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Particular requirements for oral surgical straight and contra-angle handpieces

The effectiveness of dental treatment depends largely on how well the oral structures that are to be treated can be recognised. Delicate instruments with fibre optics and press button chuck systems are available to dentists in conservative/prosthetic dentistry today.
User report: Dr. Neugebauer, Dr. Karapetian, Dr. Lingohr, Dr. Scheer, Univ. Prof. Zöller (Cologne)*

Clinical procedure

The implantological procedure, particularly in the posterior jaw, requires a precise overview. However, this is often limited due to the restricted view and inadequate illumination. The use of light-operated surgical straight and contra-angle handpieces is recommended here, particularly when carrying out sinus floor elevation. The precise illumination of the operation area during the gentle removal of the vestibular bone allows the Schneider membrane to be preserved and also allows for fewer interruptions of the operative procedure for the necessary visual inspections with external illumination. The resection of maxillary sinus septa in particular can therefore be carried out quickly.

Targeted illumination of the treatment site
left: Targeted illumination of the treatment site during the preparation of the lateral maxillary sinus window
centre: Good overview even when using the external isotonic coolant during careful bone preparation.
right: Complication-free preparation of the maxillary sinus mucous membrane

Most implant systems work with a sequence of burs dimensioned in ascending order in order to allow for gentle bone preparation. It is thereby necessary to replace the bur regularly when inserting several implants. The additional positioning of the instruments using the hexagon driver allows for easy visual inspection of the precise positioning of the instrument that has been replaced.

Preparation using system burs
left: Surgical handpiece with a reduction of 20:1 and hexagon driver for mechanical implant insertion and LED illumination.
centre: Illumination of the pilot drilling when using a drilling template created based on DVT data (Galileos, Sicat, Bonn)
right: Further preparation using system burs under precise illumination of the treatment site with internally cooled burs.

Thanks to an easy-to-use press button chuck system contained on the contra-angle handpiece head, the risk of sterile glove damage, which can occur with slide locks, is reduced. The precise positioning of the thread cutter or rotary instruments ensures that the treatment is carried out without complications and allows the user to concentrate on the clinical findings instead of possible technical complications.

Insertion of three implants in the upper jaw
left: Mechanical insertion of a XiVE® implant using a hexagon driver on the contra-angle handpiece.
right: Insertion of three implants in the upper jaw during sinus floor elevation carried out at the same time.

Since the IDS 2007, work can be carried out using a sterilizable LED for surgical use which requires sterilization. The integrated LED with its own generator in the instrument is a particular advantage for surgical instruments as it can be used with the normal, traditional sterilizable micro motors. The sterilizable LED illuminates the treatment site using daylight quality light. The built-in generator produces the current required for the power supply to the LED.

The use of corrosion-resistant materials, particularly in the aggressive area when using physiological saline solution, guards against the risk of material wear and malfunction during the relatively invasive treatment. Due to the high costs, non-multiple replacement devices are generally available, meaning that it can be assumed that there will be reliable functioning. The functionality for using the surgical instruments in the handpieces with hexagon drivers for the preparation of the cavity and implant insertion must not be modified. This is to guarantee an efficient sequence of operation.

* Source: Implantology Journal of the DGZI (German Association of Dental Implantology).