title: Specific anti cross-infection measures may help to prevent viral contamination of dental unit waterlines: a pilot study.
abstract: BACKGROUND
  In recent years, several reports have suggested, but never definitely demonstrated that dental units (DU) could be potential sources of viral cross-infections sustained by viral agents including HBV, HCV and HIV. This work aims at assessing the risk of HCV cross-infection by dental unit water lines (DUWLs).
  
  
  METHODS
  Ten anti-HCV positive viremic patients were submitted to dental treatment on three different DU (one unit fully equipped to minimize viral contamination risk). A PCR method using primers for UTR and E2 regions was used to evaluate HCV RNA presence in DUWLs sprays. A modified RNA extraction protocol was developed to eliminate the risk of low sensibility due to the presence of inhibitors in saliva. Sequences obtained from E2 PCR products amplified from blood and oral fluids were analyzed and compared.
  
  
  RESULTS
  Fluids collected from three different DU before treatment were always negative for the presence of HCV RNA; after treatment viral contamination was detected in six out of ten cases in conventional DU, in three out of ten cases on the reduced-retraction DU while was never detected in sprays taken from fully equipped DU. Comparison of E2 region sequences obtained from blood and DUWLs sprays showed identity in each patient.
  
  
  CONCLUSIONS
  Here we demonstrate that fixed DUWLs and handpieces can be contaminated by viral agents and become a vehicle of cross-infection and that a specific online active decontamination system developed for both handpieces and fixed waterlines can eliminate this risk.
authors.affiliation: Department of Public Health Sciences, University La Sapienza, Piazzale Aldo Moro 5, Rome, Italy. marco.artini@uniroma1.it
authors.forename: M
authors.initials: M
authors.lastname: Artini
authors.forename: G L
authors.initials: GL
authors.lastname: Scoarughi
authors.forename: R
authors.initials: R
authors.lastname: Papa
authors.forename: G
authors.initials: G
authors.lastname: Dolci
authors.forename: M
authors.initials: M
authors.lastname: De Luca
authors.forename: G
authors.initials: G
authors.lastname: Orsini
authors.forename: S
authors.initials: S
authors.lastname: Pappalardo
authors.forename: J W
authors.initials: JW
authors.lastname: Costerton
authors.forename: L
authors.initials: L
authors.lastname: Selan
mesh_terms: D003428:Cross Infection / Q000517:prevention & control* / Q000821:virology; D003748:Dental Equipment / Q000821:virology*; D004866:Equipment Contamination / Q000517:prevention & control*; D005618:Fresh Water / Q000821:virology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D006801:Humans; D019552:Infection Control, Dental; D010865:Pilot Projects