Source avec lien : Journal of Occupational and Environmental Hygiene, (En ligne). 10.1080/15459624.2022.2053140
Le personnel dentaire est classé parmi les professions les plus à risque d’exposition au SRAS-CoV-2 en raison de sa proximité avec la bouche du patient et des nombreuses procédures génératrices d’aérosols rencontrées dans la pratique dentaire. L’une des méthodes permettant de réduire les aérosols en milieu dentaire est l’utilisation de systèmes d’évacuation intrabuccaux. Les systèmes d’évacuation intra-oraux sont placés directement dans la bouche du patient et maintiennent un champ sec pendant les procédures en capturant les liquides et les aérosols. Bien que de nombreux systèmes d’évacuation dentaire intra-oraux soient disponibles dans le commerce, l’efficacité de ces systèmes n’est pas bien comprise. Les objectifs de cette étude étaient d’évaluer l’efficacité de quatre systèmes d’évacuation dentaire pour atténuer l’exposition aux aérosols lors de procédures simulées de détartrage ultrasonique et de préparation de couronnes.
Dental personnel are ranked among the highest risk occupations for exposure to SARS-CoV-2 due to their close proximity to the patient’s mouth and many aerosol generating procedures encountered in dental practice. One method to reduce aerosols in dental settings is the use of intraoral evacuation systems. Intraoral evacuation systems are placed directly into a patient’s mouth and maintain a dry field during procedures by capturing liquid and aerosols. Although multiple intraoral dental evacuation systems are commercially available, the efficacy of these systems is not well understood. The objectives of this study were to evaluate the efficacy of four dental evacuation systems at mitigating aerosol exposures during simulated ultrasonic scaling and crown preparation procedures. We conducted real-time respirable (PM4) and thoracic (PM10) aerosol sampling during ultrasonic scaling and crown preparation procedures while using four commercially available evacuation systems: a high-volume evacuator (HVE) and three alternative intraoral systems (A, B, C). Four trials were conducted for each system. Respirable and thoracic mass concentrations were measured during procedures at three locations including (1) near the breathing zone (BZ) of the dentist, (2) edge of the dental operatory room approximately 0.9 m away from the mannequin mouth, and (3) hallway supply cabinet located approximately 1.5 m away from the mannequin mouth. Respirable and thoracic mass concentrations measured during each procedure were compared with background concentrations measured in each respective location. Use of System A or HVE reduced thoracic (System A) and respirable (HVE) mass concentrations near the dentist’s BZ to median background concentrations most often during the ultrasonic scaling procedure. During the crown preparation, use of System B or HVE reduced thoracic (System B) and respirable (HVE or System B) near the dentist’s BZ to median background concentrations most often. Although some differences in efficacy were noted during each procedure and aerosol size fraction, the difference in median mass concentrations among evacuation systems was minimal, ranging from 0.01 to 1.48 µg/m3 across both procedures and aerosol size fractions.