hYgiene

AHIGGB111S00
03/2011
HYgiene
h:
“ . . . C L O S E AT T E N T I O N ”
w w w. a n t h o s . c o m
Stabilimento / Plant - Via Bicocca, 14/c - 40026 Imola - Bo (Italy) - tel. +39 0542 653441 - fax +39 0542 653555
Sede legale ed amministrativa / Head Quarter - Cefla s.c. Via Selice Provinciale, 23/a - 40026 Imola - Bo (Italy) tel. +39 0542 653111 - fax +39 0542 653344
Anthos has a policy of constant technological upgrading. The technical specifications may therefore be subject to change without prior notice.
HYgiene
“…I’VE CHOSEN ANTHOS.”
h:
Anthos has always been extremely attentive to hygiene. Consequently, dentists
can proceed in full respect of proper working practices and ensure the patient’s
wellbeing via the use of instruments that provide excellent performance while
safeguarding health every minute of the day.
Anthos aims for all-round wellbeing, from design methods to individual active
systems, from the details that make cleaning easy to the selection of chemical
materials compliant with quality standards; for some time now Anthos has also
met the strictest German quality standards, as DVGW certification demonstrates.
HYgiene
h:
By adding hydrogen peroxide to the mains water that feeds the dental unit, the WHE system ensures a continuous bacteriostatic effect in the water lines.
This significantly reduces the bacterial count over time and thus better safeguards the water’s microbiological qualities.
WHE
CONTINUOUS DISINFECTION
Dental units also equipped with the automatic BIOSTER system
ensure maximum microbiological effectiveness: the WHE,
in fact, avoids bacterial proliferation in the machine water lines
so that the BIOSTER can perform at the highest possible level.
Bacterial Pool
(Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Salmonella spp.,
Staphylococcus aureus, Enterococcus faecalis, Bacillus subtilis)
600 ppm
600 ppm
Time (min)
H2O2
H2O2+ Ag+10 ppm
1
7
1.60 * 10
1.60 * 107
10
1.60 * 107
1.00 * 107
20
3.30 * 106
9.90 * 105
30
1.60 * 10
9.00 * 105
40
4.00 * 10
4.00 * 102
50
4.00 * 104
100
6
4
At a concentration of 600 ppm, Peroxy Ag+ reduces bacterial
concentration by 5 logarithms after 40 minutes of contact.
This means a major long-term drop in any bacterial count
in the tubing.
In addition to carrying out continuous bacteriostasis of the water in the tubing, the WHE system performs an equally important secondary function as
it also has an EN 1717-compliant Type A inlet air gap separation device to prevent contamination of mains water.
This goal is also achieved through conscientious design of all other water circuit components on Anthos dental units and careful selection of materials,
certified as being chemically compatible as per the strict standards defined by German law and certified by DVGW. It is also possible to install the WHE
and use it exclusively for mains water contamination protection without filling the H2O2 tank.
Hygiene functions control menu
WHE emptying function control
HYgiene
h:
BIOSTER is a hygiene device that disinfects the dental unit water circuits, the disinfection cycle being carried out in the patient’s absence. Studies made
by Anthos demonstrate that good microbiological water quality can be ensured simply by executing the disinfection cycle at the end of each working day.[2]
Where desired, the disinfection cycle can be carried out more often.
BIOSTER is an automatic device available for products at the top of the Anthos range; it uses water with a 3% hydrogen peroxide (H2O2) content, the excellent
effectiveness of which has been demonstrated by several Italian universities.[2, 3, 4]
When carrying out the BIOSTER cycle, Anthos recommends
the use of a new product, Peroxy Ag+, which contains hydrogen
peroxide at 3% and silver ions. The silver ions have been added
to the hydrogen peroxide to enhance its efficiency by reducing
contact times.
It has also been demonstrated that the presence of Ag ions in
the disinfectant inhibits the formation of biofilm once the
disinfectant has been removed.[1]
Fluorescence 520 mm
BIOSTER
END-OF-WORK DISINFECTION
250
P. aeruginosa clinical isolate
200
y=13.898x
150
The graph shows biofilm formation once the disinfectant has been removed.
The difference between ‘pure’ hydrogen peroxide and hydrogen to which
silver ions have been added in inhibiting the re-growth of Pseudomonas
aeruginosa (a bacterium common in water and often found in dental unit
water lines) is evident at a glance.
100
y=4.5138x
50
y=3.5526x
0
0
5
10
15
H2O2 3%
H2O2 3% + Ag 5 pmm
H2O2 3% + Ag 10 pmm
H2O2 dilution factor
AUTOMATIC PROCEDURE
• Personnel insert the handpieces in a special container
and start the cycle by pressing a key
• Tubing is emptied using air
• Disinfectant injected
• Contact time (default 10 minutes, setting range 5 - 30 min.)
• Tubing emptied using air
• Rinse with water from mains/independent feed tank
depending on the water supply settings established prior
to BIOSTER cycle start.
CYCLE
• The cycle must be carried out once a day at the end of work
• It is also possible to carry out a new cycle before
recommencing work after a prolonged absence
(i.e. surgery closed for at least two weeks)
FLUSHING
The Flushing function allows the water left in the tubing to be changed.
Dental units featuring the BIOSTER system also have the flushing function.
Flushing cannot be defined as disinfection; it is, rather, a simple replacement
of the water from the mains supply. This function is normally used before
starting the day’s work.
Hygiene functions control menu
BIOSTER function control
HYgiene
h:
The SHS system allows water to be supplied to the dental unit via a dedicated bottle
and provides two functions:
• Water feed to dental unit independently from mains water
• Manual tubing disinfection cycle
SHS
SIMPLIFIED INDEPENDENT
WATER FEED SYSTEM
The bottle has a capacity of 1,700 ml.
To maximise hygiene a suitable quantity of Peroxy Ag+
can be added to the distilled water in the bottle to
inhibit bacterial proliferation.
Nevertheless, it is good practice to disinfect the bottle
periodically with cold sterilisers.
Cannula washing is only available on certain models from the Anthos range.
This device allows cannulae to be washed in automatic mode,
thus minimising the manual work required of the assistant.
SUCTION CANNULA
WASHING
With the manual cycle each instrument must be emptied
and filled by extracting it and pressing on the foot control.
Two bottles are supplied for the procedure: one with a grey
stripe containing distilled water and one with an orange stripe
containing disinfectant for the tubing.
While this is a convenient end-of-work function,
it is nevertheless recommended that more in-depth
washing be carried out from time to time by detaching
the corrugated tubes from the dental unit and soaking
them in a basin containing water and an appropriate
cleaning fluid.
The SHS system is very useful if the dental unit is installed
in an area where mains water is particularly hard.
FLUSHING
With the Flushing function the tubing can be filled
in semi-automatic mode, simultaneously on
all instruments (the tubing is filled with whatever
is contained in the bottle at that moment, water
or tubing disinfectant).
This significantly reduces manual disinfection cycle
completion times.
The cycle start is triggered by inserting the cannula tips in their respective connectors. The cycle is as follows:
• mains water fed intermittently for 50 seconds
• introduction of 10 ml of disinfectant liquid
• suction for another 10 seconds.
Anthos recommends the use of Ster 3 Plus for washing and decontamination of tubing, whether executed manually or
automatically. The biphynl-2-olo contained in the product is a wide spectrum disinfectant, active against Gram-positive
and Gram-negative bacteria, mycobacteria, fungi and lipophilic viruses.
The product also tolerates organic material and hard water.
FLUSHING function control
SHS
SUCTION CANNULA WASHING
HYgiene
h:
The O.D.R. (Out Drop no Retraction) device is a huge advance with respect to the anti-retraction
valves that caused so many problems on past generations of dental units; limescale encrustation
on such valves could stop them working even just a few months after their installation
on the dental unit. The anti-retraction valves were designed to prevent retraction of liquid droplets
on instrument tips.
The peristaltic pump, installed on the Classe A9 and Classe A7 Plus,
allows utilisation of sterile irrigating liquids, a function that could not otherwise be
provided by the dental unit.
This function is evidently useful in specific circumstances, such as when dental surgery
or implant operations are being carried out.
PERISTALTIC
PUMP
O.D.R.
water
air
The O.D.R. operates according to a different principle:
• during instrument operation water and air are delivered simultaneously.
• during the instrument stop phase water delivery is shut down first, then the air delivery.
• the air delivered after the water feed has been turned off carries away the last residual droplets
left on the instrument tip, preventing them from being retracted back inside the instrument.
The unit allows feed of a sterile saline solution via a non-contact disposable irrigation tube.
It can be used together with the i-MMs surgical micromotor, with externally cooled contra
angles or contra angles for hollow burs.
A bag/bottle of sterile saline solution with irrigation tube is used.
The irrigation tube is stowed inside the unit.
Saline solution feed rates are adjustable (5 different levels, from 35 ml/min to 100 ml/min).
The O.D.R. system is installed as standard on all Anthos dental units.
Peristaltic pump function control menu
(on/off and flow rate control)
h:
PASSIVE HYGIENE
To disinfect dental unit surfaces, Anthos recommends the use
Ster 1 Plus. The new balanced Ster1 Plus formula provides
an effective disinfectant action and has no adverse aging
effect on the more delicate surfaces of the dental unit.
Ster 1 plus is an intermediate level disinfectant and is
tubercolocidal, bactericidal, fungicidal and virucidal.
It is important to ensure that all the surfaces that dentist’s or
assistant’s hands can come into contact with are kept clean.
CUSPIDOR BOWL
•The cuspidor bowl is a ceramic monobloc with no interstices and is easy to disinfect
•Cup and bowl fill units are removable and can be cold-sterilised
•Air gap between rinse jet and drain is designed to prevent contamination in the event of a fault
PATIENT CHAIR
• Padding is made of a seamless co-moulded bond of SKAI, flexible PU and structural PU.
• Padding can be removed for sanitisation
• No bellows
SURFACES
• No fissures/interstices
• ASA plastics have extremely low porosity and high
resistance to disinfectant liquids
• Control panel keys protected by disposable membrane cover
REMOVABLE PARTS
• Dentist’s module and operating light handles can be removed
and cold-disinfected
• Silicon instrument support mat can be removed and autoclaved
• Cup and bowl fill unit can be removed and autoclaved
FOOT CONTROL
Most dental unit functions can be operated via the foot control:
• Patient chair position adjustment
• Recall of saved chair positions
• Instrument parameter settings
• Operating light on/off control
h:
h:
Summary chart
BIBLIOGRAPHY
Bioster-Flushing
Anthos Classe A9
Anthos Classe A7 Plus
Anthos Classe A6 Plus
Anthos Classe A5
WHE
SHS
Flushing
Cann. wash
ODR
1. Orrù et al.
Attività antibatterica
di formulati a base di
perossido di idrogeno e
sali d’argento
Anthos Classe A3 Plus
In press
Anthos Classe R7
Anthos Classe R7 Modulo
Anthos Cart Singolo
2. Orrù et al.
Evaluation of Antimicrobial
- Antibiofilm Activity of
a Hydrogen Peroxide
Decontaminating System
Used in Dental Unit Water
Lines
The Open Dentistry
Journal, 2010; 4: 140-146
3. Maddalone et al.
Concentrazioni batteriche
nell’acqua dei riuniti
odontoiatrici: valutazione
delle possibilità di controllo
offerte da un protocollo di
decontaminazione a base
di differenti concentrazioni
di perossido di idrogeno
4. Orrù et al.,
Valutazione dell’attività
antimicrobica di un sistema
decontaminante a base
di perossido d’idrogeno.
risultati in vitro e su riunito
odontoiatrico
5. Savino et al.,
Hydrogen Peroxide in the
Bacterial decontamination
of Dental units
6. Savino et al.
Decontaminazione
batterica dei riuniti
odontoiatrici
7. Zanetti et al.
Decontamination of dental
unit water systems with
hydrogen peroxide
U&U 2003; 3: 28-35
Il Dentista Moderno 2003;
settembre: 79-102
Letters in Applied
Microbiology 2003;
37: 201-206
Il Dentista Moderno 2006;
dicembre: 60-71
Il Dentista Moderno, 2007;
dicembre: 46-59
as standard optional
A complete investigation of hygiene in the dental studio is to be found in “Guidelines for Infection Control in Dental Health-Care Settings – 2003” published by US Centers for Disease Control in 2003
(http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm).
Information on biofilm can be found in several publications, such as Costerton and Stewart, “Fighting biofilm” Le Scienze, August 2001, 86-93 or Harrison et al. “Biofilm” Le Scienze, July 2006: 84-91.