Posted on: March 6, 2017

No matter how much technology a practitioner uses, there is one common instrument that everyone uses, and the majority of them use one with a 50-year-old design: the air- turbine handpiece, a staple in the armamentarium of almost every office. Most practitioners make their purchasing decisions based on the model they used in school or perhaps the ones that were used in a former or associated office. You step on the pedal and get to work. When a turbine fails, either you pop in a new one or send it out for repair. Some offices have the turbine repair unit and kit and keep the handpieces running for more than 20 years, so there does not seem to be much need to buy a new handpiece. Of course, the glamour of electrics is out there, with many amazing benefits, but there are many frugal offices that don’t want to “get into that expense” just yet. Plus, to keep up with sterilization protocols, you probably have already invested in several handpieces, usually the same model.

It looks and feels like all other turbines, but when in use, its power is immeditely noticeable.  Bien Air’s Tornado. Using ceramic ball bearings and a new turbine design, not only is it the most powerful handpiece in the class but perhaps also the quietest. There seem to be some new sleek designs and lighter materials (titanium), but if asked, how many of you would know the torque power rating of the one you are using? We are aware that with too much pressure on a tooth, many handpieces will stall or slow down. When cutting through large amalgams or crowns, we seem to apply more pressure and can manipulate the bur so it won’t stall, but you know it is generating more heat. The answer to the torque is that a typical air handpiece cuts at about 16 to 18W. Electrics maintain 35W or more and don’t usually stall due to the drive system. Aside from cost, a disadvantage of electrics was the size and weight of both the motors and the hoses. This has changed dramatically during the past few years, with smaller, lighter motors and better balance. Handpiece companies, even those who manufacture state-of-the-art electric handpieces, have taken a cue from dentists and realize that most still prefer air turbines. They are easy to connect and disconnect, and despite the advances lowering the size and weight of electrics, air turbines are lighter, thinner, and less expensive. No matter what, electrics have to be a bit more robust to accommodate the gears and shafts instead of an air hose with a small spinning top at the end. Several years ago, J. Morita reinvented the turbine by creating a “TwinPower” turbine (Figure 1), increasing power from the typical 16W to 22W. Unfortunately, this was almost unnoticed since J. Morita is not a name most associate with equipment. (Incidentally, J. Morita has an excellent cone beam unit). The TwinPower turbine handpiece looks and feels like all others, but when in use, its power is immediately noticeable. KaVo recently introduced the Mastertorque lux. The company has increased its already robust handpiece to 23W and reduced the noise level. It has also introduced “Direct Stop Technology,” which is like ABS brakes on your car. The bur stops in 0.8 seconds, reducing injury to an aberrant soft tissue or a cotton roll. (We all know that sound.) Another interesting innovation in air handpieces is Medidenta’s surgical unit, the Air King Surgical (45°). Medidenta has changed the entire airflow through the handpiece, exhausting through the back, thus eliminating the possibility of air embolism. At the same time, it has pushed the torque to 22W. Continuing with improvements in power, NSK introduced the Ti-Max Z900L , offering a whopping 26W of power (as well as a 30-month warranty). NSK has created a formidable competitor to its own line of electric models. The newest and highest power air handpiece comes from Bien Air, with its new Tornado (Figure 2). Its power tops out at a remarkable 30W, closer to the 35W of an electric. Using ceramic ball bearings and a new turbine design, not only is this the most powerful handpiece in the class but perhaps also the quietest. It offers many more advanced features, including a heat shield like the space capsules, ensuring patient safety. One notable handpiece from Toronto-based Beyes, the AirLight M800, gives you fiber-optic light without a cable, and there is a generator turbine in the handpiece that powers the LED. Finally, Midwest introduced a handpiece priced between air and electric models, the Stylus ATC. Although it is only reporting 20W, this power does not diminish unless you are pushing against the tooth with 2 hands.  In the meantime, take a hard look around your office because it might be time to retire that Borden AirRotor.