SPEEDS IN DENTISTRY

INTRODUCTION
The term ROTARY when applied to tooth cutting instruments describes a
group of instruments that turn on an axis to perform any kind of work which in
dentistry extends from cutting, abrading, finishing or polishing of tooth or any
restorative material.
Archaeological evidence suggests dental treatment dating back to 5000
.!. "arly instruments were activated by either the operator#s hands or feet. "arly
drills were powered mostly by the operator#s fingers. $r %onathan Taft &'()(* said
in his book, Textbook of +perative $entistry, that hand cutting instruments
were of good steel, well wrought and thoroughly tempered. "very process in the
manufacturing process should be most perfectly executed so as to ensure an edge
that will cut not only but also enamel &which is the hardest animal substance*.,
These instruments were heavily handled and as wide as 0.-5 inch at the cutting
edge. Taft suggested that a heavy instrument with a sharp point and a lateral
curve is often efficient in opening up cavities and cutting down strong pro.ections
of enamel.,
Therefore it can be assumed that only very large carious lesions can permit
the entry or give access to such instruments. Thus it can be said that conservative
dentistry was not practiced at that time. All actions from cutting walls to refining
the cavity were done by hand instruments. Also for access to proximal regions,
separators were used and for a bulky instrument, enough separation was re/uired
that caused deleterious effects to the tooth and supporting tissues.
Therefore the development of efficient cutting instruments was mandatory.
The first rotary instruments developed were drills or bur heads that could be
twisted in the fingers for a crude cutting or abrading action. The first rotary
instruments used for cutting were drills or bur heads that could be twisted in the
fingers for a crude cutting or abrading action. Taft described them as bur drills,.
These simple rotary instruments were capable of a very limited lateral cutting
action. Their diameters ranged from '01- to '05 of an inch and were used for
'
cavity preparations, providing a more regular and precise orifice than was
formerly possible. The 2cranton drill was made which was an improvement on
previous bur drills since it could be rotated in either direction.
3odifications thus made at that time resulted in number of hand drills4
'. 2!5A6T+6#2 $57884 could be rotated in either direction.
-. $5788 57694 could be adapted to the middle finger with a socket that
fitted against the palm of the hand.
1. !:";A87"5#2 $5788 2T+!<4 bur could be in various directions used
similar to an egg beater.
=. 3"55>#2 $5788 2T+!<4 had a flexible cable.
"arlier these drills were called as drill stocks, bur chucks or bit holders.
These were the forerunners modern $ental :andpiece,.
HANDPIECE: is a device used for holding rotating instruments, transmitting
power to them and for positioning them intraorally.
The modern handpiece came into existence after pioneering work was done
by 3orrison in '(?' when he adapted the dental foot engine from the 2inger
2ewing 3achine. This addition was important since it had a power source other
than the operator. 7n '((1 an electric dental engine was linked to the handpiece by
a flexible cable arm. 7n '@'0 a belt driven handpiece was made. 7n '@50 the first
air turbine was introduced.
LANDMARKS IN EVOLUTION OR ROTARY INSTRUMENTATION
'()0 to '(?0 A :and powered bur drills
'(?' A $ental foot engine attached
'((1 A "lectric dental engine
'@50 A Birst air turbine.
-
Although by '@'0 the necessary speed was achieved but the re/uired
cutting efficiency was not available. 2teel burs of that time could not efficiently
cut enamel even though speed was increased, it only resulted in heat production
and instrument wear.
Therefore diamond cutting instruments were developed in '@=?. These burs
worked very nicely at '5000 rpm. y '@)0 the speed increased from '0000 to
)0000 rpm.
3a.or developments that improved the efficiency of rotary instrumentation4
'* !ontra angling.
-* $evelopment of air powered turbines from previously used water powered
turbines.
ADVANCEMENT IN MODERN ROTARY INSTRUMENTATION
'@=- A 7ntroduction of $iamond points
'@=? A 7ntroduction of !arbide urs
'@50 A all earing :andpiece developed
'@51 A Bluid Turbine Type :andpiece by 6elson &50,000 rpm*
'@5= A Air driven :andpiece &'50000 rpm*
A !ontra Angle :andpiece
'@5? A 7ncreased speed of Air Turbine Briction 9rip &100000 rpm*
'@)0 A Air Turbine &)00000 rpm*
C 'n '@51 ultrasonic method was developed for removing hard tissue with a
fre/uency of '5000 to 10000 cycles per second.
1
CLASSIFICATION OF SPEED
'. According to CHARBENEAU4
a* !onventional or 8ow speed A below '0000 rpm
b* 7ncreased or :igh speed A '0000 to '50000 rpm
c* Dltra 2peed A Above '50000 rpm
-. According to STURDEVANT4
a* 8ow or 2low 2peeds &below '-000 rpm*
b* 3edium or 7ntermediate 2peeds &'-000 to -00000 rpm*
c* :igh or Dltrahigh 2peeds &above -00000*
1. According to MARZOUK4
a* Dltra 8ow 2peed &100 A 1000 rpm*
b* 8ow 2peed &1000 E )000 rpm*
c* 3edium :igh 2peed &-0000 E =5000 rpm*
d* :igh 2peed &=5000 E '00000 rpm*
e* Dltra :igh 2peed &'00000 rpm F more*
CHARACTERISTICS OF ROTARY INSTRUMENTATION4
'. 2peed
-. Gressure
1. :eat production
=. ;ibration
5. Gatient reaction
). +perator fatigue
?. 2ources of Gower
(. 7nstrument $esign
=
1. SPEED 4
2peed refers to revolutions per minute
+r
2urface feet per unit time of contact the tool has with the work to be cut.
# according to industrial investigation, maximum cutting efficiency of a tool of
uniform width ranges between 5!" surface feet #er minute$
2. PRESSURE:
3athematically, pressure H force 0 unit area
Borce4 7t is the gripping of the handpiece and subse/uent transmission to the tooth.
Area4 Area of bur in contact with tooth surface.
Gressure is inversely proportional to Area.
Gressure x Area H !onstant
Therefore a smaller tool will apply greater pressure.
This implies that if pressure kept constant for a larger tool, to remove as much
tooth structure with a smaller one, the force has to be increased.
Therefore for best efficiency and convenience of the operator, a smaller tool with
increased revolutions is best i$e o#erator will have to use minimum force$
As speed keeps on increasing pressure re/uired keeps on reducing.
'. 8ow 2peed A - to 5 pounds
-. :igh 2peed A ' pounds
1. Dltra :igh 2peed A 0.0)-5 to 0.-5 pounds & ' to = ounces*
3. HEAT PRODUCTION:
:eat is directly proportional to the a* Gressure
b* 5G3
c* Area of tooth in contact
Gulp damage occurs at '10 B &5=.= !*
5
7nflammatory changes at ''1B &=5.0 !*
C Therefore a coolant is re/uired for all practical purposes involving high speeds.
4. VIBRATION:
7t leads to a* Gatient discomfort
b* "xcessive wear of instruments
c* $estructive reaction in the tooth and the supporting tissues
$eleterious effects of vibrations are due to4
'* Amplitude4
Bre/uency is inversely proportional to amplitude. Therefore an increase in one will
cause a decrease in the other. Amplitude causes greater harm when it is high. This
implies that speed should be increased to in order to reduce amplitude.
At )000 rpm, vibration H '00 s
A'
&most annoying to the patient*.
At '00000 rpm, vibration H ')00 s
A'
&imperceptible to the patient*.
&:uman perception ends at '100 s
A'
*.
Thus, high speeds are best for patient comfort since amplitude is lesser and greater
the fre/uency is imperceptible to the patient.
-* Dndesirable modulating fre/uency4
+ld and poorly maintained e/uipment will have a fundamental vibration when in
rotation. A superimposed vibration caused due to eccentricity and wear F tear of
the individual components of the e/uipment will produce a modulated fre/uency
which will have deleterious effects.
5. PATIENT REACTION 4
Gatient reaction consists primarily of heat production, sensation to vibrations and
number of visits.
6. OPERATOR FATIGUE:
!auses 4 a* $uration of procedure.
b* ;ibrations produced.
)
c* Borce needed to control the rotating instrument.
d* 8ack of patient cooperation.
5emedies 4 a* :igh speed instrumentation.
b* Groper balancing of handpieces &contraangling*
c* 5eduction of weight of handpiece minimiIes forces needed
to control it.
. SOURCE OF PO!ER:
$epending upon the source of power4 a* Air turbine
b* Jater driven
c* elt driven
". INSTRUMENT DESIGN:
Bor rotary instrumentation re/uirements are4
7* H#$%&'()(: A device used for holding rotating instruments,
transmitting power and positioning them.
77* C*++'$, T--.: 7t can be a bur, stone, rubber cup or rubber disc.
I/ HANDPIECE:
!lassification of :andpieces based on $"27964
a* 2traight
b* 5ight angled
c* !ontra angled
!lassification of :andpieces based on source of G+J"54
a* elt drive
b* 9ear driven
c* Jater driven
d* Air driven
e* 3icromotors4 Air motor &rotary vane F swash plate type*
"lectric motor &$.! motor F "lectric induction motor*
?
!lassification of :andpieces based on 5"T"6T7+6 +B !DTT769 T++84
a* 2crewA7n Type
b* 8atch Type
c* Briction 9rip Type &wear F tear is the least*
C.#00'1')#+'-$ -1 H#$%&'()(0 2#0(% -$ DESIGN:
a* 2T5A79:T :A6$G7"!"4 2implest and most stable but not used intraorally
because of access problems. 7t is used primarily in the laboratory because of less
wear F tear.
b* 579:T A698"$ :A6$G7"!"4 ur is placed almost @0 degree to the
handpiece, hence it is difficult to handle. Jhile in use it causes a displacing force
which is @0 degree to the axis of rotation. The bur is offset from the handpiece
axis, forming a lever arm and leading to instability.
c* !+6T5A A698"$ :A6$G7"!"4 Grinciple of contraangling introduces a
second angle into the handpiece to return the tip of the bur to the long axis of the
handpiece. This removes the lever arm of conse/uent rotation of the handpiece.
(
"ngine driven instruments can be used in three types of contraAangle handpieces4
i* FULL ROTATING HAND PIECE4 7t can be latch or friction grip
type and re/uires that instruments mounted should be used only in a straight
line. Bor curved canals handpieces with 6iTi files should be used e.g.
3edidanta03icro 3ega 33 1-= reduction gear handpiece, Kuantec "T3A
"lectric Tor/ue 3otor.
2ome have tor/ue and speed control facility. 2ome also have the provision
to stall and Lreverse, if tor/ue is exceeded. The Tri AutoAMN works in gets
activated only in moist canals and stops as soon as the file is withdrawn. 7t has
a built in apex locator as well.
ii* RECIPROCATING HANDPIECE4 e.g 9iromatic :andpiece, 3=
2afety :andpiece.
975+3AT7! :A6$G7"!" accepts only latch type instruments. 7t gives a
%uarter turn motion O 1000 times per minute.
3= 2AB"T> :A6$G7"!" gives a & degree reci#rocating action and
accepts regular hand files.
"6$+A957GG"5 :A6$G7"!" has a '04' gear ratio and a '5 degree turning
motion. 7t uses regular hand instruments.
iii* VERTICAL STROKE HANDPIECE4 7t is driven by air or electricity
that delivers a vertical stroke ranging from 0.1 to 'mm. The more freely the
instrument moves in the canal, longer is the stroke. 7t has a %uarter turn
reci#rocating motion. 7t stalls if the canal is too tight.
@
MICROMOTORS: &500 to '00000 rpm*
3icromotors are slow speed motors are used for removal of soft caries, finishing
and polishing.
Advantages4
'* :igh tor/ue
-* $oes not stall because of good tor/ue at low speed
7t is of two types4
7* Air 3otors
77* "lectric 3icromotors
I/ AIR MOTORS:
Two types4
'* 5otary ;ane Type 3otor4 A number of sliding vanes hold the central core to
the cylinder wall when air is forced into the chamber at high pressure. "xpansion
of air within the chamber will drive it towards the low pressure side where is
vented out of the system.
Advantage4 '* 5uns smoothly.
-* $evelops considerable tor/ue.
$isadvantage4 Jear F Tear is high on the sealing edges of the vane.
-* 2wash Glate Type $rive Air 3otor4 7t operates by a series of pistons pressing
se/uentially against a disc which is offset against its axis of rotation. Gistons move
in tandem se/uentially, i.e. as one gets over with its movement and the other
piston starts off. The rotation of the disc operates a rotary valve which feeds air to
the pistons se/uentially.
Advantage4 :igh speed
$isadvantage4 7t is very noisy.
'0
II/ ELECTRIC MICROMOTORS:
Two types4
'* $.! 3otors4 These are $.! motors designed with an armature coil within a
permanent magnet. Gerformance depends upon design and power of the field
magnets and number of armature coils. 2peed can be altered by varying distance
between the coil and magnet. 3ore the coils, smoother it is. "lectric control
system facilitates operation and control of speed. 5esistance while cutting causes
the speed to decrease and thus to compensate for this decrease, voltage is
increased by a stabiliIer leading to an increase in speed.
Advantage4 '* 2peed
-* 9reat tor/ue control
$isadvantage4 '* !omplexity of the overall drive mechanism.
-* "ntire apparatus can not be steriliIed
-* "lectric 7nduction 3otors4 &=0000 rpm* 3otor uses a series of overlapping
fields which are energiIed se/uentially around the armature. The iron armature
contains copper rods within which eddy currents create the magnetic fields and
these react with the magnetic field produced from the armature coil which is in
motion.
Advantage4 they are maintenance free except for the bearings which need
to be changed
C oth motors re/uire air cooling as heat generation is high.
COUPLINGS:
These are used to connect air turbines and 3icromotors to the hoses of the
instrument delivery units.
Two types4
'* - :ole !onnector E ' for Jater &smaller bore*
' for Air &larger bore*
''
-* 3idAJest = :ole !onnector E ' for $rive Air 7n
' for "xhaust $rive Air +ut
' for !oolant Jater 7n
' for !oolant Air 7n
E 3 FITTING 4 COUPLING
7t allows interchange of handpieces between motors of different manufacturers. 7t
is standardiIed, reliable and an effective method of transferring the drive to the
handpiece.
CONTROL OF SPEED 5 TOR6UE
+perating speed can be optimiIed by correct selection of handpieces and
corresponding gear ratio. 3ost common method for gearing handpieces is by the
use of an (#icyclic )all Race *ear +ystem which is incorporated into the shank of
the handpiece$ 7t can either increase or decrease the speed of rotation depending
upon whichever way it is mounted. 7t is a modification of a ball race bearing.
Advantage4
'* 5elatively smooth and /uiet in operation.
-* :igh tor/ue can be transmitted without slipping of the ball bearing.
1* "asy to clean and lubricate.
C 8atest modification is (#icyclic *ear )oxes with toothed gears.
REDUCTION GEAR HANDPIECES
5eduction gear handpieces reduce the speed of the drive while increasing the
tor/ue. They are necessary for large diameter instruments like bristle brushes and
prophylaxis heads.
'-
COLOUR CODING:
7t indicates relative gear ratio of each component. :ead of handpiece is marked
with a colored dot or ring and the handpiece shank is marked with one or more
colored rings.
lue A 6o change in speed.
9reen A 2peed reduction.
5ed A 2peed increase.
C Two or more rings indicate a large change.
SPECIALIST HANDPIECES:
'* "ndodontic :andpieces4 They reciprocate, oscillate or do both.
-* Bor +ral 2urgery4 &a* Bast rotary vane motors for cutting impacted teeth.
&b* "xtremely slow speeds for bone cutting F drilling.
&c* :ighly geared and slow handpieces for implants.
CRITERIA TO BE EVALUATED !HILE USING HANDPIECES:
'* Briction4 Gresent in the gears, ball bearings etc.
-* Tor/ue4 Ability to withstand lateral pressure on the revolving tool without
decreasing its speed or reducing its cutting efficiency. 7t is dependant on the type
of bearing used and amount of energy supplied.
1* ;ibration4 7t causes patient discomfort, operator fatigue and excessive wear F
tear.
II/ CUTTING TOOL:
These include dental burs and dental stones.
A A dental bur is applied to all rotary cutting instruments that have bladed heads.
A 2tones are used for abrading.
urs are used for cutting and abrading. They are designed to operate at a
minimum speed and for a specific type of handpiece. +ptimum speed is dependant
on the nature of the cutting material and also the diameter of the instrument.
'1
"arliest burs were hand made and operated by fingers. Jith advancement
burs were made with steel although they wore out rapidly. 7n '@=?, carbide burs
and diamond points were introduced which proved to be a very great success.
CLASSIFICATION OF DENTAL BURS
7* !lassification based upon C-7&-0'+'-$
77* !lassification based upon the S8#&( -1 +8( B*9
777* !lassification based upon the L($,+8 -1 +8( H(#%
7;* !lassification based upon F*$)+'-$
7* !lassification based upon COMPOSITION4
'* 2teel urs4 2teel burs are manufactured from a steel blank. 2teel is hardened
and tempered until ;icker#s hardness number is approximately (00.
Advantage4 etter for smoothening of the cavity, making retention grooves
and in laboratory procedures.
$isadvantage4 $ue to the hardness of enamel and heat produced while
cutting enamel, they get dulled, fracture, discolor and become ineffective. 2teel
burs are only effective for cutting dentine.
-* Tungsten !arbide urs4 Tungsten !arbide urs are produced by a product of
powder metallurgy, a process of alloying in which complete fusion of the
constituents does not occur. Tungsten !arbide powder is mixed with powdered
cobalt under pressure and heated in a vacuum. A blank is formed and cut
accordingly. 2ometimes only the cutting head is formed with Tungsten !arbide or
welded to a steel blank. A 5A'0P mixture of !obalt and Tungsten !arbide
increases strength. 7ts ;icker#s hardness number is ')50A'?00.
C !arbide burs do not last long because they are brittle and easily brake at low
speeds.
'=
C !arbide burs are better for end cutting procedures, produce lower heat and have
more blade edges per diameter for cutting.
1* $iamond Goints4 These fall under the category of abrasives.
C $iamond points are more effective for both intracoronal and extracoronal tooth
preparations, beveling enamel margins on tooth preparations and enameloplasty.
77* !lassification based upon the SHAPE OF THE BUR4
'. 5ound ur &00'*
-. Jheel ur
1. 7nverted !one ur &0'0*
=. Glain !ylindrical Bissure ur
5. !ross !ut !ylindrical Bissure ur
). Glain Tapered Bissured ur
?. !ross !ut Tapered Bissured ur
(. Gear 2haped ur
@. "nd !utting ur
'0. 5ound 6ose Bissured ur
777* !lassification based upon the LENGTH OF THE HEAD4
'. 8ong
-. 2hort &pedominiature*
1. 5egular
7;* !lassification based upon FUNCTION4
'. !utting urs.
-. Golishing F Binishing urs.
'5
BASIC DESIGN OF THE BUR:
7t has three basic parts4
I/ S8#$:: 2hank is the portion that fits into the handpiece and accepts rotary
motion from the handpiece &+turdevant*.
7t has three designs types4
'* 2traight4 for straight handpiece for finishing and polishing
-* 8atch type4 shorter overall, improves access to posteriors. A 8atch type
bur fits into a $Ashaped socket, for use at low 0 medium speed as wobble is
controllable at such a speed.
1* Briction grip4 for high speed, shorter in length than latchA type and has
better access in posterior regions.
II/ N(): -9 S8#1+: intermediate portion that connects the head and the shank.
Bunctions4
'* Transmit of rotation from shank to the head.
-* Tapering provides visibility of the cutting head.
1* Grovides freedom of movement to the head.
III/ H(#%: 7t is the working end of the instrument.
:ead is designed in two waysA
'* laded ends
-* Abrasive ends
GENERAL DESIGN OF A BUR
1/ BUR TOOTH4 7t terminates in the cutting edge or blade.
7t has two faces4 &a* 8eading "dge 0 Tooth Bace4 Bace that faces the tooth.
&b* Trailing "dge 0 ack 0 Blank4 Bace that is away from tooth
')
2/ RAKE ANGLE4 5ake angle is the angle that the face of the bur tooth makes
with the radial line from the center of the bur to the blade.
7t can be 6egative4 if face 0 leading edge is beyond the radial line.
Gositive4 if the radial line leads the face.
0, 4 if radial line and tooth face coincide.
3/ LAND4 Glane surface immediately following the cutting edge.
4/ CLEARANCE ANGLE4 !learance Angle is the angle between the back of the
tooth and the work. 7t provides clearance between the work and the cutting edge to
prevent the tooth back from rubbing on the work.
5/ TOOTH ANGLE4 7t is the angle between the face and back. 7f land is present,
it is measured between the face and land.
6/ FLUTE 4 CHIP SPACE4 7t is the space between successive teeth. 6umber of
teeth in dental cutting burs is ) E (.
BUR CLASSIFICATION SYSTEM4
According to Bederation $entaire 7nternationale QB$7R and 7nternational 2tandards
+rganiIation Q72+R,
The name of a bur has &i* 2hape name
&ii* 2iIe A &'0'0
th
of a mm*.
".g4 5ound 0'0 means 0'0 x '0'0 H ' mm &head*.
'* 2hapes4 round, inverted cone, pear shaped, straight fissure etc.
-* 2iIes 4 2.2 Jhite !ompany gave @ shapes and '' siIes
!ross A !ut version H add 500 to the original bur no.
e.g. 6o. 5? crossAcut is no. 55?
Grefix of @00 for end cutting burs.
'?
FACTORS INFLUENCING CUTTING EFFICIENCY OF BURS 4
7nfluence of design and manufacturing
a* 5ake Angle
b* !learance Angle
c* 6o4 of teeth F their distribution
d* 5unAout
e* Binish of the flutes
f* :eat treatment
g* $esign of the flute ends
h* ur diameter
i* $epth of engagement
.* 7nfluence of load
k* 7nfluence of speed
A/ RAKE ANGLE4 5ake angle is the angle that the face of the bur tooth makes
with the radial line from the center of the bur to the blade.
7t can be 6egative4 if face 0 leading edge is beyond the radial line
Gositive4 if the radial line leads the face.
0, 4 if radial line and tooth face coincide
The !utting efficiency is more for positive rake angle than for a negative angle.
:owever, with a negative rake angle the cut chips move away from the blade
angle and often fracture into small dust or bits. Jhere as in a positive rake angle
the chips are larger and tend to clog the chip space or flute.
'(
Gositive rake angles can#t be used with steel burs since bulk of the bur tooth
gets decreased, increasing possibility of the bur tooth getting deformed and
fractured. Tungsten carbide burs are more suitable for this feature.
B/ CLEARANCE ANGLE4 !learance Angle is the angle between the back of the
tooth and the work. 7t provides clearance between the work and the cutting edge to
prevent the tooth back from rubbing on the work. A large clearance angle will
prevent premature dulling of the bur tooth.
C/ NUMBER OF TEETH 4 BLADES 5 THEIR DISTRIBUTION4 Dsual
number of blades is )A(. 8esser the blades, magnitude of forces at each blade and
the siIe of the chip removed increases. 8esser the teeth, lesser will be the clogging
tendency. Also lesser the blades, lesser is the temperature rise seen because a cut
chip takes away some of the heat.
urs with very large number of blades &up to =0* are designed for polishing
since they will cut very fine chips of material.
D/ RUN;OUT4 Run!Out refers to the eccentricity or maximum dis#lacement of
the bur head from its axis of rotation while the bur turns$ !linically acceptable run
out is H 0.0-1mm. 5un out depends upon the precision of the handpiece. A newer
handpiece will have lesser vibration and play between its gears. 5unAout will be
greater for a longer bur than a shorter bur. 5un out causes vibration, une/ual
cutting, heat generation and patient discomfort.
E/ FINISH OF THE FLUTES4 Jhen bur flutes are cut from a metal blank, the
cutter passes over the blank producing flutes. As the number of passes over the
flute increases, the flute keeps on getting refined and the efficiency also increases.
A bur that has had six passes with a cutter is the most refined and efficient.
'@
F/ HEAT TREATMENT4 7t is used to harden a bur a bur. 7t preserves the cutting
edge for longer duration.
G/ DESIGN OF FLUTE ENDS4 Blute ends are cut in two different styles4
a* 5evelation !ut4 Blutes come together at two .unctions near a
diametrical edge. 7t has greater cutting efficiency in direct cutting only.
b* 2tar !ut4 Blute ends come together in a common .unction at the
axis of the bur.
H/ BUR DIAMETER4 7t follows that because the length of the cut is constant the
volume of the material removed will vary directly with bur diameter as will as the
tor/ue.
I/ DEPTH OF ENGAGEMENT4 As the depth of engagement is decreased, the
force intensity on each small portion of the bur still cutting is correspondingly
increased and accordingly the average per flute revolution should also be
increased. This increase is so great that the volume of a material removed by a
shallow cut exceeds that of deeper cuts.
</ INFLUENCE OF LOAD4 8oad signifies the force exerted by the operator on
the bur head. 7t is related to the rotational speed of the bur.
'. 8ow 2peed A - to 5 pounds
-. :igh 2peed A ' pounds
1. Dltra :igh 2peed A 0.0)-5 to 0.-5 pounds & ' to = ounces*
K/ INFLUENCE OF SPEED4 5ate of cutting increases with the rotational speed
but this increase is not proportional. 7t has been found that at a speed of '50000
rpm, the time re/uired for the removal of the same weight of tooth structure is
very nearly the same as at still higher speeds. :owever, a minimum rotation speed
-0
for a given load below which the tool will not cut. 9reater the load, lower is the
minimum rotation speed.
MODIFICATIONS IN BUR DESIGNS
'. 2maller bur heads are being used as they are more effective.
-. 7ncreased effectiveness of carbide burs at high speeds.
LATEST TRENDS IN BUD DESIGNS
'. 5"$D!"$ D2" +B !5+22 !DT D524 !rosscuts are needed on fissure
burs to obtain ade/uate cutting effectiveness at low speeds, but at high
speeds they are not needed. As cross cut burs used at high speeds tend to
produce unduly rough surfaces.
-. "NT"6$"$ :"A$2 +6 B722D5" D524 "xtended head lengths for
carbide fissure burs help in reaching deeper regions. !arbide burs can be
used at high but only with an extended head. &5000A)000 rpm*
1. 5+D6$769 +B 2:A5G T7G A698"24 ur heads with rounded corners
result in lower stresses in restored teeth, enhance the strength of the tooth
by preserving dentine and facilitate in adaptation of restorative materials.
ADDITIONAL FEATURES IN HEAD DESIGN
These features include4
'. H(#% L($,+8: 7t is determined according to area of use.
-. T#&(9 A$,.(: 8ike the head length it is determined according to function.
1. N(): D'#7(+(9: Too small a diameter will result in a weak instrument and
too large a diameter will cause visibility problems.
= as length or diameter of head of a bur increases, moment arm exerted by lateral
forces also increases, and the neck diameter needs to be larger.
=. S&'9#. A$,.(: Bor efficient high speed cutting the spiral angles are reduced.
5. C9-00)*++'$,: 7n order to increase cutting pressure from rotation of the
blade and perpendicular pressure holding the blade edge against the tooth,
-'
the length of blade length in contact with tooth needs to be decreased.
!rosscutting decreases the length and also provides space for the chips to
fly off.
). F.*+(0: These are depressed areas present between the blades.
?. C-$)($+9')'+>: 7t is the direct measurement of the symmetry of the bur
head. 7ts a measure if all blades of a bur circumscribe the same circle or not
(. R*$-*+: 7t is a dynamic test that measures the accuracy with which all
blade tips pass through a single point when the instrument is rotated.
DENTAL ABRASIVES STONES:
Abrasive particles are held together by means of a binder substance which
can be ceramic &for diamond chips*, metallic, rubber or shellac. The binder is
impregnated throughout with abrasive particles of a certain grade so that even after
wear and tear the instrument stays even. Abrasive particles should be spaced so
that debris does not clog the flutes.
According to the abrasive particles, dental stones can be classified as follows4
'. $iamond Goints A most efficient
-. !arbides A 2ilicon carbide&carborundum* or oron carbide
1. 2and A Borms of /uartI
=. Aluminum +xide A 6atural or pure aluminum oxide
5. 9arnet &reddish* A Dsed for polishing and finishing
). KuartI &white* A 2ame as garnet
?. Gumice A Bormed by crushing volcanic glass
(. !uttlebone A $erived from cuttlefish used for finishing
Abrasive instruments can either be ,olded Abrasive instruments or -oated
Abrasive .nstruments$
'. 3olded Abrasive instruments4 manufactured by molding or pressing a
uniform mixture of abrasive and matrix around the roughened end of the
shank, or cementing a premolded head to the shank
--
-. !oated Abrasive 7nstruments4 have a thin layer of abrasive coated onto a
flexible backing. They are used primarily for finishing or polishing.
Bactors influencing the abrasive efficiency of dental stones4
'. 7rregularity in shape of abrasive particles
-. :ardness of the Abrasive material
1. 7mpact strength of the abrasive material
=. 2iIe of the abrasive particles
5. Gressure and 5G3
DIAMOND ABRASIVE INSTRUMENTS
These were introduced in '@=-. The instrument consists of three partsS
metal blank, powdered diamond abrasive and a metallic bonding material that
holds the diamond powder onto the blank. The metal blank is similar to the regular
bur since it has a head, neck and shank. $iamond and diamond powder used for
these instruments may be synthetic or natural in origin. $iamonds are generally
attached to the metal by electroplating a layer of metal on the blank while holding
the diamonds in place.
$iamond points conform to all shapes and siIes. There are over -00 shapes
and siIes currently in use. $iamond points are classified according to the diamond
particle siIe used on them4
'. !oarse A '-5 to '50 Tm
-. 3edium A (( to '-5 Tm
1. Bine A )0 to ?= Tm
=. ;ery Bine A 1- to == Tm
5. 2uper Bine A '0 to 1( Tm
Bine versions are used primarily for polishing and finishing.
C $iamond instruments have a very long life until the binder gives way. This
occurs due to excessive pressure applied while cutting. The heat produced due to
-1
excessive pressure causes the binder or electroplated metal as in this case to
disintegrate and exposing the underlying metal blank to be exposed.
76$7!AT7+62 B+5 $7A3+6$ A5A27;"24
'* Bor tooth preparation for bonded restorations since they produce a rougher
surface.
-* 3ost efficient to cut brittle materials like enamel but not so efficient for
dentine since they cause more plastic deformation.
1* Bor finishing and polishing.
CUTTING MECHANISMS
C*++'$, E11()+'?($(00: 7t is the rate of tooth structure removal &mm0min or
mg0 sec.
C*++'$, E11')'($)>: 7t is the percentage of energy actually producing
cutting.
!utting is of two types4 B.#%(% )*++'$, and A29#0'?( )*++'$,.
'. B.#%(% C*++'$,:laded cutting includes both rotary and hand
instrument cutting. 5otary cutting causes )rittle and /uctile fracture$
)rittle 0racture is associated with crack production due to tensile
loading at higher speeds. /uctile fracture involves plastic deformation
of material usually proceeding shear at low speeds. As the blades work
along the work, they cause shearing of the segments and accumulation
along the rake face until they fracture.
-. A29#0'?( C*++'$,: 7t is affected by the properties of the abrasive like
hardness, siIe and distribution. Jhile using diamond abrasives, most of
the material cut will be removed as chips but some material will flow
laterally around the cutting point and be left as a ridge of deformed
material on the surface. !ontinuous deformation will ultimately lead to
fracture of chips and subse/uent removal.
-=
SONICS AND ULTRASONICS
Dltrasonic refers anything that moves faster than the speed of sound. Dltrasonics
"ndodontics is based on a system in which sound as an energy source activates an
endodontic file resulting in three dimensional activation of the file in the
surrounding medium.
'. D8T5A2+67!2 A operate at -5 to 10khI
A $ue to the alternating current passing
through the ultrasonic tip, two types of effects are seen
Two types4 a* 3agnetostrictive E The pattern of vibration of the
tip is elliptical in all directions. 7t re/uires a cooling
system due to large heat production
b* GieIoelectric E The pattern of vibration of the
tip is linear or back and forth. 7t does not re/uire a
cooling system.
The action of ultrasonic is attributed to two features4 Acoustic +treaming 1
-avitation$
Acoustic 2treaming4 due to the movement of the ultrasonic tip of the
instrument, circular fluid movement is created in the fluid around the tip.
!avitation4 while the instrument oscillates in a li/uid it creates negative and
positive pressure areas. Jhen tensile strength of fluid is exceeded during positive
phase of, a cavity is formed in the negative phase. 7n the next positive phase the
cavity implodes with greats force like bubbles bursting resulting release of energy
-. 2+67!2 A operate at - to 1 khI
STERLIZATION 5 INFECTION CONROL
HANDPIECE STERILIZATION
According to the Bood and $rug Administration &B$A* F American $ental
Association &A$A* recommended that dental handpiece must be steriliIed after
each use. The recommended method of steriliIation for handpieces is steam under
pressureAAutoclave.
-5
2T"A3 %"T ADT+!8A;"4 this works on the principle of steam under
pressure.
Temperature A '1= to '1(
o
!
Time A 1 minutes
Gressure A 1- psi
<A;+<8A;" -'004 based on the principle of steam under pressure
:72T5+6 6''004 7t is a new compact ultraviolet dental handpiece
steriliIer.
7t steriliIes 50 times higher than regular steriliIers
Time A )0 seconds
2ource A D; radiation of
'0000 rpm
:andpiece steriliIation has been considered to be a potential source of cross
infection during dental treatment and accordingly steriliIation between has been
strongly recommended. 2ince the handpiece comes in contact with soft tissues,
blood and saliva causing internal and external contamination, steriliIation is very
essential.
DENTAL BURS STERILIZATION
TYPE OF BUR STERILIZATION
METHOD
@PREFERED 5
ACCEPTED/
RECOMMENDATION
'* !arbon 2teel $ry :eat +ven 2team autoclave &6+T*
!hemical vapor
"thylene oxide
-* Tungsten carbide $ry :eat +ven 2team autoclave
&6+T G5"B"5"$*
"thylene oxide !hemical vapor
&6+T G5"B"5"$*
1* 2teel urs "thylene oxide 2team autoclave F
!hemical vapor
acceptable &DT 6+T
G5"B"5"$*
$ry :eat +ven
!hemical vapor

BIOLOGICAL CONSIDERATIONS
oth the patient and the doctor are vulnerable to risk during dental procedures.
Therefore precautions should be taken for the benefit of both of these groups of
people.These is4
-)
'. P*.&#. P9()#*+'-$0: Gulp is sensitive to vibration, heat, desiccation and
loss of tubular fluid. :eat and desiccation can lead to pulpal abscess and
death of pulp. These se/uelae can take from - weeks to ) months
depending upon the degree of insult. A young pulp is more prone to
in.ury since pulp chambers are large.
"namel and dentine are good insulators of heat. Remaining
tissue is effective in #rotecting the #ul# in #ro#ortion to the s%uare of its
thic2ness$
To protect the pulp from thermal insult, air and water spray is
re/uired. Jater is much more effective as it has higher heat capacity
and carries away more heat. Air is better for finishing procedures and
slower speeds. Air water combination is best.
-. S-1+ T'00*( P9()#*+'-$0: 8ips, tongue, cheeks, gingiva and mucosa are
fre/uent areas of in.ury. Therefore precautions like ade/uate retraction,
visibility and sharp reflexes of the dentist are re/uired. 5ubber dam,
cheek retractors, mouth mirrors, evacuation tips etc should be used.
Jhile using air turbine it should be kept in mind that the bur
does not stop rotating immediately after the foot control is released.
8arge discs should be used with great care.
1. E>( P9()#*+'-$0: The patient, operator and the assistant should always
wear protective eye gear during rotary instrumentation since there is risk
of in.ury from aerosol, particles of old restorations, bacteria and tooth
structure. Grotective eye gear &with special filters like D; filters* should
be worn to prevent in.ury from light from !uring units and 8A2"52.
=. E#9 P9()#*+'-$0: The dental team is most prone to this kind of in.ury
because of continuous exposure to high pitched noise arising from air
turbines. 7t depends upon the intensity, duration and fre/uency of noise.
Auditory Threshold4 3inimum level of sound before the ear
can detect it.
Temporary Threshold 2hift4 Jhen sub.ected to a loud
-?
noise, the threshold increases as a protective mechanism.
Germanent Threshold 2hift4 !ontinuous or permanent
exposure results in a continuous shift.
Air turbines produce noise up to ?0 to @= db at
high fre/uencies. 6oise levels in excess of ?5 db in fre/uency ranges of
'000 to (000 cycles per second may cause hearing damage. 3rotective
measures are re%uired when the noise levels reaches 45db$
7ntermittent use of handpieces is recommended
so that the ear gets time to recuperate. :andpiece use should not exceed
10 minutes
5. I$8#.#+'-$ P9()#*+'-$0: $isposable masks should be worn to protect
from aerosol of water, microorganisms, tooth debris and0or restorative
materials. Aerosols also contain amalgam and composite particles.
3ercury is the ma.or constituent of amalgam vapors.
7t has been observed that aerosol dissemination occurs as far
as '0 feet from the operating site.
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