3.0 Safety Considerations- Before Using Your Laser6
3.0.1 In-Ofce Safety Issues6
3.0.2 Laser Safety Program and
Continuing Education
3.0.3 Food and Drug Administration7
3.0.4 OSHA and its Provisions8
3.0.5 Statutory Licensure8
3.0.6 Wireless Technology8
3.0.7 Precise® LTM Laser Frequency8
3.0.8 ANSI Standards8
3.1 Startup and System Check8
3.1.1 Selecting the Treatment Center8
3.1.2 Checking the Foot Pedal Installation8
3.1.3 Checking the Key Activation and
Control Panel Display
3.1.4 Checking the Laser Stop Button9
3.1.5 Checking the Disposable Fiber Cartridge9
3.1.6 Setting Modes9
3.1.7 Setting Power9
3.1.8 Setting Aiming Beam9
3.1.9 Programming your Precise® LTM9
3.2 Operating Your Laser9
3.2.1 Before Beginning Procedures9
3.2.2 During Procedures9
3.2.3 After Each Procedure10
Section 4: Preparation, Care, and Maintenance10
4.0 Disposable Fiber Cartridge10
4.0.1 Replacing the Fiber Cartridge10
4.0.2 Fiber Preparation10
4.0.3 Jacket10
4.0.4 Cladding11
4.0.5 Quartz/Silica Fiber11
4.0.6 Stripping the Fiber11
4.0.7 Cleaving the Fiber11
4.0.8 Initiating the Fiber11
4.0.9 Fiber Disinfection11
4.1 Laser Maintenance12
4.1.1 Exterior (Chassis) Laser Disinfection12
4.1.2 Calibration12
4.1.3 Handpiece Preparation12
4.1.4 Disposable Tips12
Section 5: Labels, Signs, Warnings, and Information
5.0 Federal Compliance
7
9
5.1 Danger - Laser in Use Signage
5.2 Laser Classications
5.3 Cautions
5.4 Nominal Ocular Hazard Distance (NOHD)
Section 6: Servicing
6.0 Limited Warranty15
6.1 Repairs & Returns15
Section 7: Troubleshooting15
Section 8: Electromagnetic Compatibility16
Section 9: Laser Specications18
Section 10: Glossary of Laser Terminology19
Section 11: References on Laser Dentistry19
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13
13
13
13
14
15
2
SECTION 1: INTRODUCTION
Thank you for purchasing the Precise® LTM 5 Watt Soft Tissue Diode
Laser. CAO Group (CAO) has been manufacturing diode lasers
for over a decade and we are proud of our record of quality,
performance, and safety. Today, the diode laser has become the
standard of care in addressing the common soft tissue concerns
dental professionals must address every day. Precise diode lasers
treat soft-tissue to create beautiful radiant smiles. Dental visits
are easier, faster, and better, by the quick and safe control of
bleeding, creation of room for impression material, relieve pain
or discomfort of aphthous ulcers, and a wide range of other
procedures.
The Precise LTM Diode laser may reduce procedure time and
potentially simplify performance of some treatments. Patients
are more comfortable and tissue heals quickly compared to
other common methods (e.g., scalpel, electrosurge). With well
over a decade of laser manufacturing experience, practitioner
and patient reports, we are condent that you too can achieve
these same benets.
As with any new tool or technique it is vital to take the time to learn
how to properly use it. To shorten the learning curve and support
you in becoming a Precise diode laser practitioner we provide
the following training tools at no charge.
•
Online quick-start videos found on our website at
www.preciselasers.com. These videos are a fast way to get
set-up and review a few common procedures. It is recommended
to practice on hot dogs or tomatoes before attempting any
procedures on patients.
•
One full online training course including 8 continuing education
credits is included with the purchase of each Precise laser. This
comprehensive course provides everything needed to start on the
road to becoming a laser enthusiast who is constantly scoping out
new opportunities to use new skills that improve ease of procedures
and patient outcomes. Additional courses are available to
additional users at a reduced price to Precise Laser owners.
•
When available a sales professional may conduct an in-ofce
hands-on review of basic usage of the Precise LTM. For any
technique or procedure questions please call Customer Care
who may be able to refer further training.
REMINDER
Always test re the laser outside the mouth before using it on a patient. The
doctor or hygenist, the patient, and any staff member present in the operatory
should be wearing the appropirate safety eyewear whenever the laser is being
operated. Strict adherance to protocols for safe laser use is essential.
3
SECTION 2: BEFORE OPERATING YOUR LASER
2.0 CONTENTS
The contents of the shipping container should include
the following:
Precise LTM Complete Kit
(1)Precise® LTM Unit
(1)20’ Fiber Cartridge
(1)Fiber Stripper Tool
(1)Fiber Cleaver
Package of (20) Disposable Handpiece
(1)
Tips- Straight
Package of (20) Disposable Handpiece
(2)
Tips- 60°
(2)Handpiece- Autoclavable
(1)Laser Key
(1)Wireless Foot Pedal
(1)9 Volt Lithium Battery
(1)Power Supply
(1)Power Cord
(3)Protective Glasses
(1)Precise LTM Operator’s Manual
(1)Precise LTM Chairside Guide
(1)Danger - Laser in Use Signage
(1)Procedure Guide
a
b
c
d
2.1 REMOVING THE LASER FROM THE PACKAGING
Please do not attempt to unpack the laser and install the various
components without reading this section rst. If you are unsure
about any aspect of the assembly, contact customer care at
(877) 236-4408 or customercare@caogroup.com for assistance.
It is highly recommended to retain the box the laser arrived in. It
has been designed specically to transport the laser and may be
useful should repairs become necessary in the future.
LASER ASSEMBLY INSTRUCTIONS SUMMARY
1. Attach the laser’s power cord and place the plug into the
wall receptacle.
2. Install foot pedal battery. (See Section 2.2.3)
3. Attach remote interlock, if desired (not required).
4. Check the laser stop button to see that is has been
pressed.
5. Turn on the power switch on the back of the unit.
NOTE: When the power cord is plugged in, the power
switch is turned on, and the laser stop is released, the key
will turn the unit on.
6. Place the key into the key switch receptacle and turn the
key to the right (clockwise). The control console should
light up.
2.1.1 TRANSPORTATION
Precise® lasers are susceptible to misalignment if not handled
properly. The unit should ALWAYS be handled carefully and never
banged, jarred, jolted, dropped, or hit. Do not transport the laser
unless it is completely packaged inside of the box it arrived in.
Failure to properly package the laser can result in damage to the
laser and accessories. When transporting or shipping your laser you
must always disconnect the keys, the AC Power Adapter and ber
from the laser. If you have any questions regarding transportation,
please call your authorized representative or CAO Group, Inc.
4
2
1
3
7
5
7
PROGRAM
KEY
5
AIMING
BEAM
Figu re 1
Figu re 3
6
6
POWER
INCREASE
6
POWER
INCREASE
FIBER
9
8
FIBER
RETRACT
EXTEND
3 & 4
2
READY
KEY
MODE
KEY
The aiming beam control allows for ve (5)
levels of intensity of the aiming beam. Each
bar represents 20% of maximum intensity.
Zero (0) bars indicates the aming beam is
shut off.
6. Working Beam Setting
Indicates the working beam power output
setting. Use the Power Increase or Decrease
key to adjust power settings from 0.5 to 5.0
Watts. Press and hold the desired key to
rapidly change the value.
7. Progam Setting Indicator
Indicates current program mode selected.
Program key will cycle through programs in
a clockwise direction (1-4).
8. Fiber Extend
Press and hold to extend the ber from the
cartridge.
9. Fiber Retract
Press and hold to retract the ber into the
cartridge.
f
j
e
LED DISPLAY AND CONTROL PANEL
1. Laser on Indicator
Illuminates when the foot pedal is depressed.
Indicates that the working beam energy is
g
h
Figu re 2
a. LASER STOP
b. FIBER APERTURE
c. LED DISPLAY
d. KEY SWITCH
e. CONTROL PANEL
f. MAGNETIC HANDPIECE HOLDER
g. POWER/FAN SWITCH
h. REMOTE INTERLOCK CONNECTOR
i. POWER SUPPLY RECEPTACLE
j. WARNING LOGOTYPES
4
i
emitted.
2. Ready Indicator
Illuminates when READY key is pressed. It
will blink for three (3) seconds, then remain
steady. Once it is steady on, the aming
beam can be activated.
3. Continuous Mode
Illuminates when the unit is in Continuous
Mode.
4. Pulse Mode
Illuminates when the unit is in Pulse Mode.
5. Adjustable Aiming Beam
The Precise LTM is actually two lasers in one,
the infrared laser which performs the actual
treatment and a second “laser pointer”
which illuminates red and allows the user to
view where the working beam is directed..
Each of the following items should be inspected, inserted into the
appropriate receptacle, and when applicable, locked using the
locking hub.
2.2.1 Power Cord Installation
Remove the AC adapter and the AC power cord. Push or plug
the power cord rmly into the adapter. Plug the small adapter
cord into the appropriate receptacle on the back of the laser. AC
adapter cord may not be ush when plugged in. When resistance
is met stop insertion. To prevent power surges due to electrical
storms or spikes in line voltage, we recommend that you use a
power strip with a surge suppressor or unplug the laser when you
are not present. Plug the power cord into a 110 Volt AC outlet
rated at 60 Hz. Be sure to position the equipment such that you
can quickly access and disconnect the power cord connection
from the back of the unit if the need arises.
1. Insert a Philips-head
screwdriver into one of
the screw holding down
the battery cover and
twist counter-clockwise
until the screw is fully
removed. Repeat with
the remaining screw.
2. Push down on one
end of the battery cover
while simultaneously lifting
up on the other end to
remove it.
3. Locate the battery
terminal inside the well
and gently pull the
terminal out. Do not pull
excessively on the wires.
2.2.2 Power/Fan Switch and Key Switch
The Power/Fan Switch for the laser and fan is the rst item you turn
on each day. The switch is located on the rear panel of the laser
near the lower left hand corner. The Key Switch is the major circuit
breaker for your laser. It will be the second item you turn on when
activating the laser each day. Place the laser key into the key
receptacle located near the right-hand side on the front of the
laser. (See Figure 4) Check the key switch by pushing in and turning
the key clockwise, approximately 1/4 of a turn. This is the (ON)
operating position for the key. The fan will start when the power/
fan switch is on and the key is turned. Prior to leaving the ofce,
the laser safety ofcer should check to see that the key switch has
been turned off and the key removed and stored.
2.2.4 Disposable Fiber Cartridge Replacement
A tamper sticker is in place on the ber cartridge. Do not
remove ber cartridge without contacting Customer Care
rst (877-236-4408). Warranty may be voided. After cleared
for removal by Customer Care, read directions thoroughly
before beginning.
Figu re 4 - OFF Pos itio nFigure 5 - ON Po sition
Precise® LTM Remote Interlock
The Precise LTM laser is equipped with a Remote Interlock Jack.
The Remote Interlock Jack is provided so that a clinician may install
the laser in a dedicated laser treatment room such that the laser
will be interlocked with the entrance door of the room. In such
an interlocked installation, the laser would shut off anytime the
door is opened, hypothetically, to protect the person’s eyes who
is entering the room. It is recognized that such installment is not
facilitated nor required in many operatories or clinics. To that end,
1. Turn system off.
Remove the ber from the
handpiece and fully retract
ber into the cartridge.
Place unit upside down
on a hard surface.
the Remote Interlock is available to any practitioner that requires
it. The Remote Interlock Jack is located and clearly labeled on the
rear of the laser. The miniphono jack is wired in the normally closed
position; meaning that no further action is required to operate the
laser without the interlock loop. If the interlock loop is desired you
may purchase the loop from a local electronics store. You need
only to inform the local electronics store that you require a mini
(1/8”) phono jack wired into a normally open momentary switch
and select the switch design that best suits your needs. To install the
loop, install the switch on the door and simply plug the miniphono
jack into the Remote Interlock Jack on the rear of the laser.
4. Remove the 9 volt
lithium battery from its
packaging and attach
the battery to the
terminal.
Note A:
Only use 9 Volt Lithium
batteries; alkaline
batteries are insufcient.
Keep an extra 9
volt Lithium battery.
Replacement will be
required roughly every
100 hours of use.
2. Slide ber cartridge out
and gently place on hard
surface next to the unit.
5. Place the battery in the
well with the connector to
the same side as where
the wire leads emerge
from the housing.
Note B:
Make sure the laser is
completely turned off
before replacing the
battery in the foot pedal.
3. Unscrew the empty
cartridge connector
counterclockwise and
pull straight out. Discard
the empty cartridge.
Continued on next page →
6. Replace the battery
cover and replace the
two screws. Tighten
the screws clockwise.
Be careful not to over
tighten. Let foot pedal
rest at least 1 minute
before use.
Note C:
Place the pedal face
down on a hard clean
surface.
5
3. Place the new cartridge
on its side in place of the
empty cartridge. Carefully
remove the dust cap. Do
NOT touch the end of the
connector. Grasp the
metal ring at the base of
the coupling to stabilize
and prevent breakage.
7. Slowly push the cartridge
into the bay until the
outside surface is ush with
the side of the unit. Make
sure the optical ber coil
retracts inside the cartridge
as it is gently slid into place.
4. Gently push the coupling
into the connection while
maintaining your grasp on
the metal ring. Continue
to hold the metal right.
Push the spring loaded
coupling into place and
twist clockwise until locked
into place.
8. Turn on the power to
the laser system. Press
the Extend and Retract
buttons to ensure the
ber is moving properly.
If it does not, gently push
the cartridge into the bay
further.
6. Position the cartridge to
line up with the guide tabs
on the side of the bay.
9. Don’t look directly at the
aiming beam! Make sure
the aiming beam indicator
is at a value other than
zero (0), and then press
the Ready button. DO
NOT press the foot pedal.
The aiming beam should
be visible from the end of
the ber.
2.3.1 Power Requirements
110 -120 VAC ± 10 % at 60 Hz, 1.5 Amps
Frequency Range: 45 - 63 Hz
9 Volt Lithium battery
2.3.2 Heating, Ventilation, and Humidity
The room where the laser is used should have good cooling and
heating system so that the laser can be operated within the
optimum range of 20 - 30ºC (68 - 86ºF). Avoid storing or transporting
the laser in temperatures below 0º Celsius (32º F). Operating and
storage humidity should be 5-95% RH.
2.3.3 Lighting
Overhead lighting and/or dental unit light should provide enough
illumination to allow good operator vision when activating the
laser intra-orally.
2.3.4 Combustible Chemicals and Gases
All gases that are combustible or support combustion and are used
in the operatory area where the laser is in use must be turned off
and ventilated during the procedure. Cleaning supplies or other
ammable chemical compounds should be stored in an area
away from the surgical site in order to avoid possible combustion.
2.3.5 High Speed Vacuum Systems
Plume evacuation is a priority when vaporizing tissues. The clinician
or operator, and their chair-side assistants should keep themselves
and the patient safe by using a high volume vacuum system and
high ltration masks that are suitable for virus and bacterial control.
Note: Never re working
beam if the ber is fully
retracted in cartridge.
2.2.5 Laser Stop Switch
Before activating the laser, rst check the laser stop switch to
ensure it’s locked in the “in” position (see gure 22). The switch is
the red button located on the top of the laser. The button must
be “in” to operate. If the laser stop switch is “out”; engage the
switch by pressing it. The display on the control panel should now
be lighted. To interrupt laser emissions in an emergency, depress
the button again to the “out” position.
Figu re 22 - La ser Stop di sabled (“I N”)Figu re 21 - Laser Sto p enab led (“OUT”)
If you nd that the display is still not operational, check all
attachments, keys and switches to see that they are securely
installed and, that you have an active wall plug for electricity.
(See Troubleshooting Section). If the laser cannot be activated,
please contact Customer Care (877-236-4408) who can help you
troubleshoot.
Note: This is not a power switch.
2.3 FACILITY REQUIREMENTS
In order to insure the safe use of the laser in your facility, please
check to make sure that the proposed location has the following:
6
2.3.6 Access and Visual
Access to the treatment area should allow the dental team to
restrict entry while the laser is in use. There should be a Danger
Laser In Use Safety Sign placed in a designated area adjacent to
the entry into the treatment area. See Figure 42.
SECTION 3: OPERATING YOUR LASER
3.0 SAFETY CONSIDERATIONS BEFORE USING
YOUR LASER
The safe use of the Precise LTM® is the responsibility of the entire
dental team including the doctor and the Laser Safety Ofcer
(LSO) appointed from the dental ofce team. Protocols for the safe
use of lasers have been developed by a combination of medical
and dental professionals working in concert with educators at
the university level, scientists and laser manufacturers. Dental
professionals have had to develop protocols and guidelines
for using the laser on oral soft tissues. Sound judgment and the
concern for patient safety should be the basis of all laser care.
3.0.1 In-Ofce Safety Issues
• Lighting & Ventilation: Always use the Precise LTM in a well lit
and ventilated area. Make certain that chemicals or gases
capable of supporting or causing combustion are not present
when using the laser. Use high volume vacuum to remove the
laser “plume” and provide high ltration masks for all people
including the patient and any family or guests present in the
treatment area during lasing.
•
Safety Eyewear: While using the Precise® LTM laser, doctors,
auxiliary staff, patients, and anyone attending them in the
operatory must wear the laser glasses provided with the
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