SMALL EQUIPMENT BIG IMPACT

Published Date 07/25/2019
 
You may give little thought to the reliable tools and systems you use every day to cut teeth, see better, place composites, detect early caries, and practice more productively and efficiently. Every decision you make on a clinical product, technique, or piece of equipment has direct ramifications on things like patient satisfaction, efficiency, and overhead control.

There are probably very few times in your professional career that you’ll need to select and purchase bigticket essentials, such as delivery ensembles and x-ray generators. Just as critical to clinical practice and equally complex in many cases, however, items such as handpieces and curing lights require replacement and updating relatively frequently. So, in addition to properly maintaining what you own, you should be keeping track of upgrades, innovations, and changes in technology that manufacturers are continually implementing.

With that in mind, the DPS editors have curated a selection of the latest and greatest offerings in several categories of everyday operatory dependables. On the following pages, you’ll find popular state-of-the-art systems from a wide range of manufacturers and suppliers.


HANDPIECES
Despite electric handpieces making their U.S. debut around the 1950s, most dentists are still enjoying their trusty air-driven counterparts. Thankfully, there’s room for both in the operatory, as the low-speed/ high-torque combination of electric handpieces is ideal for cutting resin and finishing procedures, while high-speed air-driven tools can be key during initial prep to reduce soft-tissue damage.

NSK’s Ti-Max Z family of electric handpieces, including the Ti-Max Z95L, features titanium construction that combines durability, high performance, ergonomics, visibility, low noise level, and power. Optimal water-spray cooling is guaranteed through a unique microfilter that prevents particles from entering the water spray.

KaVo’s ELECTROmatic Premium offers a dual motor option for easy alternation between high- and low-speed functions. A SMARTdrive sensorless control allows for high torque at low-speed ranges, while preprogrammed file systems make it easy to plan and customize endodontic sequences.

SciCan’s SANAO line of precision handpieces are ideally balanced to reduce wrist strain and miniaturized for better maneuverability. They are equipped with glass-rod fiber optics that help illuminate the oral cavity.
 
Midwest Tradition Pro
Midwest Tradition Pro

Dentsply Sirona’s newest-generation Midwest Tradition Pro still features the same unique, raised grips for ultimate control and handling, but with a computer-balanced rotor design that offers up to 50% more power than its previous generation and with ceramic bearings that help reduce friction and noise to 62 dB.

The StarDental 430 Torque by DentalEZ is designed for comfort and features a stylish satin finish. It offers 27 W of power for all procedures, along with a small head, ceramic bearing turbines, and high-quality fiber-optic glass that’s designed to withstand the rigors of steam sterilization.

Proprietary Dynamic Precision balancing is at work in the Legacy 5 high-speed handpiece from Lares, which offers whisper-quiet operation at 62.8 dBA. It features cutting power at 18 W, a 5-year warranty, and comes in standard and mini head sizes.

Medidenta’s Air-Free 90S is a high-speed surgical handpiece with a 90° angle that prevents awkward hand positions and wrist strain for the clinician. The handpiece does not allow air to vent out of its head, virtually eliminating patient discomfort and sensitivity.

Maxima Elite High-Speed Handpieces by Henry Schein have a trio of features that offer power, control, and durability. A patented Power-Boost System yields exceptional cutting power of 23 W, while Active Stop Technology eliminates spindown time and Advanced Bearing Technology reduces wear and extends the life of the handpiece.
 
HISTORICAL HANDPIECES
 
When it comes to everyday dentistry, removing decay and old crowns that need replacement can take up a big chunk of time in the operatory. Handpieces, both airdriven and electric, have helped speed up this task to the point where it’s hard to believe that long, thin burs were once twirled between a clinician’s finger and thumb to accomplish the same prep. And in some 19th-century cases, this arduous caries-removal process was skipped altogether.

Thankfully, modern technological advancements offer a brighter clinical outlook for this dentistry workhorse. Take a look at how the dental handpiece has evolved over time:


1868 George F. Green patents the first fluid-driven dental motor called “pneumatic tooth burr and drill.”

1871 A promising foot-pedal engine is introduced by James Beall Morrison, but the public dubs it “an instrument of torture that reminds most ladies of their sewing machines.”

1877 A cooling method is developed by directing a fine stream of water between the bur and tooth surface.

1948 SS White Co. introduces tungsten carbide burs, which can withstand higher speeds.

1955 Tungsten carbide burs are used in the Page-Chayes handpiece, driving speeds up to 100,000 rpm.

1957 Developed by Dr. John Borden, the Borden Airotor becomes the first commercially sound high-speed air turbine handpiece, with speeds of up to 300,000 rpm.

Today Modifications to head sizes, noise levels, and cooling systems have continued to advance the handpiece.
SANDBLASTERS/AIR POLISHING
Studies have shown that air polishing has some time-saving advantages over traditional rubber cup polishing when it comes to removing stains and plaque. It’s estimated that the controlled jet of water, air, and fine powder cleans and polishes teeth 3x faster than traditional methods, and can sink deeper into periodontal pockets of up to 5 mm.

Hu-Friedy’s AIR-FLOW handy 3.0 PREMIUM is equipped with 2 handpieces to tackle biofilm both above and below the gingival margin. A PLUS handpiece removes biofilm and stain supragingivally and in shallow periodontal pockets, while a PERIO handpiece works best for periodontal pockets greater than 4 mm.

Featuring a short, ergonomic handle, the PROPHYflex 3 by KaVo is a portable air-cleaning system for the removal of stains and plaque, as well as cleaning of enamel surfaces prior to fissure sealing. It can be connected to a MULTIflex coupler for quick disconnect and optimal portability.

Ideal for cleaning and preparing teeth prior to placing orthodontic brackets and sealants, bleaching, or fluoride treatments, Keystone’s ProphyBrite air polishing unit offers quick and gentle cleaning with no installation. It works by delivering a fine sodium bicarbonate water slurry to remove plaque and stains, with minimal clogs and wrist fatigue during use.

 
Cavitron Prophy-JetCavitron Prophy-Jet
Dentsply Sirona's Cavitron Prophy- Jet features Tap-On Technology to reduce foot pedal use. Prophy mode auto cycles automatically alternate between air polishing and rinsing without the need to touch a foot pedal, while an automated purge function allows freedom to accomplish other tasks while the system flushes.

NSK’s Prophy-Mate neo has a 60° nozzle for cleaning molar and occluding areas and an 80° nozzle for anterior teeth. It’s designed for a one-touch attachment to NSK couplings and other major coupling brands. A lightweight, compact powder holder makes it easy to hold.

The MicroEtcher IIA intraoral sandblaster from Zest Dental Solutions offers precise surface micro-roughening of metals, composites, and amalgam that improves bond strength by up to 400%. It features stainless steel construction, a replaceable carbide tip, and a permanently affixed jar lid with a spill-resistant abrasive filter.
 
INTRAORAL CAMERAS
SOPRO 617SOPRO 617

Does anyone still really need to be convinced about the value of intraoral cameras? The benefits for magnification, visualization, diagnosis, patient education, documentation, and more have been proved over the decades. What may not be as obvious are the advances offered in today’s cameras in terms of image quality, versatility, adjunct applications, ergonomics, and perhaps not least importantly—price. If you’re using a camera that’s more than a few years old, you may want to investigate what’s on the market right now…here are several exemplary systems.

Offering a 105° view for maximum visualization of distal areas, ACTEON’S SOPRO 617 features a rounded shape and a thin distal portion for patient comfort. Its aspheric lens prevents distortion and enhances image quality without adjustment.

 
CamX ElaraCamX Elara
The CamX Elara from Air Techniques incorporates proprietary capture-upon-release technology to consistently deliver sharp, steady images. Capture buttons at both the top and bottom of the camera simplify use.

Available in wired and wireless versions, Carestream Dental’s CS 1500 provides true autofocus and an intuitive lighting system to eliminate the need for manual adjustment and facilitate sharing. A wide focus range allows capture of intra- and extraoral images.

Gendex’s GXC-300 offers high-speed direct USB connection, eliminating the need for a docking station. Its true optics prevent image distortion and a side capture button allows quad-image capture. Activation is automatic via the storage holster and the always active software interface.
 
Hawk HD HAWK HD
Directly integratable with popular imaging software, MouthWatch features an ergonomic handle, a light, balanced design, fixed focus, and single-button activation for operator comfort. Button Capture Software is included with no license restrictions.

Incorporating 15 LEDs to simulate natural sunlight, Dentazon’s HAWK HD provides high-definition images with 1280 x 720 resolution and easy selection of manual or auto focus. It features a slim, lightweight design and a variablefocus liquid lens that eliminates the risk of distortion.
 
DOCTOR’S FAVORITES

doctor's favoritesRunning a large, comprehensive general practice established by his dentist father in Chicago nearly 7 decades ago, Louis Kaufman, DDS, is actively involved in researching and selecting the products to stock his armamentarium—particularly with his recent office redesign. He serves on the advisory board of numerous organizations, consults on product development, and educates clinicians internationally. Here, he describes some of his go-to products.

Sapphire Plus
I know that my worth as a clinician is determined by my judgment, analytical skills, dexterity, compassion, and other intangibles. However, as a product-based discipline, quality dentistry depends on proper instrumentation. So, I put lots of thought and effort into choosing the right hardware.

For my high-speed handpieces, I’ve been a patron of Brasseler and Dentsply Sirona Midwest for years. In addition to efficient and attentive customer service, the companies manufacture consistently reliable and durable handpieces with a style range that offers an instrument for any user and any application. They’ve been in the forefront of offering small-head designs and innovative angulation for specialty use.

I use DenMat’s Sapphire Plus plasma-arc light for all my curing. I know LED has lots of benefits, but I really appreciate the power and speed that I get with Sapphire. I have 6 in the office, one of which is over 20 years old and still going strong.

Designs for Vision is my go-to source for custom loupes. The Micro Series is compact and lightweight, yet offers precision optics and a large field of view. I also love my PeriOptix LED headlight from DenMat.

To equip my new office space, we just purchased several DentiMax Dream Sensors. After using many different intraoral sensors, I chose these for their image quality and durable construction as well as a really comfortable price point.

I'm a big fan of 2 niche products that you won’t see in every practice today. I use Tekscan’s T-Scan system that takes the guesswork out of occlusal analysis. And NuCalm is in frequent use as a noninvasive system for providing deep relaxation for anxious patients. It’s easy to administer, works quickly, and leaves no lingering post-treatment effects.


CARIES DETECTION SYSTEMS
It’s probably not exaggerating to say that detecting decay at its earliest stages is the holy grail of dental diagnostics. From the naked eye to the explorer stick to radiography, techniques have continuously evolved to become less invasive as well as more accurate and sensitive. The goal is to minimize the need for radiographs while enhancing treatment planning and conserving healthy tooth structure. While each has been shown to be an effective method of locating caries, the following 5 systems employ different technologies to get the job done.

Using auto fluorescence technology, ACTEON’s SOPROLIFE differentiates healthy from infected tissue to identify occlusal and/or proximal carious lesions. It also offers a Daylight mode to enable the capture of high-quality images for documentation and patient education.
 
CariVuCariVu
The CamX Spectra from Air Techniques incorporates 4 violet LEDs that stimulate metabolic products found in cariogenic bacteria, causing them to glow red, while healthy enamel glows green. It can detect lesions between margins of existing composite and amalgam restorations.

In conjunction with Carestream’s RVG intraoral sensors, Logicon computer-aided radiographic cariesdetection software helps locate and classify potential proximal caries with a few clicks. Information about tooth-density changes and lesion probability can be retrieved in graphical format.

 
DIAGNOdent PenDIAGNOdent Pen
CariVu from DEXIS uses transillumination technology that makes enamel appear transparent while porous lesions trap and absorb light. Non-ionizing radiation enables the clinician to see through the tooth, exposing its structure and the actual shape of any carious lesions in the mouth.

KaVo’s compact DIAGNOdent Pen is particularly suitable for identifying decay in pit and fissure areas, even when outer tooth surfaces are intact. It disperses incident laser light into the site, causing carious structure to fluoresce in proportion to the degree of caries; the result is an elevated scale reading on the display.

 
LOUPES/HEADLIGHTS
Similar to intraoral cameras, the advantages of using loupes and headlights are universally acknowledged. Originally the purview of specialists, particularly endodontists who work in micro scale, telescopic loupes are considered an integral part of the everyday armamentarium among most general dentists as well as dental hygienists. Currently available technology is lighter and more comfortable than ever. Truly, there is no downside to chairside magnification.
 
OmniOpticOmniOptic
Easily incorporated with existing loupes, the Firefly cordless headlight from DenMat eliminates the need for power packs and cables. It weighs 28 grams, offers 2 light intensity settings, and delivers a well-defined uniform spot with natural color output.

Orascoptic’s OmniOptic interchangeable magnification loupe accommodates 4 powers (2.5x, 3.5x, 4.5x, and 5.5x) to enable users to increase magnification over the course of their career without ordering a new unit. It incorporates a magnetic anchor built into the carrier lens of the frame.

Slim Sport Loupes from Seiler are designed for practices requiring affordable low-power magnification. They come in 3 magnifications (2.5x, 3.0x, and 3.5x), 3 working distances (340 mm, 420 mm, and 500 mm), and in 2 colors (black and silver).

SurgiTel’s Micro Line lightweight, fullfeature loupes are available in throughthe- lens or front-lens-mounted options. Six magnifications are offered, from 2.5x to 4.5x, on a wide range of sturdy frame styles, including Oakley sport frames.

Available with sport or titanium frames, EyeMag Smart loupes from Zeiss offer 2.5x magnification along with optimal depth of field for clear visualization of anatomical structures in deep-lying channels. A soft nose bridge and adjustable headband enable a comfortable fit.
3 LOUPE MYTHS…DEMYSTIFIED!
 
Recent studies have discovered that clinicians who use loupes at the onset of their careers may bypass the dreaded back pain, headaches, neck fatigue, and eye strain that come with improper positioning over a patient. But if you’re not new to the game (of dentistry), there’s still time. Just be careful not to believe everything you hear…

MYTH: 2.5x magnification power works for everyone
FACT: It all depends on your working distance. For example, a working distance of 20 inches is 25% longer than a working distance of 16 inches—so magnification power should be 25% greater, too.

MYTH: All loupes are equally ergonomic
FACT: Be wary of loupes that promise large declination angles, a measurement of how well the loupes help your eyes look down without bending. Ergonomic loupes should allow you to keep your head tilted at 25° or less.

MYTH: Always use the brightest LEDs
FACT: Looking at a subject with a too bright LED can wash out details, rather than illuminate them. Instead of relying on the brightest setting, look for LED headlights that have both beam uniformity and color balance.
 
ISOLATION/RETRACTION SYSTEMS
Several multitasking devices are currently available to simplify and streamline your operative procedures. Freeing up auxiliaries for other duties, these helpers combine some or all of these chairside tasks—retraction, suction, mouth prop, isolation, illumination—into a single hands-free unit. Check them out.

Featuring a brighter white light and a noncuring amber light, the Isolite 3 from Zyris incorporates a robust head design and a "smart" adapter for use with the existing HVE line. Also available is the Isodry, for isolation and moisture control without illumination.
 
Mr. Thirsty One-StepMr. Thirsty One-Step
Zirc’s Mr. Thirsty One-Step connects directly to the existing HVE line for hands-free retraction, isolation, and evacuation. The single-use device is trimmable for a custom fit and has a built-in bite block for patient comfort.

Fully autoclavable, DryShield is made of soft, flexible silicone that contours to the patient’s mouth. Each mouthpiece size features a matching interchangeable bite block providing patient comfort and accommodating most anatomy.

Sliding easily onto the vented end of the HVE tip, Kulzer’s LinguaGuard is a disposable add-on that provides retraction and tongue protection during suction. Made of a soft, BPAand latex-free polymer, it has a wrap design for a secure fit and a curved design for retraction without tissue impingement.


LED CURING LIGHTS
As LED curing lights gain popularity in the operatory for their ability to cure restorations, activate whitening procedures, and transilluminate the mouth, beware of bargain lights being sold online for next to nothing. A quality dental light should offer wavelengths compatible with most resin materials and be designed with ergonomics and safety in mind for both patient and clinician.
 
VALO CordlessVALO Cordless
Durability is key for Ultradent’s VALO. Made of high-grade aerospace aluminum and a tempered glass lens, its high-intensity 395 nm to 480 nm wavelength offers 3 power modes to satisfy all light-cured dental materials, including porcelain. VALO Cordless offers the same reliable power using 2 rechargeable lithium-ion phosphate batteries.

VOCO’s Celalux 3 is a compact but powerful option at just 2.5 oz. Its handpiece, battery, and light guide work together to emit 1,300 mW/cm2 light intensity and cure in a wavelength range of 450 nm to 480 nm.

GC America’s The Light offers intensities in High, Low, Soft Start, and Pulse modes and emits constant light power regardless of its charge level. A long-lasting lithium-ion battery can be fully charged in 180 minutes and will last for 500 10-second cycles on High. The Light 405 has a dual wavelength processor and operates from 405 nm to 490 nm.
 
SmartLite FocusSmartLite Focus
Dentsply Sirona’s SmartLite Focus uses a collimated light beam to reduce light divergence for a strong cure over larger distances. A homogeneous beam profile delivers uniform performance within the curing area.

ACTEON’s MiniLED BLACK is driven by 3 AA batteries to offer a power output of 1,250 mW/cm2 and a 10-second fast-cure mode. Its lightweight, ergonomic pen-style design has a 360° rotating light guide.

An Extended Turbo Light Guide on Kerr Restoratives’ Demi Plus offers 28% additional reach during posterior procedures. Interchangeable light guides, multiple curing options, and periodic level shifting lead to more consistent cures.

Kulzer’s cordless, pen-style Translux Wave offers one-button operation to easily choose between 10- and 20-second cures in the 440 nm to 480 nm wavelength range, Mr. Thirsty One-Step SmartLite Focus VALO Cordless while a shorter, 70°-angled light guide allows for better access to molars.

Designed for curing, whitening, or transilluminating, SDI’s Radii Plus operates at a high intensity of 1,500 mW/cm2 and offers a 6-mm depth of cure, with contra- or right-angle and ortho attachments available. Heat sink technology reduces the amount of heat emission without using a fan, while a lightweight design maximizes user comfort.

 

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