Department of Restorative Dentistry and Endodontics, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
Int J Environ Res Public Health. 2021 Apr 4;18(7):3773. doi: 10.3390/ijerph18073773.
Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o'clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended.
全世界的牙科医护人员都处于持续的恐惧和焦虑之中，因为他们在牙科诊室的有限空间内工作。在常规牙科手术中，他们会接触到气溶胶和飞沫。这些空气传播的颗粒对医护人员和患者传播传染性感染的风险很大，尤其是在 COVID-19 导致的社交距离时代。本研究旨在评估使用双孔和四孔手机进行窝洞预备后气溶胶和飞沫的污染量、持续时间、距离和飞溅量。该研究在法伊萨尔国王大学 Al Ahsa 牙科学院的牙科模拟实验室的牙科模型上进行。牙科模型被设置为倾斜位置，以模拟牙科修复程序中患者的临床手术位置。气溶胶和飞沫被收集在 1 级定性棉纤维素滤纸上。这些滤纸放置在从牙科模型头枕延伸的胶带的六个不同方向（2、4、6、8、10 和 12 点钟方向）上，最长可达 60 英寸，并放置在操作人员和助手的某些位置，如胸部、头部、前臂、大腿和口罩内侧。主要研究者在特定的 3 分钟时间内在 #11 牙上进行 V 类窝洞预备，然后在第二天，使用四孔手机在 #21 牙上进行 V 类窝洞预备。整个窝洞预备过程中使用大流量抽吸。窝洞预备后立即在所有位置更换第一张滤纸。30 分钟后取下第二组滤纸。使用透明网格计算滤纸盘上的污染面积。两种手机产生的气溶胶和飞沫的平均量没有统计学上的显著差异，然而，在窝洞预备后立即和 30 分钟后，在 12、24 和 36 英寸距离处产生的气溶胶和飞沫的量存在统计学上的显著差异，与使用的手机类型无关。建议在牙科治疗室附近的操作后立即避免移除个人防护屏障。还建议使用大流量抽吸等其他辅助手段来减少气溶胶和飞沫的传播。
