Oral support for microscanning and analysis of sublingual microcirculation.

Abstract

Oral support for micro scanning and analysis of sublingual microcirculation. The present invention relates to an oral support that provides stability and pressure control for imaging devices of sublingual blood microcirculation, wherein the support comprises a transparent tip (1) and an oral support (2), joined by means of an external thread (3) of the tip (1) and an internal thread (11) of an inclined seat (11); once the tip (1) is introduced into said support (2), the external thread (3) rotates around the internal thread (12) of the seat (11) of the oral support (2) while said tip (1) passes through the oblong hole (13) until it reaches the sublingual region of the patient from which sublingual blood microcirculation is to be studied, and the adjustment of the depth of the tip (1) and consequently of the optical tip (p) of the microscope (m) is done by the thread (3,12) without excessive pressure on the microcirculatory area to be studied;The present invention also comprises a constructive alternative provided with inner (40) and outer (33) rings configuring an orbital adjustment mechanism, which allows not only depth adjustment but also angular adjustment of the tip (21).

Description

1 / 15 “ORAL SUPPORT FOR MICRO SCANNING AND ANALYSIS OF SUBLINGUAL MICROCIRCULATION”

[001] The present invention relates to an oral support for image capture devices, which provides stability and control of the pressure of the tip applied to the sublingual region for the study of blood microcirculation.

[002] The present invention comprises means for stabilizing and supporting equipment such as a sublingual microcirculation imaging microscope.

[003] The oral support of the present invention comprises a disposable, threaded transparent tip that covers the optical tip of the micro scan image capture microscope, as well as a threaded oral support to be positioned in the patient's mouth, said support having an inclined threaded seat capable of receiving the adjustable transparent tip, allowing the reading of blood microcirculation in the sublingual region without it being pressed by the disposable cap of the optical tip, allowing the physician or healthcare professional responsible for operating the equipment and capturing the image to obtain a more precise result without loss or alteration of data, since the device is firmly fixed between the mandible and Petition 870190095998, dated 09 / 25 / 2019, page 5 / 39 2 / 15 of the patient's maxilla, generating greater stability with the desired contact pressure, for a more accurate reading.

[004] The present invention further discloses a constructive alternative, consisting of an annular adjustment support, with two independent rotation axes, providing an orbital movement and a greater degree of freedom in adjusting the positioning of the transparent tip in the sublingual reading region. Description of the state of the art

[005] In the current state of the art, equipment for capturing images for medical treatments is known, such as, for example, microcirculatory sublingual imaging microscopes that apply a force and generate an exacerbated pressure of the tip of the equipment on the tissue of the sublingual region.

[006] Microcirculation plays a crucial role in the physiological processes of organ oxygenation and nutrient exchange in humans. In a severe systemic disease (e.g., sepsis), microcirculatory dysfunction precedes macrocirculatory dysfunction in all organs of the human body; therefore, the patient may be medicated in advance.

[007] To monitor microcirculation in humans, the most studied area is the sublingual area, because it is the Petition 870190095998, dated 09 / 25 / 2019, p. 6 / 39 3 / 15 Easy access and non-invasive. This monitoring is performed by healthcare professionals (doctors, nurses and researchers) on living patients at the bedside, using handheld microscopes to capture images of the sublingual microcirculation, which are transmitted and converted directly, in real time, to a viewing monitor connected to a computer with specific software for video analysis of the microcirculation (as seen in figures 1 to 3).

[008] The term 'artifact' refers to results that are not manifestations of the natural phenomena under investigation and can be classified as pressure, illumination, focus, content and focus.

[009] Using images from handheld vital microscopes (HVMs) to assess microcirculation function requires that measurement artifacts be free from the necessary specific sensitivity, since the disposable camera tip must touch the tissue surface.

[0010] The microscope (HVM) is sensitive to motion and pressure artifacts, so during handling of this device by the physician on the surface of the sublingual tissue, an alteration in microcirculatory blood flow may occur, compromising the monitoring data. Since the microcirculation is located just below the Petition 870190095998, dated 09 / 25 / 2019, page 7 / 39 4 / 15 microscope, excessive pressure applied to the area can collapse it, and the investigation becomes unreliable (De Backer 2007). The risk of obtaining biased results is high when relying on the researcher's skill in handling pressure artifacts.

[0011] Obtaining higher quality images with HVM requires substantial operator training so that they are familiar with best practices to optimize comfort and usability (Massey 2016).

[0012] Currently, the most commonly used microscopes (HVM - Hand-held vital microscopes) are known as SDF Sidestream Dark-Field or IDF Incident Dark-Field (more recent).

[0013] It turns out that healthcare professionals do not have the necessary oral support devices to control artifacts when freely manipulating such microscopes to capture images of the sublingual microcirculation. Thus, excessive involuntary pressure applied to the area can collapse it, and the investigation becomes unreliable, since the sublingual microcirculation analyzed with the HVM is superficial and very sensitive to any change in pressure and movement when touched by the tip of the microscope camera, which magnifies the captured image more than 300 times. Objectives of the invention

[0014] To solve the drawbacks of the technique Petition 870190095998, dated 09 / 25 / 2019, page 8 / 39 5 / 15 currently, the present invention discloses an oral support with a threaded transparent tip and a threaded oral support to be positioned in the patient's mouth, said support having an inclined threaded seat capable of receiving the adjustable transparent tip in its depth, enabling the reading of blood microcirculation in the sublingual region, eliminating the known obstacles of the prior art.

[0015] The present invention further comprises a constructive alternative, consisting of an annular adjustment support, with two independent rotation axes and internal threaded seat, providing orbital movement and a greater degree of freedom in adjusting the positioning and depth of the transparent tip in the sublingual reading region.

[0016] One advantage of the present invention compared to known supports of the current art relates to the fact that it provides greater ease in handling and managing the position and precision of the image capture device tip, by adjusting its depth from the inclined threaded support existing in the oral support.

[0017] Furthermore, it provides ease of handling of the reading device by the health operator responsible for carrying out the study of sublingual blood microcirculation. Petition 870190095998, dated 09 / 25 / 2019, page 9 / 39 6 / 15

[0018] Furthermore, the oral support of the present invention is more portable and lightweight than known supports, providing the patient and operator with greater comfort in handling and operating it.

[0019] Another major advantage of the present invention relates to the fact that the accuracy in reading the monitoring data is increased, avoiding the compromise or alteration of the data. In the oral support with depth adjustment by means of a screw, a greater degree of freedom is obtained in selecting the reading position. In the case of the constructive alternative with an orbital support, there is an even greater degree of freedom in adjusting the position of the microscope's optical tip, both in angular position and in depth. Brief description of the drawings

[0020] The object of the present invention will be described in greater detail with the aid of the attached figures, which:

[0021] Figure 1 is a perspective view showing how a sublingual imaging microscope is used according to the state of the art;

[0022] Figure 2 is a side view showing how a sublingual imaging microscope is used according to the state of the art;

[0023] Figure 3 is a schematic view of a Petition 870190095998, dated 09 / 25 / 2019, page 10 / 39 7 / 15 sublingual imaging microscope being used to capture the image, coupled to a monitor and computer, according to the current state of the art;

[0024] Figure 4 is an exploded view of a threaded transparent tip of the present invention capable of being coupled to the reading tip of a sublingual imaging microscope known in the prior art;

[0025] Figure 5 is a top front perspective view of a threaded oral support of the present invention;

[0026] Figure 6 is a lower front perspective view of a threaded oral support of the present invention;

[0027] Figure 7 is a lower rear perspective view of a threaded oral support of the present invention;

[0028] Figure 8 is a top rear perspective view of a threaded oral support of the present invention;

[0029] Figure 9 is a side view in section of the oral support of the present invention and of the threaded tip before its coupling;

[0030] Figure 10 is a side view in section of the oral support of the present invention and of the threaded tip coupled to said support;

[0031] Figure 11 is a front view of the support inserted into the patient's mouth, said support being fitted with a fastening strap; Petition 870190095998, dated 09 / 25 / 2019, page 11 / 39 8 / 15

[0032] Figure 12 is a top view of the oral support of the present invention;

[0033] Figure 13 is a top view of the oral support of the present invention with the use of a dental adhesive compound;

[0034] Figure 14 is a side view in section of the oral support in microscope reading position, with the threaded tip attached to the threaded support;

[0035] Figure 15 is a top front perspective view of an alternative orbital construction of the threaded oral support of the present invention;

[0036] Figure 16 is a lower front perspective view of the orbital constructive alternative of the threaded oral support of the present invention;

[0037] Figure 17 is a lower rear perspective view of the orbital constructive alternative of the threaded oral support of the present invention;

[0038] Figure 18 is a top rear perspective view of the orbital constructive alternative of the threaded oral support of the present invention;

[0039] Figure 19 is an exploded perspective view of the orbital constructive alternative of the oral support of the present invention;

[0040] Figure 20 is a side view in section of the orbital constructive alternative of the oral support of the present Petition 870190095998, dated 09 / 25 / 2019, p. 12 / 39 9 / 15 invention and threaded tip before coupling;

[0041] Figure 21 is a side view in section of the orbital constructive alternative of the oral support of the present invention and of the threaded tip coupled to said support;

[0042] Figure 22 is a front view of the alternative orbital support introduced into the patient's mouth, said support being made using a fastening strap for the assembly;

[0043] Figure 23 is a top view of the alternative orbital construction of the oral support of the present invention;

[0044] Figure 24 is a top view of the alternative orbital construction of the oral support of the present invention using a dental adhesive compound; and

[0045] Figure 25 is a side view in section of the alternative orbital construction of the oral support in microscope reading position, with the threaded tip attached to the threaded support. Detailed description

[0046] The oral support of the present invention will be detailed in figures 4 to 14 and an alternative orbital construction will be detailed in figures 15 to 25.

[0047] According to figures 4 to 8, the present invention comprises a transparent tip (1) capable of being coupled to and coating an optical tip (P) of a sublingual imaging microscope (M), being to Petition 870190095998, dated 09 / 25 / 2019, page 13 / 39 10 / 15 at the same time attachable to an oral support (2), by means of an external thread (3).

[0048] The support (2) has a horizontal extension (4) composed of an upper surface (5) and a lower surface (6), where the upper surface (5) has through holes (7) capable of receiving a fast-drying dental modeling compound (8), as well as the lower surface (6) also has through holes (9) equally capable of receiving the dental modeling compound (8).

[0049] Said oral support (2) has a convex flap (10) that acts as a contact barrier with the patient's lips when the horizontal extension (4) is introduced into the patient's mouth.

[0050] From said convex flange (10) projects an inclined seat (11) provided with an internal thread (12) which acts as a base to receive the external thread (3) of the disposable transparent tip (1). Similarly, the lower surface (6) of the horizontal extension (4) has an oblong hole (13).

[0051] As can be seen in figures 9 and 10, once the tip (1) is inserted into said support (2), the external thread (3) rotates around the internal thread (12) of the seat (11) of the oral support (2) while said tip (1) passes through the oblong hole (13) until it reaches the Petition 870190095998, dated 09 / 25 / 2019, page 14 / 39 11 / 15 sublingual region of the patient whose sublingual blood microcirculation is to be studied. The depth adjustment of the tip (1) and consequently of the optical tip (P) of the microscope (M) is done by the thread (3,12), the tip (1) having vertical grooves (14) that act as knurling and contact point for the rotation of the tip (1) around the thread (12) of the oral support (2).

[0052] The convex flap (10) is provided with T-type attachments (15) capable of receiving a fastening and support strap (16), which supports and fixes the entire oral support assembly (2) to the patient's head, preventing unwanted displacements that could interfere with the study of blood microcirculation or even loss of reading position. This condition is best visualized in figure 11.

[0053] As can be seen in figures 13 and 14, before the oral support (2) is introduced into the patient's mouth, said oral support (2) receives the quick-drying dental modeling compound (8), deposited on the upper surface (6) and consequently holes (7), as well as on the lower surface (6) and holes (9). Thus, with the introduction of the oral support (2), the patient's dental arch presses the modeling compound (8) and, after quick drying, forms a fitting mold of said oral support (2) for reuse on the same patient, if necessary, without loss of microscope reading position. Petition 870190095998, dated 09 / 25 / 2019, page 15 / 39 12 / 15 (M) by the optical tip (P). This condition allows that, in the event that the oral support (2) needs to be removed and subsequently replaced, the position of the support (2) in the mouth is always the same, allowing the sublingual area to be studied to always be the same during the procedure.

[0054] As can be seen in figures 15 to 25, the oral support has a first constructive alternative, with a transparent tip (21) capable of being coupled to and covering an optical tip (P) of a sublingual image capture microscope (M), while at the same time being attachable to an oral support (22), by means of an external thread (23).

[0055] The support (22) has a horizontal extension (24) composed of an upper surface (25) and a lower surface (26), where the upper surface (25) has through holes (27) capable of receiving a quick-drying dental modeling compound (28), as well as the lower surface (26) has holes (29) also capable of receiving the dental modeling compound (28).

[0056] Said oral support (22) has a convex flange (30) that acts as a contact barrier with the patient's lips when the horizontal extension (24) is introduced into the patient's mouth.

[0057] Starting from the end of the horizontal extension (24) are placed bearings (31) with threaded adjustment screw (32), and from said Petition 870190095998, dated 09 / 25 / 2019, page 16 / 39 13 / 15 bearings (31) engage and are able to pivot an outer ring (33). The outer ring (33) has a horizontal shaft (34) that is housed inside the bearing (31) and, at the opposite end, the screw shaft (32) rotates around a threaded hole (35), which provides tightening after selecting the desired position. This condition is best visualized in figure 19.

[0058] The lower end (36) of said outer ring (33) has a threaded hole (37) and houses a threaded shaft (38) driven by a screw (39) from which a circular inner ring (40) is housed and able to pivot, orthogonal to the bearings (31) of the outer ring (33), thus forming an orbital motion mechanism (similar to the motion of an armillary sphere).

[0059] The outer ring (40) has a vertical axis (41) that is housed inside a hole (42) in the outer ring (33) and around which the inner ring (40) can pivot, with the actuation of the screw (39) promoting the tightening and locking of the inner ring (40) in the outer ring (33) from the threaded axis (38), which provides the tightening after selecting the desired position.

[0060] The inner ring (40) has an internal thread (42) that acts as a seat to receive the external thread (23) of the disposable transparent tip (21). Similarly, the lower surface (26) of the horizontal extension (24) Petition 870190095998, dated 09 / 25 / 2019, page 17 / 39 14 / 15 has an opening (43).

[0061] As can be seen in figures 20 and 21, once the tip (21) is inserted into said support (22), the external thread (23) rotates around the internal thread (42) of the internal ring (40) while said tip (21) passes through the opening (43) until it reaches the sublingual region of the patient whose sublingual blood microcirculation is to be studied.

[0062] The depth adjustment of the tip (21) and consequently of the optical tip (P) of the microscope (M) is done by the thread (23,42) wherein the tip (21) has vertical grooves (44) that act as knurling and contact point for the rotation of the tip (21) around the thread (42) of the inner ring (40).

[0063] The angular adjustment of the tip (21) is achieved by orbital movement of the outer (33) and inner (40) rings until the desired position for reading is selected and the fixing screws (32,39) are subsequently activated, respectively.

[0064] In this way, this constructive alternative offers both a depth adjustment of the optical tip (P) of the microscope (M) and an angular adjustment for selecting the sublingual area to be used in the measurement.

[0065] The convex flange (30) is provided with T-type fittings (45) capable of receiving a fastening strap and Petition 870190095998, dated 09 / 25 / 2019, page 18 / 39 15 / 15 support (46), which supports and fixes the entire oral support assembly (22) to the patient's head, preventing unwanted displacements that could interfere with the pressure of the tip (21) applied to the sublingual region or even loss of reading position. This condition is best visualized in figure 22.

[0066] As can be seen in figures 23 to 25, before the oral support (22) is introduced into the patient's mouth, said oral support (22) receives the quick-drying dental modeling compound (28), deposited on the upper surface (25) and consequently in the holes (27), as well as in the holes (29) of the lower surface (26). Thus, with the introduction of the oral support (22), the patient's dental arch presses the modeling compound (28) and, after quick drying, forms a fitting mold of said oral support (22) for reuse in the same patient, if necessary, without loss of microscope reading position (M) by the optical tip (P). This condition allows that, in case of need to remove the oral support (22) and subsequent replacement, the position of the support (22) in the mouth is always the same, allowing the sublingual area to be studied to always be the same during the procedure. Petition 870190095998, dated 09 / 25 / 2019, page 19 / 39

Claims

1 / 6 CLAIMS 1) “ORAL SUPPORT FOR MICRO SCANNING AND ANALYSIS OF SUBLINGUAL MICROCIRCULATION” characterized by comprising a transparent tip (1) capable of being coupled to and covering an optical tip (P) of a sublingual image capture microscope (M), while simultaneously being attachable to an oral support (2) by means of an external thread (3), wherein said support (2) has a horizontal extension (4) composed of an upper surface (5) and a lower surface (6), wherein the upper surface (5) has through holes (7) capable of receiving a quick-drying dental modeling compound (8), as well as the lower surface (6) has holes (9) equally capable of receiving the dental modeling compound (8), the oral support (2) has a convex flange (10) that acts as a contact barrier with the patient's lips when the horizontal extension (4) is introduced into the mouth. of the patient,From said convex flange (10) projects an inclined seat (11) provided with an internal thread (12) which acts as a base to receive the external thread (3) of the disposable transparent tip (1) and, in the same way, the lower surface (6) of the horizontal extension (4) has an oblong hole (13), once the tip (1) is inserted into said support (2), the external thread (3) rotates around the internal thread (12) of the seat (11) of the oral support (2) at the same time as said Petition 870200012456, of 27 / 01 / 2020, page. 5 / 21 2 / 6 tip (1) passes through the oblong hole (13) until it reaches the sublingual region of the patient whose blood microcirculation is to be studied, and the depth of the tip (1) and consequently of the optical tip (P) of the microscope (M) is adjusted by the screw (3,12) without pressing on the area to be studied. 2) “ORAL SUPPORT”, according to claim 1, characterized in that the tip (1) has vertical grooves (14) that act as knurling and contact point for the rotation of the tip (1) around the thread (12) of the oral support (2). 3) “ORAL SUPPORT”, according to claim 1, characterized in that the tip (1) is disposable. 4) “ORAL SUPPORT”, according to claim 1, characterized in that the convex flap (10) of the oral support (2) is provided with “T” type attachments (15) capable of receiving a fastening and support strap (16), which holds and secures the entire oral support assembly (2) to the patient’s head. 5) “ORAL SUPPORT”, according to claim 1, characterized in that before the introduction of the oral support (2) into the patient’s mouth, said oral support (2) receives the quick-drying dental modeling compound (8), deposited on the upper surface (6) and consequently holes (7), as well as on the horizontal opening (9) of the lower surface (6) and, with the introduction of the oral support (2), the patient’s dental arch presses the modeling compound (8) and, after quick drying, forms a fitting mold of said oral support (2) for reuse on the same patient, if necessary, without loss of reading position of the microscope (M) by the optical tip (P). 6) “ORAL SUPPORT FOR MICRO SCANNING AND ANALYSIS OF SUBLINGUAL MICROCIRCULATION” according to claim 1 and in a first constructive alternative characterized by comprising a transparent tip (21) capable of coupling and covering an optical tip (P) of a sublingual image capture microscope (M), being at the same time attachable to an oral support (22), by means of an external thread (23), the support (22) has a horizontal extension (24) composed of an upper surface (25) and a lower surface (26), where the upper surface (25) has through holes (27) capable of receiving a quick-drying dental modeling mass (28), as well as the lower surface (26) has holes (29) equally capable of receiving the dental modeling mass (28), said oral support (22) has a convex flange (30) that acts as a contact barrier with the patient's lips,when the horizontal extension (24) is introduced into the patient's mouth, from the end of the extension Petition 870200012456, dated 01 / 27 / 2020, page. 7 / 21 4 / 6 horizontal (24) bearings (31) with threaded adjustment screw (32) are seated, and from said bearings (31) an outer ring (33) is coupled and pivotable, the outer ring (33) has a horizontal shaft (34) that is housed inside the bearing (31) and, at the opposite end, the shaft of the screw (32) rotates around a threaded hole (35), which provides tightening after selecting the desired position, the lower end (36) of said outer ring (33) has a threaded hole (37) and houses a threaded shaft (38) driven by a screw (39) from which an inner circular ring (40) is housed and pivotable, orthogonally to the bearings (31) of the outer ring (33), thus forming an orbital motion mechanism,The outer ring (40) has a vertical axis (41) that is housed inside a hole (42) of the outer ring (33) and around which the inner ring (40) can pivot, with the actuation of the screw (39) promoting the tightening and locking of the inner ring (40) in the outer ring (33) from the threaded axis (38), which provides tightening after selecting the desired position, the inner ring (40) has an internal thread (42) that acts as a seat to receive the external thread (23) of the disposable transparent tip (21) and, similarly, the lower surface (26) of the horizontal extension (24) has an opening (43), once the tip (21) is inserted into said support (22), the external thread (23) rotates around the internal thread. Petition 870200012456, dated 01 / 27 / 2020, page. 8 / 21 5 / 6 (42) of the inner ring (40) at the same time as said tip (21) passes through the opening (43) until it reaches the sublingual region of the patient whose blood microcirculation is to be studied,without putting pressure on the area under study. 7) “ORAL SUPPORT”, according to claim 6, characterized in that the adjustment of the depth of the tip (21) and consequently of the optical tip (P) of the microscope (M) is done by the thread (23,42), the tip (21) having vertical grooves (44) that act as knurling and contact point for the rotation of the tip (21) around the thread (42) of the inner ring (40). 8) “ORAL SUPPORT”, according to claim 6, characterized in that the angular adjustment of the tip (21) is achieved by the orbital movement of the outer (33) and inner (40) rings until the desired position for reading is selected and the fixing screws (32,39) are subsequently activated, respectively. 9) “ORAL SUPPORT”, according to claim 6, characterized in that the tip (21) is disposable. 10) “ORAL SUPPORT”, according to claim 6, characterized in that the convex flap (30) is provided with “T” type attachments (45) capable of receiving a fastening and support strap (46), which supports and fixes the entire oral support assembly (22) to the patient's head. Petition 870200012456, dated 01 / 27 / 2020, page 9 / 21 6 / 6 11) “ORAL SUPPORT”, according to claim 6, characterized in that before the introduction of the oral support (22) into the patient's mouth, said oral support (22) receives the quick-drying dental modeling compound (28), deposited on the upper surface (25) and consequently holes (27), as well as in the holes (29) of the lower surface (26) and, with the introduction of the oral support (22), the patient's dental arch presses the modeling compound (28) and, after quick drying, forms a fitting mold of said oral support (22) for reuse in the same patient, if necessary, without loss of reading position of the microscope (M) by the optical tip (P). Petition 870200012456, dated 01 / 27 / 2020, page 10 / 21

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