Instrument for Delivery of Optical Energy to the Dental Root Canal System for Hidden Bacterial and Live Biofilm Thermolysis

Abstract

Systems, processes, techniques, and apparatus are described for thermolytic eradication of bacteria and biofilm in the root canal of a human tooth involve an elongated and flexible optical probe and a laser oscillator that provides the probe with near infrared energy. The optical probe can be sufficiently long for insertion into substantially the entire length of the root canal of the tooth. The optical probe causes lateral dispersion of the radiation from the probe throughout the root canal. The radiation is provided at an energy density and for a period of time that are necessary to selectively target bacteria and live biofilm in the dentinal tubules of an entire root canal system, at once, thereby (1) inhibiting creation of a blackbody “hot tip”, and (2) inducing laser interstitial thermotherapy (LITT) within the root-canal space. Near infrared wavelengths from about 700 nm through about 1100 nm can be used.

1 . A system for the photodamage or photothermal eradication of bacteria and biofilm in the root canal of a human tooth, said system comprising: an elongated and flexible optical probe, a laser oscillator communicating with the distal end of said optical probe through at least one optical fiber, a power supply operatively connected to said laser oscillator, and a control operatively connected to said power supply and said laser oscillator;
 (a) said optical probe being configured and arranged to disperse optical energy throughout 360° laterally of said optical probe and along the entire length of said optical probe;   (b) said optical fiber ranging in diameter between 200 to 1000μ;   (c) said optical probe ranging in diameter from ISO 20 to ISO 70;   (d) said laser oscillator generating radiation in the low infrared wavelength range of 800 nm to 1000 nm;   (e) said optical fiber being operatively connected between said laser oscillator and an ingress at the proximal end of said optical probe;   (f) said optical probe being sufficiently long for insertion into substantially the entire length of the root canal of said tooth;   (g) said optical probe causing lateral dispersion of said radiation from said probe throughout said root canal; and   (h) said control energizing said laser oscillator for dispersion of said radiation at an energy density and for a period of time to rid the root canal anatomy of microbial pathogens.   
   
   
       2 . The system of  claim 1  wherein said period of time is sufficient to destroy pathogenic microorganisms in said root canal. 
   
   
       3 . The system of  claim 1  wherein said laser oscillator comprises a diode laser. 
   
   
       4 . The system of  claim 1  wherein said laser oscillator comprises a diode laser configured and arranged to produce an output within the range of about 830 nm to about 970 nm. 
   
   
       5 . (canceled) 
   
   
       6 . A process for treatment of the root canal of a human tooth, said process comprising:
 (a) preliminary removal of bacteria and biofilm from the entire elongated space of said root canal;   (b) debridement of said entire elongated space;   (c) insertion of an elongated optical probe into said entire elongated space;   (d) transmission of low infrared radiation longitudinally into the entire length of said optical probe and laterally through the surface of said elongated probe to the surface of said root canal defining said space, and through the dentinal tubules adjoining said root canal; and   (e) said transmission being of sufficient energy density and sufficient time duration to rid the root canal anatomy of microbial pathogens.   
   
   
       7 . The process of  claim 6  wherein said optical probe is composed of a member of the class consisting of sapphire and zirconium. 
   
   
       8 . The process of  claim 6  wherein said optical probe has a surface configured and arranged for dispersion of optical energy throughout 360° laterally of said optical probe and along the entire length of said optical probe. 
   
   
       9 . The process of  claim 6  wherein said radiation is transmitted from said laser to said probe via at least one optical fiber ranging in diameter between 200 to 1000μ. 
   
   
       10 . The process of  claim 6  wherein said optical probe ranges in diameter from ISO 20 to ISO 70. 
   
   
       11 . The process of  claim 6  wherein said laser oscillator generates radiation in the low infrared wavelength range of 800 nm to 1000 nm. 
   
   
       12 . A process for treatment of an infection in the root canal of a human tooth, said process comprising:
 (a) mechanical and chemical removal of bacteria and biofilm from the elongated space of said root canal;   (b) mechanical shaping of said elongated space;   (c) insertion of an elongated optical probe into said elongated space;   (d) transmission of low infrared radiation longitudinally into the entire length of said optical probe and laterally through the surface of said elongated probe to the surface of said root canal defining said space;   (e) said transmission being of sufficient energy density and sufficient time duration to rid the root canal anatomy of microbial pathogens;   (f) obturation of said space with an apical seal;   (g) said optical probe being configured and arranged to disperse optical energy throughout 360 laterally of the optical probe and along the entire length of the probe;   (h) said radiation being transmitted from said laser to said probe via at least one optical fiber ranging in diameter between 200 to 1000μ;   (i) said optical probe ranging in diameter from ISO 20 to ISO 70; and   (j) said laser oscillator generating radiation in the low infrared wavelength range of 800 nm to 1000 nm.   
   
   
       13 . The process of  claim 12  wherein the infection includes Fusobacterium. 
   
   
       14 . The process of  claim 12  wherein the infection includes Peptostreptococcus. 
   
   
       15 . The process of  claim 12  wherein the infection includes Eubacterium. 
   
   
       16 . The process of  claim 12  wherein the infection includes Prevotella. 
   
   
       17 . The process of  claim 12  wherein the infection includes Lactobacillus. 
   
   
       18 . The process of  claim 12  wherein the infection includes Streptococcus. 
   
   
       19 . The process of  claim 12  wherein the infection includes Bacteroides. 
   
   
       20 . The process of  claim 12  wherein the infection includes Enterococcus. 
   
   
       21 . The process of  claim 12  wherein the infection includes Actinomyces. 
   
   
       22 . The process of  claim 12  wherein the infection includes Propionibacterium. 
   
   
       23 . The process of  claim 6 , further comprising (f) obturation of said space with an apical seal.