title: Comparison of ultrasonic cleaning schemes: a pilot study.
abstract: OBJECTIVE
  Ultrasonic cleaning is an effective method for cleaning dental instruments prior to sterilisation. However, there are few studies that directly compare precleaning and ultrasonic cleaning solutions. This study evaluated the efficacy of different ultrasonic cleaning schemes.
  
  
  METHODS
  Twenty representative dental instruments, five of which were soiled with a mixture of blood and hydroxyapatite, were used in a series of cleaning runs. Cleaning employed a presoaking agent, ultrasonic cleaning, or a combination of both. Two presoaking agents (Non-ionic Ultrasonic Cleaning Solution and ProEZ Foaming Enzymatic Spray) plus five ultrasonic cleaners (UltraDose, General Purpose Cleaner, Co-enzyme Concentrate, Enzol Enzymatic Detergent, and Non-ionic Ultrasonic Cleaning Solution) were compared, with tap water serving as a control. There were two cleaning times: seven and 15 minutes. After rinsing, the working ends of the instruments underwent scrubbing for 20 seconds using a dental polishing brush held in a haemostat. After scrubbing, the brush and instrument were placed in a tube containing sterile saline. Vortexing of the tube lasted 30 seconds. Testing for the post-cleaning presence of blood involved Hemastix dipsticks. These sticks measure minute amounts of blood in urine and can detect as few as 35 red blood cells per ml. Comparisons of colour change were made to a standard scale followed by assignment of numeric values.
  
  
  RESULTS
  Tap water was the poorest cleaning solution, while UltraDose was the most effective. Blood removal improved when cleaning time was increased from seven to 15 minutes. The combined effect of a presoak immersion followed by ultrasonic cleaning was the most effective cleaning scheme overall. Cleaning by either ultrasound or presoaking only was less effective. Some instruments were more difficult to clean than others.
  
  
  CONCLUSIONS
  Within the constraints of the small number of test runs performed, it was concluded that application of a presoak agent before ultrasonic cleaning produced the most effective instrument-cleaning regimen.
authors.affiliation: The University of Birmingham, School of Dentistry, Birmingham, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Walker
authors.forename: F J Trevor
authors.initials: FJ
authors.lastname: Burke
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Palenik
mesh_terms: D001769:Blood; D003762:Dental Instruments; D003902:Detergents / Q000145:classification / Q000627:therapeutic use*; D017886:Durapatite; D057487:Enzyme Therapy; D004866:Equipment Contamination / Q000517:prevention & control; D006801:Humans; D007101:Immersion; D010865:Pilot Projects; D011934:Reagent Strips; D013997:Time Factors; D014465:Ultrasonics; D014867:Water
chemical_list: D003902:Detergents; D011934:Reagent Strips; D014867:Water; D017886:Durapatite