Dental Handpieces and Accessories Chapter 35 Copyright 2009

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Dental Handpieces and Accessories Chapter 35 Copyright © 2009, 2006 by Saunders, an imprint

Dental Handpieces and Accessories Chapter 35 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Chapter 35 Lesson 35. 1 Copyright © 2009, 2006 by Saunders, an imprint of

Chapter 35 Lesson 35. 1 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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

Learning Objectives Pronounce, define, and spell the Key Terms. Discuss the historical importance of the dental handpiece. Describe the low-speed handpiece and its use in dentistry. Describe the attachments used on the lowspeed handpiece. Describe the high-speed handpiece and its uses. Review other handpieces used in dentistry. (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Learning Objectives Cont’d) Identify dental handpieces and correctly attach them to the dental unit.

Learning Objectives Cont’d) Identify dental handpieces and correctly attach them to the dental unit. Describe rotary instruments and how they are used. List the parts of a bur. Give the composition, shape, and use of the carbide and diamond burs. Identify accessories and correctly attach them to the low-speed handpiece. Identify rotary cutting instruments and correctly attach them to the appropriate dental handpiece or attachment. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Introduction Rotary instruments are used to complete different functions in the cutting, polishing, and

Introduction Rotary instruments are used to complete different functions in the cutting, polishing, and finishing of tooth structure and the restoration process Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

The Evolution of Rotary Equipment 1940 s Introduction of rotary instruments Ø Belt-driven handpiece

The Evolution of Rotary Equipment 1940 s Introduction of rotary instruments Ø Belt-driven handpiece Ø Development of diamond cutting burs Ø 1950 s Invention of tungsten carbide Ø Development of the air-driven turbine handpiece Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Dental Handpiece The handpiece is the most frequently used piece of machinery in dentistry.

Dental Handpiece The handpiece is the most frequently used piece of machinery in dentistry. It provides power to a rotary instrument that is used to complete the actual cutting or polishing of tooth structure and castings. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Low-Speed Handpiece Design Straight in appearance Ø Standard length and “shorty” Ø Speeds range

Low-Speed Handpiece Design Straight in appearance Ø Standard length and “shorty” Ø Speeds range from 10, 000 to 30, 000 rotations per minute (rpm). Ø Powers the rotary instrument in both a forward and a backward motion Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 35 -2 Low-speed handpiece. (From Boyd L: Dental instruments: a pocket guide, ed

Fig. 35 -2 Low-speed handpiece. (From Boyd L: Dental instruments: a pocket guide, ed 3, St Louis, 2009, Saunders. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Uses of the Low-Speed Handpiece Clinical Removal of soft decay and finishing of cavity

Uses of the Low-Speed Handpiece Clinical Removal of soft decay and finishing of cavity preparations Ø Finishing and polishing of restorations Ø Coronal polishing and removal of stains Ø Porcelain adjustments Ø Root canal treatment Ø Laboratory Trimming and contouring of temporary crowns Ø Trimming and relining of removable partials and dentures Ø Trimming and contouring of orthodontic appliances Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Low-Speed Attachments Straight attachments Long-shank laboratory bur Ø Prophylaxis angle attachments Ø Contraangle attachment

Low-Speed Attachments Straight attachments Long-shank laboratory bur Ø Prophylaxis angle attachments Ø Contraangle attachment Latch-type rotary instruments Ø Mandrel Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Prophylaxis Angle Used during polishing procedures to hold the prophylaxis cup and bristle brush

Prophylaxis Angle Used during polishing procedures to hold the prophylaxis cup and bristle brush Ø Two types • Plastic disposable “prophy” angle • Metal “prophy” angle Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 35 -5 Disposable prophy cup and brush. Copyright © 2009, 2006 by Saunders,

Fig. 35 -5 Disposable prophy cup and brush. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

High-Speed Handpiece Design One-piece unit with a slight curve Ø Operated by air pressure

High-Speed Handpiece Design One-piece unit with a slight curve Ø Operated by air pressure Ø Operates at speeds as high as 450, 000 rpm Ø Maintains a water-coolant system Ø Friction-grip locking system for rotary instruments Ø Fiberoptic lighting Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 35 -6 High-speed handpiece. (From Boyd L: Dental instruments: a pocket guide, ed

Fig. 35 -6 High-speed handpiece. (From Boyd L: Dental instruments: a pocket guide, ed 3, St Louis, 2009, Saunders. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Uses of the High-Speed Handpiece Removal of decay Removal of old or faulty restorations

Uses of the High-Speed Handpiece Removal of decay Removal of old or faulty restorations Reduction of the crown portion of a tooth in preparation for a crown or bridge Preparation of an outline and retention grooves for a new restoration Finishing or polishing of a restoration Sectioning of a tooth during a surgery Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Ultrasonic Handpiece Design Attaches to the dental unit Ø Powered by electricity Ø Primarily

Ultrasonic Handpiece Design Attaches to the dental unit Ø Powered by electricity Ø Primarily used for prophylaxis appointments Ø Attachments similar in appearance to scaling instruments Ø Delivers a pulsating spray of water Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 35 -9 Ultrasonic handpiece. (From Boyd L: Dental instruments: a pocket guide, ed

Fig. 35 -9 Ultrasonic handpiece. (From Boyd L: Dental instruments: a pocket guide, ed 3, St Louis, 2009, Saunders. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Uses of the Ultrasonic Handpiece Removal of calculus Removal of stains Removal of bonding

Uses of the Ultrasonic Handpiece Removal of calculus Removal of stains Removal of bonding materials from the tooth surface after orthodontic appliances are removed Removal of cement after orthodontic bands are removed Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Laser Handpiece Design Laser light beam, conducted through a fiberoptic cable, instead of rotary

Laser Handpiece Design Laser light beam, conducted through a fiberoptic cable, instead of rotary instruments Ø Resemblance to a standard handpiece Ø Water-coolant system Ø Air-coolant system Ø (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Laser Handpiece (Cont’d) Uses Cauterizing soft tissue Ø Vaporizing decayed tooth structure Ø Advantages

Laser Handpiece (Cont’d) Uses Cauterizing soft tissue Ø Vaporizing decayed tooth structure Ø Advantages Usually painless Ø Generally no need for anesthesia Ø Speed of procedure Ø Disadvantage Ø Cannot be used on teeth with existing restorations Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Air-Abrasion Handpiece Design Small version of a sandblaster Ø High-pressure delivery of aluminum oxide

Air-Abrasion Handpiece Design Small version of a sandblaster Ø High-pressure delivery of aluminum oxide particles through a small probe Ø Uses Ø Ø Ø Preparation of teeth for sealants Removal of external stains Class I through class VI preparations Endodontic access Crown margins Preparation of the a tooth surface for the cementation of a cast restoration (e. g. , crown or veneer) (Cont’d) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Air-Abrasion Handpiece (Cont’d) Uses Preparation of teeth for sealants Ø Removal of external stains

Air-Abrasion Handpiece (Cont’d) Uses Preparation of teeth for sealants Ø Removal of external stains Ø Class I through class VI preparations Ø Endodontic access Ø Crown margins Ø Preparation of the tooth surface for the cementation of a cast restoration (e. g. , a crown or veneer) Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Laboratory Handpiece Design Operates at speeds as high as 20, 000 rpm Ø Uses

Laboratory Handpiece Design Operates at speeds as high as 20, 000 rpm Ø Uses laboratory burs Ø Greater torque than that of handpieces used intraorally Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Handpiece Maintenance General considerations Wear personal protective equipment and follow universal precautions. Ø Clean

Handpiece Maintenance General considerations Wear personal protective equipment and follow universal precautions. Ø Clean debris from the external surface. Ø Clean the internal components of the handpiece. Ø Handpiece must be dry before being packaged. Ø Wrap the handpiece for sterilization. Ø Sterilize the handpiece. Ø Wipe the light port on the fiber-optic with an alcohol swab to remove any excess lubricant. Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Chapter 35 Lesson 35. 2 Copyright © 2009, 2006 by Saunders, an imprint of

Chapter 35 Lesson 35. 2 Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Learning Objectives Describe rotary instruments and how they are used. List the parts of

Learning Objectives Describe rotary instruments and how they are used. List the parts of a bur. Give the composition, shape, and use of the carbide and diamond burs Identify accessories and correctly attach them to the low-speed handpiece. Identify rotary cutting instruments and correctly attach them to the appropriate dental handpiece or attachment. Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Rotary Cutting Instruments Three basic parts to a rotary instrument Shank: Portion that fits

Rotary Cutting Instruments Three basic parts to a rotary instrument Shank: Portion that fits into the handpiece. • Straight shank • Latch type shank • Friction grip shank Ø Neck: Portion of the rotary instrument that connects the shank and the head. Ø Head: The cutting, polishing, or finishing portion. Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 35 -13 Bur parts and types of shanks: A, Long straight lab. B,

Fig. 35 -13 Bur parts and types of shanks: A, Long straight lab. B, Latch-type. C, Friction grip. (From Robinson D, Bird D: Essentials of dental assisting, ed 3, Philadelphia, 2001, Saunders. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Dental Burs Rotary instruments with sharp cutting head. Uses Tooth preparation. Ø Excavation of

Dental Burs Rotary instruments with sharp cutting head. Uses Tooth preparation. Ø Excavation of decay. Ø Finishing cavity walls. Ø Finishing restoration surfaces. Ø Taking out old fillings. Ø Finishing crown preparations. Ø Separating crowns and bridges. Ø Adjusting and correcting acrylic temporaries. Ø Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

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

Fig. 35 -15 Finishing rotary instruments (Courtesy Miltex, Inc, York, Pennsylvania. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Fig. 35 -16 Abrasive materials for rotary instruments. (D, From Boyd L: Dental Instruments:

Fig. 35 -16 Abrasive materials for rotary instruments. (D, From Boyd L: Dental Instruments: A Pocket Guide, ed 3, St. Louis, 2009, Saunders. ) Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.