User Manual
PAGE INTENTIONALLY LEFT BLANK
Contents
1 OVERVIEW ....................................................................................................................... 7
2 INDICATIONS FOR USE .................................................................................................. 8
Ha rd-Tissue ........................................................................................................................................... 8
Endodontic Surgery (Root Amputation) Indications .............................................................................. 8
Bone Surgical Indications ...................................................................................................................... 8
Laser Periodontal Procedures ............................................................................................................... 8
Soft-Tissue Indications Including Pulpal Tissues .................................................................................. 9
Root Canal Disinfection ......................................................................................................................... 9
3 EQUIPMENT DESCRIPTION ......................................................................................... 10
System Parts List ................................................................................................................................ 10
General ................................................................................................................................................ 10
Main Laser Console Elements ............................................................................................................ 10
Control Panel .................................................................................................................................. 10
Energy Monitor ............................................................................................................................... 11
Front and Back Handles ................................................................................................................. 11
Locking Wheels .............................................................................................................................. 11
Emergency Stop ............................................................................................................................. 11
Keyswitch ........................................................................................................................................ 11
Footswitch, Footswitch Connector .................................................................................................. 12
Remote Interlock Outlet .................................................................................................................. 12
Power Connection / Circuit Breaker ............................................................................................... 12
Ventilation Channels ....................................................................................................................... 12
Air Inlet Connector .......................................................................................................................... 12
Self-Contained Water Bottle ........................................................................................................... 12
Water Bottle Release ...................................................................................................................... 13
Footswitch Support Bracket ............................................................................................................ 13
Telescopic Fiber Cable Support Arm.............................................................................................. 14
WaterLase iPlus Delivery System .................................................................................................. 14
Delivery System Connection on the Laser Console ....................................................................... 15
4 SPECIFICATIONS .......................................................................................................... 16
Dimensions .......................................................................................................................................... 16
Electrical .............................................................................................................................................. 16
Air and Water Output ........................................................................................................................... 16
Optical ................................................................................................................................................. 16
WaterLase iPlus User Manual
3
Contents
5 CONTRAINDICATIONS, WARNINGS, AND PRECAUTIONS ........................................17
Contraindications ................................................................................................................................ 17
Warnings and Precautions .................................................................................................................. 17
Prescription Statement ................................................................................................................... 17
Eyewear .......................................................................................................................................... 17
Training ........................................................................................................................................... 17
Anesthesia ...................................................................................................................................... 17
Treatment, Technique and Settings ................................................................................................ 17
Hard-Tissue Procedures ................................................................................................................. 18
Soft-Tissue Procedures .................................................................................................................. 18
Curettage Procedures .................................................................................................................... 18
Fluid Entrapment and Air Embolism ............................................................................................... 18
Root Canal Procedures .................................................................................................................. 18
Root Canal Disinfection Procedures .............................................................................................. 19
Adjacent Structures ........................................................................................................................ 19
Clinical Conditions .......................................................................................................................... 19
Tissue Evaluation ........................................................................................................................... 19
Tissue Contact and Tip Breakage .................................................................................................. 19
Tip Changing .................................................................................................................................. 19
Water Splashing ............................................................................................................................. 20
Plume Removal .............................................................................................................................. 20
Dental Materials.............................................................................................................................. 20
6 SAFETY WITH THE WATERLASE ................................................................................ 21
Precautions ......................................................................................................................................... 21
Safety Instructions ............................................................................................................................... 21
Safety Classication ............................................................................................................................ 22
7 INSTALLATION .............................................................................................................. 23
Installation Instructions ........................................................................................................................ 23
Facility Requirements .......................................................................................................................... 23
Environmental Requirements .............................................................................................................. 23
Set-up Requirements .......................................................................................................................... 24
Connecting the Unit to the Operatory ............................................................................................. 24
Filling the Internal Cooling Water Reservoir ................................................................................... 24
Filling the Self-Contained Water System Bottle ............................................................................. 25
Installing the SureFire Delivery System .......................................................................................... 26
Connecting the Handpiece to the Fiber Cable ............................................................................... 28
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WaterLase iPlus User Manual
Contents
Disconnecting the Handpiece......................................................................................................... 29
Installing and Changing the Tip in the Handpiece .......................................................................... 29
8 OPERATING INSTRUCTIONS ....................................................................................... 31
Operation............................................................................................................................................. 31
Overview ........................................................................................................................................ 31
Starting the WaterLase iPlus .......................................................................................................... 31
Activating the WaterLase iPlus ....................................................................................................... 32
Turning the WaterLase iPlus Off .................................................................................................... 32
User Interface / General Navigation ............................................................................................... 32
Applications Menu .......................................................................................................................... 33
Changing and Saving the Pre-Sets ................................................................................................ 35
Settings/Memory Menu .................................................................................................................. 36
Functions for the Setting Buttons ................................................................................................... 37
Custom Settings ............................................................................................................................. 37
Description of the Functional Buttons ............................................................................................. 38
Other Screens ................................................................................................................................ 38
System Flow Chart ......................................................................................................................... 39
9 CUTTING TISSUE .......................................................................................................... 40
Introduction..........................................................................................................................................40
Hard-Tissue Cutting ............................................................................................................................ 40
Soft-Tissue Cutting .............................................................................................................................. 41
Presets for Soft- and Hard-Tissue Procedures ................................................................................... 42
10 CLEANING AND STERILIZATION ................................................................................ 43
Handpiece and Tip Cleaning and Sterilization .................................................................................... 43
Step 1—Cleaning Process ............................................................................................................. 43
Step 2—Handpiece Sterilization Process ...................................................................................... 44
Step 3—Disinfecting the Fiber Cable ............................................................................................. 45
11 MAINTENANCE AND TROUBLESHOOTING ............................................................... 46
Daily Maintenance ............................................................................................................................... 46
Mirror Check and Cleaning ............................................................................................................. 46
Mirror Inspection and Cleaning ...................................................................................................... 46
Removing the Handpiece Mirror ..................................................................................................... 47
Changing the Handpiece Mirror ..................................................................................................... 47
Mirror Alignment Check .................................................................................................................. 48
Fiber Check .................................................................................................................................... 48
WaterLase iPlus User Manual
5
Contents
Annual Maintenance ............................................................................................................................ 50
Delivery System.............................................................................................................................. 50
Laser Console ................................................................................................................................ 50
Calibration Schedule ............................................................................................................................ 51
Installation and Calibration Dates ................................................................................................... 51
Troubleshooting ................................................................................................................................... 52
Transportation ..................................................................................................................................... 53
Storage ................................................................................................................................................ 53
APPENDIX A: LABELS ...................................................................................................... 54
APPENDIX B: ACCESSORIES ........................................................................................... 61
Accessories List .................................................................................................................................. 61
APPENDIX C: TIPS ............................................................................................................. 62
Tip Types ............................................................................................................................................. 62
Tip Ferrule Colors ........................................................................................................................... 62
Tip Settings: WaterLase iPlus / Gold Handpieces .............................................................................. 62
Z - Glass Tips ................................................................................................................................. 62
Sapphire Tips ................................................................................................................................. 63
APPENDIX D: TIP INSPECTION ........................................................................................ 64
Tip Inspection Instructions ..................................................................................................................64
Tip Cleaning Instructions ..................................................................................................................... 65
Turbo Tip Inspection ............................................................................................................................ 65
Fiber Tip Inspection ............................................................................................................................. 65
APPENDIX E: SETTINGS ................................................................................................... 66
APPENDIX F: ELECTROMAGNETIC COMPATIBILITY .................................................... 75
NO MODIFICATION OF THIS EQUIPMENT IS ALLOWED.
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WaterLase iPlus User Manual
1 Overview
The WaterLase iPlus tissue cutting system is a
unique device with diverse, hard- and soft-tissue
dental applications. It utilizes advanced laser
and water atomization technologies to safely and
effectively cut, shave, contour, roughen, etch, and
resect oral hard-tissue, and direct laser energy to
perform oral soft-tissue removal, incision, excision,
ablation and coagulation. WaterLase iPlus may
also be used for specic endodontic and periodontal applications.
When used for oral hard-tissue procedures, this
YSGG solid-state laser provides optical energy
to a user-controlled distribution of atomized water
droplets and hydrated surface layer of hard-tissue.
Water present in the target tissue absorbs laser radiation, resulting in explosive molecular expansion
and ablation of hard-tissue. The water in the spray
provides cooling and hydration for the target tissue.
For oral soft-tissue procedures, the Waterlase
iPlus laser applies optical energy to the soft-tissue
for tissue removal, incision, excision, ablation, and
coagulation using direct laser energy, either with
water for cooling and hydration, or without water
for coagulation.
When used and maintained properly, the WaterLase
iPlus proves a valuable addition to a practice. Please
contact BIOLASE Customer Service at 1-800-3216717 in the U.S and Canada for any service needs;
if the user is located outside the U.S., please contact
the BIOLASE-authorized representative.
A exible Fiber Cable connects at one end to the
laser and at the other to a Handpiece that delivers
laser energy to the target tissue through a Fiber
Tip. A visible light emitted from the Handpiece
head illuminates the area of treatment. The optical
power output and atomized water spray may be
adjusted to specic user requirements for both
soft- and hard-tissue applications.
WaterLase iPlus is indicated for professional use
on adult and pediatric dental patients. Procedures
must be performed only by licensed dental
practitioners in a dental facility. Use of this device
requires proper clinical and technical prociency,
and this User Manual provides instructions for use
for those professionals who have completed the
appropriate training.
WaterLase iPlus User Manual
7
2 Indications for Use
IMPORTANT: Review all Contraindications, Warnings and Precautions presented in Section
5 before proceeding with using this device on patients.
WATERLASE IPLUS IS INDICATED FOR:
HARD-TISSUE
GENERAL INDICATIONS*
• Class I, II, III, IV and V cavity preparation
• Caries removal
• Hard-tissue surface roughening or etching
• Enameloplasty, excavation of pits and ssures
for placement of sealants
* For use on adult and pediatric patients
ROOT CANAL HARD-TISSUE INDICATIONS
• Tooth preparation to obtain access to root
canal
• Root canal preparation including enlargement
• Root canal debridement and cleaning
ENDODONTIC SURGERY (ROOT
AMPUTATION) INDICATIONS
• Flap preparation – incision of soft-tissue to
prepare a ap and expose the bone.
• Cutting bone to prepare a window access to
the apex (apices) of the root(s)
• Apicoectomy – amputation of the root end
• Root-end preparation for retroll amalgam or
composite
• Removal of pathological tissues (i.e., cysts,
neoplasm or abscess) and hyperplastic
tissues (i.e., granulation tissue) from around
the apex
BONE SURGICAL INDICATIONS
• Cutting, shaving, contouring and resection of
oral osseous tissues (bone)
• Osteotomy
LASER PERIODONTAL PROCEDURES
• Full thickness ap
• Partial thickness ap
• Split thickness ap
• Laser soft-tissue curettage
• Laser removal of diseased, infected,
inamed and necrosed soft-tissue within the
periodontal pocket
• Removal of highly inamed edematous tissue
affected by bacteria penetration of the pocket
lining junctional epithelium
• Removal of granulation tissue from bony
defects
• Sulcular debridement (removal of diseased,
infected, inamed or necrosed soft-tissue
in the periodontal pocket to improve clinical
indices including gingival index, gingival
bleeding index, probe depth, attachment loss
and tooth mobility)
• Osteoplasty and osseous recontouring
(removal of bone to correct osseous defects
and create physiologic osseous contours)
• Ostectomy (resection of bone to restore bony
architecture, resection of bone for grafting, etc.)
NOTE: Any tissue growth (i.e., cyst, neoplasm or other lesions) must be submitted to a
qualied laboratory for histopathological evaluation.
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WaterLase iPlus User Manual
2 Indications for Use
LASER PERIODONTAL
PROCEDURES
• Osseous crown lengthening
• WaterLase Er,Cr:YSGG assisted new
attachment procedure (cementum-mediated
periodontal ligament new-attachment to the
root surface in the absence of long junctional
epithelium).
• Removal of subgingival calculi in periodontal
pockets with periodontitis by closed or open
curettage.
(CONTINUED)
SOFT-TISSUE INDICATIONS
INCLUDING PULPAL TISSUES*
• Incision, excision, vaporization, ablation and
coagulation of oral soft-tissues, including:
• Excisional and incisional biopsies
• Exposure of unerupted teeth
• Fibroma removal
• Leukoplakia
• Operculectomy
• Oral papillectomies
• Pulpotomy
• Pulp extirpation
• Pulpotomy as an adjunct to root canal therapy
• Root canal debridement and cleaning
• Reduction of gingival hypertrophy
• Removal of pathological tissues (i.e., cysts,
neoplasm or abscess) and hyperplastic
tissues (i.e., granulation tissue) from around
the apex
• Soft-tissue crown lengthening
• Treatment of canker sores, herpetic and
aphthous ulcers of the oral mucosa
• Vestibuloplasty
* For use on adult and pediatric patients
• Flap preparation – incision of soft-tissue to
prepare a ap and expose the bone.
• Flap preparation – incision of hard- and soft-
tissue to prepare a ap and expose unerupted
teeth (soft-tissue impactions).
• Frenectomy and frenotomy
• Gingival troughing for crown impressions
• Gingivectomy
• Gingivoplasty
• Gingival incision and excision
• Hemostasis
• Implant recovery
• Incision and drainage of abscesses
• Laser soft-tissue curettage of the postextraction tooth sockets and the periapical
area during apical surgery
ROOT CANAL DISINFECTION
• Laser root canal disinfection after endodontic
instrumentation.
WaterLase iPlus User Manual
9
3 Equipment Description
SYSTEM PARTS LIST
The WaterLase iPlus laser systems include the following*:
• WaterLase iPlus Laser
• Display Covers (qty. 25)
• Trunk Fiber and Fiber support
• Yellow Air Tube
• Protective Laser Eyewear (3)
• (2) Handpieces
• Tip Starter Kit
• Tip Holder
*Additional accessories, including Handpieces and Tips, ordered separately.
• Tip Cleaning Kit
• Power cord, (1) US,
(1) International
• Footswitch
• User Manual
• Laser Warning sign
• Product Registration Card
• Limited Warranty
GENERAL
The WaterLase iPlus dental laser system consists of two modules:
• Main Laser Console (shown in Figures 3.1, 3.2, and 3.3)
• WaterLase iPlus Fiber Delivery System (the Delivery System, shown in Figures 3.1, 3.2, and 3.3,
consists of the Fiber Cable, Handpiece, and Tips)
MAIN LASER CONSOLE ELEMENTS
Figures 3.1, 3.2, and 3.3 show the front, rear and top views of the laser console.
CONTROL PANEL
The main laser console is controlled through a touch screen control panel. See section 8, Operating
Instructions, for details and instructions.
Safety Features
All control functions accessed through the Control Panel are located at a safe distance from the
energy output.
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WaterLase iPlus User Manual
3 Equipment Description
ENERGY MONITOR
The energy monitor measures and veries power output.
Safety Features
Power deviations of more than 20% from the selected value will cause the display to show an error
message; thelaser console will not operate until the system is reset by pressing the “Next” arrow
at the top of the touch screen. If the error message persists, please contact BIOLASE Service or the
authorized BIOLASE representative.
FRONT AND BACK HANDLES
Use the front and back handles to move and/or lift the laser console when necessary.
CAUTION: Prior to lifting, make sure the handles are not damaged.
DO NOT use the Fiber Cable to pull the laser console; this could
damage the Fiber Cable and render the laser inoperable.
LOCKING WHEELS
Allow easy transport of the laser from operatory to operatory. Press down on the front tabs on the wheels
to lock the console. Lift up the tabs to release the locking mechanism.
EMERGENCY STOP
The red button located on the front panel of the laser console, instantly turns off the laser when pressed.
Safety Features
The button will glow red to indicate an emergency stop, and the control panel will display an error
message; press the button again to restart the system. The system will be in Standby mode when
turned back on, even if it was in Ready mode at the time the Emergency Stop was activated. Push
the Ready button before using the system.
KEYSWITCH
Use to switch the laser system ON by turning the key to the horizontal position; always use only the key
provided. The key cannot be removed while it is in the ON position. Always remove the key when the laser
is left unattended.
WaterLase iPlus User Manual
11
3 Equipment Description
FOOTSWITCH, FOOTSWITCH CONNECTOR
The Footswitch activates the laser; the WaterLase iPlus laser will not activate until the user presses down
on the Footswitch. Connect and secure the Footswitch to the Footswitch connector located on the back
panel of the console.
Safety Features
A protective cover prevents unintentional pressing of the Footswitch. The protective cover can be
opened or closed by pressing it from the top.
REMOTE INTERLOCK OUTLET
Each laser has a remote plug and connector on its rear panel that enables the laser to be connected to the
remote sensor. Customers may request that the remote interlock be connected to a door switch.
Safety Features
The Safety Features turn the laser OFF when a user-provided remote switch (e.g., on the entrance
door) is triggered, protecting anyone entering the operatory while the laser is in use from inadvertent
exposure to laser radiation. To use it properly requires a normally closed pair of contacts to be
connected to pins 1 and 5 of the connector. These contacts should have no voltage associated with
them and should open on activation.
POWER CONNECTION / CIRCUIT BREAKER
Located on the back panel, allows the power cord to be attached to the laser console. The circuit breaker
serves as a line switch to separate the laser console from the main power supply (0 = OFF, 1 = ON). The
power cable can be wrapped over the holding plate above the connector when the system is not in use or
when it is being transported.
VENTILATION CHANNELS
These provide an air
ow
path to cool the system; do not cover or block.
AIR INLET CONNECTOR
Connects the laser to a compressed dry air outlet at 80-120 psi (5.5 - 8.2 bar) using the tubing provided.
SELF-CONTAINED WATER BOTTLE
Located on the rear of the laser, this detachable bottle provides the water supply for Handpiece atomization spray. Fill the self-contained water bottle with only distilled or de-ionized water. DO NOT USE TAP OR
FILTERED WATER, which can leave deposits that may damage the ber cable or Handpiece.
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WaterLase iPlus User Manual
3 Equipment Description
WATER BOTTLE RELEASE
A push button release on the top of the self-contained water bottle that allows its removal from the console
for relling.
FOOTSWITCH SUPPORT BRACKET
This bracket on the rear bottom of the laser console is designed to hold the closed Footswitch clamshell
when storing or moving the laser system. Wrap the Footswitch cable around the wrap plate above the
bracket.
Telescopic Fiber
Support Arm
Handpiece
Emergency
Stop Switch
Locking Wheels
(front only)
Fiber Delivery
System
Touch Screen
Control Panel
Front
Handle
Self-contained
Water System
Remote
Interlock Outlet
Footswitch Cable
Wrap Plate
Power Cable
Wrap Plate
Footswitch
Support Bracket
Fig 3.1 Fig 3.2
Back Handle
Ventilation
Back Panel
Keyswitch
Power
Connection &
Circuit Breaker
Ground Pin
Footswitch
Connector
Air Inlet
Connector
WaterLase iPlus User Manual
13
3 Equipment Description
TELESCOPIC FIBER CABLE SUPPORT ARM
Located at the top of the laser console, it supports the Delivery System (Fiber Cable), and extends to bear
its weight when the Handpiece is pulled forward; extension releases when the Handpiece is let go and the
arm is in a vertical position.
NOTE: Proper placement of the Delivery System Cable in the Support
Arm and of the Handpiece in the Handpiece holder is important for
the convenient and safe handling of the delivery system.
WATERLASE IPLUS DELIVERY SYSTEM
(See Section 4 for detailed description and instructions)
Fiber Delivery System
Back Handle
Water Bottle Cover
Water Bottle Release Push Button
iLase Spare Battery Charging Port
Touch Screen Control panel
Handpiece
Front Handle
14
Fig 3.3
WaterLase iPlus User Manual
3 Equipment Description
DELIVERY SYSTEM CONNECTION ON THE LASER CONSOLE
The delivery system attaches to the top of the console via a multi-connector that incorporates air, water,
cooling air, illumination waveguides, and the optical energy Fiber Cable.
HANDPIECE HOLDER
Cradles the Handpiece when it is not in use.
FIBER CABLE
A component of the delivery system: contains the optical Fiber Cable, together with the illumination
waveguides, air tubing, and water tubing. Delivers laser radiation from the laser console to the
Handpiece.
HANDPIECE
The Handpiece is rotatable and detachable from the optical shaft. It delivers optical energy, illumination,
and atomized water spray to the treatment area.
WaterLase iPlus User Manual
15
4 Specications
DIMENSIONS (W X L X H)
• Laser Console 11 x 19 x 33 in (28 x 48 x 84cm)
• Laser Console with Fiber Cable 11 x 19 x 40 in (28 x 48 x 102 cm)
• Weight 75 lbs. (34 kg)
ELECTRICAL
• Class I Medical Electrical (ME) Equipment
• Operating Voltage: 100 VAC ± 10% / 230VAC ± 10%
• Frequency: 50 / 60 Hz
• Current rating: 5A / 8A
• Main control: Circuit breaker
• On / Off control: Keyswitch
• Remote interruption: Remote interlock connector
AIR AND WATER OUTPUT
• Water type: Distilled or De-Ionized only
• External air source: 80 - 120 psi. (5.5 - 8.2 bar
• Water: 0 - 100%
• Air: 0 - 100%
• Interaction zone: 0.5 - 5.0 mm from Handpiece Tip to target
OPTICAL
• Laser classication: 4
• Medium: Er,Cr:YSGG
• Wavelength: 2.78 µm (2780nm)
• Frequency: 5 – 100 Hz
• Average power: 0.1 – 10.0 W
• Power accuracy: ± 20%
• Pulse energy: 0 – 600 mJ
• Pulse duration for “H” mode: 60 µs
• Pulse duration “S” mode: 700 µs
• Handpiece head angles: 70° contra-angle
• Gold HP Tip diameter range: 200 – 1200 µm
• Turbo Tip focal diameter range: 500-1100 µm
• Output divergence: ≥ 8° per side
• Mode: Multimode
• Aiming Beam: 635nm (red) laser, 1mW max (safety classication 1)*
• Water Level Sensor Beam: 635nm laser, 1mW max (safety classication 1)
• Nominal Ocular Hazard Distance (NOHD): 5cm
• Maximum Permissible Exposure (MPE): 3.5 x 105 W/m2
(Erbium, Chromium:Yttrium, Scandium,Gallium, Garnet)
16
WaterLase iPlus User Manual
5 Contraindications, Warnings, and Precautions
CONTRAINDICATIONS
All clinical procedures performed with the WaterLase
and care as with traditional techniques. Patient risk must always be considered and fully under stood
before clinical treatment. The clinician must completely understand the patient’s medical history prior to
treatment. Exercise caution for general medical conditions which might contraindicate a local procedure.
Such conditions may include, but are not limited to, allergy to local or topical anesthetics, heart disease
(e.g. pacemakers, implantable defribulators), lung disease, bleeding disorders, or an immune system
ciency.
Medical clearance from the patient’s physician is advisable when doubt exists regarding treatment.
iPlus
must be subjected to the same clinical judgment
de-
WARNINGS AND PRECAUTIONS
PRESCRIPTION STATEMENT
Federal Law restricts this device to sale by or on the order of a dentist or physician or other licensed
medical practitioner.
EYEWEAR
When using the WaterLase all-tissue laser system, doctor, patient, assistant, and all others insie
or entering the operatory must always wear appropriate laser protection eyewear for the 2780nm
wavelength, OD3 or greater (OD 3+). Refer to the OD specication imprinted on the glasses.
TRAINING
Only licensed professionals who have reviewed and understood this user manual, and have been
trained on how to correctly operate the system should use this device. Surgical procedures related to
soft-tissue, osseous, endodontic, or periodontal surgery should only be performed by clinicians who
have training and experience in Oral Maxillofacial, Periodontal, or Endodontic Surgery.
ANESTHESIA
Although in most cases anesthesia may not be required, patients should be closely monitored for
signs of pain or discomfort. If such signs are present, adjust settings, apply anesthesia or cease
treatment, if required.
TREATMENT, TECHNIQUE AND SETTINGS
Only licensed professionals who have reviewed and understood this user manual should use this device.
Always start treatment at the lowest power setting for the specic tissue and increase as required.
Observe clinical effects and use judgment to determine the aspects of the treatment (technique, proper
power, pulse mode, air and water settings, tip type and duration of operation) and make appropriate
power, air and water adjustments to compensate for varying tissue composition, density and thickness.
WaterLase iPlus User Manual
17
5 Contraindications, Warnings, and Precautions
HARD-TISSUE PROCEDURES
All hard-tissue (i.e. enamel, dentin, cementum and bone) procedures must be performed using air and
water spray at appropriate settings. Failure to use the spray will result in tissue thermal damage. The
long pulse settings (700 µs) are indicated only for soft-tissue applications. Do not use long pulse settings
to perform hard-tissue procedures.
SOFT-TISSUE PROCEDURES
Soft-tissue procedures can be performed using two pulse duration settings: (H) short pulse (60 µs) and
(S) long pulse (700 µs). However, the long pulse (S) range is indicated ONLY for soft-tissue applications.
CURETTAGE PROCEDURES
Exercise extreme caution when using this device in areas where critical structures (i.e., nerves and
vessels) could be damaged, such as in the apical third of the 3rd molar socket. Do not proceed with
using the laser if visibility is limited in these areas.
FLUID ENTRAPMENT AND AIR EMBOLISM
Do not direct air or spray toward tissues that may trap air or water. For example, when performing
surgical procedures, the clinician should be aware of adjacent soft-tissue pockets, cavities, or channels
that may collect or entrap air. Always use high-speed suction to remove any excess uid and avoid
directing the spray into deep pockets, cavities or channels such as the crevice resulting from the
extraction of a molar. Also, for example, avoid working through soft-tissues adjacent to the roots
of molars, especially the third inferior molars, which communicate directly with the sublingual and
submandibular spaces. Do not use the WaterLase iPlus if it is not possible to access the treatment
site without directing air into an area that may collect or entrap air. In general, the same care and
precautions should be taken when using the WaterLase iPlus as are taken when using any air and water
emitting cutting device, including the high speed drill.
ROOT CANAL PROCEDURES
The WaterLase iPlus is better suited for straight and slightly curved canals. Great care should be taken
during instrumentation of curved canals as the endodontic Fiber Tip may break or perforate through the
wall of these types of canals. If during insertion the Fiber Tip does not advance easily into the canal, do
not force the Fiber Tip inside. If necessary, pull the Fiber Tip out and use an endodontic hand le or a
broach to open the path. Do not force the Fiber Tip and/or activate the laser while moving the Fiber Tip
inside a narrow or curved canal, or through the apex. Place the end of the Fiber Tip ~2mm from the
apex or from being in contact with the wall of a curved canal. Activate the laser and spray only during
the outward stroke when the Fiber Tip is pulled towards the coronal portion of the canal.
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WaterLase iPlus User Manual
5 Contraindications, Warnings, and Precautions
ROOT CANAL DISINFECTION PROCEDURES
The same precautions and warnings stated above are applicable to root canal disinfection procedures.
The Fiber Tips designed for this indication are the radial emitting RFT2 and RFT3, which have a 200µm
and a 300µm diameter, respectively, and come in various lengths to accommodate different root canal
lengths. Effective laser root canal disinfection is performed with air and no water spray. Do not exceed
the maximum air setting for this procedure (10%).
ADJACENT STRUCTURES
WaterLase iPlus can remove both hard- and soft-tissues. Therefore, always be aware of adjacent
structures and substructures during treatments. Be extremely careful not to inadvertently penetrate
or ablate through the apex, the root canal wall, or underlying/adjacent tissues. Also, be aware and
use extreme caution working on tissue (i.e., bone, root apex, etc.) adjacent to the following structures:
maxillary sinus, mental foramen and mandibular canal, or any other major anatomical structures
(i.e., nerves). Exercise extreme caution when using this device in areas such as pockets, cavities, or
channels, where critical structures (i.e. nerves, vessels) could be damaged. Do not proceed with using
the laser if visibility is limited in these areas.
CLINICAL CONDITIONS
Use a sterile eld and aseptic technique with all procedures, especially for surgical interventions.
TISSUE EVALUATION
Any tissue growth (i.e. cyst, neoplasm and other lesions), whether removed with WaterLase iPlus or
conventionally, must be submitted to a qualied laboratory for histopathology assessment.
TISSUE CONTACT AND TIP BREAKAGE
Do not contact hard-tissues with the Fiber Tip. Hard-tissue cutting occurs in non-contact mode with the
Tip ~0.5 mm to 3 mm off the surface (3 to 5 mm for Turbo Handpiece). Tips are very brittle and fragile,
and could break if pressed against tooth or bone tissues or if forced through a narrow or curved path or
root canal. Use a bite block to prevent breakage or swallowing of the Tip from biting. High-speed suction
is required to remove any excess uid and materials resulting from accidental Tip breakage.
TIP CHANGING
Failure to correctly replace the Tip could result in damage to the Fiber Tip, Handpiece, or affect the
emission of laser energy around the Tip. A careful review of the instructions on how to replace the Tip is
recommended.
WaterLase iPlus User Manual
19
5 Contraindications, Warnings, and Precautions
WATER SPLASHING
Water from spray may splash during treatment. Use protective eyewear and/or a face shield to protect
from splashing. Use high-speed suction, as needed, to maintain a clear eld of vision during treatment.
Do not use the WaterLase iPlus if the user cannot clearly see the treatment site.
PLUME REMOVAL
Laser plume may contain viable tissue particulates. Special care must be taken to prevent infection from
the laser plume generated by vaporization of virally or bacterially infected tissue during procedures done
with the laser and minimal or no water spray. Ensure that all appropriate protective equipment (including
high-speed suction to remove the plume, appropriate masks, and other protective equipment) is used at
all times during procedures with this laser device.
DENTAL MATERIALS
Do not direct laser energy towards amalgam, gold, or other metallic surfaces. Do not direct energy
towards dental cements or other similar lling materials. Doing so may damage the WaterLase iPlus Tip
and delivery system.
20
WaterLase iPlus User Manual
6 Safety with the WaterLase
PRECAUTIONS
Failure to comply with these precautions and warnings may lead to exposure to dangerous voltage levels
or optical radiation sources. Please comply with all safety instructions and warnings.
CAUTION: Use of controls or adjustments or performance of
procedures other than those specied in this user manual may
result in hazardous radiation exposure.
DANGER: Invisible and/or visible laser radiation when the laser is
red. Avoid eye or skin exposure to direct or scattered radiation.
Class IV.
CAUTION: This laser system has been designed and tested to
meet or exceed the requirements of severe electromagnetic,
electrostatic and radio frequency interference testing. However, the
possibility of electromagnetic or other interference may still exist.
DANGER: Do not use this laser system in any manner other than
described in this user manual. Do not use the laser system if it is
suspected as functioning improperly.
SAFETY INSTRUCTIONS
Follow these safety instructions before and during treatments:
1. Remove or cover all highly reective items in the treatment area, if possible.
2. Do not operate in the presence of explosive or ammable materials.
3. All persons present in the operatory must wear protective eyewear suitable for blocking 940nm
(if using the iPlus in conjunction with 2,780nm energy (multi-wavelength glasses supplied by
BIOLASE, Inc.).
4. Do not look directly into the beam or at specular reections.
5. Direct the cutting spray toward targeted tissues only.
CAUTION: Periodically inspect eyewear for pitting and cracking.
For replacement or additional protective eyewear, please
contact BIOLASE Customer Service or the authorized BIOLASE
representative.
6. Press the Standby button on the control panel before changing the water in the reservoir and
before turning off the laser system.
WaterLase iPlus User Manual
21
6 Safety with the WaterLase
7. Move the circuit breaker to the OFF (0) position (located on the rear panel) and remove the key
before leaving the laser console unattended.
8. All operatory entrances must be marked with an approved warning sign (provided) indicating a
laser is in use.
9. Take special care to contain the laser plume (particles produced by the vaporization of virally
or bacterially infected tissue during procedures utilizing the laser and minimal or no water
spray); ensure that all appropriate protective equipment (including high-speed suction to remove
the plume, appropriate masks, and other protective equipment) is used at all times during the
procedure.
DANGER: DO NOT open system side doors. These are to be
used by authorized service personnel only. Danger from radiation
exposure and high voltage may exist.
NOTE: Please direct any safety questions to the local BIOLASE
representative, or call BIOLASE at (888) 424-6527, or BIOLASE
Service at (800) 321-6717 (US only).
SAFETY CLASSIFICATION
The following safety classications are applicable to this device:
• Laser Radiation - Class 4
• Aiming Beam - Class 1
• Type of protection against electrical shock - Type BF Applied Part: Laser Handpiece
• Not protected against water ingress - Ordinary Equipment
• Main Laser Console - IPX0
• Footswitch - IPX8
• Not suitable for use in the presence of ammable anesthetic
• Not suitable for use in oxygen-rich environments
• Operation Mode - Non-continuous with duty cycle of max 2 minutes ON, min 30 seconds OFF at
maximum power output
CAUTION: High temperatures produced in the normal use of
this laser equipment may ignite some materials (e.g., cotton wool
when saturated with oxygen); solvents of adhesive and ammable
solutions used for cleaning and disinfecting should be allowed to
evaporate before the laser equipment is used.
22
WaterLase iPlus User Manual
7 Installation
INSTALLATION INSTRUCTIONS
The WaterLase iPlus laser system must be installed by a qualied BIOLASE employee or representative
who will unpack and install the laser. Please leave all crates and shipping containers unopened until the
trained representative arrives. Complete installation, testing, and demonstration require approximately
one full day.
Please contact the representative before transporting the laser system to a different location.
Misalignment of optical components may occur during transportation if the laser is not properly packaged.
FACILITY REQUIREMENTS
ELECTRICAL SUPPLY: 100 VAC @ 15.0 Amps to 230 VAC @ 8.0 Amps, 50/60 Hz
NOTE: The main power supply of the iPlus laser system has an
isolation transformer that complies with a Transient Voltage of 4kV.
COMPRESSED AIR SUPPLY: 80 - 120 psi (5.5 - 8.2 bar)
CAUTION: Moisture in the air supply line may damage the laser
system. Please provide proper ltration to eliminate all moisture
from the air source.
ENVIRONMENTAL REQUIREMENTS
TEMPERATURE: 15 - 30 °C HUMIDITY: 20% - 80%, non-condensing
AIR SUPPLY: Connections for an air supply must be available in each operatory. Attach an air hose
with 1/4” inside diameter male quick connectors on each end between the air inlet connector and the
operatory air source.
CAUTION: Prior to connection, verify that the outlet is for the
air, NOT the water supply. Connection to the water supply may
cause damage to the WaterLase iPlus system. If the laser console
is connected to the water supply, DO NOT turn the system on;
contact the service representative.
CAUTION: DO NOT position this equipment so that it is difcult to
pull the plug from the power source.
WARNING: To avoid the risk of electric shock, this equipment must
only be connected to a supply mains with protective earth.
WaterLase iPlus User Manual
23
7 Installation
SET-UP REQUIREMENTS
CONNECTING THE LASER CONSOLE TO THE OPERATORY
1. Verify the circuit breaker is in the OFF position.
2. Verify the keyswitch is in the OFF position.
3. Connect the power cord to the rear of the laser console (Fig 3.2).
4. Verify a minimum air pressure of 80 psi (5.5 bar) is emitted from the air
supply.
5. Check the air supply for moisture.
6. Connect the air supply to the laser console’s air inlet connector at the
rear of the console (Fig 3.2).
Fi g 7.1
CAUTION: Do not connect the operatory air supply to the laser
console if water or oil is present. The air compressor may need to
be drained or cleaned and air lters installed if moisture appears.
Wet air will damage the laser system. Check the air supply weekly
to verify the absence of water and oil.
FILLING THE INTERNAL COOLING WATER RESERVOIR
The WaterLase iPlus may have been shipped with a full cooling water
reservoir. In the event the user needs to ll the reservoir, please follow the
instructions below.
1. Open the back panel door by turning two thumb screws counter
clockwise and pull back gently (Fig 7.1).
WARNING: Be careful when opening the door. Make sure it
opens easily and clears the lid and tubing of the bottle. The
bracket holding the door is mounted at the bottom hinge. Do not
apply excessive force!
Fi g 7. 2
Fi g 7. 3
Fi g 7. 4
2. Locate the internal water reservoir and verify that the white clip on the
blue tube connected to the side of the water reservoir is closed.
3. Push the button on the top connector and disconnect the tubing from the
lid (Fig 7.2).
4. Remove the lid and
24
lter
assembly (Fig 7.3, 7.4).
WaterLase iPlus User Manual
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