Aerosol and spatter mitigation in dentistry: Analysis of the effectiveness of 13 setups

Abstract

Objectives The current study aims to investigate the aerosol and spatter mitigation quality of 13 dry‐field isolation methods in a simulated setup that replicates real‐life work scenarios encountered in dental practices. Methods A crown preparation on a manikin was performed on tooth number 30 and repeated five times for each setup to simulate a patient under care. Aerosol, environmental, and operator face shield spatter, and sound intensity was measured. Generalized linear mixed models were used, and posthoc pairwise comparisons were performed to compare least‐squares means when appropriate using a Tukey adjustment. Results All tested setups showed some environmental spatter formation; however, these were able to control most (and in some cases all) spatter on the operator face shield. All methods resulted in excellent aerosol mitigation when a second line of high‐volume evacuation (HVE) was added to the device setup. However, in most setups, total sound levels exceeded 85 dB, posing a concern for prolonged noise exposure. Conclusions The Prototype device and four other tested setups with secondary HVE addition completely eliminated aerosol creation as tested. Spatter of the Face Shield was best eliminated using the Prototype device. Clinical Significance Within the limitations of this study, it can be concluded that the dental community has at its disposal equipment that can effectively mitigate aerosol and spatter.

Influence of flow rate and different size of suction cannulas on splatter contamination in dentistry: results of an exploratory study with a high-volume evacuation system

“…Besides the statistically significant differences for effective mitigate spray mist due to flow rates and suction cannula is in line with the evidence according suction equipment in dentistry [ 16 ], we measured no difference between HSP versus ADP in total (Table 1 ). This is contrary to data from other investigation, which show higher prevalence of spray mist/splatter contamination for HSP with dental turbine versus high-speed contra-angle handpiece [ 3 , 20 ] or for periodontal treatments with ADP versus ultrasonic scaling [ 17 ].…”

“…There is no dispute that a saliva ejector could aspirate saliva and coolant fluid in the mouth, but them failed to eliminate spray mist and should use in addition to a suction cannula for high-flow rate suction. But oftentimes, HVE are optimized for vacuum and not for flow rate [ 15 ] or were limited for higher power as it will cause more noise [ 16 ]. But the flow rate at the opening end of each suction cannula is the crucial physical parameter for reducing spray mist [ 15 ].…”

Air Quality in a Dental Skills Lab during the SARS-CoV-2 Pandemic: Results of an Experimental Study

“…Consequently, in a larger skills lab with a high turnover rate, generously dimensioned units are necessary. However, a higher turnover rate might lead to higher noise pollution during AGP trainings [ 7 , 30 ] and cost-intensive operations [ 31 ]. In total, the acquisition and maintenance costs of an EOS device should not be underestimated, as they require professional installation and regular changes of the potentially contaminated filters [ 27 , 30 ].…”

Spray mist reduction by means of a high-volume evacuation system—Results of an experimental study

“…Fig 2) caused more noise and intraoral cooling of the air, which could lead to discomfort [9]. Additionally, it has to be assumed that with an excessively small distance between the dental turbine and suction cannula (<10 mm), the cooling spray is directly eliminated with such high flow rates.…”

“…According to ISO 10637:2018, a suction system with an FR>250 l/min can be classified as an HVE and is highly recommended as one of the spray mist reducing procedures in dentistry with high efficacy [8]. However, dentists often tend to choose devices that offer the greatest convenience and comfort, e.g., suction systems optimized for high vacuum in combination with saliva ejectors with small diameter instead of systems with high-flow rates and appropriately sized cannula (e.g., �10 mm) with noise inherent in the system [9]. Therefore, it is not surprising that the results of a recently published intervention review found that for all kinds of suction methods, the evidence is of very low certainty due to heterogeneity, risk of bias, small sample sizes and wide confidence intervals comparing different methods of dental suction [10].…”