Cerecdoc,
I my case at the begining I did little with the water and air settings and used the presets.  I worked up to the wattage necessary to penetrate the enamel and then backed down on the watts.  I was not sure what to expect in terms of penetration once I entered dentin. I did a lot of work in dentin at 1.5W to 3W  till I got the feel and some experience.  Watching the laser work at 3.5 mag plus light let me see what was happening and whether to increase the watts.  When I was having sensitivity in the beginning I tended to use the ligajet to keep on schedule.  Now as Ron describes I am more successful with the desenstizing process and find with combination of the laser and the round bur I can complete most preparations without anesthesia.  Also the electric high speed has been very useful.  The patient rarely knows I used the high and low speed they just say that laser is nice.  Working with the higher magnification had its own learning curve.  Now one year later I am beginning to run with the big boys on the simpler stuff.  Take Bill Chen’s course.  Go to Dana Point in January to the Biolase meeting.    Buy a diagnodent and find a few smaller cavities upon which to build your skills.  Give yourself a shot in the bicuspid region of your favorite anesthetic and see first hand what a wonderful option the laser can be.  Just joking about the shot part.

Pat

Try it on your hand………..

Well actually that is one problem with the 20hz

With the continuum we have 5 different settings
3
10
20
25
30

I often will use 3 hz and 30-50 mj without water on my hand to show the kids how slow the laser cuts.

Pop, Pop, Pop…….creates little white spots on your hand.

Its a little warm at first but after a little while you feel very little. You can smell the skin burning (honestly) but it is so superficial in ablation that you can literally add water and find the white spots disappear.

With 20 Hz you want to lower you mj as low as it can go with the Biolase (it only has 2oHz)

What is the lowest energy setting in mj that you have.

Can you go to 10 mj?

Glenn

Hi there………you get wattage by multiplying

Mj (millijoules) with Hz (pulses per second)

The continuum has 5 Hz settings but Biolase has 1 setting of 20 pulses per second or 20 Hz.

Continuum has 3,10,20,25,30.

I like this ability to change the number of pulses per second both higher and lower but I digress.

If I hit a tooth 30 Hz (30 times per second) at 60 mj (millijoules) the wattage is 1.8 watts (1800 milliwatts)

With the Biolase I have only 20 Pulses per second so to get 1.8 watts the actual millijoules is 90 (20X90)

Since Biolase doesnt let you control the pulses per second (its fixed at 20) the wattage is the only figure they give.

Now heres some food for thought……..

1.8 Watts can be.

3 Hz 600 mj which would be a hammer hitting you 3 times per second.

10 Hz at 180 mj ( which is still pretty strong but not often enough pulses to cut fast) (most lasers in japan are only 10 pulses per second so they are slower)

20 Hz at 90 mj ( Biolase setting)

30 Hz at 60 mj ( my setting for cementum abfractive lesions which are moderately sensitive).

I like using the 3 pulses per second on my hand to show kids how it goes pop pop pop and doesnt cut through my hand.

The Biolase can only pulse at 20 times per second.

The theory behind this is that there are two factors affecting pain……

1. Tissue relaxation time ( time between pulses ) so with pain with the continuum I can lower the number of pulses per second.
2. Duration of each pulse. Its my understanding that Biolase has a shorter pulse duration (its quicker I think) than Continuums.

Bob the resident guru will correct me but I wanted to help clarify why the Biolase has only wattage posted (you can only control the energy not the number of pulses per second) whereas with the Continuum you can alter both energy (mj) and the repetition rate (Hz) and if you multiply the two you get the wattage.

I hope that I have not totally confused you , because I have managed not to confuse myself!! and thats something!!

Grin

Glenn

Glenn–

You give me all sorts of warm fuzzy feelin’s when you talk math like that!:cheesy:

There are laser parameter relationships that manufacturers have to select and program into a laser’s software power “matrix” as part of the laser’s original design.  These parameters include Watts, Hz, and millijoules for a given pulse duration.

The fundamental relationship used in microsecond (free-running) lasers is what Glenn so excellently described:

Watts (is the “average power” on the console) = pulse energy ( usually expressed as 1/1000 of a Joule or milli-joule) x the pulse rate (Hz or aka pulses per second/pps)

Now EVERY laser that operates in the “free-running”emision mode MUST have these parameters defined inside the software matrix of the lasers’ computer.  This includes the Waterlase, the DELight, the OpusDent, the PerioLase, the Pulsemaster, etc.

However, NOT every laser puts these parameters on the console display for the clinician to view.  For example, neither the Waterlase nor the DELight displays the pulse duration.  However, the PD has a very important role to play in tissue interactions (though engineers often don’t think so).

According to Manni’s reference, the Waterlase has a pulse duration of 140 usec and the DELight is 300 usec, so the Waterlase has roughly 2’x the pulse energy at 20 Hz at a given Watt as does the DELight.

FWIW, I have VERY strong feelings about this as I feel that lack of complete laser parameters and power emission display discourages understanding of one’s laser and delivery of energy to tissue and prevents ease of discourse of the subject of similar lasers and their effects in tissue.  Hence, we end up relying on, “Well it seems to work for me, I don’t know why you are having problems at that power?”  How does that advance the science and understanding of laser use once we get past the initial excitement over their early use?

Just as Larry got confused initially, others can become discouraged permanently.

All the device information about your lasers are supposed to be described in the operator’s manual delivered with your laser.         If not, insist on them from the manufacturer.

Bob