I’ll try to give you a first stab at an answer. Al Williams can probably give you a better answer than me.

Not sure what part of the handpiece is getting fried. You mean the distal end of the metal?

In general, when you couple the handpiece to the trunk fiber, it is designed to seal and exclude water from the erbium beam path where the optical fiber terminates in a metal coupler and where mirrors are used to reflect the erbium/chromium photons (highly absorbed into water) to the tips and out to the tissue.

Water from the trunk fiber passes out through the handpiece through a different as separate pathway and outlet, once it’s coupled, so that it can be atomized/sprayed in front of the beam path in air and on to target tissue.

If the mirrors or metal inside are not dry, the water on them acts as an absorbing “pigment” that absorbes into the water and reflects the beam back onto the metal around the optical fiber terminus. The result is a thermal event that “fries” the metal on the handpiece.

Hope that helps a little.

I need to take a closer look at the Waterlase (v1) we have to get a better idea……..

Bob

This is an outstanding but complicated question. I don’t really know the complete answer but Dr. Gregg has provided as good a response as anyone. Your question is really making us think. I believe Dr. Mark Colonna has a lot of knowledge on this subject and he can probably help us out.

First of all, don’t envision the interaction within the Waterlase trunk fiber and handpiece/mirror as that of air, water and 2780 erbium laser light. There should be three separate inputs with a central optical conduit for the erbium light and two peripheral tube or line inputs for air and water. At no point along the trunk fiber, in the handpiece or on the mirror should the erbium light be allowed to interact with water. As Dr. Gregg pointed out, if this happens it may result in a “frying” or burning of components within the fiber or handpiece due to the 2780 wavelength’s affinity for water molecules.

The central optical conduit should be completely sealed from water and directed onto the mirror to deflect the erbium photons at a right angle and down the sapphire tips. An air/water mixing chamber must exist within the head of the Waterlase handpiece which is peripheral to the central light conduit. 2780 photon interaction with water should only be exhibited distal to the end of the sapphire tip:

The question for us now becomes “How can the photon deflection mirror get wet?”. Is there leakage in the system as Dr. Kimmel proposed? Can the mirror only get wet by autoclaving the handpiece? If the system is sealed, how can reattaching the handpiece with air on “blow” off any water on the mirror? A friend with a great deal of engineering background once suggested to me that with our high humidity and variations in air conditioning in Florida, condensation may occur within the optical portion of the Waterlase trunk fiber. Biolase engineers assured me this is not possible.

You’ve posed an excellent question. I think if you follow Dr. Kimmel’s recommendations you won’t have any problems. The technology is still emerging and we need better answers for these questions.

Al

Hey Norman……what a surprise, but what a shame, that she couldnt come up with an answer.

I will also say that I dont think I could do all the steps to clean up and change the tips that you guys do…….I am glad that it is a relatively easy chore to do with the Delight as I am sure that I would fry out a ton of fibers.

Its something that I am sure will eventually be solved but until then I guess the Waterlase users must be diligent in changing tips etc.

Glenn

Great reply and yes Norman both machines are capable of doing marvelous things. I am sure that Opus , Deka , and Kavo are also capable of doing nice things in the right persons hands as well.

Do your due diligence and continue to peruse the fine clinical cases that are posted here to figure out what lasers can do.

Glenn

Thanks David , excellent pictures, gosh its tough to think about all those things before you go to work on each patient. I would have blown 2X as many fibers and tips as you have.

Wow, great thread, and again thanks for your great posts……..

Glenn

Al,

Very nice post….just an addition to the protocol, if one is to remove the handpiece….

4) When the handpiece is removed another seal is broken. It it is therefore recommended that the handpieces be dried out or purged of water prior to removal. Easiest way to purge water from the handpiece:

a) Waterlase is in STANDBY mode
b) Set Waterlase to pre-set #1(90% air, 75% water)
c) Turn water bottle toggle switch to OFF
d) Scroll the air and water settings to ON mode
e) Press READY button and water will be pushed out of the handpiece…….DO THIS FOR ABOUT 90 Sec!!!!*****
f) Press STANDBY button and then turn off the laser