Whitworth C L, Martin M V, Gallagher M, Worthington H V
General Dental Practitioner, 9 Rake Lane, Upton, Wirral, UK.
Br Dent J. 2004 Nov 27;197(10):635-40; discussion 623. doi: 10.1038/sj.bdj.4811832.
This study investigated the bacterial and fungal contamination of used dental burs. A novel assay system for comparison of efficacy of pre-sterilisation cleaning techniques for dental burs was used to evaluate manual scrubbing, enzymic agents and washer-disinfectors.
Thirty dental burs contaminated during cavity preparation were analysed for micro-biological total viable counts and species of bacteria and fungi present. To simulate clinically contaminated burs, a culture of Streptococcus sanguis NCTC 7863 was used to inoculate unused dental burs, alone and combined with blood, saliva or a mixture of blood and saliva. Contaminated burs were subjected to six pre-sterilisation cleaning techniques and the log reduction in contamination achieved by each method was assessed.
The microbial count from used dental burs ranged from 0 to 6.92 x 10(4) CFU ml(-1). Many potentially pathogenic species were identified. The decontamination assay demonstrated that autoclaving alone was not sufficient to sterilise dental burs. Manual scrubbing in air was less efficacious than manual scrubbing under water (p<0.001). The most effective method of pre-sterilisation cleaning for dental burs was a washer-disinfector.
Enzymic agents are suitable for soaking contaminated dental burs immediately after use. Washer-disinfectors are recommended as the method of choice for pre-sterilisation cleaning of contaminated dental burs.
本研究调查了使用过的牙科车针的细菌和真菌污染情况。采用一种用于比较牙科车针预消毒清洁技术效果的新型检测系统,来评估手动刷洗、酶制剂和清洗消毒器。
分析了30支在窝洞制备过程中被污染的牙科车针的微生物总活菌数以及存在的细菌和真菌种类。为模拟临床污染的车针,使用血链球菌NCTC 7863培养物单独或与血液、唾液或血液和唾液的混合物一起接种未使用的牙科车针。对污染的车针进行六种预消毒清洁技术处理,并评估每种方法实现的污染对数减少情况。
使用过的牙科车针的微生物计数范围为0至6.92×10⁴CFU ml⁻¹。鉴定出许多潜在致病菌种。去污检测表明,仅高压灭菌不足以对牙科车针进行灭菌。在空气中手动刷洗不如在水下手动刷洗有效(p<0.001)。对牙科车针进行预消毒清洁最有效的方法是使用清洗消毒器。
酶制剂适用于在使用后立即浸泡受污染的牙科车针。建议使用清洗消毒器作为对受污染牙科车针进行预消毒清洁的首选方法。