Modified-output fiber optic tips

A laser handpiece is disclosed, including a shaped fiber optic tip having a side-firing output end with a non-cylindrical shape. The shaped fiber optic tip can be configured to side-fire laser energy in a direction away from a laser handpiece and toward sidewalls of a treatment or target site.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to medical devices and, more particularly, to fiber optic tips for delivering electromagnetic radiation.

2. Description of the Related Art

Fiber optics have existed in the prior art for delivering electromagnetic radiation. Radiation delivery systems are typically used to transport electromagnetic radiation from electromagnetic energy sources to treatment sites. One common radiation delivery system can comprise a cylindrically-shaped fiber optic tip from which electromagnetic radiation is emitted in a direction toward the treatment site.

In certain applications, radiation delivery systems can be engineered to generate predetermined beam shapes and spatial energy distributions. The energy distribution of a simple delivery system, comprising a fiber optic tip, can be described as having a circular illumination area, with a so-called Gaussian distribution of beam intensities being spatially distributed within the output beam pattern or illuminated area. For instance, the output beam pattern from a fiber optic tip can comprise a central high-intensity area or “hot spot” surrounded by peripheral areas of lower intensity.

Regarding energy distributions, some beam profiling applications can require or would be optimized with radiation delivery systems capable of generating illumination distributions that vary across parts or all of the illumination area surrounding the output of the radiation delivery system. Moreover, it may also be desirable to generate non-circular illumination areas, or to generate electromagnetic radiation having predetermined energy distributions across a non-planar illumination area. Use of laser radiation having a relatively uniform power distribution over a particularly shaped area can be a practical task for multiple medical applications.

SUMMARY OF THE INVENTION

The present invention provides optical arrangements and relatively compact medical laser instruments to deliver electromagnetic radiation to treatment sites with power distributions that vary in a non-Gaussian distribution fashion, compared to cylindrical output fibers, across parts or all of the illumination area surrounding the output waveguide. The illumination areas may comprise curved surfaces, such as cavities, in which case substantial output power densities can be concentrated on sidewalls of the illumination areas. The electromagnetic radiation can comprise laser radiation, and the treatment site can comprise tissue to be treated.

The various embodiments of the present invention may include or address one or more of the following objectives. One objective is to provide a fiber optic tip having a shaped fiber optic output end (i.e., a fiber optic output end not consisting only of a planar surface orthogonal to the fiber optic axis) for delivery of electromagnetic radiation, wherein electromagnetic radiation exiting the fiber optic output end is not concentrated along the fiber optic axis. Another objective is to provide a fiber optic output end having an emission characteristic whereby electromagnetic radiation exiting the fiber optic output end is relatively weak along the fiber optic axis. Yet another object is to provide a fiber optic output end wherein all waveguide modes experience total internal reflection on a first surface of the fiber optic output end and go out through an opposite surface of the fiber optic output end. Still another objective is to provide a apparatus for directing laser energy and fluid to different target sites through different reflections within a fiber conduit and from the fiber conduit to the output end or sites, wherein different energy distributions can be provided to different treatment surfaces surrounding or in a vicinity to the fiber conduit at the same time.

Any feature or combination of features described herein are included within the scope of the present invention provided that the features included in any such combination are not mutually inconsistent as will be apparent from the context, this specification, and the knowledge of one of ordinary skill in the art. For purposes of summarizing the present invention, certain aspects, advantages and novel features of the present invention have been described herein. Of course, it is to be understood that not necessarily all such aspects, advantages or features will be embodied in any particular embodiment of the present invention. Additional advantages and aspects of the present invention are apparent in the following detailed description and claims.

DETAILED DESCRIPTION OF THE PRESENT INVENTION

Reference will now be made in detail to certain embodiments of the invention, examples of which are illustrated in the accompanying drawings. Wherever possible, the same or similar reference numbers are used in the drawings and the description to refer to the same or like parts. It should be noted that the drawings are in simplified form and are not to precise scale. In reference to the disclosure herein, for purposes of convenience and clarity only, directional terms, such as, top, bottom, left, right, up, down, over, above, below, beneath, rear, and front, are used with respect to the accompanying drawings. Such directional terms should not be construed to limit the scope of the invention in any manner.

Although the disclosure herein refers to certain illustrated embodiments, it is to be understood that these embodiments are presented by way of example and not by way of limitation. The intent of the following detailed description, although discussing exemplary embodiments, is to be construed to cover all modifications, alternatives, and equivalents of the embodiments as may fall within the spirit and scope of the invention as defined by the appended claims.

Referring more particularly to the drawings,FIG. 1illustrates a cross sectional view of the rotating handpiece10. The rotating handpiece comprises a handpiece head12, a fiber tip fluid output device14, and a removable trunk fiber assembly16. These components can be seen in a partially disassembled state inFIG. 3, wherein the axis18of the removable trunk fiber assembly16is aligned with the axis20of the handpiece head12for insertion into the handpiece head12. Once the axis18of the removable fiber assembly16is aligned with the axis20of the handpiece12, the removable trunk fiber assembly16is moved in the direction of the arrow A1into the handpiece head12, while the axes18and20are maintained in approximate alignment. The contacting surface of the outer surface of the chuck23engages the inner surface25of the rotating handpiece10, to thereby ensure alignment of the axis18of the removable trunk fiber assembly16and the axis20of the handpiece head12. As the removable trunk fiber assembly16is inserted further in the direction Al into the handpiece12, the abutting surface28engages with a corresponding abutting surface (not shown) within the collar31of the handpiece head12. The corresponding abutting surface28can be constructed to snap with the abutting surface31, as the removable trunk fiber assembly16is fully inserted into the handpiece head12. Any type of locking engagement between the abutting surface28and a corresponding abutting surface within the collar31, as known in the art, may be used to ensure that the removable trunk fiber assembly16is always inserted the same distance into the handpiece head12. As shown inFIG. 1, the distal tip38of the removable trunk fiber assembly16is brought into close proximity with the parabolic mirror41. In the illustrated embodiment, the distal tip38of the removable trunk fiber assembly16comprises a window43for protecting the trunk fiber optic45from contaminants, such as water. In the alternative embodiment shown inFIG. 2, the distal tip38ais not protected with a window. As shown inFIG. 1, the fiber tip51of the fiber tip fluid output device14is also accurately placed in close proximity to the parabolic mirror41. A loading tool17can be used to assist in the placement of the fiber tip fluid output device14into the handpiece head12, as discussed below with reference to FIGS.5and7-9. Electromagnetic radiation exiting from the output end55of the trunk fiber optic45is collected by the parabolic mirror41and, subsequently, reflected and focused onto the input end59of the fiber tip51.

In one embodiment, the electromagnetic radiation exiting from the output end55of the trunk fiber optic45comprises a wavelength on the order of 3 microns. In other embodiments, electromagnetic radiation can be supplied at wavelengths from about 0.4 micron to about 11 microns, and in typical embodiments from about 0.4 micron to about 3 microns, from a light source such as a plasma arc lamp, a LED, or a laser having a continuous wave (CW) or pulsed mode of operation. The material of the parabolic mirror41is selected to provide an efficient reflection and focusing into the input end59. As presently embodied, the electromagnetic radiation is generated from an Er:YSGG laser, and the material of the parabolic mirror41comprises a gold plating to provide reflectivity of approximately 99.9 percent. Other materials may be selected in accordance with design parameters. Other reflective surfaces and materials for the parabolic mirror41may be selected, in accordance with the laser being used and the desired efficiency of reflection. For example, if a lower reflectivity is selected, then additional cooling may be needed for the parabolic mirror41(such as a greater flow rate of cooled and/or filtered air across the surface of the parabolic mirror41).FIGS. 4a,4band4cillustrate various views of the parabolic mirrors41of the presently illustrated embodiment. The flat surface of the parabolic mirror41, which is closest to the fiber tip51, can be provided with two recessed areas66and69. These two recessed areas mate with corresponding protrusions (not shown) on the floor71of the internal chamber73of the handpiece head12. A spring loaded plunger76presses against the upper surface79of the parabolic mirror41under the pressure of the spring81. A screw cap83holds the spring81against the spring loaded plunger76. The combination of the spring loaded plunger76, the recessed areas66,69of the parabolic mirror41, and the corresponding protrusions on the floor71, together, accurately align the parabolic mirror41for efficient coupling of electromagnetic radiation between the output end55of the trunk fiber optic45and the input end59of the fiber tip51. In modified embodiments, either or both of the output end55of the trunk fiber optic45and the input end59of the fiber tip51is/are provided with an anti-reflective coating. Although it may be preferred in certain implementations to have the trunk fiber optic45perfectly aligned in relation to the parabolic mirror41and the fiber tip51, the alignment between these three elements is seldomly perfect. In the presently illustrated embodiment, the misalignment of the axis of the trunk fiber optic45and the axis of the fiber tip51is within plus or minus 1 percent error.

In a modified embodiment, a pentaprism (five-sided prism) is used instead of the parabolic mirror41for coupling the trunk fiber optic45to the fiber tip51. In addition to slight misalignment of the axis of the trunk fiber optic45, slight imperfections on the output end55of the trunk fiber optic45may also be present. The parabolic mirror41corrects for both of these slight errors, by collecting the electromagnetic radiation from the output end55of the front fiber optic45and, subsequently, focusing the electromagnetic radiation into the input end55of the fiber tip51.

The parabolic mirror41may also comprise molypdium, in an exemplary embodiment. The clamp assembly91operates to firmly grip and hold the trunk fiber optic45. In the presently illustrated embodiment, the clamp assembly91is provided with at least one slit, which extends from the distal end93of the clamp assembly91to a region95just distal of the set screw97. As presently embodied, the at least one slit extending from the distal end93to the region95just distal of the set screw97comprises two slits, which are adapted to allow the clamp assembly91to be compressed by the chuck23onto the trunk fiber optic45. The chuck23thus presses against the portion of the clamp assembly91, wherein the portion is defined between the distal end93and the region95, to thereby have the clamp assembly91squeeze and hold the trunk fiber optic45in place. In the presently illustrated embodiment, the set screw97is used to hold the chuck23in place and prevent rotation thereof. In the illustrated embodiment, the outer surface of the clamp assembly91is provided with threads99for engaging with corresponding threads on the inner surface of the chuck23. In the illustrated embodiment, the chuck23is screwed onto the threads of the clamp assembly91, before the removable trunk fiber assembly16is inserted into the handpiece12. The chuck23is screwed onto the clamp assembly91to a predetermined tightness, and then the set screw97is secured thereto to securely hold the chuck23to the clamp assembly91. Subsequently, the removable trunk fiber assembly16is inserted and secured into the handpiece head12.

Referring to FIGS.5and7-9, the fiber tip fluid output device14comprises a generally cylindrical body having an outer surface, a proximal end, a distal end, and a lumen extending between the proximal end and the distal end. The lumen is sized and shaped to accommodate the fiber tip51atherethrough so that the fiber tip51aextends through the lumen from the proximal end to the distal end of the generally cylindrical body. The fiber tip fluid output device14further comprises a plurality of apertures125extending around the generally cylindrical body. Each of the apertures125fluidly connects the outer surface to the lumen. As presently embodied, the lumen comprises a first diameter near the proximal end and a second diameter near the distal end, wherein in the illustrated embodiment the second diameter is greater than or equal to about two times the first diameter. As presently embodied, the lumen comprises a proximal lumen section and a distal lumen section, the proximal lumen section having a diameter which in the illustrated embodiment is equal to the first diameter and the distal lumen section having a diameter which in the illustrated embodiment is equal to the second diameter. The proximal lumen section comprises a proximal end, a distal end, and a lumen axis extending between the proximal end and the distal end; the distal lumen section comprises a proximal end, a distal end, and a lumen axis extending between the proximal end and the distal end; and the diameter of the proximal lumen section in the illustrated embodiment can be substantially constant along a length of the proximal lumen section between the proximal end of the proximal lumen section and the distal end of the proximal lumen section. The diameter of the distal lumen section can be substantially constant along a length of the distal lumen section between the proximal end of the distal lumen section and the distal end of the distal lumen section. In the illustrated embodiment, the first diameter transitions to the second diameter at the distal end of the proximal lumen section and the proximal end of the distal lumen section, a distal opening of the fiber tip fluid output device14has a diameter which is equal to the second diameter, and a proximal opening of the fiber tip fluid output device14has a diameter which is equal to the first diameter. In the illustrated embodiment, each of the apertures125has a diameter which is about half of the first diameter.

The apertures125can be disposed within a first depression121. A second depression extends around the generally cylindrical body near the proximal end, and a third depression extends around the generally cylindrical body near the distal end, wherein the first depression is disposed about half way between the second depression and the third depression in the illustrated embodiment. As presently embodied, the distal lumen section tapers into the proximal lumen section along a length of the lumen that in the illustrated embodiment is equal to about one third of at least one of the cross-sectional diameters of the apertures125.

The rotating handpiece10of the illustrated embodiment can use the electromagnetically induced cutting system disclosed in U.S. Pat. No. 5,741,247, the entire contents of which are expressly incorporated herein by reference. For example, an engineered and controllable atomized distribution of fluid particles is placed into an interaction for absorption of electromagnetic radiation (from the fiber tip51a) and for subsequent expansion to impart mechanical cutting forces onto a target or treatment surface. In the illustrated embodiment ofFIG. 1, separate air and fluid lines111,113, which may be similar to those described in U.S. Pat. No. 5,741,247, run parallel to one another in the distal direction toward the feed channels115,117. In other embodiments, the air and fluid lines111,113may comprise a first fluid line for carrying a first fluid and a second fluid line for carrying a second fluid, and further may comprise one or more additional fluid lines (not shown). Thus, while the illustrated embodiment describes the first fluid being air and the second fluid being water, the present disclosure is not limited to such structure and use. For example, the first and second fluids, and additional fluids, may comprise any of the components described in U.S. Pat. No. 5,785,521, the entire contents of which are expressly incorporated herein by reference. Some or all of the components of U.S. Pat. No. 5,785,521 may be premixed and carried through fluid lines, such as the lines115,117, or not premixed and mixed within the circumferential chamber119discussed below. The feed channels115,117, carrying a supply of air and water, respectively, as presently embodied, feed into circumferential chamber119. Referring toFIGS. 5a-5c, the circumferential chamber119can be formed in a first depression121of the fiber tip ferrule123. In an alternative embodiment, the section121may not have any depression.

As can be seen fromFIG. 5b, for example, four apertures125are disposed in the first depression121of the fiber tip ferrule123. In modified embodiments, other numbers of apertures may be incorporated. Air traveling into the circumferential chamber119from the feed channel115, and water traveling into the circumferential chamber119from the feed channel117, are both initially mixed in the circumferential chamber119. In one embodiment, the first and second fluids may comprise air and a medicated or flavored water, and in another embodiment the first and second fluids may comprise water and at least one other fluid. In still another embodiment, at least one of the first and second fluids may comprise a medicament, such as chlorhexidine gluconate.

The initially-mixed air and water travel from the circumferential chamber119through the orifices125and into the lumen133. The air and water is further mixed and atomized within the lumen133. The atomized water under air pressure subsequently travels along the fiber tip51in a direction toward the output end136of the fiber tip51. In a typical embodiment, the fiber tip51ais permanently affixed to and extends through the fiber tip fluid output device14. As presently embodied, three O-ring seals139are provided to seal the inside of the rotating handpiece from the air and water.

FIG. 7illustrates the loading tool17, the fiber tip fluid output device14, and handpiece head12in a disassembled configuration, andFIG. 8is an end view of the loading tool17, taken along the line8-8ofFIG. 7.

FIG. 9shows the fiber tip fluid output device14partially secured onto the loading tool17. The proximal end of fiber tip fluid output device14can be gripped by the hand of a user and slid into the slot19of the loading tool17in the direction of the arrow A2. As presently embodied slot19fits around the third depression21of the fiber tip fluid output device14, and the fiber tip fluid output device14is slid within the slot19in the direction of the arrow A2until the fiber tip fluid output device14reaches the end24of the slot19. The loading tool is then advanced in the direction of the arrow A3to firmly secure the fiber tip fluid output device14into the orifice26of the handpiece head12. The loading tool17is then removed from the fiber tip fluid output device14to leave the fiber tip fluid output device14firmly secured within the orifice26. As presently embodied, a width of the slot19is slightly larger than a diameter of the third depression21, so that the fiber tip fluid output device21can be removably and snugly held by the loading tool17.

Referring toFIG. 3, the removable trunk fiber assembly16can be provided with three radial ports for introducing air, water, and (optionally) cooling air. More particularly, a fluid radial channel161feeds fluid (e.g., water) into the fluid channel111, an air radial channel163feeds air into the air channel113, and an optional cooling-air radial channel165feeds cooling air along a cooling-air channel, which exits in close proximity to the parabolic mirror41. In a representative embodiment, the exit angle of the cooling air channel directs cooling air directly onto the parabolic mirror41, so that the cooling air is reflected from the parabolic mirror41onto the input end59of the fiber tip51and, subsequently, onto the window43. InFIG. 2, the cooling air exits from an orifice181aand is channeled directly onto the input end59aof the fiber tip51a. Subsequently, the air is directed onto the parabolic mirror41and reflected onto the output end55of the trunk fiber optic45. This configuration could also be implemented for the system ofFIG. 1, wherein the cooling air subsequently is directed onto the window43. Alternatively, in the embodiment ofFIG. 2, the cooling air exiting the orifice181acan be channeled directly onto the parabolic mirror41, focusing onto the input end59aof the fiber tip51. In the embodiments of bothFIG. 1andFIG. 2, the cooling air is subsequently channeled in the direction of the arrows A2through channels formed in the chuck23. As shown inFIG. 3a,the chuck23can have portions of its two sides removed, to thereby form channels for passage of the cooling air. The cooling air travels through the channels of the chuck23under a vacuum pressure and, subsequently, is drawn into a removal port191. Upon entering the removal port191under the vacuum, the cooling air travels in a direction opposite to the arrow A1and exits the removal trunk fiber assembly16. The four O-rings196insulate the radial channels161,163,165from one another.

FIG. 6aillustrates a side elevation view of the assembled rotating handpiece10andFIG. 6billustrates a modified embodiment of the rotating handpiece10, wherein the neck is slightly bent. InFIG. 6athe portion indicated by reference numeral203is adapted to rotate about an axis of the rotating handpiece10. The portion205does not rotate. Similarly, inFIG. 6b, the portion207is adapted to rotate about an axis of the rotating handpiece, and the portion209docs not rotate. In the embodiment ofFIG. 6b, the trunk fiber optic is configured to be slightly flexible, since the trunk fiber optic will need to bend and flex as the portion207is rotated relative to the portion209. In either of the embodiments ofFIGS. 6aand6b, the user holds the rotating portion (203or207) with his or her thumb and two fingers (such as is conventional in the art) and allows the stationary portion (205or209) to rest on a portion of the hand bridging the user's forefinger and thumb. The three fingers holding the rotating portion (203or207) contact the rotating portion and can rotate the rotating portion, as the fixed portion (205or209) does not rotate and rests on the portion of the hand bridging the hand and the forefinger.

The following figures show exemplary embodiments of radiation emitting apparatuses which are constructed to emit electromagnetic radiation in non-centered or non-concentrically focused manners, relative to the output from a cylindrically-shaped fiber optic end (i.e., a truncated fiber end), onto target surfaces or treatment sites. The target surface or treatment site can comprise, for example, a part of the body, such as a tooth, a knee, a wrist, or a portion of the jaw to be treated.

The output radiation can be engineered to have a spatial energy distribution which differs from the spatial energy distribution of a conventional truncated fiber end. More particularly, in accordance with an aspect of the present invention, a radiation emitting apparatus is constructed to generate output radiation having a spatial energy distribution with one or more energy concentrations or peaks located in areas other than a center of the spatial energy distribution. The center of the spatial energy distribution can be defined as an area aligned with (or intersecting) an optical fiber axis of the shaped fiber optic tip or an area aligned with (or intersecting) an average direction of propagation of the output radiation. According to one aspect, the center of the spatial energy distribution can be defined as a central part of a cross-section of the output radiation taken in a direction orthogonal to the direction of propagation of the output radiation.

With particular reference toFIG. 10a, a cross-sectional view of a shaped fiber optic tip comprising a conical side-firing output end in accordance with an embodiment of the present invention is shown. The side-firing output end is depicted comprising a conical shape that tapers in an output direction of propagation of electromagnetic radiation. In a typical embodiment, the side-firing output end is polished to a symmetric, or substantially symmetric, conical shape to, for example, attenuate or avoid undesirable phenomena such as masking and power losses. For example, the shaped fiber optic tip may be grasped and moved to position a distal end thereof onto an operative surface of a polishing machine. The distal end of the shaped fiber optic is then oriented with respect to the operative surface, and rotated at a steady rate to remove portions of the fiber in an even fashion about the fiber optic axis, to thereby polish the distal end of the shaped fiber optic tip into a conical side-firing output end. The shaped fiber optic tip may comprise, for example, sapphire, diamond, or quartz (glass).

In accordance with an aspect of the present invention, all beams of laser radiation exit from the side-firing output end at relatively high angles of up to 90 degrees with respect to the fiber optic axis. Consequently, as presently illustrated in the example of a conical side-firing output end transmitting into air, a dark “blind spot” is formed in front of the side-firing output end such that the output beam pattern or illuminated area comprises a non-illuminated center portion overlapping the fiber optic axis.

In an embodiment wherein the shaped fiber optic tip is formed of quartz, the shaped fiber optic tip may comprise a diameter of about 250 microns, which exemplary diameter may be suitable for, in one application, a root canal procedure. In an embodiment wherein the shaped fiber optic tip is formed of sapphire, the shaped fiber optic tip may comprise an exemplary diameter of about 750 microns, suitable, as an example, for root canal procedures.

In accordance with an aspect of the present invention, the side-firing output ends described herein may be used for caries removal from predetermined locations (e.g., side walls) of tooth cavities. Using the side-firing output ends of the present invention, undercuts may be effectively generated in caries procedures wherein each undercut may comprise a removed volume of caries defining a reverse-mushroom shaped aperture in the tooth which has a size at the surface of the tooth that is less than sizes of the aperture beneath the surface and which is to be filled with amalgam. Sizes of the aperture of such an undercut may progressively increase with distance away from the tooth surface in a direction toward a center of the tooth. For example, a dentist may insert a curved stainless steel probe into a cavity, detect caries material on a surface (e.g., sidewall) of the cavity, remove the curved stainless steel probe, insert a shaped fiber optic tip of the present invention having a side-firing output end into the cavity, position the side-firing output end to ablate the detected caries material, activate a laser to remove the detected caries material, and then (optionally) repeat the process until all detectable or a desired level of caries material has been removed. The shaped fiber optic tips of the present invention, and in particular their side-firing output ends, can thus facilitate generation of reverse-mushroom shaped apertures by way of operation of their side-firing characteristics, which can facilitate, for example, removal of tissue (e.g., caries) from side walls of the cavity down beneath the surface of the tooth.

In accordance with another aspect of the present invention, dimensions of the side-firing output ends of the shaped fiber optic tips can be selected to obtain total or substantially total internal reflection within the shaped fiber optic tip at, for example, the tip/air interface, as elucidated for example inFIG. 10b. With reference to this figure in the context of an exemplary, conically-shaped, side-firing output end, the full angle (i.e., total cone angle) at a distal region of the side-firing output end (e.g., cone) can be in the range from 10 degrees to 170 degrees, and more preferably between 50 degrees and 100 degrees. The shaped fiber optic tip can be a single fiber optic or in modified embodiments a bundle or fused bundle. Generally, the shaped fiber optic tip can have a diameter between 50 and 2000 microns, and can have a numerical aperture (N.A.) depending on the material. The exemplary shaped fiber optic tip can be made of silica or other materials, such as sapphire, or other materials disclosed in U.S. Pat. No. 5,741,247, the entire contents of which are incorporate by reference herein, and can also comprise a hollow waveguide in modified embodiments. In the exemplary embodiment ofFIG. 10b, the shaped fiber optic tip comprises a 600 micron core diameter, a numerical aperture of 0.39, an acceptance angle, α1, of 15.6 degrees, and a full cone angle of 60 degrees to 62 degrees.

The full cone angle can be determined using, for example, Snell's Law of Refraction, n0sin(α0)=n1sin(α1), for all waveguide modes to experience total internal reflection on at least one of the tapered surfaces of the side-firing output end before exiting through the side-firing output end. More particularly, in the exemplary embodiment ofFIG. 10b, the cone comprises a first tapered surface (shown near top of drawing page) and an opposing second tapered surface (shown near bottom of drawing page). According to an implementation of the present invention in which total internal reflection occurs, all light striking the first tapered surface is reflected toward and exits through the second tapered surface to thereby achieve a side-firing effect. In the illustrated example, the refractive indices n0and n1can be 1.0 and 1.45, respectively, corresponding to an implementation of a quartz conical side-firing output end transmitting into air, and further values may be implemented wherein α0=8.0 degrees and α1=5.5 degrees. Beginning with an equation that (½)αcone+α1+αt.r.=90 degrees, wherein αconeis defined as the total cone angle and αt.r. is defined as the angle for total internal reflection, the angle for total internal reflection, αt.r., can be isolated to yield αt.r.=sin−1(n0/n1) which in the present example equals 43.6 degrees. When (½)αcone=40.9 degrees, the total cone angle can be determined in the example as αcone=81.8 degrees.

Although the full cone angle in the illustrated embodiment of a cone is selected to facilitate total internal reflection, modified embodiments of cones (e.g., having other shapes or materials) or other side-firing output ends may be constructed wherein the internal reflection (i.e., reflection off of a first surface or first tapered surface, or the percentage of reflection from light first striking any tapered or other surface of the side-firing output end) is about 90% or greater. In still other embodiments, a total angle can be constructed to provide for an internal reflection of at least 75%. In further embodiments, however, other varying amounts of internal reflection can be implemented.

In an implementation of a quartz conical side-firing output end transmitting into water, the side-firing output end may be constructed to have a full angle of about 36 degrees, and in an implementation of a quartz conical side-firing output end transmitting into air, the side-firing output end may be constructed to have a full angle of about 82 degrees. In an implementation of a sapphire conical side-firing output end transmitting into water, the side-firing output end may be constructed to have a full angle of about 76 degrees, and in an implementation of a sapphire conical side-firing output end transmitting into air, in order to achieve a similar side-firing effect the side-firing output end may be constructed to have a larger full angle, such as, in the present example, about 104 degrees (as a result, generally, of the divergence angle being greater for air than water).

FIG. 11is cross-sectional view of a shaped fiber optic tip comprising a symmetric, conical, side-firing output end which is constructed similarly to that ofFIG. 10aand which is shown operated in an aqueous environment. The aqueous environment may comprise any combination of fluid (e.g., air) and liquid (e.g., water), such as a submerged liquid environment, or a sprayed or atomized liquid in air embodiment such as disclosed in, for example, U.S. Pat. No. 5,741,247 and the references cited therein. As used herein, the term “aqueous” should not be limited to denoting only water as other liquids in addition to or as an alternative to water may be used. Dimensions of the side-firing output ends of the shaped fiber optic tip can be selected to obtain total or substantially total internal reflection within the shaped fiber optic tip at the tip/aqueous interface. In the illustrated embodiment, the cone angle facilitates both total internal reflection (forming an illuminated ring pattern) and refraction (forming an illuminated center spot) at the tip/aqueous interface of the side-firing output end.

FIG. 10cis cross-sectional view of a shaped fiber optic tip comprising an asymmetric conical side-firing output end in accordance with another embodiment of the present invention. The embodiment ofFIG. 10ccan be viewed as a combination of the embodiments ofFIG. 10aandFIG. 10dand, accordingly, may be constructed for uses, or to favor uses, of either or both of those embodiments. In a representative embodiment wherein the side-firing output end is polished to a non-symmetrical conical shape as shown, all beams of laser radiation exit from the side-firing output end at relatively high angles of up to 90 degrees with respect to the fiber optic axis. Consequently, an off-axis or non-centered dark “blind spot” is formed in front of the side-firing output end such that the output beam pattern or illuminated area comprises an asymmetric ring of laser radiation at the target plane. During formation, a distal end of the shaped fiber optic tip, comprising, for example, sapphire, diamond, or quartz, may be positioned onto an operative surface of a polishing machine, and orientated during polishing in a manner to form the distal end of the shaped fiber optic tip into an asymmetric conical side-firing output end.

In an embodiment wherein the shaped fiber optic tip is formed of quartz or sapphire, the shaped fiber optic tip may have diameters of about 250 microns or 750 microns, respectively, which exemplary diameters may be suitable for, in certain applications, root canal procedures. In implementations of quartz side-firing output ends transmitting into water or air, the side-firing output ends may be constructed to have full angles of about 32 degrees or 40 degrees, respectively. In implementations of sapphire side-firing output ends transmitting into water or air, the side-firing output ends may be constructed to have a full angles of about 36.5 degrees or 52 degrees, respectively.

FIG. 10dis a cross-sectional view of a one-side firing tip comprising a shaped fiber optic tip having a bevel-cut side-firing output end according to a modified embodiment of the present invention, wherein the bevel cut tapers in an output direction of propagation of electromagnetic radiation. In a typical embodiment, the side-firing output end comprises a material such as sapphire, diamond or quartz that is polished to a bevel-cut shape. For example, the shaped fiber optic tip may be grasped and moved to position a distal end thereof onto an operative surface of a polishing machine, with the distal end of the shaped fiber optic being oriented with respect to the operative surface, and not rotated, to remove portions of and polish the distal end of the shaped fiber optic tip into a bevel-cut side-firing output end. Dimensions of the side-firing output ends of the shaped fiber optic tips can be selected to obtain total or substantially total internal reflection of electromagnetic radiation at one side and firing through the opposite bevel-cut side of the side-firing output end of the shaped fiber optic tip.

In accordance with one aspect of the present invention, all beams of laser radiation exit from the bevel-cut side-firing output end at relatively high angles of up to 90 degrees with respect to the fiber optic axis. Consequently, as presently illustrated in the example of a bevel-cut side-firing output end transmitting into air, a dark “blind spot” is formed in front of the side-firing output end such that the output beam pattern or illuminated area comprises a crescent-shaped illuminated portion juxtaposed next to an enlarged, off-center, non-illuminated portion. In an embodiment wherein the shaped fiber optic tip is formed of quartz, the shaped fiber optic tip may have a diameter of about 400 microns to about 600 microns which exemplary diameter range may be suitable for, in one application, cavity preparation procedures in which the shaped fiber optic tip can be flexed and fitted into periodontal pockets. In an embodiment wherein the shaped fiber optic tip is formed of sapphire, the shaped fiber optic tip may have an exemplary diameter of about 750 microns suitable, as an example, for cavity preparation procedures.

In various implementations of quartz or sapphire bevel-cut side-firing output ends that are to be transmitting into water or air, the side-firing output ends may be constructed to have full angles of, for example, about 45 degrees. In such examples involving full angles of about 45 degrees, undercuts may be effectively generated in caries procedures wherein each undercut may comprise a removed volume of caries defining a reverse-mushroom shaped aperture in the tooth as described above. According to other implementations, as a result, generally, of the divergence angle, indicated by dashed lines in the figure, being greater for sapphire than for quartz, in order to obtain a similar side-firing effect for a quartz shaped fiber optic tip, the full angle of the side-firing output end formed of sapphire will be smaller than that of a quartz embodiment. Similarly, according to other embodiments, as a result, generally, of the divergence angle for implementations involving transmission into air being greater than for implementations involving transmission into water, in order to obtain a similar side-firing effect for an air-transmission application, the full angle of the side-firing output end for air-transmissions will be smaller (yielding a more pointed tip) than that used for water-transmission applications. According to further implementations, as a result, generally, of the divergence angle being greater for sapphire than for quartz and the divergence angle being greater for air than water, a bevel-cut side-firing output end formed of quartz and transmitting electromagnetic radiation into water will have an even smaller full angle (producing a more pointed tip) to achieve a similar side-firing effect.

FIG. 12ais an exploded, cross-sectional view of a multi-capillary shaped fiber optic tip, andFIG. 12bis a cross-sectional view of the multi-capillary shaped fiber optic tip similar to that ofFIG. 12ain an assembled state. The components forming the multi-capillary shaped fiber optic tip may comprise any combination of materials such as, for example, sapphire, diamond, or quartz.

The distal fiber optic can be glued and/or press fitted into the intermediate-diameter cylindrical fiber optic, and the intermediate diameter cylindrical fiber optic can be glued and/or press fit into the large-diameter cylindrical fiber optic. Regarding the distal fiber optic, it can have an outer diameter of about 200 microns, and can be fabricated without (FIG. 12a) or with (FIG. 12b) a shaped side-firing end such as one of the ends depicted inFIGS. 10a,10cor10d.The embodiment ofFIG. 12bshows the distal fiber optic comprising a conical side-firing output end, and further shows the intermediate-diameter cylindrical fiber optic and the large-diameter cylindrical fiber optic conduct electromagnetic radiation and providing side-firing effects from their distal ends. Regarding the intermediate-diameter cylindrical fiber optic and the large-diameter cylindrical fiber optic, the former can have an inner diameter of about 200 microns and an outer diameter of about 400 microns and the latter can have an inner diameter of about 400 microns and an outer diameter of about 600 microns.

FIG. 13is a cross-sectional view of a shaped fiber optic tip implementing a tapered side-firing output end. The structure may comprise, for example, quartz, and may be formed, for example, by heating a conical distal tip to a glass transition temperature and then elongating (e.g., pulling) the distal tip distally, using for example chucks, to deform the structure into that shown inFIG. 13. In a typical embodiment the shaped fiber optic tip can have a maximum outer diameter of about 800 microns (near the proximal end of the illustrated embodiment) and a minimum diameter of about 100 microns (near the distal, side-firing end of the illustrated embodiment).

Although shown as a solid structure, the shaped fiber optic tip may comprise a hollow (e.g., resembling part or all of the structures/functions ofFIGS. 14aand14b, infra), or partially hollow (e.g., resembling part or all of the structures/functions ofFIGS. 15aand15b, infra), structure in modified embodiments. For example, the shaped fiber optic may comprise a hollow or partially hollow interior surrounded by an outer sidewall, which sidewall defines the shape shown inFIG. 13, or slightly modified shapes thereof, and which sidewall may or may not comprise a waveguide. The sidewall may comprise, for example, a uniform or substantially uniform thickness. The slightly modified shapes may comprise, for example, embodiments which have fewer or less-pronounced curves and consequently shapes resembling combinations of the shape shown inFIG. 13and a cylindrical shape. According to other embodiments, the slightly modified shapes may comprise, for example, embodiments which have greater or more-pronounced curves and consequently shapes having greater variations in diameter along the fiber optic axis (along any part, parts, or all of the fiber optic axis) than that shown inFIG. 13. In certain embodiments, the hollow or partially hollow shaped fiber optic tip may be configured, with or without the sidewall operating as a waveguide, to have structure and/or to operate, in whole or in part, according to one or more of the implementations depicted and described in connection with the followingFIGS. 14a,14b,15aand15b, or combinations thereof, to the extent functional, as will be apparent to one skilled in the art in light of the present disclosure. According to particular implementations, the shaped fiber optic tip may be left substantially unchanged in shape, or alternatively modified in shape, and provided with and operated in accordance with a peripheral (e.g., annular at any cross-sectional location along the fiber optic axis, or, in other words, conforming to the shape shown inFIG. 13) fluid movement path as described in connection with the followingFIGS. 15aand15b. Thus, in an exemplary construction, the peripheral fluid movement path may comprise, for example, a surgical stainless steel sleeve or cannula that conforms to the unaltered (or, alternatively, altered) surface of the shaped fiber optic tip ofFIG. 13.

FIG. 14ais a cross-sectional view of a fluid-movement fiber optic tip comprising a concentric waveguide, e.g., a non-interrupted volume, encircling a central fluid-delivery path. The fluid-movement fiber optic tip is shown being operated in an application mode wherein an aqueous environment is supplied by way of a source of positive pressure (cf. downwardly directed arrow within central fluid-delivery path) through and output from a distal end of the central fluid-delivery path.FIG. 14bis a cross-sectional view of a fluid-movement fiber optic tip similar to that ofFIG. 14awith a central fluid-delivery path being operated in an evacuation mode wherein materials (e.g., an aqueous environment and/or liquids from a treatment site) are drawn into a distal end of the central fluid-delivery path for removal thereof by way of a source of negative pressure (cf. upwardly directed arrow within central fluid-delivery path). The components forming the fluid-movement fiber optic tip may comprise materials such as, for example, sapphire, diamond, quartz, or combinations thereof. In the illustrated embodiment, a distal end of the concentric waveguide is coterminous with a distal end of the central fluid-delivery path, but in other embodiments either of the concentric waveguide and the central fluid-delivery path may extend distally past a distal end of the other. The fluid-movement fiber optic tip may comprise, in an illustrated embodiment, a hollow waveguide fiber optic tip, such as, for example, the large-diameter cylindrical fiber optic disclosed above in connection withFIGS. 12aand12b. In one embodiment, the fluid-movement fiber optic tip can have the same or similar dimensions as set forth above to describe the large-diameter cylindrical fiber optic, and in another embodiment the fluid-movement fiber optic tip can have an inner diameter of about 500 microns and an outer diameter of about 800 microns. In yet another embodiment, the fluid-movement fiber optic tip can have an inner diameter of about 300 microns and an outer diameter of about 600 microns.

Application of positive pressure to supply the aqueous (or other) environment and of negative pressure to evacuate materials from an area in proximity to the distal end can be provided through one or more of proximal ends of the central fluid-delivery paths, apertures formed (e.g., drilled) into sidewalls of the concentric waveguides as indicated in phantom in the figures, or combinations thereof. In modified embodiments, one or more of the apertures (and/or the proximal end of the central fluid-delivery path, in any combination) may be dedicated to either supplying the aqueous environment to or evacuating materials from the central fluid-delivery path. For instance, the four apertures shown in phantom inFIG. 14amay be used to deliver an aqueous environment to the central fluid-delivery path at first points in time, and the four apertures shown in phantom inFIG. 14bmay be used to remove materials from the central fluid-delivery path at second points in time. In one implementation, one or more apertures disposed in the sidewall of the concentric waveguide delivers an aqueous environment to the central fluid-delivery path at first points in time, and a proximal end of the central fluid-delivery path removes materials from the central fluid-delivery path at second points in time. Generally, such apertures may be formed anywhere along the lengths of the fluid-movement fiber optic tips, at any orientations, according to desired functions and applications. For example, it may be advantageous to form apertures for delivering an aqueous environment closer to the distal end of the central fluid-delivery path and/or at orientations to inject the aqueous environment to move distally within the central fluid-delivery path. In other embodiments, it may additionally or alternatively be advantageous to orient one or more of the aqueous-environment injecting apertures to inject the aqueous environment into the central fluid-delivery path so as to have a swirl component wherein, for example, the aqueous environment is caused to swirl about the fiber optic axis as it travels distally through the central fluid-delivery path. Application of positive pressure to supply the aqueous (or other) environment and of negative pressure to evacuate materials from an area in proximity to the distal end can be provided using any timing sequence and/or can be coordinated in any way with electromagnetic radiation being provided through the concentric waveguide of the fluid-movement fiber optic tip. All timing and operational permutations are contemplated as will be apparent to those skilled in the art. In one implementation, electromagnetic radiation is provided through the central fluid-delivery path in addition to or as an alternative to being delivered through the concentric waveguide by way of one or more sources of electromagnetic radiation (cf. downwardly-directed arrows pointing into the fluid-movement fiber optic tip). In another implementation, electromagnetic radiation having a first characteristic is provided through the central fluid-delivery path and concentrated (i.e., other than mere ambient light) electromagnetic radiation having a second characteristic is delivered through the concentric waveguide. For example, the electromagnetic radiation having a first characteristic can comprise laser energy provided from a source of concentrated electromagnetic radiation (cf. downwardly-directed solid arrow pointing into the fluid-movement fiber optic tip) through the central fluid-delivery path, and the electromagnetic radiation having a second characteristic can comprise white light such as generated by an LED and provided by way of another source of electromagnetic radiation (cf. downwardly-directed non-solid arrows pointing into the fluid-movement fiber optic tip) through the concentric waveguide, or visa versa. In certain embodiments wherein electromagnetic radiation is provided through the central fluid-delivery path (and, optionally, also through the concentric waveguide), a wavelength of the electromagnetic radiation may be selected to be highly absorbed by one or more components in the aqueous environment with the electromagnetic radiation being applied during application modes to assist distal movement of the aqueous environment through the central fluid-delivery path. For example, the aqueous environment may comprise atomized particles of water and the electromagnetic radiation may comprise laser energy from a laser having a wavelength (e.g., about 3 microns) that is highly absorbed by the water as disclosed, for example, in U.S. Pat. No. 5,741,247. This patent describes, for example, electromagnetic energy sources comprising wavelengths within a range from about 2.69 to about 2.80 microns and wavelengths of about 2.94 microns, and further describes lasers comprising one or more of Er:YAG, Er:YSGG, Er, Cr:YSGG and CTE:YAG lsaers. In such a configuration as descried in U.S. Pat. No. 5,741,247,water particles within the central fluid-delivery lumen can be contacted with the electromagnetic radiation, reacting (e.g., expanding) and being accelerated distally out of the central fluid-delivery lumen. As an example of various possible timing protocols, one or more pulses of aqueous environment can be introduced into the central fluid-delivery lumen followed by introduction of one or more pulses of electromagnetic energy into the central fluid-delivery lumen, with the sequence then repeated. In another implementation, the aqueous environment may comprise atomized particles of water and the electromagnetic radiation may comprise laser energy from a laser having a wavelength (e.g., about 1 micron) that is not highly absorbed by the water, in which case one or more pulses of aqueous environment (e.g., atomized particles or a stream of water) can be introduced into the central fluid-delivery lumen commensurate in time (or, alternatively, intermittently) with introduction of one or more pulses of electromagnetic energy into the central fluid-delivery lumen, with the sequence then being repeated.

FIG. 15ais a cross-sectional view of a fluid-movement fiber optic tip comprising a peripheral (e.g., annular) fluid-movement path encircling a central waveguide. The fluid-movement fiber optic tip is shown being operated in an application mode wherein an aqueous environment is supplied by way of a source of positive pressure (cf. downwardly directed arrows within fluid-movement path) through and output from a distal end of the annular fluid-movement path.FIG. 15bis a cross-sectional view of a fluid-movement fiber optic tip similar to that ofFIG. 15awith an annular fluid-movement path being operated in an evacuation mode wherein materials (e.g., an aqueous environment and/or liquids from a treatment site) are drawn into a distal end of the annular fluid-movement path for removal thereof by way of a source of negative pressure (cf. upwardly directed arrows within annular fluid-movement path). The fluid-movement fiber optic tip may comprise, in an illustrated embodiment, a central waveguide comprising, for example, sapphire, diamond, quartz, or combinations thereof, surrounded by a sidewall (e.g., cannula) which may comprise, for example, surgical stainless steel. In modified embodiments, a distal end of the central waveguide can be constructed to have, and/or to be operated in accordance with, descriptions of the shaped fiber optic tips of one or more ofFIGS. 10a,10c,10d,11,12b, or combinations thereof. In the illustrated embodiment, the distal end of the central waveguide extends beyond a distal end of the annular fluid-movement path, but in other embodiments the distal end of the annular fluid-movement path may be coterminous with or extend past the distal end of the central waveguide. According to a typical embodiment, the central waveguide may comprise a fiber optic having an outer diameter of about 600 microns, and the annular fluid-movement path may have dimensions of 1200 microns.

Application of positive pressure to supply the aqueous (or other) environment and of negative pressure to evacuate materials from an area in proximity to the distal end can be provided through one or more of proximal ends of the annular fluid-movement paths, apertures formed (e.g., drilled) into sidewalls (e.g., cannulas) of the annular fluid-movement paths as indicated in phantom in the figures, or combinations thereof. In modified embodiments, one or more of the apertures (and/or the proximal end of the annular fluid-movement path, in any combination) may be dedicated to either supplying the aqueous environment to or evacuating materials from the annular fluid-movement path. For instance, the four apertures shown in phantom inFIG. 15amay be used to deliver an aqueous environment to the annular fluid-movement path at first points in time, and the four apertures shown in phantom inFIG. 15bmay be used to remove materials from the annular fluid-movement path at second points in time. In one implementation, one or more apertures disposed in a sidewall of the annular fluid-movement path delivers an aqueous environment to the annular fluid-movement path at first points in time, and a proximal end of the annular fluid-movement path removes materials from the annular fluid-movement path at second points in time. Generally, such apertures may be formed anywhere along the lengths of the fluid-movement fiber optic tips, at any orientations, according to desired functions and applications. For example, as discussed above in connection withFIGS. 14aand14b, it may be advantageous to form apertures for delivering an aqueous environment closer to the distal end of the annular fluid-movement path and/or at orientations to inject the aqueous environment to move distally within the annular fluid-movement path. Likewise, in other embodiments, it may additionally or alternatively be advantageous to orient one or more of the aqueous-environment injecting apertures to inject the aqueous environment into the annular fluid-movement path so as to have a swirl component wherein, for example, the aqueous environment is caused to swirl about the fiber optic axis as it travels distally through the annular fluid-movement path. As withFIGS. 14aand14b, application of positive pressure to supply the aqueous (or other) environment and of negative pressure to evacuate materials from an area in proximity to the distal end can be provided using any timing sequence and/or can be coordinated in any way with the provision of electromagnetic radiation through the central waveguide of the fluid-movement fiber optic tip, and all timing and operational permutations that will be apparent to those skilled in the art upon reading this disclosure are contemplated.

In one implementation, electromagnetic radiation is provided through the annular fluid-movement path in addition to or as an alternative to being delivered through the central waveguide by way of one or more sources of electromagnetic radiation (cf. downwardly directed arrows pointing into the fluid-movement fiber optic tip). In another implementation, electromagnetic radiation having a first characteristic is provided from a source of concentrated electromagnetic radiation (cf. downwardly-directed solid arrows pointing into the fluid-movement fiber optic tip) through the annular fluid-movement path and electromagnetic radiation having a second characteristic is delivered by way of another source of electromagnetic radiation (cf. downwardly-directed non-solid arrow pointing into the fluid-movement fiber optic tip) through the central waveguide. For example, the electromagnetic radiation having a first characteristic can comprise white light generated by an LED provided through the annular fluid-movement path, and the electromagnetic radiation having a second characteristic can comprise laser energy provided through the central waveguide, or visa versa. In certain embodiments wherein electromagnetic radiation is provided through the annular fluid-movement path (and, optionally, also through the central waveguide), a wavelength of the electromagnetic radiation may be selected to be highly absorbed by one or more components in the aqueous environment with the electromagnetic radiation being applied during application modes to assist distal movement of the aqueous environment through the annular fluid-movement path. For example, the aqueous environment may comprise atomized particles of water and the electromagnetic radiation may comprise laser energy from a laser having a wavelength (e.g., about 3 microns) that is highly absorbed by the water as disclosed, for example, in U.S. Pat. No. 5,741,247. In such a configuration, water particles within the annular fluid-movement path can be contacted with the electromagnetic radiation, reacting (e.g., expanding) and being accelerated distally out of the central fluid-movement lumen. As an example of various possible timing protocols, one or more pulses of aqueous environment can be introduced into the annular fluid-movement path followed by introduction of one or more pulses of electromagnetic energy into the annular fluid-movement path, with the sequence then repeated. In another implementation, the aqueous environment may comprise atomized particles of water and the electromagnetic radiation may comprise laser energy from a laser having a wavelength (e.g., about 1 micron) that is not highly absorbed by the water, in which case one or more pulses of aqueous environment (e.g., atomized particles or a stream of water) can be introduced into the annular fluid-movement path commensurate in time (or, alternatively, intermittently) with introduction of one or more pulses of electromagnetic energy into the annular fluid-movement path, with the sequence then being repeated.

According to various contemplated embodiments, the cannula defining the annular fluid-movement path may comprise uniform or non-uniform thicknesses and/or may be spaced at uniform or non-uniform distances from an outer surface of the central waveguide, at various points along a length of the fiber optic axis of the fluid-movement fiber optic tip. For example, the cannula may comprise a substantially uniform thickness and may be spaced at progressively smaller distances from the outer surface of the central waveguide in a direction from the proximal end to the distal end along a length of the fiber optic axis of the fluid-movement fiber optic tip.

Regarding the side-firing output ends of the shaped fiber optic tips ofFIGS. 10a,10c,10d,11and12b, any of these output ends may be modified or otherwise formed to have non-cylindrical shapes, such as spherical, chiseled, or other light-intensity altering (e.g., dispersing) shapes, in additional embodiments.

Also, regarding the side-firing output ends of the shaped fiber optic tips ofFIGS. 10a,10c,10d,11and12b, any of these output ends further can be modified by removing parts of the distally-disposed output ends to yield, for example, truncated-cone or truncated-bevel distal ends that provide end-firing components. As examples, shaped fiber optic tips having diameters of about 600 microns to about 750 microns may be formed (e.g., polished) to have truncated planar output surfaces of about 200 microns in diameter, and shaped fiber optic tips having diameters of about 200 microns may be formed (e.g., polished) to have truncated planar output surfaces of about 50 microns in diameter.

For example, planar output surfaces centered on and perpendicular to longitudinal axes of the fiber optics can be formed. In the implementation ofFIG. 10a, for example, the pointed end of the conical tip, which in the illustrated embodiment is centered on the longitudinal optical axis of the fiber optic, can be polished flat to yield a planar output surface so that light traveling along the optical axis exits the planar output surface and continues to travel, unrefracted, along the optical axis. Thus, in the described implementation, the planar output surface is oriented to be perpendicular with, and to intersect with, the longitudinal axis of the fiber optic.

As another implementation, the beveled, side-firing output end of the construction ofFIG. 1c, which in the illustrated embodiment is not centered on the longitudinal optical axis of the fiber optic, can be polished to form a planar output surface so that light traveling in a direction parallel to the optical axis exits the planar output surface and continues to travel, unrefracted, in a direction parallel to the optical axis. Thus, the planar output surface is again oriented to be perpendicular with, but not to intersect with, the longitudinal axis of the fiber optic.

Regarding the side-firing output ends of the shaped fiber optic tips ofFIGS. 10a,10c,10d,11and12b, any of these tips and output ends may be modified or otherwise formed to have hollow interiors defining central fluid-delivery paths such as those described in connection withFIGS. 14aand14b, and/or operated as such in whole or in part as described in connection withFIGS. 14aand14b. In exemplary implementations, the hollow interiors may be centered along fiber optic axes of the shaped fiber optic tips and/or may be aligned with what would otherwise be the planar output surfaces so that the planar output surfaces are not surfaces but rather are output openings of the hollow interiors.

In other implementations, the modified output ends (e.g., planar output surfaces) may have other orientations which are not perpendicular to the optical axes of the fiber optics, and in still further implementations the modified ends may comprise curved, rounded, or other non-planar surfaces.

The modified output ends (e.g., planar output surfaces) can generate output beam patterns similar to those depicted inFIGS. 10a,10c,10dand12bbut with filled center portions as a result of laser energy passing through, unrefracted, the planar output surfaces. The shapes and intensities of the filled center portions in the output beam patterns, resulting from implementations of the modified output ends, can be changed by changing characteristics (e.g., diameter and/or surface characteristics) as will be recognized by one skilled in the art in light of this disclosure.

The filled center portion generated by incorporating a modified output end (e.g., planar output surface) into the construction of the shaped fiber optic tip ofFIG. 11will comprise, when used in an aqueous environment as shown, a filled center portion of one or more of greater size and greater intensity, as a result of laser energy passing through, unrefracted, the planar output surface.

Accordingly, the modified output ends can provide end-firing components to the side-firing output ends of the fiber optics thus generating more uniform output beam patterns. Such side-firing, end-firing combination fiber optic tips can have applicability in procedures where it is desired to irradiate sidewalls and bottom layers of a target surface. For example, the modified output ends may have applicability for periodontal pocket procedures wherein it may be desired to direct radiation to sidewalls and to the bottom surfaces during modification or removal of the periodontal pocket area.

The above-described embodiments have been provided by way of example, and the present invention is not limited to these examples. Multiple variations and modification to the disclosed embodiments will occur, to the extent not mutually exclusive, to those skilled in the art upon consideration of the foregoing description. Additionally, other combinations, omissions, substitutions and modifications will be apparent to the skilled artisan in view of the disclosure herein. Accordingly, the present invention is not intended to be limited by the disclosed embodiments, but is to be defined by reference to the appended claims.