Preventative dental hard tissue laser treatment systems, methods, and computer readable media

Abstract

In one aspect, embodiments relate to a system for preventive dental laser treatment that ensures uniform irradiation of a laser beam. The system includes a laser device configured to generate a laser beam. The laser beam has one or more of a super-Gaussian energy profile and a transverse ring mode. The system also includes a focusing optic. The focusing optic is configured to converge the laser beam having a numerical aperture of 0.1 or less to a focal region. The system also includes a handpiece configured to direct the laser beam to a surface of a tooth hard tissue. The system also includes a controller. The controller is configured to control one or more parameters of the laser source such that a portion of the surface of the tooth hard tissue is heated to a temperature in a range between 400 degrees Celsius and 1300 degrees Celsius.

Description

Technical Field

[0001] The present invention generally relates to systems and methods for preventive dental laser treatment, and more specifically, but not exclusively, to systems and methods for delivering a laser beam in certain transverse electromagnetic modes during dental treatment. Background Technology

[0002] For a long time, research has shown that certain lasers can make hard tooth tissues (such as enamel) less susceptible to acid dissolution. For example, in 1998, J. Featherstone et al., in an article entitled "CO2 Laser Inhibitor of Artificial Caries-Like Lesion Progression in Dental Enamel" published in the *Dental Journal*, demonstrated that irradiation with an infrared laser source inhibited caries progression by 40% to 85%, an article which is incorporated herein by reference. These results have been confirmed and replicated over the years. Another noteworthy project involved researchers from the University of California, San Francisco, and Indiana University, who evaluated the inhibitory effect of laser treatment on caries in different oral models. This project was documented in an article entitled "Effect of CO2 Laser Treatment on Lesion Progression in Intraoral Models," published in 2001 by J. Featherstone et al. in *Proc. SPIE*, which is also incorporated herein by reference.

[0003] One mechanism believed to help inhibit acid dissolution in laser-treated hard tissue is the removal of carbonates. Human tooth enamel is primarily (96%) composed of hydroxyapatite (HA). Specifically, HA in tooth enamel is non-stoichiometric carbonate-substituted hydroxyapatite (CaO). 10 (PO4) 6-x (OH) 2-y (CO3) x+y Where 0 ≤ × ≤ 6, 0 ≤ y ≤ 2, and containing trace amounts of fluoride (F), sodium (Na), magnesium (Mg), zinc (Zn), and strontium (Sr), as reported in an article by C. Xu et al. published in J. Material Sci. in 2014, entitled "Distribution of carbonates in enamel and their correlation with structural and mechanical properties," which is incorporated herein by reference. Xu et al.

[0004] Increased carbonate content in tooth enamel is described as being associated with decreased mechanical properties, such as crystallinity, modulus, and hardness. It has also been long reported that increased carbonate content in tooth enamel is associated with increased sensitivity to acid. For example, J. Featherstone et al. reported on "Mechanisms of Laser-Induced Decreased Enamel Solubility," first published in SPIEProc. In 1997, this paper, through citation, incorporated a study showing that removal of carbonates from tooth enamel is associated with increased resistance to caries, and complete removal of carbonates is associated with optimal resistance to caries. Caries is formed by acid dissolution or demineralization of enamel. Carbonates in tooth enamel can be removed by raising the temperature of the enamel.

[0005] The temperature range required for removing carbonates from tooth tissue has long been taught, for example, by Zuerlein et al. This is further supported by a 1999 article in *Lasers in Surgery and Medicine* entitled “Modeling the Modification Depth of Carbon Dioxide Laser-Treated Dental Enamel,” which is incorporated herein by reference.

[0006] Zuerlein et al. found that carbonates begin to be lost from enamel when it reaches temperatures exceeding 400°C during laser irradiation, but complete removal of carbonates only occurs when the enamel reaches its melting point. This is similar to the melting point of enamel, reported by Fried et al. in a 1998 article titled "IR Laser Ablation of Dental Enamel: Mechanistic Dependence on the Primary Absorber," published in Applied Surface Science, which is incorporated herein by reference.

[0007] For over 20 years, the dental research community has known that temporarily raising the temperature of tooth enamel to between 400°C and 1300°C reduces carbonate content and increases enamel's resistance to acid (e.g., cavities and erosion). However, the difficulties associated with momentarily raising a patient's tooth surface to temperatures comparable to liquid magma (e.g., lava) present numerous challenges that have not yet been addressed in commercial products.

[0008] While over two decades of scientific research has shown great promise, a close reading of the literature reveals that, in most cases (with a few notable exceptions), the hard surface of teeth is frequently damaged by laser irradiation. Often, large portions of the hard tooth surface melt, crack, or are partially ablated due to overheating during treatment, or, due to the variability of treatment parameters, some portions of the enamel remain untreated without being noticed. This usually does not negatively impact most acid-dissolving (e.g., caries suppression) measurements, but it is still a poor outcome of the treatment.

[0009] As mentioned above, some of the cited references specifically point out the need to avoid melting or cracking of the tooth hard tissue during preventative laser treatment. These references are cited below. M. Esteves-Oliveira et al., “CO2 Laser (10.6 μm) Parameters for Caries Prevention in Dental Enamel,” published in Caries Research, describes achieving caries prevention without thermal damage and is incorporated herein by reference. JW Kim et al., “Effects of 9.4 μm Pulsed CO2 Laser on Surface Morphology, Reflectivity, and Acid Resistance of Enamel Below Melting Threshold,” also demonstrates that lower energy densities can induce acid resistance in teeth without melting or cracking, published in the Journal of Biomedical Optics, 2017 and is incorporated herein by reference. Both, JW Kim et al. and M. Esteves-Oliveira et al., demonstrate that the use of CO2 lasers with a Gaussian energy distribution can induce acid dissolution resistance in the enamel surface in vitro without also melting the enamel, but other issues have arisen in attempts to commercialize this technology. For example, how can we ensure that tooth enamel never overheats during tens of thousands of treatments?

[0010] Several measures have recently been proposed to address these issues and enable potential commercialization. For example, U.S. Patent Application No. 15 / 976,272 (incorporated herein by reference) by Groves et al. describes a laser system for preventative treatment of dental hard tissues. Specifically, Groves et al. describe controlling the pulse energy of a CO2 laser beam to deliver a controlled amount of energy (e.g., not too much energy) to prevent surface modification (defined in the application as meaning cracking or melting) while still achieving therapeutic effects. To achieve this, Groves et al. describe several power and energy feedback systems for measuring pulsed laser energy between and within pulses. Real-time (e.g., less than 500 ns) measurements of infrared (e.g., wavelengths of 8 μm or greater) laser energy require the use of specialized photodiodes (e.g., mercury cadmium telluride [HgCdTe] sensors). Furthermore, these photodiodes only provide relative intra-pulse measurements of laser power. Therefore, the system must be calibrated by the user (e.g., before each treatment), typically using a thermopile to measure the absolute average power of the laser beam. It is well known that thermopile technology is inaccurate, typically providing measurements within + / - 5% of the actual laser power. Furthermore, CO2 lasers experience power output drift during normal operation, ranging from approximately + / - 10%. Due to so many sources of uncertainty, precise control of pulse energy is not perfect in commercially available devices. It is for this reason that systems like those described by Groves et al. must reduce the peak irradiance (or energy density) delivered to the hard tissues of the teeth and generate suboptimal heating of the tooth tissues to ensure that overheating does not occur. Groves et al. demonstrate exemplary suboptimal results. Figure 7 C and 7D indicate that the carbonate removal from the treated surface was incomplete.

[0011] Furthermore, unlike many tools currently used in dental operating rooms, Groves et al. describe a system that requires the use of a non-contact dental laser handpiece. Dental clinicians must use a handheld device to aim the laser beam at each surface of the tooth being treated. This places a significant burden on dental clinicians to accurately aim the laser, treat the enamel surfaces (leaving no spot untouched), avoid hitting accidental oral surfaces with the laser, and complete all of this quickly (minimizing “patient chair time”). The system taught by Groves et al., if commercially viable, would require extensive training for dental clinicians before they can use it proficiently.

[0012] While over two decades of scientific research has shown great promise, the commercialization and adoption of this technology has yet to occur anywhere in the world. One commercial barrier to adopting this groundbreaking technology is the relatively high cost of mid-infrared (e.g., wavelengths between 9 and 11 micrometers) laser sources and other high-tech components (e.g., optics for laser treatment, beam scanning systems, and articulated arms). For example, when the Solea dental laser system (from Convergent Dental in Needham, Massachusetts) was being developed, it was not FDA-approved for preventative dental laser treatments, but it did contain a mid-infrared laser source and cost over $120,000. Such high prices are commonplace for medical and dental systems that use laser sources and typically price the adoption of these systems beyond the reach of medical and dental practitioners who do not prioritize the use of the latest technologies.

[0013] For decades, systems and methods for preventative dental laser treatment have been known to the scientific community. However, existing technologies (including all the references above) have failed to (i) generate a laser beam that optimally heats tooth enamel without creating a central region of peak temperature prone to overheating; (ii) be available for use with systems that come into contact with the laser tissue, such as tools known to dental hygienists and dentists; or (iii) teach a method for implementing the required high-tech (and costly) techniques in a general dental operating room, making them accessible to all dental patients without requiring significant upfront investment from individual dentists. For dental patients to benefit from decades of scientific breakthroughs in preventative dental laser treatment, laser systems and methods must be developed that (i) reliably introduce uniform heating of the tooth hardness while preventing overheating; (ii) are easily adopted by dental clinicians and can be used quickly and safely; and (iii) offer a cost structure that is easily affordable to the dental market. Summary of the Invention

[0014] This summary is provided to introduce a range of concepts in a simplified form, which will be further described in the detailed description section below. This summary is not intended to identify or exclude key or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter.

[0015] In one aspect, embodiments relate to a system for preventative dental laser treatment that ensures uniform illumination by a laser beam. The system includes a laser device configured to generate a laser beam. The laser beam has at least one of a super-Gaussian energy distribution and a transverse ring mode. The system also includes a focusing optics device configured to converge the laser beam, having a numerical aperture of 0.1 or less, to a focusing region. The system further includes a handheld device configured to guide the laser beam onto the surface of the hard tooth tissue. The system also includes a controller. The controller is configured to control at least one parameter of the laser source such that a portion of the surface of the hard tooth tissue is heated to a temperature in the range between 400 and 1300 degrees Celsius.

[0016] In some embodiments of the system, the system also includes a steering mirror located below the focusing optics. The steering mirror is configured to reflect the laser beam toward the hard tissue of the teeth.

[0017] In some embodiments of the system, the laser device includes a beam shaper. The beam shaper is configured to shape the laser beam into at least one of a super-Gaussian energy distribution and a transverse ring mode. In some versions, the beam shaper includes at least one of an axial prism, a spatial filter, a deformable mirror, and an annular slit.

[0018] In some embodiments of the system, the laser beam has a wavelength of at least one in a first range of 200 to 500 nm and a second range of 4,000 to 11,000 nm.

[0019] In some embodiments of the system, the laser device further includes at least one of an intracavity polarization generator and a polarization converter. In some cases, the laser beam has polarization including at least one of circular, radial, tangential, and azimuth polarization.

[0020] In some embodiments of the system, at least one laser parameter of the laser beam controlled by the controller includes at least one of the following: repetition rate, pulse energy, pulse duration, average power, peak power, and wavelength.

[0021] In some embodiments of the system, the system further includes a beam scanning system. The beam scanning system is configured to scan a focal region on a portion of the surface of the hard tooth tissue.

[0022] In some embodiments of the system, the transverse ring pattern has an inner diameter that is 50% smaller than its outer diameter.

[0023] In some embodiments of the system, the transverse ring mode is the transverse electromagnetic mode (TEM)01*.

[0024] In some embodiments of the system, the focusing optics have a focal length greater than 100 mm.

[0025] In some embodiments of the system, the laser device includes a laser source with an intracavity device configured to generate at least one of a super-Gaussian energy distribution and a transverse ring mode.

[0026] In some embodiments of the system, the laser device includes a laser source with an intracavity device configured to control the power of the laser beam.

[0027] In another aspect, embodiments relate to a method for preventative dental laser treatment that ensures uniform irradiation by a laser beam. The method includes generating a laser beam having at least one of a super-Gaussian energy distribution and a transverse ring pattern using a laser device; focusing the laser beam, with a numerical aperture not greater than 0.1, onto a focal region using a focusing optics device; guiding the laser beam onto the surface of the tooth hard tissue using a handheld device; and controlling at least one parameter of the laser beam using a controller such that a portion of the tooth hard tissue surface is heated to a temperature in the range of 400 to 1300°C.

[0028] In some embodiments of the method, the method further includes using a steering mirror to reflect the laser beam toward the hard tissue of the teeth. The steering mirror is located below the focusing optics.

[0029] Laser beams in at least one of the Stokes and transverse ring modes include beam shaping using a beam shaper. In some versions, the beam shaper includes one or more of an axonal prism, a spatial filter, a deformable mirror, and a ring slit.

[0030] In some embodiments of the method, the laser beam has a wavelength of at least one in a first range of 200 to 500 nm and a second range of 4,000 to 11,000 nm.

[0031] In some embodiments of the method, the laser device further includes at least one of an intracavity polarization generator and a polarization converter. In some cases, the laser beam has polarization including at least one of circular, radial, tangential, and azimuth polarization.

[0032] In some embodiments of the method, the controller controls at least one of the following parameters: repetition frequency, pulse energy, pulse duration, average power, peak power, and wavelength.

[0033] In some embodiments of the method, the method further includes using a beam scanning system to scan a focal region on a portion of the hard tissue surface of the tooth.

[0034] In some embodiments of the method, the transverse ring pattern has an inner diameter that is 50% smaller than its outer diameter.

[0035] In some embodiments of the method, the transverse ring mode is the transverse electromagnetic mode (TEM)01*.

[0036] In some embodiments of the method, the focusing optics have a focal length greater than 100 mm.

[0037] In some embodiments of the method, the laser device includes a laser source with intracavity devices configured to generate a transverse ring mode.

[0038] In some embodiments of the method, the laser device includes a laser source having an intracavity device configured to control the power of the laser beam.

[0039] In one aspect, embodiments relate to a system for preventative radiation dental treatment. The system includes a radiation source configured to generate radiation. The radiation has a wavelength within one of two ranges, a first range of 100-500 nm and a second range of 8,000-12,000 nm. The system also includes optics configured to receive radiation at a first end, internally reflect the radiation, and bring tooth hard tissue into contact with at least one side of the optics. The optics are further configured to couple at least a portion of the radiation into the tooth hard tissue when placed in contact with at least one side of the tooth hard tissue. The system also includes a controller configured to control at least one parameter of the radiation to heat the surface of the tooth hard tissue to a temperature of at least 400 degrees Celsius.

[0040] In some embodiments of the system, the optical devices include one or more of waveguides, rods, and prisms.

[0041] In some embodiments of the system, the refractive index of the optical device is not greater than the refractive index of the hard dental tissue and not less than the refractive index of the soft dental tissue.

[0042] In some embodiments of the system, the optics are configured to couple at least a portion of the radiation into the hard tissue of the teeth using attenuated total internal reflection (ATIR), suppressed total internal reflection (FTIR), and evanescent waves.

[0043] In some embodiments of the system, the optics are also configured to substantially not couple any portion of the radiation into the tooth soft tissue when placed in contact with tooth soft tissue on at least one side.

[0044] In some embodiments of the system, the optics are also configured to be placed in contact with the interproximal surfaces of the hard tissue of the teeth.

[0045] In some embodiments of the system, the optical components include at least one of quartz, zinc sulfide, barium fluoride, magnesium fluoride, calcium fluoride, zinc selenide, and diamond.

[0046] In some embodiments of the system, the system further includes a detector configured to detect at least one characteristic of the radiation as it leaves a second end of the optics.

[0047] In some embodiments of the system, the system further includes a cooling system configured to cool optical components.

[0048] In some embodiments of the system, the system further includes a homogenizer disposed between the radiation source and the optical device to homogenize the radiation.

[0049] In another aspect, embodiments relate to a method for preventative irradiation dental treatment. The method includes generating radiation with wavelengths in one of two ranges using a radiation source, a first range between 100 and 500 nm and a second range between 8,000 and 12,000 nm; internally reflecting the radiation within an optics device configured to receive the radiation at a first end; contacting the hard tissue of the tooth with at least one side of a lens; coupling at least a portion of the radiation into the hard tissue of the tooth using the optics; and controlling at least one parameter of the radiation using a controller to heat the surface of the hard tissue of the tooth to a temperature of at least 400 degrees Celsius.

[0050] One or more of waveguides, rods, and prisms.

[0051] In some embodiments of this method, the refractive index of the optical device is not greater than the refractive index of the hard dental tissue and not less than the refractive index of the soft dental tissue.

[0052] In some embodiments of the method, using optics to couple at least a portion of radiation into the hard tissue of the teeth includes attenuated total internal reflection (ATIR), suppressed total internal reflection (FTIR), and evanescent waves.

[0053] In some embodiments of the method, the method further includes contacting the soft tissue of the tooth with at least one side of the lens; and using optics to couple substantially no part of the radiation into the soft tissue of the tooth.

[0054] In some embodiments of the method, the method further includes using optical devices to contact the interproximal surfaces of the hard tissues of the teeth.

[0055] In some embodiments of the method, the optical device includes at least one selected from quartz, zinc sulfide, zinc selenide, barium fluoride, magnesium fluoride, calcium fluoride, sapphire, and diamond.

[0056] In some embodiments of the method, the method further includes using a detector to detect at least one feature of the radiation as it exits the second end of the optics.

[0057] In some embodiments of the method, the method further includes using a cooling system to cool the optical components.

[0058] In some embodiments of the method, the method further includes using a homogenizer to homogenize the radiation.

[0059] As mentioned above, extensive research has been conducted on the increased acid resistance of tooth hard tissues using lasers. However, purchasing laser systems typically requires dental clinics to pay substantial upfront costs ($50,000 or more). This high upfront cost of laser systems is expected to slow the adoption of this potentially paradigm-shifting technology. Furthermore, the high cost of dental practice, particularly for patients most likely to benefit from treatment (e.g., those from communities with poor oral hygiene), is anticipated to limit access to this laser technology in certain situations. To accelerate the adoption of this superior technology and address this accessibility issue, novel systems and methods for the distribution of preventative laser treatments have been disclosed.

[0060] According to one embodiment, the upfront cost of a dental laser system is paid in a small recurring cost portion after the system is installed. For example, in some versions, the dental laser system is offered to dental clinics at a lower cost (minimizing upfront costs), and the clinics pay a small recurring fee to use the system. In some cases, recurring payments are made on a subscription basis (e.g., daily, weekly, monthly, or annually). Alternatively, recurring payments are made per treatment (or per number of treatments).

[0061] Commercially, unless dental laser system manufacturers can guarantee near-constant sales, there is no guarantee against lowering the price of high-tech laser systems. Unfortunately, unauthorized use can lead to unsuspecting clinicians becoming victims of fraud, or to deceptive users. Therefore, unauthorized use of laser systems (without regular payments) threatens regular payment allocation methods, thereby threatening the widespread adoption of preventative dental laser treatments. For at least these reasons, this paper presents embodiments of systems and methods designed to prevent and expose unauthorized use of preventative dental laser systems.

[0062] In one aspect, embodiments relate to a method for preventative dental laser treatment. The method includes reading machine-readable code; verifying the machine-readable code using a processor; performing laser treatment based on the verified machine-readable code; applying a dental fluoride treatment dose; and preventing future verification of the machine-readable code using the processor. Performing laser treatment includes generating a laser beam using a laser device; directing the laser beam towards the hard tissue of the tooth using an optical device; and controlling parameters of the laser beam using a laser controller to heat at least a portion of the surface of the hard tissue of the tooth to a temperature above 400 degrees Celsius.

[0063] In some embodiments of this method, the dental fluoride dosage includes one or more of sodium fluoride, stannous fluoride, titanium tetrafluoride, acidified phosphate fluoride, and fluorinated amine.

[0064] In some embodiments of this method, the dental fluoride dosage includes one or more of gels, varnishes, pastes, and foams.

[0065] In some embodiments of the method, the machine-readable code includes one or more of barcodes, two-dimensional (2D) barcodes, data matrices, digital signatures, cryptocurrencies, magnetic stripes, transponder devices, microchips, and radio frequency identification (RFID) tags.

[0066] In some embodiments of the method, verifying machine-readable code includes querying one or more items in the ledger; broadcasting to the ledger; decrypting the machine-readable code; identifying a digest in the machine-readable code; querying write-once-many-times (WORM) memory; and querying coupon authorization.

[0067] In some embodiments of the method, preventing future verification of the machine-readable code includes broadcasting one or more items to the ledger; submitting to the coupon authority; destroying the machine-readable code; writing to write-once-many-times (WORM) memory; and overwriting the machine-readable code.

[0068] In some embodiments of the method, the method further includes measuring laser variables during laser treatment. In some cases, laser variables include one or more of the following: the duration of laser treatment, the electrical energy delivered to the laser source during laser treatment, and a relative measure of the laser energy generated by the laser source during laser treatment.

[0069] In some embodiments of the method, the method further includes attaching a consumable laser accessory to a handheld device prior to laser treatment. In some cases, the consumable laser accessory includes machine-readable code.

[0070] In one aspect, embodiments relate to a system for preventative laser treatment. The system includes a code reader, a processor, and a laser treatment system. The code reader is configured to read machine-readable code. The processor is configured to verify the machine-readable code and prevent future verification of the machine-readable code. The laser treatment system includes a laser device configured to generate a laser beam, an optical device configured to direct the laser beam toward the hard tissue of the tooth, and a laser controller configured to control parameters of the laser beam to heat at least one laser beam. A portion of the hard tissue surface of the tooth is heated to above 400 degrees Celsius.

[0071] In some embodiments of the system, the optical device includes one or more of a beam transmission system, a handheld device, and a beam scanning system.

[0072] In some embodiments of the system, the optical device includes a handheld component configured to attach to a consumable laser accessory. In some cases, the consumable laser accessory includes machine-readable code.

[0073] In some embodiments of the system, machine-readable codes include one or more of barcodes, two-dimensional (2D) barcodes, data matrices, digital signatures, cryptocurrencies, magnetic stripes, transponder devices, microchips, and radio frequency identification (RFID) tags.

[0074] In some embodiments of the system, the processor is configured to verify machine-readable code by performing one or more of the following: querying the ledger; broadcasting to the ledger; decrypting the machine-readable code; identifying a digest in the machine-readable code; querying write-once-many-times (WORM) memory; and querying coupon authorization.

[0075] In some embodiments of the system, the processor is configured to prevent future verification of machine-readable code by performing one or more of the following actions in a broadcast to the ledger: submitting to the coupon authority; destroying the machine-readable code; writing to write-once-many-times (WORM) memory; and overwriting the machine-readable code.

[0076] In some embodiments of the system, the system includes instruments configured to measure laser variables during treatment. In some cases, laser variables include one or more of the following: the duration of laser treatment, the electrical energy delivered to the laser source during laser treatment, and a relative measure of the laser energy generated by the laser source during laser treatment.

[0077] In one aspect, embodiments relate to a dispensing system for preventative dental laser treatment. The dispensing system includes a sealed package, a single-use dental fluoride treatment dose located within the package, and a machine-readable code associated with the package. The machine-readable code is substantially inaccessible as long as the package remains intact. Once verified, the machine-readable code is configured to allow the use of a laser-based treatment system.

[0078] In some embodiments of the dispensing system, the dental fluoride treatment dose includes one or more of sodium fluoride, stannous fluoride, titanium fluoride, acidified phosphate, and fluorinated amine.

[0079] In some embodiments of the dispensing system, the dental fluoride treatment dose includes one or more of gels, varnishes, pastes, and foams.

[0080] In some embodiments of the distribution system, machine-readable codes include barcodes, two-dimensional (2D) barcodes, data matrices, digital signatures, cryptocurrencies, magnetic stripes, transponder devices, microchips, and radio frequency identification (RFID) tags.

[0081] In some embodiments of the distribution system, the machine-readable code includes one or more of a digital signature, a private key, a public key, and a unique identifier; and the machine-readable code is associated with data accessible to the dental laser system.

[0082] In some embodiments of the dispensing system, the dispensing system includes a consumable laser accessory. The consumable laser accessory is configured to connect to a handheld device. The consumable laser accessory includes a machine-readable code. In some cases, the consumable laser accessory includes one or more of an authentication chip, a single-wire chip, and a radio frequency identification (RFID) tag. In some cases, the consumable laser accessory is configured for intraoral use. In some cases, the consumable laser accessory is configured to guide a laser beam.

[0083] In some embodiments of the dispensing system, the dispensing system also includes a fluoride applicator. The fluoride applicator includes one or more of a tray, brush, swab, needle, syringe, and cloth.

[0084] On the other hand, some embodiments involve one or more non-transitory computer-readable media storing instructions executable by a processing device. Execution of the instructions causes the processing device to read the machine-readable code; verify the machine-readable code; perform laser treatment based on the machine-readable code; and prevent future verification of the machine-readable code. In some cases, the laser treatment includes generating a laser beam using a laser device; directing the laser beam towards the hard tissue of the tooth using the laser device; and controlling the parameters of the laser beam using a laser controller to heat at least a portion of the surface of the hard tissue of the tooth to a temperature of at least 400 degrees Celsius.

[0085] On the other hand, some embodiments relate to another dispensing system for preventative dental laser treatment. The dispensing system includes a sealed package, a machine-readable code associated with the package, and a consumable laser accessory configured to attach to a handheld device located within the sealed package. The machine-readable code is substantially inaccessible as long as the package remains intact. Once verified, the code can be configured to allow the use of a laser-based treatment system. In some cases, the consumable laser accessory includes the machine-readable code.

[0086] In some embodiments of the dispensing system, the dental fluoride treatment dose includes one or more of sodium fluoride, stannous fluoride, titanium fluoride, acidified phosphate, and fluorinated amine.

[0087] In some embodiments of the dispensing system, the dental fluoride treatment dose includes one or more of gels, varnishes, pastes, and foams.

[0088] In some embodiments of the distribution system, machine-readable codes include one or more of barcodes, two-dimensional (2D) barcodes, data matrices, digital signatures, cryptocurrencies, magnetic stripes, transponder devices, microchips, and radio frequency identification (RFID) tags.

[0089] In some embodiments of the distribution system, the machine-readable code includes one or more of a digital signature, a private key, a public key, and a unique identifier; and the machine-readable code is associated with data accessible to the dental laser system.

[0090] In some embodiments of the dispensing system, the consumable laser accessory includes machine-readable code. In some cases, the consumable laser accessory is configured for intraoral use. In some cases, the consumable laser accessory is configured to guide a laser beam.

[0091] In some embodiments of the dispensing system, the dispensing system also includes a fluoride applicator. The fluoride applicator includes one or more of a tray, brush, swab, needle, syringe, and cloth.

[0092] On the other hand, some embodiments relate to an alternative method for preventative dental treatment. This method includes reading machine-readable code; verifying the machine-readable code using a processor; performing laser treatment based on the machine-readable code; and preventing future verification of the machine-readable code using the processor. The laser treatment includes generating a laser beam using a laser device; directing the laser beam towards the hard tissue of the tooth using optics; and controlling at least one parameter of the laser beam using a laser controller to heat at least a portion of the surface of the hard tissue of the tooth to a temperature not less than 400 degrees Celsius.

[0093] Any combination and arrangement of embodiments are contemplated. Other objects and features will become apparent from the following detailed description taken in conjunction with the accompanying drawings. However, it should be understood that the drawings are intended to be illustrative only and not as definitions of limitations of this disclosure. Attached Figure Description

[0094] Non-limiting and non-exhaustive embodiments of the invention are described with reference to the following drawings, wherein, unless otherwise stated, the same reference numerals denote the same parts in all views.

[0095] Figure 1 A laser system according to one embodiment is shown;

[0096] Figure 2A The transverse ring mode energy distribution is shown in some exemplary embodiments in comparison with the Gaussian energy distribution;

[0097] Figure 2B A transverse ring pattern presented on an inclined surface is shown in an exemplary embodiment;

[0098] Figure 2C In one exemplary embodiment, it is shown that from Figure 2B The structure shown exhibits relative energy absorption and a varying polarization arrangement.

[0099] Figure 3 An optical device for laser beam shaping according to one embodiment is shown;

[0100] Figure 4 A temperature map of analytical modeling of tooth enamel irradiated by a Gaussian beam is shown according to one embodiment;

[0101] Figure 5 An analytical modeled temperature diagram of tooth enamel irradiated by a first annular beam according to one embodiment is shown.

[0102] Figure 6 An analytical modeled temperature graph of tooth enamel irradiated by a second annular beam according to one embodiment is shown.

[0103] Figure 7 A temperature map of an analytical model of tooth enamel irradiated by an ultra-Gaussian beam, according to one embodiment, is shown.

[0104] Figure 8 A flowchart of a method for preventive dental laser treatment according to one embodiment is shown;

[0105] Figure 9 An exemplary system for preventative dental laser treatment is shown according to one embodiment;

[0106] Figure 10 A preventative dental treatment system according to one embodiment is shown;

[0107] Figure 11 A flowchart of a preventive dental treatment method according to one embodiment is shown;

[0108] Figure 12 The contour temperature profile of irradiated tooth hard tissue according to one embodiment is shown.

[0109] Figure 13A An internal reflection within an optical device according to one embodiment is shown;

[0110] Figure 13B A first technique for contact coupling irradiation of dental hard tissues according to one embodiment is shown;

[0111] Figure 13C A second technique for contact-coupled irradiation of dental hard tissues according to one embodiment is shown;

[0112] Figure 14A system for preventive proximal interdental treatment according to one embodiment is shown;

[0113] Figure 15 A system for cooling optically contacted tooth hard tissue is shown according to one embodiment;

[0114] Figure 16 A system for homogenizing radiation is shown according to one embodiment;

[0115] Figure 17A A package containing consumables for preventative dental laser treatment is shown according to one embodiment;

[0116] Figure 17B An open package containing consumables for preventative dental laser treatment is shown according to one embodiment;

[0117] Figure 18A A system for performing preventative dental laser treatment is shown according to one embodiment;

[0118] Figure 18B A system for coupon verification according to one embodiment is shown;

[0119] Figure 19A A flowchart illustrating a method for performing preventative dental laser treatment according to one embodiment is shown;

[0120] Figure 19B A block diagram of a coupon issuance system according to one embodiment is shown;

[0121] Figure 19C A block diagram of a coupon decryption system according to one embodiment is shown;

[0122] Figure 19D This refers to a coupon authorization system according to one embodiment;

[0123] Figure 20A A consumable dental laser accessory according to one embodiment is shown;

[0124] Figure 20B A cross-sectional view of a consumable dental laser accessory according to one embodiment is shown;

[0125] Figure 21A A consumable dental laser accessory according to one embodiment is shown;

[0126] Figure 21B A cross-sectional view of a consumable dental laser accessory according to one embodiment is shown;

[0127] Figure 22 A block diagram of a system for authenticating laser therapy coupons according to one embodiment is shown;

[0128] Figure 23 A flowchart of a method for authenticating laser therapy coupons according to one embodiment is shown; and,

[0129] Figure 24 A block diagram of a computer-readable medium according to one embodiment is shown, the computer-readable medium including processor-executable instructions for authenticating laser treatment coupons. Specific Implementation

[0130] Various embodiments are described more fully below with reference to the accompanying drawings, which form a part of the disclosure and illustrate particular exemplary embodiments. However, the concepts of this disclosure may be implemented in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided as part of a thorough and complete disclosure to fully convey to those skilled in the art the scope of the concepts, techniques, and implementations of this disclosure. Embodiments may be practiced as methods, systems, or apparatuses. Therefore, the following detailed description should not be construed as limiting.

[0131] Transverse electromagnetic mode for uniform treatment

[0132] As mentioned above, numerous studies have been conducted on using lasers to increase acid resistance in tooth hard tissues; however, all existing studies disclose the use of lasers with Gaussian energy distribution outputs. Different wavelengths, energy levels, measurement, and control techniques have been explored, but to date, no solutions using alternative laser energy distributions have been described in the literature.

[0133] The use of Gaussian energy distributions (or near-Gaussian energy distributions, such as those produced by slab CO2 lasers that are Gaussian on one axis and unstable on the second axis) limits the performance of laser treatment. For example, see “Non-destructive evaluation of the inhibition of enamel demineralization by CO2 laser treatment using polarization-sensitive optical coherence tomography” by Hsu et al., published in the J. Biomed Optics in 2008 and incorporated herein by reference. Xu et al. showed that enamel melting is readily achievable (see...). Figure 3 a, showing melted enamel), Gaussian energy distribution leads to changes in treatment effectiveness in the laser beam focal region (see...). Figure 3(b, showing uneven melting of tooth enamel). Sustained and effective laser treatment requires maintaining the surface temperature of the laser-heated teeth with great precision. However, the use of a Gaussian energy distribution inherently leads to uneven heating of the tooth tissue. The energy-dense peak at the center of the Gaussian beam introduces peak heating to the tissue surface. Furthermore, the low-energy circumference of the laser beam (including the "wings" or "tails" of the Gaussian energy distribution) results in relatively less heating of the tissue. For this reason, there is virtually no way to eliminate variable heating of tissue with a laser beam having a Gaussian laser energy distribution. Therefore, laser systems with non-Gaussian energy distributions are needed specifically for uniform heating of the hard tissues of teeth.

[0134] A further complication of using lasers to consistently and uniformly heat tooth hard tissue is the significant variation in the energy density of the laser beam at locations far from the focal region. The energy density of the laser beam varies at a rate dependent on the convergence rate (e.g., numerical aperture [NA]) of the laser beam based on its distance from the focal region. The highest energy density occurs at the focal region. Typically, the focal region is located at a predetermined distance (e.g., focal length) from the focusing optics, which are located within the system (usually within the handheld device). Therefore, care must be taken to maintain the distance between the handheld device and the tooth surface being treated in order to control the energy density of the beam as it affects the surface. Furthermore, the energy density absorbed by the tooth surface varies depending on the angle of the optical axis relative to the tooth surface (the tooth surface absorbs more energy at more orthogonal angles). Commercially viable handsets must ultimately be used by dentists in real-world clinics. Therefore, precise placement of the focal region, coinciding with and paralleling the surface of the tooth tissue being treated, cannot be reasonably expected in situ. Instead, it is preferable to carefully specify a laser beam with an energy distribution and convergence rate that is insensitive to small deviations in the focal region. Exemplary embodiments addressing these aforementioned problems are disclosed herein.

[0135] As shown in the figure. Figure 1 The illustration shows a preventative dental laser system 100 according to one embodiment. The preventative dental laser system 100 delivers a laser beam 110 to dental hard tissue 112 (e.g., enamel, dentin, or cementum). The laser beam is generated by a laser source 114. An exemplary laser source 114 is a carbon dioxide (CO2) laser, such as the HPP DL-500 from Access Laser, Everett, Washington, USA. Typically, the laser source is selected to produce a laser that is well absorbed by the dental hard tissue 112 (e.g., having an absorption coefficient greater than 1 cm⁻¹). -1 100cm -1 Or 1,000cm -1A laser beam 110 (of a wavelength) is generated. The laser beam has a non-Gaussian transverse electromagnetic mode (TEM). For example, according to one embodiment, the laser beam 110 has a TEM including at least one ring (e.g., TEM 01*). According to some embodiments, the system 100 includes a beam shaper 116. In some embodiments, the beam shaper 116 introduces a transverse ring mode into the laser beam 110. An exemplary beam shaper 116 for introducing a transverse ring mode into the laser beam may include: one or more axial prisms 118A-B, an aperture (e.g., an annular slit located at the back focal plane of a converging lens), a spatial light modulator, an optical fiber or waveguide, a tunable acoustic gradient (TAG) lens, a diffractive optical element (DOE), a spiral phase plate (SPP), an optical phase plate, a rod homogenizer, and a spatial phase mask. Alternatively, in some embodiments, a laser beam 110 with a non-Gaussian (e.g., transverse ring) mode is generated. An exemplary laser source 114 capable of generating a laser beam 110 with a non-Gaussian (e.g., transverse ring) mode is a DC series CO2 laser from ROFIN-SINAR Laser GmbH in Hamburg, Germany. The laser beam 110 is focused into a focal region 122 by a focusing optics 120. An exemplary focusing optics is a 1-inch diameter ZnSe plano-convex lens (Thorlabs PN: LA7728-G) with a focal length of 200.0 mm and an anti-reflective coating ranging from 7 to 12 μm. In some embodiments, the laser beam 110 at the focal region 122 maintains its non-Gaussian (e.g., transverse ring) energy distribution. In some embodiments, the focal length of the focusing optics can be specified to control the convergence (and / or divergence) rate of the laser beam. A lower convergence rate (i.e., a slower optical system) reduces variations in energy distribution away from the focal region. For example, a collimated laser beam with a diameter of 10 mm, acted upon by a focusing optics with a focal length of 200 mm, converges at a numerical aperture (NA) of 0.025. In contrast, the same 10mm laser beam focused by a 50mm focal length focusing optics will converge at 0.1 NA. The table below shows the beam widths of 0.025 NA and 0.1 NA beams at a certain distance from the focal point:

[0136]

[0137]

[0138] As shown in the table above, a smaller numerical aperture (e.g., less than 0.1) allows for relatively small energy difference densities (e.g., 10%, 25%, or 50%) with small deviations from the focal region (e.g., + / - 0.5, 1, 2, 3, or 5 mm). The use of this system typically involves a clinician placing a handheld device inside the patient's mouth and pointing the laser beam at the hard tissue surface of the teeth. Therefore, the position of the focal region relative to the surface is affected by the optical path length (between the focusing optics and the surface). The optical path length must be controlled by the clinician. Precisely controlling the distance between the handheld device and the hard tissue of the teeth in the field is impractical. For this reason, in some embodiments, the focal length (or numerical aperture [NA]) is chosen to provide a pseudo-invariant energy density near the focal region (e.g., less than 10% energy density variation [e.g., flux] 1 mm from the focal point). According to one embodiment, a non-Gaussian mode is imparted to the laser beam 110 by a beam shaper comprising one or more axial prisms 118A-118B, as shown in the figure. Figure 1 As shown, in some embodiments, a first axial prism is used to form a quasi-Bessel beam 124, which then forms a diverging transverse ring beam 126. In some embodiments, the diverging ring beam 126 is directly focused by a focusing optics 122. Alternatively, a second axial prism 118B, having a wedge angle substantially equal to that of the first axial prism 118A, is used to collimate the diverging ring beam 126 into a collimated laser beam 110 having a transverse ring pattern. In some embodiments, a mask 128 is used to partially block the laser beam 110 to ensure that the central portion of the laser beam 110 is substantially free of laser energy.

[0139] According to one embodiment, the system also includes a beam scanning system. An exemplary beam scanning system includes a Risley prism, a rotating multifaceted mirror, a voice coil scanner (e.g., Optotune part number MR-15-30 from Dietikon, Switzerland), a galvanometer (e.g., the Lightning II 2-axis scanning head from Cambridge Technology, Bedford, Massachusetts, USA), and a gantry with translation focusing optics. Scanning methods related to dental laser systems are described in U.S. Patent No. 9,408,673 to N. Monty et al., which is incorporated herein by reference.

[0140] According to one embodiment, the polarization of the laser beam 110 is controlled. In some cases, an intracavity polarization generator (not shown) is used (e.g., a leaky-mode polarization grating at the output coupler of a waveguide CO2 laser). Alternatively, in other cases, an external polarization converter 130 is used to convert the laser beam to the desired polarization state. An exemplary polarization converter 130 includes a half-wave plate, a quarter-wave plate, and a linear-to-radial / tangential polarization converter consisting of eight low-order half-wave bands with a fixed and well-defined fast axis direction. In some exemplary embodiments, the laser beam 110 has cylindrical polarization (i.e., axisymmetric polarization) (e.g., radial or tangential). Alternatively, in other exemplary embodiments, the laser beam 110 has linear, circular, random, or azimuthal polarization. In some embodiments, the polarization of the laser beam affects the amount of energy delivered to the hard tissue of the teeth.

[0141] The amount of radiation reflected from a material surface (e.g., reflectivity) is related to polarization. In some cases, it is appropriate to understand the relationship between polarization and reflectivity according to Fresnel's equations. The reflectivity of s-polarized light is described by the first Fresnel equation:

[0142]

[0143] Where R s n1 is the reflectivity of s-polarized light, n2 is the refractive index of the first medium (e.g., air), n3 is the refractive index of the second medium (e.g., dental hard tissue), and θ is the refractive index of the second medium (e.g., dental hard tissue). i The incident angular radiation is reflected from the surface. The reflectivity R of p-polarized radiation... p It can be described by the second Fresnel equation as follows:

[0144]

[0145] Finally, the energy transferred into the material is all the energy that was not reflected, such as...

[0146] T s =1-R s

[0147] and,

[0148] T p =1-T p

[0149] Where T s It is s-polarized radiation transmitted into the material; and, T p It is p-polarized radiation transmitted into the material.

[0150] It is known that the polarization of laser radiation affects industrial laser applications, such as laser welding. In R. Weber et al.'s "The Influence of Radial and Tangential Polarization in Laser Material Processing," published in Physics Procedia in 2011, and cited and incorporated herein by reference, polarization control and polarization effects are outlined as they are relevant to state-of-the-art industrial laser processing activities, including laser cutting, laser welding, and laser annealing. Figure 2A -C illustrates an example showing how polarization affects the transmission of R. Weber et al. (See figure). Figure 2A This is energy distribution pattern 210, which has normalized intensity in normalized units along the first vertical axis 212 and radial position in micrometers along the first horizontal axis 214. The transverse ring pattern 216 is compared with the Gaussian pattern 218 in the figure. Refer to the figure now. Figure 2B In the diagram, laser beam 220 is shown as irradiating surface 222. This surface is not perpendicular to laser beam 220, but rather tilted at 80° relative to laser beam 220. Figure 2B The configuration shown generates absorbed energy. Figure 2B exist Figure 1 As shown in Figure 2C. A first image 230 of surface 222 illustrates the energy absorbed when the laser beam 220 is circularly polarized. A second image 232 of surface 222 illustrates the energy absorbed when the laser beam is radially polarized. A third image 234 of the surface illustrates the energy absorbed when the laser beam is tangentially polarized. (Referring to...) Figure 1 The configuration is described. For example... Figure 2B As shown, energy absorption is more constant across the entire region illuminated by the circularly polarized laser beam 230. This can be mathematically understood using the Fresnel equations described above. Figure 2A -C.

[0151] Other forms of beam shaping have been identified that produce constant (e.g., cap-shaped or flat-top) or near-constant (super-Gaussian) energy distributions. A flat-top (i.e., cap-shaped) laser energy distribution is not defined as a free-space mode because the energy distribution varies as the beam propagates. A flat-top energy distribution can be shaped using diffractive optical elements (DOEs), such as the PN:ST-273-AYA from Holo / OR of NessZiona, Israel. Other DOEs can be used to produce diffuse or uniform laser beams. Typically, all these DOEs produce a flat-top energy distribution only at the focal point (e.g., the beam waist), while outside the focal point, the energy distribution is indeterminate. For this reason, a flat-top and flat-top energy distribution (theoretically ideal for the described application) is difficult to achieve in practice. Specifically, the flat-top energy distribution must be configured so that its position along the optical axis coincides with the tooth surface. Away from the flat-top profile position along the optical axis (e.g., the focal point), the flat-top profile changes and exhibits a "hot spot" (or region of peak energy density). When located on the tooth surface, these "hot spots" can cause undesirable thermal damage to the tooth (e.g., melting, cracking, and ablation). To prevent this with a flat-top energy distribution, the optical path length to the tooth surface must be kept constant throughout the treatment. This is difficult in practice because every treatment surface of every tooth in the oral cavity must be irradiated at a clinically feasible rate (e.g., total treatment time less than 30 minutes), and due to the complexity of working within the oral cavity. Like the flat-top energy distribution, the super-Gaussian energy distribution varies with propagation distance. However, unlike the flat-top energy distribution, the variation is slow and predictable. For example, at short distances from the location of the super-Gaussian energy distribution (e.g., the focal point) (e.g., + / - 1 mm or + / - 10 mm), the shape of the energy distribution changes only slightly. Typically, the variation away from the super-Gaussian energy distribution is towards a shape that is more Gaussian or more dollopic (i.e., dog ears) within its energy distribution. This again differs from the flat-top energy distribution described above, which introduces peak fluence "hot spots" at uncertain locations during propagation. In some embodiments, the lateral energy distribution of the laser beam 110 is not a ring pattern, but has a more constant energy distribution, such as a super-Gaussian distribution.

[0152] The energy (or power) distribution of a standard Gaussian laser beam at the focal point can be modeled using the following formula:

[0153]

[0154] Among them, I (r) It represents the transverse energy (or power) density distribution, I0 is the peak energy (or power) density value (usually located at the beam center), r is the dependent variable representing the radius or distance from the beam center, and ω0 is 1 / e 2 The width of the laser beam is half of the focal length. The energy (or power) distribution of the higher-order Gaussian (e.g., super-Gaussian) laser beam at the focal point can be modeled according to the following formula:

[0155]

[0156] Where n is the order of the supergaussian beam, such as 4, 6, 8, etc. According to one embodiment, the system includes a laser source configured to generate a laser beam with a supergaussian beam profile.

[0157] In some embodiments, a phase-gradient mirror is employed within the laser resonator to generate a laser beam with a super-Gaussian beam profile. For example, researchers have shown that using a phase grating mirror to generate a super-Gaussian beam can increase energy extraction within a carbon dioxide laser. The paper "Super-Gaussian Output from a CO2 Laser Using a Graded Phase Mirror," published in Optics Letters in 1992 by P. Belanger et al., teaches the formation of a super-Gaussian output resonator with orders of magnitude below, which is incorporated herein by reference. Figure 4 and 6 In transversely excited atmospheric pressure (TEA) CO2 lasers. Later in 1998, G. Bourdet et al., in "Theoretical Study of Planar CO2 Laser Resonators with Graded-Phase Mirrors," taught that planar CO2 can theoretically increase the energy extracted from the gain medium by using graded-phase mirrors to generate quasi-super-Gaussian laser modes. Published in Optics Communications and incorporated herein by reference.

[0158] In some embodiments, active optical elements are used to generate or shape the mode of a laser beam. For example, T. Cherezova et al. reported in their 2001 paper entitled “Performance of Active Laser Resonators” the formation of 4th, 6th, and 8th order superGaussian modes in a carbon dioxide laser resonator using deformable mirrors; formation of specific intensity outputs, published in Applied Optics and incorporated herein by reference.

[0159] according to Figure 1 One embodiment is shown. (Refer to...) Figure 3Optical device 300 is used to shape laser beam 310 into an energy distribution with a more uniform energy distribution. Collimated laser beam 312 with a substantially Gaussian distribution 313 is converged to the waist near the first axial prism 314. The waist of the converged laser beam is generally centered on the first axial prism 314. The lower beam laser beam from the first axial prism 314 passes through the Bessel beam region 316 and then through the divergence ring region 318. Second axial prism 320 is located at a specified distance from the first axial prism along the optical axis of the lower beam, such that the divergence ring has a specific ring diameter, wherein the laser beam is incident on the second axial prism 320. The second axial prism 320 then corrects (e.g., collimates) the divergence ring mode into a ring mode with a substantially constant diameter (D) during its propagation. The ring mode has a ring-shaped Gaussian energy distribution 321 on the ring surface. However, since the waist of the converging beam is located near the first axial prism 314, the laser beam diverges under the influence of both the first axial prism 314 and the second axial prism 320. As a result, the ring width (w) continues to diverge as the laser beam propagates, and the ring pattern α continues to diverge. The focusing optics are located at a predetermined distance from the lower beam of the second axial prism 320, such that at the location of the focusing optics, the ring diameter (D) is generally equal to the ring width (w). Here, due to the partially overlapping ring energy distribution, the laser beam has a more constant energy distribution 323. Finally, the focusing optics 322 converges the laser beam to the focusing region. Alternatively, in some specific embodiments, the more constant energy distribution (e.g., super-Gaussian) is formed by an intracavity spatial filter or an external spatial filter of the laser cavity.

[0160] To understand and demonstrate the effect of energy distribution on enamel heating, a mathematical model is presented. The mathematical model assumes Beers radiation absorption, Newtonian convection, and Fourier conduction. The model is encoded using nodal finite element analysis as described by J. Van de Ven et al. in “Laser transmission welding of thermoplastics – Part I: Temperature and pressure modeling” published in J. Manuf. Science. English. October 2007, and incorporated herein by reference. For this model, it is assumed that radiation at a wavelength of 9.3 μm has a reflectivity of 0.4 and a heat distribution of 0.5 μm in enamel. -1的吸收系数。 It is also assumed that the 100 μS optical pulse has instantaneous rise and fall times. The temperature within the enamel after the laser pulse is found from the model.

[0161] Figure 4 The first temperature profile 410 is shown. The first temperature profile displays the enamel depth in micrometers along the first vertical axis 412 and the width of the laser beam 110 in micrometers along the first horizontal axis 414. Temperatures are grayscale encoded in degrees Celsius according to color bars 416. The laser beam 110 used for the first temperature profile includes a 1 / e... 2 Pure Gaussian energy distribution of the beam diameter.

[0162] The second temperature chart 510 is in Figure 5 As shown in the diagram. 5. The second temperature map 510 shows the depth in the enamel in micrometers along the second vertical axis 512 and the width of the laser beam 510 in micrometers along the second horizontal axis 414. The temperature is grayscale encoded in degrees Celsius according to the color bars 516. The laser beam 110 used for the second temperature map includes a transverse ring pattern with a Gaussian ring energy distribution and a 1 / e of 0.125 mm. 2 Beam width and ring diameter of 0.175 mm.

[0163] Figure 6 The third temperature curve 610 is shown. The third temperature curve 610 shows the depth in the enamel in micrometers along the third vertical axis 612 and the width of the laser beam 610 in micrometers along the third horizontal axis 614. Temperatures are grayscale encoded in degrees Celsius according to the color bars 616. The laser beam 110 used for the third temperature curve includes a transverse ring pattern with a Gaussian ring energy distribution and a 1 / e-1 / 2 of 0.125 mm. 2 Beam width and ring diameter of 0.125 mm. (Review) Figure 4-6 It demonstrates how lateral ring-mode laser irradiation can heat a larger area of ​​tissue to a constant temperature.

[0164] Figure 7 The fourth temperature curve 710 is shown. The fourth temperature curve 710 shows the depth in the enamel in micrometers along the fourth vertical axis 712 and the width of the laser beam 710 in micrometers along the fourth horizontal axis 614. The temperature is grayscale encoded in degrees Celsius according to the color bars 716. The laser beam 110 used for the fourth temperature curve includes a super-Gaussian energy distribution of order 4 and a beam width of 0.125 mm. (Review) Figure 4-7 It demonstrates how irradiation with non-Gaussian (i.e., super-Gaussian and transverse ring) mode lasers can heat a larger area of ​​tissue to a constant temperature.

[0165] As shown in the figure. Figure 8A flowchart of a method 800 for preventative dental laser treatment according to one embodiment is presented. A laser source generates a laser beam 810 having a non-Gaussian energy distribution (e.g., a transverse ring pattern). In some cases, the laser source first generates the laser beam, and then the energy distribution of the laser beam is converted to a non-Gaussian energy distribution – a Gaussian energy distribution. In other cases, the laser source naturally generates a laser beam with a non-Gaussian energy distribution. According to one embodiment, the non-Gaussian energy distribution includes a transverse ring pattern. Examples of transverse ring patterns include the TEM O1* mode, the Laguerre-Gaussian mode, the Hermite-Gaussian mode, the Bessel mode, and the Bessel-Gaussian mode. In some embodiments, the non-Gaussian energy distribution is used to produce a constant or near-constant energy distribution (e.g., super-Gaussian) at a point along the propagation of the laser beam (e.g., a focal region). The laser beam is then focused to the focal region 812, typically using focusing optics. The focal region is located near the surface of the hard tissue of the tooth (e.g., enamel). Finally, at least one parameter of the 814 laser beam is controlled to deliver controlled radiation and uniformly heat a portion of the tooth hard tissue surface to a range between approximately 400°C and approximately 1300°C. Parameters include: repetition frequency, pulse duration, pulse energy, focal region location, laser scanning speed, focal region width, wavelength, etc.

[0166] To assist in implementing the claimed invention and selecting parameters, the following table provides exemplary ranges and nominal values ​​for the relevant parameters.

[0167]

[0168] Figure 9 An exemplary system 900 is illustrated. System 900 includes a console 910. Console 910 houses components of system 900, such as a laser source that generates a laser beam, a direct current (DC) power supply for powering the laser source, a beam shaper for driving the laser source, a compressed air system for shaping the energy distribution of the laser beam, a compressed air system for delivering compressed air to provide overall cooling to the hard tissue of the tooth being treated, and a user interface 912 for user control. A beam delivery system 914 directs the laser beam to a handheld device 916. Exemplary beam delivery system 914 includes an articulated arm, a waveguide, and an optical fiber. An exemplary articulated arm is provided by Laser Mechanisms of Novi, Michigan, USA. The handheld device 916 is configured for use intraorally (i.e., within the oral cavity). Typically, the handheld device 916 includes focusing optics (not shown) that converge the laser beam to a focal region outside the handheld device 916. According to one embodiment, system 900 is operated with a foot pedal 918, which is configured to activate the laser source.

[0169] According to one embodiment, the system 900 is used by a clinician. First, the clinician inputs operating parameters into a user interface 912, for example, by using a touchscreen. Then, the clinician places a handheld device 916 in the patient's mouth and points the handheld device 916 toward the hard tissue of the teeth. For example, the clinician positions the handheld device 916 such that the focal area of ​​the laser beam coincides with or is close to the tooth surface (e.g., + / - 1 mm, 2 mm, 3 mm, or 5 mm). The clinician then activates the laser by pressing a foot pedal 918. The clinician moves the handheld device 916 within the patient's mouth, carefully guiding the focal area of ​​the laser beam toward each treatment surface of the patient's teeth.

[0170] Contact-coupled laser transmission

[0171] As shown in the figure. Figure 10 A preventative dental treatment system 1000 according to one embodiment is illustrated. The preventative dental treatment system 1000 delivers radiation (e.g., a laser beam) 1010 to dental hard tissue 1012 (e.g., enamel, dentin, or cementum). The radiation is generated by a radiation source (e.g., a laser source) 1014. An exemplary laser source 1014 is a carbon dioxide (CO2) laser, such as the HPP DL-500 from Access Laser, Everett, Washington, USA. Typically, the radiation source is selected to produce radiation that is well absorbed by the dental hard tissue 1012 (e.g., with a density greater than 1 cm). -1 100cm -1 Or 1,000cm -1The radiation 1010 is emitted at a wavelength of 200-500 nm. Exemplary wavelengths include any one of a first range between 200 and 500 nm and a second range between 4 and 12 μm. The radiation 1010 is transmitted to a handheld device 1016 using a radiation transmission system 1018. An exemplary radiation transmission system includes an articulated arm, an optical fiber, and a hollow waveguide. Some exemplary articulated arms are provided by Laser Mechanisms of Novi, Michigan, USA. The handheld device 1016 is configured for use within the oral cavity (i.e., inside the mouth). The handheld device includes a coupling optics 1020. The coupling optics 1020 receives the radiation 1010 at a first end. The radiation 1010 is transmitted within the coupling optics 1020. According to one embodiment, the radiation 1010 ultimately exits from a second end of the coupling optics. An exemplary coupling optics includes a waveguide, an optical fiber, a rod, and a prism. Because the radiation propagates within the coupling optics 1020, it is reflected within the coupling optics 1020 and its surrounding interfaces (e.g., sides). Typically, air surrounds the coupling optics 1020. In some embodiments, the coupling optics comprises one of diamond, quartz (i.e., fused silica), glass, sapphire, zinc selenide, or zinc sulfide. In one embodiment, the coupling optics 1020 is made of diamond and produced by chemical vapor deposition (CVD). CVD diamond has a refractive index of 2.38 at a wavelength of 10.6 μm. Air has a refractive index of 1.0 at a wavelength of 10.6 μm. Because air has a much lower refractive index than CVD diamond, radiation 1010 typically undergoes total internal reflection (TIR) ​​at the optical-air interface as it propagates within the coupling optics. The coupling optics 1020 is positioned within the handheld component 116 such that the surface of the coupling optics is exposed. During use of the system 1000, the coupling optics 1020 is positioned to contact the hard tissue of the teeth 1012. Depending on the radiation parameters (e.g., wavelength), coupling optics parameters (e.g., material [refractive index]), and optical path parameters (e.g., incident angle), the variation portion of radiation 1010 is transmitted to the tooth hard tissue 1012 at the contact point between the coupling optics and the tooth hard tissue 1012.

[0172] Optionally, after exiting the second end of the coupling optics 1020, radiation not delivered to the hard tooth tissue 1012 is analyzed by detector 1022. Exemplary detectors include photodiodes, spectrometers, spectrophotometers, photodetectors, pyroelectric detectors, and thermopile. In some specific embodiments, detector 1022 is used to determine the amount of energy or power of the radiation 1010 that has not penetrated into the hard tooth tissue. This measurement can indicate whether an effective treatment is being performed by determining whether energy is actually being delivered to the hard tooth tissue 1012. If a small fraction of the total radiation energy (e.g., less than or equal to 50% of the total radiation energy) is detected, it can then be inferred that radiation energy is being delivered to the hard tooth tissue 1012 and that treatment is being performed effectively. Alternatively, if a large fraction (e.g., greater than 50% of the total radiation energy) is detected, it can be inferred that radiation energy is not being effectively delivered to the hard tooth tissue 1012 and that treatment is not being performed effectively.

[0173] refer to Figure 11 Flowchart 1100 in the document describes an exemplary method of using system 1000. 11. First, radiation (e.g., a laser beam) 1110 is generated. Typically, radiation is generated using a radiation source (e.g., a laser source). Exemplary laser sources include carbon dioxide (CO2) lasers, carbon monoxide (CO) lasers, excimer lasers, fiber lasers, diode-pumped solid-state (DPSS) lasers, and semiconductor lasers. The radiation is controlled 1112. Typically, one or more parameters of the radiation are controlled by a controller. An exemplary controller includes a laser control board (e.g., Maestro from LANMark Controls Inc., Acton, Massachusetts, USA). The radiation is propagated along an optical path and coupled into an optics device. The radiation is then internally reflected within the optics device 1114. In some specific exemplary embodiments, the radiation undergoes total internal reflection (TIR) ​​as it propagates throughout the optics device. The hard dental tissue is then brought into contact with the optics device 1116. For example, the radiation is positioned along one side of the optics device where it undergoes internal reflection to directly contact the hard dental tissue (e.g., enamel or dentin). Finally, a portion of the radiation is coupled into the hard tooth tissue 1118 at the contact point between the lens and the hard tooth tissue. In some exemplary embodiments, the radiation is coupled into the hard tooth tissue via at least one of suppressed total internal reflection (FTIR), attenuated total internal reflection (ATIR), and evanescent wave.

[0174] To assist in implementing the claimed invention and selecting parameters, the following table provides exemplary ranges and nominal values ​​for the relevant parameters.

[0175]

[0176] Further description is provided below with reference to certain exemplary embodiments. According to some embodiments, an ultraviolet (UV) laser source is used to generate a UV laser beam for therapeutic purposes. Exemplary UV laser sources include diode-pumped solid-state (DPSS) lasers, fourth-harmonic Nd:YAG lasers, excimer lasers, and fiber lasers. An exemplary fiber laser family is the ULM / ULR-355 series from IPG Photonics in Oxford, Massachusetts, USA. The ULM / ULR-355 series provides a 200W average power system operating in quasi-continuous wave (CW) mode at a wavelength of 355 nm, a pulse duration of 1.4 ns, and repetition rate settings of 20, 40, and 80 MHz. Hydroxyapatite (HAP) has relatively high absorption at 355 nm. The absorption coefficient of HAP at 355 nm is approximately 0.1 μm. -1 (i.e., 1000cm) -1 To understand the potential of ultraviolet laser sources (e.g., ULM / ULR-355), a mathematical model is disclosed. The mathematical model assumes Beers absorption, Newtonian convection, and Fourier conduction. The model is coded using nodal finite element analysis as described by J. Van de Ven et al. Published in "Laser transmission welding of thermoplastics - Part I: Temperature and pressure modeling" in J. Manuf. Science. English. October 2007, and incorporated herein by reference. The model is run with assumptions of a radiant power of 200 W, a reflectivity of 40% between air and the enamel surface, and an absorption coefficient of 0.1 μm. -1 The laser beam diameter on the enamel surface is 1 mm¹ / e², and it exhibits a Gaussian distribution. Figure 12 The contour map 1200 illustrates the simulated temperature rise under the above conditions. 12.

[0177] See the reference image. Figure 12 In the diagram, contour plot 1200 shows the depth in the enamel along the first vertical axis 1212 in μm and the radial distance away from the laser beam center along the first horizontal axis 1214 in μm. Temperature in degrees Celsius is shown according to color bar 1216. Contour plot 1210 shows only half the total width of the enamel region affected by the laser beam. In other words, the center of the laser beam at the enamel surface is... Figure 12 The location (0, 0) is shown in the diagram. The peak surface temperature occurs at the center and surface of the laser beam, simulated as 974°C. (This can be seen in...) Figure 3 I saw it in [the text]. From [the text] Figure 12As can be seen, the temperature rise within the enamel can even extend to depths of tens of micrometers (e.g., 20 μm). This is because enamel absorbs ultraviolet radiation well, but not as much as it absorbs mid-infrared radiation (e.g., 9-11 μm wavelength). For example, the optical penetration depth of ultraviolet (UV) radiation (the depth at which approximately 63% of the radiation is absorbed) is about 100 μm; and the optical penetration depth of 9.3 μm wavelength radiation is about 2 μm. In some cases, the increased optical penetration depth is an advantage for treatment because less surface preparation of the tissue is required. One disadvantage of increasing the optical penetration depth is that a larger volume of enamel must be irradiated to treat the same area of ​​the tooth. Therefore, more energy must be delivered to raise the temperature of the larger volume of enamel. Returning to the example above, a 200 W laser pulse with a pulse duration of 100 μs would provide 20 mJ of pulsed energy to the tooth. Finally, the laser can be pulsed at a repetition frequency. Exemplary repetition rates include frequencies less than or equal to 100 Hz (e.g., 50 Hz). At a laser pulse energy of 20 mJ and a repetition frequency of 50 Hz, an average of 1 W of laser power is delivered to the tooth. Approximately 1 W of total heating power can be removed from the tooth by forced convection (e.g., blowing air or other fluid). Another benefit of using ultraviolet radiation treatment is the whitening of teeth due to photobleaching. J. Schoenly et al., “Near-ultraviolet laser treatment of extrinsic enamel stains,” published in Lasers Surg Med, describe the removal of extrinsic stains using a 400 nm wavelength laser. Incorporated hereby by reference in March 2012. The above examples simulate a Gaussian beam delivered to the hard tissue of the tooth to demonstrate the feasibility of using an ultraviolet laser beam for acid dissolution inhibition treatment. In some exemplary embodiments, the UV laser beam is delivered via optics that contact the hard tissue of the tooth.

[0178] Reference image. Figure 13A -C, In some embodiments, optical devices (e.g., waveguides) 1310 contact the hard tissue of the teeth to transmit radiation 1312. Figure 13A Radiation 1312 propagating through optical device 1310 is schematically shown. Figure 13A The medium 1314 surrounding the optical device 1310 is propagated. 13A is air. The refractive index of air is -1 (1.0); and the optical device typically has a refractive index greater than -1. Generally, because the refractive index of the surrounding medium 1314 is lower than that of the optical device 1310, the radiation 1312 undergoes internal reflection (e.g., total internal reflection [TIR]) within the optical device 1310.

[0179] As shown in the figure. Figure 13BA first technique for contact coupling radiation 1312 into tooth hard tissue 1316 is schematically illustrated. In this first technique, the optics 1310 has a refractive index greater than that of the tooth hard tissue. For example, in some exemplary embodiments, a high-refractive-index optical material (e.g., diamond [n = 2.38], ZnSe [n = 2.61], or ZnS [n = 2.37]) is used, and the refractive index of the enamel is approximately 1.6. In this case, the radiation 1312 reflected at the interface between the optics 1310 and the tooth hard tissue 1316 undergoes attenuated internal reflection (e.g., attenuated total internal reflection [ATIR]). An evanescent wave 1318 (i.e., an evanescent field) comprising a portion of the radiation is formed, which penetrates the tooth hard tissue 1316. The evanescent wave 1318 penetrates a specific depth 1320 into the tooth hard tissue. The depth 1320 of penetration of the evanescent wave 1318 can be approximated using the following relationship:

[0180]

[0181] Where d is the penetration depth 1320 of the evanescent wave 1318; λ0 is the vacuum wavelength of radiation 1312; l_ is the refractive index of optical element 1310; n2 is the refractive index of the material surrounding the lens (e.g., hard dental tissue 1316 or air 1314); and θ is the angle of incidence 1322 of radiation 1312 at the interface. Under total internal reflection (TIR) ​​conditions, the angle of incidence 1322 has a value greater than the critical angle. The critical angle can be approximated using the following relationship:

[0182]

[0183] Where, θ 临界 n1 is the critical angle, n2 is the refractive index of the optical element 1310, and n2 is the refractive index of the material surrounding the lens (e.g., air 1314 or dental hard tissue 1316).

[0184] For example, in one exemplary embodiment, the optics include CVD diamond with a refractive index of approximately 2.38, and the laser source includes a CO2 laser with a wavelength of 9.3 μm. In this case, the TIR critical angle between the CVD diamond and the enamel is approximately 42°, while the maximum penetration depth 1320 of the evanescent wave using an incident angle slightly larger than the critical angle (e.g., 43°) is 5 μm. Since the optical penetration depth (due to absorption) of the 9.3 μm radiation in the enamel (i.e., hydroxyapatite) (e.g., ~2 μm) is less than the evanescent wave penetration depth 1320, most of the radiation 1312 will be absorbed into the hard tissue of the tooth 1316 under these conditions.

[0185] As shown in the figure. Figure 13CA second technique for contact coupling radiation 1312 into tooth hard tissue 1316 is schematically illustrated. In this second technique, radiation 1312 is refracted into tooth hard tissue 1316. This phenomenon is sometimes understood as suppressed internal reflection (e.g., suppressed total internal reflection [[infrared spectroscopy])). In one embodiment of the second technique, the refractive index of lens 1310 is less than that of tooth hard tissue. For example, in some exemplary embodiments, a low-refractive-index optical material (e.g., UV fused silica [n = 1.5]) is used and the refractive index of enamel is approximately 1.6. In this case, radiation 1312 is refracted into tooth hard tissue 1316.

[0186] For example, one exemplary embodiment employs a UV laser source with a wavelength of 355 nm and a fused silica optics device with a refractive index of 1.5. In this case, the critical angle of the optics device 1310, using air (n=1) as the surrounding material, is approximately 42°, and the evanescent field penetration 1322 at the optical boundary using an angle slightly larger than the critical angle (43°) is approximately 0.3 μm. However, when the optics device 1310 comes into contact with the hard dental tissue 1316, the radiation 1312 is refracted into the hard dental tissue in a manner understood according to Snell's law and absorbed by the hard dental tissue. In some cases, the use of a UV laser source (355 nm) and a fused silica optics device (n=1.5) is additionally advantageous. This is because ultraviolet radiation can cause genetic damage, leading to cancer (e.g., skin cancer). For this reason, the application of ultraviolet radiation should be precisely targeted only at the hard dental tissue, and not at soft tissues (e.g., skin and mucous membranes). When surrounded by air, UV radiation undergoes TIR reflection within the optical element, thus being confined within the element and not directed to tissues not in contact with the optical element 1310. Furthermore, in some cases, UV light may not completely couple out of the optical element 1310 even in contact with oral soft tissue. The refractive index of oral soft tissue (at ultraviolet wavelengths) is close to that of water and typically lower than that of fused silica (e.g., 1.4). For example, the representative critical angle for total internal reflection between soft tissue and the fused silica optics 1310 is 69°, and the maximum evanescent wave penetration depth 1322 for a 355 nm beam with an incident angle of 70° is approximately 0.3 μm, with a unit width of approximately 10 to 30 μm. Therefore, ultraviolet radiation will not penetrate the cell nucleus; and even with direct contact between the optics and soft tissue, the likelihood of causing genetic damage to the soft tissue is significantly reduced.

[0187] In one embodiment, Figure 1 The second technique outlined in the text. When the refractive index of the hard dental tissue is less than that of the optical device 1310, such as... Figure 13CAs shown and described, suppressed internal reflection may also occur. Suppressed internal reflection also occurs when the angle of incidence is less than the critical angle between the refractive indices for optics 1310 and dental hard tissue 1316. For example, returning to the example above, using 9.3 μm radiation 1312 and CVD diamond optics 1310 with a refractive index of 2.38, the critical angle between the optics and air is approximately 25°, the critical angle between the optics and oral soft tissue is approximately 36°, and the critical angle between the optics 1310 and hard tissue 1316 is approximately 42°. This means that radiation propagating at an angle of incidence between 36° and 42° will undergo total internal reflection (TIR) ​​when the optics 1310 is in air or in contact with oral soft tissue, and suppressed total internal reflection (FTIR) is when the optics 1310 is placed in contact with dental hard tissue 1316. Therefore, tissue-specific penetration of radiation is an advantage of some embodiments, although other advantages do exist. For example, the use of contact laser delivery devices is expected to be more readily adapted for use in dental operating rooms, where most dental tools are used in contact with the hard tissues of the teeth.

[0188] Another advantage of some embodiments is that the contact coupling of the radiation can be used to treat hard tissue areas of the teeth that conventional free-space laser treatment cannot address. For example, interdental areas (i.e., the space between teeth) are common sites of caries formation and are locations where conventional lasers cannot always irradiate because there is no direct line of sight in the free space. In some exemplary embodiments, optics 1410 is configured to approach and deliver radiation 1411 to the interdental hard tissue 1412. Figure 14 An optical element 1410 is schematically shown between the first tooth 1414 and the second tooth 1414. In some embodiments, the optical element 1410 includes proximal teeth of a bar having a diameter selected as suitable (e.g., less than 2 mm, less than 1 mm, or less than 0.5 mm). In some embodiments, the bar comprises a hard material (e.g., diamond or quartz) to prevent it from breaking during use.

[0189] As shown in the figure. Figure 15The diagram illustrates an optical path 1500 according to one embodiment. Collimated radiation (e.g., a laser beam 1510) having a Gaussian energy distribution 1512 is directed incident on a first focusing optics 1514. The first focusing optics 1514 converges the radiation and directs it into a homogenizer 1516. Exemplary homogenizers include a diffractive optical element (DOE) homogenizer, a transmission diffuser, a reflection diffuser, and a rod homogenizer. An exemplary DOE homogenizer for infrared wavelengths is Holo / OR, part number HM-212-AYA, from Ness Ziona, Israel. An exemplary rod homogenizer for ultraviolet wavelengths is a 2mm aperture fused silica homogenizing rod, Edmund Optics Part No. 63-092, from Barrington, New Jersey, USA. Typically, the radiation 1510 diverges as it leaves the homogenizer. After exiting the homogenizer 1516, the radiation has a more homogenized energy distribution (e.g., flat-top, flat-top, or super-Gaussian) 1518. A second focusing optics 1520 refocuses the radiation 1510 and guides it into a coupling optics 1522. Exemplary coupling optics 1522 include prisms, Dowell prisms, waveguides, rods, ATR prisms, etc. An exemplary Dowell prism is a 10mm Dowell prism part number 85-156 from Edmund Optics. According to some embodiments, the optical path 1500 also includes waveguides or optical fibers. An exemplary prism assembly that additionally includes optical fibers is the Diamond Probe from Harrick Scientific Products, Pleasantville, NY, part number DMP-PRB. When in contact with dental hard tissue, the radiation is at least partially transmitted into the dental hard tissue. Finally, the radiation 1510 that has not transmitted into the dental hard tissue exits the coupling optics 1522 and is guided to a sensor or beam collector 1526. Irradiation treatment of tooth hard tissue 1524 increases the temperature of the tooth hard tissue surface, temporarily raising the temperature (e.g., between 400°C and 1200°C). Therefore, in some embodiments, the coupling optics are made of materials capable of handling these high temperatures (e.g., diamond, sapphire, fused silica, and quartz). Alternatively, in some embodiments, the coupling optics are consumed during each treatment and the materials are produced inexpensively, such as optical salts (e.g., barium fluoride, magnesium fluoride, and calcium fluoride).

[0190] Furthermore, in some specific exemplary embodiments, the coupling optics are actively cooled to prevent overall heating of the hard tissue of the tooth (e.g., the tooth) and / or the optics themselves. It is generally accepted that, to prevent thermal damage to the tooth, the nerve temperature within the pulp chamber should not exceed the normal value of 5.5°C. Transferring radiant energy to the tooth would cause the entire tooth to heat up. To prevent thermal damage, in some embodiments, contact cooling of the tooth is achieved by cooling the coupling optics. (See figure.) Figure 16 An embodiment of a cooling system 1600 for cooling a coupling optics 1610 is shown. The coupling optics 1610 is at least partially enclosed within a fluid path through which coolant 1614 flows. In some cases, the fluid path provides a seal around the coupling optics, allowing the coolant to directly contact the coupling optics 1610. Alternatively, the fluid path 1612 is completely separated from the coupling optics 1610, such that the coolant cools the fluid path 1612 and then the fluid path 1612 cools the coupling optics 1610. Coolant 1614 is circulated within the fluid path 1612 using a pump 1616. The coolant is cooled by a cooler 1618. An exemplary cooler includes a Peltier connector. Coolant 1614 is cooled to a sufficiently low temperature to prevent excessive heating of the hard tissues of the teeth (e.g., teeth) and not so low as to cause patient discomfort (e.g., in the range of -20°C to 20°C).

[0191] Although the exemplary systems disclosed above describe the use of a laser source to deliver radiation for treatment, non-laser-based systems are conceivable. For example, in some embodiments, the radiation is incoherent. In some cases, incoherent radiation is generated by an incoherent light source, such as a flash lamp. In a particular exemplary embodiment, UV incoherent radiation is generated by one or more of a super-powerful flash lamp, a super-powerful lamp, a mercury-super-powerful lamp, and a deuterium flash lamp.

[0192] Recurring payments for the ownership costs of laser systems

[0193] To minimize the upfront costs associated with installing a dental laser system, a distribution system is disclosed that allows for the secure allocation of coupons representing individual (or multiple) uses of the dental laser system, thereby enabling a revolving payment system. Furthermore, the system and method are disclosed to ensure that unauthorized use of the dental laser system is minimized. To successfully minimize unauthorized use, techniques are employed that result in costs associated with circumventing authorized use (e.g., through forgery, hacking, or fraud) exceeding the costs associated with purchasing genuine coupons. In other words, in commercially successful practice with the disclosed distribution system and method, the price of the coupon (representing a single use of the laser system) is correlated with the level of technical difficulty in circumventing the coupon. The systems and methods supporting the creation, distribution, and use of these coupons are described below.

[0194] As shown in the figure. Figure 17A The illustration depicts a dispensing system for preventative laser and fluoride treatment according to one embodiment. A sealed package 1700 is shown in Figure 17, intact. This package is distributed to dental clinics like other dental supplies (e.g., consumables). In many embodiments, multiple units of package 1700 are grouped together and distributed to dental clinics in multi-package form (e.g., boxes).

[0195] As shown in the figure. Figure 17B The opened package 1070 is shown. According to one embodiment, the package contains a fluoride treatment dose 1710, a fluoride applicator 1712, and a machine-readable code 1714. The exemplary fluoride dose 1710 includes a fluoride varnish, a fluoride gel, a fluoride paste, a fluoride fluid, and a fluoride foam. The fluoride dose 1710 contains any quantity of known fluoride compositions that are effective at treating tooth surfaces, such as sodium fluoride (NaF) and stannous fluoride (SnF2). The exemplary applicator 1712 includes a swab, a needle, a syringe, and a dental tray (not shown). The machine-readable code 1714 is configured to be read by a dental laser system. In one embodiment, the machine-readable code 1714 represents one (or more) dental laser treatments. Exemplary forms of the machine-readable code 1714 include barcodes, 2D barcodes, magnetic strips (not shown), transponder devices (not shown), microchips (not shown), and radio frequency identification (RFID) tags (not shown). Typically, machine-readable code 1714 represents a coupon for one or more laser treatments, and laser treatments cannot be performed without a valid coupon (or a certain number of coupons).

[0196] As shown in the figure. Figure 18A A preventative dental laser system 1800 according to one embodiment is illustrated. The dental laser system 1800 typically includes a console 1810. A laser source and a laser controller are housed within the console 1810. An exemplary laser source is a carbon dioxide (CO2) laser, such as the HPPDL-500 from Access Laser in Everett, Washington, USA. Other exemplary laser sources include carbon dioxide (CO2) lasers, carbon monoxide (CO) lasers, excimer lasers, fiber lasers, diode-pumped solid-state (DPSS) lasers, and semiconductor lasers. Typically, the radiation source is selected to produce radiation that is well absorbed by the hard tissue of the tooth 1712 (e.g., with a wavelength greater than 1 cm⁻¹). -1 100cm -1 Or 1,000cm -1radiation 1710 at a wavelength (of the absorption coefficient). The wavelength includes any one of a first range between 200 and 500 nm and a second range between 4 and 12 μm. The laser source generates a laser beam, which is guided to the handpiece 1814 through the beam delivery system 1812. Exemplary beam delivery systems 1812 include articulated arms, hollow waveguides, and optical fibers. The handpiece 1814 is configured for intraoral use to deliver the laser beam to the surface of hard dental tissue for treatment. The laser controller is configured to control at least one parameter of the laser beam during treatment. Exemplary laser parameters include pulse energy, average power, peak power, pulse duration, and repetition rate.

[0197] The laser system 1800 further includes a code reader 1816 configured to read the machine-readable barcode 1714. In one embodiment, the code reader 1816 employs a machine vision system that acquires a digital image of the machine-readable code 1714 and identifies the machine-readable code 1714. In some cases, the machine vision system includes a lens assembly, an optical sensor (e.g., a charge-coupled device [CCD] or a complementary metal-oxide-semiconductor [CMOS]), and a vision processor. The vision processor is configured to identify the code 1714 within the digital image of the machine-readable code. Exemplary software resources for reading machine-readable codes in digital images include DataMatrix within the OpenCV project. Alternatively, the machine-readable code 1714 may be stored on another device, such as a single-wire chip, an RFID tag, a thin film, and a magnetic stripe. Accordingly, in alternative embodiments, the code reader 1816 includes a single-wire chip reader (not shown), an RFID tag reader (not shown), a film reader (e.g., a camera with an illumination system), and a magnetic stripe reader (not shown). To enable the machine-readable code 1714 to successfully prevent fraudulent use of the laser system 1800, the code 1714 is verified.

[0198] A verification system 1836 according to one embodiment is shown in the block diagram of FIG. 18B. The code 1714 is first read by the code reader 1816. The code reader 1816 identifies the code and transmits the code to the verification system 1836. The verification system generally includes a processor local to the dental laser system 1800. In some cases, the verification system employs only an internal verification system 1837 to verify the code locally. For example, according to one embodiment, a single-wire authentication chip and only the internal verification system 1837 are used. In an alternative embodiment, the code 1714 includes a digital signature (e.g., a cryptographic token) present in a memory (e.g., a non-volatile memory), and the code reader includes a processor. In some cases, the code 1714 is verified by a remote system.

[0199] The verification system 1836 may use one or more networks 1838. Exemplary networks include a local area network (LAN), a wide area network (WAN), a wireless network (WiFi), a closed area network (CAN), etc. According to one embodiment, the verification system communicates code 1714 with a central server 1840 via one or more networks 1838. In some cases, the communication between the verification system 1836 and the server 1840 is encrypted (e.g., symmetric encryption or public / private key encryption). In some cases, the verification system 1836 includes additional information in its communication with the central server 1840, such as a timestamp, a unique system identifier, or information about laser treatment. The central server 1840 then compares the information transmitted from the verification system 1836 and determines the authenticity of code 1714 and whether code 1714 is valid (e.g., it has not been used before). Once the central server 1840 and the verification system 1836 have verified the code, the verification system 1836 allows laser treatment to proceed. In an alternative embodiment, the determinations performed in part by the central server are performed using one or more nodes 1842A-C. According to one embodiment, nodes 1842A-C communicate with the verification system 1836 and are queried to determine whether code 1714 is authentic and unused. In some cases, based on the principle of "proof-of-work" (e.g., using a blockchain approach), a majority of node responses are used to verify whether the conflict between the code and the nodes is satisfied. In some embodiments, each laser therapy system 1800 includes a verification node.

[0200] Typically, the verification system 1836 only allows the laser controller 1844 to operate the laser source 1846 after the machine-readable code 1714 has been verified. In some cases, the verification system 1836 budgets the use of the treatment system 1800. Some exemplary budgets are for a single treatment, a certain amount of time, a certain amount of delivered laser energy, or a certain amount of laser energy consumption. In some cases, the verification system 1836 disables the interlock device 1848 after verification to allow budgeted use. In some cases, the verification system 1836 communicates directly with (or is coupled to) the laser controller 1844 to prevent simple failure of the interlock device 1848, which would allow bypassing the verification system 1836 (and unbudgeted use). For example, in one embodiment, the laser controller 1844 includes a field-programmable gate array (FPG) (e.g., Xilinx Zynq), and the verification system 1836 includes a single-wire authentication system (e.g., MAXREFDES44# reference design from Maxim Integrated, San Jose, California, USA) that verifies the machine-readable code and communicates directly with the laser controller 1844.

[0201] After verification (or simultaneously with verification, or before verification), verification system 1836 also prevents future verification of the same code 1714. In one embodiment, preventing future verification is achieved by submitting to a central server 1840 or one or more nodes to render the machine-readable code 1842A-C invalid. In one embodiment, preventing future verification of the machine-readable code 1714 requires deletion, destruction, corruption, invalidation, or overwriting of the machine-readable code 1714. For example, in some cases, the machine-readable code 1714 is contained in a wired authentication chip, and during chip reading, the machine-readable code is overwritten, for example, to zero. Although many techniques have been described to allow system use only after verification of code 1714, unauthorized use of system 1800 is always a technically feasible possibility. Some exemplary attacks that can be used to circumvent verification system 1836 include “man-in-the-middle,” “replay attacks,” and “chip-tearing.” Since the production of each coupon needs to be relatively cheap (e.g., far less than the cost of performing a treatment), not all potential attacks can be effectively rectified. For this reason, in some embodiments, additional systems are employed to monitor system usage.

[0202] As shown in the figure. Figure 18C A block diagram of an additional subsystem of a dental laser system 1800 according to one embodiment is illustrated. A power supply (e.g., a direct current (DC) power supply) 1860 supplies power to a laser source 1846. A meter 1862 is schematically located between the power supply 1860 and the laser source 1846. In some embodiments, the meter 1862 measures the electrical energy consumed by the laser source 1846 (e.g., energy [power multiplied by time]). The measured electrical energy is an indication of the laser-on time and thus indicates the use of the laser treatment system 1800. The laser source 1846 generates a laser beam 1864 during laser treatment. According to one embodiment, the laser beam is continuously monitored by a laser power meter 1866 (e.g., a thermopile or photodetector). In some cases, a small portion of the total laser beam 1864 is “picked up.” This small portion of the laser beam is then measured by the laser power meter 1866 as a representative of the total laser beam energy. In some cases, the measurement from the laser power meter 1866 is used as another indication of the laser-on time, and thus the laser treatment system is used.

[0203] The processor receives measurements from one or both of the electricity meter 1862 and the laser meter 1866. In some embodiments, the processor records the measurements 1842A, for example locally or on a central server 1840 and / or distributed nodes, via one or more networks 1838. Recording measurements indicating usage allows for an understanding of the estimated actual system usage time. The estimated actual system usage time can later be compared with verified usage (e.g., the number of verified coupons). Just as the difference between dropout votes and vote counts indicates voter fraud, the difference between the estimated actual system usage and verified system usage (e.g., coupon usage counts) indicates fraudulent use of the laser system.

[0204] Figure 19 is a flowchart 1900 illustrating a method for preventative dental treatment according to one embodiment. First, a machine-readable code is read 1910. In some embodiments, the machine-readable code represents a coupon for one (or more) laser treatments. In some embodiments, the machine-readable code is read by a barcode reader. Alternatively, the machine-readable code is read by one or more of the following: a magnetic stripe reader, a radio frequency identification (RFID) reader, a transponder reader, and a microchip interface (e.g., a single-wire device). The machine-readable code is read 1910, and then the machine-readable code is verified 1912. In some cases, the machine-readable code is verified by determining that it is included in a list of verifiable machine-readable codes. In one embodiment, the machine-readable code is encrypted, for example, by using one or more of a symmetric encryption system and asymmetric encryption methods, and the verification of the machine-readable code includes decryption. In some cases, the machine-readable code is verified remotely (e.g., via a network), for example, via a central server or one or more nodes. In some cases, communication over the network (during verification) is further encrypted between the verification system local to the treatment system and the central server or one or more nodes. In some cases, a central server and one or more decentralized nodes comprise a ledger (e.g., a decentralized ledger). The decentralized ledger is used to track the issuance, verification, transfer, and use of coupons. In some cases, decentralized ledgers exhibiting the greatest computational effort are more trusted than contradictory decentralized ledgers demonstrating less computational work. An exemplary system for decentralized (“trustless”) ledgers is a blockchain. In some embodiments, digital signatures associated with individual processing systems are used to ensure that additions to the ledger are honest. For example, in some cases, a private key associated with a single processing system is used to encrypt a digital signature used for one or more ledgers. In some embodiments, digital signatures sent from individual processing systems also include additional information that can help verify the honest use of coupons.

[0205] Once the machine-readable code is verified (e.g., verified as an unused and other valid coupon representing laser treatment and / or verified by one or more ledger-agreement systems that the coupon is to be used), the laser treatment is budgeted and performed by the system. Figure 1 One example illustrates laser treatment. 19.

[0206] First, laser treatment begins with generating a laser beam (1914A). The laser beam is typically generated using a laser source. Exemplary laser sources include: CO2 lasers with wavelengths between 9 μm and 11 μm, fiber lasers, diode-pumped solid-state lasers (DPSS), Q-switched solid-state lasers (e.g., third-harmonic Nd:YAG lasers with a wavelength of approximately 355 nm), excimer lasers, and diode lasers. Typically, the laser beam has a wavelength that is well absorbed by the hard tissues of the teeth (e.g., with an absorption coefficient greater than 1 cm⁻¹). -1 100cm -1 Or 1,000cm -1 The laser beam is then directed toward the surface of the hard dental tissue 1914B. In some embodiments, a beam delivery system is used to guide the laser beam into the oral cavity. The laser beam is typically guided within the oral cavity using a handheld device. In some embodiments, focusing optics are used to converge the laser beam as it is directed toward the hard dental tissue, such that it reaches a focal region close to the surface of the hard dental tissue. Exemplary focusing optics include lenses (e.g., zinc selenide plano-convex lenses with an effective focal length of 200 mm) and parabolic mirrors. In some embodiments, the laser beam is scanned as it is directed toward the surface of the hard dental tissue by a beam scanning system. Exemplary beam scanning systems include Risley prisms, rotating multifaceted mirrors, voice coil scanners (e.g., Optotune part number MR-15-30 from Dietikon, Switzerland), galvanometers (e.g., Lightning II 2-axis scanning head from Cambridge Technology, Bedford, Massachusetts, USA), and gantry structures with translational focusing optics. A scanning method related to dental laser systems is described in U.S. Patent No. 9,408,673 to N. Monty et al. It is incorporated into this article by reference.

[0207] Finally, the parameters of the laser beam are controlled (1914C). Typically, the laser beam parameters are controlled to heat a portion of the hard tooth surface to a temperature ranging from 400°C to 1300°C. Exemplary laser parameters include pulse energy, pulse duration, peak power, average power, repetition rate, wavelength, duty cycle, laser focal area size, laser focal area location, and laser focal area scanning speed. During laser treatment, a laser beam is generated and directed to the surface of the hard tooth tissue. Typically, the laser beam pulses at a prescribed repetition frequency and has a defined pulse duration. Alternatively, pulses can be delivered on demand, and the pulse duration can be varied (e.g., to control the heating of the hard tooth surface). Due to the irradiation of the surface, the surface temperature typically rises instantaneously to a range between 400°C and 1300°C (e.g., within the duration of the laser pulse) and cools back to a normal temperature range (e.g., in the range of 20°C and 60°C). Due to the instantaneous temperature rise, biomaterial previously on or adhered to the surface of the hard tooth tissue (e.g., epidermis, biofilm, calculus, and plaque) is at least partially removed and / or denatured. In some embodiments, the removal of this biomaterial essentially cleans the teeth, and the laser treatment replaces other teeth cleaning procedures (e.g., scaling and polishing) typically performed during dental examinations. Furthermore, as described above, heating the surface of the hard tooth tissue removes impurities (e.g., carbonates) from the hard tooth tissue and reduces the sensitivity of the hard tooth tissue to acid dissolution (e.g., demineralization). In some embodiments, the laser treatment is performed after other treatments during a dental visit. For example, in some cases, dental laser treatment is performed only after one or more of plaque and tartar removal (using one or more manual instruments), professional dental floss, and electric polishing (i.e., preventative dental care)

[1914] . In some cases, this sequence of steps is considered advantageous because the laser treatment only cleans the outer layer of enamel (e.g., 2 μm thick), and some teeth cleaning treatments can remove a portion of the enamel (e.g., electric polishing), potentially removing the freshly cleaned enamel. According to one embodiment, additional steps are taken for preventative dental care after dental laser treatment has already been performed

[1900] .

[0208] Next, at least a portion of the surface of the tooth hard tissue 1916 is treated with dental fluoride. In one embodiment, the dental fluoride treatment agent is in the form of a gel, varnish, paste, or foam. In one embodiment, the dental fluoride treatment dose includes at least one of sodium fluoride, stannous fluoride, titanium tetrafluoride, acidified phosphate fluoride, and fluorinated ammonium. In an exemplary embodiment, the fluoride dose is in the form of a varnish and is applied to a portion of the tooth hard tissue surface using an applicator. In some embodiments, the application of the dental fluoride dose 1916 is performed after dental laser treatment. In some cases, this sequence is considered advantageous because plaque, films, and biofilms are substantially removed from the surface of the tooth hard tissue during laser treatment.

[0209] The future verification of machine-readable codes is blocked. This is achieved, for example, by making machine-readable codes unreadable (e.g., by covering a single-wire chip or RFID authentication tag). In another example, machine-readable codes are indicated as invalid (e.g., on a list or ledger). In some cases, RFID authentication tags and / or single-wire authentication chips are too expensive to represent a single use of the system, and barcodes (e.g., printed on paper or film) are used to represent a person's coupons or more treatments. This significantly reduces the cost of manufacturing coupons but also adds new difficulties to authentication.

[0210] Many systems and methods can be used to verify valid coupons and reject invalid coupons. Many exemplary subsystems are described in the following paragraphs to aid in the implementation of this invention. Figure 1 An exemplary coupon verification system and method are illustrated in Figure 19B. In this case, the coupon issuer 1920 issues a coupon 1922 and generates a machine-readable code. The coupon issuer 1920 uses a coupon identifier number (CPID) and an encryption key 1926 (e.g., a private key) to generate a digital signature representing the coupon 328. In an exemplary embodiment, the CPID 1924 includes a digest and is generated by the coupon issuer from the message using a cryptographic hash algorithm (e.g., SHA-3) or a pseudo-random number generation algorithm. In some embodiments, the CPID 1924 is recorded and grouped by manufacturing batch, box, or packaging serial number. The coupon (digital signature) 1928 is then encoded into a machine-readable code (e.g., barcode, RFID, magnetic stripe, digital signature, etc.) and the machine-readable code is isolated (e.g., packaged with disposable fluoride) and finally distributed to a processing system.

[0211] refer to Figure 1 An exemplary coupon reading and decryption system is described.

[0212] 19C. The machine-readable code 1922 is ultimately read by the reader 1930. An encryption key 1932 (e.g., a public key or a symmetric key) is used to decrypt the machine-readable code (e.g., using decryption system 1933), generating a CPID 1924. The CPID 1924 can then be verified. For example, in a simple case, the CPID 1924 is generated using an algorithm (e.g., SHA-2 or SHA-3) replicated on the treatment system; and the verification system 1934 verifies the authenticity of the CPID 1924 by checking the consistency between the CPID and the algorithm. In some embodiments, the verification system 1934 uses one or more permissions to verify the validity of the CPID 1924.

[0213] Referring to Figure 19, coupon authorization 1940 is depicted. 19D. In the simplest case, the coupon management authority only tracks the coupon identification number 1924 and the coupon validity 1942. In one embodiment, the coupon management authority 1940 also tracks additional information 1950. The coupon management authority 1940 is, in some cases, local 1800 to the verification system 1836 within the treatment system. Alternatively, the coupon authorization 1940 is remote. In some cases, the coupon management authority is decentralized, and the local coupon management authority 1940 resides within the processing system. In some cases, coupon authorization only tracks used (invalid) coupons. In one embodiment, coupon verification includes querying the coupon management authority 1940.

[0214] In another exemplary embodiment, coupons are distributed electronically using a system such as Bitcoin. In this system, the coupon inventory held by each individual processing system is tracked by a decentralized ledger system (e.g., blockchain). In this case, coupon verification includes transferring the coupon (e.g., to a distributor, coupon issuer, designated coupon collector, or invalid) and verifying whether the transfer is recorded in one or more ledgers. In some cases, the transmission includes broadcasting a digital signature (e.g., encrypted with a private key associated with the treatment system 1800) containing a message about the transmission. In some cases, the message also includes additional information. Exemplary additional information includes the treatment date and time, the total energy (lifetime) consumed by the laser system, the total energy (lifetime) generated by the laser system, data associated with machine-readable code, and, in some exemplary embodiments, the coupons are in digital form and distributed electronically.

[0215] According to one embodiment, machine-readable code 1714 is included in a consumable (e.g., single-use) head accessory. See figure. Figure 20AThe illustration shows a view of a dental laser head 2010 with an attachable tip 2012 attached. In some cases, the attachment 2012 is provided in a sealed package with a single-use fluoride dose. Figure 2 shows the attachment 2012 and the handpiece 2010. Figure 20A As shown in the cross-sectional view of Figure 20. 20B. Within the handheld component 2010, a focusing optics 2014 is positioned to converge a laser beam. Opposite to the focusing optics 2014, a reflector 2016 is positioned within the attachment 2012. The reflector 2016 has a high reflectivity (e.g., at least up to 50%) at the wavelength of the laser beam. The reflector 2016 is positioned to reflect the converged laser beam out of an aperture 417 within the attachment 2012. In some cases, the attachment is made of an injection-molded polymer. In some embodiments, the reflector 2016 is coated on the surface of the attachment 2012. Alternatively, the reflector 2016 includes a substrate separate from the attachment 2016. Exemplary coatings of the reflector 2016 include a broadband coating (e.g., silver, protected silver and gold) and a dielectric coating. Attachment 2012, in Figure 1 And in some exemplary embodiments shown in Figure 2. As... Figure 20A As shown in Figure -B, a tilting helical spring 2018 (e.g., Bal-Seal from Foothill Ranch, California, USA) is used to attach it to the handheld device 2010. In some cases, the tilting helical spring 2018 may also provide an electrical connection between a single-wire authentication chip 2020 storing machine-readable code and an electrical connection in the handheld device 2022, which ultimately connects to a processor system in laser therapy. An exemplary single-wire authentication chip is part number DS28C50 from Maxim Integrated, San Jose, California, USA. Figure 20A -B helps guide the laser beam within the oral cavity by reflecting the laser beam. In other embodiments, a consumable accessory that does not reflect the laser beam is provided.

[0216] Now refer to the diagram. Figure 21A In one embodiment, the handpiece 2110 is shown with a consumable sheath 2112 attached. The consumable sheath 2112 allows for intraoral use without sterilizing the handpiece 2110 between patients. This is because only the sheath 2112 (during normal use) comes into contact with the patient. Therefore, a new sheath is used for each patient (and thus for each new treatment). See figure. Figure 21B A cross-sectional view of the handheld component 2110 and the sheath 2112 of Figure 21 is shown. 21A. A focusing optics 2114 is positioned within the handheld component 2110. The focusing optics 2114 is configured to converge the laser beam. The lower beam opposite the focusing optics 2114 is a reflector 2116. Figure 20AIn -B, reflector 2116 is not part of consumable accessory (shelter) 2112. Instead, reflector 2116 is an integrated component of handpiece 2110. In some cases, reflector 2116 is a separate part of handpiece 2110, thus removable for maintenance. However, in such cases, reflector 2116 is not intended to be removed with each treatment. The reflector is configured to reflect the converging laser beam out of aperture 2117 within sheath 2112. In some embodiments, sheath 2112 is attached to... Figure 1 The handheld device in the middle. Figure 21B By means of a snap-on feature (not shown). Alternative attachments for the sheath and consumables are also envisioned, such as fasteners, threads, clips, magnets, and O-rings. In some embodiments, the sheath 2116 includes a single-wire authentication chip 2118. This chip includes a machine-readable code. The handheld component 2110 includes a spring-loaded pin 2120 configured to form an electrical contact between the chip 2118 and an electrical connection 2122 within the handheld component 2110. The electrical connection within the handheld component communicates with a processor in the laser treatment system that verifies the machine-readable code. In another exemplary embodiment, the sheath includes a machine-readable code in a different medium, such as a barcode, a 2D barcode, or an RFID tag.

[0217] To assist in implementing the claimed invention and selecting parameters, the following table provides exemplary ranges and nominal values ​​for the relevant parameters.

[0218]

[0219]

[0220] As shown in the figure. Figure 22A block diagram 2200 illustrates a hardware configuration according to one exemplary embodiment. The hardware includes a single-board computer (SBC) 2210 (e.g., a Raspberry Pi Compute Module 4 Lite configured with a quad-core ARM Cortex-A72 processor). Some versions of the SBC 2210 run a Linux operating system. The software of the SBC 2210, including the operating system, is stored in some cases on external Write-Once-Many (WORM) memory 2211 (e.g., a Flexxon 32GB microSD WORM). WORM 2211 storage allows data to be stored in memory without the risk of erasure. In some embodiments, a barcode reader 2212 is connected to the SBC and configured to read barcodes, such as high-capacity 2D (HC2D) barcodes. In some exemplary versions, the barcode reader 2212 includes a digital camera and a illuminator that capture barcode images together. In some versions, the camera and illuminator capture is triggered by a user interface button, which is hardwired to the GPIO digital input of the SBC 2210. An exemplary camera is a SONY IMX219 sensor, which can be connected to a dedicated standard CSI interface of the SBC2210. The SBC2210 communicates with a laser controller 2214, such as an HALaser E1701A. In some embodiments, the SBC communicates with the laser controller 2214 via an Ethernet connection. The laser controller 2214 directly controls the laser therapy system 2216 and the treatment parameters required for successful treatment. A user interface 2218, such as a foot switch, also communicates with the laser controller 2216 and allows clinicians to perform laser therapy.

[0221] The hardware configuration described in block diagram 2200 can be used to (1) read coupons; (2) decode and verify coupons; and (3) perform preventative laser treatment. First, (1) read the coupons. In some cases, the coupons will include a two-dimensional barcode adorning a consumable component, and reading the barcode will involve using dedicated barcode reader hardware 2212 located inside the device. In some cases, the barcode reading hardware will include a camera and a illuminator. High-capacity two-dimensional (2D) (HC2D) barcodes (e.g., QR codes or the like) can be used to maximize the amount of information contained within the barcode. Once the coupon has been read, it is time to (2) decode and verify the coupon. Each individual coupon can only be used once, therefore, in some versions, the early usage of previous coupons is recorded and compared with each new coupon. Furthermore, the authenticity and validity of each coupon must be carefully examined. In some exemplary embodiments, each coupon includes a digital signature. The source of the digital signature is decrypted using a key (e.g., a public key), and the authenticity (i.e., known source and immutability) of the decrypted message is verified, for example, by a one-way hash algorithm. Once the message is successfully decrypted and verified using the HASH algorithm, the coupon is considered valid (i.e., it truly represents one laser treatment). In some versions, the message is then compared to an enumerated list of previously used messages to prevent double-spending. In some versions, a Write-once-Read-Many (WORM) memory 2211 is used to store an enumerated list of coupon messages representing used coupons. Once the coupon is verified and used (e.g., the message is saved to the WORM memory), laser treatment is authorized. Then, (3) the SBC 2210 allows the user to perform laser treatment, for example by sending laser control parameters to the laser controller board 2214, which operates the laser system during treatment. Without these laser control parameters, the laser controller board 2214 cannot operate the laser system 2216 and cannot perform treatment.

[0222] As shown in the figure. Figure 23A flowchart 2300 describing a coupon authentication method according to some embodiments is shown. First, a machine-readable code is acquired 2310. For example, in some exemplary cases, a barcode is scanned. Then, the machine-readable data is decrypted 2312 using a key. In some embodiments, the key is an asymmetric key (e.g., a public key). By being able to decrypt data from the barcode using a specific public key, the controller can ensure that the decrypted content comes from a specific source possessing the private key. In this case, an authorized coupon issuer will generate and encrypt the coupon using the private key. If the coupon is decrypted using the public key of the authorized coupon issuer's private key, it is assumed that the coupon was encrypted by the authorized coupon issuer. In some embodiments, the decrypted content will contain a message and a digest. In some cases, the message contains the coupon code, and the digest is the value of the message when run through a hash algorithm. The decrypted message is then run through a specified hash algorithm. The output of the hash algorithm is then compared with the decrypted digest 2314. If they are equal, the coupon may not have been altered because it was encrypted by the authorized coupon issuer. The now-verified message (e.g., the coupon code) is then searched for on a write-once-read-many (WORM) memory storage 2316. In some embodiments, the WORM is configured to store each "used" coupon code. Therefore, if a coupon code is in the WORM, it has been used. If the currently verified coupon code is not in the WORM, the coupon code will be written to WORM 2318, and the laser system will be verified for treatment 2320.

[0223] Now refer to the diagram. Figure 24 The diagram illustrates a system 2400 for verifying laser treatment specimens according to one embodiment. System 2400 may include a processor 2420, a memory 2430, a user interface 2440, a network interface 2450, and a memory 2460, all interconnected via one or more system buses 2462. Figure 24 It constitutes an abstraction in some respects, and the actual organization of the system 2400 and its components may differ from those shown.

[0224] Processor 2420 may be any hardware device capable of executing instructions stored in memory 2430 and / or memory 2460, or may be any hardware device capable of processing data. Therefore, processor 2420 may include a microprocessor, a field-programmable gate array (FPGA), an application-specific integrated circuit (ASIC), or other similar device.

[0225] Memory 2430 may include various transient memories, such as L1, L2, or L3 caches or system memory. Therefore, memory 2430 may include static random access memory (SRAM), dynamic RAM (DRAM), flash memory, read-only memory (ROM), or other similar memory devices and configurations.

[0226] User interface 2440 may include one or more devices for communicating with system operators and other personnel. For example, user interface 2440 may include a display, mouse, and keyboard for receiving user commands. In some embodiments, user interface 2440 may include a graphical user interface. User interface 2440 may execute on a user device such as a PC, laptop, tablet, mobile device, etc.

[0227] Network interface 2450 may include one or more devices for enabling communication with other remote devices. Network interface 2450 may also allow downloading updates to software applications or known "used" coupon identifiers. For example, network interface 2450 may include a network interface card (NIC) configured to communicate according to the Ethernet protocol. Additionally, network interface 2450 may implement a TCP / IP stack for communication according to the TCP / IP protocol. Various alternative or additional hardware or configurations for network interface 2450 will be readily apparent.

[0228] Memory 2460 may include one or more machine-readable storage media, such as read-only memory (ROM), random access memory (RAM), disk storage media, optical storage media, flash memory devices, write-once-read-many (WORM) memory, or similar storage media. In various embodiments, memory 2460 may store instructions that are executed by processor 2420 or data that processor 2420 can operate on.

[0229] For example, memory 2460 may include instructions to read machine-readable code 270; verify machine-readable code 2472; and perform laser treatment 2474. Instructions for performing laser treatment may include: generating a laser beam using a laser device; directing the laser beam towards the hard tissue of the tooth using an optical device; and controlling the parameters of the laser beam using a laser controller to heat at least a portion of the surface of the hard tissue of the tooth to a temperature above 400 degrees Celsius.

[0230] Instructions may also include measures to prevent future verification of machine-readable code. Instructions for preventing future verification of machine-readable code may include broadcasting to the ledger, submitting to coupon authorization, destroying machine-readable code, writing to write-once-read-many (WORM) memory, and overwriting one or more machine-readable codes.

[0231] Instructions used to verify machine-readable code 2472 may include one or more of the following: querying the ledger, broadcasting to the ledger, decrypting machine-readable code, identifying a digest within machine-readable code, querying write-once-read-many (WORM) memory, and querying coupon permissions.

[0232] The instruction may additionally include measuring laser variables during laser treatment. Laser variables may include one or more of the following: the duration of laser treatment, the electrical energy delivered to the laser source during laser treatment, and a relative measure of the laser energy generated by the laser source during laser treatment.

[0233] The methods, systems, and apparatus discussed above are examples. Various configurations may appropriately omit, substitute, or add various procedures or components. For example, in alternative configurations, the methods may be performed in a different order than described, and various steps may be added, omitted, or combined. For example, in some embodiments, the fluoride treatment is omitted after the laser treatment. Furthermore, the features described with respect to certain configurations may be combined in various other configurations. Different aspects and elements of the configurations may be combined in a similar manner. Moreover, technology is constantly evolving, therefore, many elements are examples and do not limit the scope of this disclosure or the claims.

[0234] For example, embodiments of the present disclosure have been described above with reference to block diagrams and / or operational descriptions of methods, systems, and computer program products according to embodiments of the present disclosure. Functions / actions noted in the boxes may exhibit any incorrect order as shown in the flowcharts. For example, depending on the functions / actions involved, two blocks shown consecutively may actually be executed substantially simultaneously, or these blocks may sometimes be executed in reverse order. Additionally or alternatively, not all blocks shown in any flowchart need to be executed and / or performed. For example, if a given flowchart has five blocks containing functions / actions, it is possible that only three of the five blocks are executed and / or performed. In this example, any one of the three blocks out of the five may be executed and / or performed.

[0235] A statement that a value exceeds (or is greater than) a first threshold is equivalent to a statement that a value reaches or exceeds a second threshold that is slightly larger than the first threshold, for example, the second threshold being a value higher than the first threshold in the relevant system resolution. A statement that a value is less than (or equal to) the first threshold is equivalent to a statement that the value is less than or equal to a second threshold that is slightly lower than the first threshold (e.g., the second threshold) and the value is one value lower than the first threshold in the relevant system resolution.

[0236] Specific details are provided in the description to offer a thorough understanding of the example configuration (including its implementation). However, the configuration can be implemented without these specific details. For example, well-known circuits, processes, algorithms, structures, and techniques have been shown without unnecessary detail to avoid obscuring the configuration. This description provides only an example configuration and does not limit the scope, applicability, or configuration of the claims. Rather, the foregoing description of the configuration will provide those skilled in the art with an enabling description for implementing the described techniques. Various changes can be made to the function and arrangement of the elements without departing from the spirit or scope of this disclosure.

[0237] Several example configurations have been described, and various modifications, alternative constructs, and equivalents may be used without departing from the spirit of this disclosure. For example, the foregoing elements may be components of a larger system, where other rules may take precedence over or otherwise modify the application of various implementations or technologies of this disclosure. Furthermore, multiple steps may be taken before, during, or after considering the foregoing elements.

[0238] Since the description and illustrations of this application have been provided, those skilled in the art can conceive of variations, modifications and alternative embodiments falling within the overall inventive concept discussed in this application without departing from the scope of the appended claims.

Claims

1. A system for preventative dental treatment, comprising: A laser device configured to generate a laser beam, characterized in that the laser beam has a transverse annular pattern, the laser device further comprising a beam shaper configured to shape the laser beam into the transverse annular pattern, the beam shaper comprising one or more of an axial prism, a spatial filter, a deformable mirror, and an annular slit; a focusing optics configured to converge a laser beam having a numerical aperture of less than 0.1 to a focusing region; a handheld device configured to guide the laser beam to the surface of dental hard tissue; and... A controller configured to control one or more parameters of a laser beam, such that a portion of the hard tissue surface of the tooth is heated to a temperature ranging from 400°C to 1300°C.

2. The system according to claim 1, characterized in that, The handheld device also includes a steering mirror positioned below the focusing optics and configured to reflect the laser beam toward the tooth hard tissue.

3. The system according to claim 1, characterized in that, The laser beam has a wavelength in one or more of a first range of 200 to 500 nm and a second range of 4,000 to 12,000 nm.

4. The system according to claim 1, characterized in that, The laser device also includes one or more of an intracavity polarization generator and a polarization converter.

5. The system according to claim 4, characterized in that, The laser beam has one or more polarizations, including circular, radial, tangential, and azimuth polarizations.

6. The system according to claim 1, characterized in that, The laser beam's one or more parameters include one or more of the following: repetition rate, pulse energy, pulse duration, average power, peak power, and wavelength.

7. The system according to claim 1, characterized in that, It also includes a beam scanning system configured to scan the focused area on a portion of the surface of the tooth hard tissue.

8. The system according to claim 1, characterized in that, The inner diameter of the transverse annular pattern is less than or equal to 50% of its outer diameter.

9. The system according to claim 1, characterized in that, The lateral ring mode is a lateral electromagnetic (TEM) 01* mode.

10. The system according to claim 1, characterized in that, The focusing optics has a focal length greater than 100 mm.

11. The system according to claim 1, characterized in that, The laser device includes a laser source with an intracavitary device configured to generate the transverse ring pattern.

12. The system according to claim 1, characterized in that, The laser device includes a laser source having an intracavity device configured to control the power of the laser beam.

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