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Franz J, Scheier TC, Aerni M, Gubler A, Schreiber PW, Brugger SD, Schmidlin PR. Bacterial contamination of air and surfaces during dental procedures-An experimental pilot study using Staphylococcus aureus. Infect Control Hosp Epidemiol 2024; 45:658-663. [PMID: 38263751 PMCID: PMC11027080 DOI: 10.1017/ice.2023.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/21/2023] [Accepted: 11/09/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE The oral cavity contains numerous microorganisms, including antimicrobial-resistant bacteria. These microorganisms can be transmitted via respiratory particles from patients to healthcare providers and vice versa during dental care. We evaluated the spread of Staphylococcus aureus during standardized dental procedures using different scaling devices and rinsing solutions. METHODS During systematic therapy for dental biofilm removal (guided biofilm therapy), using an airflow or ultrasound device to a model simulation head. Staphylococcus aureus suspension was injected into the mouth of the model to mimic saliva. Different suction devices (conventional saliva ejector or a prototype) and rising solutions (water or chlorhexidine) were used. To assess contamination with S. aureus, an air-sampling device was placed near the oral cavity and samples of surface areas were collected. RESULTS S. aureus was only detected by air sampling when the conventional saliva ejector with airflow was used. No growth was observed during treatments with the ultrasonic piezo instrument or the prototype suction device. Notably, a rinsing solution of chlorhexidine digluconate decreased the bacterial load compared to water. Surface contamination was rarely detected (1 of 120 samples). CONCLUSIONS Although our findings indicate potential airborne bacterial transmission during routine prophylactic procedures, specific treatment options during biofilm removal appear to reduce air contamination. These options include ultrasonic piezo devices or the prototype suction device. The use of chlorhexidine reduced the CFU counts of S. aureus detected by air sampling. Surface contamination during dental procedures was a rare occurrence.
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Affiliation(s)
- Jessica Franz
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas C. Scheier
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Maja Aerni
- Clinic of Conservative and Preventive Dentistry, Center for Dental and Oral Medicine and Maxillo-Facial Surgery, University of Zurich, Zurich, Switzerland
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, Center for Dental and Oral Medicine and Maxillo-Facial Surgery, University of Zurich, Zurich, Switzerland
| | - Peter W. Schreiber
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio D. Brugger
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center for Dental and Oral Medicine and Maxillo-Facial Surgery, University of Zurich, Zurich, Switzerland
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Bannan A, Kamal I, Al Makishah NH, Natto ZS. Reducing microbial airborne contamination and particulate matter using different oral suctions in dental clinic: A randomized controlled clinical trial. Saudi Dent J 2024; 36:374-380. [PMID: 38419981 PMCID: PMC10897624 DOI: 10.1016/j.sdentj.2023.11.029] [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: 08/18/2023] [Revised: 11/26/2023] [Accepted: 11/26/2023] [Indexed: 03/02/2024] Open
Abstract
Aim This study aimed to assess oral suction devices in declining microbial airborne contamination level and particulate matter. Materials and methods This open-label randomized clinical trial was conducted in an educational hospital with 50 participants above 18 years of age, who had scheduled an appointment at a dental hygienist clinic for scaling procedure. Particulate matter and microbial airborne contamination levels were taken at the beginning for 15 min and during of scaling procedure. Participants were randomized to five groups: low suction, high & low suction, intraoral suction (IOS), extra-oral suction (EOS) & low suction, and IOS & EOS. Repeated measured ANOVA analysis was carried out using STATA version 13. Results Participants had aged 34.4 ± 8.1 years and the average simplified oral hygiene index was 3.5 ± 1.2. Microbial airborne contamination level for each intervention group was different to baseline; low suction, intraoral suction, high & low suction, EOS & low suction, and EOS and intraoral suction were 1089 ± 610, 296.3 ± 321.2, 43.8 ± 52.1, 17.3 ± 7.3 and 14.3 ± 3.9, respectively [P value < 0.05]. Particulate matter shows evidence of no significant difference among oral suctions [P value > 0.05]. Conclusion Low or intraoral suction was not enough to reduce microbial airborne contamination for better infection control, practitioners highly recommended to use combination of suction devices. Clinical relevance Using extra-oral with intra-oral suction, or extra-oral suction with low section, or high & low suction are potentially better in microbial airborne contamination reduction compared with low or intraoral suction only. Trial registration Clinicaltrials.gov (NCT05848245) on April 14, 2023.
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Affiliation(s)
- Abraar Bannan
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Iman Kamal
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Public Health, Faculty of Medicine, AlAzhar University, Egypt
| | - Naief H. Al Makishah
- Department of Environmental Science, Faculty of Environmental Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zuhair S. Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Jakkrawanpithak P, Powattanasuk W, Sooppapipatt N, Pudla M, Srimaneekarn N, Buranachad N, Yuma S, Supa-Amornkul S. Efficacy of antiseptics for rubber dam sterilization prior to endodontic treatment. J Oral Sci 2024; 66:5-8. [PMID: 37853618 DOI: 10.2334/josnusd.23-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
PURPOSE This study investigated the efficacy of various antiseptics for disinfection of rubber dams used during endodontic treatment, the duration of disinfection effectiveness, and the disinfection protocol employed by dental schools in Thailand. METHODS The efficacy of 10% povidone-iodine, 1.5% tincture iodine and 70% ethyl alcohol in eliminating Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) on the rubber dam was investigated. Time duration of disinfection was evaluated at 0, 30, 60, and 120 min. The two-step disinfection method adopted at Thai dental school was examined. Independent t-test or Kruskal-Wallis followed by a Dunnett's test was used for statistical analysis. RESULTS Among the three antiseptics, 10% povidone and 1.5% tincture iodine eradicated the microorganisms completely, whereas 70% ethyl alcohol did not achieve a statistically significant decrease. The duration of sterilization effectiveness was 120 min for 10% povidone-iodine, but bacteria were eliminated only at 0 min by 1.5% tincture iodine. The results also indicated that the two-step protocol scarcely eliminated the microorganisms. CONCLUSION The best antiseptic for rubber dam disinfection is 10% povidone-iodine, which remains effective for 120 min. The two-step protocol typically practiced in Thai dental schools needs to be updated. The use of 10% povidone-iodine alone is adequate for complete eradication of E. faecalis and C. albicans.
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Affiliation(s)
| | - Wifada Powattanasuk
- Mahidol International Dental School, Faculty of Dentistry, Mahidol University
| | | | - Matsayapan Pudla
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University
| | | | - Naiyana Buranachad
- Department of Advance General Dentistry, Faculty of Dentistry, Mahidol University
| | - Suraphong Yuma
- Department of Physics, Faculty of Science, Mahidol University
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Yan H, Chen H, Jiang L, Zhang J, Chen G, Yu X, Zhu H, Zhao X, Li Y, Tang W, Zhang X, Jiang N. Spatial distribution of airborne bacterial communities in caged poultry houses. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2023; 73:417-427. [PMID: 36947580 DOI: 10.1080/10962247.2023.2193162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Microbial aerosols in intensive broiler houses whose species and concentrations are closely related to human health are ubiquitous. Based on 16S rRNA gene sequencing, the aim of this study was to investigate the spatial distribution and diversity of bacterial aerosols in the air of broiler houses. Significant spatial variations in airborne bacterial concentrations were observed inside the poultry farmhouse. The results indicated that bacteria in the air samples could be grouped into a total of 1,674 OTUs. Alpha diversity analysis showed that the diversity of the microbial community at the entry of the broiler house was higher than that at the middle or the rear (p < 0.01). The Sankey diagram illustrated species dynamic changes in Proteobacteria, Firmicutes, and Actinobacteria among the different locations. From the aspect of LEfSe (LDA Effect Size) analysis, we discovered that the abundance of Planctomycetes was significantly higher in the entry than in the rear and middle. This study shows the spatial distribution of the entire bacterial community in intensive broiler houses, which offers a new perspective for studying airborne total bacteria in those environments.Implications: The bacteria contained in air aerosols from poultry houses are closely connected to animal health and production. This study aimed to investigate the spatial distribution and diversity of bacterial aerosols in the air of broiler houses. The results observed that bacterial aerosol concentrations in the examined broilers house varied greatly at different positions, and a significantly higher exposure to bacterial aerosol was observed at the middle than at the other positions (p < 0.05). The alpha diversity analysis showed that the diversity of the microbial community at the entry of the broiler house was higher than that at the middle or the rear (P<0.01). Sankey diagram illustrated species dynamic changes of Proteobacteria, Firmicutes and Actinobacteria among the different locations. The microbial communities in genus level in the samples of entry and rear were closer, while the species diversity of middle and rear samples in chicken house was highly similar (P>0.05). Altogether, results revealed that the effects of spatial factors on the diversity and abundance of bacteria in the air of closed-cage broiler houses, which poses a potential threat to the health of animals and workers in those environments.
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Affiliation(s)
- Han Yan
- College of Life Science, Ludong University, Yantai, Shandong, China
- Shandong Breeding Environmental Control Engineering Laboratory, Ludong University, Yantai, Shandong, China
| | - Huan Chen
- College of Life Science, Ludong University, Yantai, Shandong, China
- Shandong Breeding Environmental Control Engineering Laboratory, Ludong University, Yantai, Shandong, China
| | - Linlin Jiang
- College of Life Science, Ludong University, Yantai, Shandong, China
- Shandong Breeding Environmental Control Engineering Laboratory, Ludong University, Yantai, Shandong, China
- Yantai Key Laboratory of Animal Pathogenetic Microbiology and Immunology, Ludong University, Yantai, Shandong, China
| | - Jianlong Zhang
- College of Life Science, Ludong University, Yantai, Shandong, China
- Yantai Key Laboratory of Animal Pathogenetic Microbiology and Immunology, Ludong University, Yantai, Shandong, China
- Shandong Provincial Key Laboratory of Quality Safty Monitoring and Risk Assessment for Animal Products, Institute of Veterinary Drug Quality Inspection of Shandong Province, Ji'nan, China
| | - Guozhong Chen
- College of Life Science, Ludong University, Yantai, Shandong, China
- Yantai Key Laboratory of Animal Pathogenetic Microbiology and Immunology, Ludong University, Yantai, Shandong, China
- Shandong Provincial Key Laboratory of Quality Safty Monitoring and Risk Assessment for Animal Products, Institute of Veterinary Drug Quality Inspection of Shandong Province, Ji'nan, China
| | - Xin Yu
- College of Life Science, Ludong University, Yantai, Shandong, China
- Shandong Breeding Environmental Control Engineering Laboratory, Ludong University, Yantai, Shandong, China
- Yantai Key Laboratory of Animal Pathogenetic Microbiology and Immunology, Ludong University, Yantai, Shandong, China
| | - Hongwei Zhu
- College of Life Science, Ludong University, Yantai, Shandong, China
- Shandong Breeding Environmental Control Engineering Laboratory, Ludong University, Yantai, Shandong, China
- Yantai Key Laboratory of Animal Pathogenetic Microbiology and Immunology, Ludong University, Yantai, Shandong, China
| | - Xiaoyu Zhao
- Shandong Provincial Key Laboratory of Quality Safty Monitoring and Risk Assessment for Animal Products, Institute of Veterinary Drug Quality Inspection of Shandong Province, Ji'nan, China
| | - Youzhi Li
- Shandong Provincial Key Laboratory of Quality Safty Monitoring and Risk Assessment for Animal Products, Institute of Veterinary Drug Quality Inspection of Shandong Province, Ji'nan, China
| | - Wenli Tang
- Shandong Provincial Key Laboratory of Quality Safty Monitoring and Risk Assessment for Animal Products, Institute of Veterinary Drug Quality Inspection of Shandong Province, Ji'nan, China
| | - Xingxiao Zhang
- College of Life Science, Ludong University, Yantai, Shandong, China
- Shandong Breeding Environmental Control Engineering Laboratory, Ludong University, Yantai, Shandong, China
- Yantai Key Laboratory of Animal Pathogenetic Microbiology and Immunology, Ludong University, Yantai, Shandong, China
| | - Nihong Jiang
- Department of Environmental Management, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
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Kumar G, Tewari S. Acupuncture for Management of Endodontic Emergencies: a Review. J Acupunct Meridian Stud 2023; 16:1-10. [PMID: 36804816 DOI: 10.51507/j.jams.2023.16.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 05/18/2022] [Accepted: 10/19/2022] [Indexed: 02/22/2023] Open
Abstract
Root canal treatment (RCT) employed for painful endodontic conditions like apical periodontitis and irreversible pulpitis is associated with a high incidence of postoperative pain. Pharmacological management for this purpose is effective, but not entirely free from side effects and in some cases may fail to provide adequate relief. Furthermore, concerns have been raised regarding the transmission of coronavirus disease-2019 (COVID-19) as a result of the aerosols generated and prolonged chair side time required for RCT. Acupuncture is a traditional Chinese therapy commonly employed as an alternative for the treatment of pain. And what's more, the use of acupuncture has been recently reported as treatment for the management of endodontic pain as well as on the anesthetic success in patients with irreversible pulpitis. This review aims to evaluate the current evidence for acupuncture in endodontics and its potential role in emergency pain relief and management for patients. To combat this, a thorough search for literature within the field was performed in five electronic databases. Retrieved studies were screened according to the pre-defined eligibility criteria. After both an electronic and manual search, five studies were selected for review. These studies reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis and in controlling both intraoperative and postoperative pain following RCT. In addition, it was also reported to reduce anxiety surrounding the dental procedure and minimized the intake of analgesics after the endodontic procedure, which can result in some unwanted side effects. However, more in depth clinical research is required before any recommendation regarding the application of acupuncture in endodontic patients can be made.
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Affiliation(s)
- Gaurav Kumar
- Department of Conservative, Endodontics and Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Sanjay Tewari
- Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Barrett B, McGovern J, Catanzaro W, Coble S, Redden D, Fouad AF. Clinical Efficacy of an Extraoral Dental Evacuation Device in Aerosol Elimination During Endodontic Access Preparation. J Endod 2022; 48:1468-1475. [PMID: 36206990 PMCID: PMC9531367 DOI: 10.1016/j.joen.2022.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) has caused many concerns in the dental field regarding aerosol production and the transmission of the severe acute respiratory syndrome coronavirus 2 virus during dental procedures. Because of the abrupt arrival of COVID-19, there has been little to no published research on the efficacy of dental suction devices in the removal of aerosols related to COVID-19 or the impact extraoral suction devices have on patients' experiences. Therefore, the aim of this study was to measure the amount of aerosol produced during endodontic access preparation for root canal therapy with and without the use of an extraoral dental suction device and to gather information through a survey regarding patients' experiences. METHODS Aerosol measurements were recorded in 8 closed-door resident operatories each morning before the procedures, 1 minute during the procedure, and 15 minutes after the access was complete. The CICADA DTO KN99 Extraoral Dental Suction Device (Foshan Cicada, Guangdong, China) was placed in 4 operatories, whereas no DTO extraoral suction device was used in 4 control operatories. Twenty cases with DTO and 20 cases without it were completed, and the data were analyzed. RESULTS Aerosols 1 minute after access were higher with and without DTO. There was a significant reduction after 15 minutes when the DTO device was used compared to high-volume suction alone. Composite and zirconia produced the most aerosols at 1 minute. CONCLUSION The results show that the reduction of aerosols is enhanced when the extraoral suction device is used in combination with traditional high-volume evacuation. However, the increased noise level when using the device can have a negative impact on patients' dental experience.
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Affiliation(s)
- Barton Barrett
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jason McGovern
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - William Catanzaro
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Shandra Coble
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - David Redden
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ashraf F. Fouad
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama,Address requests for reprints to Dr Ashraf F. Fouad, Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, 1919 Seventh Avenue South, Room 610, Birmingham, AL 35294
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Rayyan A, Ather A, Hargreaves K, Ruparel NB. Effect of Sodium Hypochlorite in Dental Unit Waterline on Aerosolized Bacteria-Generated from Endodontic Procedures. J Endod 2022; 48:1248-1256. [PMID: 36030970 DOI: 10.1016/j.joen.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Aerosol generation in a dental setting is a critical concern and approaches that aim at decreasing bacterial load in aerosols is of high priority for dental professionals. The objectives of this study were to evaluate the relative effect of various endodontic procedures on the generation and dissemination of aerosols and the effect of 0.1% sodium hypochlorite (NaOCl) in dental unit waterlines (DUWLs) on the bacterial load in the generated aerosols in a clinical setting. METHODS The study was completed in two phases. The classical passive sampling technique using brain heart infusion agar plates was utilized. Agar plates were strategically placed throughout the operatory at pre-defined locations. PHASE I To evaluate the effect of different endodontic procedures on generation and dissemination of aerosols, we collected a total of 38 samples. Following baseline collection, test samples were collected during vital pulp therapy (VPT) full pulpotomy (n=10), non-surgical root canal therapy (NSRCT; n=10), surgical root canal therapy (SRCT; n=10), and incision and drainage (I&D; n=8) procedures. Bacterial growth was expressed as colony-forming units at 48 hours post-sample collection. Data were analyzed using 1-way analysis of variance with Tukey's multiple comparisons post-hoc test. PHASE II To evaluate the effect of 0.1% NaOCl in DUWL on the bacterial load in the generated aerosols, a total of 30 samples were collected. All procedures including VPT (n=10), NSRCT (n=10), and SRCT (n=10) were performed with 0.1% NaOCl in DUWL. Bacterial growth was expressed as colony-forming units at 48 hours post-sample collection. Data were analyzed using 2-way analysis of variance with Tukey's multiple comparisons post-hoc test. RESULTS All endodontic procedures generated aerosols at all tested locations except I&D. Aerosols were disseminated as far as 3m from the patient's head with no significant difference between various locations (p>0.05). VPT procedures generated the maximum number of aerosols compared to NSRCT and SRCT. Adding 0.1% NaOCl to DUWLs significantly reduced the bacterial load in the generated aerosols in all treatment groups compared to groups treated with untreated waterlines (p<0.05). No significant difference was noted in the bacterial load between all groups with treated waterlines (p>0.05). CONCLUSIONS All tested endodontic procedures led to the generation and dissemination of contaminated aerosols, and the addition of 0.1% NaOCl as a biocide to the DUWL led to a statistically significant reduction in the bacterial load.
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Affiliation(s)
- Ahmad Rayyan
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229
| | - Amber Ather
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229; Department of Endodontics, Virginia Commonwealth University, 520 North 12th Street, Box 980566, Richmond, Virginia 23298-0566
| | - Kenneth Hargreaves
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229
| | - Nikita B Ruparel
- Department of Endodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229.
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Aerosols generated by high-speed handpiece and ultrasonic unit during endodontic coronal access alluding to the COVID-19 pandemic. Sci Rep 2022; 12:4783. [PMID: 35314742 PMCID: PMC8935614 DOI: 10.1038/s41598-022-08739-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/09/2022] [Indexed: 12/21/2022] Open
Abstract
AbstractTo investigate the dispersion and contamination of aerosols generated during coronal access performed by high-speed handpiece and ultrasonic device. To measure the aerosol dispersion, a red dye or an Enterococcus faecalis culture broth inside the bottle of the water system of the dental and ultrasonic unit were used. Bovine extracted teeth were allocated in six groups according to the coronal access: G1: diamond bur in high-speed handpiece (HS) with aspiration (A); G2: ultrasonic (US) inserts with aspiration; G3: combined coronal access with HS and US with aspiration; and G4, G5, and G6 were performed without aspiration (WA). The distance reached by the aerosol with the dye was measured in centimeters, and for environment contamination, agar-plates were arranged at standardized distances for counting colony-forming units (CFU/mL). The ANOVA followed by the Tukey tests were applied (α = 0.05). The coronal access with HS generated higher aerosol dispersion and contamination, even with simultaneous A (P < 0.05), while US generated less aerosol even WA (P < 0.05). The aspiration did not reduce the aerosol statistically. HS is a great source of aerosols in dental clinic during the coronal access and the use of US device should be encouraged.
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Elnawam H, Abdelmougod M, Mobarak A, Hussein M, Aboualmakarem H, Girgis M, El Backly R. Regenerative Endodontics and Minimally Invasive Dentistry: Intertwining Paths Crossing Over Into Clinical Translation. Front Bioeng Biotechnol 2022; 10:837639. [PMID: 35211465 PMCID: PMC8860982 DOI: 10.3389/fbioe.2022.837639] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/11/2022] [Indexed: 11/23/2022] Open
Abstract
Regenerative endodontic procedures have been described for over a decade as a paradigm shift in the treatment of immature necrotic permanent teeth, owing to their ability to allow root maturation with subsequent enhancement of the tooth’s fracture resistance in addition to the potential for regeneration of vital intracanal tissues. Concomitantly, minimally invasive endodontics is another rising concept with the main concern of preservation of tooth structure. Stemming from their potential to preserve the original tooth structure, both regenerative and minimally invasive endodontics could be considered as two revolutionary sciences with one common goal. Achieving this goal would entail not only employing the appropriate strategies to recreate the ideal regenerative niche but modifying existing concepts and protocols currently being implemented in regenerative endodontics to address two important challenges affecting the outcome of these procedures; conservation of tooth structure and achieving effective disinfection. Therefore, the search for new biomimetic cell-friendly disinfecting agents and strategies is crucial if such a novel integratory concept is to be foreseen in the future. This could be attainable by advocating a new merged concept of “minimally invasive regenerative endodontic procedures (MIREPs),” through modifying the clinical protocol of REPs by incorporating a minimally invasive access cavity design/preparation and biomimetic disinfection protocol, which could enhance clinical treatment outcomes and in the future; allow for personalized disinfection/regeneration protocols to further optimize the outcomes of MIREPs. In this review, we aim to introduce this new concept, its realization and challenges along with future perspectives for clinical implementation.
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Affiliation(s)
- Hisham Elnawam
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Menatallah Abdelmougod
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed Mobarak
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mai Hussein
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hamdy Aboualmakarem
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Michael Girgis
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania El Backly
- Endodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Alsalleeh F, Alaathy S, Alblaihed R. Estimating the prevalence of COVID-19 disease and its effect among trainees in the endodontic postgraduate programs in the kingdom of Saudi Arabia: A web-based survey study. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_60_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dabiri D, Conti SR, Sadoughi Pour N, Chong A, Dadjoo S, Dabiri D, Wiese C, Badal J, Hoogland MA, Conti HR, Taylor TR, Choueiri G, Amili O. A Multi-Disciplinary Review on the Aerobiology of COVID-19 in Dental Settings. FRONTIERS IN DENTAL MEDICINE 2021; 2. [PMID: 35574425 PMCID: PMC9098049 DOI: 10.3389/fdmed.2021.726395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic pushed dental health officials around the world to reassess and adjust their existing healthcare practices. As studies on controlled COVID-19 transmission remain challenging, this review focuses on particles that can carry the virus and relevant approaches to mitigate the risk of pathogen transmission in dental offices. This review gives an overview of particles generated in clinical settings and how size influences their distribution, concentration, and generation route. A wide array of pertinent particle characterization and counting methods are reviewed, along with their working range, reliability, and limitations. This is followed by a focus on the effectiveness of personal protective equipment (PPE) and face shields in protecting patients and dentists from aerosols. Direct studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are still limited, but the literature supports the use of masks as an important and effective non-pharmaceutical preventive measure that could reduce the risk of contracting a respiratory infection by up to 20%. In addition to discussing about PPE used by most dental care professionals, this review describes other ways by which dental offices can protect patients and dental office personnel, which includes modification of the existing room design, dental equipment, and heating, ventilation, and air conditioning (HVAC) system. More affordable modifications include positioning a high-efficiency particulate air (HEPA) unit within proximity of the patient’s chair or using ultraviolet germicidal irradiation in conjunction with ventilation. Additionally, portable fans could be used to direct airflow in one direction, first through the staff working areas and then through the patient treatment areas, which could decrease the number of airborne particles in dental offices. This review concludes that there is a need for greater awareness amongst dental practitioners about the relationship between particle dynamics and clinical dentistry, and additional research is needed to fill the broad gaps of knowledge in this field.
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Affiliation(s)
- Darya Dabiri
- Department of Dentistry, Division of Pediatric Dentistry, University of Toledo, Toledo, OH, United States
- Correspondence: Darya Dabiri,
| | - Samuel Richard Conti
- Department of Biological Sciences, University of Toledo, Toledo, OH, United States
| | - Niloufar Sadoughi Pour
- Department of Mechanical, Industrial and Manufacturing Engineering (MIME), University of Toledo, Toledo, OH, United States
| | - Andrew Chong
- Department of Cariology, Restorative Sciences & Endodontics, University of Michigan, Ann Arbor, MI, United States
| | - Shaahin Dadjoo
- Department of Orthodontics and Dentofacial Orthopedics, The Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | - Donya Dabiri
- Department of Dentistry, Division of Pediatric Dentistry, University of Toledo, Toledo, OH, United States
| | - Carol Wiese
- Department of Dentistry, Division of Pediatric Dentistry, University of Toledo, Toledo, OH, United States
| | - Joyce Badal
- Department of Medicine, University of Toledo, Toledo, OH, United States
| | | | - Heather Raquel Conti
- Department of Biological Sciences, University of Toledo, Toledo, OH, United States
| | - Travis Roger Taylor
- Department of Medical Microbiology and Immunology, University of Toledo, Toledo, OH, United States
| | - George Choueiri
- Department of Mechanical, Industrial and Manufacturing Engineering (MIME), University of Toledo, Toledo, OH, United States
| | - Omid Amili
- Department of Mechanical, Industrial and Manufacturing Engineering (MIME), University of Toledo, Toledo, OH, United States
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12
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El karim IA, Duncan HF. Reducing Intervention in the COVID-19 Era: Opportunities for Vital Pulp Treatment. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.686701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Over the last 12 months, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) virus has emerged as a significant global health problem with extensive repercussions for the practise of dentistry. As the principle transmission-route is via droplet-spread, aerosol-generating dental procedures (AGPs) present an exquisite challenge, which either has to be avoided or performed using strict infection-control measures, which increase the deployment of resources and cost. This new working environment necessitates the adoption of simplified, yet effective procedures that reduce intervention and minimise clinical chair time to short, single visits. Vital pulp treatment (VPT) has emerged as an attractive, technically less-complicated group of biologically-based management strategies that are aimed at maintaining pulp vitality and avoiding root canal treatment (RCT). These procedures are carried out in a strict aseptic environment using a rubber dam and have a reported high success rate, suggesting that they could be considered as effective and simple alternative therapies to relieve pain and avoid multiple visit RCT and other endodontic procedures. The relevance of promoting a simple, predictable and effective alternative to traditional, more complex dentistry has never been more compelling. In this perspective article, the latest advances in VPT are highlighted, along with an analysis of their relative success and compelling reasons why we as dentists should be adopting these treatment approaches. Thereafter, case selection, prognostic factors, techniques, limitations and future prospects of these procedures are discussed.
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13
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Li L, Zeng M, Chen X, Cai S, Xu C, Xia W, Jiang L, Zou X, Chen P, Rong M. Optimizing Safe Dental Practice During the COVID-19 Pandemic: Recommendations Based on a Guide Developed for Dental Practices in China. Front Med (Lausanne) 2021; 8:619357. [PMID: 34124084 PMCID: PMC8187590 DOI: 10.3389/fmed.2021.619357] [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: 10/20/2020] [Accepted: 04/09/2021] [Indexed: 12/18/2022] Open
Abstract
The current global coronavirus disease 2019 (COVID-19) outbreak is still exerting severe global implications, and its development in various regions is complex and variable. The high risk of cross-infection poses a great challenge to the dental practice environment; it is therefore urgent to develop a set of pandemic prevention measures to ensure dental practice safety during the COVID-19 outbreak. Therefore, we combined the epidemiological characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), public emergency measures for COVID-19, characteristics of dental practice, and relevant literature reports to develop a set of dynamic practice measures for dental practices in high-, medium-, and low-risk areas affected by COVID-19. This will help dental practices to achieve standard prevention and ensure their safe and smooth operation during the pandemic. It is hoped that these measures will provide a reference basis for dental hospitals and dental clinics in their care and pandemic prevention work.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Pei Chen
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Mingdeng Rong
- Department of Periodontology and Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, China
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14
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Aminoshariae A, Azarpazhooh A, Diogenes AR, Fouad AF, Glickman GN, Kishen A, Letra AM, Levin L, Roda RS, Setzer FC, Tay FR, Hargreaves KM. Insights into the May 2021 Issue of the JOE. J Endod 2021; 47:681-683. [PMID: 33781807 DOI: 10.1016/j.joen.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Anibal R Diogenes
- University of Texas Health San Antonio School of Dentistry, San Antonio, Texas
| | - Ashraf F Fouad
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Ariadne M Letra
- University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | | | | | | | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
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