Systems and methods related to intraoral electrical stimulation

Abstract

Devices and methods for delivering electrical current to, through, or across oral gingival tissues are used to achieve several therapeutic, preventative, cosmetic, and / or regenerative benefits. These benefits include killing or reducing oral microorganisms, increasing oral vasodilation, reducing oral biofilm, improving oral blood circulation, restoring oral bone resorption, promoting oral bone formation, treating gingival recession, and promoting gingival regeneration. Other benefits include treating gingivitis, periodontitis, and halitosis, as well as other systemic diseases correlated with oral pathogens. Use of the systems and methods according to the present invention can effectively tighten epithelial contact with one or more teeth (e.g., by junctional or sulcular epithelium) and / or cause tightening of the oral epithelium, thereby improving the appearance of a human smile.

Description

[Technical Field]

[0001] The present invention relates to systems and methods relating to the non-invasive application of direct current electricity to the surface of the oral cavity, thereby promoting general oral hygiene or cosmeticity, treating periodontal diseases such as gingivitis and periodontitis, killing or reducing oral microorganisms, including bacteria that cause tooth decay, reducing oral biofilms, increasing blood flow in oral tissues, increasing saliva secretion, promoting gingival tissue regeneration, developing bone formation in the bone structure of teeth, mouths, and related areas, treating systemic diseases associated with oral bacteria, and / or treating other periodontal and oral diseases. The invention also relates to apparatus suitable for providing direct current electricity for these therapeutic, preventive, cosmetic, and regenerative effects. [Background technology]

[0002] Periodontal disease has been identified by both dentists and physicians as a risk factor for various systemic diseases. These diseases include cardiovascular disease, adverse pregnancy outcomes, and diabetes, and newly found evidence supports its association with pancreatic disease and arthritis. While many studies have established a correlation between the presence of periodontal disease and these systemic conditions, causal relationships with the majority of these conditions remain a subject of ongoing research. Several biological mechanisms have been proposed regarding how oral bacteria originating from periodontal disease may cause systemic diseases, as follows: 1. Direct effects of oral infections: Oral microorganisms and their byproducts can gain systemic access through the circulatory system by progressing through damaged tissues and inflamed periodontal ligaments in the oral cavity. By gaining systemic access, oral microorganisms have the potential to directly influence the subclinical vectors of various systemic diseases. 2. Inflammation: Individuals with periodontal disease have elevated levels of systemic inflammatory markers due to the increased level of oral bacteria. Treatment for periodontal disease has been reported to reduce levels of systemic inflammation. 3. Cross-reactivity: The progression of systemic disease may be accelerated by an immune response to bacterial heat shock proteins that produce antibodies that cross-react with congenital heat shock proteins expressed on cells in damaged tissue. cardiovascular disease

[0003] Studies investigating the potential link between periodontal disease and cardiovascular diseases, including atherosclerosis, coronary heart disease, and stroke, have found a significant positive correlation between poor oral health and the prevalence of cardiovascular disease. While both diseases share some common risk factors, recent studies suggest that periodontitis may precede and therefore contribute to atherosclerotic complications. Indeed, meta-analyses show that subjects with periodontitis are at increased risk of developing cardiovascular disease.

[0004] While it has not been definitively shown whether these bacteria cause atherosclerosis, or more precisely, invade already damaged arteries, antibodies against periodontal bacteria, including Fuseobacterium nucleatum and Streptococcus oralis, have been found in blood serum and are associated with an increased risk of coronary heart disease. Mouse studies have found that intravenous inoculation with Porphyromonas gingivalis accelerated the development of atherosclerosis. Furthermore, following oral inoculation, P. gingivalis DNA was found in the aortic tissue of those infected mice, showing observable signs of accelerated early atherosclerosis. Another study lists F. nucleatum as a synergistic agent with P. gingivalis. F. nucleatum enhances the ability of P. gingivalis to invade host cells, due to a co-aggregating effect between the two organisms. This is significant because bacteria within the ather can lead to the development of atherosclerotic plaque. Evidence to date supports the idea that periodontitis leads to systemic exposure to oral bacteria, which act as a potential source of systemic inflammatory mediators—cytokines produced within infected periodontal tissue that, once they enter the bloodstream, can cause or exacerbate atherosclerosis and coronary heart disease. Clinical research on periodontal disease has also revealed a positive link to coronary artery disease, and there is a focus on understanding the precise relationship between periodontal disease and atherosclerosis. Premature birth

[0005] Fusobaceterium nucleatum, one of the most widely recognized bacterial species found in amniotic fluid and placental infections that cause premature birth, is also often listed as a sole infectious agent in premature delivery with intact amniotic membranes. F. nucleatum is also strongly associated with various types of periodontal disease. During periodontal infection, when the oral mucosa is damaged and inflamed, and the periodontal pathogen count increases dramatically, transient levels of bacteria can appear in the bloodstream, leading to selective colonization of undesirable sites. One study demonstrated that pregnant mice injected hematogenously with F. nucleatum extracted from either amniotic fluid infection or an oral source resulted in fetal death.

[0006] Recently, human stillbirth cases have been analyzed and found that F. nucleatum actually originates from the mother's oral cavity, a fact that had not yet been proven. F. nucleatum is likely transferred from the mother's mouth via the bloodstream, where it can then cross the endothelium, proliferate and colonize in the fetal membranes, amniotic fluid, and fetus, and its presence may have contributed to fetal death. In a mouse model, hematogenous injection of F. nucleatum into pregnant mice resulted in specific bacterial colonization within the placenta, causing localized inflammation. F. nucleatum was completely cleared from maternal circulation 24 hours after injection. However, once colonized within the immunologically privileged placenta, the bacteria proliferated rapidly, leading to fetal death within 3 days. Chronic periodontal disease can mediate infections through the transfer of periodontal bacteria / inflammatory markers to the fetal-placental system. diabetes

[0007] Diabetes mellitus is an endocrine disorder stemming from genetic, environmental, and behavioral risk factors. Over the past several decades, diabetes has been considered a variant of periodontal disease, and in recent years, a bidirectional relationship between the two has been suggested. Furthermore, the presence of periodontal disease has been linked to a risk of diabetic complications, namely poor glucose control. Recent longitudinal and systematic studies have found that periodontal disease correlates with a higher risk of death from ischemic heart disease, diabetic nephropathy, end-stage renal disease, and increased insulin resistance compared to patients with mild or no periodontal disease. In type 2 diabetes, insulin resistance is linked to the action of pro-inflammatory cytokines. Periodontal disease is thought to lead to significantly higher levels of these serum markers in inflammation, thus contributing to insulin resistance. A human study examining bacterial content in adults with and without type 2 diabetes found that diabetic patients had significantly more severe periodontitis and higher levels of many oral bacteria, including Streptococcus oralis. Suppurative liver abscess

[0008] F. nucleatum has recently been linked to suppurative liver abscesses (PLA). While PLA is usually caused by bile duct lesions, diverticular diseases and bowel malignancies, atrophic gastritis, and idiopathic liver disease, PLA caused by F. nucleatum is very rare, with Escherichia coli, Klebsiella, and Enterobacter being the most commonly identified microorganisms in discharged abscesses. F. nucleatum was found in liver abscesses, but no other infectious sources were found, except for dental extracts. It is hypothesized that the co-aggregating properties of F. nucleatum allow it to be transported, destroy the colonic mucosa, and lead to bacteremia, which in turn leads to liver abscesses. Osteomyelitis

[0009] Osteomyelitis is a bone infection caused by bacteria, fungi, or other pathogens. Generally, bacteria spread from infected skin, muscle, or tendon to the bone, often occurring under skin erosions. Infections can also occur in other parts of the body and can spread hematogenously. Less frequently, Fusobacterium species have been identified from bone / joint infections in the head and neck area and have been associated with chronic periodontitis. A recent study reported a case of osteomyelitis caused by F. nucleatum complicated with a muscle abscess. The patient had no known predispositions and no other sources of infection were found, except for a history of periodontal disease. It is thought that poor oral hygiene in the patient may have led to F. nucleatum bacteremia, which then progressed to hematogenous osteomyelitis of the lower leg. arthritis

[0010] Numerous clinical studies have suggested a potential link between rheumatoid arthritis (RA) and periodontal disease, as several oral bacterial species, including P. ginvalis and Prevotella intermedia, have been identified in the synovial fluid of patients. Periodontal disease is thought to allow bacteria to penetrate through the permeable pocket epithelium in the oral cavity and reach the underlying gingival connective tissue. From there, they can be transported into the bloodstream with the ability to colonize anywhere in the body. The oral bacteria found in the synovial fluid of patients with RA are due to synovitis, which preferentially captures oral bacterial DNA, suggesting that periodontal disease may have a lasting effect on joint disease. Therefore, periodontitis may indeed be a contributing factor to the autoimmune inflammatory response characteristics of RA. Patients with RA are also at a higher risk of developing periodontal disease, thus suggesting a bidirectional relationship between the two conditions. One particular study examined the presence of bacterial DNA in the synovial fluid of natural and dysfunctional prostheses in patients with arthritis. Of the five patients in whom bacterial DNA was found, F. nucleatum was detected in four of them. This suggests that this bacterium can transfer from the oral cavity to the synovial fluid, as F. nucleatum was also found in the patients' plaque samples. oral biofilm

[0011] Periodontitis, gingivitis, and dental caries are infectious oral diseases in which oral biofilms and bacteria play a role. Biofilm formation is also involved in the pathogenesis of dental implant failures such as peri-implantitis, denture stomatitis, and oral yeast infections such as candidiasis. Oral biofilm formation begins with the formation of a peridental bacterial film on the teeth. This bacterial film consists of salivary proteins that coat the exposed surface of the teeth, mainly above the gingival margin, and planktonic bacteria begin to adhere to it. Aerobic bacteria, including Gram-positive bacteria such as S. oralis, are early colonizers that begin to form initial biofilm colonies mainly through cell division of attached bacteria.

[0012] Once the initial colonies are established, other co-aggregating bacterial species, such as F. nucleatum, P. ginvalis, and other Gram-negative anaerobic bacteria, attach to the previously formed colonies. As these colonies mature, they grow, cover the subgingival surface of the tooth, and begin to induce inflammation within the periodontal ligament. [Overview of the project] [Means for solving the problem]

[0013] The present invention relates to methods and apparatus for assisting overall oral health and / or cosmetic appearance, and more specifically to treating periodontal diseases such as gingivitis, periodontitis, and peri-implantitis, killing oral microorganisms including caries-causing bacteria, reducing oral biofilms, increasing blood flow in oral tissues, increasing saliva secretion, promoting gingival tissue regeneration, developing bone formation in the bone structure of teeth, mouths, and related areas, treating systemic diseases associated with oral bacteria, and treating other periodontal and oral diseases through the non-invasive application of weak electricity to the oral surface. Alternatively, or in addition, the use of embodiments of the systems and methods according to the present invention can lead to a reduction in periodontal pocket depth, a reduction in gingival bleeding, a reduction in gingival inflammation, and / or a reduction in clinical attachment loss. The use of the systems and methods according to the present invention has also been found to effectively tighten epithelial contact with one or more teeth (e.g., by junctional epithelium and / or sulcus epithelium) and / or cause tightening of the oral epithelium, thereby improving the appearance of a person's smile.

[0014] These effects are achieved by delivering an electric current (preferably direct current) to the gingiva through multiple electrodes that are in direct physical (or at least electrical) contact with the surface of the gingival tissue (e.g., lingual, buccal, palatal, and / or vestibular gingival tissue). The electrodes may be made of any conductive material, including, but not limited to, metals such as silver, stainless steel, copper, gold, platinum, palladium, aluminum, or their alloys, conductive nanotubes, carbide rubber, conductive silicone, or conductive polymers. Each electrode may be made of the same material as one or more of the other electrodes, or it may be made of a different material than one or more of the other electrodes. These electrodes are fitted tightly or in close proximity to the lingual and buccal surfaces of the gingiva and are in electrical contact (e.g., physical contact, or spaced-out but electrical contact) with each side (i.e., lingual and buccal) or the same side (i.e., lingual or buccal) of the gingiva, allowing electricity to pass across or along the tooth and neighboring gingival tissue.

[0015] Electrodes on each side (lingual or buccal) of the gingiva along one or more teeth may have the same polarity. Electrodes on the opposite side of the gingiva may have opposite polarity, or adjacent electrodes on the same side of the gingiva may have opposite polarity. This allows current to flow across and / or along the teeth and gingiva to electrodes positioned on the traversing gingiva, completing the electrical circuit. In other words, all electrodes on the lingual side of the gingiva may be entirely anode or entirely cathode. All electrodes on the buccal surface of the gingiva traversing the lingual surface of the gingiva may then have the opposite polarity to the lingual electrodes. The polarization of these electrodes may be reversed during or between electrical stimulation sessions. Electrodes are preferably individually programmable to anode functionality, cathode functionality, or even disconnection or high impedance states. Alternatively, a group of electrodes (e.g., all lingual electrodes) may have fixed functionality as either anode or cathode.

[0016] The mandibular and maxillary gingiva may each receive multiple electrodes. This allows for stimulation of both the maxillary and mandibular periodontal ligaments, either simultaneously or individually. The maxillary and mandibular electrode sets may be powered by two different adjustable power sources or by the same adjustable power source.

[0017] An electrical conductor (which may be wired or more preferably conductive silicone) connects the electrodes to a regulating power source. Through a current regulator, all activated anode electrodes will be connected to the negative terminal of the power source, and all activated cathode electrodes will be connected to the positive terminal of the power source. The regulating power source is capable of delivering a stable DC current within an approximate range of 1 to 500 microamperes. A preferred current setting for most stimulation sessions is within an approximate range of 50 to 250 microamperes. More preferably, the current setting is about 125 to 150 microamperes, controlled to ±10%.

[0018] According to one aspect of an embodiment of the system according to the present invention, the system includes a controller and a mouthpiece. The controller has a housing containing a variable direct current power supply, and the power supply is capable of delivering from about 1 to 500 microamperes. The mouthpiece is configured to be received within a human mouth and the mouthpiece includes at least one U-shaped channel. A plurality of exposed electrodes may be supported by the mouthpiece and coupled to a direct current power source. A reduced diameter portion preferably electrically couples the direct current power supply to the mouthpiece and physically couples the housing to the mouthpiece. The electrical coupling in the reduced diameter portion may be achieved by a plurality of conductive pins inserted into and thereby substantially surrounded by a conductive silicone trace.

[0019] According to another aspect of an embodiment of the system according to the present invention, a first one of the plurality of exposed electrodes is a cathode electrode disposed on a first side of a first one of the at least one U-shaped channels, and a second one of the plurality of exposed electrodes is an anode electrode disposed on a second side of the first channel.

[0020] According to yet another aspect of an embodiment of the system according to the present invention, the mouthpiece includes two U-shaped channels, one channel being configured to receive one or more upper human teeth and the other channel being configured to receive one or more lower human teeth.

[0021] According to another aspect of an embodiment of the system according to the present invention, the controller includes an electronic circuit network disposed within a housing, and the circuit network is configured to perform at least one of the operations and monitoring of at least one of the duration and intensity of the current provided to each electrode by a power source. The controller may further include a user input interface and a user feedback interface. The controller is also configured to store one or more counter values and an event log in a non-volatile memory, and the event log may preferably be capable of storing 2,000 event occurrences, each including a time stamp associated therewith.

[0022] According to a further aspect of an embodiment of the system according to the present invention, the variable DC power supply includes a rechargeable lithium-ion battery. The system may include a charging station that physically supports the controller housing and is capable of inductively recharging the rechargeable lithium-ion battery. The charging station may further include a hinged cover that may contain the controller and the mouthpiece, for example, for storage and / or movement.

[0023] According to further aspects of embodiments of the system according to the present invention, the system further comprises a mobile wireless communication device capable of physical layer communication with a controller, and the wireless device further includes a software application capable of software layer communication with the controller. The controller is preferably capable of transmitting counter values ​​and event logs to the application on the wireless device, such transmission occurring in response to at least one of the occurrence of a predetermined event, the end of a predetermined period, and a predetermined time of day. The application is preferably configured to display at least one transmitted counter value and event log simultaneously, and is also configured to enable storage of the transmitted counter values ​​and event logs in non-volatile memory within the wireless device. The application is also preferably configured to provide firmware updates to the controller periodically or on request.

[0024] According to further aspects of embodiments of the system according to the present invention, the mouthpiece is A first injection molding procedure using conductive silicone material to form traces and electrodes and to form a conductive skeleton, A second injection molding procedure using an insulating silicone material to encapsulate at least a portion of each trace, It may be formed by a process that includes the following steps. The second injection molding procedure is preferably performed after the first injection molding procedure.

[0025] According to one aspect of an embodiment of the method of the present invention, this method is The steps include providing a mouthpiece that supports multiple electrodes coupled to a DC current power supply, The steps include positioning the first electrode of multiple electrodes between the human cheek and the outer gingival line, in physical contact with the gingival tissue, The steps include positioning the second electrode of the multiple electrodes inside the first electrode, in physical contact with the gingival tissue, The steps include: delivering electric current from the power source to the gingival tissue, The process involves adjusting the intensity of current delivery to the gingival tissue via a controller to approximately 1-500 microamperes, A step of adjusting the duration of current delivery to 30 minutes or less via a controller, Includes.

[0026] According to another aspect of the embodiment of the method according to the present invention, the method further, The steps include storing data metrics and event logs in non-volatile memory within the controller, The steps include providing a software application on an electronic wireless device capable of communicating with a controller, Steps include pairing a wireless device and enabling communication with the controller, Steps include transferring data metrics and event logs from the controller to the wireless device, The steps include storing data metrics and event logs in the non-volatile memory of an electronic device, The steps include using a software application to examine at least some of the stored data metrics and event logs, Includes. The present invention provides, for example, the following: (Item 1) It is a system, A controller having a housing containing a variable DC current power supply source, wherein the power supply source is capable of delivering approximately 1 to 500 microamperes, and A mouthpiece configured to be received in the mouth of a human, wherein the mouthpiece comprises at least one U-shaped channel, Multiple exposure electrodes supported by the mouthpiece and coupled to a DC current power supply, The DC current power supply is electrically coupled to the mouthpiece, and the housing is physically coupled to the mouthpiece by a reduced diameter portion. Equipped with, The electrical coupling in the reduced-diameter portion is achieved by a plurality of conductive pins inserted into a conductive silicone trace and substantially surrounded by it, in a system. (Item 2) The system according to item 1, wherein the first of the plurality of exposed electrodes is a cathode electrode positioned on the first side of the first of the at least one U-shaped channel, and the second of the plurality of exposed electrodes is an anode electrode positioned on the second side of the first channel. (Item 3) The system according to item 1, wherein the mouthpiece comprises two U-shaped channels, one channel configured to receive one or more maxillary teeth of a person, and the other channel configured to receive one or more mandibular teeth of the person. (Item 4) The system according to item 3, wherein the controller comprises an electronic network located within the housing, and the network is configured to perform at least one operation and monitoring of at least one of the duration and intensity of the current supplied to each electrode by the power supply. (Item 5) The system according to item 4, further comprising a user input interface and a user feedback interface. (Item 6) The system described in item 5, wherein the controller is configured to store one or more counter values ​​and event logs in non-volatile memory. (Item 7) The event log described in item 6 is capable of storing at least 2,000 event occurrences, each including its associated timestamp. (Item 8) The variable DC current power supply system, as described in item 1, comprises a rechargeable lithium-ion battery. (Item 9) The system according to item 8, further comprising a charging station that physically supports the controller housing and is capable of inductively recharging the rechargeable lithium-ion battery. (Item 10) The system according to item 9, wherein the charging station comprises a hinged cover that may contain the controller and mouthpiece. (Item 11) The system further comprises a mobile wireless communication device capable of physical layer communication with the controller, and the wireless device further includes a software application capable of software layer communication with the controller, as described in item 6. (Item 12) The system according to item 11, wherein the controller is capable of transmitting the counter value and event log to the application of the wireless device. (Item 13) The system according to item 12, wherein the controller transmits the counter value and event log in response to at least one of the occurrence of a predetermined event, the end of a predetermined period, and a predetermined time of day. (Item 14) The system described in item 12, wherein the application is configured to display at least one transmitted counter value and an event log simultaneously. (Item 15) The system according to item 12, wherein the application is configured to enable the storage of the transmitted counter values ​​and event logs in a non-volatile memory within the wireless device. (Item 16) The system described in item 11, wherein the application is configured to provide firmware updates to the controller. (Item 17) The aforementioned mouthpiece is A first injection molding procedure using the conductive silicone material to form the trace and the electrodes and to form a conductive skeleton, A second injection molding procedure using an insulating silicone material to encapsulate at least a portion of each trace, The system described in item 1, formed by a process that includes the steps of [the specified step]. (Item 18) The second injection molding procedure is performed after the first injection molding procedure, in the system described in item 17. (Item 19) It is a method, The steps include providing a mouthpiece that supports multiple electrodes coupled to a DC current power supply, The steps include positioning the first electrode of the plurality of electrodes between the human cheek and the outer gingival line, so as to be in physical contact with the gingival tissue, The steps include positioning the second electrode of the plurality of electrodes inside the first electrode, so as to be in physical contact with the gingival tissue, The steps include delivering current from the power source to the gingival tissue, The steps include adjusting the intensity of the current delivery to the gingival tissue to approximately 1 to 500 microamperes via a controller, The steps include adjusting the duration of the current delivery to 30 minutes or less via the controller, and Methods that include... (Item 20) The steps include storing data metrics and event logs in the non-volatile memory within the controller, The steps include providing a software application on an electronic wireless device capable of communicating with the controller, The steps include pairing the wireless device and enabling communication with the controller, The steps include transferring the data metrics and event logs from the controller to the wireless device, The steps include storing the data metrics and event logs in the non-volatile memory of the electronic device, The steps include: using the aforementioned software application to examine at least some of the saved data metrics and event logs; The method described in item 19, further including the method described in item 19. [Brief explanation of the drawing]

[0027] [Figure 1] Figure 1 is a perspective view of an intraoral electrical stimulation device and associated storage and / or charging stand according to the present invention. [Figure 2] Figure 2 is a top plan view of a mouthpiece and controller according to the present invention. [Figure 3] Figure 3 is a bottom plan view of the mouthpiece and controller according to the present invention. [Figure 4] Figure 4 is a left side elevation view of a mouthpiece and controller according to the present invention. [Figure 5] Figure 5 is a rear elevation view of a mouthpiece and controller according to the present invention. [Figure 6] Figure 6 is a schematic representation of the electrical circuit of the controller according to the present invention. [Figure 7] Figure 7 is a partial cross-sectional view of an embodiment of a controller according to the present invention, obtained along line 7-7 in Figure 3. [Figure 8A] Figure 8 includes a schematic diagram of a portion of the electrical circuit in one embodiment of the controller according to the present invention. [Figure 8B] Figure 8 includes a schematic diagram of a portion of the electrical circuit in one embodiment of the controller according to the present invention. [Figure 8C] Figure 8 includes a schematic diagram of a portion of the electrical circuit in one embodiment of the controller according to the present invention. [Figure 8D]Figure 8 includes a schematic diagram of a portion of the electrical circuit in one embodiment of the controller according to the present invention. [Figure 9] Figure 9 is a front perspective view of the embodiment of Figure 1, showing the mouthpiece / controller supported by a stand. [Figure 10] Figure 10 is a front perspective view of a charging stand / case according to the present invention, which receives a mouthpiece / controller according to the present invention. [Figure 11] Figure 11 provides a table of user interface feedback that occurs at predetermined times in a given device or software state. [Figure 12A] Figures 12A-B provide a table of programmable parameters stored in the memory of the controller according to the present invention. [Figure 12B] Figures 12A-B provide a table of programmable parameters stored in the memory of the controller according to the present invention. [Figure 13A] Figures 13A-B provide a table of counters or metrics to be logged according to individual occurrences during the operation of the controller, according to the present invention. [Figure 13B] Figures 13A-B provide a table of counters or metrics to be logged according to individual occurrences during the operation of the controller, according to the present invention. [Figure 14] Figure 14 provides a table of events and associated event data recorded by the software. [Figure 15A] Figures 15A-C provide a table of controller operating functions, associated operating user tasks, and responses according to the present invention. [Figure 15B] Figures 15A-C provide a table of controller operating functions, associated operating user tasks, and responses according to the present invention. [Figure 15C] Figures 15A-C provide a table of controller operating functions, associated operating user tasks, and responses according to the present invention. [Figure 16]Figure 16 is a flowchart illustrating the operating or non-operating state of the controller according to the present invention. [Modes for carrying out the invention]

[0028] Detailed explanation The disclosure herein is detailed and precise so as to enable those skilled in the art to practice the invention; however, the physical embodiments disclosed herein are merely illustrative of the invention and may be embodied in other specific structures. Preferred embodiments are described, but details may be modified without departing from the invention.

[0029] It is known in the art that oral bacteria cannot survive when exposed to low microampere direct current electricity. Methods for killing oral bacteria and treating bacterial conditions such as gingivitis have been demonstrated in Nachman's U.S. Patent No. 4,244,373 (January 13, 1981) and Detsch's U.S. Patent No. 4,509,519 (April 9, 1985). Killing oral bacteria has the additional benefit of preventing dental caries and decay. Generally, dental caries is caused by aerobic acid-producing bacteria, whose acids cause decompensatory mineral removal from teeth. However, Nachman does not specify an optimal approach to reducing oral bacteria, including aerobic and anaerobic bacteria, at the species level, but instead teaches a general, untargeted treatment.

[0030] In studying the effects of direct current electricity on the mouth, the applicant discovered that by increasing the current level to an approximate range of 50 to 250 microamperes (μA), direct current electrical stimulation can provide novel and unexpected therapeutic, preventive, cosmetic, and regenerative benefits previously unknown in the art.

[0031] Specifically, by utilizing direct current within the aforementioned range, it has been found that such stimulation not only kills bacteria but also kills or neutralizes viruses and fungi. Research from the field of podiatry has shown that higher current levels than those used in existing oral electrical stimulation are necessary to effectively treat fungal infections ("Low-Voltage Direct Current as a Fungicidal Agent for Treating Onychomycosis", Kalinowski, et al., Journal of the American Podiatric Medical Association Vol. 94 No.6: 565-572, 2004). By applying this knowledge of increased current levels from research outside the art, the applicant has been able to add mycobacterial and virostatic benefits to methods already known to be bactericidal. The applicant's research has shown that these microbiotachygenic properties begin to take effect within approximately 5–15 minutes of stimulation, reducing microorganisms both above and below the gum line.

[0032] In addition, the applicant's clinical studies have unexpectedly demonstrated that direct currents within an approximate range of 50–250 microamperes can regenerate gingival tissue and provide a non-surgical alternative for people suffering from receding gums. While the ossogenic properties of electricity were known in the art, the connection between non-ossicular tissue regeneration and electricity was not well known in the art prior to these experiments. The unique current range associated with the method and apparatus of the present invention is one of several effective methods in the dental field for achieving effective gingival tissue regeneration in a non-surgical manner.

[0033] In further research, the applicant conducted a preclinical study examining the effects of direct current stimulation on three different oral bacteria (F. nucleatum, S. oralis, P. ginvalis) in both saline and salivary solutions. This study varied the current level, bacterial species size, solution medium, and stimulation time to develop optimal reductions for these three bacterial species associated with both periodontal disease and systemic disease.

[0034] The results of this study yielded unexpected findings, demonstrating that each different bacterium exhibited different dose-responses to DC stimulation. Through this study, the applicant identified stimulation parameters that were capable of killing up to 100% of S. oralis, 99.1% of F. nucleatum, and 52.3% of P. ginvalis in a single stimulation session lasting 30 minutes or less. This study provides specifications for DC-based stimulation of targeted pathogens, which were previously unknown in the art. The optimal stimulation parameters discovered in this study and described herein can reduce these three species of bacteria in both the supragingival and subgingival environments, and thus provide an innovative method for preventing and / or treating their associated complications, including periodontal disease, biofilm formation, and systemic diseases correlated with these oral pathogens.

[0035] In addition, scanning electron microscopy (SEM) was performed on F. nucleatum colonies approximately 30 minutes after stimulation according to the present invention to gain a deeper understanding of the mechanism by which the method according to the present invention can reduce bacterial levels. SEM images suggested that the method according to the present invention can interfere with bacterial cell division, weaken the outer membrane (cell membrane), and result in a fragile cellular structure that can be easily damaged. This phenomenon is an example of electroporation, and it is assumed that the permeability of the cell membrane can be affected by electrical stimulation, either temporarily or permanently. Furthermore, it is assumed that the electroporation caused by the method according to the present invention could play a role in developing novel therapies in molecular biology that utilize this cell permeability to introduce new materials into cells of oral pathogens or oral tissues through mechanisms including, but not limited to, genetic material (gene transfer) such as DNA, RNA, sRNA, siRNA, and plasmids. These effects would demonstrate a novel tool in targeted gene therapy for oral applications.

[0036] Specifically, the method according to the present invention has been shown to reduce the number of viable colony-forming units (CFUs) in various oral bacteria.

[0037] Table 1 below shows the 10% of Streptococcus oralis in physiological saline solution. 4 ~10 7 The effectiveness of the stimulation according to the present invention is demonstrated for bacterial cultures, down to the colony-forming unit (CFU) level, at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes. [Table 1-1] [Table 1-2]

[0038] Table 2 below shows the 10% of Streptococcus oralis in saliva solution. 4 ~10 7Shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures ranging from [Table 2]

[0039] The following Table 3 shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures of Fusobactrium nucleatum in a physiological saline aqueous solution ranging from 10 4 ~10 6 Shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures ranging from [Table 3]

[0040] The following Table 4 shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures of Fusobactrium nucleatum in saliva ranging from 10 4 ~10 6 Shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures ranging from [Table 4]

[0041] The following Table 5 shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures of Porphyromonas ginvalis in a physiological saline aqueous solution ranging from 10 5 Shows the effectiveness of the stimulation according to the present invention at current levels of 50 μA or 500 μA over durations of 5, 10, 20, and 30 minutes for bacterial cultures ranging from [Table 5-1] [Table 5-2]

[0042] Therefore, this method and the corresponding apparatus can achieve multiple preventive, therapeutic, cosmetic, and regenerative effects, combinations of which have not been previously known or available in the art. These effects include promoting oral bone formation, destroying or neutralizing oral microorganisms, regenerating gingival tissue, reducing and preventing the formation of oral biofilms, preventing caries, increasing oral vasodilation and oral blood flow, treating common oral conditions such as gingivitis and periodontitis, treating systemic diseases and conditions correlated with oral pathogens, and generally improving oral hygiene.

[0043] Now, looking at the figures, Figure 1 shows one embodiment of a stimulator 10 according to the present invention. The stimulator 10 is a standalone device comprising a mouthpiece 100 and a controller 300, which are preferably physically supported by a charging station or stand 400 and can be operationally charged. Generally, the mouthpiece 100 is sized and configured to be received in the mouth of a person, with one or more electrodes positioned in desired locations in the mouth. Also referring to Figure 2-5, the mouthpiece 100 includes at least one substantially U-shaped channel 110 configured to receive any maxillary or mandibular teeth of a person, preferably including an upper U-shaped channel 110T and an opposing bottom U-shaped channel 110B, and the channels 110 are preferably configured to receive any maxillary and any mandibular teeth of the same person simultaneously. The two U-shaped channels 110 are preferably separated from each other along at least a large portion of their length 112 by channel bases 114. The components forming the channel 110 in relation to the channel base 114 are preferably opposing lingual sidewalls 120 and buccal sidewalls 130 extending substantially perpendicularly from the channel base 114. The lingual sidewall 120 terminates at the lingual free edge 122, and along most of it (preferably along the entire lingual free edge 122), one or more lingual electrodes 124 are provided. The lingual electrodes 124 are preferably formed from conductive silicone and may be separated by one or more insulating gaps or other electrically insulating material, such as a lingual sidewall void or notch 126. The buccal sidewall 130 terminates at the buccal free edge 132, and along most of it (preferably along the entire buccal free edge 132), one or more buccal electrodes 134 are provided. The buccal electrode 134 is preferably formed from conductive silicone and may be separated by one or more insulating gaps such as buccal wall voids or notches 136, or by other electrically insulating materials such as electrically insulating silicone. The mouthpiece 100 is preferably formed (e.g., molded) from a relatively comfortable tissue-facing material, such as a material having a Shore A hardness of less than or equal to 80.

[0044] The connection between electrodes 124, 134 and the network within the controller 300 is made through the reduced-diameter portion 200. The connection from electrodes 124, 134 to the reduced-diameter portion 200 may be achieved using flexible circuit techniques such as copper-clad polyimide, but a multi-shot injection mold containing a first electrically insulating material and a second conductive material to form the electrical trace 140 may be more preferred. That is, the first mold may be used to form conductive silicone into a desired pattern extending from the first connector end to one or more electrodes 124, 134 and including it, thereby creating a conductive skeleton. The conductive skeleton may then be overmolded with electrically insulating silicone to form the majority of the mouthpiece 100 and to insulate the conductive trace 140 forming the skeleton from each other. After insulation, the exposed conductive areas are the electrodes 124, 134 and the terminal surfaces within the reduced-diameter portion 200.

[0045] The electrical trace 140 within the mouthpiece 100 is then electrically coupled to a header connector 210, which is mounted or to be mounted within the controller housing 310, as further described below. Specifically, the header connector includes pins 212, each pin being associated with and physically inserted into a conductive silicone path (140 in Figure 7) to an electrode 124 or 134. The maximum resistance of any conductive path from the terminal surface 142 of the trace 140 within the reduced diameter portion 200 to any portion of any individual electrode 124, 134 is preferably less than 25 kΩ.

[0046] Referring to Figure 7, the controller 300 preferably comprises a housing 310 configured to be fixed to the mouthpiece 100. The housing 310 contains a battery 302 and electronic circuitry for generally controlling the timing of connection (i.e., switching) of electrodes 124, 134 and for delivering charge from the battery 302. The battery 302 is preferably a rechargeable lithium-ion battery with a fully charged capacity capable of performing at least seven consecutive stimulation sessions, the duration of which such sessions is 20 minutes. The battery 302 is preferably rechargeable from a completely depleted state in less than 12 hours. The battery 302 is preferably rated for at least 200 (200) charge / discharge cycles. The circuitry may be operationally mounted on one or more printed circuit boards 304, but two circuit boards (lower board 304L and upper board 304U) are preferred to provide an improved packaging footprint. The housing 310 may preferably comprise one or more housing parts (e.g., top, bottom, sides, etc.) made of biocompatible molded polycarbonate plastic, polycarbonate / ABS alloy (PC / ABS), etc. Regardless of the materials used to construct the mouthpiece 100 and controller 300, the device 10 is preferably subjected to gravity drop (approximately 9.81 m / s) from a distance of approximately 2 m (2 m) onto a relatively hard surface (e.g., stone or ceramic tile, vinyl placed on a wooden substrate, or concrete). 2 It is possible to withstand )

[0047] Figure 6 provides a schematic diagram of the functional blocks of the circuitry contained within the housing 310, generally including a programmable microprocessor (preferably in conjunction with a communication antenna), an inductive charging network for receiving wireless inductive charging of the battery 302, hardware overcurrent protection, current and voltage feedback for monitoring delivery parameters and open-circuit conditions, and user interface components.

[0048] The controller 300 preferably provides a user input interface in the form of a single push button 306 (preferably debounced in hardware or software) and user output or feedback, preferably including one or more of a battery indicator light 312, a status (or stimulation or treatment indicator) light 314, and an audible buzzer or speaker 316. The state of the push button 306 (activated / deactivated) is monitored to control functionality. The battery indicator light 312 is preferably capable of displaying multiple colors (e.g., white and amber) in any of the following conditions: consistently lit, flashing (which may be at different rates), or alternating colors, depending on the feedback to be provided. The treatment indicator 314 is preferably capable of displaying multiple colors (e.g., red, white, and blue) in any of the following conditions: consistently lit, flashing (which may be at different rates), or alternating colors, depending on the feedback to be provided. User feedback may also be provided by touch, in addition to, or alternatively, through the use of a tactile feedback generator such as a vibration motor. Favorable feedback is as shown in the table provided in Figure 11. Notes related to Figure 11 (indicated by superscripts in the table) are as follows: 1. If this device transitions from the COMPLETE state to LOW BATTERY, the treatment LED 314 will continue to flash white, and the audible feedback will be turned off. 2. The indicator light blinks white when the battery is charging, and stays on white when charging is complete. 3. If the device is placed on the charging stand while in a FAULT state, the device will continue to display a red flashing treatment indicator light 314. The device will display a battery indicator light 312 (white flashing / white on) according to the current battery charge, but will not provide audible feedback when placed on the charger to avoid being mistaken for a resolution of the fault. 4. The battery indicator light 312 will turn off if the device 10 is left on the charger 400 for more than 10 minutes after charging is complete. The charger 400 will continue charging during this period if the battery voltage drops below the charging threshold, but the battery indicator 312 will remain off.

[0049] In general, the electrical network can be described as having multiple channels controlled and monitored by a microprocessor, each channel associated with the operation of one or more electrodes 124, 134. Channels may be enabled or disabled independently of other channels, but each channel may control multiple electrodes. In addition, or alternatively, one or more electrodes may be permanently designated and operated only as return electrodes. A preferred embodiment includes eight channels, each capable of driving a DC current of 125 μA across a resistance of up to 50 kΩ.

[0050] As can be seen in Figures 8A-8D, for each electrode channel, an enable signal 802 is received by the channel drive circuit 810. When activated, the enable signal 802 inverts a switch (MOSFET in this embodiment) and provides a voltage to a current source regulator, which then provides current to the channel output 812. A sensing resistor 814 is used to determine whether current is flowing, and preferably the amount of current flowing. CS_HIGH and CS_LOW signals are passed through a comparator circuit to activate the CH_CURRENT signal, indicating that current is flowing. CH_VOLTAGE may be monitored to determine the voltage and current levels delivered to individual channels.

[0051] The operation of the controller 300 by a user (not shown) is preferably performed by pressing a push button 306. For example, the user can start or pause the delivery of current to the mouthpiece 100 by pressing the push button 306. To prevent unintentional operation, the duration of the press on the push button 306 is sensed and debounced.

[0052] The controller 300 is preferably configured by a clinician or other trained staff member prior to the user interface with the stimulator 10. In addition, or alternatively, the patient may configure the controller 300. Preferably, the configuration of the controller 300 is carried out by attaching additional hardware components (not shown) connected to the controller 300, but may also be carried out via a wireless connection (e.g., Bluetooth®, Wi-Fi, Near Field Communication (NFC), infrared, magnetic). Finally, the controller 300 may have a default stimulation prescription plan to reduce or eliminate the initial configuration effort by the clinician or patient.

[0053] The configuration parameters preferably include the selection of an electrode configuration for providing a DC current for stimulation, the selection of a DC current output value, e.g., 6 μA, 12 μA, 18 μA, 25 μA, 50 μA, 62 μA, 75 μA, 100 μA, 125 μA, 150 μA, and 200 μA (preferably not exceeding a total current of 1,000 μA across all delivery electrodes at any given time), and the selection of a stimulation session duration (preferably 1 to 30 minutes, selectable in 1-minute increments). Exemplary preferred configuration parameters can be seen in the tables provided in Figures 12A and 12B.

[0054] The controller 300 may preferably monitor compliance with the protocol and stimulation sessions performed by the stimulator 10 and record several performance metrics, such as counts of predetermined monitored events and / or data associated with such events, in non-volatile memory (e.g., FLASH® memory). The recordings may be used by a clinician (not shown) to evaluate and discuss stimulation response and effectiveness. The controller 300 may also be configured to dynamically monitor electrical characteristics (i.e., resistance, voltage, current) and adjust stimulation parameters or settings without clinician or user intervention. A real-time clock may preferably be used and referenced to record the time and date when metrics and data are collected. Apart from the real-time clock (which may be seeded by a wireless communication device or network), a real-time counter is maintained to track the timing of automatic state changes and to track runtime (uptime).

[0055] For example, a counter may be established to track the number of times a particular event occurs. Counters such as those preferred counters shown in the tables of Figures 13A and 13B may be maintained in non-volatile memory. Some collected metrics and data may include (along with the date and time of such occurrences) the number of stimulation sessions (e.g., therapy) initiated, the number of stimulation sessions (e.g., therapy) successfully completed, the number of open-circuit failures, the number of stimulation sessions (e.g., therapy) using an open circuit, the number of stimulation sessions (e.g., therapy) using an open circuit that were still successfully completed, the number of overcurrent failures, the number of low battery failures, the number of times the device was paused, the number of stimulation sessions (e.g., therapy) that were paused but still successfully completed, the number of times the user turned on the device, the number of times the device was powered off by the user, the number of times the device was powered off by software, and the total number of minutes the device has been running since a memory reset. The recorded metrics and data are stored only in non-volatile memory within the controller 300 and may be accessed via a physical connection (e.g., a serial UART connection if the enclosure 310 is removed, or via a serial connector provided through the enclosure 310). In addition, or alternatively, the recorded metrics and data may be accessed via a wireless connection (e.g., through a software application on a BLE-enabled wireless communication device), or even automatically pushed to a wireless communication device via a wireless network and then stored on or remotely from the wireless communication device, such as on a remote data storage device networked with the wireless communication device (a cloud storage device or remote server that may be associated with the manufacturer and / or distributor of the device 10, a treatment provider (e.g., a dentist, hygienist, administrative staff), an insurance company, or a user (or the user's guardian)).

[0056] Automatic data pushing may also occur based on time intervals or event occurrences such as transitions from OFF to READY, entering the CHARGING state, or entering the OFF state. Pushed data may include user stimulation session data (e.g., patient compliance metrics), firmware version, device errors, and / or the physical location of the device 10 and / or charger 400 (if GPS or network location functionality is provided).

[0057] The specific technologies used for such data push may be assembled from generally known hardware technologies that have not previously been known to be used in conjunction with any oral device. The data push from the controller 300 may also be directly to the charger 400 as an intermediary for transmission via wireless communication networks (e.g., WAN, LAN, etc.) such as WiFi / LoRa / LoRaWAN / Helium or even low-power wide-area networks or mesh networks.

[0058] Not only may a count of specific events be maintained, but data associated with the occurrence of specific events may also be logged. The types of events to be recorded in the event log for the controller, including those shown in the table in Figure 14, may also be stored in non-volatile memory. Preferably, the event log can store a minimum of 2,000 events. If this exceeds the non-volatile memory allocated to the event log, the oldest events will be overwritten to make way for newer data.

[0059] The non-volatile memory would preferably store at least the following occurrences and related information, namely, the number of minutes of stimulation completed by the user (up to 30 minutes), whether the mouthpiece was disconnected during activation (e.g., OPEN state occurrence), whether an overcurrent fault occurred, the total charge delivered per channel over a specific stimulation duration (e.g., treatment) in units of chrome (C) or microchrome (μC), and whether a low battery fault occurred.

[0060] The controller 300 may also be configured to detect when the mouthpiece 100 is not positioned in the user's mouth during a stimulation session, as discussed in relation to Figure 8. To this end, the controller 300 monitors the delivery of current and whether the current is detected on any of the multiple cathode electrodes. If no current is detected, the controller 300 may pause the stimulation and indicate a fault condition. For example, the controller 300 monitors the stimulation circuit, including anode and cathode electrodes. The controller 300 includes a network for measuring or predicting the amount of current to be delivered to the mouthpiece 100 (delivery current), and may also measure the amount of feedback current received from the mouthpiece 100 (feedback current). The network then compares the feedback current with the delivery current, and if the difference exceeds a predetermined value (e.g., a percentage of the delivery current such as 10% to about 50%), the stimulation is preferably paused on all electrodes, and a fault message is displayed on the controller. Once the difference between the delivery current and the feedback current falls below a predetermined amount, the stimulation program or prescription plan resumes from where it left off, preferably so that the stimulation time is lost little to no.

[0061] Graph 1 below provides parameters for monitoring the current delivered to the delivery electrodes. As described above, the starting current setpoint and duration "T" are determined and set during configuration prior to the patient using the stimulator 10, and the recommended setting for duration "T" is 2 seconds. The open circuit is preferably about 80% of the starting current setpoint, and the overcurrent fault limit is preferably 120% of the starting current setpoint. The hardware limit is preferably about 200-300 μA per stimulation channel (e.g., per anode electrode). [ka]

[0062] The current is preferably polled 8 times per second when the controller 300 is delivering current to any delivery electrode.

[0063] If the detected current exceeds the preset duration and falls below the open-circuit limit, the stimulus will pause and a notification will be displayed. If the detected current exceeds the preset duration and exceeds the overcurrent fault limit, the stimulus will stop and a fault notification will be displayed.

[0064] Furthermore, the stimulator 10 is expected to be fully compatible with wireless technologies such as Bluetooth® technology, near-field communication, and Wi-Fi, and to communicate with the user's electronic device (not shown), such as a mobile phone, tablet, or personal computer. Preferably, the user may review the usage history, a pre-prescribed stimulation plan, and / or a comparison of the usage history versus the stimulation plan. The stimulator 10 may also provide notifications regarding scheduled stimulation sessions to one of the user's electronic devices. This functionality is expected to operate through an application (not shown) that can be downloaded to the user's electronic device. The application may also be configured to share this data with a central server for storage, remote monitoring by the prescribing clinician, provide one-way or two-way communication between the patient and the clinician, and / or allow the clinician to remotely adjust the stimulation parameters. In addition, firmware upgrades may be supplied wirelessly to the controller 300.

[0065] The controller 300 preferably includes wireless communication technology such as a Bluetooth Low Energy (BLE) module, which may be incorporated into a microprocessor package. When the controller 300 is powered on (i.e., not in the OFF state), the controller preferably periodically transmits BLE advertisement packets which preferably include a device identifier, such as a unique device identifier (UDI), which may be assigned by a regulatory authority such as the U.S. FDA. The BLE communication channel is preferably used to transmit information about or contained within the controller 300, such as software version, programmable parameters, event log data, counter data, and / or software status (e.g., READY, RUN, OPEN, etc.), and / or changes in any of the foregoing (since the last transmission). The BLE interface may also preferably be used to exchange information with a software application (such as a user or physician service application) on a remote wireless communication device such as a tablet computer, mobile phone, or other BLE-enabled device, which may also include a real-time clock. The real-time clock data may be received by the controller 300 from the application and stored and referenced to start, maintain, and / or update its own real-time clock.

[0066] Specifically, the application (launched on the wireless communication device) may scan BLE advertisement packets transmitted by the controller 300 (on request or periodically). By operating the user interface on the device, the user may then pair the device with the stimulator 10 by selecting it from a list of nearby advertising BLE-enabled devices. In addition, or alternatively, the application may preferably pair the wireless device with the stimulator 10 via RSSI (Received Signal Strength Indicator), where the wireless device only needs to be brought to a predetermined proximity to the device 10 for pairing. The user may operate the application's user interface to enable or disable the RSSI function.

[0067] Once a mobile device is paired with device 10, the current date and time (from the local time stored on the mobile device, or from a network such as Wi-Fi or cellular) is preferably transmitted to device 10 for storage in the event log. The application may confirm this connection and transmission by displaying the contents of the event log for the user to view. Furthermore, the application may display parameter values ​​and counters of the paired device 10. Preferably, the application provides the option to highlight and notify the user of changes in the event log, parameter values, or counter values ​​as they occur on device 10 (or immediately thereafter) to provide real-time updates.

[0068] The application may also preferably display the current software state of the device 10 and information related to that state. For example, when the device 10 is in a RUN or OPEN state (i.e., when a stimulus is in progress or paused, respectively), the application may display a timer counting down the remaining time of the stimulus cycle as well as current and voltage measurements for each channel on the device 10. While in these states, the application may also preferably provide the option to store from the device 10 an event log, parameter values ​​and counters, the UDI of the device 10, the Bluetooth® MAC address of the paired device 10, and other information as a log file (e.g., a readable or movable electronic file such as an ASCII text file or a formatted file such as a comma-separated variable (*.csv) file) stored in the memory of the wireless communication device for future display within the wireless device application or readable without the use of the application.

[0069] The application also preferably provides a user interface for transitioning the device 10 between software states, enabling remote control of the device 10 (e.g., through the use of virtual buttons) instead of requiring physical interaction with the button 306. For example, the device 10 may transition from a READY, CHARGING, or FAULT state to a SERVICE state (and vice versa). While in the SERVICE state, the application preferably allows the user to clear the contents of the event log, reset counters, update parameter values, or perform firmware updates on the device 10. The states are discussed in more detail below.

[0070] The charging station 400 according to the present invention preferably comprises a base 402 and a shell 410, as can be seen at least in Figures 1 and 10. The base 402 preferably comprises a power input (not shown), such as a USB-C receptacle. The power input is configured to receive input power from a power input source (not shown) (e.g., a DC current transformer plugged into a standard electrical outlet providing AC current). The input power is operationally coupled to a wireless charging coil (not shown), such as one defined by the Qi wireless charging standard.

[0071] The base 402 includes a controller support interface 420, which includes a rigging ridge 422 defining the rigging surface 422a. The rigging ridge 422 engages with the controller support ridge 322 and is configured to help support the controller 300 and to help align the relative positions of the wireless charging network components. The positioning and alignment of the controller 300 relative to the base 402 is preferably further assisted by one or more magnets (not shown) fixed within the controller housing 310 and the base 402. Thus, when the controller 300 is supported by the controller support interface 420, the inductive charging coil (inside the base 402) generates a magnetic field through the shell 410, which is used by the receiving coil (inside the controller 300) to charge the battery 302.

[0072] The shell 410 is preferably hollow and defines a shell cavity 412 configured to receive the entire controller 300 / mouthpiece 100 combination for storage or transport, etc. The shell cavity 412 can be accessed by changing the position of the shell 410, either by removing the shell 410 (for example, if a circumferential snap-fit ​​cooperation with the base 402 is used) or by pivoting the shell 410 around a hinged pivot point 414, such as a pinned hinge or a living hinge. Within the shell cavity, preferably integrally formed with a portion of the base 402, is a curved saddle surface 416 configured to receive the U-shaped mouthpiece 100.

[0073] Ionic or colloidal liquids or gels may be used as conductive media to increase conductivity within, across, or to the oral tissue adjacent to the electrodes, thereby reducing the electrical resistance in the mouth. These media may be placed along any desired area of ​​desired electrical contact, such as teeth, gums, or surrounding oral tissue. Examples of such media include, but are not limited to, colloidal silver gel, liquid colloidal silver, colloidal copper gel, liquid colloidal copper, colloidal gold gel, liquid colloidal gold, saline gel, liquid saline, or any combination thereof.

[0074] Colloidal silver, either overall or in combination, not only increases electrodynamic flow but also provides additional bactericidal benefits, demonstrating excellent potential. It is known that colloidal silver is bactericidal at low concentrations of around 5 percent by inhibiting bacterial adenosine triphosphate production.

[0075] This conductive medium may also contain, but is not limited to, a nutritional supplement, oregano oil. Oregano oil is thought to have many health benefits and may also be microbiota. Such microbiota properties would be effective in treating common oral infections and diseases, as well as in assisting preventive oral care.

[0076] The conductive medium may also contain a teeth whitening agent. This would allow for the addition of teeth whitening to the list of cosmetic benefits provided by embodiments of the present invention. A teeth whitening agent catalyzed by direct current electricity may be included, and furthermore, may result in a shortened teeth whitening stimulation time compared to non-electrocatalytic teeth whitening agents.

[0077] Artificial or natural flavorings may also be added to the conductive medium to provide a more appealing taste to the user, similar to the methods of flavored dental fluoride treatment. These flavorings will mask any unpleasant tastes from the raw materials of the conductive medium, as well as any tastes from the mouthpiece or electrode itself.

[0078] Therefore, at least one embodiment addresses desired needs in the field of oral hygiene and dentistry in a more effective, less invasive, and less expensive manner, while simultaneously treating common oral diseases and conditions. These embodiments promote general oral hygiene, reduce oral biofilms, treat periodontal diseases such as gingivitis and periodontitis, kill oral microorganisms including bacteria, and thus prevent tooth decay and caries, increase vasodilation and blood flow in oral tissues, promote gingival tissue regeneration, develop bone formation in the bone structure of teeth, mouths, and related areas, treat systemic diseases associated with oral pathogens, and treat other periodontal and oral diseases.

[0079] In some cases, dental procedures can disrupt oral bacterial colonies found in biofilms, introducing bacteria into the bloodstream and potentially causing bacteremia and other infections. Furthermore, it is conceivable that it may be desirable to use the mouthpiece according to the present invention immediately before performing a dental procedure. The stimulator 10 according to the present invention may be used by the patient either at home or in a dental clinic. In this way, the amount of live bacteria in the patient's mouth, both supragingually and subgingivally, can be reduced prior to the procedure, thereby reducing the risk of bacteremia and other infections. For example, but not limited to, the stimulator 10 may be used prior to dental preventive procedures or scaling and root planing procedures in a dental clinic to reduce the risk of introducing bacteria into the patient's bloodstream.

[0080] The stimulator 10 may also be used following a clinical procedure as a preventive measure against infection, including, but not limited to, post-extraction or post-implantation infection prevention scenarios.

[0081] During operation, it may be preferable that the number of anode electrodes equals the number of cathode electrodes, but alternative arrangements with different numbers of anode and cathode electrodes are also conceivable. It should be understood that targeted stimulation may be selectively provided, such as when it is desirable to treat a particular gingival area. To provide targeted stimulation, the delivery of current to other parts of the mouth is preferably prevented or reduced mechanically or electrically. In examples, mechanical prevention or reduction may be achieved by a specific arrangement of electrodes, such as providing anode or cathode electrodes on a mouthpiece at a first location of gingival tissue surrounding (a) a tooth to be removed and replaced with an implant, or (b) an empty alveolar bone from which a tooth has already been intentionally or accidentally removed, or (c) a portion of a previously placed dental implant, at least partially. Mechanical prevention or reduction may be further enhanced by providing cathode or anode electrodes on the mouthpiece at least partially in a second location of gingival tissue (preferably opposite to the first location of the tooth) surrounding (a) a tooth to be removed and replaced with an implant, or (b) an empty alveolar space from which the tooth has already been removed intentionally or accidentally, or (c) a portion of a previously placed dental implant. Mechanical reduction of electrical stimulation is achieved when two electrodes are provided as described and no other electrodes are placed on the mouthpiece. Thus, the mouthpiece may be customized for a particular user by mechanically arranging electrodes on the mouthpiece and targeting the electrical stimulation toward the dental implant site.

[0082] An embodiment of electrical prevention or reduction of untargeted current is selective electrode control by a controller. That is, as shown and described herein, a plurality of electrodes spaced apart from the mouthpiece may be mechanically provided on the mouthpiece. However, through electrical control of such electrodes, each electrode may have a selectable state for providing stimulation. The selectable electrode state may be anode, cathode, or off (e.g., tristate). Thus, if a targeted current is desired, the first electrode on the mouthpiece may be selected to be an anode or cathode electrode. The position of the first electrode on the mouthpiece may correspond at least partially to a first location of gingival tissue surrounding (a) a tooth to be removed and replaced with an implant, or (b) an empty alveolar space from which a tooth has already been intentionally or accidentally removed, or (c) a portion of a previously placed dental implant. Electrical prevention or reduction of untargeted electrical stimulation may be further enhanced by a second electrode on the mouthpiece, selected to be a cathode or anode electrode (opposite to the first electrode). The position of the second electrode on the mouthpiece may correspond at least partially to a second location of gingival tissue (on the opposite side of the first location of the tooth) surrounding (a) a tooth to be removed and replaced with an implant, or (b) an empty alveolar space from which a tooth has already been removed intentionally or accidentally, or (c) a portion of a previously placed dental implant. Electrical reduction of current stimulation is achieved when the two electrodes are selected as described and no other electrodes are activated on the mouthpiece (e.g., all other electrodes are turned off, or placed in a high-impedance state, or in a tri-state mode). Thus, the mouthpiece is mechanically standardized for multiple users but can be electrically customized to target electrical stimulation toward the dental implant site.

[0083] While the mechanical and electrical prevention or reduction of stray or untargeted currents has been described in relation to the targeting of a single dental implant site, it should be understood that such targeting can be performed simultaneously or sequentially at multiple implant sites (for example, one target site being stimulated for a predetermined time, and then a different target site being stimulated for a predetermined amount of time).

[0084] During operation, the controller 300 generally cycles through and / or between software states, some of which can be seen as described in the tables provided in Figures 15A, 15B, and 15C. Referring here to Figure 16, the preferred states of the controller 300 can be seen. In the OFF state, there is either no power supplied to the microprocessor, or there is a minimum amount of power supplied to keep the microprocessor in sleep or low-power mode, preferably maintaining only the operation of the real-time clock and possibly visual indicators (constant or intermittent). The OFF state can be entered from any other state of the controller if the push button 306 is activated for a predetermined time, such as at least 3 seconds. The OFF state can also be entered from the following states, namely OPEN, READY, COMPLETE, LOW BATTERY, CRITICAL_BATTERY, or FAULT, based on a predetermined period of inactivity. The predetermined period of inactivity is used to monitor user activity (i.e., pressing the push button 306) or correction of the OPEN condition. If any of these occur within the inactivity period, the system will enter a different state other than OFF from the respective state. The inactivity period of a given time is preferably a programmable software variable, preferably separately programmable with respect to inactivity (i.e., in the READY, COMPLETE, LOW BATTERY, CRITICAL_BATTERY, and / or FAULT states) and OPEN correction (i.e., current begins to flow again before the end of this time). The OFF state is terminated by activating the push button 306 over a predetermined time, such as at least 2 seconds.

[0085] The READY state is the state of the controller from which stimulation can be initiated. The READY state may be entered from the OFF state by activating the push button 306 for a predetermined period of time, such as at least 2 seconds. The controller 300 will remain in the READY state until either the push button 306 is activated by the user, or a period of inactivity terminates the controller from the READY state and returns it to the OFF state.

[0086] The RUN state is a state in which the delivery electrode is activated and current is delivered through it at a predetermined programmed current level for a predetermined programmed time. The RUN state is entered from the READY state by the activation of the push button 306, either intermittently or over a predetermined period of time. The software preferably initiates current delivery to the electrode channel that is activated (i.e., turned on) when the user presses the push button 306 (or virtual button) only from the READY state (i.e., the controller software will transition to the RUN state). The software monitors a stimulation (e.g., treatment) duration counter, which increments at least once per second while current is being delivered. The software compares the stimulation duration counter to a programmed TREATMENT_DURATION to determine when current delivery should end. Alternatively, in response to entering the RUN state, the software may set the initial value of the incrementing counter to TREATMENT_DURATION, then monitor the counter and determine when it reaches a value of zero, thereby indicating, and preferably, initiating, the cessation of current delivery.

[0087] Assuming that the current is delivered successfully and the stimulation duration counter has finished, the controller software will enter the COMPLETE state, where current delivery is stopped. Generally, the software will then transition to the OFF state after a predetermined period from the COMPLETE state.

[0088] Once a stimulation session is complete, or the user terminates the device in a different manner, it may be cleaned by the following process or equivalent. 1) Rinse the mouthpiece 100 with cold water for about 30 seconds. 2) (As needed, 2-4 times per month) Use a toothbrush to gently scrub the mouthpiece 100 with a mild soap (e.g., dish soap or hand soap), then rinse the mouthpiece 100 with water to remove the soap. 3) Allow to air dry (supported on stand 400).

[0089] In addition, or as an alternative, the mouthpiece may be placed in a denture cleaning solution from time to time or periodically for a duration of up to 30 minutes.

[0090] However, if there is an interruption in current delivery (e.g., indicating that the device 10 may have been removed from the user's mouth) during the RUN state, as determined by monitoring the channel current and / or voltage of one or a combination of channels (e.g., no current has been delivered across all active channels for a period of time of 2 seconds), the software will enter the OPEN state and thereby pause the stimulation duration timer. If current delivery resumes within a predetermined period (e.g., prior to the end of a counter set in the programmed INACTIVITY_DURATION_OPEN parameter), as determined by monitoring the channel current and / or voltage of one or a combination of channels, the software will return to the RUN state, resume current delivery to the activated channels, and restart (but not reset) the paused stimulation duration timer. If current delivery cannot be resumed within a predetermined period (e.g., prior to the end of a counter set in the programmed INACTIVITY_DURATION_OPEN parameter), as determined by monitoring the channel current and / or voltage of one or a combination of channels, the software will return to the OFF state.

[0091] Furthermore, during the RUN state, operational failures such as effectiveness (undercurrent) failures and overcurrent failures may occur, which may cause the controller software to transition to a FAULT state, stopping current delivery, and providing visual and / or auditory indications by the controller 300. Effectiveness failure may occur if the total current delivered across all active electrode channels falls below a predetermined programmable percentage (MIN_CURRENT_PERCENT, e.g., 75 percent (75%)) of the target value over a predetermined programmable time (MIN_CURRENT_TIME, e.g., 30 seconds). Therefore, using exemplary parameter values, if four channels are active and the target current delivery is 125 μA per channel, effectiveness failure will occur if the total current delivered falls below 375 μA (125 μA / channel × 4 channels × 0.75) over 30 seconds, as can be determined by monitoring the channel currents of all active channels. An overcurrent fault may occur when the current delivered on any channel exceeds a predetermined level, such as approximately 200 μA, or a programmable percentage of a predetermined target current level, such as 110% of a predetermined target current level, as determined by monitoring the current level of each channel. The FAULT condition is preferably terminated by requiring a press of button 306 (or a virtual button) for a predetermined time, such as 3 seconds, and requires user intervention to return to the OFF state.

[0092] The CHARGING state is entered whenever the controller 300 makes interface contact with a powered charging stand (current delivery to the electrode channels is preferably disabled) when the software is in any state other than the FAULT state. When the controller 300 is placed on the charging stand 400 in the FAULT state, this will preferably allow the battery to be charged while remaining in the FAULT state. When the controller 300 is removed from the charging stand 400, it will preferably not automatically exit the FAULT state if it was in the FAULT state when placed on it. Rather, it will remain in the FAULT state and thereby require user intervention to exit and return to the OFF state, preferably by requiring a press of button 306 (or a virtual button) for a predetermined time, such as 3 seconds.

[0093] Other states besides those shown in Figure 11, such as the LOW BATTERY state, the CRITICAL BATTERY state, and the SERVICE state, may be defined and used. The network monitors the available voltage in battery 302. In the LOW and CRITICAL BATTERY states, current delivery is deactivated, and the user is informed of the battery state through visual and / or auditory indicators. The LOW BATTERY state may be entered when the voltage of battery 302 is below a first predetermined battery activation value (e.g., 3.5 volts) when the user attempts to enter the RUN state. The LOW BATTERY state may also be entered in response to a transition between the RUN and COMPLETE states when the voltage of battery 302 is below a second predetermined battery activation value (e.g., 3.6 volts), which is preferably higher than the first predetermined battery activation value. The CRITICAL BATTERY state is preferably entered when the voltage of battery 302 is below a predetermined value (e.g., 3.1 volts) that is lower than a predetermined value for low battery in any state other than the FAULT state. This provides the ability to log events to non-volatile memory prior to power saving of the microprocessor, thereby shutting down the system in a controlled manner. If the controller 300 is powered down while in a CRITICAL BATTERY state (for example, by pressing button 306 for a predetermined period of time), it will preferably be powered on in the same state thereafter, provided it is not placed on the charger 400 during that time.

[0094] The SERVICE state may be entered through the use of a wireless communication device application that communicates with the controller 300, thereby allowing parameters to be programmed through a user interface provided thereon. The SERVICE state may be entered from any of the READY, CHARGING, or FAULT states. The SERVICE state may provide the following functionality: View and modify the programmable parameters (listed in Figure 12A-B). View counter values ​​such as those provided by the controller 300 (for example, one or more counters listed in Figure 13A-B). Resetting one or more counter values ​​on the controller 300 (and / or archiving counter indicators and values ​​on paired wireless communication devices during or after pairing). View the event log provided by controller 300 (for example, one or more events listed in Figure 14). To delete one or more events from the event log on the controller 300 (and / or archive the event logs on the paired wireless communication device during or after pairing). A non-destructive, preferably authenticated, update of the firmware on the controller 300.

[0095] Once data is acquired from the controller 300, it may be manually or automatically transferred via a wireless network by a wireless communication device and then stored remotely from there on a remote data storage device (such as a cloud storage device or remote server, which may be associated with the manufacturer and / or distributor of the device 10, the treatment provider (e.g., a dentist, hygienist, administrative staff), an insurance company, or the user (or the user's guardian)) that is networked with the wireless communication device.

[0096] When the user has completed any of the above tasks (i.e., when the user wishes to exit the SERVICE state), the user may do so through the use of an application on a mobile wireless device. From the SERVICE state, the controller transitions back to READY if the device 10 is not on an active charger 400, to CHARGING if it is on an active charger 400, or to FAULT if the SERVICE state was entered from a FAULT state. Prevention of systemic diseases

[0097] The mouthpiece according to the present invention is envisioned to be used to prevent or treat systemic diseases, as will be outlined in more detail below. The method according to the present invention has been shown to be effective in reducing the amount of oral bacteria, specifically F. nucleatum, P. ginvalis, and S. oralis. 1.Cardiovascular disease

[0098] The use of the mouthpiece according to the present invention is envisioned to be used, but not limited to, to reduce the microbial load caused by the transfer of oral bacteria, including S. oralis, P. ginvalis, and F. nucleatum, from gingival tissue to the rest of the body, and to reduce the amount of inflammatory mediators produced by oral bacteria. Furthermore, by reducing F. nucleatum, the ability of P. ginvalis to invade host cells is reduced, and therefore, the development of bacteremia, which is associated with the onset / exacerbation of atherosclerosis and coronary heart disease, is envisioned to be reduced.

[0099] The mouthpiece according to the present invention is intended to be used according to a predetermined stimulation prescription plan and may prevent, treat, and / or alleviate cardiovascular disease. In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined amount of time, at a predetermined current level and at predetermined time intervals. Furthermore, it is intended that a specific stimulation prescription plan may be determined based on the bacterial level present in the patient. According to one embodiment of the present invention, the stimulation prescription plan would consist of the patient wearing the mouthpiece according to the present invention once a day for 20 minutes at a current level of 500 μA. For acute cardiovascular conditions, this stimulation may be continued daily until the condition is resolved. For chronic cardiovascular diseases, this stimulation may be repeated continuously several times a week. 2. Stillbirth

[0100] Furthermore, it is assumed that stimulation sessions using the mouthpiece according to the present invention, in accordance with a predetermined stimulation protocol, will reduce the oral population of F. nucleatum associated with periodontal disease, and thus prevent, treat, and / or mitigate stillbirth. This reduction will, in turn, decrease the likelihood that F. nucleatum can transfer from the oral cavity into the bloodstream, which then migrate into the placenta and form colonies. The mouthpiece according to the present invention is assumed to be able to prevent stillbirth when used in accordance with a predetermined stimulation prescription plan. In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined amount of time, at a predetermined current level and at predetermined time intervals. Furthermore, it is assumed that a specific stimulation prescription plan may be determined based on the bacterial level present in the patient. According to one embodiment of the present invention, a stimulation prescription plan would consist of the patient wearing the mouthpiece according to the present invention once a day for 20 minutes for the duration of the pregnancy, at a current level of 500 μA. The stimulation parameters outlined above are 10 7 It has been demonstrated to be highly efficient in reducing the levels of S. oralis and F. nucleatum in the colony-forming unit (CFU) inoculation size. 3. Diabetes

[0101] The mouthpiece according to the present invention, when used according to a predetermined stimulation protocol, is envisioned to be usable to prevent, treat, and / or alleviate diabetes by causing a reduction in S. oralis in the oral cavity, and consequently reducing the amount of serum markers of inflammation produced by bacterial infection. In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined amount of time, at a predetermined current level and at predetermined time intervals. Furthermore, it is envisioned that a specific stimulation prescription plan may be determined based on the bacterial levels present in the patient. According to one embodiment of the present invention, a stimulation prescription plan would consist of the patient wearing the mouthpiece according to the present invention once a day for 20 minutes at a current level of 500 μA, which would effectively reduce oral levels of S. oralis and, consequently, reduce the amount of systemic inflammatory markers. This stimulation may be repeated continuously, multiple times a week, to help reduce inflammatory markers. 4. Suppurative liver abscess

[0102] The mouthpiece according to the present invention, when used according to a predetermined stimulation protocol, is envisioned to be used to prevent, treat, and / or alleviate suppurative liver abscesses by causing a reduction in F. nucleatum. Specifically, a stimulation session using the mouthpiece according to the present invention is envisioned to reduce bacterial levels, prevent F. nucleatum and other oral bacterial species from progressing to the liver, and reduce overall bacteremia. In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined amount of time, at a predetermined current level and at predetermined time intervals. Furthermore, it is envisioned that a specific stimulation prescription plan may be determined based on the bacterial levels present in the patient. According to one embodiment of the present invention, a stimulation prescription plan consists of the patient wearing the mouthpiece according to the present invention once a day for 20 minutes at a current level of 500 μA, which can effectively reduce oral levels of F. nucleatum, thereby preventing any bacteria from being transported from the oral cavity to the rest of the body. This stimulation may be repeated multiple times a week until the abscess is reduced. 5. Osteomyelitis

[0103] The mouthpiece according to the present invention, in accordance with a predetermined stimulation protocol, is intended to be used to prevent, treat, and / or alleviate osteomyelitis by causing a reduction in F. nucleatum. In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined duration, at a predetermined current level, and at predetermined time intervals. Furthermore, it is intended that a specific stimulation prescription plan may be determined based on the bacterial levels present in the patient. According to one embodiment of the present invention, a stimulation prescription plan would consist of the patient wearing the mouthpiece according to the present invention for 20 minutes per stimulation session at a current level of 500 μA, which would effectively reduce the oral level of F. nucleatum bacteria and prevent any bacteria from being transported from the oral cavity to the rest of the body. This stimulation may be used in conjunction with or separately from standard antibiotic-based treatment for osteomyelitis. When used in conjunction with antibiotics, stimulation sessions would typically occur within a 29-42 day cycle. When used separately from antibiotics, this irritant may be used once a day for several months for acute conditions, or continuously several times a week for chronic conditions. 6. Arthritis

[0104] A mouthpiece according to the present invention, in accordance with a predetermined stimulation protocol, is intended to be used to prevent, treat, and / or alleviate arthritis by causing a reduction in F. nucleatum. In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined duration, at a predetermined current level, and at predetermined time intervals. Furthermore, it is intended that a specific stimulation prescription plan may be determined based on the bacterial levels present in the patient. According to one embodiment of the present invention, a stimulation prescription plan would consist of the patient wearing the mouthpiece according to the present invention once a day for 20 minutes at a current level of 500 μA, which would effectively reduce the oral level of F. nucleatum bacteria, prevent any bacteria from being transported from the oral cavity and transferred to the synovial fluid, and reduce associated inflammation. This stimulation may be repeated continuously, multiple times a week, for this type of chronic condition. Reduce biofilm and prevent biofilm formation.

[0105] The mouthpiece according to the present invention, in accordance with a predetermined stimulation protocol, is intended to be used to prevent, treat, and / or alleviate oral biofilms by causing a reduction in F. nucleatum, P. ginvalis, and / or S. oralis (all of which are involved in oral biofilm formation). In a predetermined stimulation prescription plan, the patient would wear the mouthpiece according to the present invention for a predetermined amount of time, at a predetermined current level and at predetermined time intervals. Furthermore, it is intended that a specific stimulation prescription plan may be determined based on the bacterial levels of specific bacterial species present in the patient. According to one embodiment of the present invention, a stimulation prescription plan would consist of the patient wearing the mouthpiece according to the present invention once a day for 20 minutes at a current level of 500 μA, which would effectively reduce the oral level of F. nucleatum bacteria, prevent further biofilm formation caused by F. nucleatum, and reduce the survival rate of existing F. nucleatum biofilm colonies.

[0106] According to another embodiment of the present invention, the stimulation prescription plan comprises the patient wearing the mouthpiece according to the present invention for 20 minutes once a day at a current level of 50 μA, which will effectively reduce oral levels of P. ginvalis bacteria, prevent further biofilm formation caused by P. ginvalis, and reduce the survival rate of existing P. ginvalis biofilm colonies.

[0107] Furthermore, according to another embodiment of the present invention, the stimulation prescription plan comprises the patient wearing the mouthpiece according to the present invention for 20 minutes once a day at a current level of 500 μA, which will effectively reduce oral levels of S. oralis bacteria, prevent further biofilm formation caused by S. oralis, and reduce the survival rate of existing S. oralis biofilm colonies.

[0108] These stimulation sessions for biofilm reduction and prevention may be repeated daily for 3 to 6 weeks for acute biofilm-based problems, or continuously once a week or more for chronic biofilm problems. Treatment and / or prevention of peri-implantitis

[0109] Peri-implantitis is generally inflammation of oral tissues that are in physical contact with, surrounding, or otherwise adjacent to a dental implant and occur after its placement. This inflammation can be reduced or prevented using the method according to the present invention. This method may be performed before and / or after dental implant surgery procedures for the placement or replacement of dental implants.

[0110] A method to reduce the likelihood of peri-implantitis involves applying or directing an electric current to the vicinity of or to the gingival tissue at the future implantation site in the oral cavity prior to the partial or complete placement or replacement of the dental implant. The current may be distributed to any location throughout the oral tissue, but at least 6 μA, more preferably at least about 50 μA (preferably 300 μA or less), is delivered to the vicinity of or to the gingival tissue at the predetermined oral cavity site for future implantation. The pre-surgical stimulation regimen may consist of about 20 minutes of electrical stimulation per day for 1 to 14 days prior to the dental implant surgery procedure.

[0111] A method to reduce the likelihood of peri-implantitis (if it has not yet occurred) or to reduce peri-implantitis (if it has already occurred) involves applying or directing an electric current to the vicinity of or to the gingival tissue in the oral cavity where the implantation is located, after the dental implant has been placed or replaced, either partially or entirely. The current may be distributed throughout the oral cavity, but a current of at least 6 μA, more preferably at least about 50 μA (preferably 300 μA or less), is delivered to the vicinity of or to the gingival tissue in the oral cavity where the implantation is located. The post-surgical stimulation regimen may consist of about 20 minutes of electrical stimulation per day for 1 to 14 days after the dental implant surgery, or until the desired reduction in inflammation occurs.

[0112] Although pre- and post-surgical methods have been described separately for clarity, it should be understood that one or (preferably) both methods may be used for certain patients, i.e., mouthpiece users.

[0113] The foregoing should be considered merely illustrative of the principles of the present invention. Furthermore, since numerous modifications and changes will be readily conceivable to those skilled in the art, it is not desirable to limit the present invention to the exact structure and operation shown and described. Preferred embodiments have been described, but details may be modified without departing from the present invention.

Claims

1. It is a system, A controller having a housing containing a variable DC current power supply source, wherein the power supply source is capable of delivering approximately 1 to 500 microamperes, A mouthpiece configured to be received in the mouth of a human, wherein the mouthpiece comprises at least one U-shaped channel, Multiple exposure electrodes supported by the mouthpiece and coupled to the DC power supply to selectively receive current from the DC power supply, The DC current power supply is electrically coupled to the mouthpiece, and the housing is physically coupled to the mouthpiece by a reduced diameter portion. Equipped with, The electrical coupling in the reduced diameter portion is achieved through a connector, which optionally includes a plurality of conductive pins, the plurality of conductive pins being inserted into a conductive silicone trace and substantially surrounded by the conductive silicone trace. A system in which the plurality of exposure electrodes are configured to be in direct contact with the surface of the gingival tissue in the mouth of a human.

2. The system according to claim 1, wherein the first of the plurality of exposed electrodes is a cathode electrode positioned on the first side of the first of the at least one U-shaped channel, and the second of the plurality of exposed electrodes is an anode electrode positioned on the second side of the first channel.

3. The system according to claim 1, wherein the mouthpiece comprises two U-shaped channels, one channel configured to receive one or more maxillary teeth of a human, and the other channel configured to receive one or more mandibular teeth of the human.

4. The system according to claim 3, wherein the controller comprises an electronic network disposed within the housing, and the network is configured to perform at least one operation and monitoring of at least one of the duration and intensity of the current supplied to each electrode by the power supply.

5. The system according to claim 4, wherein the controller further comprises a user input interface and a user feedback interface.

6. The system according to claim 5, wherein the controller is configured to store one or more counter values ​​and an event log in non-volatile memory.

7. The system according to claim 6, wherein the event log can store at least 2,000 event occurrences, each including a timestamp associated with it.

8. The system according to claim 1, wherein the variable DC current power supply source comprises a rechargeable lithium-ion battery.

9. The system according to claim 8, further comprising a charging station that physically supports the controller housing and is capable of inductively recharging the rechargeable lithium-ion battery.

10. The system according to claim 9, wherein the charging station comprises a hinged cover that may contain the controller and the mouthpiece.

11. The system according to claim 6, further comprising a mobile wireless communication device capable of physical layer communication with the controller, the wireless device further comprising a software application capable of software layer communication with the controller.

12. The system according to claim 11, wherein the controller is capable of transmitting the counter value and event log to the application of the wireless device.

13. The system according to claim 12, wherein the controller transmits the counter value and the event log in response to at least one of the occurrence of a predetermined event, the end of a predetermined period, and a predetermined time of day.

14. The system according to claim 12, wherein the application is configured to simultaneously display at least one transmitted counter value and an event log.

15. The system according to claim 12, wherein the application is configured to enable the storage of the transmitted counter values ​​and event logs in a non-volatile memory within the wireless device.

16. The system according to claim 11, wherein the application is configured to provide a firmware update to the controller.

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