Cao group LTM User Manual

5 WATT SOFT TISSUE DIODE LASER.
OPERATOR’S MANUAL.
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TABLE OF CONTENTS
Section 1: Introduction 3
Section 2: Before Operating Your Laser 4
2.0 Contents 4
2.1 Removing the Laser from the Packaging 4
2.1.1 Transportation 4
2.2 Assembling the Laser 4
2.2.1 Power Cord Installation 5
2.2.2 Power/Fan/Key Switch Check 5
2.2.3 Wireless Foot Pedal Battery Installation 5
2.2.4 Disposable Fiber Cartridge 5
2.2.5 Laser Stop Switch 6
2.3 Facility Requirements 6
2.3.1 Power Requirements 6
2.3.2 Heating, Ventilation, and Humidity 6
2.3.3 Lighting 6
2.3.4 Combustible Chemicals and Gases 6
2.3.5 High Speed Vacuum Systems 6
2.3.6 Access and Visual 6
Section 3: Operating Your Laser 6
3.0 Safety Considerations- Before Using Your Laser 6
3.0.1 In-Ofce Safety Issues 6
3.0.2 Laser Safety Program and Continuing Education
3.0.3 Food and Drug Administration 7
3.0.4 OSHA and its Provisions 8
3.0.5 Statutory Licensure 8
3.0.6 Wireless Technology 8
3.0.7 Precise® LTM Laser Frequency 8
3.0.8 ANSI Standards 8
3.1 Startup and System Check 8
3.1.1 Selecting the Treatment Center 8
3.1.2 Checking the Foot Pedal Installation 8
3.1.3 Checking the Key Activation and Control Panel Display
3.1.4 Checking the Laser Stop Button 9
3.1.5 Checking the Disposable Fiber Cartridge 9
3.1.6 Setting Modes 9
3.1.7 Setting Power 9
3.1.8 Setting Aiming Beam 9
3.1.9 Programming your Precise® LTM 9
3.2 Operating Your Laser 9
3.2.1 Before Beginning Procedures 9
3.2.2 During Procedures 9
3.2.3 After Each Procedure 10
Section 4: Preparation, Care, and Maintenance 10
4.0 Disposable Fiber Cartridge 10
4.0.1 Replacing the Fiber Cartridge 10
4.0.2 Fiber Preparation 10
4.0.3 Jacket 10
4.0.4 Cladding 11
4.0.5 Quartz/Silica Fiber 11
4.0.6 Stripping the Fiber 11
4.0.7 Cleaving the Fiber 11
4.0.8 Initiating the Fiber 11
4.0.9 Fiber Disinfection 11
4.1 Laser Maintenance 12
4.1.1 Exterior (Chassis) Laser Disinfection 12
4.1.2 Calibration 12
4.1.3 Handpiece Preparation 12
4.1.4 Disposable Tips 12
Section 5: Labels, Signs, Warnings, and Information
5.0 Federal Compliance
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5.1 Danger - Laser in Use Signage
5.2 Laser Classications
5.3 Cautions
5.4 Nominal Ocular Hazard Distance (NOHD)
Section 6: Servicing
6.0 Limited Warranty 15
6.1 Repairs & Returns 15
Section 7: Troubleshooting 15
Section 8: Electromagnetic Compatibility 16
Section 9: Laser Specications 18
Section 10: Glossary of Laser Terminology 19
Section 11: References on Laser Dentistry 19
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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 condent that you too can achieve these same benets.
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-ofce
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.
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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
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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 specically 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.
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PROGRAM KEY
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AIMING BEAM
Figu re 1
Figu re 3
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POWER INCREASE
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POWER INCREASE
FIBER
9
8
FIBER
RETRACT
EXTEND
3 & 4
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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
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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..
2.2 ASSEMBLING THE LASER
2.2.3 Wireless Foot Pedal Battery Installation/Replacement
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 ofce, the laser safety ofcer 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 n Figure 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 insufcient.
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.
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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.
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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:
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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 Ofcer (LSO) appointed from the dental ofce 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-Ofce 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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