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用于减少 COVID-19 大流行期间牙科诊所气溶胶扩散的防护装置。

Protective device to reduce aerosol dispersion in dental clinics during the COVID-19 pandemic.

机构信息

Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.

Centro Médico-Odontológico da Brigada Militar do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

Int Endod J. 2020 Nov;53(11):1588-1597. doi: 10.1111/iej.13373. Epub 2020 Aug 18.

Abstract

AIM

To describe the use of a new protective device to reduce aerosol dispersion in dental clinics during the COVID-19 pandemic.

METHODOLOGY

The device consists of a rigid translucent acrylic structure (methyl polymethacrylate), adjusted to the dental chair, involving the patient's head, neck and chest. There is also a piping system to generate negative pressure, for aspiration and filtering of the air inside the device chamber. The operator works through small holes in the acrylic structure, to reduce contact with the microparticles arising from aerosols during dental procedures. Simulated dental procedures using a fluorescent dye in the water of the dental equipment were carried out, with and without the use of the device. The presence of the dye was analysed at various locations, such as on personal protective equipment (PPE), the dental chair and on the clinic floor.

RESULTS

In the simulated dental procedure without the device, the dye was obvious on surgical gloves, aprons (waist, chest, legs, fists) and face shields, as well as on the dental chair (backrest, light reflector) and clinic floor. In the simulated dental procedure using the device, the dye was observed only on surgical gloves, apron (fists), inside the pipe system and internal walls of the acrylic chamber. There was a certain limitation of movement and visualization by the dentist whilst using the device.

CONCLUSIONS

The present device is a low-cost complementary resource for use in conjunction with standard PPE, to reduce the transmission of SARS-CoV-2 in the dental setting. Further clinical trials should be carried out to test the efficacy of this device to reduce aerosol dispersion and the consequent vector of contamination, as well as the ergonomic impacts related to its use.

摘要

目的

描述在 COVID-19 大流行期间,使用一种新的防护装置来减少牙科诊所中的气溶胶分散。

方法

该装置由刚性半透明亚克力结构(聚甲基丙烯酸甲酯)组成,可调节至牙科椅,覆盖患者的头部、颈部和胸部。还有一个管道系统,用于产生负压,以抽吸和过滤装置腔室内的空气。操作人员通过亚克力结构上的小孔进行操作,以减少在牙科操作过程中产生的气溶胶的微粒接触。在牙科设备的水中使用荧光染料进行模拟牙科操作,同时使用和不使用该装置。分析了染料在不同位置的存在情况,如个人防护设备(PPE)、牙科椅和诊所地板上。

结果

在没有使用该装置的模拟牙科操作中,手术手套、围裙(腰部、胸部、腿部、拳头)和面罩以及牙科椅(靠背、反光镜)和诊所地板上都能明显看到染料。在使用该装置进行的模拟牙科操作中,只在手术手套、围裙(拳头)、管道系统和亚克力室的内壁上观察到染料。牙医在使用该装置时,其运动和可视化受到一定限制。

结论

本装置是一种低成本的补充资源,与标准 PPE 联合使用,以减少 SARS-CoV-2 在牙科环境中的传播。应进一步进行临床试验,以测试该装置减少气溶胶分散和随之而来的污染媒介的功效,以及与使用相关的人体工程学影响。

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