临床牙科操作过程中的气溶胶浓度和粒径分布。

Aerosol concentrations and size distributions during clinical dental procedures.

作者信息

Lahdentausta Laura, Sanmark Enni, Lauretsalo Saku, Korkee Verneri, Nyman Sini, Atanasova Nina, Oksanen Lotta, Zhao Jiangyue, Hussein Tareq, Hyvärinen Antti, Paju Susanna

机构信息

Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, FI-00014 Helsinki, Finland.

Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, FI-00029 Helsinki, Finland.

出版信息

Heliyon. 2022 Oct 18;8(10):e11074. doi: 10.1016/j.heliyon.2022.e11074. eCollection 2022 Oct.

DOI:10.1016/j.heliyon.2022.e11074

PMID:36303931

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9593181/

Abstract

BACKGROUND

Suspected aerosol-generating dental instruments may cause risks for operators by transmitting pathogens, such as the SARS-CoV-2 virus. The aim of our study was to measure aerosol generation in various dental procedures in clinical settings.

METHODS

The study population comprised of 84 patients who underwent 253 different dental procedures measured with Optical Particle Sizer in a dental office setting. Aerosol particles from 0.3 to 10 μm in diameter were measured. Dental procedures included oral examinations (N = 52), restorative procedures with air turbine handpiece (N = 8), high-speed (N = 6) and low-speed (N = 30) handpieces, ultrasonic scaling (N = 31), periodontal treatment using hand instruments (N = 60), endodontic treatment (N = 12), intraoral radiographs (N = 24), and dental local anesthesia (N = 31).

RESULTS

Air turbine handpieces significantly elevated <1 μm particle median (p = 0.013) and maximum (p = 0.016) aerosol number concentrations as well as aerosol particle mass concentrations (p = 0.046 and p = 0.006) compared to the background aerosol levels preceding the operation. Low-speed dental handpieces elevated >5 μm median (p = 0.023), maximum (p = 0.013) particle number concentrations,> 5 μm particle mass concentrations (p = 0.021) and maximum total particle mass concentrations (p = 0.022). High-speed dental handpieces elevated aerosol concentration levels compared to the levels produced during oral examination.

CONCLUSIONS

Air turbine handpieces produced the highest levels of <1 μm aerosols and total particle number concentrations when compared to the other commonly used instruments. In addition, high- and low-speed dental handpieces and ultrasonic scalers elevated the aerosol concentration levels compared to the aerosol levels measured during oral examination. These aerosol-generating procedures, involving air turbine, high- and low-speed handpiece, and ultrasonic scaler, should be performed with caution.

CLINICAL SIGNIFICANCE

Aerosol generating dental instruments, especially air turbine, should be used with adequate precautions (rubber dam, high-volume evacuation, FFP-respirators), because aerosols can cause a potential risk for operators and substitution of air turbine for high-speed dental handpiece in poor epidemic situations should be considered to reduce the risk of aerosol transmission.

摘要

背景

疑似产生气溶胶的牙科器械可能通过传播病原体（如严重急性呼吸综合征冠状病毒2）给操作人员带来风险。我们研究的目的是测量临床环境中各种牙科操作产生的气溶胶。

方法

研究人群包括84例患者，他们在牙科诊所环境中接受了253种不同的牙科操作，并用光学粒子计数器进行测量。测量了直径从0.3到10μm的气溶胶颗粒。牙科操作包括口腔检查（n = 52）、使用气涡轮手机的修复操作（n = 8）、高速（n = 6）和低速（n = 30）手机、超声洁治（n = 31）、使用手持器械的牙周治疗（n = 60）、根管治疗（n = 12）、口腔内X光片拍摄（n = 24）以及牙科局部麻醉（n = 31）。

结果

与操作前的背景气溶胶水平相比，气涡轮手机显著提高了<1μm颗粒的中位数（p = 0.013）和最大值（p = 0.016）气溶胶数量浓度以及气溶胶颗粒质量浓度（p = 0.046和p = 0.006）。低速牙科手机提高了>5μm的中位数（p = 0.023）、最大值（p = 0.013）颗粒数量浓度、>5μm颗粒质量浓度（p = 0.021）和最大总颗粒质量浓度（p = 0.022）。与口腔检查期间产生的水平相比，高速牙科手机提高了气溶胶浓度水平。