Biolase waterlase MDX 300 User manual

ALL-TISSUE LASER FOR DENTISTR Y
USER MANUAL
300/450

Page Intentionally Left Blank

1
5200999E REV. D\
CONTENTS
Introduction ………………………………………………………….
5
Section 1
Safety with the Waterlase …………………………………………
6
Precautions …………………………………………………………...
6
Safety Instructions …………………………………………………...
6
Plume Removal ………………………………………………………
7
Safety Features ………………………………………………………
7
Energy Monitor …………………………………………………….
7
Circuit Breaker …………………………………………………….
7
Keyswitch …………………………………………………………..
8
Footswitch ………………………………………………………….
8
Remote Interlock Outlet …………………………………………..
8
Emergency Stop …………………………………………………..
8
Control Panel ………………………………………………………
8
Layout of Control Panel ………………………………………….. 8
Section 2
Installation of the Waterlase MDX ……………………………….
9
Installation Instructions ……………………………………………...
9
Facility Requirements ……………………………………………….
9
Electrical Supply …………………………………………………..
9
Compressed Air Supply ………………………………………….. 9
Section 3
Equipment Description ……………………………………………
10
General ………………………………………………………………..
10
Optical Power Unit Elements ……………………………………….
10
Control Panel ………………………………………………………
10
Front and Back Handles ………………………………………….
10
Locking Wheels ……………………………………………………
10
Emergency Stop …………………………………………………..
10
Keyswitch …………………………………………………………..
10
Footswitch Connector …………………………………………….
10
Remote Interlock Outlet …………………………………………..
10
Power Connection / Circuit Breaker …………………………….
11
Ventilation Channels ……………………………………………...
11
Air Inlet Connector ………………………………………………...
11
Self-Contained Water Bottle ……………………………………..
11
Water Bottle Release ……………………………………………..
11
Footswitch Support Bracket ……………………………………...
11
Fiber Support Arm …………………………………………………
11
Handpiece Holder …………………………………………………
11
Waterlase MDX Delivery System …………………………………..
14
Delivery System Connection on the Unit ……………………….
14
Fiber Optic Cable ………………………………………………….
15
Protective Black Rubber Cap (for fiber optic connector) ……...
15

Contents (continued)
Optical Shaft ……………………………………………………….
15
Protective Cover (for fiber optic shaft) …………………………..
15
Handpiece ………………………………………………………….
15
Rear Plug …………………………………………………………..
15
Tip Plug …………………………………………………………….
15
Tip …………………………………………………………………...
15
Tip Remover ……………………………………………………….
15
Revolving Tip Holder ……………………………………………... 15
Section 4
Operating Instructions …………………………………………….
16
Setup …………………………………………………………………..
16
Connect Unit to Operatory ………………………………………..
16
Filling the Internal Cooling Water Reservoir ……………………
16
Fill Self-Contained Water System Bottle ………………………..
18
Secure Fiber Optic Assembly to Unit ……………………………
19
Connecting Handpiece to Fiber Optic Cable …………………...
22
Disconnecting the Handpiece ……………………………………
23
Installing and Changing the Tip in the Gold Handpiece ………
24
Tip Inspection Instructions ………………………………………..
27
Tip Cleaning Instructions …………………………………………
27
Operation ……………………………………………………………..
28
Overview ……………………………………………………………
28
Operational State Description ……………………………………
28
Key Buttons ………………………………………………………...
28
Touch Screen Controls ……………………………………………
28
To Start the Waterlase MDX ……………………………………..
30
Modify and Save Preferred Values as Presets ………………...
31
Activate the Waterlase MDX ……………………………………..
31
Turn the Waterlase MDX OFF …………………………………...
32
Settings Screen ……………………………………………………
32
User Interface – General Navigation ……………………………
33
Error Messages …………………………………………………… 34
Section 5
Waterlase MDX Specifications …………………………………...
35
General ………………………………………………………………..
35
Dimensions …………………………………………………………
35
Electrical ……………………………………………………………
35
Waterlase MDX ……………………………………………………
35
Optical ……………………………………………………………… 35
Section 6
Contraindications, Warnings and Precautions ……………….
36
Contraindications …………………………………………………….
36
Warnings and Precautions ……………………………
36
Eyewear …………………………………………………………….
36
Anesthesia ………………………………………………………….
36
Treatment, Technique and Settings ……………………………..
36

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Contents (continued)
Hard Tissue Procedures ………………………………………….
37
Soft Tissue Procedures …………………………………………..
37
Curettage Procedures …………………………………………….
37
Fluid Entrapment and Air Embolism …………………………….
37
Root Canal Procedures …………………………………………..
37
Adjacent Structures ……………………………………………….
38
Clinical Conditions …………………………………………………
38
Tissue Evaluation ………………………………………………….
38
Tissue Contact and Tip Breakage ……………………………….
38
Tip Changing ……………………………………………………….
38
Water Splashing …………………………………………………...
38
Plume Removal ……………………………………………………
39
Dental Materials ……………………………………………………
39
Training …………………………………………………………….. 39
Section 7
Clinical Applications ……………………………………………….
40
Introduction …………………………………………………………...
40
Hard Tissue Cutting ………………………………………………….
40
Soft Incision, Excision and Ablation ………………………………..
41
Presets for Soft and Hard Tissue Procedures …………………….
42
Fiber Tip Calibration Chart ………………………………………….
42
Calculating Emitted Power with Tip Attachment ………………….
43
Pre-programmed Pre-sets for General Hard and Soft Tissue
Procedures ……………………………………………………………
43
Operating Guidelines ………………………………………………..
43
Tip Inspection ………………………………………………………...
44
Visual Inspection …………………………………………………..
44
Use of Aiming Beam ………………………………………………
44
Basic Maintenance …………………………………………………..
45
Handpiece and Tip Cleaning and Sterilization ……………………
45
Step 1 – Cleaning Process ……………………………………….
46
Step 2 – Sterilization Process ……………………………………
47
Mirror Check and Cleaning ………………………………………….
49
Mirror Inspection and Cleaning …………………………………..
49
Mirror Alignment Check …………………………………………..
50
Changing the Waterlase MDX Handpiece Mirror …………………
51
Troubleshooting the Delivery System ……………………………...
52
Fiber Check …………………………………………………………..
53
Waterlase MDX Indications for Use ………………………………..
54
Hard Tissue ………………………………………………………...
54
General Indications ……………………………………………
54
Root Canal Hard Tissue Indications …………………………
54
Endodontic Surgery (Root Amputation) Indications ………..
54
Bone Surgical Indications ………………………………………...
54
Laser Periodontal Procedures ……………………………………
55

Contents (continued)
Soft Tissue Indications including Pulpal Tissues ………………
56
Root Canal Disinfection ………………………………………….. 56
Section 8
Maintenance …………………………………………………………
57
Annual Maintenance …………………………………………………
57
Daily Maintenance ……………………………………………………
57
Transportation ………………………………………………………..
57
Storage ……………………………………………………………….. 58
Section 9
Calibration ……………………………………………………………
59
Calibration Schedule ………………………………………………… 59
Appendix A Labels …………………………………………………………………. 60
Appendix B Accessories …………………………………………………………... 65
Appendix C
Clinical Procedure Guidelines ………………………………………
66
Periodontal Therapy Clinical Protocol …………………………..
66
Endodontic Therapy Clinical Protocol ………………………….. 69
Appendix D Tips: Suggested Clinical Specifications ………………………….. 73
Appendix E
Electromagnetic Compatibility ………………………………………
76

5
INTRODUCTION
The Waterlase
®
MDX Er,Cr:YSGG (Erbium, Chromium: Yttrium,
Scandium, Gallium, Garnet) tissue cutting system is a unique
device with diverse hard and soft tissue dental applications.
For hard tissue procedures, the Waterlase MDX utilizes
advanced laser and water atomization technologies to safely
and effectively perform tissue cutting, shaving, contouring,
roughening, etching and resection. For soft tissue procedures,
the Waterlase MDX utilizes direct laser energy to perform
tissue removal, incision, excision, ablation and coagulation.
Use of this device requires proper clinical and technical
training. This manual provides instructions for use for trained
dental surgeons and practitioners.
When used and maintained properly, the Waterlase MDX will
prove a valuable addition to your practice. Please contact your
authorized local Biolase representative if you have any
questions or require assistance.
5

SECTION 1
SAFETY WITH THE W A TERLASE
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 specified herein may result in hazardous radiation exposure.
DANGER: Invisible and/or visible laser radiation – Avoid eye or skin exposure to direct
or scattered radiation. Class IV.
CAUTION: This unit 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 UNIT IN ANY MANNER OTHER THAN DESCRIBED
HEREIN.
DO NOT USE THE UNIT IF YOU SUSPECT IT IS FUNCTIONING IMPROPERLY.
WARNING: No modification of this equipment is allowed
SAFETY INSTRUCTIONS
Follow these safety instructions before and during treatments:
1. Remove or cover all highly reflective items in the treatment area, if possible.
2. Do not operate in the presence of explosive or flammable materials.
3. All persons present in the operatory must wear protective eyewear suitable for
blocking 2.78μm energy.
CAUTION: Periodically inspect eyewear for pitting and cracking.
NOTE: For replacement or additional protective eyewear, please contact your
authorized local Biolase representative.
4. Do not look directly into the beam or at specular reflections.
5. Direct the cutting spray toward targeted tissues only.

7
6. Press STANDBY (Standby button) on the control panel before changing water and
before turning off the unit.
7. Press “Change HP” button on the control panel twice before exchanging
handpieces, changing water or removing the fiber optic connector from the unit.
8. Move the circuit breaker to OFF (0) position (located on rear panel) and remove
the key before leaving unit unattended.
DANGER: DO NOT open system side doors. These are to be used by authorized
Biolase service personnel only. Danger from radiation exposure and high
voltage may exist.
All operatory entrances must be marked with an approved warning sign indicating a
laser is in the operatory.
Plume Removal
Special care must be taken to prevent infection from the laser plume generated by
vaporization of virally infected tissue during procedures done with laser and minimal or no
water spray. Ensure that all appropriate protective equipment (including high-speed
suction to remove the plume, appropriately filtered masks, and other protective
equipment) is used at all times during procedures with this laser device.
CAUTION: Laser plume may contain viable tissue particulates.
SAFETY FEATURES
Energy Monitor
The energy monitor measures and verifies power output. Power deviations of more than
20%
from the selected value will cause the display to show an error message.
The unit will not operate until the system is reset by pressing the “Next” button on the
touch screen. If error messages persist please contact your authorized local Biolase
representative.
Circuit Breaker
The circuit breaker on the back panel serves as a line switch to separate the unit from the
main power supply (0 = OFF, 1 = ON).
Keyswitch
To switch unit ON, turn key to horizontal position. Use the proper key only. The key
cannot be removed while in the ON position.
Always remove key when unit left unattended for long time.

Footswitch
The Waterlase MDX will not activate until the user presses down on the footswitch. 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. The purpose is to enable a
user-provided remote switch (e.g., on the entrance door) to turn OFF the laser. To use it properly
requires a normally-closed pair of contacts connected to pins 1 and 5 of the connector. These
contacts should have no voltage associated with them and should open on activation.
Your authorized local Biolase service engineer can assist you in connecting the remote
interlock to a door switch.
Emergency stop
Press the red emergency stop button to instantly turn off the unit. 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. If the system was on when the emergency stop
was activated, the system will be in standby mode when turned back on. You must push the
“ready” button before using the system again.
Control Panel
The touch screen control panel shows the functional conditions of the system.
Layout of Control Elements
All control functions are located at a safe distance from energy output. Control panel
layout and instructions are described in Section 4, Operating Instructions.
NOTE: Please direct any safety questions to your authorized local Biolase representative,
or call Biolase at (888) 4-BIOLASE [[phone]].

9
SECTION 2
INSTALLATION OF THE WATERLASE
MDX
INSTALLATION INSTRUCTIONS
Your local authorized Biolase representative will unpack the Waterlase MDX and your
authorized Biolase service representative will install the unit. Please leave all crates and
shipping containers unopened until your authorized trained service representative arrives.
Complete installation, testing and demonstration requires approximately one full day.
The Waterlase MDX must be installed with an authorized Biolase representative; please
refer to Section 4, Operating Instructions, for setup instructions.
Please contact your authorized local Biolase representative before transporting unit to a
different location. Misalignment of optical components may occur during transportation if
the unit is not properly packaged.
FACILITY REQUIREMENTS
●Electrical Supply
100 VAC @ 15.0 Amps to 230 VAC @ 8.0 Amps, 50/60 Hz
●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 filtration to eliminate all moisture from air source.
Connections for air supply must be available in each operatory.
Attach air hose with 1/4” inside diameter male quick connectors on each end between air
inlet connector (fig. 2.2) and operatory air source.
CAUTION: Prior to connection, verify that outlet is for air, not water supply.Connection
to water supply may cause damage to the Waterlase MDX system. If the unit
was connected to the water supply, do NOT turn the system on. Contact
your authorized local Biolase service representative.

5200999 Rev. D Waterlase MDX (01/14) 5200999 Rev. D Waterlase MDX (01/14)
SECTION 3
EQUIPMENT DESCRIPTION
*
GENERAL
The Waterlase MDX dental laser system consists of two modules:
• Optical Power Unit (the Unit – shown in Figures 2.1, 2.2 and 2.4)
• Waterlase MDX Atomizing Delivery System (the Delivery System - shown – shown in
Figures 3.3 and 3.4)
OPTICAL POWER UNIT ELEMENTS
Figures 3.1, 3.2 and 3.4 show the front, rear and top views of the unit.
• Control Panel—The optical power unit is controlled through a touch-panel control
screen. Please see section 4, Operating Instructions, for detailed instructions on using the
control panel.
• Front and Back Handles—Use the front and back handles to move the
unit and lift when necessary.
CAUTION: Prior to lifting, make sure handles are not damaged. Do not use the delivery
system to pull the unit; this could damage the fiber optic and render the unit
inoperable.
• Locking Wheels—Press down on front tabs to lock the unit. Lift up the tabs to
release locking mechanism.
• Emergency Stop—Press the red emergency stop button to instantly turn off the unit.
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. If the system was on when the
emergency stop was activated, the system will be in standby mode when turned back
on. You must push the “Ready” key before using the system again.
• Keyswitch—To switch unit ON, turn key to horizontal position. Use the proper key
only. The key cannot be removed while in the ON position.
• Footswitch Connector—Connect and secure footswitch here.
• Remote Interlock Outlet—Each laser has a remote plug and connector on its rear
panel. The purpose is to enable a user-provided remote switch (e.g., on the entrance
door) to turn OFF the laser. To use it properly requires a normally-closed pair of

11
contacts connected to pins 1 and 5 of the connector. These contacts should have no
voltage associated with them and should open on activation. Customers may
request that the remote interlock be connected to a door switch.
• Power Connection / Circuit Breaker—Attach power cord to unit at this location.
The circuit breaker serves as a line switch to separate the unit from the main power
supply (0 = OFF, 1 = ON). Power cable can be wrapped over the holding plate
above the connector when system is not in use or during transportation.
• Ventilation Channels—Do not cover or block these channels. They provide an air
flow path to cool the system.
• Air Inlet Connector—Connect with tubing (included) to compressed dry air outlet at
80-120 psi (5.5 - 8.2 bar).
• Self Contained Water Bottle—Provides water supply for the handpiece
atomization spray. Fill bottle only with distilled or sterile water. Do not use tap
water.
• Water Bottle Release—When the system is in
“standby” mode, after bottle is depressurized,
push the release button and pull back to
remove the water bottle. After refilling the
bottle, replace the bottle into its holder and
secure the bottle in place.
• Footswitch Support Bracket—For storage
or moving the unit, the bracket is designed to
hold the closed footswitch clamshell. Wrap
the footswitch cable around the wrap plate
above.
• Fiber Support Arm—Supports delivery system
on the unit. It extends to support weight of the
delivery system when handpiece is pulled
forward. Extension comes back when handpiece
is released and arm is in vertical position.
• Handpiece Holder—Supports handpiece when not in
use.
NOTE: Proper placement of the Delivery System Cable in the Support Arm and of the
Handpiece in the Handpiece holder is important for convenient and safe
handling of the delivery system.
*
See illustrations pages 12-14
FIGURE 3.3: Handpiece in Handpiece Holder

5200999 Rev. D Waterlase MDX (01/14) 5200999 Rev. D Waterlase MDX (01/14)
Figure 3.1: Front V iew
Touch Screen
Control Panel
Handpiece
Front Handle
Fiber Delivery
System
Telescopic Fiber
Support Arm
Emergency Stop
Switch
Locking Wheels
(front only)

13
Figure 3.2: Rear View
Self-contained
Water System
Remote
Interlock Outlet
Footswitch Support
Bracket
Back Handle
Ventilation
Air Inlet Connector
Back Panel
Key Switch
Power Connection &
Circuit Breaker
Ground Pin
Footswitch Connector
Footswitch Cable
Wrap Plate
Power Cable
Wrap Plate

Figure 3.4: Top V iew
Trunk Fiber
Tip Holder
Water Bottle
Touch Panel
Control System
Handpiece in
Handpiece Holder
WATERLASE MDX DELIVERY SYSTEM
(See Section 4 for detailed description and instructions)
Delivery System Connection on the Unit
The delivery system attaches to the unit via a multi-connector incorporating air, water,
cooling air, illumination waveguides and the optical energy fiber optic.
Front
Water Bottle Cover
Tray for Revolving
Release Push Button

15
Fiber Optic Cable
Fiber optic cable contains the optical fiber together with the illumination waveguides, air
tubing and water tubing. Laser radiation is delivered from laser unit to the handpiece
through the optical fiber.
Protective Black Rubber Cap (for fiber optic connector)
Protects input end of the fiber optic cable when not attached to unit.
Optical Shaft
Contains fiberoptic cable, illumination waveguides and protective window.
Protective Cover (for fiber optic shaft)
Protects optical shaft when handpiece is disconnected.
To disconnect the handpiece or protective cover, pull the handpiece or protective
cover off the shaft.
Handpiece
The handpiece is rotatable and detachable from the optical shaft. It delivers optical energy,
illumination and atomized water spray to the treatment area.
Rear Plug
Protects handpiece when disconnected from optical shaft.
Tip Plug
Protects handpiece optical components from damage due to water, steam or debris
that could enter through the handpiece fiber tip orifice when tip is not in use.
Tip
The tip is detachable from the handpiece and serves as the optical power conduit to the
target tissue. Because the laser energy passes through this tip, your laser unit’s proper
function depends on the tip’s condition. A damaged tip may reflect laser energy back
into the handpiece, potentially damaging the handpiece and/or fiber optic.
Clean and inspect the tips before and after every use to maximize their useful life. See Tip Inspection
Instruction & Tip Cleaning Instructions in Section 4 for details.
Tip Remover
Tool to remove and insert tips.
Revolving Tip Holder
May hold up to 6 tips, operates as Tip Remover (follow instructions enclosed with tip holder).
NOTE: Not for use with Turbo tips.

SECTION 4
OPERATING INSTRUCTIONS
SETUP
Connect Unit to Operatory
1. Verify circuit breaker is in OFF position.
2. Verify keyswitch is in OFF position.
3. Connect power cord to unit (fig.2.2).
4. Verify minimum air pressure of 80 psi (5.5 bar) from air supply.
5. Check air supply for moisture.
CAUTION: Do not connect the operatory air supply to the unit if water or oil is present.
Air compressor may need to be drained or cleaned and air filters installed if
moisture appears. Wet air will damage the unit. Check air supply weekly to
verify absence of water and oil.
6. Connect to the unit’s air inlet connector (fig. 2.2).
Filling the Internal Cooling Water Reservoir
Your Waterlase MDX may have been shipped with a full cooling water reservoir. In the
event you need to fill 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. 4.1 and 4.2)
WARNING: Be careful opening the door. Make sure door opens easily and clears the
bottle lid and tubing. Door holding bracket is mounted at the bottom hinge.
Do not apply excessive force!

17
FIGURE 4.1 FIGURE 4.2
2. Locate internal water reservoir. Verify that white clip on the blue tube that is
connected to the side of the water reservoir is closed; (fig 4.3)
3. Push button on the top connector and disconnect tubing from the lid; (fig. 4.4)
FIGURE 4.3 FIGURE 4.4
4. Remove lid and filter assembly. (See fig 4.5 and 4.6)
WARNING: Be careful handling the water filter assembly. Do not touch white filter
material to prevent contamination and potential damage.
FIGURE 4.5 FIGURE 4.6

5. Use funnel to fill with distilled or deionized water to ¾’s full;
6. Replace filter assembly and close lid tight;
7. Plug in water connector firmly, until it “clicks” in place;
8. Power up the system:
• Switch the Power Circuit Breaker on the back panel ON;
• Turn the Keyswitch to the ON position;
• When keyswitch is turned ON, the system will begin its boot-up process. Once the
system emits second “beep” and the display screen turns dark (about 45 seconds)
push the “ON/OFF” key on the front panel;
9. Press “Ready“key. If “Water level low” error message is shown, turn the system
OFF and then refill the cooling water to ¾ full level.
10. Press “Ready” key again and let system run for 1-2 minutes to clear the air bubbles
from all components of the cooling system.
11. Close the back door and tighten the two captive screws.
FILL SELF-CONTAINED WATER SYSTEM BOTTLE
1. Make sure that the system is in the Standby mode (bottle is de-pressurized);
2. Push the bottle release button and pull the bottle out from the holder towards the back
handle; (see fig. 4.8)
FIGURE 4.7