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Using the transmission electron microscope, the ultrastructural examination was conducted to detect the presence of bacterial biofilm on the inner surfaces of the tubing in dental unit waterlines (DUWL). Samples for examination were taken from the tubes providing water to high-speed and slow-speed handpieces, and to an air-water syringe before application of a disinfection procedure. The microscopic analysis made it possible to find the biofilm in all the tubes in the dental unit which were not pre-disinfected. In these samples, no significant differences were found between high-speed, slow-speed and air-water lines.
Gram-negative bacteria concentration in water effluent from a dental unit, and in dental aerosol forming during the work of a dental handpiece, was assessed. The study was conducted on 25 dental units before and after a 2-week period of using a disinfecntant for water in dental units waterlines (DUWL). The contamination of water with Gram-negative bacteria before disinfection was 18-398 x 103 cfu/ml, and after disinfection, bacteria were not found. The concentration of Gram-negative bacteria in the air before disinfection was 0-23 x 101 cfu/m3, and after disinfection - 0-8 x 101 cfu/m3. Simultaneously, the water and air were sampled to determine bacterial endotoxin. The statistical analysis did not show correlation between endotoxin concentration and Gram-negative bacteria concentration for the water before disinfection, and for the air before and after disinfection of DUWL water. Because the number of bacteria in the water after disinfection dropped to zero, statistical methods could not be used. The performed analysis suggests that bacterial endotoxin concentration is not indicative of Gram-negative bacteria contamination. Thus, bacterial endotoxin determination is not recommended as a method of monitoring the microbiological quality of DUWL water and dental aerosols.
The concentration and composition of fungal flora in dental unit waterlines (DUWL) were evaluated. For this purpose, water samples from unit reservoirs and high-speed handpieces, and biofilm samples from the waterline walls from units were collected. Subsequently, analogous samples from DUWL were taken before and after disinfection using agent containing hydrogen peroxide. In the examined samples, the yeast-like fungi Candida albicans, Candida curvata and Geotrichum candidum were found. The following species of mould were also identified: Aspergillus amstelodami, Aspergillus fumigatus, Aspergillus glaucus group, Aspergillus (=Eurotium herbariorum) repens, Citromyces spp., Penicillium (glabrum) frequentans, Penicillium pusillum, Penicillium turolense and Sclerotium sclerotiorum (Sclerotinia sclerotiorum) . Before disinfection, Candida curvata and Candida albicans constituted the greatest proportion of the total fungi in the reservoirs water; in the water of handpieces - Candida albicans and Aspergillus glaucus group; and in the biofilm samples - Aspergillus glaucus group and Candida albicans. After disinfection, in all 3 kinds of samples, Candida albicans prevailed, constituting from 31.2-85.7% of the total fungi. The application of agent containing hydrogen peroxide caused a significant decrease both in the number of total fungi and individual fungal species, which confirms the product effectiveness in fungal decontamination of DUWL.
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The aim of this study was bacteriological assessment of the dental unit waterlines (DUWL) biofilm - concentration and composition of the aerobe and facultative anaerobe bacterial microflora, and evaluation of the influence of a disinfecting product, Oxygenal 6, on the biofilm composition. Tubing fragments were taken from 25 units twice, before and after disinfection, and bacterial suspension of the biofilm was obtained from the samples. The bacterial flora was determined with the plate culture method. Bacteria were identified with biochemical microtests: API 20E, API 20NE (bioMerieux, France) and GP2 MicroPlateTM (BIOLOG, USA). Before disinfection, the following bacteria were identified: Gram-negative bacteria - Ralstonia pickettii, Pseudomonas vesicularis, Sphingomonas paucimobilis, Xanthomonas maltophilia; Gram-positive cocci - Micrococcus luteus, Micrococcus lylae, Staphylococcus cohnii, Staphylococcus lentus, Staphylococcus spp., Streptococcus spp.; Actinomycetes - Streptomyces albus. The prevailing bacteria were: Ralstonia pickettii (78.62%), found in all the units, and Sphingomonas paucimobilis (20.45%). After DUWL disinfection, Sphingomonas paucimobilis (88.79%) dominated in the biofilm, Staphylococcus spp. - 5.61% and Pseudomonas spp. - 3.74% were next most frequently occurring bacteria, and in more than a half of the biofilm samples 100% reduction of the bacterial microflora occurred. This study confirms effectiveness of Oxygenal 6 in bacterial decontamination of the DUWL biofilm.
The aim of the study was to determine bacterial endotoxin concentration in the water flowing from a high-speed handpiece of a dental unit and in the air contained in the bioaerosol formed during dental conservative treatment. The air was collected in the space between the patient and dentist. The study was conducted on 25 operative sites (units) and had two stages: before application of a dental unit waterline (DUWL) disinfectant and after a 2-week application of disinfection procedure. The research showed that the mean concentration of bacterial endotoxin in the water flowing from high-speed handpieces was significantly reduced after the use of a disinfectant. The mean concentration of bacterial endotoxin in the air was similar at both stages - before and after application of waterline decontamination procedure. The study showed that in dental air-water aerosol, water is the main source of bacterial endotoxin contaminating the aerosol during the work with dental handpieces. Application of a user-friendly water disinfectant to significantly decrease endotoxin concentration in the DUWL water and in the aerosol, is one of recommended methods to reduce health risk.
The quality of dental unit water is of great importance since patients and dental staff are regularly exposed to water from aerosols generated during work. The main purpose of this investigation was mycological evaluation of dental unit waterlines (DUWL). The author determined the number and species of fungi present in the water from a unit reservoir which is the source of water for a dental unit, in the water flowing from a high-speed handpiece of a unit, and in the biofilm samples collected from the wall of a waterline connecting a unit reservoir and dental handpieces. The following mould fungi were identified: Aspergillus amstelodami, Aspergillus fumigatus, Aspergillus spp. from Aspergillus glaucus group, Aspergillus repens, Citromyces spp., Penicillium aspergilliforme, Penicillium pusillum, Penicillium turolense, Sclerotium sclerotiorum; yeast-like fungi: Candida albicans, Candida curvata and Geotrichum candidum. Some of them, in certain circumstances, especially in people with immunological disorders, may be a cause of opportunistic infections. Thus, it is necessary that the DUWL should be submitted to a decontamination protocol and to routine microbial monitoring to guarantee an appropriate quality of water used in dental treatment.
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