Innovation by Computer-Aided Design/Computer-Aided Manufacturing Technology: A Look at Infection Prevention in Dental Settings

Table 1

Main differences for cross-infection prevention in the case of traditional technology vs. CCT in dental office and DL.

n°	Need for	Traditional Technology	CCT
1	effective communication and coordination between the dental office and laboratory efforts to asepsis	yes	only in the case of intermediate and completed cases
2	written information regarding the methods (e.g., type of disinfectant and exposure time) used to clean and disinfect the material (e.g., impression, stone model, or appliance) and items (articulators, case pans, or lathes) according to the manufacturer’s instructions.	during all phases	only in the case of intermediate and completed cases
3	heat-tolerant items used in the mouth (e.g., metal impression tray or face bow fork) that should be heat-sterilized before being used on another patient or single-use plastic impression trays	yes	only for scanner tips
4	clean and disinfected pressure pots and water baths between patients since these are particularly susceptible to contamination by microorganisms	yes	No/ only for positioning wax
5	wearing appropriate PPE (including eyewear!) in both the office or laboratory, when handling contaminated items and until disinfection is completed	yes	only in intermediate and completed cases and after the end of the CAD
6	guarantee that the appropriate and effective cleaning and disinfection procedures are performed in the dental office or laboratory	+++	+
7	use an EPA-registered hospital disinfectant with a tuberculocidal claim, follow IFU and thoroughly rinse item before being handled in the in-office laboratory or sent to an off-site laboratory	yes	no
8	checking IFU and problems regarding the stability of impression and appliance materials during disinfection	yes	no
9	cleaning and disinfection of any items (impressions, prostheses, or appliances) as soon as possible after removal from the patient’s mouth before drying of blood or other bioburden that can occur	yes	only in intermediate and completed cases
10	a separate disinfecting, sending, and receiving area should be established to reduce cross-contamination in the dental office	yes	easier and only in intermediate and completed cases
11	identification and reduction of redundancies of procedures since impression materials could be damaged or distorted because of disinfectant overexposure	yes	no
12	cleaning, disinfecting, and covering of clinical contact surfaces as a function of the rate of use and contamination of the area	+++	+
13	fabricating stone casts after alginate impression as soon as possible to avoid dimensional changes	yes	no
14	adhesive for impression trays using some impression materials (polyether, polysulfide)	yes	no [18]
15	wastage of impression materials due to the remaking at times of conventional dental impression for inadequate detail production	yes	no
16	wastage of time due to the remaking of dental impression for inadequate detail production	+++	+
17	appliances and prostheses that should be free of contamination delivered to the patient	difficult	easy
18	responsible dental laboratory or dental office staff for the final disinfection process	yes	yes
19	a separate receiving and disinfecting area should be established to reduce contamination in the DL	yes	in intermediate and completed cases
20	waste (gypsum, waxes) management according to national laws	yes	no
21	Appropriated disposal of gypsum and toxic substances (i.e., hydrogen sulphide) when discarded into the environment	yes	no
22	laboratory items (e.g., burs, polishing points, rag wheels, or laboratory knives) which are heat-sterilized, disinfected between patients, or disposable items, or to store items in small quantities (i.e., polishing agents)	yes	low and only to reduce manufacture contamination
23	regulated medical waste and sharp items (e.g., burs, disposable blades, and orthodontic wires) in specific and resistant containers according to national rules	+++	+
24	paper for dentist prescription to DL	yes	no
25	computer antivirus	no	yes