degassed Fluids
[0174] As described herein, the treatment fluid (and/or any of
solutions added to the treatment fluid) can be degassed compared to
normal liquids used in dental offices. For example, degassed
distilled water can be used with or without the addition of
chemical agents or solutes.
[0175] a. Examples of Possible Effects of Dissolved Gases in the
Treatment Fluid
[0176] In some procedures, the treatment fluid can include
dissolved gases (e.g., air). For example, the fluids used in dental
offices generally have a normal dissolved gas content (e.g.,
determined from the temperature and pressure of the fluid based on
Henry's law). During cleaning procedures using a pressure wave
generator, the acoustic field of the pressure wave generator and/or
the flow or circulation of fluids in the chamber can cause some of
the dissolved gas to come out of solution and form bubbles.
[0177] The bubbles can block small passageways or cracks or surface
irregularities in the tooth, and such blockages can act as if there
were a "vapor lock" in the small passageways. In some such
procedures, the presence of bubbles may at least partially block,
impede, or redirect propagation of acoustic waves past the bubbles
and may at least partially inhibit or prevent cleaning action from
reaching, for example, unhealthy dental materials in tubules and
small spaces of the tooth 10. The bubbles may block fluid flow or
circulation from reaching these difficult-to-reach, or otherwise
small, regions, which may prevent or inhibit a treatment solution
from reaching these areas of the tooth.
[0178] In certain procedures, cavitation is believed to play a role
in cleaning the tooth. Without wishing to be bound by any
particular theory, the physical process of cavitation inception may
be, in some ways, similar to boiling. One possible difference
between cavitation and boiling is the thermodynamic paths that
precede the formation of the vapor in the fluid. Boiling can occur
when the local vapor pressure of the liquid rises above the local
ambient pressure in the liquid, and sufficient energy is present to
cause the phase change from liquid to a gas. It is believed that
cavitation inception can occur when the local ambient pressure in
the liquid decreases sufficiently below the saturated vapor
pressure, which has a value given in part by the tensile strength
of the liquid at the local temperature. Therefore, it is believed,
although not required, that cavitation inception is not determined
by the vapor pressure, but instead by the pressure of the largest
nuclei, or by the difference between the vapor pressure and the
pressure of the largest nuclei. As such, it is believed that
subjecting a fluid to a pressure slightly lower than the vapor
pressure generally does not cause cavitation inception. However,
the solubility of a gas in a liquid is proportional to pressure;
therefore lowering the pressure may tend to cause some of the
dissolved gas inside the fluid to be released in the form of gas
bubbles that are relatively large compared to the size of bubbles
formed at cavitation inception. These relatively large gas bubbles
may be misinterpreted as being vapor cavitation bubbles, and their
presence in a fluid may have been mistakenly described in certain
reports in the literature as being caused by cavitation, when
cavitation may not have been present.
[0179] In the last stage of collapse of vapor cavitation bubbles,
the velocity of the bubble wall may even exceed the speed of sound
and create strong shock waves inside the fluid. The vapor
cavitation bubble may also contain some amount of gas, which may
act as a buffer and slow down the rate of collapse and reduce the
intensity of the shockwaves. Therefore, in certain procedures that
utilize cavitation bubbles for tooth cleaning, it may be
advantageous to reduce the amount of the dissolved air in the fluid
to prevent such losses.
[0180] The presence of bubbles that have come out of solution from
the treatment fluid may lead to other disadvantages during certain
procedures. For example, if the pressure wave generator produces
cavitation, the agitation (e.g. pressure drop) used to induce the
cavitation may cause the release of the dissolved air content
before the water molecules have a chance to form a cavitation
bubble. The already-formed gas bubble may act as a nucleation site
for the water molecules during the phase change (which was intended
to form a cavitation bubble). When the agitation is over, the
cavitation bubble is expected to collapse and create pressure
waves. However, cavitation bubble collapse might happen with
reduced efficiency, because the gas-filled bubble may not collapse
and may instead remain as a bubble. Thus, the presence of gas in
the treatment fluid may reduce the effectiveness of the cavitation
process as many of the cavitation bubbles may be wasted by merging
with gas-filled bubbles. Additionally, bubbles in the fluid may act
as a cushion to damp pressure waves propagating in the region of
the fluid comprising the bubbles, which may disrupt effective
propagation of the pressure waves past the bubbles. Some bubbles
may either form on or between tooth surfaces, or be transferred
there by the flow or circulation of fluid in the tooth. The bubbles
may be hard to remove due to relatively high surface tension
forces. This may result in blocking the transfer of chemicals
and/or pressure waves into the irregular surfaces and small spaces
in and between teeth, and therefore may disrupt or reduce the
efficacy of the treatment. Existence of a very small amount of gas
inside the fluid may however be beneficial as the gas may form very
small volume bubbles which then act as the nucleation site for
vapor cavitation to occur (and therefore facilitate vapor
cavitation), and due to their small volume compared to the volume
of the actual vapor cavitation, their damping and interrupting
effects may be negligible.
[0181] b. Examples of Degassed Treatment Fluids
[0182] Accordingly, it may be advantageous in some systems and
methods to use a degassed fluid, which can inhibit, reduce, or
prevent bubbles from coming out of solution during treatments as
compared to systems and methods that use normal (e.g.,
non-degassed) fluids. In dental procedures in which the treatment
fluid has a reduced gas content (compared with the normal fluids)
tooth surfaces or tiny spaces in the tooth may be free of bubbles
that have come out of solution. Acoustic waves generated by the
pressure wave generator can propagate through the degassed fluid to
reach and clean the surfaces, cracks, and tooth spaces and
cavities. In some procedures, the degassed fluid can be able to
penetrate spaces as small as about 500 microns, 200 microns, 100
microns, 10 microns, 5 microns, 1 micron, or smaller, because the
degassed fluid is sufficiently gas-free that bubbles are inhibited
from coming out of solution and blocking these spaces (as compared
to use of fluids with normal dissolved gas content).
[0183] For example, in some systems and methods, the degassed fluid
can have a dissolved gas content that is reduced when compared to
the "normal" gas content of water. For example, according to
Henry's law, the "normal" amount of dissolved air in water (at 25 C
and 1 atmosphere) is about 23 mg/L, which includes about 9 mg/L of
dissolved oxygen and about 14 mg/L of dissolved nitrogen. In some
embodiments, the degassed fluid has a dissolved gas content that is
reduced to approximately 10%-40% of its "normal" amount as
delivered from a source of fluid (e.g., before degassing). In other
embodiments, the dissolved gas content of the degassed fluid can be
reduced to approximately 5%-50% or 1%-70% of the normal gas content
of the fluid. In some treatments, the dissolved gas content can be
less than about 70%, less than about 50%, less than about 40%, less
than about 30%, less than about 20%, less than about 10%, less than
about 5%, or less than about 1% of the normal gas amount.
[0184] In some embodiments, the amount of dissolved gas in the
degassed fluid can be measured in terms of the amount of dissolved
oxygen (rather than the amount of dissolved air), because the
amount of dissolved oxygen can be more readily measured (e.g., via
titration or optical or electrochemical sensors) than the amount of
dissolved air in the fluid. Thus, a measurement of dissolved oxygen
in the fluid can serve as a proxy for the amount of dissolved air
in the fluid. In some such embodiments, the amount of dissolved
oxygen in the degassed fluid can be in a range from about 1 mg/L to
about 3 mg/L, in a range from about 0.5 mg/L to about 7 mg/L, or
some other range. The amount of dissolved oxygen in the degassed
fluid can be less than about 7 mg/L, less than about 6 mg/L, less
than about 5 mg/L, less than about 4 mg/L, less than about 3 mg/L,
less than about 2 mg/L, or less than about 1 mg/L.
[0185] In some embodiments, the amount of dissolved gas in the
degassed fluid can be in a range from about 2 mg/L to about 20
mg/L, in a range from about 1 mg/L to about 12 mg/L, or some other
range. The amount of dissolved gas in the degassed fluid can be
less than about 20 mg/L, less than about 18 mg/L, less than about
15 mg/L, less than about 12 mg/L, less than about 10 mg/L, less
than about 8 mg/L, less than about 6 mg/L, less than about 4 mg/L,
or less than about 2 mg/L.
[0186] In other embodiments, the amount of dissolved gas can be
measured in terms of air or oxygen percentage per unit volume. For
example, the amount of dissolved oxygen (or dissolved air) can be
less than about 5% by volume, less than about 1% by volume, less
than about 0.5% by volume, or less than about 0.1% by volume.
[0187] The amount of dissolved gas in a liquid can be measured in
terms of a physical property such as, e.g., fluid viscosity or
surface tension. For example, degassing water tends to increase its
surface tension. The surface tension of non-degassed water is about
72 mN/m at 20.degree. C. In some embodiments, the surface tension
of degassed water can be about 1%, 5%, or 10% greater than
non-degassed water.
[0188] In some treatment methods, one or more secondary fluids can
be added to a primary degassed fluid (e.g., an antiseptic solution
can be added to degassed distilled water). In some such methods,
the secondary solution(s) can be degassed before being added to the
primary degassed fluid. In other applications, the primary degassed
fluid can be sufficiently degassed such that inclusion of the
secondary fluids (which can have normal dissolved gas content) does
not increase the gas content of the combined fluids above what is
desired for a particular dental treatment.
[0189] In various implementations, the treatment fluid can be
provided as degassed liquid inside sealed bags or containers. The
fluid can be degassed in a separate setup in the operatory before
being added to a fluid reservoir. In an example of an "in-line"
implementation, the fluid can be degassed as it flows through the
system, for example, by passing the fluid through a degassing unit
attached along a fluid line (e.g., the fluid inlet). Examples of
degassing units that can be used in various embodiments include: a
Liqui-Cel.RTM. MiniModule.RTM. Membrane Contactor (e.g., models
1.7.times.5.5 or 1.7.times.8.75) available from Membrana-Charlotte
(Charlotte, N.C.); a PermSelect.RTM. silicone membrane module
(e.g., model PDMSXA-2500) available from MedArray, Inc. (Ann Arbor,
Mich.); and a FiberFlo.RTM. hollow fiber cartridge filter (0.03
micron absolute) available from Mar Cor Purification (Skippack,
Pa.). The degassing can be done using any of the following
degassing techniques or combinations of thereof: heating, helium
sparging, vacuum degassing, filtering, freeze-pump-thawing, and
sonication.
[0190] In some embodiments, degassing the fluid can include
de-bubbling the fluid to remove any small gas bubbles that form or
may be present in the fluid. De-bubbling can be provided by
filtering the fluid. In some embodiments, the fluid may not be
degassed (e.g., removing gas dissolved at the molecular level), but
can be passed through a de-bubbler to remove the small gas bubbles
from the fluid.
[0191] In some embodiments, a degassing system can include a
dissolved gas sensor to determine whether the treatment fluid is
sufficiently degassed for a particular treatment. A dissolved gas
sensor can be disposed downstream of a mixing system and used to
determine whether mixing of solutes has increased the dissolved gas
content of the treatment fluid after addition of solutes, if any. A
solute source can include a dissolved gas sensor. For example, a
dissolved gas sensor can measure the amount of dissolved oxygen in
the fluid as a proxy for the total amount of dissolved gas in the
fluid, since dissolved oxygen can be measured more readily than
dissolved gas (e.g., nitrogen or helium). Dissolved gas content can
be inferred from dissolved oxygen content based at least partly on
the ratio of oxygen to total gas in air (e.g., oxygen is about 21%
of air by volume). Dissolved gas sensors can include
electrochemical sensors, optical sensors, or sensors that perform a
dissolved gas analysis. Examples of dissolved gas sensors that can
be used with embodiments of various systems disclosed herein
include a Pro-Oceanus GTD-Pro or HGTD dissolved gas sensor
available from Pro-Oceanus Systems Inc. (Nova Scotia, Canada) and a
D-Opto dissolved oxygen sensor available from Zebra-Tech Ltd.
(Nelson, New Zealand). In some implementations, a sample of the
treatment can be obtained and gases in the sample can be extracted
using a vacuum unit. The extracted gases can be analyzed using a
gas chromatograph to determine dissolved gas content of the fluid
(and composition of the gases in some cases).
[0192] Accordingly, fluid delivered to the tooth from a fluid inlet
and/or the fluid used to generate the jet in a liquid jet device
can comprise a degassed fluid that has a dissolved gas content less
than normal fluid. The degassed fluid can be used, for example, to
generate the high-velocity liquid beam for generating acoustic
waves, to substantially fill or irrigate a chamber, to provide a
propagation medium for acoustic waves, to inhibit formation of air
(or gas) bubbles in the chamber, and/or to provide flow of the
degassed fluid into small spaces in the tooth (e.g., cracks,
irregular surfaces, tubules, etc.). In embodiments utilizing a
liquid jet, use of a degassed fluid can inhibit bubbles from
forming in the jet due to the pressure drop at a nozzle orifice
where the liquid jet is formed.
[0193] Thus, examples of methods for dental and/or endodontic
treatment comprise flowing a degassed fluid onto a tooth or tooth
surface or into a chamber. The degassed fluid can comprise a tissue
dissolving agent and/or a decalcifying agent. The degassed fluid
can have a dissolved oxygen content less than about 9 mg/L, less
than about 7 mg/L, less than about 5 mg/L, less than about 3 mg/L,
less than about 1 mg/L, or some other value. A fluid for treatment
can comprise a degassed fluid with a dissolved oxygen content less
than about 9 mg/L, less than about 7 mg/L, less than about 5 mg/L,
less than about 3 mg/L, less than about 1 mg/L, or some other
value. The fluid can comprise a tissue dissolving agent and/or a
decalcifying agent. For example, the degassed fluid can comprise an
aqueous solution of less than about 6% by volume of a tissue
dissolving agent and/or less than about 20% by volume of a
decalcifying agent.
[0194] FIG. 3A illustrates images of root canals that compare the
use of non-degassed liquid and degassed liquid in the disclosed
pressure wave generators. As shown in image 1201 on the left side
of FIG. 3A, the use of non-degassed liquid may cause bubbles to
form in the canals, which may inhibit the propagation of energy in
some arrangements. As shown in image 1202 on the right side of FIG.
3A, the use of degassed liquid may substantially prevent the
formation of bubbles in the root canals when exposed to broadband
acoustic or pressure waves. FIG. 3B is a plot comparing the power
output for techniques using non-degassed and degassed liquids. The
power outputs plotted in FIG. 3B are measured based on the liquid
jet device described herein. As shown in FIG. 3B, at higher
acoustic frequencies, the use of degassed liquid in the disclosed
systems can generate significantly more power than in techniques
using non-degassed liquid. As illustrated in FIG. 3B, for example,
at high acoustic frequencies, the difference between power
generated by degassed and non-degassed liquids can be given by AP,
which can be in a range of about 5 dB to about 25 dB for
frequencies in a range of about 20 kHz to about 200 kHz. For
example, for frequencies in a range of about 70 kHz to about 200
kHz, AP can be in a range of about 10 dB to about 25 dB. At lower
frequencies, the differences in power generated by degassed and
non-degassed techniques may not be noticeable. At lower
frequencies, relatively high powers may be generated even with
non-degassed liquid because low frequency, large-scale fluid motion
may produce substantial momentum that contributes to the cleaning
of the tooth.
II. Console
[0195] FIG. 4 is a schematic perspective view of an example console
2. The console 2 may act as a central component of the system 1
that controls the operation of various treatment procedures,
provides a user interface 28 for the clinician to interact with the
system 1, manages data regarding the procedures performed by the
system 1, and communicates with external entities regarding the
treatment procedures and other aspects of the system 1. For
example, the console 2 can include a housing 30 to which numerous
system components are housed and/or coupled. Treatment procedure
components (e.g., mechanical, fluidic, electrical, electronic, and
data communication and management components) may be disposed in or
on the console 2 to provide a central platform from which the
clinician can perform one or more dental procedures. In some
embodiments, the console 2 may include system components suitable
for performing dental cleaning procedures, such as procedures for
cleaning root canals of teeth, carious regions from teeth, and
undesirable dental deposits (such as calculus, plaque, bacteria,
etc.) from teeth. In other embodiments, the console 2 may
additionally (or alternatively) include components suitable for
performing other dental procedures, including obturation
procedures, restoration procedures, etc.
[0196] The treatment procedure components may be disposed inside
the housing 30 to enable a compact arrangement of multiple,
interconnected components. One or more conduits 29 can couple the
treatment procedure components in the housing 30 with the tooth
coupler 3 by way of the interface member 4. For example, the
conduits 29 may include or define fluid, electrical, and/or data
communication pathways between the console 2 and the tooth coupler
3. The fluid pathways may include high-pressure tubing adapted to
convey pressurized fluid to the tooth coupler 3. Waste lines or
suction lines may convey waste fluid from the tooth coupler 3 back
to the housing 30 and/or a waste reservoir. Electrical wiring may
extend from the housing to the tooth coupler 3 to provide
electrical power to the tooth coupler 3. Fiber optic lines or other
communications pathways (which may be wired or wireless) may
provide data communication between the console 2 and the tooth
coupler 3.
[0197] As explained in more detail herein, the interface member 4
may be mechanically arranged such that the tooth coupler 3 and the
console 2 can removably engage with one another while also
accommodating different types of communication (e.g., fluidic,
electrical, data, etc.) between the console 2 and the tooth coupler
3. When the tooth coupler 3 and the interface member 4 are engaged,
the clinician can control the operation of the system 1 (including
various treatment procedures) by interacting with the user
interface 28.
[0198] FIG. 4A is a schematic perspective view of a console 2 in
accordance with another embodiment. As explained above, the console
2 can include a user interface 28 and a housing 30. A handpiece 3A
can removeably couple to the console 2 by way of one or more
conduits 29. The handpiece 3A can rest in a cradle 633. As
explained herein, the handpiece 3A can include a communications
chip (see FIG. 28). The cradle 633 can comprise a reader configured
to read data from the chip. A foot pedal or switch 634 can be
provided in electrical communication with the console 2. The foot
pedal 634 can be activated by the clinician to activate,
deactivate, and/or otherwise control the operation of the handpiece
3A and liquid jet. In addition, a high pressure purge port 635 and
a vacuum purge port 636 can be provided on the console 2. The purge
ports 635, 636 can be part of the purge system 47 disclosed herein
with respect to FIG. 5D. In particular, purge fluids can be passed
through the system and through the purge ports 635, 636 before use
in a treatment procedure. For example, before a treatment
procedure, a high pressure tube 29a (which may supply the
pressurized fluid to the jet device) may be connected to the high
pressure purge port 635. Purging fluids may be run through the
system 1 and through the high pressure purge port 635 to a waste
reservoir and/or waste system, as described herein. In addition,
before a treatment procedure, a lower pressure vacuum or suction
tube 29a (which may be in communication with a suction port on the
handpiece 3A to remove waste fluids from the tooth) may be
connected to the vacuum purge port 636. Purging fluids may run
through the system, including the evacuation system disclosed
herein, and may pass through the vacuum purge port 636 and into the
waste reservoir or system. Upon purging the system 1, the handpiece
and tubes 29a, 29b may be coupled together for the treatment
procedure.
A. Description of Console Components
[0199] FIG. 5A is a schematic system diagram of a dental treatment
system 1, according to some embodiments. The system 1 can include a
console 2 coupled to an interface member 4. As explained herein,
the interface member 4 can be configured to releasably couple to a
tooth coupler 3, such as a handpiece or treatment cap. The console
2 (e.g., the housing 30) can include multiple components configured
for various treatment procedures, such as tooth cleaning
procedures, etc. In particular, the console 2 can include one or
more fluid reservoirs 31 configured to store various types of
treatment fluids. As shown in FIG. 5A, for example, the fluid
reservoirs may store water and multiple chemicals, such as Chemical
A and Chemical B.
[0200] In some treatments, it may be desirable to mix the one or
more fluids stored in the reservoirs 31. Accordingly, a mixing
system 32 can be provided to mix the fluids to a desired amount. As
explained herein, in some treatment procedures, the use of degassed
liquids may be desirable. For example, degassed fluids may be
useful in enhancing cavitation when used in cleaning procedures. A
degassing system 33 can be provided in the console to substantially
remove, or reduce, the amount of dissolved gases in the fluid
supplied to the tooth coupler 3. As shown in FIG. 5A, in some
embodiments, the degassing system 33 may be disposed downstream of
the missing system 32. In the embodiment of FIG. 5A, for example,
the desired treatment fluid can be mixed, and, subsequently,
dissolved gases (such as dissolved oxygen) can be removed from the
mixed fluid.
[0201] A high-pressure pump 34 can be provided in the console to
drive treatment fluid to the interface member 4 and the tooth
coupler 3. The pump 34 may be a chemical resistant, high-pressure
pump in some arrangements such that the pump 34 can accommodate
both high pressure fluid flow and the chemical properties of the
treatment fluid without experiencing corrosion or other deleterious
effects. The pump 34 can be in fluid communication with the
interface member 4 by way of a fluid pathway 35. The fluid pathway
35 may similarly be made of a material and structure such that the
pathway 35 is resistant to corrosion or other negative effects
caused by the treatment fluids. The fluid pathway 35 may also be
configured to support high-pressure fluid flow therethrough. As
explained herein, the interface member 4 can releasably or
removably couple with the tooth coupler 3 to supply treatment fluid
to the tooth coupler 3.
[0202] FIG. 5B is a schematic system diagram of the system 1,
according to another embodiment. As with the embodiment of FIG. 5A,
the system 1 of FIG. 5B can include a console 2 having one or more
fluid reservoirs 31, a mixing system 32, a pump 34, a fluid pathway
35, and an interface member 4. However, unlike the embodiment of
FIG. 5A, the system 1 shown in FIG. 5B includes degassing systems
33 upstream of the mixing system 32. Indeed, the console 2 may
include a degassing system 33 or apparatus for each treatment fluid
or reservoir 31 in some arrangements. Thus, in the embodiment of
FIG. 5B, the fluids supplied by the reservoirs 31 may be degassed
before mixing the fluids together. For example, water may be
degassed by a degassing system 33, Chemical A may be degassed by a
separate degassing system 33, and Chemical B may be degassed by
another degassing system 33. After degassing each fluid supplied by
the reservoirs 31, the mixing system 32 can mix the fluids as
desired and supply the mixed and degassed fluid to the pump 34 and
fluid pathway 35.
[0203] FIG. 5C is a schematic system diagram of a system 1
according to some embodiments. As with the embodiment of FIGS.
5A-5B, the console 2 can include fluid reservoirs 31, a mixing
system 32, a degassing system 33, a pump 34, a motor 42 for driving
the pump 34, a fluid pathway 35, and an interface member 4. As
shown in FIG. 5C, the mixing system 32 may be upstream of the
degassing system 33, but in some arrangements the degassing system
33 may be upstream of the mixing system 32 (see FIG. 5B). In the
embodiment of FIG. 5C, the console 2 can include one or more
monitoring sensors 38 disposed downstream of the fluid reservoirs
31. The monitoring sensors 38 can be part of a monitoring system
and can measure various properties of the fluids before mixing
and/or degassing the fluids. For example, as shown in FIG. 5C, the
sensors 38 can measure at least one of concentration (C) and
temperature (T) of the treatment fluids before mixing. The console
2 can further include a monitoring apparatus 36 downstream of the
degassing system 33 and mixing system 32. The monitoring apparatus
36 can measure at least one of concentration (C), temperature (T),
and dissolved oxygen (DO) content of the degassed and mixed
solution.
[0204] Furthermore, the system 1 shown in FIG. 5C can include a
control unit 37 in electrical and data communication with the
components of the system 1. The control unit 37 can include various
units and/or modules. For example, the control unit 37 can include
a processing unit 39 and a power unit 40. The control unit 37 can
be in electrical and data communication with the fluid reservoirs
31 (and/or with valves that are associated with the reservoirs 31)
and the sensors 38 to control and measure the fluids supplied by
the reservoirs 31. The control unit 37 can also communicate with
the mixing system 32 and the degassing system 33 to control the
amount of fluid mixing and degassing, respectively. Further, the
control unit 37 can be in electrical and data communication with
the monitoring apparatus 36 to manage the properties of the fluid
supplied to the pump 34. The pump 34 can be driven by the motor 42
that can be controlled by the control unit 37. In addition, the
control unit 37 of the console 2 can communicate with the interface
member 4, and thus the tooth coupler 3, by way of electrical and
data pathways passing through the interface member 4 and to the
tooth coupler 3. The control unit 37 can couple to the user
interface 28, through which the user can control the treatment
procedures and/or monitor the progress of the treatment procedures
and the system 1.
[0205] FIG. 5D is a schematic system diagram of a system 1,
according to another embodiment. As with the embodiment of FIGS.
5A-5C, the console 2 can include fluid reservoirs 31, monitoring
sensors 38, a degassing system 33 associated with each fluid line,
a mixing system 32, a monitoring apparatus 36, a pump 34, a motor
42 for driving the pump 34, a waste system 41, a fluid pathway 35,
an interface member 4 configured to couple to a tooth coupler 3, a
user interface 28, and a control unit 37. As shown in FIG. 5D, the
tooth coupler 3 can be in fluid communication with the waste system
41, which can comprise a waste reservoir. For example, as explained
herein, a vacuum pump can act to suction waste fluids from the
tooth 10 by way of a suction port. A waste line can convey the
waste fluids from the tooth 10 to the waste reservoir of the waste
system 41.
[0206] In addition, in the embodiment of FIG. 5D, a purge system 47
can be provided between upstream of the interface member 4 and/or
the tooth coupler 3. For example, the purge system 47 can be
disposed downstream of and fluidly communicate with the fluid
pathway 35. In other arrangements, the purge system 47 can be
disposed between the pump 34 and fluid pathway 35. The purge system
47 can be activated by the clinician using the user interface 28
before a treatment procedure and/or for general maintenance. The
purge system 47 can be configured to operate at low pressures, e.g.
at pressures lower than that output from the pump 34. The purge
system 47 can be activated to clean out the system 1 before a
treatment procedure. For example, water can be flushed at low
pressures through the system 1 before a treatment procedure to
remove residual fluids and/or particulates that may have built up
from prior procedures. In some embodiments, the purge system 47 can
be activated to flush other fluids (such as EDTA, bleach, or any
other suitable chemical) through the system 1 at relatively low
pressures to ensure that those fluids' flow paths are functioning
correctly and/or are unobstructed. The purging fluids can pass
through the system components (for example, through the degassing
system 33, mixing system 32, monitoring apparatus 36, pump 34,
fluid pathway 35, etc.) and can be conveyed by an evacuation system
to the waste system 41.
[0207] In some embodiments, the water reservoir 31 can also be used
to supply a backflush line to the pump 34. It can be advantageous
in some embodiments to clear the pump 34 of fluids and/or other
materials after prior treatments or runs. Accordingly, water can be
supplied by way of the backflush line to the pump 34. The water can
pass through the pump 34 and substantially flush the pump 34 of
undesirable materials. A backflush waste line can convey the
flushed water and waste materials from the pump to the waste
reservoir of the waste system 41. To supply water to the pump 34, a
suitable valve may be used. For example, in some embodiments, a
solenoid valve, such as Model EW-01540-01, manufactured by
Cole-Parmer of Vernon Hills, Ill., may be used.
[0208] In addition, each fluid line associated with the fluid
reservoirs 31 can be in fluid communication with an evacuation line
upstream of the respective degassing system 33. For example, a
bypass valve can be controllably actuated to pass the respective
fluid (e.g., water, EDTA, bleach, etc.) through to the degasser 33
or to the waste system 41 along the evacuation line. The bypass
valve can be any suitable valve, such as, e.g., Model 080T2-S2038,
manufactured by Bio-Chem Fluidics Inc., of Boonton, N.J. Each fluid
evacuation line can convey a respective fluid (e.g., water,
Chemical A, Chemical B, etc.) to the waste system 41.
[0209] 1. Fluid Reservoirs
[0210] The fluid reservoirs 31 shown in FIGS. 5A-5D can be any
suitable type of reservoir or container and can contain any
suitable type of treatment fluid used in the system's treatment
procedures. For example, the reservoirs 31 may comprise plastic
bins or containers, such as high-density polyethylene (HDPE). In
various embodiments, plastic Nalgene.TM. bottles manufactured by
Cole-Parmer, of Vernon Hills, Ill., may be used. Various sizes
(such as 250 mL, 500 mL, 2 L, etc.) may be suitable. In other
embodiments, the reservoirs 31 may comprise glass, a plastic bag
(e.g., an IV bag), or any other suitable material. The reservoirs
31 may comprise any material that is chemically resistant to the
treatment fluids stored in the reservoirs 31 such that the
reservoirs 31 do not chemically degrade. The reservoirs 31 may, in
some arrangements, be disposed in a drawer or other compartment
that is slidably removed relative to the console 2. The reservoirs
31 may be designed to have a volume sufficient for treatment of at
least one patient, e.g., for at least one treatment procedure. In
other embodiments, the reservoirs 31 may have a volume sufficient
to treat multiple patients. A liquid level sensor may also be
provided to measure and/or monitor the volume of fluid in each
container 31. For example, the liquid level sensor can comprise a
capacitive sensor. In some embodiments, for example, a capacitive
sensor manufactured by Sensortechnics.TM., a part of First Sensor
AG, of Berlin, Germany (model no. CLW025F15N), may be used. Any
suitable type of level sensor can be used, such as an optical
sensor, a hydrostatic level sensor, etc. A quick connect coupler
may be provided to couple the reservoirs 31 to outlet tubing. In
some embodiments, the reservoirs 31 may be disposable such that the
clinician can dispose of the reservoirs 31 after each treatment. In
other arrangements, the reservoirs 31 may be re-usable for a number
of treatments. In some embodiments, a valve, such as a duck-bill
valve, can be provided so as to allow air in the container 31 to
prevent a vacuum from forming in the container 31.
[0211] Any suitable number of reservoirs 31 may be disposed in the
console 2. As shown in FIGS. 5A-5C, for example, three reservoirs
31 may be used. One reservoir 31 may contain water (e.g., distilled
water, purified water, etc.). Another reservoir 31 may contain a
Chemical A. In some embodiments, Chemical A may include a cleaning
treatment fluid, such as bleach, for dissociating diseased tissue
from the tooth 10. Another reservoir 31 may contain a Chemical B.
Chemical B may comprise another cleaning treatment fluid, such as
EDTA, for removing calcified deposits and/or a smear layer from the
tooth 10. Indeed, any suitable treatment fluid may be stored in the
reservoirs 31, including, e.g., bleach, EDTA, water, a
medical-grade saline solution, an antiseptic or antibiotic solution
(e.g., sodium hypochlorite), a solution with chemicals or
medications, medicaments, surfactants, nanoparticles, etc.
[0212] In some embodiments, as explained above, the system 1 can be
configured for obturation and/or restoration procedures. In such
embodiments, the reservoirs 31 can contain a suitable obturation
and/or restoration material. For example, the reservoirs 31 may
contain a root canal filling resin, a gutta percha-based material,
a calcium hydroxide-based material, a dental cement material, a
dental cement comprising zinc oxide, a filing material comprising
particles responsive to a non-contacting force field, a filling
material comprising nanoparticles, a flowable filling material, a
syringable filling material, a liner, a sealer, a cement, a paste,
and a gel. The obturation material may be disposed in the container
31 in a flowable state, which may be hardened to a solid or
semisolid state.
[0213] The fluids in the containers 31 may be in fluid
communication with the other components of the console 2 by way of
tubes coupled to outlets of the containers 31. Valves may be
provided downstream of the containers to selectively open and close
fluid pathways between the containers 31 and the remainder of the
system. The valves may be controllably actuated using the control
unit 37 in some embodiments.
[0214] 2. Degassing System
[0215] As explained herein, it can be advantageous in some
treatment procedures to supply a fluid (e.g., a liquid) that is
substantially free of dissolved gases. For example, dental cleaning
treatments can be enhanced by using treatment fluids that are
degassed so that small passageways in or through the tooth are not
blocked by bubbles and/or so that cavitation can be enhanced, as
explained herein. Accordingly, the degassing system 33 may be
configured to remove dissolved gases (such as oxygen) from each
treatment fluid to a desired amount.
[0216] The degassing system 33 can comprise any suitable degassing
apparatus, such as the PermSelect.RTM. silicone membrane module
(e.g., model PDMSXA-2500) available from MedArray, Inc. (Ann Arbor,
Mich.). Other examples of degassing units that can be used in
various embodiments include: a Liqui-Cel.RTM. MiniModule.RTM.
Membrane Contactor (e.g., models 1.7.times.5.5 or 1.7.times.8.75)
available from Membrana-Charlotte (Charlotte, N.C.); and a
FiberFlo.RTM. hollow fiber cartridge filter (0.03 micron absolute)
available from Mar Cor Purification (Skippack, Pa.). The degassing
can be done using any of the following degassing techniques or
combinations of thereof: heating, helium sparging, vacuum
degassing, filtering, freeze-pump-thawing, and sonication. In some
embodiments, degassing the fluid can include de-bubbling the fluid
to remove any small gas bubbles that form or may be present in the
fluid. De-bubbling can be provided by filtering the fluid. In some
embodiments, the fluid may not be degassed (e.g., removing gas
dissolved at the molecular level), but can be passed through a
de-bubbler to remove the small gas bubbles from the fluid.
[0217] As explained herein, the degassing system 33 can be provided
upstream or downstream of the mixing system 32. In some
arrangements, the degassing system 33 is disposed upstream of the
mixing system 32, and each treatment fluid may pass through a
separate degassing apparatus. One advantage of disposing the
degassing system upstream of the mixing system 32 is that solutes
may be added after degassing such that the solutes do not pass
through (and possibly degrade) the degassing system 33. In some
arrangements, the degassing system 33 may be configured to be
chemically compatible with the chemicals used in the treatment
solutions. The degassing system 33 can be disposed downstream of
the mixing system 32 such that the mixed fluid is degassed in a
single degasser. In still other embodiments, the degassing system
33 and the mixing system 32 may be combined into a single unit that
both mixes and degases the treatment fluid.
[0218] In some embodiments, the degassed fluid has a dissolved gas
content that is reduced to approximately 10%-40% of its "normal"
amount as delivered from a source of fluid (e.g., before
degassing). In other embodiments, the dissolved gas content of the
degassed fluid can be reduced to approximately 5%-50% or 1%-70% of
the normal gas content of the fluid. In some treatments, the
dissolved gas content can be less than about 70%, less than about
50%, less than about 40%, less than about 30%, less than about 20%,
less than about 10%, less than about 5%, or less than about 1% of
the normal gas amount. In some implementations, it may be desired
that the fluid entering the tooth coupler 3 be degassed to a
certain degree (e.g., about 40% of normal dissolved gas amount in
one example). In some such implementations, the degassing system 33
may "over-degas" the solvent so that the solvent's dissolved gas
content is below the desired degree (e.g., about 35% in this
example) so that when solute(s) are added by the mixing system 32,
the resulting fluid (solvent plus solute) is degassed to less than
the desired degree (e.g., adding un-degassed antiseptic solution
may raise the dissolved gas content to 38% in this example).
[0219] 3. Mixing System
[0220] In different treatment procedures, it may be desirable to
mix the treatment fluids supplied by the reservoirs 31 to a desired
concentration, e.g., drawing and mixing a proper volume ratio of
treatment chemicals. For example, in some cleaning treatments, it
may be desirable to mix bleach or EDTA with water to a desired
concentration, to enhance the cleaning effects for the particular
procedure, whether a root canal cleaning procedure, a caries
removal procedure, or a hygiene procedure (e.g., removing
undesirable dental deposits such as plaque, calculus, etc.). The
mixing system may adjust a multiple-way valve that is
electronically or mechanically controlled to draw the correct
amount of chemicals to prepare the prescribed concentration of the
treatment solution. For example, different amounts of different
chemicals can be mixed by activating a valve to selectively
alternate between the different chemicals. As one example, if the
system 1 is to mix water and Chemical A by a particular amount,
then the valve can be activated to alternate selection of water and
Chemical A. Accordingly, if the desired mixture is to include more
Chemical A than water by a particular concentration, then the valve
can be activated longer for Chemical A than for the water by a
particular amount. For example, a flow selection valve, such as
Model No. 080T3-S2039 manufactured by Bio-Chem Fluidics Inc., of
Boonton, N.J., may be used in some embodiments.
[0221] The mixing system may include a fluid flow control system.
The fluid flow control system may be passive in some arrangements,
and the mixing ratio may be adjusted by using proportional valves.
The proportional valve may be a multiple inlet port solenoid valve.
The proportional flow may be achieved by, for example, adjusting
cross-sections or pulsating valve openings. The fluid flow control
system may be active and the mixing ratio may be adjusted using
positive displacement metering pumps. The active configuration may
include a holding chamber to adjust for the overall system flow
rate.
[0222] Accordingly, the mixing system 32 can be configured to mix
the appropriate volumes of each fluid together in a mixing chamber.
The control unit 37 can be programmed to operate the mixing system
32 such that the inputs to the mixing system 32 comprise the
appropriate amounts or volumes of each treatment fluid. The control
unit 37 can also be programmed to selectively output the mixed
fluid to the downstream components.
[0223] 4. Pump
[0224] The pump 34 can be any suitable high-pressure pump that is
configured to pressurize the treatment fluid to a desired pressure.
In some embodiments, the pump 34 can be driven by the motor 42 or
other suitable mechanism. For example, one or more pistons can be
activated by the motor 42 to generate positive pressure flow
through the pump 34. The pump 34 may be a constant pressure or a
constant flow rate pump in various arrangements. The pump 34 can
drive the pressurized fluid to the interface member 4 by way of the
fluid pathway 35. A pressure sensor may be used to sense the
pressure of the liquid and communicate pressure information to the
control unit 37. The control unit 37 can use the pressure
information to make adjustments to the motor 42 and/or the pump 34
to provide a target pressure for the fluid delivered to the
interface 4 and tooth coupler 3. For example, in embodiments in
which the pump 34 comprises a piston pump, the control unit 37 may
signal the motor 42 to drive the piston more rapidly or more
slowly, depending on the pressure information from the pressure
sensor. The pump 34 may be actuated continuously or cyclically in
various arrangements. The pump 34 can be any suitable type of pump,
including Model 170240 manufactured by Scientific Systems, Inc., of
State College, Pa. The motor 42 can be any suitable type of
motor.
[0225] The pump 34 can deliver pressurized fluid to the interface
member 4 and tooth coupler 3 sufficient to create a fluid jet, in
some embodiments. For example, in some embodiments utilizing a
fluid jet, the pressure of the liquid that can be delivered to the
interface member 4 and/or tooth coupler 3 can be adjusted within a
range from about 500 psi to about 50,000 psi. In certain
embodiments, it has been found that a pressure range from about
2,000 psi to about 15,000 psi produces jets that are particularly
effective for cleaning treatments. In some embodiments, the
pressure can be between about 8,000 psi and about 11,000 psi, for
example, about 9,200 psi in one arrangement. In another
arrangement, the pressure can be about 10,000 psi.
[0226] 5. Fluid Pathway
[0227] The fluid pathway 35 can convey the pressurized fluid from
the pump 34 to the interface member 4. The fluid pathway 35 can be
configured to accommodate the high-pressure fluid delivered by the
pump 34 and the various chemistries of the treatment fluids passing
through the pathway 35. The fluid pathway 35 can also be flexible
such that the clinician can manipulate the fluid pathway 35 before,
during, or after treatment. For example, in some embodiments, the
fluid pathway 35 can comprise one or more tubes disposed between
the pump 34 and the interface member 4. The tubes can comprise any
suitable high-pressure, chemical-resistant material, such as a
polymer or a chemical-resistant metal such as titanium.
[0228] 6. Waste System
[0229] The console 2 can also include a waste system 41 configured
to convey waste fluids or materials from the tooth coupler 3 back
to a waste reservoir. The waste reservoir may be positioned with or
near the reservoirs 31 discussed above, or it may be positioned
separately in the console 2. For example, during some dental
treatment procedures, such as cleaning procedures, the tooth
coupler 3 (such as a handpiece) may include a suction port and/or
vents that are configured to transport waste fluids or particles
from the treatment tooth 10 back to the console 2 to the waste
system 41. The waste system 41 can couple to the tooth coupler 3 by
way of one or more waste lines. The waste lines may comprise tubes
that extend from the tooth coupler 3 back to the console 2.
Although the waste system 41 is shown as coupling to the interface
member 4 in FIG. 5C, in some embodiments, the waste system 41 may
have a separate interface or connector that couples to the tooth
coupler 3. For example, the waste line or tubes may be threaded,
snapped, or otherwise engaged with the tooth coupler 3. In some
embodiments, the waste lines are disposed on or through the
interface member 4 to connect to the tooth coupler 3. Additional
details of the waste system 41 are discussed below with respect to
the evacuation system 75 shown in FIG. 5E.
[0230] A vacuum pump can be provided to provide suction between the
tooth coupler 3 and the console 2 by way of the waste lines. One
example of a suitable vacuum pump is Model DBM30B-201 manufactured
by Brenner-Fiedler & Associates, Inc., of Riverside, Calif. For
example, the suction port may be similar to evacuation units found
in dental offices. For example, some dental evacuation units are
designed to operate at about -6 in-Hg to about -8 in-Hg and have an
airflow rate of about 7 standard cubic feet per minute (SCFM) per
chairside high-volume inlet. Independent vacuum systems can be
used. In one embodiment, the operating pressure of the evacuation
unit is about -4 to -10 in-Hg. In other embodiments, the operating
pressure is in a range of about -0.1 to -5 in-Hg or -5 to -10 in-Hg
or -10 to -20 in-Hg, or other values. In some embodiments, the flow
provided by the evacuation unit can be pulsating. In another
embodiment, the evacuation unit flow can be intermittent. In one
embodiment, the evacuation unit flow can be substantially uniform.
The air flow rate of the evacuation unit can be 5 to 9 SCFM or 2 to
13 SCFM or 0.1 to 7 SCFM or 7 to 15 SCFM or 15 to 30 SCFM or 30 to
50 SCFM, or other values.
[0231] 7. Console Monitoring System
[0232] The console monitoring systems disclosed herein can include
monitoring sensors 38 and/or the monitoring apparatus 36
illustrated in FIG. 5C. For example, the monitoring sensors 38 may
be disposed downstream of the fluid reservoirs 31 before the mixing
system 32 and degassing system 33. The monitoring sensors 38 can
measure various properties of the treatment fluids before mixing
and degassing to ensure that the fluids are adequately mixed and/or
degassed. For example, concentration sensors can be provided to
measure the concentration of each fluid. The control unit 37 can
utilize information about the concentration of each treatment fluid
to determine how much of each fluid to add in the mixing system 32
to achieve the desired mixtures.
[0233] The concentration sensors can be any suitable type of sensor
capable of measuring the concentration of the fluids. The
concentration sensor may directly measure concentration in some
embodiments. The concentration sensor may also indirectly measure
concentration by measuring pH, oxidation reduction potential (ORP),
optical density, electrical conductivity, etc. A concentration
sensor may check the prepared treatment fluid concentration and
send feedback to the mixing valves if adjustments are desired to
bring the prepared treatment solutions concentration to the
prescribed value. Some concentration sensors may measure the
conductivity of the solution to determine the concentration. One
example of such a concentration sensor is the Digital C/R Sen, ISM
3/4 NPT 0.1C Ti 2'' manufactured by Mettler-Toledo, of Greifensee,
Switzerland.
[0234] In addition, the sensors 38 may comprise temperature sensors
to measure the temperature of the solution. It may be desirable to
maintain the treatment fluid at a temperature that is not too hot
or not too cold for the mixing and degassing procedures.
Accordingly, temperature sensors (e.g., thermocouples or any other
suitable temperature sensor) may be disposed in contact or
proximate the fluid along fluid lines leading from the reservoirs
31 to the mixing and degassing systems. The control unit 37 can
receive the temperature data from the temperature sensors to
monitor the temperature at various locations in the console 2.
[0235] Other sensors, such as pressure sensors, dissolved oxygen
sensors, etc. may be provided downstream of the fluid reservoirs 31
before the mixing and degassing systems.
[0236] The monitoring apparatus 36 disposed downstream the
degassing system 33 and mixing system 32 in FIG. 5C may be provided
to measure various properties of the treatment fluid after mixing
and degassing. The monitoring apparatus 36 may include any suitable
sensors, such as concentration sensors, temperature sensors,
dissolved oxygen sensors, pressure sensors, etc. The concentration
sensors may be similar to those described above and can measure the
resulting concentration of the fluid after mixing. Similarly, the
temperature sensors can be configured to measure the temperature of
the mixed, degassed fluid before delivery to the tooth coupler 3
and patient. It can be important to ensure that the temperature is
not too hot and not too cold so as to avoid harming the patient
and/or tooth 10.
[0237] In addition, a dissolved oxygen (DO) sensor can be provided
to measure the amount of dissolved gases remaining in the mixed,
degassed fluid, which may be representative of the amount of air
dissolved in the liquid. The dissolved oxygen sensor may check the
level of dissolved oxygen in the treatment fluid, and, if the
dissolved oxygen level is not sufficient, the system may be
disabled in some arrangements, or the control unit 37 can instruct
the console 2 to engage in further degassing. Any suitable
dissolved oxygen sensor can be used, including, e.g., optical
sensors. One example of such a dissolved oxygen sensor is the Model
EOM-O2-mini-90-PHB1.511-v1 manufactured by PreSens Precision
Sensing GmbH of Regensburg, Germany.
[0238] In addition, one or more pressure sensors may be disposed
upstream or downstream of the pump 34 to measure the pressure of
liquid output from the pump 34, as explained above. Furthermore, as
above, the control unit 37 can receive and process the data output
from the monitoring apparatus 36, including data from sensors, such
as concentration sensors, temperature sensors, pressure sensors,
dissolved oxygen sensors, etc. The feedback received from the
control unit 37 can be used to adjust the various processes
performed in the console until the desired concentrations,
temperatures, pressures, and amounts of dissolved oxygen are
suitable for a particular treatment procedure.
[0239] 8. User Interface
[0240] The user interface 28 can be configured to receive
instructions from the clinician and/or to display data to the
clinician regarding a treatment procedure and/or a status of the
system. The user interface 28 can include a display configured to
display data regarding a procedure to the clinician. The display
may comprise a touch-screen display, in which the clinician can
also send instructions to the system 1 by way of the display. In
other arrangements, the user interface 28 can include a separate
keyboard, keypad, joy stick, etc. to enable the clinician to send
instructions to the console 2 and system 1. In some embodiments,
the user interface 28 may include controls for a dental
practitioner to operate the liquid jet apparatus. For example, the
controls can include a foot switch to actuate or deactuate the jet
(e.g., which may be coupled to the tooth coupler 3).
[0241] The clinician can interact with the user interface 28 to
select a treatment procedure, e.g., to select whether a particular
procedure is a cleaning procedure (e.g., of root canals, caries,
undesirable deposits, etc.), an obturation procedure, a restoration
procedure, etc. Once the procedure type is selected, the clinician
can activate the procedure and can monitor the status of the
procedure on the display. For example, the clinician may set a
desired pressure for the pump, or other desired parameters for the
jet. The clinician can set when the procedure is to begin and end
by way of the interface 28. Furthermore, the clinician can use the
user interface 28 to communicate various data about the procedure
to other entities, as explained in more detail herein with respect
to the various communications aspects of the system 1. In some
arrangements, the clinician can interact with the user interface 28
to access patient medical records or other data about the patient.
In some embodiments, the display of the user interface 28 can
display images or video of the progress of a procedure, e.g., how
much of a root canal has been cleaned, filled, etc. The clinician
can interact with the user interface 28 in some aspects to
determine how much supply of various materials is on hand, and can
access patient scheduling systems. The user interface 28 may also
have emergency systems by which the clinician can shut down the
system 1 in case of emergency. In some arrangements, the system 1
may automatically contact emergency responders, or the user
interface 28 can include a button or other interface by which the
clinician can actively seek emergency responders.
[0242] 9. Control Unit
[0243] The control unit 37 can receive data from and send
instructions to the various components of the console 2, the
interface member 4, and the tooth coupler 3. For example, as shown
in FIG. 5C, the control unit 37 can be in electrical and/or data
communication with the fluid reservoirs 31, the monitoring sensors
38 and apparatus 36, the mixing system 32, the degassing system 33,
the pump 34, the interface member 4, the user interface 28, and any
other suitable components of the system 1. The control unit 37 may
comprise a microprocessor, a special or general purpose computer, a
floating point gate array, and/or a programmable logic device.
Programmable instructions for carrying out the various processes
disclosed herein may be stored on any suitable computer readable
medium, such as a non-transitory computer readable medium (e.g., a
RAM, ROM, or any other suitable memory device). In some
embodiments, the control unit 37 may include a power unit 40
configured to supply electrical power to the various system
components.
[0244] The control unit 37 can include a processing unit 39
configured to receive, send, and/or process data regarding the
system components. For example, the processing unit 39 can receive
signals from the sensors 38 and monitoring apparatus 36, and can
process and store those signals for later use. The processing unit
39 can send instructions to valves that control the flow of fluid
from the reservoirs 31 to selectively actuate the valves in a
desired manner, e.g., to selectively cause fluid to flow from the
reservoirs 31. The processing unit 39 can similarly control the
operation of the mixing system 32 to ensure that the proper
proportions of fluids are mixed together. The processing unit 39
can control the operation of the degassing system 33 to accurately
and precisely degas the treatment fluids.
[0245] The processing unit 39 can send and receive instructions
from the pump 34 (or a motor coupled to the pump 34). As explained
above, the processing unit 39 can process the pressure of the fluid
at the output of the pump 34, and can send instructions to the
motor and pump 34 to adjust the pressure output at the pump 34 to
the desired level. As explained above, various control algorithms
(such as PID control) may be implemented to achieve the desired
pump output. In some arrangements, the console 2 and processing
unit 39 can be programmed to deliver the treatment fluid at
prescribed pressure oscillations. For example, the processing unit
39 can be programmed to control the shear thinning properties of
the fluid and/or to produce the desired pressure waves for
propagating at the treatment region of the tooth 10. The pressure
oscillations may be generated by the delivery mechanism (e.g., by
way of the pump 34 and the control unit 37), or by way of a
secondary mechanism or process (e.g., ultrasonic agitation), or a
combination of both.
[0246] The processing unit 39 can also communicate with the user
interface 28 to receive inputs from the clinician and to send data
about the procedure to be displayed to the clinician. The
processing unit 39 can communicate with the tooth coupler 3 and the
working end of the system by passing through or along the interface
member 4 in some embodiments. In other embodiments, the electrical
and data pathways (which may include optical fibers or wireless
data transmission devices) may connect to the tooth coupler 3
separate from the interface member 4.
[0247] As explained in more detail herein, the control unit 37 can
also communicate with external entities regarding the status of a
procedure or about the history of procedures performed on the
system 1. The control unit 37 can be configured to access patient
medical records and/or patient scheduling systems. The control unit
37 can also monitor office inventory, including the amounts of
fluids and other materials used for procedures, as explained
herein. As explained herein, the control unit 37 can therefore
include any suitable communications modules to enable the system 1
to communicate with external entities (such as suppliers, emergency
responders, patients, etc.).
[0248] 10. Evacuation System
[0249] FIG. 5E is a schematic system diagram of an evacuation
system 57 configured to apply a vacuum pressure to various
components of the system 1. The user interface 28 can communicate
with a vacuum pump 48, which can be any suitable vacuum pump, such
as the Model DBM30B-201 manufactured by Brenner-Fiedler &
Associates, Inc., of Riverside, Calif. The vacuum pump 48 can be
configured to apply a vacuum or negative pressure throughout the
evacuation system 57. In particular, the vacuum pump 48 can draw
fluids from the system 1 to a waste reservoir 49, which can be any
suitable container.
[0250] As explained above, the tooth coupler 3 can include a
suction port that is in fluid communication with the waste
reservoir 49 and vacuum pump 48. When the vacuum pump 48 is
activated, waste fluids and/or materials can be drawn out through
the suction port in the tooth coupler 3 and can be conveyed to the
waste reservoir 49. Similarly, during a purging operation, the
waste line (which may be the same waste line coupled to the tooth
coupler 3 in some arrangements) may be coupled to the purge system
47. Purge fluids passing through the purge system 47 can likewise
be drawn to the waste reservoir 49.
[0251] The vacuum pump 48 can apply negative pressure to other
system components by way of a vacuum system manifold 59. Although
the purge system 47 and tooth coupler 3 are not illustrated as
being inputs to the manifold 59, in some embodiments, the purge
system 47 and/or the tooth coupler 3 may pass through the manifold
59. The manifold 59 can include several inputs. For example, the
evacuation lines passing between the reservoirs 31 of treatment
fluids (e.g., water, Chemical A, Chemical B, etc.) may convey the
respective fluids to the manifold 59. A vacuum sensor 58 can
communicate with the manifold 59 to measure the pressure provided
by the vacuum pump 48 and manifold 59. The control unit 37 can
monitor and/or activate the manifold to ensure that an adequate
vacuum is provided.
[0252] Further, as explained above, the backflush line can supply
water from the reservoir 31 to the pump 34. After passing through
the pump 34, the flushed fluid can enter the manifold 59. In
addition, the vacuum system manifold 59 can apply vacuum pressures
to the degassing system(s) 33. As explained herein, in some
embodiments, the degassing systems 33 may be activated by applying
a vacuum across the inlet and outlets to draw dissolved gases out
through a semipermeable membrane. The vacuum provided by the
manifold 59 can apply suction across the degasser inlets and
outlets to activate the degassing systems 33 and to degas the
respective treatment fluids.
B. Dental Office Management Systems and Networks
[0253] The system 1 disclosed herein can advantageously act as a
core component of the dental office. The console 2 can act as a
gateway to the system 1 by way of the user interface 28 illustrated
herein, or by way of remote access using wireless or wired network
communications. Indeed, in some embodiments, the clinician can
access and/or manage many of the typical day-to-day aspects of the
dental office, including treatment procedures, dental devices and
apparatus, diagnostic, evaluation and imaging procedures and
systems, patient health and billing records, scheduling systems,
inventory systems, emergency systems, and various other systems
that are used by dentists, endodontists, and other clinicians.
[0254] FIG. 5F is a schematic diagram of the processing unit 39,
according to some embodiments. The processing unit 39 can include
or communicate with various software modules that, when executed by
a processor, perform the various methods and procedures disclosed
herein. The software modules can be stored on a non-transitory
computer readable medium, such as a memory device (e.g., RAM, ROM,
flash, or any other suitable memory known to those of skill in the
art). For example, the processing unit can comprise a controller
module 43. The controller module 43 may be configured or programmed
to control the operation of the treatment procedure components in
the system 1. As explained above with respect to FIG. 5C, for
example, the controller module 43 may be configured to control the
operation of at least one of the reservoirs 31, the monitoring
sensors 38 and apparatus 36, the mixing system 32, the degassing
system 33, the motor 42, the pump 34, valves, various components of
the tooth coupler 3, other sensors (e.g., pressure sensors, etc.),
and other mechanical, electrical, or fluidic components. The
controller module 43 may also be configured to receive data from
and send instructions to these components to monitor and manage the
operation of the system 1. For example, the controller module 43
may be programmed to receive and process instructions input to the
user interface 28 by the clinician, and may be programmed to
display or notify the clinician about the status of the system 1 or
procedures by way of the user interface 28. The controller module
43 may be programmed to communicate with the manufacturer, the
distributor and/or the service provider, and to report status of
the system and receive updates, e.g. software updates for the
console 2.
[0255] The processing unit 39 can also include a management module
44 configured to store, organize, and/or manage data about the
system 1 and about the procedures performed by the system 1. For
example, the management module 44 can be programmed to monitor the
number and type of procedures performed by the system 1, and can
log the history of the system 1 (e.g., the date, time and length of
the procedure, the clinician who performed the procedure, etc.).
The management module 44 can associate each procedure with a
particular patient and can store events recorded by the system 1
and/or by the clinician (by way of the user interface 28). For
example, if a particular event occurs during a cleaning procedure
(e.g., the patient requires a second visit due to uncontrollable
pain or drainage), then the clinician may record such an event
using the user interface 28, or various sensors of the system 1 may
automatically store such events to the system 1. As explained
herein, the system 1 can include various verification devices to
ensure that the tooth coupler 3 (e.g., a handpiece) is a valid,
sterile handpiece. The management module 44 can store such
verification data for the system 1.
[0256] Moreover, the management module 44 can track the amount of
treatment materials and disposable devices that are associated with
the system 1. For example, the management module 44 can track each
procedure and can receive information from the system sensors to
determine how much of each type of treatment fluid remains in the
fluid reservoirs 31. The management module may make the
determination based on the number of treatment procedures that drew
from the reservoirs 31, or the fluid level sensors disposed on or
near the reservoirs may send a signal to the control unit 37
indicating that additional fluid is needed at the system 1. The
control unit 37 and/or management module 44 can send a signal to
the clinician (e.g., by way of the user interface 28) that
additional fluids should be added to the system 1 and/or console 2.
Furthermore, the management module 44 may indicate that additional
tooth couplers 3 (e.g., handpieces) should be ordered based on the
number of procedures performed by the system 1 and the initial
number of couplers 3 supplied to the system 1. Likewise, the
management module can track the amount of obturation and/or
restoration materials available and can notify the clinician that
additional materials should be supplied.
[0257] The management module 44 may also track the number of
procedures that each system component has been active. For example,
the management module 44 can track how many procedures have been
performed by the mixing system 32, the degassing system 33, the
monitoring sensors or apparatus, the pump 34, the motor 42, the
fluid pathway 35, the interface 4, etc. If the number of procedures
exceeds desired safety levels for the particular component, then
the management module 44 can send a signal to the clinician (e.g.,
by way of the user interface 28) that replacement components should
be installed. Furthermore, if one of the sensors signals that a
particular component is damaged, then the management module 44 can
also notify the clinician that the damaged component should be
replaced or fixed. The management module 44 can also be configured
to notify the manufacturer, distributor and/or the service provider
and can report the matter requesting maintenance or repair. The
management module 44 can also determine when the waste system 41 is
full of waste fluids and particles, and can signal the clinician
that the waste system 41 should be emptied or replaced.
[0258] The processing unit 39 can also include a communications
module 45 configured to provide data communication with external
systems (e.g., external systems in the dental office, external
supplier systems, etc.) and/or external entities (e.g., persons,
businesses, or organizations). The communications module 45 can be
configured to communicate with the external systems and/or entities
by way of any suitable communications system, such as wireless
(e.g. 802.11 networking protocols), Bluetooth, wired networks
(e.g., fiber optic lines), mobile telephone networks (e.g., 3G, 4G,
etc.), etc. The communications module 45 can also communicate with
other system components, by way of direct wire communications,
wireless networking, radio frequency identification (RFID),
etc.
[0259] FIG. 5G is a schematic diagram of the system 1 and various
network relationships the system 1 may have with external systems
46. For example, the console 2 (for example, by way of the
communications module 45) may communicate with other cleaning
systems 46a to initiate a particular cleaning procedure and/or to
communicate the status of the procedure performed by the system 1.
For example, pre- or post-treatment cleaning may be performed by
the external cleaning system 46a. The console 2 can communicate
with restoration systems 46b and/or obturation systems 46c to
indicate the status of any procedures being performed by the system
1, and can also send instructions for the restoration systems 46b
or the obturations systems 46c to initiate their respective
procedures. For example, after the system 1 and console 2 complete
a cleaning procedure, the console 2 may indicate to the obturation
system 46c that the cleaning procedure is complete and may initiate
an obturation procedure. The obturation system 46c and the
restoration system 46b may be external systems in some embodiments.
In other embodiments, the obturation system 46c and the restoration
system 46b may be located on or near, or coupled to, the system
1.
[0260] The console 2 can communicate with an endodontic microscope
46d in the dental office (which may be integrated with or separate
from the console 2) to initiate imaging of a tooth and/or to
retrieve microscopic images of the tooth. The system 1 (e.g., the
control unit 37) can process the image and display it for the
clinician on the user interface 28. Software may analyze the image
to automatically detect unhealthy areas of the tooth, the status of
a cleaning procedure, and/or can identify areas that may be
difficult to treat (e.g., narrow or curved canals).
[0261] The console 2 can also communicate with a patient scheduling
system 46e. The patient scheduling system 46e may be a component of
the clinician's office management systems and can manage the
schedule of appointments. The console 2 can retrieve scheduling
data from the scheduling system 46e to identify when a patient is
scheduled to arrive in some embodiments. The console 2 can also
enable the clinician to communicate with the patient at the dental
chair about availability for a future appointment. In addition, the
console 2 can be configured to send reminders to patients regarding
appointments or cancellations (e.g., by e-mail, telephone, etc.).
If a particular treatment procedure is taking longer than expected,
then the console 2 can also notify the patient scheduling system
46e that the clinician may be late for his or her next
appointment.
[0262] The console 2 can also communicate with an office inventory
system 46f. As explained herein, the management module 44 can track
the inventory of materials and system components (both disposable
and re-usable). The communications module 45 can be configured to
send requests to the office inventory system 46f notifying the
system 46f that a particular material (e.g., a treatment fluid,
obturation material, etc.) or component (e.g., a handpiece, fluid
pathway, etc.) should be replaced. The clinician or the clinician's
staff can then order the materials or components that should be
replaced. Alternatively, the communications module 45 can be
configured to automatically notify the clinician's suppliers that
additional materials or components should be shipped to the
clinician's office. For example, if the management module 44
determines that additional handpieces should be ordered, then the
communications module 45 can communicate with the handpiece
manufacturer or supplier requesting additional handpieces.
[0263] The console 2 can also communicate with a suction and waste
collection system 46g, which may be integrated with or may be
separate from the system 1. For example, the console 2 can control
the activation of a vacuum pump associated with the suction system
to activate and de-activate the suction and removal of waste
materials from the treatment site. The console 2 can also track the
amount of waste fluid that fills a waste reservoir. When the waste
reservoir is filled, the console 2 can indicate that the waste
materials should be disposed of.
[0264] The console 2 can also communicate with a drilling or
mechanical abrasion system 46h. For example, in some treatments, a
conventional drill may be used to remove portions of the tooth,
e.g., to form an access opening. The console 2 can be in electrical
and/or data communication with the drilling system 46h and can
instruct the drilling system 46h to activate and deactivate based
on the clinician's instructions.
[0265] In addition, the console 2 can communicate with a patient
data management system 46i. The patient data management system 46i
may be a component of the clinician's office management system, or
it may be part of the system 1 in some arrangements. The console 2
can receive information about a particular patient, such as a
patient's biographical information (e.g., address, phone number,
occupation, etc.) and health information (e.g., health problems,
past dental procedures, x-rays, etc.). The console 2 can display
selected information about the patient to the clinician by way of
the user interface 28 in real-time. In addition, the console 2 can
send information about a particular treatment procedure to the
patient data management system 46i to record information about the
treatment in the patient's medical files. For example, the console
2 can store information about the treatment, including any
complications or other follow-up treatments (such as restoration
procedures), in the patient's medical records. In some
arrangements, the clinician can interact with the user interface 28
to make specific notes about the procedure, which can be
transmitted to the patient data management system 46i.
Advantageously, such automatic recording of treatment information
can improve the efficiency of recording patient medical data.
[0266] Irrigation or other fluid supply systems 46j can also
communicate with the console 2. For example, the console 2 may
instruct the irrigation system 46j that water or another treatment
solution should be supplied to the tooth 10. The clinician can
operate the irrigation system 46j by way of the user interface 28.
The irrigation system 46j may be integrated with or separate from
the system 1. In addition, imaging systems 46k may communicate with
the console 2. For example, the console 2 can communicate with
x-ray imaging systems, cone beam computed tomography (CBCT), or
other imaging systems to provide real-time imaging data to the
clinician, for example, by way of the user interface 28. The
clinician can activate the imaging systems 46k by way of the user
interface 28, and the desired images can be displayed on the
display. The images can also be recorded, associated with the
patient, and stored in the patient's medical files by way of the
patient data management system 46i.
[0267] The console 2 can also communicate with various emergency
systems 46l. For example, if an emergency arises (e.g., excessive
bleeding or other complications), then the clinician may activate
an emergency button or other emergency interface to notify
emergency responders of the emergency and to request an ambulance.
In some arrangements, sensors in the system 1 may detect an
emergency event and can similarly request emergency assistance.
[0268] Thus, in various arrangements, the system 1 can track the
progression of a procedure and communicate such a progression to
any desirable external entity and/or system 1. Furthermore, the
system 1 can recognize which type of treatment handpiece is
attached to the console 2 (by way of, e.g., the conduits 29). The
system 1 can switch to the settings that are required or desired to
run that specific treatment. For example, the system 1 may
recognize that the handpiece 3A coupled to the console 2 is a molar
handpiece for cleaning a root canal. The system 1 can accordingly
select a molar root canal procedure. As another example, the system
1 may recognize that the handpiece 3A coupled to the console 2 is a
handpiece for treating caries, and can accordingly select the
appropriate treatment.
[0269] In some embodiments, the console 2 can be incorporated into
a dental chair. In such embodiments, the console 2 can be formed
with the chair and can provide easy access for the clinician
conducting the treatment. In other embodiments, such as those
disclosed herein, the console 2 can be a separate, stand-alone
unit.
C. Housing for Console
[0270] FIG. 5H is a front perspective view of a system 1 having a
console 2 comprising a housing 430, according to one embodiment.
FIG. 5I is a rear perspective view of the system 1 of FIG. 5H. As
explained herein, the system components can be coupled to and/or
housed in the housing 430. As above, the console 2 can include a
user interface 428. A fluid reservoir drawer 431 can be provided to
house the fluid reservoir(s) 31. Similarly, a waste reservoir
drawer 447 can be provided to house the waste reservoir 47. The
degassing system(s) 33 can be housed in a degassing apparatus
region 433 of the housing 430, and the mixing system 32 can be
housed in a mixing apparatus region 432 of the housing 430. The
pump 34 can be housed in a pump housing region 434. As explained
herein, a fluid pathway 435 can connect the console 2 to an
interface member 404. It should be appreciated that the housing 430
shown in FIGS. 5H and 5I are only one example of a housing; any
other suitable housing may be suitable for housing the components
of the disclosed system 1.
III. Tooth Couplers
[0271] As explained herein, the tooth coupler 3 can be any suitable
mechanism configured to be coupled to the tooth 10 and to perform a
treatment procedure. In some embodiments, the pressure wave
generator 5 can be coupled to, formed with, and/or disposed at
least partially within the tooth coupler 3. The clinician can
couple a portion of the tooth coupler 3 to the tooth 10 to be
treated. In some procedures, a chamber 6 of the tooth coupler 3 or
a chamber of the tooth 10 can be at least partially or
substantially filled with a treatment fluid. The clinician can
initiate and control the procedure using the console 2, e.g., to
activate the pressure wave generator 5 to perform the desired
treatment procedure. As explained herein, the pressure wave
generator 5 can comprise a liquid jet device in some embodiments.
The tooth coupler 3 can comprise a handpiece 3A, a treatment cap
3B, etc.
A. Examples of Liquid Jet Devices
[0272] One example of a pressure wave generator 5 is a liquid jet
device, e.g., a device configured to generate a coherent,
collimated jet of liquid. FIG. 6 is a schematic side view of a
tooth coupler 3 comprising a liquid jet device 56. The liquid jet
device 56 can include a proximal portion 51, which may include or
be coupled to a nozzle 64 configured to form a liquid jet 60. The
nozzle 64 may be formed at or coupled to any suitable portion of
the tooth coupler 3 and/or guide tube 52. The liquid jet device 56
can further comprise a guide tube 52 sized and shaped to form a
channel, along which the liquid jet 60 can propagate. A distal
portion of the guide tube 52 can comprise one or more openings 53.
The openings 53 can enable the liquid jet 60 to interact with fluid
in the chamber 6 of the tooth coupler 3 and/or a chamber of the
tooth 10 (e.g., pulp cavity and/or canal spaces of the tooth 10).
The liquid jet 60 can impact upon an impingement member 54 at the
distal portion of the guide tube 52 to generate a spray 55 of
liquid that passes through the one or more openings 53. As
explained herein, the interaction of the liquid jet 60 with
surrounding fluid can generate pressure waves and/or fluid motion
sufficient to clean the tooth 10.
[0273] In certain embodiments, the system 1 may be configured to
produce a liquid jet 60 that forms a substantially parallel beam
(e.g., is "collimated") over distances ranging from about 0.01 cm
to about 10 cm. In some embodiments, the velocity profile
transverse to the propagation axis of the jet is substantially
constant (e.g., is "coherent"). For example, in some
implementations, away from narrow boundary layers near the outer
surface of the jet 60 (if any), the jet velocity is substantially
constant across the width of the jet. Therefore, in certain
advantageous embodiments, the liquid jet 60 delivered by the tooth
coupler 3 may comprise a coherent, collimated jet (a "CC jet"). In
some implementations, the CC jet may have velocities in a range
from about 100 m/s to about 300 m/s, for example, about 190 m/s in
some embodiments. In some implementations, the CC jet can have a
diameter in a range from about 5 microns to about 1000 microns, in
a range from about 10 microns to about 100 microns, in a range from
about 100 microns to about 500 microns, or in a range from about
500 microns to about 1000 microns. Further details with respect to
CC jets that can be produced by embodiments of the system and
apparatus described herein can be found in U.S. Patent Publication
No. 2007/0248932, U.S. Patent Publication No. 2011/0117517, and/or
U.S. Patent Publication No. 2012/0237893, each of which is hereby
incorporated by reference herein in its entirety for all that it
discloses or teaches
[0274] FIG. 7A is a schematic, side cross-sectional view of the
nozzle 64, in accordance with one embodiment. As explained above,
the proximal portion 51 of the tooth coupler 3 may comprise or be
coupled to the nozzle 64. The nozzle 64 can be sized and shaped
such that when a pressurized stream of liquid 62 passes through an
orifice 66 of the nozzle 64, a liquid jet 60 is formed. The nozzle
64 can comprise a circular, cylinder- or disc-like element having
an orifice 66 formed therein. The nozzle 64 may be fabricated from
a suitably rigid material that resists deformation under high
pressure such as, for example, metal, ceramic, or synthetic
sapphire or ruby. Embodiments of the nozzle 64 can be manufactured
by a variety of processes including, e.g., electroforming
(including nickel-cobalt electroforms), micro-plunge electrical
discharge machining (EDM), laser cutting, liquid jet cutting,
chemical etching, etc. The orifice 66 may have any desired shape
such as, e.g., circular, oval, rectangular, polygonal, etc. The
orifice 66 may, but need not be, substantially centered in the
nozzle 64. In some embodiments, the nozzle 64 may have two or more
orifices 66, with each orifice configured to emit a liquid jet. In
some embodiments, the tooth coupler 3 may include additional
components, for example, to assist guiding or directing the jet 60
and/or to provide aspiration.
[0275] In various embodiments, it can be advantageous for the
nozzle 64 to abruptly change the direction of the pressurized
stream of liquid 62 delivered to the orifice 66. For example,
abrupt changes in velocity of the stream of liquid 62 may lead to a
more confined jet, e.g., a coherent, collimated jet having energy
sufficient to clean a tooth (and/or to perform other procedures
discussed herein). Furthermore, as shown schematically in FIG. 7A,
it can be advantageous to increase a separation space 61 between
walls of the orifice 66 and the jet 60. Increasing the space 61 can
reduce the likelihood that the orifice 66 or other portions of the
nozzle 64 interfere with or otherwise obstruct the jet 60, or that
the jet 60 reattaches to the wall of the orifice 66, which may
result in the disruption of the coherent, collimated jet 60.
Interference from wall of the orifice 66 or other portions of the
nozzle 64 may act to reduce the energy of the jet 60, and thereby,
the effectiveness of the treatment procedure.
[0276] Different types of fluid streams (e.g., a jet or a spray)
can be generated by the nozzle 64 and/or orifice 66 based at least
in part on flow parameters, nozzle geometry, surface quality of the
orifice 66 (or other surfaces in the nozzle 64), and so forth.
FIGS. 7B and 7C are cross-section views that schematically
illustrate embodiments of a nozzle 64 having an orifice 66. Nozzles
and/or orifices can be configured in a number of ways to provide a
CC jet. For example, as schematically illustrated in FIG. 7B, in
some embodiments a relatively sharp-edged, cone-down orifice 66 can
be used. In other embodiments, other shapes can be used, e.g.,
conical orifices, capillary orifices, cone-capillary orifices, etc.
Arrow 72 shows the direction of fluid flow through the orifice 66
during operation of the liquid jet apparatus.
[0277] In the illustrated embodiments, the orifice 66 is
substantially circularly symmetric, although this is not a
requirement. The orifice 66 may, but need not, be formed at an
angle to a proximal surface 70a of the nozzle 64. The angle may be
about 0 degrees (e.g., the orifice is substantially perpendicular
to the proximal surface 70a), about 10 degrees, about 20 degrees,
about 30 degrees, about 40 degrees, about 50 degrees, about 60
degrees, or some other angle. The orifice 66 shown in FIGS. 7B and
7C comprises a proximal portion 68a that can be substantially
cylindrical with a length L.sub.1 and a diameter D.sub.1. The
orifice 66 can comprise a distal portion 68b that can be
substantially conical with a cone angle .alpha. and can have a
length L.sub.2 and a diameter D.sub.2. As schematically illustrated
in FIG. 7C, the cone angle .alpha. can be about 180 degrees, so
that the distal portion 68b is substantially cylindrical. The
diameter D.sub.2 can, but need not be, different from the diameter
D.sub.1. For example, in various embodiments, D.sub.2 can be
approximately the same as D.sub.1, D.sub.2 can be larger than
D.sub.1, or D.sub.2 can be smaller than D.sub.1. The length L.sub.2
can, but need not be, different from the length L.sub.1. For
example, in various embodiments, L.sub.2 can be approximately the
same as L.sub.1, L.sub.2 can be larger than L.sub.1, or L.sub.2 can
be smaller than L.sub.1. The orifice geometry schematically
illustrated in FIGS. 7B and 7C may cause a relatively abrupt change
in velocity of the liquid flowing through the orifice 66.
[0278] For length-to-diameter ratios L.sub.1/D.sub.1 in a range
from about 0 to about 1.2, about 0 to about 0.9, or about 0 to 0.8,
the flow may be constricted, may not reattach to the walls of the
orifice, and may form a CC-Jet with a relatively long break-up
length. In some embodiments, for example, the length-to-diameter
ratios L.sub.1/D.sub.1 may be about 1. For length-to-diameter
ratios L.sub.1/D.sub.1 in a range from about 0.7 to about 4, or
about 0.7 to about 1.2, cavitation may be induced. Initially, the
flow out of the nozzle 64 may reattach to the walls of the orifice
66, and the fluid stream may not be a CC jet. For sufficiently high
pressures (near the inlet 74 to the nozzle 64), cavitation may
occur near the inlet 74. The cavitation region can grow and may
form an air entrainment region sufficiently large to induce air
from downstream to flow up to the nozzle's outlet 76 and separate
liquid from the walls of the orifice 66, which may help create a CC
jet. In other embodiments, length-to-diameter ratios
L.sub.1/D.sub.1 above 4 can be used.
[0279] A possible advantage of using length-to-diameter ratios
L.sub.1/D.sub.1 in the range from about 0 to about 0.7 is that
cavitation may cause damage to the nozzle. Accordingly, in such
ranges of L.sub.1/D.sub.1 it may be important to select a material
strong enough for the nozzle. A possible disadvantage is that a
sufficiently hard material able to withstand relatively high
pressure may be used for the nozzle 64, which may limit the variety
of materials used for the nozzle. In some arrangements, a suitably
strong material for the nozzle may not be available to avoid
failure. A possible advantage of using length-to-diameter ratios
L.sub.1/D.sub.1 in the range from about 0.7 to about 4 is that the
larger L.sub.1/D.sub.1 ratio allows the nozzle's geometry to be
adapted for a wider range of materials. A possible disadvantage of
higher L.sub.1/D.sub.1 ratios is that cavitation may cause damage
to the nozzle 64 and lead to a shorter working life for the
nozzle.
[0280] It is believed, although not required, that for
L.sub.1/D.sub.1 ratios at least in the range from about 0 to about
4, the nozzle design may be relatively insensitive to the cone
angle .alpha.. Accordingly, cone angles near about 0 degrees can be
used (e.g., the orifice 64 is approximately a cylinder over the
length L.sub.1 and L.sub.2). In this case, the orifice 66 may be
thought of as comprising just the proximal portion 68a and not the
distal portion 68b. In other embodiments, only the distal portion
68b is used, and the orifice 66 is substantially conical. Many
possible configurations of the orifice 66 can be used, and the
examples in FIGS. 7B and 7C are intended to be illustrative and not
to be limiting.
[0281] For example, as schematically illustrated in FIG. 7C, cone
angles of about 180 degrees can be used. In this example, both the
proximal portion 68a and the distal portion 68b are substantially
cylindrical, with the diameter D.sub.2 of the distal portion 68b
larger than the diameter D.sub.1 of the proximal portion 68a. In
other embodiments, the diameter D.sub.2 of the distal portion 68b
may be smaller than the diameter D.sub.1 of the proximal portion
68a. Shaping the proximal portion 68a or the distal portion 68b
substantially as cylinders may advantageously make manufacturing
the orifice simpler. In other embodiments, cone angles in a range
from about 0 degrees to about 20 degrees, about 20 degrees to about
45 degrees, about 45 degrees to about 90 degrees, about 90 degrees
to about 120 degrees, or some other range can be used.
[0282] In various embodiments of the nozzle 64, the orifice 66 may
have a diameter D.sub.1 at the inlet 74 or a diameter D.sub.2 at
the outlet 76 that may be in a range from about 5 microns to about
1000 microns. Other diameter ranges are possible. In various
embodiments, one or both of the diameters D.sub.1 or D.sub.2 may be
in a range from about 10 microns to about 100 microns, a range from
about 100 microns to about 500 microns, or range from about 500
microns to about 1000 microns. In various other embodiments, one or
both of the orifice diameters D.sub.1 or D.sub.2 may be in a range
of about 40-80 microns, a range of about 45-70 microns, or a range
of about 45-65 microns. In one embodiment, the orifice diameter
D.sub.1 is about 60 microns. The ratio of axial length L.sub.1 to
diameter D.sub.1, the ratio of axial length L.sub.2 to diameter D2,
or the ratio of total axial length L.sub.1+L.sub.2 to diameter
D.sub.1, D.sub.2, or average diameter (D.sub.1+D.sub.2)/2 may, in
various embodiments, be about 50:1, about 20:1, about 10:1, about
5:1, about 1:1, or less. In one embodiment, the axial length
L.sub.1 is about 500 microns. In some cases, the axial length
L.sub.2 (or the ratio L.sub.2/D.sub.2) can be selected so that the
flow through the orifice 66 does not reattach to surface 70c. The
axial length L.sub.2, the diameter D.sub.2, or other parameters
shown in FIGS. 7B and 7C may be selected so that the nozzle 64 has
sufficient structural rigidity to withstand load from pressurized
fluid.
[0283] With reference to the example nozzle 64 schematically
illustrated in FIG. 7B, the curvature of corner or edge 69 is
denoted by r, and the surface roughness of surfaces 70a, 70b, and
70c is denoted by Ra. Relatively abrupt geometry changes in the
nozzle 64 may induce a relatively large velocity change, which may
lead to a relatively constricted jet. For example, the ratio of
surface roughness Ra to orifice diameter D.sub.1, Ra/D.sub.1, for
some or all of the surfaces 70a-70c may be less than about 0.01,
less than about 0.005, or less than about 0.001 in various
embodiments. The ratio of corner curvature radius r to orifice
diameter D.sub.1, r/D.sub.1, may be less than about 0.1, less than
about 0.05, less than about 0.04, less than about 0.02, less than
about 0.01, or less than about 0.004 in various embodiments. The
surface roughness Ra of the surfaces 70a, 70b, or 70c can have a
root-mean-square (rms) surface roughness less than about 10
microns, less than about 1 micron, or less than about 0.1
microns.
[0284] In certain embodiments, the nozzle 64 (or surface portions
adjacent the liquid) can be formed from a hydrophobic material. In
certain such embodiments, the contact angle (e.g., the angle formed
between a solid surface and a liquid) of the hydrophobic material
may be smaller than about .pi./2 radians. In some implementations,
the nozzle 64 may comprise stainless steel or a plastic such as,
e.g., acrylic. Other materials may be used such as, e.g., aluminum,
copper, or polycarbonate, but in some cases, nozzles formed from
such materials may not produce a substantially constricted jet.
[0285] The behavior and characteristics of liquid streams ejected
through an orifice 66 can be dependent upon the design and quality
of the orifice 66. For instance, a specific orifice design may
produce different streams of liquid ranging from a coherent,
collimated jet to a spray, depending at least in part on the edge
sharpness of the orifice 66 and the surface roughness of the
orifice 66, as explained above with respect to FIGS. 7B-7C.
Accordingly, it can be important to identify suitable dimensions,
design and surface properties of the desired orifice 66 (as
described above with respect to FIGS. 7B-7C, for example), and to
develop suitable methods of making the orifice 66 with such
properties. The present disclosure describes methods of making
orifices 66 of various designs to produce liquid streams of desired
properties, in particular, orifices 66 capable of producing
coherent collimated jets 60 (or any jet of liquid with reduced or
minimal loss of momentum over the length of travel) which can be
used as a source of acoustics, fluid circulation and/or irrigation
in dental and endodontic procedures.
[0286] As explained herein, it can be advantageous to form the
nozzle 64 having an orifice 66 defined by sufficiently smooth walls
70 and edges 69. However, many manufacturing methods may not be
able to form the orifice 66 with sufficiently smooth walls 70
and/or edges 69. FIG. 8A is a perspective view of a nozzle 64 with
a substantially cylindrical orifice 66. FIG. 8B is a top plan view
of the nozzle 64 in which edges 69 of the orifice 66 are relatively
rough. FIG. 8D is a side cross-sectional view of the nozzle 64 of
FIG. 8B with rough edges 69. The nozzles 64 with relatively rough
or jagged edges 69 and walls 70 shown in FIGS. 8B and 8D may be
undesirable for forming a liquid jet 60 in accordance with the
embodiments disclosed herein. For example, the burrs or other
non-uniformities that define the jagged edges 69 and walls 70 may
reduce the energy of the pressurized liquid entering and passing
through the orifice 66. Indeed, in some arrangements, rough or
jagged edges 69 can spread the pressurized stream of liquid 62 out
and/or induce spray, which can reduce the degree of collimation and
momentum of the liquid jet 60. Similarly, FIG. 8E is a side
cross-sectional view of the nozzle 64, in which the edges 69 of the
nozzle 64 are removed and/or rounded. As with the rough edges 69 of
FIGS. 8B and 8D, a nozzle 64 having rounded edges 69 may likewise
spread the pressurized beam of liquid and/or otherwise reduce the
energy of the jet 60, which can reduce the effectiveness of the jet
60 in various treatment procedures (e.g., by reducing the momentum
of the jet 60).
[0287] By contrast, FIG. 8C is a side cross-sectional view of a
nozzle 64 in which edges 69 of the orifice 66 are relatively sharp
and the walls 70 of the orifice 66 are relatively smooth. The
sharp, smooth edges 69 of the orifice 66 of FIG. 8C may help to
cause an abrupt transition in the stream 62 such that the velocity
rapidly changes to form a coherent collimated jet 60. The smooth
walls 70 of the orifice 66 in FIG. 8C may be sufficiently smooth
such that the walls 70 do not inhibit the momentum of the jet 66.
Accordingly, it can be important to manufacture the nozzle 64 such
that the edges 69 are relatively sharp and the walls 70 are
relatively sharp, as explained in more detail above with respect to
FIGS. 7B-7C.
[0288] Various processes may be used to form orifices 66 having
sufficiently smooth walls and/or sharp edges 69. For example, in
various embodiments, the orifice 66 can be manufactured using at
least one of a laser cutting apparatus, electrical discharge
machining (EDM), mechanical drilling or machining, injection
molding, stereolithography, punching, three-dimensional printing,
plastic extrusion, chemical etching, or other suitable techniques.
Various types of laser cutting systems may be employed. For
example, in various embodiments a femto-second laser or a
pico-second laser may be used. The laser can comprise a Ytterbium
laser in some arrangements, which can operate at about a 1070 nm
wavelength. The laser used to form the orifice 66 may be pulsed or
continuous wave (CW). In some embodiments, the laser used to form
the orifice 66 can be coupled with or formed in a stream of water.
The stream of water can comprise a coherent and collimated jet in
some embodiments. Such processes can advantageously form orifices
having smooth walls 70 and sharp edges 69 sufficient to form a
liquid jet 60 for use in the treatments disclosed herein, as
described with respect to the parameters shown and described in
FIGS. 7B-7C.
[0289] FIGS. 9A-9I are side cross-sectional views of example nozzle
profiles, according to various embodiments. In FIGS. 9A-9C, the
nozzle 64 includes an orifice 66, a proximal wall 70a and a second
wall 70b. The orientation of the second wall 70b shown in FIGS.
9A-9C can be selected to form a suitable stream of liquid, such as
a coherent collimated jet 60. In the embodiment of FIG. 9A, for
example, the second wall 70b is substantially parallel to a
direction of fluid flow through the orifice 66. By contract, the
second wall 70b of FIG. 9B is transverse to the direction of fluid
flow and tapers inwardly towards the jet 60 along the direction of
flow. The second wall 70b of FIG. 9C is transverse to the direction
of fluid flow and tapers outwardly away from the jet 60 along the
direction of flow.
[0290] In FIGS. 9D-9I, the nozzle 64 includes an orifice 66, a
proximal wall 70a, a second wall 70b, and a third wall 70c. In
various arrangements, the nozzles 64 shown in FIGS. 9D-9I can
comprise a counterbore. The respective orientations of the second
and third walls 70b, 70c can be selected to form a suitable stream
of liquid, such as a coherent collimated jet 60. For example, the
nozzle 64 of FIG. 9D includes a second wall 70b that is oriented
substantially parallel to a direction of flow and a third wall 70c
that tapers away from the jet 60 along the direction of flow. The
nozzle 64 of FIG. 9E includes an inwardly-tapering second wall 70b
and an outwardly-tapering third wall 70c. By contrast, the nozzle
64 of FIG. 9F includes an outwardly-tapering second wall 70b and an
outwardly-tapering third wall 70c.
[0291] The nozzle 64 shown in FIG. 9G may be generally similar to
the nozzle 64 shown in FIG. 7C, e.g., the nozzle 64 can include a
second wall 70b substantially parallel to a direction of flow and a
third wall 70c spaced apart radially from the second wall 70b. The
third wall 70c can also be substantially parallel to the direction
of flow. By contrast, the nozzle 64 shown in FIG. 9H can include an
inwardly-tapering second wall 70b, e.g., that tapers towards the
jet 60 along the direction of flow. The nozzle 64 shown in FIG. 9I
can include an outwardly-tapering second wall 70b, e.g., that
tapers away from the jet 60 along the direction of flow. The
nozzles 64 disclosed in FIGS. 9A-9I may be selected according to
the stream of liquid desired for a particular treatment procedure.
Furthermore, although the direction of flow is illustrated as going
from top to bottom in FIGS. 9A-9I, it should be appreciated that,
in some arrangements, the direction of fluid flow may be reversed.
For example, in some arrangements, lower pressures and/or larger
diameter nozzles may allow flow to be reversed relative to that
shown in FIGS. 9A-9I.
[0292] FIGS. 10A-10C are side cross-sectional views of a nozzle 64
at various stages of an example manufacturing process. In
particular, FIG. 10A illustrates a partially-fabricated nozzle 64'
in which a plate 73 of a suitable nozzle material (described above)
can be selected. As shown in FIG. 10B, a first trench 75 can be
formed partially through a thickness of the plate 73. The first
trench 75 may define the orifice 66 when complete. Accordingly, it
can be advantageous to define a smooth second wall 70b of the first
trench 75 so that the orifice 66 will be sufficiently smooth so as
to form a liquid jet 60. As explained herein, the first trench 75
can be formed using a process that will result in a sufficiently
smooth second wall 70b. For example, in various embodiments, the
first trench 75 can be formed using at least one of a laser cutting
apparatus, electrical discharge machining (EDM), stereolithography,
or other suitable techniques.
[0293] Turning to FIG. 10C, a second trench 77 can be formed
partially through the thickness of the plate 73 to define the third
wall 70c and the larger diameter distal portion of the nozzle 64.
In some embodiments, the second trench 77 can be formed using a
mechanical technique, such as drilling or end milling a back side
of the plate 73. However, in some arrangements, using mechanical
techniques to form the second trench 77 may yield a bottom wall 70d
that is uneven, rough, and/or jagged. A rough bottom wall 70d may
be undesirable because the portion of the bottom wall 70d that
joins with the second wall 70b at least in part defines the length
of the orifice 66. If the bottom wall 70d is rough about the
perimeter of the orifice 66, then the length of the orifice 66 may
be different along different portions of the perimeter, which can
create an uneven jet or a stream having reduced momentum.
Accordingly, in some embodiments, it can be desirable to define the
second trench 77 using a high precision process, such as a laser
cutting apparatus, EDM, stereolithography, etc. By defining a more
uniform or smooth bottom wall 70d, the length of the orifice 66 may
be maintained substantially constant, which can advantageously
improve the jet-forming characteristics of the nozzle 64.
[0294] Although FIGS. 10A-10C illustrated the first trench 75 as
being formed before the secon trench 77, it should be appreciated
that the larger second trench 77 may be formed before forming the
first trench 75. The second trench 77 may be formed using a
precision method, such as laser cutting. In other arrangements, the
second trench 77 may be formed as a counter bore with an endmill,
EDM, ehcmical etch, etc.
[0295] FIG. 11 is a schematic side cross-sectional view of a
partially fabricated nozzle 64', according to another embodiment.
In the embodiment of FIG. 11, a first plate 73a and a second plate
73b can be selected. The plates 73a, 73b may comprise any suitable
material for forming the nozzle 64, as explained above. The plates
73a, 73b may comprise the same material or a different material. A
first trench 75 can be formed through the first plate 73a. As shown
in FIG. 11, the first trench 75 may be formed through the entire
thickness of the first plate 73a. As with the embodiment of FIGS.
10A-10C, the second wall 10b of the first trench 75 may define the
second wall 70b of the orifice 66 when the nozzle 64 is completed.
Accordingly, it can be advantageous to form a smooth wall 70b such
that the nozzle 64 can form a coherent collimated jet 60. In some
embodiments, the trench 75 can be formed through the first plate
73a using any suitable process, such as a laser cutting apparatus,
electrical discharge machining (EDM), stereolithography, or other
suitable techniques. Still other techniques may be suitable.
[0296] A second trench 77 can be formed through the second plate
73b, e.g., through the entire thickness of the second plate 73b as
shown in FIG. 11. The first plate 73a and the second plate 73b can
be attached together, e.g., by a thermal pressing operation,
diffusion bonding, an adhesive, or any other suitable mechanism for
attaching the plates 73a, 73b together. Once joined, the first and
second plates 73a, 73b can define a completed nozzle 64, such as
that shown in FIG. 10C.
[0297] The second trench 77 can be formed using any suitable
technique, including techniques that may yield relatively rough
surface profiles. For example, the second trench 77 can be formed
mechanically by drilling, punching, milling, etc. In the embodiment
of FIG. 11, the surface roughness of the bottom wall 70d may be
defined at least in part by the roughness of the back side of the
first plate 73a. Accordingly, the first plate 73 may be selected to
be sufficiently smooth such that the length of the orifice 66
defined in the nozzle 64 is substantially constant. Thus, the
method of forming the second trench 77 may not affect the length of
the bottom wall 70d, and hence, the length of the orifice 66.
Although the description of the process shown in FIG. 11 discussed
an example sequence, it should be appreciated that the orders may
be reversed or switched. For example, the second trench 77 may be
formed before or simultaneously with the first trench 75. Other
orders of manufacturing the nozzle 64 may be suitable.
B. Examples of Handpieces
[0298] As explained herein, one example of the tooth coupler 3 is a
handpiece 3A. FIG. 12A is a schematic side view of a handpiece 3A,
in accordance with one embodiment. FIG. 12B is a side
cross-sectional view of the handpiece 3A. The handpiece 3A can be
configured to receive the high pressure liquid and can be adapted
at a distal end 94 to generate a high-velocity beam or jet 60 of
liquid for use in dental procedures. In some embodiments, the
system 1 may produce a coherent, collimated jet of liquid. The
handpiece 3A may be sized and shaped to be maneuverable in the
mouth of a patient by the clinician so that the guide tube 52 and
jet 60 may be directed toward or away from various portions of the
tooth 10. In some embodiments, the handpiece 3A comprises a housing
or sealing cap 170 that can be coupled to the tooth 10, e.g., that
can couple the handpiece 3A to the tooth 10.
[0299] The handpiece 3A can comprise an elongated tubular body 80
having a proximal end 93 that is adapted to engage one or more
conduits 29 from the console 2 and a distal end 94 adapted to be
coupled or attached to the tooth 10. As explained above, the one or
more conduits 29 can provide fluidic and/or electrical
communication between the console 2 and the handpiece 3A. The
conduit 29 can comprise high-pressure, chemical resistant tubing
configured to convey high pressure liquid from the console 2 to the
handpiece 3A, e.g., high pressure treatment liquids that the nozzle
64 can form into a liquid jet 60. In addition, the handpiece 3A can
comprise tubing configured to convey other suitable fluids, such as
irrigation fluids, compressed air (for example, for driving a
drilling device), etc. As explained in more detail herein, the
conduit 29 can mechanically couple to the proximal end 93 of the
handpiece 3A by way of the interface member 4.
[0300] The distal end 94 of the handpiece 3A can comprise a
pressure wave generator 5, for example, a liquid jet device 56
comprising a guide tube 52 and nozzle 64, as explained above. A
housing or sealing cap at a distal portion of the handpiece 3A can
be coupled to the tooth 10 in some embodiments. The cap may be a
detachable member that can be sized/shaped to fit on the patient's
tooth and/or to position the distal end of the guide tube 56 at a
desired location in the pulp cavity or chamber 6. A kit of caps may
be provided such that a dental practitioner can select an
appropriately-sized cap and attach it to the handpiece 3A (see,
e.g., description of tooth sizing herein) and/or tooth. The distal
end 94 of the handpiece 3A can also include a suction port 83
configured to remove material from the tooth 10 or treatment site.
The suction port 83 can be in fluid communication with a waste line
81. The waste line 81 can comprise tubing in communication with the
waste system 41 described above. For example, a vacuum pump can be
activated to provide suction to the waste line 81 and suction port
83 to enable the removal of waste materials from the tooth 10 or
treatment site. The handpiece 3A may include various other
features, including a fluid inlet for delivering treatment fluid to
the tooth 10 or treatment site, a power line (e.g., to provide
energy to a pressure wave generator), a fluid outlet, an irrigation
source for irrigating the treatment area, a light source to
illuminate the treatment area, or a combination of some or all of
the foregoing. Moreover, as explained in more detail herein, a
communications chip 92 (e.g., a radio frequency identification, or
RFID, chip) can be coupled to the handpiece 3A to provide wireless
communication between the handpiece 3A and other system
components.
[0301] The handpiece 3A can be used to apply the pressure wave
generator 5 relative to the tooth 10. The body 80 may include
features or textures that enhance grasping the handpiece 3A with
the fingers and thumb of the clinician. The handpiece 3A can be
configured to be handheld and maneuvered as desired by the
clinician during a treatment procedure. In some cases, the
handpiece 3A can be configured to be portable, movable, orientable,
or maneuverable with respect to the patient. In some
implementations, the handpiece 3A can be configured to be coupled
to a positioning device (e.g., a maneuverable or adjustable arm).
The handpiece 3A can be disposable (e.g., single-use) or reusable.
In some embodiments, the distal end 94 of the handpiece 3A can
include additional components such as, for example, a sealer or
gasket (which may be an elastomeric material or a closed-cell
foam), spacers (e.g., to position the distal end of the guide tube
52 at a desired location in the tooth 10 and/or chamber 6), vents,
etc. In embodiments in which the pressure wave generator 5
comprises a liquid jet, the jet 60 may supply any suitable
treatment fluid, such as, e.g., water, EDTA, bleach, or other
chemicals. In other embodiments, the jet 60 may be formed of and
may supply one fluid and a separate irrigation inlet can supply
additional fluids. For example, in some embodiments, the jet 60 can
comprise water (e.g., degassed water), and other treatment fluids
(e.g., chemicals such as EDTA, bleach, etc.) may be flowed into the
treatment region or tooth by a separate conduit at lower pressures.
The fluids supplied at lower pressures relative to the jet 60 can
mix with the pressurized degassed water in the tooth 10 or
treatment region to assist in cleaning the tooth 10.
[0302] The handpiece 3A can be applied to the tooth 10 so as to
create a substantially closed fluid circuit as the distal end 94 of
the handpiece 3A engages the tooth 10, thereby enabling fluid to be
delivered into and out of the chamber 6 and/or pulp cavity 11
without substantial spillage or leakage into the patient's mouth.
The handpiece 3A may include a fluid retention member (e.g.,
sponge, seal, gasket, and/or vent) to reduce the likelihood of
fluid leakage and/or to allow fluid to flow from the tooth 10
and/or chamber 6 (e.g., to inhibit overpressurization or
under-pressurization). Leakage can have various negative effects
depending on entry type, fluid type, direction, etc. The fluid
retention member can be configured to inhibit air from entering the
tooth 10 and/or chamber 6 (which may reduce the effectiveness of
cavitation) while permitting air to enter the suction port 83.
[0303] With reference to FIG. 12B, an internal high pressure fluid
supply line 82 can provide fluid communication between the liquid
jet device 56 and the proximal end 93 of the handpiece 3A. As with
the conduits 29, the supply line 82 can be adapted to reliably
convey high pressure liquid to the distal end 94 of the handpiece
3A and the liquid jet device 56, in addition to being resistant to
the chemicals included in the treatment fluids passing through the
supply line 82. As explained herein, the liquid jet device 56 can
convert the pressurized liquid supplied by the supply line 82 into
a liquid jet 60 suitable for use in various treatment
procedures.
[0304] The handpiece 3A can be connected to the conduit 29 and
system 1 by the clinician before treatment, and can be disconnected
from the conduit 29 and the rest of the system 1 by the clinician
after treatment. However, it can be challenging to provide a
removable connection between the high pressure supply line 82 and
the conduit 29, at least because it can be difficult to form a
sealed connection between the supply line 82 and the conduit 29
that can also be engaged and disengaged by the user. The high
pressures of the fluid flowing through the conduit 29 can make it
particularly, difficult to provide sealed connections between
removable components.
[0305] Accordingly, the handpiece 3A can include a connector 84 at
or near the proximal end 93 of the handpiece body 80. The connector
84 can be configured to be connected to and disconnected from the
interface member 4, which can couple the connector 84 to the
conduit(s) 29 and the rest of the system 1. Thus, the clinician can
connect the handpiece 3A to the interface member 4 and conduits 29
by way of the connector 84 to enable fluid, electrical, and/or data
communication between the handpiece 3A and the console 2. The
clinician can perform the desired treatment procedure. After the
procedure, the clinician can disconnect the handpiece 3A from the
interface member 4 and conduits 29.
[0306] The connector 84 can include an inner tubular body 85 and an
outer tubular body 86 disposed about the inner tubular body 85. As
shown in FIG. 12B, in some embodiments, the inner tubular body 85
and the outer tubular body 86 can be threaded together. An outer
surface of the connector 84 (e.g., the outer surface of the outer
tubular body 86) can include an engagement feature configured to
removably engage with the interface member 4. For example, as shown
in the FIG. 12B, a recess 90 can be formed in the outer surface of
the connector 84. In some arrangements, the recess 90 can comprise
a groove disposed circumferentially about the outer surface of the
connector 84. In other embodiments, the recess 90 can comprise one
or more discrete recessed regions in the outer surface of the
connector 84. As explained in more detail herein, the recess 90 can
receive a projection of the interface member 4 to releasably secure
the interface member 4 to the connector 84 and handpiece 3A.
[0307] The connector 84 can comprise a fluid line coupling portion
87 disposed proximal a proximal end of the high pressure fluid
supply line 82. The coupling portion 87 can be sized and shaped to
receive a corresponding high pressure line from the interface
member 4, as explained herein. The fluid line coupling portion 87
can thereby provide fluid communication between the high pressure
line(s) of the interface member 4 and the high pressure fluid
supply line 82 of the handpiece 3A. In some arrangements, the
coupling portion 87 can comprise a filter configured to remove
particulates or other debris before the debris reaches the orifice
66. The connector 84 can also include a first opening 88 and a
second opening 89 proximal the first opening 88. As shown in FIG.
12B, the second opening 89 can have a diameter larger than a
diameter of the first opening 88. As explained herein, a distal
portion of the interface member 4 can be inserted into the second
opening 89, and the distal end of the supply line of the interface
member 4 can be inserted through the first opening 88 and into the
fluid line coupling portion 87. A first gasket 91 (e.g., an o-ring)
can be disposed near the second opening 89 so as to provide
friction between the handpiece 3A and interface member 4. In some
arrangements, the first gasket 92 can assist in providing a fluid
seal. A second gasket 95 (e.g., an o-ring) can provide a fluid seal
between the first opening 88 and the coupling portion 87. The
connector 84 can thereby provide substantially sealed fluid
communication between fluid line(s) in the interface member 4 and
the high pressure fluid supply line 82, while also enabling the
engagement and disengagement between the connector 84 and interface
member 4. In the handpiece 3A shown in FIG. 12B, the connector 84
is configured to be inserted into the interface member 4, e.g., the
connector 84 may act as a male connector and the interface member 4
may act as a female connector. Thus, in the embodiment of FIG. 12B,
the connector 84 may be inserted into an aperture of the interface
member 4. In other embodiments, however, it should be appreciated
that male and female components may be interchangeable. For
example, in other embodiments, the connector 84 may act as a female
connector, and the interface member 4 may act as a male connector.
In such other embodiments, the interface member 4 may be inserted
into the connector 84. A filter may be disposed in the connector 84
or inside the handpiece 3A to prevent the nozzle from being clogged
by particles or debris.
[0308] FIG. 12C is a schematic side view of a handpiece 3A, in
accordance with another embodiment. FIG. 12D is a side
cross-sectional view of the handpiece 3A shown in FIG. 12C. The
handpiece 3A shown in FIGS. 12C-12D may be generally similar to the
handpiece 3A shown in FIGS. 12A-12B. However, unlike the embodiment
of FIGS. 12A-12B, the handpiece shown in FIGS. 12C-12D may include
a connector 84 having a shank and an engagement structure. The
engagement structure can comprise a threaded engagement features
595. For example, the threaded engagement features 595 can comprise
external threads disposed on an outer surface of the connector 84.
As explained below, the connector 84 can be inserted into an
interface member 4, and the connector 84 and interface member 4 can
be rotated relative to one another to threadably secure the
connector 84 and interface member 4. In the embodiment of FIGS.
12C-12D, therefore, the connector 84 can act as a male connector
and the interface member 4 can act as the female connector. In
other embodiments, however, the connector 84 can act as a female
connector, and the interface member 4 can act as a male
connector.
[0309] With reference to FIG. 12D, as explained above, the
handpiece 3A can include a communications chip 92 and a high
pressure fluid supply line 82 configured to convey pressurized
fluid to a liquid jet assembly at a distal portion of the handpiece
3A. The connector 84 can include an inner tubular body 85 and an
outer tubular body 86. As shown in FIG. 12D, the inner tubular body
85 can threadably couple to the outer tubular body 86. In addition,
the threaded engagement feature 595 can be disposed on an outer
surface of the outer tubular body 86. In arrangements where the
connector is a female connector, the threaded engagement features
595 can be disposed on an inner surface of the connector so as to
engage an outer surface (and threads formed thereon) of the
interface member 4. Further, as explained above with respect to
FIGS. 12A-12B, the connector 84 can include a first opening 88 and
a second opening 89 proximal the first opening 88. The second
opening 89 can be larger than the first opening 88.
[0310] A fluid line coupling portion 87 can be disposed proximal a
proximal end of the high pressure fluid supply line 82. The
coupling portion 87 can be configured to provide a transitional or
coupling region between the high pressure tubing in the interface
member 4 and the fluid supply line 82. In some embodiments, the
coupling portion 87 can include a filter and one or more gaskets
disposed therein. The gasket(s) can provide a substantial fluid
seal for the high pressure fluid lines and/or friction between the
handpiece 3A and interface member 4. The filter can act to filter
particulates and debris from the treatment fluid before the
treatment fluid reaches the orifice 66. Accordingly, as shown in
FIG. 12D, the first opening 88 can define a necked portion between
the second opening 89 and the coupling portion 87. The first
opening 88 can be sized and shaped to closely conform to an outer
surface of high pressure tubing extending from the interface member
(e.g. tubing 518 shown in FIG. 26C). The first opening 88 can act,
at least in part, to provide a high pressure fluid coupling between
the tubing 518 of the interface member and the fluid supply line 82
of the tooth coupler 3.
C. Examples of Treatment Caps
[0311] FIG. 13 is a schematic side view of a system 1 in which the
tooth coupler 3 comprises a treatment cap 3B. As with the
embodiment of FIGS. 12A-12D, a pressure wave generator 5 can be
coupled to or formed with the treatment cap 3B. A high pressure
fluid supply line 82 can supply pressurized fluid to the treatment
cap 3B and/or pressure wave generator 5. As explained above, in
some embodiments, a sealing cap may be coupled to the distal end 94
of the handpiece 3A to couple the handpiece 3A to the tooth 10. In
other embodiments, a dental handpiece may not be used, and a dental
practitioner may maneuver a sealing cap into a desired location in
the patient's mouth. The patient may bite down on the treatment cap
3B to hold the treatment cap 3B in place during a treatment. In
other embodiments, the treatment cap 3B can be clamped or attached
to the tooth 10 (e.g., via a rubber dam clamp commonly used in
endodontic procedures) such that the device doesn't require
substantial user intervention during the procedure. In some
embodiments, the clinician can adhere the treatment cap 3B to the
tooth 10 using a tooth seal material.
[0312] The treatment cap 3B can couple to the interface member 4
using a connector 84 at or near a proximal end of the sealing sap
3B and/or at a proximal end of the supply line 82. The interface
member 4 can be the same as (or similar to) the interface member 4
used to couple the handpiece 3A to the rest of the system 1. The
connector 84 can also be the same as or similar to the connectors
84 shown in FIGS. 12A-12D with respect to the handpiece 3A. The use
of a common interface member 4 and/or connector 84 can
advantageously enable the use of any suitable working end with the
console 2 and conduit 29. For example, if a particular treatment
procedure is to be performed with a handpiece 3A, then the
connector 84 on the handpiece 3A can engage the interface member 4
that is coupled to the console 2. If a particular procedure is to
be performed with a treatment cap 3B, then the connector 84 on the
treatment cap 3B (or coupled to the treatment cap 3B), which may
have the same or similar structure as the connector 84 on the
handpiece 3A, can engage the same interface member 4 as the
handpiece 3A. In other embodiments, the working end of the system 1
(e.g., a portion of the system 1 that comprises the pressure wave
generator 5) may couple to the tooth 10 and/or mouth of the patient
in a different manner. For example, in some embodiments, a
mouthpiece may be used to couple to the patient's mouth. In such
embodiments, the common connector 84 can be coupled to the working
end and can engage with the interface member 4, just as the
handpiece 3A and treatment cap 3B engage with the interface member
4.
[0313] Thus, providing a common connector 84 and interface member 4
can advantageously enable the use of different working ends with
the system 1 and console 2. For example, in some embodiments, a
handpiece 3A can couple to the interface member 4, and a treatment
cap 3B can couple to the same interface member 4. Still other
working ends of the system may similarly couple to the same
interface member 4.
D. Examples of a Tooth Sizer
[0314] In some embodiments, it can be important to measure a depth
of a tooth chamber 128, e.g., a chamber exposed by way of an access
opening 18 in the tooth 10. In some methods, a distal end of a
pressure generator 5 can be positioned inside the tooth chamber
128, (e.g., a portion of the pulp cavity 11) with the distal end at
a desired distance from a root canal orifice. By positioning the
distal end of the pressure wave generator 5 at a suitable location
in the tooth chamber 128, patient safety may be improved by, e.g.,
not over-pressurizing root canal spaces 13. By positioning the
distal end of the pressure wave generator 5 at a suitable location
in the pulp cavity 11, effectiveness of the acoustic waves 23 at
generating cavitation and cleaning effects may be increased. Other
treatment procedures, such as obturation procedures, may also be
enhanced, as explained herein. Further, fluid circulation in
portions of the tooth chamber 128 (e.g., circulation in a root
canal space 13) may be enhanced. In various methods, the vertical
distance between the distal end of the fluid dispenser and/or the
pressure wave generator 5 and the highest point of the pulpal floor
may be in a range from about 0 to 1 mm, 0 to 5 mm, 5 to 10 mm, 10
to 15 mm, 15 to 30 mm, 0 to 30 mm, or some other range.
[0315] With reference to the examples shown in FIGS. 14A and 14B, a
set or kit of sizers can be used to measure the distance between a
substantially flat surface 176 created by the tooth seal material
75 on the occlusal surface and the highest point on the pulpal
floor.
[0316] FIG. 14A schematically illustrates an example of a sizer 132
inserted into a tooth chamber 128 of an example tooth 10. In this
example, the sizer 132 is too large for the tooth chamber 128. FIG.
14B schematically illustrates another example of a sizer 132
inserted into the tooth chamber 128 of a tooth 10. In this example,
the sizer 132 is the desired size for the tooth chamber 128. The
sizer 132 can be moved laterally across the width of the chamber
128, with the solid lines showing the sizer 132 in a first position
and the dashed lines showing the sizer 132 in a different position
in the tooth chamber 128.
[0317] In the example shown in FIGS. 14A and 14B, the sizer 132 has
a handle 134 (which may be similar to that of endodontic files), a
pin 140 whose length varies among sizers of different sizes, and a
disk 136 separating the handle 134 from the pin 140. The handle 134
can be grasped in the fingers or by dental pliers. The distal
surface 138 of the disk 136 can be substantially flat. The sizer
pin 140 can be inserted into the tooth chamber 128 of the tooth 10.
The dental practitioner may determine the depth or size of the
tooth chamber 128 by inserting sizers 132 with different pin
lengths into the tooth chamber 128. In FIG. 14A, the sizer pin 140
is too long for the tooth chamber 128, because the sizer disk 136
extends above the flat surface 176 of the tooth seal 75 when a
distal end 142 of the pin 140 touches the tooth chamber floor. A
shorter sizer pin 140 can be selected and moved laterally around
the tooth chamber 128. This process can be repeated until a sizer
pin 140 is found that does not contact the pulp floor as it is
moved around the tooth chamber 128. The sizer 132 having the
correct or desired length may have the longest pin 140 that does
not come in contact with the chamber floor when the sizer disk 136
is placed over and slid laterally (schematically shown by solid
double-headed arrow 146 in FIG. 14B) on the flat surface 176 of the
tooth seal 75. FIG. 14B shows a sizer 132 with an appropriate pin
length for the illustrated tooth 10, because the distal end 142 of
the pin 140 is positioned an appropriate height above the pulp or
chamber floor (as indicated by the horizontal dashed line 144).
This sizer 132 can be used to establish the depth of the tooth
chamber 128.
[0318] In another implementation, a single sizer 132 can be used.
The sizer pin 140 can be marked or scaled with measurement indicia,
and the sizer disk 136 can be adjustable and configured to move up
or down relative to the pin 140. The dental practitioner can insert
the sizer 132 into the tooth chamber 128 and move the sizer disk
136 until it contacts the upper surface 176 of the tooth seal 75.
The sizer 132 is then removed from the tooth chamber 128, and the
position of the disk 136 relative to the measurement indicia
provides a measurement of the depth of the tooth chamber 128. The
distal end of the pressure wave generator 5 (or fluid inlet) may be
positioned at a depth slightly less than the measured depth of the
tooth chamber 128 so that the distal end is at a desired height
above the pulp chamber or tooth chamber floor (e.g., from about 1
mm to about 5 mm above the floor).
[0319] In other embodiments, a ruler or depth gauge graduated with
suitable indicia can be inserted into the tooth chamber 128 to
measure the distance from an upper surface (e.g., the flat surface
176 of a tooth seal 75, if used) to a lower surface (e.g., the
floor of the pulp chamber or tooth chamber 128). In other
embodiments, a radiograph (e.g., X-ray) of the tooth 10 may be
taken, and the size or depth of the tooth chamber 128 determined
from the radiograph.
[0320] An example method of determining a depth of a tooth chamber
128 comprises providing a kit comprising a set of sizers, where
each sizer in the set is configured to measure a different tooth
chamber depth. The method includes repeatedly inserting different
sizers into the tooth chamber 128 to determine the depth. In some
embodiments of the method, the depth is determined as the longest
sizer that does not contact the pulpal floor. In some embodiments,
the method includes moving a sizer laterally around the tooth
chamber 128.
E. Examples of a Cap and Sealer
[0321] As explained herein, the tooth coupler 3 can attach to a
tooth 10 to enable the clinician to perform a suitable treatment
procedure. FIG. 15A is a schematic side view of a tooth coupler 3
comprising a handpiece 3A coupled to a tooth 10 for a root canal
treatment procedure. FIG. 15B is a schematic side cross-sectional
view of a distal end 94 of the handpiece 3A illustrated in FIG.
15A. FIG. 15C is an enlarged cross-sectional view of the distal end
94 of the handpiece 3A shown in FIG. 15B. The handpiece 3A (or
other tooth coupler 3) may include a sealing cap 170, or cap, (and
an optional sealer 168 for providing a fluid seal) at or near the
distal end 94 that can be sized so that a distal end of a pressure
wave generator 5 is at a desired location in the tooth chamber 128.
In some systems, each sizer 132 can be associated with a cap 170
that can be applied to the tooth 10. As described, the sealing cap
170 can, in some cases, be attached to the distal end 94 of the
handpiece 3A or manually applied to the tooth 10 (e.g., without
using the handle of a handpiece as explained above with respect to
the treatment cap 3B). The cap 170 can be used so that the distal
end of the fluid inlet or pressure wave generator 5 is located at
the desired height above the chamber floor (indicated by the
horizontal dashed line 144 in FIG. 15C) when the handpiece 3A is
applied to the tooth seal 75. The size increments of the caps may
be substantially equal to the size increments of the pins 140 on
the sizers 132 illustrated in FIGS. 14A-14B. After the depth of the
tooth chamber 128 is determined using the sizers 132, an
appropriately-sized cap 170 can be selected and (optionally)
mounted on the handpiece 3A. In other embodiments, the treatment
cap 3B can comprise the sealing cap 170 and can be attached to the
tooth 10 by the clinician, as explained herein. The cap 170 can be
attached to the handpiece 3A chemically (e.g. glued, using an
adhesive), mechanically (e.g., snapped or screwed), magnetically
(e.g., by making the cap 170 and the distal end 94 of the handpiece
3A of opposite magnetic polarities), or by a combination of the
foregoing. Alternatively, the cap 170 can be attached (e.g., glued)
onto tooth 10.
[0322] The fluid connection created between the cap 170 and the
tooth 10 (or tooth seal 75) may be flexible in nature such that the
connection can accommodate movements in the handpiece 3A relative
to the tooth 10 while maintaining the fluid connection. In some
embodiments, the cap 170 is formed from a durable, biocompatible
material, and the optional sealer 168 is used to accommodate
movements and provide a good fluid connection. In other
embodiments, the cap 170 may be made from one or more materials
with different elasticities, permeabilities, and/or degrees of
firmness. For example, a softer, more permeable material can be
used to engage with the tooth 10, reducing (or potentially
eliminating) the need for a separate sealer 168. Caps can have
different shapes depending on which tooth 10 is being treated
(e.g., molar, incisor, canine, etc.).
[0323] In some cases, a relatively small amount of force is used to
create a positive seal between the tooth 10 (or tooth seal 75) and
the cap 170. For example, in the case of a handpiece 3A, the
pressure applied to the handpiece 3A to form the seal can be low
enough for the operator to comfortably apply during the procedure.
In case where the handpiece is not handheld, e.g., such as the
embodiment of the treatment cap 3B shown in FIG. 13, the sealing
cap 170 can be applied to the tooth 10 (or tooth seal 75) without
excessive clamping/holding force (e.g., by the patient biting down,
by the cap 170 being adhered to the tooth 10, etc.). The sealing
cap 170 can be used throughout the procedure and can be configured
to withstand chemical exposure (such as irrigants introduced during
the procedure).
[0324] Accordingly, the distal end 94 of the handpiece 3A (or other
tooth coupler 3) can include a cap 170 selected as described above
so as to position the distal end of the pressure wave generator 5
at a desired distance above the chamber floor (shown by the
horizontal dashed line 144 in FIG. 15C). In this example, the cap
170 includes a sealer 168 to assist in providing a substantially
water-tight connection between the cap 170 and the upper surface
176 of the tooth seal 75 (see, e.g., FIGS. 15B and 15C). FIG. 15C
shows that, in this example, the handpiece 3A includes the pressure
wave generator 5 (e.g., a liquid jet device capable of forming a
liquid jet 60), the suction port 83, and one or more vents 173. In
this example, treatment fluid enters the chamber 128 via the liquid
jet 60 and is removed by the suction port 83.
F. Examples of Magnetic Sealing Assemblies
[0325] In some embodiments, the tooth coupler 3 (e.g., handpiece
3A) can be coupled to and/or fluidly sealed with the tooth 10 by
way of a magnetic sealing assembly 200. The use of the magnetic
seal assembly 200 can provide a mechanical engagement between the
tooth 10 and coupler 3, and can provide a seal such that fluids do
not leak through the assembly 200. In addition, the magnetic seal
assembly 200 can act as a safety mechanism. For example, if the
clinician makes an abrupt movement relative to the tooth 10, the
magnetic forces may be arranged such that the tooth coupler 3
breaks away from the tooth 10 without damaging the tooth 10.
Moreover, the use of the magnetic sealing assembly 200 can act to
align the distal portion of the handpiece 3A to the tooth 10.
Advantageously, the magnetic sealing assembly 200 can substantially
align and/or center the guide tube 52 with respect to the access
opening 18 and tooth 10.
[0326] Accordingly, the magnetic forces provided by the magnetic
seal assembly 200 may be sufficiently strong so as to provide
secure mechanical engagement and a substantially sealed fluid
connection. For example, the magnetic forces normal to the major
surfaces of the magnets (e.g., the forces acting generally along a
direction extending from the distal portion of the handpiece 3A
towards the tooth 10) may be relatively strong so as to provide a
fluid seal and to resist forces that tend to pull the magnets
upwardly away from the tooth 10. However, the magnetic forces
parallel to the major surfaces of the magnets (e.g., forces acting
generally parallel to the tooth seal 75 and/or transverse to the
pressure wave generator 5) may be sufficiently weak such that, if
the clinician inadvertently moves the handpiece transversely, the
magnets can break away to avoid harming the patient.
[0327] In some embodiments, the magnetic sealing assembly 200 may
include a handpiece magnet 210 and an occlusal magnet 220, as shown
in FIGS. 16A-16C. In some embodiments, a magnetic sealing assembly
200 may also include a plurality of spacer magnets 230
(alternatively referred to herein as magnetic spacers), as shown in
FIGS. 17A-17C and 18. The spacer magnets 230 can be arranged to
provide the desired spacing between the distal end of a pressure
wave generator 5 and a floor of the tooth chamber 128, as explained
above. Although the handpiece 3A is shown in FIGS. 16A-18, it
should be appreciated that any other tooth coupler 3 may be used,
such as a treatment cap 3B.
[0328] 1. Examples of Magnetic Assemblies with Occlusal and
Handpiece Magnets
[0329] FIG. 16A is a perspective, exploded view of one embodiment
of a handpiece 3A configured to couple to a treatment tooth 10 by
way of a magnetic seal assembly 200. FIG. 16B is a schematic side
view of the handpiece 3A coupled to the tooth 10 with the magnetic
seal assembly 200. FIG. 16C is a side cross-sectional view of the
handpiece 3A and magnetic seal assembly 200 shown in FIG. 16B. The
magnetic assembly 200 may be used to provide a seal on the occlusal
surface of the tooth 10. The magnetic assembly may also be
configured to adjust the position of the handpiece tip (e.g.
pressure wave generator 5) with respect to the pulp chamber floor.
As shown in FIGS. 16A-C, for example, the magnetic assembly 200 can
include a handpiece magnet 210 coupled to or formed with the
handpiece 3A. An occlusal magnet 220 can be attached or coupled to
the tooth 10 by way of, e.g., various types of attachment media,
such as the tooth seal 75. The disclosed assembly can seal and/or
attach the handpiece 3A to the tooth 10 and can enable the user to
adjust the handpiece tip relative to a chamber in the tooth 128 or
another position on the tooth 10. For example, the handpiece magnet
210 and occlusal magnets 220 can have opposite polarities such that
the occlusal magnet 210 is attracted to the occlusal magnet 220. In
some embodiments, the occlusal magnet 220 may not be a magnet;
rather, the occlusal magnet 220 may comprise a ferrous material
that is attracted to the handpiece magnet 210. Alternatively, the
handpiece magnet 210 may comprise a ferrous metal attracted to the
occlusal magnet 220. In some embodiments, a user can rotate the
handpiece 3A to a desired location, and the magnetic assembly can
rotate with the handpiece 3A while maintaining a fluidic and/or
mechanical seal between the handpiece 3A and the tooth 10. In
addition, the handpiece magnet 210 and occlusal magnet 220 can
cooperate to substantially align and/or center the guide tube 52
with respect to the access opening 18 and tooth 10.
Handpiece Magnet
[0330] The handpiece 3A may include a fixed ring magnet on the face
of the handpiece 3A. The handpiece magnet 210 may be integrally
formed with the handpiece 3A, may be mechanically coupled to the
handpiece 3A, and/or may be removable engaged with the handpiece
3A. In some arrangements, the handpiece magnet 210 may be separate
from the handpiece 3A and can be attached to the handpiece 3A by
the user. In other arrangements, the handpiece 3A can be
manufactured to include the handpiece magnet 210. The handpiece
magnet 210 can act as a magnetic interface for the handpiece 3A.
For example, the handpiece magnet 210 can be configured to interact
with other magnets to orient the handpiece 3A relative to the
anatomy (and/or components) associated with the other magnets,
e.g., the tooth 10. In some embodiments, different polarities can
be used for handpiece magnets 210 used in different types of tooth
couplers 3. For example, in some embodiments, a positive polarity
can be used with a handpiece magnet 210 for a molar handpiece 3A,
and a negative polarity can be used with a handpiece magnet 210 for
a pre-molar handpiece 3A, or vice versa. Having different
polarities in different types of tooth couplers 3 can act as a
safety measure such that the correct tooth couplers 3 couple to the
appropriate types of teeth and occlusal magnets 220.
Occlusal Magnet
[0331] The occlusal magnet 220 may be adhered to the occlusal
surface of a built-up tooth 10 with, e.g., a UV-cure adhesive, a
tooth seal material, a bite-registration material, etc. The
occlusal magnet 220 can act as a base magnet to which other magnets
can be coupled. For example, the occlusal magnet 220 can be secured
to the tooth 10, and any suitable number or type of magnets can be
coupled to the occlusal magnet 220. The inner diameter of the
occlusal magnet 220 may be the same as or substantially the same as
the inner diameter of the spacer magnet(s) 230. The outer diameter
of the occlusal magnet 220 may be in a range of between about 10 mm
and about 17 mm. The outer diameter of the occlusal magnet 220 may
be larger than the magnetic spacers 230. The upper limit of the
outer diameter may be constrained by interference with adjacent
teeth. The thickness of the occlusal magnet 220 may be
approximately 1 mm thick depending on durability of the magnet,
e.g., in a range of about 0.5 mm thick and about 1.5 mm thick.
[0332] 2. Examples of a Handpiece and Magnetic Assembly Applied to
a Tooth Seal with Spacer Magnets
[0333] FIGS. 17A-C illustrate many of the components shown in FIGS.
16A-C. However, in the embodiment illustrated in FIGS. 17A-C, a
magnetic spacer 230 is included. FIG. 17A is a perspective,
exploded view of one embodiment of a handpiece 3A configured to
couple to a treatment tooth 10 by way of a magnetic seal assembly
200. FIG. 17B is a schematic side view of the handpiece 3A coupled
to the tooth 10 with the magnetic seal assembly 200. FIG. 17C is a
side cross-sectional view of the magnetic sealing assembly 200
disclosed in FIG. 17B. For example, a magnetic assembly 200 may be
used to seal and/or couple the handpiece 3A to the tooth 10. As
shown in FIGS. 17A-C, for example, the magnetic assembly can
include a handpiece magnet 210 coupled to or formed with the
handpiece 3A. In various procedures, such as a root canal
procedure, an access opening can be formed in the tooth 10. A
sealing and adhesion material (e.g., tooth seal 75) can be applied
to the tooth 10 around the access opening. In some arrangements,
the sealing and adhesion material can be planarized or otherwise
shaped to support a portion of the magnetic seal assembly 200. For
example, the magnetic seal assembly 200 can include an occlusal
magnet 220. The occlusal magnet 220 can be attached or coupled to
the sealing and adhesion material (e.g., attachment media). One or
more magnetic spacers (or spacer magnets) 230 can couple the
handpiece magnet 210 to the occlusal magnet 220. The magnetic
spacers 230 can be configured to provide a separation distance
between the handpiece 3A (and/or pressure wave generator 5) and a
portion of the tooth 10 (e.g., a floor or bottom surface of the
pulp chamber).
[0334] For example, as explained herein with reference to FIGS.
14A-14B, the clinician can use the sizers 132 to determine a
suitable separation distance between the floor of the tooth chamber
128 and the distal end portion of the pressure wave generator 5
(e.g., component 144 in FIG. 15C). Once the clinician determines
the desired separation distance, a suitable spacer magnet 230 can
be selected. In the embodiment of FIGS. 17A-17C, the system can
include a kit of spacer magnets 230, each spacer magnet 230 having
a different size, e.g., a different thickness corresponding to a
desired separation distance. For example, if the clinician
determines that the separation distance is about X, then the
clinician can select one or more spacer magnets 230 that
corresponds approximately to the separation distance X. The
clinician can insert the selected spacer magnet(s) 230 between the
occlusal magnet 220 and the handpiece magnet 210 to provide the
desired spacing between the distal portion of the pressure wave
generator 5 and the floor of the tooth chamber 128.
[0335] FIG. 18 is a schematic side view of a handpiece 3A coupled
to a treatment tooth 10. FIG. 18 illustrates many of the components
shown in FIGS. 17A-C. In FIG. 18, the handpiece 3A can be applied
to the tooth 10 and substantially sealed onto the tooth 10. A
pressure wave generator 5 can be coupled to or formed with the
handpiece 3A and can be disposed in a prescribed location in the
tooth 10 by way of a combination of magnets. However, in the
embodiment illustrated in FIG. 18, a plurality of magnetic spacers
230 is coupled between the handpiece magnet 210 and the occlusal
magnet 220. In particular, FIG. 18 illustrates two magnetic spacers
230 between a handpiece magnet 210 and an occlusal magnet 220.
Although two magnetic spacers are shown, it should be appreciated
that any suitable number of magnetic spacers may be used. For
example, a kit of magnetic spacers 230 can be provided to the
clinician. The kit of spacers 230 can include a plurality of spacer
magnets 230. Each of the plurality of spacer magnets 230 may have
substantially the same size or thickness in some embodiments. In
other embodiments, each of the plurality of spacer magnets 230 may
have a different size or thickness. The handpiece magnet 210, the
spacer magnets 230 and the occlusal magnet 220 can act to seal
and/or mechanically couple the handpiece 3A to the tooth 10 (e.g.,
to provide a substantially sealed liquid pathway between the
handpiece 3A and the tooth 10).
[0336] Accordingly, as explained herein with respect to FIGS.
17A-17C, the clinician may determine a desired separation distance
X between the distal portion of the pressure wave generator 5 and
the floor of the tooth chamber 128. The clinician can select from
the kit of spacer magnets 230 a set of magnets that will provide
the desired separation distance X, and can couple the selected set
of magnets 230 between the occlusal magnet 220 and the handpiece
magnet 210.
[0337] As shown in FIG. 18, a pressure wave generator 5 (such as a
liquid jet device) can be activated. Pressure waves 23 can
propagate in a tooth chamber 128 (e.g., in treatment fluid in the
tooth chamber 128 in some embodiments) to clean the tooth 10. For
example, the pressure waves 23 can propagate through the tooth
chamber 128 or tooth 10 and can have energy sufficient to
substantially remove organic material and unhealthy tissue from the
tooth 10 and/or root canals. In FIG. 18, for example, the pressure
wave generator 5 can include a proximal portion coupled to or
formed with the handpiece 3A and a distal portion configured to be
disposed in the tooth chamber 128. As shown in the exploded view in
FIG. 17A, for example, the distal portion of the pressure wave
generator 5 can pass through an opening or aperture formed through
the handpiece magnet 210, the spacer magnet(s) 230, and the
occlusal magnet 220.
[0338] Thus, each of the handpiece magnet 210, the spacer magnet(s)
230, and the occlusal magnet 220 can include or define an inner
diameter (defined by the opening or aperture) and an outer
diameter. In some embodiments, the inner diameters of the occlusal
magnet 220 and an adjacent spacer magnet 230 can be the same or
substantially the same. By having the same or substantially the
same inner diameters, the occlusal magnet 220 and the adjacent
spacer magnet 230 can be accurately aligned by the attractive
magnetic forces. In some embodiments, the inner diameters of all
the magnets (e.g., the handpiece magnet 210, the spacer magnet(s)
230, and the occlusal magnet 220) can be the same or substantially
the same to improve alignment.
[0339] In various embodiments, the magnetic strength (e.g., the
attractive force) between the occlusal magnet 220 and one or more
spacer magnets 230 can be less than the magnetic strength between
the one or more spacer magnets 230 and the handpiece magnet 210,
and/or can be less than the magnetic strength between adjacent
spacer magnets 230. In such embodiments, for example, the clinician
can break the seal between the one or more spacer magnet(s) 230 and
the occlusal magnet 220 by applying a force to the handpiece 3A in
a direction opposite to or away from the occlusal magnet 220 with a
magnitude that exceeds the attractive force between the occlusal
magnet 220 and the one or more spacer magnet(s) 230, e.g., the
attractive magnetic force between the occlusal magnet 220 and an
adjacent spacer magnet 230. The clinician can thereby remove the
handpiece 3A, handpiece magnet 210, and the spacer magnet(s) 230
from the treatment site while leaving the occlusal magnet 220
coupled to the tooth 10 (for later removal).
[0340] In other embodiments, the magnetic interfaces (e.g., the
interfaces between the magnets in the magnetic assembly) can be
designed to have attractive magnetic forces such that the clinician
can separate the handpiece 3A from the occlusal magnet 220 at any
other suitable interface. For example, in some embodiments, the
handpiece 3A can be separated from the occlusal magnet 220 at an
interface between two adjacent spacer magnets 230, and/or between a
spacer magnet 230 and the handpiece magnet 210. In such
embodiments, the magnetic strength at the separation interface
(e.g., the interface at which the magnetic assembly is to be
separated) is less than the magnetic strength at other magnetic
interfaces.
[0341] FIG. 19 is a schematic illustration of a multipoled magnet
245 configured for use in various magnets of the disclosed magnetic
assemblies. For example, the multipoled magnet 245 can be
configured for use in a handpiece magnet 210, an occlusal magnet
220, and a magnetic spacer 230. As shown in FIG. 19, for example,
the multipoled magnet 245 can included alternating polarities
(e.g., north and south) at different circumferential positions of
the magnet. For example, a mutipoled magnet 245 can include north
regions 245a, 245c and 245e, and south regions 245b, 245d and 245f.
As shown in FIG. 19, the north and south regions can alternate such
that one half of the magnet (e.g., the top half) includes two north
regions 245a and 245c and one south region 245b and such that the
other half of the magnet (e.g., the bottom half) includes two south
regions 245d and 245f and one north region 245e. Although six
polarities are shown, it should be appreciated that any suitable
number of north and south regions may be used. For example, in some
embodiments, four alternating polarities (e.g., north and south)
can be used at different circumferential positions of the magnet.
In other embodiments, eight alternating polarities (e.g., north and
south) can be used at different circumferential positions of the
magnet. Any suitable number of poles can be used.
[0342] In various embodiments of the magnetic assemblies disclosed
herein, the use of a multi-poled magnet 245 magnetized through its
thickness can be used to allow for separation of the magnets by
rotation of the handpiece 3A. For example, to secure two adjacent
magnets, the two magnets can be aligned such that regions of
opposite polarity (e.g., a north region and a south region) are
proximate one another, which results in an attractive force between
the two adjacent magnets. In some embodiments, the clinician can
separate two adjacent, coupled magnets (e.g., a spacer magnet 230
and the occlusal magnet 220, two adjacent spacer magnets 230,
and/or a spacer magnet 230 and the handpiece magnet 210) by
applying a torque to the handpiece 3A sufficient to cause the
polarities to become aligned, e.g., sufficient to cause a north
region of one magnet to align with a north region of the other
magnet and/or to cause a south region of one magnet to align with a
south region of the other magnet. Thus, in some embodiments, two
adjacent magnets can be separated by rotating the handpiece 3A at a
sufficient applied torque.
Spacer Magnets
[0343] A plurality of spacer magnets 230 with various thicknesses
may also be provided, e.g., between the handpiece magnet 210 and
the occlusal magnet 220. In the disclosed embodiment, there are 3
magnetic spacers 230 having approximate thicknesses of about 1 mm,
2 mm, and 3 mm, respectively. These three spacers can be connected
to the handpiece magnet 210 to offset the handpiece 3A from the
tooth 10 by a separation distance in a range of about 0 mm to about
5 mm. The spacer magnets 230 may have about the same inner
diameters and outer diameters to maintain alignment and strength
while stacking. The spacer magnets 230 may have an inner diameter
in a range of between about 0.01 mm to about 10 mm and may have an
outer diameter in a range of between about 1 mm and about 17 mm.
The surface area and strength of the magnet may be important
factors in determining the magnets' ability to maintain a fluid
seal between the inner and outer diameter of the magnets.
General Properties
[0344] In some embodiments, the magnets described herein may be
made from neodymium. The grade of each magnet can be selected for
the magnetic strength desired. Each magnet may be coated to protect
against chemicals. Each magnet may also be coated to be
biocompatible. The coating may also provide mechanical strength and
durability to counteract the brittleness of neodymium. The coatings
and magnets may be sterilizable, for example, with gamma radiation.
The coating and magnets may also be able to withstand manufacturing
and operating temperatures.
[0345] The inner diameter of the disclosed magnets may be in the
range of about 0.5 mm to about 10 mm. In some arrangements, the
inner diameter of each of the magnets is about the same. For
example, the magnetic spacer(s) 230 and the occlusal magnet 220 may
have the same or substantially the same inner diameter.
Advantageously, the magnetic spacer(s) 230 can be accurately
aligned with the occlusal magnet 220 by designing the spacer
magnet(s) 230 and the occlusal magnets 220 to have the same or
about the same inner diameter. In some embodiments, all the magnets
of the magnetic assembly (including, e.g., the handpiece magnet
210, the spacer magnet(s) 230 and the occlusal magnet 220) may have
the same or substantially the same inner diameters. In other
embodiments, the inner diameters of each magnet may differ.
[0346] The outer diameters of the magnets may be in a range of
about 1 mm to about 17 mm. The outer diameters for each magnet may
be dissimilar between the three magnetic sections. The thickness of
the magnetic plates may range from about 0.01 mm to about 10 mm.
The outer diameter of the occlusal magnet 220 may be larger than
the magnetic spacers 230.
[0347] Any of the magnets disclosed herein (e.g., the occlusal 220,
spacer 230, and/or handpiece magnets 210) may be ferromagnetic,
paramagnetic, diamagnetic, etc. The magnets disclosed herein can
include magnetic metallic elements, composites, rare-earth magnets
(e.g. samarium-cobalt, neodymium-iron-boron), single-molecule
magnets, single-chain magnets, nano-structured magnets, or
electromagnets. In embodiments using electromagnets, for example, a
power supply may be provided in the console 2, and power lines can
couple to the handpiece 3A by way of electrical conduits.
[0348] One or more of the magnets may be made from neodymium. One
or more of the magnets may be thoroughly or partially coated with
another material to, for example, reduce brittleness. This may,
therefore, reduce the shattering or chipping of the magnets. The
coating can also provide a food-grade or biocompatible interface to
allow color-coding, to avoid corrosion, to improve mechanical
strength, to improve sealing on the surface of the magnets,
etc.
[0349] For example, one or more of the disclosed magnets (e.g., the
occlusal 220, spacer 230, and/or handpiece magnets 210) may be
coated in Parylene C or Parylene N for mechanical strength and
durability to counteract the brittleness of neodymium. In one
embodiment, for example, a thin conformal coat of silicone may
provide the coloration of the magnet, the sealability to fluids in
between the magnets (e.g., to provide a liquid seal between the
various magnets), and the spacing between the magnets to reduce
magnetic strength when stacked. In some embodiments, the coating
can be applied between adjacent magnets to reduce the magnetic
strength between the adjacent magnets.
[0350] The magnets can be color-coded to assist the operator with
identification of a suitable spacer magnet 230 to use and/or to
guide the operator to use the proper combination of the spacers.
For example, in some embodiments, it can be important to space the
distal portion of the pressure wave generator 5 from the floor of
the pulp chamber (or other surface of the tooth 10) by a desired
amount, such that the pressure wave generator 5 is sufficiently
spaced from the tooth 10. To assist the clinician or operator in
providing sufficient separation between the pressure wave generator
5 and the tooth 10, thicknesses of the spacer magnets 230 can be
selected to provide adequate separation.
[0351] The spacer magnets 230 can be color-coded such that the
colors correspond to a measure of the tooth 10. In some
embodiments, the measure of the tooth 10 can be a depth of the pulp
chamber. Further, in some embodiments, for example, a kit can be
provided in which each spacer magnet 230 corresponds to a
corresponding measuring tool (and that may have the same color as
the corresponding spacer magnet 230). The measuring tool can be
used to measure or estimate a depth of the pulp chamber, or any
other appropriate dimension of the tooth 10. When the clinician
determines that a particular measuring tool corresponds to a
suitable separation distance between the tooth 10 (e.g., floor of
pulp chamber) and pressure wave generator 5 (and/or handpiece 3A),
the clinician can select one or more spacer magnets 230 that
corresponds to the particular selected measuring tool and that will
provide the suitable separation distance. Thus, in some
embodiments, a particular spacer magnet 230 may correspond to a
corresponding measuring tool, and may be color-coded or otherwise
identified with the corresponding measuring tool. Although
color-coding is one way to identify a spacer magnet 230 with a
corresponding measuring tool, it should be appreciated that any
other suitable way to identify a particular spacer with a
corresponding measuring tool may be used.
[0352] In various embodiments, spacers may be sized, for example,
to have a thickness in a range of about 1 mm to about 6 mm, in
increments of about 1 mm. A corresponding measuring tool (e.g., a
gauge with the same color) may also be provided for each spacer. In
another embodiment, the spacers can have thicknesses of about 1 mm,
2 mm, and 3 mm, and other separation distance values can be
provided by combining these 3 spacers. For example, a 4 mm spacer
can be made by attaching a 1 mm spacer and a 3 mm spacer. The
measuring tool (gauge) for this 4 mm spacer, for example, may have
the colors of the respective 1 mm and 3 mm spacers. Such a color
coding (or other way of identifying the combination of spacers)
would tell the operator to combine a 1 mm spacer and a 3 mm spacer
to make a 4 mm spacer.
[0353] The spacers may be color-coded only on one side to avoid an
attempt to attach them together on same-polarity surfaces, which
would make them repel each other. The spacer magnets 230 can thus
be color-coded to guide the operator as to what surfaces should be
attached together (e.g., opposite polarities). Colors may be chosen
to be easily identified even by users who have impaired vision or
color-blindness.
[0354] The coatings on the various magnets may be soft to improve
sealing. The coatings and magnets may be sterilizable with gamma
radiation, steam-autoclave, chemical sterilization, or other
methods. The magnets and their coatings may be made in such a way
to withstand one or various methods of sterilization. In addition,
the magnets and their coatings may be made to withstand
manufacturing and operating temperatures. The coating may also be
made in such a way to tolerate exposure to various chemicals; in
particular, those chemicals that may be used during the procedure,
e.g. NaOCl, EDTA, etc.
[0355] The inner diameter of all the magnets in the magnetic
assembly (e.g., the handpiece magnet 210, the spacer magnet(s) 230,
and the occlusal magnet 220) can vary or can be the same. In one
embodiment, the inner diameter of each of the magnets is the same,
or substantially the same, to enhance the automatic alignment of
the magnets. The outer diameters of all the magnets also may or may
not be the same, or substantially the same. In one embodiment for
instance, the outer diameters are substantially the same, e.g.,
about 10 mm in some arrangements. Each magnet and item in the kit
may be configured to be multiple-use (e.g., reusable) or one-use
only (e.g., disposable).
[0356] The magnetic forces and strength of the spacers may be
chosen to allow the assembly to detach from a preferred location,
e.g., from a desired magnetic interface. For instance, in one
embodiment, the strength of the magnets are chosen such that the
magnetic sealing assembly 200 detaches at the surface of the
occlusal magnet 220, e.g., such that the magnetic strength between
the occlusal magnet 220 and the spacer magnet(s) 230 is less than
the magnet strength between the other magnets.
[0357] For example, the magnets may be designed with different
grades and coating thicknesses to ensure that the separation force
between the stack of magnets applied to the handpiece 3A acts at
the occlusal-to-spacer magnet interface. Thus, the force that
causes the handpiece 3A to separate from the treatment site may
cause separation between the occlusal magnet 220 and the spacer
magnet 230 (e.g., the spacer magnet 230 adjacent to the occlusal
magnet 220 in some embodiments). The magnets may also be designed
to have the same separation force of about 2.4 lbs at the
occlusal-to-spacer magnet interface in each stacking configuration.
The force required to separate the magnets can vary between about
0.1 lbf to about 50 lbf depending on the design. In some
embodiments, the required force to separate the magnets can be in a
range of about 1 lbf to about 10 lbf. For example, in various
embodiments, the separation force between two magnets can be in a
range of about 1 lbf to about 5 lbf.
[0358] In some embodiment, the magnetic assembly is designed to not
interfere with implants, body piercings, or electronic/medical,
dental devices and tools. Many dental tools are of the 3xx series
and, thus, are mildly magnetic. In most cases of the 3xx series
stainless steel, the magnetism is not strong enough to affect
dental tools in an unpredictable way.
[0359] In certain configurations, magnets can be used as a binary
switch to alert the dentist or console of a partial separation of
two magnets. This configuration can also be used to alert the
dentist or console of correct alignment and placement of the
handpiece 3A.
[0360] In some embodiments, an oval-shaped occlusal magnet 220 can
be used. An oval shaped occlusal magnet 220 can reduce the
separation force between the spacer and occlusal magnet 220 due to
an indirect force between them. An oval shaped occlusal magnet 220
also can be oriented to accommodate different diameters of
teeth.
[0361] In some embodiments, the handpiece magnet 210 can orient
itself in a position that would prevent the dentist from using the
handpiece 3A more than once for single-use handpieces.
[0362] 3. Example Handpiece Magnets
[0363] The following specifications represent one non-limiting
example of a handpiece magnet 210. In this example embodiment, the
handpiece magnet 210 includes a fixed N52 Neodymium ring magnet on
the face of the handpiece 3A. The handpiece magnet 210 can be
attached (e.g. glued) to the handpiece 3A using, e.g., a medical
grade cyanoacrylate. The handpiece magnet 210 can be incorporated
into the handpiece 3A in such a way that the handpiece shell or
body holds the handpiece magnet 210 permanently. In some
embodiments, the inner diameter of the handpiece magnet 210 can be
in a range of about 1 mm to about 10 mm., and the outer diameter
can be in a range of about 5 mm to about 17 mm. In this example
embodiment, the inner diameter of the handpiece magnet 210 is about
5 mm and the outer diameter is about 10 mm. The overall thickness
of the handpiece magnet 210 in this example embodiment is about 2
mm. The handpiece magnet 210 can be silicone-dipped to a thickness
of 0.05 mm. Thus, accounting for the coating, the actual magnet
material thickness can be about 1.9 mm. The silicone on this magnet
can be colored (e.g. white) and can have a shore A hardness of 70.
The white color can correspond to a specific height of the chamber,
or prescribed location of the pressure wave generator 5 with
respect to the tooth 10, or both, or can correspond to another
measured value which would assist in locating and placing the
handpiece 3A properly. In one example, the handpiece magnet 210 can
be formed of Neodymium (N52 (52 MGOe)). The handpiece magnet 210
can have an outer diameter of about 0.394''+/-0.001'' (10 mm,
+/-0.025 mm). The handpiece magnet 210 of this example can have an
inner diameter of about 0.197''+/-0.001'' (5 mm, +/-0.025 mm). The
thickness of the Neodymium, including the Parylene coating, can be
about 0.075''+/-0.001'' (1.9 mm+/-0.025 mm). The thickness of the
silicone coating can be about 0.002'' (0.05 mm).
[0364] 4. Examples of Magnetic Spacers
[0365] The following specifications represent one non-limiting
example of a set of magnetic spacers 230. In this example
embodiment, there can be three N32 Neodymium (32 MGOe) ring spacers
of overall thicknesses of 1 mm, 2 mm, and 3 mm, respectively. Of
course, the dimensions disclosed above are merely examples; any
suitably dimensioned spacer magnets 230 may be appropriate. The 1
mm, 2 mm, 3 mm magnets can contain a neodymium core having
thicknesses of roughly 0.9 mm (e.g., 0.035''+/-0.001'', or about
0.9 mm+/-0.25 mm), 1.9 mm (e.g., 0.075''+/-0.001'', or about 1.9
mm+/-0.25 mm), and 2.9 mm (e.g., 0.114''+/-0.001'', or about 2.9
mm+/-0.25 mm), respectively. Each side of the spacer magnets 230
can be coated with silicone to a thickness of, for example, about
0.05 mm (e.g., 0.002''). As one non-limiting example, the silicone
on the 1 mm, 2 mm, and 3 mm spacer can be colored, for example,
Yellow, Red, and Blue, respectively. The silicone can have a shore
A hardness of 70. The spacer magnets 230 can have the same or
substantially the same inner diameters and outer diameters to
maintain alignment and strength while stacking. The spacer magnets
230 can have an inner diameter in a range of between about 0.01 mm
to about 10 mm, or more particularly, in a range of about 1 mm to
about 10 mm, and can have an outer diameter in a range of between
about 5 mm and about 17 mm. For example, in this example, the
spacer magnets 230 can have an inner diameter of about 5 mm (e.g.,
0.197''+/-0.001'', or about 5 mm, +/-0.025 mm) and can have an
outer diameter of about 10 mm (e.g., 0.394''+/-0.001'', or about 10
mm, +/-0.025 mm). The surface area, the coating, and strength of
the magnet, among other parameters, can determine the magnets'
ability to maintain a fluid seal between the inner and outer
diameter of the magnet.
[0366] The three different spacers (e.g., Blue--3 mm, Red--2 mm,
Yellow--1 mm) can be coupled to the handpiece magnet 210 to offset
the handpiece 3A from the tooth 10 and occlusal magnet 220 by a
suitable separation distance, e.g., about 0 mm to about 5 mm. A
summary of the specifications for the non-limiting example
embodiment is provided below.
[0367] As explained herein, various combinations of spacer magnets
230 can be used to provide the appropriate separation between the
tooth 10 and the handpiece 3A or pressure wave generator 5. Table 1
lists various example combinations of spacers for particular tooth
depths. In the non-limiting example of Table 1, for example, it may
be desirable to provide a total separation between the tooth
chamber floor and the handpiece magnet of about 10 mm. It should be
appreciated that in other arrangements, other separations may be
suitable. Accordingly, if the tooth depth is 5 mm in this example,
then the clinician may apply spacer magnets 230 in a combination
suitable to provide an additional 5 mm spacing, for a total of 10
mm separation. Similarly, if the tooth depth is 6 mm, spacers 230
can provided in a combination to provide an additional 4 mm, and so
on.
TABLE-US-00001 TABLE 1 Example spacer magnet combinations based on
tooth depth Tooth Sizer Depth Spacers Used Colors Spacer Colors 5
mm 3 mm + 2 mm Blue + Red Blue + Red 6 mm 3 mm + 1 mm Blue + Yellow
Blue + Yellow 7 mm 3 mm Blue Blue 8 mm 2 mm Red Red 9 mm 1 mm
Yellow Yellow 10 mm None White None (White Handpiece Magnet)
[0368] 5. Examples of Occlusal Magnets
[0369] The following specifications represent one non-limiting
example of an occlusal magnet 220. In this example embodiment, the
occlusal magnet 220 can include a Neodymium N32 (32 MGOe) magnet
placed onto a tooth 10. The occlusal magnet 220 can contain a
neodymium core having a thickness of about 0.9 mm (e.g.,
0.035''+/-0.001'', or about 0.9 mm+/-0.25 mm), which can include a
Parylene coating. Each side of the magnet 220 can be coated with
silicone to a thickness of 0.05 mm (e.g., about 0.002''). The
occlusal magnet 220 can have an inner diameter in a range of
between about 0.01 mm to about 10 mm, or more particularly, in a
range of about 1 mm to about 10 mm, and can have an outer diameter
in a range of between about 5 mm and about 17 mm. In this example,
the outer diameter of the occlusal magnet 220 can be about 10 mm
(e.g., 0.394''+/-0.001'', or about 10 mm+/-0.025 mm). The dimension
of the outer diameter may be constrained by interference with
adjacent teeth, e.g., such that the outer diameter may be small
enough such that it does not interfere with or contact adjacent
teeth. The inner diameter of the occlusal magnet 220 can be about 5
mm (e.g., 0.197''+/-0.001'', or about 5 mm+/0.025 mm) in this
example. The silicone on the occlusal magnet 220 can be colored
grey and can have a shore A hardness of 70. The occlusal magnet 220
can be adhered to the occlusal surface of a built-up tooth 10 with
Light-cure GC TION Gingival Protectant. An occlusal magnet tool can
be used to ensure that the dentist places the occlusal magnet 220
on the tooth 10 in the correct orientation and centered on the
tooth 10. The occlusal magnet tool can also serve as a light-post
to direct the light from a light-cure gun to the light-curing GC
TION.
IV. Interface Members
[0370] As explained above, it can be advantageous to provide an
interface member 4 configured to be connected to, and disconnected
from, a tooth coupler 3. A proximal end of the interface member 4
can couple to the conduit 29 which provides fluid, electrical,
and/or data communication with the console 2. A distal end of the
interface member 4 can engage with a connector 84 coupled to or
formed with a proximal portion of the tooth coupler 3. The
interface member 4 and connector 84 can be configured such that the
clinician can easily connect and disconnect the connector 84 from
the interface member 4. Moreover, as explained herein, it can be
challenging to provide adequate sealing for removable couplers when
high pressure fluid passes through the system components. In the
disclosed embodiments, adequate sealing can be provided in the
interface member 4 and/or connector 84 to reduce or eliminate
leakage of treatment fluids at the point of connection.
[0371] FIG. 20A is a three-dimensional perspective view of an
interface member 4, according to one embodiment. The interface
member 4 can have a proximal portion 311 adapted to couple to the
conduit(s) 29 that are connected to the console 2. As explained
herein, the conduit(s) 29 can provide fluid, electrical, data,
and/or other types of communication with the console 2. The
interface member can have a distal portion 304 configured to engage
with the connector 84 of the tooth coupler 3 (e.g., the handpiece
3A). The interface member 4 can comprise an outer shell 301 and an
inner shell 302. As shown in FIG. 20A, the inner shell 302 can be
disposed inside the outer shell 301. As explained herein, the inner
shell 302 and outer shell 301 can be rotationally coupled together
by a spring, such that the inner shell 302 and outer shell 301 are
rotationally biased relative to one another.
[0372] A conduit coupler 303 can be mechanically coupled to the
inner shell 302. The conduit coupler 303 can be coupled to or
formed with the conduit(s) 29, and can provide fluid communication
between the conduit 29 and the inner shell 302 when engaged with
the inner shell 302. As illustrated below, the conduit coupler 303
can threadably couple to the inner shell 302 in some
arrangements.
[0373] The inner shell 302 can include a latch 307 on an outer
surface of the inner shell 302. As shown in FIG. 20A, the latch 307
may be positioned proximal the outer shell 301. As explained in
more detail below, the interface member 4 shown in FIG. 20A is in a
disengaged configuration, in which the interface member 4 is
disconnected and/or disengaged with the tooth coupler 3 (e.g.,
handpiece 3A, treatment cap 3B, etc.). In some embodiments, in the
disengaged configuration, the latch 307 is urged into a notch 310
formed in the outer shell 301. In an engaged configuration
(illustrated and explained below with respect to FIGS. 24A-24C),
the latch 307 may be rotated relative to the disengaged
configuration and may bear against an edge 309 of the outer shell
301. The edge 309 of the outer shell 301 can prevent the latch 307
from translating distally, which can ensure that the outer shell
301 and inner shell 302 remain in the engaged configuration, as
explained in detail below.
[0374] FIG. 20B is a three-dimensional perspective, exploded view
of the interface member 4 shown in FIG. 20A. As in FIG. 20A, the
interface member 4 shown in the exploded view of FIG. 20B can
include the outer shell 301, the inner shell 302, the slider 308,
and the conduit coupler 303. As shown in FIG. 20B, the slider 308
can be disposed within the inner shell 302, and the distal portion
of the inner shell 302 can be disposed within the outer shell 301,
e.g., such that the latch 307 remains proximal the edge 309 of the
outer shell 301 when engaged. The slider 308 can be disposed near
the distal end 304 of the interface member 4, as illustrated in
FIG. 20A. Further, the slider 308 can include a rib 321 extending
radially outward from the slider 308. The inner shell 302 can
include a plurality of apertures 317. As explained below, one or
more projections (e.g., ball bearings) can be disposed through the
apertures 317 to engage with the recess 90 of the connector 84 when
in the engaged configuration.
[0375] The conduit coupler 303 can be threadably coupled to the
inner shell 302. A high pressure interconnect 322 can threadably
engage within the conduit coupler 303. The interconnect 322 can
include a distal high pressure tube 318 configured to convey a high
pressure fluid or liquid between the conduit 29 and the handpiece
3A. A sealing joint 323 can be formed near the proximal end of the
interconnect 322 and can couple to the conduit(s) 29 to form a
sealed interface between the interconnect 322 and the conduit(s)
29.
[0376] The interface member 4 can also include an inner spring 314
and an outer spring 313. The inner spring 314 can be disposed
within the inner shell 302 between the rib 321 of the slider 308
and the conduit coupler 303. When the slider 308 is translated
proximally, the rib 321 can bear against the inner spring 314 to
compress the inner spring 314 proximally between the rib 321 and
the conduit coupler 303.
[0377] The outer spring 313 can have a distal end coupled to an
inner wall of the outer shell 301 and a proximal end coupled to an
outer wall of the inner shell 302. The outer spring 313 can be
disposed in a space between the outer shell 301 and the inner shell
302, and can traverse a helical path about the inner shell 302.
Indeed, the helical path can traverse a helical angle between the
proximal and distal ends of the outer spring 313. The outer spring
313 can have a relaxed state and a compressed state. For example,
if the outer spring 313 traverses N turns (including fractional
turns) about the inner shell 302 in the relaxed state, where N is a
positive real number, then the helical angle in the relaxed state
is about 360*N degrees.
[0378] In the compressed state, the outer spring 313 can be
compressed axially (e.g., proximally) and circumferentially (e.g.,
about a circumference of the inner shell 302). In the compressed
state, a helical angle between the distal and proximal ends of the
spring 313 can be less than that when in the relaxed state. For
example, in the compressed state, the outer spring 313 can be
compressed circumferentially by an amount d turns, where d is a
real number of turns about the inner shell 302 (and indeed may be a
fractional number of turns). Accordingly, in the compressed state,
the helical angle of the outer spring 313 can be about 360*(N-d)
degrees. Thus, when in the compressed state, the ends of the outer
spring 313 are rotationally displaced relative to when in the
relaxed state.
[0379] FIG. 21 is a three-dimensional perspective view of a
handpiece 3A and interface member 4 prior to engagement. Prior to a
treatment procedure, the clinician can select a suitable tooth
coupler 3, which in the embodiment of FIG. 21 comprises a handpiece
3A. As explained herein, the handpiece 3A can be configured for any
suitable treatment procedure, e.g., a tooth cleaning procedure, an
obturation procedure, etc. The interface member 4 can be coupled
with a distal end of the one or more conduits 29, which may provide
at least one of fluidic, electrical, and/or data communication with
the console 2. For example, the conduit 29 can comprise a high
pressure fluid pathway configured to convey pressurized treatment
fluid to the handpiece 3A. As shown in FIG. 21, the interface
member 4 is in the disengaged configuration such that the latch 307
is disposed in the notch 310 of the outer shell 301.
[0380] To connect the handpiece 3A with the interface member 4, the
clinician can insert the connector 84 of the handpiece 3A into the
distal portion 304 of the interface member 4. The clinician can
urge the connector 84 and handpiece 3A proximally (e.g., along a
proximal direction 312) until the connector 84 engages with the
interface member 4 to secure the interface member 4 and the
handpiece 3A together. Of course, it should be appreciated that the
clinician could likewise urge the interface member 4 distally
towards the connector 84 until the connector 84 and interface
member 4 engage. Once secured in the engaged configuration, the
handpiece 3A and interface member 4 may be fixed relative to one
another along a longitudinal direction, e.g., fixed relative to the
proximal direction 312. However, the handpiece 3A may rotate
relative to the interface member 4 when engaged. Allowing the
handpiece 3A to rotate relative to the interface member 4 can
enable the clinician to better manipulate the handpiece 3A during
the procedure. In addition, once engaged, the interface member 4
and connector 84 provide a substantially sealed fluid pathway
between the conduit 29 and the handpiece 3A.
[0381] FIG. 22A is a side view of the handpiece 3A and the
interface member 4 before inserting the connector 84 into the
interface member 4, for example, when the interface member 4 is in
the disengaged configuration. FIG. 23A is a side cross-sectional
view of the arrangement shown in FIG. 22A. As shown in FIGS. 22A
and 23A, a proximal portion 305 of the connector 84 of the
handpiece 3A can be positioned near the distal portion 304 of the
interface member 4. As explained above with respect to FIGS.
12A-12B, the connector 84 can include the first opening 88, the
second opening 89 proximal the first opening 88, the first gasket
91, the second gasket 95, the fluid line coupling portion 87, and
the recess 90. A proximal end of the high pressure supply line 82
can be disposed near and/or distal to the fluid line coupling
portion 87. The waste line 81 can extend from the handpiece 3A
proximally to the console 2 and the waste system 41.
[0382] With reference to FIG. 23A, the slider 308 can be disposed
within the inner shell 302, and the inner spring 314 can be
disposed within the inner shell 302 distal the conduit coupler 303.
A distal portion of the inner spring 314 can be disposed about a
proximal portion of the slider 308. The rib 321 of the slider 308
can bear against the inner spring 314. Accordingly, the slider 308
can be linearly biased relative to the conduit coupler 303 by way
of the inner spring 314.
[0383] The outer shell 301 and the inner shell 302 can be rotatably
coupled to one another by the outer spring 313. The outer spring
313 can be disposed in a space between the inner shell 302 and the
outer shell 301, and can be disposed about a circumference of the
inner shell 302. For example, a distal end of the outer spring 313
can connect to an inner wall or surface of the outer shell 301, and
a proximal end of the outer spring 313 can connect to an outer wall
or surface of the inner shell 302.
[0384] One or more projections 315, which may be ball bearings, can
be disposed in a cavity 324 formed in an inner surface of the outer
shell 301. Indeed, as shown in FIG. 23A, the projection 315 can be
positioned in the cavity 324 through the aperture 317 in the inner
shell 302. In particular, the projection 315 can be disposed in the
cavity 324 between a proximal-facing shoulder 319 of the outer
shell 301 and a distal-facing shoulder 316 of the outer shell
301.
[0385] In the disengaged configuration shown in FIG. 23A, the outer
spring 313 is in the compressed state, such that the spring 313
applies a distally-directed force against the outer shell 301
(e.g., to the left as shown in FIG. 23A). In particular, the outer
spring 313 can apply a longitudinal force that presses the
distal-facing shoulder 316 against the projection 315. However, in
the disengaged configuration, the slider 308 is linearly biased
distally such that outer walls of the slider 308 force the
projections 315 radially outward into the cavity 324 of the outer
shell 301. Accordingly, in the disengaged configuration, the
position of the slider 308 (biased distally by the inner spring
314) maintains the projections 315 within a space defined by the
cavity 324 of the outer shell 301 and the apertures 317 of the
inner shell 302.
[0386] FIG. 22B is a side view of the handpiece 3A and the
interface member 4 after aligning the connector 84 with the
interface member 4. FIG. 23B is a side cross-sectional view of the
arrangement shown in FIG. 22B. In FIGS. 22B and 23B, the interface
member 4 is still in the disengaged configuration, in which the
handpiece 3A and interface member 4 are not yet secured together.
For example, before securing the handpiece 3A and interface member
4, the clinician can align and insert the proximal portion 305 of
the connector 84 into receptors formed in the distal portion of the
slider 308.
[0387] Turning to FIGS. 22C and 23C, the clinician can apply
additional force to further advance the connector 84 and handpiece
3A proximally relative to the interface member 4 until the
connector 84 and interface member 4 are secured together. Thus,
FIG. 22C is a side view of the handpiece 3A and the interface
member 4 in the engaged configuration. FIG. 23C is a side
cross-sectional view of the engaged configuration illustrated in
FIG. 22C.
[0388] In the engaged configuration, the proximal portion 305 of
the connector 84 bears against the slider 308 to advance the slider
308 proximally relative to the inner shell 302. As explained above,
in the disengaged configuration, the outer spring 313 is biased
such that it applies a distally-directed force against the outer
shell 301 to cause the distal-facing shoulder 316 against the
projection 315. When the recess 90 (which may comprise a
circumferential groove) is positioned adjacent the projection 315,
the distal-facing shoulder 316 (which is biased distally by the
outer spring 313) can urge the projection 315 radially inward into
the recess 90 to secure the connector 84 and handpiece 3A to the
interface member 4.
[0389] In addition, when the connector 84 and interface member 4
are thereby engaged, the outer shell 301 can extend distally to
cause the outer spring 313 to be in the relaxed state. Accordingly,
as explained above, in the relaxed state, the outer spring 313 can
extend longitudinally such that the ends of the spring 313 are
longitudinally elongated, and can also extend circumferentially
such that the ends of the outer spring 313 are rotationally
displaced relative to the compressed state. In the relaxed state,
therefore, the helical angle of the spring 313 can be larger than
when in the compressed state.
[0390] When in the engaged configuration, the projection(s) 315 can
prevent the handpiece 3A from translating longitudinally relative
to the interface member 4. The methods and apparatus disclosed
herein can therefore provide a relatively simple mechanism for
connecting a tooth coupler 3 with the interface member 4. In
addition, as shown in FIG. 23C, the interface member 4 and
connector 84 can provide a sealed fluid pathway between the
handpiece 3A and conduit(s) 29 through which the high pressure
treatment fluids can pass. For example, when engaged, the high
pressure tube 318 of the interconnect 322 can extend distal of the
slider 308 and can be received through the first opening 88 of the
connector 84. The tube 318 can pass within the second gasket 95 and
to the coupling portion 87 of the connector 84. The coupling
portion 87 can provide sealed fluid communication between the high
pressure supply line 82 of the handpiece 82A and the high pressure
tube 318 of the interconnect 322. The gaskets 91, 95 can assist in
sealing the pressurized fluid passing through the tube 318 and
supply line 82 to prevent or mitigate liquid from leaking during
operation of the system 1.
[0391] Accordingly, the interface member 4 and connector 84 can
provide secure mechanical engagement and sealed fluid communication
between the handpiece 3A and the conduits 29 during a treatment
procedure. The clinician can initiate and conduct the treatment
procedure using the console 2. When the procedure is completed, the
clinician can remove the handpiece 3A from the interface member 4.
In some arrangements, as explained herein, the clinician can
dispose the handpiece 3A after the procedure.
[0392] FIG. 24A is a three-dimensional perspective view of the
handpiece 3A coupled to the interface member 4 prior to
disengagement. For example, in the engaged configuration shown in
FIG. 24A, the latch 307 is rotated relative to the notch 310. As
explained above, when the projection 315 is urged into the recess
90 of the connector 84, the outer spring 303 becomes relaxed and
elongates both longitudinally and circumferentially. Accordingly,
in the engaged configuration of FIG. 24A, the outer spring 313 is
relaxed and the latch 307 is rotated circumferentially relative to
the notch 310. In the engaged configuration, the edge 309 of the
outer shell 301 bears against the latch 307 to prevent the latch
from translating distally and disconnecting the handpiece 3A from
the interface member 4.
[0393] To disengage and/or disconnect the handpiece 3A from the
interface member 4, the inner shell 302 can be rotated in a
direction w to substantially align the latch 307 with the notch
310. FIG. 24B is a three-dimensional perspective view of the
handpiece 3A when the latch 307 is substantially aligned with the
notch 310. Aligning the notch 310 with the latch 307 can permit the
inner shell 302 and outer shell 301 to translate towards one
another. To disengage the handpiece 3A from the interface member 4,
the clinician can move the outer shell 301 towards the inner shell
302, or vice versa. For example, the clinician can translate the
outer shell 301 proximally (e.g., in the proximal direction 312)
relative to the inner shell 302, or can translate the inner shell
302 distally relative to the outer shell 301. Translating the outer
shell 301 and inner shell 302 towards one another can cause the
distal end of the slider 308 to bear against the projections 315 to
force the projections 315 radially outward into the cavity 324 and
into the disengaged configuration.
[0394] Once the interface member 4 and connector 84 are disengaged,
the handpiece 3A can be moved distally relative to the interface
member 4, e.g., along a distal direction 320. FIG. 24C is a
three-dimensional perspective view of the handpiece 3A and
interface member 4 after disconnection. When disengaged, the latch
307 can be urged into the notch 310. The interface member 4 may be
configured to couple to another tooth coupler 3 for a subsequent
treatment procedure.
[0395] FIG. 25A is a three-dimensional perspective, cross-sectional
view of an interface member 4 according to another embodiment. In
some arrangements, the handpiece 3A and interface member 4 may be
accidentally disengaged. For example, the clinician may
inadvertently rotate the outer shell 301 relative to the inner
shell 302, risking disconnection of the handpiece 3A. It can be
important to ensure that inadvertent disconnections are avoided,
particularly during a treatment procedure. Accordingly, the
interface member 4 of FIG. 25A includes a locking collar 325
adapted to prevent accidental disengagement of the handpiece
3A.
[0396] Like the embodiments presented above with respect to FIGS.
20A-24C, the interface member 4 of FIG. 25A can include an outer
shell 301, an inner shell 302, a slider 308, a conduit coupler 303,
an interconnect 322, an inner spring 314, an outer spring 313, and
one or more projections 315. In addition, the locking collar 325
can be threadably mounted relative to the outside surface of the
inner shell 302. A retaining ring 326 can also be provided on the
interconnect 322. As shown in FIG. 25A, for example, the retaining
ring 326 can be inserted into dimples in outer surfaces of the
interconnect 322. In some embodiments, the retaining ring 326 can
act to prevent translation of other components (e.g., the conduit
coupler 303) relative to the ring 326 and/or interconnect 322.
[0397] FIG. 25B is a three-dimensional perspective view of the
interface member 4 of FIG. 25A in the disengaged configuration. By
contrast, FIG. 25C is a three-dimensional perspective view of the
interface member 4 of FIG. 25A in the engaged configuration. In the
disengaged configuration of FIG. 25B, as explained above, the latch
307 can be disposed in the notch 310 of the outer shell 301. The
outer spring 313 can be in a compressed configuration. In the
engaged configuration of FIG. 25C, the latch 307 can be
rotationally offset from the notch 310, for example, because the
outer spring 313 is relaxed relative to the disengaged
configuration. In the engaged configuration of FIG. 25C, the edge
309 of the outer shell 301 can prevent the latch 307 and inner
shell 302 from translating distally relative to the outer shell
301.
[0398] During use, however, the clinician may accidentally cause
the latch 307 to rotate relative to the outer shell 301. If the
latch 307 and notch 310 substantially align, the handpiece 3A (or
other tooth coupler 3) may become inadvertently disengaged. The
locking collar 325 can act to rotationally secure the inner shell
302 relative to the outer shell 301. For example, as shown in FIG.
25C, the locking collar 325 can be threaded or otherwise coupled to
the inner shell 302. The distal end of the locking collar 325 can
engage with a proximal-most edge of the outer shell 301. The
resulting mechanical interference between the locking collar 325
and the outer shell 301 can prevent accidental disengagement
between the handpiece 3A and the interface member 4.
[0399] FIG. 26A is a perspective exploded view of a handpiece 3A
and interface member 4 before engagement, in accordance with
another embodiment. FIG. 26B is a perspective, cross-sectional view
of the handpiece 3A and interface member 4 illustrated in FIG. 26A.
For example, as explained above with respect to FIGS. 12C-12D, the
handpiece 3A can include a connector 84 having a threaded
engagement feature 595, which can comprise external threads on an
outer surface of the connector 84. The interface member 4 can
comprise an outer shell 501 and an inner shell 502 disposed at
least partially within the outer shell 501. The inner shell 502 can
mechanically and fluidly engage the conduit 29. In the embodiment
of FIGS. 26A-26B, the connector 84 of the handpiece 3A can be
inserted into the interface member 4. The connector 84 can be
rotated relative to the interface member 4 about an axis w
extending along a longitudinal axis of the system 1, or vice versa,
to removably secure the connector 84 to the interface member 4. For
example, the threaded engagement feature 595 can engage with an
inner surface of the outer shell 501 in some embodiments. In other
embodiments, the interface member 4 can act as the male connector
and can be inserted into and rotated relative to the connector
84.
[0400] FIG. 26C is a side cross-sectional view of the handpiece 3A
before engagement with the interface member 4. FIG. 26D is a side
cross-sectional view of the handpiece 3A after engagement with the
interface member 4. As shown in FIGS. 26C-26D, the high pressure
fluid supply line 82 can be disposed distal of and can fluidly
communicate with a filter 587 disposed in the coupling portion 87
of the connector 84. The filter 587 can act to filter undesirable
particulates and debris from the fluid before the fluid passes
through the orifice 66 and jet assembly. A proximal gasket 592 and
a distal gasket 591 can be disposed in a cavity of the connector
84. An intermediate gasket 593 can be disposed between the proximal
gasket 592 and the distal gasket 591. The gaskets 591, 592, 593 can
act to provide a substantial fluid seal to prevent fluids from
leaking from the high pressure fluid path. In some arrangements,
the proximal gasket 592 and the distal gasket 591 can each comprise
polyether ether ketone (PEEK) rings. The intermediate gasket 593
can comprise an ethylene propylene diene monomer (EPDM) rubber
o-ring.
[0401] The interface member 4 can further include a high pressure
interconnect 522 that can threadably engage within the inner shell
502. The interconnect 522 can include a distal high pressure tube
518 configured to convey a high pressure fluid or liquid between
the conduit 29 and the handpiece 3A. A sealing joint 523 can be
formed near the proximal end of the interconnect 522 and can couple
to the conduit(s) 29 to form a sealed interface between the
interconnect 522 and the conduit(s) 29.
[0402] The outer shell 501 can include threads 583 on an inner
surface of an aperture 504 formed in the shell 501. The threads 583
can threadable engage with the threaded engagement feature 595 of
the connector 84 to releasably secure the interface member 4 and
the connector 84 of the handpiece 3A. Accordingly, the connector 84
and handpiece 3A can be rotated relative to the interface member 4,
or vice versa, to couple the interface member 4 to the handpiece
3A. The high pressure tube 518 of the interconnect 522 can be
received through the openings 588, 589 of the connector 84 such
that the distal end of the high pressure tube 518 extends inside a
portion of the filter 587. Thus, high pressure treatment fluids
passing through the interconnect 522 and through the high pressure
tube 518 can be filtered by the filter 587 before passing through
the fluid supply line 82 to the jet assembly.
[0403] The embodiment shown in FIGS. 26A-26D can advantageously
provide a simpler and more secure removable connection between the
interface member 4 and the handpiece 3A (or other tooth coupler 3).
For example, the interface member 4 of FIGS. 26A-26D can include
only two components in some arrangements, enabling simpler and more
cost effective manufacturing procedures. Furthermore, as explained
above, some interfaces may be configured such that the clinician
may accidentally disengage the handpiece 3A from the interface
member 4. The embodiment shown in FIGS. 26A-26D can provide a safer
connection because it may be more difficult for the clinician to
accidentally disengage the connector 84 from the interface member
4. Indeed, to disengage the connector 84 and handpiece 3A, the
clinician may thread the connector 84 about a direction opposite to
that used for connecting the connector 84 and interface member 4.
Threadably disengaging the handpiece 3A and interface member 4 may
enable the clinician controllably disconnect the handpiece 3A and
interface member 4, while preventing accidental disengagement.
Furthermore, in some arrangements, disconnection of the handpiece
3A may be unsafe for the clinician and patient, as the
high-pressure jet or fluid stream may cause injury. If the threaded
connection between the handpiece 3A and interface member 4 shown in
FIGS. 26A-26D becomes slightly unscrewed, then pressure within the
lines 518, 82 may slowly release such that if complete
disconnection occurs, the high pressure built up in the system 1
may be released before it can injure the patient and/or
clinician.
[0404] Moreover, as explained herein, it can be advantageous for
the clinician to be able to rotate the handpiece 3A relative to the
conduit(s) 29 and/or console 2, e.g., to improve maneuverability
during a treatment procedure. Accordingly, the arrangement shown in
FIGS. 26A-26D can include a swiveling mechanism to enable the
clinician to rotate the handpiece 3A without disengaging the
handpiece 3A from the interface member 4. For example, as shown in
FIGS. 26C-26D, the interface member 4 can include one or more
projections 590 inserted into corresponding recesses 589 (which may
comprise a circumferential groove) in the interface member. As
shown in FIGS. 26C-26D, for example, the projections 590 can be
formed in or through the outer shell 501, and the recesses 589 can
be formed in an outer surface of the inner shell 502. In some
embodiments, the projections 590 can comprise a set screw, a
spring-loaded pin, etc. that can engage the recesses 589. The
projections 590 and recesses 589 can cooperate to prevent lateral
(e.g., longitudinal movement in proximal and/or distal directions)
translations, while permitting relative rotation or swiveling
between the interface member 4 and the connector 84.
[0405] FIG. 27A is a side cross-sectional view of a handpiece 3A
and interface member 4 prior to engagement, according to yet
another embodiment. FIG. 27B is a side cross-sectional view of the
handpiece 3A and interface member 4 shown in FIG. 27A after
engagement. The embodiment shown in FIGS. 27A-27B may be generally
similar to the embodiment shown in FIGS. 26A-26D. For example, the
interface member 4 can include threads 583 that rotatably couple to
corresponding threadable engagement features 595 of a connector 84.
In addition, the connector 84 and interface member 4 can be
configured to couple to one another by snap-fit engagement. For
example, in some embodiments, the connector 84 can include a flange
572 extending radially outward from the connector 84. The interface
member 4 can include a recess 573 at a distal end. When the
interface member 4 is threaded onto the connector 84, the recess
573 can snap onto the flange 572 to further secure the interface
member 4 and connector 84. Moreover, the snap-fit engagement can
signal to the clinician that there is secure engagement between the
handpiece 3A and interface member 4.
V. Recording Data about Various System Components
[0406] As explained herein with respect to FIGS. 5F-5G, the console
2 can organize and manage information about the various system
components and treatment procedures performed by the system 1. In
some embodiments, suitable system components can transmit data
regarding to the console 2 (e.g., the processing unit 39) regarding
the status or disposition of the component itself or about
treatment procedures associated with the component. For example, as
explained herein, various system components may be disposable. For
disposable components (such as the handpiece 3A, treatment cap 3B,
etc.), it can be important to verify that the component has not
been used in a procedure before to assist in determining whether or
not the component is unsanitary. Furthermore, it can be important
to ensure that the disposable component is a valid component that
is legally and/or clinically suitable for use with the system 1.
Additional data regarding the system components may be
desirable.
[0407] In some embodiments, the handpiece 3A can include a memory
device configured to store and/or communicate information about at
least one of a treatment procedure and the handpiece 3A. The memory
device may be a passive system or an active system. FIG. 28 is a
schematic perspective view of a handpiece 3A having a memory device
comprising a communications chip 92 (e.g., a wireless or wired
communications chip) coupled thereto and configured to communicate
with a wireless reader 96. In some embodiments, the communications
chip 92 can comprise a radio frequency identification (RFID) chip,
and the reader 96 can comprise a RFID reader. For example, in one
embodiment, the RFID chip can be a GammaTag.RTM. manufactured by
Verigenics.TM. of Southampton, Pa. The wireless reader 96 can
communicate with the chip 92 on the handpiece 3A when the handpiece
3A is brought within range of the reader 96. The communications
chip 92 can be programmed with information about the particular
handpiece 3A to which the chip 92 is coupled. For example, the
communications chip 92 can be programmed to store information
regarding at least one of the type of tooth coupler 3 or handpiece
3A (e.g., a molar handpiece, pre-molar handpiece, etc.), whether or
not the handpiece 3A has been used in a treatment procedure,
information concerning any treatment procedures performed by the
handpiece 3A (e.g., at least one of date and time of procedure,
name of clinician, name of patient, location of treatment, type of
procedure, etc.), whether or not the handpiece 3A is a genuine
product by way of, for example, a unique identifier associated with
the particular handpiece 3A (e.g., whether the handpiece 3A is
supplied by or manufactured by an authorized entity), date of
manufacture, lot or serial number, etc. As explained herein, the
handpiece 3A can comprise a suitable dental treatment assembly,
such as, e.g., a fluid jet device.
[0408] When the handpiece 3A is brought into range of the reader 96
(such as when the handpiece 3A is placed in a cradle containing the
reader 96), the reader 96 can read the data stored on the
communications chip 92. As explained herein, it can be important to
reduce the risk of infection or contamination by disposing the
handpiece 3A after a single treatment procedure. In some
embodiments, the communications chip 92 of the handpiece 3A can be
specially configured to have memory space for storing data
indicating that the handpiece 3A has never been used in a treatment
procedure. When the handpiece 3A is proximate the reader 96, the
reader 96 and chip 92 can communicate over an encrypted data link
in some arrangements. Before, during, or after the initial
treatment procedure, the reader 96 can write to the chip 92 data
indicating that the handpiece 3A has been used in a treatment
procedure. For example, in some embodiments, the reader 96 can
physically erase the data stored or allotted to a particular
location on the chip 92, or can otherwise permanently indicate on
the chip 92 that the handpiece 3A has been used before. The reader
96 can be in data communication with the console 2 (whether
wireless or wired communication), and the console 2 can identify
that the handpiece 3A has been used previously. If it is determined
that a particular handpiece 3A has been used previously, then the
system 1 can prevent the clinician from performing another
procedure using that particular handpiece 3A. The system 1 can
thereby assist in ensuring that the handpiece 3A is sanitary or
sterile before use in a treatment procedure.
[0409] In addition, the chip 92 can store information relating to
the serial number or other unique identifying information related
to the particular handpiece 3A. Thus, the manufacturer, owner, or
supplier can ensure that the system 1 is used only with authorized
handpieces 3A (or other types of tooth couplers 3). For example,
the reader 96 can read a unique identifier (such as serial number,
etc.) from the chip 92 and can determine whether or not the
particular handpiece 3A is an authorized handpiece. If the
handpiece 3A is not authorized for use with the system 1, then the
system 1 can prevent the clinician from using the unauthorized
handpiece 3A or other tooth coupler 3.
[0410] The chip 92 can store and transmit any suitable information
regarding the handpiece 3A and/or a treatment procedure performed
by the handpiece 3A. For example, in some embodiments, the chip 92
on board the handpiece 3A can record information about the
procedure, such as treatment type, treatment duration, patient
name, treatment outcome, etc. Information related to the treatment
can be sent to the console 2 by way of the reader 96. For example,
in some embodiments, if a treatment is ended prematurely, then the
chip 92 can store and transmit to the reader 96 that the treatment
was incomplete. In some embodiments, the chip 92 on the handpiece
3A can identify whether there were any malfunctions or other
defects in the handpiece and can transmit such information to the
console 2. The manufacturer can utilize information regarding such
defects to apply refunds to the customer and/or to improve system
design. Any other suitable information about the handpiece 3A
and/or treatment procedures can be stored on the chip 92.
[0411] Although the chip 92 and reader 96 of FIG. 28 are described
as communicating by way of RFID, any suitable communications
protocol may be suitable. For example, in some embodiments,
wireless internet connections (e.g., under the 802.11 standards),
Bluetooth, etc. may be used. In still other embodiments, wired data
connections may be used to communicate between the handpiece 3A and
the reader 96 or console 2.
[0412] Furthermore, although FIG. 28 relates to communication
between the handpiece 3A and a reader 96, it should be appreciated
that any other suitable system component can communicate
information regarding the component's status, or a status of a
treatment procedure, to the console 2. For example, the high
pressure conduit 29 can include information regarding the number of
treatment procedures performed and/or the amount of time the
conduit 29 (or any other component) has been in service in the
system 1. When the number of procedures and/or time of service
exceeds a desirable threshold, the console 2 can indicate to the
clinician that the particular component should be replaced.
[0413] Reference throughout this specification to "some
embodiments" or "an embodiment" means that a particular feature,
structure, element, act, or characteristic described in connection
with the embodiment is included in at least one embodiment. Thus,
appearances of the phrases "in some embodiments" or "in an
embodiment" in various places throughout this specification are not
necessarily all referring to the same embodiment and may refer to
one or more of the same or different embodiments. Furthermore, the
particular features, structures, elements, acts, or characteristics
may be combined in any suitable manner (including differently than
shown or described) in other embodiments. Further, in various
embodiments, features, structures, elements, acts, or
characteristics can be combined, merged, rearranged, reordered, or
left out altogether. Thus, no single feature, structure, element,
act, or characteristic or group of features, structures, elements,
acts, or characteristics is necessary or required for each
embodiment. All possible combinations and subcombinations are
intended to fall within the scope of this disclosure.
[0414] As used in this application, the terms "comprising,"
"including," "having," and the like are synonymous and are used
inclusively, in an open-ended fashion, and do not exclude
additional elements, features, acts, operations, and so forth.
Also, the term "or" is used in its inclusive sense (and not in its
exclusive sense) so that when used, for example, to connect a list
of elements, the term "or" means one, some, or all of the elements
in the list.
[0415] Similarly, it should be appreciated that in the above
description of embodiments, various features are sometimes grouped
together in a single embodiment, figure, or description thereof for
the purpose of streamlining the disclosure and aiding in the
understanding of one or more of the various inventive aspects. This
method of disclosure, however, is not to be interpreted as
reflecting an intention that any claim require more features than
are expressly recited in that claim. Rather, inventive aspects lie
in a combination of fewer than all features of any single foregoing
disclosed embodiment.
[0416] The foregoing description sets forth various example
embodiments and other illustrative, but non-limiting, embodiments
of the inventions disclosed herein. The description provides
details regarding combinations, modes, and uses of the disclosed
inventions. Other variations, combinations, modifications,
equivalents, modes, uses, implementations, and/or applications of
the disclosed features and aspects of the embodiments are also
within the scope of this disclosure, including those that become
apparent to those of skill in the art upon reading this
specification. Additionally, certain objects and advantages of the
inventions are described herein. It is to be understood that not
necessarily all such objects or advantages may be achieved in any
particular embodiment. Thus, for example, those skilled in the art
will recognize that the inventions may be embodied or carried out
in a manner that achieves or optimizes one advantage or group of
advantages as taught herein without necessarily achieving other
objects or advantages as may be taught or suggested herein. Also,
in any method or process disclosed herein, the acts or operations
making up the method or process may be performed in any suitable
sequence and are not necessarily limited to any particular
disclosed sequence.
* * * * *