SECTION EDITOR
a surface disinfectant on a
ichard A. Bass, DDS,a Kevin D. Plummer,
Eugene F. Anderson, MBAC
United States Army Dental Activity, Fort Hood, Texas
This study determined the effect of a disinfectant
samples were immersed in a disinfectant solution and in control solutions. The
results indicate that a saturated calcium sulfate (clear slurry) solution with 0.525%
sodium hypochlorite was an effective disinfectant
dental cast. (J PROSTHET DENT 1992;67:723-5.)
he use of various disinfectants on dental impres-
sion materials is well documented.lm5However, many clini-
cians are unsure of the correct disinfection steps to use and
many dental laboratories are receiving dental casts that
may not be properly disinfected. The dental technician is
at risk for contracting infectious diseases from contami-
nated materials.6 The obvious solution is to use a method
to disinfect a dental cast without damage that is at the same
time inexpensive, reliable, and time-effective. Some infor-
mation is available on the biologic effect of cast disinfec-
tion on contaminating organisms.7 However, a qualitative
analysis on the effect of the disinfecting method on the
dental cast has not been documented. There is a general
lack of information on new infection control methods for
use in the laboratory. These critical concerns led to this in-
vestigation. The purpose of this study was to quantify one
method for dental laboratory personnel to use when a den-
tal cast is received th.at may have a questionable disinfec-
tion status.
The use of clear slurry water (saturated calcium sulfate)
is a reliable method for soaking dental casts with no dam-
age to the surface.8 This method of cast treatment is the
basis for the disinfection procedure that will be examined
in this article. This investigation compared the effects of a
solution of saturated calcium sulfate and of a solution of
saturated calcium sulfate with 0.5 % sodium hypochlorite
(disinfectant) on gypsum casts and related this data to
clinical practice.
The opinions and assertionscontainedherein arethe private views
of the authors and are not to be construed as official or as
reflecting the views of the Department of the Army or the De-
partment of Defense.
%Iajor, Dental Corps, USA; Senior Resident, Advanced Educa-
tional Program in General Dentistry.
bMajor, Dental Corps, USA; Chief, Removable Prosthodontics;
Assistant Director, Advanced Educational Program in General
Dentistry.
Wajor, USA; Testing and Experimentation Command.
1Ol1133588
THE JOURNAL OF PROSTHETIC DENTISTRY
DDS,b and
solution on dental casts. Stone
and acted without damage to the
MATERIAL AND METMODS
Test specimens were made in the following manner. Hy-
drophilic vinyl polysiloxane impression material (Reprosil,
L. D. Caulk Division, Dentsply International, Milford,
Del.) was used to make impressions of a stainless steel test
block as described in American Dental Association (ADA)
Specification No. 19.gThese impressions were used to pre-
pare test casts of improved dental stone (Vel-Mix Stone,
Kerr Corp., Romulus, Mich.) according to ANSI/ADA
Specification No. 19.g
Thirty acceptable impressions were made from the orig-
inal stainless steel test block. The impressions were used
according to the specification to produce 30 acceptable
dental casts for the t&t procedure. The reproduction of a
0.025 mm line on the test specimen was the surface detail
to be analyzed after immersion in three different solutions.
The 30 casts were randomly divided into six groups for the
testing procedure.
The three types of solutions to be tested for their effects
on the surface of the casts were prepared in the following
manner. One week before the test date, a solution of tap
water was placed in a clean plastic container 9 inches in di-
ameter and 2 inches high. A watertight cover was placed on
the container. This solution was labeled test solution 1. The
second test solution was made by placing clean: fully set
dental stone pieces in a clean plastic container identical to
the one used for solution No. 1, and filling this container
with distilled water. This solution was not to be used for 48
hours to allow the dissolution of the calcium sulfate from
the dental stone. This was then a typical saturated calcium
sulfate (clear slurry) solution used to wet dental casts
without surface damage during laboratory procedures.
This solution was labeled test solution 2. The third test so-
lution was made by placing clean, fully set dental stone
pieces in a clean plastic container identical to the others,
and filling this container with sodium hypochlorite diluted
to a 0.525 % concentration with distilled water. This solu-
tion was labeled test solution 3. Test solution 3 has been
shown to be an effective antimicrobial agent when used on
dental stone casts for periods of at least ‘/z hour.7
723
 BASS, PLUMMER: AND ANDERSON

Slurry Water Slurry/Disinfectant Tap ater

SAMPLE
m Half H our Exposure EM One H our Exposure
Fig. 1. Summary of raw data. Average scores by all evaluators on test specimens.

Table I. Protocol for test specimens microscope and the following grading criteria: Score the
test specimen on a scale of one to four. A score of one in-
Test soltation 30 minutes 60 minutes
dicates perfect reproduction of the grooves of the steel die;
Tap water n=5 n=5 a score of two indicates very good reproduction with some
Clear slurry n=5 n=5 surface distortion; a score of three indicates loss of conti-
Slurry/Disinfectant n=5 n=5 nuity of the test lines; and a score of four indicates complete
obliteration of most of the grooves. All 30 specimens were
given to the evaluator in random order without the evalu-
Table II. Linear combinations for testing ator’s knowledge of the test that had been run on the spec-
imen. Fig. 1 represents the average scores by all evaluators
Analysis of variance on the test specimens. A repeated measurement analysis of
Degrees of Sum of Mean F p variance procedure was used to analyze the scores assigned
Source freedom squares square value Value to each specimen (Table II).

Solution 2 44.52 22.26 71.97 0.01 RESULTS

Time 1 4.23 4.22
Solution x Time 2 1.28 0.64
The test specimens were randomly assigned to test solu-
tions and immersion times in the manner described in Ta-
ble I. The test solutions were at room temperature for the
duration of the investigation. After complete immersion for
the specified time interval, the test casts were allowed to
dry in air for 24 hours before evaluation.
13.64 0.01
The most important source of variation wa.s the solution
2.08 0.13
(tap water or slurry or slurry/disinfectant) (Table II). The
pattern of means for the different solutions was not the
same for the three test solutions (Fig. 1). The mean values
for tap and slurry water were considerably higher than the
mean values for slurry water with disinfectant.
Fig. 1 shows that the pattern of means for tap water and
slurry differed significantly from the pattern for slurry wa-
ter with disinfectant. It should be noted that no test spec-
imen from the slurry water with disinfectant group was
given a score higher than 1.5 points.

Evaluation of the test specimens was carried out by four DISCUSSION

evaluators. The evaluators were given a stone sample of the The results indicate that tap water can damage the sur-
test specimens that had not been immersed in any test so- face of dental stone casts over a period of time. The use of
lutions as a control. They were given a 20 power binocular clear slurry water to wet cast surfaces without clinically

724 MAY 1992 VOLUME 67 NUMBER 5

DISINFECTING DENTAL CASTS
significant damage was supported by this investigation.
The addition of the sodium hypochlorite to the clear slurry
as a disinfectant did not cause any damage to the surface
of the test specimens.
The use of clear slurry water with disinfectant can be
easily incorporated into the daily routine in any dental of-
fice or laboratory to provide a reliable, inexpensive proce-
dure to ensure the proper disinfection of stone casts. Even
though disinfection at the clinician level is a more preferred
method, the backup procedure can be used in all laborato-
ries to include those casts that may not have had proper
disinfecting steps before the stone was poured.
Thirty improved stone test specimens were fabricated in
a uniform manner. Five were totally immersed in tap wa-
ter for Yz or 1 hour. Five were totally immersed in clear
slurry water for l/z or 1 hour. The remaining specimens
were totally immersed in clear slurry water/O.525 % sodium
hypochlorite solution for YZor 1 hour. Four evaluators ex-
amined the stone surfaces and scored the specimens
according to the damage of the specimen surface by the test
solutions. An analysis of variance (ANOVA) was applied to
the data.
As has been known for some time, even short exposure
to tap water can damage the surface of stone casts. Clear
slurry water provides the wetting needed for laboratory
procedures without cast damage. In this study the addition
of sufficient sodium hypochlorite to act as a disinfectant to
the clear slurry water did not cause any change to the
THE JOURNAL OF PROSTHETIC DENTISTRY
quality of the cast surface compared with the plain clear
slurry water. The addition of the sodium hypochlorite to
clear laboratory slurry costs little in both material and time
for the clinician or technician. Even if the clinician prop-
erly disinfects impressions before laboratory handling, the
clear slurry/disinfectant soak reminds the technician each
time the cast is handled that his or her health is being pro-
tected.
REFERENCES
1 Tyler R, Tobias RS. An in vitro study of the antiviral properties of an
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1989;17:137-9.
2. Wilson SJ, Wilson HJ. The effect of chlorinated disinfecting solutions
on alginate impressions. J Restor Dent 1967;3:86-9.
3. Johnson GH, Drennon DG. Accuracy of elastomeric impressions disin-
fected by immersion. J Am Dent Assoc 1980;116:525-30.
4. Minagi S, Yano N. Prevention of acquired immunodeficiency syndrome
and hepatitis B. Part II. Disinfection method for hydrophilic impression
materials. J PROSTHET DENT 1987;58:462-5.
5. Herrera SP, Merchant VA. Dimensional stability of dental impressions
after immersion disinfection. J Am Dent Assoc 1986;113:419-22.
6. Sabatini BM. Don’t let it happen to you-precautions against hepatitis
B and other infectious diseases. Trends Techniques Contemp Dent Lab
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I. Tebrock OC, Engelmeier RL. Managing dentai impressions and casts of
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8. Rudd KD, Morrow RM. Comparison of effects of tap water and slurry
water on gypsum casts. J PROSTHET DENT 1970;24:563-9.
9. ANSI/ADA Specification no. 19. Chicago: American Dental Association,
1976:sections 4.3.7-4.3.7.2 and section 4.3.8.
Reprint requests to:
DR. R. A. BASS
USA DENTAL ACTIVITY
FORT JACKSON. SC 29207
725