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Jamjoom FZ, Aldghim A, Aldibasi O, Yilmaz B. In vitro evaluation of the impact of intraoral scanner, scanning aids, and the scanned arch on the scan accuracy of edentulous arches. J Prosthodont 2024. [PMID: 38953541 DOI: 10.1111/jopr.13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/22/2024] [Indexed: 07/04/2024] Open
Abstract
PURPOSE To assess the accuracy of complete maxillary and mandibular edentulous arch scans obtained using two different intraoral scanners (IOSs), with and without scanning aids, and to compare these results to those obtained using conventional impression methods. MATERIALS AND METHODS Two IOSs were used (TRIOS 4 [TRI] and Emerald S [EMR]) to scan maxillary and mandibular typodonts. The typodonts were scanned without scanning aids [TRI_WSA and EMR_WSA groups] (n = 10). The typodonts were then scanned under four scanning aid conditions (n = 10): composite markers [TRI_MRK and EMR_MRK groups], scanning spray [TRI_SPR and EMR_SPR groups], pressure indicating paste [TRI_PIP and EMR_PIP groups], and liquid-type scanning aid [TRI_LQD and EMR_LQD groups]. Conventional impressions of both arches were also made using irreversible hydrocolloids in stock trays [IHC] and using polyvinyl siloxane (PVS) impression material in custom trays (n = 10) which were digitized using a laboratory scanner. Using a metrology software program, all scans were compared to a reference scan in order to assess trueness and to each other to assess precision. Trueness and precision were expressed as the root mean square (RMS) of the absolute deviation values and the statistical analysis was modeled on a logarithmic scale using fixed-effects models to meet model assumptions (α = 0.05). RESULTS The main effect of arch (p = 0.004), scanner (p < 0.001), scanning aid (p = 0.041), and the interaction between scanner and scanning aid (p = 0.027) had a significant effect on mean RMS values of trueness. The arch (p = 0.015) and scanner (p < 0.001) had a significant effect on the mean RMS values of precision. The maxillary arch had better accuracy compared to the mandible. The TRIOS 4 scanner had better accuracy than both the Emerald S scanner and conventional impressions. The Emerald S had better precision than conventional impressions. The scanning spray and liquid-type scanning aids produced the best trueness with the TRIOS 4 scanner, while the liquid-type scanning aid and composite markers produced the best trueness for the Emerald S scanner. CONCLUSION The scanned arch and the type of scanner had a significant effect on the accuracy of digital scans of completely edentulous arches. The scanning aid had a significant effect on the trueness of digital scans of completely edentulous arches which varied depending on the scanner used.
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Affiliation(s)
- Faris Z Jamjoom
- Restorative and Prosthetic Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Adhwaa Aldghim
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Omar Aldibasi
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
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Hlaing NHMM, Lee H, Jeong Y, Park JM, Lee SJ, Lee JH. Influence of crown shade, translucency, and scan powder application on the trueness of intraoral scanners. J Dent 2024; 144:104969. [PMID: 38537881 DOI: 10.1016/j.jdent.2024.104969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/10/2024] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES Natural teeth and dental restorations present with various shades and levels of translucency. This study aimed to determine whether these variations in ceramic crowns and scan powder application affect the trueness of intraoral scanners. METHODS Eight identical premade resin typodonts, each prepared for a crown on the maxillary right second molar, were used. Eight lithium disilicate crowns, distinguished by two levels of translucency (high and low) and four shades (BL1, A2, A3, and A4), were fabricated to an identical design and cemented onto each typodont, providing eight distinct experimental groups (2 levels of translucency × 4 shades). Reference scans were acquired using a desktop scanner. Test scans were performed ten times for each experimental group using two different intraoral scanners (Medit i700 and CEREC Primescan AC), with and without the application of scan powder (n = 10). Three-dimensional metrology software was used to assess the trueness of the intraoral scan datasets. Statistical analysis involved the Kruskal-Wallis H test, Mann-Whitney U test, and independent t-test (α=0.05). RESULTS For powder-free intraoral scan datasets, the crown shade did not significantly affect trueness within each translucency group (P = 1.000). For both intraoral scanners, compared with low translucency groups, higher marked deviations were exhibited by high translucency groups (P<.001). Scan powder use largely mitigated these differences (P>.05) and enhanced the trueness of the intraoral scan (P<.01). CONCLUSIONS Shade did not significantly influence the trueness of intraoral scans. High-translucency crowns were scanned with less accuracy than were low-translucency crowns. CLINICAL SIGNIFICANCE Unlike tooth shade, translucency significantly affected the accuracy of intraoral scans. Therefore, considering the use of scan powder when scanning objects with high translucency may be beneficial.
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Affiliation(s)
- Nan Hsu Myat Mon Hlaing
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Hyeonjong Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Yuwon Jeong
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ji-Man Park
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul, Republic of Korea; Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jae-Hyun Lee
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul, Republic of Korea; Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea.
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Sobhani-Nasab A, Banafshe HR, Atapour A, Khaksary Mahabady M, Akbari M, Daraei A, Mansoori Y, Moradi Hasan-Abad A. The use of nanoparticles in the treatment of infectious diseases and cancer, dental applications and tissue regeneration: a review. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 5:1330007. [PMID: 38323112 PMCID: PMC10844477 DOI: 10.3389/fmedt.2023.1330007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/12/2023] [Indexed: 02/08/2024] Open
Abstract
The emergence of nanotechnology as a field of study can be traced back to the 1980s, at which point the means to artificially produce, control, and observe matter on a nanometer level was made viable. Recent advancements in technology have enabled us to extend our reach to the nanoscale, which has presented an unparalleled opportunity to directly target biomolecular interactions. As a result of these developments, there is a drive to arise intelligent nanostructures capable of overcoming the obstacles that have impeded the progress of conventional pharmacological methodologies. After four decades, the gradual amalgamation of bio- and nanotechnologies is initiating a revolution in the realm of disease detection, treatment, and monitoring, as well as unsolved medical predicaments. Although a significant portion of research in the field is still confined to laboratories, the initial application of nanotechnology as treatments, vaccines, pharmaceuticals, and diagnostic equipment has now obtained endorsement for commercialization and clinical practice. The current issue presents an overview of the latest progress in nanomedical strategies towards alleviating antibiotic resistance, diagnosing and treating cancer, addressing neurodegenerative disorders, and an array of applications, encompassing dentistry and tuberculosis treatment. The current investigation also scrutinizes the deployment of sophisticated smart nanostructured materials in fields of application such as regenerative medicine, as well as the management of targeted and sustained release of pharmaceuticals and therapeutic interventions. The aforementioned concept exhibits the potential for revolutionary advancements within the field of immunotherapy, as it introduces the utilization of implanted vaccine technology to consistently regulate and augment immune functions. Concurrently with the endeavor to attain the advantages of nanomedical intervention, it is essential to enhance the unceasing emphasis on nanotoxicological research and the regulation of nanomedications' safety. This initiative is crucial in achieving the advancement in medicine that currently lies within our reach.
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Affiliation(s)
- Ali Sobhani-Nasab
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Banafshe
- Physiology Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Atapour
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Khaksary Mahabady
- Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Akbari
- Department of Surgery, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Abdolreza Daraei
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yaser Mansoori
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Amin Moradi Hasan-Abad
- Autoimmune Diseases Research Center, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
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Kim MJ, Kuroda M, Kobayashi Y, Yamamoto T, Aizawa T, Satoh K. Visualization of airborne droplets generated with dental handpieces and verification of the efficacy of high-volume evacuators: an in vitro study. BMC Oral Health 2023; 23:976. [PMID: 38062423 PMCID: PMC10704774 DOI: 10.1186/s12903-023-03725-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic led to concerns about the potential airborne transmission of the virus during dental procedures, but evidence of actual transmission in clinical settings was lacking. This study aimed to observe the behavior of dental sprays generated from dental rotary handpieces and to evaluate the effectiveness of high-volume evacuators (HVEs) using laser light sheets and water-sensitive papers. METHODS A dental manikin and jaw model were mounted in a dental treatment unit. Mock cutting procedures were performed on an artificial tooth on the maxillary left central incisor using an air turbine, a contra-angle electric micromotor (EM), and a 1:5 speed-up contra-angle EM (×5EM). Intraoral vacuum and extraoral vacuum (EOV) were used to verify the effectiveness of the HVEs. The dynamics and dispersal range of the dental sprays were visualized using a laser light sheet. In addition, environmental surface pollution was monitored three-dimensionally using water-sensitive papers. RESULTS Although the HVEs were effective in both the tests, the use of EOV alone increased vertical dispersal and pollution. CONCLUSIONS The use of various types of HVEs to reduce the exposure of operators and assistants to dental sprays when using dental rotary cutting instruments is beneficial. The study findings will be helpful in the event of a future pandemic caused by an emerging or re-emerging infectious disease.
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Affiliation(s)
- Min Jung Kim
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University, School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Mana Kuroda
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University, School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Yoshikazu Kobayashi
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University, School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Takahisa Yamamoto
- Department of Mechanical Engineering, National Institute of Technology, Gifu College, 2236-2 Kamimakuwa, Motosu-city, Gifu, 501-0495, Japan
| | - Takako Aizawa
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University, School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Koji Satoh
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University, School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
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Du Y, Zhao F, Tao R, Liu B. Effect of forceful suction and air disinfection machines on aerosol removal. BMC Oral Health 2023; 23:652. [PMID: 37684672 PMCID: PMC10492290 DOI: 10.1186/s12903-023-03369-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUNDS Dental procedures involving drilling and grinding can produce a significant amount of suspended aerosol particles (PM) and bioaerosols. This study aims to analyze the size and concentration of aerosol particles generated during drilling and to investigate the effectiveness of two air exchange systems, namely forceful suction (FS) and air disinfection machines (DM), in removing PM. METHODS For this study, 100 extracted permanent teeth were collected and divided into three groups: without suction (n = 50), suction with forceful suction (n = 25), and suction with air disinfection machines (n = 25). The removal rate of suspended aerosol particles was analyzed using particle counters and air data multimeter. RESULTS When drilling and grinding were performed without vacuum, 0.75% of the aerosol particles generated were PM2.5-10, 78.25% of total suspended aerosol particles (TSP) were PM2.5, and 98.68% of TSP were PM1. The nanoanalyzer measurements revealed that the aerodynamic diameter of most aerosol particles was below 60 nm, with an average particle diameter of 52.61 nm and an average concentration of 2.6*1011 ultrafine aerosol particles. The air change per hour (ACH) was significantly lower in the air disinfection machines group compared to the forceful suction group. Additionally, the number of aerosol particles and mass concentration was significantly lower in the air disinfection machines group compared to the forceful suction group in terms of PM2.5 levels. However, the forceful suction group also reduced the mass concentration in PM10 level than the air disinfection machines group. CONCLUSION In conclusion, the air exchange system can reduce the aerosol particles generated during drilling and grinding. Comparing the two air exchange systems, it was found that the air disinfection machines group reduces the number of aerosol particles and mass concentration in PM2.5 levels, while the forceful suction group reduces the mass concentration in PM10 level.
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Affiliation(s)
- Yaru Du
- Department of hospital allergy, Medical department, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Fei Zhao
- Department of Periodontal I, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Ran Tao
- Medical department, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Bing Liu
- Department of Periodontal I, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
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Ma X, Kim WH, Lee JH, Han DW, Lee SH, Kim J, Lee D, Kim B, Shin DM. The Effectiveness of a Novel Air-Barrier Device for Aerosol Reduction in a Dental Environment: Computational Fluid Dynamics Simulation. Bioengineering (Basel) 2023; 10:947. [PMID: 37627832 PMCID: PMC10452020 DOI: 10.3390/bioengineering10080947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
The use of equipment such as dental handpieces and ultrasonic tips in the dental environment has potentially heightened the generation and spread of aerosols, which are dispersant particles contaminated by etiological factors. Although numerous types of personal protective equipment have been used to lower contact with contaminants, they generally do not exhibit excellent removal rates and user-friendliness in tandem. To solve this problem, we developed a prototype of an air-barrier device that forms an air curtain as well as performs suction and evaluated the effect of this newly developed device through a simulation study and experiments. The air-barrier device derived the improved design for reducing bioaerosols through the simulation results. The experiments also demonstrated that air-barrier devices are effective in reducing bioaerosols generated at a distance in a dental environment. In conclusion, this study demonstrates that air-barrier devices in dental environments can play an effective role in reducing contaminating particles.
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Affiliation(s)
- Xiaoting Ma
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam 999077, Hong Kong;
| | - Won-Hyeon Kim
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea; (W.-H.K.); (S.-H.L.); (J.K.); (D.L.)
| | - Jong-Ho Lee
- Daan Korea Corporation, Seoul 06252, Republic of Korea;
| | - Dong-Wook Han
- Department of Cogno-Mechatronics Engineering, College of Nanoscience and Nanotechnology, Pusan National University, Busan 46241, Republic of Korea;
| | - Sung-Ho Lee
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea; (W.-H.K.); (S.-H.L.); (J.K.); (D.L.)
| | - Jisung Kim
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea; (W.-H.K.); (S.-H.L.); (J.K.); (D.L.)
| | - Dajung Lee
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea; (W.-H.K.); (S.-H.L.); (J.K.); (D.L.)
| | - Bongju Kim
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea; (W.-H.K.); (S.-H.L.); (J.K.); (D.L.)
| | - Dong-Myeong Shin
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam 999077, Hong Kong;
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Matys J, Gedrange T, Dominiak M, Grzech-Leśniak K. Quantitative Evaluation of Aerosols Produced in the Dental Office during Caries Treatment: A Randomized Clinical Trial. J Clin Med 2023; 12:4597. [PMID: 37510712 PMCID: PMC10380424 DOI: 10.3390/jcm12144597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Effective removal of aerosols generated during dental treatment is crucial for maintaining biosafety in dental practice. This study aimed to measure the aerosol amount and the number of aerobic bacteria in the air during caries treatment. METHODS The study involved 50 molar teeth (n = 50) in the mandible in 50 patients divided into two groups based on the type of a high-volume evacuator (HVE); G1 (n = 25) conventional HVE (EM19 EVO, Monoart® Euronda, Vicenza, Italy) and G2 (n = 25) a new, wider, customized HVE. The PC200 laser particle counter (Trotec GmbH, Schwerin, Germany) was used to measure aerosol particles in a range of 0.3-10.0 μm near the operator's mouth. The study used 60 microbiological plates with a microbiological medium (Columbia Agar with 5% Sheep Blood) to check the number of aerobic bacteria in the air. RESULTS The mean value of aerosol particles in the G1 group (conventional HVE) was 54,145 ± 7915, while in the G2 group (test, wider evacuator) was lower and amounted to 32,632 ± 1803. (p < 0.001). The median total bacteria count in the air per cubic meter in control, G1 (HVE), and G2 (NEW-HVE) groups were 50 [36-60]; 772 [643-881]; 120 [92-139], respectively. (p < 0.05). Gram-positive cocci were the predominant bacteria in the plates: Micrococcus sp. (50%), Bacillus species (36.4%), Staphylococcus epidermidis (3.8%), Staphylococcus saprophyticus (3.8%). CONCLUSIONS the application of the wider high-volume evacuator increases the air purity during caries treatment as well as the biological safety of a dental office.
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Affiliation(s)
- Jacek Matys
- Oral Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
- Department of Orthodontics, Technische Universitat Dresden, 01307 Dresden, Germany
| | - Tomasz Gedrange
- Oral Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
- Department of Orthodontics, Technische Universitat Dresden, 01307 Dresden, Germany
| | - Marzena Dominiak
- Oral Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Kinga Grzech-Leśniak
- Oral Surgery Department, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23284, USA
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Tang F, Wen X, Zhang X, Qi S, Tang X, Huang J, Zhu C, Shang G, Xu Y, Cai J, Wang R. Ultrafine particles exposure is associated with specific operative procedures in a multi-chair dental clinic. Heliyon 2022; 8:e11127. [PMID: 36276750 PMCID: PMC9574865 DOI: 10.1016/j.heliyon.2022.e11127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/12/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- Fengqin Tang
- Department of Stomatology, Clinical Medical College of Shanghai Tenth Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xueyun Wen
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Xu Zhang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Shengcai Qi
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, PR China,Department of Prosthodontics, Shanghai Stomatology Hospital, Fudan University, Shanghai, PR China
| | - Xiaoshan Tang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Jieying Huang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Chenjie Zhu
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Guangwei Shang
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Yuanzhi Xu
- Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China,Corresponding author.
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, PR China,Corresponding author.
| | - Raorao Wang
- Department of Stomatology, Clinical Medical College of Shanghai Tenth Hospital of Nanjing Medical University, Nanjing, PR China,Department of Stomatology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, PR China,Corresponding author.
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Fennelly M, Gallagher C, Harding M, Hellebust S, Wenger J, O'Sullivan N, O'Connor D, Prentice M. Real-time Monitoring of Aerosol Generating Dental Procedures. J Dent 2022; 120:104092. [PMID: 35304203 DOI: 10.1016/j.jdent.2022.104092] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We aimed to quantify aerosol concentrations produced during different dental procedures under different mitigation processes. METHOD Aerosol concentrations were measured by the Optical Particle Sensor (OPS) and Wideband Integrated Bioaerosol Sensor (WIBS) during routine, time-recorded dental procedures on a manikin head in a partitioned enclosure. Four different, standardised dental procedures were repeated in triplicate for three different mitigation measures. RESULT Both high-volume evacuation (HVE) and HVE plus extra-oral suction (LEV) eradicated all procedure-related aerosols, and the enclosure stopped procedure-related aerosols escaping. Aerosols recorded by the OPS and WIBS were 84 and 16-fold higher than background levels during tooth 16 FDI notation (UR6) drilling, and 11 and 24-fold higher during tooth 46 FDI notation (LR6) drilling, respectively. Ultrasonic scaling around the full lower arch (CL) or the full upper arch (CU) did not generate detectable aerosols with mitigation applied. Without mitigation the largest concentration of inhalable particles during procedures observed by the WIBS and OPS was during LR6 (139/cm3) and UR6 (28/cm3) drilling, respectively. Brief aerosol bursts were recorded during drilling procedures with HVE, these did not occur with LEV, suggesting LEV provides protection against operator errors. Variation was observed in necessary fallow times (49 - 280 minutes) without mitigation, while no particles remained airborne when mitigation was utilised. CONCLUSION This data demonstrates that correctly positioned HVE or LEV is effective in preventing airborne spread and persistence of inhalable particles originating from dental AGPs. Additionally, a simple enclosure restricts the spread of aerosols outside of the operating area. CLINICAL SIGNIFICANCE Employing correctly positioned HVE and LEV in non-mechanically ventilated clinics can prevent the dispersal and persistence of inhalable airborne particles during dental AGPs. Moreover, using enclosures have the additive effect of restricting aerosol spread outside of an operating area.
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Affiliation(s)
- Mehael Fennelly
- School of Chemistry and Environmental Research Institute, University College Cork; Department of Pathology, University College Cork.
| | | | - Mairead Harding
- University Dental School & Hospital, University College Cork; Oral Health Services Research Centre, University College Cork
| | - Stig Hellebust
- School of Chemistry and Environmental Research Institute, University College Cork
| | - John Wenger
- School of Chemistry and Environmental Research Institute, University College Cork
| | - Niall O'Sullivan
- School of Chemistry and Environmental Research Institute, University College Cork
| | | | - Michael Prentice
- Department of Pathology, University College Cork; APC Microbiome Institute, University College Cork
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10
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Nóbrega MTC, Bastos RTDRM, Mecenas P, de Toledo IP, Richardson-Lozano R, Altabtbaei K, Flores-Mir C. Aerosol generated by dental procedures: A scoping review. J Evid Based Med 2021; 14:303-312. [PMID: 34936216 DOI: 10.1111/jebm.12461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND The current pandemic has raised awareness of aerosol dispersion in dental offices. This scoping review was conducted to assess the amount and spread of aerosol generated by dental procedures. METHODS This scoping review followed the PRISMA-ScR protocol and was conducted by searching multiple databases adopting a core search structure for each database. Detailed eligibility criteria were applied. The authors placed no restrictions on study design, year of publication, and study location. The literature search was updated on September 15, 2021. RESULTS A total of 51 papers were included in this scoping review. The risk of bias assessment was not conducted as per guidelines. The majority of studies found microorganisms, bloodstains, splatters of aerosol, and particles in the air part of the search strategy. Publication dates ranged from 1969 to 2021. Data came from different dental settings locations. Several factors were identified that have an effect on the amount and spread of the aerosol and spatter. CONCLUSION Although it is clear that the microbial contamination occurred mainly during aerosol-generating dental procedures, our understanding of the contamination level, spread, and half-life are limited.
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Affiliation(s)
| | | | - Paulo Mecenas
- Department of Orthodontics, Federal University of Pará, Belém, Pará, Brazil
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11
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In Situ Measurement of Airborne Particle Concentration in a Real Dental Office: Implications for Disease Transmission. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178955. [PMID: 34501544 PMCID: PMC8431666 DOI: 10.3390/ijerph18178955] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 01/02/2023]
Abstract
Aerosols generated during dental procedures are one of the most significant routes for infection transmission and are particularly relevant now in the context of COVID-19 pandemic. This study aimed to assess the effectiveness of an indoor air purifier on dental aerosol dispersion in dental offices. The spread and removal of aerosol particles generated from a specific dental operation in a dental office are quantified for a single dental activity in the area near the generation and corner of the office. The effects of the air purifier, door condition, and particle sizes on the spread and removal of particles were investigated. The results show that, in the worst-case scenario, it takes 95 min for 0.5-μm particles to settle and that it takes a shorter time for the larger particles. The air purifier expedited the removal time at least 6.3 times faster than the case with no air purifier in the generation zone. Our results also indicate that particles may be transported from the source to the rest of the room even when the particle concentrations in the generation zone dropped back to the background. Therefore, it is inaccurate to conclude that indoor purifiers help reduce the transmission of COVID-19. Dental offices still need other methods to reduce the transmission of viruses.
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12
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Effects of Natural Ventilation and Saliva Standard Ejectors during the COVID-19 Pandemic: A Quantitative Analysis of Aerosol Produced during Dental Procedures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147472. [PMID: 34299930 PMCID: PMC8308059 DOI: 10.3390/ijerph18147472] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/19/2022]
Abstract
The novel Coronavirus Disease 2019 (COVID-19) pandemic has renewed attention to aerosol-generating procedures (AGPs). Dental-care workers are at high risk of contamination by SARS-CoV-2. The aim of this study was to evaluate the efficacy of standard saliva ejectors and natural ventilation in reducing particulate matter (PM) concentration during different routine dental procedures in the pandemic period. The DustTrak monitor was used to measure PM1, PM2.5, PM10, and breathable (<4 microns) total dust during 14 procedures performed with and without the presence of natural ventilation in a dental unit. Moreover, measurements were performed near the practitioners or near the standard saliva ejectors during the different procedures. In the latter condition, reduced levels of PM10 were recorded (82.40 ± 9.65 μg/m3 vs. 50.52 ± 0.23 μg/m3). Moreover, higher levels of PM (53.95 ± 2.29 μg/m3 vs. 27.85 ± 0.14 μg/m3) were produced when the dental unit's windows were open. At the same time, the total level of PM were higher during scaling than during other procedures (data suggest not to adopt natural ventilation-both window and door opened-during dental procedures). It was also demonstrated that the use of standard saliva ejectors can considerably reduce the total released amount of PM10.
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13
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The Effect of Er:YAG Lasers on the Reduction of Aerosol Formation for Dental Workers. MATERIALS 2021; 14:ma14112857. [PMID: 34073474 PMCID: PMC8198823 DOI: 10.3390/ma14112857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 12/22/2022]
Abstract
Infection prevention in dental practice plays a major role, especially during the COVID-19 pandemic. This study aimed to measure the quantity of aerosol released during various dental procedures (caries and prosthetic treatment, debonding of orthodontic brackets, root canal irrigation) while employing the Er:YAG lasers combined with a high-volume evacuator, HVE or salivary ejector, SE. The mandibular second premolar was extracted due to standard orthodontic therapy and placed in a dental manikin, to simulate typical treatment conditions. The particle counter was used to measure the aerosol particles (0.3–10.0 μm) at three different sites: dental manikin and operator’s and assistant’s mouth area. The study results showed that caries’ treatment and dental crown removal with a high-speed handpiece and the use of the SE generated the highest aerosol quantity at each measured site. All three tested Er:YAG lasers significantly reduced the number of aerosol particles during caries’ treatment and ceramic crown debonding compared the conventional handpieces, p < 0.05. Furthermore, the Er:YAG lasers generated less aerosol during orthodontic bracket debonding and root canal irrigation in contrast to the initial aerosol quantity measured in the dental office. The use of the Er:YAG lasers during dental treatments significantly generates less aerosol in the dental office setting, which reduces the risk of transmission of viruses or bacteria.
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14
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Oh HS, Lim YJ, Kim B, Kim MJ, Kwon HB, Baek YW. Influence of Scanning-Aid Materials on the Accuracy and Time Efficiency of Intraoral Scanners for Full-Arch Digital Scanning: An In Vitro Study. MATERIALS 2021; 14:ma14092340. [PMID: 33946471 PMCID: PMC8124155 DOI: 10.3390/ma14092340] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
This study was performed to verify the influence of scanning-aid materials on the accuracy and time efficiency of full-arch scanning with intraoral scanners. The full-arch reference model was constructed by a 3D printer and scanned with a model scanner to obtain the reference dataset. Four experimental groups (application of ScanCure (SC-80, ODS Co, Incheon, Korea), IP Scan Spray (IP-Division, Haimhausen, Germany) and Vita Powder Scan Spray (Vita Zahnfabrik, Stuttgart, Germany), and no treatment) were designed, and the scans were executed (trueness, n = 5) using two intraoral scanners: I500 (Medit Co., Seoul, Korea) and TRIOS (3shape, Copenhagen, Denmark). All acquired scan data were compared with the reference datasets using the 3D superimposition method and 2D linear measurements. In the 3D analysis, intragroup data were compared with each other (precision, n = 10). Time efficiency was also verified by comparing the scan times of the four experimental groups. In the 3D analysis, the root mean square (RMS) value of the precision of the scanned image was statistically significantly more accurate in the scanning-aid agent-treated groups than in the no-treatment group (p < 0.05). However, the RMS values of trueness and the types of scanning-aid materials were not significantly different. In the 2D measurements, the increased scan distance generated a greater distance deviation. The working time was significantly shorter in the scanning-aid agent groups than in the no-treatment group, with statistical significance (p < 0.05). Therefore, in clinical situations, the application of scanning-aid materials is recommended to reduce scanning time and more efficiently obtain the full-arch scanned image.
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Affiliation(s)
- Hyun-Su Oh
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
| | - Young-Jun Lim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
- Correspondence: (Y.-J.L.); (B.K.); Tel.: +82-2-2072-2940 (Y.-J.L.); +82-2-2072-4455 (B.K.)
| | - Bongju Kim
- Dental Life Science Research Institute, Seoul National University Dental Hospital, Seoul 03080, Korea
- Correspondence: (Y.-J.L.); (B.K.); Tel.: +82-2-2072-2940 (Y.-J.L.); +82-2-2072-4455 (B.K.)
| | - Myung-Joo Kim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
| | - Yeon-Wha Baek
- Department of Prosthodontics, Seoul National University Gwanak Dental Hospital, School of Dentistry, Seoul National University, Seoul 03080, Korea;
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15
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Kun-Szabó F, Gheorghita D, Ajtai T, Hodovány S, Bozóki Z, Braunitzer G, Antal MÁ. Aerosol generation and control in the dental operatory: An in vitro spectrometric study of typical clinical setups. PLoS One 2021; 16:e0246543. [PMID: 33539439 PMCID: PMC7861533 DOI: 10.1371/journal.pone.0246543] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/20/2021] [Indexed: 11/18/2022] Open
Abstract
Dental turbines and scalers, used every day in dental operatories, feature built-in water spray that generates considerable amounts of water aerosol. The problem is that it is not exactly known how much. Since the outbreak of COVID-19, several aerosol safety recommendations have been issued-based on little empirical evidence, as almost no data are available on the exact aerosol concentrations generated during dental treatment. Similarly, little is known about the differences in the efficacy of different commercially available aerosol control systems to reduce in-treatment aerosol load. In this in vitro study, we used spectrometry to explore these questions. The time-dependent effect of conventional airing on aerosol concentrations was also studied. Everyday patient treatment situations were modeled. The test setups were defined by the applied instrument and its spray direction (high-speed turbine with direct/indirect airspray or ultrasonic scaler with indirect airspray) and the applied aerosol control system (the conventional high-volume evacuator or a lately introduced aerosol exhaustor). Two parameters were analyzed: total number concentration in the entire measurement range of the spectrometer and total number concentration within the 60 to 384 nm range. The results suggest that instrument type and spray direction significantly influence the resulting aerosol concentrations. Aerosol generation by the ultrasonic scaler is easily controlled. As for the high-speed turbine, the efficiency of control might depend on how exactly the instrument is used during a treatment. The results suggest that scenarios where the airspray is frequently directed toward the air of the operatory are the most difficult to control. The tested control systems did not differ in their efficiency, but the study could not provide conclusive results in this respect. With conventional airing through windows with a standard fan, a safety airing period of at least 15 minutes between treatments is recommended.
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Affiliation(s)
- Fruzsina Kun-Szabó
- Department of Optics and Quantum Electronics, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Dorottya Gheorghita
- Department of Esthetic and Operative Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Tibor Ajtai
- Department of Optics and Quantum Electronics, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Szabolcs Hodovány
- Department of Optics and Quantum Electronics, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Zoltán Bozóki
- Department of Optics and Quantum Electronics, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | | | - Márk Ádám Antal
- Department of Esthetic and Operative Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
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16
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Llandro H, Allison JR, Currie CC, Edwards DC, Bowes C, Durham J, Jakubovics N, Rostami N, Holliday R. Evaluating splatter and settled aerosol during orthodontic debonding: implications for the COVID-19 pandemic. Br Dent J 2021:10.1038/s41415-020-2503-9. [PMID: 33414542 PMCID: PMC7789079 DOI: 10.1038/s41415-020-2503-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/16/2020] [Indexed: 01/30/2023]
Abstract
Introduction Dental procedures produce splatter and aerosol which have potential to spread pathogens such as SARS-CoV-2. Mixed evidence exists on the aerosol-generating potential of orthodontic procedures. The aim of this study was to evaluate splatter and/or settled aerosol contamination during orthodontic debonding.Material and methods Fluorescein dye was introduced into the oral cavity of a mannequin. Orthodontic debonding was undertaken with surrounding samples collected. Composite bonding cement was removed using a speed-increasing handpiece with dental suction. A positive control condition included a water-cooled, high-speed air-turbine crown preparation. Samples were analysed using digital image analysis and spectrofluorometric analysis.Results Contamination across the eight-metre experimental rig was 3% of the positive control on spectrofluorometric analysis and 0% on image analysis. Contamination of the operator, assistant and mannequin was 8%, 25% and 28% of the positive control, respectively.Discussion Splatter and settled aerosol from orthodontic debonding is distributed mainly within the immediate locality of the mannequin. Widespread contamination was not observed.Conclusions Orthodontic debonding is unlikely to produce widespread contamination via splatter and settled aerosol, but localised contamination is likely. This highlights the importance of personal protective equipment for the operator, assistant and patient. Further work is required to examine suspended aerosol.
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Affiliation(s)
- Hayley Llandro
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - James R Allison
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; School of Dental Sciences, Newcastle University, UK
| | - Charlotte C Currie
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; School of Dental Sciences, Newcastle University, UK
| | - David C Edwards
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; School of Dental Sciences, Newcastle University, UK
| | - Charlotte Bowes
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; School of Dental Sciences, Newcastle University, UK
| | - Justin Durham
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; School of Dental Sciences, Newcastle University, UK
| | | | | | - Richard Holliday
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; School of Dental Sciences, Newcastle University, UK.
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17
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Gund M, Isack J, Hannig M, Thieme-Ruffing S, Gärtner B, Boros G, Rupf S. Contamination of surgical mask during aerosol-producing dental treatments. Clin Oral Investig 2020; 25:3173-3180. [PMID: 33108485 PMCID: PMC7590255 DOI: 10.1007/s00784-020-03645-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022]
Abstract
Objectives Surgical masks are usually contaminated during dental treatment. So far it has not been investigated whether a surgical mask itself can be a source of microbial transmission. The aim of this study was therefore to investigate the microbiological contamination of surgical masks during dental treatment and the transfer of microorganisms from the mask to the hands. Materials and methods Five dental treatment modalities were studied: carious cavity preparation (P-caries, n = 10), tooth substance preparation (P-tooth, n = 10), trepanation and root canal treatment (P-endo, n = 10), supragingival ultrasonic application (US-supra, n = 10), and subgingival periodontal ultrasonic instrumentation (US-sub, n = 10). Bacterial contamination of mask and gloves worn during treatment was tested by imprinting on agar plates. Additionally, before masks were tested, their outer surface was touched with a new sterile glove. This glove was also imprinted on agar. Bacteria were identified by MALDI TOF mass spectrometry. Colony-forming units (CFU) were scored: score 0: 0 CFU, score 1: < 102 CFU, score 2: > 102 CFU, score 3: dense microbial growth. Results All masks and all gloves used during treatment displayed bacterial contamination (sample scores 0/1/2/3: masks 0/46/3/1 and gloves 0/31/10/9). After touching the masks with new sterile gloves, microorganisms were recovered with the following contamination scores: P-caries: 4/6/0/0, P-tooth: 2/8/0/0: P-endo: 7/3/0/0, US-supra: 0/9/1/0, US-sub: 2/8/0/0. No statistically significant differences were detected between the treatment modalities. Streptococci spp. and Staphylococci spp. representing the oral and cutaneous flora dominated. Conclusions Surgical masks are contaminated after aerosol-producing dental treatment procedures. Used masks have a potential to be a source of bacterial contamination of the hands. Clinical relevance Dental staff should avoid touching the outer surface of masks with their hands to prevent transmission of pathogens. It is recommendable to change the mask after each treated patient followed by hand disinfection.
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Affiliation(s)
- Madline Gund
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Saarland University Hospital, Kirrberger Str. 100, Building 73, 66421, Homburg/Saar, Germany
| | - Jonas Isack
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Saarland University Hospital, Kirrberger Str. 100, Building 73, 66421, Homburg/Saar, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Saarland University Hospital, Kirrberger Str. 100, Building 73, 66421, Homburg/Saar, Germany
| | - Sigrid Thieme-Ruffing
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Department of Hospital Hygiene, Saarland University, Homburg, Germany
| | - Gabor Boros
- Department of Oral Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Stefan Rupf
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Saarland University Hospital, Kirrberger Str. 100, Building 73, 66421, Homburg/Saar, Germany.
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18
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Ochsmann E, Brand P, Kraus T, Reich S. Ultrafine particles in scanning sprays: a standardized examination of five powders used for dental reconstruction. J Occup Med Toxicol 2020; 15:20. [PMID: 32612668 PMCID: PMC7324966 DOI: 10.1186/s12995-020-00271-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 06/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background Intraoral matting sprays for chairside systems can release fine or ultrafine particles or nanoparticles at dentists’ workplaces and cause work-related health problems by inhalation exposure. Until now, little is known about the magnitude of the ultrafine fraction, when using these scanning sprays. Hence, more information is needed for workplace risk assessments in dental practices. Methods Five commonly used dental spray-powders were examined under standardized conditions. Ingredients were taken from the respective safety data sheet. Particle number-size distributions and total number concentrations were analyzed with a fast mobility particle sizer, and reported graphically as well as mean particle fractions smaller than 100 nm. Based on these measurements, risk assessments were conducted, and particle depositions in the lung were modelled. Results The mean fraction of particles smaller than 100 nm varied between 9 and 93% depending on the matting agent and mode of application of the intraoral scanning spray. Propellants can represent a large fraction of these particles. Titanium dioxide, pigment-suspensions, talcum and others particles, which can pose relevant health risks, were listed as ingredients of scanning sprays in safety data sheets. Nevertheless, the deposited fraction of hazardous particles in the lung of employees in dental practices seems to be small (15%) during this dental procedure. Conclusions Our results suggest that dentists’ personnel can be exposed to hazardous fine and ultrafine particles. Though extensive standardized measurements and systematic evaluation of safety data sheets were used for this study, they cannot sufficiently assess and categorize potential workplace-related health risks.
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Affiliation(s)
- E Ochsmann
- Institute for Occupational, Social and Environmental Medicine, Faculty of Medicine, RWTH University Hospital, Aachen, Germany.,Institute for Occupational Medicine, Prevention and Occupational Health Management, University of Lübeck, Lübeck, Germany
| | - P Brand
- Institute for Occupational, Social and Environmental Medicine, Faculty of Medicine, RWTH University Hospital, Aachen, Germany
| | - T Kraus
- Institute for Occupational, Social and Environmental Medicine, Faculty of Medicine, RWTH University Hospital, Aachen, Germany
| | - S Reich
- Department of Prosthodontics, Implantology and Biomaterials, Faculty of Medicine, RWTH University Hospital, Aachen, Germany
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Oh HS, Lim YJ, Kim B, Kim WH, Kim MJ, Kwon HB. Influence of Applied Liquid-Type Scanning-Aid Material on the Accuracy of the Scanned Image: An In Vitro Experiment. MATERIALS 2020; 13:ma13092034. [PMID: 32349333 PMCID: PMC7254253 DOI: 10.3390/ma13092034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 11/17/2022]
Abstract
The study was designed to evaluate the effects of a liquid-type scanning-aid material on the accuracy and time efficiency of intraoral digital impressions compared to those of two different types of powder scanning-aid material and the powder-free scanning method. Three reference models (inlay, onlay, and bridge) were fabricated by a 3D printer and scanned with a model scanner to make the reference datasets. Four experimental groups (application of ScanCure, VITA, IP, and no treatment) were established, and the scans were acquired (each n = 5) using the Trios 3® (3 Shape, Copenhagen, Denmark). All scan data were digitally superimposed with the reference data (trueness, n = 5), and group comparisons were performed for each group (precision, n = 10). Time efficiency was evaluated by comparing the working times for scanning the models. The liquid-type ScanCure group showed fewer errors than the IP and VITA groups in all three reference models. Particularly, in the inlay model, the ScanCure group showed high accuracy compared to the powder-type groups (IP and VITA) with statistical significance (p < 0.001). The working time of the no-treatment group was longer than that of the agent groups in all reference models (p < 0.001). Notably, in the bridge model, the working time of the ScanCure group was shorter than that of the IP and VITA groups. Unlike other spray-type scanning-aid materials, this liquid-type material has the advantage of being thinly and uniformly applied to the object surface at the time of use. These findings suggest that the liquid-type scanning-aid material would be more accurate in achieving shape reproducibility using an intraoral scanner than the other two spray-type groups.
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Affiliation(s)
- Hyun-Su Oh
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
| | - Young-Jun Lim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
- Correspondence: (Y.-J.L.); or (B.K.); Tel.: +82-2-2072-2940 (Y-J.L.); +82-2-2072-4455 (B.K.)
| | - Bongju Kim
- Dental Life Science Research Institute & Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea;
- Correspondence: (Y.-J.L.); or (B.K.); Tel.: +82-2-2072-2940 (Y-J.L.); +82-2-2072-4455 (B.K.)
| | - Won Hyeon Kim
- Dental Life Science Research Institute & Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea;
| | - Myung-Joo Kim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea; (H.-S.O.); (M.-J.K.); (H.-B.K.)
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20
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Liu MH, Chen CT, Chuang LC, Lin WM, Wan GH. Removal efficiency of central vacuum system and protective masks to suspended particles from dental treatment. PLoS One 2019; 14:e0225644. [PMID: 31770413 PMCID: PMC6879156 DOI: 10.1371/journal.pone.0225644] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/08/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND High levels of suspended particulate matters (PMs) and bioaerosols are created by dental procedures. The present study aimed to evaluate the size and concentration of PMs produced by drilling and grinding teeth, and to assess the efficiency of central vacuum system and protective masks for the removal of PMs. METHODS A total of 20 extracted permanent teeth were collected. A novel experimental system and particle counter were used to evaluate the PMs produced by dental procedures and the PM removal efficiency of a central vacuum system and surgical/N95 masks. RESULTS The number concentration of total PMs produced by drilling and grinding teeth was significantly higher than the indoor background concentration. The average aerodynamic diameter of particle was generally less than 1 μm. The average number concentration of ultrafine particles was 2.1x1011 particles/m3 during tooth drilling and grinding. The efficiency of the central vacuum system was 35.74% for PM≥0.5 and 35.41% for PM10. For PM≥0.5, the ratios of inside and outside masks were 0.8-1.34 without vacuum and 1.18-1.36 with vacuum. No difference was found with the use of surgical/N95 masks during dental therapy, with or without vacuum use. CONCLUSIONS High levels of PMs were found during tooth drilling and grinding procedures, especially among PM1. The PM removal efficiency of a central vacuum system and surgical/N95 masks were limited.
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Affiliation(s)
- Ming-Hui Liu
- Department of Pediatric Dentistry, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chi-Tsung Chen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Chuan Chuang
- Department of Pediatric Dentistry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Ming Lin
- Department of General Practice Dentistry, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Gwo-Hwa Wan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
- Department of Obstetrics and Gynaecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
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Schmalz G, Hickel R, van Landuyt KL, Reichl FX. Scientific update on nanoparticles in dentistry. Int Dent J 2018; 68:299-305. [PMID: 29786135 PMCID: PMC9379019 DOI: 10.1111/idj.12394] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Nanoparticles having a size from 1 to 100 nm are present in nature and are successfully used in many products of daily life. In dental materials, nanoparticles are typically embedded but they may also exist as by-products from milling processes. Possible adverse effects of nanoparticles have gained increased interest, with the lungs being the main target organ. Exposure to nanoparticles in the dental laboratory is addressed by legal regulations. In dental practice, nanoparticles are mainly produced by intra-oral grinding/polishing and removal of materials, by wear of restorations or release from dental implants. Based on worst-case mass-based calculations, the additional risk as a result of exposure to nanoparticles is considered to be low. However, more research is needed, especially on vulnerable groups (patients with asthma or chronic obstructive pulmonary disease). An assessment of risks for the environment is not possible because of lack of data. Exposure-reduction measures mainly include avoidance of abrasive processes (for example, by proper sculpturing), cooling by the use of water spray and sufficient ventilation of treatment areas.
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Affiliation(s)
- Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital, Regensburg, Germany
- Department of Peridontology, University of Bern, Bern, Switzerland
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | | | - Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
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Kim RJY, Park JM, Shim JS. Accuracy of 9 intraoral scanners for complete-arch image acquisition: A qualitative and quantitative evaluation. J Prosthet Dent 2018; 120:895-903.e1. [PMID: 30006228 DOI: 10.1016/j.prosdent.2018.01.035] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/29/2018] [Accepted: 01/29/2018] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM Different intraoral scanners (IOSs) are available for digital dentistry. However, information on the accuracy of various IOSs for complete-arch digital scans is limited. PURPOSE The purpose of this in vitro study was to evaluate the trueness and precision of complete-arch digital scans produced by 9 IOSs, using the superimposition method, and to compare them based on characteristics including the data capture principle and mode and the need for powder coating. MATERIAL AND METHODS Nine IOSs were used to obtain standard tessellation language (STL) data for a bimaxillary complete-arch model with various cavity preparations (N=10). The scanning performance was evaluated quantitatively and qualitatively. For quantitative evaluation, the images were processed and analyzed using 3-dimensional (3D) analysis software. After we superimposed the datasets, trueness was obtained by comparing it with the reference scan, and precision was obtained from intragroup comparisons. The IOSs were compared based on the data capture principle and mode and the need for powder coating. Statistical analyses were conducted using a Kruskal-Wallis test, followed by multiple Mann-Whitney U tests for pairwise comparisons among groups (α=.05). For qualitative evaluation, surface smoothness and sharp edge reproducibility of the digital images were compared. RESULTS The median precision values were lowest in the TRIOS model (average, 34.70 μm; maximum, 263.55 μm) and highest in the E4D model (average, 357.05 μm; maximum 2309.45 μm). Median average trueness values were lowest in the TRIOS model (42.30 μm) and highest in the Zfx IntraScan model (153.80 μm). The CS 3500 model had the lowest median maximum trueness values (450.75 μm); the E4D model had the highest values (2680.55 μm). Individual image and video sequence data captures showed similar median average trueness values (P>.05); the median maximum values of individual images were higher than those of the video sequence (P<.05). Swept source optical coherence tomography (SS-OCT) exhibited higher trueness values than those of other scanning principles (P<.05). The FastScan and True Definition, which require powder coating, showed significantly better trueness than other IOSs that did not require powdering (P<.05). The E4D, PlanScan, and Zfx IntraScan models had an increased tendency to produce images with imperfect surface features and to round off sharp edges. CONCLUSIONS The E4D and Zfx IntraScan models did not perform as accurately as the other IOSs. The data capture principle of SS-OCT and the mode of individual image acquisition exhibited inferior trueness. The FastScan and True Definition, which require powder coating, exhibited better trueness. The qualitative aspects of the IOSs varied in terms of polygon shapes, sharp edge reproducibility, and surface smoothness.
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Affiliation(s)
- Ryan Jin-Young Kim
- Assistant Professor, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ji-Man Park
- Clinical Associate Professor, Department of Prosthodontics, Yonsei University, College of Dentistry, Seoul, Republic of Korea.
| | - June-Sung Shim
- Professor, Department of Prosthodontics, Yonsei University, College of Dentistry, Seoul, Republic of Korea
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Schmalz G, Hickel R, van Landuyt KL, Reichl FX. Nanoparticles in dentistry. Dent Mater 2017; 33:1298-1314. [PMID: 28951037 DOI: 10.1016/j.dental.2017.08.193] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Nanoparticles having a size from 1 to 100nm are present in nature and are successfully used in many products of daily life. Nanoparticles are also embedded per se or as byproducts from milling processes of larger filler particles in many dental materials. METHODS AND RESULTS Recently, possible adverse effects of nanoparticles have gained increased interest with the lungs being a main target organ. Exposure to nanoparticles in dentistry may occur in the dental laboratory, by processing gypsum type products or by grinding and polishing materials. In the dental practice virtually no exposure to nanoparticles occurs when handling unset materials. However, nanoparticles are produced by intraoral adjustment of set restorative materials through grinding/polishing regardless whether they contain nanoparticles or not. Nanoparticles may also be produced through wear of restorations or released from dental implants and they enter the environment when removing restorations. The risk for dental technicians is taken care of by legal regulations. Based on model worst case mass-based calculations, the exposure of dental practice personnel and patients to nanoparticles through intraoral grinding/polishing and wear is low to negligible. Accordingly, the additional risk due to nanoparticles exposure from present materials is considered to be low. However, more research is needed, especially on vulnerable groups (asthma or COPD). An assessment of risks for the environment is not possible due to the lack of data. SIGNIFICANCE Measures to reduce exposure to nanoparticles include intraorally grinding/polishing using water coolants, proper sculpturing to reduce the need for grinding and sufficient ventilation of treatment areas.
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Affiliation(s)
- Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital, Regensburg, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany
| | | | - Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany.
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Schmalz G, Galler KM. Biocompatibility of biomaterials – Lessons learned and considerations for the design of novel materials. Dent Mater 2017; 33:382-393. [DOI: 10.1016/j.dental.2017.01.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/31/2017] [Indexed: 12/14/2022]
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Park JM. Comparative analysis on reproducibility among 5 intraoral scanners: sectional analysis according to restoration type and preparation outline form. J Adv Prosthodont 2016; 8:354-362. [PMID: 27826385 PMCID: PMC5099127 DOI: 10.4047/jap.2016.8.5.354] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/24/2016] [Accepted: 08/08/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The trueness and precision of acquired images of intraoral digital scanners could be influenced by restoration type, preparation outline form, scanning technology and the application of power. The aim of this study is to perform the comparative evaluation of the 3-dimensional reproducibility of intraoral scanners (IOSs). MATERIALS AND METHODS The phantom containing five prepared teeth was scanned by the reference scanner (Dental Wings) and 5 test IOSs (E4D dentist, Fastscan, iTero, Trios and Zfx Intrascan). The acquired images of the scanner groups were compared with the image from the reference scanner (trueness) and within each scanner groups (precision). Statistical analysis was performed using independent two-samples t-test and analysis of variance (α=.05). RESULTS The average deviations of trueness and precision of Fastscan, iTero and Trios were significantly lower than the other scanners. According to the restoration type, significantly higher trueness was observed in crown and inlay than in bridge. However, no significant difference was observed among four sites of preparation outline form. If compared by the characteristics of IOS, high trueness was observed in the group adopting the active triangulation and using powder. However, there was no significant difference between the still image acquisition and video acquisition groups. CONCLUSION Except for two intraoral scanners, Fastscan, iTero and Trios displayed comparable levels of trueness and precision values in tested phantom model. Difference in trueness was observed depending on the restoration type, the preparation outline form and characteristics of IOS, which should be taken into consideration when the intraoral scanning data are utilized.
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Affiliation(s)
- Ji-Man Park
- Department of Prosthodontics, Seoul National University Gwanak Dental Hospital, Seoul, Republic of Korea
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