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牙科气溶胶和喷溅的减轻:13 种设置效果的分析。

Aerosol and spatter mitigation in dentistry: Analysis of the effectiveness of 13 setups.

机构信息

Medical University of South Carolina, James B. Edwards College of Dental Medicine, Charleston, South Carolina, USA.

出版信息

J Esthet Restor Dent. 2021 Apr;33(3):466-479. doi: 10.1111/jerd.12717. Epub 2021 Feb 1.

Abstract

OBJECTIVES

The current study aims to investigate the aerosol and spatter mitigation quality of 13 dry-field isolation methods in a simulated setup that replicates real-life work scenarios encountered in dental practices.

METHODS

A crown preparation on a manikin was performed on tooth number 30 and repeated five times for each setup to simulate a patient under care. Aerosol, environmental, and operator face shield spatter, and sound intensity was measured. Generalized linear mixed models were used, and posthoc pairwise comparisons were performed to compare least-squares means when appropriate using a Tukey adjustment.

RESULTS

All tested setups showed some environmental spatter formation; however, these were able to control most (and in some cases all) spatter on the operator face shield. All methods resulted in excellent aerosol mitigation when a second line of high-volume evacuation (HVE) was added to the device setup. However, in most setups, total sound levels exceeded 85 dB, posing a concern for prolonged noise exposure.

CONCLUSIONS

The Prototype device and four other tested setups with secondary HVE addition completely eliminated aerosol creation as tested. Spatter of the Face Shield was best eliminated using the Prototype device.

CLINICAL SIGNIFICANCE

Within the limitations of this study, it can be concluded that the dental community has at its disposal equipment that can effectively mitigate aerosol and spatter.

摘要

目的

本研究旨在模拟牙科临床实际操作场景,评估 13 种干式隔离方法在模拟环境中的气溶胶和飞沫减少质量。

方法

在牙模 30 号牙上进行牙冠预备,并对每种设置重复五次,以模拟正在接受治疗的患者。测量气溶胶、环境和操作人员面罩飞沫以及声强。使用广义线性混合模型,在适当情况下使用 Tukey 调整进行最小二乘均数的事后两两比较。

结果

所有测试的设置都显示出一定程度的环境飞沫形成,但这些设置都能够控制大部分(在某些情况下是全部)操作人员面罩上的飞沫。当在设备设置中添加第二行高容量抽吸(HVE)时,所有方法都能极好地减少气溶胶。然而,在大多数设置中,总声级超过 85dB,这对长时间暴露于噪音中提出了担忧。

结论

原型设备和其他四个经过测试的设置(增加了二次 HVE)完全消除了气溶胶的产生。使用原型设备可以最好地消除面罩上的飞沫。

临床意义

在本研究的限制范围内,可以得出结论,牙科界已经拥有可以有效减少气溶胶和飞沫的设备。

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