高速牙科手机冷却剂输送和设计对气溶胶和液滴产生的影响。
The effect of high-speed dental handpiece coolant delivery and design on aerosol and droplet production.
机构信息
School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, United Kingdom; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom.
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom.
出版信息
J Dent. 2021 Sep;112:103746. doi: 10.1016/j.jdent.2021.103746. Epub 2021 Jul 13.
OBJECTIVES
High-speed dental instruments produce aerosol and droplets. The objective of this study was to evaluate aerosol and droplet production from a novel electric micromotor handpiece (without compressed air coolant) in real world clinical settings.
METHODS
10-minute upper incisor crown preparations were performed in triplicate in an open-plan clinic with mechanical ventilation providing 3.45 air changes per hour. A 1:5 ratio electric micromotor handpiece which allows water coolant without compressed air (Ti-Max Z95L, NSK) was used at three speeds: 60,000 (60 K), 120,000 (120 K), and 200,000 (200 K) revolutions per minute. Coolant solutions contained fluorescein sodium as a tracer (2.65 mmol L ). High-speed air-turbine positive control, and negative control conditions were conducted. Aerosol production was evaluated at 3 locations (0.5 m, 1.5 m, and 1.7 m) using: (1) an optical particle counter (OPC; 3016-IAQ, Lighthouse) to detect all aerosol; and (2) a liquid cyclone air sampler (BioSampler, SKC Ltd.) to detect aerosolised fluorescein, which was quantified by spectrofluorometric analysis. Settled droplets were detected by spectrofluorometric analysis of filter papers placed onto a rig across the open-plan clinic.
RESULTS
Local (within treatment bay) settled droplet contamination was elevated above negative control for all conditions, with no difference between conditions. Settled droplet contamination was not detected above negative controls outside the treatment bay for any condition. Aerosol detection at 1.5 m and 1.7 m, was only increased for the air-turbine positive control condition. At 0.5 m, aerosol levels were highly elevated for the air-turbine, minimally elevated for 200 K and 120 K, and not elevated for 60 K.
CONCLUSIONS
Electric micromotor handpieces which use water-jet coolant alone without compressed air produce localised (within treatment bay) droplet contamination, but are unlikely to produce aerosol contamination beyond the immediate treatment area (1.5 m), allowing them to be used safely in most open-plan clinic settings.
目的
高速牙科器械会产生气悬液和液滴。本研究的目的是评估新型电动微电机手机(无压缩空气冷却剂)在实际临床环境中气悬液和液滴的产生情况。
方法
在具有机械通风的开放式临床环境中,以 3.45 空气交换/小时的速度进行三次上切牙冠制备 10 分钟。使用允许使用水冷却剂而无需使用压缩空气的电动微电机手机(Ti-Max Z95L,NSK),转速分别为 60000 转/分(60K)、120000 转/分(120K)和 200000 转/分(200K)。冷却剂溶液中含有荧光素钠作为示踪剂(2.65mmol L)。进行高速气涡轮阳性对照和阴性对照条件。使用:(1)光学粒子计数器(OPC;3016-IAQ,Lighthouse)检测所有气溶胶;和(2)液体旋风空气采样器(BioSampler,SKC Ltd.)检测气溶胶化的荧光素,通过分光荧光光度分析进行定量。在开放式临床环境中放置的滤纸上通过分光荧光光度分析检测沉降液滴。
结果
与阴性对照相比,所有条件下治疗舱内的局部(治疗舱内)沉降液滴污染均升高,但各条件之间无差异。在治疗舱外的任何条件下,均未检测到高于阴性对照的沉降液滴污染。在 1.5 米和 1.7 米处检测到的气溶胶,仅在空气涡轮阳性对照条件下增加。在 0.5 米处,空气涡轮的气溶胶水平高度升高,200K 和 120K 则略有升高,而 60K 则没有升高。
结论
仅使用水射流冷却剂而不使用压缩空气的电动微电机手机会产生局部(治疗舱内)液滴污染,但不太可能在治疗区域以外产生气溶胶污染(1.5 米),因此可以在大多数开放式临床环境中安全使用。