The performance of air-turbine handpieces in general dental practice

OBJECTIVE: To investigate variation in performance measures of fibre-optic, high-speed air-turbine handpieces during the course of daily use in general dental practice. MATERIALS AND METHODS: Four groups of five new high-speed fibre-optic handpieces were used in the routine treatment of patients over a period of 30 months by four general dental practitioners in two dental practices: Groups A, B: Super-Torque Lux 3 650B (KaVo, Biberach, Germany); Group C: BORA 898LE (BienAir SA, Bienne, Switzerland) and Group D: Toplight (W&H Dentalwerk, Burmoos, Austria). The dental practice teams had been rehearsed in the procedures to be followed before starting the study. Each dentist used the handpieces in strict rotation, while the groups were rotated monthly between practitioners. Four performance characteristics were measured before use, then at regular intervals: free-running speed (Hz) and bearing resistance (microNm) were measured using a purpose-built testing machine (Darvell-Dyson); illuminance (lux) and sound pressure level (dB(A)) were also measured. Handpieces were cleaned and lubricated in accordance with manufacturers' directions; all were autoclaved wet at 134 degrees C for three minutes. RESULTS: Free-running speed showed an initial increase after use for Groups A, B and C, which may be associated with a decrease in bearing resistance. All handpieces in Group C suffered bearing failure between months 21 and 23, preceded by a substantial increase in noise, while those in Group D suffered failure of the fibreoptic system between months 18 and 24. Other deterioration due to use was identified but Groups A, B and D were still in use at month 30. CONCLUSIONS: Variation in free-running speed, bearing resistance, illuminance and sound pressure level can be used effectively to monitor changes in air-turbine handpieces due to normal use. Although an increase in bearing resistance is associated with decreasing free-running speed, noise appears to be a useful indicator of imminent bearing failure. Assiduous adherence to manufacturers' directions for cleaning and lubrication may have contributed to increased bearing life.