Application nozzle for cleaning an implant part, in particular for use in a system for cleaning a component contaminated with biofilm, in particular an implant part

Abstract

The invention relates to an application nozzle (20, 56, 56', 56'') for applying an active dental substance in the oral cavity of a patient, in particular for a system (1, 1') for cleaning an implant part (2) contaminated with biofilm. According to the invention, the application nozzle comprises a main body or nozzle body (30, 72), into which at least one media channel (32, 76) is integrated for supplying a cleaning electrolyte from the connection region (26, 80) to the treatment end (28, 82), and a number of electrical conductor elements (34, 36, 84, 86) are integrated, wherein the main body or nozzle body (30, 72) is designed as a main body or nozzle body (30, 72) which extends out, in a planar manner, in a longitudinal direction from a connection region (26, 80) to a free treatment end (28, 82) and of which the cross section tapers towards the treatment end (28, 82).

Description

[0001] Description

[0002] Application nozzle for cleaning an implant part, in particular for use in a system for cleaning a biofilm-contaminated

[0003] component, in particular an implant part

[0004] The invention relates to an application nozzle for dispensing a dental agent into a patient's oral cavity for cleaning an inserted dental implant. It further relates to a system for cleaning a component contaminated with biofilm, in particular an implant component, using such an application nozzle.

[0005] From WO 2014 / 075755 A1 , WO 2014 / 122187 A1 , WO 2014 / 122188 A1 , WO 2016 / 023998 A1 and WO 2021 / 018871 A1 , the disclosures of which are incorporated by reference in their entirety, a treatment element, in particular for use with an implant part, and a method for cleaning a dental implant part are known. Such cleaning of an implant part may be desirable or necessary to ensure the preservation of the inserted implant in the bone substance. A biofilm containing bacteria that can ultimately lead to chronic and recurring infections can form on the solid surface of implants, which is surrounded by tissue and tissue fluid. This clinical picture is referred to as peri-implantitis.Particularly in the dental field, similar to periodontitis, a combination of neglected oral hygiene, adhesion of biofilm to the typically micro-rough surface of the dental implant, and other factors are responsible for the full-blown development of peri-implantitis, which is characterized by increasing stress and destruction of the hard and soft tissue. The areas where the hard and / or soft tissue recede are usually covered with a biofilm.

[0006] The cleaning process described in the cited publications is based on the concept of killing and removing the contaminating biofilm or germs from the implant surface without damaging the implant surface. This involves an electrolytic process in which ions (cations and / or anions) are transported through the biofilm using electrostatic forces. These ions react chemically or electrochemically at the implant surface. These reactions create new compounds and / or convert the ions themselves and / or parts of these ions into the atomic state. Furthermore, there is the possibility that the ions may react with the surface material (e.g., forming an oxide layer or removing material).This process not only kills germs due to the chemical substances formed, but also causes the formation of gas bubbles that mechanically remove the biofilm. This effect, which provides both a chemical and a mechanical component, can be the most important component in biofilm removal, as the biofilm, due to its complex properties and the bond formed, can be comparatively resistant to chemical or biological influences. However, the mechanical lifting effect of the gas bubbles formed breaks up the bond, making the biofilm components accessible again to chemical or biological influences.

[0007] The germicidal effect of this process is based on various effects. Firstly, by applying an electrical voltage, ions from the biofilm itself (including from the bacteria) are transported to the anode or cathode. This can lead to the killing of bacteria and viruses. Furthermore, the ions can undergo biochemical reactions as they pass through the biofilm, which can also lead to the killing of bacteria and / or viruses. Another possible killing effect is that the newly formed chemical compounds on the implant surface have antibacterial, antiviral, and / or antifungal effects. This can, of course, also occur when the ions transform into the atomic state.

[0008] The treatment element described in the aforementioned applications is specifically designed to perform this cleaning process directly on the inserted dental implant, preferably while the post is in the bone in the patient's mouth. For this purpose, the treatment element is intended to be connected directly to the inserted post and then to apply a suitable treatment fluid, which, when exposed to an electrical current, can serve as the basis for the desired electrolytic process, in the immediate vicinity of the inserted post into the affected area of ​​the adjacent bone substance and to apply the electrical current. Therefore, the use of this treatment element requires the establishment of both mechanical and electrical contact with the inserted post.For this purpose, with the design of the treatment element described in the aforementioned application, the prosthetics on the dental implant and, if necessary, its abutment must generally be temporarily removed for the purpose of securing it to the post. The performance of such a procedure is therefore primarily considered therapeutic in the sense that inflammation in the oral area near the implant is already present, and an existing biofilm must be detached and removed. The measures required for treatment are accordingly extensive.

[0009] Furthermore, there is now also the desire or need to make the described treatment concept, i.e. the combined application of electrical current and an electrolytic cleaning fluid to the affected implant, also usable for preventative or prophylactic treatments. In contrast to therapeutic treatment, which can be associated with corresponding expenditure, the treatment concept should be designed to be particularly flexible and implementable with little expenditure. The invention is therefore based on the object of specifying an application nozzle for a treatment system of the above-mentioned type, with which the application of the aforementioned treatment concept is also enabled for prophylaxis in a particularly simple and cost-effective manner. Furthermore, a treatment system particularly suitable for use with the application nozzle should be specified.

[0010] With regard to the application nozzle, this object is achieved according to the invention with a nozzle body into which at least one media channel for supplying a cleaning electrolyte from the connection area to the treatment end and a number of electrical conductor elements are integrated, on the one hand, wherein the nozzle body is designed as a body extending flatly in a longitudinal direction from a connection area to a free treatment end and tapering in its cross section towards the treatment end.

[0011] Advantageous embodiments of the invention are the subject of the dependent claims. Further and / or alternative advantageous embodiments of the invention, as well as further embodiments considered independent inventions, are also apparent from the description of the figures.

[0012] The invention is based on the consideration that, especially when using the aforementioned treatment concept in prophylaxis, particularly simple handling of the system components is desirable. On the other hand, with such an application, treatment should be possible without further interventions in the substance, for example the temporary dismantling of the prosthesis or the like. According to the invention, it is therefore assumed that the treatment takes place as part of a regular dental examination or prophylactic treatment, during which the inserted implant - without prior dismantling of the prosthesis or the like - is to be treated and contacted in the area of ​​its anchorage in the bone. Access to the implant surface to be treated should therefore essentially be via the periodontal pockets associated with the implant, in which the causative bacteria would accumulate in an increasing number anyway in the event of an impending inflammation.The application nozzle should therefore be designed with a correspondingly compact construction for good usability within the respective periodontal pockets and / or between the implant and the adjacent tooth.

[0013] To accommodate this, one aspect of the invention provides for the design of the application nozzle or treatment head as a substantially flat component. This does not mean that the treatment head could or should be designed two-dimensionally; rather, it should be understood that the application nozzle, or the nozzle body forming it, should be a body extending substantially along a basal plane or base plane, while still exhibiting a certain thickness in the third spatial direction. Viewed in cross-section, however, this also means that the lateral extent of the nozzle body in the basal plane is significantly greater than the thickness in the direction perpendicular to it.In terms of application, this means that the free or treatment end of this nozzle body can be inserted comparatively easily into the aforementioned dental pockets by, for example, aligning the basal plane of the nozzle body essentially parallel to the outer surface of the implant.

[0014] Furthermore, the nozzle body should taper in its cross-section toward the treatment end. The free or treatment end of the nozzle body thus essentially has a flat, relatively narrow, or even tapered contour, making it particularly easy to insert into the periodontal pockets.

[0015] According to one aspect of the invention, the conductor element(s) is / are positioned in or on one of the media channels in such a way that they are wetted by the cleaning electrolyte flowing in the respective media channel. This ensures reliable electrical contact and thus the desired process control as described above. In order to enable the application of even comparatively larger quantities of cleaning electrolyte into the periodontal pocket with a particularly compact design, and in particular to be able to flood it if necessary, the nozzle body should also be provided with a plurality of outflow openings in an outflow area arranged near the end of the treatment, which can be used jointly to apply the electrolyte.For this purpose, according to one aspect of the invention, a branching media channel is integrated into the nozzle body, which opens into a plurality of application openings on the outlet side, so that these can be supplied with electrolyte via a common supply. Alternatively, several media channels can be present on the inlet side, which transport the same medium or are connected to the same media container, or to different media containers, all of which contain virtually the same or the same medium.

[0016] In plan view, the nozzle body can in particular have a contour shaped like a triangle.

[0017] In an advantageous development, several of the outlet openings are arranged in an outflow direction aligned laterally with the longitudinal axis. This allows the entire space in the periodontal pocket around the free or treatment end of the nozzle body to be easily flooded with cleaning electrolyte.

[0018] This allows the electrolyte to be applied in a targeted manner in the area of ​​the free or treatment end of the treatment head or the application nozzle, particularly enabling precise introduction into the periodontal pocket.

[0019] According to one aspect of the invention, the application nozzle can generally be used as a treatment head in a system for cleaning a component contaminated with biofilm or can be intended for this use.

[0020] In order to enable the production of an enormous number of such application nozzles and thus mass production, with regard to the intended use of the application nozzles in the dental care and prophylaxis sector, a particularly suitable design is advantageously selected, which allows the provision of a functionally reliable application concept even when using comparatively inexpensive materials. To accommodate this, a film material is advantageously provided as the base material for the production of the nozzle body. This film material can be constructed by laminating a plurality of film layers on top of one another to form a suitable composite body.The base body or nozzle body, in which the media channels opening into the respective application opening on the outlet side are arranged, is thus formed in this advantageous embodiment, which is considered to be independently inventive, from a layered body constructed as a laminate from a plurality of film pieces.

[0021] The media transport channels provided for transporting the electrolyte to the designated discharge point in this composite body, which each open into the application openings of the composite body on the output side, can be provided by recesses made in the respective foil. The use of a foil-based technology with subsequent lamination enables enormous flexibility in the design and installation of such media channels, since the required free spaces or empty spaces within the composite body can be created in a variety of ways and with a wide variety of geometries through suitable shaping in the respective foil, for example, by the particularly preferred punching or laser cutting.The media channels can be manufactured, in particular, through the planned use of lamination technology, for example, by producing a central film with corresponding cutouts and then laminating it together with a continuous film on the top and bottom sides to form a composite body, similar to a film sandwich. This allows the media distribution in the individual channels to be controlled very precisely through their spatial design.

[0022] Polyamide is advantageously provided as the base material for the films or film pieces; alternatively, however, another suitable film material such as PVC, PP or PE or even a combination of different film materials can also be considered advantageous. According to one aspect of the invention, the material is selected in particular with regard to the fact that the application nozzle is also intended for use by trained medical personnel, for example in connection with treatment by a dentist. The film material is particularly preferably selected with regard to its material properties, in particular its stiffness or strength, such that the stiffness of the laminate or composite body formed from the film pieces is not too great and injuries in the oral cavity are thus largely ruled out.

[0023] In a particularly advantageous embodiment, considered to be independently inventive, the nozzle body is constructed from at least three film layers that differ in their material properties and are functionally adapted to different requirements. In particular, according to one aspect of the invention, a central film layer arranged between two adjacent film layers can be formed entirely or partially from a harder film material, i.e., in particular, with a different Shore hardness or modulus of elasticity, than the two adjacent film layers. Thus, the central film layer orone of the film pieces forming it can determine the contour or spatial shape of the nozzle body in the manner of a support structure, whereas the comparatively softer outer film layers can be designed to be flexible and deformable and thus significantly reduce the risk of injury in the event of contact, for example, of the oral mucosa with the nozzle body.

[0024] According to one aspect of the invention, the media channels are formed by the respective recess in a middle or inner film, which is laterally delimited by the respective side edges of the adjacent film pieces.

[0025] The respective media channel is then delimited on the top and bottom by the correspondingly laminated, continuous base or cover foil. In order to be able to safely and reliably provide comparatively large free cross-sections of the respective media channels, suitable for the passage of even larger quantities of electrolyte, with correspondingly wide recesses in the middle or central foil, in an advantageous embodiment considered to be independently inventive, several of the media channels are provided with integrated spacers.

[0026] In a particularly advantageous embodiment, which is also regarded as independently inventive, the application nozzle is also designed, with regard to its geometric design and dimensions, for the intended use for the precise introduction of electrolytes into the oral area of ​​a patient. In this case, it is advantageously taken into account in particular that application could also be provided into the interdental spaces or the periodontal pockets of the patient. According to one aspect of the invention, an application nozzle designed particularly suitably for this purpose has a nozzle body constructed as a laminate from the film pieces with a total thickness of 0.3 - 2 mm, preferably 0.5 - 1.5 mm, particularly preferably 0.7 - 1.2 mm. Correspondingly, the film pieces forming the laminate advantageously each have a film thickness of 50 - 500 μm, preferably 80 - 350 μm, particularly preferably 100 - 250 μm.

[0027] In an advantageous further development, the application nozzle according to the type described above is designed as a disposable or single-use product and is therefore intended for single use only.

[0028] According to one aspect of the invention, the application nozzle is provided with electrical conductor elements to reliably adjust the current flow intended for the aforementioned treatment concept. Firstly, the current flow is established via the cleaning electrolyte conveyed in the media channels so that the basic processes can be initiated. To ensure this, according to one aspect of the invention, a number of conductor elements assigned to a first electrical polarity are integrated into the nozzle body and positioned in or on one of the media channels in such a way that the respective conductor element is wetted by the cleaning electrolyte flowing in the respective media channel.In the particularly preferred media-side parallel connection of two or more media channels, which can be connected on the inlet side via a branching point arranged in the nozzle body or via a distribution system arranged upstream of the nozzle body to a common electrolyte container or to a plurality of functionally interconnected electrolyte containers, one such conductor element assigned to the first polarity is preferably arranged in at least two of these media channels. According to this aspect of the invention, at least two of the conductor elements assigned to the first electrical polarity are thus integrated into the nozzle body.

[0029] Furthermore, direct electrical contact with the implant is important for the intended mode of action during implant treatment. This should also be achieved via the application nozzle, since, unlike the concepts described above, disassembly of the prosthesis is not provided for in this case, and thus electrical contact with the implant via its interior or the area exposed at the top is not possible. To nevertheless enable reliable direct electrical contact with the implant, according to one aspect of the invention, a conductor element associated with a second electrical polarity is integrated into the nozzle body. This conductor element, viewed in the longitudinal direction, projects beyond the treatment end formed by the nozzle body.This conductor element is thus exposed at its end and can therefore be brought into direct contact with an exposed outer surface of the implant, for example, within the periodontal pocket, and thus into electrical contact. This serves as the electrical counterpole to the conductor elements described above, allowing the current flow to be adjusted by connecting a suitable current or voltage source.

[0030] In a particularly preferred embodiment, the treatment head is designed as a single-use or disposable product. This can be achieved, for example, by destroying the treatment head after use, i.e., after removal from the other components of the treatment system used, or otherwise rendering it unusable. According to an aspect considered to be independently inventive, the application nozzle is used in a system for cleaning a component contaminated with biofilm, in particular an implant component.

[0031] With regard to the system for cleaning a component contaminated with biofilm, in particular an implant part, with such an application nozzle, the above-mentioned object is achieved with a handle which is provided with a number of electrical and media connections in such a way that both the electrical conductor elements and the media channels of the application nozzle can be connected to corresponding electrical or media supply lines in the handle.

[0032] In a particularly advantageous embodiment, the treatment system is designed as a mobile device, eliminating the need for fixed connections to external peripherals. For this purpose, a replaceable reservoir for cleaning electrolyte is advantageously arranged in the handle.

[0033] The advantages achieved by the invention are, in particular, that the design of the nozzle body as a flat component tapering towards the free end allows the intended treatment of the inserted implant to take place via the associated pocket, to which access is provided via the aforementioned spatial shape. Major preparatory measures for carrying out the treatment, such as dismantling the prosthesis, can therefore be omitted. Furthermore, the media channel integrated into the nozzle body, which branches off there, enables a particularly simple, uniform and space-filling application of the electrolyte via the majority of downstream application openings, particularly suitable for reliably applying the electrolyte to the entire periodontal pocket.

[0034] An embodiment of the invention is explained in more detail with reference to a drawing. In the drawing:

[0035] FIG. 1 shows a dental implant inserted into the oral bone of a patient, FIG. 2 shows a schematic view of a mobile treatment system,

[0036] FIG. 3 shows a treatment head of the treatment system according to FIG. 2 in perspective view,

[0037] FIG. 4 shows the treatment head according to FIG. 3 in longitudinal section,

[0038] FIG. 5 shows a schematic diagram of a stationary treatment system,

[0039] FIG. 6 shows an application nozzle of the treatment system according to FIG. 5 in perspective view,

[0040] FIG. 7 shows the application nozzle according to FIG. 6 in cross section,

[0041] FIG. 8 shows a basal segment of the application nozzle in FIG. 6 in a perspective view in a sequence of manufacturing steps,

[0042] FIG. 9 shows a partial enlargement of the treatment area of ​​the active ingredient applicator, as shown in FIG. 8.

[0043] FIG. 10 shows a basal segment of the application nozzle according to FIG. 6 in an alternative design in a perspective view in a sequence of manufacturing steps,

[0044] FIG. 11 shows an alternative embodiment of an application nozzle of the treatment system according to FIG. 5 in perspective view,

[0045] FIG. 12 shows a basal segment of the application nozzle. FIG. 11 in a perspective view in a sequence of manufacturing steps,

[0046] FIG. 13 shows a further alternative embodiment of an application nozzle of the treatment system according to FIG. 5 in plan view, FIG. 14 shows an electrode region of the application nozzle according to FIG. 13 in plan view,

[0047] FIG. 15 shows a further alternative embodiment of an application nozzle of the treatment system according to FIG. 5 in a perspective view,

[0048] FIG. 16 shows a further alternative embodiment of an application nozzle of the treatment system according to FIG. 2 or 5 in a sequence of manufacturing steps,

[0049] FIG. 17 shows an enlarged view of a treatment end of the application nozzle according to FIG. 16,

[0050] FIG. 18 shows an enlarged view of the contact head of the application nozzle according to FIG. 16,

[0051] FIG. 19 shows a treatment head comprising the application nozzle according to FIG. 16 in partial section,

[0052] FIG. 20 shows the treatment head according to FIG. 19 in a side view,

[0053] FIG. 21 shows an enlarged alternative embodiment of the treatment end of the application nozzle according to FIG. 16,

[0054] FIG. 22 shows a contact plug for the treatment head according to FIG. 19 in perspective in front view, and

[0055] FIG. 23 shows the contact plug according to FIG. 22 in perspective view from the rear.

[0056] Identical parts are provided with the same reference numerals in all figures.

[0057] In general, dental implant systems, especially two-part implant systems, are subject to the problem that the penetration of bacteria or germs into the tissue near the insertion site, particularly in the area of ​​the external thread inserted into the jaw, can lead to inflammation or foci of inflammation. Such inflammation, particularly as a result of peri-implantitis, can lead to serious damage to the tissue and bone in the area of ​​the insertion site, especially if it develops and solidifies over a longer period of time. Without appropriate countermeasures, these damages can result in the entire implant system having to be removed from the bone. After bone augmentation, it must be re-fitted with an implant system or replaced with other prosthetics.This highly undesirable effect caused by peri-implantitis can lead to total loss of the implant system, necessitating further surgical interventions such as scraping out the affected area of ​​the jawbone and replacing it with a new implant system. Such removal can also result in bone loss or other tissue loss, which, in extreme cases, can lead to the point where a new implant is no longer possible. Such a need for replacement caused by peri-implantitis can also arise relatively long after the initial insertion of the implant system—for example, up to several years or even decades.

[0058] The germs or bacteria observed in connection with peri-implantitis can in principle colonize the interior of the implant components, but usually adhere preferentially directly to the surface of the dental implant inserted into the jawbone in the area of ​​contact with the surrounding tissue or bone material, i.e. particularly in the area of ​​the external thread. In this area, the surface of the dental implant can be roughened or similarly to particularly promote ingrowth into the tissue or bone and to support the healing of the dental implant after insertion. However, it is precisely in the area of ​​such a roughened surface, which is actually considered particularly beneficial for the implant system, that the colonization of germs or bacteria can occur more frequently, whereby the roughness makes targeted removal of the existing germs or bacteria even more difficult.

[0059] There is therefore an urgent need for suitable countermeasures to effectively combat the source of inflammation in the event of impending or already occurring peri-implantitis, while preserving the implant system in place, and to kill and / or remove the invading germs so that healthy tissue or healthy bone substance can subsequently form in the area around the external thread. To this end, it is desirable, in addition to specifically killing the germs or bacteria in the affected area, to also reliably remove their material residues and fragments from the affected space so that the affected area can subsequently be filled with healthy tissue or bone material, and a close connection can again form between the outer surface of the dental implant and the surrounding tissue or bone material.In addition, the biofilm formed by the bacterial coating, including the organic residues of killed bacteria, should be reliably removed.

[0060] To enable this, a treatment concept for cleaning a component contaminated with biofilm, in particular an implant part, is known from the publications WO 2014 / 075755 A1, WO 2014 / 122187 A1, WO 2014 / 122188 A1, WO 2016 / 023998 A1, and WO 2021 / 018871 A1, the disclosures of which are incorporated by reference in their entirety. In this treatment concept, the contaminated surface of the implant is wetted with an electrolytic cleaning fluid and subjected to a current flow. The combination of a suitably selected electrolyte and current application causes, among other things, gas bubbles to form directly on the implant surface, which blast off any adhering biofilm and thus contribute to cleaning the surface. A continuous supply of the electrolyte rinses the area to be cleaned (e.g. the pocket) and thus removes the dissolved congregations.In contrast to the publications cited above, however, the primary objective here is not therapeutic treatment of peri-implantitis or tissue inflammation that has already occurred, but rather prophylactic treatment, in which the onset of inflammation or its further spread is prevented within the framework of a standardized, preventative treatment. This can, for example, prevent existing mucositis from developing into peri-implantitis.

[0061] The use of a treatment system 1 intended for this purpose is shown schematically in FIG. 1. This shows a dental implant 2 inserted into the oral bone of a patient. For clarification, FIG. 1 shows a so-called dental pocket 8 adjacent to the dental implant 2 in the area of ​​its external thread 4 and the jawbone 6, which usually forms in the form of an increasingly widening gap between the tooth substance or the jawbone 6 and the surrounding soft tissue 10. Bacteria tend to accumulate in such a pocket 8, which can lead to later inflammation, in the case of healthy teeth in the form of periodontitis, and in the case of an inserted dental implant 2, to the aforementioned peri-implantitis.

[0062] The treatment system 1 is intended to counteract this in the form of prophylaxis and at an early stage, i.e. when bacterial infestation is imminent or already spreading or when a biofilm is forming. In terms of its mode of action, it is designed according to the concept of the aforementioned publications: On the one hand, it is designed to specifically kill the germs or bacteria present in the insertion area of ​​the dental implant 2 by specifically administering a bactericidal but human-compatible cleaning or disinfectant. On the other hand, it is designed to detach any residues or fragments of germs and / or bacteria that may already be adhering to the surface of the dental implant 2, particularly in the area of ​​the external thread 4, from the outer surface of the dental implant 2 by applying a suitable current or electric shocks, so that they can then be washed out.In a first embodiment, which is independently considered inventive both with regard to the design of the system and with regard to the intended method steps of the treatment method, the treatment system 1 is designed as a mobile system, as schematically illustrated in FIG. 2. The system 1 comprises a handle 12, which is provided with suitable reservoirs and storage elements with regard to the intended mode of operation, i.e., the application of both electrical current pulses and a suitably selected electrolytic cleaning fluid to the dental implant 2 in the region of the periodontal pocket 8. For this purpose, a suitable battery 14 (or any other suitable current or voltage source) and a storage container 16 for cleaning electrolyte are integrated into the handle 12.The storage container 16 is designed as a replaceable container, allowing for easy refilling after the contents have been used up. The storage container 16 could, in particular, be designed in the manner of an ampoule for a medicinal agent, whereby the media-side connection can be implemented via a Lüer connection, using established filling and connection concepts.

[0063] In the illustrated embodiment, the handle 12 is connected on the media side and also electrically to a transition piece 18. These components, which could in principle also be designed as a single functional part, form a reusable component that can be used in a variety of treatments, for example, as part of a standardized preventive measure for a large number of patients. To enable the actual treatment, the actual application nozzle, referred to in this embodiment as the treatment head 20, is connected to it. Due to hygiene and care considerations, the treatment head 20 is designed for single use only and is therefore a single-use or disposable product.The treatment head 20 is provided with a number of electrical and media connections such that both the electrical conductor elements and the media channels of the treatment head 20 can be connected to corresponding electrical or media supply lines 22, 24 in the handle 12 or in the transition piece 18.

[0064] The treatment head 20, also referred to as a nozzle, which is shown in FIG. 3 in perspective view and in FIG. 4 in longitudinal section, has a base body 30 extending in a longitudinal direction from a connection side 26 to a free treatment end 28, into which a number of media channels 32 for supplying the cleaning electrolyte from the connection side 26 to the treatment end 28 and a number of electrical conductor elements 34, 36 are integrated. In a manner regarded as independently inventive, it is designed in a particularly simple manner for the intended use in a prophylactic treatment, i.e. the electrical contacting of the dental implant 2 and the targeted application of the cleaning electrolyte into the periodontal pocket 8. In particular, account is taken of the fact that the practitioner should be able to contact the implant 2 precisely despite very cramped space conditions.In order to make this possible, the spatial shape of the base body 30 is suitably selected taking into account the fact that a tooth pocket 8 usually forms in the form of a gap extending along the tooth or implant surface.

[0065] To take this into account, according to one aspect of the invention, the design of the treatment head 20 in the manner of a flat spatial body as an essentially flat component is provided. The treatment head 20 or the base body 30 forming it is thus designed as a body extending essentially along a basal plane or ground plane, the thickness of which, viewed in cross-section, is kept significantly smaller than its lateral extent in the basal plane. In terms of application, this means that the free or treatment end 28 of the base body 30 can be introduced into the periodontal pockets 8 relatively easily by aligning the basal plane of the base body 30, for example, essentially parallel to the outer surface of the implant 2. Furthermore, the base body 30 tapers in its cross-section towards the treatment end 28.The free or treatment end 28 of the base body 30 thus essentially has a flat, comparatively narrow, or even tapered contour, making insertion into the periodontal pockets 8 particularly easy. In the exemplary embodiment, this results, as can be seen, for example, from the longitudinal section shown in FIG. 4, in the base body 30 having a triangular-shaped contour in plan view.

[0066] To reliably ensure the conceptually intended direct electrical contacting of the dental implant 2 during a prophylactic treatment, the base body 30 has an integrated conductor element 34 assigned to a first electrical polarity, which, viewed longitudinally, protrudes beyond the treatment end 28 formed by the base body 30. This conductor element 34 is thus exposed at its end and can therefore be brought into direct contact with an exposed outer surface of the implant 2 within the dental pocket 8, thus bringing it into electrical contact. It is preferred to connect the implant 2 cathodically; accordingly, the conductor element 34 is provided for connection in cathodic polarity.

[0067] Furthermore, to complete the electrical current path provided within the framework of the treatment concept, at least two conductor elements 36, in the exemplary embodiment exactly two, assigned to a common second electrical polarity are integrated into the base body 30. These form the electrical opposite pole to the conductor element 34 described above and are accordingly provided in the exemplary embodiment for an anodic circuit. By connecting the current or voltage source provided in the handle 12, the current flow can thus be adjusted. The conductor elements assigned to the second electrical polarity serve, according to the concept described in the documents cited above, to establish the current flow via the supplied cleaning electrolyte, so that the basic processes can be triggered.To ensure this, the treatment head 20 is designed for the precise delivery of the cleaning electrolyte into the tooth pocket 8, so that the desired current path can be established via it. For this purpose, the base body 30 is provided with a number of outlet openings 40 for the cleaning electrolyte in an outlet area 38 located in the area of ​​the treatment end 28, each of which is connected to one of the media channels 32. This allows the electrolyte to be delivered in a targeted manner in the area of ​​the treatment end 28 of the treatment head 20 and thus, if necessary, directly into the respective tooth pocket 8.

[0068] In this case, it is considered particularly important that the cleaning electrolyte is reliably applied in direct electrical contact with the anodically connected conductor elements 36. This ensures that—as intended by the concept—the current flows via the electrically conductive cleaning electrolyte, which ultimately results in the desired generation of the ionic reactions and, if applicable, the gas bubbles on the surface of the implant 2. To ensure this, the conductor elements 36 assigned to the anodic, second electrical polarity are positioned in or on one of the media channels 32 in such a way that they are wetted by the cleaning electrolyte flowing in the respective media channel 32.

[0069] A number of the outflow openings 40 are also arranged in an outflow direction aligned laterally with the longitudinal axis, as can be seen, for example, in the perspective view in FIG. 3. This allows the entire space in the tooth pocket 8 around the treatment end of the base body 30 to be easily flooded with cleaning electrolyte.

[0070] In an alternative embodiment, the treatment system 1' can also be designed as a stationary system, as shown in the exemplary embodiment in FIG. 5. This can be intended, in particular, for use in the context of a dental treatment, such as a cleaning or prophylactic measure, or even a therapeutic treatment. The treatment system 1' comprises a central supply unit 52, to which an application nozzle 56 is connected via an intermediate handle or handpiece 54 as the actual treatment head or treatment element. Due to hygiene and care considerations, the application nozzle 56 is designed for single use only and is therefore a single-use or disposable product.

[0071] Even if the treatment head 20 described above is explained in combination with the mobile treatment system 1 and the application nozzle 56 described in more detail below is explained in combination with the stationary treatment system 1 ', it goes without saying that within the scope of the present both could also be used in the other treatment system 1 , 1 ' with otherwise the same design, ie the treatment head 20 described above instead of the application nozzle 56 in the stationary treatment system 1 ' and the application nozzle 56 instead of the treatment head in the mobile treatment system 1 .

[0072] The application nozzle 56 is connected via connecting elements, in the exemplary embodiment via PVC or silicone hoses 57, for the media-side connection to an electrolyte cartridge or ampoule 58 arranged in the supply unit 52. Furthermore, it is connected via electrical connecting lines 60 to a control unit 62 arranged in the supply unit 52. The electrolyte ampoule 58 and the control unit 62 are arranged together with a buffer battery 64 provided for the on-demand power supply of the control unit 62 and with a pump 66 in a common outer housing 67 of the supply unit 52. The application nozzle 56 is provided with a number of electrical and media connections such that both the electrical conductor elements 60 and the media-side connecting hose 57 formed by the PVC / silicone hoses can be suitably connected.

[0073] The electrolyte ampoule 58 is provided for providing a cleaning electrolyte, as disclosed, for example, in the documents WO 2014 / 075755 A1, WO 2014 / 122187 A1, WO 2014 / 122188 A1, WO 2016 / 023998 A1, and WO 2021 / 018871 A1, the disclosures of which are incorporated by reference in their entirety. The connecting hose 57 connecting the electrolyte ampoule 58 to the application nozzle 56 on the media side can be shut off by a hose valve 68 arranged in the region of its passage through the outer housing 67 and controllable by the control unit 62. This hose valve can start the electrolyte flow when opened and stop it again when closed. According to one aspect of the invention, the hose valve 68 can be designed in particular as a pinch valve which, in the blocking mode for blocking, uses the comparatively soft hose material to deform it in a squeezing manner until it is completely blocked.

[0074] The electrolyte ampoule 58 is designed as a disposable product and thus as an exchangeable storage container, so that it can be disposed of after its contents have been used up and replaced with a new ampoule. The electrolyte ampoule 58 could in particular be designed in the manner of an ampoule for a medicinal active ingredient, wherein, using established filling and connection concepts, the media-side connection can be implemented via a Lüer connection. In the exemplary embodiment, the electrolyte ampoule 58 is designed, in an embodiment considered to be independently inventive, with a comparatively soft ampoule body that can be compressed, for example, during manual use by the user, in order to dispense the contained active ingredient. According to a further aspect considered to be independently inventive, a pressure chamber 70 is positioned in the interior of the outer housing 67.The pressure chamber 70 is connected to the pump 66, which is designed as an air pump. As soon as the internal pressure in the pressure chamber 70 is sufficiently increased via the pump 66, this overpressure, utilizing the deformability of the ampoule body, results in the ampoule being compressed and the active ingredient contained being released. This independently inventive embodiment thus enables an "encapsulated" release of the active ingredient, for which no direct contact with the ampoule body is necessary. Especially in combination with the pinch valve described above, this enables particularly simple access and process control from the outside via electrical signal lines, thus enabling automation. The electrolyte ampoule 58 is thus inserted into the pressure chamber 70 according to this aspect of the invention for the operation of the system 1.In the pressure chamber 70, an overpressure of 0.8 - 1.5 bar, preferably 1.0 - 1.2 bar, is built up by the pump 66 and maintained as constant as possible. The resulting outflow of electrolyte is controlled by the hose valve 68. When open, the hose valve 68 allows flow and stops it by squeezing the hose. Through the interaction and appropriate control of the pump 66 on the one hand and the hose valve 68 on the other, the media flow from the electrolyte ampoule 58 can be suitably controlled and, if necessary, regulated.

[0075] Furthermore, the electrolyte ampoule 58 can also be pressed out using other mechanical, pneumatic or hydraulic systems.

[0076] With regard to the intended preferred use in the field of dental care or prophylaxis, the application nozzle 56 shown in perspective view in FIG. 6 is specifically designed for high functionality with a particularly simple construction, so that production is possible even in extremely large quantities with only limited manufacturing costs. For this purpose, the application nozzle 56 has a nozzle body 72 as an essential functional component, into which, on the one hand, a number of media channels 76 for the active ingredient to be applied, i.e. in particular the cleaning electrolyte, are integrated, on the other hand, and a number of electrical conductor elements 78 for generating the intended current flow through the cleaning electrolyte.It is specifically designed, in a manner considered to be independently inventive, for the intended use in a prophylactic treatment, i.e., the electrical contacting of the dental implant 2 and the targeted delivery of the cleaning electrolyte into the pocket 8, in a particularly simple manner. Particular account is taken of the fact that the practitioner should be able to contact the implant 2 with precision despite very limited space. To enable this, the spatial shape of the nozzle body 72 is suitably selected, taking into account the fact that a pocket 8 is usually formed in the form of a gap extending along the implant surface.

[0077] To take this into account, according to one aspect of the invention, the application nozzle 56 is designed in the manner of a flat spatial body as a substantially planar component extending in a longitudinal direction from a connection region 80 to a free treatment end 82. The application nozzle 56, or the nozzle body 72 forming it, is thus designed as a body extending substantially along a basal plane or base plane, the thickness of which, viewed in cross-section, is significantly smaller than its lateral extent in the basal plane. In terms of application, this means that the free or treatment end 82 of the nozzle body 72 can be introduced into the periodontal pockets 8 relatively easily, for example by aligning the basal plane of the nozzle body 72 substantially parallel to the outer surface of the implant 2.

[0078] Furthermore, the nozzle body 72 tapers in its cross-section toward the treatment end 82. The free or treatment end 82 of the nozzle body 72 thus essentially has a flat, comparatively narrow, or even tapered contour, making insertion into the tooth pockets 8 particularly easy. In the exemplary embodiment, this results in the nozzle body 72, in plan view, at least in sections, having a triangular-shaped contour.

[0079] In order to reliably ensure the conceptually intended direct electrical contacting of the dental implant 2 during a prophylactic treatment, at least two conductor elements 84 assigned to a common first electrical polarity are integrated into the nozzle body 72, in the exemplary embodiment exactly two. Furthermore, to complete the electrical current path provided within the scope of the treatment concept, the nozzle body 72 has, as a further conductor element 78, an integrated conductor element 86 assigned to a second electrical polarity, which, viewed in the longitudinal direction, protrudes beyond the treatment end 82 formed by the nozzle body 72. In the exemplary embodiment shown in FIG. 6, two conductor elements 86 configured in this way are provided.These conductor elements 86 are thus exposed at their ends and can therefore be brought into direct contact with an exposed outer surface of the implant 2 within the pocket 8, thus bringing it into electrical contact. It is preferred to connect the implant 2 cathodically; accordingly, the conductor elements 86 are provided for connection in cathodic polarity.

[0080] The conductor elements 84 are only schematically shown in FIG. 6. These form the electrical opposite pole to the conductor elements 86 described above and are accordingly provided for an anodic circuit in the exemplary embodiment. The current flow can thus be adjusted by connecting the current or voltage source provided in the handle 54. According to the concept described in the aforementioned publications, the conductor elements 84 assigned to the first electrical polarity serve to establish the current flow via the supplied cleaning electrolyte, so that the basic processes can be initiated.

[0081] To ensure this, the application nozzle 56 is designed for precise and comprehensive application of the cleaning electrolyte into the pocket 8, so that the pocket 8 can be flooded as efficiently and comprehensively as possible, thus reliably establishing the desired current path via the cleaning electrolyte. For this purpose, the media channel 76 integrated into the nozzle body 72 and provided for supplying the cleaning electrolyte is branched in such a way that the media channel 76 extending from a media connection 88 splits into several channels at a branching point 90 within the nozzle body 72 and is connected via these on the outlet side to a plurality of outflow or application openings 74 arranged in an outflow area 92 provided in the region of the treatment end 82.In the exemplary embodiment, the application openings 74, which are connected in parallel on the media side, are positioned on both sides and with a lateral outflow direction at the treatment end 82, allowing a uniform discharge of the cleaning electrolyte to both sides of the application nozzle 56. This allows the electrolyte to be applied in a targeted manner to the entire spatial surroundings of the treatment end 82 of the application nozzle 56 and thus, if necessary, directly into the respective pocket 8. Specifically, it is thus possible to flood the pocket from the apical side via the treatment end 82 and laterally somewhat further upwards, in each case via the outflow or application openings 74.

[0082] With regard to the desired cost-effective design suitable for high production runs, according to one aspect of the invention, the nozzle body 72, as particularly clearly seen in the cross-sectional view in FIG. 7, is designed in the manner of a laminate body as a layered body constructed from a plurality of film pieces 94. The respective media channels 76 are formed in a film layer 96 of the laminate by a recess introduced into the respective layered film. By designing the application nozzle 56 or its nozzle body 72 as a film composite body or laminate, suitable application nozzles 56 can be provided cost-effectively and in large quantities using comparatively simple means and with enormous flexibility in spatial design.

[0083] The application nozzle 56 or its nozzle body 22 is formed in the manner of a laminate or layer stack by a number of film pieces 94 arranged one above the other and glued, welded, or otherwise connected to one another at their contact surfaces. The film pieces 94 each have a film thickness d of approximately 100-250 μm and thus within a preferred range of 50-500 μm. The application nozzle 56 or its nozzle body 72 constructed as a laminate from the film pieces 94 thus has a total thickness D of approximately 0.7-1.2 mm, i.e. within a preferred range of 0.3-2 mm, so that the desired insertion into the pocket 8 is possible without any problems.

[0084] The media channels 76 can be created by punching or lasering into the respective film piece 94, so that the application nozzle 56 can be designed with particularly simple means and with particular flexibility in terms of its spatial configuration and the type and number of media channels. As can also be seen from the illustration in FIG. 4, a number of the media channels 76 can be provided with integrated spacers 100, so that a comparatively flat, comparatively wide media channel 76 can be formed to provide comparatively large flow cross-sections.

[0085] According to one aspect of the invention, the one-piece application nozzle 56 shown in FIG. 6 is designed as a film layer or composite body, or as a laminate for the entire nozzle body 72 forming the application nozzle 56. In the exemplary embodiment, the application nozzle is also constructed from film layers 96, 98 that differ in terms of their material selection and parameters, with a central middle film layer 98 of a first film material being covered on both sides by a side or outer film layer 96 of a different film material. The film layer 98 and the film layers 96 differ in their material properties and are functionally adapted to different requirements.In the exemplary embodiment, the central film layer 98 consists of a comparatively harder film material, i.e., in particular, with a comparatively higher Shore hardness or Young's modulus, while the other film layers 96 are rather softer. Thus, the central film layer 98 can define the contour or spatial shape of the nozzle body 72 in a form-defining manner, like a support structure, whereas the comparatively softer outer film layers 96 can be designed to be flexible and deformable, thus significantly reducing the risk of injury in the event of contact, for example, between the oral mucosa and the nozzle body 72.

[0086] In the exemplary embodiment, the application nozzle 56 consists entirely of such a film composite. This construction is clearly evident from the representation of the layered sequence of the structure in FIG. 8 and its enlargement in FIG. 9.

[0087] The structure of the film layer package is shown in FIG. 5 using a sequence, starting from the first, bottommost film layer 96, with the step-by-step addition of the further film layers 96, 98. Accordingly, FIG. 8a shows the bottommost or first film layer 96, which, viewed in plan view, is already adapted to the desired shape of the nozzle body 72. Starting from the connection region 80, the width tapers towards the treatment end 82. The film piece 94, which has already been pre-cut in its outer contour in this way, is also provided with embossed grooves 102. In a subsequent step during the construction of the film stack, as shown in FIG. 8b, a conductor wire 106, bent at its free end 104, is inserted into these to form the aforementioned conductor element 86.The bent end 104 projects forward beyond the base area formed by the foil piece 94, i.e. beyond the treatment end 82, as is provided for the conductor element 86 in accordance with the design.

[0088] During the layered construction, a further piece of film 94, also forming a film layer 96, is then applied to the lower film layer 96 thus provided with the conducting wire 106 and, for example, laminated on. This resulting film stack is shown in FIG. 8c. It thus comprises two superimposed film layers 96. The last film layer applied covers the previously inserted conducting wire 106, so that the conductor element 86 formed thereby is only visible in this illustration at the end 104 that still protrudes beyond the treatment end 82. The conductor element at end 104 thus serves to contact the implant and is insulated in the remaining area. The conducting wire 106 can therefore only be electrically contacted, for example from the control unit, via contact openings 107 provided continuously in all film layers 96, 98.On its upper surface, the upper foil layer 96 is also provided with embossed grooves 108. Furthermore, it includes an embossed or punched receiving groove 110 in the connection area 80.

[0089] A conductor wire 112 is then inserted into each of the grooves 108, as shown in FIG. 8d. The conductor wires 112 serve to form the above-mentioned conductor elements 84 assigned to a first polarity. After the conductor wires 112 have been attached, the next film layer 98 is applied to the resulting layer package, as shown in FIG. 8e. The film layer 98 forms the central film layer 98 and is made of a comparatively harder film material, i.e., in particular, with a comparatively higher Shore hardness or modulus of elasticity, while the other film layers 96 are rather softer. The film layer 98 can thus assume the function of a supporting or shaping layer, which gives the entire package a certain rigidity and mechanical stability.

[0090] It is clearly visible in FIG. 8e that the film layer 98 is constructed in several parts and is formed from a number of film pieces 94. The film pieces 94 are arranged at a distance from one another, leaving recesses 114 in between. These recesses 114 form the media channels 76 integrated into the nozzle body 72, which can be designed with a high degree of freedom due to the possibilities offered by the processing of the films (lasering, punching). In the exemplary embodiment in FIG. 8e, it is clearly visible that, starting from the provided media connection 88, the media channel 76 branches off at a branching point 90 provided in the connection area 80 and continues in three subsequent channel pieces, one central and two lateral, up to the respective outflow openings 74.The common media connection 88 is connected to three outflow or application openings 74 via the thus branched media channel 76; these are thus connected in parallel on the media side.

[0091] In the two lateral sections of these three parallel-connected channel pieces, the conductor elements 112 are positioned such that they are wetted by the medium flowing in the respective media channel 76. This allows electrical contact to be established via the conductor elements 112 with the medium flowing there. For contacting from the periphery, the conductor elements 112 are, as can be seen in FIG. 8d, guided segmentally at their end segments 116 through contact holes 118 provided there. According to one aspect of the invention, these holes are arranged continuously through the entire foil stack, so that, for example, a connector plug could be inserted to establish electrical contact with the respective conductor element 112. This contacting concept, utilizing the contact holes 107, 118 extending through the entire foil stack, is also considered to be independently inventive.This utilizes the fact that the conductor wires 106 integrated into the foil stack, running parallel to its base plane, allow for an overall flat design with a low overall height. Nevertheless, reliable electrical contact can be achieved by tightly inserting suitable connecting elements, such as connecting pins, into the respective contact holes 107, 118, thus bringing them into close surface contact with the conductor segments running there without damaging them.

[0092] In particular, a connecting pin with a diameter slightly larger than the respective contact hole 107, 118 can be used. When this pin is pushed into the respective contact hole 107, 118, it deforms due to its geometry, creating intimate contact with the connecting pin. The conductor element can be designed as a wire, as described above, but preferably also as a foil or other flat element, since this deformability provides a particularly useful contacting option.

[0093] Alternatively, contact can be made by simply pressing a contact pin or similar onto a wire or conductor track without the need for an opening or hole in the conductor track.

[0094] In a further step, a connection tube 120 is inserted into the receiving groove 110 of the lower film layers 96 to form the media connection 88, as shown in FIG. 8f. This connection tube can be a metal or ceramic tube, or alternatively a plastic tube or a rolled piece of film. A tapered film stack would also be possible. This would be a particularly cost-effective variant, since all film layers would only have to have one tapered end. However, the media connection or media sealing would be comparatively more complex. For optimized sealing, it is also possible to compress the film stack and press a tube or a nozzle with a conical connection geometry into the media opening.The flexibility (elasticity / plasticity) of the foil stack allows sufficient media sealing with the appropriate pressing force of the conical nozzle.

[0095] Subsequently, two additional foil pieces 96 and the corresponding components between them, as shown in FIG. 8c, are applied in a substantially mirror-symmetrical manner, resulting in the application nozzle 56 shown in FIG. 6. In the exemplary embodiment, this consists of a structure of five foil layers 96, 98, with two conductor elements 86 provided symmetrically to the central media channel 76 leading longitudinally to the treatment end 82. This is clearly visible in the enlarged view of the outflow area 92 in FIG. 9.

[0096] The intended design of the application nozzle 56 and the intended manufacturing process, in particular lasering or punching the contours for the media channels 76, allows enormous flexibility in the design and configuration of the hollow spaces, cavities, or media volumes provided in the layer package or laminate. Polyamide is intended as the base material for the film layers 96, 98 or film pieces 94; alternatively, however, another suitable film material such as PP or PE or even a combination of different film materials can also be considered advantageous. As an alternative to using the film pieces 94 shown in Figures 6 and 8, whose outer contours are already punched out, it is also possible to only perform the inner punching and embossing in advance and to carry out the outer shaping only after lamination.

[0097] In this case, it is considered particularly important that the cleaning electrolyte is reliably applied in direct electrical contact with the anodically connected conductor elements 84 formed by the lead wires 112. This ensures that—as intended by the concept—the current flows via the electrically conductive cleaning electrolyte, which ultimately results in the desired generation of the ionic reactions and, if applicable, the gas bubbles on the surface of the implant 2. To ensure this, the conductor elements 84 assigned to the anodic, second electrical polarity are positioned, as described, in or on one of the media channels 76 in such a way that they are wetted by the cleaning electrolyte flowing in the respective media channel 76.

[0098] An alternative embodiment of the application nozzle 56 in its construction as a foil layer package is shown in a representation of a sequence in FIG. 10 analogous to FIG. 8, also starting from the first, lowest foil layer 96, with the step-by-step addition of the further foil layers 96, 98. The variant, which is otherwise structurally identical to the embodiment according to FIG. 8, differs from this in the design of the line elements 84 provided as anode, which are wetted with the cleaning electrolyte during operation. In contrast to the lead wires 112 shown in FIGS. 8c, 8d, these line elements 84 in the exemplary embodiment shown in FIG. 10, as is particularly clear from FIG. 10c, are designed as a metal coating 120, preferably made of gold or platinum, applied to the underlying foil layer 96, for example by vapor deposition (sputtering, galvanization, etc.).

[0099] A conductor element 84 formed by such a metal coating 120 has the particular advantage that it can be contoured and shaped particularly flexibly. In particular, its surface contour can be adapted to the projection of the respective media channel 76 onto the film layer 96. This makes a particularly large contact surface, namely essentially the entire base area of ​​the respective media channel 76, available for electrically contacting the cleaning electrolyte flowing in the media channel 76 in a material-saving manner. In particular, the distance of the conducting elements 84 from the application opening 74 can be very easily varied and adjusted as needed, e.g., in the event of product developments or adaptations. In a particularly advantageous embodiment considered to be independently inventive, the conductor element 84 is applied by a printing process, preferably a screen printing process.According to one aspect of the invention, the conductor element 84, optionally in addition to further conductor tracks, can be manufactured using a suitable screen printing paste, for example, based on titanium. The conductor tracks preferably comprise silver, gold, or titanium as the base material.

[0100] In a further aspect considered to be independently inventive, insulation or other functional structures provided between the conductor tracks can also be applied using a printing process, preferably a screen printing process. In general, according to a further independently inventive aspect, some or all of the conductor tracks can be formed from silver as the base material, wherein, according to one aspect of the invention, they can be provided with a protective coating of carbon to protect them from corrosion resulting from contact with the electrolyte and / or from mechanical damage. Such silver conductor tracks can, in particular, be overprinted with a carbon coating.

[0101] A further alternative embodiment of an application nozzle 56', which is regarded as independently inventive, is shown in perspective view in FIG. 8 and in a representation of a sequence in FIG. 9 which is analogous to FIG. 5. In this embodiment too, the application nozzle 56' is designed as a foil layer package, the structure of which is shown in FIG. 9 using a sequence, also starting from the first, lowest foil layer 96. Alternatively, the conductor element 126 (preferably made of titanium, gold or platinum) is shown individually in FIG. 9b for better illustration. This conductor element 126 is firmly fixed to the underside of the foil layer 96 of FIG. 9c and is shown separately in FIG. 9b merely for reasons of understanding and illustration. In the exemplary embodiment shown in FIGS. 8, 9, the application nozzle 56' is comparable to that in FIG.7, with anodic conductor elements 84 each formed by a metal coating.

[0102] FIG. 9a shows the bottom or first film layer 96, which, likewise viewed from above, is already adapted to the desired shape of the nozzle body 72. The film piece 94, whose outer contour has already been pre-cut in this manner, is provided in this embodiment with a central embossed groove 122. This groove 122 can also be embossed during the lamination process. In a subsequent step during the construction of the film stack, as shown in FIG. 9b, a tongue element 124 is inserted into this groove to form the cathodic conductor element 86'. At its free end 104, the tongue element 124 protrudes forward beyond the base area of ​​the film layer 96 formed by the film piece 94, i.e., beyond the treatment end 82, as is also provided for the conductor element 86'.

[0103] Analogous to the examples described above, for the application nozzle 56', a further, likewise a foil layer 96 is subsequently applied and, for example, laminated onto the lower foil layer 96 thus provided with the conductor element 86'. Analogous to the example shown in FIG. 7, the anodic conductor elements 84 are applied to said layer in the form of metal coatings 120 (FIG. 9c) and the tongue element 126 is attached beneath said layer. The foil layer 96 in FIG. 9c is thus coated on its top and bottom sides with electrically conductive layers, preferably made of titanium, gold, and / or platinum. The next foil layer 98, formed from several foil pieces 94, is then applied to the resulting layer stack (FIG. 9d).Analogous to the previously described variants, the film layer 98 forms the central film layer 98 and is formed, at least over the circumference of one or more of the film pieces 94 forming it, from a preferably harder film material, i.e., in particular, with a comparatively higher Shore hardness or modulus of elasticity. However, it is also possible that all film layers are made of the same material.

[0104] FIG. 9d also shows the film pieces 94 arranged at a distance from one another, which leave recesses 114 between them to form the media channels 76 integrated in the nozzle body 72. In the two lateral media channels formed thereby, which are connected in parallel on the media side, the metal coatings 120 are positioned such that they are wetted by the medium flowing in the respective media channel 76. In a further step, a connection tube 120 is inserted into the receiving groove 110 of the lower film layers 96, which is also provided in this variant, to form the media connection 88 (FIG. 9d). Subsequently, as can be seen in FIG. 9d, a further film layer 96 and the corresponding components in between, as can be seen in FIG. 9b, are also applied in an essentially mirror-symmetrical manner. The film layer 96 in FIG. 9e is as shown in FIG.9c is preferably provided on both sides with electrically conductive layers forming the two electrodes. Subsequently, a final film layer 96 is applied and fixed (preferably laminated), resulting in the application nozzle 56' shown in FIG. 8.

[0105] The special feature of this embodiment of an application nozzle 56', which is considered to be independently inventive, can be seen in the design of the cathodic conductor elements 86'. As mentioned above, these are fixed to a film layer 96 and together form a tongue element 124, on which a contacting electrode 126 designed as a metal coating 120 is applied on the outside, i.e., in the perspective view shown in FIG. 8, on top of or below the respective projecting free end 104 projecting beyond the treatment end 82 of the nozzle body 72. Utilizing the design freedom provided by the design as a metal coating 120, this contacting electrode 126 is structured according to one aspect of the invention and can be designed as an element for contact detection of the implant 2.

[0106] Such contact detection serves to determine on the device side whether the implant 2 is securely electrically contacted, so that treatment can therefore be started and carried out reliably. Several variants are conceivable for such contact detection. For example, there is the possibility of a capacitive measurement between the conductor elements 86 and the implant 2. As soon as the implant 2 is contacted by an electrode 86, the capacitance between the two conductor elements 84 and 86 changes in a measurable manner. Alternatively, a voltage can be applied within the pocket 8 after the electrolyte has flowed through it. This results in a current flow. As soon as the implant 2 is contacted, the surface area of ​​the electrode increases immensely, which, at a constant voltage, results in an increase in the current. This can be measured and evaluated.

[0107] Another possibility is voltage measurement. As soon as the application nozzle 56, 56' is inserted into the pocket 8 and flooded with electrolyte, a galvanic element is created, formed from the conductor elements 84 and 86 (anode and cathode). Preferably, the conductor elements 86 are connected cathodically and, like the implant 2 itself, are made of titanium or a titanium alloy, and the conductor elements 84 are connected anodically and preferably made of gold or platinum or a metal, preferably titanium or a titanium alloy, which has been coated with gold or platinum. Due to the contacting of the implant 2, the surface area of ​​the electrode contacting it is significantly enlarged. This also results in a change in the voltage of the galvanic element or in the maximum possible output current. This can be measured and evaluated accordingly.

[0108] Implant contact can also be established via an impedance measurement between the two electrodes. In this case, the impedance of the electrodes also changes during the electrical contact with implant 2.

[0109] Another possibility is to attach one or more auxiliary electrodes to one of the previously mentioned procedures, which are used exclusively for implant detection measurements using one of the measurement techniques already mentioned.

[0110] In a manner considered to be independently inventive, however, implant detection is provided by means of the conductor element 86' contacting the implant 2, preferably the cathode, in the embodiment shown in FIGS. 8 and 9. The external contacting electrode 126, as shown in FIG. 11 in an enlarged plan view in the installed state and without the last, partially insulating foil layer 96 from FIG. 10, is designed as a structured conductor element.

[0111] The metal coating 120 forming the contacting electrode 126 is divided into at least two (two in the exemplary embodiment) conductor elements 128, 130 arranged side by side on the tongue element 124. The conductor elements 128, 130 are separate and can be contacted independently of one another. Implant detection is possible by checking for a short circuit between these conductor elements 128, 130. If the implant 2 contacts both conductor elements 128, 130 and thus a reliable contact is established between the contacting electrode 126 and the implant surface, the conductor elements 128, 130 are short-circuited via the implant 2. This can also be measured and evaluated accordingly.

[0112] In the illustrated embodiment, which is considered particularly advantageous and independently inventive, the two conductor elements 128, 130 are designed with a comparatively complex structure, with a comparatively large number of thin conductor tracks. In the exemplary embodiment, these are comb-like and arranged alternately directly next to one another. This enables particularly effective measurement, since in this way a short circuit can be created at a large number of local locations through implant contact. In particular, this is intended to largely prevent the implant 2 from contacting only one of the conductor elements 128, 130. In such a case, the implant 2 would indeed be contacted and could be safely cleaned, but the electronic evaluation based on the detection of a short circuit would still not detect any implant contact.Preferably, alternating conductor tracks are provided, positioned as close together as possible and designed as thinly as possible. Preferably, the conductor tracks and / or the spaces between them are narrower than 250 μm, 100 μm, or 60 μm.

[0113] A further alternative embodiment of an application nozzle 56", which is also considered to be independently inventive, is shown in perspective view in FIG. 12. In this embodiment, the application nozzle 56" is also designed as a foil layer package and, analogous to the variants described above, consists of a structure of five foil layers 96, 98. In contrast to the variants described above, this application nozzle 56" comprises, in addition to the outflow or application openings 74 for the electrolyte arranged laterally on the nozzle body 72 in the region of the treatment end 82, additional application openings 132. These are arranged, with reference to the planar design of the nozzle body 72, according to one aspect of the invention, on the top and bottom sides of the nozzle body 72, thus penetrating the top and bottom foil layers 96, respectively.The media channels 76 running inside these film layers 96 are thus also connected to the environment on the media side via the application openings 132. The implant is preferably contacted cathodically with the conductor element 86. The conductor elements 84, which are preferably connected anodically, are located below the application openings 132 on both sides. The conductor elements 84 on both sides are not electrically connected to each other.

[0114] This embodiment is based on the concept, considered to be independently inventive, that automated orientation detection for the application nozzle 56" inserted into the pocket 8 is possible in this way. For this purpose, the metal coatings 120 arranged on both sides of the central foil 98 and forming the anodic conductor elements 84 can be electrically contacted and controlled independently of one another. Since the application nozzle 56" is flat in its end treatment area 92, the surface of the application nozzle 56" is usually aligned substantially parallel to the implant surface when the treatment end 82 is inserted into the pocket 8. This means that each of the conductor elements 84 is located either on the side of the central foil 98 facing the implant 2 or on the side facing away from it.Since the side facing the implant 2 is comparatively shorter from the implant surface than the side facing away from it due to the application openings 132, it is very easy to determine which of the anodic conductor elements 84 is facing the implant 2 and which is not by means of a resistance / conductance measurement. This can be very advantageous and desirable, since the efficient and reliable current supply to the implant 2 is desired and intended. In contrast, a concomitant current supply to the surrounding soft tissue 8 can be undesirable and may possibly lead to damage or even death of tissue parts. To avoid this, the exclusive current supply and thus use of the side of the application nozzle 56" facing the implant 2 can be provided.Since the energized anode 84 is located directly and very close to the implant, in contrast to the variants of Figures 3 to 9, the possibly very small current flowing through the tissue is minimized to the maximum and no longer or almost no longer present.

[0115] A further alternative embodiment of an application nozzle 56"', which is also considered to be independently inventive, particularly with regard to its method of manufacture, is shown in a sequence of the steps of its manufacture in FIG. 16. This embodiment of an application nozzle 56"' is also based on the principle of construction as a film stack, wherein a number of functional films are used which are suitably handled at different stages in the sense of a simplified construction that is also suitable for large quantities.

[0116] In this variant, the media channel film 140 shown in FIG. 16a is provided as the central functional film, which will form the middle film of the film layer package in the finished application nozzle 56'". This consists, analogously to the embodiments described above, of a number of film pieces 142 which are designed and positioned such that they form the media channel 76 and the application openings 74 branching off from it and connected to it. This central media channel film 140 is embedded or wrapped in an anode film 144 surrounding it, as shown in FIG. 16b. The anode film 144, punched out of a piece of film with a suitable contour, is wrapped around the media channel film 140 at a wrapping point 146 so that it covers both sides and thereby seals the media channel 76. On the inside and thus in the illustration, FIG.16b, the anode foil 144 is provided with a conductor layer adapted to the "underlying" media channel 76, which, during operation, establishes electrical contact with the electrolyte conducted in the media channel 76. According to one aspect of the invention, this anode conductor layer 148 can be printed on the inside of the anode foil 144 and, according to a further aspect of the invention, consists of a suitably selected conductive material, in particular a metal such as gold or titanium. Preferably, and according to a further aspect of the invention and with a view to favorable manufacturing costs, especially for large quantities, the anode conductor layer 148 consists essentially of silver, which, in a preferred and inventive development, is provided with a carbon coating - preferably also printed - with a view to the expected contact with the electrolyte.

[0117] In order to enable electrical contacting of the anode conductor track layers 148, which are actually located on the inside in this package construction, a fold of the anode foil 144 is also provided in an independently inventive manner in the head region of the foil stack being formed. According to one aspect of the invention, the foil molding forming the anode foil 144 has two folding wings 150 in its head region (one "on top" in the folded state shown in FIG. 16b and one "on the bottom" not visible in this illustration). These folding wings 150, on which the anode conductor track layer 148 is continued as far as a contacting region 152, are folded over along a folded edge 154 after the anode foil 144 has been applied to the media channel foil 140 and thus come to lie on the top or bottom anode foil 144. In the illustration in FIG.16b, this can be seen on the side edge 156 on the anode foil 144 formed by the overlying folding wing 150. This design achieves in a simple and cost-effective manner that the contacting regions 152 are located on the top and bottom sides on the outside of the foil stack being formed and are thus accessible for electrical contacting of the anode conductor layer 148. Subsequently, in a similar manner, the resulting foil package is embedded or wrapped into a surrounding cathode foil 158 using a folding process, as shown in FIG. 16c. The cathode foil 158, punched out of a piece of foil with a suitable contour, is folded over the package comprising the media channel foil 140 and the anode foil 144 at a folding point 160 and thus now forms the outermost foil layer on both sides of the now five-layer foil package.On its outer side, and thus easily accessible for electrical contacting, the cathode foil 158 is provided with a cathode conductor layer 162. This, in turn, is connected to a contacting area 164. According to one aspect of the invention, the cathode foil 158 is dimensioned such that, after its attachment, its edge abuts the side edge 156 of the folded flap 150, so that the surface of the resulting foil package is almost flat.

[0118] In a further processing step, as shown in FIG. 16d, the cathode foil 158 is insulated on the outside by applying a suitable insulating material as an insulating layer 165 according to one aspect of the invention. According to one aspect of the invention, the insulating layer 165 can also be applied using a printing process, analogous to those described above, preferably a screen printing process, whereby this application can take place before or after the application of the cathode foil 158 to the anode foil 144.

[0119] As a result of these steps, the nozzle body 166 shown in FIG. 16d, which can be used as an application nozzle 56"', is created. The treatment end 168 of this nozzle body 166 is shown enlarged in FIG. 17. The layer structure of the foil stack forming the nozzle body 166, created by the folding, is clearly visible. The end region of the treatment end 168 is also kept free of the insulating layer 165, so that the cathode conductor layer 162 is freely accessible in this region. The cathode conductor layer 162, which is divided into a number of parallel conductors 170 in this region, can thus be used in the desired manner to contact the implant. The contact head of the nozzle body 166 shown in FIG. 16d, which can be used as an application nozzle 56"', is shown enlarged in a side view in FIG. 18. The layer structure of the foil stack is also clearly visible here.It can also be seen that - as described above - due to the all-round folding design used and the resulting symmetrical structure of the foil stack, the contacting regions 152 and 164 for the anode conductor layer 148 and the cathode conductor layer 162, respectively, are present both on the top and bottom of the foil stack and are thus present in pairs. Furthermore, it can be clearly seen in this illustration that - as provided according to an aspect of the invention considered to be independently inventive - free spaces 172 are provided between the contacting region pairs 152, 164 in the media channel foil 140, which, due to the elastic properties of the foils, allow elastic inward deformation of the stack in the region of the contacting regions 152, 164. Likewise, the inlet 174 of the media channel 76, via which the latter can be connected to a suitable media reservoir, can be seen in this illustration.

[0120] According to one aspect of the invention, the application nozzle 56"' having the nozzle body 166 can be used to provide a treatment head 180 by providing it with a suitable housing 182 in the connection area. The treatment head 180 thus formed, which is considered to be independently inventive, is shown in partial section in FIG. 19 and in a side view in FIG. 20. In a manner considered to be independently inventive, the nozzle body 166 is guided into the housing 182 by means of a suitable overmolding made of elastic material, preferably a rubber-silicone overmolding. Likewise, the fluid inlet, i.e. the connection of the media inlet 174 to a corresponding media reservoir, can be made of elastic material or with an elastic overmolding.This allows, in addition to the high level of tightness of the system, which is beneficial for use, the correct alignment of the nozzle body 166 itself and relative to the handpiece, as well as the sealing of the supply hose and the sealing of the handpiece, including the connecting contacts, in a particularly simple manner, thus eliminating the need for additional sealing elements such as O-rings. In an embodiment considered to be independently inventive, the treatment end 168 of the nozzle body 166 can be configured for automated contact detection with the component to be treated, in particular the dental implant 2, by suitable routing of the cathode conductor layer 162.In this embodiment, which is considered to be independently inventive, the conductors 170 of the cathode conductor layer 162 are not continuously in contact with one another in the region of the treatment end 168', i.e., in the region of the transition point 160, but are divided into two comb-like, interlocking conductor groups. The conductors 170a of the first conductor group, which are arranged in the region of the transition point 160 alternating with the conductors 170b of the second conductor group, are connected exclusively to one of the external contacting regions 164, and the conductors 170b of the second conductor group are connected exclusively to the other contacting region 164.In the “normal” state, there is therefore no electrically conductive connection between the two contacting areas 164, and the detection of a mechanical and / or electrical contact with the component 2 to be treated can be carried out by detecting an electrically conductive connection between the two contacting areas 164.

[0121] For the electrical contacting of the application nozzle 56''', according to an aspect considered to be independently inventive, the targeted use of the deformability of the film stack of the nozzle body 166 is provided. This is based on the knowledge that a resilient element is usually provided for electrical plug connections, with which, after establishing mechanical contact, electrical contact is reliably established using the spring force of such an element. In order to utilize this for the nozzle body 166 in a particularly reliable and simple manner, the use of the spring force of the already fundamentally elastic film stack of the nozzle body 166 is provided. For this purpose, the previously mentioned free spaces 172 between the respective pairs of contacting regions 152, 164 are provided, in a manner considered to be inventive.To establish the electrical connection in the sense of a plug connection, a contact plug 190 is provided, which is shown in perspective in a front view in FIG. 22 and in a rear view in FIG. 23. According to one aspect of the invention, the contact plug 190 comprises a front contact area 192, which is provided for establishing a secure mechanical and electrical contact with the treatment head 180, and a rear contact area 194, which can be connected to a corresponding downstream system.

[0122] In the frontal contact area 192, the contact plug 190 is provided, on the one hand, for establishing reliable mechanical contact with the treatment head 180. It therefore comprises jaw-like housing halves 196, which are arranged opposite one another to form a clear gap 198. The clear gap 198 is dimensioned such that, within the limits of manufacturing tolerances, it is approximately slightly less than the total height of the foil stack forming the nozzle body 166. The aim of the design is to enable the foil stack to be inserted into the clear gap 198 without excessive mechanical stress, whereby it is slightly squeezed and thus fixed. This fundamentally enables a mechanically reliable attachment of the nozzle body 166 in the frontal contact area 192 of the contact plug.

[0123] In addition, the contact plug 190 comprises, in its front contact area 192, two pairs of electrical contact plugs 200, 202, which are each electrically connected to associated rear contact plugs 204, 206. The front contact plugs 200, 202 are provided, in pairs, for establishing electrical contact with the contact areas 152, 164. To establish reliable electrical contact, the elasticity of the foils of the foil stack forming the nozzle body 166 is utilized in combination with the aforementioned free spaces 172 in an embodiment considered to be independently inventive. The free spaces 172 allow a receding deformation of the anode foil 144 and cathode foil 158 in this spatial area into the free spaces 172.Accordingly, according to this aspect of the invention, the contact plugs 200, 202 of each pair are spaced apart from each other by a distance smaller than the total thickness of the foil stack and thus also the clear width of the clear gap 198. By inserting the foil stack into the frontal contact area 192, the contact plugs 200, 202 are each pushed onto an associated contact area 152, 164 in a manner considered to be inventive, which resiliently retracts into the corresponding free space 172 due to the dimensioning.

[0124] This design allows the typically provided spring-loaded contacting of an electrical contact to be realized within the nozzle body, which is designed as a disposable product, so that the reliability, service life and wear of the other system components can be kept correspondingly low.

[0125] List of reference symbols

[0126] 1 , r treatment system

[0127] 2 dental implants

[0128] 4 external threads

[0129] 6 jaw bones

[0130] 8 pockets

[0131] 10 Soft tissue

[0132] 12 Handle

[0133] 14 Battery

[0134] 16 storage containers

[0135] 18 Transition piece

[0136] 20 treatment heads

[0137] 22, 24 supply lines

[0138] 26 Connection side

[0139] 28 End of treatment

[0140] 30 basic bodies

[0141] 32 media channels

[0142] 34, 36 ladder element

[0143] 38 Outlet area

[0144] 40 Outlet opening

[0145] 52 supply unit

[0146] 54 handle

[0147] 56, 56', 56",

[0148] 56'" application nozzle

[0149] 57 PVC or silicone hoses

[0150] 58 electrolyte ampoules

[0151] 60 connecting cable

[0152] 62 Control unit

[0153] 64 buffer battery

[0154] 66 Pump

[0155] 67 housings

[0156] 68 Hose valve Pressure chamber Nozzle body Application opening Media channel Electrical conductor element Connection area Treatment end, 86 Conductor element

[0157] Media connection branching point outflow area foil piece, 98 foil layer

[0158] spacers

[0159] Nut

[0160] End

[0161] Conductive wire contact opening groove

[0162] Receiving groove Conductive wire Recess End segment Contact holes Metal coating Groove

[0163] Tongue element

[0164] Contacting electrode, 130 conductor element

[0165] Application openings Media channel foil Foil piece Anode foil 146 Transfer point

[0166] 148 Anode conductor layer

[0167] 150 folding wings

[0168] 152 Contact area

[0169] 154 fold edge

[0170] 156 side edge

[0171] 158 Cathode foil

[0172] 160 transshipment point

[0173] 162 Cathode conductor layer

[0174] 164 Contact area

[0175] 165 Insulating layer

[0176] 166 nozzle bodies

[0177] 168, 168' End of treatment

[0178] 170, 170a,

[0179] 170b ladder

[0180] 172 open space

[0181] 174 Entrance

[0182] 180 treatment head

[0183] 182 housings

[0184] 190 contact plugs

[0185] 192 frontal contact area

[0186] 194 rear contact area

[0187] 196 housing halves

[0188] 198 clear gap

[0189] 200, 202 electrical contact plugs

[0190] 204, 206 rear contact plug d foil thickness

[0191] D Total thickness

Claims

Claims Application nozzle (20, 56, 56', 56") for applying a dental active ingredient in the oral cavity of a patient, in particular for a system (1, 1') for cleaning a biofilm-contaminated implant part (2), with a base or nozzle body (30, 72) in which, on the one hand, at least one media channel (32, 76) is integrated for supplying a cleaning electrolyte from the connection area (26, 80) to the treatment end (28, 82) and, on the other hand, a number of electrical conductor elements (34, 36, 84, 86) are integrated, wherein the base or nozzle body (30, 72) is a base or nozzle body (30, 72) extending in a planar fashion in a longitudinal direction from a connection area (26, 80) to a free treatment end (28, 82) and tapering in its cross-section towards the treatment end (28, 82). 72).Application nozzle (20, 56, 56', 56") according to claim 1, wherein the conductor element(s) (34, 84) are positioned in or on one of the media channels (32, 76) such that they are wetted by the cleaning electrolyte flowing in the respective media channel (32, 76). Application nozzle (20, 56, 56', 56") according to claim 1 or 2, wherein at least one of the media channels (32, 76) branches within the base or nozzle body (30, 72) and opens on the outlet side into a plurality of application openings (40, 74) arranged in an outlet area (38, 92) provided in the region of the treatment end (28, 82). Application nozzle (20, 56, 56', 56") according to one of claims 1 to 3, in the base or nozzle body (30, 72) of which at least two conductor elements (34, 84) assigned to a common first electrical polarity are integrated. Application nozzle (20, 56, 56', 56") according to claim 4, wherein the conductor elements (34, 84) associated with the first electrical polarity are positioned in or on one of the media channels (32, 76) such that they are wetted by the cleaning electrolyte supplied from a common electrolyte ampoule flowing in the media channels (32, 76). Application nozzle (20, 56, 56', 56") according to any one of claims 1 to 5, wherein a conductor element (36, 86) associated with a second electrical polarity projects longitudinally beyond the treatment end (28, 82) formed by the base or nozzle body (30, 72). Application nozzle (20, 56, 56', 56") according to one of claims 1 to 6, wherein a number of the application openings (40, 74) are arranged in a flow direction oriented laterally to the longitudinal direction.Application nozzle (20, 56, 56', 56") according to any one of claims 1 to 7, the base or nozzle body (30, 72) having a triangular contour in plan view. Application nozzle (56, 56', 56") according to any one of claims 1 to 8, the nozzle body (72) being designed as a laminated body composed of a plurality of film pieces (94). Application nozzle (56, 56', 56") according to claim 9, wherein the media channels (76) in a film layer (96, 98) of the laminate are formed by a recess (114) in the respective film layer. Application nozzle (56, 56', 56") according to claim 9 or 10, the media channels (76) being provided with integrated spacers (100). Application nozzle (56, 56', 56") according to one of claims 9 to 11, the nozzle body (72) of which is made up of at least three film layers (96, 98). wherein a number of film pieces (94) forming a central film layer (98) arranged between two adjacent film layers (96) are made of a harder film material than the two adjacent film layers (96). Application nozzle (20, 56, 56', 56") according to any one of claims 1 to 12, designed as a single-use product. System (1, 1') for cleaning a component contaminated with biofilm, in particular an implant part, comprising an application nozzle (20, 56, 56', 56") according to any one of claims 1 to 12, and a handle (12, 54) provided with a number of electrical and media connections such that both the electrical conductor elements (34, 36, 84, 86) and the media channels (32, 76) of the application nozzle (20, 56, 56', 56") can be connected to corresponding electrical or media supply lines in the handle (12, 54) or in an associated transition piece.System (1 ) according to claim 13, in the handle (14) of which a replaceable reservoir (16) for cleaning electrolyte is arranged.

Images