Department of Periodontology, School of Dentistry, Fluminense Federal University, Rua Mário Santos Braga, nº 28, Centro, Niterói, Rio de Janeiro, CEP 24040-110, Brazil.
Department of Specific Information, School of Dentistry, Fluminense Federal University, Dr. Silvio Henrique Braune Street, 22 - Centro, Nova Friburgo, RJ, 28625- 650, Brazil.
BMC Oral Health. 2024 Apr 5;24(1):417. doi: 10.1186/s12903-024-03996-2.
Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments can carry, in addition to water, droplets of saliva, blood, and microorganisms, which can pose a risk of infections for healthcare professionals and patients. Due to the COVID-19 pandemic, this gained attention.
The aim was to carry out a systematic review of the evidence of the scope of the aerosol produced by ultrasonic scaler in environmental contamination and the influence of the use of intraoral suction reduction devices.
Scientific literature was searched until June 19, 2021 in 6 databases: Pubmed, EMBASE, Web of science, Scopus, Virtual Health Library and Cochrane Library, without restrictions on language or publication date. Studies that evaluated the range of the aerosol produced by ultrasonic scaler during scaling/prophylaxis and the control of environmental contamination generated by it with the use of low (LVE) and high (HVE) volume evacuation systems were included.
Of the 1893 potentially relevant articles, 5 of which were randomized controlled trials (RCTs). The meta-analysis of 3 RCTs showed that, even at different distances from the patient's oral cavity, there was a significant increase in airborne bacteria in the dental environment with the use of ultrasonic scaler. In contrast, when meta-analysis compared the use of HVE with LVE, there was no significant difference (P = 0.40/CI -0.71[-2.37, 0.95]) for aerosol produced in the environment.
There is an increase in the concentration of bioaerosol in the dental environment during the use of ultrasonic scaler in scaling/prophylaxis, reaching up to 2 m away from the patient's mouth and the use of LVE, HVE or a combination of different devices, can be effective in reducing air contamination in the dental environment, with no important difference between different types of suction devices.
许多牙科使用的器械都是旋转器械，如手机、水注射器和超声洁牙机，它们会产生气溶胶。这些器械产生的喷雾除了水之外，还可能携带唾液、血液和微生物的飞沫，这可能会给医护人员和患者带来感染的风险。由于 COVID-19 大流行，这一点引起了关注。
旨在对超声洁牙机产生的气溶胶范围在环境污染方面的证据进行系统评价，并评估使用口腔内抽吸减少装置的影响。
在 6 个数据库（Pubmed、EMBASE、Web of science、Scopus、Virtual Health Library 和 Cochrane Library）中搜索截至 2021 年 6 月 19 日的科学文献，不限制语言或出版日期。纳入评估在洁牙/预防治疗期间超声洁牙机产生的气溶胶范围，以及使用低（LVE）和高（HVE）容量抽吸系统控制其产生的环境污染的研究。
在 1893 篇潜在相关文章中，有 5 篇是随机对照试验（RCT）。3 项 RCT 的荟萃分析显示，即使在距离患者口腔不同的距离处，使用超声洁牙机时，牙科环境中的空气中细菌数量也显著增加。相比之下，当荟萃分析比较 HVE 与 LVE 的使用时，环境中产生的气溶胶没有显著差异（P=0.40/CI -0.71[-2.37, 0.95]）。
在洁牙/预防治疗期间使用超声洁牙机时，牙科环境中的生物气溶胶浓度会增加，距离患者口腔可达 2 米，使用 LVE、HVE 或不同设备的组合可以有效降低牙科环境中的空气污染，不同类型的抽吸设备之间没有重要差异。
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