Dental Sterilizers Showdown: Manual vs. Automatic

Written by Deanna Otts-Whitfield, RDH, BSDH, MSHQS, CDIPC

Sterilizers are an integral piece of a dental practice. Different machines have different qualities and features that may help or inhibit efficiencies of the sterilization process. Capacity, automatic versus manual, price, and ease of use are aspects to consider when purchasing a sterilizer.  

What do you need?

Sterilizers vary in size and function. Choosing the right one(s) for your office helps improve efficient sterilization processes and increases productivity. Consider the size of your space, schedule, and staff. Is one tabletop sterilizer adequate for your practice? You may need two different types of sterilizers. Is dry-heat sterilization a method you need for particular instruments? Is flash sterilization a practice you need to use often? Let’s discuss manual versus automatic sterilizers.

Manual Sterilizers

Manual sterilizers have been around since the early 1900s. The dependability and wide range of temperate and time settings have kept this type of sterilizer still in practice. Manual models are less expensive to purchase and repair. Disadvantages include the time it takes to operate the machine. One must fill the chamber with water and manually close and tighten the door. Setting the time and temperature is done by the operator. Once the sterilization cycle is complete, one has to exhaust the chamber and manually set the dry cycle. Manual sterilizers have fewer safety features and no real-time monitoring controls.

Automatic Sterilizers

On the other hand, automatic sterilizers save time by automating the entire process from beginning to end. With a push of a button, the machine will fill the chamber, set the temperature, run the predetermined time, and initiate the dry cycle. A display screen will show what process the cycle is in and indicate failure detection. A printer or WiFi connectivity option allows data to be tracked and recorded. Some automatic sterilizers can connect to an autofill water system. Automatic sterilizers are more costly to purchase and can be more expensive to repair.

Midmark

Midmark Ritter sterilizers are some of the more recognized brands in the industry. The company has been around since 1915 and is located in Ohio. The M11 and M9 Ultraclave steam sterilizers offer an automatic tabletop machine that can be equipped with a data logger or printer. The monitoring device attaches to the top of the machine and records time, pressure, and temperature. The device stores the information on a USB drive that uploads to a PC, or a printer attachment is available for older models. The M11 boasts a large chamber of 11” in diameter by 18” deep. The M9 has a modest chamber capacity of 9” in diameter by 15” deep. The automatic function of the machines will allow staff to press a button and walk away, knowing that the sterilizer will fill the chamber with water, sterilize, and vent without additional attention. An LED display will remind you when weekly and monthly maintenance is due. Pre-programmed settings and real-time alerts allow staff to operate the machine quickly and comfortably. The standard warranty for a new M9 or M11 is five years. Midmark no longer offers the M3 UltraFast nor the manual M7 SpeedClave, but they can be found on reputable refurbished sites such as Duraline. A new Midmark M11 can set you back $7500.

Tuttnauer

Another recognized brand is Tuttnauer. This company is based in The Netherlands but has a strong presence worldwide, including in North America. The company makes automatic and manual tabletop steam sterilizers. A variety of automatic models offer mechanical monitoring with an optional built-in printer. Furthermore, the newest models, T-EDGE 10 and 11 autoclaves offer a touchscreen and WiFi capabilities to monitor with a phone or PC. An added benefit is the closed-door drying cycle, which will ensure instrument packs are completely dry at the end of the cycle. The 3870EAP model boasts the largest chamber, sitting 15” in diameter and 30” deep. Manual Tuttnauer autoclaves do not have pre-set settings, but the dials are easy to control. The 3870M is the manual version of the previously mentioned sterilizer and has the same capacity. The manual models do not offer a monitoring printer. Tuttnauer offers a two-year warranty for automatic sterilizers and a one-year warranty for manual models. There are a variety of sizes and functions to fit any practice. A new T-Edge 11 automatic can run around $7000. The popularity of Tuttnauer places them at the top of the industry when it comes to sterilizers.

Pelton& Crane

Pelton & Crane was founded by a dentist and an electrical engineer in 1900. The company was once the crème de la crème of the industry, offering equipment other than sterilizers. In May 2020, during the height of the COVID-19 pandemic, they announced they would no longer manufacture dental equipment. Pelton & Crane sterilizers are still widely used and can be purchased from refurbished companies. The tried-and-true OCM Omniclave and OCR models are still in use today. The large capacity Magnaclave is excellent for a large, busy practice with a 15” diameter by 20” deep chamber. The company has changed its website to a customer service and resource center. Some warranties are still honored, according to their website.

SciCan

The Coltene SciCan company is popular in dental offices with the STATIM Cassette Autoclave. The cassette autoclaves are faster and more compact. A cycle is shorter since the steam is injected into the cassette, which is often smaller than a chamber, and the water reservoir does not need to be full. This allows delicate and unwrapped instruments to be flash sterilized and used immediately after the cycle. STATIM autoclaves are beneficial because they are compact, allowing them to fit in smaller spaces. The G4 2000 and 5000 models offer a display that shows data, or the WiFi capability can send monitoring specs to a tablet or laptop. These models can be connected to the VistaPure system, allowing for automated filling. In addition, a direct-to-drain system is provided by VistaCool, allowing wastewater to drain automatically. The company offers chamber autoclaves, the STATCLAVE G4 and BRAVO G4, comparable to other brands. Both models provide monitoring data to be transferred via WiFi. The largest of the STATIM G4 series costs around $7000, and the STATCLAVE can cost around $10K. Cassette autoclaves are beneficial because the cassette is easily replaceable without replacing the entire machine—the SciCan company warranty their machines for one year. Often, distribution sales companies will add or extend a warranty.

Steam under pressure is the most common and recommended form of sterilization in the dental office, but orthodontic practices sometimes prefer dry-heat sterilizers. Dry heat is easier on delicate instruments and does not cause rust or corrosion. Maintenance is little to no on these pieces of equipment, and they are less expensive than steam sterilizers. The biggest downfall is the time it takes to heat the chamber, which can be close to an hour. CPAC Environmental Solutions makes the SteriDent dry-heat sterilizer and offers a three-year warranty. Another model CPAC makes is the RapidHeat™ RH-Pro11 and Pro9, which uses forced air to circulate through the chamber. This sterilizer claims to use 15% less energy than a steam autoclave and completes an entire cycle in as little as 21 minutes. Dry-heat sterilizers require a different sport test (B. atrophaeus) than a traditional steam autoclave spore test (G. stearothermophilus) to ensure sterility.

From automatic to manual sterilizers, your dental practice has plenty of choices. Sterilizers come in a variety of sizes and price ranges. It is crucial to consider the pace of your office and useability when choosing which or how many sterilizers are needed.

References:

• Andrews, N. (2023, February 13). The Importance of the Autoclave Cassette. Sterilizer Autoclave Solutions. Retrieved June 9, 2023, from https://statimusa.com/2023/02/the-importance-of-the-autoclave-cassette/

• Dubrey, J. (2019, April 19). STATIM Cassette Autoclave Introduction. Sterilizer Autoclave Solutions. Retrieved June 9, 2023, from https://statimusa.com/2019/04/statim-cassette-autoclave-introduction/

• (2016, September 18). Steam Sterilization: Guideline for Disinfection and Sterilization in Healthcare Facilities 2008. Centers for Disease Control. Retrieved May 24, 2023, from https://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/steam.html