PS…looks like it was an accurate post of pictures. MAKE SURE YOU LOOK THROUGH THE END OF THE HANDPIECE WITH MAGNIFICATION. It is the ONLY way you can really see this.
Mark

In my opinion, this thread and subsequent replies are some of the most significant yet posted on the Forum. This thread and photos should be printed and saved by anyone using or considering purchase of a “hard tissue” Erbium laser.

Use of the Erbium around metals and old metal-containing bases/restorations damages the laser “tips”. In the case of some Erbiums it also damages the reflective mirror in the “head” of the “handpiece”. Damage to the mirror results in eventual failure of the trunk fiber delivery system – my technician explained this to me after my last trunk fiber failure. I’ve suspected this for over a year but finally have some official confirmation.

And it’s not just as simple as avoiding usage of the laser around amalgam or PFM crown margins. I notice “sparking” on removal of old composites and old bases/liners. Until you begin removal, there is no way to predict whether the old composite/base/liner will cause sparking. With mirrored handpiece systems, if you see sparking, you can be assured you are causing damage to the tip, mirror and eventually the trunk fiber delivery system.

Dr. Colonna has done us a great service by providing the first photos I have seen which document damage to a mirrored handpiece delivery system. Those who use or are considering purchase of such systems would be wise to print these photos and check your handpieces on a regular basis.

Al

That’s pretty cool, Glenn. So the tip just pops right into the end of the fiber?

How much did that burned out tip set you back?

Al

Do you take those pics thru a microscope Mark, like Glen does. They are awesome!
So, the strait tip handpiece of continuum delight is less subject to amalgam damage than the 90deg handpiece of waterlase?
Greg

Man, is this not the coolest thread or what? We gotta get the word out so people can see these images.

I don’t know jack about engineering, but I’m going to go out on a limb and propose a theory:

Biolase developed a “handpiece” delivery system because they knew this would feel very familiar to dentists. If anyone ever looked at the ADT Cavilase it was developed similarly with a “handpiece”. Problem is, you can’t bend a trunk fiber 90 degrees, so Biolase put a mirror in the “head” of the handpiece to reflect the laser beam down the tip and into the treatment area.

Unfortunately, the mirror gets burned or pitted when one touches a metal-containing restoration/base/liner because as Mark said, the laser energy is reflected back up the tip and onto the mirror. As the dentist continues to use the instrument, the outgoing laser energy hits the damaged mirror and is reflected back into the trunk fiber, thus resulting in trunk failure.

But why use a “handpiece” mirrored delivery system at all? The shape of the handpiece casing is what was designed in the 1950’s to contain air turbines or the same as is now used in electric handpieces for gears. I don’t like the laser “handpiece” because it is hard for me to see around the “head” – particularly because it is set at 90 degrees unlike modern air/electric handpieces.

Crawling further out on the limb:

Glenn’s ConBio DeLight trunk fiber does not fail because there is no mirror(although there is an optional “handpiece”). Glenn uses a “pen-like” delivery system, looks similar to an electro/radiosurge unit(he showed me diagrams). I propose that in the ConBio DeLight the trunk fiber does not fail because there is no mirror and the tip acts like a “shear pin” or “weakest link”. When the tip is damaged there will be a reduction in cutting efficiency but no mirror-reflected damage back into the trunk fiber.

Just a crazy theory. Ya’ll let me know what you think and let’s continue this great dialogue!

Al

Here is a picture of a tip, that has a split starting at about 8 o’clock, it runs from the edge of the tip to the inside edge. Very hard to see without magnification. THESE are the tough ones to see, shine your operatory light through them, that seems to help. (like transillumination).

Mark