Chapter 35

Dental Handpieces and Accessories

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Introduction
Rotary instruments complete different functions in the cutting, polishing, and finishing of tooth structure and the restoration process.

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The Evolution of Rotary Equipment

1940s
Introduction of rotary instruments. Belt-driven handpiece. Development of diamond cutting burs.

1950s
Invention of tungsten carbide. Development of the air-driven turbine handpiece.

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Dental Handpiece
Most frequently used piece of machinery in
dentistry. The handpiece provides the power to a rotary instrument that completes the actual cutting or polishing of tooth structure and castings.

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Low-Speed Handpiece
Design
Straight in appearance. Standard length and shorty. Speed ranges from 10,000 to 30,000 rotations per minute (rpm). Operates the rotary instrument in either a forward or backward movement.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Fig. 35-2 Low-speed handpiece.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Low-Speed Handpiece-contd
Uses of the low-speed handpiece
Intraoral Removal of soft decay and fine finishing of a cavity preparation. Finishing and polishing of restorations. Coronal polishing and removal of stains. Extraoral Trimming and contouring temporary crowns. Trimming and relining of removable partials and dentures. Trimming and contouring of orthodontic appliances.

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Low-Speed Attachments
Straight attachment receives a long-shank
laboratory bur, the contra-angle attachment, and the prophy angle attachment. Contra-angle attachment receives latch type rotary instruments and mandrel.

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Low-Speed Attachments-contd
Prophylaxis Angle
Used during polishing procedures to hold the prophy cup and bristle brush. Two types Plastic disposable prophy angle Metal prophy angle

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High-Speed Handpiece
Design
One-piece unit with a slight curve in appearance. Operates from air pressure. Operates at speeds up to 450,000 rpm. Maintains a water-coolant system. Friction-grip locking system for rotary instruments. Fiber-optic lighting.

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High-Speed Handpiece-contd
Uses of the high-speed handpiece
Removes decay. Removes an old or faulty restoration. Reduces the crown portion of the tooth for the preparation of a crown or bridge. Prepares the outline and retention grooves for a new restoration. Finishes or polishes a restoration. Sections a tooth during a surgery.

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Ultrasonic Handpiece
Design
Attached to the dental unit. Powered by electricity. Attachments are similar in appearance to scaling instruments. Delivers a pulsating spray of water.

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Ultrasonic Handpiece-contd
Uses of the ultrasonic handpiece
Removes calculus. Removes stain. Removes bonding materials from a tooth surface after orthodontic appliances are removed. Removes cement after orthodontic bands are removed.

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Laser Handpiece
Design
Uses a laser light beam instead of rotary instruments. The laser is conducted through a fiber-optic cable. Resembles a standard handpiece. Maintains a water-coolant system. Maintains an air-coolant system.

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Laser Handpiece-contd
Uses:
Cauterizes soft tissue. Vaporizes decayed tooth structure. Advantages: Usually painless. Patient usually does not require anesthesia. Proceed with procedure faster. Disadvantage: Cannot be used on teeth with existing restorations.

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Air-Abrasion Handpiece
Design
Small version of a sandblaster. Produces a high-pressure delivery of aluminum oxide particles through a small probe.

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Air-Abrasion Handpiece-contd
Uses
Prepares teeth for sealants. Removes external stains. Class I through class VI preparations. Endodontic access. Crown margins. Prepares a tooth surface for the cementation of a cast restoration, such as a crown or veneer.

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Laboratory Handpiece
Design
Operates at speeds up to 20,000 rpm. Uses laboratory burs. Provides greater torque than handpieces used intraorally.

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Handpiece Maintenance
General considerations
Wear personal protective equipment and follow universal precautions. Clean debris from the external surface. Clean the internal components of the handpiece. Handpiece must be dry before being packaged. Wrap the handpiece for sterilization. Sterilize the handpiece. Wipe the light port on the fiber-optic with an alcohol swab to remove any excess lubricant.

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Rotary Cutting Instruments

Three basic parts to a rotary instrument:
Shank: Portion that fits into the handpiece. Straight shank Latch type shank Friction grip shank Neck: Portion of the rotary instrument that connects the shank and the head. Head: The cutting, polishing, or finishing portion.

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Fig. 35-12 Types of shanks.

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Dental Burs
Rotary instruments that have a sharp cutting

head. Uses Tooth preparation. Excavation of decay. Finishing cavity walls. Finishing restoration surfaces. Taking out old fillings. Finishing crown preparations. Separating crowns and bridges. Adjusting and correcting acrylic temporaries.

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Types and Shapes of Burs

Diamond rotary instruments are used for
their cutting ability, which shortens preparation time and increases productivity. Finishing rotary instruments: The more cutting surfaces on the head of a bur, the greater the polishing capability.

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