You said 5.5 watts defocus. At what distance from the tooth is defocus. And what is the air and water setting.

I zapped my palm pretty good at 6 watts and no water about three inches away with my waterlase the other day. I can hear you laughing!

Please spell it out so a dummy like me can get the details.

My training on anesthesia was about .5 watts about 10mm from the tooth with no air or water to speak of.

There is a big difference between 5 watts and .5 as I was trained to do. What am I missing?

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

Hi Pat,
One of the things I have noted over time is that teeth with fractures, crazes, and especially worn areas due to bruxism, have much more sensitivity than most with the laser. In addition, it seems that lower molars especially are more prone to extra sensitivity. I usually make sure I anesthetize with at least 5.5W for almost 2 minutes, BUT if the patient is already “jumpy”, or as you say, a little on edge, they expect pain, so, I just numb them anyway, as I have learned the hard way. They may not be feeling anything, but their PERCEPTION is that of discomfort, and there is no winning in that situation as you found out! I wish I could tell you I have had no problems in that regard, but I can’t. I think if you would have just tapped gently with an explorer on his tooth, he would have reacted, and sometimes I do just that to “test” the patients expectations before I even start. As far as the improved potential, you are right, the composite will have good retention from the laser prep alone as well as the bonding agents too. You did good, as usual, caring for your patient. Sorry I couldn’t help you along any further. Bob, what are your thoughts as you read this thread? Glenn? Ron?
Mark