Dental high-speed turbine handpiece is also referred to as dental handpiece or handpiece in the industry. However, the abbreviation of dental high-speed turbine mobile phone is ambiguous, which is easily confused with low-speed mobile phone or dental cleaning mobile phone.
In the daily clinical application of stomatology, dental high-speed turbine handpiece is one of the most important treatment tools. The invention of dental high-speed turbine mobile phone is a major breakthrough in dental cutting instruments. It can not only greatly improve the efficiency and effect of oral clinical treatment, but also greatly reduce the pain of patients in the treatment process. At the same time, the advent of dental high-speed turbine mobile phones has also triggered a major innovation in dental mobile phones around the world. In just a few years, most of the countries and regions with better economies in the world have almost completely replaced the traditional motor-driven mobile phone operation, making a great contribution to the clinical treatment and prevention of stomatology.
Since the dental high-speed turbine mobile phone is so important in the clinical application of dentistry all over the world, we might as well share all aspects of it together.
The dental high-speed turbine mobile phone, which came out in 1957, is a high-speed rotary cutting medical device driven by air flow. Its main functions are to cut teeth, prepare cavities, prepare teeth and trim teeth. The rotational speed of the commonly used ball-bearing dental high-speed turbine handpieces can vary from 300000 rpm to 500000 rpm, while the rotational speed of the suspended air bearing dental high-speed turbine handpieces can reach 600000 rpm. Although the suspended air bearing dental high-speed turbine handset has a high rotational speed and a long service life, it is rarely used because of its high noise and low torque.
The internal structure of dental high-speed turbine handpiece is extremely precise, and its machining accuracy requirements are also very high. Its appearance structure is mainly divided into three parts, namely, head, body and pipe interface. The turbine rotor located in the head of dental high-speed turbine mobile phone is called "heart", "core" or "collet" (with shell), and even called "bearing" by many people, with different names. There are also several different names in English, such as Rotor, Turbine, Cartridge, etc. The turbine rotor is the core part and the most precise part of the dental high-speed turbine handset, which is mainly composed of a clamping shaft, a wind wheel and a pair of bearings.
There are many kinds of dental high-speed turbine mobile phones. In addition to their quality differences, they also have a variety of different appearances and a variety of ancillary functions. For example, the loading and unloading methods of car needles include ejector pin type, screw type and button type; Cooling methods include single hole spray, double hole spray, three hole spray and four hole spray; With lighting function; With air blowing function; With anti-suction function; With quick connector; In terms of torque, there are also large and small, as well as mini handpieces for rear teeth and children, and even automatic pressure limiting in other aspects.
The dental high-speed turbine mobile phone is not only a high-precision, high-efficiency, but also a very "delicate" dental instrument. Therefore, we must understand its use and maintenance methods. The current laws and regulations stipulate that all medical devices sold on the market must be accompanied by a user manual to introduce users to the relevant common sense and correct use methods, as well as maintenance methods.
At present, the state attaches great importance to the management of medical devices. The dental high-speed turbine mobile phone is a regulated Class II medical device. According to the law, all medical devices sold in the domestic market must be registered by the State Food and Drug Administration before they can be sold, and the manufacturer must obtain a medical device manufacturer's license before they can be allowed to produce. At the same time, the laws and regulations stipulate that the manufacturer's full name, detailed address, contact information, medical device registration number, medical device manufacturer license number, and production date must be clearly listed on the product package of the medical device. Those who do not sell according to the regulations or use medical devices that do not conform to the relevant regulations are illegal. According to the news, many users (including medical institutions) were prosecuted and punished by the relevant departments because they did not know the relevant regulations and bought dental mobile phones that did not conform to the regulations (the packaging box did not conform to the regulations). It was a little innocent indeed.
Dental high-speed turbine handpiece is an indispensable and important equipment in the clinical treatment of stomatology, but it has to have close contact with saliva, blood, tissue fragments, secretions and dental plaque in the mouth of patients in the process of application, so its external and internal can be subject to different degrees of pathogenic microorganism pollution. Relevant data show that the diagnosis and treatment of oral diseases is one of the diagnosis and treatment items with high cross-infection rate, and plays an important role in the prevention and control of infection in hospitals. Therefore, the internal and external cleaning, disinfection and sterilization of mobile phones are very important.
In the past, the domestic industry only used alcohol or other disinfection liquids for external disinfection of dental mobile phones, including high and low speed, and little attention was paid to the internal pollution of mobile phones. In recent years, with the rapid rise of AIDS cases, the prevalence of hepatitis B, the development of information, and the increase of foreign exchanges, this cross infection problem in the process of oral medicine has attracted extensive attention and high attention from relevant departments. After years of hard research and preparation, the Ministry of Health of China has quickly taken corresponding measures and formulated relevant laws and regulations on the disinfection of oral instruments, especially the disinfection and sterilization of mobile phones.
In March 2005, the Ministry of Health issued the "Technical Operation Specifications for Disinfection of Dental Medical Devices in Medical Institutions", which made clear provisions and specific requirements for the disinfection and sterilization of oral medical devices and the prevention of hospital infection and iatrogenic infection. It is required in this document that all kinds of oral diagnosis and treatment instruments, including dental mobile phones, car needles, root canal treatment instruments, tooth extraction instruments, surgical treatment instruments, periodontal treatment instruments, dressings and so on, which come into contact with patients' wounds, blood, damaged mucous membranes or human tissues, must be sterilized before use. The document also specifically stipulates that all medical devices that enter the patient's mouth must meet the requirements of "one person, one use, one sterilization".
With regard to the disinfection method of dental handpieces, the academic community believes that it is not advisable to use chemical disinfectant immersion method for disinfection, for the following reasons: 1. Saliva, blood and other pollutants in the mouth easily enter the interior of dental handpieces, and are not easy to clean. 2、 The internal structure is relatively complex and the pipeline is narrow, which is unfavorable for the entry of disinfectant; III After the mobile phone is cleaned and lubricated, the lubricating oil will form an oil film on the inner wall of the mobile phone lumen, blocking the contact between the disinfectant and the dirt attached to the inner wall of the lumen, so it is difficult to achieve the sterilization effect; 4、 The concentration of chemical disinfectants is not easy to control, easy to make mistakes and affect the disinfection effect. 5、 Can not be monitored by biological monitoring method; 6、 Sterile operation must be followed after sterilization, such as washing with sterile water after sterilization and wiping with sterile towel after washing, which is very inconvenient; 7、 The instruments soaked and sterilized with chemical disinfectants are unpackaged. They must be used immediately after sterilization or stored in other sterile containers, otherwise they will be contaminated soon; 8、 Chemical disinfectants will cause damage to mobile phones to varying degrees and affect their service life.
In addition, the use of dry-heat disinfection method is very harmful to mobile phones, and the disinfection effect is not ideal, so it is not recommended. The reasons are as follows: First, the effective disinfection temperature must reach 170 ℃, which is too high. Due to its high temperature, it is easy to damage the molecular structure of the materials of various parts of the dental mobile phone, and even the overall structure of the mobile phone, which directly leads to the mobile phone can not continue to use. 2、 The temperature within the disinfection range is uneven, which is difficult to ensure the effectiveness of sterilization. 3、 Mobile phones are prone to discoloration and aging, affecting the appearance. 4、 It cannot be used for disinfection with packaging bags.
The use of high temperature and high pressure steam sterilizer for sterilization is currently considered to be the most effective and feasible disinfection and sterilization method, and also meets the requirements of the Technical Operation Specifications for Disinfection of Dental Diagnostic and Medical Devices in Medical Institutions issued by the Ministry of Health (implementation date: May 1, 2005).
The dental handpieces are sterilized by high temperature and high pressure steam sterilizer. The operation process is as follows:
Step 1: Check the condition of the mobile phone.
In addition to the saliva and blood of some patients, the surface of used mobile phones may sometimes be stained with some adhesive or dental filling materials. These residual substances should be removed first. Mobile phones that have problems and need to be repaired should be collected and marked before disinfection. Mobile phones should not be sent to maintenance personnel for maintenance before disinfection to avoid spreading diseases.
Step 2: Clean dental handpieces.
At present, the cleaning methods of dental handpieces mainly include manual cleaning, automatic cleaning machine cleaning, and ultrasonic cleaning machine cleaning.
1、 Manual cleaning method:
1. First of all, operators should prepare for protection, such as wearing gloves, masks, goggles, and anti-penetration aprons.
2. Rinse the outside of the mobile phone with flowing water, which can remove some dirt on the surface and even inside of the mobile phone, and reduce the load of pollutants. Only the external surface of the dental mobile phone can be cleaned, so the cleaning of the internal pipeline can only rely on high-quality cleaning lubricating oil. The air flow and some components of the cleaning lubricating oil can play a certain role in cleaning. In addition, for optical fiber dental handsets, the optical fiber should also be cleaned. Generally, alcohol cotton yarn can be used for wiping
3. Flush the pipeline with clean water for at least 30 seconds. It can remove a large amount of pollutants in the pipeline.
4. Inject cleaning from the air inlet of the mobile phone
Lubricants (different filling methods are different due to different brands and models, see the manual of dental mobile phone used). It can clean the pipes and components inside the machine head, and also play the role of mechanical lubrication, protect the bearings, reduce wear, extend the service life of the turbine components, and improve the working efficiency of the mobile phone.
2、 Use automatic cleaning machine for cleaning.
Using automatic instrument cleaning equipment to clean the mobile phone can not only clean the surface of the dental mobile phone, but also clean the internal pipeline of the mobile phone, which can achieve good cleaning effect, and is also very convenient to operate. Generally, the whole cleaning process can be completed automatically by pressing the switch of the equipment.
3、 Ultrasonic cleaning machine for cleaning.
The method of using ultrasonic cleaner to clean mobile phones has always been adopted by many people. Indeed, this method can achieve the purpose of removing dirt, and the effect is very significant. However, we do not recommend this method, because the ultrasonic shock wave will cause some damage to the bearing of the mobile phone during the cleaning process, thus affecting the service life of the mobile phone.
Step 3: Clean and lubricate the interior of dental handpieces.
The internal cleaning and lubrication of the dental mobile phone is to inject cleaning and lubricating oil into the mobile phone, which is a necessary step for the maintenance of the dental mobile phone. This step will directly affect the performance of the dental mobile phone, including its speed, torque and noise, and ultimately affect its service life. At present, the main methods of oil injection are manual oil injection and automatic equipment oil injection.
1、 Manual oil filling. At present, manual oil injection mainly uses spray type clean lubricating oil, but a few people still use more traditional oil bottle drip injection. The spray type cleaning lubricating oil is obviously more effective than the oil bottle drip method. First, the spray type cleaning lubricating oil is a pressurized air flow, which is easy to carry away the dirt in the mobile phone pipeline, and also promotes the mobile phone turbine operation, so it can more effectively remove the dirt and residual oil in the dental mobile phone turbine cavity and its bearings. Second, the clean lubricating oil sprayed by the spray type is atomized, which is conducive to its uniform adhesion in the turbine components and plays a very good protective effect. However, the traditional oil bottle drip method cannot achieve such effect.
There are several points to pay special attention to when using spray type oil injection: 1. The operator should wear a mask and goggles to prevent infection during operation. 2. Dental mobile phones should be put into prepared paper sleeves or plastic bags before oil injection, so as to prevent oil mist from polluting the surrounding environment during injection. 3. Select a suitable nozzle, align and press the air inlet at the back of the dental mobile phone for 2 seconds. 4. After injection, the dental handpiece should be operated to the normal speed to drain the excess oil in the pipe and the handpiece. After filling oil, clean the outside of the dental mobile phone, then put it into a paper-plastic composite packaging bag, and seal it with a sealing machine to prepare for the next disinfection procedure.
2、 Full-automatic oil filling equipment. In recent years, dental mobile phone oiling equipment has become more and more automatic and multifunctional. Its function is not only limited to filling oil for dental mobile phones, but also to provide "nursing services" for dental mobile phones in an all-round way. Some automatic equipment can not only complete the internal and external cleaning, bearing lubrication, residual oil removal and other procedures of dental mobile phones, but also have the function of drying. The use of fully automatic equipment can not only save time and manpower, reduce the risk of contamination of staff, but also make the working environment cleaner and sanitary. Because the automatic equipment is not manually operated, its oil injection volume is very accurate, which will not cause insufficient oil injection, nor waste due to excessive oil injection, which can save costs.
Step 4: disinfection and sterilization of mobile phones.
Before using high temperature and high pressure steam sterilizer for sterilization, there are several points that must be paid attention to. 1、 Determine the reliability of sterilization effect of sterilizer. 2、 Confirm that the mobile phone can be sterilized at high temperature. III. The disinfection packaging bag used should be able to withstand the sterilization conditions, not easy to be damaged, have good heat vapor penetration performance, and can block the invasion of microorganisms, so as to ensure that the mobile phone can be sterilized.
1、 Use a pre-vacuum high-pressure steam sterilizer for sterilization. Traditional sterilizers have different levels, which can be generally divided into two types: those with pre-vacuum and those without pre-vacuum. To achieve good high-temperature sterilization effect, it is best to use high-pressure steam sterilizer with three pre-vacuums.
Put the packed mobile phone into the high-pressure steam sterilizer with pre-vacuum, and the paper surface of the paper-plastic composite packaging bag is upward, so as to ensure that there is an appropriate gap between the packaging bags to facilitate the discharge of air during pre-vacuum, the infiltration of steam during sterilization, and the discharge of moisture during drying.
In the sterilization process of mobile phones, to ensure the effectiveness of sterilization, it must be maintained for at least 3 minutes when the temperature reaches 134 ℃, or at least 15 minutes when the temperature reaches 120 ℃. The high-pressure steam sterilizer with pre-vacuum will automatically start after the sterilization process is completed
Vacuum heating and drying procedure can remove the residual humidity of the mobile phone, and the drying effect is ideal.
II Sterilize with card steam sterilizer.
Card steam sterilizer is a kind of disinfection equipment specially designed for rapid sterilization of medical devices, which can save time. The whole process of sterilization of non-wrapped devices only takes 6-9 minutes, which is conducive to the turnover of devices. The use concept of the card type steam sterilizer is the tray type disinfection method without wrapping the instruments. The Technical Operation Specification for Sterilization of Dental Medical Devices in Medical Institutions states that the sterilization instruments using the quick card type sterilizer can be packed without sealing the bag, and can be stored in the sterile container for standby after exposed sterilization, but once opened for use, the validity period shall not exceed 4 hours. Due to the short sterilization cycle of the card steam sterilizer, the damage to the equipment is relatively small. It is very suitable for sterilization of dental handpieces.
Step 5: mobile phone sterilization effect test.
We have paid so much manpower and material resources to sterilize mobile phones in order to ensure the effectiveness of preventing cross infection, so the final procedure of mobile phone sterilization effect detection is very important. No matter what kind of steam we use