Handpieces have come a long way since the first Bor- den Air Rotor in 1957. Today, each handpiece manu- facturer touts features of their latest model. Which features are worth considering and which are mar- keting hype? Many of the more popular handpiece brands have price points of $1,000 to $1,500 each. When you factor in the advice to have three handpieces per operatory, you are looking at a substantial investment in an admittedly vital part of your practice. This article will give some highlights to consider when choosing a handpiece.
Most dentists would say you can’t have too much power. If this describes you, head size should be your first consideration. It is good to have a couple of different head sizes available to you so that you can tailor your handpiece choice to the procedure. Most manufacturers offer as many as three head sizes within the same model – pedo, standard, and torque head. Owning more than one head size gives you the option of choosing the largest size head for that procedure and saving the smaller head handpieces for cases where access is a challenge. Generally, the larger the head size, the more torque so your procedures go faster, reduc- ing wear and tear. The larger turbines also turn slower which puts less stress on the turbine’s components.
Quick connect vs fixed back end
Handpieces that have a quick connect have several advantages and you should weigh these benefits against the extra cost of the handpiece and the cost of purchasing a quick connect for each operatory. These styles of handpiece make between-patient maintenance easier, especially if you have an automated hand- piece lubricator. Doctors and staff like them because they are more convenient and the swivel helps keep the hose out of the way during use. Lastly, the back end is more durable if dropped since there are no exposed tubes to get bent or damaged.
This may be less of a consideration unless you have an office with tile flooring or your handpieces are subjected to rough han- dling. In this case, I would strongly consider a handpiece made from stainless steel. Some examples are Midwest Tradition and Star 430.
Titanium has become a buzzword within the last several years. In my experience, titanium has been more of a benefit to the handpiece manufacturer’s marketing department than to the durability of the handpiece. Many handpieces sold as titanium have a titanium handle and plated brass head or the head (the most vulnerable part) may be titanium but thin and marginally more durable than the more common plated brass. The reso- nant frequency of these handpieces seem to give them a higher, more pronounced pitch to my ears, however weight is less with titanium.
If you are happy with your operatory light and head lamp, this is a feature you may not want to pay more for (usually at least $100 per handpiece). Many new handpieces are not offered in non-optic models. Most handpieces with optics have replaced fiber optics with glass optic rod. The older fiber optics use a epoxy binder that yellows over time and is less durable. Over time, debris thrown off from procedures degrades the optics like rock chips in your car’s windshield. Be- cause of this light output degrades over time (much faster with fiber optics). LED lighting is the latest, it offers a brighter, whiter light that does not heat up and does not degrade. Some models of W&H with this lighting have had problems with a cir- cuit board inside the handpiece going out, but these problems seem to have been resolved with their latest models. Now there are self-powering LED handpieces that have a small electric generator inside the drive air line of the handpiece that powers the LED. This offers the advantage of the latest LED lighting without having to modify your delivery unit. The longevity of these handpieces is not yet known.
Chip water spray
Mulitple spray ports have the advantage of more uniform and finer cooling mist. Unfortunately these smaller ports are sus- ceptible to clogging up. If you use water treatment tablets in your water supply bottle you should cut the pickup line inside the bottle so it is at least an inch above the bottom. Doing this will help keep any undissolved tabs out of the small passages of your handpieces. You may still need to use distilled water with these types. Single spray ports rarely clog and are easier to clear when they do. They do occasionally get out of alignment so they don’t hit the bur like they should (this can be repaired).
In conclusion, the first consideration in your handpiece pur- chase decision should be your budget. There are handpieces over $1,200 that I cannot recommend and ones under $300 that I do. Working within your budget, consider which of the above features are important to you and weigh their benefits in your application. Be wary of spending too little – quality and price are correlated and saving money with the purchase will usually cost you more in ongoing maintenance.