Dental cutting with diamond burs: heavy-handed or light-touch?
Purpose: The cutting efficiency of diamond dental burs using different handpiece loads was evaluated against simulated enamel, a machinable glass ceramic (Macor).
Materials and methods: An ultra-high-speed dental handpiece was mounted in a frictionless bearing so that the pressure applied at the contact interface between the dental bur and the cutting substrate was controlled. One type of coarse- and two types of medium-grit diamond burs were studied. Handpiece loads of 44, 91.5, and 183 g were applied at the bur/Macor interface, and cutting efficiency was determined as the amount of Macor removed in ten 30-second-duration cuts that were 4 mm in length. The data were analyzed by one-way ANOVA and a post-hoc Scheffé test at an a priori alpha = 0.05.
Results: Cutting efficiency depended on both the diamond grit of the bur and the load applied to the handpiece.
Conclusions: The pressure used by most dentists, about 100 g at the bur tip, appears to be optimal for medium-grit burs. If the pressure applied to the handpiece is markedly increased, there was no increase in cutting efficiency for medium-grit burs. In contrast, an increased handpiece pressure raises the cutting efficiency of coarse-grit burs but the effect of this enhanced rate of cutting on the pulpal tissues is uncertain. Cutting efficiency also appeared to be dependent on debris accumulation between the diamond chips.