FIBER OPTIC ACCESSORIES

Fiber optic accessories provide the operator a source of artificial illumination through the dental handpiece. The clinical applications of a fiber optic handpiece are almost limitless. It is useful in general inspection and transillumination of the oral cavity and tooth structure to help identify and diagnose inter-proximal caries, stains, decay, calculus, crazing and hair line cracks in natural and artificial teeth, location of excess cement, and smoothness of crown preparations.

Most fiber optic systems are activated by touch or an air-electric switch. Many systems also have an intensity control that permits adjustment of the light intensity to suit individual pReferences and needs.

Fiber optic technology involves the transmission of light through long, thin fibers of glass or transparent material. The light travels, nonelectrically, through the fiber by reflecting from wall to wall without transmitting or generating heat. This makes fiber optics completely safe for use in the oral cavity.

Each individual fiber is approximately 25 microns in diameter, or about 1/3 the size of human hair. A cluster of fibers is called a fiber optic bundle. The bundles are enclosed inside the handpiece and positioned to direct the light along the same line as the dental bur.

Level I maintenance on the fiber optic system is to clean the fiber optic surfaces on both ends of the handpiece after each patient. To do this, wet a cotton swab with isopropyl alcohol and clean both ends before the sterilization cycle. This prevents residual debris and handpiece lubricant from baking onto the fiber optic surfaces, which results in reduced light output. Read the manufacturer's instructions for additional care, maintenance, and bulb replacement requirements.

ELECTRIC HANDPIECE

This type of handpiece attaches directly to a small electric motor and is normally used in the prosthetic lab. The electric handpiece is portable, lightweight, and has variable speeds of 2,500 to 25,000 rpm (fig. 11-11). Units are initially activated by an on/off switch and controlled by a foot switch. Another switch controls the left or right torque action similar to the forward and reverse of the low-speed handpiece. The electric handpiece uses long, smooth-shanked rotary instruments.

Electric handpieces require minimal maintenance and adjustments. Consult the manufacturer's instructions for specific requirements and guidelines.

IDENTIFYING ROTARY INSTRUMENTS

Rotary instruments are used in conjunction with dental handpieces. The rotary instrument group includes a great number of small, separate items. These instruments are made from many materials and combinations of materials ranging from diamonds to very finely detailed steel. Rotary instruments have many uses, such as preparing cavities, finishing restorations, trimming dentures, polishing teeth, and removing bone during oral surgery. Rotary instruments are a vital part of most dental treatment

Figure 11-11.\Electric handpiece.

procedures. Your role with this group ranges from keeping an adequate number of rotary instruments in the treatment room to changing them in the handpiece.

Basic Rotary Instruments

Rotary instruments, such as burs, have three basic parts: head, neck, and shank (fig. 11-12). The head of the bur is the working or cutting portion, which is made in many sizes and shapes. The neck, which is the narrow portion of the bur connects the shank and the head. The part of the bur that fits into the handpiece is the shank. The length of the shank depends on the specific use of the bur, whereas the shape of the shank is designed to fit into a specific handpiece.

We have already discussed the several types of handpieces used in dentistry. Each rotary instrument is used in a particular handpiece. To indicate in which handpiece the rotary instruments function, they have been classed as friction grip, straight handpiece, or latch contra-angle handpiece types (fig. 11-13). The friction grip (FG) instruments are abbreviated as FG and are used in high-speed handpieces and friction grip low-speed contra-angles. These burs have small, smooth shanks that are held in the handpiece by friction against a metal or plastic chuck, or by a wrench-tightened metal chuck. Friction grip burs are available in short shank and miniature (pediatric), as well as the commonly used standard length.

Figure 11-12.\Bur parts and basic shank designs.

Figure 11-13.\Classification of rotary instruments

The straight handpiece rotary instruments are abbreviated as (SHP). They are used in electric straight handpieces and in slow-speed, air driven straight handpieces. The shank on the straight handpiece instruments is larger in diameter than the FG shank and at least twice as long.

The latch contra-angle handpiece instrument is identified as angled handpiece (AHP) or latch-angle (LA). This instrument is used in conventional latch contra-angle handpieces. Common AHP rotary instruments have a notched shanked with the same diameter as the SHP instruments but are about half the length. However, some AHP instruments are made with short or long shanks.

Dental burs are available in many shapes and sizes. The basic shapes of bur heads are the round, inverted, pear-shaped, end and side cutting, straight/tapered plain fissure, and tapered/straight crosscut fissure as shown in figure 11-14.

Burs are made of either steel or carbide. Steel burs are used in the slow-speed handpiece and dull after only one use when cutting enamel of teeth and should be discarded after use or when directed by the dentist. Steel burs being used on dentin under slow-speed often generate heat in the tissue of the tooth, causing discomfort to the patient. The dentist will use the very lowest speed to reduce the chance of heat and discomfort.

High-speed handpieces use a carbide bur. Because of its hardness, the carbide bur can be used many times to cut hard enamel tooth structure without becoming dull. However, carbide burs are brittle and have a tendency to fracture under pressure. The carbide bur operates most efficiently at high speeds with light pressure.

TYPES, USE, AND MAINTENANCE OF MISCELLANEOUS EQUIPMENT

Several pieces of equipment are commonly used in many dental specialties. These items include provider and assistant mobile chairs, amalgamators, and visible light curing units.