Category Round-Up: Handpieces

Dr. Parag R. Kachalia;

Category Round-Up: Handpieces

January 18, 2013

Dental Products Report, Dental Products Report-2013-01-01, Issue 1

Over the last decade many new technologies have been incorporated into dental practices including digital impression systems, diode lasers, digital radiography, LED curing lights, and caries detection devices, yet many individuals are using the exact same handpiece they have always used. Most likely this is an air-driven handpiece with a high pitched whistle and a moderate amount of torque.

The whistle and vibration of these handpieces tend to cause a fair amount of anxiety in our patients and the soothing environment clinicians try to provide in their offices is destroyed the moment they step on the rheostat.

The question must be asked whether handpieces have evolved beyond these issues.

The Borden highspeed air driven handpiece debuted in 1957 and this introduction revolutionized dentistry; however only incremental changes have occurred in the air handpiece arena since this time. Air-driven handpieces today are certainly lighter, smaller and somewhat quieter then they once were; however these advancements are still relatively minor. Practitioners continue to battle the fact that air-driven handpieces tend to loose their cutting efficiency with dense materials and patients continue to have anxiety based on the noise and vibration associated with these handpieces.

The solution to these issues resides with electric handpieces. Electric handpieces have been available to the marketplace for many years and while Europeans and Asians would not think about going back to air-driven handpieces the penetration rate in the United States is still relatively low. Practitioners in the United States have been slow to adopt this technology because traditional electric handpieces tended to be heavy, bulky, difficult to maintain, and somewhat confusing to use.

The marketplace was clearly aware of the fact that electric handpieces have a tremendous amount torque leading to cutting efficiency; however in many peoples eyes the bulkiness of the product and warnings related to potentially burning patients was not worth the benefit.

In an air-driven handpiece the speed is a function of the amount of pressurized air that can flow through the turbine. Unfortunately, as rotary cutting instruments meet resistance, the speed at which it can turn decreases and cutting efficiency is lost. In addition, air handpieces tend to have a fair amount of vibration and the concentricity of rotary instruments decreases. In an electric handpiece, air only plays the role of speed regulation as the air approaches a sensor. When a bur meets resistance an electric motor is able to output more energy and continue cutting at essentially the same speed. Historically large motors with intricate carbon brushes were needed to maintain this torque level. Equally important electric handpieces are able to cut more concentrically, leading to highly refined preparation.

Advancements in electric handpieces today allow them to me be lighter, smaller, quieter, easier to maintain, and more simple to operate compared to the earlier generations. In addition these benefits have come without sacrificing the tremendous torque and precision cutting ability of electric handpieces.

Weight and size
The size and weight of electric handpieces have dropped significantly over the last couple of years. Manufacturers such as KaVo, Bien Air, SciCan, and NSK now offer short motors which are nearly 30 to 40 percent lighter and shorter than motors offered only a few years ago.

Quiet
The noise level of traditional air-driven dental handpiece has been a nuisance to patients and can damage the hearing of clinicians over the course of a career. Manufacturers today have electric hanpieces that operate at nearly 20 decibels less than traditional air handpieces. It is estimated that human ear senses a reduction of 10 decibels as almost a 50 percent decrease in loudness.

Maintenance
In years past electric handpieces contained carbon brushes that needed to be changed periodically to maintain ideal performance. Today’s handpieces are brushless and many manufactures have created simple plugin cleaning units to help maintain the precision performance of the handpiece.

Simple operation
In years past many felt electric handpieces were confusing to use because of all the adjustments that could be made. Manufacturers today have integrated simplicity into their handpieces by integrating simple to use touch panels and pre programmability. Manufacturers like Bien-Air have integrated an iPad into their surgical handpiece line and KaVo has created a product called COMFORTdrive that is a simple plug and play electric handpiece that does not need any adjustments.

A new generation of electric handpieces are available to the profession and practitioners should consider an upgrade to these highly precise instruments. This upgrade will immediately be noticeable to patients in terms of increased comfort. In addition it will lead to a positive return on investment in terms of practice efficiency and precision.