NSK Varios Combi Pro User manual

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Thank you for purchasing Varios Combi Pro. Please read this Operation Manual carefully before use for operating instructions and care and
maintenance guidelines so that you can use it for many years to come through a correct use. Keep this Operation Manual within easy reach of
users for future reference.
* Some sections are indicated with the mark(s) below to show the mode(s) related to the section.
Description regarding Ultrasonic Mode
Description regarding Prophy Mode under Powder Mode
Description regarding Perio Mode under Powder Mode
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User and Intended Use
User: Dentist, dental hygienist
Intended Use: Tooth surface cleaning, removal of plaque or calculus, tooth resection, expansion or cleaning of root canal, removal of foreign
substances, root canal obturation, enhancing adhesion of fixed restorations, incision or removal of periodontal tissue
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Precautions for handling and operation
Please read these precautions carefully and use only as intended or instructed.
Safety instructions are intended to avoid potential hazards that could result in personal injury or damage to the device.
Safety instructions are classified as follows in accordance with the seriousness of the risk.
Class Degree of Risk
WARNING Hazard that could result in serious injury or damage to the device if the safety instructions are not correctly followed.
CAUTION Hazard that could result in light or moderate injury or damage to the device if the safety instructions are not correctly
followed.
NOTICE General product specification information highlighted to avoid product malfunction and performance reduction.
– Contents –
1. User and Intended Use ...................................................................................... 1
2. Precautions for handling and operation .......................................................................... 1
3. Accessory List ............................................................................................ 5
4. Names of Components ...................................................................................... 6
5. Installation............................................................................................... 8
6. Check before treatment .................................................................................... 11
7. Using the Ultrasonic Mode .................................................................................. 12
8. Using the Powder Mode .................................................................................... 16
9. Maintenance ............................................................................................ 20
10. Care and Maintenance .................................................................................... 24
11. Other Functions ......................................................................................... 29
12. Periodical Maintenance Checks.............................................................................. 29
13. Error Code............................................................................................. 30
14. Troubleshooting ......................................................................................... 30
15. Specifications .......................................................................................... 33
16. Classification of Equipment................................................................................. 33
17. Operation Principle....................................................................................... 34
18. Symbol ............................................................................................... 34
19. Warranty .............................................................................................. 34
20. Option Parts List ........................................................................................ 35
21. Spare Parts List ......................................................................................... 35
22. Disposing product ....................................................................................... 36
23. EMC Information (Electromagnetic Compatibility Information) ........................................................ 36
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WARNING
<Ultrasonic Mode and Powder Mode>
•Do not handle the power cord with wet hands. Wet hand contact with electricity may result in an electric shock.
•Keep away from explosive substances and flammable materials.
•If the product overheats or smells of burning, immediately turn off the power and disconnect the main power cord. Contact your Authorized
NSK Dealer.
•TO PREVENT ELECTRIC SHOCK, use a main electrical outlet that is earthed.
•Do not operate close to patients with cardiac pacemakers as there is a danger that it may affect the pacemaker.
•The system functions normally in the environment where the temperature is at 0 - 40°C (32 - 104°F), humidity at 35 - 75% RH, and no
moisture condensation in the Control Unit. Using in conditions outside these limits may cause malfunction.
•Be careful not to get water or liquid disinfectant in the Control Unit. This could cause short circuits and lead to fire and/or electric shock.
•Repeatedly turning the Main Power Switch ON and OFF may blow a fuse.
•If water droplets, chemicals, solvents or antiseptic solution come into contact with the Control Unit, Handpiece, Handpiece Cord, Handpiece
Hose, etc., wipe them off immediately. Failure to do so may result in discoloration or deformation.
•Connect to a public water system that provides drinkable water at a water pressure between 0.1 and 0.3MPa. Using with an incorrect water
pressure may result in insufficient water supply, inoperability, or malfunction.
•Use a water softener, etc. to lower the hardness of the water, because using water with a high degree of hardness may cause mineral or
limescale deposits in the water circuit, which can lead to problems such as insufficient water levels, operation problems, or breakdown.
When doing so, use a Water Tube with a Water Filter to prevent device breakdown due to the foreign material in tap water, and refer to
“10-3 Changing the Water Filter” to replace the Water Filter as required.
•Do not sterilize using ultraviolet light. Doing so may result in discoloration of the Handpiece.
•Hold the plug when pulling out the Handpiece Cord or Handpiece Hose. Pulling the Cord or Hose may cause disconnection or damage.
<Ultrasonic Mode>
•Always use the water supply. Insufficient water supply results in overheating, which may damage the surface of the patient’s tooth.
•Do not allow the patient or assistant to look directly into the LED of the Handpiece or Handpiece Cord. Doing so may damage eyesight.
<Powder Mode>
•Do not use on the following patients.
–Those with medical complications or allergies
–Those who have pre existing conditions (Eg Cardiac, Pulmonary, Renal disturbance or High blood pressure)
–Those with respiratory diseases.
–Those with pathologically deep periodontal pockets (6mm or more) or mucosal lesions. Prolonged application of the spray to soft tissue or
salivary glands may cause powder air to enter soft tissue or salivary glands, resulting in emphysema.
–Those with severe digestive ulcers.
–Those with renal dysfunction.
–Those with lung or cardiac disturbance or ventilatory impairment.
–Those with an artificial heart valve or artificial joint
–Those with allergies. Depending on the patient’s constitution, allergy symptoms or stomatitis may be caused in very rare cases. If such
symptoms are detected, stop using the product immediately and seek medical attention.
•During use, both the operator and the assistant should always wear protective glasses and protective face masks. Also, continuously
vacuum and collect ejected powder during use. If any powder gets into the eyes, eyes wash out immediately with copious amount of water
and consult an ophthalmologist.
•Set the supply air pressure to 0.55 - 0.75MPa and use clean, dry air. Using with the incorrect pressure may result in insufficient spray
pressure (power), inoperability or malfunction.
<Prophy Mode>
•Do not spray directly onto the cement in the root canal, decalcified enamel, filling, margin of a prosthesis or filling.

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WARNING
<Perio Mode>
•When using Perio Mode, pay attention not to cause emphysema as air containing powder is sprayed into periodontal pockets. If emphysema
is caused by treatment using Perio Mode, stop using this product immediately and seek medical attention.
•Do not use on the following patients. Using on periodontal pockets for these patients may result in bacillemia.
–Patients with endocardial inflammation
–Patients who have a contagious illness or disease
–Patients with an immune deficiency disease (neutropenia, granulocytopenia, agranulocytosis, diabetes, hemophilia)
–Patients undergoing irradiation treatment, chemotherapy, or antibiotic treatment
•Do not use on the following patients. (Excluding the using without the Nozzle Tip)
–Those with damage or abnormality in the oral cavity.
–Those with hyperemia, hemorrhage or inflammation in the oral cavity.
–Those that tend to develop inflammation or sores in the oral mucous membrane.
•Use this product only for maintenance after basic periodontal treatment. Never use it for other purposes.
•Use Perio Mode only on periodontal pockets that meet the following conditions:
–Periodontal pockets caused by gum disease
–Periodontal pockets of less than 6mm that have undergone basic periodontal treatment
•Check the depth of periodontal pockets with a measurement probe or photography before use.
•Use the designated cleaning powder only. Use of other powders may result in malfunction, substandard performance or damage to the
substantia ossea and dentine, or may cause emphysema. NSK cannot accept any liability for issues that occur as a result of the use of
powder other than those designated.
•Nozzle Tip for Perio Mode included in the product package is a sterile item. When using these products, follow the instructions below.
–Nozzle Tip is a single-use item. Do not reuse nor resterillize it as product breakage or infection could occur.
–Check before use that the package is NOT open nor damaged. If the package is open or damaged, do not use that Nozzle Tip as it may be
damaged or contaminated.
–Observe the use-by date written on the Nozzle Tip package label. Do not use expired products as product breakage or infection could
occur.
CAUTION
<Ultrasonic Mode and Powder Mode>
•Read this Operation Manual before use to fully understand the product functions and file for future reference.
•When operating the product always consider the safety of the patient.
•The end user shall be responsible for any judgment that relates to the application of this product to a patient.
•Users are responsible for the operational control, maintenance and continual inspection of this product.
•This device is for indoor use only.
•Keep the Control Unit on a level surface.
•Do not attempt to disassemble the product nor tamper with the mechanism except as recommended by NSK in this Operation Manual.
•Do not allow any impact on to the product. Do not drop the product. The Glass Rod and Handpiece may be damaged if the Ultrasonic
Handpiece is dropped.
•Operators and all others in the area must wear eye protection and a mask while using this product.
•Should the product function abnormally, cease operation immediately and contact your Authorized NSK Dealer.
•Push the Handpiece securely and fully onto the Handpiece Cord or Handpiece Hose when connecting.
•Do not autoclave the Handpiece Cord or the Handpiece Hose. Use alcohol to disinfect the Cord or Hose after use.
•Do not use high acid water or sterilizing solutions to wipe, immerse or clean the product.
•This product is not delivered in a sterile condition, except for the Nozzle Tip (option) and must be autoclaved prior to use. Refer to “9-3
Sterilization” for details.
•Perform regular function and maintenance checks.
•If the product is not used for a long period check it is functioning correctly before using on a patient.
•To avoid clinical downtime it is recommended that a spare be kept on hand in case of a breakdown during surgery.
•Always replace the fuse with the same specified rating.
•This product is rated Medical Electrical equipment. EMC (Electromagnetic compatibility) is described in the documentation included.
•Installation and use of this product requires special precautions regarding EMC according to the EMC information.
•Portable and mobile RF communications equipment can affect Medical Electrical equipment. Do not use RF equipment near the product.
•The use of ACCESSORIES such as handpieces and cables, other than those specified by the manufacturer, with the exception of handpieces
and cables sold by the manufacturer of this product as replacement parts for internal components, may result in increased EMISSIONS or
decreased IMMUNITY of this product.
•This product should not be used adjacent to, or stacked with, other equipment. If adjacent or stacked use is necessary, this product should
be observed to verify normal operation in the configuration in which it will be used.

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CAUTION
•The system may present a possibility of malfunction when used in the presence of an electromagnetic interference wave. Do not install the
system in the vicinity of any device which emits magnetic waves. Turn off the Main Power Switch of the system as an ultrasonic oscillation
device or an electrode knife is located close to the vicinity of use.
•U.S. Federal law restricts this device to sale by or on the order of a licensed physician.
•For safety’s sake, install the Control Unit in a place where the AC Power Cord can be easily removed. (It is possible to disconnect the control
unit from the power source by removing the AC Power Cord.)
<Ultrasonic Mode>
•The temperature of the Tip surface may reach 65°C without using coolant water. To avoid this event, be sure to use coolant water.
<Powder Mode>
•Be very careful to ensure cleaning powder does not enter the patient’s mucosal areas (eyes, nose, etc.) other than the oral cavity. Also,
protect the face with a towel or protective glasses, etc., to prevent the cleaning powder from getting into the patient’s eyes.
* If the patient wears contact lenses, have the patient wear safety glasses or remove his/her contact lenses before treatment.
•Make sure the compressed air supply is clean and dry. Water or oil content mixed in the air supply may cause solidification of the cleaning
powder inside the product.
•Securely attach the Chamber Cap to prevent the chamber cap from being blown off, which may lead to an injury.
•Do not open the Chamber Cap during use. Doing so may result in powder being ejected from the chamber cap due to high pressure in the
chamber.
•Before connecting the Handpiece Hose, Chamber and Handpiece, or the Chamber and Control Unit, be sure to blow off all water from the
connections of the Hose and the Chamber with dry air. Failure to do so may result in moisture entering the air supply, causing solidification
of the cleaning powder inside the product.
•Depending on the use environment, the temperature of the Powder Handpiece surface may reach 50°C.
•If too much cleaning powder is put into the Chamber, the proper amount of powder may not be sprayed at the start of use.
•Powder scatters easily because it is very fine. Fill the Chamber slowly and be sure to prevent the powder from scattering.
•Powder stored for a long time in opened packaging may become moist and clog. Always use new, dry powder. When using bottled powder
(option), securely fasten the bottle lid after use.
•Apply Vaseline, etc., to the patient’s lips to prevent drying or chapping at the corners of the mouth.
NOTICE
•No special training is required for this device.

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3
Accessory List
Tip is mounted in the Tip Wrench
No. Part Name Quantity
1 Control Unit 1
2 Irrigation Bottle 1
3 Chamber (For Prophy use) 1
4 AC Power Cord 1
5 Foot Control 1
6 Handpiece Cord 1
7 Ultrasonic Handpiece 1
8 Handpiece Hose (For Prophy use) 1
9 Powder Handpiece (For Prophy use) 1
10 Air Hose 1
11 Water Filter Set 1
12 Sterilization case 1
13 Tip and Tip Wrench 3
* Not shown in the illustrations above
NOTICE •FLASH pearl and Perio-Mate powder (option) used in Powder Mode are referred to as “Powder” in this Operation Manual unless
otherwise specified.
•Optional Perio Kit need to be purchased separately in order to use Perio Mode. Refer to “20 Option Parts List” for details of Perio
Kit.
No. Part Name Quantity
14 FLASH pearl 5
15 Ring Wrench 1
16 Spanner Wrench (5×8) 2
17 Turbine Oil 1
18 Spare O-Ring 7 types
19 Cleaning Wire (L) 1
20 Cleaning Wire (S) 1
21 Cleaning File 1
22 Cleaning Brush 1
23 Unlocking tool 1
24 Operation Manual (This manual)* 1
25 Tip-Power Guide* 1
26 Tip Card* 1
27 Varios Combi Pro Quick Operation Guide* 1

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4
Names of Components
Irrigation Bottle Base Connector
Handpiece Cord Connector Socket
Ultrasonic Handpiece
Handpiece Cord Plug
Handpiece Cord
Handpiece Cord Connector
Irrigation Bottle Cap
Irrigation Bottle
Nozzle (For Prophy use)
Handpiece Holder
Chamber Cap
Chamber Base Connector
Handpiece Holder
Handpiece Holder
Chamber (For Prophy use)
Lock Button
Handpiece Hose Connector Socket
Handpiece Hose Connector
Handpiece Hose (For Prophy use)
Powder Handpiece (For Prophy use)
Handpiece Hose Plug (For Prophy use)
Fuse Box
AC Power Cord Connector Socket
Water Tube Connector
Air Hose Connector
Power Switch
Foot Control Cord Connector Socket
Air Filter
Irrigation Pump
Foot Control Cord Plug
Foot Control Cord
Foot Control Hanger
Button B
Button C
Button D
Button A

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4-1 Operation Panel
(4) Operation Mode Select Key
(5) Auto-Cleaning Key
(6) Irrigation Mode Select Key
(3) Irrigation Volume Key(2) Power Level Key
(1) Ultrasonic Mode Select Key
(1) Ultrasonic Mode Select Key
Switches the Ultrasonic Mode between P (Perio), E (Endo),
G(General). The strongest power level is G, followed by E and P.
Power Level, Irrigation Level, and Irrigation Mode can be set for
each mode.
(2) Power Level Key
Sets the power level using the / keys.
(3) Irrigation Volume Key
Sets the irrigation volume using the / keys.
(4) Operation Mode Select Key
Switches between “Ultrasonic Mode” and “Powder Mode.”
(5) Auto-Cleaning Key
Starts Auto-Cleaning. Refer to “9-1-1 Auto-Cleaning” (Ultrasonic
Handpiece) or “9-2-1 Auto-Cleaning” (Powder Handpiece) for
details.
Ultrasonic Mode:
Sprays tap water for 15 seconds, then sprays water from the
Irrigation Bottle for 30 seconds to clean the Ultrasonic Handpiece.
Powder Mode:
Sprays air and water at the same time for 10 seconds and then
sprays only air for 35 seconds.
(6) Irrigation Mode Select Key
Switches the Irrigation Mode (Bottle or tap water) for Ultrasonic
Mode. Tap water is always used for Powder Mode.
4-2 LCD Panel
(1) Power Level Indicator
(2) Operation
Mode Display (3) Powder Mode Display
(4) Irrigation Volume Indicator
(5) Error Display
(6) Irrigation Mode Display
(7) Power Level Display
(8) Ultrasonic Mode Display
(1) Power Level Indicator
Displays the current power on the Bar Graph Indicator.
(2) Operation Mode Display
Displays the current Operation Mode (Ultrasonic or Powder).
(3) Powder Mode Display
Displays the set chamber (Prophy or Perio) (only when Powder
Mode is in use).
(4) Irrigation Volume Indicator
Displays the selected Irrigation Level on the Bar Graph Indicator.
(5) Error Display
Displayed when an error occurs. Refer to “13 Error Code” for
details.
(6) Irrigation Mode Display
Displays the Irrigation Mode (Bottle or tap water) for Ultrasonic
Mode. Tap water is always used for Powder Mode.
(7) Power Level Display
Displays the current Power Level as a number.
(8) Ultrasonic Mode Display
Displays the current Ultrasonic Mode (P/E/G).

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4-3 Foot Control
When using Ultrasonic Mode When using Powder Mode
A: Power Down C: Power up
B: Switches P/E/G B: Rinse (Irrigation and air)
D: Vibration and irrigation D: Powder, irrigation, and air
C: Power up A: Power down
Ultrasonic Mode
A: Power Down
Reduces the power level.
B: Switches P/E/G (Ultrasonic Mode)
Toggles Ultrasonic Mode in the order of P (Perio) E (Endo)
G (General) P (Perio)... every time the button is depressed.
C: Power up
Increases the power level.
D: Vibration and irrigation
Vibrates and irrigates while the button is depressed.
Powder Mode
A: Power Down
Reduces the power level.
B: Rinse (Irrigation and air)
Sprays water and air while the button is depressed.
C: Power up
Increases the power level.
D: Powder, irrigation, and air
Sprays powder, water, and air while the button is depressed.
5
Installation
5-1 Connecting the AC power cord
1) Turn the Power Switch to OFF before connecting the AC power cord.
2) Insert the AC Power Cord so that it correctly fits into the AC Power Cord Connector
Socket at the back of the Control Unit (Fig. 1).
3) Plug the AC power cord into a wall outlet specified for medical use.
CAUTION
•Do not tug the AC power cord by holding and pulling its cord.
•Make sure that the device has completely stopped before removing or
inserting the AC power cord.
Fig. 1

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5-2 Connecting the Air Hose
1) Insert one end of the Air Hose deep into the Air Hose Connector (Fig. 2).
2) Pull the Air Hose gently and check that the Hose does not come out.
3) To remove the Air Hose, pull the Air Hose out while pushing the blue ring toward the Control Unit (Fig. 3).
CAUTION
•Use clean dry air. Powder may clog if the air contains moisture or oil.
Air Hose
Fig. 2
Push the blue ring
Fig. 3
5-3 Connecting the Foot Control
1) Insert the Foot Control Hanger so that it fits correctly into the holes at the rear of the Foot Control (Fig. 4).
2) Insert the Foot Control Plug into the Foot Control Cord Connector Socket with the mark facing upwards (Fig. 5).
Fig. 4
mark
Foot Control Cord Plug
Fig. 5
5-4 Connecting the Handpiece Cord (Ultrasonic Handpiece)
Connect the Handpiece Cord Connector to the Handpiece Cord Connector Socket
with the mark facing upwards (Fig. 6). Push it in all the way.
CAUTION
•Check that the Handpiece Cord Plug is clean and dry before connection.
mark
Handpiece Cord
Fig. 6

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5-5 Connecting the Handpiece Hose (Powder Handpiece)
1) Use air to dry the Handpiece Hose Connector Socket and Handpiece Hose
Connector.
2) Insert the Handpiece Hose Connector so that it fits correctly into the hole on the
Handpiece Hose Connector Socket and fasten the Connector nut (Fig. 7).
Chamber
Handpiece Hose Connector nut
Fig. 7
5-6 Connecting and disconnecting the Handpiece
CAUTION
•Be sure to only use the supplied Handpiece.
5-6-1 Ultrasonic Handpiece
(1) Connection
Align the dots on the Ultrasonic Handpiece and the Handpiece Cord Plug. Push
the Handpiece straight into the connector (Fig. 8).
(2) Disconnection
Hold the Ultrasonic Handpiece and the Handpiece Cord Plug and pull the
Handpiece out.
Dots
Handpiece backend
Ultrasonic Handpiece Handpiece Cord Plug
Fig. 8
WARNING
•To avoid electric shock, do not touch the electrical contacts on the Handpiece Connector.
CAUTION
•Do not twist the Handpiece or Handpiece Cord when removing the Handpiece. Doing so may damage the Connector electrical
contacts, resulting in malfunction.
5-6-2 Powder Handpiece
(1) Connection
1) Use air to dry the connection between the Handpiece and Handpiece Hose
Plug.
2) Push the Powder Handpiece straight into the Handpiece Hose Plug (Fig. 9).
(2) Disconnection
Hold the Powder Handpiece and the Handpiece Hose Plug, and pull the
Handpiece out.
Powder Handpiece Handpiece Hose Plug
Fig. 9

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5-7 Connecting the Water Tube
1) Insert one end of the Water Tube (the end with the water filter) deep into the Water Tube Connector (Fig. 10).
2) Connect the other end of the Water Tube to the water outlet on the dental unit.
3) Pull the Water Tube gently and check that the Tube does not come out.
4) To remove the Water Tube from the Water Tube Connector, pull the Water Tube out while pushing the green ring toward the Control Unit
(Fig. 11).
Water Tube
Water Filter Case
Fig. 10
Push the green ring
Fig. 11
WARNING
•Use a water softener, etc. to lower the hardness of the water, because using water with a high degree of hardness may cause
mineral or limescale deposits in the water circuit, which can lead to problems such as insufficient water levels, operation
problems, or breakdown. When doing so, use a Water Tube with a Water Filter to prevent device breakdown due to the foreign
material in tap water, and refer to “10-3 Changing the Water Filter” to replace the Water Filter as required.
CAUTION
•If the water outlet on the dental unit has not been used for a long time, water may contain rust, etc. when it is run for the first
time. Make sure that the water is clear before connecting the Water Tube.
•Insert the Water Tube firmly into the Water Tube Connector when connecting it to the Control Unit. Water may leak if the Tube is
not inserted correctly.
6
Check before treatment
Before use, operate the product without a patient present to confirm there is no abnormal vibration, noise, heat, etc. Also check the following
points.
– Ultrasonic Handpiece: LED lights and water flows.
– Powder Handpiece: Powder, air and water are supplied correctly.
If you notice anything unusual when checking or operating this product, stop using it immediately and contact your authorized NSK dealer.
When you perform Auto-Cleaning, the water inside the Handpiece Cord/Hose is ejected, which may make stop water from flowing when using
the Control Unit the next time. If that happens, set the Irrigation Volume to 10, and operate the Handpiece for about 30 seconds after water
starts to come out. Refer to “14 Troubleshooting” if water does not start to come out after more than 20 seconds, even if you set the Irrigation
Volume to 10.

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7
Using the Ultrasonic Mode
7-1 Water System Setup
Using the Bottle
1) Remove the Dust Cover from the Irrigation Bottle Base Connector (Fig. 12).
2) Remove the Irrigation Bottle Cap and fill the Bottle water or disinfectant solution to the desired level.
3) Close the Irrigation Bottle Cap securely and insert the Bottle Joint straight into the Irrigation Bottle Base Connector (Fig. 13).
Pull the Irrigation Bottle straight up to remove it.
Dust Cover
Irrigation Bottle Base Connector
Fig. 12
Joint
Fig. 13
CAUTION
•Only use the dedicated Varios Combi Pro series bottle.
•Insert the Irrigation Bottle straight. Failure to do so may damage the O-ring.
•Clean the Irrigation Bottle and the Irrigation Bottle Cap with clean water after use and before storage.
•Attach the Dust Cover to the Irrigation Bottle Base Connector when the Irrigation Bottle is not mounted.
•Ensure the liquid temperature is below 35˚C.
•Do not put strong acids (such as highly acidic water, superacid water, or electrolysis water) or hypochlorous acid water in the
Irrigation Bottle as they may cause water clogging or metal corrosion.
Using Tap Water
1) Make sure that the Water Tube is firmly connected to the Water Tube Connector of the Control Unit. Refer to “5-7 Connecting the Water
Tube” for details.
2) Open the water valve of the dental unit and set the water pressure between 0.1 - 0.3MPa (1.0 - 3.0kgf/cm2). If the water pressure
exceeds 0.3MPa, use a Water Pressure Reducing Valve (option) to adjust the water pressure to within the specified range. Refer to “20
Option Parts List” for details about the water pressure reducing valve.
7-2 Mounting the Tip
1) Check that the screw parts of the Handpiece and Tip are clean (Fig. 14).
2) Push the Tip into the distal end of the Handpiece and screw the Tip until it is lightly tightened (Fig. 15).
Screw Part
Fig. 14
Fig. 15

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3) Match the square shape of the Tip with the hole of the Tip Wrench, then insert the Tip into the hole. Rotate the Wrench until it makes a
click sound and cannot rotate any further. During this procedure, hold the Handpiece so that the Handpiece Cord does not become twisted.
When removing the Tip, rotate the Wrench in the direction of the “Loosen” arrow (Fig. 16).
Tighten
Loosen
Fig. 16
WARNING
•Do not allow contact with gingival, mucosa and/or skin. Doing so may result in injury or burns.
•USE ONLY NSK genuine tips when using this product. Problems including Handpiece damage, failure and accidents resulting
from the use of non-NSK tips are not covered in the warranty. The following types of issues may occur when using Non-NSK
Tips:
–Inappropriate vibration caused by incompatible screws.
–Accidental ingestion of broken tips by the patient.
–Damage or premature wear of the Handpiece screw
CAUTION
•Be careful not to twist the Handpiece Cord when tightening the Tip.
•Be careful when attaching or removing a Tip that is longer than the Tip Wrench, as there is a risk of injury from the point of the
Tip.
•Do not use a Tip which has been damaged, bent or corroded as it may break during use.
•To avoid damaging the Tip thread or disengagement of the Tip, always make sure that the Tip is inserted at the correct angle
and firmly tightened.
•If debris is found on the Tip thread, clean the Tip immediately. Failure to do so may result in noise or insufficient vibration.
•Do not attempt to sharpen or bend the Tip as doing so may result in the Tip breaking during use, noise or insufficient vibration.
•The Tip is a wear item. Worn Tips have an increased risk of noise, breakage or insufficient vibration. Replace the Tip if noise or
insufficient vibration occurs.
•Use the supplied Tip Wrench to mount the Tip. Rotate the Wrench until it makes a click sound and cannot rotate any further. If
the Tip is not tightened sufficiently, insufficient vibration or noise may occur.
•When mounting a Tip, always wear sterile surgical gloves and use a sterilized Tip, Handpiece and Tip Wrench.
•Ensure that the power setting does not exceed the recommended Power Level. Failure to do so may result in noise, tip breakage
or injury to the patient.
•Do not use Tips that are not designed for removing metal or prosthetic crowns for this purpose. Doing so may result in the tip
breaking and falling into the patient’s mouth.
•Remove the Tip before attaching or removing the Handpiece or the Handpiece Cord to avoid to avoid injury with the Tip.
•If insufficient vibration is observed during operation, remove the Handpiece from the patient’s mouth, and depress the Foot
Control again. If this does not improve the condition, the Tip may have loosened during use. Check that the Tip is securely
mounted.
•If the Tip becomes loose, makes noise, or does not vibrate sufficiently even though it has been tightened until it makes a click
sound, the Tip Wrench may be worn out. The Tip Wrench is a wear item and should be replaced once a year.

14
Using the Tip Card
CAUTION
•Tips are wear items. Use the supplied Tip Card to check the Tip condition and replace the Tip if necessary.
Place the neck of the Tip in the cut out of the Tip Card. Measure the length of the Tip and check the replacement timing (Fig. 17). To
guarantee safe and effective use, it is recommended that Tips be replaced with the Tip meets the yellow line (1mm of wear).
Tip Card
Green: No wear - Tip is OK
Tip replacement is not necessary.
Yellow: Wear of 1mm - Tip is showing some wear
Tip replacement is recommended.
Red: Wear of 2mm - Tip is badly worn
Tip must be replaced.
Fig. 17
CAUTION
•Tips are consumables. The efficiency of dental scaling decreases
approximately 25% when the top of the Tip wears 1mm and
approximately 50% when it wears 2mm. In addition, the vibration
condition changes owing to the wear, which may damage a patient’s
tooth surface. Periodically check the Tip wear condition using the Tip
Card, and replace the Tip with a new one in good time.
25% decrease 50% decrease
Fig. 18
7-3 Power Level Setting
1) Touch the Ultrasonic Mode Select Key to select the
Mode. The selected Mode is displayed on the LCD
Panel as P/E/G (Fig. 19).
2) Touch the Power Level Key ( / ) to set the
Power Level. The Power Level Display and the
Power Level Indicator increase or decrease in
accordance with the selected level (Fig. 20).
CAUTION
•Ensure the power setting does not
exceed the recommended Power Level.
(Refer to the supplied “Tip-Power
Guide” or “Tip Guide” for the maximum
power of each Tip.)
NOTICE •Touch and hold the Power Level Key to
increase or decrease the Power Level
continuously. An alarm is heard when
the maximum or minimum level is
reached.
•To irrigate without vibrating the Tip, set
the Power Level to “0 (zero)” and the
Irrigation Volume to 1 bar or more.
Ultrasonic Mode Select Key
Operation Mode Display
Fig. 19
Power Level Display
Power Level Key
Power Level Indicator
Fig. 20

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15
7-4 Irrigation setting
Touch the Irrigation Mode Select Key to select the Irrigation Mode (Bottle or tap
water). The selected Mode is displayed on the LCD Panel as an icon (Fig. 21). Bottle Tap water
Fig. 21
7-5 Operation
1) Depress the desired button on the Foot Control. A “beep” sound is heard, the Tip starts vibrating and the LED on the Handpiece lights up.
2) Adjust the Irrigation Volume by touching the Irrigation Volume Keys ( / ) while checking the irrigation from the Tip.
CAUTION
•As a safety feature, this product does not operate when the power switch is turned on while the Foot Control is depressed. In
this case, an alarm sound is heard and the Ultrasonic Mode Display (P/E/G) and “ULTRASONIC” blinks alternately. Release the
Foot Control and depress it again.
•Always use irrigation. If there is insufficient irrigation the Handpiece will overheat and may injure the surface of the patient’s
tooth.
•Check that clean water is spraying adequately before use.
•Water may not spray smoothly if the Irrigation Volume is set to a low level. In this case, temporarily increase the Irrigation Volume
temporarily and depress the Foot Control. Check that water is spraying smoothly from the Tip and adjust the Irrigation Volume
again.
•Do not forcibly rotate the Handpiece Holder as doing so may damage the Holder.
NOTICE •The LED of the Handpiece stays lit for about 5 seconds after the Foot Control is released (Afterglow function).
•Ultrasonic Mode (P/E/G), Power Level, Irrigation Mode settings and Irrigation Volume are stored after the power is turned off and
the same settings are applied when the power is turned on next time (Last Memory function).
•If the Irrigation Volume is too low with the Irrigation Volume set to 10 or the Irrigation Volume is too high with the Irrigation
Volume set to 1 while the Irrigation Mode is set to tap water, adjust the basic Irrigation Level. Refer to “11-3 Basic Water Level
Setting” for details.
•A buzzing sound may be emitted, but this does not indicate a malfunction.
During the Handpiece operation :
You can: Adjust the Power Level and Irrigation Volume
You cannot: Change the Ultrasonic Mode or Irrigation Mode settings and perform Auto-Cleaning
7-6 After treatment
Perform maintenance after use on each patient. Refer to “9 Maintenance” for details.
CAUTION
•This product may malfunction if correct maintenance is not performed.
7-7 Protection Circuit
This product may overheat internally if the control
unit is used at power 8 or higher in G mode for an
extended amount of time. In this case, the Protection
Circuit reduces the Power automatically (Power 7).
Bar Graph Indicator flashes from 8 to 10 (Fig. 22).
The indicator stops flashing when the protection
circuit is released. However, in this case the Power
Level does not increase automatically. Increase the
Power Level manually if required. Fig. 22
NOTICE •The Power Level cannot be increased to 8 or higher when the protection circuit has operated (while the bar graph indicator is
flashing).
•The Bar Graph Indicator stops flashing when the Power Level is reduced below 7. It starts flashing again if the Power Level is
increased to 7 while the Protection Circuit function is active.

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8
Using the Powder Mode
The optional Perio Kit must be purchased in order to use the Perio Mode. Refer to “20 Option Parts List” for details about the Perio Kit.
8-1 Water System Setup
1) Make sure that the Water Tube is firmly connected to the Water Tube Connector of the Control Unit. Refer to “5-7 Connecting the Water
Tube” for details.
2) Open the water valve of the dental unit and set the water pressure between 0.1 - 0.3MPa (1.0 - 3.0kgf/cm²). If the water pressure
exceeds 0.3MPa, use a Water Pressure Reducing Valve (option) to adjust the water pressure to within the specified range. Refer to “20
Option Parts List” for details about the water pressure reducing valve.
CAUTION
•Only use drinkable water for irrigation.
8-2 Powder Preparation
1) Select the Chamber and powder to be used with this Mode. Fill the Chamber with
powder up to the “MAX” line (approximately 80g of FLASH pearl or approximately
50g of Perio-Mate powder) (Fig. 23).
Mode Chamber Powder
Prophy Mode For Prophy use FLASH pearl
Perio Mode For Perio use Perio-Mate powder
2) Close the Chamber Cap securely until it fits the Chamber completely and insert the
Chamber straight to the Control Unit (Fig. 24). The type of inserted Chamber is
displayed on the LCD Panel as one of the following icons (Fig. 25).
“MAX” line
Fig. 23
Fig. 24
Perio Mode Prophy Mode
Fig. 25
WARNING
•Use the designated powder only. Using other powders may lead to product failure, damage to the tooth or may cause
emphysema. In addition, it may also cause performance reduction of the product. We cannot accept any liability for failures
caused by using other powders.
CAUTION
•Securely attach the Chamber Cap to prevent the chamber cap
from being blown off, which may lead to an injury (Fig.26).
•Before inserting the Chamber into Control Unit, make sure the
O-Rings of the Chamber Base Connector are not damaged or
torn (Fig.24). Damaged or torn O-Rings could lead to poor
operation or malfunction. Fig. 26
•Insert the Chamber into the Control Unit straight. Inserting at an angle could damage the O-Rings, leading to malfunction.
•If too much cleaning powder is put into the Chamber, the correct amount of powder may not be sprayed immediately after starting use.
•Do not use powder that has been stored in an open package or leftover powder. Using such powder may cause clogging of the
Nozzle. Do not mix leftover powder with new powder.
•Before inserting the Chamber, check the Chamber Base Connector for water, etc., and wipe it clean if it is wet. Failing to do so
may cause powder clogging.
•Do not use discolored powder.
•Always securely close the powder container lid. Failure to do so will attract moisture which may cause clogging.
•If powder adheres to the Chamber and/or the Chamber Cap, clean it immediately or the Cap will become difficult to close.
•Do not invert the Chamber while it contains powder inside. Inverting the Chamber could lead to powder clogging.

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CAUTION
•As a safety feature, this product does not operate if the Foot Control is depressed when the Chamber is mounted incorrectly. An
alarm sounds heard and the tooth icon and “POWDER” flash alternately. Mount the Chamber correctly.
•The Perio-Mate Powder (option) scatters easily because it is made of very fine particles. Fill the Chamber slowly to prevent the
powder from scattering, and be careful not to swallow the powder or allow it to get into eyes.
•FLASH pearl is almost insoluble in water. To avoid clogging of the pipes by using FLASH pearl, periodical cleaning and
maintenance of the vacuum hose, saliva ejector and separator are necessary.
8-3 Attaching/removing the Nozzle Tip
8-3-1 Attaching the Nozzle Tip
Attach the Nozzle Tip (option) securely and firmly to the Nozzle of the Powder
Handpiece (for Perio use) (Fig. 27).
WARNING
•Do not use a deformed or damaged Nozzle Tip. It may detach during
use.
Nozzle Tip
Fig. 27
CAUTION
•Be sure to attach the Nozzle Tip securely and firmly as illustrated
(Fig. 28). If the Tip is attached incorrectly, it will fall off and may be
accidentally ingested by the patient.
•When attaching a Nozzle Tip to the Powder Handpiece, always wear
sterile surgical gloves and make sure that the Powder Handpiece is
sterilized.
Fig. 28
8-3-2 Removing the Nozzle Tip
Use the Perio-Mate Nozzle Tip Remover (option) to remove the Nozzle Tip (Fig. 29)
and dispose of the Nozzle Tip when removed.
WARNING
•The Nozzle Tip can only be used once. Do not reuse or sterilize the
Nozzle Tip as it may be damaged or contaminated. If the Nozzle Tip is
reused, it may not operate correctly due to deformation during removal,
or it may detach during use resulting in accidental ingestion by the
patient. The same applies to a Tip that has been accidentally removed.
Perio-Mate Nozzle Tip Remover
Fig. 29
8-4 Power Level Setting
Touch the Power Level Keys ( / ) to set the Power
Level. The Power Level Display and the Power Level
Indicator increase or decrease in accordance with
the selected Power Level (Fig. 30).
NOTICE •If you specify this setting without
attaching the Chamber, the Power Level
when using the Prophy mode is set.
Power Level Display
Power Level Key
Power Level Indicator
Fig. 30
8-5 Irrigation setting
1) Touch the Irrigation Volume Keys ( / ) to adjust the Irrigation Volume.
2) Depress the Foot Control to spray powder into a spittoon, etc., to confirm that powder, air and water are appropriately sprayed.
3) Adjust the Irrigation Volume while checking the irrigation from the Nozzle.
NOTICE •If the Irrigation Volume is too low with the Irrigation Volume set to 10 or the Irrigation Volume is too high with the Irrigation
Volume set to 1, adjust the basic Irrigation Level. Refer to “11-3 Basic Water Level Setting” for details.
•If you perform adjustment without attaching the Chamber, the Irrigation Volume when using the Prophy mode is set.

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8-6 Operation
Powder, water, and air are supplied when the Foot Control button D is depressed. Water and air are supplied when the Foot Control button B
is depressed. Observe the operating instructions explained in “8-6-1 Using Prophy Mode” and “8-6-2 Using Perio Mode.”
WARNING
•Never spray powder toward a human body including the operator and the assistant other than to the tooth surface.
•Stop use immediately if the hose swells or air or powder leaks from connections between the Chamber and Hose during use.
•Spray water while using this product.
•Be sure to use a vacuum tube (and a saliva discharge tube together if necessary) to prevent the patient from ingesting a large
amount of powder. Avoid continuous use over long periods and allow the patient to rinse out the mouth whenever necessary.
CAUTION
•As a safety feature, this product will not switch on when the Power Switch is turned to ON while the Foot Control is depressed.
An alarm sound is heard and the tooth icon and “POWDER” flash alternately. Release the Foot Control then depress it again.
•Before treatment, adjust the Power Level and the Irrigation Level before using on the patient.
•Reduce the Power Level when treating around marginal gingiva.
•Do not spray vertically onto the tooth surface.
•Maintain the distance between the tip of the Nozzle of the Handpiece to the tooth surface as explained in “8-6-1 Using Prophy
Mode” and “8-6-2 Using Perio Mode.”
•Do not rotate the Handpiece Holder forcibly as it may damage the Holder.
NOTICE •A buzzing sound may be emitted, but this does not indicate a malfunction.
8-6-1 Using Prophy Mode
Keep the Nozzle at a distance of 3 - 5mm from the tooth surface and at an angle
of 10 - 60 degrees (Fig. 31).
WARNING
•Never point toward soft tissue, gum, or the subgingival area.
CAUTION
•Spray from the root to the incisal edge of the tooth.
10 - 60 degrees
3 - 5mm
Fig. 31
8-6-2 Using Perio Mode
Using with the Nozzle Tip
Insert the Nozzle Tip deeper than 3mm into the periodontal pocket (Fig. 32).
Powder may not be sprayed efficiently into the periodontal pocket if the depth is
less than 3mm.
Using without the Nozzle Tip
Remove the Nozzle Tip from the Nozzle of the Handpiece to remove plaque at the
supragingival area and gingival margin, or to remove biofilm and light stains. Keep
the Nozzle at a distance of 5 - 10mm from the tooth surface and at an angle of 30
- 60 degrees (Fig. 33). Never point the Nozzle directly toward the oral mucous
membrane or in periodontal pockets.
Fig. 32
30 - 60 degrees
5 - 10mm
Fig. 33

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WARNING
•When using without the Nozzle Tip, never point toward the oral mucous membrane.
•Do not use this product in an area immediately after scaling the tooth surface in a periodontal pocket. Doing so may cause
bacteremia.
•Do not insert the Nozzle Tip more than once into the same periodontal pocket during the same treatment.
•Powder may be sprayed for a maximum of 5 seconds in the same periodontal pocket (maximum 20 seconds for one tooth).
Never spray powder for longer than the specified time.
•Do not force the Nozzle Tip into a periodontal pocket.
•Do not spray powder while the Nozzle Tip end is located at the bottom of a periodontal pocket. Doing so may cause emphysema.
•Do not use the Nozzle Tip in any places other than periodontal pockets.
•Setting the Power Level too high may cause emphysema. Adjust the Power Level to an adequate level while checking the
patient’s condition.
CAUTION
•The alarm sound is heard every 5 seconds when using Perio Mode.
•In Perio Mode, the Power Level is automatically reduced to a weaker level compared to the same setting for Prophy Mode.
8-6-3 During Handpiece operation
You can: Adjust the Power Level and Water Volume
You cannot: Change Irrigation Mode settings and perform Auto-Cleaning
8-6-4 Releasing residual pressure
The Chamber Cap cannot be opened after operation due to buildup of air pressure inside the Chamber increasing during operation.
Release the pressure remaining in the Chamber before putting powder in the Chamber or removing the Chamber from the Control Unit.
CAUTION
•The remaining powder and water comes out of the Handpiece while releasing the residual pressure. Prepare a container such as
a cup to catch the powder and water.
1) Take the Powder Handpiece out of the Handpiece Holder.
2) Place the Handpiece into the container to catch powder and water.
3) Touch and hold the Auto-Cleaning Key for about 1 second. Beeps are heard and the residual pressure starts to be released.
4) The operation stops when all the residual pressure is released from the Chamber.
8-7 After treatment
Perform maintenance after use on each patient. Refer to “9 Maintenance” for details.
If the Nozzle Tip (option) is attached to the Nozzle, remove and dispose of it before maintenance.
CAUTION
•Failure to perform maintenance may result in malfunction.
NOTICE •The Power Level and Irrigation Mode settings are stored after the power is turned off (Last Memory function).