Statement of problem
As single-use rotary cutting instruments and electric handpieces become more available,
the performance of these instruments with electric as compared to turbine handpieces
requires evaluation. In addition, if rotary cutting instruments marketed as single-use
instruments are used for multiple patients, the effects on their performance of cleaning,
sterilization, and repeated use are of interest to the clinician.
Purpose
The purpose of the study was to evaluate how the cleaning, autoclaving, and repeated
use of single-use and multiuse rotary cutting instruments, with either a turbine or
electric handpiece, affected their performance.
Material and methods
The effects on cutting performance of 2 handpieces (turbine and electric), 2 cleaning
and sterilization conditions (cleaned and autoclaved versus noncleaned and nonautoclaved),
and 6 different diamond rotary cutting instruments (4 single-use and 2 multiuse) during
simulated tooth preparations were evaluated by using a 24-treatment condition full-factorial
experimental design. A computer-controlled dedicated testing apparatus was used to
simulate the cutting procedures, and machinable glass ceramic blocks were used as
the cutting substrate for tangential cuts. In addition, for each treatment condition,
8 consecutive cuts, for a total of 192 cuts, were measured to assess the durability
of the rotary cutting instruments. A linear mixed model was used to study the effect
of instrument type, handpiece, cleaning, and sterilization, as well as the status
and number of cuts on the outcome variables. The Tukey honestly significant difference
test was used for the post hoc pairwise comparisons (α=.05).
Results
Performance, as measured by the rate of advancement, decreased with the repeated use
of rotary cutting instruments (P<.001), while cleaning and sterilization procedures improved the average performance
of the 8 cuts (P=.002). The electric handpiece showed a greater load than the turbine (P<.001) and a lower rate/load metric, but no differences in the rate of advancement.
Significant differences were also detected among the different rotary cutting instruments
tested with the Two Striper, which showed the highest cumulative performance of all
groups.
Conclusions
The repeated use of both single-use and multiuse rotary cutting instruments decreased
cutting performance. The use of a cleaning and sterilization procedure between cuts
improved the average cutting performance. During a tangential cutting process, although
the ease of advancement (rate/load) was greater for the turbine, the electric handpiece
did not produce a statistically different cutting rate.
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Article info
Publication history
Published online: November 18, 2013
Footnotes
This project was supported by a Tylman grant from the American Academy of Fixed Prosthodontics.
Identification
Copyright
© 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
