CAO Group Precise LTM User manual

1
5 WATT SOFT TISSUE DIODE LASER.
OPERATOR’S MANUAL.

2
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
2.2 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
7
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
9
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 Laser Chassis Disinfection 12
4.1.2 Calibration 12
4.1.3 Handpiece Preparation 12
4.1.4 Preparation for Lasing
4.1.5 Disposable Tips
12
12
Section 5: Labels, Signs, Warnings, and Information 13
5.0 Federal Compliance 13
5.1 Danger - Laser in Use Signage 13
5.2 Laser Classications 13
5.3 Cautions 13
5.4 Nominal Ocular Hazard Distance (NOHD) 14
Section 6: Servicing 15
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 nearly a decade and we 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 issues dental
professionals must address every day. CAO diode lasers are used
to create beautiful soft tissue that compliments the radiant smile
created for your patients; to quickly and safely control bleeding
and provide room for impression material; to relieve pain and
discomfort from aphthous ulcers; and for a wide range of other
procedures that make dental visits easier, faster, and better.
With a Precise® LTM Diode Laser you will nd that soft tissue
procedures are performed more quickly and easily and that your
patients will also be more comfortable and tissue will heal more
quickly compared to other typically used methods (e.g., scalpel,
electrosurgery). Based on reports from many dentists and dental
hygienists, we believe that you too will quickly achieve these
same benets.
To help speed your comfort and familiarity with using your Precise
LTM laser, CAO has put together three different training tools that
are available to you at no charge.
• Introduction to Easier Soft Tissue Management with the
Precise® LTM – this online course is designed to help you
and your team understand the benets of using the Precise
laser, how it operates, how to use it to better manage
soft tissue, how and where to begin using the Precise LTM.
• In-ofce hands-on training when convenient. Our sales professionals
will conduct an in-ofce hands-on review of the Precise LTM and
overview its use as well as train your staff on its easy operation.
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.

4
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
(1) Package of (20) Disposable Handpiece
Tips- Straight
(2) Package of (20) Disposable Handpiece
Tips- 60°
(1) 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
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, call your authorized dealer
representative for assistance. Though highly unlikely, you may need
to return the laser for service or repair and the shipping container
you received with your laser has been especially designed to
transport the laser.
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.
2.2 ASSEMBLING THE LASER
Each of the following items should be inspected, inserted into the
appropriate receptacle, and when applicable, locked using the
locking hub.
SECTION 2: BEFORE OPERATING YOUR LASER
1
65
4
3
2
Figure 1
7
8
9
Figure 2
Figure 3
3
5POWER
DECREASE
FIBER
RETRACT
2 READY
KEY
FIBER
EXTEND3 & 4
MODE
KEY
7 PROGRAM
KEY
6 AIMING
BEAM
17
5
2
4
6
5POWER
INCREASE
89
LED DISPLAY AND CONTROL PANEL
1. Laser on Indicator
Illuminates when the foot pedal is depressed.
Indicates that the working beam energy is
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. 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. Hold the desired key to rapidly
change the value.
6. 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 the direction when in use.
The aiming beam conrol allows for ve (5)
levels of intensity of the aiming beam, each
bar representing 20% of maximum intensity.
Zero (0) bars means the aming beam is shut
off.
7. Progam Setting Indicator
Indicates which current program mode is
selected. The Program key will cycle through
the programs in a clockwise direction.
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.
1. LASER STOP
2. FIBER APERTURE
3. LED DISPLAY
4. KEY SWITCH
5. CONTROL PANEL
6. MAGNETIC HANDPIECE HOLDER
7. POWER/FAN SWITCH
8. REMOTE INTERLOCK CONNECTOR
9. POWER SUPPLY RECEPTACLE
10. WARNING LOGOTYPES
10

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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.
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.
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 above.) 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
by the LSO.
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,
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.
2.2.3 Wireless Foot Pedal Battery Installation
Remove the battery cover from the underneath side of the foot
pedal. Insert the enclosed 9 Volt Lithium battery. Replace the
battery cover. The foot switch is now ready for operation.
1. Insert a Phillips-head screwdriver into the screw holding
down the battery cover. Rotate the driver counter-
clockwise until the screw comes out completely. Repeat
for the other screw holding down the battery cover.
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 pull the
terminal out. Do not pull excessively on the wires.
4. Remove the battery from its packaging and attach the
battery to the terminal.
5. Place the battery in the well with the connector to the
same side as where the wire leads emerge from the
housing.
6. Replace the battery cover and replace the two screws.
Turn the driver clockwise to tighten the screws. The
screws are sufciently secure once they no longer turn
with gentle nger-applied force. Do not over-tighten.
Place the pedal face up. Allow at least 1 minute after
completing this procedure before turning on the laser.
Note A: An extra 9 Volt Lithium battery should be
kept in your ofce inventory as the battery should
be replaced every 100 hours of continuos operation.
Note B: Make sure the laser is completely turned
off before replacing the battery in the foot pedal.
Note C: Place the pedal face down on a hard, clean
surface.
2.2.4 Disposable Fiber Cartridge
When it comes time to install a new cartridge, carefully
remove the new ber cartridge from the packing.
Figure 6 - Step 1
Figure 11 - Step 6
Figure 7 - Step 2 Figure 8 - Step 3
Figure 9 - Step 4 Figure 10 - Step 5
Figure 4 - OFF Position Figure 5 - ON Position
Figure 12 - Step 1 Figure 13 - Step 2 Figure 14 - Step 3
Figure 17 - Step 6
Figure 15 - Step 4 Figure 16 - Step 5
Figure 20 - Step 9
Figure 18 - Step 7 Figure 19 - Step 8

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1. Turn system off. To replace the ber cartridge, make sure
the ber is removed from the handpiece and the ber is
fully retracted into the cartridge.
2. Carefully pull the old cartridge sideways away from the
laser until the cartridge is fully removed.
3. Reach into the cartridge bay to disconnect the optical
ber. This is done by unscrewing counterclockwise the
connector from the housing, then pulling the connector
straight out. Set the old cartridge aside.
4. Position the new cartridge adjacent to the open bay.
Carefully remove the dust cap from the end of the
connector. CAUTION: Do not touch the end of the
connector with your nger or with any object. Insert the
connector into the port.
5. Push on the connector while screwing clockwise. Give
a gentle tug on the connector (not the ber cable) to
ensure the connector is locked in place.
6. Position the cartridge to line up with the guide tabs on the
side of the bay.
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 is retracting inside the cartridge as you
do so. Turn on the power to the laser system.
8. Press the Extend and Retract buttons to ensure the ber is
moving properly. If it does not, push the cartridge into the
bay further.
9. Don’t look directly at the aiming beam! Make sure the
aiming beam indicator is at a value other than zero (0),
then press the Ready button. DO NOT press the foot
pedal. The aiming beam should be visible from the end of
the ber. If it is not, then remove the cartridge and conrm
that the ber connector is securly attached.
Note: Never re working beam if the ber is fully retracted
in cartridge.
2.2.5 Laser Stop Switch
Before you can activate the laser, you must rst check to see if the
laser stop switch is locked in the “in” or “out” position. The switch is
the red button located on the top of the laser. Engage the switch
by pressing it. The button must be “in” to operate. 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. 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 your authorized distributor who can help you
troubleshoot. If the control panel does light up when you enable
the laser stop, you should test the switch again by depressing it
to turn the laser off. If the laser stop switch is in the “out” position,
the laser will not turn on.
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:
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.
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 40 on page 13.
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.
The following entities have inuence over laser use.
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 a high ltration masks for all
Figure 22 - Laser Stop disabled (“IN”)Figure 21 - Laser Stop enabled (“OUT”)

7
people including the patient, 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
Precise® LTM system, which is appropriate for use with this
type of device. If additional glasses are obtained, they must
have the same specications for wavelength and optical
density as the glasses provided with this equipment. Never
point the laser tip directly at the face, eyes or skin of anyone
while emitting energy. The aiming beam is also capable of
causing eye damage.
• Test Firing the Laser: Always test-re the Precise® LTM prior to
using it intra-orally. Using a power of 1 Watt continuous wave
or less, place the laser in the ready mode. Then, activate
the laser for 1 - 2 seconds while aiming the ber onto a 2 x 2
gauze sponge moistened with water. Do not use alcohol or
any other combustible material to moisten the 2 x 2 sponge
as it may ignite.
• Fiber Preparations: After cleaving and stripping the ber,
photo-initiation of the ber tip will allow the operator to remove
tissue more rapidly when contact procedures are indicated.
Gingival debris on the tip will retain the heat and it should be
removed. The tip will also begin to blacken and deteriorate
as it retains the heated debris and can break if not removed
by cleaving it. Clean the tip often using a 2 x 2 gauze sponge
moistened with water. Do not use combustible liquids to moisten
the 2 x 2.
• Danger - Laser In Use Signage: Each operatory where the
Precise® LTM is used should have a “Laser In Use” sign placed
at the operatory entrance when a procedure is in progress.
This signage will help to reduce occurences of eye damage
caused by inadvertent exposure to laser energy. See Figure
40 on page 13.
• Sharps Disposal and Sponge Removal: Remove cleaved ber
remnants and place them into a sharps container for disposal.
All sponges used for cleanup of lasers and bers should be
disposed of in a bag for contaminated soft products.
• Plume Evacuation: Use high volume evacuation
suction during procedures to remove laser smoke or
‘plume’ debris. Use masks suitable for viral ltration.
Caution - laser plume may contain viable tissue particulates.
• Key Switch: When the key switch is in the ON position (turn
clockwise to the right so it is 90 degrees in the vertical position),
the laser has been enabled and can be activated while in the
READY status. When not in use, insure that the key has been
turned off or that the laser is placed in the STANDBY status.
• Safety Education: Provide comprehensive safety procedure
training for all ofce personnel and include the staff in all outside
laser courses when possible. Be certain that all members of the
dental team understand how the laser works and can advise
patients as to their safety and advantages over conventional
procedures.
• Laser Security: To prevent the unauthorized use of the laser
while not in use, the key should be removed from the unit and
maintained by the LSO.
• Laser Stop Options: Any of these mechanisms can be used to
shut down the emission of laser energy in a real or perceived
emergency.
1. Foot Pedal – remove your foot to stop lasing
2. Engage the laser stop button
3. Key – turn off the key
4. Switch the Power to the off position (O)
5. Power Cord – unplug from the wall outlet
• Hard Tissue Procedures: The Precise® LTM diode is not an
appropriate laser for hard tissue procedures. The diode laser
is attracted to melanin, hemoglobin and to some extent, to
water and oxygenated hemoglobin. Avoid prolonged exposure
of the energy when working in and around the cervical areas
of the tooth. Due to the thin layer of enamel in this area, the
laser’s energy may be absorbed by the hemoglobin in the
pulp and pulpal hyperemia may occur. Extended exposure to
laser energy could lead to pain and possible pulpal necrosis.
3.0.2 Laser Safety Program and Continuing Education
We recommend implementation of a Laser Safety Program
appropriate for your dental ofce. The plan may include the
following:
• Delegation of authority and responsibility for supervision and
control of the laser to a designated LSO.
• Minimum Training requirements for users of the laser.
• Laser security against unauthorized use of the laser.
• Standard operating procedures to regulate the work environment
in order to protect the patient and ofce staff from laser hazards.
The safe use of a laser is the responsibility of the (LSO) who can
be a full or part-time employee or the laser operator. It is their
responsibility to train the staff, maintain records concerning training
and the laser’s performance, perform safety checks, and prepares
the laser for use on a daily basis. The LSO must keep records of any
incidents that relate to the failure of the laser or any adverse effects
related to laser therapy and report such incidents as prescribed
by law. The laser safety ofcer assures that a medical follow-up
has been sought or has occurred following any adverse incident
during treatment. The LSO is responsible for the training of all ofce
personnel who are involved with the laser preparation and use.
Daily checks of the facility and equipment are also the LSO’s
responsibility. The LSO should test re the laser each day prior to
beginning each treatment procedure. For more information on
the contents of a Laser Safety Plan, you can review ANSI Standard
Z136.3 for Safe Use of Lasers in Health Care Facilities or TR IEC
60825-8 Guidelines for the Safe Use of Medical Laser Equipment.
The LSO should insure that the operator and staff attend laser
courses taught by qualied laser educators. Ongoing reviews of
laser safety procedures should be a part of normal ofce routine.
3.0.3 Food and Drug Administration
Manufacturers of products subject to performance standards
under the Federal Food, Drug, and Cosmetic Act, Chapter
V, Subchapter C - Electronic Product Radiation Control are
required to certify compliance with the regulations and furnish
various reports to the Center for Devices and Radiological
Health (CDRH). For medical laser manufacturers, additional
review by the FDA of the safety and effectiveness of the device
is required. Companies who intend to market a medical laser
today must receive authorization from the FDA to permit the
device into commercial distribution. There are two forms of
premarket clearance procedures. The premarket notication
510(k) procedure is principally used for those devices that are
documented to be substantially equivalent to legally marketed
Class I and Class II devices. For new devices not equivalent to
legally marketed devices, a more complex
PMA is required.

8
3.0.4 OSHA and its Provisions
Worker safety is the responsibility of the employer and is regulated
by OSHA (Occupational Safety and Health Administration), a
division of the U.S. Department of Labor. OSHA has issued no
specic standard for safe use of lasers but recognizes ANSI standard
Z136.1 as a source for analyzing safety with respect to medical
lasers. For more information see OSHA Technical Manual (TED
1-0.15A) Section III, Chapter 6, 1999. CAO Group, Inc. recommends
implementation of a Laser Safety Program for the safety of your
patients and ofce staff in connection with the use of the Precise®
LTM 5 Watt Soft Tissue Diode Laser.
3.0.5 Statutory Licensure
Usually, states or provinces do not have a specic licensure
requirement for use of a laser by a dentist. Most states require
hygientists to attend licensure training that includes both a
lecture and hands-on training. Prior to using the laser, the hygiene
applicants are required to pass a prociency test for certication.
These courses are usually taught by members of the Academy of
Laser Dentistry who possess instructor credentials. Check with your
state licensing board regarding the applicable requirements for
using lasers in dentistry.
3.0.6 Wireless Technology
In order to promote efcient use of the radio spectrum in various
global markets the United States Federal Communications
Commission (U.S. FCC) and other international government
agencies have developed technical standards for devices that
are capable of emitting radiofrequency energy when in use – such
as wireless data cards. These products need to receive certain
identication numbers in accordance with the Commission
Equipment Authorization rules prior to marketing in U.S. markets.
The Code of Federal Regulations, Title 47 (47 CFR), Part 15 covers
the rules for the operation of unintentional, intentional or incidental
radiators. Any electrical or electronic devices incorporating a
digital circuitry and operating with an oscillator or clock speed of
greater than 9kHz requires approval to this rule. There are various
types of FCC Part 15 approvals, depending on the nature of
the product and its intended use. In Canada, IC-RSS 210 (Radio
Standards Specication) sets out the requirements for license
exempt low-power intentional radiators. This standard is very closely
harmonized in terms of permitted frequencies, types of operation,
and other technical requirements to the FCC requirements, but a
separate certication application is required for Canada. In the
European Community, compliance with several safety directives
and testing to EN 300 328, EN 60950 and EN 301 489 is required
for this type of device. The manufacturer is required to provide a
Declaration of Conformity as evidence of its compliance with the
various regulatory requirements.
3.0.7 Precise®LTM Wireless Frequency
The 2.4GHz frequency is very popular for networks and other
wireless devices that share similar technology like Bluethooth®
cell phones, Wi-Fi® devices, wireless networks, cordless phones,
CAD/CAM machines, wireless video senders, even microwave
ovens. The nature of spread-spectrum modulation in the 2.4 Ghz
frequency means that a multitude of devices can co-exist in
the same 2.4 GHz spectrum (as should be obvious, since many
devices use 2.4 GHz and operate well on a daily basis). Bluetooth
and Wi-Fi devices use multiple channels, recovering data reliably
out of noise in the 2.4 GHz spectrum. They will hop around strong
interference, and quickly re-try for uninterrupted operation -- and
can even avoid channels or areas of the band in use by other
devices by adaptive hopping. Since the Precise® LTM wireless
transmitters have a much lower power output, it is highly unlikely
that they would “interfere” with higher-power devices. Even if this
were possible, the higher-power devices would quickly switch
to another channel to achieve uninterrupted operation. The
Precise® LTM wireless receiver use an entirely different protocol,
and therefore cannot (receive) data from Bluetooth or Wi-Fi
devices. The converse is also true; their protocol methods are
incompatible. Precise® LTM diode laser wireless technology
is electronically coded. Each pedal and Precise® LTM diode
laser share a UNIQUE SERIAL NUMBER INTERLOCK protocol for
reliable operation:
• A Precise LTM pedal communicates with only one Precise®
LTM diode laser; there is 2-way electronic code which must
be veried for every transmission and acknowledge. The
pedal and laser unit are interlocked to only each other’s
electronic codes.
• If data from another Precise® LTM pedal is ever received,
embedded verication measures ensure that it is always
ignored and discarded.
• If data were ever received from another wireless device with
a compatible protocol scheme (2.4GHz frequency), it would
immediately be discarded in the same way.
In summary, the wireless transmitters in the Precise® LTM diode laser
have less than 2% of the output power of typical Bluetooth® or
Wi-Fi® devices, and therefore have no signicant potential as an
interference source. Precise LTM wireless receiver is incompatible
with Bluetooth or Wi-Fi devices and therefore cannot mistakenly
receive data from such devices. Through a unique internal
communication structure, and strict verication of all incoming
data, nothing activates an Precise LTM diode laser except the
wireless pedal which it is paired with via electronic code.
3.0.8 American National Standards Institute (ANSI) -
Safety Standards
ANSI is a non-governmental, non-prot agency that has established
guidelines and safety standards for the use of lasers and other
electro-optics. The provisions of ANSI Z 136.3 outlines standards for
lasers used in dentistry and the assessment of laser risks. ANSI also
establishes guidelines for safety eyewear and classies all lasers
based on their potential for damage to eyes or tissue. See page
14 for NOHD requirements.
3.1 STARTUP AND SYSTEM CHECK
3.1.1 Selecting the Treatment Center
The laser should be placed in an area with good ventilation and
lighting. The electrical service required is a 110 Volt A/C outlet - 60
Hz. The area where the laser is placed should be free of standing
water. Combustible gases or those that support combustion should
be turned off and all ammable materials or chemical stored in
the area should be removed.
3.1.2 Checking the Foot Pedal Installation
It is recommended to use a 9 Volt Lithium battery to power
the cordless foot pedal. This type of battery has been
tested to last for over 100 hours of foot pedal operation.
Note: A 9 Volt Alkaline battery may be used, however the

9
life expectancy of an Alkaline battery is less than 35 hours of
operating time.
3.1.3 Checking the Key Activation and Control Panel Display
Turn the Key Switch on the front of the laser to the “On” position by
turning it approximately 1/4 turn to the right (clockwise). The control
panel should light up and show the laser is in Standby Mode.
3.1.4 Checking the Laser Stop Button
Check the Laser Stop Switch to see that it has not been pressed.
If it has, release it by pressing it slightly. See page 6, section 2.2.5.
3.1.5 Checking the Disposable Fiber Cartridge
Before using the laser, check the ber cartridge to see that it is
rmly seated. Depress the extend/retract button on the control
panel to see that it is functioning properly. After checking the ber
cartridge power, extend some ber from the cartridge. You will
want to have approximately 3 feet (1 meter) of ber available to
strip the ber, cleave the ber, initiate the ber, and disinfect the
ber. When the ber is prepared, the handpiece and tip should be
attached. Once prepared place the handpiece into the holder
on the laser. The extend and retract button for ber cartridge
operation should not be depressed during laser operation. Examine
the ber tip to insure that you have not created a ber tip shard
during the cleaving process. The shard can act like a miniature
scalpel and cause damage while diffusing the light beam and
lowering the laser’s power.
3.1.6 Setting Modes
Review your power and mode requirements and then depress the
mode button to select either Continuous or Pulse mode. The mode
you have selected will be displayed on the LED screen and will
be designated by a (Continuous Mode) or (Pulse Mode).
3.1.7 Setting Power
Select your power by pressing the up or down arrow until you
have reached the desired wattage. Beginning with a low of
0.5 Watts, the power increases in increments of 100 mW up to a
maximum of 5.0 Watts (Continuous Mode). By holding the up or
down arrow, you can have an uninterrupted increase until you
reach your desired power.
3.1.8 Setting Aiming Beam
The aiming beam can be turned on and off by pressing the
aiming beam button on the laser control panel. Press this button to
progressively increase the aiming beam intensity from zero (0) (off)
to full intensity. Press the key once more to cycle back to zero (0).
Each bar represents approximately 20% of the aiming beam output.
Note: Adjusting the intensity of the aiming beam has no effect on
the output power of the working laser.
3.1.9 Programming your Precise® LTM
You are able to easily set four (4) different combinations of Power,
Mode and Aiming Beam Intensity. The initial Precise factory setting
is 1.4 W Power + Continuous Mode + 80% Aiming Beam Intensity.
To set your programs, push the Program key to display one of the
program numbers. Choose the desired Power level, the desired
Mode and the desired Aiming Beam Intensity. Press the READY
button – your settings have been saved. Repeat for each of the
four programs. You may change your settings as often as you like.
The settings saved into the four programs will be retained even if
the laser is turned off.
NOTE: Whenever your press the READY button, the settings
displayed on the unit will be saved into the unit’s memory for the
program setting shown.
3.2 OPERATING YOUR LASER
3.2.1 Before Beginning Procedures
Examine the ber tip to insure that you have not created a ber
tip shard during the cleaving process. The shard can act like a
miniature scalpel and cause damage while diffusing the light
beam and lowering the laser’s power. Depress the “Ready” button
and the aiming beam can light after 3 seconds. Review your power
and mode requirements and then depress the mode button to
select either or mode.
3.2.2 During Procedures
• Test re the laser outside the mouth by activating the laser
into a 2 x 2 gauze sponge that has been moistented with
water to prevent combustion. Do not use ammable liquids
to wet the sponge.
• Standby and Ready Status: The status of the laser will be in
Standby which is a non-active status. The laser will not emit
energy while in Standby, even if you depress the foot pedal.
On the top-center of the control panel you will see the “Ready”
button. See Figure 3.2. Press this button to place the unit into
the ready status. When this button is pressed whatever settings
are displayed on the unit will be saved into the unit’s memory
for the program setting shown. The settings saved into the
four programs will be retained even if the laser is turned off.
The laser will now be ready to emit energy as you depress
the foot pedal.
• Depress the foot pedal and make short quick strokes at the
lowest power that you can to remove the target tissues while
lightly contacting it.
• Continuous Mode ( ): In setting up the laser while in the
mode, you will deliver the amount of energy in Joules in one
second equal to the value indicated in the working beam
setting, i.e., set the laser for 2 Watts and while activated the
laser will deliver 2 Joules per second as long as you have the
foot pedal depressed. The mode is generally the fastest way
to ablate tissues but heat can build up and cause collateral
damage to the target and adjacent tissues. Cool the tissues
being lased by using periodic blast of air from a triplex syringe
and high speed suction. You may use water to cool in areas
where there is prolonged exposure to the laser’s beam. Avoid
using the air syringe when you have an opening in soft tissue
adjacent to or within the surgery site. An air embolism may
occur as a result of air captured within the tissue during the
cooling process.
• Pulse Mode( ): Pulsing the laser energy will allow some
cooling of the tissue inbetween emissions of energy. The
“duty cycle” is the percentage of the time in each second
that the laser is emitting energy. The pulses per second, the
duty cycle and, the energy intensity per pulse will determine
your average power. In the pulsed mode, the Precise LTM®
is programmed to deliver 10 pulses per second with each
Figure 23 - Fiber with a shard (a bad cleave)

10
pulse lasting for 0.05 seconds. The duty cycle is set for 50%
so you will have 1 energy pulse with 1 period of rest with no
energy between each pulse. If the laser is producing energy
at 1 pulse per second for 0.5 seconds per pulse, you will be
producing energy for a total of 0.5 seconds. The result will be
an average energy per second that will be 50% of what you
have set the laser for. Therefore, when using pulsed energy,
you will have to adjust your power upward in order to achieve
the same rate of work as the same power set in . Two Watts
of Pulsed energy will be the same average power output
as 1 Watt . Remove your foot from the foot pedal and use
a clean 2 x 2 gauze sponge moistened with water to remove
debris from the ber tip. Do not use ammable liquids to wet
the sponge. Place the laser in Standby mode by turning
“Ready” off until you are ready to start another procedure.
Tissue Responses to Laser Energy: Maximum results will be
achieved by regulating the power and the speed that the
operator moves the ber tip. Tissue charring is an undesirable
after effect of too much power or the tip moving too slowly.
Always use the least amount of power necessary to complete
your procedure. The ideal tissue response will show little or no
discoloration after lasing and there will be less residual damage
and faster healing. Avoid penetrating or damaging the
periosteum and do not use the laser on alveolar bone. Because
the laser energy is attracted to melanin and hemoglobin,
power must be reduced when treating patients with darker
soft tissue. Always begin lasing with the lowest power you can
use to remove or modify the target tissues. Avoid damage to
the gingival sulcus by moving the ber tip quickly and using
low power settings. Check to make sure you have a good
cleave of the ber so that no shard is present on the tip. A
shard may act as a miniature scalpel and damage the small
blood vessels, thus preventing hemostasis and coagulation.
3.2.3 After Each Procedure
• Cleave used ber tip and discard in suitable biowaste disposal.
• Wipe the outside of the ber using a disinfectant or sterilization
solution and then retract the ber by depressing the RETRACT
button on the control panel. Do not retract the distal end of
the ber into the cartridge.
• Turn the key to the off position if you are not going to be
starting another procedure and remove key.
• Record the Powers and Total Lasing Times used for each
procedure in the patient’s chart.
Example:
Patient Name Mary Jones
Procedure Gingivectomy #6 and #7
#6 Lasing time 90 seconds @ 2.0 Watts
air cooled
#7 Lasing time 60 seconds @ 1.5 Watts
air/water spray
SECTION 4: PREPARATIONS, CARE,
AND MAINTENANCE
The ber optic element of a laser is responsible for carrying the light
from the diode array to the tissue being treated. The dental laser
bers are usually made of quartz, sapphire, silica or a combination
of those elements. Quartz/silica is the most popular product used
in diode lasers. Be advised about the potential hazards when
inserting, steeply bending or improperly securing the ber optics to
the chassis. Laser radiation exposure may occur in these instances
which could be harmful to yourself, your staff, and your patient.
Special care should be taken not to break or snap the ber.
As the Aiming Beam passes down the same delivery system as the
Working Beam, it provides a good method of checking for integrity
of the delivery system. If the aiming beam spot is not present at
the distal end of the delivery system, its intensity is reduced or it
looks diffused, this is a possible indication of a damaged or an
inproperly working delivery system.
4.0 DISPOSABLE FIBER CARTRIDGE
The ber cartridge is a removable assembly with a plug-in
capability that provides power for the internal retraction device.
This cartridge is disposable after all ber has been used. This
cartridge is not autoclavable.
4.0.1 Replacing the Fiber Cartridge
A white mark on the ber indicates 6’ of ber remaining on the
cartridge. At this point, a new ber cartridge should be ordered.
When the cartridge is empty, it should be released from the laser
aperture and gently removed. Slowly slide the cartridge out to
the left using the dovetail as a guide. The ber cartridge can be
thrown away.
Note: Retain the ber end cap. DO NOT discard the end cap.
4.0.2 Fiber Preparation
Using the EXTEND button on the control panel, press the button
to extend (toward the front of the laser) the ber. Extend 3 - 4’ of
ber and feed it through the ber locking collar after you have
loosened the collar. The ber should extend about 1’ beyond the
distal end of the handpiece so that you can strip the ber and
place the disposable tip.
Do not continue to use the ber tip once you have observed that
the tip has a blackened appearance that is greater in length
than 2 - 4 mm from the previous cleave spot. The protein debris
of gingival tissue accumulates on the tip during surgery and
retains extreme heat that can cause rapid tip deterioration and
subsequent breakage. This is especially important when using the
laser for periodontal pocket debridement. During surgery, clean
the tip often using a 2 x 2 sponge moistened with water. Do not
use alcohol or other combustible liquids to moisten the 2 x 2 gauze
sponge and do not use the sponge while the tip is hot. Always use
a cold disinfectant solution like BIREX® or CIDEX® to wipe off the
ber jacket before retracting the ber. The ber can be advanced
or retracted by using the retract and extend buttons on the front
control panel.
The ber cartridge is a removable assembly with a plug-
in capability that provides power for the internal retraction
device. This cartridge is disposable after all ber has been used.
This cartridge is not autoclavable. The ber cartridge contains
approximately 20’ (6 meters +) and is wound onto a spool. The
ber itself has three components:
• Jacket
• Cladding
• 400 micron quartz/silica ber
4.0.3 Jacket
This is the protective cover for the ber system and usually is made
of a synthetic material that is clear or white in color. There can be