Real-time Monitoring of Aerosol Generating Dental Procedures

Fennelly, Mehael; Gallagher, C; Harding, Máiréad; Hellebust, Stig; Wenger, John C.; O’Sullivan, Niall; O’Connor, David J.; Prentice, Michael B.

doi:10.1016/j.jdent.2022.104092

Cited by 18 publications

(15 citation statements)

References 32 publications

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“…The generation of aerosol and splatter creates a significant risk for airborne contamination within the dental clinic [ 1 , 2 , 3 , 4 ]. Most routine dental treatments are aerosol-generating procedures that produce a mixture of splatter and aerosols that contain saliva, blood, and viable microorganisms (including bacteria and viruses) [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, there is a chance that airborne contaminants will enter the ventilation system and spread infection. The risk of air contamination can be reduced by the ventilation system’s high-efficiency particulate air (HEPA) filters and UV chambers [ 2 ]. Air disinfection with a lamp that produces UV light between 250 and 265 nm has demonstrated extremely high fungicidal, virucidal, and bactericidal action [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the faculty of dentistry does not provide each dental student with a dental assistant. Moreover, dental work is a difficult process that necessitates a good view of the operation field, and the procedures are frequently associated with patient saliva, dispersed aerosol, and splatter [ 1 , 2 , 3 ]. Moreover, aerosol and splatter are carriers of infection from the blood and saliva [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Dissemination of Aerosol and Splatter Using Suction Device during Ultrasonic Scaling: A Pilot Study

2022

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Objective: This study compared the aerosol and splatter diameter and count numbers produced by a dental mouth prop with a suction holder device and a saliva ejector during ultrasonic scaling in a clinical setting. Methodology: Fluorescein dye was placed in the dental equipment irrigation reservoirs with a mannequin, and an ultrasonic scaler was employed. The procedures were performed three times per device. The upper and bottom board papers were placed on the laboratory platform. All processes used an ultrasonic scaler to generate aerosol and splatter. A dental mouth prop with a suction holder and a saliva ejector were also tested. Photographic analysis was used to examine the fluorescein samples, followed by image processing in Python and assessment of the diameter and count number. For device comparison, statistics were used with an independent t-test. Result: When using the dental mouth prop with a suction holder, the scaler produced aerosol particles that were maintained on the upper board paper (mean ± SD: 1080 ± 662 µm) compared to on the bottom board paper (1230 ± 1020 µm). When the saliva ejector was used, it was found that the diameter of the aerosol on the upper board paper was 900 ± 580 µm, and the diameter on the bottom board paper was 1000 ± 756 µm. Conclusion: There was a significant difference in the aerosol and splatter particle diameter and count number between the dental mouth prop with a suction holder and saliva ejector (p < 0.05). Furthermore, the results revealed that there was a statistically significant difference between the two groups on the upper and bottom board papers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative Dissemination of Aerosol and Splatter Using Suction Device during Ultrasonic Scaling: A Pilot Study

2022

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“…Experimental studies have reported that extra-oral suction devices are effective strategies to reduce aerosol dispersion in dental clinics, with some studies reporting greater than 90% reduction in aerosol concentration (Allison et al, 2022;Fennelly et al, 2022) while other studies reported a more modest reduction of 38%-86% (Ou et al, 2021;Remington et al, 2022). These experimental studies cannot be directly compared to our CFD results because they did not report PM 10 , but rather used different metrics of aerosol concentration, such as particle counts.…”

Section: Discussionmentioning

confidence: 90%

“…This particle size range represents small droplets that can remain suspended in air for an extended period of time as opposed to larger particles (diameter > 10 μm) that tend to deposit near the patient's mouth due to gravitational settling. This range of particle sizes with 16 size bins was selected because it is commonly used in instrumentation to monitor aerosol concentrations (Allison et al, 2021(Allison et al, , 2022Sergis et al, 2021;Vernon et al, 2021;Ye et al, 2021;Fennelly et al, 2022). The particles had a density (ρ) of 1000 kg/m 3 so that the geometric diameter was equivalent to the aerodynamic diameter.…”

Section: Computational Fluid Dynamics-particle Transport Simulationsmentioning

confidence: 99%

Quantifying strategies to minimize aerosol dispersion in dental clinics

Dey

Tunio

Boryc

et al. 2023

Exp. Comput. Multiph. Flow

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Many dental procedures are aerosol-generating and pose a risk for the spread of airborne diseases, including COVID-19. Several aerosol mitigation strategies are available to reduce aerosol dispersion in dental clinics, such as increasing room ventilation and using extra-oral suction devices and high-efficiency particulate air (HEPA) filtration units. However, many questions remain unanswered, including what the optimal device flow rate is and how long after a patient exits the room it is safe to start treatment of the next patient. This study used computational fluid dynamics (CFD) to quantify the effectiveness of room ventilation, an HEPA filtration unit, and two extra-oral suction devices to reduce aerosols in a dental clinic. Aerosol concentration was quantified as the particulate matter under 10 µm (PM 10 ) using the particle size distribution generated during dental drilling. The simulations considered a 15 min procedure followed by a 30 min resting period. The efficiency of aerosol mitigation strategies was quantified by the scrubbing time, defined as the amount of time required to remove 95% of the aerosol released during the dental procedure. When no aerosol mitigation strategy was applied, PM 10 reached 30 µg/m 3 after 15 min of dental drilling, and then declined gradually to 0.2 µg/m 3 at the end of the resting period. The scrubbing time decreased from 20 to 5 min when the room ventilation increased from 6.3 to 18 air changes per hour (ACH), and decreased from 10 to 1 min when the flow rate of the HEPA filtration unit increased from 8 to 20 ACH. The CFD simulations also predicted that the extra-oral suction devices would capture 100% of the particles emanating from the patient’s mouth for device flow rates above 400 L/min. In summary, this study demonstrates that aerosol mitigation strategies can effectively reduce aerosol concentrations in dental clinics, which is expected to reduce the risk of spreading COVID-19 and other airborne diseases.

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Particle generation and dispersion from high-speed dental drilling

Kumar

Liu

et al. 2023

Clin Oral Invest

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Real-time Monitoring of Aerosol Generating Dental Procedures

Cited by 18 publications

References 32 publications

Comparative Dissemination of Aerosol and Splatter Using Suction Device during Ultrasonic Scaling: A Pilot Study

Comparative Dissemination of Aerosol and Splatter Using Suction Device during Ultrasonic Scaling: A Pilot Study

Quantifying strategies to minimize aerosol dispersion in dental clinics

Particle generation and dispersion from high-speed dental drilling

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