Municipal Health Office of Florianópolis, Brazil.
Federal University of Santa Catarina, Florianópolis, Brazil.
J Dent. 2018 Sep;76:9-18. doi: 10.1016/j.jdent.2018.06.019. Epub 2018 Jun 26.
To answer the focused question, "What are the prevalence of percutaneous injuries (PIs) on dentists, the location with the highest prevalence, and the dental instrument most responsible for these injuries?" As secondary outcomes, the prevalence by geographic location, type of PI, sex distribution, and dentist's specialty were also considered.
Observational descriptive studies investigating the prevalence of percutaneous injuries on dentists were included.
Five electronic databases and three partial grey literature searches were performed.
The MAStARI tool assessed the potential risk of bias (RoB) among the studies, while the GRADE approach determined the level of evidence.
Among 2284 identified studies, 55 were included. Three studies were classified as low RoB, 17 as moderate RoB, and 35 as high RoB. The sample size ranged from 9 to 4107 dentists.
The PI prevalence in dentists ranged from 7.72% (95% confidence interval [CI]: 0.93-37.59) to 66.74% (95%CI: 29.83-94.51). North America was the most affected region, while South America was the least affected. Differences between sexes were not significant. The dental bur was the most commonly reported dental instrument causing PIs.
Owing to the very low GRADE level of evidence, caution should be applied when considering these findings and further research is required.
A high PI prevalence among dentists was noticed, and most were caused by dental burs. These findings imply that PIs should be considered by every dentist and proper measures instituted to reduce their prevalence.
回答聚焦问题，“牙医发生经皮损伤（PIs）的流行率是多少，发病率最高的部位，以及导致这些损伤的最主要的牙科器械是什么？”作为次要结果，还考虑了地理位置、PI 类型、性别分布和牙医专业的流行率。
纳入了调查牙医经皮损伤流行率的观察性描述性研究。
进行了五项电子数据库和三项部分灰色文献检索。
MAStARI 工具评估了研究中潜在的偏倚风险（RoB），而 GRADE 方法则确定了证据水平。
在 2284 项确定的研究中，有 55 项被纳入。三项研究被归类为低 RoB，17 项为中度 RoB，35 项为高 RoB。样本量从 9 名牙医到 4107 名牙医不等。
牙医经皮损伤的流行率范围为 7.72%（95%置信区间[CI]：0.93-37.59）至 66.74%（95%CI：29.83-94.51）。北美是受影响最严重的地区，而南美洲则受影响最小。性别之间的差异无统计学意义。牙科钻头是最常报告导致 PIs 的牙科器械。
由于 GRADE 证据水平非常低，在考虑这些发现时应谨慎，并需要进一步研究。
牙医经皮损伤的流行率较高，且大多数由牙科钻头引起。这些发现表明，每个牙医都应考虑 PIs，并采取适当措施降低其流行率。
