The efficacy of an extraoral scavenging device on reduction of splatter contamination during dental aerosol generating procedures: an exploratory study
The efficacy of an extraoral scavenging device on reduction of splatter contamination during dental aerosol generating procedures: an exploratory study
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DOI：
10.1038/s41415-020-2112-7
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发表时间：
2020-09-11
影响因子：
2.6
通讯作者：
Din, Ahmed
中科院分区：
文献类型：
--
作者：
Shahdad, Shakeel;Patel, Tulsi;Din, Ahmed
介绍这项研究是在SARS-CoV-2大流行的情况下进行的，这使得英国牙科陷入停顿。市场上最近出现了未经证实的口外清除剂（EOSs），它们声称可以降低颗粒扩散的风险。目的研究市售EOS装置在牙科气溶胶发生程序（AGP）中减少污染的有效性。次要目的是调查开放式和封闭式牙科手术室之间的差异。方法在牙科假人上模拟牙科手术，将柠檬酸（10%）添加到水管中，并将通用指示纸（UIP）放置在手术室、临床医生和助手的关键位置。分析与UIP上含有柠檬酸的飞溅物的沉降相关的色度变化，以计算飞溅物污染的百分比强度。结果EOSs导致手术部位污染频率降低20%，平均污染强度降低75%。临床医生和助理的平均强度污染分别降低了33%和76%。使用橡胶坝和四手牙医导致进一步减少。讨论本探索性研究证明了在模拟牙科环境中的飞溅物污染。牙科对气溶胶的关注需要对更小的颗粒进行进一步的定量研究。结论：在可能的情况下，应继续常规使用四手牙科和橡胶坝，以最大限度地降低AGP期间的风险。然而，根据我们的研究结果，使用EOS设备可以进一步减轻飞溅的幅度和浓度。
IntroductionThis study was conducted in light of the SARS-CoV-2 pandemic, which brought UK dentistry to a standstill. The market has seen a recent influx of unproven extraoral scavengers (EOSs), which claim to reduce the risk of particulate spread. AimsTo investigate the efficacy of a commercially available EOS device on contamination reduction during dental aerosol generating procedures (AGPs). The secondary aim was to investigate differences between open and closed dental operatories. MethodDental procedures were simulated on a dental manikin using citric acid (10%) added to the water lines with universal indicating paper (UIP) placed in strategic locations in the operatory, on the clinician and assistant. Chromatic change related to settling of splatter containing citric acid on the UIP was analysed to calculate percentage intensity of splatter contamination. ResultsEOSs resulted in 20% reduction in frequency and 75% reduction in mean intensity of contamination of operatory sites. There was a 33% and 76% reduction in mean intensity contamination for clinician and assistant, respectively. Use of rubber dam and four-handed dentistry resulted in further reduction. DiscussionThis exploratory study demonstrates contamination by splatter in a simulated dental setting. The concern in dentistry regarding aerosol requires further quantitative investigation of smaller particles. ConclusionsThe routine use of four-handed dentistry and rubber dam should continue where possible to maximise risk mitigation during AGPs. However, on the basis of our findings, the use of an EOS device can further mitigate the magnitude and concentration of splatter.