WO2008116576A1 - Dispositif comprenant au moins une paire de lances, conçu pour nettoyer, désinfecter et lubrifier des instruments médicaux à orifices étroits - Google Patents

Dispositif comprenant au moins une paire de lances, conçu pour nettoyer, désinfecter et lubrifier des instruments médicaux à orifices étroits Download PDF

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Publication number
WO2008116576A1
WO2008116576A1 PCT/EP2008/002147 EP2008002147W WO2008116576A1 WO 2008116576 A1 WO2008116576 A1 WO 2008116576A1 EP 2008002147 W EP2008002147 W EP 2008002147W WO 2008116576 A1 WO2008116576 A1 WO 2008116576A1
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WO
WIPO (PCT)
Prior art keywords
nozzle tube
instrument
cleaning
drive
disinfecting
Prior art date
Application number
PCT/EP2008/002147
Other languages
German (de)
English (en)
Inventor
Gerhard HÜCKER
Original Assignee
Sinepro Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sinepro Gmbh filed Critical Sinepro Gmbh
Publication of WO2008116576A1 publication Critical patent/WO2008116576A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/002—Cleaning devices specially adapted for dental instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
    • A61L2/16—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor using chemical substances
    • A61L2/22—Phase substances, e.g. smokes, aerosols or sprayed or atomised substances

Definitions

  • 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.
  • rotating or oscillating instruments for surgical, periodontal or endodontic procedures can either be prepared by machine or manually.
  • 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.
  • 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.
  • an integrated heat step or a subsequent steam sterilization is generally provided.
  • a flushing device for internal flushing and holding dental handpieces and contra-angles 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.
  • 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.
  • 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.
  • 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.
  • a disinfecting system for handpieces of dental equipment 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.
  • 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.
  • a sterilization device for dental handpieces 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.
  • a device for cleaning and disinfecting medical and surgical instruments 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.
  • 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.
  • 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.
  • This ensures that the entire surface and the spray channels of the medical instrument are cleaned and disinfected.
  • 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.
  • 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.
  • 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.
  • Such a device can be used according to the invention particularly advantageous for simultaneous cleaning, disinfecting and lubricating dental hand, angle or turbine pieces.
  • 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.
  • the smaller nozzle tube of each nozzle tube pair has smaller nozzles than those of the large nozzle tube.
  • 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.
  • 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.
  • the disinfectant is an alcoholic compound, most preferably isopropyl alcohol, or a mixture of different alcohols.
  • 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.
  • any other disinfectant may be used as individual components or two- or multi-component mixtures depending on the application.
  • surfactant-containing detergent mixtures or the like can be used as cleaning agents.
  • 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.
  • 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.
  • 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.
  • the spray channels of the instrument are also treated in parallel during the respective cleaning or disinfection steps.
  • 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.
  • 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.
  • 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.
  • 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.
  • the device 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.
  • 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.
  • 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.
  • a two-component disinfectant can be premixed in a reservoir, wherein the compound chlorine dioxide is formed by the mixture of the two components.
  • advantages also result from the use of a peroxide compound as a disinfectant.
  • FIG. 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
  • 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
  • Fig. 3B the pressure vessel B in plan view as a sectional view.
  • FIGS. 1a and 1b 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.
  • 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.
  • 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.
  • the larger diameter nozzle tube 3b is connected to the pressure vessel A7a shown in FIGS. 2A and 2B
  • the smaller diameter nozzle tube 3a is connected to the pressure vessel B7b shown in FIGS. 3A and 3B, respectively.
  • the two components 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.
  • two peristaltic pumps promote the two components in a reaction vessel.
  • the solution can be used and is pumped from the reaction vessel into the pressure vessel B 7b.
  • the remaining solution from the reaction vessel is automatically pumped into the drain.
  • the instrument 8 moves downwards into the cleaning cylinder 2.
  • 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.
  • a small amount of a special lubricating oil is injected into the drive of the instrument 8.
  • an overpressure is maintained until the end of the process.
  • 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.
  • the first phase of the high pressure wash with water from the öruckbenzoiter A 7a the water is blown out with compressed air of about 6 bar for a period of 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.
  • 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.
  • the surface of the instrument 8 is uniformly wetted with disinfectant solution and the spray channels filled with disinfectant solution.
  • 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.
  • the entire process including cleaning, disinfecting and care can be done in about 145 seconds.

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  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
  • Apparatus For Disinfection Or Sterilisation (AREA)

Abstract

La présente invention concerne un dispositif et un procédé conçus pour nettoyer, désinfecter et lubrifier des instruments médicaux à orifices étroits (8), laquelle invention est caractérisée en ce que le dispositif (1) comprend un cylindre de nettoyage (2), un couvercle de fermeture (4) qui est situé sur le cylindre de nettoyage (2) et qui comprend un adaptateur standard (5) conçu pour recevoir l'instrument médical (8), une unité d'entraînement (6) conçue pour déplacer la paire de lances (3) ou l'adaptateur standard (5), un moyen d'alimentation en huile lubrifiante situé dans le couvercle de fermeture (4), des conduites situées dans le couvercle de fermeture et conçues pour faire passer de l'eau, une solution désinfectante ou de l'air dans les canaux de pulvérisation de l'instrument médical (8), un récipient sous pression A (7a), un récipient sous pression B (7b), ainsi qu'une unité de commande qui comprend une unité d'utilisation. Selon cette invention, la mobilité relative entre la ou les paires de lances et l'adaptateur standard permet de soumettre complètement l'instrument médical à nettoyer aux milieux de traitement.
PCT/EP2008/002147 2007-03-24 2008-03-18 Dispositif comprenant au moins une paire de lances, conçu pour nettoyer, désinfecter et lubrifier des instruments médicaux à orifices étroits WO2008116576A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102007014213A DE102007014213B4 (de) 2007-03-24 2007-03-24 Vorrichtung zum Reinigen, Desinfizieren und Schmieren von englumigen medizinischen Instrumenten
DE102007014213.9 2007-03-24

Publications (1)

Publication Number Publication Date
WO2008116576A1 true WO2008116576A1 (fr) 2008-10-02

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PCT/EP2008/002147 WO2008116576A1 (fr) 2007-03-24 2008-03-18 Dispositif comprenant au moins une paire de lances, conçu pour nettoyer, désinfecter et lubrifier des instruments médicaux à orifices étroits

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DE (1) DE102007014213B4 (fr)
WO (1) WO2008116576A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102019135883A1 (de) * 2019-12-30 2021-07-01 Vivonic Gmbh Verfahren zur Desinfektion und Funktionsüberwachung eines Chlorsensors

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0300945A2 (fr) * 1987-07-24 1989-01-25 Micro Mega S.A. Appareil automatique pour le nettoyage des pièces à main de dentisterie
EP0634177A1 (fr) * 1993-07-16 1995-01-18 Stanley Clifford Jennings Autoclave
DE4323815A1 (de) * 1993-07-15 1995-01-19 Siemens Ag Verfahren und Vorrichtung zur hygienischen Aufbereitung von medizinischen, insbesondere zahnmedizinischen Instrumenten
WO1996041686A1 (fr) * 1995-06-13 1996-12-27 Bitiess Microtecnica S.A. Dispositif universel servant au nettoyage, a la desinfection et a la sterilisation en profondeur d'instruments dentaires, chirurgicaux et d'usage veterinaire ainsi qu'a d'autres fins
GB2398501A (en) * 2003-02-24 2004-08-25 Patrick Brian Clayton Cleaning and/or sterilising device
WO2006039509A1 (fr) * 2004-09-30 2006-04-13 Dentsply International Inc. Dispositif de sterilisation et procede pour steriliser des embouts manuels dentaires

Family Cites Families (8)

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Publication number Priority date Publication date Assignee Title
FR2641973B1 (fr) * 1989-01-20 1991-04-19 Bene Pierre Yves Dispositif de nettoyage et de desinfection d'instruments medicaux et chirurgicaux
IT1233632B (it) 1989-06-14 1992-04-07 Augusto Cattani E C Spa Off Impianto di disinfezione, in particolare per manipoli di riuniti dentali
DE4024171C2 (de) 1990-07-30 1996-02-22 Kaltenbach & Voigt Verfahren und Pflegesatz zum Desinfizieren und Pflegen von ärztlichen, insbesondere zahnärztlichen Instrumenten
DE4244753C2 (de) 1992-10-22 1998-04-09 Kaltenbach & Voigt Vorrichtung zum Reinigen und/oder Desinfizieren und/oder Pflegen von ärztlichen oder zahnärztlichen Bearbeitungsinstrumenten, insbesondere Handstücken
DE19626871B4 (de) 1996-07-04 2005-01-27 Miele & Cie. Kg Spülvorrichtung zur Innendurchspülung und Halterung zahnärztlicher Hand- und Winkelstücke
US6773685B2 (en) * 2000-12-04 2004-08-10 Peter Johansen Apparatus for sterilizing dental handpieces
DE10145818C1 (de) * 2001-09-17 2002-10-10 Alfill Engineering Gmbh & Co K Sterilisiervorrichtung mit H202-Verdampfer
US7435398B2 (en) * 2004-11-12 2008-10-14 Nitram Dental A/S Apparatus for sterilizing dental hand pieces

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0300945A2 (fr) * 1987-07-24 1989-01-25 Micro Mega S.A. Appareil automatique pour le nettoyage des pièces à main de dentisterie
DE4323815A1 (de) * 1993-07-15 1995-01-19 Siemens Ag Verfahren und Vorrichtung zur hygienischen Aufbereitung von medizinischen, insbesondere zahnmedizinischen Instrumenten
EP0634177A1 (fr) * 1993-07-16 1995-01-18 Stanley Clifford Jennings Autoclave
WO1996041686A1 (fr) * 1995-06-13 1996-12-27 Bitiess Microtecnica S.A. Dispositif universel servant au nettoyage, a la desinfection et a la sterilisation en profondeur d'instruments dentaires, chirurgicaux et d'usage veterinaire ainsi qu'a d'autres fins
GB2398501A (en) * 2003-02-24 2004-08-25 Patrick Brian Clayton Cleaning and/or sterilising device
WO2006039509A1 (fr) * 2004-09-30 2006-04-13 Dentsply International Inc. Dispositif de sterilisation et procede pour steriliser des embouts manuels dentaires

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DE102007014213B4 (de) 2009-04-30
DE102007014213A1 (de) 2008-09-25

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