A Look at “Lectrics” By: Martin B. Goldstein, DMD
Official DentalTown Townie

It’s happened to all of us. Somewhere along the line, something new is placed in our hands for purposes of carrying out something old. It might have been the titanium driver that guaranteed an extra fifty yards off the tee; or perhaps it was the titanium road bike intended to lighten your cycling package. Some of these “new and betters” have turned out to be utter flops.

There have been times, however, when the ‘eureka moment’ hits and suddenly you feel empowered. A novelty takes over that seems to rejuvenate whatever it was that we’ve become quite accustomed to. What golfer among us (heck, even non-golfers) doesn’t recall the first time they swung a Big Bertha™? The club seemed to swing itself owing to a featherweight shaft and perfectly balanced head. Even if the ball didn’t go further, it felt like it did, sounded like it did and due to a new trajectory, looked like it did. As a result, the game became more fun. Something old had become something new.

We enjoy a profession in which innovations are commonplace. Many are helpful but few grab hold of what it is that we do most; cut teeth. Having attended the 2001 Greater New York Dental Meeting, it became apparent to me that the newest dental “must have” was an electric high-speed handpiece. While cutting some dried up molars on a plaster block I was pretty blown away to find that I couldn’t stall the burr no matter how hard I pushed. I was also wowed by the muted engine noise as well as the ability to easily adapt this new functionality into my existing high-speed set up using the very same pedal that I was already using. My only objection to the “lectric” as I’ll call it, was the weight that accompanied the motor needed to make it all happen. I wasn’t sure if I’d be able to get used to it. As often happens in shows, I got sidetracked by the plethora of newer and betters, ultimately leaving the show just a little more confused than when I had entered its halls. Still, the thought of the ‘lectric lingered…I couldn’t quite push it out of my mind.

A few weeks later, I stumbled across an email on one of the dental online listings that contained an offer to sample NSK’s ‘lectric offering without obligation. Well you can guess I jumped all over this and within two email exchanges with Traci Vlcek, a regional sales manager for NSK, a date of arrival had been set. So far as I was concerned, it couldn’t happen soon enough. While waiting for its arrival I decided to do a little research on NSK’s ‘lectric to better understand what I was getting into.

The NSK system was based on the Ti-Max EL400 engine (See Figs. 1 and 2) and, like the other systems available, could be connected to my existing delivery system via standard four-hole tubing. (See Fig. 3) The control box could be external to my delivery unit (the simplest solution) (See Fig. 4) or jury-rigged into my delivery system’s control box. In any case, my good ole “floor mounted” foot pedal would remain the modus operandi. What seemed to distinguish the Ti-Max EL400 was that the engine housing as well as the various inserts notably the E95L (See Fig. 5) were constructed of titanium. By this time just about everyone knows that titanium means lighter. So didn’t it make sense to offset some of the weight of the ‘lectric’s motor, with a material known for great strength and low mass. Is this starting to sound like a golf club commercial? Well if it is, it can’t be helped. Because, as I was delighted to find out, the new Ti-Max EL400/E95L combination was beautifully balanced, felt great in my hands (albeit heavier than what we are used to) and was a “looker” to boot. Somehow a gold hue is imparted to the titanium housing that when coupled with (please forgive me) its sexy looks makes a very nice showing when perched on your delivery unit. (Hey...we’re dentists; handpieces can be sexy!)

Figure 1		Figure 2
Figure 3		Figure 4
Figure 5

I know looks aren’t everything. What good is a blonde handpiece if it doesn’t add something to the mix? After having used NSK’s ‘lectric in concert with their titanium air driven, the NL95S, for nearly six months I can report that they represent a formidable combination, the one-two punch, if you will. Consider the ‘lectric, THE ENFORCER (not a bad name for a new titanium driver…). Pop in a fat, coarse diamond and be prepared to blow through old amalgam and composite with unprecedented ease. Slow and steady but deliberate finger guidance will make short work of whatever stands in the way of your intended preparation. The copious, three-port water spray will keep everything cool while washing away debris. The extra weight of the handpiece seems to back up your intentions, keeping the absolutely concentric diamond very much on track. Certainly the E95L/Ti-Max EL400 combination is capable of any preparation but it seems to rise to the occasion when faced with a heavy load. Additionally, the built-in fiber optic offers a bright, broad beam that’s comfortable on the eyes. For those not having fiber optics built into their rigs (such as myself), consider this capability a nice little perk. It comes with the control unit.

I’d be remiss if I didn’t mention that the Ti-Max EL400 engine is really the centerpiece of an electric delivery system. Multiple inserts are available that provide for all handpiece solutions from slow speed, ratio reduced inserts, to those suitable for laboratory purposes. Changing functionality is as simple as plugging in the tool needed and hitting a single control button on the control console to select the appropriate gear reduction and RPM setting.

As mentioned above, while sampling the Ti-Max EL400 system I was also afforded an opportunity to try NSK’s titanium air-driven high speed. The E95L’s air-driven counterpart is the NL95S. It is attached to your delivery unit via a convenient swiveling “coupler” that allows the user to simply plug in the handpiece; easy on, easy off; similar to its ‘lectric sibling. The lightweight afforded this beauty by its titanium construction is immediately perceptible. I’ve never used a handpiece that felt so effortless to control. Nor did I expect it to possess the torque that it did; considerable power in a very tidy package.

It’s worth noting that the NSK line is distinguished not only for being the world’s first all titanium body handpiece, but also for its patented “clean head system” and “non-retraction valve.” The clean head system reduces internal contaminations and thus improves cartridge life (See Fig. 6) while the non-retraction valve reduces the “suck back” phenomenon thus providing additional protection from water line contamination. (See Fig. 7) Additionally, NSK’s ceramic ball bearings are said to allow for higher speeds with less wear, thus extending turbine life (See Fig. 8).

Figure 6

Figure 7

Figure 8

Vive La difference
To be sure, there are differences to be noted when operating a ‘lectric as compared to an air-driven. As alluded to above, a slower, steadier, firmer motion takes advantage of the handpiece’s additional torque. Using a lighter stroking motion will result in behavior that is much like a conventional air driven with somewhat less tactile sense, owing to the mass of the unit. One needn’t worry about cooking the prepared tooth since the water spray is abundant, providing proper cooling and cutting lubrication. When necessary, the water spray can be shut off via the normal water switches on your unit. Due to the use of your floor pedal to control the handpiece’s RPMs, it’s possible to run it at less than the maximum 200,000rpm, but I found that in most instances the water spray and cutting performance were optimal when I had it floored.

It didn’t take long for me to develop a routine that found me alternating use of the ‘lectric and air-driven during the same preparation sessions; using the E95L to carry out the bulk of the work and the NL95S to fine tune and finish. Make no mistake; either handpiece was perfectly capable of both starting and finishing the job at hand, “unassisted.” It’s just nice to have the added muscle, sure footedness and reduced engine noise offered by the ‘lectric during a long session of tooth preparation.

A Happy Ending?
So how did my trial period pan out? Rest assured, NSK will have to pry my little fingers off of the Ti-Max EL400 and E95L if they expect to get it back.
As alluded to in the opening paragraph, we are occasionally granted access to a new technology that seems to empower us, making mundane tasks more enjoyable. Certainly, ‘lectrics represent a new approach to high-speed instrumentation with several companies now offering similar packages. As I always say, be an informed consumer and see for yourself what the market has to offer.
Could I continue to practice without this new technology? OF COURSE I COULD! I just wouldn’t want to...now where’s my checkbook? DT

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Dr. Goldstein is a 1977 graduate of the University of Connecticut School of Dental Medicine and practices general dentistry in a group setting in Wolcott, Conn. He enjoys promoting the cosmetic side of his practice and has found it helpful to incorporate high-tech methodology into his daily routine to accomplish this. Dr. Goldstein contributes editorial to leading dental publications.

Doctor Goldstein can be contacted at martyg924@cox.net or at his office at 203-879-4649. He is prepared to speak on both digital imaging in dentistry and on the use of high-tech methodology to further the cosmetic practice.

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