PolymeracÏnõÂ lampa v ordinaci zubnõâho leâkarïe a riziko prïenosu. Dental light-curing units and the riskof infections

Transcription

1 rocïnõâk22 ORTODONCIE PolymeracÏnõ lampa v ordinaci zubnõâho leâkarïe a riziko prïenosu infekcïnõâho agens Dental light-curing units and the riskof infections *MUDr. Eva Sedlata Jura skovaâ, **Doc. RNDr. Ivanka MatousÏ kovaâ, Ph.D. *Ortodonticke oddeï lenõâ Kliniky zubnõâho leâ karïstvõâ LF UP Olomouc *Department of Orthodontics, Institute of Oral Medicine, Medical Faculty of Palacky University, Olomouc **U stav preventivnõâho leâ karïstvõâ LF UP Olomouc **Department of Preventive Medicine, Medical Faculty of Palacky University, Olomouc Souhrn CõÂl: CõÂlem studie bylo upozornit na duê lezïityâ vyâ znam hygieny v ordinaci zubnõâho leâ karïe, a to konkreâ tneï ve vztahu k zubnõâm polymeracï nõâm lampaâ m jako mozïneâ mu zdroji infekcï nõâho agens a naâ sledneâ ho sï õârïenõâ nemocnicï nõâch naâ kaz. Materia l a metodika: Do souboru bylo zahrnuto 59 bakteriaâ lnõâch steïruê z povrchu polymeracï nõâch lamp. Vy sledky: Z kultivacï nõâch vyâ sledkuê prïevazï ujõâ grampozitivnõâ bakterie s dominancõâ koagulaâ za negativnõâch stafylokokuê (CoNS). V jednom prïõâpadeï byl prokaâ zaâ n Staphylococcus aureus. Pouze v jednom prïõâpadeï byla prokaâ zaâ na gramnegativnõâ bakterie, a to kmen Pseudomonas aeruginosa. Dle bakteriaâ lnõâ kultivace byly pouze dveï polymeracï nõâ lampy kultivacï neï negativnõâ. ZaÂveÏr:Epidemiologicke sï etrïenõâ ukaâ zalo sï patnou konecï nou dekontaminaci polymeracï nõâch lamp a jejich nevhodneâ ulozïenõâ po skoncï enõâ pracovnõâ doby, kdy jsou vystaveny spadu prachovyâchcïaâ stic jako mozïneâ ho nosicïe infekcï nõâho agens (Ortodoncie 2013, 22, cï. 1, s ). Abstract Aim: The study aims to focus on the importance of hygiene in the dentist offices, specifically in relation to dental light-curing units as a potential source of infectious agent and the resulting spread of hospital infections. Material and methods: The sample included 59 bacterial swabs from polymerization lamps surfaces. Results: Within cultivation results gram-positive bacteria prevail dominated by coagulase-negative staphylococci (CoNS). In one case Staphylococcus aureus was proved. Only in one sample a gram-negative bacterium was proved, specifically genus Pseudomonas aeruginosa. Bacterial cultivation showed that only two polymerization lamps had negative results. Conclusion: Epidemiological examination proved unsatisfactory final decontamination of polymerization lamps and their inappropriate deposition after office hours - they were exposed to dust particles that are potential carriers of infectious agent (Ortodoncie 2013, 22, No. 1, p ). KlõÂcÏ ovaâ slova: polymeracï nõâ lampa, infekcï nõâ agens Key words: light-curing units, infectious agent U vod DodrzÏ ovaâ nõâ dezinfekcï nõâch a sterilizacï nõâch postupuê, ktereâ je soucï aâ stõâ provoznõâho rïaâ du kazïdeâ ordinace zubnõâho leâ karïe, je jednõâm z nejduê lezïiteï jsï õâch opatrïenõâ k zamezenõâ prïenosu infekcï nõâho agens. Ordinace zubnõâho leâ karïe je rizikovyâm pracovisïteï m, kde muêzïe dochaâ zet Introduction To avoid potential transmission of infections, every dentist should follow strict disinfection and sterilization protocols. Dentist surgery is a risky workplace where infectious agent may be transmitted - due to some procedures - via airflow and the following sedi redakce@orthodont-cz.cz

2 ORTODONCIE rocïnõâk22 v souvislosti s urcï i tyâ mi vyâ kony k prïenosu infekcï nõâho agens proudeï nõâm vzduchu a naâ sledneâ sedimentaci mikroaerosolu na povrchy a prïedmeï ty v okolõâ krïesla, vcï etneï odeï vu a oblicï eje osï etrïujõâcõâho leâ karïe. VelmicÏasto muê zï e takeâ dojõât k prïenosu infekce kontaktem, jak prïõâmyâm, tak neprïõâmyâm. V nasïem cïlaâ nku chceme upozornit na mozïnyâprïenos infekcï nõâho agens v souvislosti s pouzïõâvaâ nõâm polymeracï nõâch lamp. CõÂlem epidemiologickeâho sï etrïenõâ bylo oveïrïit uâcï innost provaâdeïneâ konecïneâ dekontaminace, kteraâ se uskutecïnï uje na koncipracovnõâ doby. Metodika Epidemiologicke sï etrïenõâ probõâhalo na Klinice zubnõâho leâ karïstvõâ FN Olomouc a LF UP v Olomoucina konzervacï nõâm, protetickeâ m, pedostomatologickeâ m, parodontologickeâ m a ortodontickeâ m oddeï lenõâ. Vlastnõ sï e- trïenõâ bylo provedeno v dobeï prïed prïõâchodem zdravotnickyâ ch pracovnõâkuê na pracovisï teï ipacientuê k osï etrïenõâ, mezisï estou a sedmou hodinou ranõâ, kdy meï ly byâ t polymeracï nõâ lampy dekontaminovaâ ny na koncipracovnõâ doby prïedesï leâ ho dne dezinfekcï nõâm prïõâpravkem na baâ zialkoholu, kteryâ je urcï en k okamzïiteâmu pouzï itõâ pro rychlou dezinfekci. Ma baktericidnõâ, virucidnõâ, sporicidnõâ, mykobaktericidnõâ a fungicidnõâ uâcïinnost. SteÏ ry byly odebraâ ny z polymeracï nõâch lamp, ktereâ byly k dispozici u stomatologickyâ ch souprav na vsï ech vyâ sï e uvedenyâ ch oddeï lenõâch. SÏ etrïenõâ probõâhalo na dvou typech polymeracïnõâch lamp: 1) starsï õâtyp - halogenovaâ polymeracï nõâlampa (obr. 1) Lokalizace - pocï et provedenyâch steïruê : sveï tlovod - 23, ochrannyâ sï tõât - 8 steïruê,teï lo lampy - 3 steï ry a 6 steïruê z ochrannyâch bryâlõâ. 2) novyâ typ - LED polymeracï nõâ lampa (obr. 2) Lokalizace - pocï et provedenyâch steïruê : sveï tlovod (plastovaâ cï ocï ka) - 10 steï ruê, prïidrzï ovacõâ a ochrannyâ si- mentation of microaerosol on the surfaces and objects near the dentist chair, including the wear and face of an attending dentist. Infectious agent is often transmitted through direct or indirect contact. Our work pays attention to possible transmission related to the use of light-curing units. The aim of epidemiological examination was to assess the effectiveness of the final decontamination performed at the end of dentist's office hours. Method Epidemiological examination was performed at the Institute of Oral Medicine in Olomouc, departments of conservative dentistry, prosthodontics, pediatric dentistry, periodontics and orthodontics. The examination was carried out before the staff and patients appeared, i.e. between 6:00 a.m. and 7:00 a.m. At the time polymerization lamps should be decontaminated with disinfection cleaner based on alcohol which is meant for quick disinfection. It eliminated bacteria, viruses, spores, mykobacteria and fungicides. Swabs were taken from polymerization lamps in all the departments mentioned. There were two types of light-curing units: 1) An old type - halogen polymerization lamp (fig.1) Localization - number of swabs: light guide - 23, protective shield - 8, body - 3, protective glasses - 6 Obr. 1. Halogenova polymeracï nõâ lampa. Fig. 1. Halogen polymerization lamp Obr. 2. LED polymeracï nõâ lampa. Fig. 2. LED polymerization lamp redakce@orthodont-cz.cz 29

3 rocïnõâk22 ORTODONCIE likonovyâ prstenec lampy - 4 steï ry, jednoraâ zovyâ PVC ochrannyâ naâ vlek polymeracï nõâ lampy - 5 steïruê. Mikrobia lnõâ kontaminace byla stanovena u 33 polymeracï nõâch lamp, z jejichzï povrchuê bylo provedeno celkem 59 steïruê. SteÏ ry byly zhotoveny vatovyâmivyâteï rovkami, ktereâ byly prïedem zvlhcï eny ve sterilnõâm fyziologickeâ m roztoku. Primokultivace probõâhala v tekuteâ m pomnozï ovacõâm meâ diu (thioglykolaâ tovyâ bujon) prïiteploteï 37 C po dobu 48 hodin. Na sledovalo vyocï kovaâ nõâ na pevnou puê du - krevnõâ agar a Sabouraudovu puê du s chloramfenikolem. Kultivace probõâhala za stejnyâ ch podmõânek jak uvedeno vyâsï e. KonecÏ neâ hodnocenõâ naâruê stu mikrobiaâlnõâch koloniõâ na krevnõâm agar bylo po 48 hodinaâ ch, Sabouraudova puê da byla hodnocena 5. den kultivace. Kvalitativnõ hodnocenõâ kultivacõâ prokaâ zanyâ ch koloniõâ bylo provedeno na zaâ kladeï jejich biochemickyâ ch vlastnostõâ mikrotesty Lachema. RozlisÏ enõâ stafylokokuê na kmeny koagulaâ za pozitivnõâ a koagulaâ za negativnõâ bylo provedeno pomocõâ latexoveâ aglutinace setem STAPHY- TEC PLUS. Vy sledky Z kultivacï nõâch vyâ sledkuê je patrnaâ jasnaâ prïevaha grampozitivnõâch bakteriõâ a v teâ to skupineï dominujõâ koagulaâ za negativnõâ stafylokoky (CoNS). Jen v jednom prïõâpadeï byl prokaâ zaâ n Staphylococcus aureus. Pouze Tab. 1. Zastoupenõ bakteriaâ lnõâch kmenuê na povrchu halogenoveâ polymeracï nõâ lampy Tab. 1. Bacterial tribes found on the halogen polymerization lamp surface Lokalizace steï ru - sveï tlovod (n=23) Location of swab - light guide Staphylococcus aureus CoNS * Enterococcus sp Bacillus subtilis Pseudomonas aeruginosa Negative cultivation Lokalizace steï ru - ochrannyâ sï tõât (n=8) Location of swab - protective shield CoNS * Bacillus subtilis Negative cultivation Lokalizace steïru-teï lo lampy (n=3) Location of swab - body of lamp Bacillus subtilis Lokalizace steï ru - ochranneâ bryâle (n=6) Location of swab - goggles CoNS * Micrococcus sp * CoNS = koagulaâ za negativnõâ stafylokok coagulase-negative staphylococcus 2) A new type - LED polymerization lamp (fig.2) Localization - number of swabs: light guide (plastic lenses) - 10, protecting and supporting silicon volute of the lamp - 4, disposable plastic wrap - 5. Microbial contamination was found in 33 polymerization lamps, from the surface of which 59 swabs were made. Swabs were done with cotton-wool swabs wetted in sterile physiological solution. Prime cultivation was performed in a liquid medium (thioglycolate buillon) at 37 C for 48 hours. Then there was inocculation into firm ground - blood agar and Sabouraud agar with chloramphenicol. Cultivation was performed under the same circumstances as mentioned above. The final evaluation was made after 48 hours for blood agar, and on the 5th day for Sabouraud agar. Qualitative evaluation of colonies proved by cultivation was made according their biochemical characteristics with Lachema tests. Differentiation of staphylococci into coagulase-positive and coagulase-negative was done with help of latex agglutination with STAPHYTEC PLUS set. Results The results show strong prevalence of gram-positive bacteria; the group is dominated by coagulase-negative staphylococci (CoNS). Staphylococcus aureus Tabulka 2. Zastoupenõ bakteriaâ lnõâch kmenuê na povrchu LED polymeracï nõâ lampy. Table 2. Bacterial tribes on LED polymerization lamp. Lokalizace steï ru - sveï tlovod (n=10) Location of swab - light guide CoNS * Micrococcus sp Bacillus subtilis Lokalizace steï ru - ochrannyâ silikonovyâ prstenec Location of swab - protective sillicon ring (n=4) CoNS * Bacillus subtilis Lokalizace steï ru - jednoraâ zovyâ ochrannyâ naâ vlek Location of swab - disposable protective wrap (n=5) CoNS * 2 40,0 Bacillus subtilis 4 80,0 * CoNS = koagulaâ za negativnõâ stafylokok coagulase-negative styphylococcus redakce@orthodont-cz.cz

4 ORTODONCIE rocïnõâk22 v jednom prïõâpadeï byla prokaâzaâ na gramnegativnõâ bakterie, a to kmen Pseudomonas aeruginosa. V obou prïõâpadech je nutneâ povazï ovat tyto bakteriaâ lnõâ kmeny za patogennõâ. BohatsÏ õâ druhoveâ zastoupenõâ bylo u obou typuê lamp prokaâzaâ no na sveï tlovodu (tab. 1, tab. 2). U halogenoveâ polymeracï nõâ lampy bylo provedeno 23 steï ruê sveï tlovodu, pouze ve dvou prïõâpadech byla kultivace negativnõâ. V prïõâpadeï polymeracï nõâ LED lampy bylo provedeno 10 steï ruê sveï tlovodu, negativnõâ kultivace nebyla aniv jednom prïõâpadeï. SteÏ ry byly odebraâ ny ze 6 kusuê ochrannyâch bryâlõâ volneï polozï enyâ ch na pracovnõâm stole. V peï ti prïõâpadech byl kultivacõâ prokaâ zaâ n koagulaâ za negativnõâ stafylokok, v jednom prïõâpadeï kmen Micrococcus sp. Diskuse U stnõâ dutina maâ podobneâ mnozï stvõâ bakteriõâ jako tlusteâ strïevo, tj na gram vlhkeâ vaâ hy tkaâneï. Jsou zde prïõâtomneâ bakterie aerobnõâ i anaerobnõâ [1]. KromeÏ bakteriõâ jsou velmi nebezpecïnyâm biologickyâm materiaâ lem sliny, ktereâ vprïõâpadeï prïõâtomnostikrve mohou obsahovat ipuê vodce viroveâ hepatitidy B a C a takeâ puê vodce HIV. InfekcÏ nõâ agens viroveâ ho charakteru nenõâ mozïneâ beï zï neï prokaâ zat, pouze v souvislosti s biologickyâ m materiaâ lem je nutneâ myslet na mozïneâ riziko jeho prïenosu. SoucÏ asneï takeâ platõâ, zï e v populacise zvysï uje pocï et imunosuprimovanyâ ch pacientuê, kterïõâ jsou rovneï zï pacienty zubnõâch leâ karïuê.u teâ to skupiny lidõâ pak bakterie, ktereâ jsou beïzïneï rïazeneâ mezinepatogennõâ nebo podmõâneïneï patogennõâ, mohou vyvolat onemocneïnõâ. CõÂlem nasï õâ studie bylo upozornit na mozïnyâ prïenos infekcï nõâho agens v souvislosti s pouzïõâvaâ nõâm polymeracï nõâch lamp. V soucï asneâ odborneâ literaturïe cï eskeâ izahranicï nõâ se naâ m nepodarïilo najõât obdobnou studii. Nema me mozï nost srovnat naâ minalezeneâ vyâ sledky sï e- trïenõâ s jinou podobnou studiõâ. Pouze v technickyâch naâ vodech jednotlivyâ ch vyâ robcuê polymeracï nõâch lamp je uvedeno upozorneï nõâ o nutnostidezinfekce nebo sterilizace teâ to nezbytneâ stomatologickeâ pomuê cky. V nasï ich vyâ sledcõâch jsme pouze ve dvou prïõâpadech prokaâ zaly patogennõâ bakteriaâ lnõâ kmen (Staphylococcus aureus, Pseudomonas aeruginosa). VsÏ echny pozitivnõâ kultivacï nõâ naâ lezy sveï dcï õâ pro neuâ cï innou konecï nou dekontaminaci po skoncï enõâ pracovnõâ doby a takeâ pro nevhodneâ ulozï enõâ polymeracï nõâch lamp. Ve veï tsï i neï prïõâpaduê v dobeï provaâ deï nõâ sï etrïenõâ byly volneï polozï eneâ na pracovnõâ desce a prïõâstupneâ spadu prachovyâch cï aâ stic, na kteryâch muê zïe byât prïõâtomneâ iinfekcï nõâm agens. Pro ordinace zubnõâch leâ karïuê existujõâ zaâ sady dezinfekce a sterilizace opakovaneï pouzï õâvanyâ ch pomuê cek a naâstrojuê. V CÏ eskeâ republice jsou daâ ny legislativou - VyhlaÂsÏka cï. 195/2005 Sb., kterou se upravujõâ podmõânky prïedchaâ zenõâ vzniku a sï õârïenõâ infekcï nõâch onemocneï nõâ a hygienickeâ pozï adavky na provoz zdravotnickyâ ch za- was found only in one case. Again, only in one case, a gram-negative bacterium was proved - Pseudomonas aeruginosa. In both cases these bacteria should be considered as pathogens. In both halogen and LED lamps more species were detected on the light guide surface (table 1 and 2). In halogen lamps there were taken 23 swabs from the light guide; only in two the cultivation was negative. In LED lamps there were taken 10 swabs from the light guide; all cultivations proved positive findings. Swabs were taken from 6 goggles (protective glasses) that were placed on the working table. In five the cultivation proved coagulase-negative staphylococcus, in one Micrococcus sp. Discussion In oral cavity we can find similar amount of bacteria as in large intestine, i.e per one gram of wet tissue weight. There are both aerobic and anaerobic bacteria [1]. Apart from bacteria, saliva is a very dangerous biological matter - if blood is present, saliva may contain a cause of viral hepatitis B and C, as well as HIV. Infectious agent of viral character is hard to prove under normal conditions; however, we should always bear in mind a potential risk of its transmission. At the same time it holds true that in the population the number of immunosupressed patients increases. In these people bacteria that are normally categorized as non-pathogenic or conditionally pathogenic may elicit disease. The aim of our study was to bring attention to potential transmission of an infectious agent related to the use of polymerization lamps. Current literature, Czech or foreign, does not deal with the problem. Therefore, we cannot compare our results with other studies. Only in instruction manuals by individual manufacturers of light-curing units we can read the warning about the necessary disinfection or sterilization. In our results there are only two cases with proven pathogenic bacterial tribe (Staphylococcus aureus, Pseudomonas aeruginosa). All positive cultivation findings show ineffective final decontamination after office hours as well as inappropriate storage of the lamp. Mostly they were placed on the working table and thus exposed to dust particles which may bear infectious agent. Dental surgeries should follow regulations establishing disinfection and sterilization procedures for the repeatedly used tools and instruments. In the Czech Republic this is a part of legislation - Ordinance No. 195/2005 Sb., regulating the conditions for the prevention of origin and transmission of contagious diseases, and hygienic requirements for the operation of health-care facilities and institutions of social care [2]. The problem arises from the fact that not all redakce@orthodont-cz.cz 31

5 rocïnõâk22 ORTODONCIE rïõâzenõâ a uâ stavuê sociaâ lnõâ peâcï e [2]. Proble mem je, zïe ne vsï echny pomuê cky pouzï õâvaneâ v ordinaci zubnõâho leâ karïe je mozïneâ dezinfikovat nebo sterilizovat podle legislativy. To platõâ i pro polymeracï nõâ lampy, ktereâ jsou v ordinacizubnõâho leâ karïe velmicï asto pouzï õâvaneâ, a to jak k tvrzenõâ vyâ plnï ovyâ ch materiaâ luê, tak k beï lenõâ zubuê. Pouze neï kterïõâ vyâ robciv technickeâ m naâ vodu k pouzï õâvaâ nõâ polymeracï nõâch lamp uvaâdeï jõâ podrobneï jsï õâ popis zpuê sobu dezinfekce cï ijineâ ho dekontaminacï nõâho postupu. VsÏ e zaâ visõâ na pouzïiteâ m materiaâ lu a technologii vyâ roby polymeracï nõâ lampy. NeÏ kterïõâ vyâ robcidoporucï ujõâ pouzï õâvat jednoraâ zoveâ ochranneâ plastoveâ naâ vleky, ktereâ chraâ nõâ lampu prïed zatecï enõâm kapaliny a zabranï ujõâ prïenosu infekcïnõâho agens mezijednotlivyâ mipacienty.[3] Tyto jednoraâ zoveâ ochranneâ naâ vleky jsou deklarovaneâ jako nesterilnõâ. Kultivacõ jsme na nich prokaâ zaly kmen koagulaâ za negativnõâho stafylokoka a kmen Bacillus subtilis. Obdobne naâ lezy se vyskytujõâ u jednoraâ zovyâ ch nesterilnõâch rukavic. Po pouzï itõâ se odklaâ dajõâ do odpadu, kteryâ nese oznacï enõâ - ¹infekcÏ nõâ materiaâ lª. Dle uâ stnõâho sdeï lenõâ, nejsou tyto jednoraâ zoveâ ochranneâ naâ vleky zubnõâmileâ karïi vzï dy pouzïõâvaâ ny a ne vsï ichni vyârobcije prïiklaâ dajõâ ke vsï em typuê m polymeracï nõâch lamp. U neï kteryâch typuê polymeracï nõâch lamp lze vyjmout sveï tlovod, kteryâ lze sterilizovat. Sterilizace se nesmõâ provaâdeï t chemickyâmi prostrïedky nebo horkyâ m vzduchem, pouze parou pod tlakem. Dezinfekce ostatnõâch dõâluê, vcï etneï sveï tlovodu mezijednotlivyâmiosï etrïenõâmipacientuê, se provaâdõâ ubrouskem napusï teï nyâ m dezinfekcï nõâm prostrïedkem. DezinfekcÏ nõâ prostrïedek nesmõâ proniknout do prïõâstroje. RozpousÏteÏ dla cï iabrazivnõâ cï isticï e se nesmõâ v zïaâ dneâm prïõâpadeï pouzï õâvat [4, 5]. DoporucÏ en je dezinfekcï nõâ prostrïedek na baâ zialkoholu [3]. PrÏinasÏ em epidemiologickeâm sï etrïenõâ jsme pouze ve dvou prïõâpadech kultivacõâ prokaâ zaly patogennõâ bakteriaâ lnõâ kmen. Jednalo se o kmen Staphylococcus aureus a kmen Pseudomonas aeruginosa. V obou prïõâpadech byl bakteriaâ lnõâ kmen prokaâzaâ n steï rem sveï tlovodu polymeracï nõâ lampy. Z duê vodu rizika malyâch cï õâsel zde nebylo provedeno statistickeâ vyhodnocenõâ. VeÏ tsï ina naâ miprokaâ zanyâ ch bakteriaâ lnõâch kmenuê patrïõâ do skupiny nepatogennõâch nebo podmõâneïneï patogennõâch bakteriõâ. PrÏesto se domnõâvaâ me, zï e zde existuje riziko prïenosu infekcï nõâho agens mezipacienty. V nasïem epidemiologickeâm sï etrïenõâ jsme prokazovaly pouze bakteriaâ lnõâ kontaminaci pouzï õâvanyâ ch polymeracï nõâch lamp. ZaÂveÏr Epidemiologicke sï etrïenõâ, ktereâ bylo zameï rïeno na bakteriaâ lnõâ kontaminaci polymeracï nõâch lamp pouzï õâvanyâch v ordinaci zubnõâho leâ karïe prokaâ zalo: 1. neuâcï innou konecï nou dekontaminaci polymeracïnõâch lamp po skoncï enõâ pracovnõâ doby a tools used in the dentist surgery may be disinfected or sterilized in accordance with the regulations. This applies to polymerization lamps, that are often used both to cure filling materials and for teeth bleaching. Only some producers included in their User's Guide detailed description of disinfection or other ways of decontamination. Everything depends on the material used and on the technology of production. Some manufacturers recommend disposable plastic wraps protecting the lamp against liquid leak and preventing infectious agent transmission between individual patients [3]. The disposable protective wraps are declared non-aseptic. The cultivation proved genus coagulase-negative staphylococcus and tribe Bacillus subtilis. Similar findings were recorded for disposable non-aseptic gloves. After the use they are put in waste marked ¹infectious materialª. We were told that disposable protective wraps are not used consistently by the dentists, and they are part of the polymerization lamp package only in some manufacturers. In some types of polymerization lamps it is possible to remove the light guide that may undergo sterilization. However, chemical solutions or warm air cannot be used, only steam under pressure. Other parts, including the light guide between individual patients, are disinfected by means of a cloth with disinfection cleaner. The cleaner must never get into the apparatus. Dissolving agents or abrasive cleaners must not be used [4, 5]. Disinfection cleaner with alcohol is recommended [3]. Our epidemiological examination proved pathogenic bacterial tribe only in two cases. They were Staphylococcus aureus and Pseudomonas aeruginosa. In both cases bacterial tribe was proved in the swab taken from the light guide of the polymerization lamp. Due to the risk of small numbers we decided against statistical processing of the data. Most bacterial tribes found belong to the group of non-pathogenic or conditionally pathogenic bacteria. Nevertheless, we believe that there exists the risk of infectious agent transmission between the patients. Our examination dealt only with bacterial contamination of polymerization lamps in use. Conclusion Epidemiological examination focused on bacterial contamination of polymerization lamps used in dentist surgery proved the following: 1. ineffective final decontamination of polymerization lamps at the end of office hours, 2. inappropriate storage of polymerization lamps when they are not used - they should be protected against dust particles fall-out. To minimize the risk of infectious agent transmission during the use of polymerization lamps according redakce@orthodont-cz.cz

6 ORTODONCIE rocïnõâk22 2. sï patneâ ulozïenõâ polymeracï nõâch lamp v dobeï, kdy nejsou pouzïõâvaâ ny, meïly by byât chraâneï ny protispadu prachovyâch cï aâ stic. Pro minimalizaci rizika prïenosu infekcï nõâho agens prïi pouzïõâvaâ nõâ polymeracï nõâch lamp dle vyâsï e uvedenyâch vyârobcuê je mozï neâ doporucï i t: 1. pouzï õâvat jednoraâ zoveâ ochranneâ naâ vleky, ktereâ jsou soucïaâ stõâ polymeracï nõâch LED lamp (obraâ zek 3) 2. dodrzï ovat vyâsï e uvedenaâ doporucï enõâ vyârobce pro pruê beï zï nou ikonecï nou dekontaminaci polymeracï nõâch lamp a 3. polymeracï nõâ lampu v dobeï, kdy nenõâ pouzïõâvaâna uklaâ dat tak, aby byla chraâ neï na protispadu prachovyâch cïaâ stic. to the manufacturers mentioned above we recommend: 1. to use disposable protective wraps which are part of polymerization LED lamps package (fig.3) 2. to follow recommendations of manufacturers given above dealing with continuous and final decontamination of polymerization lamps, 3. to store the polymerization lamp when not in use so that it is protected against dust particles pollution. Authors have no commercial, proprietary or financial interest in products or companies mentioned in the article. AutorÏi nemajõâ komercï nõâ, vlastnickeâ nebo financï nõâ zaâ jmy na produktech nebo spolecï nostech popsanyâ ch v tomto cïlaâ nku. Literatura/References 1. BednaÂrÏ M. a kol.: Le karïskaâ mikrobiologie. 1. Vyd. Praha: Marvil, s VyhlaÂsÏka cï. 195/2005 Sb., kterou se upravujõâ podmõânky prïedchaâ zenõâ vzniku a sï õârïenõâ infekcï nõâch onemocneï nõâ a hygienickeâ pozï adavky na provoz zdravotnickyâ ch zarïõâzenõâ auâ stavuê sociaâ lnõâ peâcïe. 3. SDI, SDI Radii plus 4. 3M ESPE EliparTM S10. 3M ESPE AG Dental Products. p M Unitek, OrtholuxTM Luminous Curing Light MUDr. Eva Sedlata Jura skovaâ Ortodonticke oddeï lenõâ Kliniky zubnõâho leâ karïstvõâ LF UP PrÏehled chystanyâch domaâ cõâch akcõâ 2013: ROD OSTRAVA 25.± Doc. MUDr. Olga JedlicÏ kovaâ, CSc. ¹FunkcÏ nõâ aparaâ tyª PrÏehled chystanyâch zahranicï nõâch akcõâ 2013: 26.± th Congress of the European Association of Orthodontics Reykjavik, Island * * * Informace: ROD Ostrava ± BeÏ lovaâ Olga, MojmõÂrovcuÊ 799/45, Ostrava-Mar. Hory Tel.: , , obchod@rod-ostrava.cz CÏ lenskyâ poplatek pro rok 2013 cï inõâ 1500,- KcÏ nebo 65,- EUR. CÏ lenoveâ v zameï stnaneckeâ m vztahu 800,- KcÏ nebo 35,- EUR. Postgraduanti, duê chodci a zïeny na materïskeâ dovoleneâ 300,- KcÏ nebo 15,- EUR. RegistracÏ nõâ polatek cï inõâ 500,- KcÏ nebo 20,- EUR. PrÏedplatne cï asopisu Ortodoncie pro necï leny CÏ OSje 1000,- KcÏ za rok nebo 40,- EUR. U hrada poplatku do , cï.uâ.: /0100, konst. symbol: 0558, variab. symbol: rodneâ cï õâslo. PrÏi nezaplacenõâ prïõâspeï vkuê po dvou põâsemnyâch urgencõâch bude ukoncï eno cï lenstvõâ v CÏ OS. redakce@orthodont-cz.cz 33