11
other colors used but there are no standardized color systems to
denote the diameter of the
ber or its use.
4.0.4 Cladding
This is the material on the outside of the quartz/silica ber that is
used to block the lateral escape of laser energy as it traverses the
ber. During stripping, you may “nick” the cladding and you will
likely see the red aiming beam light as it escape the site of the
damage. This is not a danger if all people in the area have the
appropriate safety eyewear.
4.0.5 Quartz/Silica Fiber
The ber is fairly exible but can be broken if bent into a small circle
or bent at an angle of 90 degrees. The cladding will burn as protein
from the gingiva accumulates on the ber and will deteriorate
the tip. It can fracture if not cleaved once the blackened area
has reached 3 - 4 mm. Stop lasing and wipe off the tip regularly
as you work to avoid accumulation of protein debris. Use water
on a 2 X 2 gauze sponge to clean the tip. Do not use ammable
materials like alcohol products when cleaning a hot tip. Dispose
of all small ber remnants after you have cleaved the ber. They
should be kept in a small box with a lid until they can be properly
disposed of in the “sharps” container.
4.0.6 Stripping the Fiber
The ber’s jacket is removed using a “stripper”. Once a ber tip
is initiated and begins retaining debris from the tissues during
lasing, you will get a deterioration of the ber tip. When you have
a blackened tip that extends 3 - 4 mm up the ber shaft, it is time
to cleave the ber and strip the jacket to prepare for the next
procedure. Begin by selecting enough jacket so that when it is
removed, you will have approximately ⅜” of bare ber exposed.
Place the ber in the stripper and grasp that portion of the ber that
will have the jacket removed between your thumb nail and index
nger. (See Figure 24). Grasp the ber with the stripper by applying
pressure to the handles. With a slow steady force, remove the
jacket by pulling the ber away from the stripper. (See Figure 25).
4.0.7 Cleaving the Fiber
As the tip deteriorates, it is more likely to fracture and could
fall into the sulcus or a deep periodontal pocket. To avoid this
problem, it is prudent to periodically “cleave” the discolored
tip. The cleave is made after stripping off the jacket to expose
approximately ¼” - ⅜” of bare ber. (See Figure 27). The cleave
should be made at a point approximately ½” (8 - 10 mm) from the
site of the previous cleave so that there is no visible discoloration
of the tip. The operator should place their index nger at the spot
of the proposed cleave so as to stabilize the ber. Using the pen
style cleaver, draw the cleave blade across the top of the ber
with enough pressure to ”score” the ber. (See Figure 30). With
the thumb and index nger of each hand holding the ber at a
spot approximately ½” on either side of the cleave mark, break
ber against cleave. (See Figure 31). After you have cleaved the
ber, point it perpendicular to a white piece of paper and place
the laser in READY mode. Hold the tip approximately ½” from the
paper and you should see a near perfect circle of red light. If you
have a large comet effect radiating from the circle, you have not
obtained a good cleave. (See Figure 29). If the circle has just a
small comet effect, it will probably work.
Always dispose of the ber tip remnants in the “Sharps”
container immediately after cleaving the ber.
4.0.8 Initiating the Fiber
The tip of the ber should be cleaved to provide a at surface that
can be prepared to retain heat by introducing it to a dark material
like ink, blood or water color paints. The easiest way to prepare
the tip is to lightly move the at surface of the tip across a piece
of articulating paper at about 1 Watt . The tip will retain the ink
and the ink will make the tip glow if you exceed 1 - 2 seconds while
in contact with the paper. Prolonged heating will accelerate the
deterioration of the tip (See Figure 32).
4.0.9 Fiber Disinfection
The ber and spool remain in the ber cartridge and are not
autoclavable. Once stripped, cleaved and initiated, the tip will
reach temperatures of several hundred degrees centigrade,
thus, as the laser emits energy, it will rid the tip of pathogens.
Figure 24 - Adjustable Fiber
Stripping Tool
Figure 25 - Remove ¼” to ⅜” of
the jacket with stripper tool
Figure 30 - Make one pass
using light but steady pressure
Figure 31 - Break the ber
against the cleave
Figure 27 - Adjustable
Fiber Stripping Tool
Figure 28 - Adjustable
Fiber Stripping Tool
Figure 29 - Laser prole
after cleaving.
Figure 32 - Move the tip left
or right while lightly touching
the paper
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