Abstract
BackgroundIn restorative dentistry, the use of high-speed air turbine, which generates aerosols, can be associated with the transmission of airborne diseases. New laser technologies could be useful in reducing the amount of aerosols, but there is a lack of scientific research on this topic. Material and MethodsThis is a descriptive study to analyze the amount of aerosols produced after class I cavity preparation using high-speed air turbine (group 1) and Er,Cr:YSGG laser with two different parameters (groups 2 and 3). Fluorescein dye was incorporated into the coolant reservoir in order to visualize the production of aerosols during each procedure. Tooth preparation was performed in a typodont with human lower molar tooth under rubber dam isolation. The procedure was carried out in a transparent plastic box to avoid aerosols dispersion. Sixteen grade I cellulose filter discs were distributed along the surfaces of the box. The area contaminated with aerosols in the filters was measured using ultraviolet illumination. ResultsIn group 1, the contaminated surface area covered with fluorescein dye reached 77.3% (1349 cm2) of the total; in group 2 (laser with 80% water) we observed 7.3% (128 cm2) and in group 3 (laser with 40% water) it was 3.8% (68 cm2). The reduction in water parameter from 80% to 40% coincided with 48% reduction of the contaminated area on the filter discs. Focusing on the surfaces of the box, we noted that the mean contamination on the left side was more than on the right side in all three experimental groups. In group 1 using air turbine, we measured a mean of 102.6[±7.5 SD]cm2 on the left side, compared to 70.6[±32.3 SD]cm2 on the right side. In laser groups 2 and 3, a mean of 12.8[±14.9 SD]cm2 and 6.8 [±5.7SD]cm2, respectively, was described on the left surface versus 0 cm2 of surface contamination on the right surface. ConclusionsThe contaminated area during the procedure of class I cavity preparation, is reduced by 70% using Er,Cr:YSGG laser compared to high-speed turbine. A slightly higher contamination was observed between laser groups with 80% versus 40% water. The use of Er,Cr:YSGG laser in restorative dentistry can be a valid treatment alternative to reduce aerosols production compared to conventional high-speed rotary instruments. Key words:Er,Cr:YSGG laser, Aerosols, SARS-CoV-2, Rotary instruments, conservative dentistry.
Highlights
The pandemic triggered by the novel coronavirus causing Severe Acute Respiratory Syndrome (SARSCoV-2) started in December 2019 in Wuhan, China [1], affecting 195 countries around the world
The contaminated area during the procedure of class I cavity preparation, is reduced by 70% using Er,Cr:YSGG laser compared to high-speed turbine
The use of Er,Cr:YSGG laser in restorative dentistry can be a valid treatment alternative to reduce aerosols production compared to conventional high-speed rotary instruments
Summary
The pandemic triggered by the novel coronavirus causing Severe Acute Respiratory Syndrome (SARSCoV-2) started in December 2019 in Wuhan, China [1], affecting 195 countries around the world. Expression of angiotensin-converting enzyme 2 (ACE2) receptor, which is used by SARS-CoV-2 as a way of cellular invasion was found in salivary glands, epithelial cells of the tongue, T cells, B cells, fibroblasts and epithelial oral mucosal lining, suggesting that the oral cavity is a possible medium for direct virus invasion and attachment [9] This explains the peak in viral load in saliva during the first week following onset of symptoms and subsequent decline [10]. The use of hard tissue lasers may be an alternative technique in many dental procedures traditionally performed by rotary instruments to reduce the amount of aerosols Their introduction in dentistry started in the late 1980’s with advantages such as the absence of smear layer, bactericidal nature and tissue selectivity depending on the wavelength of the laser [18]. The objective of this study is to describe the quantity of aerosols generated during class I cavity preparation performed with three different techniques: using a rotatory instrument (high-speed turbine) and Er,Cr:YSGG laser with two different parameters. In laser groups 2 and 3, a mean of 12.8[±14.9 SD]cm and 6.8 [±5.7SD]cm, respectively, was described on the left surface versus 0 cm of surface contamination on the right surface
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