Dental Handpiece Contamination: A Systematic Review Of Reprocessing Protocols And Interprofessional Responsibilities

Abstract

Background: Dental handpieces are critical instruments in routine and surgical dental procedures, yet their complex internal mechanisms make them vulnerable to microbial contamination. Inadequate reprocessing may result in cross-contamination, biofilm persistence, and occupational exposure risks for dental personnel. Despite existing infection prevention guidelines, variability in reprocessing protocols and compliance remains a concern.

Objective: To systematically review the evidence on dental handpiece contamination and evaluate the effectiveness of reprocessing protocols, while clarifying interprofessional responsibilities within dental healthcare teams.

Methods: A systematic review was conducted following PRISMA guidelines. Electronic databases were searched for studies evaluating contamination levels and reprocessing effectiveness of dental handpieces. Eligible studies included experimental, observational, and clinical assessments of cleaning, lubrication, sterilization, and storage protocols. Data were extracted on contamination outcomes (e.g., microbial counts, residual protein, ATP levels) and workflow components. Risk of bias was appraised using design-appropriate tools.

Results: Evidence indicates that contamination may persist particularly within internal turbine chambers when cleaning is insufficient or protocols deviate from manufacturer instructions. Automated cleaning systems combined with validated sterilization cycles demonstrated more consistent decontamination outcomes compared with manual-only approaches. Variability in compliance and documentation was commonly reported.

Conclusion: Effective dental handpiece reprocessing requires standardized, validated protocols and clearly defined interprofessional responsibilities to ensure patient and occupational safety.