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一种减少气溶胶的牙科抽吸系统的临床研究。

A clinical investigation of dental evacuation systems in reducing aerosols.

出版信息

J Am Dent Assoc. 2021 Jun;152(6):455-462. doi: 10.1016/j.adaj.2021.02.013.

Abstract

BACKGROUND

The route of transmission of severe acute respiratory syndrome coronavirus 2 has challenged dentistry to improve the safety for patients and the dental team during various treatment procedures. The purpose of this study was to evaluate and compare the effectiveness of dental evacuation systems in reducing aerosols during oral prophylactic procedures in a large clinical setting.

METHODS

This was a single-center, controlled clinical trial using a split-mouth design. A total of 93 student participants were recruited according to the inclusion and exclusion criteria. Aerosol samples were collected on blood agar plates that were placed around the clinic at 4 treatment periods: baseline, high-volume evacuation (HVE), combination (HVE and intraoral suction device), and posttreatment. Student operators were randomized to perform oral prophylaxis using ultrasonic scalers on 1 side of the mouth, using only HVE suction for the HVE treatment period and then with the addition of an intraoral suction device for the combination treatment period. Agar plates were collected after each period and incubated at 37 °C for 48 hours. Colony-forming unit (CFU) counts were determined using an automatic colony counter.

RESULTS

The use of a combination of devices resulted in significant reductions in CFUs compared with the use of the intraoral suction device alone (P < .001). The highest amounts of CFUs were found in the operating zone and on patients during both HVE and combination treatment periods.

CONCLUSIONS

Within limitations of this study, the authors found significant reductions in the amount of microbial aerosols when both HVE and an intraoral suction device were used.

PRACTICAL IMPLICATIONS

The combination of HVE and intraoral suction devices significantly decreases microbial aerosols during oral prophylaxis procedures.

摘要

背景

严重急性呼吸综合征冠状病毒 2 的传播途径使牙科面临挑战,需要在各种治疗过程中提高患者和牙科团队的安全性。本研究的目的是评估和比较在大型临床环境中,使用不同的牙科抽吸系统在减少口腔预防程序中产生的气溶胶的效果。

方法

这是一项采用单中心、对照临床试验设计,采用分口设计。根据纳入和排除标准,共招募了 93 名学生参与者。在 4 个治疗期(基线、大体积抽吸(HVE)、联合(HVE 和口腔内抽吸装置)和治疗后),在诊所周围放置血液琼脂平板收集气溶胶样本。学生操作人员被随机分配在一侧口腔使用超声洁牙机进行口腔预防,在 HVE 治疗期仅使用 HVE 抽吸,然后在联合治疗期添加口腔内抽吸装置。每个治疗期后收集琼脂平板,并在 37°C 孵育 48 小时。使用自动菌落计数器确定菌落形成单位(CFU)计数。

结果

与单独使用口腔内抽吸装置相比,联合使用两种设备可显著降低 CFU(P <.001)。在 HVE 和联合治疗期间,操作区和患者身上的 CFU 数量最多。

结论

在本研究的限制范围内,作者发现当同时使用 HVE 和口腔内抽吸装置时,微生物气溶胶的数量显著减少。

实用意义

在口腔预防程序中,HVE 和口腔内抽吸装置的联合使用可显著减少微生物气溶胶。

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