Apparatus and method for treating peri-implantitis using UVC

Abstract

The present disclosure is directed to systems and methods for the treatment of peri-implantitis using ultraviolet light. In some embodiments, the ultraviolet light is ultraviolet-c light with a wavelength of 100-280 nanometers. In some embodiments, the ultraviolet-c light renders the surface of the implant hydrophilic and more susceptible to cellular protein attachment. In some embodiments, an apparatus for treating peri-implantitis using ultraviolet light includes a handpiece with a flexible reduced diameter section and a rotatable tip at the end of the flexible reduced diameter section. In some embodiments, the handpiece includes a contra-angle dental handpiece or a straight dental handpiece that can be coupled to and direct ultraviolet light from either an end firing tip or a side firing tip.

Description

[Background technology]

[0001] (Related Applications) This application claims the benefit of and priority to U.S. Provisional Patent Application No. 63 / 172,486, filed April 8, 2021, and entitled "TREATMENT OF PERI-IMPLANTITIS USING ULTRAVIOLET-C LASERS," which is incorporated by reference in its entirety herein.

[0002] The placement of dental implants is an increasingly important service that can significantly improve a patient's health and overall quality of life. It is important that the surrounding soft tissue and bone osseointegrate with the implant. Recently, it has been discovered that certain methods of treating the surfaces of implants (e.g., titanium, zirconium) with UVC (ultraviolet C) light or non-thermal plasma ("NTP") before they are first implanted improve the hydrophilic nature of the implant. This results in fluids and proteins from the surrounding tissues being attracted to the surface of the implant and forming a more secure bond. Current methods of treating implants with UVC light are limited to placing a new implant in a sealed container containing a UVC lamp and then exposing the implant to intense UVC light for 10 seconds to 15 minutes or more. However, no device or method currently exists for in situ treatment of exposed surfaces of implanted implants that have failed to bond partially or completely to the surrounding tissue.

[0003] Patients who develop peri-mucositis and peri-implantitis over time due to infection, adverse body reactions to dental materials, and / or bone loss at the implant site request revision surgery. In these cases, bone degeneration leaves little or nothing to hold the implant screw on, and therefore they are effectively "free-floating" at the implant site. These free-floating implants can be easily removed, but removal is undesirable for implants that are still at least partially attached to the bone. With the current state of the art, there is only about a 50% success rate in achieving the same hydrophilic bond with new tissue and graft material on the implant as is seen with new implants. These failed cases become intractable, meaning that many cases recur after the implant restoration procedure.

[0004] Thus, a need exists for methods and devices that significantly improve success rates for revision surgical implants. Summary of the Invention [Means for solving the problem]

[0005] In some embodiments, the present disclosure is directed to an apparatus and method for treating an implant placed in a patient's mouth. In some embodiments, the method includes the following steps: (1) cleaning the defect area by removing granulation tissue and / or pathological tissue from the area; (2) preparing the area for implantation material; and (3) directing laser energy (e.g., Er, Cr:YSGG 2,790 nm laser, 9,300 or 10,600 nm CO laser). 2(3) applying a UVC treatment to the exposed implant surface using an instrument (such as a UVC laser, a 1,064 nm Nd:YAG or NIR diode laser, or an Er:YAG 2,940 nm laser) to remove remaining bioburden and / or treat the exposed implant surface; (4) applying a UVC treatment to the exposed implant surface using an instrument; (5) applying a graft material to reconstruct the peri-implantitis affected area; and (6) applying a collagen barrier to anchor the implant in place for healing and restoration.

[0006] In some embodiments, the present disclosure is also directed to an ultraviolet (UV) instrument configured and arranged to deliver ultraviolet light, such as UVC light at 100-400 nm, to the exposed implant surface. Although specific wavelengths of UVC are used in connection with some embodiments throughout this disclosure, it should be understood that any disclosure of a method and / or apparatus using UVC (e.g., the 100-280 nm portion of the UV spectrum) is also a disclosure of a method and / or apparatus using ultraviolet light at wavelengths of 100-400 nm or an apparatus emitting plasma from one or more tip openings. In some embodiments, the present disclosure is also directed to a UVC instrument configured and arranged to deliver UVC light at 253.7 nm to the exposed implant surface. In some embodiments, the present disclosure is directed to an NTP instrument configured and arranged to deliver a plasma photofunctionalization process to the exposed implant surface. In some embodiments, the photofunctionalization process includes emitting hot or cold plasma energy from a tip opening of the instrument. FIG. 12 serves as a reference for the shape and configuration of both the plasma instrument and / or the UVC instrument, according to some embodiments. As used herein, an exposed implant surface is any portion of an implant of any material that is surgically secured within a patient's mouth, where at least a portion of the implant is not covered by bone and / or tissue during a treatment procedure. Some embodiments of the present systems are directed to a UVC instrument and directional delivery system that is configured and arranged to apply UVC light at 253.7 nm to the implant surface, including a posterior portion of the exposed implant surface.

[0007] In some embodiments, the UVC instrument comprises one or more fluid conduits. In some embodiments, at least one of the one or more fluid conduits is a fluid delivery conduit configured and arranged to deliver a fluid to or adjacent to the implant site. In some embodiments, the fluid comprises water. In some embodiments, the fluid comprises an acid etchant. In some embodiments, the fluid comprises hydrogen peroxide. In some embodiments, the fluid is a gas. In some embodiments, the fluid is air.

[0008] In some embodiments, at least one of the one or more fluid conduits is a fluid cooling conduit configured to remove heat from the UVC instrument. In some embodiments, the one or more fluid conduits are configured and arranged to circulate or move a cooling fluid in and out of a UVC tip that constitutes at least a portion of the UVC delivery system. In some embodiments, at least a portion of the UVC instrument adjacent to the UVC tip is a neck or other structure that is flexible and / or adjustable. In some embodiments, the neck can be bent up to 180° relative to the instrument handpiece so that while the handpiece extends outside the patient's mouth, UVC light can be directed onto an implant surface that faces the posterior portion of the oral cavity.

[0009] In some embodiments, the UVC instrument includes one or more UVC tips. In some embodiments, the one or more UVC tips are removable. In some embodiments, at least a portion of the one or more UVC tips includes an optical opening configured and arranged to allow UVC light to pass therethrough. In some embodiments, the opening is located at the distal end of the UVC tip, where a plane parallel to the opening at the surface and parallel to the distal surface would be approximately perpendicular to a plane that bisects the central axis of the handpiece and / or the constrictor, so that UVC light is directed onto the implant surface from the distal end. In some embodiments, the optical opening is located on one side of the one or more UVC tips adjacent to the distal end of the tip, along the side of the tip, where a plane tangent to the opening and / or parallel to the distal end and perpendicular to the distal end would be parallel to a plane that bisects the central axis of the handpiece and / or the constrictor, so that UVC light is directed onto the implant surface from the side of the tip. In some embodiments, at least a portion of one or more UVC tips, including a UVC opening on a side thereof, is rotatable so that the UVC light can be directed at any angle between 0° and 360°. [Brief description of the drawings]

[0010] [Figure 1] FIG. 1 depicts the mechanism for the transformation of an implant surface from hydrophilic to hydrophobic, according to some embodiments.

[0011] [Diagram 2] FIG. 2 is a depiction of cytoaffinity for acid-etched titanium surfaces with different aging and with and without UV treatment, according to some embodiments.

[0012] [Diagram 3] FIG. 3 is a diagrammatic representation of how cellular proteins react with a UVC-treated implant surface, according to some embodiments.

[0013] [Figure 4] FIG. 4 illustrates the complex fibrin deposition structure after UVC treatment, according to some embodiments.

[0014] [Diagram 5] FIG. 5 depicts undesirable deposit structures on an implant that is not treated with a UVC treatment described herein, according to some embodiments.

[0015] [Figure 6] FIG. 6 is a radiograph of an exemplary peri-implantitis site prior to treatment with the methods described herein, according to some embodiments.

[0016] [Figure 7] FIG. 7 is a high-resolution photograph of the peri-implantitis site shown in FIG. 6 prior to treatment with the methods described herein, according to some embodiments.

[0017] [Figure 8] FIG. 8 is a photograph of an ablation laser suitable for the methods described herein, according to some embodiments.

[0018] [Figure 9] FIG. 9 is a high-resolution photograph showing an ablation laser cleaning an exposed implant surface, according to some embodiments.

[0019] [Figure 10] FIG. 10 depicts an acid etching step, according to some embodiments.

[0020] [Figure 11] FIG. 11 shows a UVC fixture that utilizes direct exposure from a mercury lamp generating UVC at 254 nm, according to some embodiments.

[0021] [Figure 12]FIG. 12 illustrates a hand piece with a flexible neck and interchangeable tip for directing ultraviolet light (eg, UVC light) onto a partially exposed implant, according to some embodiments.

[0022] [Figure 13] FIG. 13 illustrates two interchangeable handpiece variations and a removable optically transmitting component, according to some embodiments.

[0023] [Figure 14] FIG. 14 depicts a straight handpiece with one or more UVC light emitting diodes (LEDs) at the distal end, according to some embodiments.

[0024] [Figure 15] FIG. 15 illustrates a contra-angle handpiece and one or more UVC light projection arrays, according to some embodiments.

[0025] [Figure 16] FIG. 16 illustrates a linear handpiece and light projection array, according to some embodiments.

[0026] [Figure 17] FIG. 17 illustrates the insertion of graft material into an implant site, according to some embodiments.

[0027] [Figure 18] FIG. 18 shows a radiograph three months post-op showing successful bonding of the graft material to the remaining implant, according to some embodiments.

[0028] [Figure 19] FIG. 19 illustrates a computer system that enables or comprises the present systems and methods, according to some embodiments of the present system. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0029] Detailed Description FIG. 1 depicts the mechanism for the transformation of an implant surface from hydrophilic to hydrophobic according to some embodiments. As titanium ages, the exposed surface becomes contaminated with carbon-containing organic molecules and other non-organic molecules present in the atmosphere. The reduction in hydrophilicity caused by the contamination causes fluid repulsion. This repulsion effect also applies to fluids in cells, as shown in FIG. 2. However, studies have shown that cell affinity increases dramatically after surface treatment with ultraviolet light, particularly UVC light.

[0030] FIG. 3 is a diagram showing how cellular proteins react with a UVC-treated implant surface. As shown in the far left column 301, organic and / or inorganic materials from the atmosphere bind to the implant 302 through van der Waals forces, forming surface contaminants 303. This binding not only contaminates the surface, but also changes the electronic state of the surface. The center column 304 shows how application of UVC at about 254 nm removes the surface contaminants 303, which also change the electronic state. This in turn makes the surface of the implant hydrophilic and susceptible to cellular protein attachment, as shown in the right column 305. As the systems and methods described herein are implemented according to some embodiments, the implant will now be susceptible to cellular attachment and bodily fluids (e.g., blood) will be wicked onto its surface.

[0031] Figure 4 illustrates the complex fibrin adhesion structure 401 after UVC treatment as described herein, according to some embodiments. As shown, the adhesion is very complex and attempts to pull the fibrin apart 402 resulted in shredded fibrin, as opposed to it peeling off intact, as would be expected in a non-UVC treated implant, according to some embodiments. Figure 5 depicts the undesirable adhesion structure for an implant not treated with UVC, with low density adhesions and / or gaps 501, according to some embodiments.

[0032] FIG. 6 is a radiograph of an exemplary peri-implantitis site prior to treatment with the methods described herein, according to some embodiments. FIG. 7 is a high-resolution photograph of the peri-implantitis site shown in FIG. 6 prior to treatment with the methods described herein, according to some embodiments. In some embodiments, the first step in the method is to remove at least a portion of the implant component 701 and prepare the site for implantation. In some embodiments, as a non-limiting example, it is necessary to implant the entire area between the bone structures of implants #12 702 and #14 703 to create new bone structure for the entire implant site.

[0033] In some embodiments, the next step in the method is to clean and disinfect the surface of the implant. Figure 8 is a photograph of an ablation laser suitable for cleaning and disinfecting one or more implant surfaces, according to some embodiments. Figure 9 is a high-resolution photograph showing the ablation laser 901 of Figure 8 cleaning an exposed implant surface 902, according to some embodiments. In some embodiments, the ablation laser 901 is first used to remove residual granulation tissue and / or pathological tissue in the defect area. In some embodiments, the next step is to use the ablation laser 901 to clean bioburden from the exposed implant surface, including the areas between the implant threads.

[0034] Although the implant surface may be visually clean, at the atomic level, the aged titanium is still contaminated and in a hydrophobic state. It has been found that even treatment with an ablative laser is not sufficient to remove enough contaminants to return the implant surface to a hydrophilic state. In some embodiments, the next step to clean the implant surface 902 and prepare it for implantation material is to acid etch the exposed implant surface to remove bacterial endotoxins. FIG. 10 depicts the acid etching step, according to some embodiments. In some embodiments, after the acid etching is completed, the acid is removed and / or washed away. In some embodiments, the next step is to remove the denatured endotoxins. The preferred compound for this procedure is ethylenediaminetetraacetic acid (EDTA), but other substances and compounds may also be used.

[0035] In some embodiments, a subsequent step is to convert this to hydrogen peroxide (H 2 O 2 ) to remove any residual acid from the implant site, which also removes any remaining bioburden. While these steps are assumed to be the best mode, other methods can be employed to fulfill the steps of cleaning and preparing the area for treatment using UVC light with a wavelength of about 254 nm, according to some embodiments. Some embodiments apply UVC within ±5 nm of application of 254 nm. Some embodiments described herein include all or a portion of the UVC wavelength range (100-280 nm), and some embodiments also include the use of both UVA, independent of each other and / or in conjunction with each other.

[0036] In some embodiments, after the cleaning step, UVC treatment at 253.7 nm (as used herein, references to 254 nm and 253.7 nm are interchangeable for purposes of defining claim assignments and boundaries) is applied to the exposed implant surface. In some embodiments, the method of applying UVC treatment includes applying UVC to the implant so as not to exceed an implant surface temperature of 40° C. In some embodiments, the system is configured to modulate the power of the UVC source to prevent the implant from reaching a temperature above 40° C. FIG. 11 shows a UVC instrument configured to direct exposure to the implant surface from a mercury lamp generating UVC at 254 nm, according to some embodiments. In some embodiments, the UVC instrument includes a handpiece 1101, a side opening 1102 located proximate to a distal end 1103, and a UVC light 1104. In some embodiments, the method includes UVC treatment at about 254 nm (e.g., 253.7 nm) using one or more UVC instruments described herein.

[0037] 12 illustrates a flexible hand piece 1200 for directing ultraviolet light (e.g., UVC light) onto a partially exposed implant, according to some embodiments. In some embodiments, the flexible hand piece 1200 comprises a hand piece base 1201. In some embodiments, attached to the hand piece base 1201 is a flexible neck 1202. In some embodiments, the flexible neck 1202 is configured to bend and hold a bent position to direct light from a UVC light 1203 disposed within a tip 1204 into a patient's mouth. In some embodiments, the bending functionality can be provided by pivoting and / or sliding elements and / or linkages.

[0038] In some embodiments, light is emitted from the side light opening 1205. In some embodiments, the tip 1204 is configured to rotate about its longitudinal axis 1213 where it connects to the flexible neck 1202. In some embodiments, the flexible neck 1202 is configured to rotate about the longitudinal axis of the hand piece base 1201 and the tip 1204 is configured to rotate with the flexible neck 1202. In some embodiments, the tip 1204 is removable from the flexible neck 1202 and / or the hand piece base 1201. In some embodiments, the flexible neck 1202 and / or the hand piece base 1201 are configured to allow for multiple different types of tips, such as the tip 1206. In some embodiments, the tip 1206 comprises a distal opening 1207 configured to allow light from the UVC light 1208 to be shined therethrough.

[0039] FIG. 13 illustrates two interchangeable hand piece variations and a removable light transmitting component, according to some embodiments. In some embodiments, the hand piece includes a contra-angle hand piece 1310 with a side firing tip 1311 (or end firing tip). In some embodiments, the hand piece includes a straight hand piece 1320 with a side firing tip 1321 (or end firing tip). In some embodiments, one or more hand pieces (e.g., flexible hand piece 1200, contra-angle hand piece 1310, straight hand piece 1320, and / or combinations thereof) are configured to couple at their distal ends to a fiber assembly 1330. In some embodiments, the fiber assembly 1330 includes a fiber optic cable 1331 configured to transmit light from one or more light emitting systems including one or more of a mercury arc lamp system 1340, a single UVC LED system 1350, a UVC LED array system 1360, and a UVC flash lamp system 1370.

[0040] In some embodiments, the mercury arc lamp system 1340 is configured to reflect light from the mercury arc lamp 1341 into a lens system (e.g., one or more collimators) 1342, which includes a reflector 1343, which then focuses the UVC light into the fiber optic cable 1331. In some embodiments, the fiber optic cable 1331 is configured to transmit the UVC light into the fiber assembly 1330, which is configured to direct the UVC light out of the side firing tip 1311, 1321 (or end firing tip) when the fiber assembly 1330 is inserted into one or more hand pieces described herein.

[0041] In some embodiments, the single UVC LED system 1350 comprises a single UVC LED 1351. In some embodiments, the single UVC LED system 1350 is configured to direct UVC light emitted from the single UVC LED 1351 into a lens system 1352, which focuses the light into a fiber assembly 1330, which then directs the UVC light out of the side firing tips 1311, 1321 (or end firing tips).

[0042] In some embodiments, the UVC LED array system 1360 comprises a plurality of UVC LEDs 1361. In some embodiments, the UVC LED array system 1360 is configured to direct UVC light emitted from the UVC LED array 1361 into a lens system 1362, which focuses the light into the fiber assembly 1330 and subsequently out the side firing tips 1311, 1321 (or end firing tips).

[0043] In some embodiments, the UVC flash lamp system 1370 comprises a lens system 1372, one or more filters 1373, one or more UVC flash lamps 1374, and one or more reflectors 1375 configured to direct UVC light into the fiber assembly 1330 and then out the side firing tips 1311, 1321 (or end firing tips).

[0044] 14 depicts a linear handpiece 1400 in which one or more UVC LEDs are positioned at a distal end of the linear handpiece 1400, according to some embodiments. In some embodiments, the distal end 1401 of the linear handpiece 1400 comprises a single UVC LED 1402, a UVC LED array 1403, a mercury arc lamp system 1404, and / or a flash lamp system 1405 in a handpiece body 1406 configured to project UVC light from the distal end 1401.

[0045] FIG. 15 illustrates a contra-angle handpiece 1510 and one or more UVC light projection arrays 1530, 1540, 1550, according to some embodiments. In some embodiments, the distal end 1511 of the contra-angle handpiece 1510 comprises one or more of a lamp 1531 (e.g., a mercury arc lamp or a flash lamp configured to emit UVC light), a single UVC LED 1541, and / or a UVC LED array 1551. In some embodiments, the distal end 1511 comprises a reflector 1532. In some embodiments, the reflector 1532 is configured to reflect light from the one or more UVC light sources 1531, 1541, and / or 1551 toward a lens system 1512. In some embodiments, the lens system 1512 at the distal end 1511 is configured to direct the UVC light onto an angled mirror 1513. In some embodiments, the angled mirror 1513 is configured to direct light to a side firing tip 1520 (or end firing tip) configured to deliver UVC light to the implant surface. In some embodiments, an end firing tip is used in place of a side firing tip (or end firing tip) for any of the handpiece variations described herein.

[0046] FIG. 16 illustrates a linear hand piece 1610 and one or more UVC light projection arrays 1630, 1640, 1650 according to some embodiments. In some embodiments, the distal end 1611 of the linear hand piece 1610 comprises one or more of a lamp 1631 (e.g., a mercury arc lamp or a flash lamp configured to emit UVC light), a single UVC LED 1641, and / or a UVC array 1651. In some embodiments, the one or more UVC light sources 1631, 1641, and / or 1651 comprise a reflector configured to reflect light into a lens system. In some embodiments, the distal end 1611 comprises a lens system 1612 configured to direct UVC light into an end launch tip 1620 (or an end launch tip according to some embodiments) configured to deliver UVC light to the implant surface. In some embodiments, the linear hand piece 1610 comprises.

[0047] In some embodiments, the graft material is then selected and applied. A harder, more crystalline, less absorbent graft material will reduce adhesion to the conditioned titanium surface according to some embodiments, so absorbable graft materials are preferred. In some embodiments, the combination of xenografts, cortical bone chips, cortical and cellulose bone grafts has been found to be less effective, since the more hydroxyapatite (HA) density increases, the more likely it is that multinucleated giant cell complexes will form, which leads to connective tissue formation instead of bone. In some embodiments, cancellous allografts and / or allogeneic methods that completely absorb and release free ionic calcium have given satisfactory results and can be combined with autologous biologics.

[0048] 17 shows the application of particulates formed in a dish according to some embodiments. Using this method, the particulates are formed around the implant body, which prevents the particulates from migrating out of the site according to some embodiments. In some variations, the particulates are compacted using a number of bone plugs, and material continues to be added until the ideal volume is reached.

[0049] In some embodiments, after the graft material is added, the next step is to add a collagen membrane barrier. In some embodiments, in many peri-implantitis cases, a critical wall is missing from the defect site. In some embodiments, when the wall is missing, only a barrier (e.g., an absorbable collagen barrier) will help maintain the integrity of the implant site. In some embodiments, holes are formed in the membrane (e.g., two in this case), which are configured and arranged to match the remaining implant. The implant passes through the membrane, which is covered and formed over the bone graft composite. In some embodiments, the absorbable collagen membrane should not be the last layer, as it is not bioreactive.

[0050] In some embodiments, a subepithelial connective tissue graft (SECT) is used, often from a palate donor site, or from soft tissue such as Alloderm if more tissue is needed. In some embodiments, the final layer is an autologous fibrin membrane in the form of L-PRF (leukocyte-containing platelet rich fibrin). In some embodiments, a button hole (e.g., two small button holes) is made in the PRF membrane, which allows the membrane to stretch over and between the two implant abutments, and the membrane is then pressed down to the shoulders of the two abutments. In some embodiments, this allows for good closure without the need to worry about getting a perfect primary flap closure over the graft material. In some embodiments, a provisional bridge is then placed over the final layer. In some embodiments, a periosteal release can also be used to get good primary closure over the collagen membrane and the PRF membrane.

[0051] FIG. 18 shows a radiograph of the same case three months post-op, according to some embodiments. In some embodiments, this radial implant volume is typical of the results seen with UVC treatment of an exposed implant surface according to the methods described herein. In some embodiments, the radiograph shows strong adhesion to the pre-exposed implant surface and new bone growth in the implant area, allowing for a new implant in the same site. In some embodiments, both the new implant and the used implant are exposed to UVC light using the UVC tool described herein. In some embodiments, the lab milled post is also treated with UVC as described herein for soft tissue adhesion.

[0052] In some embodiments, the present disclosure is also directed to a UVC instrument configured and arranged to deliver UVC light at 254 nm to an exposed implant surface. As used herein, an exposed implant surface is any portion of an implant of any material that is surgically secured in a patient's mouth, where at least a portion of the implant is not covered by bone and / or tissue. Some embodiments of the present system are directed to a UVC instrument configured and arranged to apply UVC light at 254 nm to a posterior portion of the exposed implant surface that faces a posterior portion of the oral cavity and / or is away from the mouth and / or may not be visible when viewed through the mouth.

[0053] In some embodiments, the UVC instrument, including the hand piece 1200, comprises one or more fluid conduits 1209, 1210, 1211, and 1212. In some embodiments, at least one of the one or more fluid conduits 1209-1212 is a fluid delivery conduit configured and arranged to deliver a fluid to the implant site. In some embodiments, the fluid includes water. In some embodiments, the fluid includes an acid etchant. In some embodiments, the fluid includes hydrogen peroxide. In some embodiments, the fluid is a gas. In some embodiments, the fluid is air. In some embodiments, at least one of the one or more fluid conduits is a liquid delivery conduit 1209, 1211. In some embodiments, at least one of the one or more fluid conduits is a gas delivery conduit 1210, 1212. In some embodiments, the UVC instrument, including the hand piece 1200, is configured to simultaneously deliver both gas and liquid to the implant site. One or more handpiece variations shown in Figures 12-16 may include one or more tubes and / or associated functionality described herein, according to some embodiments. It should be understood that various features from some embodiments, such as tube arrangements, are non-limiting examples meant to aid one of ordinary skill in making and using the system. Features from some embodiments may be readily combinable with features from some other embodiments, and such interchangeability may be combinable for purposes of defining allocations and boundaries of embodiments of the system.

[0054] In some embodiments, at least one of the one or more fluid conduits 1209-1212 is a fluid cooling conduit configured to remove heat from the UVC instrument. In some embodiments, the one or more fluid conduits are configured and arranged to circulate a cooling fluid into, through, and / or out of the UVC tip. In some embodiments, at least a portion of the UVC instrument adjacent to or comprising the UVC tip is a necked down section 1202 that is flexible and / or adjustable. In some embodiments, the necked down section 1202 can bend up to 180° relative to the instrument hand piece while the hand piece extends outside the patient's mouth so that UVC light can be directed onto an implant surface facing a posterior portion of the oral cavity.

[0055] In some embodiments, the UVC instrument 1200 includes one or more UVC tips 1204, 1206. In some embodiments, at least a portion of the one or more UVC tips 1204, 1206 includes a light opening 1205, 1207 configured and arranged to allow UVC light to pass therethrough. In some embodiments, the light opening 1207 is at the distal end of the UVC tip and is approximately perpendicular to the neck. In some embodiments, the light opening 1205 is located on a side of the one or more UVC tips 1204 adjacent to and / or perpendicular to a plane parallel to the central axis of the handpiece base 1201 and neck 1202 along the distal end of the tip 1204. In some embodiments, at least a portion of the one or more UVC tips 1204 that includes a UVC light opening 1205 on the side is rotatable such that the UVC light may be directed at any angle between 0° and 360° when in the patient's mouth. In some embodiments, the system includes an ergonomic handpiece that can be coupled to a wide variety of tips. Some embodiments include handpieces configured to be coupled to side-firing or end-firing tips, each configured to provide a light pattern for the methods described herein. In some embodiments, the pattern is configured to keep the temperature of the implant below 40° C. In some embodiments, the distal fiber assembly is coupled to the UVC light source by an optical fiber. In some embodiments, the UVC light source is modular and easily coupled and uncoupled from the fiber. Some embodiments include a light source comprising a UVC single LED, a UVC LED array, and / or a mercury arc lamp.

[0056] Some embodiments include a controller for the UVC instrument, which may comprise any type of computer system. In some embodiments, the controller is configured to prevent the surface of the implant from reaching a temperature above 40° C. FIG. 19 illustrates a computer system 1910 that enables or comprises the present systems and methods according to some embodiments of the present systems. In some embodiments, the computer system 1910 can operate and / or process computer executable code of one or more software modules of the aforementioned systems and methods. Additionally, in some embodiments, the computer system 1910 can operate and / or display information within one or more graphical user interfaces (e.g., HMIs) integrated with or coupled to the present system.

[0057] In some embodiments, the computer system 1910 may include at least one processor 1932. In some embodiments, the at least one processor 1932 may reside in or be coupled to one or more conventional server platforms (not shown). In some embodiments, the computer system 1910 may include a network interface 1935a and an application interface 1935b coupled to the at least one processor 1932 capable of processing at least one operating system 1934. Further, in some embodiments, the interfaces 1935a, 1935b coupled to the at least one processor 1932 may be configured to process one or more software modules (e.g., enterprise application 1938, etc.). In some embodiments, the software application module 1938 may include server-based software and may operate to host at least one user account and / or at least one client account and to transfer data between one or more of these accounts using the at least one processor 1932.

[0058] With the above embodiments in mind, it should be understood that the system may employ various computer-implemented operations involving data stored in a computer system. Also, the above-described databases and models described throughout this disclosure may store analytical models and other data on computer-readable storage media in the computer system 1910 and on computer-readable storage media coupled to the computer system 1910, according to various embodiments. Additionally, in some embodiments, the above-described applications of the system may be stored on computer-readable storage media in the computer system 1910 and on computer-readable storage media coupled to the computer system 1910. In some embodiments, these operations require physical manipulations of physical quantities. Usually, although not necessarily, in some embodiments, these quantities take the form of one or more electrical, electromagnetic, magnetic, optical, or magneto-optical signals that can be stored, transferred, combined, compared, and otherwise manipulated. In some embodiments, computer system 1910 may comprise at least one computer readable medium 1936 coupled to at least one of at least one data source 1937a, at least one data storage device 1937b, and / or at least one input / output 1937c. In some embodiments, computer system 1910 may be embodied as computer readable code on computer readable medium 1936. In some embodiments, computer readable medium 1936 may be any data storage device that may store data, which may then be read by a computer (such as computer 1940). In some embodiments, computer readable medium 1936 may be any physical or material medium that may be used to tangibly store desired information or data or instructions and that may be accessed by computer 1940 or processor 1932.In some embodiments, the computer readable medium 1936 can include hard drives, network attached storage (NAS), read only memory, random access memory, FLASH® based memory, CD-ROM, CD-R, CD-RW, DVD, magnetic tape, other optical and non-optical data storage devices. In some embodiments, various other forms of computer readable medium 1936 can transmit or carry instructions to a remote computer 1940 and / or at least one user 1931, including routers, private or public networks, or other transmissions or channels, both wired and wireless. In some embodiments, the software application module 1938 can be configured to transmit and receive data to and from a database (e.g., to and from the computer readable medium 1936, including a data source 1937a, which may comprise a database, and a data storage device 1937b), and data can be received by the software application module 1938 from at least one other source. In some embodiments, at least one of the software application modules 1938 can be configured within the computer system 1910 to output data to at least one user 1931 via at least one graphical user interface rendered on at least one digital display.

[0059] In some embodiments, the computer-readable medium 1936 can be distributed over a conventional computer network via a network interface 1935a, where the system embodied by the computer-readable code can be stored and executed in a distributed fashion. For example, in some embodiments, one or more components of the computer system 1910 can be coupled to transmit and / or receive data over a local area network ("LAN") 1939a and / or an Internet-coupled network 1939b (e.g., wireless Internet, etc.). In some embodiments, the networks 1939a, 1939b can include a wide area network ("WAN"), a direct connection (e.g., through a Universal Serial Bus port), or other forms of computer-readable medium 1936, or any combination thereof.

[0060] In some embodiments, the components of the networks 1939a, 1939b may include any number of personal computers 1940, including, for example, desktop computers and / or laptop computers, or any fixed, generally non-mobile Internet appliances coupled through the LAN 1939a. For example, some embodiments include one or more of a personal computer 1940, a database 1941, and / or a server 1942 coupled through the LAN 1939a, which may be configured for any type of user, including an administrator. Some embodiments may include one or more personal computers 1940 coupled through the network 1939b. In some embodiments, one or more components of the computer system 1910 may be coupled to transmit or receive data through an Internet network (e.g., network 1939b, etc.). For example, some embodiments include at least one user 1931a, 1931b wirelessly coupled to access one or more software modules of the system including at least one enterprise application 1938 via input and output ("I / O") 1937c. In some embodiments, computer system 1910 can enable at least one user 1931a, 1931b to be coupled to access enterprise application 1938 via I / O 1937c through LAN 1939a. In some embodiments, user 1931 can comprise user 1931a coupled to computer system 1910 using a desktop computer and / or laptop computer or any fixed, generally non-mobile Internet appliance coupled through Internet 1939b. In some embodiments, user can comprise mobile user 1931b coupled to computer system 1910.In some embodiments, user 1931b may connect using any mobile computing device 1931c wirelessly coupled to computer system 1910, including, but not limited to, one or more personal digital assistants, at least one cellular telephone, at least one mobile telephone, at least one smartphone, at least one pager, at least one digital tablet, and / or at least one fixed or mobile Internet appliance.

[0061] The subject matter described herein is directed to technical improvements to the treatment and prevention of peri-implantitis by in situ treatment of exposed implant surfaces. This disclosure details how a machine including one or more computers, comprising one or more processors and one or more non-transient computers, implements several embodiments of the system and its improvements over the prior art. The instructions executed by the machine cannot be implemented in a human's mind or derived by a human using pen and paper, but require the machine to convert process input data into useful output data. Also, the claims presented herein do not attempt to link the judicial exception with known conventional steps implemented by a general purpose computer, or they do not attempt to link the judicial exception by simply relating it to the technical field. Indeed, the systems and methods described herein are unknown and / or not in the public domain at the time of filing, and they provide the advantages of technical improvements not known in the prior art. Furthermore, the system includes unconventional steps that limit the claims to useful applications.

[0062] It should be understood that the system is not limited in its application to the details of the structures and the arrangement of the components set forth in the preceding description or illustrated in the drawings. The systems and methods disclosed herein fall within the scope of numerous embodiments. The foregoing discussion is presented to enable a person skilled in the art to make and use the embodiments of the system. It should be understood that any part of the structures and / or principles included in some embodiments can be applied to any and / or all embodiments, and that features from some embodiments presented herein can be combined with other features from some other embodiments. Thus, some embodiments of the system are not intended to be limited to the exemplified content, but are to be accorded the widest scope consistent with all principles and features disclosed herein.

[0063] Some embodiments of the system are presented with specific values ​​and / or set points. These values ​​and set points are not intended to be limiting, but merely examples of higher versus lower configurations, and are intended as an aid to one of ordinary skill in the art in making and using the system.

[0064] Moreover, in its role as lexicographer, Applicant hereby assigns express claim meanings and / or disclaimers to the following terms:

[0065] Applicant defines any use of "and / or," such as, for example, "A and / or B" or "at least one of A and / or B," to mean element A only, element B only, or elements A and B together. Additionally, the listing of "at least one of A, B, and C," the listing of "at least one of A, B, or C," or the listing of "at least one of A, B, or C, or any combination thereof" is defined to mean, respectively, element A only, element B only, element C only, or any combination of elements A, B, and C, such as, for example, AB, AC, BC, or ABC.

[0066] "Substantially" and "about" when used in conjunction with values ​​encompass a variation of 5% or less in the same unit and / or scale of that which is being measured, unless otherwise specified.

[0067] "Concurrently" as used herein includes delays and / or latencies associated with conventional and / or proprietary computers, such as the processors and / or networks described herein, that attempt to process multiple types of data at the same time. "Concurrently" also includes the time it takes for a digital signal to be transferred from one physical location to another, whether through wireless and / or wired networks and / or within processor circuitry. With respect to the physical steps listed, "concurrently" includes time differences between steps of up to 5 seconds.

[0068] As used herein, the terms "can" or "may" or derivatives thereof (e.g., the system is capable of exhibiting X) are used for descriptive purposes only and are understood to be synonymous and / or interchangeable with "configured to" (e.g., a computer is configured to execute instructions X) when defining the allocations and boundaries of the system.

[0069] Additionally, the term "configured to" means that the limitations recited in the specification and / or claims must be arranged in such a way as to perform the recited functions, and "configured to" excludes structures in the art that are "capable" of being modified to perform the recited functions, but for which the associated disclosure in the art does not have any explicit teaching to do so. For example, the recitation of "a container configured to receive fluid from structure X at an upper portion and deliver fluid to structure Y at a lower portion" is limited to systems in which structure X, structure Y, and the container are all disclosed as being arranged to perform the recited functions. The recitation "configured to" excludes elements that may simply be "capable" of performing the recited functions by those structures, but for which the associated disclosure (or lack thereof) does not provide any teaching to make such modifications to meet the functional limitations among all the recited structures. Another example is "a computer system configured or programmed to execute a sequence of instructions X, Y, and X." In this example, the instructions must be present on a non-transitory computer readable medium such that a computer system is "configured" and / or "programmed" to execute the recited instructions, and "configured to" and / or "programmed to" exclude the art of teaching a computer system with a non-transitory computer readable medium that is merely "capable of" having the recited instructions stored thereon, but does not have any teaching of instructions X, Y, and Z programmed and stored thereon. The recitation "configured to" can also be construed as synonymous with operatively connected when used in conjunction with physical structure.

[0070] The foregoing detailed description should be read with reference to the figures, in which like elements in different figures have like reference numerals. The figures, which are not necessarily to scale, depict some embodiments and are not intended to limit the scope of embodiments of the present system.

[0071] Any of the operations described herein that form part of the invention are useful machine operations. The invention also relates to a device or apparatus for performing these operations. The apparatus can be specially constructed for the required purpose, such as a special purpose computer. When defined as a special purpose computer, the computer can also perform other processes, program execution, or routines that are not part of the special purpose, while still being capable of operating for the special purpose. Alternatively, the operations can be processed by a general purpose computer that is selectively activated or configured by one or more computer programs stored in a computer memory, cache, or obtained over a network. When data is obtained over a network, the data can be processed by other computers on the network, for example, a cloud of computing resources.

[0072] An embodiment of the present invention can also be defined as a machine that transforms data from one state to another. The data can be represented as electronic signals and represent an object that can electronically manipulate the data. The transformed data can, in some cases, be visually depicted on a display and represent a physical object resulting from the transformation of the data. The transformed data can be stored in a storage device generally or in a specific format that allows for the construction or depiction of a physical and tangible object. In some embodiments, the manipulation can be performed by a processor. In such examples, the processor thus transforms data from one thing to another. Still further, some embodiments include methods that can be processed by one or more machines or processors that can be connected via a network. Each machine can transform data from one state or thing to another and can also process the data, store the data in a storage device, transmit the data via a network, display the results, or communicate the results to another machine. Computer-readable storage media as used herein refers to physical or tangible storage devices (as opposed to signals) and includes, without limitation, volatile and nonvolatile, removable and non-removable storage media implemented in any method or technology for the tangible storage of information such as computer-readable instructions, data structures, program modules, or other data.

[0073] Although the method operations are presented in a particular order according to some embodiments, the execution of those steps is not necessarily in the order recited unless explicitly specified. Also, other housekeeping operations can be performed between operations, operations can be adjusted so that they occur at slightly different times, and / or operations can be distributed in the system to allow for the occurrence of processing operations at various intervals associated with the processing, so long as the processing of the overlay operations is performed in the desired manner and results in the desired system output.

[0074] Although the present invention has been described above with reference to certain embodiments and examples, it will be understood by those skilled in the art that the present invention is not necessarily so limited, and that numerous other embodiments, examples, uses, modifications, and departures from the embodiments, examples, and uses are intended to be encompassed by the claims appended hereto. The entire disclosure of each patent and publication cited herein is incorporated by reference as if each such patent or publication were individually incorporated herein by reference. Various features and advantages of the present invention are set forth in the following claims.

Claims

1. 1. A system for use in a method for treating peri-implantitis on one or more dental implants placed in a patient's mouth using ultraviolet light, the method comprising: (1) cleaning the area around the one or more dental implants; (2) preparing the area for implantation material; (3) removing any remaining bioburden from the exposed implant surface; (4) applying an ultraviolet light treatment to the exposed implant surface; (5) applying the graft material around the exposed implant surface; (6) applying a collagen barrier over the implant material; Including, the system.

2. The system of claim 1 , wherein cleaning the area comprises removing granulation tissue and / or pathological tissue from around the one or more dental implants.

3. 10. The system of claim 1, wherein the step of removing the remaining bioburden comprises treating the exposed implant surface with directed laser energy.

4. The system described in claim 1, wherein the step of providing the ultraviolet light treatment to the exposed implant surface includes providing ultraviolet c (UVC) light to the exposed implant surface in a wavelength range of 100 nm to 280 nm.

5. The system described in claim 1, wherein the step of providing the ultraviolet light treatment to the exposed implant surface includes providing ultraviolet c (UVC) light to the exposed implant surface in a wavelength range of 249 nm to 259 nm.

6. The system of claim 1, wherein the step of providing the ultraviolet light treatment to the exposed implant surface includes providing an ultraviolet light fixture configured to apply ultraviolet c (UVC) light to the exposed implant surface in a wavelength range of 100 nm to 280 nm.

7. The system described in claim 6, wherein the ultraviolet light instrument is configured to apply the UVC light to the exposed implant surface, the exposed implant surface facing at least partially toward a posterior and / or inner portion of the patient's oral cavity.

8. The system described in claim 6, wherein the ultraviolet light instrument comprises a straight dental handpiece.

9. The system described in claim 8, wherein the collagen barrier is configured to substantially fixate the transplant material in place for healing and restoration.

10. An apparatus for treating an implant placed in a patient's mouth, comprising: A handpiece and an ultraviolet light source; Tip and Equipped with the tip is coupled to a distal end of the handpiece; the handpiece is configured to direct ultraviolet light from the ultraviolet light source to the tip; An apparatus wherein the handpiece and the tip are configured to allow the ultraviolet light to be directed onto an exposed surface of a dental implant in the patient's mouth.

11. The device described in claim 10, wherein at least a portion of the exposed surface faces a posterior portion of the oral cavity.

12. The device described in claim 10, wherein at least a portion of the exposed surface is not visible when viewing inside the patient's mouth.

13. The device described in claim 10, wherein the handpiece and the tip are configured to allow the ultraviolet light to be directed onto the exposed surface of the dental implant while at least a portion of the handpiece extends outside the patient's mouth.

14. The handpiece comprises a contra-angle dental handpiece; the tip is one of an end tip and a side firing tip; the contra-angle dental handpiece is configured to couple to the side firing tip or the end firing tip; the side firing tip and the end firing tip are each configured to direct the ultraviolet light onto the exposed surface of the dental implant.

11. The apparatus of claim 10.

15. The handpiece further comprises a flexible reduced diameter portion, the flexible reduced diameter section is configured to bend to direct the ultraviolet light onto the exposure surface.

11. The apparatus of claim 10.

16. The device described in claim 15, wherein the tip is configured to be coupled to the flexible reduced diameter portion.

17. The device described in claim 16, wherein the tip is one of an end tip and a side-firing tip.

18. The device described in claim 16, wherein the tip is configured to emit the ultraviolet light from a side of the tip.

19. The device described in claim 17, wherein the ultraviolet light is ultraviolet C light (UVC) with a wavelength of 100 to 280 nm.

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