Clinical Foundations - Hand Piece Case Studies

Question 1

Your first patient of the day Sam Benet is 12 years old and scheduled for an annual
hygiene appointment. Based on the x rays, dental hygienist identifies presence of calculus. What type of dental handpiece(s) and bur shank will you set up and why?

Answer 1

a) Ultrasonic handpiece with attachment
* Note: When patient requires removal of calculus, ultrasonic handpiece will be
set up and used first. (only dental hygienist can use it or dental assistant with the scaling module)

b) Slow Speed Handpiece Contra Angle with either screw type head and screw type
bur (rubber cup) or latch type head and latch type bur (rubber cup) or Cordless slow speed handpiece with its attachments
* These handpieces are used when removal of bacterial plaque or extrinsic
stains are necessary.
Rheostat to activate rotations

Question 2

Mary Fleming is scheduled for a 1.4 MOD (dental filling/ restoration). What type of
dental handpiece(s) and bur shank will you set up and why?

Answer 2

a) High speed handpiece with a fissure/friction type bur or fiberoptic type
handpiece (light feature added for better visibility)
* Used to cut tooth and remove decay, contour the tooth, refine and adjust
restorations.
b) Slow Speed Handpiece Contra Angle with Latch type head and Latch type
bur.

Note: If laser handpiece is available, dentist will delegate if set up is required.
* Used to vaporize decayed tooth but mostly used to remove lesions,
tumors, reduce bleeding or remove excess tissue
Rheostat to activate rotations
* Used to remove decay, polish, refine and adjust restorations
Or Electric handpiece (slow or high-speed options. Use is the same.)

Question 3

Ken Smith received a partial upper denture last week and now he is scheduled for an appointment because the denture feels uncomfortable. What type of dental
handpiece(s) and bur shank will you set up and why?

Answer 3

a) Slow Speed Handpiece: Straight and laboratory Bur- Acrylic

• Partial denture is a removable dental appliance, therefore patient will be
  asked to remove the partial denture. The dentist will make extra oral
  adjustments (adjustments made outside the mouth) by trimming away any
  material that causes discomfort.

Rheostat to activate rotations

Question 4

Lisa Omar is scheduled for preventive appointment, a dental hygienist asked you to set up a handpiece that she uses to remove dental plaque. What type of dental
handpiece(s) and bur shank will you set up and why?

Answer 4

a) Slow Speed Handpiece Contra Angle
Latch type head or screw type head
Latch type bur or screw type bur
Or
b) Cordless slow (speed handpiece, rechargeable)
* These handpieces are used when remove bacterial plaque or extrinsic stains are present
Rheostat to activate rotations

Question 5

Your dental office had cancellations therefore you decided to do some work in the dental lab. There are few things that need to be finished for the dentist such as;
make a lower whitening tray, trim study model etc. What type of dental handpiece(s) and bur shank will you set up and why

Answer 5

a) Laboratory slow speed straight handpiece and laboratory Bur- Acrylic
* This type of handpiece is used in laboratory settings not operatory settings
therefore bur and the handpiece itself does not require sterilization, disinfection only as we do not work directly with patients.

Question 6

The dentist will need to remove access tissue along 4.8 D area for Zachary Nolan.
What type of dental handpiece(s) and bur shank will you set up and why?

Answer 6

Laser handpiece with attachment
* Used to remove excess tissue (vaporize decayed tooth but mostly used to
remove lesions, tumors, reduce bleeding)
Rheostat to activate rotations

Question 7

Your patient Sara Lee got a dental filling yesterday. Today she is scheduled for 20
min bite adjustment on the same filling as she is not able to bite well. What type of
dental handpiece(s) and bur shank will you set up and why?

Answer 7

a) Slow Speed Handpiece Contra Angle
Latch type head
Latch type bur
b) High speed handpiece or Fiberoptic type
Friction/ Fissure type bur

• Handpieces required as per dental filling. (see point 2)
  Rheostat to activate rotations

Question 8

Your patient Akira Otomo is scheduled for a 4.6 MO filling. What type of dental
handpiece(s) and bur shank will you set up and why?

Answer 8

a) High speed handpiece with a fissure/friction type bur or fiberoptic type
handpiece (light feature added for better visibility)
* Used to cut tooth and remove decay, contour the tooth, refine and adjust restorations.
b) Slow Speed Handpiece Contra Angle with Latch type head and Latch type bur.
* Used to remove decay, polish, refine and adjust restorations
Or Electric handpiece (slow or high-speed options. Use is the same.)
Note: If laser handpiece is available, dentist will delegate if set up is required,
Used to vaporize decayed tooth but mostly used to remove lesions, tumors, reduce bleeding or remove excess tissue

Question 9

Your patient Chloe Zhao is scheduled for a 1.6 MO filling. What type of dental handpiece(s) and bur shank will you set up and why?

Answer 9

Answer:
a) High speed handpiece with a fissure/friction type bur or fiberoptic type handpiece (light feature added for better visibility)
* Used to cut tooth and remove decay, contour the tooth, refine and adjust
restorations.
b) Slow Speed Handpiece Contra Angle with Latch type head and Latch type bur.
* Used to remove decay, polish, refine and adjust restorations
Or Electric handpiece (slow or high-speed options. Use is the same.)
Note: If laser handpiece is available, dentist will delegate if set up is required, used
to vaporize decayed tooth but mostly used to remove lesions, tumors, reduce bleeding or remove excess tissue

Question 10

11.Your patient Ava Duvernay is scheduled for a 5.5 MO filling. What type of dental
handpiece(s) and bur shank will you set up and why?

Answer 10

Answer:
a) High speed handpiece with a fissure/friction type bur or fiberoptic type handpiece
(light feature added for better visibility)
* Used to cut tooth and remove decay, contour the tooth, refine and adjust
restorations.
b) Slow Speed Handpiece Contra Angle with Latch type head and Latch type bur.
* Used to remove decay, polish, refine and adjust restorations
Or Electric handpiece (slow or high-speed options. Use is the same.)

Note: If laser handpiece is available, dentist will delegate if set up is required, used
to vaporize decayed tooth but mostly used to remove lesions, tumors, reduce bleeding or remove excess tissue

Question 11

Your patient Deepa Metha is scheduled for a preventive appointment at SAIT clinic.
What type of dental handpiece(s) and bur shank will you set up and why?

Answer 11

a) Slow Speed Handpiece Contra Angle with either screw type head and screw type bur (rubber cup) or latch type head and latch type bur (rubber cup) or Cordless slow speed handpiece with its attachments
* These handpieces are used when removal of bacterial plaque or extrinsic
stains are present. Handpiece is not set up at SAIT clinic right away as patient must be seen by the dentist/ hygienist first to determine if preventive (tooth polishing can happen) If patient has lots of calculus
present on their teeth, patient will have to have scaling done first before polishing. (Note: we never polish teeth that have calculus present)
Rheostat to activate rotation