Dental Mitigation Strategies to Reduce Aerosolization of SARS-CoV-2.
Dental Mitigation Strategies to Reduce Aerosolization of SARS-CoV-2.
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DOI：
10.1177/00220345211032885
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发表时间：
2021-12
影响因子：
7.6
通讯作者：
Nattress BR
中科院分区：
文献类型：
--
作者：
Vernon JJ;Black EVI;Dennis T;Devine DA;Fletcher L;Wood DJ;Nattress BR
限制感染传播是牙科所有人安全的核心，特别是在当前严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行期间。气溶胶产生程序(AGP)对牙科实践至关重要；必须了解与AGP相关的病毒传播的内在风险以及可用的缓解策略的有效性。在牙科手术环境中，使用空气涡轮或高速对角机头(HSCAH)进行牙冠准备和根管置入程序，通过橡胶坝或大容量吸引器进行缓解，以及无缓解对照。使用幻影头，以1.5mLmin−1流量的人工唾液感染Φ6噬菌体(SARS-CoV-2的替代病毒)，其空斑形成单位为~108个−1，反映了已报道的唾液SARS-CoV-2水平的上限。用Φ6噬菌体宿主紫丁香假单胞菌修饰的琼脂平板测定了生物气溶胶的扩散。病毒空气浓度使用MicroBio MB2空气采样进行评估，颗粒物数量使用Konomax 3889GEOα计数器进行评估。与空气涡轮机相比，在没有缓解、吸入和橡胶坝的情况下，HSCAH机分别减少了99.72%、100.00%和100.00%的沉降生物气溶胶。在相同缓解措施下，空气中噬菌体浓度分别降低了99.98%、100.00%和100.00%。使用大容量吸入的HSCAH，无论是在非飞溅沉降板上还是在程序后6-10分钟采集的空气样本中都没有检测到噬菌体。据我们所知，这项研究是第一次报道在牙科诊所将活性病毒雾化作为风险确定的标志。虽然该模型代表了SARS-CoV-2可能扩散的最坏情况，但这些数据表明，使用HSCAHs可以极大地降低病毒气雾化的风险，从而消除临床休眠时间的需要。此外，我们的发现表明，仅使用颗粒分析不能提供足够的洞察力来了解生物气溶胶感染的风险。
Limiting infection transmission is central to the safety of all in dentistry, particularly during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Aerosol-generating procedures (AGPs) are crucial to the practice of dentistry; it is imperative to understand the inherent risks of viral dispersion associated with AGPs and the efficacy of available mitigation strategies. In a dental surgery setting, crown preparation and root canal access procedures were performed with an air turbine or high-speed contra-angle handpiece (HSCAH), with mitigation via rubber dam or high-volume aspiration and a no-mitigation control. A phantom head was used with a 1.5-mL min−1 flow of artificial saliva infected with Φ6-bacteriophage (a surrogate virus for SARS-CoV-2) at ~108 plaque-forming units mL−1, reflecting the upper limits of reported salivary SARS-CoV-2 levels. Bioaerosol dispersal was measured using agar settle plates lawned with the Φ6-bacteriophage host, Pseudomonas syringae. Viral air concentrations were assessed using MicroBio MB2 air sampling and particle quantities using Kanomax 3889 GEOα counters. Compared to an air turbine, the HSCAH reduced settled bioaerosols by 99.72%, 100.00%, and 100.00% for no mitigation, aspiration, and rubber dam, respectively. Bacteriophage concentrations in the air were reduced by 99.98%, 100.00%, and 100.00% with the same mitigations. Use of the HSCAH with high-volume aspiration resulted in no detectable bacteriophage, both on nonsplatter settle plates and in air samples taken 6 to 10 min postprocedure. To our knowledge, this study is the first to report the aerosolization in a dental clinic of active virus as a marker for risk determination. While this model represents a worst-case scenario for possible SARS-CoV-2 dispersal, these data showed that the use of HSCAHs can vastly reduce the risk of viral aerosolization and therefore remove the need for clinic fallow time. Furthermore, our findings indicate that the use of particle analysis alone cannot provide sufficient insight to understand bioaerosol infection risk.
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在国际牙科指南中对气溶胶生成缓解的综述。
影响因子：
3.3
作者：
Robertson C;Clarkson JE;Aceves-Martins M;Ramsay CR;Richards D;Colloc T;CoDER Working Group
通讯作者：
CoDER Working Group
影响因子：
4.4
作者：
Holliday R;Allison JR;Currie CC;Edwards DC;Bowes C;Pickering K;Reay S;Durham J;Lumb J;Rostami N;Coulter J;Nile C;Jakubovics N
通讯作者：
Jakubovics N
DOI：
10.14219/jada.archive.1989.0131
发表时间：
1989-07-01
影响因子：
3.9
作者：
COCHRAN, MA;MILLER, CH;SHELDRAKE, MA
通讯作者：
SHELDRAKE, MA
影响因子：
4.5
作者：
Ionescu AC;Brambilla E;Manzoli L;Orsini G;Gentili V;Rizzo R
通讯作者：
Rizzo R
影响因子：
7.4
作者：
King, M. -F.;Noakes, C. J.;Camargo-Valero, M. A.
通讯作者：
Camargo-Valero, M. A.