September 1, 2010
by George Freedman DDS, FAACD, FACD
The dental electric handpiece is steadily winning converts in North America. These handpieces have been the more popular choices for practitioners in Europe and Asia for several decades. The reasons were initially practical: the older and less penetrable construction of buildings in these regions made it very difficult to run air lines from a central compressor to remote dental units. In addition, the single operatory set up and small space typical of these practices makes a compressor both unnecessary and loudly obtrusive.
In most practices, handpieces have a role in just about every task from occlusal adjustments to tooth preparation to surgery and everything in between. In response to the profession’s demands, manufacturers produce a wide range of dental handpieces; some are workhorses designed for handling most dental office tasks while others are focused on specific procedures.
The large number of handpiece manufacturers creates competition in ongoing development and price structures, both welcome features for the dentist consumer. Developments that herald clinical benefits are seen rather often in the handpiece industry, typically several times each year. Given that the dental handpiece is the most commonly utilized technology tool of the dental practice, it is essential that the practitioner be up-to-date with as many of these innovations as possible.
Electric handpiece motors generate up to 200,000 rpm of rotation. While this is significantly less than the 400,000 rpm often seen for air driven units, the multiplier handpieces (usually identified by a red ring) can increase the rotation considerably. The important feature, however, is that electric handpieces can produce up to 60 watts of cutting power vs. less than 20 watts for most air driven units. Thus, the electric handpiece will not slow down or stop as the bur is applied to various tooth and restorative materials; it simply continues cutting with a constant torque through the entire speed range, regardless of the load.
Electric turbines offer a greater concentricity of the rotating bur during cutting. Thus, the bur tends to “wobble” less than it would with an air driven handpiece. This results in a decreased “chatter” of the bur blades against the tooth structure, and a more defined, cleaner cut. Precise, continuous margins are easier to prepare. The faster preparation with the electric handpiece creates less heat buildup at the tooth surface.
In fact, this smoother cutting function of the electric handpiece provides a “milling” of the tooth structure rather than the “chopping” that is seen commonly seen with air turbines.
Electric handpieces are generally quieter, saving important wear and tear on the dental team’s ears, an important bonus. The smoother operation milling also decreases the high-pitched whine often heard with air driven units.
Electric motors and handpieces are often heavier than comparable air driven units; their ergonomic design and scientifically developed balancing often make this additional weight virtually unnoticeable. Overall, electric motor cutting is faster and more effective, resulting in less operator fatigue at the end of the day and greater comfort for both the patient and the dentist.
Fiber optic illumination has become an indispensable part of the dental armamentarium over the last two decades. Fortunately, many electric handpieces are equipped with fiber optic illumination. This feature increases the visibility within the operating field, a highly desirable outcome. As dentists age, and their visual acuity in low light situations diminishes, illumination is not an option; it is a basic requirement for effective continued practice.
The handpiece often represents a very significant part of the practice activity, and thus, of the practice overhead. Thus, it is important to select handpieces that are specifically suited to the dentist’s particular needs. They must be easy and comfortable to use. Handpieces should facilitate (not hamper) the procedures for which they are specifically designed, and they must have adequate torque in order to rotate the operative burs quickly enough such that they can be useful in removing enamel, dentin, filling materials, crowns, bridges, polishing, etc.
While certain handpieces command a higher price (and electric motors typically do), their cost must be weighed against their greater efficiency, speed, and endurance. It is often found that a slightly higher up-front expense pays many dividends in both short and long-term calculations. DPM
Dr. Freedman is a founder and past president of the American Academy of Cosmetic Dentistry, a co-founder of the Canadian Academy for Esthetic Dentistry and a Diplomate of the American Board of Aesthetic Dentistry. Dr. Freedman sits on the Oral Health Editorial Board (Dental Materials and Technology) is a Team Member of REALITY and lectures internationally on dental esthetics and dental technology. Dr. Freedman maintains a private practice limited to Esthetic Dentistry in Markham, ON.
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