In an article published in the November issue of Orthodontic Products, Jason B. Cope, DDS, PhD (pictured), and his co-authors offer orthodontists clear, simple guidance on how to sterilize miniscrew implants. The article, titled "Guidelines for Miniscrew Implant Sterilization and Use," begins by summarizing what OSHA, the CDC, the ADA, and the AAO have to say about miniscrews, and concludes with a list of five items an orthodontist should always use when placing mininscrew implants:

1) A sterile MSI: many manufacturers sell MSIs that come in a single-dose unit sterile package, which eliminates the clinician having to sterilize the MSI and being held to more stringent CDC guidelines. MSIs purchased nonsterile must undergo separate, more stringent sterilization guidelines as outlined above.
2) A self-sealing sterilization pouch: most of these come with an integrated chemical indicator embedded in the pouch, and when sterilized the indicator arrow turns from blue to purple.
3) Sterile instruments: sterilized in either a self-sealing sterilization pouch or an instrument cassette enclosed in a self-sealing sterilization pouch.
4) Antimicrobial hand soap: for hand washing prior to donning clean medical exam gloves.
5) Powder-free medical exam gloves: the literature indicates no difference in infection rates with sterile as compared to clean, nonsterile gloves for nonsurgical extractions, which are more invasive than MSI placement.

Other authors of the article are John W. Graham, DDS, MD; Sebastian Baumgaertel, DMD, MSD, FRCD(C); S. Jay Bowman, DMD, MSD; Jack Fisher, DMD; James J. Hilgers, DDS, MS; Sarandeep S. Huja, DDS, PhD; David E. Paquette, DDS, MS, MSD; Mohammad R. Razavi, DDS, MSD, FRCD(C); Nicole Scheffler, DDS, MS; and Paul M. Thomas, DMD, MS, FDSRCS (Edin).