Disinfection and sterilization of dental instruments in a hospital dental clinic.
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Test organisms forced mechanically into lubricated, rotating dental instruments (handpieces) were all killed during autoclaving at 134 degrees C for 8 min, even when protected by serum and oil. The test organisms were: Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, and spores of Bacillus stearothermophilus. Also when testing the sterility of autoclaved simulated instrument surfaces (brass cylinders and pieces of a cotton fabric) which had been inoculated with bacteria and dried before they were sprayed with oil, there was no growth of the test organisms. In addition to the other test organisms, spores of Bacillus subtilis and Gram-positive, anaerobic bacteria isolated from used handpieces that had been exposed to several autoclavings were used. Some of the handpieces that had been left to dry after use in the dentist's office before they were autoclaved, were shown not to be sterile. Therefore, the authors suggest that autoclaving of the instruments should take place shortly after use and prescribed cleaning.
Long handle dental instruments were inoculated with oral organisms or with B subtilis and immersed in a glass bead sterilizer at 400 F (204 C). It required from 12 to 14 minutes to sterilize the instruments at that temperature.
Comparisons were made of several dip-applied corrosion inhibitors for protection of carbon steel dental instruments during autoclaving. Although none were totally effective, several provided significant corrosion inhibition. Sodium nitrite and one proprietary inhibitor were about equally effective and notably superior to the other inhibitors investigated. Because sodium nitrite is a food preservative that is relatively harmless when ingested in small quantities, whereas commercial inhibitors are of proprietary composition and unspecified toxicity, we prefer to use sodium nitrite for corrosion inhibition during autoclaving. Sodium nitritie is readily available from chemical suppliers and is generally much less expensive than most commercial inhibitors. Although the autoclave used in this investigation is typical of many used in clinical situations, minor variations in design, steam impurities, and other unknown factors might effect the results. Further research is needed to determine the corrosive effects of impurities in the steam supply, residual detergents, method of postautoclave drying, steam supply deoxygenation, pH, and possibly the use of oxygen scavengers within the autoclave.
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The author describes an inserted basket system which conformes to the size of the dental instrumentarium and of the tank of the ultrasonic cleaning apparatus.
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