Aerosols Generated during Endodontic Treatment: A Special Concern during the Coronavirus Disease 2019 Pandemic

Abstract

Aims (1) To investigate aerosolized microorganisms generated during endodontic emergencies and non—surgical root canal therapy (NSRCT); (2) To assess how far airborne microbial spread; and (3) To verify the spatial distribution of airborne microbial spread. Methods A total of 45 endodontic procedures were sampled, including full pulpotomy (n=15), pulpectomy (n=15), and NSRCT (n=15). Samples were collected during room resting (s1) and after the treatment (s2). The passive air sampling technique using settle plates was applied. Agar plates were set at different locations in the operatory. The colony-forming unit (CFU) was counted in BHI blood agar plates. A set of agar plates containing selective chromogenic culture media was used for the isolation and presumptive identification of target microorganisms. Fungi were investigated using Sabouraud Dextrose Agar. Results Pulpotomy generated the lowest mean CFU count (p<0.05). There was no difference between the mean CFU counts found in pulpectomy and NSRCT (p>0.05). A higher mean CFU count was found close to the patient’s mouth (0.5m) than at a 2m distance in pulpectomy and NSRCT (P<0.05). There was no difference between the mean CFU count found in front of the patient’s mouth versus diagonal in pulpectomy and NSRCT (p>0.05). S. aureus (22/ 45, 48.8%) was the most frequent bacteria species. Longer treatment times were associated with higher CFU counts. Conclusion Our findings indicated that pulpotomy generates less aerosolized microorganisms than pulpectomy and NSRCT. Moreover, the proximity to the patient’s mouth and the treatment duration implicated in the level of contamination.

Optimizing Safe Dental Practice During the COVID-19 Pandemic: Recommendations Based on a Guide Developed for Dental Practices in China

“…Studies have shown that using rubber dams during operations reduced colony counts by 82.7% (lamp-side sampling) and 83.9% (chest-side sampling) ( 95 ). Most studies have formed a broad consensus that rubber dams effectively reduced splatter transmission by 33% and reduced surface bacterial contamination by 80–99% during aerosol generation ( 96 ). Therefore, the use of rubber dams, where possible, can be effective in reducing aerosol formation during clinical operations.…”

Regenerative Endodontics and Minimally Invasive Dentistry: Intertwining Paths Crossing Over Into Clinical Translation

“…In particular, the dental community faced unique challenges, leading to the development of treatment strategies changes to reduce the risks of virus transmission to patients/dental practitioners ( Bahador et al, 2021 ). In endodontics, a shift towards minimally invasive endodontic procedures was suggested over more invasive modalities highlighting a new role for these therapies in light of the COVID-19 pandemic ( Azim et al, 2020 ).…”

Aerosols generated by high-speed handpiece and ultrasonic unit during endodontic coronal access alluding to the COVID-19 pandemic

“…Aerosols generated during dental procedures have become a target of concern and discussion 1 , 2 , since are vectors of infective agents including bacteria, yeasts, filamentous fungi, and viruses 3 – 7 . So, aerosol particles show high potential for contamination that not only reach the dental care professional and patients, but also all exposed surfaces of the dental unit and the operatory environment 6 , 7 .…”

“…So, aerosol particles show high potential for contamination that not only reach the dental care professional and patients, but also all exposed surfaces of the dental unit and the operatory environment 6 , 7 . Not different, there is a risk of transmission of acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which results in the COVID-19 disease, in dental practice carried by aerosol particles 2 , 3 from blood, saliva, and other body fluids exposure of symptomatic and asymptomatic patients, combined with instruments that generate aerosols 8 .…”