STERILIZATION AND

DISINFECTIONS IN
PROSTHODONTICS
PRESENTED BY :- Dr Vishwajeet Ausarmal (1st MDS)
CONTENTS

● Introduction
● Definition and Terminologies
● Physical Agents
● Chemical Agents
● Level of disinfectants
● Spaulding's Classification
● Sterilization and disinfection in prosthodontics
● Recent Advances
● Conclusion
2
 INTRODUCTION:

Dentistry is a branch of surgery that involves

exposure of a person or materials to
saliva/blood and other infectious materials
either directly or indirectly.

Mantena, S.R., Mohd, I., K, P.D., Mc, S.S., Av, R., & Rao D, B. (2019). Disinfection of Impression Materials: A Comprehensive Review of Disinfection.
International Journal of Dental Materials.
3
TERMINOLOGIES
❏ Sterilization: The use of a physical or chemical procedure
to destroy all microorganisms including large numbers of
resistant bacterial spores

❏ Disinfection: The destruction or removal of all pathogenic

organisms, or organisms capable of giving rise to infection.

❏ Asepsis: It is the state of complete absence of viable

pathogenic microorganisms in any environment.

❏ Decontamination: The process to reduce or eliminate

microorganisms from medical devices, surfaces and
environment such that they cannot reach vulnerable sites
to cause infection.

Ferro KJ, Morgano SM, Driscoll CF, Freilich MA, Guckes AD. Kent L Knoem schild, McGarry TJ: The glossary of prosthodontic terms. J Prosthet Dent . 2017:2017;117:e1--e105.

4
 PHYSICAL AGENTS

Ultrasonic
Sunlight and
Drying Radiation Filtration sonic
vibrators

Dry heat Moist heat

.Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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DRY HEAT
Flaming: materials can be sterilized by holding them over a
Bunsen flame till they become red hot.

Incineration: This is an excellent method for sterilization for

destroying biomedical waste.
Materials are reduced to ashes.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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HOT AIR OVEN
● Widely used method of sterilization by dry heat.

● A holding period of 160°C for 2 hours is

necessary to sterilize

● Example:Glassware, forceps, scissors, scalpels,

all glass syringe, swabs

.Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
7
GLASS BEAD STERILISER

● High temperature (210O C -230O C) for 10-30

seconds to inactivate microorganisms.

● use- endodontic files, burs

.Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 MOIST HEAT

.Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 PASTEURIZATION OF MILK
❏ Holder method
❏ Flash method

● In holder method milk is heated at

63°C for 30 minutes.
● In flash method milk is heated at 72°C
for 15-20 seconds.
● Followed by cooling quickly to 13°C
or lower.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Insippisation
Media such as Lowenstein- Jensen and Loeffler's serum are
sterile by heating at 80- 85°C for half an hour.

❏ Vaccine bath
Bacterial vaccines are sterilised in special
vaccine bath at 60°c for one hour.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Boiling
Most of the Vegetative bacteria are killed immediately at 90-
100°C but bacterial spores can withstand long periods of
boiling.
❏ Tyndallisation
An exposure to 100°C for 20 minutes on three consecutive
days..

❏ Steam sterilizer

free steam is used to sterilize culture media which may

decompose if subjected to higher temperatures
A Koch or Arnold steamer is usually used .

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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AUTOCLAVE
Autoclaves provide a physical method for
disinfection and sterilization.

Is used to sterilize surgical equipment,

laboratory instruments, pharmaceutical items,
and other materials.

It can sterilize solids, liquids,

hollows, instruments of
various shapes and sizes

Lakshman Samarannayake. Essential Microbiology For Dentistry. 5th Edition. Poland: Elsevier
13
 Effective autoclave cycles

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
The principle of the autoclave:

Lakshman Samarannayake. Essential Microbiology For Dentistry. 5th Edition. Poland: Elsevier
15
 Types of autoclave

Gravity displacement autoclaves High-speed pre-vacuum autoclaves

Lakshman Samarannayake. Essential Microbiology For Dentistry. 5th Edition. Poland: Elsevier
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 TYPES OF AUTOCLAVE
Gravity displacement
autoclaves high-speed pre-vacuum
autoclaves

 are small, automatic  they are fitted with a vacuum

bench-top autoclaves. pump (or ejector) to ensure air
removal from the sterilizing
 work on the principle of
chamber and load before the
downward displacement of steam is admitted.
air
 instantaneous steam
 the penetration time into
penetration into loads.
porous items is prolonged
because of incomplete air
elimination
 Sterilization cycle

Type N Type B Type S

Lakshman Samarannayake. Essential Microbiology For Dentistry. 5th Edition. Poland: Elsevier
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 Based on three types of sterilization
cycle
1. Type N
2. Type B
3. Type S
 These cycles differ in
the manner in which air is removed(vaccum)
the types of load they can sterilize
items wrapped during sterilization
 Cycle type : N type

 Method of air removal : passive air removal from the

sterilizer chamber (gravity displacement) by steam .

 Type of load : Unwrapped, solid items

 Cycle type : B type

❖ Method of air removal :

Active (forced) air
removal using a
vacuum pump

❖ Type of load :
Wrapped or unwrapped
solid items

Wrapped or unwrapped
hollow items
 Cycle type : S type

 Method of air
removal : Active
(forced) air removal
(steam pulsing)

 Type of load:
Designed to process
air-retentive loads
e.g. tubular devices.
IMMEDIATE USE SYSTEM STERILIZATION
(IUSS) “FLASH” STERILIZATION
•Is a modification of conventional steam sterilization, in
which the product to be sterilized is placed in an open
tray or in a specially designed, rigid, covered container to
allow rapid penetration of steam.

•These sterilizers operate at 134 C for 3-10 minutes.

Decontamination and Reprocessing of Medical Devices for Health-care Facilities World Health Organization and Pan American Health Organization, 2016
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CHEMICAL VAPOR PRESSURE
STERILIZATION (CHEMICLAVING)
It is process of sterilizing using
chemical vapour under pressure,to
achieve sterilization it should be
operated at 131 c for 1 hr at 20lbs

Decontamination and Reprocessing of Medical Devices for Health-care Facilities World Health Organization and Pan American Health Organization, 2016
24
FILTRATION
❏ Filtration uses membranous filters that have tiny pores that let the liquid pass through
but prevent bigger particles such as bacteria to pass through the filter.

Filtration

Sintered glass
Membrane filter Candle filters Seitz filters
filter

Tuttnauer Team How Does Filtration of Liquids in the Lab Work? March 26, 2017 25
RADIATION
Two types of radiation are used for
sterilization.
❏ Non ionizing
UV radiation has been used for disinfection
of drinking water , titanium implants
❏ Ionizing
X-rays, gamma rays and cosmic rays
are highly lethal to DNA and other vital
constituents

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Gamma Radiation
Gamma Radiation kills microorganisms by
attacking the DNA molecule leading to
Substantial Decrease in Organism Survival
❏ Electron Beam Radiation (E-Beam
Radiation)
High energy electrons capable of inducing
biological damage.
❏ X-Ray Radiation
More penetrating than gamma-rays or electron
beams

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Ultrasonic
Ultrasonic action helps to thoroughly clean
devices with joints or multiple components that
are difficult to clean manually.(rubber products)
❏ Microwave
Microwaves are used in medicine for disinfection
of soft contact lenses, dental instruments,
dentures

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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LEVELS OF DISINFECTION
❏ High-level disinfection
glutaraldehydes with phenols,hydrogen peroxide,
hydrogen peroxide with peracetic acid,ortho-
phthalaldehyde.
❏ Intermediate level disinfection
Ethanol (70% to 90%), chlorine,iodophor, phenols for
maximum time of 10 mins.
❏ Low-level disinfection
Quaternary ammonium solution for maximum time of 10
min)

Boylan RJ, Goldstein GR, Schulman A. Evaluation of an ultraviolet disinfection unit. Journal of Prosthetic Dentistry. 1987 Nov
1;58(5):650-4. 29
INSTRUMENT CLASSIFICATION BASED ON POTENTIAL TO SPREAD
INFECTION (Spaulding's classification)

Earle Spaulding proposed sterilization or disinfection of inanimate objects and surfaces based on the
degree of risk involved in their use.

1
• CRITICAL ITEMS

2
• SEMI CRITICAL ITEMS

• NON CRITICAL ITEMS

3

Boylan RJ, Goldstein GR, Schulman A. Evaluation of an ultraviolet disinfection unit. Journal of Prosthetic Dentistry. 1987 Nov
1;58(5):650-4. 30
 ❏ Critical items
Surgical instruments, burs,scalpel blades, forceps,
implants, etc.

❏ Semi-critical items
Mouth mirror, impression trays,
tweezers, amalgam
condensers,handpiece,probe

Boylan RJ, Goldstein GR, Schulman A. Evaluation of an ultraviolet disinfection unit. Journal of Prosthetic Dentistry. 1987 Nov
1;58(5):650-4. 31
 ❏ Non-critical items
X-ray tubes, chair light handles, face bow

Boylan RJ, Goldstein GR, Schulman A. Evaluation of an ultraviolet disinfection unit. Journal of Prosthetic Dentistry. 1987 Nov 1;58(5):650-4.
DISINFECTANTS

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 CHEMICAL
Alcohols:
AGENTS • ethyl,
• isopropyl
Gases: Aldehydes:
• ethylene oxide, • formaldehyde,
• formaldehyde, • glutaraldehyde
• beta propiolactone • Orthophthalaldehyde

Surface-active Peracetic acid,

agents and Hydrogen
Metallic salts peroxide

Halogens and
Dyes
Phenols

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
Alcohol
Alcohol refers to water-soluble chemical compounds
❏ Ethyl alcohol
Ethyl alcohol, at concentrations of 60%–80%, is a
potent virucidal agent inactivating all of the
lipophilic viruses

❏ Isopropyl alcohol
Ethyl alcohol, at concentrations of 60%–80%, is a
potent virucidal agent inactivating all of the
lipophilic viruses .leader,ciprit,hydrox

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
35
ALDEHYDES
❏ Formaldehyde
Formaldehyde gas used for fumigating rooms, isolation
rooms and laboratories.Formalin

❏ Glutaraldehyde
It is recommended for use on surgical instruments where
residual blood may be present.Glutol,cidex.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Hydrogen Peroxide
High-level disinfectants
It is bactericidal, virucidal, sporicidal, and
fungicidal.Oxychem

❏ Peracetic acid
Chemically sterilize medical, surgical and dental
instruments.Clorox

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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HALOGENS
❏ Iodine in an aqueous and alcoholic
solution has been widely used as a
skin disinfectant
Compounds of iodine with non-ionic
wetting or surface-active agents known as
iodophores.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Iodophors
Used as antiseptics and high-level disinfectants.
Wokadine,iodoprep.
❏ Chlorine
They have a broad spectrum of antimicrobial
activity.Wokadine
❏ Chlorine dioxide
Test strips are available for some products to check
that the solution is at an effective concentration.
❏ Sodium hypochlorite
Is a broad spectrum disinfectant that is effective for
the disinfection of viruses , bacteria, fungi and
myobacterium.
Commercially available: Chemdent,
septodont
Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
39
PHENOL
Bactericidal effect of phenols is due their capacity
to cause cell membrane damage, inactivation of
membrane-bound oxidases and dehydrogenases
leading to lysis and death of the microorganism.
Commercially available:Dettol, Lysol.

❏ Chlorhexidine gluconate
Chlorhexidine in a conc. of 0.2% is also most
effective antiplaque & antigingivitis agent.
Commercially available:Hexidine ,rexidine

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press
40
Surface-active agents
Producing a reduction in surface tension. They
are widely used as wetting agents, detergents
and emulsifiers.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
41
GASES

❏ Ethylene oxide
It is especially used for sterilizing heat-sensitive
equipment like heart-lung machines, respirators,
suture materials, dental equipment, books and
clothing.

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
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 ❏ Formaldehyde gas
This is employed for fumigation of operation
theatres and other rooms.
The sealed room is left unopened for 48 hours after fumigation

Ananthanarayan And Panikers. Textbook Of Microbiology. 10th Edition. India: Universal Press.
STERILIZATION AND
DISINFECTION IN
PROSTHODONTICS
 CONSIDERATIONS FOR DENTAL LABORATORIES

 Whatever comes to the dental laboratory must be decontaminated or

shipped decontaminated to the dental laboratory.
 On the other hand, the dental laboratory should also decontaminate
impressions, casts or appliances that have been exposed to the
patient prior to handling with bare hands.
Impression trays and materials

IMPRESSION TRAYS
❏ Metallic : Autoclave
❏ Plastic : Ethylene Oxide
❏ Custom tray made of acrylic resin : Discarded

Methods Of Disinfecting Impressions

❏ Spraying
❏ Immersion

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
46
 ❏ Impression Compound
Immersed in 1:10 sodium hypochlorite or 1:213
iodophor for 10 min

❏ Alginate Irreversible Hydrocolloid

Spray with 1:10 sodium hypochlorite and 1:213
iodophors

❏ Agar Reversible Hydrocolloid

Immersed in 1:10 sodium hypochlorite or 1:213
iodophor.for 10 mins

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
47
 ❏ Zinc Oxide Eugenol
immersed in 2% glutaraldehyde or a 1:213 iodophor
solution for 10 minutes.

❏ Polysulphide and Addition Silicone

Immersed in 2% Glutaraldehyde, 1:213 iodophors;
1:10 sodium hypochlorite solution,complex
phenolics.

❏ Polyether
Have a tendency to distort when placed in aqueous
solutions.Spraying in 1:213 iodophors; 1:10 sodium
hypochlorite solution

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
48
Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
49
 ❏ Disinfection of Casts
casts be disinfected by spraying until wet or immersing in
a 1:10 sodium hypochlorite or an iodophor or
glutaraldehyde.
Microwave radiation of casts for 5 mins at 900W gives
high level disinfection of the gypsum casts.

❏ Disinfection Of Custom acrylic resin impression

trays
disinfected by spraying with surface disinfectants or
immersing in either 1:213 iodophor or 1:10 sodium
hypochlorite.

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
50
 ❏ Disinfection Of Wax Bites & Wax Rims
Spray method using an iodophor
For adequate disinfection these should remain for longer
time in tuberculocidal disinfection.

❏ Dentures
soaking the dentures in 2% glutaraldehyde solution for
10 minutes or soaking in sodium hypochlorite solution for
10 minutes.

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
51
 ❏ Dental prostheses
● Scrubbing should be done with brush to remove
debris.
● Placed in sealable plastic bags or beakers filled with
ultrasonic cleaning solution for calculus removal.
● The prostheses should be removed, rinsed under
running tap water and dried.
● iodophors or chlorine compounds are preferred for
heat cured denture base resin
● Damage occurs after only 10 minutes of immersion
in glutaraldehyde with phenol

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
52
 Fixed metal/porcelain prosthesis
May be disinfected by immersion in
glutaraldehyde for 10 mins.

Immersion in diluted hypochlorite without

apparent harm to the device.

Bhat, et al.: Infection control in the prosthodontic laboratory The Journal of Indian Prosthodontic Society | June 2007 | Vol 7 | Issue 2
53
 IMPLANTS
Pre sterilized with Gamma radiation
Surgical Drills, Surgical and Prosthetic Tools,
Surgical and Prosthetic Trays Torque Wrenches /
Ratchet
Cp-ti are sterilized by e-beams

Cleaning and sterilization guildelines for implant , nobel biocare

54
 ● To avoid contamination of kit box it is
recommended to pick it using a tweezer.

● Removal of residual tissue or bone

debris by scrubbing with nylon brush
immersing the instruments in lukewarm
water.

● Pre-cleaning in an ultrasonic bath is

recommended.

Cleaning and sterilization guildelines for implant , nobel biocare

55
● Flush the internal channel/lumina with 20ml
cleaning solution using the irrigation syringe.

● Components are loaded in a instrument tray

before placing in washer/ disinfector

● Kit boxes are disassembled before cleaning

and disinfection

Cleaning and sterilization guildelines for implant , nobel biocare

56
Sutures
Sutures are pre sterilized by gamma
radiation
Sutures can be re- sterilized by
1.10 minutes completely immersed in
povidone iodine 10% solution, then rinse in
sterile saline/water.
2.Ethylene Oxide

57
 BURS
Dental burs are identified as potential vehicle for
cross infection in dental office due to their
contact with saliva, blood, teeth and bone
❏ Diamond and carbide burs:
After use they are placed in 0.2% glutaraldehyde
with sodium phenate for at least 10 minutes,
cleaned with a bur brush or in an ultrasonic bath.
Sterilize in an autoclave or dry heat
❏ Steel burs:
May get damaged by autoclaving. Can be
sterilized by using a chemical vapor sterilizer or
glass bead sterilizer at 230C for 20-30 seconds

Sangameshwar Sajjanshetty et al., Decontamination Methods Used for Dental Burs-A Comparative Study , Journal of Clinical and Diagnostic Research. 2014 Jun, 58
Vol-8(6): ZC39-ZC41
 HANDPIECE
Autoclave offers the best results as regarding
the sterilization of handpieces in the short
time.

Although the effectiveness of sterilization of

the internal structures is unclear,

Sreekumar S, Varghese K, Abraham JP, Jaysa JJ. An in vitro evaluation of the efficiency of various disinfection and sterilization methods to decontaminate dental
handpieces. J Dent Res
59
 DENTAL LABORATORY
All prosthesis removed from the mouth should be
carefully rinsed under running water, cleaned of
debris in an ultrasonic cleaner whenever possible,
and disinfected.

All impressions should be rinsed and disinfected

before dental stone models are fabricated.

Bhat Vs, Shetty M, Shenoy K. Infection Control In The Prosthodontic Laboratory. The Journal Of Indian Prosthodontic Society. 2017 Apr 1;7(2):62.

60
 ❏ Lathe
Lathe attachments, such as stones, acrylic
burs, and rag wheels, should be removed
from the lathe after each use and stored in a
disinfectant

Lathe shields and air filtrations should be

used to contain contaminated splashes, and
airborne contamination.

Bhat Vs, Shetty M, Shenoy K. Infection Control In The Prosthodontic Laboratory. The Journal Of Indian Prosthodontic Society. 2017 Apr 1;7(2):62.

61
 Sterilization of Operation Theatre/ Implant
Room
To sterilize the operation theatre fumigation widely
employed for huge areas like operation theatres.

Aldekol- 5% is sprayed for 30 minutes. OT must be

Closed for 2 hrs.

Daily U.V. Irradiation for 12 -16 hours is recommended

and is to be switched off 2 hrs before entering OT

Gupta C, Vanathi M, Tandon RCurrent Concepts in Operative Room Sterilisation. 2019 Oct 12];25:190-194.
62
 ❏ HAND HYGIENE

Hands should be cleaned frequently in order to prevent

Healthcare Associated Infection.

❏ HAND CLEANSERS
POVIDONE IODONE 7.5-10% povidone iodine, (surgical
hand scrub)
PARA CHLORO mete XYLENOL(PCMX) 2% concentration

❏ HAND RUB

Alcohol based hand rub is used as an alternative to hand

washing and is the recommended product for ensuring
effective hand hygiene in all patient

Brandt R, Coffey J, Baker Ps. Infection Control In A Prosthodontic Residency Program. Journal Of Prosthodontics. 2013 Mar;2(1):51-5. 63
 RECENT ADVANCES
Extended cycle: “A steam sterilization cycle
with longer exposure and/or dry times than
those commonly provided by the sterilizer
manufacturers (e.g. while a normal cycle
might be 4 minutes at 270°F, an extended
cycle could be 15 minutes at 270°F.)

Understanding the challenges of extended steam sterilization cycles.Steven Kirckof, Susan Flynn, and Martha Young MANAGING INFECTION CONTROL

66
 COVID 19 VIRUS

1. Coronavirus disease (COVID-19) is an infectious

disease caused by a newly discovered coronavirus.

2. Most people infected with the COVID-19 virus will

experience mild to moderate respiratory illness
and recover without requiring special treatment.
 Prevention
To prevent infection and to slow transmission of COVID-19, do
the following:

1. Wash your hands regularly with soap and water, or clean

them with alcohol-based hand rub.

2. Maintain at least 2 meter distance between you and people

coughing or sneezing.

3. Avoid touching your face.

4. Avoiding shaking hands when greeting others.
Cover your mouth and nose when coughing or sneezing.

Stay home if you feel unwell. (home quarantine)

Refrain from smoking and other activities that weaken the lungs.

Practice physical distancing by avoiding unnecessary travel and staying away from
large groups of people.

Melika lotfi, Michel Hamblin, Nima Rezaei. COVID-19 : Transmission, prevention, and potential therapeutic opportunities Elsevier 2020 may
CONCLUSION
When properly used, disinfection and sterilization can ensure the safe use of
invasive and non-invasive medical devices. However, disinfection and sterilization
guidelines must be strictly followed.

Infection control, sterilization and disinfection has helped to decrease the concerns
of the health care personnel and in providing a safe environment for both patient
and personnel.

70
REFERENCES
• Guideline for Disinfection and Sterilization in Healthcare Facilities (2008),
Centers for Disease Control and Prevention
•Satyanaryana Raju Mantena1, Irfan Mohd2, Pradeep Dev K2 Disinfection of Impression
Materials: A Comprehensive Review of Disinfection international Journal of Dental Materials
2019; 1(1)
•Understanding the challenges of extended steam sterilization cyclesSteven Kirckof, Susan
Flynn, and Martha Young MANAGING INFECTION CONTROL
•Gupta C, Vanathi M, Tandon RCurrent Concepts in Operative Room Sterilisation. 2019 Oct
12];25:190-194.
•Shajahan et.al , Dental unit waterlines disinfection using hypochlorous acid-based
disinfectant J Conserv Dent. 2016 Jul-Aug; 19(4): 347–350
•Sangameshwar Sajjanshetty et al., Decontamination Methods Used for Dental Burs-A
Comparative Study , Journal of Clinical and Diagnostic Research. 2014 Jun, Vol-8(6): ZC39-
ZC41

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•A guide to the decontamination of reusable surgical instruments, national health services
March 2013
•Muthuraman et al /Int.J. ChemTech Res. 2015,8(2),pp 897-911.
• Infection Prevention and Control Policies and Procedures national health services January
2018
•Mantena SR. Mohd I, Dev KP, Suresh Sajjan MC, Ramaraju AV, Bheemalingeswara Rao D.
Disinfection of Impression Materials: A Comprehensive Review of Disinfection Methods. Int J
Dent Mater. 2019; 1(1): 07-16.
• Decontamination and Reprocessing of Medical Devices for Health-care Facilities World
Health Organization and Pan American Health Organization, 2016
• Basavanna ms, Dimensional Stability of Three Commercially Available Heat-Cured Denture
Acrylic Resins in India: An In-Vitro Study Journal of Clinical and Diagnostic Research. 2016
Mar, Vol-10(3): ZC27-ZC31

•
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THANK YOU

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