WO2008116576A1

WO2008116576A1 - Device having at least one nozzle tube pair for cleaning, disinfecting and lubricating small-diameter medical instruments

Info

Publication number: WO2008116576A1
Application number: PCT/EP2008/002147
Authority: WO
Inventors: Gerhard HÜCKER
Original assignee: Sinepro Gmbh
Priority date: 2007-03-24
Filing date: 2008-03-18
Publication date: 2008-10-02
Also published as: DE102007014213A1; DE102007014213B4

Abstract

The invention relates to a device and a method for cleaning, disinfecting and lubricating small-diameter medical instruments (8), characterized in that the device (1) comprises a cleaning cylinder (2), a closing cover (4) on the cleaning cylinder (2) with a standard adapter (5) that is suitable for receiving the medical instrument (8), a drive unit (6) for moving the nozzle tube pairs (3) or the standard adapter (5), a means for supplying lubricating oil in the closing cover (4), feed lines in the closing cover for introducing water, disinfecting solution or air into the spray channels of the medical instrument (8), a pressure tank A and a pressure tank B (7a, 7b), and a control device having an operating unit, wherein due to the relative mobility between the nozzle tube pair, or pairs, and the standard adapter the treatment media are fully applied to the instrument to be cleaned.

Description

Device with at least one nozzle tube pair for cleaning, disinfecting and lubricating Englumigen medical instruments

The invention relates to a device and a method for cleaning, disinfecting and lubricating Englumigen medical instruments, in particular for the cleaning, disinfection and lubrication of dental hand, angle or turbine pieces.

In general, rotating or oscillating instruments for surgical, periodontal or endodontic procedures can either be prepared by machine or manually. In the latter option, external cleaning and disinfection are carried out manually without a treatment device, generally by wiping with a surface disinfectant, followed by internal cleaning and care with an oil, and final sterilization in the steam sterilizer. In particular, the initial manual external cleaning is often insufficient or not sufficiently standardized and is also associated with infection risks for the person responsible for the cleaning.

Automated refurbishments are often performed using thermal cleaning and disinfection procedures in equipment with means to connect the medical instruments and validated program sequences for exterior and interior cleaning, exterior and interior disinfection, care and lubrication and possible subsequent steam sterilization. In the case of corresponding devices for dry cleaning and disinfection, an integrated heat step or a subsequent steam sterilization is generally provided.

According to DE 196 26 871 a flushing device for internal flushing and holding dental handpieces and contra-angles is known, which are arranged in an instrument insert in the washing chamber of a program-controlled dishwasher and supplied with pre-filtered rinse and cleaning liquid become. However, such a device has the disadvantage that a complete area-wide surface cleaning of each individual instrument can not be guaranteed and also no simultaneous lubrication of the drive of the instrument takes place.

DE 40 24 171 describes a process for the care of, in particular, medical and dental instruments, which comprises the steps of external cleaning, disinfection, internal drying and care, post-purification and external drying and cooling. This known method has the disadvantage that the disinfection takes place by boiling in a water bath, which requires a complex heating of the water in a boiler to about 80 ⁰ C. In addition, the entire process duration is about 20 minutes.

According to DE 42 44 753 a device for cleaning and / or disinfecting and / or care of medical or dental processing instruments, in particular handpieces, with a washing container and at least one carrier for arranging the processing instrument in the washing is known. In this case, water is heated accordingly for the purpose of disinfection, so that in a treatment step C, the handpieces inside and outside wetted with boiling water and thus can be disinfected. The whole process takes about 20 minutes.

According to EP 0 403 442 a disinfecting system for handpieces of dental equipment is known, consisting of a container, a tank for receiving disinfecting liquid, at least one spraying device which is controllably supplied with the liquid from the tank for receiving disinfecting liquid and a means for Generation of heat inside the container. With this system, a disinfection of an instrument with the help of heat and chlorine water is achieved.

WO 96/41686 A1 describes a device for the exterior and interior cleaning and sterilization of dental, surgical and veterinary instruments, comprising a chamber with an outer wall and an inner wall. wall, which are separated by a cavity, wherein holes are provided on the inner wall, can be sprayed by the fluids and / or air in a predetermined order on the instrument. The chamber has in particular a downwardly tapering, conical shape.

No. 6,773,685 B2 discloses a device for disinfecting and sterilizing dental handpieces, wherein, for example, water or compressed air can be sprayed and sucked off via bores let into the bottom of a cleaning vessel. With this device, a cleaning of channels within the instrument as well as an oiling of the drive can be achieved.

According to WO 2006/039509 A1, a sterilization device for dental handpieces is described, wherein steam can be introduced via at least four openings in the bottom of the steam chamber.

US 2006/0104875 A1 describes a device for sterilizing dental handpieces in a pressure chamber, wherein water or steam are introduced into the chamber via bores at the bottom of the pressure chamber.

According to US Pat. No. 4,988,485 A, a device for cleaning and disinfecting medical and surgical instruments is described, wherein the inner wall of a tubular body is equipped with atomized disinfectant atomizing nozzles and each nozzle is assigned to an injector, to which the disinfecting liquid and compressed air are supplied. The air supply means of the injectors comprise a circular and circular, extending over 360 degrees line, which is arranged around the tubular body in a direction transverse to the axis of its plane.

DE 43 23 815 A1 describes a method and a device for the hygienic preparation of medical instruments, wherein nozzle arms arranged around the instrument in a star or triangular manner are arranged on a mold. housing wall, which limits the cleaning chamber on the back, are fixed. The nozzle arms are formed as hollow conduits and have a plurality of nozzle outlet openings, which are arranged aligned at a certain angle to the surface of the instrument. The nozzle bores can be arranged along the nozzle arms not only in one plane but in several planes offset from one another by a certain angle.

The known devices or methods of the type mentioned above have the disadvantages that either no simultaneous cleaning, disinfecting and lubricating medical instruments is possible or the combination of the used cleaning and disinfection steps is unfavorable. Thus, in the known systems, a heat step is usually integrated, which in addition to a thermal load on the medical instrument also has the consequence that possible residual impurities harden and remain permanently attached to the instrument. Furthermore, the cleaning or disinfecting medium is introduced in a fixed direction in the said devices, which may not be ensured in particular, especially in angled instruments complete coverage of the surface with the treatment medium.

The object of the present invention was to overcome the disadvantages of devices for cleaning, disinfecting and lubricating medical instruments, in particular dental hand, angle or turbine pieces, in particular an autoclaving step and also other heat treatments for the purpose of germ killing should be avoided. Furthermore, the process should be carried out in a space-saving device in the shortest possible time. In addition, prior to the disinfecting step, such efficient and complete purification takes place, which above all completely removes protein contaminants on the surface and inside the medical instrument. The above-mentioned object has been achieved by a device for cleaning, disinfecting and lubricating narrow-gauge medical instruments, the device comprising a cleaning cylinder, a closure lid on the cleaning cylinder with a standard adapter suitable for receiving the medical instrument, a drive unit for moving the Nozzle tube pairs or the standard adapter, a means for the supply of lubricating oil in the closure cap, - Supplements in the cap for introducing water, disinfectant solution or air in the spray channels of the medical instrument, a pressure vessel A and a pressure vessel B and a control device with a control unit comprises , wherein - in the cleaning cylinder at least three by 75 to 130 ° radially and by 5 to 30 mm axially movable nozzle tube pairs are arranged, wherein a nozzle tube pair each consists of two nozzle tubes with different diameters and the smaller Düsenr ear of each nozzle tube pair is arranged in each case laterally to the large nozzle tube and the closure cap is statically supported with the standard adapter; or in the cleaning cylinder at least one static nozzle tube pair is arranged, wherein a nozzle tube pair each consists of two nozzle tubes with different diameters and the smaller nozzle tube of each nozzle tube pair is arranged laterally to the large nozzle tube and the standard adapter radially and by 5 to 30 mm axially movably mounted with respect to the nozzle tube pair (s); or in the cleaning cylinder at least one movable nozzle tube pair is arranged, wherein a nozzle tube pair each consisting of two nozzle tubes with different diameters and the smaller nozzle tube of each pair of nozzle tubes each arranged laterally to the large nozzle tube and the standard adapter is statically supported and the nozzle tube pair / s on a circular path along the inner wall of the cleaning tion cylinder axparallel around the standard adapter are guided around.

Very important for the effectiveness of the device according to the invention, on the one hand, the relative movement between the instrument attached to the standard adapter and the nozzle or the nozzle / s and on the other hand, the simultaneous treatment of Sprühkanäle the medical instrument. This ensures that the entire surface and the spray channels of the medical instrument are cleaned and disinfected. Thus, a complete movement of the instrument to be cleaned with the treatment media is achieved by a relative mobility between the nozzle tube pair (s) and the standard adapter or the instrument attached thereto via a further specific adapter. At the same time the drive of the instrument is lubricated.

A particularly effective and thorough cleaning is achieved with a device comprising a cleaning cylinder, a closure cap on the cleaning cylinder with a standard adapter suitable for receiving the medical instrument, a drive unit for moving the nozzle tube pairs, a means for supplying lubricating oil in the closure cap , Feeds in the closure cap for introducing water, disinfectant solution or air into the spray channels of the medical instrument, - a pressure vessel A and a pressure vessel B and a control device with a control unit, wherein in the cleaning cylinder at least three, preferably exactly three or four, by 75 up to 130 ° radially and by 5 to 30 mm axially movable nozzle tube pairs are arranged, wherein a nozzle tube pair each consisting of two nozzle tubes with different diameters and the smaller nozzle tube of each nozzle tube pair laterally to the large Düsenro hr is arranged and the cap is stored statically with the standard adapter. In a further advantageous embodiment variant, the drive unit, which is arranged outside the cleaning cylinder, consists of a lifting device, preferably a lifting motor, and a device, preferably a motor, for the oscillation. It is particularly advantageous if each nozzle tube pair has 8 nozzles each. In this case, for example, 4 nozzles may be provided in each nozzle tube. Of course, more than 4 or fewer than 4 nozzles per nozzle tube may be present. But of particular advantage is a matching number of nozzles in the two nozzle tubes of a nozzle tube pair, which are particularly advantageous also mounted at a height.

The cleaning cylinder may for example have a diameter of 60 to 90 mm, preferably 75 mm, and for example a height of 160 to 210 mm, preferably 185 mm. The cleaning cylinder may be made of polyamide, for example.

In such a device can be used according to the invention particularly advantageous for simultaneous cleaning, disinfecting and lubricating dental hand, angle or turbine pieces.

It is also advantageous if the three nozzle tube pairs are arranged to be axially movable by 95 ° and by 16 mm. Such axial and radial movement of the nozzle tube pairs ensures that the spray pattern covers the entire instrument and thus ensures complete cleaning and disinfection of the entire surface.

Furthermore, it is advantageous if the smaller nozzle tube of each nozzle tube pair has smaller nozzles than those of the large nozzle tube. In this case, it is also advantageous if the exit angles of the nozzles of the smaller nozzle tube are inclined by 30 to 60 °, preferably by 45 °, to those of the large nozzle tube. In an advantageous embodiment of the device according to the invention, cleaning and / or disinfecting agents are located in one or more storage containers inside or outside the device. This has the advantage that the cleaning and / or disinfecting agent from one or more storage containers in the pressure vessel B can be fed. Preferably, the disinfectant is an alcoholic compound, most preferably isopropyl alcohol, or a mixture of different alcohols. Alternatively, the cleaning and / or disinfecting agent may be a two-component mixture, with chlorine dioxide being produced by the mixture of the two components. The disinfectant may contain a peroxide compound. According to the invention, however, any other disinfectant may be used as individual components or two- or multi-component mixtures depending on the application. For example, surfactant-containing detergent mixtures or the like can be used as cleaning agents.

From the use of an alcoholic disinfectant there is the advantage that it evaporates automatically after completion of the disinfection of the O- berfläche of the instrument to be cleaned. Even if, on removal of the instrument from the device, residues of the disinfectant were still present on the surface, they would evaporate outside the device after a short time. Optionally, however, the device may include a suitable means for heating the interior of the cleaning cylinder and / or the surface of the medical instrument, so that the drying of the instrument is accelerated or assisted.

It is also advantageous if the means for supplying lubricating oil in the Verschliussdeckei in the drive of the medical instrurnents with a reservoir, which is located inside or outside of the device, is connected. In this case, the means in the closure cap for the supply of lubricating oil in the drive of the medical instrument is preferably connected to a reservoir. Further advantages result from a method according to the present invention for cleaning, disinfecting and lubricating English language medical instruments with a drive in a device according to one or more embodiments described above, the method comprising the following steps:

Fixing the medical instrument via an adapter specific to the instrument on the standard adapter of the lid, retracting, for example shutting down, the instrument in the cleaning cylinder and switching on the drive, - injecting a small amount of a special lubricating oil into the drive of the instrument, wherein in the drive to the end A pre-cleaning phase in which dirt is soaked on the instrument by the misting of water and / or a surfactant-containing cleaning agent, a high-pressure washing with drinking water and finally with air, a disinfection phase in the disinfectant on the inner and the outer surface of the instrument is applied, optionally a Nachspülphase in which the disinfectant is removed from the inner and outer surfaces of the instrument, simultaneous co-treatment of Sprühkanäle during the respective cleaning or Disinfection steps with water and / or a cleaning agent, disinfectant solution or air in instruments with spray channels, - if necessary, drying of the instrument and

Disconnection of the compressed air and the drive of the instrument and extension of the instrument.

To carry out this procedure, only the following system requirements on the device or in the environment are necessary: electrical voltage, water and compressed air must be present, at least one container for a disinfectant must be filled and lubricating oil must be filled in another container. Furthermore, it is advantageous if the spray channels of the instrument are also treated in parallel during the respective cleaning or disinfection steps. For this purpose, water or disinfectant solution as well as air can be introduced into the spray channels of the medical instrument via appropriate feeds in the closure cap of the cleaning cylinder via adapters into the medical instrument. In this case, a particularly effective cleaning can be achieved when the water and / or the air is pressed pulsating out of the nozzles or passed through the channels of the instrument.

It is furthermore of particular advantage if the method comprises the following steps:

a) fixation of the medical instrument via an adapter specific to the instrument on the standard adapter of the cover with a slight rotation, b) retraction of the instrument in the cleaning cylinder and switching on the drive, c) injecting a small amount of a special lubricating oil into the drive of the instrument, wherein d) introducing water from a pressure vessel B by means of compressed air into the spray channels of the instruments and into the three larger nozzle tubes for 10 seconds, the water leaving the nozzles being compressed with compressed air e) first phase of a high-pressure wash with drinking water and / or a cleaning agent from the pressure vessel A for 10 seconds, wherein the water and / or the cleaning agent blown out with a compressed air of 6 bar from the nozzles of the smaller nozzle tubes f) second phase of the high pressure wash m it air from the pressure vessel A for 10 seconds, g) disinfection for 30 seconds analogously to process step d) with disinfectant solution from the pressure vessel B instead of water, h) rinsing for 30 seconds identical to method step d), i) drying for 10 seconds identical to method step f) and j) switching off the compressed air and the drive of the instrument and extending the instrument.

According to this method, preferably dental handpieces, angle pieces or turbine pieces can be cleaned, disinfected and lubricated particularly advantageously. Special advantages of this process result from the possibility of quick and gentle cleaning, disinfection and care of the instruments. The combination of a pre-cleaning phase with cold water with a high pressure wash with water results in a particularly effective removal of contaminants, in particular protein deposits. Since in this method, the arrangement and movement of the nozzle tube pairs the spray pattern covers the entire instrument, a complete and effective disinfection of the entire instrument can be ensured in the subsequent disinfection phase. In the process of the invention, no heat or heat step for germ killing is necessary because a purely chemical disinfection is performed. This results, on the one hand, in the particular shortness of the overall procedure duration of a few minutes and, on the other hand, in the avoidance of recurring thermal stress on the sensitive medical instruments.

If it is not possible to introduce the water into the spray channels because they are clogged with impurities, the device aborts the process, a warning signal sounds and the user must first make sure that these channels are free.

Furthermore, according to the method according to the invention, it is advantageous if the three nozzle tube pairs are moved axially during the method steps c) to i) by 75 to 130 °, preferably by 95 °, radially and by 5 to 30 mm, preferably by 16 mm. This will ensure that the spray pattern covers the entire instrument. Furthermore, it is advantageous if the method steps b) and c) are initiated simultaneously, ie that injection of a small amount of gen amount of a special lubricating oil in the drive of the instrument already during the insertion of the instrument into the cleaning cylinder.

The method step e) can also be modified so that the cleaning is carried out with a surfactant-containing detergent as an intermediate step during the high-pressure washing with drinking water, so water and detergent, for example, be applied alternately.

Furthermore, it is advantageous if the method steps b) to j) run automatically after the device is switched on. The use of an alcohol as a disinfectant has the advantage that rinsing is not absolutely necessary. Fully desalted water may be used in the optional post-rinse phase. Any disinfectant based on alcohol can be stored in the storage container. Optionally, a two-component disinfectant can be premixed in a reservoir, wherein the compound chlorine dioxide is formed by the mixture of the two components. Alternatively, advantages also result from the use of a peroxide compound as a disinfectant.

Further advantages and details are explained in the following embodiment with reference to the drawings.

Show it:

1A shows an inventive device for cleaning, disinfecting and lubricating medical instruments in a sectional view,

FIG. 1B shows the device according to FIG. 1A in a plan view as a sectional illustration, FIG.

2A is a pressure vessel A in sectional view, 2B shows the pressure vessel A in the plan view as a sectional view,

Fig. 3A shows a pressure vessel b in sectional view and

Fig. 3B, the pressure vessel B in plan view as a sectional view.

According to an embodiment of a device for cleaning, disinfecting and lubricating a dental instrument are shown in FIGS. 1a and 1b, four nozzle tube pairs 3 inside the cleaning cylinder arranged peripherally therein. In a drawing, not shown embodiment with three nozzle tube pairs 3, these are arranged peripherally corresponding, for example, at a distance of 120 ° to each other in the interior of the cleaning cylinder. In the upper area of the cleaning cylinder 2, a closure lid 4 serves on the one hand to seal the cleaning cylinder 2 and on the other hand to receive the medical instrument 8 via an adapter 5. The dental instrument 8 to be treated is placed on the adapter provided for this purpose and then on the standard adapter 5 fixed with a slight twist. For the axial and radial movement of the nozzle tube pairs 3, a lifting motor 6a and a motor for the oscillation 6b of a drive unit 6 are arranged below the cleaning cylinder 2 outside of the cleaning cylinder. The two nozzle tubes 3a and 3b of a nozzle tube pair 3 are arranged parallel to one another and with their axes parallel to the longitudinal axis of the cleaning cylinder 2. In this case, the larger diameter nozzle tube 3b is connected to the pressure vessel A7a shown in FIGS. 2A and 2B, and the smaller diameter nozzle tube 3a is connected to the pressure vessel B7b shown in FIGS. 3A and 3B, respectively.

When using a two component disinfectant, the two components must be mixed a certain time before use. If 90 disinfecting operations were required per day, a consumption of approx. 30 ml of disinfectant solution per process would require around 2.7 l of disinfectant solution per day. The total volume of the nozzle pipes and The lines to the pressure vessel B 7b is approximately 2.2 ml. The water present in the lines at that time would be completely displaced. Halving the spraying time, for example to 5 seconds, also halves the consumption of disinfecting solution without affecting the result. The volume of the pressure vessel B 7b in this embodiment is in the interior 1, 5 I and the volume of the two external reservoir for the two components of the disinfectant each 1 I. After a defined time before starting work, two peristaltic pumps promote the two components in a reaction vessel. After the activation time, the solution can be used and is pumped from the reaction vessel into the pressure vessel B 7b. At the end of work, the remaining solution from the reaction vessel is automatically pumped into the drain.

After pressing a start button, not shown in the drawing, the instrument 8 moves downwards into the cleaning cylinder 2. First, via a solenoid valve, which is not shown in the drawing, compressed air in the spray channels of the instrument 8, not shown in the drawing. If the pressure before and after the solenoid valve is the same, this means that either no spray channels are present in the instrument 8, for example with instruments with external spray guidance, or that the existing spray channels are blocked and therefore can not be disinfected. In both cases, an optical and / or audible warning signal. Only after confirmation of this message by the user, the work continues.

In a further method step, a small amount of a special lubricating oil is injected into the drive of the instrument 8. In the drive then an overpressure is maintained until the end of the process. At the same time a small amount of water is passed through nozzle tubes with eight nozzles in a pre-cleaning for prewashing via a pressure vessel B 7b and nebulized with compressed air from other nozzle tubes, which are supplied from the pressure vessel A 7a with compressed air. The water is also forced through the spray channels of the instrument 8. In the subsequent High-pressure washing is carried out after a contact time of the water in the prewash of 10 seconds, the first phase of the high pressure wash with water from the öruckbehäiter A 7a, the water is blown out with compressed air of about 6 bar for a period of 10 seconds. After a further 10 seconds, the second phase of high-pressure washing until the pressure vessel A 7a is empty and now air flows from the nozzle. This is used to blow off the excess water on the surface of the instrument 8. At the same time the spray channels of the instrument 8 are blown free by means of compressed air. The removal of the water in of particular importance, since otherwise a dilution of the subsequently applied disinfectant would take place.

The disinfection is analogous to the prewash, with the exception that in the pressure vessel B 7b now no water, but disinfectant solution is included. Thus, the surface of the instrument 8 is uniformly wetted with disinfectant solution and the spray channels filled with disinfectant solution. After the exposure time of, for example, 30 seconds prescribed by the manufacturer of the disinfectant, the rinsing of the surface and of the rinsing channels takes place analogously to the method step of prewashing. With compressed air from the pressure vessel A 7a, the water is blown from the instrument surface, the spray channels are also dried with compressed air. After about 10 seconds, this process is completed, the compressed air and the drive are turned off and the instrument 8 moves up. Thus, the entire process including cleaning, disinfecting and care can be done in about 145 seconds. LIST OF REFERENCE NUMBERS

1 Apparatus for cleaning, disinfecting and lubricating English-language medical instruments

2 cleaning cylinders

3 nozzle tube pair

3a smaller diameter nozzle tube 3b larger diameter nozzle tube

4 sealing covers

5 standard adapters

6 Drive unit for moving the nozzle tube pairs 6a Lifting motor 6b Motor for oscillation

7 Pressure vessel 7a Pressure vessel A 7b Pressure vessel B

8 medical instrument

Claims

claims:

1. A device for cleaning, disinfecting and lubricating English language medical instruments (8), characterized in that the device (1)

a cleaning cylinder (2), a closure lid (4) on the cleaning cylinder (2) with a standard adapter (5) suitable for receiving the medical instrument (8), a drive unit (6) for moving the nozzle tube pairs (3) or

Standard adapters (5), a lubricant supply means in the cap (4),

Inlets in the cap for introducing water, disinfectant solution or air into the spray channels of the medical instrument

(8), a pressure vessel A and a pressure vessel B (7a, 7b) and a control device with an operating unit, wherein - in the cleaning cylinder (2) at least three by 75 to 130 ° radially and by 5 to 30 mm axially movable nozzle tube pairs ( 3) are arranged, wherein a nozzle tube pair (3) consists of two nozzle tubes (3a, 3b) with different diameters and the smaller nozzle tube (3a) of each nozzle tube pair (3) is arranged laterally to the large nozzle tube (3b) and the standard Adapter (5) is stored statically; or in the cleaning cylinder (2) at least one static nozzle tube pair αi iycυi ui ici ιoι, vvuuci σn ι L / USCI H II II μααi

jσvvσiia of -VVVOI UUSCI I- pipes (3a, 3b) consists of different diameters and the smaller nozzle tube (3a) of each nozzle tube pair (3) each side of the large nozzle tube (3b) is arranged and the standard adapter (5) radially and is movably mounted 5 to 30 mm axially with respect to the nozzle tube pair (s); or in the cleaning cylinder (2) at least one movable nozzle tube pair (3) is arranged, wherein a nozzle tube pair (3) consists of two nozzle tubes (3a, 3b) with different diameters and the smaller nozzle tube (3a) of each nozzle tube pair (3 ) are each arranged laterally to the large nozzle tube (3b) and the standard adapter (5) is statically supported and / the nozzle tube / e (3) are arranged on a circular path along the inner wall of the cleaning cylinder axpa- rallel around the standard adapter guided around ,

2. Apparatus according to claim 1, characterized in that the drive unit (6) outside the cleaning cylinder (2) is arranged and consists of a lifting device (6a) and a device (6b) for the oscillation.

3. Device according to claims 1 and 2, characterized in that a nozzle tube pair (3) each has eight nozzles.

4. Device according to claims 1 to 4, characterized in that the nozzle tube pairs (3) are radially movable by 95 ° and axially movable by 16 mm.

5. Device according to claims 1 to 4, characterized in that the smaller nozzle tube (3a) of each nozzle tube pair (3) has smaller nozzles than that of the large nozzle tube (3b).

6. Device according to claims 1 to 5, characterized in that the outlet angle of the nozzles of the smaller nozzle tube (3a) by 30 to 60 ° to those of the large nozzle tube (3b) are inclined.

7. Apparatus according to claim 6, characterized in that the outlet angles of the nozzles of the smaller nozzle tube (3a) are inclined by 45 ° to those of the large nozzle tube (3b).

8. Device according to claims 1 to 7, characterized in that the cleaning and / or disinfecting agent from one or more storage containers in the pressure vessel B (7b) can be fed.

9. Device according to claims 1 to 8, characterized in that it is the disinfectant is an alcoholic compound or a mixture of different alcohols.

10. Device according to claims 1 to 8, characterized in that a means for heating the interior of the cleaning cylinder (2) and / or the surface of the medical instrument (8) is provided.

11. Device according to claims 1 to 10, characterized in that the means in the closure lid (4) for the supply of lubricating oil in the drive of the medical instrument (8) is connected to a reservoir.

12. A method for cleaning, disinfecting and lubricating English language medical instruments with a drive in a device (1) according to one of claims 1 to 11, wherein the method comprises at least the steps:

Fixation of the medical instrument (8) via an adapter specific to the instrument to the standard adapter (5) of the closure lid (4),

Retracting the instrument (8) into the cleaning cylinder (2) and switching on the drive of the instrument (8),

Injecting a small amount of a special lubricating oil into the drive of the instrument (8), whereby an overpressure is maintained in the drive until the end of the process, a pre-cleaning phase in which soils are soaked on the instrument (8) by the misting of water,

a high-pressure washing with drinking water and / or a cleaning agent and finally with air,

a disinfecting phase in which disinfectant is applied to the inner and outer surfaces of the instrument (8),

simultaneous co-treatment of the spray channels during the respective cleaning or disinfection steps with water and / or a cleaning agent, disinfectant solution or air for instruments with spray channels,

- Shutdown of the compressed air and the drive of the instrument (8) and extension of the instrument (8).

13. The method of claim 12, wherein the method comprises the steps of:

a) fixing the medical instrument (8) via an adapter specific to the instrument to the standard adapter (5) of the closure lid (4) with a slight rotation,

b) retracting the instrument (8) into the cleaning cylinder (2) and switching on the drive,

c) injecting a small amount of a special lubricating oil into the drive of the instrument (8), wherein the drive maintains an overpressure until the end of the process,

d) introducing water from a pressure vessel B (7b) by means of compressed air into the channels of the instruments (8) and into the larger nozzle tubes (3b) for 10 seconds, the water leaving the nozzles with compressed air from the nozzles of the smaller nozzle tubes (3a) from a further pressure vessel A (7a) is atomized,

e) first phase of a high-pressure wash with drinking water and / or a cleaning agent from the pressure vessel A (7a) for 10 seconds, wherein the water and / or the cleaning agent is blown out with a compressed air of 6 bar,

f) second phase of high-pressure washing with air from the pressure vessel A (7a) for 10 seconds,

g) disinfection for 30 seconds analogously to process step d) with disinfectant solution from the pressure vessel B (7b) instead of water,

h) rinsing for 30 seconds identical to process step d),

i) drying for 10 seconds identical to process step f) and

j) shutdown of the compressed air and the drive of the instrument (8) and extension of the instrument (8).

14. The method according to claims 12 and 13, characterized in that the instruments (8) are dental hand, angle or turbine pieces.

15. The method according to claims 12 to 14, characterized in that the spray pattern covers the entire instrument (8) by the nozzle tube pairs (3) during the process steps c) to i) by 75 to 130 ° radially and 5 to 30 mm are moved axially.

16. The method according to claims 12 to 15, characterized in that the nozzle tube pairs (3) during the process steps c) to i) are moved radially by 95 ° and axially by 16 mm.

17. The method according to claims 12 to 16, characterized ciass the method steps b) and c) are initiated simultaneously.

18. The method according to claims 12 to 17, characterized in that the method steps b) to j) run automatically after switching on the device (1).

19. The method according to claims 12 to 18, characterized in that an alcohol is used as a disinfectant.

20. Use of a device according to one of claims 1 to 11 for cleaning, disinfecting and lubricating Englumigen medical instruments (8), characterized in that the medical instruments (8) are dental hand, angle or turbine pieces.