This review aimed to evaluate the contamination rate of dental unit waterlines (DUWL) with Pseudomonas aeruginosa and Legionella pneumophila in several countries in the Middle East.Literature search was conducted in databases such as PubMed, Scopus, Web of Science, and Google Scholar to gather studies published from the beginning of 2000 to 30th April 2020. Medical Subject Headings (MeSH) terms were; \"Legionellosis\"; \"Legionnaire\", \"Legionellosis\", \"L. pneumophila\", \"dent\", \"dental\", \"dentistry\", \"Dental Unit Waterlines\", \"dental water\", \"DUWL\", \"Middle East\", \"P. aeruginosa\", \"Iran\", \"Turkey\", \"Iraq\", and \"Jordan\". The search was independently conducted by two of the authors. Data was analyzed using Comprehensive Meta-Analysis software.Almost all studies included in this review reported a high rate of bacterial contamination of DUWL, which exceeded the current standard bacterial contamination level of <200 (CFU) mL-1 recommended by the American Dental Association (ADA). The combined prevalence of L. pneumophila from four countries (Iran, Jordan, Turkey, and Iraq) was 23.5% (95% Cl: 6.5-57.7), and the combined prevalence of P. aeruginosa was reported 21.7% (95% Cl: 7.1-50.1%).This study showed a high bacterial contamination rate of DUWL with opportunistic pathogens. So, it is recommended to prevent biofilm formation in DUWL, some measures should be extended by practical approaches allowing for water quality control and improvement on-site in the dental practices such as mobile filtration units, chlorination and disinfection chemicals.

UNASSIGNED: Dental unit water lines (DUWLs) may be contaminated by aerobic bacteria in clinical settings and comprehensive disinfecting methods should be considered without delay. Herein, this study aims to investigate the timeliness and dynamic bacteriostatic effects of different forms of nanometer silver (NMS) disinfectant on bio-film in DUWLs.
UNASSIGNED: Bacterial DUWLs samples were respectively treated with different NMS forms, including liquid phase and solid phase at the concentrations of 0.25%, 0.5%, 1% and 2% and their bacteriostatic effects were observed at the 1st, 4th, 7th, 14th, 28th day.
UNASSIGNED: The bacteriostatic effects of liquid phase NMS at all concentrations were unsatisfactory and the bacteriostatic rate was only 20% at the 1st day. However, there appeared massive bacteria growth at the 4th, 7th, 14th, 28th day. Comparatively, no bacteria growth was found at the 1st, 4th, 7th, 14th, 28th day after sterilizing with different concentrations of solid phase NMS and the bacteriostatic rate was 100%.
UNASSIGNED: Microbial contamination in DUWLs can be disinfected by different NMS forms, among which solid phase NMS is more bactericidal against bacteria bio-films, demonstrating significant roles of solid phase NMS in preventing DUWL contamination.

Contaminated dental unit water lines (DUWLs) are a possible source for spreading micro-organisms in dental practices. This study reports the microbial load of the water from DUWLs of a large dental school over time. The water quality of 231 dental chairs was tested three times over 1.5 years; 175 DUWLs at student clinics and 56 DUWLs at staff clinics. DUWLs at the staff clinics met the Dutch requirement of 100 colony-forming units/mL. An increasing number of DUWLs at the student clinics complied with this requirement, indicating that the local protocols are adequate but that compliance can be improved.

BACKGROUND: Routine dental procedures produce aerosol and splatter, which pose a potential risk to the clinician and dental personnel, as well as the immunocompromised patient. Reports indicate that the ultrasonic scaler is the greatest producer of aerosol and splatter.
OBJECTIVE: The study aimed to evaluate the contamination distance, contamination amount and contamination duration of aerosol produced during ultrasonic scaling.
METHODS: The study was performed on a mannequin fitted with phantom jaws on a dental chair. Mock scaling was done for 15 min using an auto-tuned magnetostrictive ultrasonic scaler with the simultaneous use of a low volume saliva ejector. An ultrafiltrate-containing fluorescent dye was used in the reservoir supplying the scaler unit. Filter paper discs were placed in different positions and distances in the operatory. Immediately following scaling, the filter paper discs were replaced with new ones. This was done every 30 min for a total duration of 90 min.
RESULTS: Maximum contamination was found on the right arm of the operator and left arm of the assistant. Contamination was also found on the head, chest and inner surface of the face mask of the operator and of the assistant. The aerosol was found to remain in the air up to 30 min after scaling.
CONCLUSIONS: The occupational health hazards of dental aerosols can be minimized by following simple, inexpensive precautions.

A dental unit water line (DUWL) equipped with a device designed to automatically and continually flush a bacteriostatic solution of hydrogen peroxide (WHE) and a discontinuous disinfecting system (BIOSTER) was evaluated. In the first instance a preliminary sensitivity test on a large number of microorganisms (bacteria and fungi) was tried with a H(2)O(2) range from 100 to 800 ppm. The bacteria frequently reported in DUWL (including Pseudomonas spp, Streptococcus spp., Staphylococcus spp., E. coli) and some periodontal pathogens showed a minimum inhibitory concentration from 100 to 300 H(2)O(2 )ppm (also including M. marinum and C. albicans). However, H(2)O(2) did not show any inhibitory effects against: A. actinomycetemcomitans, C. glabrata C. parapsilos, F. nucleatum, M. micros. In a second step, the DUWL was experimentally infected with S. faecalis, E. coli, P. aeruginosa, S. aureus. After disinfection steps with 3% H(2)O(2), the inhibitory effect on planktonic forms and on sessile biofilm was measured. In a third step, the count of 16S rRNA gene copies by real time PCR at different points of the DUWL described an accrue of bacterial slime in \"hot spot\" regions characterized by irregular/slow water flux (valves, elbows). However these results suggest that hydrogen peroxide is not only able to inhibit bursts of planktonic bacteria inside the DUWL, but that it could also be effective against sessile biofilm containing heterotrophic microorganisms derived from domestic water line contamination. In addition some oral pathogens could be contaminating and surviving in DUWL.