Dental Handpiece

Dental pieces, as you would expect, is a vital instrument in dentistry. The first dental handpieces were introduced back in the late 1860s, and it revolutionized the world of dentistry. Two traditional types of dental handpieces were introduced during this period. These two types of handpieces have evolved throughout the years and have become considerably more sophisticated and efficient in its current modern iteration.

Throughout the years, since the inception of traditional dental handpieces, this instrument has undergone various redesigns, tweaks, and improvements. Currently, dental handpieces come with numerous contra-angle attachments which augments the overall efficiency of dentists in regards to their craft. Modern dental handpieces have also expanded their usage from the typical dental operations to more advanced and complicated procedures such as tooth restoration, surgical removal of various tissues in the oral cavity prepping for root canal operations, as well as implantation of dental implants.

At the forefront are the two primary types of dental handpieces that were introduced during the late 1860s and early 1870’s – these are the air-driven and electric dental handpieces – both of which has their specializations, benefits, and drawbacks. As you would expect, the significant difference between the two types of dental handpieces also correlates with the kinds of add-ons or attachments that are available for each variation. Understandably, an accessory that is employed on an electric dental handpiece won’t be compatible with the air-driven model. If you are curious as to which type is the superior one, alas, that question cannot be answered straightforwardly. Surveying with several dentists will yield mixed results. Simply put, preferring one dental handpiece type over the other is a matter of personal preference and is subjective with each case.

Now, let us take a closer look at the two traditional types of dental handpieces to understand further the strengths and weaknesses that each variation has to offer.

• Air-Turbine Dental Handpieces

As the name implies, the air-turbine dental handpiece utilizes high-speed air pressure to operate dental handpieces like cutting instruments. This type of dental device has been the most widely used in most parts of the world due in large part to its cost-effective price range as well as repairs. Air-turbine handpieces are also quite powerful and can quickly remove damaged tooth with relative ease. There is also its lightweight and compact design which makes air-turbine handpieces easy to maneuver and position inside the patient’s oral cavity.

Air-turbine handpieces can operate at a maximum output of 400,000 rpm but are recommended to run under 300,000 rpm. While those numbers are quite impressive, there is one drawback to air-turbine dental instruments, and that is with the low torque that this type of equipment can produce. What this means that if faced against heavier loads, the speed (rpm) can drop considerably to almost half of its actual output. Let’s say you pushed the air-turbine handpiece to 300,000 rpm, once it touches a significantly sturdy surface, the speed can drop to around 170,000 rpm due to the intense resistance it will go up against. This is air turbines major drawback and is something you must consider.

• Electric Dental Handpieces

On the other side of the coin is the electric handpiece. This type of dental handpiece is powered by an electrical supply and operates using a high-powered motor. Electric dental handpieces are also quite versatile and precise with how much power is used as called for during a specific procedure. Compared to their air-turbine counterpart though, electric type handpieces generate a significantly lower speed at 200,000 rpm max. Of course, other models can provide higher rpm, but 200,000 is pretty much the average count that you will encounter in the market.

What electric handpieces lack in speed/power, they more than make up for with their stable and constant torque. This means that electric dental handpieces are best suited for tackling heavier loads and can cut through almost anything related to dental care with relative ease. As we have noted earlier, 200,000 rpm is the average speeds that you can expect with this type of dental handpiece – however, you can increase that with the help of add-ons. This is another advantage of electric handpieces: versatility. Dentists can equip this type of handpiece with a wide selection of attachments to handle various cases and scenarios that they might come across during certain dental operations. Some of the procedures that electric dental handpieces can excel at include high-speed and low-speed restorative and endodontic services, surgical as well as other laboratory procedures.

Electric dental handpieces are also considerably quieter, and since it does not utilize air pressure, the risk of developing air embolism on the site of surgery is completely removed from the equation. Also, the stable and constant output of power and torque means that electric dental cutting handpieces are best suited for eliminating delicate bridges and crowns. This steady power and speed will also make dental restoration procedures easier. Due to its ability to maintain constant torque, it is highly advisable for dentists who are used to operating with an air-turbine handpiece first to familiarize themselves with electric instruments power. This type of dental handpiece requires a lighter approach as dentists won’t usually need to apply additional pressure when cutting through the tooth.

As for the disadvantages of electric handpieces, you can expect drawbacks that are common with all motor equipment. One of the most glaring problems is overheating, which can not only damage the kit but can also cause injury to patients. There have been cases wherein a patient suffered third-degree burns in their oral cavity due to the electric handpiece overheating. You should also take into account that this type of dental handpiece is considerably heavier than air-turbine models. There is also the issue of its more complex configuration which means that some dentists might need time to be correctly oriented with using this type of dental handpiece.

Sub-Categories of Dental Handpieces

Besides the two major types of handpieces, there is also a sub-category that you should be aware of to help you figure out which type to use for a specific situation.

• Contra-Angle Dental Handpieces

This type of handpiece features angular bends applied into the design of the instrument’s shaft. As it is designed to be maneuverable, it is used when operating hard to reach areas of the mouth during dental procedures.

• High-Speed Dental Handpieces

Dental handpieces that can clock up to 800,000 rpm is categorized as a high-speed or ultra-speed dental handpiece. This type of dental handpiece utilizes a water spray, which is located on the head of the device. This helps keep the motor cool during use and prevent the instrument from overheating. Some models even feature fiber-optic laser light which helps improve the overall precision and accuracy of the dentist during complex dental procedures.

• Low-Speed Dental Handpieces

Similar to the high-speed dental handpiece, the low-speed variation is pretty self-explanatory as to its main feature. This type of dental handpiece can generate a maximum steady output of 10,000 rpm, with 6,000 rpm being the lowest. This dental handpiece is primarily used when polishing or applying the finishing touches to a dental operation.

• Attachments/Add-ons to Dental Handpieces

Due to the technological advancements in science and medicine, dental handpieces also evolved its design and features throughout the years. This included the development of attachments to the main handpiece that further enhanced its pre-conceived uses. These attachments not only helped in improving the dental handpiece’s applications, it also helped in broadening utilization of these devices.

Some of the most common dental handpiece attachments that you will find will include the following:

• LED light attachment
• 360° swivel head attachment
• Contra-angle attachments

High-Speed Dental Handpieces Dental handpieces that can clock up to 800,000 rpm is categorized as a high-speed or ultra-speed dental handpiece. This type of dental handpiece utilizes a water spray, which is located on the head of the device. This helps keep the motor cool during use and prevent the instrument from overheating.

An instrument for holding dental burs to remove tooth structure or to smooth and polish restorative materials. Handpiece rotations are measured in rotations per second. Handpieces may be powered by electric motor or air turbines and are characterized as high speed or low speed depending on their rotational speed.

I would like to reiterate that I am not recommending one type over the other as this is subjective to each individual. Some prefer the traditional air-turbine handpiece while others are more comfortable with the convenience that electric handpieces provide. Keep in mind that advanced features are all for naught if the clinician is not confident or comfortable with using such devices.

Each dentist will find the use of either air-turbine or electric dental handpieces to be limiting or reassuring. It all depends on the clinician’s personal preference. Now that you understand that there is no definite ideal type between the two, let us go through the essential factors that you should consider when choosing your dental handpiece setup.

• Should I get air-turbine or electrical dental handpieces?

This is the most crucial question that you should ask yourself from the get-go. As we have already presented earlier in this article, both types of dental systems have their advantages and disadvantages. Hopefully, you have already formed an opinion between the two types of dental handpieces with the detail we have provided for you.

Based on records, the air-turbine system is still the most generally used type in most dental clinics. However, statistics have shown that electric dental handpiece systems are steadily becoming more and more popular. The upward trend was first spotted in Europe and has steadily expanded to other countries. The reason for the steady rise of electric dental systems is, first and foremost, progress. There is no denying that electric dental instruments provide far more flexibility, features, and convenience to both the clinician and patients.  

Electric dental systems are also far more efficient and quite easy to install into any facility compared to air-turbine units. Convenience is the primary selling point of the more advanced electrical dental system. That said, air-turbine systems are considerably more cost-effective, easier to maintain, and cheaper to repair. Some dentists are also trained in using traditional instruments and are more comfortable in using air-turbine equipment compared to electric ones.

• What are the known issues in air-turbine and electric dental handpieces?

Again, the air-turbine system’s dependability has been proven and tested throughout the years. Air-turbine handpieces are known for its durability, and affordable cost and are generally lightweight and compact. On the other hand, electric handpieces are far more versatile and still offers ample room for improvement – which this type has extended thanks to the advancements in technology.

Since we are in the topic of air-turbine and electric – I think we should also touch upon an underlying issue that has plagued the clinicians for quite some time now: hearing problems. This issue is caused by the high-pitched/high-frequency whirring sound that is emitted by air-turbine systems. Studies have shown that this high-frequency sound can cause hearing damage over time and has proven to be a detriment for dentists in performing their duties. Electric dental handpieces are far quieter and can eliminate this issue, which is another factor to add into consideration.

While air-turbine dental handpieces are still considerably lighter and more compact, electric dental system manufacturers are steadily tweaking their design to match up to what air-turbine systems offer in this particular aspect. In fact, some electric dental handpiece models have reduced 15% to 30% of the previous model’s size and weight within five years.

• Look for units that are compatible attachments such as optimal lights.

Nowadays, it is pretty common to find dental handpieces that come with add-ons, such as optimal lighting. Dental light attachments typically used halogen lamps, but this is slowly but surely being replaced by LED lights (introduced in this field back in 2007) soon. LED optimal light attachments offer far better-quality performance compared to the original halogen light.

LED lights generate minimal heat; it is long-lasting, cost-effective, and offers more accurate light color accuracy. We highly recommend you get attachments to your dental handpiece (whether air-turbine or electric) as this has become an industry standard for quite some time. We also suggest that you get optimal light attachments that incorporate LED lighting instead of halogen light bulbs. Additionally, there is another recent advancement in this particular category, and that is with the multiple LED design. The numerous LED illumination attachments ensure optimum dental visibility that not only puts a light on the surgical site but the entirety of the oral cavity.

Attachment Selection Conditions

Now that you have an idea as to which type of dental handpiece best suits your needs, it is time to go through the several attachments that will significantly help facilitate dental procedures. We will go through each essential add-on as well as the variations that you may encounter in each part.

• Dental Handpiece – Head Technology

When it comes to the head technology of dental handpieces, a general rule of thumb would be to always opt for the smaller one. You do not want the head of your dental instrument to obstruct your view of the oral cavity, so pick one that has a sleek and ergonomic design. You should also take into account the measurement of both the head and bur. In regards to the size of the turbine, 17mm is a good number. In contrast, the handpiece’s head must stay within a diameter of 9mm.

Another essential feature in this category the hygienic head technology. This is a vital feature to have when it comes to the safety of the patient as well as ensure optimum shelf-life of the device. The reason for the importance of this particular technology is due to the turbine rotor vacuum that happens when the unit is slowing down. The risk of sucking in contaminated air into the device is quite high. By using the hygienic head design, the contaminated air is expelled from the bypass channels and are prevented from contaminating the device itself.

• Dental Handpiece – Speed Range

When it comes to the ideal speed that dental handpieces should be able to achieve, 400,000 rpm is the optimum number in regards to cutting capability. In this category, a 1.6mm FG chuck system is considered as the industry standard at the moment. What makes this system ideal is that operators are not required to utilize an additional tool when it comes to replacing the burs. You should also be well aware of the importance of actuation and retaining force factors. Actuation force must be maintained at the recommended rating to ensure that accidental actuation is prevented. As for the retaining force of the mechanism, it must be enough to secure the bur at all times.

• Cooling Systems

This is an imperative component when it comes to electric dental handpieces as this type of system is highly susceptible to overheating problems. Cooling systems in dental handpieces also doubles as a spray system. This feature also works to clean debris and abraded material from the surgical site. The current standard in this technology is the multiple spray channel technology which provides improved efficiency to what the previous spray system model offered.

Importance of Dental Handpiece Maintenance

Cleaning dental handpieces can be quite complicated, depending on the design. This is why we recommend you choose an instrument that offers a simplified and easy cleaning procedures. A streamlined maintenance and cleaning process are highly advised in regards to dentistry practices. Proper cleaning and maintenance will also help prolong the lifespan of your instruments while also keeping them reliable and efficient at all times.

While I do believe this second part is a given, I would still like to stress the importance of proper sterilization of dental equipment. This is where top-tier hardware shines as these are designed to undergo regular and constant sterilization procedures without it affecting the functionality of the instrument in the long run.

Keep in mind to follow the manufacturer’s instructions when performing sterilization with your instruments. For example, manufacturers will indicate the maximum temperature recommended during the sterilization process. Make sure that you follow said guidelines to the letter.