Decontamination and use of endodontic hand files in dental practice in Pretoria

Abstract

The risk of cross-contamination validated the need to assess the adequacy of cleanliness of dental instruments following decontamination procedures. Neither the extent of single-use nor the efficacy of decontamination of endodontic hand files following routine cleaning and sterilisation procedures in South Africa was known. The first aim of this study was to determine the amount of visible debris left on endodontic hand files collected from dental practice in Pretoria, South Africa, following the application of routine decontamination procedures. Secondly, the study aimed to determine the prevalence and attitudes regarding the single-use of these instruments. Twenty-seven dental practices voluntarily took part in this study. Each participant was requested to submit 15 previously used and decontaminated endodontic hand files. A short questionnaire regarding the single-use of endodontic files was completed by participants. A coding system was used to guarantee the anonymity of the participants. Files were examined for the presence or absence of remnant debris using a stereomicroscope at ten and 40 times magnification. A novel scoring system was used to rate the position of the debris. Statistical evaluation of the data estimated the frequency and proportions of debris on the endodontic hand files, in each scoring position. Cohen’s Kappa statistic was used to assess the repeatability of the scoring system. Four hundred and one endodontic hand files were collected from 27 participants. It was found that 94% of the samples were contaminated with debris. Examiner agreement was found to be fair to moderate over the entire dataset. No participants reported practising the single-use of endodontic hand files. Great variation existed in the way that endodontic hand files were decontaminated. The primary reason provided by participants for the re-use of endodontic hand files was financial concerns regarding single-use protocols.