Treatment of dynamic instruments - Aftercare and maintenance
Treatment of dynamic instruments
With the dynamic instruments, all instruments are meant that generate movement:
- Corner pieces, in which a distinction must be made between:
- Powered by a micromotor (red, orange, blue and green);
- Compressed air driven corner pieces: air motors (turbine corner pieces);
- Tartar removal equipment, in which a distinction must be made between:
- Electrically operated instruments such as the Satelec, Cavitron, EMS;
- The Sonicflex to be connected to compressed air.
When cleaning, disinfecting and sterilizing the dynamic instruments, these two essentially different types of instruments each have to undergo an appropriate reconditioning.
The corner pieces require regular oil lubrication to keep functioning properly. They are simply called hand and corner pieces.
The tartar removal equipment works on the basis of high-frequency vibration and requires no lubrication.
Explanation of corner pieces
Cleaning, disinfection and sterilization corner pieces
- Use a thermodesinfector with special adapters for hollow instruments.
- Hand and corner pieces are cleaned, thermally disinfected or sterilized with the following options:
- Thermodesinfector with special adapters;
- Hand and corner piece cleaner with thermal disinfection / sterilization option;
- Hand and corner piece cleaner without thermal disinfection / sterilization followed by (possibly packaged) sterilization.
- Hollow instruments for which there are no adapters for the thermodisinfector must be cleaned manually and then sterilized in a Class B autoclave. There are various devices on the market for cleaning, disinfecting or sterilizing hand and corner pieces. For detailed information about the correct application of the devices, about the possibilities they have (disinfection or, for example, sterilization), the website of the VGT can be consulted. Below are descriptions of some commonly used devices.
- An Assistina only cleans and lubricates the corner pieces; for reuse in category B this is insufficient, let alone for use in category A. Yet there is an application for this device, namely when the corner pieces are sterilized in an autoclave.
- In the DAC Universal, up to six hand and angle pieces can be cleaned, disinfected and internally sterilized in a single cycle of only twelve minutes. The hand and corner pieces are also lubricated at the end of the cycle.
The era when the sterilization of corner pieces caused a great deal of damage is far behind us.
The use of a hand and corner piece cleaner or the right preparations for sterilization in a class B autoclave increases the life span of the hand and corner pieces significantly, which means huge savings (in money and annoyance)!
If the corner pieces externally still show visible contamination after a cycle in the DAC (for example residual polishing paste), then the corner pieces should be pre-treated with a nail brush under flowing water.
Another possibility is to add special cleaning tablets that can be supplied by the manufacturer.
The effectiveness of this hand and corner piece cleaner must also be periodically tested. The manufacturer supplies test equipment for this. For critical use of the corner pieces, it is important to know whether a run has been sufficiently sterilized in the hollow space or packaging. A separate attachment with internal test strip must therefore rotate during the run.
An ordinary TST strip might suffice for semi-critical applications. Make sure that the placement is correct, because of the rapid disruption of the sensors in the device.
Explanation for tartar removal equipment
The ultrasound tips must always be loosened and at least rotated in the thermodesinfector for reuse at the next patient.
The Sonicflex is usually reconditioned in the DAC just like a turbine angle. In the long term, however, there may be problems with the many smears. That is why in some hand and corner piece cleaners (Kavo Lifetime) a specially supplied 'pief' can be inserted into the Sonicfllex, which means that the distribution of the oil does not cause much hindrance.
The Cavitron inserts can easily be placed in the thermodisinfector.
Then they should preferably be introduced into the autoclave because of the very narrow channel for the water supply that can not be sufficiently achieved in the thermodisinfector.
The piezoelectric tartar instruments (EMS and Satelec), according to the manufacturer, can not withstand the strong detergents of the thermodisinfector. (In practice, however, this often does not seem to be a problem.) Whether or not in the thermodisinfector, also with these instruments the hollow space inside has to be sufficiently reconditioned by working in the autoclave.
Remove the hand and corner pieces from the appliance after sterilization and store them in a drawer or cabinet in a prescribed manner (upright or in a cassette), where they are protected against aerosol and dust.