Abstract
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has triggered the paralysis of dental services ascribed to the potential spread of severe acute respiratory syndrome (SARS)-CoV-2. Aerosol-generating procedures (AGPs) are common in dentistry, which in turn increase the risk of infection of the dental personnel due to the salivary presence of SARS-CoV-2 in COVID-19 patients. The use of rubber dam isolation (RDI) and high-volume evacuators (HVE) during AGPs is recommended to control dental aerosols, but the evidence about their effectiveness is scarce. This first study aimed to compare, in a simulated patient, the effectiveness of the following strategies: standard suction (SS), RDI and RDI + HVE. Using the laser diffraction technique, the effect of each condition on the volume distribution, average size and concentration of coarse (PM10), fine (PM2.5) and ultrafine (PM0.1) particles were evaluated. During the teeth drilling, the highest volume fraction of dental aerosol particles with SS was below 1 μm of aerodynamic diameter. Additionally, the RDI + HVE significantly reduced both the ultrafine dental aerosol particles and the concentration of total particulate matter. AGPs represent a potential risk for airborne infections in dentistry. Taken together, these preliminary results suggest that isolation and high-volume suction are effective to reduce ultrafine dental aerosol particles.
Highlights
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has triggered several forms of collateral damage but one obvious effect is the paralysis of dental services caused by the potential spread of severe acute respiratory syndrome (SARS)-CoV-2 [1]
Our study demonstrates that the location of the tip of the high-volume evacuator, facing the aerosol-generating procedure side, and combined with rubber dam isolation, significantly reduce the volume fraction of the ultrafine particles (PM0.1 or nanoparticles)
The ultrafine particles here detected corresponded to the highest proportion among aerosol dental particles in the hazardous range [21,26,28] when standard suction is implemented
Summary
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has triggered several forms of collateral damage but one obvious effect is the paralysis of dental services caused by the potential spread of severe acute respiratory syndrome (SARS)-CoV-2 [1]. In dentistry, approaches such as preventive, restorative and surgical use water-cooled rotary devices (i.e., high-speed handpieces) to perform interventions that are considered aerosol-generating procedures (AGPs) [2,3,4]. There is a lack of evidence that supports the effectiveness of RDI and HVE, either alone or combined, to control dental aerosols during dental restorative procedures [4,13,14,15]
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