University of Bristol Dental Hospital, Bristol, UK.
JDR Clin Trans Res. 2021 Apr;6(2):115-127. doi: 10.1177/2380084421989946. Epub 2021 Jan 29.
INTRODUCTION: This article aims to review the current national and international dental guidance produced during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic to identify the level of consensus on aerosol-generating dental procedures (AGDPs). The outcomes intend to encourage increased collaboration with respect to dental guidelines in relation to the SARS-CoV-2 pandemic, as well as to improve decision making and safety for dental patients and staff. METHODS: This rapid review was conducted by 2 authors (MKV and KD), with the support of a third author (SD), to assess current guidelines related to dental AGDPs. This streamlined review approach allowed synthesis of data in an efficient manner in the rapidly evolving environment associated with the SARS-CoV-2 pandemic. RESULTS: The findings identified 1) a lack of consistency in reporting which procedures were deemed an AGDP; 2) that high-speed handpieces, air-water syringes, and mechanical scalers were consistently considered high-risk AGDPs; 3) a lack of consensus on the risk of coronavirus disease 2019 (COVID-19) transmission with the use of slow-speed handpieces; 4) a general agreement, when described, that rubber dam and high-volume evacuation can significantly reduce aerosol production; and 5) a lack of consistency in reporting whether procedures constitute a low, moderate, or high risk of COVID-19 transmission. The findings are discussed in relation to the guidance and future recommendations. CONCLUSION: It is recommended that future published guidance should indicate the risk stratification (low/moderate/high) of each procedure/exposure in a standardized international approach. KNOWLEDGE TRANSFER STATEMENT: The results of this rapid review can be used by clinicians to increase their awareness of international guidance on aerosol-generating procedures in dentistry. It will also encourage those publishing future guidance to provide an internationally standardized, risk-stratified approach to describing aerosol-generating procedures. Currently, it allows clinicians to consider aerosol-generating procedures as a risk spectrum.
简介:本文旨在回顾在严重急性呼吸系统综合征冠状病毒 2 (SARS-CoV-2) 大流行期间制定的当前国家和国际牙科指南,以确定在产生气溶胶的牙科操作 (AGDPs) 方面的共识程度。其目的是鼓励加强与 SARS-CoV-2 大流行相关的牙科指南方面的合作,并提高牙科患者和医护人员的决策安全性。
方法:由 2 名作者 (MKV 和 KD) 在第 3 名作者 (SD) 的支持下进行了这项快速综述,以评估与牙科 AGDP 相关的现行指南。这种简化的综述方法使数据在与 SARS-CoV-2 大流行相关的快速发展的环境中以高效的方式得到综合。
结果:研究结果确定了以下几点:1)缺乏一致性报告哪些程序被认为是 AGDP;2)高速手机、水-气注射器和机械洁牙器被一致认为是高风险的 AGDP;3)对于使用低速手机是否会传播 2019 年冠状病毒病 (COVID-19),缺乏共识;4)当被描述时,普遍认为橡皮障和大体积抽吸可显著减少气溶胶的产生;5)缺乏一致性报告程序是否构成 COVID-19 传播的低、中或高风险。讨论结果与指南和未来建议相关。
结论:建议未来发表的指南应采用标准化的国际方法,说明每个程序/暴露的风险分层(低/中/高)。
知识转移陈述:该快速综述的结果可被临床医生用于提高对牙科产生气溶胶程序的国际指南的认识。这也将鼓励未来发布指南的人提供一种国际标准化的、风险分层的方法来描述产生气溶胶的程序。目前,它允许临床医生将产生气溶胶的程序视为风险谱。
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