Fluid and pulsed energy output system

This application is a continuation of U.S. application Ser. No. 11/330,388, filed Jan. 10, 2006 and entitled FLUID CONDITIONING SYSTEM, the entire contents of all which are expressly incorporated herein by reference. U.S. application Ser. No. 11/330,388 claims the benefit of U.S. Provisional Application No. 60/645,427 (Att. Docket BI9694CIPPR), filed Jan. 19, 2005 and entitled FLUID CONDITIONING SYSTEM, U.S. Provisional Application No. 60/696,475 (Att. Docket BI9903PR), filed Jul. 1, 2005 and entitled FLUID CONDITIONING SYSTEM, and U.S. Provisional Application No. 60/709,714 (Att. Docket BI9914PR), filed Aug. 19, 2005 and entitled FLUID CONDITIONING SYSTEM, the entire contents of all which are expressly incorporated herein by reference. U.S. application Ser. No. 11/330,388 is a continuation-in-part of U.S. application Ser. No. 11/033,044 (Att. Docket BI9694P), filed Jan. 10, 2005 and entitled FLUID CONDITIONING SYSTEM, the entire contents of which are expressly incorporated herein by reference. U.S. application Ser. No. 11/033,044 claims the benefit of the above-referenced U.S. Provisional Application No. 60/535,110. U.S. application Ser. No. 11/330,388 is also a continuation-in-part of U.S. application Ser. No. 10/435,325 (Att. Docket BI9002CNCPCNDIV), filed May 9, 2003 and entitled FLUID CONDITIONING SYSTEM, which is a divisional of U.S. application Ser. No. 09/997,550 (Att. Docket BI9002CNCPCN), filed Nov. 27, 2001 and entitled FLUID CONDITIONING SYSTEM, issued as U.S. Pat. No. 6,561,803, which is a continuation of U.S. application Ser. No. 09/256,697 (Att. Docket BI9002CONCIP), filed Feb. 24, 1999 and entitled FLUID CONDITIONING SYSTEM, issued as U.S. Pat. No. 6,350,123, which is a continuation-in-part of U.S. application Ser. No. 08/985,513 (Att. Docket BI9001CON), filed Dec. 5, 1997 and entitled FLUID PARTICLES FOR ELECTROMAGNETICALLY INDUCED CUTTING, now abandoned, which is a continuation of U.S. application Ser. No. 08/522,503 (Att. Docket BI9001P), filed Aug. 31, 1995 and entitled ATOMIZED FLUID PARTICLES FOR ELECTROMAGNETICALLY INDUCED CUTTING, issued as U.S. Pat. No. 5,741,247, the entire contents of all which are expressly incorporated herein by reference.

1. Field of the Invention

The present invention relates generally to medical cutting, irrigating, evacuating, cleaning, and drilling techniques and, more particularly to a device for cutting both hard and soft materials and a system for introducing conditioned fluids into the cutting, irrigating, evacuating, cleaning, and drilling techniques.

2. Description of Related Art

A prior art dental/medical work station 11 is shown in FIG. 1. A vacuum line 12 and an air supply line 13 supply negative and positive pressures, respectively. A water supply line 14 and an electrical outlet 15 supply water and power, respectively. The vacuum line 12, the air supply line 13, the water supply line 14, and the electrical outlet 15 are all connected to the dental/medical (e.g., dental or medical) unit 16.

The dental/medical unit 16 may comprise a dental seat or an operating table, a sink, an overhead light, and other conventional equipment used in dental and medical procedures. The dental/medical unit 16 may provide, for example, water, air, vacuum and/or power to instruments 17. These instruments may include, for example, an electrocauterizer, an electromagnetic energy source, a sonic or ultrasonic source, a mechanical or electrical drill, a mechanical saw, a canal finder, a syringe, an irrigator and/or an evacuator. Various other types, combinations, and configurations of dental/medical units 16 and subcomponents implementing, for example, an electromagnetic energy device operating with a spray, have also existed in the prior art, many or most of which may have equal applicability to the present invention.

The electromagnetic energy source is typically a laser device coupled with a delivery system. The laser device 18a and delivery system 19a, both shown in phantom, as well as any of the above-mentioned instruments, may be connected directly to the dental/medical unit 16. Alternatively, the laser device 18b and delivery system 19b, both shown in phantom, may be connected directly to the water supply line 14, the air supply line 13, and the electric outlet 15. The mentioned and other instruments 17 may be connected directly to any of the vacuum line 12, the air supply line 13, the water supply line 14, and/or the electrical outlet 15.

The laser device 18 and delivery system 19 may typically comprise an electromagnetic cutter for dental or medical use, although a variety of other types of electromagnetic energy devices operating with fluids (e.g., jets, sprays, mists, or nebulizers) may also be used. An example of one of many varying types of conventional prior art electromagnetic cutters is shown in FIG. 2. According to this example of a prior art apparatus, a fiber guide tube 30, a water line 31, an air line 32, and an air knife line 33 (which supplies pressurized air) may be fed from the dental/medical unit 16 into a hand-held apparatus 34. A cap 35 fits onto the hand-held apparatus 34 and is secured via threads 36. The fiber guide tube 30 abuts within a cylindrical metal piece 37. Another cylindrical metal piece 38 is a part of the cap 35. When the cap 35 is threaded onto the hand-held device 34, the two cylindrical metal tubes 37 and 38 are moved into very close proximity of one another. The pressurized air from the air knife line 33 surrounds and cools a laser beam produced by the laser device as the laser bridges a gap or interface between the two metal cylindrical objects 37 and 38. Air from the air knife line 33 flows out of the two exhausts 39 and 41 after cooling the interface between the two metal cylindrical objects 37 and 38.

Energy from the laser device exits from a fiber guide tube 42 and is applied to a target surface of a treatment/surgical site, which can be within a patient\'s mouth, for example, according to a predetermined surgical plan. Water from the water line 31 and pressurized air from the air line 32 are forced into the mixing chamber 43 wherein an air and water mixture is formed. The air and water mixture is very turbulent in the mixing chamber 43, and exits the mixing chamber 43 through a mesh screen with small holes 44. The air and water mixture travels along the outside of the fiber guide tube 42, and then leaves the tube 42 and contacts the area of surgery. The air and water spray coming from the tip of the fiber guide tube 42 helps to cool the target surface being cut and to remove materials cut by the laser.

Water is generally used in a variety of laser cutting operations in order to cool the target surface. Additionally, water is used in mechanical drilling operations for cooling the target surface and for removing cut or drilled materials therefrom. Many prior art cutting or drilling systems use a combination of air and water, commonly combined to form a light mist, for cooling a target surface and/or removing cut materials from the target surface.

The use of water in these and other prior art systems has been somewhat successful for purposes of, for example, cooling a target surface or removing debris therefrom. These prior art uses of water in cutting and drilling operations, however, may not have allowed for versatility, outside of, for example, the two functions of cooling and removing debris. In particular, medication treatments, preventative measure applications, and aesthetically pleasing substances, such as flavors or aromas, may have not been possible or used during cutting or drilling operations, including those using systems with water, for example, for cooling or removing debris from a target surface. A conventional drilling operation may benefit from the use of an anesthetic near the drilling operation, for example, but during this conventional drilling operation only water and/or air are often used. In the case of a laser cutting operation, a disinfectant, such as iodine, could be applied to the target surface during drilling to guard against infection, but this additional disinfectant may not be commonly applied during such laser cutting operations. In the case of an oral drilling, cutting, or therapy operation, unpleasant tastes or odors, which may be unpleasing to the patient, may be generated. The common use of only water during this oral procedure does not mask the undesirable taste or odor. A need has thus existed in the prior art for versatility of applications and of treatments during drilling and cutting procedures.

Compressed gases, pressurized air, and electrical motors are commonly used to provide a driving force for mechanical cutting instruments, such as drills, in dentistry and medicine. The compressed gases and pressurized water are subsequently ejected into the atmosphere in close proximity to or inside of the patient\'s mouth and/or nose or any other treatment/surgical site. The same holds true for electrically driven turbines when a cooling spray (air and water) is typically ejected into the patient\'s mouth, as well. These ejected fluids commonly contain vaporous elements of tissue fragments, burnt flesh, and ablated or drilled tissue. The odor of these vaporous elements can be quite uncomfortable for the patient, and can increase trauma experienced by the patient during treatment, drilling, or cutting procedures. In such drilling or cutting procedures, a mechanism for masking smells and odors generated from the cutting or drilling may be advantageous.

Another problem exists in the prior art with bacteria growth on surfaces within dental or surgical operating rooms. Interior surfaces of air, vacuum, and water lines of a dental/medical unit, for example, are subject to bacteria growth. In water lines, the bacterial growth is part of the biofilm that may form on an inside of tubing forming a water line. Additionally, the air and water used to cool the tissue being cut or drilled within a patient\'s mouth are often vaporized into air above a tissue target to some degree or are projected onto a target surface. This vaporized air and water together with projected fluid may condense onto a surface of exposed tissue as well as onto the dental/medical equipment proximal to the treatment site. These surfaces typically are moist, a condition that can promote bacteria growth, which is undesirable. A system for reducing the bacteria growth within air, vacuum, and water lines, and for reducing the bacteria growth resulting from condensation on exterior surfaces (e.g., instruments, devices, or tissue), is needed to reduce sources of contamination of the treatment site as well as contamination of equipment adjacent to the treatment area within a dental/surgical operating room.

An embodiment of the present invention comprises a fluid conditioning system adaptable to existing medical and dental apparatuses, including those used for cutting, irrigating, evacuating, cleaning, drilling, and therapeutic procedures. The fluid conditioning system may employ flavored fluid in place of or in addition to regular tap water or other types of water (e.g., distilled water, deionized water, sterile water, or water with a controlled number of colony forming units (CFU) per milliliter, and the like), during various clinical operations. In an exemplary case of a laser surgical operation, electromagnetic energy is focused in a direction of tissue to be cut or treated, and a fluid router routes flavored fluid in the same direction. The flavored fluid, which may appeal to the taste buds of a patient undergoing the surgical operation, may include any of a variety of flavors, such as a fruit flavor or a mint flavor. In procedures employing a mist or air spray, scented air may be used to mask a smell of burnt or drilled tissue. The scent may function as an air freshener, even for operations outside of dental applications.

Conditioned fluids may be used for hydrating and cooling a surgical site and/or for removing tissue. The conditioned fluids may include an ionized solution, such as a biocompatible saline solution, and may further include fluids having predetermined densities, specific gravities, pH levels, viscosities, or temperatures, relative to conventional tap water or other types of water. Additionally, the conditioned fluids may include a medication, such as an antibiotic, a steroid, an anesthetic, an anti-inflammatory, an antiseptic or disinfectant (e.g., antibacterial or antiseptic), adrenaline, epinephrine, or an astringent. A typical conditioned fluid may also include vitamins (e.g., vitamin C (ascorbic acid), vitamin E, vitamin B-₁ (thiamin), B-₂ (riboflavin), B-₃ (niacin), B-₅ (pantothenic acid), B-₆ (pyridoxal, pyridoxamine, pyridoxine), B-₁₂ (cobalamine), biotin or B complex, bioflavonoids, folic acid, vitamin A, vitamin D, vitamin K), aloe vera, a natural anti-inflammatory, antioxidant or anti-histamine remedy and other such ingredients and solutions, herbs, remedies or minerals. Still further, the conditioned fluid may include a tooth-whitening agent that is adapted to whiten teeth of patients. The tooth-whitening agent may comprise, for example, a peroxide, such as hydrogen peroxide, urea peroxide, or carbamide peroxide, or any other whitening agent. The tooth-whitening agent may have a viscosity on an order of about 1 to 15 centipoises (cps). In other embodiments, fluid conditioning agents additionally may comprise anticaries, antiplaque, antigingivitis, and/or antitartar agents in fluid or solid (i.e., tablet) form.

Introduction of any of the above-mentioned conditioning agents to conventional fluid such as tap water (or other types of water such as distilled water, deionized water, sterile water, or water with a controlled number of CFU/ml, and the like) used in a cutting, drilling, or therapeutic operation may be controlled by a user input. Thus, for example, a user may adjust a knob or apply pressure to a foot pedal in order to introduce iodine into water before, during (continuously or intermittently), or after a cutting operation (including ablation or vaporization) has been performed. An amount of conditioning may be applied to air, fluid (e.g., water), and/or jet, spray, mist, nebulizer mist or any other type of such sprays as a function of a position of the foot pedal, for example. A pre-measured or pre-mixed dose of conditioning agents may be introduced via a cartridge according to an embodiment of the present invention. In another embodiment, a cartridge is provided that will mix an appropriate dose of conditioning agent(s) prior to or during a procedure. The cartridge can be implemented, alone or as part of a fluid delivery system, at any location in a path of a fluid source or lines or along an air line or at an air source. The cartridge can also be part of a separate fluid delivery system that provides, for example, sterile and non-sterile fluids to a handpiece (dental, medical regular or medical endoscopic).

According to one broad aspect of the present invention, an apparatus using conditioned fluid to treat a target (e.g., a tissue target), comprises a fluid output pointed in a general direction of an interaction region (e.g., interaction zone), the fluid output being constructed to place conditioned fluid (e.g., conditioned fluid particles) into the interaction region, the interaction region being defined at a location (e.g., volume) adjacent to (e.g., on, or if interaction zone above) the target and the conditioned fluid being compatible with the target, and further comprises an electromagnetic energy source pointed in a direction of the interaction region, the electromagnetic energy source being constructed to deliver into the interaction region a concentration (e.g., a peak concentration) of electromagnetic energy (e.g., that is greater than a concentration of electromagnetic energy delivered onto the target), the electromagnetic energy having a wavelength which is substantially absorbed by the conditioned fluid in the interaction region, wherein the absorption of the electromagnetic energy by the conditioned fluid energizes the fluid (e.g., causes the fluid to expand) and wherein disruptive forces are imparted onto the target.

The fluid output can be configured to generate a spray (e.g., jet, mist, or nebulizer mist) of atomized particles for placement into a volume of air above the tissue to be cut, and electromagnetic energy from the electromagnetic energy source, for example, a laser beam generated by a laser device, can be focused into the volume of air. The electromagnetic energy has a wavelength, λ, which may be chosen so that the electromagnetic energy is substantially (e.g., highly) absorbed by the atomized particles in the volume of air. In certain implementations, absorption of the electromagnetic energy by the atomized fluid particles causes the atomized fluid particles to expand, explode and/or to otherwise impart disruptive/removing (e.g., mechanical) forces (e.g., cutting) onto the tissue. In certain implementations, absorption of the electromagnetic energy by the atomized particles causes the atomized particles to expand or explode and disruptive/removing cutting forces are imparted onto the tissue. The expanding or exploding can cause an effect, whereby, at least to some extent, the electromagnetic energy does not directly cut the tissue but, rather, or additionally, expanding or exploding fluid and fluid particles are used, at least in part, to disrupt and/or cut the tissue. In other embodiments, exploding atomized fluid particles may not affect at all, or may affect a percentage but not all of, the cutting of tissue. Examples of such embodiments are disclosed in U.S. application Ser. No. 11/033,032, filed Jan. 10, 2005 and entitled ELECTROMAGNETIC ENERGY DISTRIBUTIONS FOR ELECTROMAGNETICALLY INDUCED DISRUPTIVE CUTTING, the entire contents of which are incorporated herein by reference to the extent compatible and not mutually exclusive. The atomized fluid particles may be formed from fluid conditioned with flavors, scents, ionization, medications, disinfectants (e.g., antibacterial agents and antiseptics), and other agents such as anticaries, antiplaque, antigingivitis, and antitartar agents in fluid or solid (tablet) form, as previously mentioned.