Table 2.

Updated characteristics and procedures for IOS reconditioning after the lesson of COVID-19 pandemic [6].

Actions	Current and Future Solutions
Avoid microbial transmission by refraining from touching with bare or contaminated hands or with torn gloves	●Voice commands > Touch screen > Keyboard ●Reduce unnecessary touch/contact points ●Avoid touching the optical surface of the wand ●Remove and replace gloves after each patient procedure ●Fresh gloves before reconditioning (cleaning and disinfection)
	●Medical-grade PC keyboard with low-profile key design and flat keys for easy cleaning and thorough surface disinfection; 360° safeguard against dirt and splashed water; silicone membrane for highest hygiene; sealed key field
	●Medical mouse with a silicone membrane protecting against ingress of dirt and liquids (water, spray liquid disinfectant)
	●Wireless scanner
	●Ease of use
Limit the microbial contamination by reducing contact with respiratory fluids, oral surfaces, saliva splashing, or dirty/deteriorated/scratched mirrors	○No requirement of contrast medium (powder) ○Anti-fogging system (with heat > air flux) ○Scanning speed, accuracy, and precision → scanning time ○Accuracy of diagonal scanning ○ Prefer smaller wand tip dimension: • Cerec Primescan (10 × 11 mm) • Carestream (13 mm × 13 mm) • 3M true definition (14.4 mm × 16.2 mm) • Planmeca PlanScan (48 mm × 53 mm) • Align iTero element (50 mm × 68 mm) ○Visually inspect the wand and the scanner tip for signs of deterioration (corrosion, discoloration, pitting, and cracks) or any other kind of damage
Lessen contamination caused by air	✓Position of the scanner, cart and mobile in relation to dental chair, DHCW, air ventilation and units with HEPA filters
	✓Disposable sleeves
	✓Store instrument and accessories in a dry and dust-free location
	✓Antimicrobial-coated barrier for PC keyboard and mouse
Ensure safe reuse	➢Clear MIFU and easy reconditioning
−wand	➢Constructive solutions (smooth and curved surfaces, small-sized joints; removable parts, electric quick couplings) to limit contamination or render it more ergonomic
	➢Pay attention to the indents, grooves, joints, vents of all parts, and severe kinks in the cable
	➢Disinfect the first 10 centimetres of sensor cable
	➢Use compatible cleaners and disinfectants (details in Section 3.4.3)
	➢Disinfectant on wipes or impregnated wipes for homogeneous dispersion of disinfectant on surfaces that are at all angles, and less dispersion in air, minor vaporization, and inhalation exposure to components
−scanner and scanner tip	➢Disinfect all the sensors
	➢Rinse and brush the external surfaces of the tip under warm running water (3–3.5 L/min, 30–35 °C) for a minimum of 15” ➢Details for cleaners in Section 3.4.3. ➢Brush tips and scanner ward until visibly clean for at least 30” ➢Use a soft bristled brush to avoid scratching the mirror ➢Avoid contact between the mirror and the plastic handle of the bristled brush ➢Rinse the mirror and surrounding crevice under running water for an additional 15 s ➢Use a lens tissue or lint-free cloth or inert impregnated wipes to remove anything from the mirror in the tip.
	➢Autoclavable scanner tips ➢DO NOT stack tips on or around other metal instruments or near integrator class 5 ➢Sterilise scanner tips in cassette or wrapped in sterilization pouches/tray
−physical barriers	❖Hooding of disposable sleeves in front of the patient
	❖Medical-grade barriers with antimicrobial activity
	❖Antimicrobial surface of scanner ward
	❖Optical-medical-grade barriers
	❖Clean&Remind function with a fading LED, hardware-based, on the keyboards and high-touch surfaces for reminding the user to perform cleaning/disinfecting procedure according to protocol, with a lock in the absence of it