WO2001097685A1 - Integrated diagnostic system for the oral cavity - Google Patents

Integrated diagnostic system for the oral cavity Download PDF

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Publication number
WO2001097685A1
WO2001097685A1 PCT/EP2001/006632 EP0106632W WO0197685A1 WO 2001097685 A1 WO2001097685 A1 WO 2001097685A1 EP 0106632 W EP0106632 W EP 0106632W WO 0197685 A1 WO0197685 A1 WO 0197685A1
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WIPO (PCT)
Prior art keywords
periodontal
diagnostic system
patient
risk
situation
Prior art date
Application number
PCT/EP2001/006632
Other languages
French (fr)
Inventor
Pierpaolo Cortellini
Maurizio Tonetti
Original Assignee
Tangram-Odis S.R.L.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tangram-Odis S.R.L. filed Critical Tangram-Odis S.R.L.
Publication of WO2001097685A1 publication Critical patent/WO2001097685A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271—Specific aspects of physiological measurement analysis
    • A61B5/7275—Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H15/00—ICT specially adapted for medical reports, e.g. generation or transmission thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
    • A61B5/4542—Evaluating the mouth, e.g. the jaw
    • A61B5/4547—Evaluating teeth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Epidemiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Primary Health Care (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Biomedical Technology (AREA)
  • Artificial Intelligence (AREA)
  • Signal Processing (AREA)
  • Psychiatry (AREA)
  • Physiology (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Endoscopes (AREA)
  • Investigating Or Analyzing Materials By The Use Of Ultrasonic Waves (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

An integrated diagnostic system for the oral cavity, which allows various levels of dental analyses, comprising a software program for a diagnostic classification of the patient, a series of diagnostic products necessary for the tests and relative technological and patient-assistance data.

Description

INTEGRATED DIAGNOSTIC SYSTEM FOR THE ORAL CAVITY
Tooth decay and periodontal disease are widespread conditions which can cause significant destruction to the stomatognatic apparatus, necessitating at times intensive therapy and consequent social costs comparable to those caused by serious illnesses such as coronary disease or AIDS.
The treatment of periodontal diseases and tooth de- cay, however, as also the prostodontic reconstruction of parts of the dental arches, which is often necessary, is often effected in the absence of accurate diagnostic observations; this leads to frequent short and long term failure. Furthermore, the application of dental implants is often carried out without a diagnosis of periodontal and/or microbiological suitability, which provides a better guarantee of therapeutic success.
In short, the causes of tooth decay and periodontal diseases are well known but the existing diagnostic elements are not appropriately organized for allowing an overall vision of diseases relating to the oral cavity; there are single diagnostic methods for evaluating a person's cariogenicity or the presence of halitosis or bac- terial strains prevalent in the oral cavity, but there is no system for guiding the operator, whether it be a dentist or an oral diagnostic center, in classifying the patient to enable accurate diagnosis, allowing scientific decisions to be made as to which preventive and therapeu- tic options are most appropriate for maintaining or obtaining the dental and periodontal health of the patient. The objective of the invention is therefore to indicate an integrated diagnostic system for the oral cavity, which overcomes the above drawbacks. Firstly, this integrated diagnostic system for the oral cavity proposes the rapid identification of the main pathologies of the oral cavity of a patient by means of screening tests.
Among the main objectives of the present invention, we would first of all like to mention the evaluation of the cariological situation and risk of being affected by tooth decay.
Another purpose of the present invention is to set up an integrated diagnostic system for the oral cavity which allows a diagnosis of halitosis to be effected on a patient, revealing the origin.
A further objective of the present invention relates to an integrated diagnostic system for the oral cavity, which allows an evaluation to be made of the periodontal situation pf a patient and the risk of being affected by periodontitis .
Yet another objective of the present invention relates to an integrated diagnostic system for the oral cavity, which allows a clinical and instrumental evalua- tion to be made, relating to risks for patients in the field of implant therapy.
Last but not least, the present invention relates to an integrated diagnostic system for the oral cavity which is both simple and rapid to use and which can be effected at relatively low costs, in view of the advantages obtained.
These and other objectives are achieved by means of an integrated diagnostic system for the oral cavity, according to claim 1, to which reference should be made for the sake of brevity.
An applicative program for electronic processors advantageously allows a series of clinical and microbiological parameters of the patient to be correlated, by means of appropriate algorithms, and the risk of becoming subject to tooth decay, to be evaluated.
Furthermore, the above system correlates the case history of the patient, the data deriving from an objec¬ tive examination and, in particular, periodontal examination, data deriving from laboratory tests, such as the genetic test and microbiological tests, and provides a diagnostic opinion, evaluating the gravity and diffusion of the periodontal disease and the risk to which the patient is exposed for the insertion of osseo-integrated implants . The same software program also correlates case history and dietetic data with instrumental and objective examinations to identify the presence, gravity, patho- genesis and origin of the halitosis.
Further objectives and advantages of the present in- vention will be more evident from the following description which relates to an illustrative and preferred, but non-limiting, embodiment of the integrated diagnostic system for the oral cavity, according to the present invention, and from the enclosed figures, wherein: - figures 1-5 represent a series of block schemes relating to the main parameters used by the algorithms, which form the basis of the software program used in the integrated diagnostic system for the oral cavity, according to the present invention. With reference to the above figures, the procedure according to the invention is obviously based on the fact that a particular type of medical report is required for a certain patient, depending on the gravity of the oral situation of the above patient, which is initially con- firmed by screening the main pathologies of the oral cav- ity.
The patient may subsequently be subjected to more detailed diagnostic procedures with the relative medical reports . All the services provided by the integrated diagnostic system, according to the invention, are prepared in the form of medical reports together with case sheets.
The general examination and diagnostic in-depth analyses are guided by a software program installed on a dedicated electronic processor.
The operator can also use the software with vocal commands, going through the questions required by relative questionnaires to obtain the necessary medical reports; when he has finished, the operator can refer, via internet, to a remote service centre which supplies, in very short times, the complete medical report of each patient.
The software is continuously up-dated; these adjournments can be simply and rapidly received through the network by all dentists in Italy and abroad.
In particular, this applicative software allows up to 5 interrogation chapters or subjects of the patient to be conducted, which are correlated in many points : personal data, screening, tooth decay, halitosis, periodon- tal situation. The interrogation relating to personal data has, in turn, five algorithmic categories, such as the list of patients under analysis, the personal data of each single patient, the case history relating to any possible clini- cal problems of the patient, the dental formula suitable for indicating any possible missing teeth, and other documents, such as a summary of the tests prescribed and those effected and a printout with the list of the prescriptions of tests to be carried out. As far as the screening is concerned, this comprises an evaluation of the tooth decay situation, starting from the number of fillings, decayed and missing teeth, of the periodontal situation, for example an evaluation of the mobility, recessions, furcations and periodontal pockets, halitosis, meaning the presence or absence of halitosis, with an organoleptic control test, and the situation relating to the temporo-mandibular joint or TMJ.
The decay parameter is subdivided into an additional three interrogation categories and more precisely, case history, specification of the decay problem, food report which examines the patient's diet, laboratory tests, specifications of the tooth decay situation, such as salivary flow, saliva buffer power and lactobacilli and streptococci present, and the decay risk parameter which indicates the probability of not having any further tooth decay in the future .
The characteristics of halitosis are revealed through the case history (patient's and others' opinion on the intensity of bad breath, food habits, alcohol, to- bacco, hygiene, digestive system, other symptoms) , the organoleptic test (halitosis zone, prevalent origin, examination of the tongue, food stagnation and salivation) and halitometry, an instrumental examination which measures the quantity of volatile sulfurated compounds and the prevalent halitosis zone.
The periodontal situation comprises the periodontal case history; an objective examination guided by data insertion per sextant, including the oral and lingual situation of the gums, furcations, recessions, pockets and relative bleeding, any plaque possibly present and mobility; various radiological and laboratory tests, such as the search for any pathogenic germs present or the DNA test for individual susceptibility to periodontitis or other hematological tests. The software processes various interesting parameters which are taken into consideration for the diagnosis, according to the invention and referring, in particular, to: 1) periodontal graphs, which indicate the situation of the pockets, recessions, bleeding, bacterial plaque, sites with furcations, mobility and number of ad- herent gum sites; ' 2) periodontal statistics, which are capable of graphically representing the percentage subdivision of sites with pockets having a depth upon examination of over 4 mm, the number of furcations subdivided into gravity of the defect, gravity of edentulism, the percentage of sites with bleeding upon examination and details of the plaque situation for each single tooth, subdivided by zone.
This enables a detailed and structured diagnosis of the oral cavity to be effected with the help of all possible information, which is continuously up-dated in the applicative program and in the diagnostic products available.
Clinical, laboratory and research experience in the dental and periodontal field has allowed a series of parameters to be selected, which predict, to different extents, the various pathologies which afflict the oral cavity.
In particular, these parameters refer to: dietetic factors and the risk of tooth decay, microbiological situation and risk of tooth decay; quantitative salivation measuring and risk of tooth decay; determination of saliva pH and risk of tooth decay; microbiological situation and risk of being affected by periodontal disease; microbiological situation and risk of perimplantitis; ge- netic predisposition towards periodontopathy; radio- graphic situation and risk of tooth decay; radiographic situation and risk of being affected by periodontal disease; radiographic situation and risk of perimplantitis; depth upon examination of the periodontal pockets and the risk of periodontopathy; bleeding upon examination and the risk of being affected by periodontitis; the presence of tooth decay, periodontitis and particular diets associated with halitosis. Finally, account must be taken of a final combined evaluation of the parameters identified in the previous points, in order to arrive at a diagnosis, bearing in mind the gravity of the single pathologies (decay, halitosis, periodontitis, implant risk) or a combination of these; said diagnosis is therefore based on a study of new research and discoveries in world-wide literature and is continually up-dated on the basis of new facts presented.
Furthermore, the present invention proposes a rela- tive sales process of the applicative program used and diagnostic products currently available, allowing the client to simply install the software program on his own electronic processor and subsequently examine the patient in accordance with the interrogations and make any diag- nostic tests held necessary by the software program. After inserting the answers, the operator can send the printouts indicated by the applicative program via internet to a service centre which electronically processes the medical reports and sends them back to the cli- ent via internet.
In this context, there is also the possibility of training clients by means of formative courses, whose cost is included in a three-monthly subscriber's fee.
Telephone assistance is also available for problems associated with using the software program or the use of the diagnostic products supplied and software up-dating whenever improvements are effected.
The client can also purchase the necessary diagnostic products directly from the distributor. Diagnostic products requiring laboratory procedures which cannot be effected by the client will be sent by the latter to an address indicated, to enable the laboratory selected to send the results back as soon as possible. The dentist, or one of his assistants, can directly carry out any laboratory tests when allowed by the specific diagnostics.
Finally, a three-monthly fee can be invoiced by the distributor for training, use and periodical up-dating, through the network, of the software program contents. The invoicing is made for each single medical re- port, on the basis of a pre-established price-list and, in the case of non-payment, the electronic delivery of the medical report will be interrupted. In the case of prolonged insolvency, the distributor will interrupt all services.
If the non-payment relates only to consultation via internet, in order to obtain medical reports, it will be decided whether or not to continue the supply of diagnostic products. The service users described are trained by the distributor and, after the first pilot period, the initial users will become speakers at training courses destined for new clients.
Assistance for the use of the software program and diagnostics is guaranteed by the distributor, whereas the storage, distribution, invoicing, book-keeping, training and assistance are entrusted to external structures.
The above description clearly describes the characteristics of the integrated diagnostic system for the oral cavity, object of the present invention, together with the advantages .
Finally, numerous variations can evidently be applied to the diagnostic system for the oral cavity, object of the present invention, without excluding any of the novelty principles which characterize the inventive idea. It is also evident that in the embodiment of the invention, the materials, forms and dimensions of the details illustrated can vary according to the demands and can be substituted with other technically equivalent al- ternatives .

Claims

1. An integrated diagnostic system for the oral cavity, which allows various levels of dental analyses, characterized in that it comprises a diagnostic classification software program and the diagnostic products necessary for the tests, in order to obtain at least one of the following types of medical reports for a patient: identification of the main pathologies of the oral cavity; - evaluation of tooth decay and of the risk of being affected by tooth decay; diagnosis of halitosis and observation of its origin; evaluation of the periodontal situation and of the risk of becoming affected by periodontitis; clinical and instrumental Implant risk evaluation
2. The integrated diagnostic system according to claim 1, characterized in that said software program correlates, by means of algorithms, a series of clinical and microbiological parameters, evaluates the risks for said patient of being affected by tooth decay, correlates the case history of the patient, the data deriving from an objective examination and periodontal examination, the data deriving from laboratory tests, and it provides a diagnostic opinion, evaluating the gravity and diffusion of periodontal diseases and the risks for said patient of the insertion of osseo-integrated implants.
3. The integrated diagnostic system according to claim 2, characterized in that said software program correlates the case history and dietetic data of said patient with a series of instrumental and objective tests, in order to identify the presence, gravity, pathogenesis and origin of said halitosis.
4. An implementing method for the integrated diagnostic system according to claim 1, characterized in that it comprises at least the following phases:
- interrogation of said software in order to formulate questions contained in various questionnaires for obtaining the different types of medical reports re- quired; subsequent network interrogation of a remote service center, which provides said medical reports; continuous up-dating of said software.
5. The integrated diagnostic system according to claim 2, characterized in that said software program comprises a series of variables, correlated with each other, which can be controlled.
6. The integrated diagnostic system according to claim 5, characterized in that said variables comprise personal data, a screening variable, number of decayed teeth and the possible risk of tooth decay with case history, food report and laboratory tests, halitosis with case history, organoleptic test, halitometry and the periodontal situation with periodontal case history, the insertion of periodontal data, periodontal tests with relative graphs and statistics.
7. The diagnostic system according to claim 6, characterized in that said personal data comprises a series of algorithmic categories, such as a list of patients, a list of the personal data of each patient, a case history, information on the dental situation and documents on tests prescribed and effected and said screening variable comprises the number of decayed teeth present, the situation relating to periodontitis, halitosis and the temporo- andibular joint.
8. The diagnostic system according to claim 2, characterized in that said algorithms of said software process a series of parameters relating to the various pathologies of the oral cavity, such as the microbiological situation and the risk of tooth decay, measurement of the salivation, risks of periodontal diseases, the risk of perimplantitis, genetic predispositions, radiographic situation, risk of periodontitis, a combined evaluation of the parameters for a diagnosis indicating the gravity of the single pathologies or pathologies associated with each other .
9. ( The method according to claim 4, characterized in that it comprises a further promotion phase of said software and said diagnostic products, whereby an operator can send the printouts prepared by said software via internet to a service centre, which electronically processes the medical reports and sends them back via internet to the operator.
10. The method according to claim 9, characterized in that it comprises a further training phase of said operator, whose cost is included in a pre-fixed fee, a telephonic assistance phase and an up-dating phase of said software.
PCT/EP2001/006632 2000-06-19 2001-06-19 Integrated diagnostic system for the oral cavity WO2001097685A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT2000MI001370A IT1318584B1 (en) 2000-06-19 2000-06-19 INTEGRATED DIAGNOSTIC SYSTEM FOR THE ORAL CABLE.
ITMI2000A001370 2000-06-19

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WO2001097685A1 true WO2001097685A1 (en) 2001-12-27

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WO (1) WO2001097685A1 (en)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997011635A1 (en) * 1995-09-28 1997-04-03 Grail Sven F H Medical record system
US5619991A (en) * 1995-04-26 1997-04-15 Lucent Technologies Inc. Delivery of medical services using electronic data communications
WO1998002836A2 (en) * 1996-07-12 1998-01-22 Iliff Edwin C Computerized medical diagnostic system utilizing list-based processing

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5619991A (en) * 1995-04-26 1997-04-15 Lucent Technologies Inc. Delivery of medical services using electronic data communications
WO1997011635A1 (en) * 1995-09-28 1997-04-03 Grail Sven F H Medical record system
WO1998002836A2 (en) * 1996-07-12 1998-01-22 Iliff Edwin C Computerized medical diagnostic system utilizing list-based processing

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Publication number Publication date
IT1318584B1 (en) 2003-08-27
ITMI20001370A0 (en) 2000-06-19
ITMI20001370A1 (en) 2001-12-19

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