An Herbal Alternative to Control Nosocomial Pathogens in Aerosols and Splatter During Ultrasonic Scaling

Rajachandrasekaran, Yamini; Valiathan, Mohan; Jayaraman, Bagavad Gita; Mahalakshmi, Krishnan; Padmavathy, Kesavaram

doi:10.4034/pboci.2019.191.106

Cited by 3 publications

(2 citation statements)

References 21 publications

(28 reference statements)

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“…Studies were published between 1992 and 2020. Approximately a quarter (6/21) were split-mouth design RCTs (21-25), 13 were full-mouth design (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), and one did not provide details of study design (41). The vast majority were parallel-arm TCTs (19/21) and two were RCTs of cross-over design.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…One study had all participants as their own controls (41). Of the 21 RCTs, 18 used chlorhexidine (CHX)-containing mouth rinse as either a test (21,22,24,26,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) or as a positive control group (27). Other agents tested were novel antiseptics (four studies) (22,23,25,36), herbal essential oils, EO (two studies) (28,37), cetylpyridinium chloride, CPC (three studies) (32,35,38), povidone iodine (two studies) (30,31), chlorine dioxide (one study) (24), aloe vera (one study) (30), and herbal extract (two studies) (34,40).…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

et al. 2021

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Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations.Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting.Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies.Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18–70). Agreement between assessors was high (Kappa >0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias.Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.

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Section: Characteristics Of the Studiesmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

et al. 2021

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Evidence on Airborne Pathogen Management from Aerosol‐Inducing Practices in Dentistry – How to Handle the Risk

Koletsi,

Belibasakis,

Eliades

2023

Debonding and Fixed Retention in Orthodontics

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Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

2020

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The aim of this systematic review and network meta-analysis was to identify and rank the effectiveness of different interventions used in dental practice to reduce microbial load in aerosolized compounds. Seven electronic databases were searched to April 6, 2020, for randomized controlled trials (RCTs) or nonrandomized prospective studies in the field. Study selection, data extraction, and risk-of-bias assessment were performed for all included studies, while the outcome of interest pertained to differences in bacterial load quantification through the use of different interventions prior to aerosol-generating procedures in dental practices. Random effects frequentist network meta-analysis was performed, with mean difference (MD) and 95% CI as the effect measure. Confidence in the documented evidence was assessed through the newly fueled CINeMA framework (Confidence in Network Meta-analysis) based on the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation). Twenty-nine clinical trials were deemed eligible, 21 RCTs and 8 nonrandomized studies, while 11 RCTs contributed to the network meta-analysis, comprising 10 competing interventions. Tempered chlorhexidine (CHX) 0.2% as compared with nonactive control mouth rinse, prior to routine ultrasonic scaling, was most effective toward reduced postprocedural bacterial load with an MD of −0.92 (95% CI, −1.54 to −0.29) in log10 bacterial CFUs (colony-forming units). For CHX 0.2%, an MD of −0.74 (95% CI, −1.07 to −0.40) was observed as compared with control. Tempered CHX 0.2% presented the highest probabilities of being ranked the most effective treatment (31.2%). Level of confidence varied from very low to moderate across all formulated comparisons. These findings summarize the current state of research evidence in the field of aerosolized bacteria in dentistry. Instigated by the era of SARS-CoV-2 pandemic, the stipulation of a broader evaluation of the aerosolized microbes, including viruses, potentially coupled with disinfectant-based prevention schemes should be prioritized.

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An Herbal Alternative to Control Nosocomial Pathogens in Aerosols and Splatter During Ultrasonic Scaling

Cited by 3 publications

References 21 publications

Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

Evidence on Airborne Pathogen Management from Aerosol‐Inducing Practices in Dentistry – How to Handle the Risk

Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

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