Chapter 35

Dental Handpieces and

Accessories
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Introduction
Rotary instruments complete different
functions in the cutting, polishing, and
finishing of tooth structure and the
restoration process.

Copyright 2003, Elsevier Science (USA). All rights reserved.

The Evolution of Rotary Equipment

1940s
Introduction of rotary instruments.
Belt-driven handpiece.
Development of diamond cutting burs.

1950s
Invention of tungsten carbide.
Development of the air-driven turbine
handpiece.
Copyright 2003, Elsevier Science (USA). All rights reserved.

Dental Handpiece
Most frequently used piece of machinery
in dentistry. The handpiece provides the
power to a rotary instrument that
completes the actual cutting or polishing
of tooth structure and castings.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Low-Speed Handpiece
Design
Straight in appearance.
Standard length and shorty.
Speed ranges from 10,000 to 30,000
rotations per minute (rpm).
Operates the rotary instrument in either
a forward or backward movement.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Fig. 35-2 Low-speed handpiece.

Copyright 2003, Elsevier Science (USA). All rights reserved.

Low-Speed Handpiece-contd
Uses of the low-speed handpiece

Intraoral
Removal of soft decay and fine finishing
of a cavity preparation.
Finishing and polishing of restorations.
Coronal polishing and removal of stains.
Extraoral
Trimming and contouring temporary
crowns.
Trimming and relining of removable
partials and dentures.
Trimming and contouring of orthodontic
appliances.

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Low-Speed Attachments
Straight attachment receives a

longshank laboratory bur, the contraangle attachment, and the prophy angle
attachment.
Contra-angle attachment receives
latch type rotary instruments and
mandrel.

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Low-Speed Attachments-contd
Prophylaxis Angle
Used during polishing procedures to
hold the prophy cup and bristle brush.
Two types
Plastic disposable prophy angle
Metal prophy angle

Copyright 2003, Elsevier Science (USA). All rights reserved.

High-Speed Handpiece
Design
One-piece unit with a slight curve in
appearance.
Operates from air pressure.
Operates at speeds up to 450,000 rpm.
Maintains a water-coolant system.
Friction-grip locking system for rotary
instruments.
Fiber-optic lighting.

Copyright 2003, Elsevier Science (USA). All rights reserved.

High-Speed Handpiece-contd
Uses of the high-speed handpiece
Removes decay.
Removes an old or faulty restoration.
Reduces the crown portion of the
tooth for the preparation of a crown
or bridge.
Prepares the outline and retention
grooves for a new restoration.
Finishes or polishes a restoration.
Sections a tooth during a surgery.
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Ultrasonic Handpiece
Design
Attached to the dental unit.
Powered by electricity.
Attachments are similar in
appearance to scaling instruments.
Delivers a pulsating spray of water.

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Ultrasonic Handpiece-contd
Uses of the ultrasonic handpiece
Removes calculus.
Removes stain.
Removes bonding materials from a
tooth surface after orthodontic
appliances are removed.
Removes cement after orthodontic
bands are removed.

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Laser Handpiece
Design
Uses a laser light beam instead of
rotary instruments.
The laser is conducted through a
fiberoptic cable.
Resembles a standard handpiece.
Maintains a water-coolant system.
Maintains an air-coolant system.

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Laser Handpiece-contd
Uses:

Cauterizes soft tissue.

Vaporizes decayed tooth structure.
Advantages:
Usually painless.
Patient usually does not require
anesthesia.
Proceed with procedure faster.
Disadvantage:
Cannot be used on teeth with existing
restorations.

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Air-Abrasion Handpiece
Design
Small version of a sandblaster.
Produces a highpressure delivery of
aluminum oxide particles through a
small probe.

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Air-Abrasion Handpiece-contd
Uses
Prepares teeth for sealants.
Removes external stains.
Class I through class VI preparations.
Endodontic access.
Crown margins.
Prepares a tooth surface for the
cementation of a cast restoration, such
as a crown or veneer.

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Laboratory
Handpiece
Design
Operates at speeds up to 20,000 rpm.
Uses laboratory burs.
Provides greater torque than
handpieces used intraorally.

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Handpiece Maintenance
General considerations

Wear personal protective equipment and

follow universal precautions.
Clean debris from the external surface.
Clean the internal components of the
handpiece.
Handpiece must be dry before being
packaged.
Wrap the handpiece for sterilization.
Sterilize the handpiece.
Wipe the light port on the fiberoptic with
an alcohol swab to remove any excess
lubricant.

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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
Neck: Portion of the rotary instrument that
connects the shank and the head.
Head: The cutting, polishing, or finishing
portion.

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Fig. 35-12 Types of shanks.

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Dental Burs
Rotary instruments that have a sharp

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

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Types and Shapes of Burs

Diamond rotary instruments are

used for their cutting ability, which

shortens preparation time and increases
productivity.
Finishing rotary instruments: The
more cutting surfaces on the head of a
bur, the greater the polishing capability.

Copyright 2003, Elsevier Science (USA). All rights reserved.