背景:牙科中使用的许多仪器都是旋转的,比如手机,水注射器,和产生气溶胶的超声波洁牙器。这些仪器产生的喷雾可以携带,除了水,唾液的小滴,血,和微生物,这可能会给医疗保健专业人员和患者带来感染的风险。由于COVID-19大流行,这引起了注意。
目的:目的是对超声洁牙器产生的气雾剂在环境污染中的范围以及使用口腔内减吸装置的影响进行系统评价。
方法:直到2021年6月19日,在6个数据库中搜索了科学文献:Pubmed,EMBASE,WebofScience,Scopus,虚拟健康图书馆和Cochrane图书馆,没有语言或出版日期的限制。包括评估使用低(LVE)和高(HVE)容积排空系统在结垢/预防过程中由超声洁牙器产生的气溶胶范围以及控制其产生的环境污染的研究。
结果:在1893篇潜在相关文章中,其中5项为随机对照试验(RCTs)。3项随机对照试验的荟萃分析表明,即使在不同的距离病人的口腔,使用超声波洁牙机,牙科环境中空气传播的细菌显着增加。相比之下,当荟萃分析比较使用HVE和LVE时,在环境中产生的气溶胶没有显着差异(P=0.40/CI-0.71[-2.37,0.95])。
结论:在洁牙/预防中使用超声洁牙机期间,牙科环境中生物气溶胶的浓度增加,到达距离患者口腔2米的地方,并使用LVE,HVE或不同设备的组合,可以有效减少牙科环境中的空气污染,不同类型的抽吸装置之间没有重要区别。
BACKGROUND: Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments can carry, in addition to water, droplets of saliva, blood, and microorganisms, which can pose a risk of infections for healthcare professionals and patients. Due to the COVID-19 pandemic, this gained attention.
OBJECTIVE: The aim was to carry out a systematic
review of the evidence of the scope of the aerosol produced by ultrasonic scaler in environmental contamination and the influence of the use of intraoral suction reduction devices.
METHODS: Scientific literature was searched until June 19, 2021 in 6 databases: Pubmed, EMBASE, Web of science, Scopus, Virtual Health Library and Cochrane Library, without restrictions on language or publication date. Studies that evaluated the range of the aerosol produced by ultrasonic scaler during scaling/prophylaxis and the control of environmental contamination generated by it with the use of low (LVE) and high (HVE) volume evacuation systems were included.
RESULTS: Of the 1893 potentially relevant articles, 5 of which were randomized controlled trials (RCTs). The meta-analysis of 3 RCTs showed that, even at different distances from the patient\'s oral cavity, there was a significant increase in airborne bacteria in the dental environment with the use of ultrasonic scaler. In contrast, when meta-analysis compared the use of HVE with LVE, there was no significant difference (P = 0.40/CI -0.71[-2.37, 0.95]) for aerosol produced in the environment.
CONCLUSIONS: There is an increase in the concentration of bioaerosol in the dental environment during the use of ultrasonic scaler in scaling/prophylaxis, reaching up to 2 m away from the patient\'s mouth and the use of LVE, HVE or a combination of different devices, can be effective in reducing air contamination in the dental environment, with no important difference between different types of suction devices.