流量和不同尺寸吸引管对牙科中喷溅污染的影响：使用大容量抽吸系统的探索性研究结果。
Influence of flow rate and different size of suction cannulas on splatter contamination in dentistry: results of an exploratory study with a high-volume evacuation system.
机构信息
Clinic of Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Haus B), 24105, Kiel, Germany.
出版信息
Clin Oral Investig. 2022 Sep;26(9):5687-5696. doi: 10.1007/s00784-022-04525-7. Epub 2022 May 10.
OBJECTIVES
SOPs recommend high-volume evacuation (HVE) for aerosol-generating procedures (AGPs) in dentistry. Therefore, in the exploratory study, the area of splatter contamination (SCON in %) generated by high-speed tooth preparation (HSP) and air-polishing (APD) was measured when different suction cannulas of 6 mm diameter (saliva ejector (SAE)), 11 mm (HC11), or 16 mm (HC16) were utilized versus no-suction (NS).
MATERIALS AND METHODS
Eighty tests were performed in a closed darkened room to measure SCON (1m circular around the manikin head (3.14 m) via plan metrically assessment through fluorescence technique. HSP (handpiece, turbine (Kavo, Germany)) or APD (LM-ProPower (Finland), Airflow®-Prophylaxis-Master (Switzerland)) for 6 min plus 5 s post-treatment were performed either without suction or with low-flow (150 l/min for SAE) or high-flow rate (250 l/min/350 l/min for HC11/HC16) suction. All tests were two-tailed (p≤0.05, Bonferroni corrected for multi-testing).
RESULTS
Irrespective the AGP, SCON was higher for NS (median [25th; 75th percentiles]: 3.4% [2.6; 5.4]) versus high-flow suction (1.9% [1.5; 2.5]) (p=0.002). Low-flow suction (3.5% [2.6; 4.3]) versus NS resulted in slightly lower but not statistically significantly lower SCON (p=1.000) and was less effective than high-flow suction (p=0.003). Lowest contamination values were found with HC16 (1.9% [1.5; 2.5]; p≤0.002), whereat no significant differences were found for HC11 (2.4% [1.7; 3.1]) compared to SAE (p=0.385) or NS (p=0.316).
CONCLUSIONS
Within study's limitations, the lowest splatter contamination values resulted when HC16 were utilized by a high-flow rate of ≥250 l/min.
CLINICAL RELEVANCE
It is strongly recommended to utilize an HVE with suction cannulas of 16mm diameter for a high-flow rate during all AGPs and afterwards also to disinfect all surface of patients or operators contacted.
目的
操作规范建议在牙科使用高容量抽吸（HVE）进行产生气溶胶的程序（AGP）。因此，在探索性研究中，测量了高速牙预备（HSP）和空气抛光（APD）时使用直径为 6 毫米的不同抽吸套管（唾液喷射器（SAE））、11 毫米（HC11）或 16 毫米（HC16）与无抽吸（NS）相比产生的飞溅污染面积（SCON 以%表示）。
材料和方法
在封闭的暗室内进行了 80 次测试，通过荧光技术通过平面计量评估来测量 SCON（距人体模型头部 1m 处的圆形，直径为 3.14m）。HSP（机头，涡轮机（德国卡瓦））或 APD（LM-ProPower（芬兰），Airflow®-Prophylaxis-Master（瑞士））进行 6 分钟加治疗后 5 秒，要么没有抽吸，要么使用低流量（SAE 为 150 l/min）或高流量（HC11/HC16 为 250 l/min/350 l/min）抽吸。所有测试均为双尾（p≤0.05，经多重测试校正的 Bonferroni）。
结果
无论 AGP 如何，与高流量抽吸（1.9%[1.5;2.5]）相比，无抽吸（NS）时 SCON 更高（中位数[25%；75%]：3.4%[2.6;5.4]）（p=0.002）。与 NS 相比，低流量抽吸（3.5%[2.6;4.3]）的 SCON 略低，但无统计学意义（p=1.000），且效果不如高流量抽吸（p=0.003）。HC16 产生的污染值最低（1.9%[1.5;2.5]；p≤0.002），而 HC11（2.4%[1.7;3.1]）与 SAE（p=0.385）或 NS（p=0.316）相比，差异无统计学意义。
结论
在研究的限制范围内，当使用≥250 l/min 的高流量时，HC16 产生的飞溅污染值最低。
临床相关性
强烈建议在所有 AGP 期间使用 16 毫米直径的高容量抽吸（HVE）和抽吸套管，并在治疗后对所有接触到的患者或操作人员的表面进行消毒。
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