A Comprehensive Guide to Choosing Dental Handpieces for Different Specialties

Guide to Choosing Dental Handpieces for Different Specialties

Today, we’ll delve into how dentists can select the right handpiece based on their area of expertise. There are nuances known to manufacturers and concerns that matter to clinicians. We’ll bridge these perspectives and provide a detailed breakdown. We’ll start by reviewing the most important features, then move on to classifying handpieces by specialty.

Key Differences

Dental handpieces are primarily divided into two major categories: dental turbines and mechanical handpices. Mechanical handpieces are powered by a motor. The tool connects to the dental unit and is attached to either an air-driven or electric motor, relying on the rotation of shafts for operation.

Turbine handpieces, on the other hand, operate using compressed air supplied from a compressor through a turbine hose. These require an adapter—a quick-connect coupling. When selecting a turbine handpiece, it’s important to clarify the type of connection: how many channels it has and whether it includes a light source.

Speed

High-speed models are, of course, turbine handpieces. Their speeds are generally similar, as most manufacturers follow a standard design. However, it’s worth noting that turbine handpieces don’t maintain a constant speed; they slow down upon contact with hard tissues. This is why many dentists prefer speed-increasing handpieces.

For example, if a turbine handpiece with a speed of 400,000 RPM is pressed against a tooth, it will slow down depending on the pressure applied. With lateral pressure, the speed can drop by more than half. You’ve likely noticed that the turbine speeds up as soon as you stop touching hard tissues. Speed-increasing handpieces don’t have this issue, as they are powered by a motor that’s harder to slow down, ensuring more stable preparation.

Angled handpieces often feature color-coded markings to help clinicians quickly identify their speed characteristics:

To calculate the speed of a speed-increasing handpiece with a 1:5 transmission, multiply the motor speed by 5. For instance, if your motor runs at 20,000 RPM, the bur will rotate at 100,000 RPM. However, to fully unlock the tool’s potential, it’s advisable to use it with an electric motor, which can achieve speeds of up to 40,000 RPM, resulting in 200,000 RPM with a 1:5 transmission.

For speed-reducing handpieces, the calculation works inversely. For example, a handpiece with a 7.4:1 reduction ratio will reduce a 40,000 RPM motor speed to 5,405 RPM at the bur. If the motor speed is reduced to 20,000 RPM, the bur speed will halve again.

Some handpieces consist of two parts—a body and a head—each with its own reduction ratio. For instance, if the body reduces by 7.4 times and the head by 2 times, the total reduction is 14.8 times, resulting in a bur speed of 2,703 RPM at a motor speed of 40,000 RPM.

Not all dentists use speed-reducing handpieces. Those with adjustable motor speeds can simply use a 1:1 transmission handpiece and set the desired speed. However, speed-reducing handpieces offer higher torque, making them ideal for polishing, hygiene, and therapeutic procedures.

Other Key Features

  1. Noise Levels: Most handpieces on the market operate between 50-70 dB. For example, 57 dB is barely noticeable—a quiet hum that’s comfortable for both the dentist and the patient. To compare your handpieces, use a smartphone app with a sound meter, ensuring no background noise for accurate readings.
  2. Power: Measured in watts (W), power indicates the work done per unit of time. Lower power means less tissue removal capacity, requiring more pressure and potentially damaging the handpiece. Turbine handpieces’ power depends on the rotor group and air pressure in the hose. Popular models range from 18-20 W.
  3. Lighting: Handpieces with built-in lights provide additional illumination, complementing the dental unit’s light. Options include handpieces with built-in generators or light guides. LED lighting is now standard, offering bright, white light that’s easy on the eyes.
  4. Spray Systems: Most handpieces feature a spray system to cool the bur and irrigate the preparation area. Optimal designs have 3-4 spray points to ensure adequate water flow. Handpieces without sprays are suitable for short procedures with minimal risk of overheating.

Choosing Handpieces by Specialty

  1. Prosthodontists: High-speed handpieces are ideal for prosthodontists, as they often work with large volumes of tissue. Models with speeds of 200,000 RPM or higher are recommended. Powder-jet tools are also useful for creating microtextures on teeth. Ensure the powder delivery system is adjustable and easy to maintain.
  2. General Dentists: For caries preparation, angled handpieces with 1:1 transmissions and speed-reducing models are commonly used. Speed-reducing handpieces are particularly useful for low-speed tasks like preparing the floor of a cavity. Turbine handpieces are suitable for larger caries removal.
  3. Endodontists: Endodontic handpieces are designed for specific endo motors. Alternatively, speed-reducing handpieces with specialized heads for different file diameters can be used. However, endo motors remain the safest and most precise option.
  4. Surgeons: In implantology, speed-reducing handpieces with a 20:1 transmission are essential, as implant placement requires low speeds (up to 50 RPM). Surgical turbines with 45-degree angled heads are also useful for accessing distal areas, such as molars. These turbines feature special air vents to prevent air embolism.
  5. Hygienists: For polishing and cleaning, 1:1 or speed-reducing handpieces are ideal. Hygienic handpieces with a speed of around 5,000 RPM and 70-degree reciprocating movements prevent paste splatter and protect the head from clogging.

Conclusion

Selecting the right dental handpiece is crucial for efficient and effective treatment. By understanding the key features and matching them to your specialty, you can enhance your clinical outcomes and patient satisfaction. Whether you’re a prosthodontist, general dentist, endodontist, surgeon, or hygienist, there’s a handpiece designed to meet your specific needs. Always consider factors like speed, power, noise, and lighting to make the best choice for your practice.

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