Forums › Erbium Lasers › General Erbium Discussion › PowerLAse AT
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dkimmelSpectatorThis morning I was going through Manni’s book to get me ready to pick on Bob and Del next weekend and came across the Fotona’s lasers.
It does appear that Lares is now marketing this laser in the states.
http://www.fotona.si/medical/fidelis_plus.aspIt” target=”_blank”>http://www.laresdental.com/product….
http does have a variable pulse rate 2-50HZ I could not find the breakout of what is between 2 and 50 and how many different pulse rates it has.
Pulse duration is also variable 50us,100us , 300us, 600us and 1000us.
It does appear to be a digital unit as the pulses durations are square.It is used out of contact except for soft tissue where it can be used in contact.
The variable pulse duration is interesting. At 1000us it would seem that there would be a bit of heat. Then again at 2 HZ it would be interesting to see the effect on soft tissue and caries. 100 us at enamel sounds about right. I like the idea of 600us for soft tissue.
We all know how carious dentin can be a pain to remove with the ER at times. It would be interesting to see how using 50us and varing the pulse rate as well as 300 us. It seems 1000us would be too much at the higher HZ but at 2 HZ it would interesting to see.
It does seem Fotona believes at the 50us pulse is better because it is faster then the thermal diffusion in dental tissue and faster than the formation of the albation cloud above the tissue.
Anyone out there played with this unit?
Interesting how what used to be thought of as a marketing ploy seems to becoming rather mainstream.:)
Glenn van AsSpectatorDavid….saw it in Australia where it has a big following as Laurie Walsh likes it.
The people selling it are really respected and they also sell the KTP bleaching (green light) units.
What I saw was an articulated arm. A big unit. IT cut very fast on the videos in the anterior but in non contact mode it would seem to be very difficult to use in the posterior.
That is about what I can tell you.
Glenn
Robert Gregg DDSSpectatorHey David,
Nice try! You’re still in the Front Row!
1000 usec is 1000usec and just too dang long of exposure time to either hard or soft tissue even at low rep rates.
The medical laser companies doing research in dermatology laser applications and skin resurfacing figured that out a while ago for skin. I’ll tell you later this week what they discovered……..;)
Bob
dkimmelSpectatorNot the front row.!
That’s like church. Darn hard to sleep on the front row!!!!
AnonymousGuestQUOTEQuote: from dkimmel on 9:01 am on July 3, 2005
This morning I was going through Manni’s book to get me ready to pick on Bob and Del next weekend and came across the Fotona’s lasers.
It does appear that Lares is now marketing this laser in the states.
<a href="http://www.laresdental.com/products/yag/plat_spec.asphttp://www.fotona.si/medical/fidelis_plus.asp
It” target=”_blank”>http://www.laresdental.com/product….
http does have a variable pulse rate 2-50HZ I could not find the breakout of what is between 2 and 50 and how many different pulse rates it has.
Pulse duration is also variable 50us,100us , 300us, 600us and 1000us.
It does appear to be a digital unit as the pulses durations are square.It is used out of contact except for soft tissue where it can be used in contact.
The variable pulse duration is interesting. At 1000us it would seem that there would be a bit of heat. Then again at 2 HZ it would be interesting to see the effect on soft tissue and caries. 100 us at enamel sounds about right. I like the idea of 600us for soft tissue.
We all know how carious dentin can be a pain to remove with the ER at times. It would be interesting to see how using 50us and varing the pulse rate as well as 300 us. It seems 1000us would be too much at the higher HZ but at 2 HZ it would interesting to see.
It does seem Fotona believes at the 50us pulse is better because it is faster then the thermal diffusion in dental tissue and faster than the formation of the albation cloud above the tissue.
Anyone out there played with this unit?
Interesting how what used to be thought of as a marketing ploy seems to becoming rather mainstream.:)
David,
In the J Oral Laser Applications 2004 ;4,
there is an article regarding this laser and its cutting efficiency. The conclusion was –“The study shows that optimal erbium dental laser pulses are of approximately 50usec duration.At this duration,both the heat diffusion and derbris screening effects are minimized, leading to very efficient laser ‘drilling’. The laser ablation speeds under these conditions are larger than those achieved by classical mechanical burs”M&M was 450mj w/ varible pulse durations from 50-1000usec
Results- ” the analysis of the results show that the ablation efficiency increases by a factor of 5 when the pulse durations are decreased from 1000 to 50 usec.”
As an aside, I spent some time talking w/ a user at the ALD (Fotona ERII-erbium only)and he was very pleased with the laser and didn’t seem to think that the articulated arm was a problem-long enough and flexible enough. He did say he thought it would be awhile before it was sold in the US due to the patent lawsuits happening at the time.
Hopefully, Bob will share the 1000usec comments with all of us. IMO the ability to use a very short pulse duration in this laser may indicate some future direction for their competitors.
Happy 4th everyone!
Robert Gregg DDSSpectatorHopefully, Bob will share the 1000usec comments with all of us. IMO the ability to use a very short pulse duration in this laser may indicate some future direction for their competitors.
It has been my long held belief (since 1996-7) that the parameteres for erbium cutting of enamel, dentin and soft tissue have not been well studied or established in tissue models or in vivo studies, before devices have been designed and sold in the marketplace.
Fotona’s 50usec PD for hard tissue is a step in the right direction, where 1000 is not. I believe the Fidelis/Powerlase AT was designed about 10 years ago in Slovakia, so it really pre-dates the present erbium laser designs by a few years……..
I’ve previously said that I think we are seeing the early to middle term stages of erbium technology that addresses the delivery issues and the device parameters.
Unlike Nd:YAG which has overcome and addressed the deficiencies of the early devices (in the Periolase MVP-7), erbiums still have a ways to go.
As long as there ae engineers and business men making guesses at what works clinically, instead of investing in basic science and in vivo clinical research–by people who know what they are doing and looking for clinically–then we will see the continued Darwinian development of erbiums.
The thermal relaxation constant is the time it takes for 50% of the heat applied to a substance to dissipate. 1000 usec is well beyond the TRC for soft tissue. I have not found any use for long pulse duration on hard tissues that I could reproduce in vivo……
Bob
SwpmnSpectatorI’m evaluating the Lares PowerLase AT this weekend in Orlando. Help me make a list of questions.
Unit also has a free-running pulsed 1064nm Nd:YAG with 15Watt maximum Average Power. Whew that seems like a lot!
Pulse Duration on Nd:YAG is 100, 180 and 320usec. No 650? Repitition rate 10-100Hz.
Erbium is delivered via articulated arm, Nd:YAG from a separate optical fiber.
SwpmnSpectatorQUOTEJ Oral Laser Applications 2004 ;4,
there is an article regarding this laser and its cutting efficiency. The conclusion was “The study shows that optimal erbium dental laser pulses are of approximately 50usec duration.At this duration,both the heat diffusion and derbris screening effects are minimized, leading to very efficient laser ‘drilling’. The laser ablation speeds under these conditions are larger than those achieved by classical mechanical burs”M&M was 450mj w/ varible pulse durations from 50-1000usec
Results- ” the analysis of the results show that the ablation efficiency increases by a factor of 5 when the pulse durations are decreased from 1000 to 50 usec.”
Do we have Internet access to the entire paper or if someone has hard copy, could you fax it to me at 727-466-0197(preferably within 24 hours)?
Thanx,
Al
dkimmelSpectatorAllen checkout the HP and let me know how they are . They look a little big?
Glenn van AsSpectatorAllen today in the throwaway journal Dental Products Review I saw an ad for the Lares laser (NdYag and Erbium Yag ) that said for the first time ever a laser was faster than the handpiece. They also have a stand alone erbium.
I would like to know the study (there was a graph which I didnt spend alot of time looking at).
Next off how does it cut posterior teeth, are there contact or close to contact tips or is it a window. It cut fine on the videos I saw in the anterior with a window but no tips, but in the posterior that is darn hard.
Let me know what you think of the articulated arm. How often does it need replacement, they told me it had gold mirrors on the inside which didnt need replacement often. Again this was in Australia and I really like the guys there, they were great with me. They had a big following there.
Its a big unit but interesting enough and its great that you are able to test it out. Its neat to see everyone here just trying to find both the good and bad things from each laser.
As Bob said , with time the almost perfect Erbium will arrive.
cya
Glenn
AnonymousGuestGlenn,
The laser has both a window tip and smaller, more conventional tips (don’t remember if contact or not). Looking at the procedures shown in N.O. I remember thinking that ,other than biostim, I couldn’t imagine using the ‘window tip’ for much. Seems like it would be very difficult to aim at your target.I hope our newest members from Fotona, in Slovenia, will participate in this discussion and give us some insight.
Allen, you have a fax this morning and we look forward to hearing your impressions.
Robert Gregg DDSSpectatorQUOTEQuote: from Swpmn on 1:03 pm on July 5, 2005
I’m evaluating the Lares PowerLase AT this weekend in Orlando. Help me make a list of questions.Unit also has a free-running pulsed 1064nm Nd:YAG with 15Watt maximum Average Power. Whew that seems like a lot!
Pulse Duration on Nd:YAG is 100, 180 and 320usec. No 650? Repitition rate 10-100Hz.
Erbium is delivered via articulated arm, Nd:YAG from a separate optical fiber.
15 watts is a lot of FRP Nd:YAG! Far more than needed for dentistry.
Lares uses the “Full Width Full Max” (FWFM) method of calculating Pulse Duration. Most manufacturers and conventions use “Full Width Half Max” (FWHM). It is calculated off an oscilloscope from the waveform of the pulse duration that appears on the scope.
So the Powerlase AT Nd:YAG is more like 150, 300, 1000 usec measured at FWHM, instead of 100, 180 and 320 usec measured FWFM…..
Not to confuse you, of course, but just one more layer to understanding what temporal emission mode you need to know about a study M&M or manufacturer’s claims.
Bob
SwpmnSpectatorQUOTEAllen, you have a fax this morning and we look forward to hearing your impressions.Ron:
Thank you for the fax.
SwpmnSpectatorQUOTELares uses the “Full Width Full Max” (FWFM) method of calculating Pulse Duration. Most manufacturers and conventions use “Full Width Half Max” (FWHM). It is calculated off an oscilloscope from the waveform of the pulse duration that appears on the scope.So the Powerlase AT Nd:YAG is more like 150, 300, 1000 usec measured at FWHM, instead of 100, 180 and 320 usec measured FWFM…..
Not to confuse you, of course, but just one more layer to understanding what temporal emission mode you need to know about a study M&M or manufacturer’s claims.
Bob
Bob:
Actually, this does confuse and I’m disappointed we don’t have a standardized method of measuring Pulse Duration in order to make objective comparisons across different manufacturers.
Is there a simple method to convert and standardize FWFM vs. FWHM PD numbers?
To add to the confusion, on one of the pages I’ve downloaded from Lares, there is an asterisk(*) next to mention of the 120usec PD. The footnote states: Full width half maximum. This is in reference to the Lares PowerLase ST6 Nd:YAG.
Robert Gregg DDSSpectatorBob:
Actually, this does confuse and I’m disappointed we don’t have a standardized method of measuring Pulse Duration in order to make objective comparisons across different manufacturers.
Tell me about it. At least you now know that you have to ask what convention is being used…….Remember that this discussion and awareness is largey new to most with lasers. But now that several manufacturers have seen the value in this “marketing gimick”, more doctors will become aware of this next layer of the laser onion.
Is there a simple method to convert and standardize FWFM vs. FWHM PD numbers?
No, not really because the numbers depend on whether the pulse is Bell shaped or square shaped. Square shaped will give you similar numbers at the middle of the oscilloscope and at the top of the square-shaped waveform on the scope–in theory at least.
Whereas a Bell shaped pulse will have a rise time and a peak that varies. So the analog pulse is fatter in the middle (FWHM) and narrow at the top (FWFM).
To add to the confusion, on one of the pages I’ve downloaded from Lares, there is an asterisk(*) next to mention of the 120usec PD. The footnote states: Full width half maximum. This is in reference to the Lares PowerLase ST6 Nd:YAG.
I know. That has been a typo in their literature since October 1999. It should be FWFM.
No need for me to advise them, was there? I mean, their CD-ROM is a complete Standard Proficiency with certification and blessings from the ALD, so everyone associated with that information should know what they are talking about. Doesn’t it make you wonder what else is not accurate in their literature and CD-ROM?
Bob
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