1. Instrument Reprocessing
Raghunath Puttaiah, BDS, MPH
Dental - Innovative Devices & Educational Solutions

2. Basic Rules in Reprocessing
Always clean instruments before sterilization
Sterilization required for Critical and Semi-critical items
Only disinfect if equipment cannot be sterilized
Heat or heat + chemical methods superior to chemical immersion methods
Weekly sterilization monitoring
Test ultrasonic machine monthly
Take good care of reprocessing equipment

3. Adaptation of Spaulding’s Classification to clinical surfaces
Critical*
Semi-critical surfaces*
Non-critical surfaces
Environmental surfaces
* These items enter the oral cavity and must be single-
use-disposable or sterilized

4. PPE required for reprocessing+
Eyewear + Mask + Gown + Utility Gloves

5. 5a. Manually clean and rinse only if sonication has not
Reprocessing Cycle
Separate instruments
From waste
Immerse in
Holding solution
3. Sonicate
instruments
1a. Sharps and
Regulated Waste
7. Sterilization and use
4. Rinse instruments
1b. Non-regulated
waste
6. Dry and bag for
sterilization
5. Inspection of
instruments
5a. Manually clean and rinse
only if sonication has not
achieved cleaning
Sterilization monitoring to be done weekly

6. Manual cleaning Don’t do this
Manual scrubbing instruments to be done only if visible
debris seen after sonication. It should be done with a
long handle brush while wearing utility gloves

7. Types of ultrasonic solutions
Non Ionic Detergents
Cationic Detergents
Anionic Detergents
Enzymatic Solutions
The Same can be used as a holding solution
Some solutions can be corrosive

8. Foil test for efficacy of the ultrasonic cleaning process
Part of the foil that was
not submerged in the
bath
Uniformly pitted area
that was submerged
in the bath

9. Common methods of sterilization in dentistry
Autoclave
Chemiclave
Rapid heat transfer

10. Dry Heat Sterilization using Dry Heat: Slow Fast Rapid Heat Transfer
Temp 1600C (3200F) 1700C (3400F) 1900C (3750F)
Time minutes 60 minutes minutes*
*6 minutes for unpackaged, 12 minutes for packaged

11. Sterilization Steam Under Pressure
STERILIZATION USING AUTOCLAVE
Temperature C (2500F)
Pressure psi
Time* minutes
Temperature C (2730F)
Pressure psi
Time* minutes
* Does not include warm-up / drying / cool-down time

12. Steam Under Pressure Warm-up time Sterilization Time Drying+Cooldown
< minutes >
Packaging material must allow penetration of steam
paper, plastic, surgical muslin
Do not use closed metal or glass containers

13. Unsaturated Chemical Vapor
Temperature C (2700F)
Pressure psi
Time minutes
Packaging materials:
allow vapors to precipitate on item surface
vapors must not react with packaging
no contact of plastics with side of sterilizer
Perforated Metal Trays Are Ideal
Solid Trays, Sealed Glass Jars are BAD

14. Sterlization Monitoring
All sterilizers that are used must be monitored at least weekly
For Dry Heat Sterilizers
Bacillus subtilis
For Autoclaves and Chemiclaves
Bacillus stearothermophilus

15. Sterlization Monitoring

16. Outcomes of monitoring
Successful-
No growth
Failure - b. subtilis
Failure - b. stearothermophilus