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[牙科印模材料的消毒问题]

[Problems in disinfection of dental impression materials].

作者信息

Borneff M, Fuhr K, Behneke N

机构信息

Hygiene-Institut, Universität Heidelberg, Abt. Hygiene und Med. Mikrobiologie.

出版信息

Zentralbl Bakteriol Mikrobiol Hyg B Umwelthyg Krankenhaushyg Arbeitshyg Prav Med. 1989 Apr;187(4-6):365-81.

PMID:2500803
Abstract

In view of the risk of infection of the dentist and his staff in the dental surgery and dental laboratory and also of the patient with regard to hepatitis B and potentially also of AIDS, interruption of possible chains of infection by means of specific disinfection measures is to be demanded. Whereas appropriate hygiene concepts exist for disinfection of instruments, surfaces of equipment and furniture with regard to selection and application of various methods which may be considered, there are still extensive deficits for the domain of impression materials and their possible decontamination. In this regard, dentists frequently lack information with an adequate scientific basis that is understandable and oriented to practical requirements. Owing to the diversity of materials and their different behavior (cf. Tab. 1), appropriate recommendations can only be made on the basis of extensive studies. We assume that a practically relevant procedure must meet the following requirements: 1) sufficiently high rates of bacterial reduction in accordance with the guidelines of the DGHM, 2) lack of alterations in the dimensions or surfaces of the materials, 3) universal applicability, 4) practicability within a time period which is acceptable for smooth operation of the practice, 5) can be employed without problems for the staff. The object of the report are bacteriological results and materials testing data for the application of various methods of disinfection to selected impression materials. To summarize, it can be stated with regard to the bacteriological results that disinfection of impression materials is possible with fulfillment of the criteria specified above, but that there is a pronounced dependence of the results on the product formulation of the disinfectant and also of the impression material (cf. Fig. 4 and 5). Investigations of the material-related effects of the disinfection measures showed that extrapolation of the findings from one group of materials to another is also not possible in this connection, and that moreover the materials used to produce the model must also be included besides the impression materials used (cf. Fig. 9). Accordingly, statements on the suitability of a disinfection procedure are present admissible at most for the respective combination of materials tested, which makes practical introduction problematical.

摘要

鉴于在牙科手术和牙科实验室中,牙医及其工作人员以及患者面临感染乙型肝炎甚至可能感染艾滋病的风险,必须要求通过特定的消毒措施来中断可能的感染链。虽然在器械、设备表面和家具消毒方面,对于各种可考虑的方法的选择和应用已经存在适当的卫生理念,但在印模材料领域及其可能的去污方面仍存在大量不足。在这方面,牙医常常缺乏具有充分科学依据、易于理解且符合实际需求的信息。由于材料的多样性及其不同特性(参见表1),只有在进行广泛研究的基础上才能给出适当的建议。我们认为,一个实际可行的程序必须满足以下要求:1)根据德国卫生微生物学会的指导方针,细菌减少率足够高;2)材料的尺寸或表面无变化;3)普遍适用性;4)在诊所顺利运营可接受的时间段内具有实用性;5)工作人员使用时无问题。本报告的目的是提供对选定印模材料应用各种消毒方法的细菌学结果和材料测试数据。总而言之,就细菌学结果而言,可以说在满足上述标准的情况下,印模材料的消毒是可行的,但结果明显取决于消毒剂的产品配方以及印模材料(参见图4和图5)。对消毒措施与材料相关影响的研究表明,在这方面也无法将一组材料的研究结果外推至另一组材料,而且除了所使用的印模材料外,还必须包括用于制作模型的材料(参见图9)。因此,关于消毒程序适用性的陈述目前最多只能适用于所测试材料的相应组合,这使得实际应用存在问题。

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