Dental drill

A high-speed dental handpiece.

A dental drill or dentist's drill is a small, high-speed drill used during dental procedures, usually to remove decay and shape tooth structure prior to the insertion of a filling or crown. A dental drill may also be used in the cleaning and shaping of root canals during endodontic treatment, or to remove old or temporary fillings or crowns prior to the insertion of new or permanent restorations. The term "dental drill" is considered the more colloquial form of the term "dental handpiece," although it can also be construed as to include the power source for one or more handpieces, a "dental engine." "Handpiece" and "engine" are more generic and euphemistic terms for generic dental tools.

Modern dental drills can rotate at up to 400,000 rpm,[1] and generally use hard metal alloy bits known as burrs. Dental burrs come in a great variety of shapes designed for specific applications. They are often made of steel with a tungsten carbide coating, or of tungsten carbide entirely. The burr may also have a diamond coating.

Dental drills, which have a distinctive, shrill sound, are often a prominent factor in many people's fear of dentistry.

History

Foot-powered dental drill

The Indus Valley Civilization has yielded evidence of dentistry being practiced as far back as 7000 BC.[2] This earliest form of dentistry involved curing tooth related disorders with bow drills operated, perhaps, by skilled bead craftsmen.[3] The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective.[4] Cavities of 3.5 mm depth with concentric groovings indicate use of a drill tool. The age of the teeth has been estimated at 9000 years. In later times, mechanical hand drills were used. Like most hand drills, they were quite slow, with speeds of up to 15 rpm. In 1864, British dentist George Fellows Harrington invented a clockwork dental drill named Erado.[5] The device was much faster than earlier drills, but also very noisy. In 1868, American dentist George F. Green came up with a pneumatic dental drill powered with pedal-operated bellows. James B. Morrison devised a pedal-powered burr drill in 1871.

The first electric dental drill was patented in 1875 by Green, a development that revolutionized dentistry. By 1914, electric dental drills could reach speeds of up to 3000 rpm. A second wave of rapid development occurred in the 1950s and 60s, including the development of the air turbine drill.

The modern incarnation of the dental drill is the air turbine (or air rotor) handpiece, developed by John Patrick Walsh (later knighted) and members of the staff of the Dominion Physical Laboratory (DPL) Wellington, New Zealand. The first official application for a provisional patent for the handpiece was granted in October 1949. This handpiece was driven by compressed air. The final model is held by the Commonwealth Inventions development Board in Canada. The New Zealand patent number is No/104611. The patent was granted in November to John Patrick Walsh who conceived the idea of the contra angle air-turbine handpiece after he had used a small commercial-type air grinder as a straight handpiece. Dr. John Borden developed it in America and it was first commercially manufactured and distributed by the DENTSPLY Company as the Borden Airotor in 1957. Borden Airotors soon were also manufactured by different other companies like KaVo Dental, which built their first one in 1959.[6]

Current iterations can operate at up to 800,000 rpm, however, most common is a 400,000 rpm "high speed" handpiece for precision work complemented with a "low speed" handpiece operating at a speed that is dictated by a micromotor which creates the momentum (max up to 40,000 rpm) for applications requiring higher torque than a high-speed handpiece can deliver.[7]

Dental burr

See also: Burr (cutter)
A collection of various burrs used in dentistry.
Dental rotary instruments - boreri

A dental burr is a type of burr (cutter) used in a handpiece. The burrs are usually made of tungsten carbide or diamond. The three parts to a burr are the head, the neck, and the shank.[8]

The heads of some burrs (such as tungsten carbide burrs) contain the blades which remove material. These blades may be positioned at different angles in order to change the property of the burr. More obtuse angles will produce a negative rake angle which increases the strength and longevity of the burr. More acute angles will produce a positive rake angle which has a sharper blade, but which dulls more quickly. The heads of other commonly used burrs are covered in a fine grit which has a similar cutting function to blades (e.g. high speed diamond burrs).

There are various shapes of burrs that include round, inverted cone, straight fissure, tapered fissure, and pear-shaped burrs. Additional cuts across the blades of burrs were added to increase cutting efficiency, but their benefit has been minimized with the advent of high-speed handpieces.[8] These extra cuts are called crosscuts.

Due to the wide array of different burrs, numbering systems to categorize burrs are used and include a US numbering system and a numbering system used by the International Organisation for Standardisation (ISO).

Maintenance

The instrument needs to be disinfected after every usage to prevent infection during succeeding incisions. Due to the mechanical structure of the device, this must not be done with alcoholic disinfectant, as that would destroy the lubricants. Instead it has to be done in an autoclave after removing the drill, washing the instrument with water and lubricating it.[9][10]

Alternatives

Starting in the 1990s, a number of alternatives to conventional rotary dental drills have been developed. These include laser ablation systems and air abrasion devices (essentially miniature sand blasters) or dental treatments with ozone.

Other uses

Dental drills and burrs are commonly used by jewellers and hobbyists for high-precision drilling work.

References

  1. ↑ Medical Discoveries, 2010. Dental Drill.
  2. ↑ Coppa, A. et al. 2006. Early Neolithic tradition of dentistry. Nature. Volume 440. 6 April 2006.
  3. ↑ "Stone age man used dentist drill". BBC News. 6 April 2006.
  4. ↑ MSNBC (2008). Dig uncovers ancient roots of dentistry.
  5. ↑ "BDA Museum: Collections: Dental equipment: Clockwork drill and dental engine". British Dental Association. 7 June 2013. Retrieved 9 September 2015.
  6. ↑ http://www.kavo.com/functions/csdownload3.aspx?file=History_Banner_Turbinen_en.pdf&id=38225&org=003&key=f75a119947f217606e0dd24e773215d382de9e5eed84ca4365ec74cfa82a3a7b&key2=4b4e5113d2a3c22bb3d250563ff808758ae0e2ebc59d84036f2de57df20a5d3b History of Dental Turbines
  7. ↑ Handpiece, Use, Care and Maintenance", Franzel, Mattana. University Detroit Mercy School of Dentistry literature 2007
  8. 1 2 Summit, James B., J. William Robbins, and Richard S. Schwartz. "Fundamentals of Operative Dentistry: A Contemporary Approach." 2nd edition. Carol Stream, Illinois, Quintessence Publishing Co, Inc, 2001. Pages 139 - 143. ISBN 0-86715-382-2.
  9. ↑ "http://www.praezimed.it/menutenzione-di-strumenti/manutenzione-contrangoli Maintenance Instruction for Dental Drills (Italian)"
  10. ↑ "http://www.implantate.com/robert-koch-institut-hat-die-neuen-hygienerichtlinien-fuer-die-zahnarztpraxis-veroeffentlicht-bdiz-ma.html Hygiene Instructions for Dentists (German)"

External links

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