Topographic aspects of airborne contamination caused by the use of dental handpieces in the operative environment
Topographic aspects of airborne contamination caused by the use of dental handpieces in the operative environment
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DOI：
10.1016/j.adaj.2020.06.002
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发表时间：
2020-09-01
影响因子：
3.9
通讯作者：
Brambilla, Eugenio
中科院分区：
文献类型：
--
作者：
Ionescu, Andrei C.;Cagetti, Maria G.;Brambilla, Eugenio
背景牙科手机的使用会产生含有微生物、细菌和病毒的气溶胶，这代表了空气传播交叉感染的高风险情况。本研究的目的是使用生物示踪剂绘制和量化牙科手术环境的生物污染。将变形链球菌悬浮液注入人体模型的口中，操作者使用空气涡轮机、弯手机或超声洁牙机进行标准化牙科手术。在牙科综合治疗台和手术环境的周围表面上的90个部位测量了示踪剂的存在。所有测试仪器都将示踪剂散布在整个牙科综合治疗台和周围环境（包括墙壁和天花板）上。污染的方式和程度与距传染源的距离有关。空气涡轮机、弯手机和超声洁牙机的最大示踪探测距离分别为360 cm、300 cm和240 cm。在使用空气涡轮机后，手术环境的任何表面都没有示踪剂。当担心大流行性疾病病原体的空气传播时，应注意尽量减少或避免使用旋转和超声波仪器。这项研究支持牙科协会的建议，以避免治疗产生气溶胶，特别是在大流行期间。迫切需要涉及气溶胶的牙科手术的管理指南，以及旨在消除感染因子的气溶胶修饰方法。
Background. The use of dental handpieces produces aerosols containing microbial agents, bacteria, and viruses representing a high-risk situation for airborne cross infections. The aim of this study was to map and quantify the biological contamination of a dental operatory environment using a biological tracer.Methods. Streptococcus mutans suspension was infused into the mouth of a manikin, and an operator performed standardized dental procedures using an air turbine, a contra-angle handpiece, or an ultrasonic scaler. The presence of the tracer was measured at 90 sites on the dental unit and the surrounding surfaces of the operatory environment.Results. All tested instruments spread the tracer over the entire dental unit and the surrounding environment, including the walls and ceiling. The pattern and degree of contamination were related to the distance from the infection source. The maximum distance of tracer detection was 360 centimeters for air turbine, 300 cm for contra-angle handpiece, and 240 cm for ultrasonic scaler. No surface of the operative environment was free from the tracer after the use of the air turbine.Conclusions. Attention should be paid to minimize or avoid the use of rotary and ultrasonic instruments when concerns for the airborne spreading of pandemic disease agents are present.Practical Implications. This study supports the recommendations of dental associations to avoid treatments generating aerosols, especially during pandemic periods. Guidelines for the management of dental procedures involving aerosols, as well as methods for the modification of aerosols aimed to inactivate the infective agent, are urgently needed.