There’s a bit of a debate, with very strong opinions, about whether a fixed fiber or continuous fiber is better. Many dentists swear by one or the other and when it comes to picking a laser for your practice, it’s an important decision to make. Here are the biggest differences between continuous and fixed fibers.
Fixed fibers are housed within the tip, already stripped and cleaved. The only step before you’re ready to get is if the procedure requires tip initiation. While 400 microns is the most common fiber size, the Precise SHP are actually 4 different tip sizes to give the dentist more versatility. Arguments for or against fixed fibers come down to leakage, price, and convenience.
Will it leak?
Some claim that fixed fibers leak energy at the connection thus making it less effective. This isn’t exactly true. The connection, or junction, is the point where the fiber in the handpiece connects with the fiber in the tip. That tiny space is where some energy does escape however the energy is then absorbed by the surrounding materials within the handpiece. The dentist and patient are never affected by it. It is true that no fixed fiber tip can be 100%, so calibrations are made to compensate for that. We use the term junction efficiency to refer to the raising of the unit power so that it the lost energy at the junction won’t affect overall performance. If you have set the laser to use 1 watt for the procedure, the laser will produce 1 watt.
Does it affect your wallet?
Fixed fibers are more expensive in the long run. Some dentists believe that in order to save money they will just keep the laser tip used for that patient later. No dentist should ever do this. Not only are there sanitary issues, overall bad practice issues, but this can cause harm to the patient. If kept and used repeatedly, the fiber may split at the ends creating a mini scalpel thus rendering the positive aspects of the laser ineffective. Fixed fiber tips are disposable and meant for only one use for a reason. If your priority to save as much money as possible leads you to consider that choice, please get a continuous fiber.
Convenient or not?
Speed in prep time is one of the biggest arguments for a fixed fiber laser; some dentists seem to go blue in the face because they believe this argument is incorrect. Both sides have some truth. If a laser company tells you that it will take minutes every time to strip and cleave your continuous fiber, that is wrong. However, there is a learning period. Stripping and cleaving correctly is still a learning process that you will have to go through to perfect. So in the beginning, it may take you a little longer, you may mess up and use more fiber. But once you are proficient, then prep time will only take a manner of 5 seconds or so. For those who don’t want to go through that process and are looking for something immediately ready, right from the beginning, the fixed fiber is more convenient.
Continuous fiber models are known for having an overall lowest cost-per-patient savings because the fiber is housed in the unit giving the dentist control over how much fiber is used at a time. With each use, the tip must be thrown away and the fiber cut back to a new, unused section. Most continuous fiber units have a management system to extend or retract the fiber lessening mess and tangles. Once the fiber is fed through the disposable tip, it must be stripped and then cleaved before use.
How to strip and cleave
Stripping means removing the outer layer of the fiber known as the insulation while cleaving is creating a controlled break on the end face of the fiber. Use the fiber stripper to remove that insulation and access the optical fiber inside. Place the fiber cleaver (or cleaving stone) at a 45-degree angle to the optical fiber to make the cut. The fiber must never be cut at a 90-degree angle or using the stone to cut all the way through the fiber. Instead, run the stone at that 45-degree angle along the fiber twice to scribe it. This creates a breaking point along the fiber allowing you to then snap it with your fingers. Check the tip by turning the light on and holding it against a piece of paper. A red circle of light should be very clear and defined; you correctly stripped and cleaved the fiber.
While the fixed fibers come in a variety of sizes, continuous fibers only come in 400 microns. This really isn’t a detriment because this fiber size can be used in all procedures. It’s excellent at clearing away tissue quickly and precisely. Unless you’re needing to get into the pulp chamber or to do a non-contact procedure for a large area quickly, 400 microns is the best size.