Comprehensive Review and Comparison of the Disinfection Techniques Currently Available in the Literature

Evaluation of the effect of chemical disinfection and ultraviolet disinfection on the dimensional stability of polyether impression material: an in-vitro study

BACKGROUND

Various methods, chemical and physical, disinfect dental impressions. Common chemicals include 1% Sodium Hypochlorite and 2% glutaraldehyde, while UV radiation is a prevalent physical method. Few studies compare their effects on dimensional stability in polyether impressions. This study aims to assess such stability using different disinfection methods. Therefore, this study was planned to evaluate the dimensional stability of polyether impression material using different disinfection methods.

METHODS

This in vitro study compared the effects of chemical disinfectants (1% Sodium Hypochlorite and 2% glutaraldehyde) and UV irradiation on the dimensional stability of polyether impression material. Groups A, B, C, and D, each with ten samples (N = 10), were studied. Group A was untreated (control). Group B was treated with 2% glutaraldehyde for 20 min, Group C with 1% Sodium Hypochlorite for 20 min, and Group D with UV rays for 20 min. A pilot milling machine drill was used to make four parallel holes labeled A, B, C, and D in the anterior and premolar regions from right to left. After sequential drilling, four implant analogs were positioned using a surveyor for accuracy. Ten open-tray polyether impressions were made and treated as described in the groups, followed by pouring the corresponding casts. Distortion values for each disinfection method were measured using a coordinate measuring machine capable of recording on the X- and Y-axes.

RESULTS

A comprehensive analysis was conducted using the one-way ANOVA test for distinct groups labeled A, B, C, and D, revealing significant differences in the mean distances for X1, X2, X4, X5, and X6 among the groups, with p-values ranging from 0.001 to 0.000. However, no significant differences were observed in X3. Notably, mean distances for the Y variables exhibited substantial differences among the groups, emphasizing parameter variations, with p-values ranging from 0.000 to 0.033. The results compared the four groups using the one-way ANOVA test, revealing statistically significant distance differences for most X and Y variables, except for X3 and Y4. Similarly, post-hoc Tukey's tests provided specific pairwise comparisons, underlining the distinctions between group C and the others in the mean and deviation distances for various variables on both the X- and Y-axes.

CONCLUSIONS

This study found that disinfection with 1% sodium hypochlorite or UV rays for 20 min maintained dimensional stability in polyether impressions.

Comparative analysis of dimensional changes in autoclavable polyvinyl siloxane (PVS) impressions under various Sterilization/Disinfection Protocols: A randomized controlled trial

Background

Impressions that maintain their dimensional stability after autoclaving effectively control cross-infection and contamination resulting from a patient's oral secretions.

Purpose

The study aimed to assess the dimensional stability of autoclavable polyvinyl siloxanes after disinfection and sterilization.

Methods

A stainless steel metal model containing three full veneer crown preparations was fabricated according to ANSI/ADA specification No. 19. Reference grooves were established on the occlusal and axial surfaces of the abutments for accurate measurements. Forty impressions were created from the master model using single-step impression technique monophase polyvinyl siloxane material (AFFINIS, Coltene/Whaledent, Altstatten, Switzerland). The impressions were categorized into four groups: Group A (control, ten untreated impressions), Group B (ten disinfected impressions with 5.25 % sodium hypochlorite [NaOCl]), Group C (ten disinfected impressions with 2 % glutaraldehyde), and Group D (ten autoclaved impressions at 134 °C for 18 min). Subsequently, stone casts were produced using type IV gypsum products (Gelstone R, BK Giulini Chemie, Ludwigshafen/Rh., Germany). The dimensional accuracy of the obtained casts was assessed by measuring the inter-abutment measurements (between the abutments) and the intra-abutment measurements (diameter and height of the abutments). These measurements were performed using a universal measuring microscope (Olympus stereomicroscope B061 Imaging Corp. Tokyo, Japan) with a precision of 0.001 mm. The dimensions of the stone casts from the study groups were then compared to those of the control group. Data analysis was performed using a one-way ANOVA with a significance level of α = 0.05.

Results

AFFINIS impressions subjected to chemical disinfection in 5.25 % NaOCl and 2 % glutaraldehyde with different immersion times showed slight expansion in the intra- and inter-abutment measurements. The impressions autoclaved at 134 °C for 18 min showed slight shrinkage in the intra- and inter-abutment measurements. The dimensional change was statistically non-significant, and the percent of dimensional changes within the experimental groups was within the clinically accepted limit (α < 0.5).

Conclusion

AFFINIS polyvinyl siloxanes retain dimensional stability suitable for clinical use when subjected to chemical disinfection and steam autoclaving.

Knowledge about methods of disinfection of dental impression among dentists from Ecuador post SARS-COV-2 pandemic

Purpose

The aim of this study is to evaluate the understanding of the management of methods and practices of disinfection of dental impressions applied by general dentists and specialists in oral rehabilitation, post SARS-COV-2 pandemic.

Introduction

The oral cavity has a favorable environment for the growth and multiplication of bacteria and viruses, serving as the gateway to viruses such as SARS CoV-2 virus. Given that patients may be hosts of this infectious disease, stricter biosecurity measures in dental offices and a better understanding of the disinfection processes of dental impressions should be considered in addition to avoiding cross-infections, which are very common in our work environment.

Materials and methods

Descriptive, analytical, survey with the topic "Methods and practices of disinfection of dental impressions" that was composed of 14 questions based in OHPD (Oral Health Preventive Dentistry), n = 452 respondents who met the following inclusion criteria: general practice dentists from Ecuador who actively take dental impressions, specialists in oral rehabilitation with 5 years of experience, surveys with information of complete items, n = 270 professionals; n = 192 general dentists, dental hygienist and n = 78 oral rehabilitation specialists.

Results

n = 270 professionals evaluated, with a mean of p = 0.0. At 426 responses with a p value of <0.05, 30.4 % of responses indicated ignorance in the management of dental impressions, with a standard deviation of 2.744, with significant differences between professions (p = 0.035) and higher average knowledge of sample management within specialist dentists, (Chi p = 0.410 p > 0.05).

Conclusion

The understanding of the management of dental impressions among general dentists and specialists in oral rehabilitation is limited.

Efficacy of an impression disinfectant solution after repeated use: An in vitro study

Statement of problem

There are very few studies using Benzalkonium Chloride (BAC) as an active disinfection agent for immersion techniques and there are no studies investigating the efficacy of repeated use of a disinfectant solution.

Purpose

This study evaluated an impression disinfectant by testing bacterial contamination of disinfectant batches used in a clinical setting after repeated use.

Materials and methods

Liquid samples were collected from impression disinfectant solutions used to disinfect dental impressions taken at a university dental clinic. The experimental samples (500 ml from 1 L of solution) were collected from teaching and professional clinics and the in-house commercial processing laboratory and stored at room temperature each day of clinic operation over five weeks. To determine to what extent the disinfectant efficacy of the active product decreased over time, the following tests were carried out: a. Inoculation b. Gram staining technique c. Matrix Assisted Laser Desorption/Ionization Mass spectrometry (MALDI- MS). Microbial growth was monitored and photographed. A culture revival was made from colonies grown on sheep blood agar, to isolate pure colonies incubated for 24 h at 37 °C. Each morphologically distinct type of colony was gram stained and MALDI spectrometry analysis was performed using the VITEK MS (BioMerieux Inc.).

Results

Evidence of growth of bacteria was detected in teaching clinics' samples, and no growth from the professional clinic or the commercial laboratory.

Conclusions

The study demonstrated that impression disinfectanat solution tested is effective against common oral bacteria, despite some rare species such as Bacillus circulans, Bacillus horneckiae, Bacillus altitudinis/pumilus and Bacillus cereus showing evidence of survival in solutions used for disinfection of impressions. However, in a high use teaching clinic environment its efficacy deteriorated. Though a second level disinfection protocol in the commercial laboratory-maintained impression disinfection.

Efficacy and design requirements of UV light cabinets for disinfection of exchangeable non-sterilizable "dental objects"

Non-sterilizable items such as prosthodontics items constitute a high risk of transmitting dangerous pathogens, including Coronavirus, between patients and healthcare personnel. Although UV rays are recognized for their germicidal efficacy, large and expensive UV devices previously hindered their adoption in dental offices. During the COVID-19 pandemic, small UV devices became available for domestic use, albeit with varying designs and effectiveness. Our study assesses the disinfection capacity of a UV light cabinet for four dental materials and discusses crucial design features for effective performance. Specimens of each material (silicone impressions, stone cast, acrylic denture base, and indelible pencils) were contaminated with Escherichia coli Bl21, and randomly divided into three study groups: UV device (UVG), impressions disinfection solution (SG), and control (CG). The experiment was repeated thrice, and disinfection efficacy assessed by colony forming units (CFU) count. A 2.5-min UV exposure achieved full disinfection for all materials. Significantly different results were found between groups (p < 0.05, one-way ANOVA, Tukey HSD), except for indelible pencils, where UVG and SG were both highly effective. UV cabinets surpass SG's disinfection efficacy. Compact UV devices can offer affordable, portable, and efficient disinfection for non-sterilizable dental objects, with careful consideration of wavelength, exposure, intensity, and safety.

The Potential Uses of Baobab Tree's Medicinal Effects in Dentistry: A Literature Review

Adansonia digitata (Baobab) tree is an African tree with a long history in traditional medicine. The local inhabitants of Africa have been using the different tree components to treat medical diseases, such as fever, diarrhea, malaria, cough, dysentery, and microbial infections. Recently, the tree gained the attention of scientists due to its medical and pharmaceutical properties and nutritional values, which generated a myriad number of investigations regarding its phytochemical and macro- and micronutrient contents. The fruit pulp is especially rich in vitamin C, pectin, fibers, and minerals such as calcium, magnesium, potassium, phosphorus, zinc, iron, and copper. Additionally, the leaves contain high levels of calcium, while the seeds are considered a good source of protein and fat. Altogether, they contain a variety of polyphenols, fatty acids, and amino acids. The tree extracts possess potent antioxidant, cell-protective, and anti-inflammatory activities. However, no information was found in the literature about the use of Baobab tree products in the dental field. The aim of this review is to discuss the well-documented medical effects and chemical and mineral components of the different Baobab tree parts from a dental point of view to open more areas of research concerning its potential applications in the dental field. Antioxidants and vitamin C are known to help in maintaining healthy periodontal and gingival tissues. They also help in wound healing and alveolar bone integrity. Moreover, phytochemicals and phenolic compounds have been utilized in controlling dental plaque and manufacturing intracanal medications as they manifest antimicrobial and anti-inflammatory activities. Furthermore, calcium and phosphorus incorporation in dental biomaterials is commonly used in vital pulp therapy and repairing bone defects. After reviewing the reported medicinal and pharmaceutical activities of the Baobab tree, it can be inferred that the tree extracts possess potential uses in the dental field, which requires further investigation for validation.

Evaluation of Intraoral Full-Arch Scan versus Conventional Preliminary Impression

An accurate impression is vital during prosthodontic rehabilitation. Digital scanning has become an alternative to conventional impressions. This study compares conventional preliminary impression techniques with digital scanning, evaluating the efficiency, treatment comfort, and trueness. Impressions of 28 patients were taken using conventional and digital techniques. The efficiency of both impression techniques was evaluated by measuring the mean working time. A visual analog scale questionnaire (1-10) was used to appreciate the participants' perceptions of discomfort. Morphometric measurements, which were carried out to determine the differences between the casts, were made on the buccolingual cross sections of teeth 11 and 31 and the distolingual and mesiobuccal cusp tips of each first molar. The total treatment time was 75.5 min for conventional and 12 min for digital impressions. The patients scored a mean discomfort assessment of 6.66 for conventional and 9.03 for digital scanning. No significant differences existed between the examined areas (p < 0.05, Wilcoxon and Mann-Whitney tests) of the digital casts obtained by both techniques. The intraoral scan can be considered as an alternative to conventional preliminary impressions for performing study model analysis during orthodontic treatment planning. The digital impression is more comfortable and accepted by the patients than the conventional impression and has a shorter working time.

Effect of Sterilization on the Dimensional and Mechanical Behavior of Polylactic Acid Pieces Produced by Fused Deposition Modeling

To successfully implement additive manufacturing (AM) techniques for custom medical device (MD) production with low-cost resources, it is imperative to understand the effect of common and affordable sterilization processes, such as formaldehyde or steam sterilization, on pieces manufactured by AM. In this way, the performance of low-risk MDs, such as biomodels and surgical guides, could be assessed for complying with safety, precision, and MD delivery requirements. In this context, the aim of the present work was to evaluate the effect of formaldehyde and steam sterilization on the dimensional and mechanical stability of standard polylactic acid (PLA) test pieces produced by fused deposition modeling (FDM). To achieve this, PLA samples were sterilized according to the sterilization protocol of a public hospital in the city of Bucaramanga, Colombia. Significant changes regarding mechanical and dimensional properties were found as a function of manufacturing parameters. This research attempts to contribute to the development of affordable approaches for the fabrication of functional and customized medical devices through AM technologies, an issue of particular interest for low- and middle-income countries.

Effect of chemical disinfection on the dimensional stability of polyvinyl ether siloxane impression material: a systemic review and meta-analysis

BACKGROUND AND OBJECTIVES

Polyvinyl ether siloxane (PVES) possesses ideal characteristics for making precise and accurate dental impressions. PVES dimensional stability owes to its better polymeric properties derived from its parent materials poly ethers and polyvinyl siloxanes. As recommended use of chemical disinfecting agents is getting more popular, there is a growing concern associated with the effect of disinfectants on PVES dimensional stability. This study was aimed to understand the PVES behavior when subjected to chemical disinfectants.

MATERIALS AND METHODOLOGY

The data was collected from research studies retrieved from Google Scholar, Scopus, and PubMed using MeSH terms of keywords "vinyl polyether siloxane AND Disinfection" or (Vinyl polyether siloxane OR polyvinyl siloxane ether OR PVES) AND (disinfectant OR disinfection)" without any restriction to publication date. The PRISMA (Preferred Reporting Items for Systemic Review and Meta-Analysis) directions were observed during the data collection, screening of studies, and meta-analysis. The primary data were retrieved, and batch exported from databases using Harzing's Publish or Perish software; primary analysis was performed in Microsoft Excel, while statistical analysis for effect size, two-tailed p-values, and heterogeneity among studies was performed using Meta Essentials. The effect size was calculated using Hedge's g values at the 95% confidence level using the random-effects model. Heterogeneity among studies was measured using the Cochrane Q and I².

RESULTS AND CONCLUSION

Dental impressions made from the PVES elastomeric impression materials showed no significant changes in dimensional stability. Immersion in the chemical disinfectant for 10 min was associated with clinically irrelevant changes in the dimensions of the PVES impressions. Disinfection with sodium hypochlorite was associated with clinically significant changes in dimensions, with a two-tailed p-value of 0.049. Disinfection with 2-2.5% glutaraldehyde solution was not associated with any significant dimensional variability.

Disinfection of 3D-printed surgical guides using virgin coconut oil (in vitro study)

BACKGROUND/OBJECTIVE

Disinfection of a 3D-printed surgical guide is of utmost importance as it comes into contact with hard and soft tissue during implant placement so it poses a potential risk of pathogenic transmission. Methods used for disinfection in the surgical field should be reliable, practical, and safe for the instruments and the patients. The objectives of this study were to compare the antimicrobial potential of 100% Virgin Coconut Oil, 2% Glutaraldehyde, and 70% Ethyl Alcohol used to decontaminate 3D-printed surgical guides.

MATERIALS AND METHODS

Thirty identical surgical guides were printed and cut into two halves (N = 60). Both halves were then contaminated with a defined amount of human saliva samples (2 ml). The first half (n = 30) was sub-grouped into three study groups which were immersed in one of the three disinfectants for 20 min as follows; group VCO was immersed in 100% Virgin Coconut Oil, group GA was immersed in 2% Glutaraldehyde, and group EA was immersed in 70% Ethyl Alcohol. The second half (n* = 30) was sub-grouped into three control groups which were immersed in sterile distilled water as follows group VCO*, group GA*, and group EA*. The microbial count was expressed as colony-forming units per plate and the comparison of the antimicrobial potential of the three tested disinfectants between the three study and three control groups was done using the One-Way ANOVA test.

RESULTS

The culture results of three study groups revealed no bacterial growth with the highest % of reduction in the mean microbial count of the oral microorganisms (about100%) and an uncountable bacterial growth was shown between the three control groups (more than 100 CFU/plate) representing the baseline of the oral microorganisms. Therefore; statistically significant differences were found between the three control and three study groups (P < .001).

CONCLUSION

The antimicrobial potential of Virgin Coconut Oil was comparable and equivalent to Glutaraldehyde and Ethyl Alcohol with a significant inhibitory action against oral pathogens.

Ozone Decontamination of Medical and Nonmedical Devices: An Assessment of Design and Implementation Considerations

The control of infectious diseases can be improved via carefully designed decontamination equipment and systems. Research interest in ozone (a powerful antimicrobial agent) has significantly increased over the past decade. The COVID-19 pandemic has also instigated the development of new ozone-based technologies for the decontamination of personal protective equipment, surfaces, materials, and indoor environments. As this interest continues to grow, it is necessary to consider key factors affecting the applicability of lab-based findings to large-scale systems utilizing ozone. In this review, we present recent developments on the critical factors affecting the successful deployments of industrial ozone technologies. Some of these include the medium of application (air or water), material compatibility, efficient circulation and extraction, measurement and control, automation, scalability, and process economics. We also provide a comparative assessment of ozone relative to other decontamination methods/sterilization technologies and further substantiate the necessity for increased developments in gaseous and aqueous ozonation. Modeling methodologies, which can be applied for the design and implementation of ozone contacting systems, are also presented in this review. Key knowledge gaps and open research problems/opportunities are extensively covered including our recommendations for the development of novel solutions with industrial importance.

The microbiological effect of virgin coconut oil on the morphological and volumetric dimensional changes of 3D printed surgical guides (in vitro study)

BACKGROUND/OBJECTIVES

Disinfection of surgical guides is mandatory for intraoperative use. Virgin Coconut Oil may be a potent alternative disinfectant; however, its effect has not been fully discussed in dentistry. The objectives of this study were to compare the morphological and the volumetric dimensional changes of 3D printed surgical guides after immersion in three disinfectants: 100%Virgin Coconut Oil, 2% Glutaraldehyde, and 70% Ethyl Alcohol and to assess the antimicrobial effectiveness of the tested disinfectants.

MATERIALS AND METHODS

A surgical guide was designed using open platform software to print thirty guides and then cut them into two halves (N = 60). Pre-disinfection scans of the first half of the three study groups (n = 30) were performed using Cone-beam Computed Tomography, then immersed for 20 min in three disinfectants as follows: group VCO was immersed in 100% Virgin Coconut Oil, group GA was immersed in 2% Glutaraldehyde, and group EA was immersed in 70% Ethyl Alcohol. Post-disinfection scans of the first half of the three study groups (n = 30) were performed and then compared morphologically and volumetrically using an analyzing software program The second half of the three control groups (n* = 30) were soaked for 20 min in sterile distilled water as follows: group VCO*, group GA*, and group EA* for the assessment of the antimicrobial effectiveness of the three tested disinfectants.

RESULTS

At the morphological assessment of the dimensional changes, group VCO were the most accurate with the lowest mean deviation value of 0.12 ± 0.02 mm and root mean square value of 0.12 mm, group GA and group EA were less accurate with mean deviation value of = 0.22 ± 0.05 mm and = 0.19 ± 0.03 mm and root mean square value of 0.22 and 0.20 respectively (p < 0.001). At the volumetric assessment, group VCO showed lower volumetric changes with a mean deviation value of 0.17 ± 0.10 mm, root mean square value of 0.19 mm, than group GA with mean deviation value of 0.23 ± 0.10 mm, root mean square value of 0.25 mm and group EA with mean deviation value of 0.27 ± 0.11 mm, root mean square value of 0.29 mm, however, no statistically significant differences were found between the three study groups (p = 0.10). The antimicrobial effectiveness of the three tested disinfectants showed a hundred percent (100%) reduction in the total microbial count in the first half of the three study groups treated with the three disinfectants revealing no bacterial growth, however, statistically significant differences were found between the second half of the three control and the first half of the three study groups. (p < 0.001).

CONCLUSIONS

Virgin Coconut Oil showed higher morphological dimensional accuracy of the tested surgical guides than Glutaraldehyde and Ethyl Alcohol without causing any volumetric dimensional changes in the 3D printed surgical guides after disinfection for 20 min and the antimicrobial effectiveness was the same between the three tested disinfectants without showing any microbial growth.

Investigation of the Antimicrobial Effect of Different Disinfectants on Alginate Measurement Materials

Objective The impression materials are contaminated with pathogenic microorganisms carried by saliva and blood in the mouth. The aim of this study is to evaluate the antimicrobial activity of 1 and 5.25% sodium hypochlorite (NaClO) and zeta 7 solution, a commercial disinfectant, on alginate and to compare it washing with distilled water.

Methods Samples obtained from alginate impressions taken from eight pediatric patients selected in accordance with the inclusion criteria with a size of 1 × 1 cm were subjected to five different disinfection protocols. After samples were vortexed in 3-mL physiological saline, 1-mL volume were inoculated onto brain heart infusion agar and cultured at 37°C for 72 hours to determine the number of colony-forming units/mL. Streptococcus mutans, Staphylococcus aureus, Escherichia coli, Candida albicans were used as control strains. The data obtained were statistically evaluated by using analysis of variance and post-hoc tests. The differences were considered statistically significant when p < 0.05.

Results All of the disinfectant solutions tested were effective in the disinfection of the impression materials examined. The control group with no treatment and the water and flushing group had a significantly higher bacterial load compared to the other disinfectant-treated groups in terms of bacterial load, and no significant difference has been observed between the disinfectant solutions (p < 0.05). Simple rinsing of the impressions in sterile water reduced the number of microorganisms but did not decontaminate the impressions.

Conclusion Washing with water alone is insufficient for measured disinfection. Although NaClO is an effective disinfectant even at low concentrations, microorganism growth was not observed at 5.25% concentration. It is appropriate to use NaClO at 1 and 5.25% concentrations for impression disinfection.

Application of Ultraviolet-C Radiation and Gaseous Ozone for Microbial Inactivation on Different Materials

With the advent of the COVID-19 pandemic, there has been a global incentive for applying environmentally sustainable and rapid sterilization methods, such as ultraviolet-C radiation (UVC) and ozonation. Material sterilization is a requirement for a variety of industries, including food, water treatment, clothing, healthcare, medical equipment, and pharmaceuticals. It becomes inevitable when devices and items like protective equipment are to be reused on/by different persons. This study presents novel findings on the performance of these sterilization methods using four microorganisms (Escherichia coli , Staphylococcus aureus , Candida albicans , and Aspergillus fumigatus) and six material substrates (stainless steel, polymethyl methacrylate, copper, surgical facemask, denim, and a cotton-polyester fabric). The combination of both ozone and UVC generally yields improved performance compared to their respective applications for the range of materials and microorganisms considered. Furthermore, the effectiveness of both UVC and ozone was higher when the fungi utilized were smeared onto the nonabsorbent materials than when 10 μL droplets were placed on the material surfaces. This dependence on the contaminating liquid surface area was not exhibited by the bacteria. This study highlights the necessity of adequate UVC and ozone dosage control as well as their synergistic and multifunctional attributes when sterilizing different materials contaminated with a wide range of microorganisms.

The Effect of Hypochlorous Acid Disinfectant on the Reproduction of Details and Surface Hardness of Type III Dental Stone

Introduction Gypsum products have been used for many years in dentistry. They are used to make casts that are used in different dental laboratory procedures. It is considered a source of contamination because it comes in contact with blood and saliva that are found on dental impressions. Because it is difficult to make sure that every impression brought to the dental laboratory has been cleaned and because cleaning impressions is a complicated process that can lead to problems because of the way impression materials are made, cleaning the cast has become a key part of preventing infections. For this study, we used two ways (immersion and spray) to apply a hypochlorous acid (HOCl) disinfectant solution to type III dental stone to see how they affected the stone's surface hardness and its ability to show surface details accurately. Materials and methods A total of 100 samples of type III dental stone, 50 samples for each test, which include the reproduction of detail test and surface hardness test, were prepared and randomly divided into five groups, 10 samples for each test group, which include group A (control), group B (immersion in 200 ppm HOCl disinfectant for five minutes), group C (spraying with 200 ppm HOCl disinfectant for five minutes), group D (immersion in 0.6% sodium hypochlorite (NaOCl) disinfectant for five minutes), and group E (spraying with 0.6% NaOCl disinfectant for five minutes). Results The results showed that all the samples had met the reproduction of detail test requirement after disinfection with HOCl, while a significant reduction in the surface hardness of type III stone samples was also shown. Conclusion The less undesirable effects of HOCl disinfectant solution on the surface hardness of type III dental stone when compared to sodium hypochlorite, as well as the absence of adverse effects on detail reproduction, made the HOCl disinfectant solution a good choice for dentists and dental laboratory personnel for cast disinfection and contamination control.

Microbial Inactivation: Gaseous or Aqueous Ozonation?

For decades, ozone has been known to have antimicrobial properties when dissolved or generated in water and when utilized in its gaseous form on different substrates. This property (the ability to be used in air and water) makes it versatile and applicable to different industries. Although the medium of ozonation depends on the specific process requirements, some industries have the inherent flexibility of medium selection. Thus, it is important to evaluate the antimicrobial efficacy in both media at similar concentrations, an endeavor hardly reported in the literature. This study provides insights into ozone’s efficacy in air and water using two Gram-negative bacteria (Escherichia coli NTCC1290 and Pseudomonas aeruginosa NCTC10332), two Gram-positive bacteria (Staphylococcus aureus ATCC25923 and Streptococcus mutans), and two fungi (Candida albicans and Aspergillus fumigatus). For gaseous ozonation, we utilized a custom-made ozone chamber (equipped with ultraviolet lamps), whereas an electrolysis oxygen radical generator was applied for ozone generation in water. During gaseous ozonation, the contaminated substrates (fabric swatches inoculated with bacterial and fungal suspensions) were suspended in the chamber, whereas the swatches were immersed in ozonated water for aqueous ozone treatment. The stability of ozone nanobubbles and their resulting impact on the aqueous disinfection efficiency were studied via dynamic light scattering measurements. It was observed that ozone is more effective in air than in water on all tested organisms except Staphylococcus aureus. The presented findings allow for the adjustment of the treatment conditions (exposure time and concentration) for optimal decontamination, particularly when a certain medium is preferred for ozonation.

Disinfection Procedures and Their Effect on the Microorganism Colonization of Dental Impression Materials: A Systematic Review and Meta-Analysis of In Vitro Studies

Dental impressions are contaminated with potentially pathogenic microorganisms when they come into contact with patient blood, saliva, and plaque. Numerous disinfectants are used; however, no sole disinfectant can be designated as universal for all the impression materials. Thus, the aim of this study is to systemically review the literature to evaluate the effect of the existing disinfection procedures on the bacterial colonization of dental impression materials. This systematic review and meta-analysis was conducted according to the PRISMA statement. PubMed (MEDLINE), Web of Science, Scopus, EMBASE, and SciELO databases were screened up to April 2021. Eligibility criteria included in vitro studies reporting the antibacterial activity of disinfectant solutions in dental impression materials. The meta-analysis was performed using Review Manager (version 5.3.5). A global comparison was performed with the standardized mean difference based on random-effect models at a significance level of α = 0.05. A total of seven studies were included in the meta-analysis. The included studies described the effect of disinfection processes with chlorhexidine gluconate, alcohol, sodium hypochlorite, glutaraldehyde, and hydrogen peroxide in alginate, polyvinyl siloxane, and polyether impression materials. The meta-analyses showed that the use of chlorhexidine, alcohol, glutaraldehyde, and sodium hypochlorite reduced the colony-forming units by a milliliter (CFU/mL) in alginate (p < 0.001). On the other hand, glutaraldehyde, sodium hypochlorite, and alcohol reduced the CFU/mL in polyvinyl siloxane (p < 0.001). Finally, alcohol and glutaraldehyde reduced the CFU/mL in polyether material (p < 0.001). High heterogenicity was observed for the alginate and polyvinyl siloxane materials (I2 = 74%; I2 = 90%). Based on these in vitro studies, the disinfection of impression materials with several disinfection agents reduces the CFU/mL count.

Dimensional Stability of Elastomeric Impression Material After Disinfection Via Immersion and Microwave Irradiation

Aims:

This study aimed to evaluate and compare the dimensional stability of two elastomeric impression materials, namely polyvinyl siloxane (PVS) and vinyl siloxanether (VSE), subjected to chemical immersion and microwave irradiation for disinfection.

Materials and Methods:

Sixty discs of PVS and VSE impression materials each were prepared using a stainless-steel test die and ring in accordance with ANSI/ADA Specification No. 19. Twenty discs of each impression material were disinfected by chemical immersion for 10 min; another 20 discs were subjected to dry microwave irradiation for 3 min. The other 20 discs served as a control group. Dimensional stability measurements were then performed using an image analyzer at 20× magnification. The data were analyzed by one-way analysis of variance (α=0.05) and Bonferroni (post hoc) test for multiple comparisons to detect significant differences between the groups.

Results:

When subjected to microwave irradiation, both PVS and VSE showed dimensional changes, but the changes were within the limit of 1.5% set by ANSI/ADA (P<0.00). VSE showed markedly better results than PVS for both disinfection methods. The immersion disinfection method resulted in a higher average percentage of linear dimensional changes than both the microwave irradiation and the control for VSE and PVS impression materials.

Conclusion:

VSE exhibited excellent dimensional stability than PVS under both chemical immersion and microwave irradiation. Microwave irradiation using conventional microwave ovens can be used in clinical settings as an alternative to other disinfection techniques because the dimensional changes of the elastomeric impression materials subjected to microwave irradiation have been observed to be within the clinically acceptable limit set by the ANSI/ADA standard.

Intraoral scanning reduces procedure time and improves patient comfort in fixed prosthodontics and implant dentistry: a systematic review

OBJECTIVES

The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.

MATERIALS AND METHODS

Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.

RESULTS

Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.

CONCLUSIONS

Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.

CLINICAL RELEVANCE

Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.

3D cone-beam C.T. imaging used to determine the effect of disinfection protocols on the dimensional stability of full arch impressions

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Cone-beam computed tomography assessed the dimensional stability of impressions.

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The two common impression materials: alginate or polyvinylsiloxane were evaluated.

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Five commercial disinfectant agents were tested on materials’ stability.

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All disinfectant agents did not affect materials’ stability.

Aim

This study aimed to investigate the dimensional stability of irreversible hydrocolloid and polyvinylsiloxane (P.V.S.) impressions after exposure to four commercial disinfectants using cone-beam computed tomography (CBCT).

Materials and Methods

Two different impression materials were tested: irreversible hydrocolloid and P.V.S. Four disinfection solutions were applied: BirexSE, Opti-Cide3, COEfect MinuteSpray, and CaviCide Spray. Distilled water was used as a control group. Each solution remained in contact with the impression for 5 min. Additional contact time of 5 min compromises time for scanning. The materials were evaluated for dimensional stability after the impression of a maxillary complete edentulous template via CBCT before and after being in contact with the disinfectant agents. Measurements were assessed on the digital models from A-B, B-C, and C-A points. Paired analyses (Wilcoxon Signed Rank test or paired Student's t-test) were used to analyze each measurement before and after the contact with the disinfectant agents. The variance for each measurement was also analyzed via a one-way analysis of variance or Kruskal-Wallis.

Results

Overall, there were no statistical differences among the points measurements in the irreversible hydrocolloid or P.V.S. between initial and final assessments (p > 0.05). The used disinfectant agents in this study did not influence each measurement's variation on irreversible hydrocolloid or P.V.S. (p > 0.05). All agents showed an effect on the dimensional stability of both impression materials. The differences in the three dimensions ranged between 0.34 and 1.54%.

Conclusion

Within 10 min of removing the impression from the master cast, is study's findings indicated that the four commercially available disinfectants did not influence the dimensional stability of irreversible hydrocolloid or P.V.S. Further studies should be performed to elucidate the antimicrobial effect of these solutions applied as a spray on the surface of irreversible hydrocolloid and P.V.S. impressions.

Evaluation of Antimicrobial Effects on Dental Impression Materials and Biofilm Removal by Sodium Dichloroisocyanurate

Dental materials are inevitably contaminated with oral microorganisms. To prevent transmission of infectious diseases, impressions need to be disinfected. In the present study, we examined the disinfection effects on impression materials and biofilm removal by sodium dichloroisocyanurate (SDIC). Exponentially growing Streptococcus mutans, Escherichia coli, Staphylococcus aureus and Candida albicans, and dental plaque bacteria were suspended in phosphate buffered saline (PBS) and exposed for 1, 5 and 10 min to 1 mL of the 10 ppm, 100 ppm, 1,000 ppm, and 10,000 ppm SDIC solutions. The bactericidal effect was evaluated by colony forming units of each microorganisms. Moreover, the effect of SDIC solution on S. mutans biofilm was examined. Bactericidal effects of SDIC solutions on oral bacteria on dental impression surfaces were assessed and the surface quality of dental casts after immersion in SDIC solution for 30 min was observed under a scanning electron microscope. The number of all bacterial strains, including plaque bacteria, were significantly decreased by SDIC solution treatment in a dose-dependent manner. Significant S. mutans biofilm removing activity of SDIC was observed in 1,000 and 10,000 ppm solution. The number of oral bacteria adhering to the surfaces of impressions markedly decreased following 10-min immersion in the 1,000 ppm SDIC solution. The 30-min immersion of dental impression in the 1,000 ppm SDIC solution did not adversely affect the surface roughness of dental casts. The results indicate that SDIC Solution is useful to deactivate oral bacteria on dental impression.

Micro-structured copper and nickel metal foams for wastewater disinfection: proof-of-concept and scale-up

It is necessary to disinfect treated wastewater prior to discharge to reduce exposure risks to humans and the environment. The currently practiced wastewater disinfection technologies are challenged by toxic by-products, chemicals and energy demand, a range of effectiveness limitations, among other concerns. An effective, eco-friendly, and energy-efficient alternative disinfection technique is desirable to modernize and enhance wastewater treatment operations. Copper and nickel micro-structured metal foams, and a conventional copper mesh, were evaluated as disinfecting surfaces for treating secondary-treated wastewater contaminated with coliform bacteria. The micro-structured copper foam was adopted for scale-up study, due to its stable and satisfactory bactericidal performance obtained over a wide range of bacterial concentrations and metal-to-liquid ratios. Three scales of experiments, using two types of reactor designs, were performed using municipal wastewater to determine the optimal scale-up factors: small lab-scale batch reactor, intermediate lab-scale batch reactor, and pilot-scale continuous tubular reactor experiments. The performance was evaluated with the aim of minimizing metal material requirement with respect to bactericidal efficiency and leaching risks at all scales. Copper foam, at or above optimal conditions, consistently inactivated over 95 % of total coliforms, fecal coliforms and E.coli in wastewater at various scales, and leachate copper concentrations were determined to be below Canadian guideline values for outfall. This study successfully implemented the "structure" strategy of process intensification, and opens up the possibility to apply micro-structured copper foam in a range of other water disinfection systems, from pre-treatment to point-of-use, and should thus become a topic of further research.

Effect of heat sterilization and chemical method of sterilization on the polyvinyl siloxane impression material. A comparative study

Background:

Dental impression is a crucial part of the process of constructing a well-fitting prosthesis. In the clinical scenario, impressions can act as a vehicle for the transfer of bacteria and fungi. Therefore, an attempt was made to evaluate the dimensional accuracy of the newly introduced polyvinyl siloxane (PVS) impression material upon autoclaving and comparing it to the traditional means of chemical disinfection.

Materials and Methods:

A cross-sectional comparative in vitro study was conducted. Three groups were made for testing different sterilization methods. The sample size for the study was kept as 30 observations in each of the three groups. Test samples were prepared by making an impression of the die using the putty-wash technique. Statistical analysis was done by applying unpaired t-test, paired t-test, one-way analysis of variance (ANOVA) and post hoc Tukey's honestly significant difference (HSD).

Results:

Initial mean of samples of group I were compared to A (actual measurement of metal ruled block = 24.960), a dimensional change of 1.6% was found. Similarly, in group II, a change of 1.59% was found and in group III the change was 1.7%. There was mean shrinkage of 24.557 mm in group I, 24.586 mm in group II, and 24.535 mm in group III and these changes were found statistically significant.

Conclusion:

Dimensional changes in the impression material after disinfection with 2% glutaraldehyde were considered high compared to autoclaving and, hence, it may not be advisable to disinfect this material with 2% glutaraldehyde.

Cross-contamination and infection control in intraoral digital imaging: a comprehensive review

Dental health care workers are subjected to various infectious disease agents that are present in patients' saliva and blood which make infection control and universal prevention methods indispensable to the dental practice given that some of these diseases cause loss of work and time for dental staff and patients; some of them cause serious morbidity; and some of them currently have a poor prognosis and no effective treatments. Although dental radiographic procedures are not invasive, and there are no incidents such as injuries caused by dental instruments, they are a potential infection source because of contamination with saliva and blood, and comprehensive infection control procedures also apply to the radiology clinic. In addition, contact with a large number of patients in dental schools and clinics in a short period of time, and the fact that radiographic procedures are performed in the same environment as other dental procedures in dental offices increase the significance of infection control in dental radiology. Major advances in computer technology have enabled digital imaging systems to develop rapidly and to become common in dental practice as an alternative to conventional film-based imaging. The use of digital sensors in dental radiology introduced unique infection control challenges and required the revision and modification of existing infection control techniques. In this review, studies concerning the risk of cross-contamination and challenges of infection control with digital image sensors are comprehensively reviewed and infection control protocols that should be followed in intraoral digital imaging using both direct and indirect systems are thoroughly examined.

The effect of disinfectants on the accuracy, quality and surface structure of impression materials and gypsum casts: A comparative study using light microscopy, scanning electron microscopy and micro computed tomography

The aim of this study was to compare the effect of several commercially available disinfectants on the accuracy of various types of impression materials and their compatibility with gypsum including surface quality and structure evaluation. Four alginate and three elastomeric impression materials in combination with disinfectants Aseptoprint Liquid, Zeta 7 solution, Silosept and Dentaclean Form were tested. The dimensional changes, detail reproduction, the compatibility with gypsum and surface/subsurface morphology were evaluated using light microscopy, scanning electron microscopy and micro computed tomography. Two alginate materials disinfected in Dentaclean Form exhibited the most significant differences (p<0.0001). The loss of detail on some alginate impressions in combination with this disinfectant including deterioration and change of morphology of gypsum surfaces was observed. Porosity in subsurface area and exposed large particles were detected. It was confirmed that the desired properties of impressions may be negatively affected in combination with some disinfectants.

Innovation by Computer-Aided Design/Computer-Aided Manufacturing Technology: A Look at Infection Prevention in Dental Settings

Recent data indicates limited awareness and compliance on infection prevention procedures by dental offices and by dental laboratories. Guidelines for infection prevention in dentistry have been published by Centres for Disease Control and Prevention since 2003; the section “IX-Special consideration” includes a subsection concerning the prevention in dental laboratories, but it has not been modernised in later versions to fit the needs of traditional and computer-aided technology. Traditional techniques required disinfecting items (impression, chewing waxes, and appliances) with well-suited products, which are also chosen for limiting impression changes or appliance deterioration. Effective procedures are available with difficulties. Some of these contain irritant or non-eco-friendly disinfectants. The transport of impression, to dental laboratories, is often delayed with limited precautions for limiting cross-infection. Gypsum casts are frequently contaminated mainly by bacteria and their antibiotic-resistant strains and even stored for long periods during dental implant supported restoration and orthodontic therapy, becoming a hidden source of infection. Nowadays, computer-aided design/computer-aided manufacturing technology seems to be an interesting way to promote both business and safety, being more comfortable for patients and more accurate than traditional technology. A further advantage is easier infection prevention since, for the most part, mainly digital impression and casts are not a source of cross-infection and the transport of contaminated items is reduced and limited to try-in stages. Nevertheless, a peculiar feature is that a digital electronic file is of course unalterable, but may be ruined by a computer virus. Additionally, the reconditioning of scanner tips is determinant for the optical characteristics and long term use of the scanner, but information for its reconditioning from producers is often limited. This study focuses on some critical points including (a) insufficient guidelines, (b) choice of proper procedure for scanner reconditioning, and (c) data protection in relation to patient privacy.

A simple and effective method for addition silicone impression disinfection

PURPOSE

Although dental impression disinfection is determinant to reduce the cross-infection risk, some studies have shown that, in real practice, the disinfection procedures vary considerably. Thus, the aim of this study was to evaluate the antimicrobial effectiveness and the impact on the dimensional stability of addition silicone' impressions of water wash and the most clinically used disinfection solutions: 3% hydrogen peroxide, commercial disinfectant MD520 (Durr) and 1% and 5.25% sodium hypochlorite.

MATERIALS AND METHODS

For this investigation, dental impressions were taken on 16 volunteer dental students. The antimicrobial effectiveness of each procedure was evaluated by pour plate method. The dimensional stability was evaluated using a standardized stainless-steel model, according to ANSI/ADA nº19 specification.

RESULTS

The study results showed that water wash does not alter the dimensional stability of addition silicone impressions but doesn't reduce the microbial load of the material (P>.05). On the other hand, addition silicone disinfection by immersion with 3% hydrogen peroxide, MD520 (Durr), or sodium hypochlorite at 1% and 5.25% does not alter the dimensional stability significantly but reduces > 99.9% of the microbial load of the impressions (P<.001).

CONCLUSION

Addition silicone impressions should always be disinfected after water wash in order to reduce effectively the cross-infection risk. All disinfectants tested showed high antimicrobial efficiency without significant changes in three-dimensional shape of impressions. Hydrogen peroxide and sodium hypochlorite are of particular importance because are easily accessible in dental setting. The less explored hydrogen peroxide could be a valuable alternative for silicone impressions disinfection.

Comparative Evaluation of the Effect of Chemical Disinfectants and Ultraviolet Disinfection on Dimensional Stability of the Polyvinyl Siloxane Impressions

Context

Infection control is an important concept in the present day practice of dentistry. Disinfection of dental impressions is part of the daily routine in a dental clinics. After disinfection, it is important that impressions remain dimensionally stable.

Aim

The purpose of this study was to compare the effect of chemical disinfectants and ultraviolet (UV) disinfection on the dimensional stability of the polyvinyl siloxane impressions.

Objectives

The objective of the study is (1) To evaluate the effect of chemical disinfectant (2% glutaraldehyde and 1% sodium hypochlorite) and UV disinfectant on the dimensional stability of polyvinyl siloxane impression material. (2) Comparative evaluation of the dimensional discrepancy between the cast poured from the polyvinyl impressions material, that is subjected to chemical disinfectant and UV disinfectant to that of cast poured from impressions that were nondisinfected.

Materials and Methods

A customized tray was fabricated to make impressions. Impressions were divided into four groups, 10 samples were disinfected with 2% glutaraldehyde for 20 min, 10 samples were disinfected with 1% sodium hypochlorite for 20 min, 10 samples were disinfected with UV light for 20 min, and 10 samples were not subjected to disinfection which served as control group. All the samples were poured after 30 min in die stone. Measurements were recorded using traveling microscope of 0.001 accuracy. Statistical analysis used in this study was the one-way ANOVA test.

Results

The result showed significant dimensional changes in samples disinfected with 2% glutaraldehyde and 1% sodium hypochlorite, whereas samples disinfected with UV disinfectant unit showed no significant dimensional changes when compared with control group samples. Within the chemical groups, impressions disinfected with 1% sodium hypochlorite showed more discrepancy in the dimensions when compared to the 2% glutaraldehyde disinfected group.

Conclusions

UV light disinfectant can be safely used to disinfect impressions as compared to chemical disinfectants in clinical prosthodontic procedures.

Sterilisation in Dentistry: A Review of the Literature

In a small and medium-sized dental facility, the correct management of the sterilisation and presterilisation phases plays a fundamental role in good management of instruments and personnel, in order to ensure conditions that are more efficient with less down time. Nowadays, instrument sterilizers are increasingly efficient in achieving results, both in terms of time and size, and ensure that materials are sterile and ready to be stocked in a reasonable time. A literature search for articles related to revision work was performed using electronic databases such as PubMed, Scopus, and Google Scholar. The following keywords have been entered in the previously mentioned databases: sterilisation instruments; dental autoclave; precleaning; instruments disinfectants. The records obtained were screened by three reviewers, and only relevant articles were read full text. In addition, the timings of dental and sterilisation procedures were measured, and from these, suggestions are made in order to improve the efficiency of instrumentation management (facility used as study subject: University Dental Clinic, University of Foggia) as a function of the health-care interventions. We arrived at the conclusion that without doubt, sterilisation of instruments and products plays a fundamental role, but the efficiency of the sterilisation and presterilisation procedures cannot be separated from managing the personnel in charge by giving them specific and precise tasks.

Effect of Different Disinfectants on Bacterial Aerosol Diversity in Poultry Houses

To better understand the effect of different disinfectants on the types and quantities of microorganisms in a broiler chicken house, five different types of disinfectants, including ozone, available chlorine, quaternary ammonium salt, glutaraldehyde, and mixed disinfectant, were used. The broiler house microbial communities were analyzed by high-throughput sequencing combined with air sampling. The results showed that the concentrations of airborne aerobic bacteria in the empty broiler houses after application of different disinfectants were significantly reduced compared to a house untreated with disinfectant (P < 0.05 or P < 0.01), and the number of inhalable particles of airborne aerobic bacteria sharply decreased after disinfection. Of the five disinfectants, the mixed disinfectant had the best disinfection efficacy on the total microbial communities (P < 0.05). A total of 508,143 high-quality sequences were obtained by high-throughput sequencing, which identified 1995 operational taxonomic units. In total, 42 phyla and 312 genera were identified. The structures of airborne microbial communities in the broiler houses after the different disinfectants were applied differed. In the house treated with the mixed disinfectant, the microbial communities containing opportunistic pathogens, such as Escherichia-Shigella, Bacillus, and Pseudomonas, had the lowest abundance, with a significant decrease compared to the house untreated with disinfectant. The alpha diversity index showed low diversity of the microbial communities in the house treated with mixed disinfectant. In contrast to the other four disinfectants, only a small amount of bacteria was detected in the air sample in the house treated with the mixed disinfectant; specifically, only four phyla were found (Proteobacteria, Bacteroidetes, Actinobacteria, and Firmicutes). The mixed disinfectant produced a positive effect on disinfection for four phyla; however, it didn’t thoroughly eliminate them. At genus level, Bacillus, Arenimonas, and Shinella could not be detected in the house treated with the mixed disinfectant, but were detected in houses treated with other disinfectants. The high-throughput sequencing results revealed that the combination of multiple disinfectants exhibited a good disinfection efficacy and that this technique could disinfect the air of broiler houses. These results will help guide the development of a reasonable program for broiler house disinfection.