Quality of cross-infection control in dental laboratories. A critical systematic review

Abstract

To identify reported practices for cross-infection control in dental laboratories and to quantify the importance of the flaws encountered. Systematic search (cross-infection AND dental laboratory) at EMBASE, PubMed, SciELO and Scopus databases. Papers reporting on cross-sectional studies providing original data about cross-infection knowledge, practices and attitudes of dental technicians. Papers reporting on a single laboratory or institution were excluded. Data extraction was undertaken independently by three reviewers using a purpose made form. The outcome of this study was analyzed in five aspects, namely process organization, disinfection, working environment, use of individual protective equipment and vaccination policy. The systematic search output was 1651 references and 11 papers were finally selected. Flaws were more frequently identified in terms of vaccination policy, biological safety of the working environment and use of individual protective equipment (100%). Slightly better results were found in terms of organization of the cross-infection control process (89.47%) and disinfection practices (85.71%). The application of the formula for disclosing the relative importance of the flaws identified in the literature prioritizes the need for interventions aimed at improving the organization of the cross-infection control procedures, followed by training in item disinfection. The control of the working environment together with the use of individual protective equipments rank closely in importance, followed by the existence of a vaccination policy. Sub-standard cross-contamination practices seem to be a common finding in dental laboratories, which may well compromise the quality of certain dental treatments.