Surgical

Frenectomy





Gingivectomy





Gingivectomy (with brackets)





Gingival contouring





Gingival contouring for crowns





Troughing of crown preparation





Tissue ablation (crown seating)





Immediate implant provisional





Opening tissue for immediate implant placement





Opening tissue for an SDI (mini implant)





Implant recovery





LBR laser tissue decontamination





LAPT laser cauettage





Herpatic lesion treatment





Venous lake treatment





Fibroma excision






Getting started

Setting up your new laser





Tip selection


The Picasso Lite laser has many tips available for it and they all can fit on the multi-tip handpiece. These tips come in boxes of 25 (20 for 200 micron), in either, one shape and length or as an assortment of the shapes and lengths. These tips come in 3 diameters (200 micron, 300 micron and 400 microns) and two lengths (5 and 10 mm). The 200 micron tips come in a standard length of 20 mm. These tips are easy to now distinguish by their colors. The green plastic sleeves are 200 micron, the purple sleeves are 300 micron and the orange sleeves are all 400 micron diameters. Choice of which tip to use is somewhat of a personal preference. Individually the user may find that one tip or another works better in their hands. The primary tip of choice for surgical procedures such as crown troughing, gingivectomies and laser bacterial reduction is a 400 micron orange tip that is 5mm in length. The reason for this is that this tip is sturdy, doesn't break readily, and allows for ease of use in most situations where soft tissue ablation is required. In some situations which require a longer tip (i.e. crown troughing on posterior teeth that have long clinical crowns),use the longer 10mm orange tip. These tips are more flexible though so care must be taken to not break them. One additional consideration on tip selection is that should the tip become chipped, or fractured during use, and it is 10 mm long, it can often be re-cleaved shorter and reused on the same patient without the clinician having to use a second tip for the same procedure. All tips come pre-bent at an angle of around 60 degrees but because of the metal cannula that extends from the plastic sleeve, one is able to bend the tip over your thumb to an angle of 90 degrees. Often for certain procedures this is of benefit when working in certain areas where access is difficult (posterior teeth where crown troughing is required with limited inter-occlusal opening). If the clinician prefers a straight tip, they can also straighten the metal cannula which is advantageous for working in anterior areas of the mouth. It is very important to make sure that a gap does not exist in the connection of the disposable tip to the Multi tip handpiece. The connection between the plastic sleeve and the metal portion of the handpiece must be firm (no gap). There is an audible “click” when the tip is inserted on the hand-piece all the way. If this connection is not tight then energy can be lost at this point and then the clinician will require greater energy to complete the given task. Take a read of Dr. Glenn van As's whole article The Diode Laser - Tip Selection and Initiation. HERE.




Tip activation


After selecting the tip that you wish to use, you must consider whether to INITIATE the tip or not. The simple rule is that any time that you wish to be in contact with tissue and ablate it, the tip must be initiated. The process of initiating the tip will concentrate the laser energy in the tip essentially making it a “hot tip”. The laser light is turned into heat and hence this process is called a photo-thermal reaction. The heat that is generated causes a localized zone of vaporization, surrounded by zones of carbonization (try to keep this char zone as small as possible), coagulation and hyperthermia. The higher the settings, typically the faster the vaporization, but the greater these other zones of unwanted lateral thermal damage may be. In keeping with the Academy of Laser Dentistry’s most current guidelines, which “advise the use of the lowest average fluence to avoid risks of excessive heat complications whenever possible,” The total treatment time must also be kept in mind in trying to minimize the collateral thermal damage that can be created by prolonged exposure to laser energy through settings that are not above the ablation threshold required for vaporization. How to activate a laser tip

  1. Select appropriate single use disposable tip.
  2. Select single piece of blue articulating ribbon (Bausch is a good brand).
  3. Set the laser at a low setting of 0.5 watts.
  4. Drag the tip over the articulating paper while firing the laser.
  5. Repeat 3 or 4 times. The tip should glow an incandescent orange when stepping on the foot pedal (like a candle flame).
  6. Touch initiated tip to tissue holding tip stationary and look for signs of ablation (laser plume, and vaporisation of tissue).
  7. Begin procedure or reinitiate tip if needed on the articulating paper.




Why choose AMD Picasso





AMD Picasso Lite unboxing - Dental Products Report






Articles

Laser assisted bleaching


Take a read of Dr. Glenn van As's article Power Laser Bleaching with the AMD Picasso Lite Diode Laser HERE.




Laser assisted bacterial reduction


Take a read of Dr. Glenn van As's article The diode laser in Endodontics HERE.




Tissue management in restorative dentistry


Take a read of Dr. Glenn van As's article T he Diode Laser for Tissue Management in Restorative Dentistry HERE.




Diode laser frenectomy in lower anterior


Take a read of Dr. Glenn van As's article Diode laser frenectomy in lower anterior HERE.




From fundamentals to procedures


Take a read of Dr. Donald J. Coluzzi's article From fundamentals to procedures HERE.




Gingivectomies with the AMD Picasso Lite Diode Laser


Take a read of Dr. Glenn van As's article Gingivectomies with the AMD Picasso Lite Diode Laser HERE.




Gingivectomies in Orthodontics


Take a read of Dr. Glenn van As's article The Diode Laser for Gingivectomies in Orthodontics HERE.




The diode laser for gingival recontouring in cosmetic dentistry


Take a read of Dr. Glenn van As's article The Diode Laser for Gingival Recontouring in Cosmetic Dentistry HERE.




Electrosurge v.s the diode laser (2)


Take a read of Dr. Glenn van As's article Reasons to Replace A Electrosurge Unit with a Diode Laser-Part Two HERE.




Electrosurge v.s the diode laser (1)


Take a read of Dr. Glenn van As's article Reasons to Replace A Electrosurge Unit with a Diode Laser-Part One HERE.




Hemostatis and the diode laser


Take a read of Dr. Glenn van As's article Hemostatis and the Diode Laser — “A little dab will do ya!” HERE.




The diode laser for pulp capping


Take a read of Dr. Glenn van As's article The Diode Laser - The Diode Laser for Pulp Capping HERE.




The diode laser in hental hygiene (2)


Take a read of Dr. Glenn van As's article The diode laser in Dental Hygiene–Part Two HERE.




Implant dentistry and the AMD Picasso Lite diode laser


Take a read of Dr. Glenn van As's article Implant Dentistry and the AMD Picasso Lite Diode Laser HERE.




Frenectomies with the AMD Picasso Lite diode laser


Take a read of Dr. Glenn van As's article Frenectomies With the AMD Picasso Lite Diode Laser HERE.




The AMD Picasso Laser for tissue management in cementing implant retained crowns


Take a read of Dr. Glenn van As's article The AMD Picasso Laser for Tissue Management in Cementing Implant Retained Crowns HERE.




The diode laser to uncover teeth, brackets and implants


Take a read of Dr. Glenn van As's article Uncovering the Tooth: The Diode Laser to Uncover Teeth, Brackets and Implants HERE.




The diode laser to uncover teeth, brackets and implants


Take a read of Dr. Glenn van As's article Uncovering the Tooth: The Diode Laser to Uncover Teeth, Brackets and Implants HERE.




Tip Selection and Initiation


Take a read of Dr. Glenn van As's article The Diode Laser - Tip Selection and Initiation. HERE.




Laser Safety in Dentistry: A Position Paper


Take a read over the Laser Safety Comittee, Academy of Laser Dentistry's paper Laser Safety in Dentistry: A Position Paper HERE





Safety

Laser Safety in Dentistry


Safe use of lasers in a dental practice must be achieved by following a program of laser safety activities and procedures which are monitored, reviewed and audited to achieve best practice. Dental practitioners have always been committed to providing a safe working environment for their staff, patients and other persons who visit their premises, so far as reasonably practicable. This includes the use of lasers and intense light sources which pose a risk from inadvertent exposure. The ADA assists its members with advice on how to establish appropriate working protocols. This advice aligned with formal jurisdictional requirements as they exist in Queensland, Tasmania, and Western Australia, and in other jurisdictions, in order to reinforce the importance of the current (March 2018) version of AS/NZS 4173 Safe use of lasers and intense light sources in health care. This national standard is aligned with International Electrotechnical Commission (IEC) standards. Lasers are classified according to their potential associated with their emissions, to cause injury to human eyes and skin, as defined in AS/NZS IEC 60825.1:2014 Safety of Laser Products Part 1: Equipment classification and requirements, and AS/NZS IEC 60825.14:2011 Safety of Laser Products Part 14: A User's guide.

  • Class 1 lasers are fully enclosed and their design prevents accidental exposure.
  • Class 2 lasers emit visible light, and are less than 1 milliwatt (mW) in power. Eye protection is provided by normal aversion responses such as the human blink reflex.
  • Class 3R lasers have powers less than 5 mW.
  • Class 3B lasers have powers from 5 to 500 mW, and produce visible or invisible light that is hazardous under direct viewing conditions. They are powerful enough to cause eye damage, and may also cause skin burns.
  • Class 4 lasers have a power above 500 mW and are capable of causing both eye damage and burns to the skin.
Australian Standard/New Zealand Standard (AS/NZ): Standards Australia and Standards New Zealand are commonly responsible for developing joint standards, which are documents that set out specifications, procedures and guidelines that aim to ensure products, services and systems are safe, consistent and reliable. The International Electrotechnical Commission (IEC) is an international standards organisation that prepares and publishes international standards for all electrical, electronic and related technologies, collectively known as "electrotechnology". Therapeutic Goods Administration (TGA): Is the part of the Australian Department of Health concerned with the safeguarding and enhancement of the health of the Australian community through effective and timely regulation of therapeutic goods. Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) is the Australian Government Department primary authority on radiation protection and nuclear safety. Definitions LASER is Light Amplification by Stimulated Emission of Radiation, which is the means by which lasers generate visible, ultraviolet or infrared emissions. DENTAL PRACTITIONER is a person registered by the Dental Board of Australia to provide dental care. Practitioners who are using lasers should:
  • follow the requirements of AS/NZS 4173 in ensuring laser safety in the clinical workplace;
  • undertake training in the requirements for laser safety;
  • complete the manufacturer’s required device-specific training;
  • ensure it is listed on the Australian Register of Therapeutic Goods;
  • formally assess the risks for using lasers in their own clinical environment and apply relevant protective measures (including area controls, window blinds, etc) as needed;
  • install compliant warning signs for rooms where Class 3B or Class 4 lasers will be used;
  • ensure that there is sufficient laser protective eyewear for staff, patients and any other persons within the laser hazard zone;
  • use suction during laser surgical procedures to minimise the risks from inhaling plumes created by the laser;
  • use appropriate personal protective equipment such as high filtration masks for procedures that generate large amounts of plume;
  • ensure that reprocessing of laser handpieces is undertaken in accordance with infection control requirements and the manufacturer’s instructions;
  • choose laser parameters (wavelengths, doses and irradiance) that are appropriate for the treatment of the individual patient and the clinical condition;
  • use their clinical skills to deliver safe and effective care, choosing the appropriate method (with a laser or other device) when this offers benefits over existing treatments for the patient;
  • familiarise themselves with the current clinical applications and protocols for laser use; undertake continuing education or further training in laser applications in dentistry; ensure that dental assistants are educated regarding laser safety issues;
  • only undertake procedures that are within their scope of clinical practice.
You can download the ADA policy statement HERE but remember, they are only your association. Please consult with your State Goverments for their requirements and restrictions.




Western Australia restrictions


Dentists must hold a licence under the Radiation Safety Act to use Class 3B and/or Class 4 lasers. To apply for a licence you will need to complete and submit a licence application form HERE. To be eligible for a licence, you will need to be registered as a dental practitioner with AHPRA and have attended a recognised laser safety course. See courses and examinations for further information on recognised radiation safety courses.




Queensland restrictions


Any person who uses dental radiation apparatus (laser apparatus or X-ray equipment) for dental purposes must hold a use licence issued under the Radiation Safety Act 1999. This includes:

  • registered dentists
  • registered oral health therapists
  • registered dental therapists
  • registered dental hygienists
  • dental assistants
  • student dental assistants
  • student dental practitioners.
A use licence can be for 1, 2, or 3 years. Applications to renew your licence must be made before your current licence expires.

You can apply for a licence by completing this form.




Tasmanian restrictions


To deal with a radiation source (X-ray, Class 3B or Class 4 laser, IPL used for cosmetic purposes, MRI/NMR unit or sealed and unsealed radioactive material) in Tasmania you need a licence issued under the Act. The Act specifies ‘dealings’ such as, use, possess, store, acquire, dispose, sell, service, repair, install, transport and manufacture a radiation source. It is an offence to deal with a radiation source other than in accordance with a licence (S13 the Act). Applications for a licence under the Act 2005 are assessed by looking at the:

  • compliance of a radiation source against the following approved safety standards;

  • x-ray equipment

  • lasers

  • equipment containing sealed radioactive material

  • training and skills of people wishing to use the radiation source and;

  • compliance of the place against approved Standards for places.

To apply for a new licence you should:
  • Check that the person(s) you wish to add to your licence have the necessary training and qualifications to use the intended radiation source(s).
  • Read the information on how to apply
  • Complete and submit an application form
  • For a new premises contact an accredited person to ensure the place with comply with standards.
  • Obtain a certificate of compliance for the place from the accredited person
  • Submit the certificate of compliance for the place together with an application to register the place
Note applications under the Mutual Recognition Act (if you hold an equivalent licence in other parts of Australia or New Zealand) can be made. Please read the guidance information and submit a completed statutory declaration form together with the appropriate application for licence form.




Laser Safety in Dentistry: A Position Paper


Take a read over the Laser Safety Comittee, Academy of Laser Dentistry's paper Laser Safety in Dentistry: A Position Paper HERE





CONTACT US

Australia: 1300 029 383

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support@osseogroup.com.au  

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Commonwealth of Australia

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