Hi from Australia Mitchell and congrats on the OPus.

I will tell you that you cant really transfer the settings from the Opus to the Delight or visa versa because they have two different delivery systems.  

Yours is a hollow waveguide meaning that it is a hollow tube with a coating on the inside which reflects the laser energy down the hollow tube from the box itself to the operating site.  The hollow tube is a less expensive method of getting the laser energy to the site and it is easier to use from a manufacturing standpoint,than a fiber which can be very tricky to build.  The erbium wavlengths are long compared to the shorter wavelengths of the diodes and NdYag, and it is much more difficult engineering wise to get these long wavelengths to follow down an optical fiber than it is to get them in either a hollow waveguide or an articulated arm so many companies use this system (Deka, Fotona (Fidelis), OPus etc.).

The importance of this is that there is also alot more attenuation with the hollow waveguide, and loss of energy in the beam as it travels down the waveguide. The Opus unit will tell you what energy is coming out of the box but not what is actually hitting the tooth.  For instance if the fiber is bending alot when you approach the tooth (in other words it isnt straight but it is curved) then you will get alot less energy with the OPus than what your setting says you are getting. I can calibrate my fiber and discover what % of transmission is occurring down the fiber. New fibers are 88% + and drop with age where one of my two units is around 71% and the other is 81%. WHen it gets to around 65% it has to be replaced. My oldest unit is 5 years old now and the fiber hasnt been replaced but I dont use it as much anymore. I am getting Error 24 messages now which means that the unit power is not being as predictably produced but apparently the latest thing that Hoya is able to do is replace the Flash lamp (wild but true) and almost always for 800 dollars you have a brand new unit for argument sake. I thought this was cool…….

Attenuation of the beam when you bend the hollow waveguide is almost like defocussing the beam.  With the Delight bending of the fiber doesnt make as much of a difference.  

In addition tip size is important because a larger tip in diameter will give you a lower power density, and so a 600 micron tip will cut slower at the same power setting as a 400 micron tip.

Finally the type of tip (quartz vs the harder sapphire) and the number of Hz (the Opus has 12-20 hz, compared to the Delight having 3-30 Hz) can all have a role in the development of settings……….

So what would I do with this conundrum…….sheesh Glenn just give me the darn settings will you!!

Well here is what I would do…….

Enamel is set at 12 watts (12 times 1000 mj / 1000) and the dentin at 5 watts (10 times 500mj/ 1000) and in comparison my settings for class 5 lesions are roughly
1.5 -2.4 watts which is significantly lower. My settings for Occlusal enamel where you need far more energy to cut than buccal enamel are 6 watts + 25 Hz and 240 mj. My settings for dentin are 3-4 watts (30 Hz and 100-140 mj) and my settings for cementum are in the 1.5 to 2w range. REmember that bevels on enamel require FAR less energy than occlusal enamel that you are trying to ablate for predictable bonding so keep your cavosurface enamel bevel energies lower.

Your laser will have less pulses per second (12 or 10 hz) vs 30 Hz but each pulse will be more powerful than mine.  

I think that I would try a lower setting at first for the Class V lesions.  Perhaps try them on an extracted tooth, or in the first instance with anaesthetic on the patient so sensitivity is taken out of the equation and you can evaluate the cut.

I would start in your case on a class V with perhaps settings on cementum of

10 Hz and 150-240 mj or
20Hz and a lower setting of 75-120 mj to equal my settings.

I will tell you that this will cut much slower than the settings you are have preset on your machine BUT there may be alot less sensitivity with these.  These settings would be for a 600 micron tip (higher) and 400 micron tip (lower settings).  The Opus tips are larger if I remember at 800, 1000 and 1200 microns so you may need to increase your settings SLIGHTLY.

If you are getting sensitivity do one of several things…….

1. Defocus the beam (pull away slightly)
2. Bend the hollow waveguide.
3. Turn down the mj or Hz.

Finally, Mitchell , I apologize for the length and in some ways the confusion for this post on why my settings might be quite different for an OPus user than either of the fiber users (Biolase or Delight) but the Opus power at the tip might in some instances apparently be only 15% of what the unit is posting as its power exiting the box.

In addition with loupes that are high powered or the microscope I have discovered that I can be far more efficient in my settings because I dont need a buffer of more energy to help me cut still when the tip leaves the optimal cutting zone which happens more when the operator is using no mag or very low mag than when they are using high powered magnification systems.

Ask Mark Colonna , DAvid Kimmel or Allen Williams if they can use lower settings when they use their high powered loupes than their low powered loupes and I bet they tell you they can.

In addition scopes users like Andrew Shearon, Ron Kaminer, and Kelly Blodgett might also mention how raising the mag improves their ability to cut at the same power settings because they can visualize the interaction of the tip with the target tissue so much better.

I hope this helps and again sorry for the long winded explanation but the Opus user will have different settings than others.

Jeff Cranska (Benchwarmer) is a VERY experienced Opus User and he might be able to give you some exact settings for what he uses.  My settings when converted over to wattage will be a low end starting point but in the end I think that with the hollow waveguide, the larger tips , and the attenuation of energy with this unit that you will have to increase the settings to cut the same speed with relatively the same lack of sensitivity.

You can use higher energy settings but in the end you might find it cuts faster but with WAY more sensitivity and in addition the bevel on your enamel will be very deep and the prisms will be very fragile to bond too giving you microleakage in a year or two…….ask me how I know!!

Take care and I am lecturing in Australia right now and wont be back until November 7=8th so I do tune in periodically to LDF but not as often .

Oh Ya one more thing………nobody calls me Dr. van As expecially my good colleagues like you.  My dad is Dr. van As (GRIN) , I am just plain ol Glenn!!

Take care

Glenn

(Edited by Glenn on the road at 4:56 pm on Oct. 25, 2004)

Mitchell,
Welcome to the LDF.
I’ve been using the OpusDuo Erbium since it was first released a couple of years ago.
What laser do you have? Your settings look awfully high.
As Glenn said, laser interaction is regulated by tip output, tip size and Hertz.
What type of tip and size are you using?
I like using the 800micron conical contact Sapphire tips.
I use the variable Hertz control, starting at 12 Hz and dropping for pain control w/ the foot pedal if needed.
Initial setting for Cl I,II enamel 700mJ. Cl III, IV, V enamel 350mJ. All dentin caries 350mJ. All with water spray.
A power meter at the tip will show you actual tip output, I show about about 2/3 loss from settings to tip, in ideal positioning (straight guide).
Be careful w/ 1000mJ, especially with 600micron and smaller tips. Will remove carious dentin without control.
Be careful.
Jeff

Mitchel,
I don’t understand what you’re doing.
What laser are you using?
Why metal tips? Why cutting defocused at 100mJ? Why bathing the tooth w/ defocused energy w/o a tip?
Put a contact tip on the handpiece, set to a carious dentin setting (350mJ) 12 Hz, use water, remove the caries, then restore.
It should take seconds to see the caries being ablated, should be no reason to use anesthetic. Remenber Hertz is what hurts. Decrease the Hz, but increase your Watts to remove cairies or any tissue.
You are using some strange settings, where did you get them from?
Jeff

kghabou,
If you do a search on this site you will find settings for about any procedure you want to use the laser for.

If you have questions once you’ve found settings for a certain procedure, ‘fire’ away.

Welcome to the forum!