J Am Dent Assoc. 2022 Apr;153(4):309-318.e1. doi: 10.1016/j.adaj.2021.08.011. Epub 2021 Dec 21.
The COVID-19 pandemic has increased the importance of minimizing exposure to aerosols generated during dental procedures. The authors' objective was to measure the aerosolized particles in the breathing zone of operators using several facial protection and filtration methods.
Twenty-one dentists performed maxillary anterior incisor veneer preparations using a microscope and drape and loupes with or without a face shield. In each test condition, the following 3 levels of filtration were tested: no filtration, a high-volume evacuator [HVE], and an HVE with an extraoral suction device. Measurements were made using a mass monitor attached to the operator's chest with inlet within 10 inches of the operator's face.
The authors found that the microscope and drape provided the lowest levels of aerosolized particles compared with loupes with or without a face shield (P < .001). There was no detectable difference in the concentration of particles between operators wearing a face shield and wearing loupes alone (P = .47). The particles in each test condition were lowered when an HVE was used (P < .001) and further lowered with an extraoral suction device.
The findings of this study suggest that the use of a surgical microscope and bag barrier drape, HVE, and extraoral suction device result in the lowest concentration of aerosolized particles. The face shield did not appear to offer any protection from aerosolized particles. HVE and extraoral suction were effective in decreasing aerosols regardless of the type of facial protection used.
Dentists can reduce exposure to aerosols with a drape, HVE, and extraoral suction.
COVID-19 大流行增加了最大限度减少牙科操作过程中产生的气溶胶暴露的重要性。作者的目的是使用几种面部保护和过滤方法测量操作人员呼吸区域中的气溶胶化颗粒。
21 名牙医使用显微镜和带有或不带有面罩的头灯和放大镜进行上颌前切牙贴面准备。在每个测试条件下,测试了以下 3 种过滤水平:无过滤、高容量抽吸器(HVE)和带口腔外抽吸装置的 HVE。使用安装在操作员胸部的质量监测器进行测量,入口位于操作员面部 10 英寸内。
与头灯和面罩或不带面罩的放大镜相比,显微镜和头灯提供的气溶胶化颗粒最低(P<0.001)。佩戴面罩和单独佩戴放大镜的操作员之间的颗粒浓度没有差异(P=0.47)。使用 HVE 时,每个测试条件中的颗粒浓度降低(P<0.001),并进一步降低使用口腔外抽吸装置。
本研究的结果表明,使用手术显微镜和袋状屏障头灯、HVE 和口腔外抽吸装置可降低气溶胶化颗粒的浓度。面罩似乎不能提供对气溶胶化颗粒的任何保护。HVE 和口腔外抽吸无论使用哪种面部保护装置都能有效地减少气溶胶。
牙医可以使用头灯、HVE 和口腔外抽吸来减少对气溶胶的暴露。