Oral Health Group
Feature

INFECTION CONTROL: Performance Handpieces Demand Efficient and Optimal Care

July 1, 2000
by R.A.Clappison, DDS, FRCD(C) Prosth., FACD


Today’s “Universal Precautions” require the sterilization of handpieccs after each patient use. Current handpieces and high-tech air turbines offer durability, built-in light sources, good spray patterns and overall excellent performance. High performance demands not only excellent components but also careful, consistent maintenance in order to protect the original investment and to obtain trouble-free operation for the normal life of the handpiece.

In pre-sterilization procedures, if debris is not expelled it can be baked onto bearings causing an imbalance of the handpiece dynamics. Excess lubricant and cleaner can congeal in the sterilization process resulting in premature wear and deterioration.

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No matter how detailed the training of staff to perform handpiece purging, lubrication and sterilization, constant supervision is required to meet the standards of infection control and maintenance. Service technicians report that the greatest number of problems occur in offices with staff turnover where the correct preparation and sterilization information is not passed on to the new staff member.

Three automatic handpiece lubricating and cleaning systems and two manual purging systems are described in alphabetical order. One consideration for convenience is to attempt to utilize handpieces from the same manufacturer in order to minimize changing adapters in the purging system.

AUTOMATED SYSTEMS

The advent of automated handpiece lubrication systems brings new ease-of-use technology to the profession. Costs may appear elevated but against that can be balanced the consistent cleaning and lubrication that enhances the life of the handpieces. Another plus is the reduction in staff time and supervision and, after all, the system is tax-deductable. Small practices usually have smaller staff numbers – the system frees hands for needed tasks. Larger, multiple operatory practices, in addition to the above benefits, can find the convenience in effort and time a very great asset.

Assistina 301 Plus, adec/W&H This enclosed system automatically (Fig. 1) cleans and lubricates and purges both airand water channels in handpieces, turbines, air motors and dental scalers inabout 35 seconds. The W&H cleaning fluid is aldehyde free, non-toxic andbiologically degradable in water. The service oil is stated to be completelyharmless to health. A source of clean, dry air is required and is regulated by an internal automatic pressure regulator. A built-in replaceable filter absorbs and contains the aerosol mist. A quick disconnect system with two universal adapters is supplied and other adapters are available for nearly all makes of handpieces. Sufficient cleaning liquid and service oil for 7,000 cycles is included. Over 38,000 Assistinas have been sold worldwide.

– Manufacturer – adec/W&H

– No electrical power required Air supply – 65-140 psi

– Counter top footprint – approx. 8-in. H, 7.5-in,W, 16-in. Deep

– Suggested List Price $2372. (Can.)

– Cost per use can be as low as 2.5 with bulk purchase of lubricant.

QUATTROCARE

This automatic instrument is designed to purge, clean and lubricate four handpieces at a time with the press of a button. Compressed air combined with a new biodegradable cleaning mixture froths up immediately and cleans and lubricates the innermost components of the handpiece in 30 seconds. A red LED lights up and a sound is emitted if the can is empty. Other signals aid in rectifying faults such as an unclosed door. A compressed air gauge and air adjustment control are mounted into the rear panel. The counter top footprint is approximately 13.5-in. wide, 11.0-in. deep, and 14.6-in. in height. Power consumption is low – 115 v. / 20 watts.

– Manufacturer – KaVo: Distributor in Canada – SciCan

– Order Number: QUATTROcare Unit 411- 7800- List Price $4, 100 (Can.)

– QUATTROcare Spray 411-7720 – List Price $65.45 (Can.)

– Operational Cost – 16 per handpiece

SIRONA HYGIENE CENTER

At the touch of a button this three program (Fig. 3) automated system produces cleaned, disinfected, lubricated, sterilized and partially cooled handpieces. It accepts, straight, contra-angle and high speed handpieces – some require available adapters. Two cassettes are supplied – the second accepting wrapped handpieces or hygiene items. In addition, a disinfection steam system is programmed within the system and there are three options available with each cassette. An impulse system cleans the outside of the handpieces as well as the drive and spray channels. The handpieces are first disinfected with steam and then lubricated with special lubricants. Sterilization is by steam at 134C. The inside and outside of the handpieces are pre-dried by counter vacuum and then cooled by pumped sterile air. The system can be connected to a printer for documentation.

– Manufacturer – Sirona Dental Systems

– Power supply – 230 v., approx 2,000 Watts

– Air Supply – 71 -114 psi

– Counter top footprint – 16.1-in high, 17.3-in wide by 23.6-in. deep allowing for connections clearance

– Suggested list price $11,995. (Can.)

MANUAL SYSTEMS:

DCI HANDPIECE FLUSH SYSTEM

This compact table-top model purges the air (Fig. 4)and the water coolant line but does not automatically lubricate. There is an easy to read gauge and adjustable air pressure incorporating a 35 micron filter. The excess lubricant is collected in a bottle at the rear. Eight different adapters are available for various hand-piece designs. DC I recommends Clave Safe, a non-toxic sterile lubricant void of propellants.

– Manufacturer- DCI International

– Order Number – #4060 (less adapter)

– Suggested retail price approximately $225 (Can)

DENTSPLY/MIDWEST HANDPIECE AIR STATION

This air source station expels lubricant and debris from the handpiece but does not (Fig. 5) automatically lubricate, It eliminates thenecessity to return to the operatory to expel the cleaner, lubricant and debris -an in-convenient procedure. It allows single handed activation by pressingdown on the receiver. The air station also incorporates a second receiver forMidwest low speed attachments thereby avoiding the need to place them on alow speed motor. The air regulator is preset to ensure the recommended airpressure.

Twelve “Spray Guards” are provided with the station. These capture debris and lubricant expelled during the purging process. The spray guards can be used with other purging systems that do not utilize an enclosure.

– Manufacturer – Dentsply/Midwest

– Dimensions – 8 x 23/8 x 41/2 inches (L x W x H)

– Order Number #380800 $615(Can.)

– Extra Spray Guards – #380150 Box of 100 $39.95 (Can.)

CONCLUSION

The requirement of sterilization of precision handpieces, motors and turbines has been met by superior technology to maintain and protect handpieces in an unfriendly but necessary environment – STEAM.

The above systems can simplify pre-sterilization handpiece care, extend handpiece life and in the case of the Sirona Hygiene Center – sterilize.

Robert Clappison, DDS, FRCD(C), is Oral Health’s Infection Control and Health Issues Board Member.

Oral Health welcomes this original article.


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