Periodontal system and method of subgingival therapy

Abstract

A periodontal system (10) includes a hand tool (12) having a body (18) and a first tip (20) coupled to a first end (22) of the body. Optical paths (14) extends through at least a portion of the body and into the first tip (22). The optical paths (14) facilitate the transmission of one or more light waves to and / or from a subgingival region of a patient's mouth. The periodontal system (10) also has a visualisation system (16) and an associated electronic display (28). The visualisation system (16) is coupled to the optical paths (14) and generate, from some of the light waves, a real time visual representation of at least a first portion of the subgingival region of a patient's mouth on the electronic display (28). The first tip (22) is arranged to deliver at least one periodontal therapy including, manual scraping of calculus, laser ablation of calculus and laser sterilisation.

Description

[0001] PERIODONTAL SYSTEM AND METHOD OF SUBGINGIVAL THERAPY

[0002] TECHNICAL FIELD

[0003] The present disclosure relates to a periodontal system and a method of subgingival therapy. The therapy may include, but is not limited to, removing subgingival calculus and subgingival sterilisation. The system and method enable real time viewing of a subgingival region during delivery of the therapy.

[0004] BACKGROUND ART

[0005] Calculus (also known as tartar) is a form of hardened plaque. It may form both above and below the gum line, known as supragingival and subgingival calculus, respectively. The existence of calculus may cause bad breath, receding gums and gingival inflammation.

[0006] Plaque may be removed at home by brushing and flossing. However once hardened to form calculus, removal is generally performed by a dentist or dental technician using instruments such as an ultrasonic scaler and periodontal scaler or curette. Use of these instruments is often uncomfortable and painful for the patient. Also, considerable skill is required on behalf of the dentist or technician to manipulate mirrors and other visualisation aides in one hand while using the instrument with the other, particularly when removing subgingival calculus.

[0007] Current preventative dental care is limited by the inability to detect early-stage subgingival changes before they progress to clinical disease. Early detection and intervention at the preventative stage could significantly reduce the burden of periodontal disease, particularly in underserved populations where access to specialized periodontal care is limited.

[0008] Zest Dental Solutions market a dental endoscope that allows clinicians and hygienists to see magnified details of tooth anatomy below the gum line which help to diagnose and treat periodontal disease. This may assist a dental technician in identifying calculus for removal with a separate standard curette. In one scenario a dental technician may hold the dental endoscope in one hand and use the other to manipulate a curette for the removal of calculus. This may require extensive training to acquire the degree of dexterity and skill needed to simultaneously use both the dental endoscope and the curette. In another scenario a dental technician may use the same hand to alternately operate the dental endoscope and the curette.

[0009] Subgingival sterilisation may also be required for various periodontal actions such as removing calculus, treating gingivitis, during the installation, or inspection, of dental implants. The above references to the background art do not constitute an admission that the art forms a part of the common general knowledge of a person of ordinary skill in the art. The above references are also not intended to limit the application of the disclosed periodontal instrument and a method of subgingival therapy to any particular form of the instrument or type of therapy.

[0010] SUMMARY OF THE DISCLOSURE

[0011] In one aspect there is disclosed a periodontal system comprising: a hand tool having a body, and a first tip coupled to a first end of the body; one or more optical paths that extends through at least a portion of the body and into the first tip the one or more optical paths arranged to facilitate the transmission of one or more light waves to and / or from a subgingival region of a patient’s mouth; a visualisation system and an associated electronic display, the visualisation system coupled to the one or more optical paths and capable of generating from some of the light waves a real time visual representation of at least a first portion of the subgingival region of a patient’s mouth on the electronic display; wherein the first tip is arranged to deliver at least one periodontal therapy.

[0012] In one aspect the visualisation system comprises an endoscope wherein the real time visual representation is a real time image of the at least a first portion of the subgingival region on the electronic display.

[0013] In one embodiment the visualisation system is an optical coherence tomography (OCT) system and the real time visual representation is a representation on the electronic display of different types of tissue the at least a first portion of the subgingival region.

[0014] In one embodiment the OCT system produces the real time visual representation of the first subgingival region by splitting an associated imaging laser beam into an imaging portion directed to the at least a first portion of the subgingival region and a reference portion directed to a reference arm and combining reflections of the imaging portion with reflections of the reference portion.

[0015] In one embodiment the one or more optical paths are arranged to facilitate the transmission of one or more light waves to and / or from the first portion of the subgingival region and a second portion of the subgingival region; and wherein the visualisation system is capable of generating from some of the light waves, and displaying on the electronic display, a real time visual representation of the first portion and the second portion of the subgingival region.

[0016] In one embodiment the periodontal system comprises an optical switch arranged to alternately switch light waves from the first and second portions of the subgingival region coupled to the visualisation system at rate sufficient to enable the visualisation system to generate on the electronic display a real time visual representation of both the first and the second subgingival regions.

[0017] In one embodiment the electronic display is located remotely from the hand tool for displaying the real time visual representation.

[0018] In one embodiment the electronic display is located on the body of the hand tool.

[0019] In one embodiment the electronic display includes a plurality of light emitting devices each of which is arranged to change between two different visually perceptible states dependant on a type of subgingival tissue which are illuminated by the light waves.

[0020] In one embodiment the plurality of light emitting devices are located on the body of the tool.

[0021] In one embodiment the at least one periodontal therapy is manual removal of calculus and first tip includes a working edge to enable manual scraping for the removal of subgingival calculus.

[0022] In one embodiment the periodontal system includes a therapeutic laser arranged to generate light waves in the form of a therapeutic laser beam and wherein the tool and the first tip are arranged to deliver the therapeutic laser beam to the first subgingival region, wherein the at least one periodontal therapy includes one or both of laser ablation of subgingival calculus in the first portion of the subgingival region and laser sterilisation of the first portion of the subgingival region.

[0023] In one embodiment the at least one periodontal therapy also includes manual removal of calculus, and the first tip includes a working edge to enable manual scraping for the removal of subgingival calculus, wherein the system is able to remove subgingival calculus by one or both of manual scraping and laser ablation. In one embodiment one of the one or more optical paths is an ablation laser beam optical path for transmitting the therapeutic laser beam through the body and the first tip and onto the first portion of the subgingival region.

[0024] In one embodiment the periodontal system includes a multiplexer for alternately switching through a common one of the one or more optical paths (a) light waves that are coupled to the visualisation system for generating on the electronic display the visual representation, and (b) the therapeutic laser beam.

[0025] In one embodiment the periodontal system comprises a second tip coupled to a second end of the body, the second tip being of a shape and configuration which is a mirror image of the first tip.

[0026] In one embodiment the first and second tips are demountable coupled to the tool body to facilitate changing of the tips.

[0027] In one embodiment the optical paths comprise respective single optical fibres, or respective bundles of optical fibres.

[0028] In one embodiment the periodontal system includes: a first set of one of more optical fibres that extend into the first tip and define at least a first optical path to the first tip, a second set of one or more fibres that extends into the second tip and define at least a first optical path to the second tip; a slot formed in the body that extends axially between the first and second ends; and a carriage through which the respective sets of one of more optical fibres extend into the slot, the carriage arranged to slide along the slot.

[0029] In one embodiment the tip is formed with a window at which the one or more optical paths terminate, and the working edge is spaced from the window and oriented so that light waves being transmitted to the first portion of the subgingival region are directed towards the working edge.

[0030] In one embodiment the periodontal system according comprises at least one fluid flow path that extends through the tool body and the tip to facilitate a flow of fluid to and / or from a patient’s mouth.

[0031] In a second aspect there is disclosed a method of subgingival therapy comprising: using a single hand tool having at least a first tip at one end to simultaneously facilitate the viewing of a real time visual representation of a subgingival therapy site in the subgingival region form a point of view of the first tip; and delivering by use of the first tip at least one periodontal therapy.

[0032] In one embodiment the method comprises forming one or more optical paths that extend through the single hand tool and tip and couple to a visualisation system, wherein light waves are arranged to travel through the one or more optical paths and to the optical visualisation system and operating an electronic display connecting the optical visualisation system to provide the visual representation.

[0033] In one embodiment the method comprises using the tip to deliver one or more of the following periodontal therapies: (a) manual scraping or removal of calculus; (b) laser ablation of calculus, (c) sterilisation via application of a laser beam.

[0034] BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Notwithstanding any other forms which may fall within the scope of the periodontal system and a method of subgingival therapy as set forth in the Summary, specific embodiments will now be described, by way of example only, with reference to becoming drawings in which:

[0036] Figure 1 is a schematic representation of one broad and general form of the disclosed periodontal system which may be used to realise the disclosed periodontal method showing a hand tool with a tip for delivering one or more periodontal therapies, an umbilical which may carry at least one or more optical paths, and a console.

[0037] Figures 2a, 2b and 2c are schematic representations of different visualisation systems that may be incorporated in the disclosed periodontal system and method.

[0038] Figure 3a is a schematic representation of one form of tip that may be incorporated in one embodiment of the disclosed periodontal system and method and is arranged to facilitate the simultaneous visualisation of a subgingival region and the manual scraping of calculus from that region.

[0039] Figures 3b is an enlarged view of detail B shown in Figure 3a.

[0040] Figure 4a is a schematic representation of another form of tip attached to a tool body where the tip to facilitate the simultaneous visualisation of a subgingival region and manual scraping of calculus but where the tip is of a different configuration and geometry to that shown in Figures 3a and 3b.

[0041] Figures 4b is an enlarged view of detail B shown in Figure 4a.

[0042] Figures 5a and 5b are views from opposite sides of another form of tip coupled to a hand tool, where the tip is arranged to facilitate the simultaneous visualisation of a subgingival region and one or both of manual scraping of calculus and laser therapy which may include laser ablation of calculus.

[0043] Figures 5c and 5d are enlarged views of details C and D shown in Figures 5a and 5b.

[0044] Figure 5e is a 3-dimensional view of the tip shown in Figures 5c-5d view of detail E shown in Figure 5a.

[0045] Figures 6a and 6b illustrate opposite sides of a form of tip attached to a tool body where tip is arranged to facilitate the simultaneous visualisation of a subgingival region and deliver only a laser-based periodontal therapy or treatment to the subgingival region.

[0046] Figure 7a is a schematic representation of a form of the hand tool and tip shown in Figures 5a-5 e but where the tip and associated hand tool are modified by the addition of a channel to facilitate the delivery of a fluid into a patient’s mouth.

[0047] Figure 7b is an enlarged view of detail B shown in Figure 7a.

[0048] Figures 8a and 8b are schematic representations of an embodiment of the disclosed periodontal system arranged in a modular form allowing the interchanging of the tips coupled to the hand tool to thereby deliver different periodontal therapies.

[0049] Figures 9a, 9b and 9c are schematic representations of an optical path management system that may be incorporated in embodiments of the disclosed periodontal system and method.

[0050] Figure 10 is a block diagram of one form of visualisation system that may be incorporated in embodiments of the disclosed periodontal system, this form being an optical coherence tomography (“OCT”) imaging system. Figures 11a, 11 b and 11 c are examples of images of gum, calculus, and tooth tissue derived by the OCT imaging system.

[0051] DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

[0052] Specific embodiments of the disclosed periodontal system and a method of subgingival therapy will now be described by way of example only. The terminology used herein is for the purpose of describing the particular embodiments only and is not intended to limit the scope of the disclosed periodontal system and method. Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art to pertaining periodontal system and method. In the drawings, it should be understood that like reference numbers refer to like parts.

[0053] The general idea of the disclosed periodontal system and method is to enable or otherwise provide a real time visual representation of a patient’s mouth and teeth including gingival subgingival region while performing at least one periodontal therapy. The system and method use a hand held tool (or more simply referred to herein as “tool”). The tool has a body for a user to hold. The tool also has at least one tip that is coupled to one end of the body. The tip defines the point of view for the real time visualisation. The tip is also arranged to deliver the at least one periodontal therapy.

[0054] To provide a real time visual representation of the subgingival region, the tool is formed with one or more optical paths that extends through at least a portion of the body and into the tip. Light waves are transmitted through one or more optical paths and radiate from the tip to illuminate a first aspect of a subgingival region in a patient’s mouth. The light waves reflected by the subgingival region are transmitted back through the one or more optical paths.

[0055] The optical paths may be arranged to facilitate the transmission of one or more light waves to and / or from the first portion of the subgingival region and a second portion of the subgingival region. In such an arrangement the visualisation system is capable of generating, from some of the light waves, and displaying on the electronic display, a real time visual representation of the first portion and the second portion of the subgingival region. The first and second aspect may be the opposite sides of a common subgingival region. For example, the first aspect may be that looking towards gum tissue which forms one side of the subgingival region while the second aspect is that looking towards a tooth on the opposite side of the subgingival region. This makes it easier to differentiate between types of tissue being viewed. In particular it enables a user to more readily differentiate between gum tissue and subgingival calculus / teeth / bone. Once the desired therapy site is visually identified the user may then manipulate or otherwise operate the tool to deliver the treatment or therapy available through or via the tip.

[0056] The optical paths may be in the form of one or a bundle of optical fibres.

[0057] Different visualisation systems may be used to generate different visual representations of a subgingival region. These include for example (a) an endoscope (i.e., camera), and (b) an optical coherence tomography (“OCT”) imaging system. The OCT system typically emits a low powered infrared laser, and provides a transactional image with a penetration depth up to about 1-2 mm.

[0058] In one embodiment the therapy delivered by the tip may be manual calculus removal. In such an embodiment the tip may be in the form of a curette with a working edge for scraping calculus from a tooth surface.

[0059] In another embodiment the therapy delivered by the tip may be a periodontal laser therapy. Such therapy may be (a) laser ablation of calculus, or (b) laser sterilisation the subgingival region, or (c) both laser ablation of calculus and sterilisation the subgingival region.

[0060] In one embodiment where laser therapy is available, the tool may be provided with a dedicated laser therapy optical path that is used only for transmission of the periodontal laser therapy. This laser therapy optical path is separate from the optical path(s) used for providing the visual representation. The provision of a dedicated laser optical path and separate visualisation optical paths(s) allow optimisation of each for characteristics such as wave frequency, power, and waveform to perform their respective functions.

[0061] Nevertheless, in another form of the above laser therapy embodiment, a common optical path (e.g. a first optical path) may be arranged to transmit both the light waves used by the visualisation system, and the laser beam for the periodontal laser therapy. In that event the visualisation light waves and therapeutic laser beam may be switched to travel along the common optical path in the hand held tool, for example by use of a wavelength division multiplexer at a sufficiently fast rate so that to the user is presented with real time live visual representation, including a real time image of the subgingival region while being treated by the therapeutic laser. A switching rate of about 30Hz or faster, e.g., 50Hz is sufficient to provide the user with an image that appears as continuous live motion. The periodontal system may include a console to reach the hand tool is operatively connected. The console may have an electronic display enabling a user of the periodontal system to view the visual representation of the subgingival area to which treatment is be delivered. The console may also be provided with user interface for controlling or otherwise operating the tool. The periodontal system may also include a pair of smart glasses which is provided with an electronic display which a periodontist or other therapist can wear to view the visual representation of the subgingival area.

[0062] Some forms of the tool incorporated in the periodontal system may be provided with a single tip at one end of the tool body. However, in other embodiments the tool may be provided with respective tips at each end of the body. In one form of the tips are arranged to provide the same treatment which are mirror images of each other in terms of shape and configuration. This allows the user to use the same tool to treat the same surface of a tooth but from opposite sides by simply turning the tool around.

[0063] When the tool has a tip at each end a cable management system may be provided to maintain the integrity of the optical paths (and any electrical conductors) for each tip. When the optical paths are provided by respective sets of one or more optical fibres the cable management system may be in the form of a slot formed in the tool body that extends axially between the first and second ends, and a carriage through which the respective sets of one of more optical fibres extend into the slot, where the carriage can slide along the slot.

[0064] In further embodiments the periodontal system may be provided with a degree of modularity allowing different tips for applying different periodontal therapies to be demountably coupled or otherwise connected to a common tool body.

[0065] The periodontal system may also include a channel capable of directing a fluid into the subgingival region. The fluid may be for example water to rinse away shattered calculus or cool the region. Alternately or additionally the periodontal system may be arranged to enable the delivery of: (a) a gas such as air to blow away small particles of shattered calculus or dry the viewed subgingival region; and / or (b) a vacuum for extracting shattered calculus and other debris.

[0066] Broad Overview

[0067] Figure 1 shows one broad and general form of the disclosed periodontal system 10, that may be used to perform the disclosed periodontal method. The periodontal system 10 includes a hand tool 12, a first optical path 14 and a visualisation system 16. The hand tool 12 (hereinafter referred to simply as “tool 12”) has a body 18 and a first tip 20 coupled to a first end 22 of the body 18. As explained in greater detail later, the tip 20 is arranged to deliver at least one periodontal therapy.

[0068] The first optical path 14 extends through at least a portion of the body 18 and into the tip 20. The optical path 14 also extends through an umbilical 24 to a console 26. Light waves are transmitted through the optical path 14 and radiate from the tip 20 to illuminate a patient’s subgingival region. Light waves reflected from the subgingival region are transmitted back through either through a same optical path 14, or another through another optical path and received by the visualisation system 16. The visualisation system 16 has an electronic display 28 which in this broad overview is provided in the console 26. The visualisation system 16 generates a real-time visual representation of the subgingival region which is visible on the electronic display 28. The console 26 also has a user interface 30 enabling a user to operate and control the periodontal system 10. The console may include, by way of a nonlimiting example: an ON / OFF switch; a record switch which when operated records images or other representations of a patient’s mouth and subgingival regions; switches and buttons to adjust or control characteristics of the images or representations on the display 28; and means for adjusting the power output of lasers incorporated in the periodontal system 10 for providing the periodontal therapy.

[0069] Embodiments of the periodontal system 10 enables a periodontist or other dental therapist to simultaneously view a representation of a subgingival region and deliver a periodontal therapy or treatment. The visual representation is from the viewpoint of the tip 20. This arises because an end of the one or more optical paths 14 from which reflected waves are received is located in the tip 20.

[0070] Visualisation Options

[0071] Figures 1 and 2a illustrate one embodiment for providing a visual representation of a work area, such as a subgingival region to which the tool 12 is applied. In this option the visualisation system 16 and the associated electronic display 28 are housed in the console 26. As explained in greater detail later, the visualisation system 16 can take different forms including an endoscope and an optical coherence tomography (“OCT”) imaging system. The electronic display 28 in this embodiment may be in the form of an LCD or OLED display for example of the type commonly incorporated in smart phones. Figure 2b shows a variation where there is an electronic display 28b integrated into the hand tool 12. In this embodiment the electronic display 28b is in addition to the electronic display 28 in the console 26. Though in one variation the periodontal system 10 may be provided with only the electronic display 28b. In another variation where both displays 28 and 28b are present, the displays may be arranged to provide different forms of images or visual representations. For example, the display 28 may display a natural light generated image of the work area, while the display 28b may provide an image or representations produced by illumination with ultraviolet light transmitted through one of the optical paths.

[0072] Figure 2c shows a further variation on the arrangement of Figure 2b, where an electronic display 28c is also integrated into the hand tool 10 but the display 28c is formed from a plurality of light emitting devices 32. The devices 32 are arranged to change between two different visually perceptible states dependant on a type of subgingival tissue illuminated by the incident light wave. The display 28c may be incorporated when the visualisation system is an OCT imaging system. The light emitting devices 32 may for example be in the form of respective LED’s that emit light of different colour for example green, yellow and red and change state from ON to OFF dependent upon the type of tissue seen from the viewpoint of the tip 20. The electronic display 28 on the console may also provide images generated by the OCT imaging system. Though in an alternative form, if the visualisation system incorporates both an endoscope and OCT system, the display 28 may be arranged to display an actual image of the work area seen by the tip 20, while the display 28c provides an indication of the type of tissue being viewed.

[0073] As described in greater detail below, embodiments of the system may incorporate automatic or Al-driven switching between optical paths to alternate between tissue views. It may also use real-time image classification to provide on-screen warnings, suggestions, or restrict activation of the laser in unsafe conditions. The images shown on the electronic display 28 may be in the form of an Al generated animation of the subgingival region with different tissue types delineated to assist the user in accurately targeting the application of the required therapy.

[0074] In a further embodiment which is not illustrated, an electronic display may be incorporated in smart glasses worn by the therapist. The electronic display in the glasses may be arranged to display any of the images or visual representation described above. In such an embodiment it is envisaged that smart glasses may be wirelessly connected to the visualisation system within the console 26. Indeed, the smart glasses may also be arranged to function as a user interface for controlling the periodontal system 10. This may be in addition to, or instead of, the user interface in the console 26. in the same way as described above in relation to the console 26.

[0075] Tip and Periodontal Therapy Options

[0076] Figures 3a-7b illustrate several types of tips 20a, 20b, 20c, 20d, 20e (which may be referred to in general as tip or tips 20) that may be incorporated in embodiments of the periodontal system 10 to deliver different types or combinations of periodontal therapy.

[0077] In various embodiments, the periodontal tool 12 and associated tips 20 may be designed to withstand sterilisation protocols commonly employed in dental practice. For example, the hand tool and tips may be fabricated from stainless steel or high-grade polymers that are autoclavable without degradation of optical performance. In these embodiments, the optical fibres are embedded in such a way that their distal ends are flush with the surface of the tip, thereby minimising crevices that could harbour biological contaminants and simplifying sterilisation. The tool 12 may be designed such that the optical fibre ends and any associated lenses, and prisms (discussed later) remain optically aligned and undamaged after repeated autoclave cycles. In alternate embodiments, the tips 20 may be configured for single-use applications, supplied in sterile packaging, and disposable after treatment. This dual approach permits clinical flexibility: reusable tips 20 may be employed in high- throughput practices, whereas disposable tips may be used in cases where reprocessing facilities are limited or where sterility assurance is paramount. In either arrangement, the console may include system checks to confirm tip sterility or usage status prior to enabling therapy delivery.

[0078] Figures 3a and 3b illustrate one form of tip 20a enabling the manual removal of calculus by physical or mechanical scraping of a working edge 34 of the tip 20a against a tooth. The tip 20a is in the general form of that found on a standard dental curette but modified by the addition of an internal passageway 36 which carries one or more optical paths. The optical paths are coupled the visualisation system 16. In this particular embodiment the one or more optical paths comprise a single optical fibre 38. But as explained later the one or more optical paths may be in the form of respective optical fibres or respective bundles of optical fibres.

[0079] In this embodiment the optical fibre 38 at the distal end of the tip 20a is largely encased by the material forming the tip 20a leaving a viewing window 40 exposed. As a consequence, this form of tip 20 is able to facilitate the production of an image or visual representation of one side only of the working area in which it is applied. The visualisation system to which the optical path 38 is coupled may be an endoscope type imaging system or an OCT imaging system. In this embodiment the viewing window is substantially co-linear with the working edge 34.

[0080] Figures 4a and 4b illustrate a variation in this embodiment where a tip 20b is formed with a working edge 34 and a window 40 at which one or more optical paths terminate. The window 40 is spaced along the length of the tip 20 from the working edge 34. The window 40 is orientated so that light waves transmitted through the optical paths for the purposes of producing a visual representation are directed at the working edge 34. More particularly the window 40 lies in a plane that is transvers to a longitudinal axis of the tip. The working edge 34 lies in a plane transverse to that of the window 40. The window is located intermediate of the length of the tip 20.

[0081] Figures 5a-5e illustrate a form of tip 20c that may be incorporated in the periodontal system 10 for enabling a combination of manual scarping of calculus and laser periodontal therapy. The laser therapy could include one or both of laser ablation of calculus and sterilisation of a working area region inside a patient’s mouth such as a subgingival region.

[0082] The tip 20c has a rounded distal end with diametrically opposite cutouts or windows 44a and 44b. The tip 20c also has a working edge 34 that is formed adjacent to the window 44b. The working edge has the same functionality as that described above in connection with the tips 20a and 20b. A passageway (not visible in these Figures) extends through the tip 20c and provides for three separate optical paths. In the illustrated embodiment the optical paths are in the form of respective optical fibres 46, 48 and 50. The optical fibres 46 and 48 provide signals to a visualisation system in the form of an OCT imaging system for producing visual representations of types of tissue viewed through the respective windows 44a and 44b. The optical fibre 50 provides an optical path for a therapeutic laser for delivering treatment to the working area view through the window 44b. The therapeutic laser as well as the OCT system are housed in the console 26.

[0083] Each of the optical paths 46, 48 and 50 is provided at its end with prisms 46p, 48p and 50p, respectively. When in use, the tool 10 is operated so that the prism 46p faces gum tissue while the prisms 48 and 50, and the working edge 34, face a patient’s teeth. This arrangement allows the visualisation system and electronic display to present visual representations sourced from the optical path 48 including the prism 48p to identify whether a surface being viewed is calculus, enamel or gum tissue giving the periodontist immediate feedback. The imaging provided via prism 46a and optical fibre 46 assist in calibrating the periodontal system 10 by constantly referencing the gum tissues OCT readings and data.

[0084] When calculus is detected, either the therapeutic laser may be operated, or the working edge 34 used to scrape away the calculus. When the laser is used for ablation (or indeed sterilisation) a laser beam is directed through the optical fibre 50 and associated prism 50b onto the calculus. Naturally, if gum or enamel is detected the user will not operate the laser for the purpose ablation. Though it is still possible to use the laser for sterilisation.

[0085] Figures 6a and 6b illustrate left and right hand views of a tip 20d that is arranged to facilitate the generation of images or visual representations from opposite sides of a subgingival region while also enabling the delivery of a laser periodontal therapy.

[0086] The tip 20d is in substance the same as the tip 20c and differs only in the omission of the working edge 34. For this reason, the tip 20d is only able to deliver a laser periodontal therapy rather than both laser therapy and manual scraping. To this end the tip 20d has the same internal passage, windows 44a and 44b, and optical paths, namely the optical fibres 46, 48 and 50, and associated prisms 46p, 48p, and 50p, as the tip 20b.

[0087] Figures 7a and 7b illustrate an embodiment of the periodontal system 10 where the hand tool 12 and associate tip 20e is arranged to deliver or otherwise conduct the flow of one or more fluids. The fluids may include water and air. In such embodiments one or more channels are formed in the body 18 and the tip 20e through which respective fluids can flow. As illustrated in Figures 7a and 7b one form of the tip 20e is provided with a channel 59 for conducting the flow of water into a patient’s mouth. The channel 59 opens at a location adjacent to an end of the tip 20e that delivers the periodontal therapy. In this embodiment the tip 20e has a working edge 34 for the manual scraping of calculus, and an optical path terminating in prism 50p for delivering a laser therapy such as laser ablation of calculus or sterilisation, and imaging optical fibres the same for the tip 20c with the prism 48p of fibre being visible in this view.

[0088] In some embodiments, the one or more channels 59 may be incorporated as integrated irrigation channels within a tip 20 to direct fluid, such as water or saline, to the subgingival region. This serves multiple purposes: firstly, to cool the tissue and dissipate heat generated during laser ablation, thereby preventing collateral damage to enamel, dentin, or gingival tissues; secondly, to facilitate the mechanical removal of dislodged calculus fragments and bacterial biofilm from the treatment pocket; and thirdly, to maintain optical clarity for imaging by washing away blood or debris that could obscure the optical path. In some arrangements, irrigation may be pulsed in synchrony with therapeutic laser firing to enhance the efficiency of calculus fragmentation via photoacoustic micro-explosions in a water film. The flow rate and timing of irrigation may be controlled via the console or footswitch and may be operator- selectable depending on tissue type and treatment mode. Additional channels may be provided for air insufflation to dry the treatment site or for suction to extract debris, further improving visibility and reducing patient discomfort.

[0089] Water can be sprayed through the channel 59 for one or a combination of purposes. One of these is to assist in the laser ablation process. Er:YAG and Er,Cr:YSGG lasers which may be used to produce the therapeutic laser beams are strongly absorbed by water. When the laser beam illuminates a water film at the tip 20e and in a subgingival pocket, the absorbed energy causes micro-explosions (known as a photoacoustic effect). These micro-explosions mechanically chip off calculus and ablate soft tissue with minimal thermal penetration. The delivery of water may also in dissipating excess heat which may be produced by the therapeutic laser. This assists in preventing energy being absorbed too deeply into tooth enamel / dentin which may otherwise cause the formation of cracks, carbonisation, or pulp damage. In addition, providing a continuous water stream through the channel 59 washes away calculus fragments, bacteria and tissue debris. It also improves visibility in the subgingival pocket. The water may also be used to wash out calcium debris from the lenses, or the optical system in general. This may avoid artifacts in the generated images.

[0090] A further channel (not shown) may be provided for the delivery of a jet of air. In a further variation another channel may be provided for connection to a suction source for extracting fluid and particles from the patient’s mouth. Such an additional channel may open on a face or surface of the tip 20e spaced from that onto which the illustrated channel 59 opens.

[0091] While the tip 20e in Figures 7a and 7b provides both laser and manual therapy the provision of one or more channels 59 for the delivery removal of one or more fluids as described above may be incorporated in any of the embodiments of the disclosed periodontal system 10 disclosed in this specification.

[0092] Modularity - Interchangeability of Tips.

[0093] As shown in Figures 8a and 8b some embodiments of the periodontal system 10 the tool 12 may be formed with mutually detachable body 18 and tip 20. In such embodiments the body 18 and tip 20 may be considered as modules that can be demountable coupled together. The tip 20 module may contain an integrated lens aligned with the optical fibre(s) that extend through the body 18. A coupler 52 on the body 18 may detachably couple to the tip 20 using via one of a plurality of coupling mechanisms or system, including but not limited to: a snap- on coupling, a magnetic snap coupling, and a thread coupling including a single-thread turn- to-fit coupling. This modularity allows clinicians to interchange tips 20 of different shapes depending on tooth location and geometry, while enabling detached modules to be disinfected or sterilized for reuse with subsequent patients. Additionally, it enables tips that provide different functionality, e.g., tips 20a, 20b, 20c, 20d and 20e, to be used with a common body 18 and console 26.

[0094] Twin Tip Tool

[0095] In the embodiments shown in Figures 1-8b the tool 12 is provided with a tip 20 at one end 22 of the tool body 18. But other embodiments are possible as shown in Figures 9a-9c where the tool 12 has a tip 20 at the end 22 and a second tip 20m at an opposite end 54 of the body 18. The tip 20m may be a mirror image in terms of shape and geometry of the tip 20. This allows a clinician to treat the same surface of a tooth from both the left hand side and the right hand side by turning the tool 12 in their hand. The mirror image tips 20, 20m will in most circumstances have the same functionality in relation to the therapy that they can deliver. Though there is no technical reason the tips 20 and 20m must be mirror images of each other, nor have the same functionality.

[0096] To maintain the integrity of the operative connection between the console 26 and the tool 12, the periodontal system 10 in this embodiment is provided with a cable management system 56. The operative connections include the optical paths and corresponding optical fibres as well as any electrical conductors that run power or signals between the tips 20, 20m and console 26. The cable management system 56 may be in the form of a slot 58 formed in the tool body18 that extends axially between the first and second ends 22, 54, and a carriage 60 through which the respective sets of one of more optical fibres extend into the slot 58. The carriage 60 is arranged to slide along the slot 58 from end to end as shown in Figure 8c. So, if the tip 20 is to be used the carriage 60 is slid along the slot 58 to the end 54, whereas if the tip 20m is to be used the carriage is slid along the slot to the end 22.

[0097] In this embodiment a portion of the length of the umbilical near the tool 12 is split into two strands 62, 62m. Each strand 62, 62m carries the set of optical paths including optical fibre(s) and electrical conductors required for the functioning and operation of the therapy to be delivered by the respective tips 20, 20m. The stands 62, 62m lie in the body 18 along the slot 58 and connect to their respective tips 20, 20m. This may be via respective couplers 52, 52m.

[0098] The carriage 60 has two openings 64 through which the strands 62, 62m can slide into and out of the slot 58. Various mechanisms may be used to prevent the stands 62, 62m from being pulled out of the slot 58 other through the openings 64 as the carriage 60 is slid between ends 22 and 54 of the body 18. One mechanism is to provide two resilient strips of material along the slot, one on each side that either slightly overlap, or touch, or leave a gap therebetween that is smaller than the diameter of the strands 62, 62m. In this arrangement the carriage 60 may have depending guides that locally spread the strips apart to allow the strands 62, 62m to move out of and into the slot 58 as the carriage is slid along the body 18. An alternate mechanism is to provide a rotatable cylinder within the body 18 that surrounds the strands 62, 62m and is provided with a spiral slot that winds about an axis of the cylinder and extends for nearly the full length of the cylinder, stopping short of the ends of the cylinder. The spiral slot is formed with a width slightly greater than the distance between the strands 62, 62m from where they commence to curve from lying parallel to the slot 58 to extending through the openings 64. As the carriage is slid along the body 18, the cylinder rotates thereby turning its spiral slot to always keep a portion of the spiral slot immediately below the carriage and facing the slot 58.

[0099] OCT Visualisation System and Laser Therapy

[0100] Figure 10 is a block diagram of an OCT imaging system 16 that may be used as the visualisation system in embodiments of the periodontal system 10. In this embodiment the OCT imaging system 16 incorporates two optical paths in the form of optical fibres 46 and 48 that are used for OCT imaging of opposite sides of a subgingival region. This embodiment also includes the optical fibre 50 for a laser beam produced by a therapeutic laser 68.

[0101] One end of the optical fibres 46, 48 and 50 terminate in the hand tool 12 at respective prisms 46p, 48p and 50p, for example as shown in Figured 5a-5e. Respective graded refractive index (GRIN) lenses 46s, 48s and 50s may be optically coupled between their corresponding optical fibre and prism. The prisms and lenses may be coated with anti-reflective coatings to minimize reflections and enhance overall performance.

[0102] The design of the hand tool 12 / optical probe determines the ability to provide high-fidelity imaging within the subgingival environment. In one form, the probe tip 20 includes two optical fibres positioned within 2 mm of the distal surface of the tip, each terminating at a prismatic lens. These prisms may be oriented at approximately 90 degrees to redirect the imaging beam laterally towards the adjacent tooth and gingival tissue. The field of view of each prismatic lens may be approximately 2 mm in diameter, optimised to encompass the typical width of a subgingival pocket while maintaining high axial and lateral resolution. Locating optical fibres bilaterally enables simultaneous or alternating acquisition of tissue images from opposing sides of the pocket, which improves tissue differentiation (e.g., distinguishing calculus from gum on one side and from enamel or cementum on the other). The optical fibres may be fixed within the body 18 of the tool 12 to maintain precise alignment under repeated mechanical stress and sterilisation. In some embodiments, anti- reflective coatings may be applied to the prisms or lenses to reduce backscatter and enhance signal quality. The (GRIN) lenses provide beam shaping and focusing, allowing a working distance of approximately 1-2 mm with spot sizes as small as 35 pm, sufficient for delineation of fine tissue structures and calculus deposits.

[0103] When provided, the GRIN lenses assist in focusing the optical signal that travel through the optical fibres and direct them through respective windows 44 in the tip 20. As previously mentioned, the windows 44 may be circumferentially spaced 180° about the tip 20. It should be noted however that in an alternate embodiment, the optical fibres 46, 48, and 50 forming the optical paths that can be cut and polished at a specific angle, so forming an effective prismatic lens in situ without requiring coupling with a GRIN lens 46s, 48s, 50s and prism 46p, 48p and 50p.

[0104] The OCT system 16 comprises a light source 70 (typically a low power infrared laser providing an imaging laser beam), a reference arm 72, the visual display 24 and an optical coupler system 76. The optical coupler system 76 optically couples the imaging optical paths / optical fibres 46, 48, the light source 70, the reference arm 72, and the visual display 26. The light source is optically coupled to the optical coupler system 76 by an optical path 77.

[0105] The optical coupler system 76 includes a beam splitter 78, circulators 80, 82 and an optical coupler 84. The splitter 78 is coupled to one port 80a of the circulator 80 though an optical path 86, and to one port 82a the circulator 82 though an optical path 88. A second port 80b of the circulator 80 is optically coupled to the optical fibres 46, 48 via an optical path 90 and an optical switch 94. A second port 82b of the circulator 82 is optically coupled to the reference arm 72 by an optical path 96 via an optical switch 98. The ports 80c and 82c of the circulators 80 and 82 are optically coupled to the coupler 84 through optical paths 100 and 102, respectively. The coupler 84 is coupled to the visual display 24 via an optical path 104.

[0106] The reference arm 72 comprises two of optical path 106a and 106b (referred to in general as “optical path 106” in the singular and “optical paths 106” in the plural), and corresponding axially movable mirrors 108a and 108b (referred to in general as “mirror 108” in the singular and “mirrors 108” in the plural).

[0107] An optical isolator 114 is placed in the optical fibre 50 between the therapeutic laser 68 and the end of the optical fibre 50 located in the tip 20. The isolator 114 blocks reflected laser light from reaching the laser 68. The laser is arranged to emit a laser beam of a wavelength and power required for the desired therapy. The specific laser wavelength will be determined by the target tissue and selected to avoid damage to the adjacent tissues. For example, sterilisation of an infection might require a different wavelength to removing black calculus and that different to removing light coloured calculus. In one embodiment the laser may an Er:YAG laser emitting a laser beam at a wavelength of about 2,940 nm which more suited for light-coloured calculus ablation. This wavelength is also absorbed by water which may be beneficial as the water absorption at 2940 nm limits collateral thermal damages to surrounding tissues (e.g., carbonization of root surface); hence, water irrigation can be used to shatter calculus by transferring the micro-explosive force of water vaporisation to the calculus. This phenomenon is called photo-mechanical or thermo-mechanical ablation. Also, in some embodiments the laser 68, may comprise a plurality of lasers emitting laser beams of different wavelength to perform different therapies.

[0108] Each of the optical paths 77, 86, 88, 90, 96, 100, 102, 104, 106 and 112 may be in the form of: single optical fibres; or, bundles of fibres in a common sheath. These optical fibres as well as the optical fibres 46, 48 and 50 may be single mode fibres or multi-mode fibres.

[0109] The system 10 also includes a driver or controller which is operatively associated with the laser 68, light source 70, display 28, and optical switches 94, 98. Most conveniently but not essentially, the driver / controller may be incorporated in the console 26 and accessible through the interface 30. Alternately the driver / controller may be in the form of a laptop computer connectable to the console 26. In either instance the driver / controller may be programmed with software to enable control and oversight of the operation of the laser 68, light source 70, display 28, and optical switches 94, 98; as well as being responsive to operator commands and inputs. In further embodiments, the driver / controller may incorporate an advanced software platform configured to provide a comprehensive user interface. In one embodiment, the interface may be presented on a touchscreen console display The display may allow simultaneous adjustment of laser power, wavelength, and pulse duration, irrigation flow rate, and imaging resolution. The software may also provide real-time OCT image display with overlays generated by automated analysis algorithms, such as tissue classification modules distinguishing calculus, gingiva, and enamel. The user interface may include safety interlocks whereby therapeutic laser delivery is inhibited unless the OCT system verifies correct probe placement and identification of target calculus. In some embodiments, alerts or visual cues may be provided to the operator on the console 26 or via wearable smart glasses, including coloured indicators or warning icons when non-target tissue is detected or when probe tip temperature exceeds a threshold. The software may further record treatment sessions, capturing parameter settings, OCT images, and event logs for regulatory compliance and patient records. Remote connectivity may also be provided for data export, software updates, or integration with electronic health records. In certain implementations, the console may support semi-automated or Al-assisted operation, whereby the system can suggest optimal laser parameters or automatically terminate laser firing once the calculus has been ablated and confirmed removed by OCT imaging

[0110] The visualisation system 16 operates as follows.

[0111] The light source 70 emits light waves as a broad band infrared laser beam which may be centred about 850nm, 1300nm, or 1550nm wavelengths. This beam will be referred to herein after as the “visualisation laser beam”. These wavelengths are particularly suitable for transmission in optical fibres due to their relatively low attenuation. The visualisation laser beam from the light source 70 travels through the optical path 77 to the beam splitter 78. The beam splitter 78 splits the light wave into two portions, one travels through the path 86 to circulator 80 while the other travels through the optical path 88 to the circulator 82. The beam splitter 78 may operate in a non-symmetrical manner providing more light power to the portion travelling along one of the paths 86, 88 than the other. For example, 80% of the optical power may be directed along the path 86, with 20% of the optical power directed along the path 88.

[0112] The visualisation laser beam travelling through the path 86 is received at the port 80a and directed by the circulator 80 to travel along the path 90, to the optical switch 94. For the time being, the switch 94 is arranged to direct the visualisation laser beam to the optical path 46 which is then emitted through the window 44a by action of the lens 46s and prism 46p onto a target. In this instance the target may be a subgingival region the patient’s mouth.

[0113] Some of the visualisation laser beam which strikes the target is reflected back through the prism 46p, lens 46s, optical fibre 46, switch 94, and optical path 80 to the circulator port 80b. The reflected visualisation laser beam is directed through port 80c, and optical path 90 to the coupler 84.

[0114] The visualisation laser beam travelling along optical path 78 is received at the port 82a of the circulator 82 and exits through port 82b to travel along the optical path 96 to the optical switch 98. Assume that the switch 98 is arranged to direct the visualisation laser beam to the optical path 106a. The visualisation laser beam is then reflected by the mirror 108a travel back along the optical path 106b, optical switch 98 and the optical path 96, to be received at the circulator port 82b. This reflected light is directed by the circulator 82 to the port 82c and travels along optical path 102 to the optical coupler 84, where is coupled with the reflected light from the target. The combined visualisation laser beams (or signal) are detected by a photodetector (not shown), and a resultant image of the subgingival region is provided on the display 28.

[0115] Strong interference occurs when the light from the reference arm 72 and the target have travelled the same optical distance, or more particularly where the respective optical path lengths differ by less than the coherence length of the light source. The optical path 106a (and 106b) are arranged to ensure this relationship of optical path lengths. In this regard the mirror position can be manually adjusted to optimally fine tune the path length of the reflected image for subtraction. Axially scanning the mirror 108a is equivalent to performing optical sectioning of the target, allowing for the generation of map or image of optical reflectivity versus depth.

[0116] In this embodiment, there are two optical paths 46 and 48 which view different areas of the subgingival region, with respective paths 106a and 106b in the reference arm 72. By synchronising the switches 94 and 98 so that at any particular instance reflected light at the coupler 84 combines only light reflected through the paths 46 and 106a; or, 48 and 106b, an image of different areas or sites of the subgingival region they be visualised on the display 28. By switching the switches 94 and 98, at a sufficiently fast rate these two areas can be displayed simultaneously in real time, or near real-time to provide the user with the ability to visually differentiate between calculus / teeth / bone and gum tissue. In embodiments where the system 10 has only a single optical path, e.g., fibre 46 (and single path 106b) a user may rely on a marking on the body 18 of the hand tool to provide a guide as to the nature of the subgingival tissue being viewed in the display 28. In such embodiments the switches 94 and 98 are not required.

[0117] When the laser 68 is activated, a resultant laser beam can be transmitted through the optical path 50 and associated lens 50s and prism 50p onto a portion of the subgingival region being viewed on the display 28 and to which laser therapy is required. Consequently, the laser beam also illuminates and treats that site in the subgingival region. By providing the laser beam at an appropriate wavelength and power, it is able to deliver the required therapy to that site.

[0118] When using an embodiment of system 10, the user may initially locate a tip 20 of the tool body 60 in the subgingival region of a person’s mouth, i.e., below the gum line. In the event that two or more optical paths 14 are provided (e.g., by optical fibres 46 and 48) in the system 10 which illuminate different areas of the subgingival region the user may be able to easily distinguish calculus / teeth / bone from gum tissue, i.e., a patient’s dental side from their gum side. This may require some manipulation of the tool by the user.

[0119] Once a therapy site has been visualised, the user may operate a switch to activate the laser 68. The switch for example be provided on: the tool body 18 itself and by the same hand holding the tool, or on a pedal operated by the foot of the user or associated with a microphone and voice recognition software to enable voice activation.

[0120] It is further envisioned that activation of the laser 68 may be automated by computer software / artificial intelligence in the driver to recognise or otherwise discriminate from the image the path 14a, or 14b which is viewing the dental side, select which path viewing the dental side and switch sides (i.e., paths) accordingly to apply the therapeutic laser beam to the dental side only.

[0121] In a variation to this embodiment the laser beam from the therapeutic laser 68 may be routed via an optical fibre 50f and a wavelength division multiplexing (WDM) coupler 92 (shown in phantom line) to the optical switch 94. The WMD coupler 92 and the optical switches 94 and 98 may be operatively associated with the activation of the laser 68 as follows. Optical switch 94 connects the optical fibre 50f to the optical fibres 46 or 48 through which the therapy site is visualised, and the optical switch 98 connects the optical path 96 to the corresponding optical path 106a, or 106b. The WMD coupler 92 alternately switches the therapeutic laser beam and the light from the imaging light source 70 to the optical switch 94. As a consequence, the therapy site viewed in the display 28 is alternately imaged by the imaging laser beam from the light source 70 and treated by the therapeutic laser beam from the laser 68. The switching rate of the WMD coupler 92 is arranged to be sufficiently fast so that to the user the display 24 provides to the eye of the user a continuous live image representative of the therapy site while the laser therapy is being delivered.

[0122] Example of OCT Imaging system.

[0123] In one example made for the purpose of verifying the imaging functionality of the system 10 an OCT imaging system was constructed to acquire interferometric OCT imaging data. The OCT imaging system employed a swept-source laser (EXALOS® laser diode with a centre wavelength of 1310 nm, and a 100 nm bandwidth), providing an axial resolution of 20 pm. The system 10 used a tool 12 of a general configuration as shown in Figs 6a and 6b, but for the purposes of testing the imaging functionality, the tool 12 had only a single optical path in the form of a single-mode optical fibre. The optical fibre was coupled to a 0.5 mm diameter graded-index (GRIN) lens, polished at an 8° angle to minimize back-reflections. The GRIN lens was integrated with a focusing element that provided a working distance of 1 .5 mm and a spot size of 35 pm.

[0124] Using a frozen pig jaw having some teeth that were very clean and others with clear signs of calculus buildup, tooth, gum and calculus tissue were imaged. Recording of each image was for a duration of 5 to 10 seconds, corresponding to 42 to 83 frames. Each frame consists of 240 axial lines (“A-lines”), representing scans at multiple depths for a single point. For each tissue type, 80 OCT scans were collected, resulting in a balanced dataset across the three tissue categories. OCT images showing the 240 A-lines within a single frame for gum, calculus and tooth tissue are shown in Figures 11 a-11 c respectively.

[0125] Gum is a soft tissue composed of connective tissue, collagen, and blood vessels. Its hydrated and cellular nature gives it moderate scattering and some absorption. In the OCT image shown in Fig 11 a, the gum tissue appears as bright superficial bands with layered patterns that gradually fade with depth.

[0126] Calculus is mineralized bacterial plaque made up of irregular crystalline deposits of calcium phosphate. It’s rough and heterogeneous surface causes strong and irregular scattering. In the OCT image shown in Fig 11 b, calculus shows noisy and streaky signals without a clear boundary. Tooth consists mainly of enamel and dentin, both highly mineralized and crystalline. Enamel gives a sharp reflection at the surface while the dense structure below produces minimal internal scattering. In the OCT image shown in Fig 11c, tooth appears as a clear and uniform bright boundary with a relatively clean deeper region.

[0127] The images display differences that are used in practise to distinguish between the tissue types: Gum shows smooth layered scattering that fades with depth. Calculus produces irregular noisy scattering with streaky features. Tooth displays a sharp and uniform bright boundary with little internal scattering.

[0128] Various digital techniques can be used to analyse the images and corresponding data acquired by the OCT imaging system to classify the three tissue types. One technique is a Support Vector Machine (SVM) based analysis where the A-line signals are used as input features. Alternately a convolutional neural network (CNN) based classification system may be used to perform frame-level classification where each frame consisted of a plurality of A- lines, enabling the model to leverage the spatial relationships across multiple A-lines within a frame. This approach captures more complex and representative patterns for periodontal tissue differentiation.

[0129] In addition to the uses and therapies mentioned above, embodiments of the system and method may also be suitable to investigate dental root abscesses and potentially sterilise these in situ.

[0130] The interfaces between adjacent teeth / implants are typically difficult to monitor with conventional caries detection tools. In a further application the disclosed periodontal implement 10 may be used as a caries detection probe, to generate depth images of calculus regions or early dental caries (white lesions) and treat them in real time.

[0131] In summary, from the above detailed description it will be apparent that embodiments of the system and method may incorporate various features that can be implemented via software embedded in the system 10, such as: a / , the provision of user-friendly guides and warnings on the display 28, which may be generated by implementation of artificial intelligence (Al), b / automatic detection between tooth and gum, so determining which side of the tip 20 to use for its current placement, c / . automatic cessation of the therapeutic laser 68 operation once the calculus destruction has been accomplished in any specific target area identified by the periodontal system, d / . preventing the therapeutic laser to operate on tooth itself or adjacent soft tissue, and only allowing the therapeutic laser 68 to operate on undestroyed calculus. e / . associated control of a water and or air jet that may be incorporated in the side of the hand tool 12 to clear away debris for example from of destroyed calculus.

[0132] While several exemplary embodiments have been presented in the foregoing detailed description, it should be appreciated that a vast number of variations exist. It should also be appreciated that the exemplary embodiments of the periodontal implement and method are only examples, and are not intended to limit the scope, applicability, or configuration of the present disclosure in any way. Rather, the foregoing detailed description will provide those skilled in the art with a convenient road map for implementing an exemplary embodiment of the disclosed periodontal system and method.

[0133] In the claims which follow, and in the preceding description, except where the context requires otherwise due to express language or necessary implication, the word “comprise” and variations such as “comprises” or “comprising” are used in an inclusive sense, i.e., to specify the presence of the stated features but not to preclude the presence or addition of further features in various embodiments of the system and method as disclosed herein.

Claims

CLAIMS1 . A periodontal system comprising: a hand tool having a body, and a first tip coupled to a first end of the body; one or more optical paths that extends through at least a portion of the body and into the first tip the one or more optical paths arranged to facilitate the transmission of one or more light waves to and / or from a subgingival region of a patient’s mouth; a visualisation system and an associated electronic display, the visualisation system coupled to the one or more optical paths and capable of generating from some of the light waves a real time visual representation of at least a first portion of the subgingival region of a patient’s mouth on the electronic display; wherein the first tip is arranged to deliver at least one periodontal therapy.

2. The periodontal system according to claim 1 wherein the visualisation system comprises an endoscope wherein the real time visual representation is a real time image of the at least a first portion of the subgingival region on the electronic display.

3. The periodontal system according to claim 1 wherein the visualisation system is an optical coherence tomography (OCT) system and the real time visual representation is a representation on the electronic display of different types of tissue the at least a first portion of the subgingival region.

4. The periodontal system according to claim 3 wherein the OCT system produces the real time visual representation of the first subgingival region by splitting an associated imaging laser beam into an imaging portion directed to the at least a first portion of the subgingival region and a reference portion directed to a reference arm and combining reflections of the imaging portion with reflections of the reference portion.

5. The periodontal system according to claim 4 wherein the one or more optical paths are arranged to facilitate the transmission of one or more light waves to and / or from the first portion of the subgingival region and a second portion of the subgingival region; and wherein the visualisation system is capable of generating from some of the light waves, and displaying on the electronic display, a real time visual representation of the first portion and the second portion of the subgingival region.

6. The periodontal system according to claim 5 comprising an optical switch arranged to alternately switch light waves from the first and second portions of the subgingivalregion coupled to the visualisation system at rate sufficient to enable the visualisation system to generate on the electronic display a real time visual representation of both the first and the second subgingival regions.

7. The periodontal system according to any one of claims 1 to 6 wherein the electronic display is located remotely from the hand tool for displaying the real time visual representation.

8. The periodontal system according to any one of claims 1 to 6 wherein the electronic display is located on the body of the hand tool.

9. The periodontal system according to claims 3 to 6 wherein the electronic display includes a plurality of light emitting devices each of which is arranged to change between two different visually perceptible states dependant on a type of subgingival tissue which are illuminated by the light waves.

10. The periodontal system according to claim 9 wherein the plurality of light emitting devices are located on the body of the tool.11 . The periodontal system according to any one of claims 1 to 10 wherein the at least one periodontal therapy is manual removal of calculus and the first tip includes a working edge to enable manual scraping for the removal of subgingival calculus.

12. The periodontal system according to any one of claims 1 to 10 including a therapeutic laser arranged to generate light waves in the form of a therapeutic laser beam and wherein the tool and the first tip are arranged to deliver the therapeutic laser beam to the first subgingival region, wherein the at least one periodontal therapy includes one or both of laser ablation of subgingival calculus in the first portion of the subgingival region and laser sterilisation of the first portion of the subgingival region.

13. The periodontal system according to claim 12 wherein the at least one periodontal therapy also includes manual removal of calculus, and the first tip includes a working edge to enable manual scraping for the removal of subgingival calculus, wherein the system is able to remove subgingival calculus by one or both of manual scraping and laser ablation.

14. The periodontal system according to claim 12 or 13 wherein one of the one or more optical paths is an ablation laser beam optical path for transmitting the therapeuticlaser beam through the body and the first tip and onto the first portion of the subgingival region.

15. The periodontal system according to claims 12 or 13 including a multiplexer for alternately switching through a common one of the one or more optical paths (a) light waves that are coupled to the visualisation system for generating on the electronic display the visual representation, and (b) the therapeutic laser beam.

16. The periodontal system according to any one of claims 1 to 15 comprising a software and / or artificial intelligence driver or controller arranged to exert automatic control of the delivery of the at least one periodontal therapy.

17. The periodontal system according to claim 16 wherein when the at least one periodontal therapy is laser ablation delivered by an ablation laser; the driver or controller is arranged to prevent operation of the therapeutic laser on tissue other than undestroyed calculus.

18. The periodontal system according to claim 16 or 17 wherein the driver or controller is arranged automatically cease operation of the therapeutic laser upon complete destruction of calculus detected by the periodontal system.

19. The periodontal system according to any one of claims 1 to 15 comprising a software and / or artificial intelligence driver or controller arranged to provide on the electronic display the real-time visual representation with overlays generated by automated tissue classification algorithms to provide a user with visual delineation of different tissue types including calculus, gingiva, bone and enamel.

20. The periodontal system according to any one of claims 1 to 19 comprising a second tip coupled to a second end of the body, the second tip being of a shape and configuration which is a mirror image of the first tip.21 . The periodontal system according to any one of claims 1 to 20 wherein the first and second tips are demountable coupled to the tool body to facilitate changing of the tips.

22. The periodontal system according to any one of claims 1 to 21 wherein the first and second tips are constructed to be sterilisable.

23. The periodontal system according to any one of claims 1 to 22 wherein the optical paths comprise respective single optical fibres, or respective bundles of optical fibres.

24. The periodontal system according to 23 including: a first set of one of more optical fibres that extend into the first tip and define at least a first optical path to the first tip, a second set of one or more fibres that extends into the second tip and define at least a first optical path to the second tip; a slot formed in the body that extends axially between the first and second ends; and a carriage through which the respective sets of one of more optical fibres extend into the slot, the carriage arranged to slide along the slot.

25. The periodontal system according to any one of claims 10 to 24 wherein the tip is formed with a window at which the one or more optical paths terminate, and the working edge is spaced from the window and oriented so that light waves being transmitted to the first portion of the subgingival region are directed towards the working edge.

26. The periodontal system according to any one of claims 1 to 25 comprising at least one fluid flow path that extends through the tool body and the tip to facilitate a flow of one or more fluids into and / or from a patient’s mouth.

27. A method of subgingival therapy comprising: using a single hand tool having at least a first tip at one end to simultaneously facilitate the viewing of a real time visual representation of a subgingival therapy site in the subgingival region form a point of view of the first tip; and delivering by use of the first tip at least one periodontal therapy.

28. The method according to claim 27 comprising forming one or more optical paths that extend through the single hand tool and tip and couple to a visualisation system, wherein light waves are arranged to travel through the one or more optical paths and to the optical visualisation system and operating an electronic display connecting the optical visualisation system to provide the visual representation.

9. The method according to claim 26 or 27 comprising, using the tip to deliver one or more of the following periodontal therapies: (a) manual scraping or removal of calculus; (b) laser ablation of calculus, (c) sterilisation via application of a laser beam.

Images