Sterilization Protocols In Dentistry - A Review - PharmaInfo
Lakshya Rani et al /J. Pharm. Sci. & Res. Vol. 8(6), 2016, 558-564Sterilization Protocols in Dentistry – A ReviewLakshya Rani1,stDr.Pradeep211 Year BDS , Assistant Professor2Department of Conservative dentistry, Saveetha Dental College, ChennaiINTRODUCTION:Sterilization (or sterilisation) is a term referring to anyprocess that eliminates (removes) or kills (deactivates) allforms of life and other biological agents (such as viruseswhich some do not consider to be alive but are biologicalpathogens nonetheless), excluding prions which cannot bekilled,includingtransmissibleagents(suchas fungi,bacteria, viruses,prions, spore forms,unicellulareukaryotic organisms such as plasmodium, etc.) present ina specified region, such as a surface, a volume of fluid,medication, or in a compound such as biological culturemedia. Sterilization can be achieved with one or more ofthe following: heat , chemicals, irradiation, high pressure,and filtration. Sterilization is distinct from disinfection,sanitization, and pasteurization in that sterilization kills,deactivates, or eliminates all forms of life and otherbiological agents. Today’s busy dental practices face aserious challenge: to maintain or increase productivitywhile ensuring that patient safety remains a top priority. Attimes, these may seem like incompatible goals. Advancesin dental processing equipment, however, have empoweredpractices to develop safer processes while realisingefficiencies and ultimately, saving money. A cleaning andsterilization process that meets ADA and CDC guidelines eamlining of this process requires anunderstanding of proper methods, materials, and devices.Many methods of instrument reprocessing are available.Use of a complete system that encompasses and fulfils allelements that are critical maximizes efficiency andminimizes risks. Closed cassette systems provide a moreefficient and safer way to process, sterilize and organizeinstruments in a dental office - these eliminate manualsteps during instrument reprocessing such as handscrubbing and time-consuming sorting of instruments,thereby improving safety and increasing efficiency.Effective and efficient infection control in the dental officeis essential for the safety of patients and to ensure thatproductivity does not suffer. Infection control programs allinclude the cleaning and sterilization of reusable dentalinstruments and devices. Care must be taken by the dentalhealthcare professional to ensure that all instruments arecleaned prior to sterilization, and that this is carried out in asafe manner to avoid injury and puncture wounds. Use ofclosed-system cassettes reduces the risk to dentalhealthcare professionals when executing infection controlprograms. When using ultrasonic cleaners, washers andsterilizers, it is important to always follow themanufacturer’s instructions. It is also important to consultwith the manufacturer of dental instruments and devices asneeded to ensure complete sterilization and to avoiddamage to these items. Assurance of sterility of instrumentsand devices can be obtained through the use of one ofseveral tests, and these tests must be performed regularly toensure that the sterilizer is sterilizing all instruments anddevices and that these are safe for use on patients.STERILIZATIONANDDISINFECTIONOFDENTAL INSTRUMENTS:CATEGORIES :According to the Centers for Disease Control, dentalinstruments are classified into three categories dependingon the risk of transmitting infection. The classifications ofcritical, semicritical and noncritical are based on thefollowing criteria:1) Critical instruments are those used to penetrate softtissue or bone, or enter into or contact the bloodstream orother normally sterile tissue. They should be sterilizedafter each use. Sterilization is achieved by steam underpressure (autoclaving), dry heat, or heat/chemical vapour.Critical instruments include forceps, scalpels, bone chisels,scalers and surgical burs.2) Semi-critical instruments are those that do not penetratesoft tissues or bone but contact mucous membranes or nonintact skin, such as mirrors, reusable impression trays andamalgam condensers. These devices also should besterilized after each use.In some cases, however,sterilization is not feasible and, therefore, high-leveldisinfection is appropriate. A high-level disinfectant isregistered with the U.S. Environmental Protection Agency(EPA) as a "sterilant/disinfectant" and must be labeled assuch.3) Non-critical instruments are those that come into contactonly with intact skin such as external components of x-rayheads, blood pressure cuffs and pulse oximeters. Suchdevices have a relatively low risk of transmitting infection;and, therefore, may be reprocessed between patients byintermediate-level or low-level disinfection. Anintermediate-level disinfectant is EPA-registered as a"hospital disinfectant" and will be labeled for"tuberculocidal" activity (e.g., phenolics, iodophors, andchlorine-containing compounds). A low-level disinfectantis EPAregistered as a "hospital disinfectant" but is notlabeled for "tuberculocidal" activity (e.g., quaternaryammonium compounds). The tuberculocidal claim is usedas a benchmark to measure germicidal potency. Germicideslabeled as "hospital disinfectant" without a tuberculocidalclaim pass potency tests for activity against threerepresentative microorganisms: Pseudomonas aeruginosa,Staphylococcus aureus, and Salmonella choleraesuis Sterilization: There are many stages for instrument sterilization.They are presoaking; cleaning; corrosion control andlubrication; packaging; sterilization; handling sterileinstruments; storage. Distribution558
Lakshya Rani et al /J. Pharm. Sci. & Res. Vol. 8(6), 2016, 558-564Agents used in sterilizationPhysical agents:1. Sunlight2. Drying3. Dryheat: flaming, incineration, hot air4. Moist heat: pasteurization, boiling, steam underpressure, steam under normal pressure.5. Filtration: candles asbestos pads, membranes6. Radiation7. Ultrasonic and sonic vibrationsChemical agents:1. Alcohols: ethyl, isopropyl, trichlorobutanol2. Aldehydes: formaldehyde, glutaraldehyde3. Dyes4. Halogens5. Phenols6. Surface-active agents7. Metallic hyde,betaTransport of instruments to the sterilization area :Most dental offices have a designated area for instrumentreprocessing that is separate from the dental treatmentroom. This is ideal, since cleaning, sterilizing and storinginstruments in the same room where the delivery of patientcare is provided increases the risk of cross-contamination.The removal and disposal of single-use sharps such asneedles, blades, orthodontic wires and glass must be doneat the point of use, typically in the dental treatment room.Some instruments and materials are single-use only. Singleuse items should be segregated in the operatory, and thosethat are sharp or otherwise pose a risk of injury must bediscarded into a sharps container Items without risk, suchas a saliva ejector, can be thrown into the trash. Finally, thetray or cassette of reusable instruments is taken to thecleaning and sterilization area for processing.To prevent accidental injury with the contaminatedinstruments, special handling should be used to transportthe instruments to the cleaning and sterilization area.2 TheCenters for Disease Control and Prevention (CDC) statesthat, “Contaminated instruments should be handledcarefully to prevent exposure to sharp instruments that cancause percutaneous injury. Instruments should be placed inan appropriate container at the point of use to preventpercutaneous injuries during transport to the instrumentprocessing area.” In addition, the Occupational Safety andHealth Administration (OSHA) says, “The person handlingthe instruments through removal, cleaning, packaging andsterilization needs to use heavy-duty gloves to help preventinjury with sharp contaminated instruments.” Althoughheavy-duty gloves (utility gloves) may feel more awkwardthan examination gloves, they provide extra protectionwhile handling instruments during the cleaning, rinsing,drying, packaging and sorting procedures that take placeduring instrument reprocessing.(3)The fine tactilesensitivity needed during dental procedures is not necessaryduring instrument cleaning and sterilization; therefore,heavy-duty gloves pose no problem in this regard.Additionally, nitrile utility gloves are available in a varietyof sizes, allowing a more secure fit.Cleaning:Using mechanical means of instrument cleaning rather thanhand scrubbing should minimize handling ofinstruments.(4)If procedures are used whereby handscrubbing is necessary, heavy-duty (utility) gloves, mask,eyewear and gown should always be worn whilecleaning. (5)Minimize the risk of puncture injury byscrubbing only one instrument at a time while holding itlow in the sink. Use of a system utilizing locked cassetteseliminates the need to sort, handle and hand scrubindividual instruments - reducing the risk of infection fromcontaminated instruments - and results in savings of, onaverage, five minutes during instrument reprocessing, aswell as fewer damaged instruments, since the instrumentsare locked in position during reprocessing . As with anystandardized procedure, a standardized instrumentreprocessing protocol also results in easy staff training andcross-training.In general, three classifications of mechanical cleaningdevices are available for the dental office. They are theultrasonic cleaner, instrument washer and instrumentwasher/disinfector.Ultrasonic cleaning devices:An ultrasonic cleaner uses sound waves, that are outside thehuman hearing range to form oscillating bubbles, a processcalled cavitation. These bubbles act on debris to remove itfrom the instruments. Some manufacturers also useintermittent or sweeping sound waves to help improve thedevice’s cleaning ability and to decrease the potential forhot spots in the ultrasonic bath. Specialized detergentformulations are available for the solutions in ultrasonicmachines. When selecting a cleaning agent to use in theultrasonic cleaner, always consider the effect on materialsand instruments. Household products are inappropriatebecause they cause pitting, corrosion, rust or other damageto instruments, and potentially to the ultrasonic chamber.Therefore, it is best to follow the manufacturer’sinstructions, thereby choosing a solution that is compatiblewith the unit and the instruments. The procedure forcleaning the instruments in the ultrasonic cleaner is asfollows(5) Suspend instruments in the ultrasonic bath using a rackor basket fitted to the unit. Do not lay instruments directly on the bottom of theultra sonic cleaner, as this can interfere with cleaningand cause damage to instruments and the ultrasonicmachine. Avoid overloading the ultrasonic device, since thatcould inhibit its cleaning ability.It is important to follow the manufacturer’s instructions forthe ultrasonic cleaning cycle.In general, the timer is activated for three to six minutes forloose instruments and ten to twenty minutes for instrumentcassettes, and the timing is adjusted as necessary. While theultrasonic device is running, the lid or cover should be kept559
Lakshya Rani et al /J. Pharm. Sci. & Res. Vol. 8(6), 2016, 558-564on to reduce the release of aerosol and spatter into the areafrom the ultrasonic cleaner. Routinely replacing thecleaning solution in the ultrasonic machine is important,and is necessary at least once a day, more often with heavyusage.Instrument washers:Instrument washers use high-velocity hot water and adetergent to clean instruments. Widely used for decades inhospitals and large facilities as part of the centralsterilization process, these devices have recently becomeavailable for the dental office. These devices requirepersonnel to either place instruments in a basket or to useinstrument cassettes during the cleaning and drying cycles.Instrument washers for dental offices come in two differentdesigns. One is a counter-top model. This type does notrequire professional installation. The other type is built-inand resembles a kitchen dishwasher . It functions much thesame as the counter-top model, but it has a larger capacityand requires professional installation. Some models havethe ability to dry the instruments after washing, some donot.(5)Instrument washers/thermal disinfectors:These devices may look like the instrument washersdescribed above; however, there is one importantdifference. The high temperature of the water and chemicaladditives in these devices cleans and disinfects theinstruments. The significance of this lies in how personnelcan handle the instruments after the process. Upon removalfrom a thermal disinfector, instruments can be more safelyhandled, and if the dental healthcare professional were tosustain a puncture injury, it would not require the follow-upthat a contaminated exposure requires.All instrument washers and thermal disinfectors use either adetergent or a water-softening agent. It is possible for thepH of some of these chemicals to be incompatible withcertain metals in dental instruments. For specificrecommendations, the manufacturer of the dentalinstruments and the manufacturer of the instrument washershould be consulted.Instrument washers and thermal disinfectors are approvedmedical devices that have been rigorously tested to meetFood and Drug Administration (FDA) requirements forsafety and efficacy of medical devices; householddishwashers are not appropriate for use in a dental office.Instrument examination and careCleaning instruments, provides a good opportunity toexamine, replace or remove damaged instruments; lubricateitems such as hand pieces(6) and otherwise prepareinstruments for sterilization. Instruments must be drybefore packaging - if drying was not part of the cleaningprocess, time must be taken to dry the instrumentscompletely. High-quality metal dental cassettes speciallydesigned to withstand high temperatures are preferred foruse with steam and chemical vapor sterilizers. Moststerilizers on the market today offer a cassette rack, whichhelps to prevent over-loading in the sterilizer, therebyreducing the risk of ineffective sterilization and ultimatelyof infection and cross-infection.Packaging:Packaging used for instruments and cassettes prior tosterilization includes wrap, paper pouches, plastic pouches,combination paper/plastic pouches and nylon tubing.Sterilization packaging is specifically designed to allowpenetration of heat, steam or vapour and then to seal thesterilized instruments inside the package for sterile storage .After sterilization, instruments should remain in packagesuntil use. Different materials are appropriate for differenttypes of sterilizers.(7,8)Unless otherwise specified, allpackaging is single use only. Using tape to resealpreviously used packaging material may inhibit its abilityto continue to function as intended by the manufacturer.Sterilization:Parameters such as time, pressure and temperature varyaccording to the type of sterilizer, materials being sterilizedand individual models within sterilizer brands. The firststep in determining the settings for the sterilizer is to referto the manufacturer’s instructions. Sterilizers are medicaldevices, requiring clearance by the Food and DrugAdministration before manufacturers may offer them forsale. The FDA requires rigorous testing to ensure anadequate margin of safety in each cycle type described inthe instructions. Failing to follow the instructions of themanufacturer is ill advised, since it may result ininadequate sterilization of the instruments or devices in thesterilizer. It is never appropriate to use a household device,such as a toaster oven, for sterilization of dentalinstruments, devices, or equipment.Steam autoclave:Steam autoclaves are the most commonly used type of heatsterilizer in dental practices. Two types of processesemploy steam under pressure. The difference between thetwo is the manner in which the machine evacuates the airfrom the sterilization chamber and then introduces thesteam.Gravity displacement sterilizers rely on the forces ofgravity to force air out of the chamber through air escapevents. The steam entering the chamber from the waterreservoir displaces the air as it leaves the chamber. Thecombination of pressurization of the chamber, steam and ahigh temperature for a prolonged period has the ability tokill virtually all microorganisms. This is the most commontype of autoclave found in dental offices in the UnitedStates. A typical cycle for wrapped instruments includesheat-up and pressurization time, followed by a 15-to-30minute cycle during which sterilization is taking place(121 C at 15 psi). The sterilization cycle time decreases asthe temperature is increased. It is important to use cycletimes and temperatures described in the owner’s manual,and never to interrupt the sterilization cycle to remove oradd items, or for any other reason. Interruption of the cyclewill result in instruments that are not sterile and thereforenot safe for use on patients. After the sterilization cycle, thesterilizer must depressurize and the packs remain in thesterilizer for drying. The drying phase may take anywherefrom 20-45 minutes. The unit must only be opened aftercompletion of the drying cycle. Upon removal from the560
Lakshya Rani et al /J. Pharm. Sci. & Res. Vol. 8(6), 2016, 558-564sterilizer, sterile packs must be stored in a clean, dry area.Packs that become wet, torn, contaminated, or otherwisecompromised require resterilization(9).Pre vacuum autoclaves (also called Class B or Type Bsterilizers) use a variety of technologies to remove air fromthe chamber before the steam enters, thus creating avacuum. Most use a pulse vacuum to ensure elimination ofair from the chamber. This is generally a more efficientmeans of pressurizing the chamber; therefore, the operatormay notice some minor time saving in the start-up of thepre vacuum sterilizers. Most pre vacuum sterilizers use atemperature of 132 C-135 C for 3-10 minutes to achievesterilization. This higher temperature may be unacceptablefor some items, such as Teflon-coated instruments. Totaltime for pressurization, sterilization, venting and drying isgenerally considerably shorter than that for gravitysterilizers - about 45 minutes.Advantages of Autoclaves :1. Autoclaving is the most rapid and effective method forsterilizing cloth surgical packs and towel packs.2. Is dependable and economical3. Sterilization is verifiable.Disadvantages of Autoclaves :1. Items sensitive to the elevated temperature cannot beautoclaved.2. Autoclaving tends to rust carbon steel instruments andburs.3. Instruments must be air dried at completion of cycleDry-heat sterilization (convection and static air):Dry-heat sterilization employs high temperatures forextended periods to achieve sterilization of instruments.The method of heat circulation in dry-heat sterilizers isusually convection, which helps to ensure that the heatcirculates throughout the sterilization chamber during theprocess. Mechanical convection is more effective; thesterilizer contains a fan or blower that continually circulatesthe heated air to maintain a uniform temperature throughoutthe chamber. Most commercially available dry-heatsterilizers on the market today are of this type.The higher temperature of a dry-heat sterilizer means thatpaper will scorch and plastic will melt. (10)Specializedpackaging material is available for dry-heat sterilizers.Most hand pieces will not tolerate the higher temperaturesof a dry-heat sterilizer. Mechanically driven hand piecesthat contain turbines and bearings are susceptible todamage at higher temperatures. The manufacturer’sinstructions should be checked for compatibility ofinstruments, devices, and materials with the unit and thehand-piece manufacturer’s instructions should be followedfor preparation of the hand- piece prior to sterilization andfor sterilization itself.(10)Unsaturated chemical vapor sterilization:Unsaturated chemical vapor sterilization relies upon the useof a proprietary chemical that contains formaldehyde,alcohol and other inert ingredients, instead of water, toproduce a vapor to promote the sterilization. Use of thisproprietary chemical also results in the vapor having lesshumidity and therefore being less corrosive to sensitiveinstruments than if water were used.Sterility assurance:All the efforts that go into the preparation of instrumentsare futile if the sterilization process itself is not successful.There is no way of seeing that instruments are sterile bysimply observing the sterilizers and packs, even though achemical or mechanical indicator may have changed. Anindicator such as autoclave tape may change colour whenexposed to heat, but there is a possibility that the heat wasnot present for the proper length of time or that there wasinadequate pressure. Indicators that go on the outside of thepacks are useful for identifying processed and unprocessedpacks. Failure of sterilization can occur due to mechanicalmalfunction of the sterilizer or due to operator error. Thereare several methods to provide assurance of sterility.(10)Operator error:It is common to rely upon the automated functions of thesterilizer to tell the DHCP if there is a problem with thesterilization process. Most sterilizers have a system tonotify the operator of mechanical malfunction, butsterilizers cannot notify the operator whether the contentsof the instrument packs or cassettes are sterile or not.Operator error in loading the sterilizer could result infailure to sterilize all the packs in spite of the proper time,temperature and/or pressure. It is important to avoidoverloading the sterilizer or loading packs(10) and cassetteson top of one another; use of a cassette system helps toreduce operator error due to overloading. The heat and/orsteam must be able to circulate throughout the chamber andbetween the packs or cassettes for successful sterilization.Chemical indicators:Chemical indicators indicate the presence of certainconditions during the sterilization cycle, such as thepresence of heat and steam.(10)There are fiveclassifications of indicators recognized by the FDA, and itis important to note that it is now recommended that allpacks or cassettes include internal and external indicators.Class 1 - Process Indicators: These are placed on theoutside of packs and are useful in determiningwhich packs have been properly processedversus those that have not. Class 1 processindicators include autoclave tape and the colourchange indicators embedded on the outside ofsterilization packaging materials.Class 2 - Bowie-Dick Indicators: These show the pass/failin pre vacuum sterilizers. This test is conducteddaily with the chamber empty, (10) during thefirst cycle of the sterilizer, and is available as akit from commercial sterilization monitoringcompanies.Class 3 - Temperature-Specific Indicator: These react toone of the critical parameters of sterilization andindicate exposure to a specific value such astemperature or psi.561
Lakshya Rani et al /J. Pharm. Sci. & Res. Vol. 8(6), 2016, 558-564Class 4 - Multi-parameter Indicators: These react to twoor more of the critical parameters in the samemanner as Class 3 indicators.Class 5 - Integrating indicators: These are designed toreact to all critical parameters of sterilizationcycles. When used properly, integratingindicators may serve as the basis for the releaseof processed items, excluding implants. It isimportant to follow the manufacturer’s specificinstructions for use regarding a test challengepack.Biological monitoring:The use of biological monitors (spore tests) is the mostreliable method to validate that the sterilizer is functioningand that the sterilization of instruments is effective . Thesemonitors consist of paper strips or vials impregnated withbacterial spores that are specifically resistant to thesterilization process. New spore tests have been developedthat enable completion of biological monitoring in-officeand yield results in as little as 24 hours. These tests allowquick remediation and validate proper infection controlprocedures without a long lag time during which thesterilization procedure may have become ineffective but isnot known. It is recommended that biological monitoringbe conducted at least weekly (11)and with every load thatincludes an implantable device.Clinical sterilization:Infection control: Microorganisms are ubiquitous. Sincepathogenicmicroorganismscausecontamination, infection and decay, it becomesnecessary to remove or destroy them from materialsand areas.This is the objective of infection control andsterilization(13)DEFINITIONS: INFECTION CONTROL – Also called “exposurecontrol plan” by OSHA is a required office programthat is designed to protect personnel against risks ofexposure to infection. STERILIZATION: Use of a physical or chemicalprocedure to destroy all microorganisms includingsubstantial numbers of resistant bacterial spores.Sterilization means the destruction of all life forms.(Ronald B Luftig)(13)Sterilization is the process of killing or removing allviable organisms. (MIMS – PLAYFAIR) STERILE: Free from all living microorganisms;usually described as a probability (e.g., theprobability of a surviving microorganism being 1 in 1million). DISINFECTION: Destruction of pathogenic andother kinds of microorganisms by physical orchemical means. Disinfection is less lethal thansterilization, because it destroys the majority ofrecognized pathogenic microorganisms, but notnecessarily all microbial forms (e.g., bacterial spores). Disinfection is a process of removing or killing nfection refers to the destruction of pathogenicorganisms. (Ronald B Luftig)DISINFECTANT: A chemical agent used oninanimate objects to destroyvirtually all recognizedpathogenic microorganisms, but not necessarily allmicrobial forms (15)ASEPSIS: prevention of microbial contamination ofliving tissues or sterile materials by excluding,removing or killing microorganisms.Infection control:Preprocedural mouth rinse:Phenolic related essential oils; Bis-biguanides; Quaternaryammonium compounds; Halogens; Oxygenating agent; Acommercial mouthrinse containing 0.05 percent CPC whenused as a preprocedural mouthrinse was equally effective asCHX in reducing the levels of spatter bacteria generatedduring ultrasonic scaling(12).Hand sterilization:For routine dental examination procedures, hand washing isachieved by using either a plain or antimicrobial soap andwater. The purpose of surgical hand antisepsis is toeliminate transient flora and reduce resident flora to preventintroduction of organisms in the operative wound, if glovesbecome punctured or torn. At the beginning of a routinetreatment period, watches and jewelry must be removedand hands must be washed with a suitable cleanser. Handsmust be lathered for at least 10 seconds, rubbing allsurfaces and rinsed. Clean brushes can be used to scrubunder and around the nails. Must be repeated at least onceto remove all soil.Hand cleansers: Chlorhexidine based – these contain 2- 4%chlorhexidine gluconate with 4% isopropyl alcohol in adetergent solution with a pH of 5.0 to 6.5. They havebroader activity for special cleansing(e.g: for surgery,glove leaks, or when clinician experiences injury). Butit can be hazardous to eyes. Povidone iodone – contain 7.5-10% povidone iodine,used as a surgical hand scrub. Parachlorometexylenol(PCMX)–theyarebactericidal and fungicidal at 2% concentration. Nonirritating and recommended for routine use. Alcohol hand rubs- ethyl alcohol and isopropylalcohol are widely used at 70% concentration. Theyare rapidly germicidal when applied to the skin.(15)Personal barrier protection: Personal protective equipment (PPE), or barrierprecautions, are a major component of Standardprecautions. PPE is essential to protect the skin and the mucousmembranes of personnel from exposure to infectious orpotentially infectious materials. The various barriers are gloves, masks, protective eyewear, surgical head cap & overgarments (15)562
Lakshya Rani et al /J. Pharm. Sci. & Res. Vol. 8(6), 2016, 558-564n95 particulate respirator: National Institute for Occupational Safety and Health(NIOSH) introduced a rating system which identifiesthe abilities of respirators to remove the most difficultparticles to filter, referred to as the most penetratingparticle size (MPPS), which is 0.3µm in size. The “N” means “Not resistant to oil”. N95: captures at least 95% of particles at MPPS. N99: captures 99% of particles at MPPS. N100: captures 99.97% of particles (13)Eye wearCAUSES OF EYE DAMAGE:1. Aerosols and spatter may transmit infection2. Sharp debris projected from mouth while using airturbine handpiece, ultrasonic scaler may cause eyeinjury.3. Injuries to eyes of patients caused by sharp instrumentsespecially in supine position (13)DISINFECTION : it’s a vital part of sterilization.Disinfection is always at least a two-step procedure:The initial step involves vigorous scrubbing of the surfacesto be disinfected and wiping them clean.(18)The second step involves wetting the surface with adisinfectant and leaving it wet for the time prescribed bythe manufacturerThe ideal disinfectant has the following properties(19)1. Broad spectrum of activity2. Acts rapidly3. Non corrosive4. Environment friendly5. Is free of volatile organic compounds6. Nontoxic & nonstaining7. High-level disinfection: Disinfection process thatinactivates vegetative bacteria, mycobacteria, fungi,and viruses but not necessarily high numbers ofbacterial spores. (17)8. Intermediate-level disinfection: Disinfection processthat inactivates vegetative bacteria, the majority offungi, mycobacteria, and the majority of viruses(particularly enveloped viruses) but not bacterialspores.9. Low-level disinfectant: Liquid chemical germicide.OSHA requires low-
Sterilization Protocols in Dentistry - A Review Lakshya Rani1, Dr.Pradeep2 1st Year BDS1, Assistant Professor2 Department of Conservative dentistry, Saveetha Dental College, Chennai INTRODUCTION: Sterilization (or sterilisation) is a term referring to any process that eliminates (removes) or kills (deactivates) all
Slide 1 Welcome to Cleaning, Disinfection & Sterilization, Part 2 of 2. Slide 2 One way to achieve sterilization is with steam. Steam sterilization uses 4 parameters to achieve sterilization. These include the
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aging or steam sterilization, it is believed that samples can be stored for an indefinite time after exposure to steam sterilization without any adverse effects on properties. Table 2 Effects of steam sterilization results on KetaSpire KT-820 Property As-Molded KT-820 at 500 Cycle
Education & Training Objectives After completion of this self-study activity, the learner will be able to: 1. Describe available options for sterilization packaging and containment . “A sterilization wrap (pack, sterilization wrapper, bag or accessories) is a device intended to be used t
The sterilization is the process of heating to a high enough temperature (usually more than 100 C) for specific time to kill almost all bacteria. The sterilized milk can be stored at room temperature for a long period of time. The sterilization of milk has the following characteristics. Temperature more than 100 C is used in the process.File Size: 422KBPage Count: 11
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