Ch. 35 - Dental Handpieces and Accessories

Dental Handpieces Dental Handpieces and Accessoriesand Accessories

Chapter 35Chapter 35

Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.


Lesson 35.1Lesson 35.1


Learning ObjectivesLearning Objectives

Pronounce, define, and spell the Key Terms.Pronounce, define, and spell the Key Terms. Discuss the historical importance of the dental Discuss the historical importance of the dental

handpiece.handpiece. Describe the low-speed handpiece and its use in Describe the low-speed handpiece and its use in

dentistry.dentistry. Describe the attachments used on the low-speed Describe the attachments used on the low-speed

handpiece.handpiece. Describe the high-speed handpiece and its uses.Describe the high-speed handpiece and its uses. Review other handpieces used in dentistry.Review other handpieces used in dentistry.(Cont’d)(Cont’d)



Cont’d)Cont’d)

Identify dental handpieces and correctly attach them to Identify dental handpieces and correctly attach them to the dental unit.the dental unit.

Describe rotary instruments and how they are used.Describe rotary instruments and how they are used. List the parts of a bur.List the parts of a bur. Give the composition, shape, and use of the carbide Give the composition, shape, and use of the carbide

and diamond burs.and diamond burs. Identify accessories and correctly attach them to the Identify accessories and correctly attach them to the

low-speed handpiece.low-speed handpiece. Identify rotary cutting instruments and correctly attach Identify rotary cutting instruments and correctly attach

them to the appropriate dental handpiece or them to the appropriate dental handpiece or attachment.attachment.


IntroductionIntroduction

Rotary instruments are used to complete Rotary instruments are used to complete

different functions in the cutting, polishing, different functions in the cutting, polishing,

and finishing of tooth structureand finishing of tooth structure

and the restoration processand the restoration process


The Evolution of Rotary EquipmentThe Evolution of Rotary Equipment

1940s1940s Introduction of rotary instrumentsIntroduction of rotary instruments Belt-driven handpieceBelt-driven handpiece Development of diamond cutting bursDevelopment of diamond cutting burs

1950s1950s Invention of tungsten carbideInvention of tungsten carbide Development of the air-driven turbine handpiece Development of the air-driven turbine handpiece


Dental HandpieceDental Handpiece

The handpiece is the most frequently used The handpiece is the most frequently used

piece of machinery in dentistry. It provides piece of machinery in dentistry. It provides

power to a rotary instrument that is used to power to a rotary instrument that is used to

complete the actual cutting or complete the actual cutting or

polishing of tooth structure polishing of tooth structure

and castings. and castings.


Low-Speed HandpieceLow-Speed Handpiece

DesignDesign Straight in appearanceStraight in appearance Standard length and “shorty”Standard length and “shorty” Speeds range from 10,000 to 30,000 rotations per Speeds range from 10,000 to 30,000 rotations per

minute (rpm).minute (rpm). Powers the rotary instrument in both a forward and Powers the rotary instrument in both a forward and

a backward motion a backward motion


Fig. 35-2 Low-speed handpiece.Fig. 35-2 Low-speed handpiece.(From Boyd L: (From Boyd L: Dental instruments: a pocket guideDental instruments: a pocket guide, ed 3, St Louis, 2009, Saunders.), ed 3, St Louis, 2009, Saunders.)


Uses of the Low-Speed HandpieceUses of the Low-Speed Handpiece ClinicalClinical

Removal of soft decay and finishing of cavity preparationsRemoval of soft decay and finishing of cavity preparations Finishing and polishing of restorationsFinishing and polishing of restorations Coronal polishing and removal of stainsCoronal polishing and removal of stains Porcelain adjustmentsPorcelain adjustments Root canal treatmentRoot canal treatment

LaboratoryLaboratory Trimming and contouring of temporary crownsTrimming and contouring of temporary crowns Trimming and relining of removable partials and denturesTrimming and relining of removable partials and dentures Trimming and contouring of orthodontic appliances Trimming and contouring of orthodontic appliances


Low-Speed AttachmentsLow-Speed Attachments

Straight attachmentsStraight attachments Long-shank laboratory burLong-shank laboratory bur Prophylaxis angle attachmentsProphylaxis angle attachments

Contraangle attachmentContraangle attachment Latch-type rotary instrumentsLatch-type rotary instruments Mandrel Mandrel


Prophylaxis AngleProphylaxis Angle

Used during polishing procedures to hold the Used during polishing procedures to hold the prophylaxis cup and bristle brushprophylaxis cup and bristle brush Two typesTwo types

• Plastic disposable “prophy” anglePlastic disposable “prophy” angle

• Metal “prophy” angle Metal “prophy” angle


Fig. 35-5 Disposable prophy cup and brush.Fig. 35-5 Disposable prophy cup and brush.


High-Speed HandpieceHigh-Speed Handpiece

DesignDesign One-piece unit with a slight curveOne-piece unit with a slight curve Operated by air pressureOperated by air pressure Operates at speeds as high as 450,000 rpm Operates at speeds as high as 450,000 rpm Maintains a water-coolant systemMaintains a water-coolant system Friction-grip locking system for rotary instruments Friction-grip locking system for rotary instruments Fiberoptic lighting Fiberoptic lighting


Fig. 35-6 High-speed handpiece.Fig. 35-6 High-speed handpiece.(From Boyd L: (From Boyd L: Dental instruments: a pocket guideDental instruments: a pocket guide, ed 3, St Louis, 2009, Saunders.), ed 3, St Louis, 2009, Saunders.)


Uses of the High-Speed HandpieceUses of the High-Speed Handpiece

Removal of decayRemoval of decay Removal of old or faulty restorationsRemoval of old or faulty restorations Reduction of the crown portion of a tooth in Reduction of the crown portion of a tooth in

preparation for a crown or bridge preparation for a crown or bridge Preparation of an outline and retention Preparation of an outline and retention

grooves for a new restoration grooves for a new restoration Finishing or polishing of a restoration Finishing or polishing of a restoration Sectioning of a tooth during a surgery Sectioning of a tooth during a surgery


Ultrasonic HandpieceUltrasonic Handpiece

DesignDesign Attaches to the dental unitAttaches to the dental unit Powered by electricityPowered by electricity Primarily used for prophylaxis appointmentsPrimarily used for prophylaxis appointments Attachments similar in appearance to scaling Attachments similar in appearance to scaling

instrumentsinstruments Delivers a pulsating spray of waterDelivers a pulsating spray of water


Fig. 35-9 Ultrasonic handpiece. Fig. 35-9 Ultrasonic handpiece. (From Boyd L: (From Boyd L: Dental instruments: a pocket guideDental instruments: a pocket guide, ed 3, St Louis, 2009, Saunders.), ed 3, St Louis, 2009, Saunders.)


Uses of the Ultrasonic HandpieceUses of the Ultrasonic Handpiece

Removal of calculusRemoval of calculus Removal of stainsRemoval of stains Removal of bonding materials from the tooth Removal of bonding materials from the tooth

surface after orthodontic appliances are surface after orthodontic appliances are removedremoved

Removal of cement after orthodontic bands Removal of cement after orthodontic bands are removed are removed


Laser HandpieceLaser Handpiece

DesignDesign Laser light beam, conducted through a fiberoptic Laser light beam, conducted through a fiberoptic

cable, instead of rotary instrumentscable, instead of rotary instruments Resemblance to a standard handpieceResemblance to a standard handpiece Water-coolant systemWater-coolant system Air-coolant systemAir-coolant system

(Cont’d)(Cont’d)


Laser HandpieceLaser Handpiece


UsesUses Cauterizing soft tissueCauterizing soft tissue Vaporizing decayed tooth structureVaporizing decayed tooth structure

AdvantagesAdvantages Usually painlessUsually painless Generally no need for anesthesiaGenerally no need for anesthesia Speed of procedureSpeed of procedure

DisadvantageDisadvantage Cannot be used on teeth with existing restorations Cannot be used on teeth with existing restorations


Air-Abrasion HandpieceAir-Abrasion Handpiece

DesignDesign Small version of a sandblasterSmall version of a sandblaster High-pressure delivery of aluminum oxide particles through a High-pressure delivery of aluminum oxide particles through a

small probesmall probe

UsesUses Preparation of teeth for sealantsPreparation of teeth for sealants Removal of external stainsRemoval of external stains Class I through class VI preparationsClass I through class VI preparations Endodontic access Endodontic access Crown margins Crown margins Preparation of the a tooth surface for the cementation of a cast Preparation of the a tooth surface for the cementation of a cast

restoration (e.g., crown or veneer)restoration (e.g., crown or veneer) (Cont’d)(Cont’d)


Air-Abrasion HandpieceAir-Abrasion Handpiece


UsesUses Preparation of teeth for sealantsPreparation of teeth for sealants Removal of external stainsRemoval of external stains Class I through class VI preparationsClass I through class VI preparations Endodontic access Endodontic access Crown margins Crown margins Preparation of the tooth surface for the Preparation of the tooth surface for the

cementation of a cast restoration (e.g., a crown or cementation of a cast restoration (e.g., a crown or veneer) veneer)


Laboratory HandpieceLaboratory Handpiece

DesignDesign Operates at speeds as high as 20,000 rpmOperates at speeds as high as 20,000 rpm Uses laboratory burs Uses laboratory burs Greater torque than that of handpieces used Greater torque than that of handpieces used

intraorally intraorally


Handpiece MaintenanceHandpiece Maintenance

General considerationsGeneral considerations Wear personal protective equipment and follow Wear personal protective equipment and follow

universal precautions. universal precautions. Clean debris from the external surface. Clean debris from the external surface. Clean the internal components of the handpiece. Clean the internal components of the handpiece. Handpiece must be dry before being packaged. Handpiece must be dry before being packaged. Wrap the handpiece for sterilization. Wrap the handpiece for sterilization. Sterilize the handpiece. Sterilize the handpiece. Wipe the light port on the fiber-optic with an Wipe the light port on the fiber-optic with an

alcohol swab to remove any excess lubricant. alcohol swab to remove any excess lubricant.



Lesson 35.2Lesson 35.2



Describe rotary instruments and how they are Describe rotary instruments and how they are used.used.

List the parts of a bur.List the parts of a bur. Give the composition, shape, and use of the Give the composition, shape, and use of the

carbide and diamond burscarbide and diamond burs Identify accessories and correctly attach them Identify accessories and correctly attach them

to the low-speed handpiece.to the low-speed handpiece. Identify rotary cutting instruments and correctly Identify rotary cutting instruments and correctly

attach them to the appropriate dental attach them to the appropriate dental handpiece or attachment.handpiece or attachment.


Rotary Cutting InstrumentsRotary Cutting Instruments

Three basic parts to a rotary instrumentThree basic parts to a rotary instrument Shank: Portion that fits into the handpiece. Shank: Portion that fits into the handpiece.

• Straight shankStraight shank

• Latch type shankLatch type shank

• Friction grip shankFriction grip shank

Neck: Portion of the rotary instrument that Neck: Portion of the rotary instrument that connects the shank and the head. connects the shank and the head.

Head: The cutting, polishing, or finishing portion. Head: The cutting, polishing, or finishing portion.


Fig. 35-13 Bur parts and types of shanks: A, Long straight lab. Fig. 35-13 Bur parts and types of shanks: A, Long straight lab. B, Latch-type. C, Friction grip.B, Latch-type. C, Friction grip.

(From Robinson D, Bird D: Essentials of dental assisting, ed 3, Philadelphia, 2001, Saunders.)(From Robinson D, Bird D: Essentials of dental assisting, ed 3, Philadelphia, 2001, Saunders.)


Dental BursDental Burs

Rotary instruments with sharp cutting head. Rotary instruments with sharp cutting head. UsesUses

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


Fig. 35-15 Finishing rotary instrumentsFig. 35-15 Finishing rotary instruments(Courtesy Miltex, Inc, York, Pennsylvania.)(Courtesy Miltex, Inc, York, Pennsylvania.)


Fig. 35-16 Abrasive materials for rotary instruments.Fig. 35-16 Abrasive materials for rotary instruments.(D, From Boyd L: Dental Instruments: A Pocket Guide, ed 3, St. Louis, 2009, Saunders.)(D, From Boyd L: Dental Instruments: A Pocket Guide, ed 3, St. Louis, 2009, Saunders.)


Ch. 35 - Dental Handpieces and Accessories

Documents

Transcript of Ch. 35 - Dental Handpieces and Accessories