Use Of High-speed Handpiece Research Articles

Ultrafine particles exposure is associated with specific operative procedures in a multi-chair dental clinic

Air quality in dental clinics is critical, especially in light of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, given that dental professionals and patients are at risk of regular exposure to aerosols and bioaerosols in dental clinics. High levels of ultrafine particles (UFP) may be produced by dental procedures. This study aimed to quantify ultrafine particles (UFP) concentrations in a real multi-chair dental clinic and compare the levels of UFP produced by different dental procedures. The efficiency of a high-volume evacuator (HVE) in reducing the UFP concentrations during dental procedures was also assessed. UFP concentrations were measured both inside and outside of a dental clinic in Shanghai, China during a 12-day period from July to September 2020. Dental activities were recorded during working hours. The mean (±standard deviation) concentrations of indoor and outdoor UFP during the sampling period were 8,209 (±4,407) counts/cm3 and 15,984 (±7,977) counts/cm3, respectively. The indoor UFP concentration was much higher during working hours (10,057 ± 5,725 counts/cm3) than during non-working hours (7,163 ± 2,972 counts/cm3). The UFP concentrations increased significantly during laser periodontal treatment, root canal filling, tooth drilling, and grinding, and were slightly elevated during ultrasonic scaling or tooth extraction by piezo-surgery. The highest UFP concentration (241,136 counts/cm3) was observed during laser periodontal treatment, followed by root canal filling (75,034 counts/cm3), which showed the second highest level. The use of an HVE resulted in lower number concentration of UFP when drilling and grinding teeth with high-speed handpieces, but did not significantly reduce UFP measured during laser periodontal therapy. we found that many dental procedures can generate high concentration of UFP in dental clinics, which may have a great health impact on the dental workers. The use of an HVE may help reduce the exposure to UFP during the use of high-speed handpieces.

The impact of the COVID-19 pandemic on dental practice in Brazil

Introduction: Dentists are at high risk of contamination by COVID-19 due to the proximity to the patients' oral cavity and airways. Objective: To elucidate the behaviors and adversities experienced by dentists because of the COVID-19 pandemic. Methods: This descriptive study invited 1.811 dentists affiliated with professional associations, dental cooperatives, and health insurance providers from São Paulo State, Brazil, in 2020 of which 473 agreed to participate. The data collection, using Google Forms, included the variables: sociodemographic conditions; characteristics of dental work; level of healthcare and sources of information about the pandemic; changes in the work process, financial impact with personal protective equipment (PPE) and biosafety measures; and consequences of the pandemic in the professional practice. Results: The 473 dentists (40.36±13.44 years), were mostly women (52.22%), had a specialty (55.60%), and were self-employed professionals (73.36%). It was observed that 78.01% of professionals had a reduction in their monthly income. The average of patients treated daily decreased by 35.48%. It was found that 30.44% of professionals had difficulty with the use of PPE, 3.59% contracted COVID-19, and 53.03% decided to postpone the appointment if the patient with suspected or confirmed COVID-19 sought treatment, even in emergencies. The use of high-speed handpieces was reported by most professionals (n=428; 90.48%). Conclusion: Behaviors: dentists used PPE and assigned very high or high levels of precaution about COVID-19. Adversities: dentists reported an increase in operating costs, changes in the work process, a decrease in appointments, and a reduction in the monthly income.

The Efficacy of High-Volume Evacuators and Extraoral Vacuum Aspirators in Reducing Aerosol and Droplet in Ultrasonic Scaling Procedures during the COVID-19 Pandemic.

SARS-CoV-2 can be carried by aerosols and droplets produced during dental procedures, particularly by the use of high-speed handpieces, air-water syringes, and ultrasonic scalers. High-volume evacuators (HVEs) and extraoral vacuum aspirators (EOVAs) reduce such particles. However, there is limited data on their efficacy. This study aimed to determine the efficacy of HVE and EOVA in reducing aerosols and droplets during ultrasonic scaling procedures. Three ultrasonic scaling simulations were conducted on mannequins: 1. saliva ejector (SE) was used alone (control); 2. SE was used in combination with HVE; and 3. SE was used in combination with HVE and EOVA. Paper filters were placed on the operator's and assistant's face shields and bodies, and the contamination of aerosols and droplets was measured by counting blue spots on the paper filters. All data were analyzed for normality using the Kolmogorov-Smirnov test. The differences between each method were analyzed using a two-way ANOVA, followed by a posthoc test. The differences were considered statistically significant when p < 0.05. Using HVE and EOVA reduced aerosols and droplets better than using SE alone or SE and HVE: the posthoc test for contamination revealed a significant difference (p < 0.01). The assistant was subjected to greater contamination than the operator during all three ultrasonic scaling procedures. The usage of HVE and EOVA significantly reduced aerosols and droplets compared with using SE solely. Using these techniques together could prevent the transmission of airborne disease during dental cleanings, especially COVID-19. Further studies of aerosol-reducing devices are still needed to ensure the safety of dental workers and patients.

A to Z Steps of In-person Screening, Treatment, and Caring Procedure in Orthodontic Clinics During COVID-19 Pandemic: A Rapid Mini-review

Background: A novel coronavirus emerged from Wuhan, China, in December 2019. Dental healthcare providers are at the highest risk of exposure since the primary source of the virus is saliva, and dentists are the front-line personnel working with the oral cavity. Since orthodontic treatment is a long-term procedure for children and teenagers, and because of the critical gap in preparing a specific guideline on orthodontic treatment procedures, orthodontic practitioners have faced numerous complicated issues in this regard. This mini-review aimed to summarize the facts that the orthodontic settings should be aware of the dental difficulties during COVID-19 with a particular focus on orthodontic treatment. Methods: In this short review, electronic databases of Medline, Scopus, Web of Science, and Google Scholar were searched for relevant articles and guidelines from January 2019 to March 2021 using the following key terms: “COVID-19,” “SARS-CoV-2,” “Pandemic,” “Orthodontics,” and “Orthodontists.” Results: Gathering recommendations of experts and several guidelines led to the following crucial steps in orthodontic procedures: screening through a telehealth questionnaire; admitting just patients into the dental center; ventilating the waiting room; measuring the temperature of patients’ bodies; disinfecting the dental unit and instruments after each visit; using personal protective equipment; washing hands; minimizing the use of high-speed handpieces to reduce the aerosol generation; and sterilization of archwires, orthodontic markers, photographic retractors, molar bands, burs, miniscrews, and unit waterline with proper methods. Conclusions: All dentists should be up-to-date on cross-transmission of SARS-CoV-2 and follow the international infection control protocols as well as national/provincial/local guidelines and apply them to the regional settings after generalization and matching with the condition.

Lessons Learned from the COVID-19 Pandemic in Implant Dentistry Settings

In 2019, Wuhan city of China announced the epidemic of COVID-19 as a public health disaster which has been recognized as an uncommon type of single stranded RNA virus belonging to Coronaviridae family and then quickly spread all over the world. Clinically symptomatic patients are identified as the primary source of COVID-19 transmission. Most of dental procedures require the use of high-speed handpieces which leads to aerosol generation. Implant dentistry is the field of dentistry which deals with prosthetic rehabilitation with minimal aerosol generation ensuring an aseptic surgical environment. There are several decisive recommendations regarding COVID-19 precautions that should be appreciated in implant dentistry. Sharp drills in slow speed drilling machines are preferred during surgery. Regular irrigation with high volume suction is greatly encouraged. Osteotomes are encouraged over ultrasonic devices to minimize the generation of aerosols during surgical procedures. Immediate implants placement is more preferred as the number of visits to the dentists is reduced. Impression techniques should be shifted to the digital approach instead of conventional methods. Full mouth rehabilitation cases requiring complex procedures should be accomplished restrictedly.

English

Air emphysema as a consequence of dental procedures is a rare but dangerous state if not diagnosed and treated timely. It can occur incidentally or iatrogenically in many dental procedures such as restorations, endodontic and periodontal treatments, surgical and non-surgical tooth extraction, and use of air or water sprays and syringes.1-6 Subcutaneous emphysema of dental origin most commonly occurs after surgical extraction of an impacted mandibular third molar.7 Several studies have reported that the use of high speed hand-piece during surgical extraction led to escape of air into the subcutaneous tissues. 7-10 Wilson (1983) reported subcutaneous emphysema in the eyelids after extraction of the maxillary molar teeth due to vigorous irrigation combined with air and water spray for 10 seconds.6 Subcutaneous emphysema in the cheek after extraction of the maxillary third molar without using high speed hand-piece is not a common phenomenon. In the present case, we demonstrate air emphysema in the cheek associated with hematoma after extraction of the impacted right maxillary 3rd molar. Since it was a soft tissue impaction, no hand-piece was used during the tooth removal. The purpose of this case report is to create awareness among the dental surgeons about the simple extraction procedures that may lead to air emphysema associated with hematoma.

Utilizing Aligners to Solve the COVID-19-Affected Orthodontic Practice Conundrum!

Dentists all around the world are facing a dilemma on whether to resume their practice or not and the ones who have made the effort to resume work, feel they are at high risk of getting infected by the coronavirus. A majority of dental treatments require the use of high-speed handpieces as well as ultrasonic scalers which can make it even more dangerous for the treating dentists and assistants as these release aerosols which could aid in virus transmission. High-quality personal protective equipment is hard to procure and, if so, is very expensive adding to the cost of running clinics during this period. One of the main issues plaguing dentists practicing orthodontics is the inability to see their patients regularly during this period, which can cause a lot of unwanted tooth movements. This is where aligners can be of big help as the entire treatment planning process can be done virtually and the treatment can be monitored without the need of the patient having to visit the clinic physically.

Subcutaneous emphysema during removal of suture after intraoral surgery

Subcutaneous emphysema is relatively rare postoperative complication in the oral and maxillofacial region. Most cases reported in maxillofacial area relate to the use of high-speed handpiece. However, in this case, subcutaneous emphysema was caused by compressed air blow performed during suture removal. Cone-Beam Computed Tomography was conducted to evaluate the extent of diffusion bubbles.. In this report, we describe etiology, diagnosis, prevention and management of subcutaneous emphysema in the maxillofacial area.

Eye-related trauma and infection in dentistry.

Despite numerous technological and medical developments achieved in recent years, a significant amount of occupational health problems still exist in modern dentistry. The risk of eye injury is mostly attributed to the use of high-speed hand pieces and ultrasonic devices. A dental clinic may be the source of eye-related infection and injury because of mechanical, chemical, microbiological and electromagnetic irritants. Accidents may cause facial injuries that involve eyes of the clinicians, patients as well as dental assistants. Eye injuries can vary from mild irritation to blindness. The use of eye protection tools, such as protective goggles and visors, reduces the risk of eye damage or complete loss of vision while working with dangerous and floating materials. Therefore, all precautions should be taken, even when performing common procedures for which the risk expectancy is relatively low. Clinicians should be aware that they are also responsible for providing adequate protection for their assistants and patients, as well as themselves.

Comparative Evaluation of Microleakage in Conventional and RMGIC Restorations following Conventional and Chemomechanical Caries Removal: An in vitro Study.

ABSTRACT%Background: Conventional caries removal involves use of high-speed handpiece. Current concepts of caries excavation in cavitated lesions consist of manual excavators. Principles of minimal invasive approach indicate the need to excavate only carious tissue.Aim: The aim of this study was to compare the microleakage in conventional and resin modified glass ionomer cement restorations following conventional and chemomechanical caries removal.Design: Hundred class I carious human mandibular first molar s were collected and divided into two groups: I and II (50 each). Each group was further divided into subgroups, i.e. (IA, IB and IIA, IIB). Caries was completely removed using conventional method in group one and chemomechanically in group two. The teeth in group IA, IIA are restored with conventional glass ionomer comment (GIC) and in group IB, IIB restored with resign-modified glass ionomer comments (RMGIC), followed by fnishing and polishing. Subsequently, the specimens were thermocycled and then placed in dye solution. The teeth were sectioned through the restorations and evaluated for microleakage scores using a stereomicroscope. The data were analyzed using Mann-Whitney U-test.Results: Statistical analysis showed no significant difference in microleakage between the conventional GIC and RMGIC following conventional and chemomechanical caries removal method.Conclusion: Carisolv is minimally invasive and an effective alternative treatment for the removal of occlusal caries.How to cite this article: Pavuluri C, Nuvvula S, Kamatham RL, Nirmala SVSG. Comparative Evaluation of Microleakage in Conventional and RMGIC Restorations following Conventional and Chemomechanical Caries Removal: An in vitro Study. Int J Clin Pediatr Dent 2014;7(3):172-175.

Irrigation rates and handpieces used in prosthodontic and operative dentistry: results of a survey of North American dental school teaching.

A data baseline on dental cutting methodologies was established by means of a survey of North American dental school teaching. Sixty-four North American dental schools were surveyed regarding their recommendations on handpiece usage and coolant flow rates in fixed prosthodontics and operative dentistry. High-speed handpieces were the instruments of choice for tooth preparation in fixed prosthodontics. In operative procedures, recommendations for sole use of the high-speed, the low-speed, or both handpiece types were more uniform. North American dental schools advocate greater use of high-speed than low-speed handpieces. Although the use of high-speed handpieces predominate in schools in Canada and Puerto Rico, there is a proportionately higher use of low-speed handpieces than in US dental schools. Few (approximately 1 in 5) schools made recommendations on coolant flow rates during cutting procedures.