Effective sterilization and disinfection are critical for infection control in dental practices, reducing healthcare-associated infections and ensuring patient safety. This review explores the principles, applications, and limitations of various sterilization and disinfection methods used in dentistry, including heat sterilization (steam and dry heat), chemical sterilization (ethylene oxide, hydrogen peroxide), and radiation methods (ultraviolet (UV) and gamma rays). Emphasis is placed on the effectiveness of each method against a range of pathogens, their suitability for different dental instruments, and advancements in technology such as vaporized hydrogen peroxide systems and antimicrobial coatings. Autoclave sterilization remains a cornerstone due to its reliability, while methods like UV rays and ozone offer innovative, material-friendly alternatives. The importance of verifying sterilization efficacy through biological indicators and maintaining proper storage protocols to ensure sterility is also highlighted. By integrating traditional techniques with emerging technologies, dental practices can enhance infection control standards while adapting to modern challenges. Sterilization by Pressurized Steam Moist heat sterilization is performed using pressurized steam, allowing bacterial death through the coagulation of bacterial cellular proteins. This process is carried out by directly exposing the instruments to a temperature of 121-132°C at 12 psi for a minimum of 15 minutes. The sterilization time may vary depending on the quantity and density of items inside the autoclave chamber, a device widely used in medical and dental fields [ 27 - 29 ]. Some biological indicators on the market include a pH indicator, which changes color when spore growth occurs, making it easier to detect [ 30 ]. Ardeshna et al. evaluated bacterial contamination on orthodontic appliances and tested various sterilization methods, including steam autoclave. The appliances were contaminated with bacteria such as Staphylococcus aureus , Staphylococcus epidermidis , Lactobacilli , and Klebsiella pneumoniae . The autoclave method was highly effective in eliminating all bacterial contamination, providing reliable sterilization [ 1 ]. Among the sterilization methods tested, dry heat at 121°C for 30 minutes effectively eliminated all bacterial contamination. While effective, the study noted that dry heat sterilization could potentially degrade the properties of some orthodontic materials, making its use dependent on the specific material's tolerance to heat [ 1 ]. Chemical Sterilization Chemical sterilization is crucial for thermosensitive dental instruments or materials that cannot withstand high-temperature methods, such as steam sterilization. Among the most common techniques are the use of unsaturated chemical vapor, 2% glutaraldehyde, and hydrogen peroxide. The study suggests UVC chambers as a time-efficient disinfection alternative, but validation is required for specific instruments [ 41 ]. Gamma rays: Gamma rays are a form of radiation derived from the radioactive decay of atomic nuclei, making them widely used for sterilizing medical and dental devices and grafts. Due to their short wavelengths, gamma rays have high penetration power and energy, allowing them to effectively destroy microorganisms. Among their advantages, gamma rays can penetrate dense materials, making them effective for sterilizing complex medical devices. All methods achieved complete sterilization while preserving the ECM molecular structure. Gamma radiation and ethylene oxide provided excellent results but were limited by high costs and accessibility issues. demonstrated the efficacy of far-infrared radiation (FIR) in preventing microbial contamination on the outer packaging of sterilized surgical instruments during storage [ 50 ]. FIR treatment effectively inhibited microbial growth, reducing colony-forming units (CFUs) to zero over a 30-day storage period, compared to 68.2% contamination in untreated packages, which included 34 bacterial species like Staphylococcus and Bacillus spp. FIR's ability to lower humidity in storage areas was identified as a key factor, creating an environment less conducive to microbial survival. This provision has become mandatory since its publication in the Official Gazette of the Federation [ 29 ]. As stated in NOM 013, the sterilization process is fallible, making it essential to continuously monitor equipment using biological indicators. These indicators are the only globally accepted tools for evaluating the effectiveness of sterilization processes [ 29 ]. Verification With Biological Indicators Specifically, to evaluate the sterilization process of autoclaves and dry heat sterilizers, the endospores of G. stearothermophilus are used for autoclaves, while B. atrophaeus is used for dry heat processes. These endospores provide an objective confirmation of whether sterilization equipment is functioning correctly, as they assess the elimination of highly resistant bacterial spores. Regular use of these indicators is vital to ensure that sterilization protocols are properly followed, thereby contributing to patient safety [ 32 ]. Use of biological indicators in sterilization processes The use of biological indicators in sterilization processes involves placing these indicators inside the equipment before starting the sterilization cycle. The cycle is then executed according to the previously established parameters. Once the process is complete, the indicators are processed to evaluate their effectiveness. There are two possible outcomes when assessing the biological indicators. A result with no bacterial growth indicates that the sterilization equipment has functioned correctly. Conversely, the presence of bacterial growth suggests that the sterilization procedure was ineffective. This is critical, as a sterilization process is defined by the complete elimination of pathogenic agents [ 32 , 52 ].